MHP Sellors LLP secured a substantial six figure settlement, without admission of liability, for a woman who suffered permanent Cauda Equina Syndrome (CES) after multiple missed red flags, delayed MRI follow‑up, and a critical failure to act during the narrow window in which her condition remained reversible. By the time emergency spinal decompression was performed, irreversible neurological damage had already occurred.

 

What Happened

The client experienced escalating low‑back and radicular leg pain. Over the following weeks, she developed multiple clinical red flags, including:

• Worsening radicular pain;
• Two episodes of bowel leakage;
• MRI scan showing L4/5 disc herniation with nerve root compromise;
• Inability to pass urine — a pivotal sign of evolving CES.

Despite these signs, she was not admitted at A&E, and was instead advised to return the next morning. Emergency decompression did not occur until more than 18 hours after the critical deterioration.

 

The Missed Red Flags & Lost Window of Opportunity

Expert evidence from the UK identified clear, actionable opportunities when permanent injury could and should have been prevented

Key Missed Opportunities

• An MRI should have been ordered when symptoms escalated.
• Second opportunity for urgent imaging was missed.
• Reporting bowel leakage should have triggered urgent spinal referral.
• MRI available showing severe L4/5 compression.
• Inability to pass urine = critical red flag.
• Failure to admit her represented the turning point between reversible and permanent CES.

 

What Should Have Happened

According to the expert evidence for the Plaintiff:

• Decompression before noon on the material day
  → Would have avoided all bowel and bladder dysfunction and neuropathic pain.
• Decompression before midnight on the material day
  → Would likely have resulted in minimal symptoms and avoided catheterisation/manual evacuation.
• Even surgery before midday on the material day
  → Would have resulted in a significantly better outcome than the injury she now lives with.

 

Permanent Life‑Changing Consequences

Because the window for treatment was missed, the client now lives with permanent cauda equina neuropathy, including:

• Neurogenic bladder – requiring self‑catheterisation 4–5 times daily, with leakage between catheterisations.
• Neurogenic bowel – requiring manual evacuation twice per day and unpredictable leakage.
• Loss of perineal and sexual sensation.
• Chronic neuropathic pain affecting mobility, sleep and functionality.
• Severe emotional distress, low mood, and loss of confidence.

These symptoms are irreversible and will require lifelong management.

 

Outcome

Despite significant liability disputes, MHP Sellors LLP negotiated a substantial six figure settlement, without admission of liability, reflecting:

• Permanent neurological injury.
• Loss of function and independence.
• Ongoing care needs and specialist treatments.
• Psychological and emotional impact.
• Loss of quality of life.

This case highlights the essential need for early MRI escalation, urgent referral for red‑flag symptoms and prompt decompression in suspected CES.

 

Contact 

For expert legal advice and support on Cauda Equina Syndrome, spinal injuries or delayed diagnosis cases, please contact Ronan Hynes, Partner or a member of our Healthcare & Serious Injury team on 061 414 355 or alternatively via email at [email protected]