Medical Malpractice and Cauda Equina Syndrome

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Written By: Michael Warfe and Ryan Marinacci, Student-at-Law

Cauda equina syndrome is a rare neurological condition of the nerves in the lower spine that can have life-altering consequences if it is not quickly diagnosed and treated.  Unfortunately, many tragic and avoidable cases of medical malpractice involve missed or delayed diagnoses of cauda equina syndrome as this condition accounts for a disproportionately high volume of legal claims despite how rare it is.

The condition occurs when there is damage to the bundle of spinal nerves at the L1-L5 level, which is known as the cauda equina or “horse-tail.”

Signs and symptoms include:

  • Bladder and bowel dysfunction (e.g. inability to urinate or void, loss of control, and/or lack of sensation while urinating or voiding)
  • Loss of anal and perianal tone and reflex
  • Saddle anesthesia (i.e. numbness of the groin, thigh, and buttock area)
  • Back pain
  • Pain radiating down the legs
  • Inability to walk and leg weakness
  • Sexual dysfunction

Diagnosis is confirmed by magnetic resonance imaging of the spine.  Early detection and emergency surgical decompression are critical because these deficits can become permanent if the condition is left untreated for too long.

Unfortunately, lower back pain often does not receive proper attention in the emergency room, especially where it is chronic, and this can delay the diagnosis and treatment of cauda equina syndrome.  In other words, the damage may become permanent when the early signs and symptoms of cauda equina syndrome are missed by physicians and nursing staff who may lack experience and awareness of this condition or do not complete a fulsome assessment of their patient.  By the time imaging is ordered because symptoms worsen, the condition cannot fully be reversed even with emergency spinal surgery.

Cases of medical malpractice involving cauda equina syndrome are often complex.  For a legal claim to succeed, a plaintiff must prove three things.  First, the plaintiff must establish that the medical attention he or she received fell below or breached the standard of care expected in the circumstances.  This could include performing incomplete assessments, missing obvious signs and symptoms, or discharging prior to performing medical imaging.

Second, the plaintiff must show that the breach in the standard of care caused the injury.  That is, would the plaintiff have suffered these injuries if not for the breach?  Where the answer is “the plaintiff would not have suffered these injuries or the injuries would not have been this extensive if not for the sub-standard care he or she received,” causation can be established.

Finally, the plaintiff must prove which damages were caused by the breach.  These can include damages for pain and suffering, loss of income, and future cost of medical care.

The lawyers at McLeish Orlando have developed expertise in this area by successfully representing numerous plaintiffs in complex and highly technical cases of medical malpractice.  If you have been diagnosed with cauda equine syndrome and believe you suffered injuries because the doctors, nurses, or hospital missed early signs and symptoms or delayed treatment, contact the lawyers at McLeish Orlando for an assessment of your case.  There is no charge for initial consultations.

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