Award of €120k for severe damage to bladder caused by delayed surgery

Personal injuries – medical negligence – plaintiff (b.19.10.1962) attended hospital as inpatient with back pain on several occasions in 2006 – allegation of failure to diagnose developing Cauda Equina Syndrome (CES) – permanent bladder and bowel damage alleged to have resulted from failure to identify and treat her condition – whether back surgery fell below acceptable standard – whether further back surgery necessary – whether fragment of disc permitted to cause ongoing damage to nerves, causing further irreversible bladder and bowel damage – plaintiff has no useful bladder function – whether surgery should have been wide laminectomy rather than less radical hemilaminectomy – prior medical history included discectomy in 1994 and 18 months of urinary incontinence in 1994 – relevant test re medical negligence – court rejects allegation that surgery was substandard – case complicated by fact of plaintiff attending different hospitals – court satisfied that there was a failure by defendant to ensure that plaintiff had an urgent MRI scan following her latest admission to hospital in March 2006 – red flags indicative of CES at that time – surgery delayed by 48 hours due to failure to ensure urgent MRI scan – which injuries and symptoms can be connected to the CES – to what extent those injuries and symptoms can be ascribed to the delay in the surgery – expert evidence and literature are not clear as to the significance of delayed surgery in cases of CESI and CESR – court satisfied that delay led to more severe damage to bladder – even in the absence of negligence the plaintiff was highly unlikely to have recovered full bladder function – plaintiff required to self-catheterise twice daily – court not satisfied that plaintiff has established any other injuries (eg bowel problems or loss of genital sensation) which can be related to the delayed surgery – even if plaintiff had received optimum care for her CESR she would have sustained permanent neurological damage to her bladder – general damages €120,000.