Can I make a claim if my GP failed to refer me for cauda equina syndrome?

Being told that your symptoms are nothing serious can be reassuring at the time. But if your condition later turned out to be cauda equina syndrome, you may now be questioning whether your GP should have acted sooner.

You may be able to make a medical negligence claim if your GP failed to refer you for urgent assessment when they should have done so. To establish a claim, we’d need to show that the care you received fell below the expected standard and that the delay caused you avoidable harm.

It can be difficult to know what your GP should have done, especially when you didn’t know that your symptoms could point to a serious condition.

A GP has a duty to provide care that meets the standard expected of a reasonably competent doctor. This includes:

• Listening to your symptoms
• Considering serious conditions where appropriate
• Arranging further assessment when your symptoms call for it.

Your GP doesn’t have to get every diagnosis right. Cauda equina syndrome can be difficult to identify, and many symptoms can have other causes. The legal question is whether your GP acted reasonably based on the information available at the time.

If your symptoms should have raised concerns about cauda equina but your GP didn’t arrange urgent assessment, this could be a breach of their duty of care and you could have a GP negligence claim.

You may feel unsure about what your GP should have recognised, particularly if you had already been told that your symptoms were linked to back pain.

NICE guidance says symptoms that should trigger an immediate referral for assessment for cauda equina syndrome include:

• Severe lower back pain that travels into the leg
• New problems with your bladder
• New problems with your bowel
• Problems with your sexual function
• New numbness around the area between the legs

This doesn’t mean that everyone with back pain needs an emergency referral. Your GP must consider your symptoms as a whole and use their clinical judgement. However, if your symptoms should have prompted urgent assessment, and your GP doesn’t make this referral, this is potentially grounds for a claim.

It can be upsetting if you remember telling your GP about worrying symptoms, but the medical records do not seem to reflect what you said. Your medical records can provide important evidence about the care you received. They may help show what happened during your appointment and why your GP decided not to refer you.

We’d also look at any advice you received about what to do if your symptoms became worse. This is known as safety-netting advice. An independent medical expert can consider the records alongside the other evidence in your case, like your recollection of what was discussed at the appointment, which we can include in your witness statement. They can then assess whether the care you received met the required standard.

You may feel certain that you should have been referred sooner. However, a failure to refer doesn’t by itself establish a claim. We also need to consider causation. This means looking at whether an earlier referral would probably have resulted in a better outcome for you.

For example, an independent medical expert may consider whether an earlier hospital assessment would probably have led to timely diagnosis and treatment which would have led to a materially better outcome for you or your injuries would have been avoided entirely. This can be particularly important if you have been left with lasting problems after a delay in diagnosis or treatment.  This helps us assess what compensation you may be entitled to.

Susan Prior, Head of Department and a Partner at Fletchers shares “Cauda equina syndrome is a medical emergency so it is vital that red flag symptoms are properly recorded and acted upon. When investigating these cases, we look carefully at what our client reported, what was documented in the medical records and whether appropriate urgent referral was made. A failure to recognise and act on those warning signs can have devastating and life-changing consequences. At Fletchers, we are experienced at supporting our clients and navigating them through the legal complexities of bringing a claim of this nature.”

Please do not assume that you can’t claim because you followed your GP’s advice. If your GP reassured you that your symptoms were not serious, you should have been able to rely on what you were told.

All of the circumstances of your case will be considered carefully. This includes looking at the advice your GP gave you and whether they told you when to seek further help.

Our team represented a client who had severe back pain that spread into her legs. She also had numbness and problems passing urine. Her first GP advised her to continue taking ibuprofen and stay mobile. The GP didn’t warn her about cauda equina or tell her to seek urgent help. She became increasingly concerned but didn’t take further action because she had been reassured by the GP.

She later saw another GP who recognised the possibility of cauda equina and arranged her immediate admission to hospital. An MRI scan confirmed the diagnosis and she needed surgery. Expert evidence supported her claim as a neurosurgeon concluded that an earlier referral would probably have led to diagnosis sooner and a complete recovery. The claim settled for £145,000 shortly before trial. This outcome meant our client had financial security and access to the resources she needs to manage her condition and live as independently as possible.

You may feel unsure about contacting a solicitor. You may also worry that you’ll be told there is no case. You don’t need to know whether your GP was negligent before you speak to us. Our medical negligence team can listen to what happened and explain whether you may have grounds for a claim. We can obtain your medical records and arrange independent medical evidence where appropriate. We’ll explain what the evidence means and keep you informed as your case progresses.

We understand that cauda equina syndrome can leave people facing major changes to their lives. You may now face treatment and care requirements that you hadn’t expected. You may also be facing changes to work or your independence. If you believe your GP should have referred you sooner, our GP negligence team can help you understand what happened and whether you may be entitled to compensation. Speak to us today.