DENTO-LEGAL Special Focus Inside This Issue..........
Featuring Specialist Endodontist Dr B David Cohen Call Dr Cohen now on 07000 Dr Cohen (3726436)
click here to visit Dr cohen’s website and download his app www.endodontistmanchester.co.uk
Awarding A Lifetime Of Excellence
Dr B David Cohen The Federation of Forensic & Expert Witnesses is delighted to announce Dr B David Cohen - Specialist Endodontist & Dental Expert Witness of the year. Dr Cohen has been selected as the recipient of this year’s Independent Award. This Award scheme was created by the Federation of Forensic & Expert Witnesses to profile it’s members who have shown a commitment to contribute outstanding work within their chosen speciality. In this particular case, Dr B David Cohen received this honour in recognition of the lifetime of commitment he has given to the field of Dentistry; both to his patients and to the Expert Witness Industry. Independent to the Federation, these Awards are designed to raise the profile and highlight the ‘best experts’ in their given fields of expertise. The Federation achieves this goal by making Lawyers and Barristers, who follow the Federation via links to its’ website or read its’ E-mag, aware of the recipients of these accolades.
Federation of
Forensic & Expert witnesses
Award 2019
Dr B David Cohen is a Manchester based expert and has a special interest in Dentistry, Dental negligence and personal injury cases including all subjects like: • General Dentistry • Accidents • Slip and trips • Road traffic accidents • Accidents at work • Sports accidents • Endodontic problems inc. clinical negligence Specific area of expertise in clinical negligence cases is that of endodontics (root canal treatment/therapy). And of course is available to advise in any of these subjects that may need a dento - legal report needed for the courts. We fully recommend Dr B David Cohen and we are pleased to announce him as this year’s recipient.
You can book a consultation with Dr B David Cohen or instruct him direct at:
07000 (665277) dento-legal@endodontistmanchester.co.uk www.endodontistmanchester.co.uk
THE BACKGROUND OF AWARD RECIEVING EXPERT WITNESS 2018-2019
Dr B David Cohen (Specialist Endodontist) PhD, MSc, BDS, MFGDP, LDSRCS, CUEW, MEWI, CertMR GDC registration number: 45658
I am a Specialist Endodontist, and I like to think that for over 30 years I have been helping general dental practitioners solve their endodontic problems. In that time I have treated something over 25,000 teeth! I qualified in 1971 from the Royal Dental Hospital of London and 1972 from the Royal College of Surgeons of England. Following qualification I worked in general practice in Manchester. At a lecture by an endodontist in 1976 I became interested in Endodontics, and in order to advance my knowledge in this field I undertook a number of postgraduate courses in the United States at Boston University School of Graduate Dentistry, under the leadership of Dr. Herbert Schilder. In 1981 I commenced part-time postgraduate research in Endodontics, which led to me being awarded an MSc in 1984 on the strength of a thesis entitled "An Investigation into the relative merits of some Endodontics Filling Systems". In 1986 I was invited to undertake further research work, culminating in me being awarded a PhD by the University of Manchester in 1991 on the basis of my thesis entitled "Development and Evaluation of Endodontics Filling and Pulp Capping Materials". This led to the development of new materials in both areas of root filling and pulp capping and worldwide patents for such materials. In 1981 I opened a practice 'Limited to Endodontics' part-time, which has now grown to me being in full time practice. I now spread my time between Manchester, Nottingham, and Crewe, and latterly Gibraltar.
For a number of years I taught postgraduate Endodontics and undergraduate studies as a Lecturer at Manchester Dental Hospital, and I currently hold the position of Honorary Research Associate at Manchester University. I was admitted to the endodontic specialist register as soon as the register was inaugurated in 1998. I have written widely on endodontic subjects and in 1994 I was a Visiting Fellow to the Singapore Ministry of Health. I have also lectured extensively in the U.K. and U.S.A. I have served as the President of the British Endodontic Society and Chairman and/or executive member of a number of local dental and endodontic associations. I have also since 1979 been a member and regular attender at meetings of the American Association of Endodontists. In addition, I have been producing dento-legal reports for many years, and have to date produced over 2,000 reports for solicitors, both claimant and defendant. In 2005 I was awarded a Certificate of Expert Witness Accreditation by Cardiff University, in 2008 I was accepted as a member of the Expert Witness Institute, and in 2013 the Certificate in Medical Reporting. Outside dentistry I love spending time with my family, especially my six young grandchildren. I also enjoy learning Spanish and violin (both rather badly), photography, collecting whisky and vodka miniatures and as I have a pilot’s licence, I really enjoy flying. I have been very active in my local Jewish community, including a stint of three years as the President of my local synagogue, and I have recently finished a 4 year term as an LEA Governor at a local high school.
“Dear David, Thanks for your email. I think your report was one of the best I have seen for a long time and you have been added to our new database of experts which is to be forwarded to Dental Protection. Kind regards”Esther N
Dr B David Cohen Specialist Endodontist and Accredited Expert Witness
PhD MSc BDS MFGDP LDSRCS CUEW MEWI CertMR
I have now been preparing expert witness reports for over 30 years, having prepared over 2000 of them. Most of these have been completed in the last 7-10 years since the Woolf reforms, and following my formal training on the Cardiff University Expert Witness Certification course. I am trained to be involved in acting as an expert witness on behalf of the court, appointed by either claimant or defendant, and as a single joint expert. My training and experience also include court/ tribunal procedures, and cross examination. Endodontics clinical negligence My specific area of expertise in clinical negligence cases is that of endodontics (root canal treatment/ therapy). I have prepared reports for both claimants and defendants
Personal Injury Cases
Dr Cohen prepares condition and prognosis reports for facial and dental injuries caused by:
• Accidents • Slip and trips • Road traffic accidents • Accidents at work • Sports accidents • Endodontic problems inc. clinical negligence DENTO-LEGAL SERVICES Correspondence address
122 Hilton Lane Prestwich Manchester M25 9QX dento-legal@endodontistmanchester.co.uk www.endodontistmanchester.co.uk Phone: 07000 665277
Consultations are available in: Manchester | Nottingham | Crewe & Gibraltar
Mr. AJ Ray-Chaudhuri
BDS MFDS RCSEd MJDF RCSEng LLM AFHEA FDS RCSEng
Accredited Expert Witness in Dentistry
AJ has 15 years of experience as a dentist and continues to work in the filed of dentistry. He is an NHS Consultant and Head of a department of Restorative dentistry as well as working in private practice. AJ is actively involved in postgraduate education and lectures locally, regionally and nationally.
He is recognised by the GDC as a specialist in four fields:
• Restorative Dentistry • Periodontics • Endodontics • Prosthodontics
AJ has a Master’s degree in Law from Cardiff University and has completed his Bond Solon Expert Witness training AJ undertakes over 100 reports per year on behalf of both Defendants and Claimants. For further information please visit the website or contact us directly
aj@advancedrestorativecare.com www.advancedrestorativecare.com
Dr Katharine Winstone PHD, BDS
Expert Witness Qualifications: PHD (Doctorate - London University 1986), BDS (Batchelor of Dental Surgery London University 1980)
Details: I have owned and worked in a mixed NHS and private general dental practice with my husband for 35years following post graduate training as a house officer and registrar and a PHD in Pathology. I regularly run postgraduate dental courses on treatment planning and aspects of restorative dentistry. I have provided over 430 reports since starting dents-legal work in 2007 in about equal numbers for defendants and claimants. I have been called as a witness at the General dental Council on more than 8 occasions, been involved in many case conferences and joint expert conferences and been appointed as single expert for the Court.
Training: Bond Solon Court Skills - 2009 London Bond Solon - Writing Expert Witness Reports - Manchester 2008 Cross Examination Skills – Bond Solon 2011 Certificate in Civil Procedure Rules - Bond Solon 2011 Bond Solon Expert witness Conference 2012, 2013, 2015 The Dental Protection Conference 2017
Membership: Royal College of Surgeons – Faculty of General Dental Practitioners British Society of Periodontology Vice-Chair Board of Trustees of Gravesend Grammar School Trust Trustee of the Kent Cancer Trust
Dr Katharine Winstone
New Ash Green Dental Centre Meadow Lane New Ash Green Longfield Kent DA3 8PR
t: 01474 879 800 f: 01474 873 495 e: katharinewinstone@mac.com
Professor Paul Tipton B.D.S., M.Sc., D.G.D.P., UK Specialist in Prosthodontics & Expert Witness London | Manchester
Professor Paul Tipton is a leading authority in UK Dentistry. Regularly featured in the Dentistry’s Top 50 Most Influential People in Dentistry, he has been a pioneering figure in the industry. In addition to being a specialist in Prosthodontics since 1999, he has been in private practice for over 30 years and is currently Clinical Director of T Clinics in Manchester and London. A keynote speaker at dental conferences around the world, Professor Tipton has lectured at home and abroad throughout his professional life including Australia, the US, Dubai, South Africa, Singapore and India. He is the founder of Tipton Training Ltd which has seen over 3500 UK dentists pass through many of his one year courses in Restorative, Aesthetic and Implant Dentistry. Professor Tipton has assembled a team of dental expert witnesses who work with him at T Clinics nationwide. All areas of Dentistry are covered including General Dentistry, NHS and Private, Cosmetic and Restorative Dentistry, Implantology, Oral Surgery, Orthodontics, Periodontics and Endodontics. Experts range from experienced Private Practitioners to those with Masters degrees that limit their practice to special areas of Dentistry, to Specialists, Consultants and Professors and span across the whole of the UK. All experts write the highest quality of reports in all fields ranging from Personal Injury to Road Traffic Accidents to Clinical Negligence.
07786327978 | becky@drpaultipton.co.uk www.drpaultipton.com | www.tclinic.co.uk 1. Throughout your years of experience as an expert, what common mistakes do other dental professionals make which does have the potential to lead to losses: Most of the common negligence cases that we see in dentistry are to do with periodontal disease and lack of diagnosis and lack of treatments which has in turn led to tooth loss and then the need to replace the teeth, usually with dental implants. Dental implants are a very costly treatment and usually not available in the health service and often should the negligence have led to loss of many teeth then treatment cost can be in the region of £50,000 in order to replace these missing teeth with implants. The second most common cause of negligence is then due to tooth extraction where it has not been explained to the patient that there are other options which could lead to the tooth being saved. The patient is then not fully informed of other treatment options and if they had been fully informed they would have taken another route which would have led to the tooth being treated. Again, once the tooth has been removed the usual replacement is with the dental implant and a single tooth replacement is often in the region of £3,000 to £4,000. The newer types of dental negligence which we are seeing more and more is to do with complex treatments for which the dental practitioner is either inadequately trained or he has not given the patient a reasonable estimate of the costs and the outcome together with the pros and cons of such treatment. Here the more expensive treatments include dental implants, cosmetic dentistry with veneers, etc., and also short-term orthodontics.
Patients are very often disappointed when having veneers or crowns placed that the end result does not match their expectations which can again then lead to a claim. Most dentists often do not complete enough diagnostic work in advance of treatment so that the end result can be easily previewed by patients and amended as required. Dental implants have a failure rate and this is often overlooked when placing dental implants. The expected failure rate has always been in the region of 5% in the lower jaw and 10% in the upper jaw. More recently, however, there is peri-implantitis disease which has led to an increase in the failure rates in some patients. Again this is often overlooked during the treatment planning stage. The patients are on the assumption that their implants will last them a lifetime. Short-term Orthodontics can not only improve the patient’s appearance but can also provide problems with the patient’s bite in the long term and this can lead to claims due to poor function or to problems with the bite leading to problems with the temporomandibular joints and treatment being required in order to treat the temporomandibular joints.
2. How have you seen dental education change over the years? Do you think that this has affected the occurrence of legal cases? Dental education has changed massively over the years and I have been involved in it very closely with my company Tipton Training. We have trained dentists over the last 20 years both in the UK and abroad in some of the complex issues of the newer techniques in dentistry. Due to government cutbacks and lack of funding, often now some of the newer graduates are graduating from dental school without basic knowledge and without having performed some of the basic dental tasks in sufficient numbers to be proficient. This then leads to a lack of confidence on the dentist’s part which can be reflected in the quality of treatment that is provided.
3. How would you deal with negligence, whiplash and general accident cases differently? Do any of those have different requirements when producing a medicolegal report? Negligence cases take the most amount of time and are often very, very complex involving multiple dentists over a period of time during which the patient was treated. This is especially so in the area of periodontal disease where lack of care, lack of treatments and diagnoses may have been going on for a decade or more and the patient has seen multiple dentists or who have continued to non-diagnose the disease process and to not treat it which is kind of complex then to apportion the negligence percentage to each of the dentists involved in the case. The most important factor which is often overlookedby some experts is the issue of causation and understanding that it is then not enough just to deal with liability for the case to have merit. General whiplash and accident cases are far more easy and are reflected in the fact that the reports are cheaper to produce and are often of a more factual nature.
4.
What advise do you have for solicitors when choosing dental experts?
The choice of dental expert should be based on the understanding and knowledge of their field and certainly, expertise should be of a minimum an established private practitioner who has over 10 years of general dental practice. Alternatively, dentists who have gone on to have further education in a particular field, such as Master’s degrees or Specialists in Periodontics, Endodontics, Orthodontics, Prosthodontics, General Dentistry and Implantology, and finally to Professors or Consultants when required. It is also important to have continuity when choosing an expert and knowing that they have been through adequate training in the expert witness field and have enough experience in that field to write reports which are legible, easy to read and precise, and that they understand a basic knowledge of the legal system so as to help the court reach its opinion if required. I would also suggest that having a nationwide panel of experts who are all trained to the same standard and degree and whose reports have a similar if not identical makeup makes life easier for the solicitor and barrister when dealing with a large number of cases. We at LegalMEx employ experienced general dental practitioners, dentists with Master’s degree in their chosen field, Specialist Consultants and Professors in all areas of general and specialist dentistry and also on a nationwide basis so continuity is guaranteed.
5.
Tell me about your specialism of Prosthodontics.
I am a Specialist in Prosthodontics and also a Professor of Restorative and Cosmetic Dentistry in the City of London Dental School. Prosthodontics is that speciality which deals with the replacement of teeth and this can be via crowns, veneers, bridges and implants. Restorative dentistry entails not only prosthodontics but also periodontics, prosthetics and endodontics and cosmetic dentistry includes aesthetic dentistry and again veneers, crowns, implants, bridgework, all of a cosmetic nature. Prosthodontics would also include treatment of the temporomandibular joints and bite. This treatment is often wholly performed by dentists who have inadequate training in the field of occlusion(bite). Being a specialist in Prosthodontics and a Professor of Restorative and Cosmetic Dentistry gives me an overall view of all the fields involved in Restorative, Cosmetic and General Dentistry which is essential when writing reports and coming to opinions as to plans and treatments.
Dr Cooke provides a veterinary Expert Witness service on behalf of the defence, prosecution and as a SJE. He takes instructions from members of the public, veterinary and legal professionals as well as welfare and conservation organisations. He produces detailed reports backed by 37 years in general practice and laboratory experience which are supported by contemporary peer reviewed sources. He is confident at testing the veracity of other Expert's opinions and will undertake professional negligence cases. His experience in Veterinary medicine and surgery relates to small pets - cats, dogs, rabbits, ferrets, birds and rodents as well as the exotic pet species and British wildlife. His work with veterinary diagnostic laboratories includes forensic post mortem examinations and crime scene investigation, writing, training and lecturing.
Dr Stephen W. Cooke BVSc, MRCVS
Veterinary Surgeon
Fee structure conforms to LAA restrictions across the board.
Memberships inc: MRCVS, The Federation of Forensic and Expert Witnesses.
Contact now to instruct Veterinary Advisors Ltd Tel: 07768 006935 71 - 75 Shelton Street Mobile: 07940 572823 Covent Garden Email: stephenwcooke@icloud.com London Website: www.veterinaryadvisors.co.uk WC2H 9JQ
Mr. Robert Hensher FRCS FDSRCS
Consultant Oral & Maxillo-Facial Surgeon
Mr. Robert Hensher has undertaken broad training in orthopaedics, casualty, general and vascular surgery and held Senior Registrar positions at Westminster & Queen Mary’s Roehampton Hospitals, and Great Ormond Street Hospital for Sick Children together with University College Hospital. He was employed in the role of Consultant Oral & Maxillo-Facial (OMF) Surgeon to Gloucester Cheltenham & Cirencester Hospitals in 1986 – 2000. Whilst in this role, Mr. Hensher had a special interest in jaw surgery and pioneered TMJ Replacement, for which he now has a national and international reputation. Mr. Hensher has written chapters in standard text books and numerous professional papers and was one of the first non-American Surgeons to be invited to join the American Society of TMJ Surgeons. In a recent interview, Mr. Hensher explained that: “experience is vital as one’s advice and opinions improve in depth and veracity with repetition and learning. Qualifications give access to posts in the training grades and indicate the level of professional education obtained; however they do not indicate the experience an individual has gained.” Mr. Hensher attends court as an Expert Witness relatively infrequently at present, about once or twice a year, although this is increasing. He accepts instructions which require him to examine and report on patients about equally for prosecution, defence and on a single expert basis. “Early engagement of an expert usually saves time and money,” explained Mr. Hensher. “Of course, discussion may subsequently take place, but a senior opinion at the outset sets the tone and (should raise)
As an expert, Mr. Hensher has received instructions and reported on the following example cases: • • • •
Failed TMJ Prostheses; joints were constructed by the inserting surgeon. Failed bone grating and TMJ prosthesis post trauma. Death by post operative haemorrhage (HM Coroner’s Inquest). Death post cancer resection (HM Coroner’s Inquest, scheduled for Dec 2015).
Mr. Robert Hensher is a founding member of The Association of Dental Implantology and The British Association of TMJ Surgeons. He is also a member of The American Association of TMJ Surgeons and a Fellow to The British Association of Oral and Maxillofacial Surgeons.
The Hospital The King edward vii Beaumont Street London W1G 6AA 02074673236 For further information, please call Mr. Robert Hensher on 02074673236, email medico legal enquiries to roberthensher@kingedwardvii.co.uk /
MR. WILLIAM STUART HISLOP
BDS MBChB FRCSEd FFSTEd FDSRCSEd FDSRCPS Not only has Mr. William Stuart Hislop BDS MBChB FRCSEd FFSTEd FDSRCSEd FDSRCPS built-up an impressive reputation over the past 20 years working as a Consultant Oral and Maxillofacial Surgeon at Crosshouse Hospital, Kilmarnock and now at the Queen Elizebeth University Hospital in Glasgow but he is also fast becoming acknowledged as a highly experienced, reliable Expert Witness; carrying out around thirty reports per year for both defence and prosecution, as well as producing reports for injury and negligence cases. Having gained a Medical Degree from Bristol University in 1987 and a Dental Degree from Dundee University in 1978, Mr. Hislop is able to combine his extensive academic training with the practical experience he has gained working at the cutting-edge of surgery in Scotland. Specialising in head and neck ablative and reconstructive surgery for malignancy, salivary gland surgery, together with facial aesthetic and cancer surgery, Mr. Hislop is highly experienced in dealing with facial trauma; having carried out over 500 microvasular cases in his career. Mr. Hislop added: "Within the west of Scotland I also carry out surgical dermatology for skin cancer and deal with facial trauma, as well as dental implants and dento alveolar surgery. I also have previous experience in orthognathic and tempopro mandibular joint surgery." The diagnosis of skin cancer and its corresponding treatment has recently come under new guidelines. Individuals must now be seen within two weeks of the identification of a suspicious ulcer. Keeping up to date with changes in legislation and medical procedures, Mr. Hislop is aware that this may represent a fresh challenge to the medico-legal work of expert witnesses.
A Member of the British Medical Association; British Association of Oral & Maxillofacial Surgeons and the British Association of Head & Neck Oncologists, Dr. Hislop has undertaken the position of Honorary Clinical Senior Lecturer at the University of Glasgow for more than two decades. In a recent interview Dr Hislop outlined what it takes, in his opinion, to provide the very best service as an Expert Witness: "When being called upon to act as an Expert Witness there is no substitute for experience and obtaining extra qualifications. Experience allows work place gathering of information over a career lifetime that informs decision making. This can be used in the clinic operating room or courtroom. Extra qualifications show that reading and gathering of knowledge in the specialist area has been undertaken. This means that all clinical; and legal decisions are underpinned by a thorough knowledge of the specialist area."
Medico-legal Practice
"It's vital to instruct an Expert Witness at the beginning of an investigation/legal case, as this allows the expert to be available for advice from the start. There are numerous cases that are unlikely to be successful and having the expertise initially may save clients time and money." "I currently carry out approximately thirty MedicoLegal Reports per year for both defence and prosecution, attending court once a year on average. It is important when being instructed that you do not forget that you act for the court and giving a balanced report reduces the need for court attendance. I work for the prosecution and defence equally." "Being involved before the case has been submitted to the courts has proved to be very helpful. One of the common problems I see is the uncertainty as to whether the matter is a failure in the duty of care by lack of consent or by negligence."
Case Study: "I was asked to see a lady who had a weak lower lip following a facelift. This can happen and she was warned about it. The surgeon them offered her a muscle transposition operation to try and get function into her lip. The operation did not go well and she was left with a weak tongue and slurred speech. She wished to make a claim on the grounds of lack of consent when in fact the complication was so rare it would have not been reasonable to mention it. However the injury should not have happened and there was a failure in the duty of care whilst carrying out the procedure. The expert intervention meant that the case was submitted under the correct terms and was settled without a court case." Having published over 30 publications in peer reviewed journals throughout his career, Dr. Hislop would like to further develop the Medico-Legal side of his practice and would be pleased to discuss your individual requirements for an Expert Witness.
For further information, please call Mr. William Stuart Hislop on 01563 827 488 or email medico-legal enquiries to: stuarthislop@supanet.com
Mr Peter Revington
Maxillofacial Surgeon www.mrprevington.co.uk
Peter Revington TD. BDS.MB.BS.MScD. FDS FRCS(Eng)
Consultant Oral and Maxillofacial Surgeon I originally trained in dentistry, qualifying in 1976, before working for the Medical research council to acheive my masters degree. I then returned to the NHS and after completing my dental fellowship, I joined the army. After five years with the armed forces, I left to study medicine at Charing Cross/ Westminster. After completing my surgical fellowship, I returned to my original specialty to complete my higher surgical training at Kings College Hospital, before taking up my appointment as Consultant Oral Maxillofacial Surgeon at Frenchay Hospital in December 1994.
With the closure of Frenchay & the centralisation of the Maxillofacial service, I moved to the Bristol Royal Infirmary/Bristol Children's Hospital, which is now my NHS base. My special interest is in Facial deformity surgery. I am a member of the Cleft Lip and palate team, with a focus on secondary cleft surgery. My other surgical interests include facial trauma ( I am on the faculty of a number of training workshops, for the army and others) Temporomandibular joint surgery and salivary gland disease. I am a member of the BMA, a Fellow of the British Association of Oral & Maxillofacial surgeons.
Tel: 0117 3429625 E: peter.revington@uhbristol.nhs.uk Secretary: cathatkinsonuk@yahoo.co.uk Private Secretary Tel: 0117 9804081 E: Tracy.ryan@spirehealthcare.com W: www.mrprevington.co.uk