Lawyer Monthly is pleased to present Dr. Charles E Rawlings as an expert witness and neurosurgeon, as well as a nationally recognized plaintiff’s medical malpractice attorney. He has published extensively about the condition and treated many cauda-equina patients. He explains why early diagnosis and treatment of cauda-equina syndrome is so important and the many ways that it can be treated.
Cauda equina Syndrome (CES) is a severe neurological condition that was first described in 1934 by Mixter and Barr. Any entity that exerts pressure on the cauda, equina, including hematomas and tumours, can cause it. Cauda Equina Syndrome is a condition that occurs in between 2 and 6 percent of lumbar disc herniations. Cauda Equina Syndrome is a secondary condition to disk herniations.
Cauda Equina Syndrome is a neurological disorder that manifests in low back pain, bilateral or unilateral legs pain (radiculopathy), saddle anesthesia (reduced sensations in the perineum and buttocks and anus), motor weakness, sensory deficit, bladder or bowel dysfunction.
Patients with cauda-equina syndrome can present to their family physicians or to specialists, but a greater percentage will present to the emergency department to receive initial evaluation and treatment. Medical negligence can be caused by certain acts or omissions of emergency department staff.
These acts or omissions include the failure of nursing staff to document or communicate patient’s symptoms, signs, and progression thereof; failure by a physician or physician to obtain an accurate, complete history, accompanied with a complete physical exam, including rectal examination; failure to recognize cauda-equina Syndrome and failure to refer a patient to emergency imaging, consultation, referral, or referral once the patient has been diagnosed with cauda.
Cauda Equina Syndrome is best treated by a referral and early diagnosis. This will allow for surgical treatment within 48 hours. Below are some of the symptoms along with a brief description of the appropriate treatments.
Cauda Equina Syndrome is a neurological condition that results from pressure on the cauda, equina, generally caused by a ruptured intervertebral disk. Low back pain, bilateral or unilateral lumbar radiculopathy and motor deficits, as well as bladder dysfunction or bowel dysfunction, are all symptoms of Cauda equina Syndrome. Cauda Equina syndrome is defined by authors only when there is bladder dysfunction. Cauda Equina syndrome is not a condition that can be diagnosed without bladder dysfunction. Most ruptured lumbar discs can be treated either with success or as an interim treatment until surgery is necessary.
Cauda Equina Syndrome is a real surgical emergency. It is the only absolute indication that a patient suffering from a ruptured disc in their lumbar spine should be treated. Studies show that patients with lumbar disc ruptures should be treated as soon as possible. However, most authors recommend immediate surgery. Studies have shown that the results are less likely to be successful if they wait 48 hours.
Shapiro points out the serious legal implications of cauda-equina disorder. “Serious implications regarding emergency room management and doctor office management of this issue exist”. Practitioners must view cauda-equina as an emergency situation that requires both immediate diagnostic and treatment. To avoid these “serious law implications”, they should continue to treat it like any other surgical emergency. Urinary dysfunction patients must be treated immediately, especially if they have suffered an acute change and other discogenic symptoms. The doctor must be informed about the condition and have the ability to order an MRI to assess the cauda equina as well as the lumbar spine.
Cauda Equina Syndrome is a real surgical emergency. It is the only absolute indication that a patient suffering from a ruptured disc lumbar is being treated.
The physician must also recognize that cauda Equina Syndrome is a serious surgical emergency and should be immediately referred to or consulted with a spine surgeon. Without consultation or studies, the patient should not be allowed to linger. This is especially true for evenings, weekends, and holidays. A patient suffering from acute cauda-equina syndrome can’t be treated routinely and that would be medical negligence.
If cauda-equina Syndrome is diagnosed and treated negligently, the victim must be compensated for any permanent paralysis, neurological deficits, pain and suffering, lost wages and emergency transportation costs, future and current medical treatment, and rehabilitation costs.
They must gather all relevant medical records if they believe they have suffered cauda Equina Syndrome, or damages therefrom. They must also gather all medical documentation, lost wages (such as W-2s and tax returns), and any other expenses related to their condition. For further assistance, they should immediately contact The Rawlings Law Firm.
Charles E Rawlings, MD
301 N Main St Suite1020, Winston-Salem NC 27101, USA
Tel: +1 336-725-6444
Dr. Charles E Rawlings, a Board-certified neurosurgeon, was involved in medical malpractice litigation for 14 years as a consultant and case reviewer. He also served as expert witness before becoming an attorney. He draws on his many years of experience in the legal and medical spheres to help clients get their cases resolved. Super Lawyers recognize Dr. Rawlings as one of the Top 100 attorneys by The National Trial Lawyers. He has also received many other awards. He is a member of the Bars in Texas, South Carolina and New Jersey. He has successfully handled multiple malpractice claims relating to cauda-equina syndrome.