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Delay in treatment of spinal abscess results in man becoming tetraplegic

Man with existing spinal cord injury, left with additional upper limb deficit due to delay.

Over 30 years ago, Frank was involved in a motorcycle accident and suffered a spinal cord injury which rendered him paraplegic. He developed a syrinx (a fluid-filled cavity) in his spinal cord which was effectively treated by surgery.

In September 2014, he was admitted to hospital complaining of a pain in his neck, his left shoulder and left arm and was experiencing weakness in both his arms. The consultant recognised the importance of an MRI scan, but no scan was performed because Frank had a spinal sacral stimulator in place and the radiology department was reluctant to scan him.

Frank continued to experience upper limb weakness and this gradually worsened. However, there was a delay in his transfer to a neurological centre by three days. An MRI scan was eventually performed which showed an epidural abscess which was causing spinal cord compression and he underwent emergency decompressive surgery that evening.

Around three years later, Frank developed another syrinx which led to a deterioration in his upper limb strength and utility. We argued that this further deterioration was due to the delay in the treatment of the spinal abscess years earlier.

Frank had been a T4 complete paraplegic but is now also a C1 incomplete tetraplegic. He is no longer able to transfer safely and suffers with complete lack of sensation down his right arm and hand and has reduced sensation in his left arm and hand.

He has reduced dexterity and pain in both hands and is restricted in his ability to work in the way he used to. His physical restrictions have also had an adverse effect on his mental health. Frank requires one to one support throughout the day and a sleep-in carer at night. In the last few years of his life, he will require two-to-one support during the day.

The Defendant made an early admission on breach and a partial admission on causation. However, it was denied that the recurrence of the syrinx was caused, or materially contributed to, by the delay in treatment of the spinal abscess by three days.

We secured interim payments of £150,000 for Frank to put in place a case manager, support assistance and therapy. However, the Defendant argued that the case was not worth any more than that and all support had to be stopped when the interim payments were exhausted.

As we approached a trial on breach of duty and causation, we were successful in agreeing a settlement award of £1 million for Frank which took into account a 40% litigation risk, bearing in mind the complex causation arguments, hotly disputed between both sides’ experts.

Lesley Herbertson, Partner in clinical negligence at Potter Rees Dolan, who acted for Frank, said:

Frank’s recurrent syrinx actually developed during the course of the case and his physical deterioration was apparent. Whilst our experts were of the view that the recurrence of the syrinx was materially contributed to by the 3-day delay in treating the spinal abscess in September 2014, the Defendant Trust’s experts took a different view, and it was clearly going to be a finely balanced issue at trial. Therefore, to secure an amount of compensation for Frank, which was significantly higher than the Defendant’s original offer to settle, and which would enable him to meaningfully contribute towards the support he needed going forward, was an excellent result.

* The names and identifying details of the client have been changed to protect the privacy of individuals involved.

Lesley Herbertson is a Partner within Potter Rees Dolan's Clinical Negligence department. If you have any questions relating to this case study or clinical negligence generally and wish to speak with Lesley, please call our free phone on 0800 027 2557. Alternatively, you can contact Lesley directly through her profile page on our website.

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