Why Do Medical Professionals Fail To Diagnose Cauda Equina?

Cauda Equina Syndrome is a rare condition; this should not

, however, prevent medical professionals from making a quick and accurate diagnosis.

Indeed, there are very common symptoms associated with spinal compression, and any patient presenting the tell-tale signs should be treated with urgency. A suspected diagnosis of Cauda Equina Syndrome should be made and tests immediately carried out to either confirm or rule out this theory. It is incredibly important doctors' act with such caution, or a patient's condition will rapidly progress to the 'complete' stage whereby permanent neurological damage is unavoidable.

But despite the known risks of a delay in diagnosis, medical professionals repeatedly fail to detect Cauda Equina Syndrome, in turn causing the patient life-altering health complications such as incontinence and paralysis. Evidently the consequences are of an extremely serious nature. So why, exactly, do doctors and nursing staff continually neglect to make an accurate diagnosis?

Cauda Equina Syndrome and Medical Error

Cauda Equina Syndrome is when the bottom of the spinal canal becomes compressed. This will lead to symptoms such as altered bowel and urinary habits, leg weakness, anaesthesia of the saddle regions and poor anal tone. This is known as the 'incomplete' stage, as a patient will not have complete urinary retention (ie. he or she can still urinate but it may be difficult to do so). As compression continues, the nerves will become increasingly damaged until eventually the condition moves into the 'complete' stage. This means a patient is unable to urinate despite having a full bladder, which then usually leads to overflow incontinence.

However, it is absolutely vital the condition is treated while it is still incomplete, as a patient with complete Cauda Equina Syndrome will not be able to make a full recovery. Nevertheless, medical professionals often fail to recognise the early signs of spinal compression, instead believing a patient to be suffering from a more minor condition such as a urinary tract infection. A mistake such as this can occur from any number of reasons, with some of the most common including:-

- Healthcare staff are ignorant of the symptoms associated with Cauda Equina Syndrome, particularly junior doctors;

- There is a failure to perform any diagnostic tests;

- There is a failure to intervene before the red flag symptoms of complete Cauda Equina Syndrome;

- There is a failure to refer a patient to a spinal specialist.

Claiming for Cauda Equina Syndrome

A delay in diagnosis will have devastating consequences, as there is only a small window in which incomplete Cauda Equina Syndrome can be treated. The condition is one which rapidly deteriorates, and it is generally accepted that decompression must be carried out within 48 hours of the onset of symptoms. That is why it is so important for doctors to carry out further diagnostic tests, even if there is only a small suspicion that Cauda Equina Syndrome is present. If there is a failure to do so, there could be a case of medical negligence.

by: Julie Glynn

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