The claimant, a 50-year-old woman, received £220,000 for the cauda equina syndrome she developed following spinal surgery in October 1997. The claimant became doubly incontinent and suffered impaired mobility, impaired working capacity and depression as a result of her injury.
Claimant: Female, 46 years old at date of accident; 51 years old at date of settlement.
Clinical Negligence: On 21 June 1990, the claimant sustained a back injury in a domestic accident. She developed severe sciatica and in 1996 she was added to the neurosurgical waiting list at the defendant’s hospital. While waiting for her operation the claimant’s condition deteriorated. By the time she was admitted for surgery, she had been off work for 18 months. In October 1997, she was admitted from the waiting list to the defendant’s hospital for a lumbar laminectomy and right microdiscectomy at L4/5. In the event, the surgeon entered at the wrong level, performed a laminectomy at L3/4 and failed to remove the prolapsed disc. Following the operation, the claimant developed neurological symptoms. She was taken back to theatre on the second post-operative day, where a haematoma was evacuated, the prolapsed disc material was removed and the L4/5 nerve root was decompressed. The claimant did not recover neurologically and she brought an action against the defendant alleging that: (i) the surgeon was negligent in operating at the wrong level and in failing to remove the prolapsed disc; (ii) there was a 36-48 hour negligent delay in responding to the signs of cord compression; (iii) the defendant’s negligence was the cause of the claimant’s cauda equina syndrome and (iv) but for the negligence the claimant would have resumed her full level of activity within six months of surgery and would have progressed in her career.
Liability disputed. Breach of duty was admitted in respect of the first operation; breach of duty as to the post-operative care was denied. Causation was denied in its entirety.
Injuries: The claimant developed cauda equina syndrome with a permanent neurological deficit affecting her lower right leg and foot, her saddle area and her perineum. The claimant’s mobility was impaired. She limped, could not walk long distances and was unsteady over uneven ground. The claimant was also unable to stand on tip-toe or on ladders, or ride a bicycle. Her right leg and foot were partially numb. The claimant had no control of her bladder, having to self-catheterise and maintain a copious intake of fluids. She was prone to frequent urinary tract infections, had no control of her bowel and was incontinent of wind and faeces. The claimant lost all sensation to the saddle area and perineum, including loss of all sexual sensation. The claimant suffered from depression, which was treated with anti-depressant medication and counselling.
Effects: In mid-2000, the claimant returned to work as a teacher, although her long-term employability was uncertain. The school environment triggered urinary tract infections and she had considerable periods off work. Her stamina was significantly reduced. The claimant’s employer made efforts to find her a suitable post but eventually her status was reduced to supernumerary teacher.
Prognosis: The claimant’s condition was permanent and no improvement or deterioration was likely, although management of her problems could be expected to become more difficult with age and she would require some additional care. Recovery from her depression was unlikely in the absence of improvement in her physical condition. The claimant’s life expectancy was unaffected.
Out of Court Settlement: £220,000 total damages.
Background to damages: The case was settled on a global basis and no particular breakdown of damages was agreed upon between the parties. Settlement was reached before exchange of medical evidence. At the outset, the claimant contended that all her injuries were attributable to the alleged negligent acts and omissions and, on that basis, £75,000 was estimated as the appropriate figure for pain, suffering and loss of amenity. However by the date of settlement further medical evidence had been obtained that suggested that the claimant would have suffered some loss of control in any event (retaining control to a socially acceptable degree). On that basis, £60,000 was felt to be a more appropriate figure in respect of pain suffering and loss of amenity. The remainder of the damages related to past and future care costs, future costs of aids, equipment and chiropody services, and loss of earnings.
Jane McNeil QC instructed by Henmans (Oxford) for the claimant. Andrew W Lewis instructed by Hempsons (Harrogate) for the Defendant.
Document No: M0200406. Reproduced by kind permission of Lawtel (www.lawtel.com)