Back injuries can be particularly difficult to diagnose and treat and sometimes patients with suspected prolapsed or slipped discs may be prescribed rest rather than surgical intervention. Surgery can also involve the risk of further problems through nerve disruption and scarring.
It was not perhaps so surprising then when 34 year old photographer and mother of three Heather Tait who attended Cheltenham General Hospital in July 2009 suffering from severe back pain was sent home with advice and medication.
Mrs Tait's condition deteriorated overnight and when she returned to hospital the following day a scan revealed that she was suffering from a massive prolapsed disc.
As a result of the delay she developed the devastating back condition, cauda equina syndrome. Since then she has suffered constant pain, was doubly incontinent and was left with a range of distressing physical and mental symptoms which had a severe impact on her personal and professional life. If she had the scan and surgery earlier she would not have developed the symptoms.
The key failure was that although the doctors suspected she had a prolapsed disc, she was sent home without an MRI scan which would have revealed the extent of her problems. As a result of their delay her untreated condition dramatically deteriorated overnight.
Bolam and Bolitho test
The standard test is as follows:"A doctor is not negligent if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art… Putting it the other way round, a doctor is not negligent, if he is acting in accordance with such a practice, merely because there is a body of opinion that takes a contrary view". The Court however can reject a body of medical opinion and choose another competing view if "satisfied that the body of expert opinion cannot be logically supported at all".
This is a case where, on one view the A&E team adopted a fairly standard approach: many people suffer from back ache and many back strains resolve with rest, saving time consuming and expensive resources such as MRI scans and reviews. Here, however the approach caused devastating harm which a more prudent approach would have avoided. NHS providers must weigh the risks of not investigating complaints properly and must design and implement affective clinical procedures to protect patients and identify risks. In this case, the court awarded £2.4m in damages to Mrs Tait.