Chris from Patient Centered Training describes a patient who developed cauda equina syndrome after treatment, and how he handled the emotional fallout and communication to avoid legal trouble. The story illustrates why clear patient communication matters in serious medical situations.
Hey, guys, it's Chris from Patient Centered Training and today's video. I actually want to talk about what was probably the scariest situation I've ever had in my career. And that was the time I triggered Corda Equiner in one of my patients. Really scary for me, really scary for the patient, obviously. And luckily it didn't go the way it could have. And I want to talk about why I think that was and how I think I managed to avoid what could have been a very serious legal situation. I. And a pretty major complaint. And basically, long story short was this patient, she'd come in for treatment a couple of years ago, had responded quite well, disappeared, came back, said, yeah, I should have come in a while ago. Life got busy. And I remember noticing every time I treated her, I'd adjust her just looked like a standard low back pain case. But she would be quite sore for a couple of days after treatment. And we all know that can happen, but it happened about the same level each time. And I remember after her fifth treatment thinking I might ask and see if there's any inflammatory symptoms, any spondyloarthropathy stuff below the surface. And that was on the Friday. Treated her, adjusted her. She was due in, I think, middle of next week. On Monday, her friend who she'd referred in came in and said, oh, by the way, have you heard from so? And so she had spinal surgery on the weekend. I went, what? She's like, yeah, some emergency. Apparently she couldn't move her legs. The ambulance picked her up and, you know, she was very nearly paralyzed. She's just recovering from surgery at the moment. Oh, my God. Panicking inside. I treat this patient and just before I bring the next one, I see an email pops up from the patient saying, hey, just to let you know, after the treatment on Friday, I developed cauda equina syndrome. I woke up doubly incontinent and couldn't move my legs. So I've just had an emergency double laminectomy. I won't be coming in for a little while. Just letting you know. And fortunately for me, because I was in full panic mode here, I'm checking the notes, going, oh, my God, did I miss anything? I definitely asked about red flags. I definitely check reflexes. There was no radiculopathy. I didn't do anything wrong. Unfortunately, before I had a chance to call the patient, I had a bunch of other patients. So by the time I was able to pick up the phone, I've been able to calm down and think it through. A little bit, because my first reaction was, oh, my God, I have to call this patient to make sure she's not going to sue me, because she might. She's going to think I caused that. I've got to tell her that this isn't my fault and this is just a random chance thing, because I remember getting the sense from this patient that if you crossed her, she was not going to let it go. She struck me as somebody even before this happened who I thought could be a bit litigious. But luckily, by the time I pick up the phone, I've thought it through and I thought, okay, you know what? This patient's just gone through a terrifying experience. I'm going to call her and make sure she's okay because I'm her chiropractor and I'm worried about her. That was true. And I'm gonna make sure she's okay and see where she's at. And I did. And I picked up the phone, just went, you know, Sarah, I just. I just saw your email. I heard what's happened. Are you okay? I just wanted to see how you were doing. And I let her explain what happened. And basically the day after treatment, she woke up incontinent, couldn't move her legs. You know, all the stuff we freak out about. But she tells me that she went to hospital and the nurse she saw who triaged her basically said, you got sciatica, you're kind of wasting our time. We're going to send you home with painkillers. Fortunately for her, she flagged down the doctor while she was in a bed in the corridor because she didn't have a room, just needed to go to the toilet, didn't know what to do, couldn't walk. And the doctor realized what was going on, arranged an emergency mri, had a double laminectomy, a massive cauda equina. The surgeon said if it had been another hour, she probably wouldn't walk again or be able to use the toilet by herself. Really, really serious. Fortunately, she was recovering. Since then, she's felt like she's doing quite a bit better. But she says, you know what? Obviously this is. This is a thing that gets missed a lot because I put it into Google and all the top paid adverts when you put in cord aquina syndrome are all medical negligence solicitors. So this is getting missed a lot. I remember thinking, oh, God, that's not where I wanted this to go. And she went, yeah, I can't believe that nurse didn't listen to me because I said to her, did you tell the nurse that you were doubly incontinent? I. She went, yeah. Did you tell her she had, you know, you were paralyzed, you couldn't move both legs? She went, yeah, I told her it was both legs. And she's like, no. She just said it was sciatica, you know, claims I didn't tell them that. And last I heard that that nurse was hearing from her solicitor. She was planning on taking her to call. Fortunately for the patient, she made a good recovery. I spoke to her a few weeks later. I've had a little bit of numbness. Everything else was absolutely fine. And she's telling me this, and she goes, well, you know, I know it's probably your adjustment that triggered it. Again, I freak out thinking, oh, God, I really didn't want to go this way. But, you know, it was probably gonna happen. Like, I was getting sore after each one. The surgeon said, yeah, if it wasn't that, it was gonna be something else, so, you know, it wasn't your fault. I remember thinking, oh, okay, good. She's like, yeah, but I'm. I'm definitely. I'm talking to my solicitor about that nurse because I was nearly paralyzed because of her for not listening. So, again, it goes to show, A, how important listening is. But B, I'm pretty sure if I picked up the phone, panicking, getting very defensive, I don't know. But it might have planted a seed of, oh, Chris is worried about something. Has he done something wrong? And I know the solicitors often encourage them to go after every single person in the chain of events. Fortunately, never went that way. She made a good recovery. I don't know what happened to the nurse, but if you're ever in that situation, take the time to just calm it down and think it through. And if you're going to pick up the phone, your first energy should be to listen to the patient and to show you're concerned about them. Because she got that from the phone call. She said, oh, it's so lovely of you to call, by the way. It's really nice of you because I was freaking out. I was really, really worried. I just went, yeah, of course. I can imagine. I wanted to make sure you're okay. And if you pick up and you get very defensive, like I said, it may go a different way because the energy you're presenting is, I'm worried about me, not I'm worried about you. So hopefully that never happens to you. Hopefully. You never have a situation with a patient who gets cord required or anything that's serious. But if there's ever a patient who's upset or in a complaint, really try to show them. Your reason for getting in touch with them is to make sure they're okay first. Let yourself have that kind of panic reaction and calm down a little bit there because it will make a big, big difference. And obviously do a good job listening because that was the difference between me and that nurse and why that nurse has taken a call and why I'm still on good terms with this patient because that could have gone very differently. So little thing about that. The other thing I wanted to mention here as well, just briefly for those of you who haven't seen started a Facebook group. I've been producing loads more videos like this. I'm still going to put out a newsletter occasionally, but I've been putting out nearly daily videos in this group. So if you find these emails useful, if you find these videos useful, join that group. If you search Patient Centered Chiropractors in Facebook, you'll find it there. You just apply to join. You know, we'll grant you access there. I'll put a link for where you can find it at the bottom of the emails here at the bottom of this link as well. So there's loads more content. I'm really putting quite a lot of videos into that and then it completely free for anybody who wants to join. If you've got any questions about things, anything you want to ask me, by all means get in that group. You can ask me, we can get advice from others. It's going to be quite a collaborative effort. I'll be sharing quite a lot of exclusive content just in there. So if you want to join the group, check that out, have a look at the link below and sign up where you can search Patient Centered Chiropractors. I'll let you in. If you're an osteo or physio as well, don't worry. But find that group there and hopefully we'll see you in the group.
