Malpractice Suits for Failing to Diagnose Cauda Equina Syndrome?
Our office has successfully handles malpractice cases involving the failure to make a timely diagnosis of Cauda Equina Syndrome. Malpractice cases are based on the failure to make a timely diagnosis and delays in implementing proper treatment. Responsible parties may include emergency department physician and health care providers, attending physicians who fail to order proper tests such as CT scans and MRI’s, radiologists who misread imaging studies such as CT scans or MRI’s, and nurses who ignore patient complaints.
What Is Cauda Equina Syndrome?
Cauda equina syndrome is a surgical emergency that occurs when something compresses on the spinal nerve roots. Urgent treatment is necessary to prevent permanent spinal cord injury. Malpractice cases are based on the failure to make a timely diagnosis and delays in implementing proper treatment.
Cauda equina syndrome affects a bundle of nerve roots called cauda equina (Latin for horse’s tail). They send and receive messages to and from the legs, feet, and pelvic organs. These nerves are located at the lower end of the spinal cord in the lumbosacral spine and resemble a horse’s tail. Cauda equina is the Latim phrase for the horse’s tail.
Causes of Cauda Equina Syndrome
Common causes of cauda equine syndrome include:
— A severe ruptured disk in the lumbar area (the most common cause).
— Narrowing of the spinal canal (stenosis).
— A spinal lesion or malignant tumor.
— A spinal infection, inflammation, hemorrhage, or fracture.
— A complication from a severe lumbar spine injury such as a car crash, fall, gunshot, or stabbing.
— A birth defect such as an abnormal connection between blood vessels (arteriovenous malformation).
Symptoms of Cauda Equina Syndrome
— Severe low back pain.
— Pain, numbness, or weakness in one or both legs that causes you to stumble or have trouble getting up from a chair.
— Loss of or altered sensations in the legs, buttocks, inner thighs, backs of your legs, or feet that is severe or gets progressively worse. Often the numbness affects the distribution of nerves in the areas of your body that would sit in a saddle (called saddle anesthesia).
— Problems with bladder or bowel function, such as trouble eliminating urine or waste (retention), and incontinence.
— Sexual dysfunction that has come on suddenly.
Diagnosing Cauda Equina Syndrome
The diagnosis of cauda equina syndrome is made as follows:
— Medical history,
— Physical examination including assessment of strength, reflexes, sensation, stability, alignment, and motion.
— Magnetic resonance imaging (MRI) scan, to produce three dimensional images of the spine.
— Myelogram — an X-ray of the spinal canal after injection of contrast material — which can pinpoint pressure on the spinal cord or nerves.
— Computed tomography (CT) scan.
Treating Cauda Equina Syndrome
Cauda equina syndrome must be treated promptly to relieve nerve pressure. Surgery must be done urgently to prevent permanent damage, such as paralysis, loss of bladder and bowel control, sexual function and other problems. Studies have shown that the best results occur when treatment is initiated within 48 hours of the onset of symptoms. Delays in treatment can lead to permanent damage.