Case Studies

Claim against surgeon for leaving haemostatic material in the spinal canal and failing to respond to clear signs of Cauda Equina Syndrome


We secured six figure damages for a patient who was left with permanent urinary, bowel and sexual dysfunction and mobility issues after spinal surgery.

She underwent a discectomy for back and nerve pain privately on a non emergency basis. During the operation, the surgeon encountered significant bleeding and used a haemostatic material to deal with this, leaving the material in the spinal canal after the surgery. While there was no criticism of the fact that our client suffered a bleed or of the surgeon’s use of the haemostatic material, guidance on this material makes it very clear that using it and leaving it in the spinal canal carries a high risk of nerve compression. Despite this, the surgeon did not provide any instructions to our client or the nursing staff to be alert to signs of nerve compression.

Almost immediately post operatively, our client noticed and reported signs consistent with evolving Cauda Equina Syndrome (compression of the nerves at the base of the spine). These nerves will progressively sustain permanent damage if the compression is not relieved – making this a condition that requires urgent treatment. Despite reporting what are known as ‘red flags’ of Cauda Equina Syndrome and her surgeon being aware of these symptoms, there is no evidence that the possibility of Cauda Equina Syndrome was considered and no steps were taken to investigate the cause of her symptoms. A few days later she was discharged home, still complaining of these symptoms.

Shortly after returning home, the claimant became completely incontinent. She was readmitted to the same clinic under a different surgeon. An MRI scan confirmed compression of the Cauda Equina nerves and she underwent further surgery to decompress them. During that surgery, the blood soaked haemostatic material was removed from the spinal canal. Post operatively our client improved in some respects but she has been left with permanent disability including weakness in her legs, loss of control over urinary and bowel function, loss of sexual sensation and psychological symptoms as a result of her very limited lifestyle and the embarrassment and awkwardness of her condition. She has gone from being an active and sociable individual to someone who is largely confined to the house and her life has been very significantly affected.

We were instructed to investigate a claim against the surgeon and obtained independent expert evidence from another spinal surgeon. This surgeon believed the operating surgeon was negligent in failing to remove the haemostatic material after stopping the bleeding, not being alert to the risk of our client developing Cauda Equina Syndrome and failing to respond to clear signs that this was happening. 

The claim was presented to the surgeon and his defence organisation. After significant delays, they responded to say that the claim was denied in full. We therefore proceeded to investigate all aspects of our client’s condition, including obtaining urology, gynaecology, colo rectal and psychiatric expert evidence, and then issued proceedings. Following service of proceedings, the surgeon’s defence organisation indicated a willingness to settle the claim and negotiations began – resulting in a substantial settlement for our client.


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Penningtons Manches LLP

Penningtons Manches LLP is a limited liability partnership registered in England and Wales with registered number OC311575 and is authorised and regulated by the Solicitors Regulation Authority. San Francisco is an associated office.

Penningtons Manches LLP