Cauda Equina Syndrome Delay in Treatment Brings $1.2 Million Settlement in NH

2016 NH Medical Malpractice Trial Report

Delay in diagnosis and treatment of New Hampshire woman's cauda equina syndrome, results in permanent injuries.

The plaintiff is a 28-year-old woman who suffered a delay in the diagnosis and treatment of cauda equina syndrome, resulting in permanent foot drop and bowel and bladder dysfunction.

In March 2013, the plaintiff presented to the emergency room with back pain and numbness and tingling in both legs. She reported that her legs had suddenly felt weak, numb, and tingly as she was getting dressed that morning. She was unable to walk and was in severe pain.

In the ER, the plaintiff was evaluated by the defendant surgeon, who noted her complaint of constant back pain; however, he noted that the numbness and weakness of her lower extremities had resolved and that she had normal bowel and bladder function. The defendant reviewed results of a lower back MRI that showed a very large central L3-L4 disc herniation with significant nerve compression. The defendant did not think the plaintiff had cauda equina syndrome at that point, but he felt she was at risk for developing cauda equina syndrome and required monitoring for worsening of her symptoms.

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Cauda Equina Syndrome MRI image of spine

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The defendant surgeon admitted the plaintiff to the hospital for pain control and oral steroids with the hope that her symptoms would improve with medication; however, if her symptoms did not improve, then he noted that surgery may be necessary.

Over the next two days, the plaintiff continued to experience pain and numbness. Between the second and third day in the hospital, she stopped urinating, an indication that her cauda equine syndrome was progressing. The defendant nursing staff did not report this change to the defendant surgeon, and the surgeon did not evaluate her during this time period.

The following morning, when the defendant surgeon returned to evaluate the plaintiff and learned of the change in urinary function, he immediately made arrangements to take the plaintiff to the operating room for surgery to relieve the compression on her spine and on the nerves that control bowel, bladder, and leg function. Unfortunately, the damage to her nerves was irreversible, and the plaintiff was left with permanent foot drop and loss of sensation in her right leg, as well as bowel and bladder dysfunction.

The plaintiff claimed that the defendant surgeon was negligent when he failed to diagnose her cauda equina syndrome when she first presented to the hospital and when he failed to emergently bring her to the operating room for decompressive surgery that first day. She further claimed that the defendant hospital and nursing staff were negligent when they failed to recognize and appreciate her signs and symptoms of cauda equina syndrome and when they failed to emergently report worsening symptoms of her cauda equina syndrome to the defendant surgeon. The plaintiff claimed that had the defendants rendered appropriate care, her cauda equina syndrome would have been timely and properly diagnosed and treated, she would have been taken for emergent surgical decompression, her cauda equina syndrome would not have been permitted to progress, and, she would not have suffered the severe and permanent neurological injuries with which she lives today.

The case settled before trial for $1,200,000.00.

Lubin & Meyer attorney Nicholas Cappiello represented the plaintiff in this New Hampshire medical malpractice lawsuit.

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