Decision Report 202007151

Summary

C attended Queen Elizabeth University Hospital (QEUH) on a number of occasions prior to being diagnosed with cauda equina syndrome (CES, a narrowing of the spinal column where all of the nerves in the lower back suddenly become severely compressed). C required two emergency surgical procedures and has been significantly impacted by the condition. C complained that there were missed opportunities to diagnose CES, and about the clinical assessments carried out at QEUH.

C's complaint concerned assessments in A&E and in gynaecology (specialists in the female reproductive system). We took independent advice from a consultant in emergency medicine and a consultant gynaecologist. We found that C was assessed appropriately during each admission to A&E. We found that C was displaying no red flag symptoms and that appropriate follow-ups were arranged. We also found that C was not exhibiting symptoms which would indicate CES, nor was C displaying symptoms which would have triggered immediate imaging. We were satisfied that C was assessed appropriately and that it was reasonable to arrange follow-up gynaecology assessment later that day. We did not uphold these aspects of the complaint.

We also found that C was appropriately assessed when they attended the emergency gynaecology appointment. There was no clinical evidence to suggest C needed emergent care. The doctor noted no symptoms of CES and consulted with the consultant on call before discharging C with appropriate advice. We found this was reasonable. We did not uphold this aspect of C's complaint.