Forensic & Expert witness magazine Spring 2018 by Federation of Forensic and Expert Witnesses

Use of force, management of challenging behaviour and custody cases (police and prison)

HELP FOR YOUR CASE IS HERE........

Safer Custody Expert Witness

Joanne Caffrey INSIDE THIS ISSUE POCA | RTA | DRUG DRIVING | SAFER CUSTODY

Myles James Overton Taylor

Consultant Obstetrican & Gynaecologist BA (Oxon) MRCOG PhD

Expert witness specialising in: • General Obstetrics • Gynaecology • Fetal Medicine

My particular areas of expertise include general obstetrics, fetal medicine, multiple pregnancy - including twin to twin transfusion syndrome, intrapartum care and general gynaecology. I have been involved in medico legal work for over 10 years, producing medical reports for around 40 to 50 cases per year, mainly in cases involving clinical negligence. The majority of my medico legal work is on behalf of claimants although I am willing to perform defence work. Depending on the complexity of the case, I can usually produce reports within 3 - 6 months of instruction.

Nuffield Health Exeter, Wonford Road, Exeter, EX2 4UG Tel: 07790 070751 Fax: 01392 406605 Email: mylesjotaylor@gmail.com Website: www.mylestaylor.co.uk

A word from the editor

am honoured to be entrusted with a magazine that has broken so much ground in the last 4 years Recently the Federation of Forensic and Expert Witness has relaunched us with better design and a great new approach to helping Experts put there services across to Legal eagles. Forensic and expert witness magazine is a publication that doesn’t just report on developments in the industry but brings you the countries leading experts, what they offer, and how they can help you with putting your case together; it stands for something. We embrace the idea that business contacts serve a purpose in our world that goes beyond money, and that a professional and expert opinion can be a vehicle for progress within putting a great team together to win those all important cases. We believe these higher goals don’t contradict the quest for success. On the contrary, we’re convinced legal teams that reflect and embody them will be tomorrow’s leaders. We are passionately interested in the nitty-gritty of what makes court cases really work for you and celebrate the professional people in all types of expert fields, at all levels, who inspire courts to make the correct decisions on the facts. I hope this issue–which touches on everything from Safer Custody issues to Psychology,RTA's,Firearms,Health and Safety, Cardiology,Handwriting,Fraud,Forensic Accountancy to Medical negligence,Dentistry, Gynaecology,Urology and all types of Medico-legal work –helps get your wheels turning. I’d love your feedback about this issue, Forensic and expert witness magazine in general, and our new Website including all our Members from the Federation of Forensic and Expert Witnesses. If your firm has new ideas or needs help finding an expert in whatever field, I’d love to hear about that. You can email me at andrew@forensicandexpertwitness.co.uk. And if you wish to join and become a member get on our Directory, in our CV download section and of course feature your article in our magazine get in touch we are happy to help.

Cheers to the relaunch of this years magazine Andrew Simpson Chief Editor Federation of

Forensic & Expert witnesses Joanne Caffrey

Vincent Theobald-Vega Health and Safety Consultant and Expert Witness

In addition to becoming a Police first class advanced driver, he also passed both passenger service vehicle (PSV) and heavy goods vehicle (HGV) driving tests.

"twenty three years of my policeSurgeon service were in Consultant Urological & road policing, the last 15 years exclusively involved in theWitness attendance, in investigation and reporting of Expert Urological Cases

For many years he assisted the Ford Motor Company with testing and development of preproduction road vehicles and received training for both racetrack and off road driving."

Expert Witness

Safety 4 HEd

Bespoke as Standard

One of the things that make Vincent Theobald-Vega different from a lot of other experts is the breadth of his experience. Expert witnesses tend to be specialists in one, narrow area, but Vincent has worked in agriculture, forestry, construction, asbestos, fire issues, chemical issues, laboratories, even genetically modified organisms. Vincent says: “My huge range of expertise allows me to take tools and techniques from one discipline and work with them in another. This makes life so much simpler when trying to find solutions to problems, as you can lift certain aspects and apply them to another situation. That is what health and safety is all about, finding solutions to problems.” “Real life doesn't classify problems for you, you need to be flexible and understand that situations are often complex. To get to the bottom you need an in depth look that isn't obsessively looking at things from one perspective only.”

Charges from the HSE

The HSE charges a Fee for Intervention at £129 per hour, that is over £1000 per day per Inspector, with more than one often being involved in a case. Vincent's charges are much more modest and he can assist with preventing costs rising out of control. Legal aid cases also are undertaken and Safety 4 Hed's fees can be spread for longer engagements.

Multi Award Winning

•

The use of force in custody, education, care and General Consultancy

clinical settings varies greatly with many staff having limited, or no, knowledge of risk associated with certain demographics of service users. Too many injuries and deaths are avoidable in my Investigations opinion. I have trained several thousands of staff over the years concerning safer restraints and the managing down of physical interventions.

•

Audit and Inspection

•

Fire Risk Assessment

•

Training

•

Second Opinion

I am sure that we have all heard of (or have personal experience of) constructing a case around a certain set of parameters only to find that the Expert has had to concede a number of critical points upon which your case hinged. Why is that so common, and what can you do about it?

Firstly, it is important to understand where your Expert’s experience is likely to have come from. Typically, Experts in this field come in two distinct categories – Academics or retired experienced Police Officers. The academic route often deals with the complex analysis and mathematical parts of the discipline exceptionally well. Often filled full of research papers and robust discussions of physics, however often a little underwhelming with regards to scene process, evidence and that ‘feel’ for a live collision scene. Alternatively, the Police Officer route, with an understanding of live collision scene that is unparalleled, a strong knowledge of the law, and a confidence in giving live evidence, but perhaps a little vague when it comes to propping up their opinion with cutting edge research or mathematical modelling.

Graham Oakley MIMI

Great Britain has one of the best road safety

We have those Experts demonstrate that not only have they recordsthat in can Europe and the world. Despite a ‘seen that happen in real life’, they have also published academic material now being taught to Collision Investigators in the field. hugethe rise in traffic over that the is last few decades, This is what sets FCIR apart.

the number of people killed on our roads has fallen from around 5,500 per year in the mid But it doesn’t stop there, with the advancement in vehicle-based technology marching on at a rate faster 1980s to well under 2,000 in 2011.away However, than ever, the role of a Collision Investigator is moving from the conventional measurement of skid the number deaths rose inMeasuring 2011, from marks, to interrogating vehicleof airbag modules. the1,850 locus of a collision is less about the use of This means that Demonstrating complex collisions to a tape measure the and previous more aboutyear stateto of 1,901. the art 3D laser scanning. five people diewith on Britain's roads everyand day.more about 3D animations. CCTV has a Court is less about explaining toy cars and diagrams

advanced leaps-and-bounds from the simple, ‘say what you see’ approach, to the forensic analysis down In –the aftermath of a Roadequipment Traffic collision, it isfor vital for and analysis – indeed they we were to the millisecond FCIR have specialist to allow such those in the Legalofprofession seekequipment the services of aby the Police. instrumental in the development the Hometo Office used professional Expert Witness who has the knowledge andif aexpertise required to was prepare high-quality When establishing motorcycle headlamp illuminated, why instruct an Expert who would use an written and reports providing independent, optical microscope only,evidence when a Scanning Electron Microscope (SEM) allows you to scientifically analysis constructive opinions relating to the incident. the fracture face of a bulb filament? Again, FCIR possess this skill set. Court ofproceedings are should highly be expensive and time These are the types questions that asked when instructing an Expert, to see if they are consuming so it isthe essential that an Witness is – or if this is the Expert you will be remaining current and extracting full amount of Expert information for you able toside’! handle the court process with confidence and meeting on the ‘other competence.

Choosing the right Expert is essential,

Since 2015 Vincent and Safety 4 HEd have been winning awards for the breadth and quality of his work. This is supported by the satisfaction of Safety 4 HEd's clients and the vetted status on the UK Register of Expert Witnesses. A full list of awards is available on the website, including the Lawyer Monthly Expert Witness Award, which they have also won this year 2018!

Services

•

Any change? This is what 2 hours of HSE time look like.

For Safer Custody, the use of force and the management of challenging behaviour

Graham is able to draw on his vast experience

having attended more than 1,000 accident scenes ROBYN J.S. WEBBER during his 30 year Police career, as he explained in a recent interview: MD FRCSEd (Urol)

That's exactly what you can expect to receive from with significant consequences if the choice is the wrong one. collision investigation consultant Graham Oakley MIMI who has built-up an impressive reputation within the Ensuring that justice is done and that the Claimants and Defendants situations are accurately put is the legal industry for his expertise as an Expert Witness keystone of FCIR’s principles. It is to this end that we offer a free of charge initial review into any matters in the field of accident investigation and presentation that our clients may have so that everyone is in a clear position from the beginning. of evidence at all levels of court proceedings. In 1983 Graham became a founder member of a Police Forensic Collision Investigation Unit, a post he held until retirement: "During my Police career I attended many courses on advanced driving, collision investigation, motor vehicle examination, traffic law and technology related to motor vehicles."

serious and fatal road collisions throughout the county of Essex. These incidents ranged from minor Having qualified from the University of Otago, Dunedin, New Zealand in non-injury collisions to multi vehicle fatal motorway Graham has carried out investigations on behalf of 1987, Robyn J.S. Webber emigrated to thepresentation UK in 1989, where she undertook crashes, often necessitating of expert the Police Federation of England and Wales, HM witness evidence at all levels of judicial further training obtaining the FRCS(Urology) inproceedings 1998. She was appointed customs & Excise, Border Force, the AA and the from Magistrates' Court, Coroners Court, Crown RAC: as a consultant urological surgeon at Hairmyres Hospital in East Kilbride Court, County Court, through to the High Court and in 2000, and in 2005 the Robyn to Fife and is now based at the Victoria Centralmoved Criminal Court. "I have also acted as a Consultant Adviser to

Hospital Kirkcaldy. She also works in the NHS hospitals a television company, film companyinand major unique background has provided me with a tour operator, and haveand madeStpresentations Andrews.toSheThis is currently Clinical Lead for Urology sound knowledge of the subject and the confidence government ministers in Russia, Azerbaijan, handle ininterest a totally in professional manner all aspects added: of "I collision have had atoparticular Kazakhstan and Ukraine Robyn on the subject of and roadduring traffic my incidents". medical education and training, time investigation." at Hairmyres Hospital was Associate Director of Medical Education. Currently I am an examiner theconsultancy appropriately On retiring from the police, Graham set-up his own forensic collision FRCS(Urol) leader of the range oral question named Crash Detectives Ltd from examination, which he offers a wide of professional services to the writing group for the the FRCS(Urol) and an assessor legal and insurance industries throughout UK and in Europe including: for the MRCS examination. I am also a Regional Advisorevidence for the Royal College of Surgeons •Evaluation of all Surgical documentary of Edinburgh. •Evaluation of police statements and reports •Evaluation of cctv and dashcam recordings Investigation Having worked a variety of medical publications and scientific reconstruction offor collisions in the past 20years, Robyn is able to draw on her •Interviewing witnesses expertise in medical journalism and editing in her •Collision scene photography and plans position Deputy Editor of Surgeons •Video recordingspresent including in-caras scene drive-through. News. She a former editor of Urology News, •Mechanical inspections of allistypes of vehicles former editor of SN Global, and a former member of the web editorial team for BJU International.

in Dunfermline for NHS Fife.

A 30 year old woman wit of pain in her lower bac days later she attends h describes feeling numb complains of constipatio

Her constipation is attrib her medication is chang returns to hospital the fo is catheterized, and has Neurological examinatio buttocks and inner thigh spine is requested. This demonstrates a larg she undergoes an urgen residual symptoms inclu and continuing difficulty Her symptoms vary, at urine and may be constip episodes of urinary and do not improve. She bec of her income, and her e bladder and bowel sym her long term relationsh

CO Writing approximately 50 reports as an Expert Witness per year, Robyn is equally well versed in giving evidence in court.

In addition to having undertaken medico-legal past 11 years, Robyn has also been Throughout her career Robyn has taken an a Clinical Advisor to both the Parliamentary and Graham has for several years in directories UK Register of Expert Witnesses, activebeen part included in the activities of the of Royal Society of Health ServicesSociety Ombudsman, and an independent of Expert Witnesses, Association Personalbeing Injurya Lawyers and is now pleasedClinical to be associated withNHS. Medicine;ofcurrently Council Member for the Advisor to the Forensic and Expert Witness. RSM Section of Urology.

A 25 year old man sus fall from a motorcycle. H his urethra, and has suff the time of the acciden damage to the nerve an the accident. Although improvement, he is unlik will require treatment as active.

To view some of the many case onWitness projects has successfully In acting asstudies a Expert forGraham investigations "Pleasecompleted note that I can only undertake visitiswebsite: Robyn required www.crashdetectives.co.uk to give her professional opinion to write a report on the instruction of a on: All aspects of urological surgery, urological solicitor or other competent body," To learn more contact: malignancy, delayed diagnosis of urological E:enquiries@crashdetectives.co.uk Robyn explained, " Graham Oakley conditions, urinary incontinence, complications If you require a urologist expert report, email: enquiries@crashdetectives.co.uk T: 01245 of 323246 TVT/TOT mesh surgery, clinical negligence, Tel: 01245 323246 and think I may be able to help you, M: 07768informed 792341consent and personal injury including Mobile: 07768 792341 genito urinary tract injury, renal and pelvic trauma please ask your solicitor to contact me." W:www.crashdetectives.co.uk Web:www.crashdetectives.co.uk and erectile dysfunction.

His urethral trauma p developing a urethral str 18 months later, with sym flow. He undergoes an performed using a spec Within months the strict a urethroplasty, a large but places him at risk incontinence, which may

Legal aid and single joint expert instructions undertaken work for the

* Statistics provided by RoSPA

T: 07915 423924 F: 448701249975 E: medicalreport@btinternet.com

W: www.p

Dr Nick Cooling

My Experience of the Interface Between Serious Personal Injury Cases and Psychiatry:

Consultant Psychiatrist

Lessons Learnt in Twenty-Five Years

MBBS, MRCPsych, Dip Clin Psych

My career as a full-time Psychiatric expert began with three disasters: Hillsborough, The Bradford Fire Disaster and The Sowerby Bridge Disaster. The Hillsborough Disaster was extremely traumatic for family members, as the whole unfolding disaster could be seen on television. I remember watching the match in my living-room and coming to the realization that there were going to be multiple fatalities. Subsequently, as psychiatric expert for one of the families, I saw a large quantity of forensic evidence, post mortem evidence and police statements on blank sheets of paper! Over subsequent years, it became increasingly apparent that there was a credibility issue which was on-going. The family members were further traumatized by their sense of injustice and failure of closure. There was mounting anger regarding the lies and dishonesty displayed by police officers. In later years I have provided evidence for multiple terrorist events. The Omagh Bomb case was a legal landmark because it was the first time that victims, families and survivors sued the alleged perpetrators for damages and won their civil case. The case went to a full hearing, but I was the only psychiatric expert. No defendant expert was appointed. The Childers Fire Disaster in Australia provided me with useful experience of an horrific fire-setting event which caused multiple fatalities amongst international backpackers staying in a hostel. I assessed the Dutch victims in Amsterdam, after their return from Australia. I was the single named expert. Of course, not all my work involves major disasters and terrorist events. I also carry a large case-load of road traffic accident victims, workplace accidents and victims of emotional, physical and sexual abuse. Assessing multiple victims for the Irish Redress Board was particularly challenging.

For legal practitioners and my fellow psychiatric experts my key learning experiences have been in the following areas: 1.

The types of psychiatric injury that are common in serious personal injury cases:

Depression, anxiety, specific isolated phobia, post-traumatic stress disorder, somatic symptom disorder, obsessional presentations, adjustment disorder and substance-abuse are frequently identified. Previous psychiatric vulnerability is an important factor which shapes the psychiatric manifestations and consequences of trauma. Psychologically robust individuals may have very little in terms of mental health consequences, even in the face of prolonged torture or almost unimaginable horror. The medico-legal assessment provides a unique opportunity to gain insights into how the long-term mental health of the individual may have been impacted. Often, the assessment uncovers psychological disorder which has never been recognized at the primary or secondary healthcare level. Medico-legal psychiatry can provide an entirely new perspective in terms of diagnosis, causation, prognosis and treatment.

Issues relating to timely psychiatric diagnosis, early treatment and the effect that early psychological treatment may have on long-term prognosis:

In primary healthcare a significant proportion of cases of depression are never diagnosed. Victims of road traffic accidents often present with traumatic stress and phobic anxiety, but diagnoses are often missed, meaning that symptomatic chronicity becomes an issue, with significant impact on social and family life, occupational functioning and overall quality of life. It is well-recognized in clinical practice that up to 20% of cases of depression may approach chronicity and people may be left with residual symptoms, even if remission has taken place. Modern antidepressant treatment and cognitive-behavioural therapy can be very effective in terms of reducing the length of depressive episodes. Maintenance prophylactic treatment may reduce future recurrent episodes. Routine NHS healthcare may miss important psychiatric presentations which follow trauma and personal injury cases may provide a different route to obtaining accurate diagnosis and then appropriate treatment. The modern civil litigation process now provides an additional opportunity for victims to access effective treatment. This can be life-changing. In my experience, even in cases of historical trauma, the medico-legal process, challenging and traumatic as it can be, may well provide a pathway to receiving effective treatment, achieving a sense of closure and finality. Victims of road traffic accidents and industrial injuries may well be able to access effective psychotherapy in a timely fashion, without languishing on an NHS waiting-list! Experts are required to provide joint statements of areas of agreement and disagreement. The opportunity of having the diagnostic understandings of two experts assists the Court, but it can also assist and inform clinical understanding, providing a potential pathway for best-practice treatment and ultimate recovery. Experts have an important opportunity for improving and enhancing psychiatric prognosis, even in severe and difficult cases.

Joanne Caffrey

Expert Witness 3.

The influence of the litigation process on the psychiatric/psychological injury:

There is often an assumption that the litigation process is anxiety-provoking and traumatic for the Claimant. Certainly, prolonged litigation can be very dispiriting for individuals, but effectively managed litigation, with prompt access to expert opinion can be very helpful. Legal practitioners need to be aware of their role in terms of assisting the identification of accurate medical diagnosis and subsequent treatment. Providing regular feedback to claimants and being proactive in terms of moving cases forward towards settlement can be a very helpful process. The process can be greatly assisted by the development of a good dialogue between legal practitioners and their chosen experts. This can transform outcomes. The provision of information for claimants and managing expectations is very important. Well-conducted cases may well produce much better outcomes from the medical perspective, reducing long-term psychiatric/psychological morbidity.

The need for Insurers to agree and facilitate requests for early treatment in order to improve the outcomes for claimants:

Given the fact that psychiatric chronicity can have such a negative impact on individual functioning, Insurers have a particularly important role in terms of identifying and facilitating treatment pathways. In terms of psychiatric conditions, this may well reduce the ultimate level of exposure financially, as well as achieving fair and helpful outcomes for concerned individuals. Similar gains can also be identified in Orthopaedic and Pain Management cases.

I am an Expert Witness for ‘Safer Custody’ and the management of challenging behaviour & use of force. The main sectors I work with are the custody (prison and police) and education sectors. I have also experience of hospitals and security settings. The use of force in custody, education, care and clinical settings varies greatly with many staff having limited, or no, knowledge of risk associated with certain demographics of service users. Too many injuries and deaths are avoidable in my opinion. I have trained several thousands of staff over the years concerning safer restraints and the managing down of physical interventions.

Picking the right expert:

Psychiatric experts may have an important role in terms of how a PI case develops and unfolds. One size of expert rarely fits all. Careful research of an expert’s curriculum vitae to ensure that they have the relevant expertise and up-to-date practice is very important. In my opinion a particular issue to watchout for is a balanced practice, being instructed by Defendants and Claimants in roughly equal measure. Picking an expert with an unbalanced practice can be fraught with dangers. In the field of serious personal injury cases, previous track-record and experience is very important in terms of producing an accurate, well-evidenced diagnostic formulation, assessment of causation and a convincing prognosis, with advice regarding best-practice treatment. Dr Nick Cooling MBBS, MRCPsych, Dip Clin Psych Consultant Psychiatrist With grateful thanks to Abraham Kallis of Chris Kallis Solicitors for support and advice Shaldon, Devon March 2018

For Safer Custody, the use of force and the management of challenging behaviour

‘Safer Custody’ refers to the safeguarding of staff and detainees within the custodial system, from the moment of arrest to detention at police custody, court cells, prisons and all associated transport between. I was a custody sergeant from 1996 to 2003 inclusive, then progressed to custody staff training and assessment, and joint police/prison custody planning. In 2012 I received a British Excellence in Performance Award for my contribution to ‘safer custody’ on a national basis. The Criminal Justice System custody estate has progressed significantly since 1996 when custody was seen as a punishment for detainees. Staffing was usually by newly appointed sergeants, as I was, or sergeants heading towards retirement, or being disciplined. Safer Custody aims to prevent, or reduce to the minimum, deaths or injuries connected with self-harm, suicide, use of force, underlying medical conditions, head injuries, malicious or accidental incidents. The whole custody process is holistically governed by the principles of ‘Safer Custody’, regardless of which institution, or agent, is providing the service to the detainee. Providing a common framework of understanding and care of the detainee and having the ability to share information via systems such as the PNC. (Police National Computer). The same principles of ‘safer custody’ can apply to children within the care and custody of the education system, who may also be suffering from special educational needs and disabilities.

Safer custody covers a wide variety of issues for safeguarding the staff, the service users and others, which are applicable for police and prison custody, court cells and contractor transport companies, such as:

• Custody staffing, training levels, and paperwork • Risk assessment processes for condition of detainee / prisoner • High risk issues e.g. head injuries, positional asphyxia, excited delirium • Building risk assessments e.g. ligature points, alarm systems, fire safety • Information sources e.g. PNC, PER, • Health conditions and use of the health care providers • Control & restraint techniques and use of • Transportation e.g. fleet management issues, PECs (prison escort and custody services), • Management & supervision e.g. visits and rousing • Equality & individual needs e.g. females, juveniles, disabilities, foreign nationals • Healthcare & medication needs • Cell occupancy • Out of cells – exercise, showers or interviews • Hygiene e.g. bedding, toilets, clothing & cleaning • Food safety – choking assessments, food hygiene • Dependencies – alcohol, drugs • Mental health – assessments, medical needs, adaptations • Technology – CCTV, audio recording • Deaths or injuries in custody procedures

Custody officers and staff should be familiar with the signs or behaviours of a detainee that may indicate an increased level of risk and/or requirement for a higher level of monitoring. Custody officers need to be aware of the enhanced risk of suicide and self-harm during periods of detention. Detainees who are deemed to be a high risk of suicide or selfharm must be seen by a healthcare professional (HCP) and kept under close proximity supervision. This allows officers and staff to engage with the detainee and intervene if required. Deaths in custody increase disproportionately during the early days in custody, with younger male prisoners being at increased risk and the larger demographic, however although women prisoners account for only 5.5% of the prison population they account for half of all self-harm incidents. The governance of the education system may be easier to understand, but there are currently no national restraint techniques or principles of practice for safeguarding children in the education system and use of force on them. The Department of Education leaves it to each school to decide their approach to training and what systems they will implement. I work with over 200 schools and there is little common understanding or application of systems, unlike the criminal justice custody systems. Schools are under immense pressure to reduce costs and often sub standard training is introduced to a school which is not tailored to the demographics of the child or staff. This makes it unsafe and unfit for purpose. For example a child with downs syndrome is highly likely to have heart disease, respiratory disorders and hyper mobility of joints. Even special schools who should be the most knowledgeable in dealing with these children lack the understanding of risk associated with restraint and conduct too many restraints. The emphasis in many schools is the application of restraints rather than the avoidance of restraints. A current issue I am concerned with is the increase in creation of ‘calming rooms’ within the care and education sectors. With little national guidance service providers are creating ‘calming rooms’ which are not therapeutic and contain many ligature points plus the adopted practices of such rooms is dubious and potentially abuse and false imprisonment.

The cases I have worked on in the last 12 months include: • Prison custody suicides and self harm where staff have failed to identify risk factors and control measures for prisoners; • Prisoners being assaulted by other prisoners despite risks being reported to staff; • Custody staff being injured in assaults from prisoners due to staff shortages and failure to communicate risk; • Injuries to staff and service users from hand cuffs and other equipment; • School staff injured by children due to lack of training in de escalation and inappropriate restraint techniques; • Children being injured by excessive use of force by staff without any pro active attempts to manage down cases of violence; • Failure to identify ligature points in custody areas which have allowed the opportunity for prisoners to then self harm; • Security staff in a hospital restraining a person who died during the restraint • Inappropriate use of calming rooms I have worked for coroner, civil and criminal cases and deliver training and consultancy on these topics.

www.joannecaffreyexpert.co.uk / www.totaltrain.co.uk

Dr. George Stein

DCH M.Phil MRCP FRCPsych

Consultant Psychiatrist T: 0208 462 7722 E:georgestein86@gmail.com W:www.drsteinlegalreports.co.uk Dr Stein qualified in medicine from University College Hospital and worked for a few years in general medicine obtaining his MRCP before going on to train as a psychiatrist at the Maudsley Hospital obtaining the MRCPsych in 1976. His principal consultant appointment was in Bromley starting in 1982 where he also ran the mother and baby unit for 15 years. He worked for 25 years as an NHS consultant in Bromley and then did a short spell in the Gordon Hospital in London and worked for 2 years in Guildford He has and diagnosed and treated the full spectrum of psychiatric disorders whilst working in the NHS and. He has always worked in private practice where more neurotic and stress disorders such as post traumatic stress disorder feature more prominently. He has a long association with the British Journal of Psychiatry and worked as an assistant editor for a number of years and co-edited both editions (1998 and 2007) of College Seminars in Adult General Psychiatry the National text book published by the Royal College of Psychiatrists. He has published research on post natal illnesses, lithium, personality disorders and a variety of other topics. Medico-legal work In recent years Dr Stein has specialized in medico-legal work as well as private practice. He sees about 60 to 80 cases per year and gives evidence in court around 10-15 times per year. There are two main areas of interest. First he has specialized in personal injury cases. They take the form of traffic accidents, work accidents, and injuries as a consequence of medical treatment where psychiatric problems can sometimes follow on. In these cases teasing out precisely how much of the psychiatry actually relates to the injury itself and how much to other pre existing issues represents the core of the problem and he conducts a detailed and in depth analysis of each case. In personal injury cases he has worked for both the claimant (60%) and defendant(40%) but in most other types of case the more recent pattern has been to be commissioned as mainly as a single joint expert ( SJE). The second main area of expertise is in the realms of Child Protection. Mothers who are in care proceedings often have psychiatric disorder and the courts require an unbiased assessment of its relevance to the childcare and any associated risks there might be for the child. Such assessments are complicated and entail making a detailed adult psychiatric assessment of the mother as well as an understanding of the social circumstances leading to the removal of the child, and these cases will often come with several large files. He has completed around 140 assessments of this type and been to court on more than 30 occasions as an expert witness on the psychiatry involved in child protection cases and judges have sometimes commended the detail and quality of these reports. He has a good understanding of the social services and legal issues as well as the psychiatry involved in these cases. Areas covered have been in the family courts ( Child protection cases and contact cases); criminal courts ( psychiatric assessment individuals with a wide variety of offences) Civil courts ( mainly personal injury post traumatic stress disorder; other personal injury; somatisation ;psychiatric aspects of obstetrics and employment issues) He also covers assessments for the whole gamut of adult general psychiatry including some forensic psychiatry and is able to visit prisons as and when this is required.

General Medical Council No 1278286 | Royal College of Psychiatrists Membership No 3990

The Role of the Psychologist in Assessing Fitness to Plead and Stand Trial

The law on unfitness to plead is concerned with whether or not an accused is able to stand trial and, if not, the procedure that should be used to deal with that accused. If at any time during the Court process the defendantâ&#x20AC;&#x2122;s competency to stand trial is questioned a full and detailed assessment should be sought. An example would be a defendant who as a result of very low intellectual ability is unable to follow the process of his or her trial. In England and Wales, the test known as the Pritchard test is applied by the courts when deciding whether a defendant is unfit to plead, however the test is outdated and inconsistently applied. Following a consultation paper in 2010 and an issues paper in 2014, on 13 January 2016 the Law Commission published its report on unfitness to plead. The Law Commission proposed that the new test should centre upon the defendantâ&#x20AC;&#x2122;s decision making capacity and capacity for effective participation in their trial. This brings the new test in line with modern Court proceedings and the test for capacity in civil proceedings which focuses on decision making abilities (Mental Capacity Act 2005).

p until recently the determination of a defendant’s lack of capacity relied on the evidence of two or more registered medical practitioners in general such practitioners were psychiatrists. The new legislation has recognised that other professionals are suited for this role. In particular psychologists are routinely involved in assessing, formulating and treating mood and cognitive disturbances and consideration of the assistance required for defendants to participate effectively in the trial process may be better suited to the expertise of a psychologist than a psychiatrist. Consequently, the Law Commission has stipulated that one of the experts must be a registered medical practitioner duly approved under section 12 of the Mental Health Act and the second expert can be either a registered medical practitioner, registered psychologist or an individual having a qualification appearing on a list of appropriate disciplines approved by the Department of Health.

A separate but closely related issue is criminal responsibility, major mental illnesses and cognitive difficulties if severe enough, may impact upon criminal responsibility and the input of a Psychologist in these cases can also be invaluable. Cases can range from trying a juvenile as an adult, to capacity to form intent, to assessing diminished capacity in an individual with a learning disability or older person who is suffering from dementia. Assessment by a psychologist can identify areas of concern to help inform whether any cognitive factors would mitigate criminal responsibility. For example, in the case of an adolescent with autism and moderate learning disabilities and who commits an offence it may be that age-related knowledge, poor cognitive skills, social understanding, theory of mind deficits (being able to evaluate others perspectives, emotional reactions and thoughts) are important factors to take into consideration.

A psychological assessment will usually include a detailed evaluation of the defendant’s mental health, cognitive functioning, verbal reasoning and comprehension skills, attention and concentration, short term memory, decision making abilities, suggestibility and any other relevant psychological factors. This information will be used in order to form an opinion about whether the defendant is deemed to be fit or unfit to plead and/or stand trial but more importantly the expert can make recommendations to the Court which will allow a vulnerable defendant to fully participate in the proceedings. At the heart of the Law Commissions’ recommendations is the belief that there should be a full trial wherever possible. This is because only such trials engage all the fair trial processes and guarantees for those involved. A departure from a full trial should be a last resort that is only taken when it is in the best interests of the defendant. In order to fulfil these criteria reasonable adjustments to the criminal process should be made.

Dovehouse Psychology Services Dr Sharna Lewis BSc Hons, MSc, DClinPsy, CPsychol Chartered Clinical Psychologist and Expert Witness (Midlands Area) I have considerable experience of conducting Court reports in matters of personal injury, clinical negligence, mental capacity, assessment of cognitive functioning, mental health and personality, fitness to plead/stand trial. I am registered with the BPS and HCPC.

T: 07716846488 E:info@dovehousepsychology.com w:www.broadoakshealthclinic.com

Fitness to plead – case example one – a woman with learning disabilities Reason for assessment

Ms Karim an Asian lady in her 40’s was referred for an assessment. She was facing serious allegations of fraud (including dishonestly obtaining a British passport and beach of immigration) which she denied and was due to appear at Crown Court. Her solicitors reported that she did not appear to understand what was happening at her last Court hearing and appeared to agree with everything that was being suggested to her which made it difficult to take her instructions.

Assessment

The assessment included a detailed background history (including early developmental history, educational and occupational functioning) an assessment of mental health, cognitive functioning/IQ, adaptive functioning, verbal memory/recall and suggestibility. Ms Karim spoke Punjabi and her English was very poor. The assessment was conducted with the use of an interpreter. Ms Karim reported that her father was from Pakistan and her mother was English she was born in the UK. She was sent to Pakistan to live when she was four years old and never received any formal schooling. Ms Karim married in Pakistan and then came back to live in the UK when she was 18 years old. Although a full IQ assessment could not be completed due to language barriers Ms Karim was found to have a nonverbal IQ of 63 and extremely poor adaptive functioning. She was unable to read or write and relied upon family and neighbours to assist her with most aspects of independent living (including cooking, washing, finances). Ms Karim had a very poor understanding of the charges and the proceedings and did not understand her role in instructing a solicitor. She was also found to be highly suggestible and presented with acquiescence i.e. tendency to agree with questions/statements put to her.

Summary and conclusions

It was concluded that Ms Karim even with the use of an intermediary did not have capacity to take part in proceedings and therefore was deemed unfit to stand trial. Although a separate issue the assessment also highlighted the fact that it was highly unlikely that Ms Karim possessed the cognitive and literacy skills needed to have physically committed the offences she was charged with and it was unlikely that she was criminally responsible.

Fitness to plead – case example two – a man with a head injury Mr Davies was referred for an assessment in connection with charges of historical sexual abuse. He had pleaded not guilty and was due to attend a trial at Crown Court. Mr Davies was in his sixties and had suffered a series of strokes three years previous to the allegations been made. The assessment included a detailed background history, assessment of mental health, cognitive functioning/IQ, adaptive functioning, assessment of executive functioning and memory. Although Mr Davies non-verbal IQ was found to be in the normal range he presented with cognitive deficits in working memory and verbal comprehension which impacted on his ability to respond verbally to questions put to him. Mr Davies was relatively independent in the home but required support to access the community. Before his stroke Mr Davies was of average intelligence had worked as a bus driver. Mr Davies was found to have a good understanding of the charges against him, the role of the professionals involved and of the prosecution evidence. It was concluded that with the appropriate support Mr Davies did have capacity to stand trial as long as the recommendations suggested were put in place. This included the use of an intermediary to support Mr Davies throughout the whole of the trial process and reasonable adjustments being made e.g. extra breaks in order to recap and summarise proceedings, practical support getting to and from the Court, avoiding leading questions during cross examination and questions to be written down with extra time allowed for Mr Davies to formulate a considered response.

References: Assessment of Capacity in Adults: Interim Guidance for Psychologists (2006), The British Psychological Society. Code of Practice for Mental Capacity Act (2005), Department of Health. Unfitness to Plead, Volume one and two, (2016) Law Commission.

Kathryn Thorndycraft-Pope

Handwriting and Signature Authenticity

athryn Thorndycraft-Pope has been working within handwriting forensics for twentyfive years, initially with the Grampian Police Force and, in the last Eighteen years, as an Independent Forensic Document Examiner from her office in Aberdeenshire. As a trusted expert, the majority of cases that Kathryn receives instructions on include questioned signatures on Will disputes, leases & contracts, multiple/second mortgage applications, guarantees etc. This year, Kathryn has provided reports for drink-driving offences whereby the accused denies that their signature is on the form (i.e. not agreeing to the blood test). She has also worked on several handwriting cases in the past focused on the letters involved in attempted murders. mps A Forensic Handwriting/Document Expert becomes involved when the authenticity of a document is in question. For instance, when a Criminal Defence Lawyer or Lawyer specialising in family problems has a divorce case to deal where a loan has been taken out with the joint property as security or sometimes a second mortgage. One party knows nothing about this but the other partner has simulated their signature to secure the money. The expert will then have to prove whether or not one of the signatures has been simulated or if in fact, are genuine signatures which appear on the agreement. This example is a common occurrence in Kathryn's work.

Case examples: Case Examples The consequences of expert witness casework often involves a case going to Court and, depending on the severity or amount of the actual fraud, could be punishable through Community Service, a large fine or up to 25 years imprisonment.

Discussing her role, Kathryn explained: â&#x20AC;&#x153;I need, whenever possible to examine the original documents but often only a photocopy is available, which I can use as 'best evidence' but does affect my conclusion. I have to meet up with the clients and obtain their formal handwriting samples and also a quantity of 'known' everyday signatures as found on passports, driving licences, store/ credit/debit cards etc.â&#x20AC;? This enables Kathryn to establish a persons 'natural variation' as no one can write exactly the same each time they write. Kathryn will then draw out and note all the formations, heights, widths, layout, slope, use of punctuation and even items such as the crossing of 't' dotting of 'i' of the 'questioned' and the 'known' writings comparing them to establish whether or not they are genuine or a possible simulation. If the possibility of simulation is evident and there are key signs such as tremor, hesitation and tracing; Kathryn will take photographs of the evidence and prepare a Forensic Science Report and if appropriate, an Illustration describing her findings for use in Court or during industrial tribunals.

A large case Kathryn was involved with in the last year involved Car Hire Documents, where the expert was able to prove all details and signatures had been forged. This was a case involving two large drugs gangs in Scotland chasing each other; one in a hired car from which a gun was fired at the other car - which ended up as a murder case. Kathryn was able to prove that her client was not involved after she attended a prison to obtain his handwriting samples - four other people in this case were each given 25 years in prison. In another interesting case, Kathryn was asked to investigate a case of fraud that took place in Nairobi, where a gentleman died and the only person present was his girlfriend who had emptied the house and sold it, possibly by forging his signature. The time frame to undertake these examinations can vary. A single signature fraud usually takes about 7 hours to undertake all as mentioned above. However, Kathryn's caseload is very large so, when a case is received, she can usually complete and return a report within a month - often depending if it has a Court date. As a Certified Document Examiner, award-winning Kathryn is a Member of the Expert Witness Institute and a Member of NADE - National Association of Document Examiners, and as such regularly attends the annual NADE Conferences usually held in the USA & the Worshipful Company of Security Professional in Inner City of London. Catriona MacDonald has a Master of Science in Document Analysis from University of Central Lancashire and she has completed 12 months internship with my firm FHDI , she is now undertaking Joint Forensic Science Reports as part of her 2 yrs training with myself.

Kathryn Thorndycraft-Pope CDE MEWI FHDI (Forensic Handwriting & Document Investigation) T:+44 (0) 1569 764 508, M:+44 (0) 7710 655 838; E:kt@fhdi.co.uk W:www.fhdi.co.uk

Our goal is to assist clients, their legal advisors and the Courts to better understand the unique aspects of medical evidence in individual cases, so that they can make more informed decisions.

PROFESSIONAL QUALIFICATIONS & ACADEMIC DISTINCTIONS •FRCS Edinburgh 1977 •FRCS Ireland for services to victims of trauma and developing the ATLS System in the Irish Republic 1993 •FRCS England (by election) for services to Surgical Education in the UK 1995 •FRCP London for services to Medical Education (in Northern Ireland region) 1997 •PGDL, College of Law, London, 1999 •Appointed Miller Professor of Surgery, University of Johannesburg 2001 •Werner Korte Gold Medal for services to German Surgical Education 2002 •International Development Advisor, Royal College of Surgeons, England (Tutor since 1994, Principal Tutor for Faculty Development 2003-2008) •Medal of the Swedish Surgical Society for services to medical education 2005 •FRCS Glasgow for international services to medicine 2008 •Rudolf Pichlmayr Medaille of the German Surgical Society

The Importance of Preliminary/Screening Advice in Medical Negligence Cases A 72 year old with Alzheimer’s Disease was admitted to a respite unit for several weeks so that his wife could go on holiday. At home he would sleep in his own bed although occasionally in the night he would get up and wander around. He did not require a stick and had no problems with his sense of balance. He was able to feed and clothe himself with minimal assistance. The Respite Unit was part of a more general ward in a Community Hospital. He was in a four bed unit as part of a 24 bed ward which at night was staffed by two nurses and three nursing assistants. There were no bed rails on his bed and the floors were carpeted. Ten days after admission he got out of bed at 3am as he wanted to go to the bathroom. He fell down beside the bed onto his left side. The noise of the fall attracted one of the nursing assistants in another bay. He was put back into bed and seen by a doctor. The following morning an x-ray of his hip confirmed a fracture. The family instigated a claim on his behalf for medical negligence because of the fall. The lawyers involved obtained reports from an Orthopaedic Expert in relation to the fracture, a Geriatric Specialist in relation to some potential increase in his levels of confusion after the incident and especially in rehabilitation. The statement of claim indicated that the gentleman should have been more closely supervised and there should have been bed rails in place. Unfortunately there was no initial report in relation to liability and causation. There was in fact no indication why this gentleman should have been subjected to any “special” nursing care over and above that which was available on the ward, nor was there any indication for the use of bed rails which in some circumstances could have served to increase his levels of confusion. It is of note that he did not have any bed rails in place at home. The case was easily defended at a preliminary stage although unfortunately the legal firm had already incurred considerable expense in obtaining other reports for which they were not able to recover their costs from the family, who were of limited means. This is an important lesson in case management. Any case which has a potential for a suit in medical negligence should have a preliminary screening report in order to ensure that the elements of duty, breach and consequential damage are likely to be in place, prior to commissioning any other costly specialist reports. MDU figures for 2016 show that less than one in six actions in medical negligence actually succeed with the vast majority failing on the grounds of causation. It must be remembered that subsequence is not the same as consequence.

Initial screening is therefore essential to manage client expectations at an early stage. This avoids unnecessary effort and costs for all concerned. Too many cases are taken to Court with no chance of success. This is stressful for both the client and their legal advisor and indeed for the medical personnel involved.

Gains Recognition with Top Award FORENSICS INDUSTRY

E-MAGAZINE

AWARD NEWS

PSYCHOLOGICAL SERVICES AWARD 2015 It gives us great pleasure to announce that MIDLANDS PSYCHOLOGICAL SERVICES LTD has been chosen as this year’s winner of the coveted PSYCHOLOGICAL SERVICES AWARD 2015, an independent Award Scheme sponsored by Forensic & Expert Witness E-Mag. In presenting this Award the team at Forensic & Expert Witness E-Mag were particularly impressed with the fact that Chartered Clinical Psychologist and founder of the company Dr. Dennis Trent, a Associate Fellow of the British Psychological Society, has been providing Expert Witness Reports for over 20 years dealing with Child Protection/Custody issues, Pre-Sentence Reports, Risk Assessments, Fitness to Plead, Learning Disabilities and other court related psychological assessments. This Award Scheme was created in order to recognise those businesses and individuals who have made an outstanding contribution to their particular field. Forensic & Expert Witness E-Mag is always keen to bring attention to those who are providing a product or service that stands out from the crowd and deserves to be appreciated not only by its’ readers, but also by a wider audience. Acknowledged both locally and nationally this Award is a milestone for Midlands Psychological Services Ltd and forms the final piece of the jigsaw that confirms the company's success.

On receiving this accolade Dr. Trent has this to say:

“All of us at Midlands Psychological Services are honoured to have received this award. It is the combined efforts of many who have made it possible and it is shared by all of us.” Explaining the need for psychology in child protection Dr. Trent added: “It has often been said that the greatest asset of any culture is its children. To say that they are our future is like saying that day is light and night is dark. Someone who has been blind from birth may not understand that and it would appear that kind of blindness is more common than we would sometimes like to admit. The protection of children, while a widely recognised ideal, is often derailed by political and financial based decisions which are not in the best interest of our children. Children tend to see the world in a markedly concrete manner. That is to say that in a child’s life there is black and white with little or no grey. Things are either good or bad, right or wrong with little ability to recognise nuances between the two extremes. If a child has done a ‘bad’ thing, it is easy for the child to assume that he or she is a bad person. They also tend to take on responsibility for events and situations over which they have no control. Although they will often attempt to evade responsibility by denying an obvious action, they make connections which make sense at a concrete level, but which do not stand up to rational examination. “If I had eaten my corn Mum and Dad wouldn’t be fighting. If they weren’t fighting they wouldn’t be getting a divorce, therefore it is my fault they are getting a divorce” is a good example of concrete reasoning. It appears to be linear in that one leads to the next, but when examined the components, i.e., eating corn and getting a divorce, are very tenuously related at best. In years of clinical practice I have never met a couple who divorced because the child did not eat their corn. While to an adult it may be a flashpoint, to a child it is the reason.

Children rely on adults for their very existence. We know that nurturing a child is essential to the development of the child. Shortly after World War II children in an orphanage were investigated because the infant nearest the door always did better than the others and it was not known why. When cameras were placed in the room it was noted that when the matron would turn out the lights at the end of the day she would reach down and caress the child nearest her before she left the room. Even a seemingly simple gesture as a passing caress is enough to have a positive impact on an infant’s life. The primary damage, other than physical, of child abuse is a breach of the trust relationship between children and adults. When the very person a child relies on for safety, security and nurturing creates an environment which is not safe, secure or nurturing, the child will often take responsibility for having created that environment. Anyone who has worked with abused children will recognise such statements as, “I deserved it”, “if I hadn’t....”, and “it was my fault”. These same statements are frequently heard when working with adult survivors of child abuse. If children cannot trust the environment, then when they become adults their ability to trust themselves as well as others is likely to be impaired, thus having a marked effect on both their self-concept and their ability to empathise with others.

Most parents recognise that it is important to have a consistent meal and bedtime schedule for their children. It establishes a structure within which a child can experiment and play, and forms the basis for the child’s sense of security and stability. When a child is abused there is little ability for the child to experiment or play as most of the child’s efforts will be directed at stabilising the environment and ‘pleasing’ the abuser in an attempt to avoid future abuse. This is likely to set a pattern for future behaviour as an adult. Since the individual sees little self value, efforts are often directed at gaining a sense of value from others, often by establishing a relationship to gain that sense of value. The problem is that people will not accept something they do not believe to be true, and therefore the individual will negate any value given by a partner. The lack of trust will cause a ‘testing’ of the relationship to find the breaking point and, when reached, another partner will be sought to gain the sense of value which was not obtained in the first relationship. As such, a pattern of unstable relationships follow, often with significant domestic violence inherent within those relationships. Sex enters into the equation in that within the Western culture, sex is frequently seen as an indicator that emotional intimacy, acceptance, love and approval or value has been established. While the individual in almost all cases is searching for an emotional intimacy, that is acceptance and security, what is achieved is a physical intimacy devoid of the very thing being sought. It is often seen by the individual that the answer to this dilemma of poor self-concept, lack of trust in others and feelings of estrangement is to have a baby. A baby is often viewed as someone who will love unconditionally and give worth to the individual. The child is viewed as there for the parent, not the parent there for the child. What is not recognised is that within a poor relationship a child is demanding and an added stress. Now the pattern repeats as the parents are not receiving what they wanted from the child and the child is therefore often seen as the problem.

In conclusion Dr. Trent went on to say:: "Psychologists are best placed to help tease out that level of appropriateness. They can also assist Social Services in assessing the appropriateness of potential foster carers and support social workers in working with both children and adults.

The problem is now exacerbated by taking the child out of the family and placing him or her in care, a process designed to protect the child. While it is understood that a social worker wants to progress a career, multiple changes of social workers only increases the instability in the child’s life. The same applies to Foster Parents. While there are many very good foster parents, children who have been taken from families present many problems for those foster parents who are less able or willing to deal with those problems. Placement in multiple foster homes is not uncommon and again will be more damaging than helpful. Unfortunately, there is no formal psychological assessment of potential foster carers or children’s homes workers and while experts in social care systems, social workers are not always best placed to assess the psychological make-up of parents who are very adept at covering over abuse and presenting themselves as caring individuals. Enter the psychologist. Psychologists are extensively trained to make the assessment of risks to children. With tested and proven instruments, many of which identify information the individual is not aware is being sought, the underlying risk presented by taking a child from a family unnecessarily, or placing a child into a high risk environment, often can be avoided. As fully independent experts we have the ability to view parents, children and environments from a completely objective viewpoint keeping the needs of the child paramount. We can make recommendations to the Court as to the needs of the child as well as ways in which the parent can improve themselves and their parenting skills in order to provide a more safe and secure environment for their child. We can assess the level of risk a parent or potential partner presents to a child. While past behaviour is a good indicator of future behaviour, it is not an absolute predictor. It is well accepted that the best place for a child is with the parents when that is safe and appropriate.

Most importantly, they can assist the Court to make a decision which is in the best interest of the child. Failure to do so will only build a significantly greater problem for the future. It is commonly accepted that the incidence of mental disorders in the prison population has markedly increased over the past years. The protection of children and early intervention facilitated by formal assessments of risk posed to them by parents, partners and carers is the first step in reducing, and turning around, a time bomb with huge personal, social and financial costs for the future."

For further information contact: Dr. Dennis Trent, MIDLANDS PSYCHOLOGICAL SERVICES

Tel: (0121) 224-3051, Fax: (0121) 224 3252, Email: mps@midpsych.co.uk Website: www.midpsych.co.uk

DR. DAWN BAILHAM

MSc Forensic Psychology, DClinpsych (Doctorate in Clinical Psychology), BSc (Hons) Psychology, AFBPS, CAT Practitioner

Dr. Dawn Bailham is able to draw on her background in forensic mental health, in which she has assessed and treated adults and children, together with her extensive academic training, to provide a highly professional, independent service as a Consultant Clinical Psychologist & Expert Witness. A trained DBT therapist and qualified Cognitive Analytical Therapist (CAT Practitioner), Dr. Bailham has been a qualified Clinical Psychologist now for 14 years, working in a variety of settings dealing with people with complex mental health needs, as Dr. Bailham outlined in a recent interview: “My experience of working in the NHS within Child and Adolescent Mental Health Services (CAMHS), in Looked after Children’s Services, and adult Forensic Mental Health Inpatient Services has given me great insight in mental health issues. The insight and knowledge I have gained I have applied to Child and Family Law cases to gain an understanding of how they impact on parenting capacity, child development, and the emotional wellbeing of children.

A sign of Dr. Bailham’s commitment to further develop her knowledge-base is evident in that she has also obtained the Cardiff University Bond Solon certificate in Criminal Law. Offering her services as an Expert Witness for both the prosecution and defence, as a single or joint Expert, Dr. Bailham has attended court on numerous occasions to give expert evidence for cases relating to Family Law and more recently Criminal Law. Her key areas of interest are the development of personality disorders, post traumatic stress disorder, juvenile sex offending and applications of Cognitive Analytical Therapy (CAT). “More recently I have been instructed by Local Authorities in pre-care proceeding cases to give my opinion in Child and Family cases particularly where there are child protection concerns,” Dr. Bailham told us, “The value of this as an Expert has been to guide Local Authorities in terms of appropriate psychological interventions for parents to sometimes prevent care proceedings, as well as provide a psychological understanding of why issues within families have developed. This can assist professionals in understanding parenting concerns, their communication with parents, and to be more empathic about how parenting difficulties have arisen. In criminal cases as an Expert Witness I have been asked to give an opinion at the early stages of a case as to whether a perpetrator or victim has the capacity to instruct a solicitor, which has been helpful to inform the Courts especially with vulnerable adults who come into contact with the Criminal Justice Services.” As you would expect of such a consummate professional, Dr. Bailham is an Associate Fellow of the British Psychological Society (BPS), a Practitioner Psychologist with the Health & Care Professions Council (HCPC), as well as being a Member of the National Organisation for Treatment of Sexual Abusers (NOTA).

Beginning working in forensic mental health has given me great insight into mental health issues within a legal framework and how they contribute to offending in Criminal Law and impact on parenting capacity and insight in family law cases. I feel an important aspect of my role in Expert Witness cases has been sharing psychological formulations to inform the Court, and to assist the Court in making sense of issues regarding parenting, child protection, and the future risk of offending, or victimisation of vulnerable adults and children. I currently work in a residential care service on a part-time basis with young people aged 16 - 25 years with complex mental health problems and emerging personality disorders. I have recent experience of working with young adults with histories of sexually harmful behaviour some of which have had offending histories. My role involves management, assessment and intervention to address clinical needs e.g. Cognitive Behavioural Therapy, Dialectical Behavior Therapy and Cognitive Analytical Therapy. I also have experience of developing and managing the running of a sex offender treatment programme. Prior to my role working in the forensic inpatient service I worked in an NHS community Child Adolescent and Mental Health Service (CAMHS) delivering DBT to adolescents with histories of self-harm, attempted suicide, and emerging personality disorders, some of which also had offending histories and were known to the Youth Offending Service. I have had previous experiences of developing and managing the delivery of a sex offender.

Below you will find typical examples of the types of cases undertaken by Dr. Bailham in her capacity as an Expert Witness: I have been instructed on a number of cases where domestic violence has been an issue in the family, and I have been asked my opinion on a parents‘ insight into these risks, their ability to protect their children, and the psychological impact on children. In terms of Child and Family Law I am often asked to assess parents where there may be personality difficulties, mental health problems, and/or substance misuse issues. More recently I have been asked to assess parents insight and ability to protect their children from adults with a sex offending history, this could be a parent with a history of this type of offence, or parents who associate with adults with this history. I am often asked to assess children where the child has a history of sexually harmful behaviour, or young people who come into contact with the Criminal Justice Services for other offences. With Criminal Law cases I am often instructed to assess vulnerable adults, or children who have been victims of crime; to assess the psychological impact on them, and their ability to instruct a solicitor. At other times I have been instructed to assess young people who come into contact with the Criminal Justice Services in terms of their mental health functioning, the presence of learning disabilities, and capacity to instruct and understand Court proceedings.

Consultant Clinical Psychologist & Expert Witness

Mobile Tel: 07801 266 010 / Email: dawnbailhan@icloud.com

Saul Myerson

Cardiologist & Expert Witness MBChB, MD, FRCP, FESC

Prof. Myerson is a cardiologist specialising in diagnostic testing, particularly advanced cardiac imaging, and he has an international reputation for cardiac magnetic resonance imaging. He is often consulted about diagnosing particularly difficult cases, and asked to identify the causative processes involved. “These areas of expertise fit well with medico-legal cases in cardiology, which often revolve around correct diagnosis, particularly differentiating normal from abnormal findings; causation and the likely time frame; and the appropriate actions followed by the medical team.” he explained in a recent interview. Other areas of practice relevant to medicolegal work include:Assessing future risk/prognosis and the suitability of patients for cardiac surgery (e.g. viability studies, and assessing the severity of valve disease). Prof. Myerson has acted on behalf of both defence and prosecution in the Court of Law and is also happy acting as a single joint witness. His assessments and reports are always objective and focussed on best medical practice. However, most cases that Prof. Myerson has taken instruction on have avoided coming to court – detailed and objective reports allowing for an informed discussion between legal teams, so that a settlement can be reached, avoiding court costs. Discussing the role of a single joint expert. Prof. Myerson explained that: “The appointment of a single joint expert can add value to the judicial system. The Expert Witness will prepare a truthful, objective report and, in my own examples, detail how and which things were done well and which aspects were not managed so well and how these differences may have affected the outcome.”

A fair and objective report for both sides leads to a wholly accepted expert opinion and can improve the chances of an agreement being made without the expense of attending court in most cases,” he concluded.

Professor. Myerson is a member of

• The Royal College Of Physicians • The European Society Of Cardiology • The British Cardiovascular Society • The British Society For Echocardiography • The Society For Cardiovascular Magnetic Resonance • The British Society For Heart Valve Disease.

Case example: “I have been an expert witness on several cases involving sports screening,” Prof. Myerson explained. “A robust and accurate approach is required for the cardiologist undertaking an assessment (usually as a result of an initial screening test being abnormal); a recent case also highlighted the importance of good communication and appropriate handling in avoiding a legal challenge.” A professional footballer for a premier league club had an abnormal ECG but normal cardiac imaging. His likelihood of a cardiomyopathy was higher than the normal population but still low (<10%), and he was allowed to continue playing. However, an appropriate consultation with him did not occur and the abnormalities and potential risks were not discussed with him, denying him the opportunity to consider his options which included detraining for a period of time to see if the changes resolved. Unfortunately, the player suffered a cardiac arrest in his first professional game and, although he was resuscitated, he suffered significant neurological damage and required lifelong nursing care subsequently. The family won a High Court case for compensation and ongoing care costs, despite the normal imaging tests, due to the club’s failure to implement an appropriate process for assessment, and the failure of communication denying the player the opportunity of making an informed choice.

Asked about the importance of instructing an Expert Witness at the beginning of an investigation/legal case, opposed to asking for an opinion at a later stage of the proceedings, Prof. Myerson explained: “Knowing whether you have a strong case / can defend a case is crucial to avoiding unnecessary legal work, and being able to focus on the important aspects. This requires a good understanding of the medical issues, and an expert witness is best placed to provide that level of detailed advice, unless the legal team are particularly well informed in that specialist area. It can save much expense and effort if the correct path is identified at the start.” Prof. Myerson states that “although an initial assessment from the bare details is possible, it is not as beneficial as an actual expert's opinion – this is surely a better option whilst remaining objective.”

Consultant Cardiologist, Associate Professor of Cardovascular Medicine and clinical lead for cardiac imaging in Oxford, with specific expertise in diagnostic testing, including all forms of cardiac imaging and functional cardiac assessment. Professor Myerson is based in the internationally renowned cardiac MRI department in Oxford and provides expert advice on all areas of cardiology including cardiomyopathy, coronary disease, heart valve disease and aortic disease. He has a significant cardiac research portfolio including clinical trials and has over 70 peer-reviewed publications. He is an editor of three Oxford Handbooks in Cardiology.

T:01865 234 571 E:saul.myerson@cardiov.ox.ac.uk W:www.oxfordcardiologist.com

DR. KHALID MAHMOOD

Consultant Cardiologist & Expert Witness

Having undertaken the post of Consultant Cardiologist at Solihull Hospital, Heart of England NHS Trust for the past 8 years, since 2013 Dr. Khalid Mahmood has also offered his services as a MedicoLegal Expert Witness. You only have to look at the extensive academic training Professor Mahmood has undertaken, leading to him achieving qualifications including Mb ChB, MRCP (UK), together with the wealth of practical experience on which he can draw, to appreciate that he has all the necessary credentials to provide a highly efficient, unbiased service as an Expert Witness. In a recent interview Dr. Mahmood told us: “I have over eight years experience as a consultant cardiologist with a wide variety of clinical interests. This has allowed me to gain knowledge and experience of many different clinical cases which allows me to provide critical review of cases where I am asked to act as an Expert Witness.I also have experience in general internal medicine which broadens my knowledge base and helps to review cases in more detail and with wider expertise.”

Dr. Mahmood has been requested to give evidence in as an Expert Witness in court cases on a number of occasions, including those listed below: •

A case which took place at a Coroners Court: Independent Expert Witness - Review of a case of in hospital mortality

•

A case for which Dr. Mahmood acted as an independent Expert Witness on behalf of the Crown Prosecution service regarding case of mortality linked to alleged medical negligence.

•

Dr. Mahmood acted as an independent Expert Witness: Medico-legal compensation injury claims - multiple.

•

Dr. Mahmood acted as an independent Expert Witness in a case which took place in Crown court- Case involving motorist involved in fatal car accident.

Dr Mahmood is involved in advanced cardiology training and teaching as evident in the fact that he has been the Educational lead for medical student teaching; undertaken a Regional role in SpR teaching/assessment, together with undertaking MRCP training and providing a contribution to core medical training for FY1 and FY2 trainees. Also regularly attending international and national Seminars & Workshops, as part of his commitment to continually develop his knowledge-base. As you would expect of such a consummate professional, Dr. Mahmood is a Member of the Royal College of Physicians, a Member of the Medical Defence Union and a Member of the British Medical Association.

If required, Professor Mahmood is happy to provide details of three referees.

TO DISCUSS YOUR REQUIREMENTS FOR AN EXPERT WITNESS CONTACT:

DR. KHALID MAHMOOD Tel: 07795460224 Email: khalidmahmood99@hotmail.com

Somek & Associates is one of the biggest providers of Expert Witnesses in the UK delivering highly professional trained experts in a range of health professions: Occupational Therapy, Care experts, Physiotherapy, Speech & Language Therapy, Nursing, Midwifery, and other key health professions

Alison Somek Alison is CEO of Somek & Associates, which has been established for over 20 years. She a Consultant Occupational Therapist and specialises in orthopaedics, brachial plexus/ Erb’s Palsy, upper limb hand injuries and general medical and surgical cases.

‘An excellent reputation...’ www.somek.com

Somek & Associates is one of the largest providers of Expert Witness services in the UK, delivering highly professional trained experts in a range of health disciplines. Their depth and breadth of experience covers all types of personal injury and clinical negligence. Somek and associates was set up in 1997 by Alison Somek, CEO of Somek and Associates who had previously worked in the National Health Service for over 20 years, as an occupational therapist / care expert. Alison has seen the medico–legal environment change dramatically over this period, but has always been passionate about professionalism and independence in her role as an expert witness, continuing to ensure that the integrity of the expert witness is embodied in the work of the associates and company as a whole. Somek now have over two hundred experts, which include, occupational therapists (care experts), nurses, midwives, physiotherapists, speech and language therapists, and other allied health professions. This is reflective of the growth in need for expert witnesses in a range of health care professions allied to medicine, as well as the high regard for Alison and the team at Somek and Associates. Somek and associates are able to offer competitive fees, deferred payment terms and fee estimates upon request. They welcome feedback and respond with a ‘can do’ attitude to flourish in this ever-changing complex environment. Somek have a robust recruitment process for experts and provide an extensive training programme which all experts are required to attend, covering topics from the role of the expert witness to Courtroom skills. They work in conjunction with leading expert training organisations and offer in house courses and an Annual Conference for all experts, with specialist speakers including solicitors and barristers. All their experts continue to undertake clinical practice either in a statutory or independent setting. They provide reports for litigation (liability and quantum), which are fully CPR compliant, or for advisory purposes. Somek reports, which are frequently commended, are well written and presented and are relevant to the complexity and size of the case, are clearly structured and summarised conclusions and costings, meet agreed deadlines. Somek and associates remain passionate about the integrity of the expert witness role, and as a company, we boast a balanced portfolio of claimant and defendant instructions in equal measure. Professionalism, objectivity, independence and understanding of legal principles and tests as well as relevant procedure rules (especially CPR 35), are all key factors that Somek strives for and it is these core values that has led to Somek and Associates’ outstanding reputation in the field. Alison and the team at Somek & Associates have a goal to make Somek and Associates the organisation of choice for expert witness services in the UK.

‘An excellent reputation...’ T: 01494 792711| E: admin@somek.com | W: www.somek.com 9 Chess Business Park, Moor Road, Chesham. HP5 1SD

www.somek.com

ARE THE COURTS GETTING INTO THE HOT TUB?

Are the courts getting into the hot tub? From 1st April 2013, the civil courts in England and Wales have been able to hear expert evidence concurrently. In 2016, the Civil Justice Council (CJC) carried out a study to see what was happening in practice and to make some recommendations. In December 2017, the Civil Procedure Practice Direction on concurrent evidence was amended. This article looks at the study, the amendments and recent experience and makes some suggestions for experts and instructing parties. PD35.11 opened the door to concurrent expert evidence and set out a process which the courts could follow. The wording of the 2017 amendments further encourages the use of concurrent expert evidence (“CEE”), and allows for evidence to be given “in any appropriate manner”. What does this mean? Let’s look first at CEE as set out in PD35.11.4. Essentially, it envisages that the experts are sworn in together; each is invited by the judge to give their views on the first issue; each may be asked questions by the judge; the judge may invite the experts to comment on, and ask questions about, each others’ views. The process is described as a discussion. Following that process, the parties’ representatives will be invited by the judge to ask questions of the experts, in order to test the correctness of an expert’s view, or to clarify it, or to elicit evidence which has not already been considered. The 2013 PD stated that a full cross-examination or re-examination is “neither necessary nor appropriate”. Interestingly, the 2017 amendment does not contain those words, therefore allowing cross examination to take place. There are some themes to this style of hearing evidence: (i) (ii) (iii)

it is a judge-led (inquisitorial style) approach; it is a discussion, focussing on one issue at a time; any adversarial element is limited, albeit not removed.

The decision to hear expert evidence concurrently is at the court’s discretion, as is the ability to modify the procedure outlined above. The CJC report (1) was a thorough review, relying on questionnaires and interviews of judges, experts and lawyers. It found that the use of CEE is more widespread than had perhaps been thought, had been used even prior to the appearance of PD35.11 and not just in the civil courts. (The Family Court has used it, as have Arbitrations for some time; the CJC focussed on the civil courts). The report makes a number of recommendations; this article looks at the variations of CEE found and at issues of preparation of, and communication with, expert witnesses.

Variations (i)

Sequential back-to-back evidence

The experts are called at the same time and are both sworn in. C’s expert is examined, cross-examined and re-examined on issue 1; then D’s expert goes through the same process. The same could be applied to a cluster of issues, rather than one at a time. The court can ask questions at any stage. Essentially, this is the usual adversarial process, counsel-led not judge-led. The difference is that it is issue-driven and the parties will have agreed the list of issues to work through and the running order. (ii)

Hot tubbing, or judge-led joint examination of experts

This practice follows PD35.11 as set out above. The theme of the process is the judge-led discussion of the issues (iii)

Hybrids

As seen above, PD35.11 gives the judge a wide discretion to modify the process. The CJC report notes that it is a discretion “oft exercised”. The hybrids involve more, or less, involvement by counsel; more, or less, leading from the judge; experts commenting on each other’s evidence; experts being invited to question each other on their evidence. Now, this must be good news as it shows a willingness in the judiciary to adapt the way in which expert evidence is heard, according the needs of a particular case, which is likely to focus more precisely on the issues and so to deal with the evidence more efficiently. (iv)

The teach-in

The court has appointed a neutral expert to give high level assistance to the judge before the trial; they do not deal with the specifics of the case, but essentially give the judge a tutorial to aid their understanding of the issues. The report’s findings are favourable to the use of these different approaches, as appropriate to the needs or issues in each case. One of the issues to have emerged is that of communication with the expert witness, as we shall see from the experience described below. The 2017 amendments cover all those variations by the phrase “any appropriate manner” and expressly include the option of the sequential back-to-back evidence, now referred to as the “issue by issue” basis. The decision on what method to adopt is very much at the court’s discretion. The reality - one expert witness’ experience Care expert JB, an occupational therapist, is an associate of Somek and Associates. She is a reasonably experienced expert and has undergone comprehensive training in the role of the expert witness, CPR, report writing skills and courtroom skills. The medico-legal intelligence has indicated that CEE has not really been implemented in clinical negligence or personal injury cases with a few exceptions, Judges preferring to stick with the traditional trial. Trials, as we all know, are rare and prior to May 2017 none of Somek and Associates’ 200 experts had been “hot tubbed”. As a consequence training in CEE has been limited and was not felt to be a priority, despite it being a possibility since 2013 as stated in the rules (PD35.11). So imagine the slight feeling of panic when, upon speaking to her solicitor just a few hours earlier, JB was told she and her counterpart were to be “hot tubbed”!

What actually happened? JB was warned for court and initially held 5 days Monday to Friday; she was finally informed she would not be required until Wednesday. On Monday afternoon, the call came through asking her to be available at Middlesborough CC at 10am on Tuesday, a day earlier. Thankfully, she was able to sort care for her children and drive to Middlesborough that evening for court the following day, still in the belief that this would be a “normal” trial! The following morning she was informed that the expert witnesses would be hot tubbed. She knew a little about CEE from a brief discussion on the courtroom skills training and what she had read PD35.11. But what is described in PD35.11 did not happen. What proceeded was a “variation” on that which is described in PD35.11, and we now know that such “variations” are indeed used according to the Judge’s preference. JB and her counterpart (CP) were both asked to take the oath. JB was directed to the witness stand and CP to the jury box. What ensued was not the procedure described in PD 11 whereby the Judge, having distilled the issues in dispute from a previously prepared agreed joint statement, asks questions and invites the experts to question one another. What took place took the form of “sequential, back-to-back evidence”, whereby JB and her counterpart underwent examination in chief and cross examination dealing with three issues in dispute: Issue 1: Issue 2: Issue 3:

Task based care v reimbursement for all time family spent at house Future needs - when paid care would start from Claimant’s care needs in any event

Each of the above was taken in turn with the Claimant’s expert undergoing examination and then cross examination on issue 1 followed by the defendant’s expert, before proceeding to issue 2. The Judge interjected very periodically. In other words this was a fairly usual and adversarial trial process, the only differences being the following: 1) 2) 3) 4)

Both experts were under oath and therefore were unable to communicate with their own counsel during their counterpart’s evidence – to the detriment of counsel I am sure. The issues in dispute were agreed and were the only focus of examination, as opposed to respective Counsel determining their own questions. Each issue in dispute was addressed in turn by the court and both experts, as opposed to the Claimant’s expert giving all evidence first, followed by the Defendant’s evidence. Both experts were required to stand for the duration, including while the counterpart was being questioned.

This procedure was not explained to the expert witnesses. They were not informed of what they could and could not do e.g. were they allowed to take into the “witness box” a pen and blank piece of paper to take notes during the counterpart’s evidence? Were they allowed to participate (as described in PD35.11) by putting a hand up and asking a question of the counterpart or putting an alternative view? In the nervous panic neither expert thought to ask the court for advice regarding such matters. We would strongly request that the legal parties advise their experts in advance when CEE will be implemented and give them as much information as possible. Giving oral evidence is always a nerve wracking affair – attending courtroom skills training undoubtedly helps to prepare the expert and calm the nerves, at least in terms of knowing what is going to happen.

This all flies out of the window if the process is significantly altered! All parties, court, lawyers and experts, want the best performance of the experts to achieve the best outcome for the case and throwing them rudely into the hot tub as opposed to easing them down the steps while holding a rail, will not help! JB’s assessment of the procedure – well, it made some sense to go through each issue in dispute one by one hearing all evidence, before moving on to the next. It was good to have the three issues in dispute confirmed and to know that this would be the limit of the examination. It was frustrating not being able to comment on some aspects of her counterpart’s evidence and to be able to assist counsel on technical matters of fact. Standing for such a long period caused her to wish she had eaten a more hearty breakfast! Fatigue is not helpful to performance and allowing expert witnesses to sit while listening and giving evidence would seem to be a sensible and reasonable option. Above all JB wished she had been advised of the procedure in advance, in order to prepare and clarify any points of order. It seems this was not really much of a departure from the normal trial, and rather a long way from Lord Justice Jackson’s proposal that Judges should ask the questions, taking a more inquisitorial approach designed draw out the best evidence with greater clarity. So has there been any update since 2017? We asked Chris Pamplin, Editor of he UK Register of Expert Witnesses, who responded “In our survey work we have seen the number of experts with direct experience of it (CEE) increase from 8% in 2013 to 12% in 2017. But, that is such a small increase it could just be small number variability. What has been consistent is those experts who have been involved very much think (80% in the 2017 survey) that it is an improvement over the traditional approach. My guess as to why it has been very slow to grow is that lawyers still prefer the pure adversarial approach as it leaves them much more in control!”

TIPS

So, what are the messages for expert witnesses: 1) CEE IS happening 2) 3) 4) 5) 6) 7) 8) 9) 10)

CEE is being introduced in a variety of forms – the above being just one Experts should read the December 2017 update to PD35.11 Be prepared for the unexpected! When warned for trial, ask to be informed in plenty of time if there is a possibility or likelihood of being hot tubbed Read the CJC empirical study on CEE – or at least Appendices A and C; but note that at the present time these are only recommendations and other variations may be used, under the 2017 amendment Watch the EW press for updates on CPR in respect of CEE, which will take on board at least some of the recommendations of the study. Do not simply accept a new procedure that you are not familiar with, without asking questions to clarify the do’s and don’ts for you, the expert witness Attend training to familiarise yourself further with the variations of CEE, thus increasing your self confidence Have a good breakfast and make sure water is available – if you need to sit for health reasons, request to do so.

What is clear is that this is an evolving process. In our view, that is undoubtedly a good thing, if the aim is to enable the parties, instructing solicitors, counsel, the judge and the experts to focus more precisely on the issues. A mini-inquisitorial process, within the overall adversarial one, is likely to take time to evolve fully and to be understood.

Meet some of The Experts

The key is good communication. What happened to JB is not helpful. The CJC report recognises that the judge can decide to use some form of CEE at any stage. It is clear that any order to make use of it should be made as early as possible to allow all involved to prepare properly. It is also clear that any such order should be communicated to the experts by their instructing solicitors “forthwith” – not simply on arrival for the hearing. Strictly speaking this is covered by clause 8 in the Practice Direction, albeit our experience is that solicitors need reminding of this!

Elise Warner

Jessica Thurston

Amanda Agbebi

Sharon Beattie

Elise is Somek’s Clinical Business Manager and deals with all enquiries and instructions from solicitors ensuring they receive our most appropriately experienced expert witness for their clients.She is an Occupational Therapist and is experienced in physical disability, care of the elderly, general medicine and surgery and orthopaedics

Jess is our Medico – Legal Services Manager and Senior Consultant. She is an Occupational Therapist and her speciality is in upper and lower limb amputees, care of the elderly, falls trauma and orthopaedics and general surgery.

Our aim in writing this article is to encourage the use and development of CEE by the courts and to encourage experts and their lawyers to maintain clear and quick communication as they do so.

Good Luck! Alison Somek, CEO, Somek & Associates Nicholas Deal, Expert Witness Trainer, Bond Solon May 2018 Reference 1, Civil Justice Council, Concurrent Expert Evidence and "Hot-Tubbing" in English Litigation since the "Jackson Reforms", A Legal and Empirical Study, 25th July 2016.

Mandy is Somek’s Associate Clinical Development lead (Liability) and is a Registered Nurse. She specialises in Intensive Therapy and High Dependency Nursing

Sharon is an Occupational Therapist in Independent Practice and one of Somek’s senior supervisory team, who mentor our experts and provide clinical supervision.She is experienced in neurology and adult physical disability

Expert Witness Professor Paul Tipton B.D.S., M.Sc., D.G.D.P., UK Specialist in Prosthodontics Professor Tipton gained his Masters Degree after two years study at the Eastman Dental Hospital and London University graduating with an MSc in Conservative Dentistry. The following year he began teaching the new MSc in Restorative Dentistry at Manchester University and now has his own Restorative, Cosmetic and Implant courses run from his Tipton Training Academies in Leeds, Manchester, London and Liverpool. Professor Tipton is an experienced Expert Witness with over 30 years acting as an Expert Witness. He is a founding member of the Academy of Expert Witnesses, a member of the Academy of Experts, the Expert Witness Institute, the Personal Injury Lawyers and Fellow of the Royal Society of Medicine. 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.

Federation of

Forensic & Expert witnesses

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 Masterâ&#x20AC;&#x2122;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 Masterâ&#x20AC;&#x2122;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.

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.

Professor Paul Tipton qualified from Sheffield University and established a purely private in St. Anns Square , Manchester in 1986.

Prior to that he played cricket for England Under 19â&#x20AC;&#x2122;s in 1972/73 and turned professional for Lancashire County Cricket club in 1974 , continuing to play cricket for Lancashire between 1974-1978 and then for Cheshire CCC from 1980-1984. After two years study at the Eastman Dental Hospital and London University he graduated with a Masters Degree (MSc) in Conservative Dentistry in 1989. The following year he began teaching the new MSc in Restorative Dentistry at Manchester University. In 1992 Paul was awarded the Diploma in General Dental Practice from the Royal College of Surgeons of England and appointed a member of the BDA Independent Practice Committee. In 1999 Paul was awarded Specialist status in Prosthodontics from the General Dental Council. He regularly lectures bot internationally and at home and is renowned for his one-year Restorative , Cosmetic and Implant Dentistry courses, where over 2500 dentists have graduated during the last 20 years and for his numerous articles on Implantology and Cosmetic and Restorative Dentistry. He is on the editorial board of Private Dentistry Magazine ; Restorative & Aesthetic Practice and Indian Journal of Prosthodontics and was a founding director of the British Academy of Aesthetic Dentistry and the British Academy of Cosmetic Dentistry. In 2014 he was made visiting Professor of Restorative and Cosmetic Dentistry at the City of London Dental School. He is currently the President of the British Academy of Restorative Dentistry (BARD) and is a Fellow of the International Academy for Dental Facial Esthetics (IADFE).

www.drpaultipton.com

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.

"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."

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

"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

jak

ROBYN J.S. WEBBER MD FRCSEd (Urol)

Consultant Urological Surgeon & Expert Witness in Urological Cases Having qualified from the University of Otago, Dunedin, New Zealand in 1987, Robyn J.S. Webber emigrated to the UK in 1989, where she undertook further training obtaining the FRCS(Urology) in 1998. She was appointed as a consultant urological surgeon at Hairmyres Hospital in East Kilbride in 2000, and in 2005 Robyn moved to Fife and is now based at the Victoria Hospital in Kirkcaldy. She also works in the NHS hospitals in Dunfermline and St Andrews. She is currently Clinical Lead for Urology for NHS Fife. Robyn added: "I have had a particular interest in medical education and training, and during my time at Hairmyres Hospital was Associate Director of Medical Education. Currently I am an examiner the FRCS(Urol) examination, leader of the oral question writing group for the FRCS(Urol) and an assessor for the MRCS examination. I am also a Regional Surgical Advisor for the Royal College of Surgeons of Edinburgh. Having worked for a variety of medical publications in the past 20years, Robyn is able to draw on her expertise in medical journalism and editing in her present position as Deputy Editor of Surgeons News. She is a former editor of Urology News, former editor of SN Global, and a former member of the web editorial team for BJU International. Throughout her career Robyn has taken an active part in the activities of the Royal Society of Medicine; currently being a Council Member for the RSM Section of Urology. In acting as a Expert Witness for investigations Robyn is required to give her professional opinion on: All aspects of urological surgery, urological malignancy, delayed diagnosis of urological conditions, urinary incontinence, complications of TVT/TOT mesh surgery, clinical negligence, informed consent and personal injury including genito urinary tract injury, renal and pelvic trauma and erectile dysfunction.

CASE STUDY No.1: CAUDA EQUINA SYNDROME: A 30 year old woman with a long history of back pain and “sciatica” attends her GP complaining of worsening of pain in her lower back and tingling in her buttocks. Her GP increases her analgesia prescription. Two days later she attends her local Accident and Emergency Department. Her pain has worsening, and she describes feeling numb over her buttocks and inner thighs, and has difficulty in passing urine. She also complains of constipation. Her constipation is attributed as a side effect of her analgesia, her medication is changed again, and she is discharged. She returns to hospital the following day, in retention of urine. She is catheterized, and has over a litre of urine in her bladder. Neurological examination reveals loss of sensation over the buttocks and inner thighs, and an emergency MRI scan of her spine is requested. This demonstrates a large central disc prolapse at L4/L5 and she undergoes an urgent decompression. Post operatively her residual symptoms include numb ‘patches’ over her buttocks, and continuing difficulty with both urination and defecation. Her symptoms vary, at times she has difficulty in passing urine and may be constipated, on other days she experiences episodes of urinary and fecal incontinence. These symptoms do not improve. She becomes housebound, leading to a loss of her income, and her embarrassment and distress over her bladder and bowel symptoms contribute the breakdown of her long term relationship.

CASE STUDY NO.2: CONSEQUENCES OF A MALE PELVIC FRACTURE Writing approximately 50 reports as an Expert Witness per year, Robyn is equally well versed in giving evidence in court. In addition to having undertaken medico-legal work for the past 11 years, Robyn has also been a Clinical Advisor to both the Parliamentary and Health Services Ombudsman, and an independent Clinical Advisor to the NHS.

"Please note that I can only undertake to write a report on the instruction of a solicitor or other competent body," Robyn explained, " If you require a urologist expert report, and think I may be able to help you, please ask your solicitor to contact me."

T: 07915 423924 F: 448701249975 E: medicalreport@btinternet.com

A 25 year old man sustained a fractured pelvis following a fall from a motorcycle. He also sustained a partial rupture of his urethra, and has suffered from erectile dysfunction since the time of the accident. Erectile dysfunction occurs due to damage to the nerve and blood supply in the penis following the accident. Although he may have some spontaneous improvement, he is unlikely to regain full erectile function and will require treatment as long as he wishes to remain sexually active. His urethral trauma places him at risk of subsequently developing a urethral stricture. He developed such a stricture 18 months later, with symptoms of an increasingly poor urinary flow. He undergoes an optical urethrotomy (a procedure performed using a special ‘telescope’ to divide the stricture). Within months the stricture recurs, and he elects to undergo a urethroplasty, a larger open operation, which is curative, but places him at risk of complications including urinary incontinence, which may be permanent in some patients.

W: www.privatehealth.co.uk/patientadvice/legal-services/

MR. SUDHANSHU CHITALE Consultant Urological Surgeon & Expert Witness

Whether acting on behalf of the plaintiff or defendant, when dealing with cases of medical malpractice the Physician acting as an Expert Witness, is one of the most important figures in malpractice litigation. Specialising in Urology, Sexual Medicine, Andrology, Uro-oncology, Paediatric Urology, Female Urology, Emergency Urology and Endourology, Consultant Urological Surgeon Mr. Sudhanshu Chitale is able to draw on his considerable academic training, which led to him achieving a Masters in General Surgery (MS), Diploma in Urology, Diplomate National Board : DNB-Urology, Fellowship of the Royal College of Surgeons in Urology (FRCS-Urol), Fellowship of the European Board of Urology (FEBU), together with his extensive practical experience covering a wide range of areas including Prostate Cancer and Benign Prostatic Enlargement (BPH); TURP / Bladder Cancer: TURBT; Diagnostic Cystoscopy; PSA Test and Advice; Cystitis/UTI; Kidney Stones / Ureteric stones: lasertripsy / ureteroscopic extraction, Testicular Lump / Pain, post –vasectomy complications , Genitourinary Trauma, is able to provide an independent, professional service as an Expert Witness. Depending upon the case in question, Mr. Chitale is also able to utilise his expertise in Andrology when acting as an Expert Witness, covering the following issues: • • • • • • • • •

Male sexual Dysfunction (MSD): Peyronie's Disease Premature Ejaculation / Erectile dysfunction Male Infertility Vasectomy and Vasectomy Reversal Hypogonadism and Testosterone therapy Genital cancers (Testis / Penis), scrotal lumps Prostate / BPH and all prostatic diseases Adult / Paediatric Circumcision As well as offering specialist advice /services in the outpatient / day case / inpatient settings, Mr Chitale remains available for addressing any emergency or worrisome situations / episodes

• • • • • • • • • • • • •

Haematuria (Blood in the Urine) Haemospermia (Blood in the Semen) Acute Painful testis Testicular trauma Penile trauma / fracture sustained during intercourse Paraphimosis (Foreskin rolled back and stuck) Finding of worrisome lump in the testis: fear of cancer Finding of a raised / elevated PSA blood test reading on routine check Acute stoppage of urine (Urinary retention) Urinary Tract infections in men and women Blocked / painful kidney due to stone disease Genito-urinary Trauma inc intra-operative urinary tract injuries to the ureter / bladder Catheter related complications / suprapubic cystostomy insertion related complications

Having completed the Bond Salon Course on Medico-Legal Report Writing, Mr. Chitale has been on the Expert Witness Directory since October 2013, and is extremely knowledgeable in writing Medico-Legal Reports, as he explained: “I have also compiled several expert witness reports and overview reports on breach of duty and causation / prognosis both for defendants and claimants. Mr. Chitale also successfully completed the Expert Witness Course arranged by MPS/BAUS at the RCSE in 2014, as well as having recently undertaken Courtroom Skills training and Cross Examination Training at Bond Salon in January this year.

As part of his continual commitment to research and development, Mr. Chitale has been involved in a number of research projects for which he has been the Principal Investigator (PI). Having led the first ever Prospective Randomised Controlled double blind Trial of ESWT vs sham therapy for Peyronie's disease (published in BJU Int. in Dec 2009), Mr. Chitale had the honour to be chosen as an coinvestigator for two Randomized Controlled Trials (RCT) in Urology and contributed significantly to patient selection and recruitment, as well as help bring the studies to completion.

The following two trials have been published in peer-reviewed journals. • •

A prospective randomised single blind comparison of ureteric stents composed of firm and soft polymer: (Multi-centre trial: Norwich, Wakefield, Bristol UK) A multi-centre randomised controlled study to compare the impact of different ureteral stent lengths on patients' quality of life using a validated questionnaire: (Multi-centre trial: Norwich, Wakefield, Bristol UK).

Mr. Chitale has also conducted and published outcomes of several Clinical Audits, one of which has had significant impact on current clinical practice; published in the Journal of sexual Medicine (JSM), this Audit highlighted the link / relationship between Lower Urinary tract Symptoms (LUTS) and Erectile Dysfunction (ED). The high esteem in which Mr. Chitale’s expertise is held within the profession is highlighted by the fact that he holds a post of Honorary Senior Lecturer at the UCL Medical School, London and has been proud recipient of The Top Teacher Award for 2013-14 by popular student vote when 1100 voted. As you would expect from such a consummate professional Mr. Chitale is a Member of a number of leading organisations including: British Association of Urological Surgeons; British Medical Association; American Urological Association and European Association of Urology. All of the above signify that Mr. Chitale has all the necessary credentials to offer a highly professional service as an Expert Witness; including the preparation of Medico-Legal Reports and appearing in Court, in negligence cases relating to cases involving his specialist areas of expertise. FOR MORE INFORMATION PLEASE CONTACT: Mr. Sudhanshu Chitale Private Urology London C/O Highgate Hospital 17-19 View Road London N6 4DJ Free Phone: 0800 025 7519 Secretary: urologysecretary.sc@gmail.com Email: chitalenorwich@aol.com

Simon Fulford FRCS (Urol) FORENSICS INDUSTRY

E-MAGAZINE

AWARD NEWS

Simon Fulford FRCS (Urol)

Consultant Urological Surgeon & Award-winning Expert Witness in cases of Compensation for Post Spinal Injury, Post Accidental Injury, Post Head Injury & Urological medical negligence The Senior Management team of the Forensics & Expert Witness E Magazine are delighted to announce, Simon Fulford as the deserving recipient of the Expert Witness Award for Urology 2014. The Award reflects the professionalism and experience that Mr. Fulford brings to the forefront of medico-legal cases that he is instructed on, as well as the highly respected expert witness testimony that he provides in the court of law.

hen it comes to medical negligence and personal injury claims its vital for those in the legal sector to seek the independent, unbiased advise from a professional Surgeon. When it comes to court cases for compensation for spinal cord injury, cauda equina syndrome, pelvic fractures and urological medical negligence cases, Simon Fulford FRCS (Urol) has become recognised as a leading provider of Expert Witness Reports for Barristers and Lawyers on both sides of the case, as well as for law enforcement agencies. Boasting an MBBS Bachelor of Medicine & Surgery from London University, Fellow of the English Royal College of Surgeons,Together with subspecialist qualification in Urology (FRCSurol) is able to combine these qualifications with the wealth of practical expertise he has gained throughout his illustrious career. From his first post in August 1987 as House Surgeon dealing with general and vascular surgery at Dulwich Hospital, through to his current position as Consultant Urological Surgeon at James Cook University Hospital, which he has held for the past 17 years, as he explained in a recent interview: "I am one of twelve consultants in a very busy department of Urology serving a population in the Tees Valley of over a million. I am also Consultant Urologist to the regional spinal injuries unit based at James Cook University Hospital which provides acute and long term care to patients with spinal cord injury from the whole of the North of England. In addition I see NHS , private and medico legal patients at BMI Woodlands Hospital Darlington.

Simon Fulford FRCS (Urol)

My primary interest within Urology is the care of the neuropathic bladder in patients with spinal injuries or neurological disease. I see and manage large numbers of patients with spinal cord injury, Multiple Sclerosis, Parkinsons disease and many other neurological conditions. I regularly perform urodynamic investigations on such patients and offer a full range of management options ranging from ongoing surveillance to major urinary tract reconstructive procedures." Holding Membership to a number of major quality organisations including BMA; GMC; RCS; MPS and BAUS, Simon is also a member of the Teesside Urological Cancer MDT, and also pelvic exenteration for advanced gynaecologica or colorectal cancer. A great deal of Simon's medico legal work involves patients with Cauda Equina Syndrome (CES). The Cauda Equina is a bundle of nerves that lie within the spinal canal below the termination of the spinal cord from the level of the first or second Lumbar Vertebra to the coccyx. It is vulnerable to injury by compression. Most commonly this will be caused by a prolapsed inter vertebral disc but can also be the result of spinal fracture, tumours of the spine, congenital or degenerative spinal conditions or complications of procedures such as lumbar puncture or spinal anaesthetic.

On receiving the Forensics & Expert Witness E Magazine’s Award, Mr. Fulford commented:

“I was initially surprised to hear of the award but am very happy to accept it. I regard it as recognition of the quality of the reports I produce and an acknowledgment of the hard work I put in to them.”

CES is the combination of low back pain, sciatica, saddle anaesthesia (loss of sensation around the anus and over the buttocks), motor weakness in the leg(s) combined with bladder and bowel disturbance (retention and / or incontinence) and loss of sexual function. Forming part of the Cauda Equina, the Sacral nerves supply the bladder, bowel, urethral sphincter, anal sphincter and the sexual organs. All of which can be effected by CES. Patients with established CES should be referred to a Urologist with an interest in Neuro Urology to be assessed and helped with their pelvic organ dysfunction. Unfortunately many cases of CES result in litigation for alleged negligence in relation to diagnosis or treatment. It is important that in these cases expert opinion from a Urologist with an interest in Neuro Urology in regard to pelvic organ dysfunction is sought in order to nsure appropriate assessment of ongoing disability, treatment and prognosis.

On his medico legal work, Simon had this to say: "I have been preparing expert witness reports since shortly after appointment and have attended training courses in medico legal report writing. Having appeared in court as an expert witness for both claimant and defendant, as well as receiving joint instructions, I currently receive instructions for approximately six to ten cases per month.

The cases I have reported on include post spinal injury compensation claims, post accidental injury compensation claims post head injury compensation claims, along with urological medical negligence cases and criminal injury cases." As you would expect from such a dedicated professional, Simon is committed to research and development as a means of introducing new techniques: "I have run audits on several new techniques and procedures which include artificial sphincter insertion, BoTox injection and implantation of Invance and Advance male slings. These results have been presented at local, national and international meetings and in some cases published. We have been collaborating with Professor Jenny Southgate of York University and currently our third research fellow is writing up her thesis on the Ketamine Induced Cystitis currently. This is an exciting research opportunity as understanding it may well improve our understanding and management of other painful bladder syndromes. I am therefore working with other urologists, epidemiologists, public health doctors, drug abuse experts and basic scientists to develop a comprehensive study of these patients.

FOR FURTHER INFORMATION PLEASE CONTACT: SIMON FULFORD FRCS (Urol) Tel: 07855312901 Email: simonfulford@nhs.net

MR NIKHIL SHAH FRCS(Tr & Orth) FRCS, MCh(orth), MS(orth), DNB(orth) MBBS

Consultant Orthopaedic & Trauma Surgeon Wrightington Hospital Mr Nikhil Shah can act as an expert witness in personal injury and clinical negligence cases, taking instructions from either claimant or defendant or as a Single Joint Expert.

He can provide medico legal reports for personal injury claims involving: •Trips and slips • Whiplash • Ankle, knee and hip fractures, lower limb injuries • Pelvic and acetabular fractures •Long bone and articular fractures •Soft tissue injuries • Low velocity impact cases

Mr Shah can provide clinical negligence related reports in his specialist areas of expertise concerning: • Primary and revision hip and knee replacements • Pelvic and acetabular fractures • Long bone and periarticular trauma

T: 0161 393 3059 E: Nikhil.shah@consultantcare.com

Mr Nikhil Shah, c/o Consultantcare Ltd, Riverside Centre, Alexandra Hospital, Mill Lane, Cheadle, SK8 2PX

ANDREA DENBY INTERPRETOR/TRANSLATER

As a freelance Interpreter/Translator Researcher Andrea Denby is able to draw on her many years’ experience of interpreting/translating for the Legal sector, the Probation Service and UKVI; having completed close to 2,000 hours in Magistrates' Court, Crown & Family Court, interpreting assignments for Tribunals and working for the Police and assisting Solicitors in the preparation of cases. Able to speak English and Hungarian fluently on a legal professional level, Andrea is also able to read and have basic conversational skills of German; with her knowledge of Latin having proven to be an extremely important asset in helping her to understand legal arguments. Andrea is able to draw on her extensive academic training, which includes having attended the ELTE in Budapest, where she gained an MA degree in English and Hungarian Language and Literature, before going on to become a certified Doctor of Philosophy in comparative literature at the University College, London. Following which she successfully passed a Diploma qualification in Public Service Interpreting (DPSI) in Law through the Chartered Institute of Linguists, London. Later utilising this experience, Andrea has since taught DPSI online between 2015 and 2017, as well as DIP Trans online during 2017. After competition of her DPSI, Andrea then furthered her education by achieving a Graduate Diploma in Law, English Law at the University of Westminster. With 2011 seeing Andrea successfully complete an MOJ Independent Assessment in HungarianEnglish Legal Interpreting course (Tier 1) at Middlesex University, London. Currently, Andrea Denby serves as a mentor at the University of Westminster, through her own company, Hungarian Translation and Research which was founded over 14 years ago and has been on the official register of Translators/Interpreters since June 2007.

Andrea added: "I am fully aware of our professional codes of conduct and work with the CPS; the Police and Translation department of Thebigword, the LSA interpretalk department, K-International,Global Voices and Languagelinkplus translation agencies as well as UK LST, Easytalk and a new agency called Reliance Translations. In 2016, Andrea completed a family law assignment at the Supreme Court which was booked by Languagelinkplus. Having been a Member of the NRPSI Hungarian Translation & Research for over 14 years, Andrea also holds Membership to a number of other leading professional bodies including the Chartered Institute of Linguists, the APCI and the International Association of Professional Translators and Interpreters (IAPTI). Course Tutor at South Thames College - Mariana Asminian was certainly impressed with the standard of Andrea's work: "I teach legal interpreting courses at South Thames College and Andrea has been marking my student's translations for the past year or so, helping me ad-honorem by checking translations and providing guidance to my Hungarian students on grammar and terminology as required. They greatly appreciated the knowledgeable feedback Andrea provided them. In recognition of her input and great help, I issued Andrea with a Confirmation of CPD carried out for our college."

T: 01284 728 707 M: 07729152115 E: adenby@hotmail.com

XPC Services, Dr. Graham Mould Pharmaceutical & Toxicology Expert Witness

Welcome to XPC Services Providing expert advice on all things pharmaceutical

xpc

XPC Services provide expert witness advice and wri�en reports for prosecu�ng and defence counsels on drug related criminal and similar cases. Clients include the Crown Prosecu�on Service (CPS), Police Authori�es and many private solicitors. With over 40 years experience in the pharmaceu�cal industry, academia and the NHS, XPC Services expert Dr. Graham Mould holds extensive and broad knowledge in the ac�on of drugs on the body and how the body responds when drugs are taken. His area of exper�se include clinical pharmacy, clinical pharmacology and toxicology. Dr. Mould is also ideally placed to advise on drug therapy. Previously based at the Royal Surrey County Hospital, Guildford, Dr. Mould has been heavily involved in the close clinical monitoring of pa�ents who were receiving potent drugs, as well as observing the ac�on of drugs in healthy volunteers and in pa�ents. Over the last ﬁve years, Dr. Mould's skills have developed in report wri�ng and assessing the ac�on of drugs in criminal cases where the ac�on of drugs might have been responsible. The role of the Expert Witness is to assist the Court on specialist or technical ma�ers within their exper�se. Dr. Mould is able to provide an unbiased opinion to the facts presented. His reports are clear and portrayed in numbered paragraphs for ease of reference. Wri�en in detail using the latest research, reports are generally wri�en within two to three weeks following an instruc�on and can be modiﬁed in the light of new evidence.

Dr. Mould has appeared as an Expert Witness in Magistrates and Crown Court on a number of occasions. He has been instructed to formulate reports centred around cases: • • • • • • •

involving the administra�on and eﬀect of prescrip�on and over-the-counter medicines in the young and elderly. driving under the inﬂuence of drugs and/or alcohol. drug assisted sexual or criminal assault. the use of illicit drugs. errors in dispensing of prescribed medicines. interpreta�on of toxicology reports rela�ng to drug concentra�ons. assessing results of overdose situa�ons. Recent cases have included:

•

Prescrip�on drugs and alcohol and the eﬀects of depression and violence in terms of wounding with intent.

•

Drug involved in sexual assaults through the spiking of drinks in bars and club. The volume of cases of this nature seems to have increased in the last twelve months due to the number of drugs and other substances that are now available.

•

The use of dinitrophenol as a slimming agent or to build muscle mass. This compound which is largely purchased online requires the user to ingest a potent and toxic compound and individuals have died as a result of taking it.

T: 01483 685 785 W: www.xpertwitness.co.uk

Award-winning RSW Medicolegal Ltd Outlines The Advantages Of Instruct Direct

Federation of

Forensic & Expert witnesses

Since its inception, Stourbridge-based RSW Medicolegal Ltd has achieved an enviable reputation for the provision of high quality Medico Legal Reports in the field of orthopaedic related personal injury cases. A highly experienced Trauma and Orthopaedic Surgeon, Founder and Managing Director of the Company, Richard Scott-Watson has been the Director and sole Medical Examiner at RSW (incorporating in 2001) for over 28 years. Able to draw on over 28 years’ experience, Mr. Scott-Watson is a single expert with a particular interest and expertise in general orthopaedics, fractures and trauma; musculoskeletal injuries and all aspects of bone and soft tissue injury including limb and spinal injuries. He is particularly interested in the disability aspect of cases, an as this is what matters most to the claimant. As you would expect from such a consummate professional, Mr. Scott-Watson is a member of the Oxford Medical and Legal Society, as well as attending industry-led conferences each year, depending on the relevance of the subject matter.

Richard Scott Watson

In a recent interview Mr. Scott-Watson outlined the advantages in an Expert Witness being instructed directly, as opposed to using the services of an agency/intermediary: “To begin with the solicitor gets to choose the expert. Some solicitors ask agencies only for the shortest waiting list but many solicitors prefer the direct contact once they have tried it. As it is far more efficient and cheaper. Some solicitors give the impression that agencies indicate that they can only get the expert through the agency and are surprised that direct instructions can be given. It is never the case that an agency owns an expert and direct instructions can always be sent. Another key advantage to instructing an Expert Witness directly would be that Agencies normally take around 50% or more of the fee the expert would normally charge. Therefore, unless the fee is regulated, the solicitor ends up being charged considerably more than the expert would charge direct in every case that they have (accidentally) revealed their charges – usually another 10 – 30%. The value to the expert is next to nothing, in fact frequently agencies obstruct the smooth running of a case. Of course, the practicality is that the expert accepts end of case payment with direct instruction, but for nearly twice the fee for the same work, that seems reasonable. Many claimant solicitors still seem to be unaware that when liability is admitted, the expert’s fee becomes a disbursement and there is no need to wait to end of case It is no coincidence that what used to be independent agencies have largely been bought out by big companies – they make a lot of money for the work they do.”

When asked if clients using an Agency always have access to the correct expert, who has experience in their particular niche, Mr. Scott-Watson told us: “No. The agencies rarely know or use the expert’s particular areas of specialisation. Some do not even get the speciality correct, and in the last year I have been sent two hernias and a head injury, neither of which are Orthopaedic cases. The criteria agencies use are usually things like speed of return of report but agencies often collect such data incorrectly and so fail to instruct the most efficient experts. I recently had an agency tell me that 25% of my cases were on time. In fact it was over 95% but their figures were skewed by them failing to correctly record when they were sent reports – resulting in the reports looking late and them asking for repeated duplicates – in one case seven times. The agencies also are first point of contact for many claimants – which many find a very tiresome process. In my experience, the benefits a client receives from instructing an expert directly in terms of cost, service and ease of liaising with the expert speak for themselves. In terms of cost, they get what they are paying for as opposed to the agency taking half of it or more. If there is a problem with a late set of documents or adjustment to a report this can be done quickly but through an agency, three weeks or more for every alteration is common. Some agencies hold reports for weeks before sending them on – the record I have seen is ten months. Needless to say the expert was blamed for the delay when it was entirely the fault of the agency. I have also had instructions to agencies being mis-interpreted, so one case recently where the agency had failed to send to correct notes, even though they had them, resulted in a significant delay in sending the report. Eventually the solicitor had to send the notes direct after I had been threatened with non-payment for the report due to delays: Delays entirely caused by the agency that passed on the threat. The Solicitor was very happy once the problem was sorted out direct, which probably would never have been possible if the agency had continued to be in the middle.” In what cases, can the use of an agency be a useful course of action, if any? “Agencies can be useful to experts as they provide volume, but they need to because of the very low fees they pay. They also provide diary systems (cost, but no value) and electronic transmission of records (cost, but no value).” When asked if there were any legal developments or incoming Government legislative changes that will affect the use of agencies and/or experts in the future, Mr. Scott-Watson explained: “I think MedCo really missed a trick in stopping fraud. The initial GP reports are almost valueless and entirely subjective as they do not insist on the contemporaneous notes, which are vital in every case. Equally, with agencies taking most of the fee in these cases, the time taken to complete a case is about a third of what is required to do the job properly in most cases. They actually encourage fraud, as all the claimant has to do is either say they are already recovered (so nothing to find and contradict) or that the symptoms were severe, but no longer are. This means that a high level of disability is recorded for part of the period prior to the report being written, which had by that time partially recovered. In almost every case where I see the claimant later, the contemporaneous notes contradict all or most of any period of severe disability. As the Government changes the scenery, we currently have little or no idea what the future holds, but the recent increase in fees for agencies will probably lead only one way – agencies taking an even greater percentage of the fee for the small percentage of the work they do.”

DR. NICHOLAS PADFIELD MBBS FRCA, FFPMRCA

Consultant in Pain Medicine & Expert Witness DR. NICHOLAS PADFIELD manages to combine his duties as a Consultant in Pain Management and Anaesthesie at Guys and St. Thomas Hospital NHS Foundation Trust, with the professional service he provides as an Expert Witness. In a recent interview, Dr. Padfield outlined the importance of an Expert Witness not only being able to draw on their practical experience but also having undertaken extensive academic training within their field of expertise:

padfield

“As lead for Clinical Governance in the largest Pain medicine department in the UK, I have gained a lot of experience in complaint resolution, clinical standards of care and analysis of events ’when things go wrong’ that is readily translatable to the forensic setting. I have also attended a training course and been examined in Civil Mediation, which develops skills that are useful in the forensic setting. I believe it is important to see both sides, hence I accept both claimant and defendant instructions. My opinion will often devolve to the contemporaneous medical, occupational employment records, especially in complex cases. Analysis for consistency and corroboration is key when estimating reliability of statements. Clinical experience is also relevant when apparent errors of medical judgement are uncritically promulgated between practitioners especially when cases have significant labels such as ‘CRPS’ or ‘Fibromyalgis’ for example. Involvement in research also emphasises, the importance and role of the consent process, especially when explaining risk, which is particularly pertinent in negligence cases.” Acting on behalf of claimants and defendants, Dr. Padfield has been required to attend district, county and high courts.Dr. Padfield added: “ I am frequently subpoena’d but most cases usually compromise before they are heard in court.

This year to date I have been subpoena’d for TEN cases but so far have not had to attend to give evidence as the cases have been compromised. I have not been instructed as a single joint expert for the last three years.” When asked if he felt it important for an Expert Witness to receive instructions at the beginning of a case rather than further down the line, Dr. Padfield went on to say: “A prompt start on tackling issues can speed the process. I also think that joint consultations and examinations, when both experts (claimant and defence) simultaneously examine a claimant and jointly prepare the report, can also speed the process. This is down to the experience of the solicitor running a particular litigation. However in complex cases the process seems to take longer than it should. I think choosing the right expert to settle the case rests with the experience of the instructing solicitor and the nature of the medical problem arising from the alleged negligent act – whether personal injury or medical mishap. Pain medicine experts often receive instructions towards the end of multi-track cases and are best placed to ‘wrap things up’ because of the multidisciplinary nature of their work and experience.

As you would expect of such a consummate professional Dr. Padfield is a Member of a number of leading Societies including:

• • • • •

British Pain Society International Neuromodulation Society Neuromodulation Society of UK and Ireland British Medical Association Medico-legal Society

Holding the Diploma of Fellow Royal College of Anaesthetists (FRCA) and Fellow in the Faculty of Pain Medicine, Royal College of Anaesthetists (FFPMRCA), Dr. Padfield is listed in the Expert Witness Directory. When asked to give a brief synopsis of the types of cases he has undertaken in the past, Dr. Padfield told us: “Personal Injury Cases - dealing with causation, condition and prognosis; with ‘discussion’ over CRPS, Fibromyalgia, Neuropathic pain, Rehabilitation, Pain management programmes, Spinal Cord Stimulation. Negligence Cases - Whilst I very rarely deal with liability cases, I have been instructed by both claimant and defendant in anaesthetic cases where liability was an issue, mostly dealing with causation from orthopaedic, neurosurgical or other surgical mishaps, condition and prognosis with a view to recommendations for treatment.”

DR. NICHOLAS PADFIELD MBBS, FRCA, FFPMRCA Consultant in Pain Medicine & Expert Witness T: 020 7349 9717 M: 07850903021 W: www.drnicholaspadfield.com 49 Smith Street London SW3 4EP

logan

MR. ATUL KHANNA MBA, MBBS, FRCS, FICS, Dip EurB (Plast) FRCS (Plast)

Consultant Plastic, Reconstruction & Hand Surgeon & Expert Witness MR ATUL KHANA trained in general surgery from l983, when he qualified, to 1989. After which he decided to undertake specialist training in plastic, reconstructive and hand surgery, as he explained in a recent interview: “I have been in Consultant practice since 1998 and have been a Consultant Plastic Surgeon at Sandwell General Hospital since June 1999. My work involves the treatment of all types of hand injuries, burns, facial and soft tissue injuries, elective hand surgery, breast surgery, scars and deformities, skin cancer and cosmetic surgery. Mr Khanna holds membership to a number of leading organisations including being a member of the Society of Expert Witnesses, the British Association of Plastic Surgeons, the British Association of Aesthetic Plastic Surgeons and the British Burns Association. Mr. Khanna has also written a chapter for the Encyclopeadia of Forensic & Legal Medicine entitled “Medical Malpractice in Cosmetic and Plastic Surgery”

Mr Khanna’s qualifications are as follows: M.B.B.S Osmania University July 1983 F.R.C.S. Royal College of Physicians and Surgeons of Glasgow November 1989 F.I.C.S. International College of Surgeons June 1994 M.B.A. Open Business School, Open University December 1994 F.R.C.S. (Plast) Intercollegiate Board in Plastic Surgery March 1997 Dip. Eur. B( Plast) European Board of Plastic Reconstructive and Aesthetic Surgery (EBOPRAS) November 1998 For more than a decade now Mr Atul Khanna has combined his work as a Consultant Plastic Surgeon with the professional services he provides as an Expert Witness working on Medicolegal cases for which he has provided Solicitors with over 2100 medical reports over the last 10 years. Cases undertaken by Mr. Khanna have predominantly dealt with the following areas of expertise:

• • • •

Hand surgery: Sequelae of hand injuries and surgery Soft tissue injury: Sequelae of post traumatic scarring Burns management: Sequelae of disability following burns injury, scarring and surgery Medical negligence in Cosmetic Surgery

“When acting as an Expert Witness I understand that my duty to the Court is to provide independent assistance to help the Court on the matters within my expertise. I appreciate that this duty overrides any obligations to those by whom I have been instructed or by whom I am paid. In preparing medical reports I strive to be accurate and complete, having mentioned all matters which I regard as relevant to the opinions I have expressed; all of which lie within my field of expertise.”

The Case Study below is a typical example of the work undertaken by Mr. Khanna as an Expert Witness: This report is entirely independent and has been prepared for the court on the instructions provided by Solicitors following an injury sustained by Mr Smith on the 23.1.2000 and details his treatment, condition and prognosis. Mr Smith was 45 years old at the time of the injury and now is 46 years old. His occupation at the time of the injury was that of an extrusion operator. His occupation now remains the same. His hobbies at the time of the injury were playing golf. His hobbies remain the same. Mr Smith is right handed. This report is based on an interview and examination of Mr Smith carried out on 7.5.2002 at Sandwell Healthcare NHS Trust, Lyndon, West Bromwich, West Midlands B71 4HJ. No one was present at the time of the interview. SUMMARY OF INSTRUCTIONS I have been asked to examine Mr Smith and prepare a full and detailed written report, dealing with relevant pre accident medical history, the injury sustained, treatment received and the present condition, in particular with the capacity for work and giving a definitive prognosis. EXAMINATION The examination I carried out was specifically for this report and was confined to an assessment of the scars and deformity that Mr Smith has following the injury he sustained on the 23.1.2000. COMMENTS AND PROGNOSIS Summary One year four months ago Mr Smith sustained an injury to his left middle finger while at work. This was a crush communited injury affecting the distal phalanx and the nail bed. This was treated with dressings for four weeks following the injury. He was off work for five weeks following the injury. He required regular analgesia for six weeks following the injury and not partake in his hobbies for two months following the injury. Currently he has problems with pins and needs while in the cold. He is concerned about the appearance of his left middle finger and has hyper extension of his left middle finger. Comments Regarding injury to left middle finger and treatment recommendations Mr Smith sustained a significant crush injury to his left middle finger. This resulted in a communited fractured of the distal phalanx and an injury to the nail bed as well. This was treated with dressings. Regarding employment prospects and hobbies Mr Smith was unable to return to work for five weeks following the injury. He currently manages in the same capacity. If he were to lose his current job he would not be at a disadvantage on the labour market unless he had early progression of arthritis in his finger. Mr Smith is an avid golfer. He manages to play golf but following a game has pain in his left middle finger. He does however manage to soldier on and this injury has not yet affected his handicap. At the time of signing the report I consider it to be complete and accurate. I will notify those instructing me if, for any reason, I subsequently consider that the report requires any correction or qualification. I believe that the facts within my own knowledge which I have stated in this report are true and that the opinions I have expressed are correct.

T: T: 0121 0121 507 507 3455 3455 -- M: M: 07880 07880 797 797 235 235 -- E: E: atulkhanna@doctors.org.uk atulkhanna@doctors.org.uk -- W: W: www.atulkhanna.co.uk www.atulkhanna.co.uk

Mr Aidan Fitzgerald Consultant Plastic Surgeon, Reconstructive & Aesthetic Surgeon & Expert Witness

Based in Sheffield at the Royal Hallamshire Hospital, Mr. Aidan Fitzgerald MB ChB MPhil FRCS(Plast.) has achieved an impressive reputation not only as a Consultant Plastic, Reconstructive & Aesthetic Surgeon, but also as an Expert Witness in cases of Personal Injury Claims & Clinical Negligence in Plastic & Cosmetic Surgery. Aidan’s area of expertise for his Private Practice lies in Breast and Body contouring surgery, Aesthetic Facial Rejuvenation, Skin cancer. Added to this Aidan’s NHS patients are able to take advantage of his skill in Head & Neck Surgery, Facial Reanimation Microsurgical Reconstruction, Body Contouring (post weight loss), as well as Skin Cancer.

A Full Member of the British Association of Plastic, Reconstructive & Aesthetic Surgeons, as well as being on the GMC Specialist Register for Plastic Surgery No: 3325803, Aidan undertakes medicolegal reports both in the areas of Personal Injury and Medical Negligence; with his medical negligence work being split 50:50 between claimant and defendant.

aiden

Aidan boasts a wealth of practical experience, together with academic qualifications; including gaining an MB., Ch.B. (University of Liverpool) 1988 M.Phil. (University of Bradford) 1998 FRCS (Edinburgh.) 1993; FRCS (Glasgow.) 1993 ; FRCS (plastic surgery) 2001 Professional bodies Full member of the British Association of Plastic Reconstructive and Aesthetic Surgeons General medical council no. 3352580

Aidan has the facility to see clients both adults and children for medico-legal work in Sheffield, Doncaster, Nottingham, Leeds London and Manchester at the following venues: • 10 Harley Street, London • Sheffield – Claremont Hospital • Doncaster – Park Hill Hospital • Nottingham – Russell Square Consulting Suites • Leeds – Nuffield Hospital • Manchester – Calderbank Medical Chambers

Aidan took a higher research degree, going on to obtain an M.Phil. from the University of Bradford in 1998. After which he undertook higher surgical Training in Scotland involving placements in Edinburgh and Glasgow, following which he obtained FRCS (Plastic Surgery) in 2001, as he explained in a recent interview: “Subsequent to this I spent a year each in Melbourne - Australia and Toronto - Canada gaining further experience in Reconstructive and Cosmetic Surgery of the Breast and Head and Neck, before returning in 2003 to Sheffield with my wife and children.” In his present post as a Consultant Plastic Surgeon at the Sheffield Teaching Hospitals NHS Trust, Aidan is able to draw on his experience and skill in the field of reconstructive microsurgery, facial reanimation and the treatment of skin cancers.

“For those clients unable to attend hospital I am happy to arrange a ‘home’ visit which would usually take place within a few weeks of receiving instruction and I would expect to complete a report for the client within 2-3 weeks.”

“I would be delighted to be consulted on any question of cosmetic surgery in the areas of breast surgery such as augmentation, reduction or uplift; body recountouring. Together with other areas such as liposuction or abdominoplasty and facial rejuvenation including blepharoplasty or facelift. I would also be delighted to be consulted concerning minor skin blemishes such as moles or cysts, as well as skin cancers that may require excision.”

Mr Aidan Fitzgerald Consultant Plastic Surgeon MB, ChB, M.Phil, FRCS (Ed), FRCS (Glas), FRCS (Plast) Please contact via E mail E: ampfitzgerald@hotmail.com

FIVE SUGGESTED FACTORS MAKING PONZI SCHEMES SUCCESSFUL I. Gullibility Where a person goes ahead with a financially risky behaviour despite danger signs, or unresolved questions. One can have a high IQ and still prove gullible. People of average and above-average intelligence fail to use their intelligence fully or efficiently when addressing everyday decisions.

NORMAN COWAN

FCA FABRP MCIArb MEWI

•

IF YOU ARE SENT BY GOD, I WELCOME YOU; BUT IF YOU COME FROM THE DEVIL, DON’T GO AWAY : STARTING WITH AN UNBELIEVABLE INVESTMENT RETURN!

Published on April 27, 2018

The promise of earning a return far above the market rate is something irresistible to many who just want to increase their personal fortune. Going back to 1920 probably the most famous exponent of an investment fraud, was Charles Ponzi, from whom the expression “Ponzi Scheme” is derived. His promised rate of return was a 200%. Since there was no underpinning business, the real return was limited and was paid from receipts from newer investments.

REASONS FOR PONZI SCHEMES HAVING AN INITIAL SUCCESS Since the collapse of the Charles Ponzi scheme there have been over 60 worldwide similar schemes. The most infamous was that set up by Bernard Madoff which lasted for over thirty-years being exposed in December 2008 having managed to con investors out of over $65 billion. The irony was that Madoff was a highly respected financial expert, giving an air of respectability, with investors being mostly well educated and supposedly having a degree of financial acumen. Often, high returns encourage investors to leave their money within the scheme, so the operator does not actually have to pay out very much to investors. The promoter will simply send statements showing how much they have earned, which maintains the deception that the scheme is an investment with high returns. At the same time promoters also try to minimize withdrawals. Having provided expert reports in connection with two Ponzi schemes, I have wondered how these schemes proliferate. The basic mechanism is the tendency of humans to model their actions on the behaviour of other humans termed “irrational exuberance. In simplest terms, the fact that so many people seem to be making big profits on the investment, and telling others about their good fortune, makes the investment seem safe and too good to pass up

II. Situation An individual, before investing must consider whether to invest in a risky venture, which is more likely if the social and other situational pressures are strong. The Madoff scam, for example, had strong social feedback pressures. where the reputation of Madoff may have affected the judgment of the potential victims. However, Madoff was rarely involved with the individual investors, relying on feeder funds to collect money from individual clients and pass it on to him for investment, with hedge fund managers trusting Madoff because of his reputation. Indeed, he had given steady returns over a long period of time. Since the individuals dealt with long established hedge funds, they didn’t question how the returns were achieved, relying, not-surprisingly, on the hedge funds having done their research. III. Cognition Gullibility can also include a lack of clear thinking. Individuals can have a high IQ yet still be quite gullible. Impulse and intuition driven by emotion often lead to irrational decisions even among the most intelligent. Human nature being what it is will suggest the willingness to take the easy way out and place complete trust in others. IV. Trust Human relationships depend on interpersonal trust. An unwillingness to contradict or question a trusted colleague or friend helps the Ponzi promotor. Alan Greenspan said that “the wise person knows when to trust and when not to”. It can be difficult to say no if there is no reason to disbelieve. V. Emotion Emotion is part of every gullible act. The Ponzi scheme investor has an overwhelmingly strong desire to increase his wealth. This desire is so strong that it interferes with logical reasoning and causes the individual to exhibit gullible and irrational behaviour.

WHY DO PONZI SCHEMES COLLAPSE? Ponzi schemes require a consistent flow of money from new investors to continue. With little or no legitimate earnings Ponzi schemes tend to collapse when it becomes difficult to recruit new investors or when many investors ask for their investment back.

CONCLUSION

"Alas, our frailty is the cause, not we: For such as we are made of, such we be"

So how do Ponzi schemes continue to proliferate. In my opinion it is the status and confidence of the Ponzi operator, where that person holds the conviction that the operation is legitimate and will continue. Even Charles Ponzi at his trial stated that “in his belief the business was always lawful”. Years after the trial he maintained that he was brought down by a mysterious conspiracy of officials and others whose actions were unjustified.

William Shakespeare

www.crgforensics.co.uk

mjn

We are experienced in:

Commercial disputes

Accident/injury claims

Valuations

Insurance claims

For further information please contact us:

vanessa.winspeare@mjn-forensics.co.uk

Telephone: 01747 834 412 or 07414 862 990

www.mjnforensics.co.uk

Tracing its roots back to 1933, MDD is an award winning forensic accounting firm specialising in economic damage quantification calculations. In situations such as business disputes, natural or manmade catastrophes, business interruption, fraud or defective product recall, MDD can help by accurately determining the value of harm or injury that has been inflicted on a person or property. We regularly work with law firms, government entities, multinational corporations, small businesses, insurance mdd companies and independent adjustment firms to provide independent objective assessments that enable fair and equitable settlements.

Our forensic accountants are exceptionally dedicated, singularly qualiﬁed experts with proven track records who provide clear and concise assessments that stand up to scrutiny. Our partners and senior staff regularly provide extensive litigation services and expert witness testimony in courts, arbitrations and mediations throughout the world.

Professional Experience Overview

> Automotive > Chemical Manufacturing > Entertainment & Hotels/ Restaurants > Food & Beverage > Mining > Pharmaceuticals > Power Generation > Pul & Paper > Retailers & Wholesalers > Steel & Aluminium > Technology

Paul joined MDD Forensic Accountants’ London, England office in 1999. He moved to Asia in 2004 to establish the ﬁrm’s Singapore office before returning to MDD London three years later where he is currently a Partner.

Practice Areas

With forensic accounting professionals in over 40 offices on 5 continents, MDD has global resources to assist our clients with their forensic accounting needs. Our work spans more than 130 countries and 800 industries. We have highly qualiﬁed resources available at all levels who not only boast accounting qualiﬁcations from several international bodies but also undergo regular intensive internal training. We speak over 30 languages and hold 18 distinct professional designations, with many possessing additional credentials in fraud detection and valuation.

Industry Experience

Paul Isaac | Partner ACMA, CGMA, MEWI, MAE Marlow House 1a Lloyds Avenue London EC3N 3AA E: pisaac@mdd.com T: +44 203 384 5499 M: +44 7725 509 918

> Business Interruption > Contingent BI > Business Valuation > Cyber > Increased Costs of Working > Litigation Support > Loss of Profits > Product Liability and Product Recall > Stock & Contents

Paul’s forensic accounting practice focuses on economic damage quantification relating to both insured and uninsured matters. Within the insurance field, Paul has extensive experience in dealing with business interruption claims including loss of profits and increased costs of working for both property and liability insurers. Paul has also a depth of experience in handling fidelity, stock & contents and valuation matters. He has worked on files ranging from £25,000 to those in excess of £200 million. Paul also has significant experience in the catastrophe service areas dealing with Business Interruption and CBI losses for Insurers and Reinsurers arising from high profile catastrophes such as 2017 Hurricanes Harvey, Irma and Maria, 2011 Thailand Floods, 2011 Japan earthquake, 2007 UK floods, 2004 Asian Tsunami. Paul’s non-insurance work includes working for both claimants and defendants where financial loss is alleged arising from contractual dispute or tort. He has also assisted clients in tracing proceeds of crime and shareholder disputes.

Litigation and Arbitration Experience Paul has extensive experience in litigation support services. He has provided both written expert reports and witness testimony for the High Court and at Arbitration (including LCIA, ICC and ICSID). He has assisted in numerous mediations and is a member of the Expert Witness Institute and Academy of Experts.

> mdd.com

MANDERSTAM INTERNATIONAL GROUP Expert Engineers in Process and Industrial Engineering

Niche consultancy prospers in the “CSI” role within engineering. There is evidence that the way to defend the U.K.'s global position in engineering consultancy is to provide a quality of service and speed of response that reflect our national education and character. Manderstam International Group are expert engineers in process and industrial engineering, established in 1941, that provides independent, bespoke engineering and investigative services. Our specialised team comprises talented, wellqualified chartered engineers who perform the "CSI" role within the engineering sector, particularly in the process and industrial engineering industries: oil/ gas, petroleum refining, gas to liquids and biofuels, petrochemicals and gas technology, power generation pharmaceuticals, fertilisers, pesticides, salt based industries, steel and nonferrous manufacturing and processing, coating technology, food processing, cement, glass manufacture and vegetable oils and fats. We have a varied workload of investigative and forensic engineering that provide some of the most demanding and intellectual challenges. These roles take "no prisoners", but our engineers find that if they can meet the challenges the rewards are there. The 30 second appraisal of your companies perform ance in the process industries ! Manderstam carries out global benchmarking studies in process industries enabling our client’s management to critically review the performance of its asset against its industries top performers. Manderstam holds a global data- base of cost and operating performance indices for all process equipment that has been maintained and compiled from over 200 process plants in the last 15 years.

Peter Lumley

Eur. Ing. B.Sc., C.Eng., I.Mech.E., A.S.A.B.E. Expert Engineer in Process and Industrial Engineering in the fields of Oil and Gas, Petrochemicals, Pharmaceuticals and Manufacturing. Manderstam's expert engineers are involved in some of the largest civil litigation cases in the UK:Our experts have prepared expert reports and advised strategy and given evidence in extremely complex cases on behalf of both independent UK and multinational companies. Manderstam acted as expert witnesses in the largest civil litigation case in the UK, providing expert evidence in oil storage design and construction following the explosion at the Buncefield¹ oil storage depot in December 2005.

Aftermath of Buncefield explosion 11th December 2005

Our reports permit top management immediately (in 30 seconds!) to ascertain its asset performance against its industry's top performers that enable identification of the "low hanging fruit", for process operating and maintenance improvements. Our methodology of using normalisation using equipment complexity factors enables different types and sizes of process plant to be normalised and compared directly. Our benchmarking methodology can be used to estimate operating and maintenance costs, not only of existing plants, but of projected plants in order to accurately model the sensitivity of future operational costs and manpower. This approach was used by BP in the Azerbaijan offshore fields prior to commitment of project costs. Our methodology was used by British Gas in the Morecambe Bay offshore fields for an assessment of their operating costs and man- ning levels as part of an independent assessment for discussion with the unions. A further use of our benchmarking methodology was the estimating of a client's suppliers operating and maintenance costs in a dispute over supplier pricing.

We have been instructed by most of the leading international and domestic law firms. We have received over 60 instructions by the leading UK and international law firms and given oral evidence 24 times in the UK High Court and International Arbitration.

Engineering Clinic Manderstam has a wealth of market and technical information which is not readily accessible from the public domain. Such data, allied to our talented forensic style analysis and approach to problem-solving, has enabled us to offer an "engineering clinic" service. Much as when the individual has a medical problem, they visit the doctors- here we are offering a service when a company has an engineering problem it visits the experts to seek a solution.

Manderstam will answer questions on market and technical matters, within 48 hours. Manderstam International Group Email: plumley@manderstam.com Tel: 0207 730 9224 MIGL@manderstam.com Web site: www.manderstam.com

MANDERSTAM INTERNATIONAL GROUP

Independent Asbestos Expert Witness & Opinion CONSULTING ENGINEERS IN PROCESS AND INDUSTRIAL ENGINEERING

PRINCIPALS:

• • • • • • • •

Eur.Ing.P.D.Lumley, B.S.c, C., Eng.,I. Mech.E. Dr.J.A.Rakestraw, B.sc.,ARCS,phD, Dic

EXPERT WITNESSES FOR:

Mechanical and Process Engineering Manufacturing Industries Oil and Gas Industries Petrochemicals and Chemicals Pharmaceuticals Fertilizers and Pesticides Metallurgic Industries Safety and Environmental

10 Greycoat Place Westminster, London SW1P 1SB T: 020 7730 9224 F: 020 7823 3058 E: plumley@manderstam.com

WWW.manderstam.com

Individual Member 2012-2018

With over 20 years direct asbestos industry experience, Matthew offers expert witness and opinion on Asbestos exposure, regulatory compliance, remediation and management. •

Exposure

•

Survey/Analytical quality and practice

•

Remedial disputes and standards

•

Compliance

•

Testing

Holder of the Cardiff University Law School & Bond Solon (CUBS) civil expert certificate

www.principis.co.uk matt@principis.co.uk

ADJUDICATION Asbestos expert witness/opinion Overview

Challenge

A £362 million demolition and construction project, suffered significant unexpected costs and project delays due to several asbestos discoveries, for which the contractor sought compensation events. Appointed following the completion of all asbestos abatement and remediation works to those affected areas.

Working within a large team incorporating 3 experts from different fields, required specific and timely communication to achieve both aims and deadlines. Instruction was received following the completion of all surveys and asbestos remediation, with areas having been demolished and excavated. The quantity of reports and information relating to the works particularly records of instruction and communications between parties was extensive. Conflicting information between contractors and the client, meant that thorough reviews of all information and the creation of an exact timeline relating to the matter was necessary.

Project Summary Instructed by the client and their appointed solicitors to provide expert opinion as part of an adjudication process under NEC 3 contract. Expert opinion was sought on the inspections standards of the appointed consultant and the subsequent actions of the main and principal contractors in their addressing asbestos related discoveries. Specifically, an assessment of costs relating to removal and reasonableness of costs against works undertaken.

Sector Commercial/construction.

Location Undisclosed – UK

ADJUDICATION Asbestos expert opinion/witness Approach

As with all expert opinion works undertaken by Matthew, his approach is always to remainChallenge independent and Overview report all matters to the client irrelevant of instructing A £362 million demolition and within a large team incorporating 3 experts from different party. project, The starting point was theWorking formulation of a and timely communication to achieve both aims construction suffered fields, required specific significant unexpected costs and timeline to determine site activities and dates, thisInstruction was and deadlines. was received following the completion of all project achieved delays due to several surveysofand asbestos remediation, with areas having been demolished through the thorough review 4 months asbestos discoveries, for which the and excavated. The quantity of reports and information relating to the individual captured on time-lapse camera. The contractor soughtimages compensation works particularly records of instruction and communications between events. use Appointed following the parties extensive. Conflicting information between contractors and of the visual aids helped determinewas appropriate completion of all asbestos the client, meant that thorough reviews of all information and the opinions and observations working practices abatement and remediation works relating to creation of an exact timeline relating to the matter was necessary. to thoseand affected areas. dates and times. Alongside this review evidence Approach identifying all relevant correspondence and instructions Project Summary relating to all survey and remediation to ensure As works, with all expert opinion works undertaken by Matthew, his approach is always to independent and report all matters to the client suitable could surveys Instructed by theopinions client and theirbe made against initialremain irrelevant of instructing party. starting point was the formulation of • TheExposure appointed solicitors to provide and further instructed reports or remedial exercises. a timeline to determine site activities and dates, this was achieved expert opinion as part of an The interpretation of site works completed through review of 4 months individual images captured on through the thorough adjudication process under NEC 3 time-lapse camera.on The •use ofSurvey/Analytical the visual aids helped determine quality & practice contract. Expert opinion review of reports andwas methods helped form opinion appropriate opinions and observations relating to working practices and sought on the inspections standards competencies of individuals carrying out site surveys, evidence dates and times. Alongside this review identifying all relevant of the appointed consultant and the correspondence and instructions relating to alldisputes survey and&remediation remedial other • Remedial standards subsequent actionsworks of the or main and investigations in the absence works, to ensure suitable opinions could be made against initial surveys principal contractors in their of any training records being provided. Such reviews and further instructed reports or remedial exercises. The interpretation addressing asbestos related helped Specifically, provide opinions against ofHealth & completed Safety through site works review of reports and methods helped discoveries. an • Compliance form opinion on competencies of individuals carrying out site surveys, assessment of costs relating to Executive (HSE) Regulations, Approved Codes of remedial works or other investigations in the absence of any training removal and reasonableness of Practice (ACOP) and guidance relating asbestos records to being provided. Such helped provide opinions against costs against works undertaken. • reviews Testing Health & Safety Executive (HSE) Regulations, Approved Codes of Practice also accreditations to relevant standards and affiliations (ACOP) and guidance with associated trade bodies and their considered goodrelating to asbestos also accreditations to relevant Sector standards and affiliations with associated trade bodies and their practice. Appraisal of reasonableness of costsgood and time considered practice. Commercial/construction. Holder of the Cardiff University Law was undertaken with programme and contract experts Appraisal of reasonableness of costs and time was undertaken with School & Bond Solon CUBS) appointed by the client, whereby suitable opinions programme andwere contract experts appointed by the client, (whereby Location suitable opinions were provided based on all information. provided based on all information. civil expert certificate.

Expert witness & opinion on:

Undisclosed – UK

Project Outcome

Report provided as part of adjudication and adjudicator found in favour of the client, the contractor submitted programme related delays and costs were significantly reduced.

E:matt@principis.co.uk W:www.principis.co.uk

Professor Palmer has acted as an Expert Witness on behalf of the Crown in the public inquiry into the disaster on the Piper Alpha platform, in subsequent litigation in the Court of Session, Edinburgh; on behalf of British Columbia Hydro and Power Authority in hearings on the proposed submarine pipeline to Vancouver Island before the Public Utilities Commission of British Columbia in 1983-84; on behalf of the Metropolitan Borough of Wallasey in the planning enquiries into the proposed Bromborough Dock North Reclamation Area development and the proposed pipeline to Point of Ayr; in litigation and arbitration in England, Scotland, Switzerland and France.

When it comes to providing a highly professional EXPERT WITNESS SERVICE Professor Andrew Palmer has all the necessary credentials achieved in his academic training combined with the wealth of practical experience on which he is able to draw. Following a solid academic groundng at Royal Liberty School, Romford, Essex, England, Andrew Palmer gained a BA Degree in Mechanical Sciences from Cambridge University, England; before achieving his palmer Ph.D. at Brown University, Providence RI, USA and a DSc (honorary) Degree from Clarkson University in 2007. He was Jafar Research Professor of Petroleum Engineering at Cambridge University from 1995 to 2006, and after he retired from Cambridge a Professor at the National University of Singapore from 2006-2015, when he retired from the post; Jafar Research Professor of Petroleum Engineering, Cambridge University from 1995-2005; a Fellow of Churchill College, Cambridge from 1967 to present day and visiting Professor at Harvard University from 2002-2003. A member of the management committee, Professor Palmer took an active part in the planning and startup of an Institute for research into petroleum, made possible by a £20 million benefaction from BP and engaging the Departments of Earth Sciences, Applied Mathematics, Engineering, Chemical Engineering and Chemistry. He has been a member of the Faculty Board and the Degree Committee of the Department of Engineering of Cambridge University, a member of the Chemical Engineering Syndicate, a member of the Advisory Committee of the Scott Polar Research Institute, and a Director of the Møller Centre at Churchill College. He is also a Trustee of American University Sharjah Professor Palmer remains much involved in the offshore petroleum industry, and has been engaged to advise on projects in Alaska, the Gulf of Mexico, the Timor Sea, West Africa, Sakhalin, the northern Caspian Sea, Australia and the North Sea. He is also in demand as an Expert Witness and an Arbitrator.

PROFESSOR ANDREW PALMER - BA., Ph.D, DSc CONSULTANT ENGINEER & EXPERT WITNESS Prof Palmer holds Membership/Fellowships to a number of leading Societies including • • • • • •

Fellow of the Royal Society Fellow of the Royal Academy of Engineering; Fellow of the Institution of Civil Engineers; Chartered Engineer; Member of the Society of Petroleum Engineers; Member of the UK Register of Expert Witnesses

In a recent interview Professor Palmer explained the importance of an Expert Witness having a good allround knowledge of his specialist subject: “I think it is quite important for an Expert Witness to have a sound academic knowledge-base combined with a high level of practical experience in order to provide a professional service as an Expert Witness. A lawyer does not necessarily know what a Fellow of the Royal Society really is, and he certainly is unlikely to know how bad some fellows would be as witnesses, but all the same the qualification is sought after and would impress the Court. Similarly, previous experience as a witness is relevant, because a lawyer can find out through the grapevine if he breaks up unquestioning, if he strays outside his expertise, if he makes wild statements, and so on.”

“When acting as an Expert Witness in the UK I used to attend Court three or four times a year, for adjudications, public enquiries and acting as an adjudicator. I have had fewer instructions since I came to Singapore, in part because it is a long way from the UK where I am best known, in part because judges have been promoting the idea that in civil cases the parties should seek to reach a solution by mediation, an idea I strongly support.” When asked if he felt it was important to instruct an Expert Witness at the beginning of an investigation/ legal case, as opposed to asking for an opinion at a later stage of the proceedings Prof Palmer told us: “I think it valuable to involve an Expert Witness at an early stage, but always provided that that can be done without compromising the position of the Witness as someone whose responsibility is to the Court, rather than as a partisan.” Prof Palmer is fluent in many languages to various degrees including French, Dutch, German (fluent speaking and reading, slow written); Italian, Spanish, Russian (slow speaking, reading and writing); Chinese (elementary speaking, reading and writing). The named inventor on four patents, Prof Palmer has written five books on structural mechanics, subsea pipelines, petroleum and dimensional analysis, and more than 270 scientific papers and technical articles on plasticity, soil mechanics, structures, pipelines, risk and reliability, ice and permafrost.

Below Prof Palmer outlined some cases where he had acted as an Expert Witness: “The first is public knowledge and there is no confidentiality issue. In some of the other cases, the parties would not wish the whole matter to be publicised again, and I have had to be discrete.

1. After the Piper Alpha offshore platform disaster, there was a public enquiry and later a long case in The Court of Session in Edinburgh. I gave evidence in both. In the Court of Session, I was principally concerned with the breakdown of the firewall between modules B and C after the first explosion in module B, and how the fragments of the wall struck and damaged the condensate pipeline in module C. 2. An international consulting company had offices in several countries. The senior managers in the US office walked out and set up their own company. 3. Two underwater pipelines laid by one contractor A had to be connected by a short L-shaped length of pipe (‘spoolpiece’ in the industry jargon). The spoolpiece was to be fabricated and installed by a second contractor B. When it came to be time to fit the spoolpiece , it would not fit the gap. A said that B had not measured correctly. B said that the pipe ends had moved after the gap had been measured. 4. In the Channel Tunnel, short sections of two pipelines fell off their supports while they were being tested. Eleven companies were involved in different ways. I was instructed by one of them, and explained why it had happened, but it did not go to Court because a settlement was reached.

Prof. Andrew Palmer 200 Pasir Panjang Road #02-15, Pasir Park View, Singapore 118571 Tel: +65 6639 9803; +65 9836 1848 (mobile) Email: andrewpalmer241@gmail.com

Chartered Architect, Arbitrator & Expert Witness Aston House Queensway Court Queensway Hemel Hempstead Hertfordshire HP1 1LS T: 01442 261163 E: info@mevans1.co.uk W:www.mevans1.co.uk

Evans & Co. Ltd. was established in 1999. The two directors Michael Evans Dip.Bs MRICS MCIOB and Richard Hodgson BSc (Hons) MRICS MCIOB each have extensive commercial experience built up over thirty years.

Expert Witness Services We can provide advice in relation to all aspects of building disputes within our professional competence and in particular in respect of dilapidations, building defects, party walls, boundary disputes and service charge works.

www.williambates.co.uk William Bates

BSc (Hons), Dip.Arch., RIBA, ACIArb Independant Architect with RIBA Chartered Practice status and Member of The Chartered Institute of Arbitrators, with extensive Expert Witness experience, both as a party Expert and as a Single Joint Expert, in the following areas: Architect Professional Negligence and Fee Disputes. Architect / Client /Builder Disputes Party Wall Disputes / Town Planning disputes Building Defects arising from New Build, Conversions, Refurbishments, Alterations and Extensions, particularly in the Domestic Sector. Proficient in the analysis of evidence and the preperation of Reports. Public Inquiry and High Court experience. Registered with the UK Register of Expert Witness. Waterlow Legal, X-Pro and Expert Witness.’Member of the Society of Expert Witnesses’ and ‘Listed on the RIBA panel of Expert Witnesses’.

UK wide coverage

M:07734 471400 T:01435 812973 E:will@williambates.co.uk Oaklands, High Street, Horam, Heathfield, East Sussex TN21 0EJ

Mr. David Rusholme Chestertons Expert Property Consultant

Property disputes can arise from all manner of scenarios. Case can involve residential and commercial properties; building land for redevelopment, buildings used for leisure purpose, new builds and mortgages. Located in London's prestigious Mayfair, Chestertons is a renowned property consultancy, and provides highly regarded expert witness services. Chestertons' David Rusholme qualified as a Chartered Surveyor in 1987 and has acted on many expert witness cases, and was involved with the famous SAMCO case in early 1990’s – a landmark case which limits the total liability to surveyors on claims. He has also acted on many cases involving various property types from commercial to residential property and these have included some of most prestigious addresses in central London. In his professional career, David held the position of Head of Valuation at RICS where he was responsible for overseeing valuation standards in UK and linking in to International Valuation Standards (IVS). As an expert witness, David has acted on the behalf of many unusual properties such as theme parks, car parks and top hotels. A very experienced valuer and property professional, David Rusholme has been FRICS qualified since 1998. and today, he is Head of Professional Services at Chestertons – a firm which deals with a wide range of property situations. Mr. Rusholme is a well known and highly respected expert witness having appeared in Court both in England and Scotland. He has also attended several high profile mediations. David has attended court many times in civil claims, matrimonial matters and even criminal cases and has acted as a Single and Joint expert in the family Court. His specialist areas include fraud and professional negligence claims.

The expert witness services of Chestertons and in particular, David Rusholme take a no-nonsense approach on giving an unbiased and honest opinion. The company's impartial advice is provided whilst tapping into a wealth of practical experience which exists in the firm as a whole. “Instructing an expert who is truly independent can save much time and money,” David explained. “I believe the opinion given at the outset must stand the same level of scrutiny as the court process itself.” As an FRICS qualified Chartered Surveyor as well as a member of The Expert Witness Institute, throughout his career in property consulting, David Rusholme has accepted instructions on a range of cases as an expert witness. Examples include:

• A case where a surveyor was accused of over valuing a property by more than £10m. By looking at the contemporary evidence and stating what the valuation practice was at the valuation date, David's evidence led to a very successful mediated outcome. • Parties to a divorce needed guidance on a whole portfolio of property across the UK. David acted as single joint expert and guided both sides through their questions and concerns - resulting again in a successful outcome outside court. • David acted on behalf of the owners of a prominent house in one of the best areas of Mayfair to demonstrate it was not being sold at an under value. The whole process was concluded within 5 days at Court from start to finish. • An expert was needed to prove fraud in the sale of 10 properties in the UK and David provided advise involving 5 days in the witness box which assisted in a successful prosecution.

David comments that there “are a number of common areas where solicitors and other professionals seek expert valuation advice.” His top ten expert property areas are: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Disputes over professional negligence such as potential over valuation of property. Potential mistakes by solicitors in conveyancing or drafting leases. Disputes over land development agreements. Matrimonial disputes where the parties need a single or joint property expert. Advise for tax calculations regarding land and property values, such as CGT where valuations dating back all the way to 1982 are sometimes needed. Surveyor representation for rent reviews or lease renewals Expert appointments for surveyors or valuers under leases or land contracts Probate valuations which need to be professionally prepared to avoid challenge by the tax authorities Dispute arising from litigation, administration or receivership of property assets The need to value property involved in fraud cases.

For further information, please contact David Rusholme at Chestertons Property Consultants

Tel: 020 3040 8250, email: david.rusholme@chestertons.com or visit the firm's website at www.chestertons.com

Vincent Theobald-Vega Health and Safety Consultant and Expert Witness

Safety 4 HEd Bespoke as Standard

Charges from the HSE

Multi Award Winning Since 2015 Vincent and Safety 4 HEd have been winning awards for the breadth and quality of his work. This is supported by the satisfaction of Safety 4 HEd's clients and the vetted status on the UK Register of Expert Witnesses. A full list of awards is available on the website, including the Lawyer Monthly Expert Witness Award, which they have also won this year 2018!

Any change? This is what 2 hours of HSE time look like.

Services •

General Consultancy

•

Investigations

•

Audit and Inspection

•

Fire Risk Assessment

•

Training

•

Second Opinion

Vincent Theobald-Vega

Health and Safety Consultant and Expert Witness

Qualifications and Memberships FIIRSM

Fellow of the International Institute of Risk and Safety Management.

FRSPH

Fellow of the Royal Society for Public Health

CMIOSH

Chartered Member of the Institution of Occupational Safety and Health

MISTR

Member of the Institute for Safety in Technology and Research

EurOSHM

European Occupational Safety and Health Manager Member of the Health and Safety Lawyers Association Honorary member of The Federation Of Forensic And Expert Witnesses

Micro CV 1989 – HSE as HM Inspector of Health and Safety Undertook numerous prosecutions (including defended cases) on various areas such as construction, asbestos and dangerous machinery. 1999 – moved to Newcastle University 2002 – Head of Safety for Newcastle University Renewed the health and safety culture, reducing accident rates despite increases in students, staff and complexity of work undertaken. Additional skills developed in fire safety, biological and chemical issues. Included work with genetically modified organisms and high hazard pathogens. 2012 – Freelance consultancy as Safety 4 HEd. Clients large and small including Universities, technical companies, international organisations, other consultancies, and charities. From 2014 started undertaking expert witness services, including Civil and Criminal cases. Crown Court witness work undertaken in 2017.

Experienced with difficult working situations

Having worked with most things from Asbestos exposures to electrical explosions, Vincent is ideally placed to help you with difficult cases. Vincent is also an experienced lecturer and qualified teacher, used to explaining things in straightforward ways and pitching to people of all walks of life and backgrounds. Use the website at www.safety4hed.co.uk to find out more about us – or contact Vincent directly by email at vincent@safety4hed.co.uk or telephone on 07940 564889. We are physically located just outside Newcastle-upon-Tyne but undertake work nationally.

T:07940 564889 E:vincent@safety4hed.co.uk W:www.safety4hed.co.uk

The experts at FCIR are experienced in writing expert reports and producing exhibits for all Courts. They are conversant with Civil and Criminal Procedure Rules and routinely provide live evidence in Court. FCIR are often instructed in cases of Causing Death by Dangerous Driving, Murders, Causing Serious Injury by Dangerous Driving and the Careless Driving counterparts. They are also regularly instructed in multi million pound litigations and are routinely praised for the level of detail included in their analyses. FCIR use the latest specialist equipment in their analysis, from Control Module downloads from vehicles to 3D Laser scanning of a collision locus. When it has to be right, FCIR are the team to deliver. FCIR are specialists in the analysis of road traffic collisions and the investigation of incidents involving road users of all types. They offer expert witness services in both civil and criminal cases, covering the following areas:  Full In-depth Analysis

 Vehicle Examinations

 Plans/Scale Drawings

 Reconstruction Reports

 Scene Photographs/Videos

 Incident Data Recorder/CDR Analysis

 Verification of Expert Reports

 CCTV Analysis

 3D Laser Scanning / Simulation

The science of reconstructing a Road Traffic Collision Instructing an Expert is sometimes a tricky choice. How do you know who to trust with a high value catastrophic loss case or a Death by Dangerous Driving matter, after all standing on the steps of the Court would be a bad time to find out you have chosen poorly! I am sure that we have all heard of (or have personal experience of) constructing a case around a certain set of parameters only to find that the Expert has had to concede a number of critical points upon which your case hinged. Why is that so common, and what can you do about it?

But, what if you didn’t have to choose and could actually have both? There is a huge strength in an Expert who has, not only been at the scene of countless road traffic collisions and been responsible for the collection of the evidence, but also written the academic papers that support the advancements of knowledge in the field. That is exactly what FCIR pride themselves upon! We have those Experts that can demonstrate that not only have they ‘seen that happen in real life’, they have also published the academic material that is now being taught to Collision Investigators in the field. This is what sets FCIR apart. But it doesn’t stop there, with the advancement in vehicle-based technology marching on at a rate faster than ever, the role of a Collision Investigator is moving away from the conventional measurement of skid marks, to interrogating vehicle airbag modules. Measuring the locus of a collision is less about the use of a tape measure and more about state of the art 3D laser scanning. Demonstrating complex collisions to a Court is less about explaining with toy cars and diagrams and more about 3D animations. CCTV has advanced leaps-and-bounds from the simple, ‘say what you see’ approach, to the forensic analysis down to the millisecond – FCIR have specialist equipment to allow for such and analysis – indeed they we were instrumental in the development of the Home Office equipment used by the Police. When establishing if a motorcycle headlamp was illuminated, why instruct an Expert who would use an optical microscope only, when a Scanning Electron Microscope (SEM) allows you to scientifically analysis the fracture face of a bulb filament? Again, FCIR possess this skill set. These are the types of questions that should be asked when instructing an Expert, to see if they are remaining current and extracting the full amount of information for you – or if this is the Expert you will be meeting on the ‘other side’!

Choosing the right Expert is essential, with significant consequences if the choice is the wrong one. Ensuring that justice is done and that the Claimants and Defendants situations are accurately put is the keystone of FCIR’s principles. It is to this end that we offer a free of charge initial review into any matters that our clients may have so that everyone is in a clear position from the beginning.

Graham Oakley MIMI Great Britain has one of the best road safety records in Europe and the world. Despite a huge rise in traffic over the last few decades, the number of people killed on our roads has fallen from around 5,500 per year in the mid 1980s to well under 2,000 in 2011. However, the number of deaths rose in 2011, from 1,850 the previous year to 1,901. This means that five people die on Britain's roads every day. In the aftermath of a Road Traffic collision, it is vital for those in the Legal profession to seek the services of a professional Expert Witness who has the knowledge and expertise required to prepare high-quality written evidence and reports providing independent, constructive opinions relating to the incident. Court proceedings are highly expensive and time consuming so it is essential that an Expert Witness is able to handle the court process with confidence and competence. That's exactly what you can expect to receive from collision investigation consultant Graham Oakley MIMI who has built-up an impressive reputation within the legal industry for his expertise as an Expert Witness in the field of accident investigation and presentation of evidence at all levels of court proceedings. In 1983 Graham became a founder member of a Police Forensic Collision Investigation Unit, a post he held until retirement: "During my Police career I attended many courses on advanced driving, collision investigation, motor vehicle examination, traffic law and technology related to motor vehicles."

In addition to becoming a Police first class advanced driver, he also passed both passenger service vehicle (PSV) and heavy goods vehicle (HGV) driving tests.

Graham is able to draw on his vast experience having attended more than 1,000 accident scenes during his 30 year Police career, as he explained in a recent interview:

For many years he assisted the Ford Motor Company with testing and development of preproduction road vehicles and received training for both racetrack and off road driving."

"twenty three years of my police service were in road policing, the last 15 years exclusively involved in the attendance, investigation and reporting of serious and fatal road collisions throughout the county of Essex. These incidents ranged from minor non-injury collisions to multi vehicle fatal motorway crashes, often necessitating presentation of expert witness evidence at all levels of judicial proceedings from Magistrates' Court, Coroners Court, Crown Court, County Court, through to the High Court and the Central Criminal Court.

Graham has carried out investigations on behalf of the Police Federation of England and Wales, HM customs & Excise, Border Force, the AA and the RAC: "I have also acted as a Consultant Adviser to a television company, film company and major tour operator, and have made presentations to government ministers in Russia, Azerbaijan, Kazakhstan and Ukraine on the subject of collision investigation."

This unique background has provided me with a sound knowledge of the subject and the confidence to handle in a totally professional manner all aspects of road traffic incidents".

On retiring from the police, Graham set-up his own forensic collision consultancy appropriately named Crash Detectives Ltd from which he offers a wide range of professional services to the legal and insurance industries throughout the UK and in Europe including: •Evaluation of all documentary evidence •Evaluation of police statements and reports •Evaluation of cctv and dashcam recordings Investigation and scientific reconstruction of collisions •Interviewing witnesses •Collision scene photography and plans •Video recordings including in-car scene drive-through. •Mechanical inspections of all types of vehicles

Legal aid and single joint expert instructions undertaken Graham has for several years been included in directories of UK Register of Expert Witnesses, Society of Expert Witnesses, Association of Personal Injury Lawyers and is now pleased to be associated with Forensic and Expert Witness.

To view some of the many case studies on projects Graham has successfully completed visit website: www.crashdetectives.co.uk To learn more contact: E:enquiries@crashdetectives.co.uk Graham Oakley email: enquiries@crashdetectives.co.uk T: 01245 323246 Tel: 01245 323246 M: 07768 792341 Mobile: 07768 792341 W:www.crashdetectives.co.uk Web:www.crashdetectives.co.uk * Statistics provided by RoSPA

D & HB Associates Experts in Road Traffic Offences • • • • • • • •

Accident Investigation and Reconstruction, both Criminal and Civil Offences from Speeding to Causing Death by Dangerous Driving and Death by Careless Driving Tachograph Analysis Vehicle and Component Examination Stolen Vehicle Examination and Identification Locus Reports, Scale Plans and Photographs Statement Taking Tyre Technology* Federation of Forensic & Expert witnesses * We are affiliated to New Law Associates Ltd (tyre specialists)

D&HB Associates Ltd are a team of 5 former highly trained Police Officers who between us served for a total of over 100 years on the Police Traffic Division. Our consultants are recognised ‘Experts’ in the field of Accident Reconstruction being members of various organisations including the Institute of Traffic Accident Investigators and the Expert Witness Institute. Having now retired, we specialise in preparing reports for the Court in all Criminal Cases from Speeding through to the most serious offence of Causing Death by Dangerous Driving and the new offence of Causing Death by Careless Driving. We also prepare reports in Civil Cases for Solicitors and Insurance Companies, being fully conversant with our duties under the Civil Procedure Rules. We work for both Claimant and Defendant and as a Single Joint Expert. As a team, we not only specialise in accidents, but all incidents where a driver has been charged with motoring offences. Our expertise covers all motor vehicles, cars, motorcycles, goods vehicles and buses, all our consultants not only holding licences to drive all vehicles, but they are also ‘Police Advanced Drivers’ trained to the highest possible level. Whilst preparing reports for accidents which involve all types of vehicles, in particular we specialise in motorcycle accidents and accidents involving emergency response vehicles, police, fire and ambulance. We also examine all stolen/suspect stolen motor vehicles as to their true identity. If you want an ‘Expert’ to provide a report, be it for criminal or civil proceedings look no further. D&HB Associates will provide you with a report which will be honest and true. We will point out the bad points as well as the good! As a company we provide reports in well over 200 cases per year. We have no limits as to where we travel. Not only do we work throughout the UK and Ireland, but also most of Europe, the Caribbean and the Far East. Should you require and further information, please do not hesitate to contact us. We do not charge for an initial consultation. References from solicitors and barristers can be sent on request.

T: 01538 722544 | M: 07973 289162 | E:info@dandhb.com | W:www.dandhb.com