Forensic &
EXPERT WITNESS
SPRING 2020
How We Can Help You With
PERSONAL INJURY
INSIDE THIS ISSUE
THE WORLD’S NO1 SURGICAL COACH
Rodney Peyton OBE
Personal Injury | Medical Negligence | Expert Interviews
Our goal is to assist clients advisors and the Courts to bet the unique aspects of medica individual cases, so that they informed decisio
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
s, their legal tter understand al evidence in can make more ons.
Alternative Medical Treatments Many lay people purport to have the ‘gift of healing’ and often appeal to a gullible population who are looking for a ‘quick fix’. At the end of the day, some of these therapies work – in which case they are medicinal, or they do not, and sometimes cause considerable harm. What happens when a patient is harmed by such therapy? The case involves a ‘cryotherapist’ who, as a treatment for chronic foot pain, utilised liquid nitrogen mist. After the third such therapy to a foot, spread out over several weeks, the foot became itchy, tender and a punctate rash appeared. The rash started to peel, and the patient was unable to wear any shoes because she could not stand pressure in the area. It took three months for the skin to settle down and the patient was left with some permanent discolouration of the skin in the area which had been subjected to the treatment. The patient had signed a form indicating her own past medical history but was never given any information about the treatment itself, apart from being told it was an excellent method of managing chronic pain. When such a patient has been treated by a member of a professional body and difficulties occur, there is redress. For instance, in a case where a patient was burned during a course of heat treatment administrated by a physiotherapist, even though this was carried out in a manner approved by the Chartered Society of Physiotherapists, the court found that warnings alone were an inadequate safe guard for the patient.
What happens when someone is not a member of a professional body, claims to be a ‘healer’ but is of no professional standing. Against what standard are they to be judged? The duty of care in this scenario goes right back to the initial Stevenson case with a duty of care towards your neighbour, not to make promises or indulge in any practice which is liable to bring your neighbour to harm. This case opens up wider questions about unregulated ‘therapies’ particularly when the promises made may stop a patient seeking proper medical management of a condition which may be otherwise amenable to therapy. MDU figures for 2017 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.
For fast and effective screening of all potential medical negligence cases contact Peyton Medico Legal Services now on 028 87724177 or email rpeyton@rpeyton.com
Q&A
With Richard Scott Watson Director of RSW medico Legal Ltd How did you become an expert witness?
In 1990 I took on a long term locum Consultant post and it just started from there. It started gradually with the ore simple minor injuries and just built up over the years.
What has been your most challenging expert witness case?
There was one murder trial, which taxed everyone involved. As far as personal injury is concerned, a five day trial with a litigant in person proved particularly challenging, but we still won.
I know that you deal with a range of cases, but can you specify a common case that you tend to deal with on a regular basis? There’s a lot of RTAs. It has not reduced, the attempts at fraud have not reduced and the system is creaking under the weight of very low standard initial reports.
What is your average turnaround time for a report?
Quickest – about 3 hours. Average if I have all the notes etc, will be three to five days.
“Is the Expert an Expert Witness?”
expert witness What are your qualifications with in your industry sector and qualifications that support your expert witness work or comment on recent events or conferences you have attended?
This again centres on ‘is the Expert an Expert Witness?’ With the qualification and courses available I would say that anyone who has not at least done regular training cannot call themselves an Expert Witness for cases covered by Part 35. Preferable all should have the Cardiff University Expert Witness Certificate run by Bond Solon.
What makes you the go to expert witness in your specific field? How often would you say your critical analysis is the game changer in a claim?
I wish I knew! One of the problems in this field is lack of feedback. I get about two feedback letters a year.
What do you feel is key to being an effective expert witness? Training, training, training (and practice). There are a lot of exceedingly good experts out there who do fantastic work in the NHS but they are not Expert Witnesses and do not understand the rules (although they sign their reports to say they do).
Has anything changed in the years of you acting as expert witness for clients?
We used to have the Defendant’s hired guns. Lord Woolf came along and made rules to stop all that. Every time I go to Court it is because the Defendants have managed to find a hired gun willing to risk his career to support their case (they can be referred to the GMC for breaking the Part 35 rules). Little has changed, largely because the Courts will not enforce when faced with these non-Experts.
I stick to the rules, so everybody knows where I am coming from. I am willing to change my opinion if new evidence says I should, but will not do so purely under pressure without that evidence.
Is there any aspect of expert witness that you feel would surprise someone who was considering adding this to their CV? Solicitors constantly (like about twice a week) ask for reports to be made more favourable (valuable) for their clients. They know they should not do so, and that we should not agree to such requests, especially since LVI vs Khan has shown Experts the danger of altering reports without evidence, although it was an absolute rule prior to that anyway.
To instruct RSW directly please contact: 01384 441 126 carolcouzens@ymail.com rswmedicolegal@gmail.com
RSW Medico Legal Ltd
Dr Oliver Segal MBBS MD FRCP(London) FHRS
Consultant Cardiologist Dr Oliver Segal is a Consultant Cardiologist who specialises in electrophysiology –
The study of heart rhythm disorders. Dr Segal has nearly 20 years’ experience in the management of arrhythmias, performing catheter ablation and implanting pacemakers, defribrillators and other cardiac devices. He is based at The Harley Street Clinic and Diagnostic Centre and St. Bartholomew's & University College Hospitals in London.
Over the past five years Dr Segal has written expert witness reports for clinical negligence cases pertaining to many different aspects of cardiac electrophysiology and devices. He attended and then taught at the ‘Keeping Clinicians out of Court’ medico-legal course at Northwick Park Hospital for several years.
Dr Oliver Segal Consultant Cardiologist MBBS MD FRCP(London) FHRS Harley St Clinical Diagnostic Centre | 16 Devonshire Street | London | W1G 7AE 020 7034 8278 | Email: Email
Luke Meleagros BSc, MBBS, MD, FRCS
Consultant Surgeon & Medical Negligence Expert Witness What has been your most challenging expert witness case? A case in the High Court several years ago. The case lasted all week, from Monday morning to Friday afternoon. I was in the witness box for a full day on the first day and for the morning of the second day. I was not allowed to communicate with anybody involved in the case overnight between the first and second day of giving my evidence. The case was a complex one, regarding the Claimant’s care following bowel cancer surgery and postoperative complications. I was acting as expert witness for the Defendant. I was last to give evidence, after the Claimant, the two Defendant surgeons and the expert for the Claimant. There were many issues discussed at trial, including detailed reviews of the clinical records, of the CT scan and x-ray images and the oral evidence of the Claimant and the surgeons. Moreover there was a detailed scrutiny of a large body of scientific literature and arguments on the interpretation of the literature by the experts, the two Counsels and the Judge. The two experts failed to agree a joint statement prior to the trial and the final statement filed with the Court remained unsigned. The Claimant expert produced new evidence when he was in the witness box, including new opinions on the facts of the case and also new scientific articles not previously disclosed to the Defence. From the start of the trial I felt that my expert views were fundamentally challenged by the Claimant’s Counsel and did not appear sufficiently persuasive to the Judge.
I presented a comprehensive and detailed account of my views and my interpretation of the scientific literature. However at the conclusion of the trail the Court found in favour of the Claimant and the Defence lost the case. To date I have given evidence in Court as expert witness in 10 cases. This is the only case that the party for which I acted as expert witness has lost.
I know that you deal with a range of cases, but can you specify a common case that you tend to deal with on a regular basis?. Acute appendicitis is a very common clinical condition. It may be assumed that the presentation, diagnosis and treatment of acute appendicitis are standard and straight forward. However there are many pitfalls in the diagnosis and the surgical or nonsurgical treatment of acute appendicitis. I have dealt with many cases of missed or delayed diagnosis of acute appendicitis, cases of misdiagnosis of acute appendicitis as other conditions or misdiagnosis of other acute abdominal conditions as acute appendicitis and cases of inadequate/substandard surgery. Potential breaches of duty in acute appendicitis can lead to delays in surgical treatment (appendicectomy), they can cause a more serious or complicated disease, they can result in inappropriate/unnecessary surgery or the need for additional surgery and they can cause increased risks of long-term health issues and potential health problems.
What is your average turnaround time for a report?
It depends on the complexity of the case. Some reports, with limited records to be reviewed and issues that are straight forward do not take long to prepare. With such reports, perusal of records, review of any relevant literature and consideration of the matters to be included and discussed in the report is not a challenging or lengthy process. My turnaround time for these reports can be only a few days from receipt of instructions. However there are other cases which are complex, with extensive records that take several hours, sometimes days to review fully. Sometimes an extensive review of the scientific literature is necessary. And it is necessary to consider and ponder/weigh up the relevant matters first before undertaking preparation of the report. My turnaround time for these reports can be a few weeks from receipt of instructions. In addition to the level of complexity of the case, my turnaround time is also dependent on how many reports are pending at any one time. Given that I receive several new instructions every month, as well as requests to review new documents and prepare responses in cases that I have already reported on, sometimes the turnaround time can be as long as 8 weeks.
How often would you say your critical analysis the game changer in a claim?
This is a difficult question to answer, mainly because I do not have feedback from solicitors to indicate what if any weight my critical analysis carried in settling any particular case. I know that the opinions expressed in my reports are set out, usually verbatim, in solicitors’ Letters/Particulars of Claim or Letters of response/Defence. Of course my opinions are, almost as a rule, challenged by the other party, as would normally be expected in litigation. I do not know how often my expert reports or other contributions can be considered as a game changer. However, I know that at least three cases that were due to go to Court the other party discontinued largely based on my critical analysis detailed in documents such as experts’ joint reports prepared shortly before the trial date.
What do you feel is key to being an effective expert witness? Objective and critical analysis of the facts; detailed knowledge of the issues that are fundamental to the case, including a good knowledge and
understanding of the relevant scientific literature; thoughtful consideration of all the relevant matters before starting to prepare the report; a logical sequence of arguments which are consistent and not contradictory to each other set out in the report. And very important is that the expert’s report is presented in a language and manner that renders it fully comprehensible to lay persons, i.e. legal professionals, who may not have any background in the specialist medical issues of a particular case.
Has anything changed in the years of you acting as expert witness for clients?
Obviously the Civil Procedure Rules have changed. The role of the expert witness is very clearly defined. The expert witness can no longer express views or opinions based on narrow personal views or beliefs that cannot be supported by independent evidence such as may be found in scientific literature. I find that expert discussions based on agendas prepared by the parties is much commoner now than it was in the past. There is a tendency by the solicitors and the courts to favour an approach whereby the experts are instructed to discuss the crucial matters in a case. Possibly this practice is intended to assist the solicitors in settling the case. Or possibly the purpose is to narrow the areas of disagreement in order to allow the Court to focus on a narrow range of issues only. However I have found that on most occasions there is only little agreement between the experts.
What are your qualifications with in your industry sector and qualifications that support your expert witness work?
I have the following qualifications: BSc in Biochemistry; MBBS (University of London), which is the basic medical degree awarded after completing training in Medical School; FRCS (England), which is the Diploma of fellow of the Royal College of Surgeon, the postgraduate qualification in Surgery; MD (University of London), which is a doctorate in Medicine obtained after undertaking a period of research followed by preparation of a thesis. Therefore I have medical and surgical qualifications as well as qualifications in scientific research. These qualifications enable me to critically analyse clinical cases within my areas of expertise, namely general abdominal laparoscopic and colorectal surgery, and also review and evaluate scientific research and articles which are relevant in the cases under consideration.
“My clinical experience is a crucial qualification that supports my expert witness work�.
Of course my academic qualifications are significantly supported and enriched by my clinical experience in the fields of surgery over many years as a trainee in surgery and as consultant surgeon. My clinical experience is a crucial qualification that supports my expert witness work.
What makes you the go to expert witness in your specific field? The parties that instruct me are best placed to answer this question. There are a number of excellent experts in the field of general/abdominal surgery and I am not privy to the selection criteria solicitors apply when they select any particular expert. I have been preparing medicolegal expert reports for over 20 years. Some years the total number of reports exceeded 100. I prepare on average 1-2 reports per week. I have given evidence in Court as expert witness on 10 occasions, mostly in the last 5 years. Therefore I have extensive experience in expert witness work and given the number of instructions I receive, at least for some solicitors I am the go to expert in my specific field. I like to think that my work is recognised for the quality of my reports, my expert oral evidence given in Court, the plain language in the reports and the clear explanations provided that enable lay persons to understand and be able to analyse what can sometimes be complex medical issues.
Is there any aspect of expert witness that you feel would surprise someone who was considering adding this to their CV?
Expert witness work is very fulfilling both intellectually and also in terms of improving a doctor’s clinical practice. As a result of my experience as expert witness, I have broadened my knowledge in medicine and surgery greatly over the years. Also I have become much more aware of many very important aspects in patient care and management, including effective communication, detailed counselling regarding benefits and risks of surgical procedures and the importance of presenting choices to patients with relevant information such as to enable them to make an informed decision. I have applied to my clinical practice the important lessons I learned and experience I have gained through my medicolegal practice. Expert witness work has many important benefits. But it is also challenging work that requires many hours of study and preparation in order to achieve the standards required when performing this important role in the legal system.
For further information please contact Dr Meleagros 020 8527 0977 l.meleagros@btinternet.com jawdobson@gmail.com
Prof Muntzer Mughal MB ChB, FRCS, ChM
Consultant Surgeon & Honorary Clinical Professor Professor Mughal has a 30-year experience as a consultant general surgeon. This includes elective and emergency general surgery although he specialises in upper gastrointestinal surgery. This includes the full range of benign conditions such as the treatment of gastro-oesophageal reflux, achalasia and oesophageal strictures, as well as malignant conditions such as oesophagogastric cancer and gastrointestinal stromal tumours. He has particular expertise in the management of complications of upper gastrointestinal surgery such as anastomotic leak, oesophageal perforation and failed antireflux surgery. His surgical expertise includes oesophageal reconstruction and treatment of tracheo-oesophageal fistulae. In his previous roles as Clinical Director and Head of Service, Professor Mughal has considerable experience in the management of serious incidents. He is also on the panel for the Royal College of Surgeons of England invited Review Mechanism and, over the last 14 years, has led on a number of reviews of surgical services in England and Wales. Professor Mughal has a 15-year experience of medicolegal practice. He has attended several courses and is registered with the National Expert Witness Agency. Over the years he has taken instructions on a variety of cases including those relating to cancer of the stomach and oesophagus, surgery for gastro-oesophageal reflux, hiatus hernia and achalasia, oesophageal perforation and chemical injury, complications of oesophagogastric and bariatric surgery, abdominal sepsis, gastrointestinal bleeding and abdominal wall hernias.
Prof Muntzer Mughal MB ChB, FRCS, ChM Consultant Surgeon & Honorary Clinical Professor
Please contact Prof Mughal for further information 07789 695446 | muntzer@btinternet.com | muntzer.mughal@nhs.net
www.muntzermughal.com
Prof Muntzer Mughal
MB ChB, FRCS, ChM Consultant Surgeon & Honorary Clinical Professor
• • • • • • • • • • • • • • • • • • • • • •
Professor Mughals Medical Expertise Includes The Following Conditions:
General Surgery Upper Gi Surgery Abdominal Wall Hernias Hiatus Hernia Gastroesophageal Reflux Achalasia Gastric Cancer Oesophageal Cancer Oesophageal Perforation Boerhaave Syndrome Oesophageal Stricture Caustic Oesophageal Injury. Peptic Ulcer Barrett’s Oesophagus Gallstones Cholecystectomy Bile Leaks Biliary Injury Oesophagectomy Gastrectomy Anastomotic Leak Chyle Leak
Please contact Prof Mughal for further information 07789 695446 | muntzer@btinternet.com | muntzer.mughal@nhs.net
www.muntzermughal.com
Eric Drabble MBBS, MS, MA, FRCS, FRCS(Ed)
Breast, Breast Reconstructive and Oncoplastic Surgeon General and Hernia Surgeon
Specialist in presenting clear explanations of: . How an event or mishap occurred . What has occurred and why . The implications and expected outcomes of mishap or injury I carry out approximately 20+ medico-legal reports per annum. My reports are written in clear terms for the court and instructing lawyers, interpreting and explaining medical language and terms.
T:01752 761850 T: 07533 186772 E: pbgsurg@icloud.com Former Chairman of the Peninsula Breast Cancer Network, South west regional representative of ABS and BASO and chair of PHNT Breast MOT group
Dr Krishnaswamy Madhavan MBBS, MD, FRCR
Consultant Clinical Oncologist Dr Krishnaswamy Madhavan can act as an expert witness, including the preparation of medico-legal reports, in negligence cases involving radiotherapy and chemotherapy.
His Specialist Areas Of Expertise Include: • Tumour Sites • Neuro-Oncology • Gynae-Oncology • Head, Neck And Thyroid Cancers • Skin Cancer & • Diagnostic Pathways. Dr Madhavan can undertake cases on behalf of either claimant or defendant and reports can usually be prepared within 10 working days from receipt of all relevant information.
2020
Federation of ederation of
Expert witnesses sic Forensic & Expert&witnesses
Please Contact Dr Madhavan for more information
01376 564459 01702 435555 07737 695086 sharanyaltd@gmail.com
Southend University Hospital Prittlewell Chase WESTCLIFF-ON-SEA Essex SS0 0RY
Dr Nick Plowman MA, MD, FRCP, FRCR
Is Senior Clinical Oncologist to St Bartholomew's Hospital and The Hospital for Sick Children Great Ormond Street, London. He also undertakes honorary duties at St Mark's Hospital in Harrow, the country's leading specialist hospital for colorectal and intestinal disease, and at Moorfield's Eye Hospital, London. His research ventures have led to changes in best stander care in the treatment of breast and prostate cancer. He wrote his thesis on aspects of lung cancer. Dr Plowman performs circa 70 medico legal reports a year and has 20 years experience in such reports for claimants and defence re: liability and causation in adult and childhood cancer. Dr Plowman graduated from Guy's Hospital Medical School in 1974, having previously gained First Class Honours in both the Medical Sciences Tripos and the Natural Sciences Tripos at Cambridge University. He then completed his thesis at Cambridge University before joining St Bartholomew's Hospital, where he has been Head of Department since 1989.
Expert in prostate cancer treatment
Nick Plowman is a Harley Street based expert on the use of radiation therapy and chemotherapy for the treatment of cancer, with a special interest in improving cure rates in cancer, whilst reducing the side effects of therapy.
Modern computers and radiotherapy machines are used to mould the high dose of radiation to the tumour itself, minimising the risk of damage to the surrounding healthy organs and tissues and reducing any side effects to the bladder and bowel. This treatment is suitable for patients in whom the cancer has not progressed beyond the capsule covering the prostate gland.
Private treatment
Dr Plowman is available for consultation at his rooms in Harley Street. He is able to offer the latest techniques in the management and treatment of cancer, with a special interest in:
• • • • • • • •
Prostate cancer Breast cancer Central nervous system cancers Paediatric cancers Urological cancers Cancers affecting the eye Thyroid and endocrine cancer Lung cancer
Dr Plowman is recognised as one of London's leading experts in the treatment of prostate cancer, using the most up-to-date techniques:
External beam radiotherapy
conformal
Seed implantation brachytherapy
A number of small, radioactive seeds are put into the prostate gland. Over a period of a few months, they deliver a localised high dose of radiation. The surrounding tissues only receive a very low dose, lessening the risk of damage. The seeds have faded away by the end of the treatment time and this therapy offers a low side effect option for the treatment of early prostate cancer.
Hormone therapy
Lowering the amount of testosterone in the body with medicines can reduce the chance of an early prostate cancer returning or can shrink or slow the growth of an advanced tumour that has spread beyond the capsule of the prostate. Treatment is dependent on the precise grade and stage of the cancer and Dr Plowman is able to offer experienced advice.
Key Published Papers • Overviews on breast and gastrointestinal cancer (modern management) • Optimal methods of treating prostate cancer • The complications of Cancer Management (Ed P.N.Plowman) • Stereotactically delivered Brain Radiation Therapy (Radiosurgery) and brain tumour therapies • Paediatric Oncology (Ed P.N.Plowman, CR Pinkerton)
Stereotactic radiotherapy
As well using the most modern standard radiotherapy machines, Dr Plowman is at the forefront of this new technology that uses a single targeted dose of radiation to treat tumours that were not otherwise killed by standard radiation therapy or were situated in dangerous positions. The treatment is delivered using specially designed linear accelerator machines:
Gamma Knife
This is a safe, accurate and reliable state-of-theart machine that targets the affected cancer site only. There is no open surgery and the patient can be discharged within 24 hours. Because of its accuracy, the Gamma Knife is used for the treatment of tumours near the brain stem and optic nerve.
CyberKnife
This machine has a robotic arm that can deliver targeted high-dose radiation to tumours anywhere in the body, even parts that are moving such as the lung. Damage to the surrounding tissues is minimised and CyberKnife offers painless treatment for some tumours that were previously considered to be inoperable or untreatable.
Clinical interests
Dr Plowman's clinical interests include the diagnosis and treatment of breast cancer, brain tumours, endocrine cancer, urological cancer; cancers in children & young persons (chemotherapy & radiotherapy) and the use of stereotactic radiotherapy (CyberKnife And GammaKnife). Dr Plowman's special interests are directed towards improving cure rates in cancer, whilst reducing the side effects of therapy. He is an expert on both radiation therapy and chemotherapy. In medical oncology, his main contribution has been the demonstration of the importance of adrenal sex steroid production in both breast and prostate cancer and he pioneered therapies aimed at interrupting these pathways in both diseases that have now become standard treatment across the world.
Research interests
Reducing the toxicity of drug/chemotherapy and radiation therapy for cancer treatment.
P N Plowman MA MD FRCP FRCR Consultant Clinical Oncologist 14 Harmont House 20 Harley Street London W1G 9PH
T: 020 7631 1632 E:postmaster@pnplowman.demon.co.uk W:www.prostatecancertreatment.co.uk W:www.canceradvice.co.uk
Cardiology Expert Witness
Federation of
Forensic & Expert witnesses
Dr Toomas Sarev FRCP, FESC Consultant Cardiologist
Areas of Expertise: I am a Consultant Interventional Cardiologist and Cardiology Service Director at NNUH, Norwich. I cover all aspects of heartrelated problems in adults. I am mostly interested in ischaemic heart disease and coronary interventions. I work as an independent medico-legal expert and am particularly interested in cardiological issues related to clinical negligence and personal injuries.. I am a Consultant Interventional Cardiologist and Cardiology Service Director at NNUH, Norwich. I cover all aspects of heart-related problems in adults. I am mostly interested in ischaemic heart disease and coronary interventions. I work as an independent medico-legal expert and am particularly interested in cardiological issues related to clinical negligence and personal injuries. The waiting time for my next medico-legal appointment is 1-2 weeks and report completion time is 3-6 weeks, depending on the complexity of the questions and issues. I keep myself up to date with CPR. To ensure the best practice as an expert, I have attended workshops arranged by Lynden Alexander and Giles Eyre via Professional Solutions Learning and Development at 12 Bloomsbury Square, London, a course of successful communication at experts’ meetings and preparing to give oral evidence in court and an advanced workshop in writing expert reports in Jan 2017. I have completed medico-legal expert training courses via specialistInfo.com at 218 Strand, London, led by the wellknown Jonathan Dingle and Judith Kelbie; the courtroom skills course and clinical negligence medico-legal course in November 2014. I also completed a refresher in medico-legal expert advanced training in September 2014. I am a member of the Norfolk and Norwich Medico-Legal Society and The Medico-Legal Society of London. I subscribe to their journal and the Medical Law Review.
Kardiostar Ltd
6 The Ridings CRINGLEFORD Norfolk NR4 6UJ 07432 552056 medicolegal@kardiostar.com kardiostar.com
Dr Duncan S Dymond is a consultant cardiologist who has been undertaking expert witness and medico-legal work for more than 8 years completing 1-2 reports a week for personal injury and medical negligence cases. He has also completed expert witness work for the General Medical Council, the Medical Defence Union and the Crown Prosecution Service as well as accepting private instructions directly from solicitors. Dr Dymond is extensively published with more than 100 scientific articles to his name. He has been Consultant Cardiologist at St Bartholomews Hospital for 31 years, now holding the title of Consultant Emeritus, and is in practice in central London. Currently Dr Duncan Dymond is actively involved in most aspects of adult cardiology. He sees patients with chest pains, shortness of breath, dizziness and collapse, palpitations etc. He has maintained his expertise in the use and interpretation of radioisotope imaging techniques in both diagnosing coronary artery disease and in the assessment of its prognosis. He is also widely experienced in the use of EBCT calcium scanning to assess future risk, and has an interest in the developing techniques of CT angiography and magnetic resonance imaging of the heart.
As far as procedures are concerned, his major expertise is in the field of percutaneous coronary intervention (PCI) which involves the use of stents to open blocked or narrowed arteries. Dr Duncan Dymond has been in this field since 1980 and in fact was among the first to use balloon technology in the UK. He specialises in complex cases such as multivessel disease, chronically blocked arteries, and narrowings in bypass grafts as a few examples. His results, success and complication rates are produced each year as part of the NHS appraisal process. Harley Cardiology Ltd
34 Circus Road St John's Wood London NW8 9SG 0207 079 4260 medicolegal@harleycardiology.com www.drduncandymond.com
Dr. Khalid Barakat MA MB BS MD FRCP(UK) PGCert MedSim
Consultant Cardiologist Dr Khalid Barakat achieved an MA in Physiological Sciences at Trinity College, Oxford and completed his MBBS and MD at the University of London. He has been practising as a Consultant Cardiologist since 2004, initially at Wexham Park Hospital, Slough, where he worked until 2016. He was instrumental in repatriating NHS cardiology services from London to a local setting, which was highly beneficial for the local patient population and was very well received.
In 2006 Dr Barakat set up a private cardiology practice – Windsor Cardiology - with his colleague Dr Stephen Rex. He offers outpatient clinics and interventional procedures to private patients in Berkshire, Buckinghamshire, Oxfordshire and West London. Additionally, he was appointed Director of Cardiovascular Simulation at Bart’s Heart Centre in December 2016 and is the BCS National Lead for Simulation based Training. He is in the process of mapping simulation-based learning to the cardiology training curriculum.
Dr Barakat’s specialist areas of clinical practice are: invasive cardiology (coronary angiograms) | interventional cardiology (coronary angioplasty), coronary artery disease (acute coronary syndromes | unstable angina, angina and myocardial infarction) permanent pacemaker implantation and heart failure.
He has an active interest in teaching. For more information please contact Contact Karen Holmes Practice Manager Windsor Cardiology LLP Opening Hours 8.30am – 5.00pm Monday to Friday
www.windsorcardiology.com T: 01753 660845 | F: 01753 662849 | Email: enquiries@windsorcardiology.com
Dr Sam Firoozi MBBS (Hons), MRCP
Consultant Cardiologist
Consultant Cardiologist with expertise in: • Interventional Cardiology (angioplasty, stenting) • Coronary Artery Disease • General Cardiology and Hypertension.
He has experience in writing medico-legal reports including reports on clinical negligence.
Memberships:
• British Cardiovascular Intervention Soc. (BCIS); British Cardiovascular Soc. (BCS) • The Federation of Forensic and Expert Witnesses. For further information please contact Dr Sam Firoozi:
Department of Cardiology St Georges Hospital SW17 0QT
M: 07803 345 438 E: emmastroud.medsec@gmail.com F: 0208 711 3573
THE WORLD’S NO1 SURGICAL COACH
Rodney Peyton OBE
Q&A
We managed to catch up with Mr Peyton OBE earlier this year. He has more than 30 years experience as an expert witness, has been acknowledged as the World’s Number One Surgical Coach and has been voted several times as Expert Witness of the Year.
We started by asking him:1 How have your experiences made you a “go to” expert in your field? My experience as both a military and civilian surgical consultant, particularly through the “Troubles” in Northern Ireland, has meant that I had a wide range of experience dealing with acute trauma from the front line to the operating room. I have dealt with a wide range of orthopaedics and general surgery and have been involved in many thousands of personal injury and medical negligence cases over the years. I continue to teach both doctors and lawyers in medicolegal practice and produce bi-weekly online medicolegal commentaries on interesting cases.
2 So, what do you believe are the keys to being an effective Expert Witness? Experts must act at all times with integrity, remaining independent and objective. They must remain highly competent in their own area of expertise and have a clear understanding of the legal framework. They must also have excellent communication skills.
3 What are the biggest changes that have occurred over the years you have acted as an Expert Witness? Being an expert witness has become more professionalised since I started all those years ago. Courts have tightened up in relation to their expectation of witnesses and, of particular importance, has been the loss of immunity from liability. Public adverse criticism can have a great impact on an expert’s personal, professional and indeed financial well-being.
4 What qualifications do you require within your industry which supports your work? As a medical expert witness, I am expected to demonstrate up-to-date, relevant professional recognition in the specific branch of medicine under discussion. This is done through regular appraisal, revalidation and recertification which leads to full registration in the appropriate medical register held by the General Medical Council.
5 So, what is the number one thing to look for when considering if there has been medical negligence? Screening reports are vital, looking at an early stage for the triad of duty, potential unreasonable breaches of the standard of care and then the “but for” consequential damage. Such reports should also indicate which specific specialities should be involved as it is not always obvious from the outset.
6 What have you found to be the most common misunderstanding about what constitutes medical negligence? From a client’s point of view, it is understandable they may be annoyed when their health does not improve after medical intervention. However, poor patient outcomes are not necessarily due to medical negligence and this can be difficult to explain to a client – or even the legal profession! It is necessary for both doctors and lawyers to be empathetic, but not sympathetic, and to know clearly the difference between the two.
“As a medical expert witness, I am expected to demonstrate up-to-date, relevant professional recognition in the specific branch of medicine under discussion.” 7 Given all of this, what do you believe are the duties of an Expert Witness? The object is to assist those in litigation including clients, their legal advisers and the Court to clearly understand the nature of the “medical” evidence in individual cases so they can make informed decisions. This is extremely important as studies show up to 80% of potential cases do not in fact succeed.
8 What advice would you give to lawyers when choosing an Expert Medical Witness? Get to know your experts and understand that just because a doctor has a good clinical reputation does not mean they are reasonable or reliable witnesses in Court. Make inquiries through colleagues who have used them and preferably see them in action. Meetings with Barristers can be particularly useful to get an idea of how they are likely to stand up under cross examination. As well as professional expertise, communication skills are paramount.
9 Everyone has biases, so how do you maintain integrity in your role as an Expert Witness? I suppose it is a combination of expertise and experience, remembering in particular the duty to the Court and not to one side or the other. All of us have been asked from time to time to alter our reports to show clients in a better, or worse, light. This should be steadfastly resisted unless new factual evidence has been produced, in which case, the expert should carefully consider the impact of the evidence and, if this leads to a change of opinion, clear reasoning should be given.
10 Finally, is there any other aspect of being a Medical Expert Witness that you think would surprise someone who is considering starting out? Any report may end up in Court and this should be considered from the outset. Experts are expected to know their responsibilities to the Court and may be questioned about their knowledge when giving evidence. Stay neutral and have good reason to defend your opinion. Be open to change if new evidence is presented but take time to think this out, even if it means asking for a recess. The job is to educate and help others understand the issues from a medical stand point. That means explaining in words lay people and the Court can understand. Remember, you are giving your opinion, the Court will listen to others and make its decision on balance. Do not get emotionally tied up with the outcome but do consider what happened to see if there are any further learnings for yourself.
+44(0)28 8772 4177 info@rpeyton.com www.rpeyton.com
Dr Paul Sigston MBChB FRCA FRCP(Edin) FFICM
Consultant in Anaesthesia and Intensive Care
Dr Sigston is a consultant in both Anaesthesia and Intensive Care Medicine. He was appointed to a consultant position in Tunbridge Wells in 1998. He works in the NHS and also the private sector locally. He qualified from Edinburgh University in 1987 and underwent training in Medicine, Anaesthetics and Intensive Care in both adults and paediatric practice. In addition to clinical practice, Dr Sigston has held a number of senior leadership positions including Medical Director and Responsible Officer and in addition sits as a Royal College Advisor on Consultant Interview Panels. In his many years of senior medical leadership position, Dr Sigston has widespread experience of managing clinical negligence issues, civil claims and coroner’s court hearings. He is conversant with the workings of the legal system and the needs of various parties. He was heavily involved in the defence of a corporate manslaughter case involving the Trust: this case was successfully defended with a dismissal of the case by the judge (R v Dr Errol Cornish and Maidstone and Tunbridge Wells NHS Trust). Dr Sigston has completed specialist Expert witness training with Bond Solon.
M:07712 007 051 E: paul@sigston.co.uk E: paul.sigston@nhs.net W: www.sigston.co.uk Tunbridge Wells Hospital, Pembury, Tunbridge Wells. Kent TN2 4QJ
Training Bond Solon
Membership
General Medical Council, Royal College of Anaesthetists, Royal College of Physicians of Edinburgh, Faculty of Intensive Care Medicine, European Society of Anaesthesia Medical and Dental Defence Union of Scotland. The Federation of forensic and expert witnesses
Dr Clifford Piers Clifford graduated from Oxford University in 1984 with a first class degree before completing his medical training at St Mary’s Medical School, London in 1987. His cardiological training was predominantly at the Hammersmith Hospital, where he still works as an Interventional Cardiologist. He was appointed as a Consultant Cardiologist to Buckinghamshire Hospitals NHS Trust in 1999. He is now the Clinical Lead for Cardiology, the Chairman of the Division of Medicine, and has developed highly successful angioplasty and investigative units which are unrivalled by other district hospitals. He has developed vast experience, skill and expertise in all areas of adult cardiology with a particular interest in coronary intervention, the modern treatment of hypertension, atrial fibrillation and the inherited cardiomyopathies.
Dr Piers Clifford BA (Oxon) 1st Class FRCP MD MBBS
Also in 1999, Dr. Clifford began his private practice at the Chiltern Hospital to further meet the needs of Buckinghamshire residents and to allow him to offer the very highest standard of personalised patient care. He now also offers consultations at the Shelburne Hospital in High Wycombe, HCA Chiswick, and HJE in St Johns Wood, London. Dr. Clifford has three children and lives in central London. He plays competitive tennis, enjoys good food and fine wine, and likes to spend as much time as possible in the mountains. However, his sons tend to keep him on the touchline and his daughter in the clothes shops. Support Staff Dr. Clifford’s secretary, Catherine Teasdel, is a vastly experienced medical secretary who has worked alongside him for the last 11 years. On the rare occasion when she is not available, a support secretary will always be on hand to answer your queries and provide access to your test results.
Cardiac Specialist
PIERS CLIFFORD CARDIAC SPECIALIST
Medico Legal
Contact
Dr. Clifford has extensive experience in providing medico legal reports and examinations in matters relating to the cardiovascular system. He aims to achieve a rapid turnaround, usually providing the report within a week of the request, and to provide a definitive opinion to assist with obtaining a quick and satisfactory resolution to each case. Dr Clifford has produced medicolegal reports for medical negligence claims for the last 5 years, acting predominantly for the Claimant, and has adjudicated on cases deciding whether doctors are fit to practice. He performs medical assessments for fitness to fly and to race high performance vehicles. As Clinical Lead for cardiology He is instrumental in developing protocols for safe patient care and has a particular interest in measuring quality of health care delivery. Dr Clifford has undertaken expert witness training with Bond Solon and has received the Cardiff University CUBS certificate. Dr Cliffords research interest is in the molecular genetics of cardiovascular disease and he is Principal Investigator in 15 clinical trials including studies on coronary stenting, using novel technologies to reduce infarct size in heart attack, the modern treatment of atrial fibrillation and in cardiac rehabilitation. Dr Clifford has won National awards (PEN award for continuity of care, finalist for HSJ Value in Healthcare and an award for commercial research from Dame Sally Davies). He is on the Council of the British Cardiovascular Society.
Contact Direct 01494 425 004 07879 440 929 info@piersclifford.co.uk www.piersclifford.co.uk
Mr Kulvinder Lall is one of the United Kingdom's leading cardiac surgeons. Qualifying in 1989 from the University of London he has trained in Cardiothoracic Surgery in London, Glasgow and Sydney. He was appointed to St Bartholomew's Hospital as one of the youngest cardiac surgeons in the UK aged 36. As an NHS Surgeon he has performed in excess of 5,000 heart operations with outstanding results as measured by the Care Quality Commission and the Department of Health. Mr Lall has been producing medico legal reports for the past five years in cases involving all aspects of cardiac and thoracic surgery. These reports include aspects relating to surgical care and those following trauma to the structures of the chest. Mr Lall can act on behalf of either claimant or defendant or as a Single Joint Expert. Turn around time for reports is 20 working days or less depending on the complexity of the case.
Aortic Valve Replacement
For more information please contact
MR KULVINDER LALL
NHS Enquiries
T | +44 (0) 203 465 5149 E l cherrie.sharma@bartshealth.nhs.uk
Coronary Artery Bypass Grafting
Private, Insurance, Overseas & Medico-Legal Enquiries T | 020 7234 2288 E | melanie.todd@medicaladminservices.co.uk
www.cardiothoracic-surgeon.co.uk/
Thoracic Aortic Aneurysm
Dr Cooke provides a veterinary Expert Witness service on behalf of the defence, prosecution and as a SJE. He takes instructions from members of the public, veterinary and legal professionals as well as welfare and conservation organisations. He produces detailed reports backed by 37 years in general practice and laboratory experience which are supported by contemporary peer reviewed sources. He is confident at testing the veracity of other Expert's opinions and will undertake professional negligence cases. His experience in Veterinary medicine and surgery relates to small pets - cats, dogs, rabbits, ferrets, birds and rodents as well as the exotic pet species and British wildlife. His work with veterinary diagnostic laboratories includes forensic post mortem examinations and crime scene investigation, writing, training and lecturing.
Dr Stephen W. Cooke BVSc, MRCVS
Veterinary Surgeon
Fee structure conforms to LAA restrictions across the board.
Memberships inc: MRCVS, The Federation of Forensic and Expert Witnesses.
Contact now to instruct Veterinary Advisors Ltd Tel: 07768 006935 71 - 75 Shelton Street Mobile: 07940 572823 Covent Garden Email: stephenwcooke@icloud.com London Website: www.veterinaryadvisors.co.uk WC2H 9JQ
DR RAPHAEL PERRY MEDICO-LEGAL EXPERT FRCP, DM, B.Med.Sci, BM BS
Consultant Cardiologist & Specialist in Coronary Intervention / Medical Director & Deputy Chief Executive
CONSULTANT CARDIOLOGIST AND EXPERT WITNESS Dr Raphael Perry has a wide experience of general and tertiary centre cardiology and cardiovascular disease.
Since his Consultant appointment in 1991 at the The Cardiothoracic Centre, Liverpool, he has undertaken a heavy clinical workload in his areas of interest. One such area of interest is Interventional Cardiology in which he has been involved in over 8,000 cases. Year after year he has performed the largest number of coronary interventions in an increasing variety of patient sub - groups. In addition, he has until recently been heavily involved in the clinical development of Echocardiography. As a consultant cardiologist, clinical lecturer in medicine and an associate medical director, Dr Perry has vast experience in his specialist field and as such is appointed on up to 60 cases per year as an expert witness. His turnaround time from instruction to completion of a report, depending on the amount of documentation, is usually between 10 - 12 weeks. He is willing to act as a single joint expert with his workload split 60% claimant, 20% defendant and 20% joint.
DR RAPHAEL PERRY
"I have wide experience of general and tertiary centre cardiology/cardiovascular disease. My areas of sub-speciality at the regional centre are in ischaemic heart disease, coronary intervention, acute coronary/ intensive care and echocardiography. In addition to patient care I have experience in managing training grade doctors in clinical research. I have been actively engaged in medicolegal work for more than 20 years and have had specific training in the same. I am well versed in the production of a wide range of medical reports, tribunals and court appearances."
Dr Perry has undergone medico legal training courses with APIL and Bond Solon and has CPD points in expert evidence.
Qualifications
Qualified at: Nottingham Qualifications: FRCP, DM, B.Med.Sci, BM BS
Memberships include:
Membership of Medico Legal organisations (including Registered Expert Witness:): Expert Witness, Your Witness, APIL, The Federation of Forensic and Expert Witnesses I am registered with the NPIA (National Policing Improvement agency) and regularly work for IPCC (Independent Police Complaints Commission)
Contact now to chat or instruct direct: Ms G Gowing (secretary) Tel: 0151 600 1399 Fax: 0151 600 1254 Mob: 07766 337 777 Liverpool Heart & Chest Hospital NHS Foundation Trust Thomas Drive, Broadgreen, Liverpool L14 3PE Email: raphael.perry@lhch.nhs.uk
www.cardiacspecialist.info
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
Professor Saul Myerson
General Cardiologist & Expert Witness
Prof. Saul Myerson is a general cardiologist. His specialist areas involve diagnostic testing, particularly advanced cardiac imaging. Prof. Myerson also holds an international reputation for cardiac magnetic resonance imaging and is often consulted about diagnosing particularly difficult cases/diagnoses, and asked to identify the causative processes involved. “These areas of expertise fit well with common medicolegal 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. Assessing future risk/prognosis and the suitability of patients for cardiac surgery (e.g. viability studies, and assessing the severity of valve disease) also form part of Prof. Myerson's practice; this is also very helpful for medico-legal work. Mostly receiving direct instruction from lawyers; 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 indifferences 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 examples: “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, Prof. Myerson identified that 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.
Another recent case which Prof. Myerson was involved in concerned a patient with severe multi-organ failure (including liver and kidney failure) who had poor cardiac function. Identifying whether the cardiac failure caused the liver and other organs to fail, or that the severe liver and kidney failure (and secondary sepsis) led to cardiac dysfunction was important - the cardiac failure might have been picked up during a visit by the patient’s GP ten days prior to admission when the patient was unwell. In this case, the severity and type of liver failure was too great to have been secondary to the cardiac failure, and it was more likely that liver failure due to hepatitis was the primary cause – this would have been more difficult to identify until jaundice had occurred (after the GP had seen the patient), and the GP was found not to be negligent.
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 legal aspects. This requires a good understanding of the medical issues, and only an expert witness can provide that level of advice really, 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.”
For further information, please contact Prof. Saul Myerson
T:01865 222 770. E:saul.myerson@cardiov.ox.ac.uk
Mr Neil Roberts MB ChB MRCS MD FRCS (C-Th)
Consultant Cardiothoracic Surgeon Mr Neil Roberts is a consultant cardiothoracic surgeon practising in the NHS at Barts Heart Centre in the city of London. He also has a private practice based in Harley Street in London. Mr Roberts entered the specialist register in 2011 and has been a consultant cardiac surgeon since February 2011. He is experienced in all aspects of adult cardiac surgery. He has also been the clinical governance lead in his department for the last 3 years, and has therefore extensive experience in incident reviews, complaint responses and negotiating the clinical governance systems within the NHS. Mr Roberts is trained in medicolegal and expert witness report writing through courses with Bond Solon and has been writing medicolegal reports for three years.
Mr Roberts accepts cases involving :
• Clinical Negligence report writing – aspects of breach of duty and causation • Personal Injury – aspects of current condition and prognosis
• • • •
His areas of interest and experience include:
Clinical governance, surgical safety standards, WHO checklist compliance Serious incidents and Datix incident investigations and process All aspects of adult cardiothoracic surgery Pre intervention decision making in cardiology and cardiac intervention – was the correct process followed, was the patient discussed in the appropriate MDT according to current best practice, were the international guidelines followed and alternatives discussed with the patient? • Consent issues
Medicolegal report writing estimated turnaround time of less than 21 days, depending on the complexity of the case. Terms and conditions are available on request
Clinical Negligence report writing – aspects of breach of d
Mr Neil Roberts Mr Roberts treats patients in the NHS and also in private practice at Harley Street.
Should you wish to exercise patients choice within the NHS just ask your refering cardiologist or your GP to refer you to Mr Roberts in writing at The Barts Heart Centrel address on the home page of this website and we will arrange an appointment. If you would like to be seen as a private patient just call or email and we will arrange an appointment. Mr Roberts is registered with all the main health care insurance companies and our team will make all the necessary arrangements with them prior to your appointment.
Mr Neil Roberts
Operations Performed • • • • • • • • • •
Coronary artery bypass graft surgery Aortic valve replacement TAVI Aortic root replacement Replacement of the ascending aorta Surgery for aortic dissection Mitral valve surgery Surgery for cardiac tumours eg left atrial myxoma Surgery for atrial fibrillation Closure of the left atrial appendage
Plus many others and combinations of the above
Consultant Cardiothoracic Surgeon NHS practice Barts Heart Centre St Bartholemews Hospital London EC1A 7BE 0203 765 8689 Neil.roberts6@nhs.net Private Practice and Medicolegal 88 Harley Street London W1G 7HR 0207 034 8962 neil@mrneilroberts.com secretary@mrneilroberts.com
www.mrneilroberts.com
duty and causation Personal Injury cardiology and cardiac
Professor Daniel
J M Keenan
Consultant Cardiothoracic Surgeon BSc(Hons), MB, BCh, FRCS, FEACTS.
Danny Keenan is a Professor of Cardiothoracic Surgery at Manchester University NHS Foundation Trust. He has a vast experience in heart and lung procedures. He has worked in various roles in the health service during his career. He led several important innovations in cardiac surgery, both within his hospital and nationally. Professor Keenan has the distinction of chairing the first Clinical Reference Group in Cardiac Surgery for NHS England. His experience encompasses a wide variety of professional activities. He is the Associate Medical Director to the Manchester University NHS Foundation Trust dealing with appraisal and revalidation and has experience in dealing with doctors in difficulty. As Medical Director (part-time) to the Healthcare Quality Improvement Partnership in London, he runs the National Clinical Audit programme. He chairs, for NICE, the Indicator Advisory Committee. He was seconded from the Manchester University NHS Foundation Trust to the Healthcare Commission and the Care Quality Commission, serving as the National Advisor on Hospital Services.
•
Areas of Expertise include: • • • • • • • • • • • • • • •
Cardiothoracic Surgery Cardiac Surgery Cardiothoracic Trauma Thoracic/Chest Trauma Fractured Ribs Flail Chest Heart Disease Heart Valve Surgery Thoracic Aortic Surgery Aneurysm Repair of the Thoracic Aorta Coronary Artery Bypass Grafting Ischaemic Heart Disease Left Ventricular Aneurysm Mitral Regurgitation Aortic Stenosis
Memberships: • General Medical Council (Specialist Register 1382637) • Fellow, Royal College of Surgeons • Society of Cardiothoracic Surgeons of Great Britain and Ireland • Fellow, European Association for Cardiothoracic Surgery Clinical Forensic and Legal Medicine Section: The Royal Society of Medicine • The Federation of Forensic and Expert Witnesses
He has been a highly successful Consultant Cardiothoracic Surgeon at the Manchester Heart Centre, based at the Manchester Royal Infirmary, for over 30 years and was Clinical Director of this large and successful unit in Central Manchester, from 1998 until 2002. He practised the full range of adult cardiac surgery and has been heavily involved in the management of thoracic (chest) trauma, managing closed and open injuries. He is honorary Professor of Cardiothoracic Surgery to the University of Manchester. Professor Keenan has also operated at The Alexandra Hospital Cheshire and carries out medicolegal work at The Beeches Consulting Centre, Manchester and in Central London. His experience in dealing with medico-legal cases spans his surgical career. He has been involved in this area of activity, working both in the areas of personal injury but also in the areas of malpractice and negligence. He represents both claimants and defendants and has worked for individual practitioners and Trusts and has appeared as an Expert Witness.
With Rooms in Manchester and London, his coverage is National. Internationally, he works in Singapore.
Please contact: Francesmary Hobbs francesmary.hobbs@icloud.com 07989 582668
Myles James Overton Taylor
Consultant Obstetrican & Gynaecologist BA (Oxon) FRCOG, 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
Mr Philip Coleridge Smith
DM MA BM FRCS Emeritus Reader in Surgery, UCL Medical School
Areas of expertise • • • • • • •
Peripheral vascular disease Deep vein thrombosis Spider veins Thrombosis Varicose veins Venous insufficiency Venous ulcer
Mr Philip Coleridge Smith is one of London's leading vascular surgeons. Operating at the British Vein Institute he is an expert in the treatment of varicose veins. He lectures at University College London and has been the editor of the medical journals, ‘Phlebology’ and ‘The European Journal of Vascular and Endovascular Surgery’. He is currently President of the British Association of Sclerotherapists and is acknowledged as an international authority and expert in venous disease, including the management of vein problems using ultrasound-guided sclerotherapy and other modern methods of vein ablation. Throughout his career he has treated several thousand patients using injection techniques.
T:0870 609 2389 E:p.coleridgesmith@adsum-healthcare.co.uk W:www.bvi.uk.com W:www.medical-expert-witness.co.uk
The British Vein Institute 24-28 The Broadway, Amersham HP7 0HP
PROFESSOR BRUCE BRAITHWAITE MChir MA MB FRCS FRCS (Gen Surg)
FOUNDER OF VEINCARE, CONSULTANT VASCULAR SURGEON & EXPERT WITNESS
Professor Braithwaite has been a teaching hospital Consultant Vascular and General surgeon since 2000. He has a wide range of expertise in arterial and venous surgery, including endovascular abdominal aortic aneurysm repair, and peripheral bypass surgery. He is the Secondary Care Specialist for an NHS Clinical Commissioning Group and was Chairman of a Hospital Clinical Governance Committee. He is a Founding Member and Director of Operations for a National Partnership of Clinicians, Alliance Health Group, for whom he set up the Governance policy. He has been involved in national and international research projects in vascular disease and has published over 60 peer reviewed articles. He has a particular interest in varicose veins, deep and superficial venous disease particularly the outcome of deep vein thrombosis. He runs a specialised clinic for patients, receiving referrals from around the UK and has promoted and pioneered some of the latest treatments for the condition. He is an authority on arterial thrombosis, lower limb ischaemia, varicose vein disease, and the complications of diabetes, including amputations. He has experience in the management of vascular trauma. He currently prepares over 30 reports per year for clients involved in trauma and medical negligence claims. He is happy to be involved in either claimant or defendant activity and can see clients in London and the East Midlands.
PROFESSOR BRUCE BRAITHWAITE Please contact
T: 07967 636 769 (Secretary Dawn) T: 0800 170 7470 E: expert@bdb.org.uk
W: www.bdb.org.uk
SIMON FULFORD FRCS (Urol) CONSULTANT UROLOGICAL SURGEON & EXPERT WITNESS When it comes to medical negligence and personal injury claims it is vital for those in the legal sector to seek the independent, unbiased advice from a professional Surgeon. When it comes to court cases for compensation for Spinal Injury, Head Injury, pelvic fracture & Urological medical negligence cases, Simon Fulford FRCS (Urol) has become recognised as a leading provider of Expert Witness Reports in to the consequences of such injuries on bladder, bowel and sexual function for Barristers and Lawyers on both sides of the case, as well as for law enforcement agencies. Simon qualified as Bachelor of medicine and surgery from London University in 1987 and he trained in general surgery becoming a fellow of the English royal college of surgeons in 1992. He then trained in Urology and gained his FRCS(urol) in 1999. During this training he worked in numerous Urology units around the country and also in the Princess Royal spinal injury centre in Sheffield. he has been a consultant at James Cokk University Hospital, Middlesbrough for the past 18 years and has a wealth of experience in many aspects of Urology as he explained in a recent interview: “I am one of ten 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 also treat NHS and private patients at BMI Woodlands Hospital Darlington and run a busy Medico-legal practice.
My primary interest within Urology is the care of the Neuropathic bladder in patients with spinal cord injuries or neurological disease. I see and manage large numbers of patients with spinal cord injury, Cauda Equina Syndrome, Multiple Sclerosis, Parkinson’s 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. In addition I have a major role supporting Urological colleagues assisting with cancer surgery by creating orthotopic neobladders following cystectomy for bladder cancer. I am also regularly involved in pelvic exenterations for gynaecological cancers and caesarean sections in patients with previous Urological surgery or renal transplants. I also manage many urinary tract injuries and fistulae referred from across the North East. 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.
For Further Information Please Contact: Simon Fulford Frcs (Urol) 07855312901 Simonfulford@Nhs.net
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 ensure appropriate assessment of ongoing disability, treatment and prognosis.
In a similar way spinal cord injury inevitably affects pelvic organ function that requires highly specialised management and is of course highly relevant to a personal injury compensation case. Pelvic organ function can also be adversely affected by other injuries including pelvic fractures and head injuries and Simon believes that the expert reports ha has prepared in such cases have been important in reaching appropriate settlement.
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 ten cases per month. The cases I have reported on include spinal injury compensation claims, accidental injury compensation claims, 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. Within Urology we have recently become aware of a new syndrome called Ketamine Induced Cystitis. This is an exciting research opportunity as understanding it may well improve our understanding and management of other painful bladder syndromes. I have supervised several clinical research fellows working between York University and JCUH and we are working with other urologists, epidemiologists, public health doctors, drug abuse experts and basic scientists to develop a comprehensive study of these patients.”
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.
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: robynwebber@nhs.net
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 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 and practical 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 surgical 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 Solon 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 Solon 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 a co-investigator 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) and Excellence in Medical Education Award in 2015/16. 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 116, Harley Street, London W1G 7JL Tel: 07979 143368 Secretary: urologysecretary.sc@gmail.com Email: chitalenorwich@aol.com Website: www.privateurologylondon.co.uk
Mr John H Scurr
Vascular Expert Witness Reports
John Scurr Medico Legal
Mr John H Scurr
Consultant General and Vascular Surgeon Senior Lecturer
Whilst the majority of clinical interventions result in a very satisfactory outcome, a few cases do not. In the majority of cases where a patient is dissatisfied the reason for this dissatisfaction may simply be a failure to understand the procedure or the lack of appropriate advice. Very few people start a medico- legal claim with the sole purpose of obtaining large sums of money. It has been possible to identify patients with a significant claim and in some cases claims where the patient has suffered a life altering experience. The first step in conducting a medico-legal case may be to obtain advice from a solicitor. Many solicitors are now experts in this area and will know who to instruct. We are approached on a regular basis by people who are concerned about the validity of a claim and we are in a position to advise both on the validity of the claim and on the solicitor who can manage the case. We are in a position to provide a simple case analysis which will identify the merits of the case and point a solicitor in the right direction. More detailed reports can be provided which are suitable for solicitors issuing proceedings. John Scurr has had considerable experience in the preparation of all forms of reports, both clinical negligence and personal injury. He has appeared in Court on many occasions and many cases have been seen as highly successful. In some instances a successful case may not involve the Court at all but will involve a satisfactory resolution at an early stage.
John Scurr trained as a mediator and has considerable expertise in the preparation of Medico Legal reports both in the field of clinical negligence and personal injury.
MBBS (Hons), BSc (Hons 1st Class) FRCS Lister Hospital Chelsea Bridge Road London SW1W 8RH Unit 509/510 Q House 76 Furze Road Sandyford Dublin 18 Ireland Area of work: United Kingdom & Ireland 020 7259 0692 & 00 353 1 293 7863 annemarie@jhsgroup.ie margaret@medicolegalchambers.ie.
For Medico-Legal issues please contact us initially on +353 1 2937863 and margaret@medicolegalchambers.ie. John Scurr continues to provide a clinical service. He works closely with Mr Philip Coleridge Smith (another of our Federation members and expert witness) re the management of varicose veins.
Federation of
Forensic & Expert witnesses
Mr Laszlo Papp
MD, PhD, EBSQ-Vasc (2003) Consultant in Vascular Surgery
Areas of Expertise:
My clinical expertise including day-to-day patient care
• operating lists, arterial and venous surgery • Aortic aneurysm surgery • Carotid artery surgery • Vascular access surgery (dialysis) • Under and postgraduate teaching. Currently based in North Wales with a number of notable achievements, including winning the right to stage the 2013 ESVS annual meeting.
Mr Laszlo Papp
MD, PhD, EBSQ-Vasc (2003) Consultant in Vascular Surgery 01248 384303 pl1963@hotmail.com
w
Mr Pau
BSc(Hons), MBBS, MRCS
Consultant in Vascular He is responsible for the strategic and operational oversight of the vascular practice across the acute hospitals within Barts Health NHS Trust (The Royal London Hospital, St Bartholomew’s Hospital, Whipps Cross Hospital, Newham University Hospital). Also Clinical Lead, Vascular Surgery, Barts Health NHS Trust, April 2013 – present and, Clinical Director, North East London AAA Screening Programme, September 2012 - present. He was appointed to a General surgery NTN (LDN/021/023/N) in the NE Thames region in 4/2001. Mr Flora has undertaken Expert Witness training and is on panel as an expert for The Medico-Legal Experts Practice (TMLEP).
Mr Flora has expertise in the follow
• Open Vascular/Endovascular surgery and hybrid techniques to treat vascular disea • Aortic Aneurysms (Thoracic, infrarenal) • Peripheral aneurysms (Femoral, Popliteal, visceral) • Peripheral arterial disease • Varicose veins • Carotid disease • Thoracic outlet syndrome • Popliteal entrapment syndrome • AV malformations • Sympathectomy: Cardiac and for Hyperhidrosis • Removal of complex neck tumours with ENT or Maxillo-facial surgeons, where carotid reconstru • General/Laparoscopic surgery • Hernia repair • Appendicectomy • Cholecystectomy • Trauma • Barostim Therapy: Performed the first Barostim implant surgery in the UK on two patients at the Ro This is a new treatment for patients with resistant hypertension for whom no current treatm • Cardiac Thoracoscopic Sympathectomy • Google Glass to perform vascular surgery. His team was the first to perform an Open AAA and Car procedures using this technology to further the teaching and training experience • CALM study: Use of Carotid stent to treat resistant hypertension
ul Flora
S, FRCS(GenSurg), MSc
r and General Surgery He aims to provide timely, clear independent reports to the medical profession on the back of 10 years of experience as a consultant surgeon. He fully understands the requirements of instructing solicitors, in particular the restricted timescales for civil litigation, the limitation of expertise, and the absolute need for independent, balanced consideration. Mr Flora is happy to take instruction from claimant and defendant as well as act as a single joint expert. He aims to complete the report within 4 weeks of seeing clients Fees and a terms and conditions sheet can be provided on request.
wing:
ases.
uction is necessary
oyal London Hospital. ment works.
rotid Endarterectomy e
Memberships: The Royal College of Surgeons of England, Member of International Society of Endovascular Specialists (ISES), Vascular Society, Association of laparoscopic surgeons of Great Britain and Ireland. The Federation of Forensic and Expert Witnesses member 2019.
Mr Paul Flora
Consultant in Vascular and General Surgery 116 Harley Street London W1G 7JL Contact: Eli Alfaro Tel: 07340 770730 (Eli Alfaro) Mobile: 07711 670623 Email: paulflora@me.com Alternate Email: thesurgeonslih@gmail.com
Dr Robert Marcus MB, FRCP, FRCPath
Consultant Haematologist Dr Robert Marcus, MA, FRCP, FRCPath is Consultant Haematologist at Kings College Hospital London. He qualified in Medicine from University College Hospital Medical School in London in 1977 and specialised in haematology at the Royal Postgraduate Medical School and the Royal Free Hospital. Prior to joining King’s in 2008, Dr Marcus was Consultant Haematologist in Addenbrooke’s Hospital in Cambridge for 20 years where he established the bone marrow transplant unit and developed a particular interest in lymphoma and related disorders. Dr Marcus’ research interests include the development of novel therapies for lymphoma, and has been a Chief investigator in a large number of practice changing studies. Recently he has developed further expertise in the management of Cerebral Lymphoma and Lymphoproliferative disorders in patients with HIV and after organ transplantation Dr Marcus was until recently the chairman of the NCRI low-grade lymphoma working party designing new studies in this field and has been examiner for the Royal College of Pathologists.
Dr Robert Marcus Consultant Haematologist
EXPERT WITNESS SUBJECTS COVERED INCLUDE Haematological malignancy. Leukaemia. Myeloma. Hodgkin's disease. Bone marrow transplantation. Peripheral blood stem call transplantation. Stem cell and bone marrow transplantation laboratory and clinical aspect. He is medical advisor to the Lymphoma Association, and Vice President of Leukaemia Care Dr Marcus has authored more than 150 peer-reviewed manuscripts and reviews, including national guidelines on follicular, cerebral and post transplant lymphoma He has co-edited 4 books , including new text books on Multiple Myeloma and Lymphoma, published in 2013 by Cambridge University Press Special interests Haematooncology, with a special interest in Lymphoma Hodgkins Disease and other lymphoproliferative disorders of blood and bone marrow
Special interests
Kings College Hospital Department of Haematology Denmark Hill LONDON SE5 9RS
Haemato-oncology, with a special interest in Lymphoma, Hodgkin’s Disease and other lymphoproliferative disorders of blood and bone marrow. He is also helping to establish a joint Haemochromatosis clinic at London Bridge.
020 7009 4271 | 07702 591767 | marcus.re@gmail.com | office@robertmarcusconsultancy.co.uk
Introducing MLAS Our New Members Of The Federation Of Forensic & Expert Witnesses Medical & Legal Admin Services (MLAS) is committed to providing high quality, maximum efficiency and excellent service to our customers. We pride ourselves on our innovation and willingness to go the extra mile. Our primary focus is to enable our customers to achieve their goals. We do this by improving efficiency and ensuring quality. At MLAS we provide a wide range of administrative services and we are able to tailor these to suit the specific needs of all our customers. At MLAS we understand the importance of detail with any instruction received and our primary focus is meeting the instructing parties’ expectations as efficiently as possible, ensuring the highest quality of service. We are the instructing parties first point of contact with new instructions or enquires, we ensure that you are kept up to date throughout the report process, allowing our expert to deal with the case.
How we work for you • • • • • • • • •
We assign two administration professionals to each expert case to ensure optimum service Our administrators have access to the expert’s diary to book in urgent appointments We will chase any document or information you require We manage the expert’s administration, calendar schedules and logistics, so we are best placed to give you the information you require instantly We will update you regularly as to what stage the report process is at We will notify you if there are any additional documents required or missing Our administrators are always available by telephone or email We do not charge you for our services, our contractual relationship is with our experts There are no hidden costs!
Contact us now for more information or to speak with one of our dedicated team.
0114 245 5423 enquiries@mlas.co.uk www.mlas.co.uk
Our Experts are amongst the most accomplished medical professionals in the UK PAIN MANAGEMENT Dr Mark Alexander-Williams, Consultant Anaesthetist Specialising in Pain Medicine Dr Alexander-Williams r is happy to write medico legal reports for Claimants, Defendants or joint Alexander-Williams has been instructions. Dr Alexande carrying out this work for five years and up until ecently fitted this work around a recently a busy clinical workload, this work is now performed in pre-booked sessions. Dr Neal Edwards, ds, Medico Legal Expert in Musculoskeletal Disease, Pain Management and Anaesthesia Dr Edwards ds has been preparing Medical Reports specialising in Musculoskeletal Conditions and Pain Management since January 2000 and cur currently prepares an average of 40 reports per month. Dr Edwards attends court if and when Edwa equi required. Dr Edwards has also been involved with Medical Negligence cases in both Pain Management and Anaesthesia. Dr Dimitriy Leschinskiy, Leschinski Consultant in Pain Medicine and Anaesthesia Dr Leschinskiy is a full time Consultant in Pain Medicine and Anaesthesia. His special interests e musculoskeletal and are post-traumatic pain and neuropathic pain conditions. He is particularly interested in issues estoration in pain patients and the of functional restoration role of opioids in non-malignant pain.
Dr Mark Miller, r Consultant in Pain Management, Medico Legal Practitioner Dr Miller has been writing medico legal reports eports in pain management since 2000. He writes on average 30 per month. Dr Miller has extensive experience in both claimant and defendant work and has done a large number of joint reports. eports. He has experience in clinical negligence work. NURSING/MIDWIFERY Ms Lynda ynda Lee, Medico legal Expert in Nursing and Ca Care Ms L Lynda ynda Lee can act as an expert witness, including the preparation reparation of care ca needs reports eports and appearing in court, in all cases relating elating to nursing care. ca Her reports care eports for palliative ca include those suffering with mesothelioma, cancer and other terminal conditions. As well as quantum reports, eports, she accepts instructions to produce reports on liability,, medical negligence and loss of services and also undertakes ofessionals allied to assessments alongside professionals medicine to produce oduce a multi-professional report. Her reports are e split 50:50 between claimant and defendant in both liability and quantum cases. Ms Lee has gained accredited Expert Witness ough Cardiff f University/Bond Solon. status through
Our Experts are amongst the most accomplished medical professionals in the UK UROGYNAECOLOGY/OBSTETRICS
NEUROSURGERY/SPINAL SURGERY
Dr Wael Agur, Urogynaecologist Dr Agurâ&#x20AC;&#x2122;s interest is in clinical negligence and product liability case work in relation to transvaginal implants (mesh and graft) for incontinence and prolapse. He also provides clinical negligence reports in general obstetrics and gynaecology. Dr Agur attended and gave evidence at court proceedings in Australia as one of the world-renowned experts and has recently appeared on the BBC Panorama programme focusing on transvaginal mesh implants.
Mr Debapriya Bhattacharyya, Consultant in Neurosurgery and Spinal Surgery Mr Bhattacharyya has been preparing Medical Reports as an expert in neurosurgery since 2007. Mr Bhattacharyya specialises in medical negligence, personal injury and compensation cases in general neurosurgery and cases related to his areas of special interest.
Mr Mohamed Riad Consultant Urogynaecologist Mr Mohamed Riad is a Consultant Urogynaecologist as well as a General Gynaecologist. Mr Riad is the RCOG (Royal College of Obstetricians and Gynaecologists) College Tutor at The Royal Wolverhampton NHS Trust providing oversight to training of doctors aspiring to become specialists in the field. In addition, he is accredited to provide training to doctors wishing to do the advanced training skill module in Urogynaecology. Mr Riad has experience in writing medico legal reports on transvaginal implants (mesh and graft) for incontinence and prolapse. He also provides clinical negligence reports in general obstetrics and gynaecology.
Mr Henry Budd, Spinal Surgery Mr Budd is a full time Consultant Spinal Surgeon with Royal Devon and Exeter NHS Foundation Trust. He is particularly interested in the degenerative spine including cervical, thoracic and lumbarsacral pathology. He is on the Specialist Register for Trauma and Orthopaedic Surgery. Mr Mark Prempeh, Spinal Surgeon Mr Prempeh is a Consultant Spinal Surgeon with Ipswich NHS Trust and Mid Essex Hospital Trust. His special interest includes degenerative spine disease, anterior lumbar surgery, spinal infections and minimal invasive (keyhole) surgery. Mr Prempeh is on the Specialist Register for Trauma and Orthopaedic Surgery.
MEDICAL & LEGAL ADMIN SERVICES OUR ETHOS
Perfection is our goal. We offer an excellent service, employ high quality professionals with the correct attitude and experience to ensure we excel in the work that we do for the expert. Our culture is one of honesty, support and respect. We live our culture and we encourage our experts to become part of that way of life too. At MLAS we pride ourselves on providing the most efficient service to our experts. We appreciate that all our experts have varied working schedules and commitments. Our administrators cater to this when they work for you, and to ensure your administration work is completed to the highest standard.
Our primary focus for you as a medico legal expert is: 1. To maximise the efficiency of your practice 2. Grow or consolidate your business in line with your needs Maximise Efficiency
Business Growth And Consolidation
We will manage all of your communication and administration
Promote you to established legal representatives when cases arise
You will have two administrators assigned to you
Continuously raise and improve your profile in the legal sector
We will manage your diary and logistics to save you time
We will promote you on our website
We will transcribe your dictation and proof read your documents on request
You will have an active Business Relationship Manager promoting your fields of expertise
At MLAS we have a strong working relationship with our experts, this includes trust and working to the highest level to get the best results for all parties.
If you require any information, please contact our office on the details below to discuss further. Contact us now for more information: enquiries@mlas.co.uk 0114 2455423 @MedLegAdmin https://www.linkedin.com/company/mlas/
www.mlas.co.uk
MLAS SERVICES FOR EXPERTS
We offer an excellent and comprehensive service covering all aspects of administration from external communication and logistics through to finance management.
COMMUNICATION • • • • • •
Manage all enquiries and instructions from Insurance Companies and Solicitors Be main point of contact between solicitor and expert Resolve administrative enquiries and prepare written responses Answer, screen and transfer all inbound phone calls Supplementary report management Liaise with appropriate customers to organise and facilitate joint discussions
LOGISTICS • • • • • • •
Agree expert’s terms of engagement and confirm fees Manage expert’s diaries Confirm appointments in writing with customer and clients Organise suitable travel and/or accommodation for experts to examine clients where necessary Monitor medical records and ensure these are available to the expert prior to meeting with the client Minimise/manage DNA’s through efficient organisational processes Co-ordinate conferences with counsel and attendance in court
ADMINISTRATION • • • • • • • •
Typing up of medical reports provided in the form of dictation Proof read medical reports before onward distribution Maintain and secure correspondence, records and documents relating to the clients Carrying out general clerical duties to include filing, typing and photocopying Maintain internal computer records and filing systems Make sure all reports are prepared and submitted in a timely manner to meet customer deadlines Paperless office available through specialist scanning service Dedicated and secure electronic storage of all medical records
FINANCE • • • • • •
Raising invoices using an agreed finance package Chasing payments and providing statements Maintaining detailed record of payments Regular updates from our finance team Regular upkeep and monitoring of management accounts Regular liaison with experts’ accountants updating VAT and income
MARKETING & PROMOTIONS • • • •
Marketing at the Bond Solon annual conference and other national events Feature on our Website Continuously raise experts’ profile in the legal sector Dedicated Business Relationship Manager, marketing and promoting expert
Our Experts Mr Martin Knight Consultant Endoscopic Spine Surgeon
We are delighted to announce that Medical and Legal Administration Services (MLAS) have partnered with Mr Martin Knight Consultant Endoscopic Spine Surgeon and Medico Legal Expert in Spinal and Referred Pain to deliver his logistical support. Mr Knight trained in London and is an internationally acknowledged leader in Endoscopic Aware State Minimal Invasive Lumbar Spine Surgery (EMISS). Mr Knight has experience with Personal Injury and Clinical Negligence claims for both Defendant and Claimant with the focus on unbiased assessment for the court. He has unique experience of aware state endoscopic surgery which serves to define the real-time source of spinal pain. Mr Knight will be able to offer Claimantâ&#x20AC;&#x2122;s an appointment within 2-4 weeks of instruction with an expected turnaround time for completed reports within 4-6 weeks. Reports can be completed within a shorter time frame dependent on urgency.
Experts: To work with MLAS contact our Business Relationship Manager Andrew Kwame: Telephone:07562 717854 Email: To giveAndrewOsei-Kwame@mlas.co.uk instruction please contact:
Please add Mr Knightâ&#x20AC;&#x2122;s details to your expert database and contact MLAS using the details below for any work you may wish him to undertake.
Medico Legal Expert in Spinal and Referred pain
Telephone: 0114 2455423 Solicitors/Insurers: Email: enquiries@mlas.co.uk To give instruction please contact: Or visit www.mlas.co.uk. Telephone: 0114 2455423
Mr Knight is able to see clients in: Harley Street Medical Centre (UME) 27 Harley Street London
Our Experts Mr Mark Prempeh Consultant Spinal Surgeon
We are delighted to announce that Medical and Legal Administration Services (MLAS) have partnered with Mr Mark Prempeh a Medico Legal Expert in Spinal Surgery, to deliver his logistical support. Mr Mark Prempeh is a Consultant Spinal Surgeon with Ipswich NHS Trust and Mid Essex Hospital Trust. His special interest includes degenerative spine disease, anterior lumbar surgery, spinal infections and minimal invasive (keyhole) surgery. He is fully registered with the General Medical Council and on the Specialist Register for Trauma and Orthopaedic Surgery. Mr Prempeh will be able to offer Claimant’s an appointment within 2 to 4 weeks of instruction with an expected turnaround time for completed reports within 4-6 weeks. Reports can be completed within a shorter time frame dependent on urgency. Please add Mr Prempeh’s details to your expert database and contact MLAS using the details below for any work you may wish him to undertake. Experts: To work with MLAS contact our Business Relationship Manager Andrew Kwame: Telephone:07562 717854 Mr Prempeh Email: AndrewOsei-Kwame@mlas.co.uk
Medico Legal Expert in Spinal and Referred Pain is able to see clients in: • Cambridge • Peterborough • Chelmsford • Ipswich • Kings Lynn
Solicitors/Insurers: To give Should instruction you please require contact: any further information or are interested in instructing Mr Prempeh Telephone: 0114 2455423 please do not hesitate to contact Paula at: Email: enquiries@mlas.co.uk
paulajames@mlas.co.uk, telephone – 0114 2455423 or visit www.mlas.co.uk
Our Experts Dr Andrew Logan Pain Management Expert
We would like to make you aware that MLAS are now partnering with medico legal expert Dr Andrew Logan, a Pain Management Expert and he is available to take instruction. Dr Logan’s specialist medico legal areas are: • All aspects of adult pain relief
Dr Andrew Logan is a Consultant in Pain Management with a specific interest in all aspects of adult pain relief and/or rehabilitation from painful conditions. Dr Logan covers a population of approximately 350,000 in the NHS and also engages in private practice and medico legal work at the Grosvenor Nuffield Hospital. Dr Logan has been engaged in medico legal work related to pain management since 1996 and has developed a specialist interest in this over the past 5 years. Dr Logan has written many reports usually for claimant’s in personal injury cases but has more recently been involved with defendant related cases particularly in clinical negligence as well as personal injury. Dr Logan can offer Claimant’s an appointment within 2 to 4 weeks of instruction with an expected turnaround time for completed reports within 4 -6 weeks. Reports can be completed within a shorter time frame dependent on urgency. Experts: Please add Dr Logan’s details to your expert database and contact MLAS To work with MLAS our below for any work you may wish him to undertake. using contact the details Business Relationship Manager Andrew Kwame: Telephone:07562 717854 Email: AndrewOsei-Kwame@mlas.co.uk
Medico Legal Expert in Spinal and Referred Pain Dr Logan conducts appointments in:
Solicitors/Insurers: • Chester • contact: Cheshire • The Wirral • Liverpool • London To give instruction please Telephone: 0114 2455423 Should you require any further information or are interested in instructing Dr Logan Email: enquiries@mlas.co.uk please do not hesitate to contact Paula at:
paulajames@mlas.co.uk, telephone – 0114 2455423 or visit www.mlas.co.uk
Medical & Legal Admin Services • Medical & Legal Admin Services (MLAS) is committed to providing high quality, maximum efficiency and the best medico legal expertise to both claimant and defendant solicitors.
• We deliver the logistical support for some of the most accomplished medical experts in the UK. • We ensure that reports are of the highest quality and deadlines are always met. • If you are a solicitor or insurer and need to secure the services of a medico legal expert look no further. • We provide expertise in a variety of case types including but not restricted to; Persistent Pain, Spinal Injury, Oncology, Obstetric Emergencies, Gynaecology, Orthopaedics and Neurodegenerative Conditions. Services for Experts - We offer an excellent and comprehensive logistics service, that includes managing all communications, travel and diary meetings, administration, finance, marketing and promotion. Contact us to consolidate or grow your Medico Legal practice.
Become a Mentor – We will work with Medico legal experts with a mature practice who can help to develop the next generation of medico legal experts, whilst still growing their own practice and increasing their own revenue.
Email: enquiries@mlas.co.uk Telephone: 0114 2455423 Twitter:@MedLegAdmin Web: www.linkedin.com/company/mlas - Medical & Legal Admin Services: Registered address: Haywood House, Hydra Business Park, Nether Lane, Sheffield, S35 9ZX.
Experts: To work with MLAS contact our Business Relationship Manager Andrew Kwame: Telephone:07562 717854 Email: AndrewOsei-Kwame@mlas.co.uk Solicitors/Insurers: To give instruction please contact: Telephone: 0114 2455423 Email: enquiries@mlas.co.uk
ve i e rec opy o t c re erly e h ck uart i l e C ee Q s a r ple our f y
Mr Fortune Iwuagwu
Consultant Plastic, Reconstructive and Hand Surgeon. On finishing his basic surgical training, Mr Iwuagwu embarked on training in all aspects of Plastic and Reconstructive surgery in various internationally recognised units in the country including Billericay (now Chelmsford), Manchester, Nottingham and Bristol. He furthered his training in his chosen subspecialty (Hand Surgery) as the British Society of Surgery of the Hand Fellow in the highly reputable Hand Unit in Chelmsford. He later undertook a Hand and Microsurgery Fellowship in the world recognised Kleinert and Kutz Hand Surgery Centre, Louisville , Kentucky USA where he trained under Dr Harold Kleinert recognised as one of the fathers and pioneers of modern hand surgery. Mr Iwuagwu was appointed a Consultant Plastic, Reconstructive and Hand Surgeon at the St Andrews Centre for Plastic Surgery and Burns, Broomfield Hospital, Chelmsford and the Whipps Cross University Hospital, London in 2002. St Andrewâ&#x20AC;&#x2122;s centre is the regional centre for plastic surgery and has one of the busiest hand trauma units in the country dealing with all aspect of hand trauma and post trauma sequelae.
His main interests are: * Hand trauma * Post hand trauma reconstruction * Breast reconstruction and scars
Special Medicolegal Interests: * * * * *
Scars Burn scars Hand injuries Soft tissue reconstruction Cosmetic surgery
He also performs a significant amount of general plastic surgery.
Qualifications MBBS University of Nigeria 1986 MSc University College London 1996 FRCS Royal College of Surgeons of Edinburgh 1993 FRCS Royal College of Physicians and Surgeons of Glasgow 1993 FRCS (Plast Surgery) Royal College of Surgeons of Edinburgh 2000
Medico-legal Experience: Mr Iwuagwu has been preparing medico-legal reports for medico-legal agencies and solicitors for more than 14 years. He prepares approximately 100 medical reports a year. The distribution is approximately claimant (80%) to defendant (20%). From instruction to completion of report is approximately three weeks if the client and medical records are available for examination/review. Mr Iwuagwu has undertaken specialist expert witness training. Mr Iwuagwu has attended the Bond Solon course - Excellence in Report writing Written Evidence in June 2011 and, the Premex annual Clinical Negligence seminar in June 2016. Essex, London and Nationwide
Membership * * * * * *
British Society for Surgery of the Hand, British Association of Plastic,Reconstructive and Aesthetic Surgeons, Expert Witness Institute, Society of Expert witnesses, Association of Personal Injury Lawyers (APIL), The Federation of Forensic and Expert Witnesses
Please contact Lisa for further information T: 01277 219752 | M: 07508 824858 | F:01277 219752 Email: austingracesuk@aol.com | Website: www.austingraces.com
Mr Richard Matthews
MB BS(London) FRCS(Eng) FRCS(Edin)MAE Consultant Cosmetic & Reconstructive Plastic Surgeon
Member of The Academy of Experts and a founder member and former President of the Warwickshire Medico-Legal Society, Mr Matthews has great experience in preparing Medical Reports for Solicitors for clients who have suffered personal injury, frequently taking instruction on a Single Joint Medical Expert basis. He also provides professional advice in cases of alleged medical negligence within his sphere of medical expertise. Personal Injury
Issues associated with:
All soft tissue injuries of the upper limb and hand Soft tissue injuries of the face Soft tissue injuries of the body Scarring Burns, scalds and thermal injuries Clinical Negligence Issues associated with: Soft tissue damage from trauma, including burns, scalds & thermal injuries Soft tissue damage from disease Tissue loss &/or scarring arising from medical or surgical actions Skin Cancer Surgery General Plastic & Reconstructive Surgery Cosmetic Surgery
Professional Memberships, Fellowships & Registrations The Academy of Experts UK Register of Expert Witnesses The Federation of Forensic & Expert Witnesses British Association of Plastic, Reconstructive & Aesthetic Surgeons (BAPRAS) British Association of Aesthetic Surgeons (BAAPS) British Society for Surgery of The Hand (BSSH) British Burn Association (BBA) Royal College of Surgeons of England Royal College of Surgeons of Edinburgh General Medical Council (GMC) Specialty Register for Plastic Surgery Professional Indemnity: The Academy of Experts
Mr Richard Matthews is a highly experienced Consultant Cosmetic & Reconstructive Plastic Surgeon. After qualifying as a Doctor at St Thomas Hospital Medical School in London, Mr Matthews trained widely in General Surgery, Orthopaedics, Urology and Paediatric Surgery before commencing his career in Plastic Surgery, progressing through five Regional Centres for Burns & Plastic Surgery, absorbing the art and craft of cosmetic and reconstructive plastic surgery. This included two years as Burns Research Fellow at the renowned Queen Victoria Hospital and Blond-McIndoe Research Centre at East Grinstead, during which he had notable papers published on the management of burns in pregnancy and the use of amniotic membranes for wound healing. He became fully accredited in Plastic Surgery, including Cosmetic and Reconstructive aspects, in 1984, was European Travelling Scholar of The British Association of Plastic Surgeons (now called BAPRAS) in 1985 and was appointed Consultant Plastic Surgeon in the National Health Service for Coventry & Warwickshire (catchment: 1 million) in 1986. From 1986 to 2006, when, as Head of the Unit, he effected its transfer to the new University Hospital for Coventry & Warwickshire, he radically modernised and expanded the Plastic Surgery Unit, introducing modern techniques and services for congenital abnormalities, such as cleft lip & palate and abnormal hands, for soft tissue diseases of the hand, such as Dupuytren’s contracture, for Breast Reconstruction and Head and Neck Reconstruction in cancer cases, including microsurgical procedures, and worked hard to improve standards of care for skin cancer. He served for four years as the first Chair of the Skin Cancer Site Specific Group of the Arden Cancer Network.
Mr Matthews has been West Midlands Regional Chair for Burns & Plastic Surgery and Regional Specialty Advisor to the Royal College of Surgeons of England and has served variously as Clinical and Medical Director within the NHS. Mr Matthews has over 30 years’ experience as an Expert Witness in his specialist field, preparing on average 60 Medical Reports a year, 40% instructed by the Claimant’s solicitor, 40% instructed by the Defendant’s solicitor and 20% as a Single Joint Expert. Mr Matthews keeps up to date by attending Professional Association meetings and other CPD events, such as The Academy of Experts one day Seminars, as well as reading relevant Journals and the ‘Your Witness’ newsletter of the UK Register of Expert Witnesses. His election to The Academy of Experts recognised his wealth of experience and expertise.
T:: 01926 436341 fax: 01926-422659 E: Sally.Bates@nuffieldhealth.com W:www.richardmatthewsplasticsurgeon.co.uk
Mr Brent Tanner has worked as a Consultant Plastic and Reconstructive Surgeon since 1984. First and foremost his work has been at the Queen Victoria Hospital in East Grinstead where he was Director of the McIndoe Burns Unit. For the last ten years he has solely devoted his time to cosmetic surgery.
Instructions undertaken on behalf of either claimant or defendent or as a single joint expert in cases relating to plastic and reconstructive surgery, including burns and scars and cosmetic surgery.
2019
Federation of Federation of
Expert witnesses sic Forensic & Expert&witnesses 01892 740044 | brenttanner@brenttanner.co.uk | www.brenttanner.co.uk
Dr Michael Bone
BSc (Hons) MB DCH FRCP
Consultant Physician
Dr Michael Bone has been a Consultant Physician (General Internal, Respiratory and Clinical Allergy) for over 30 years and still provides supervision of acute unselected medical intake at one of England's consistently top performing NHS Trust Hospitals. Over the years he has acted as clinical lead in asthma and COPD, lung cancer, tuberculosis and interstitial lung diseases and critical care medicine. He ran a pleural diseases service, initiating medical thoracoscopy in 1985 and inaugurated a joint rheumatological lung clinic in the early 1990's. With early training in paediatrics and immunology, he ran a joint allergy and asthma service for 16 years and remains an active member of the northern paediatric allergy group.
Dr Bone has been engaged in medico-legal assessments and reporting since 1982. He has had extensive experience with occupational asthma and hypersensitivity reactions, such as farmers lung and industrial dust diseases, from his time at the MRC pneumoconiosis unit in South Wales and later in the Midlands. Over the last 18 years in the North East he has acquired extensive experience with asbestos related lung diseases.
Tel: 07545 587004 Email: rhonda_bone@hotmail.com Dr Michael Bone, M B Consulting Ltd, Spire Hospital, Picktree Lane, Washington, Tyne & Wear NE38 9JZ
Hand & Wrist Surgery by Stephen Lips
Stephen is an Orthopaedic Upper Limb Surgeon with a specialist interest in hand and wrist surgery, training and working within the Mersey deanery having merited an honours degree at Liverpool Medical School. The majority of his orthopaedic surgical experience involves upper limb surgery, having finalised his training with one of the few nationally recognised advanced training post fellowships in hand/wrist surgery and successfully completing the British diploma in hand surgery. His surgical practice includes traumatic injuries to the upper limb and elective hand/wrist surgery including nerve disorders.
Mr Stephen Lipscombe | BSc, MBChB, FRCS, DipH 01925 598217 | stephen.lipscombe@consultantcare
scombe
HS | Consultant Orthopaedic Surgeon e.com | www.privatehandsurgeon.co.uk
Mr Martin Heaton BMedSci, BM BS, MD, FRCS, FRCS (Plast)
Consultant in Plastic & Reconstructive Surgery
Mr Martin Heaton, MD FRCS, FRCS(PLAST), Consultant Plastic Surgeon. Mr Heaton undertakes the full range of expert advice from second opinions to formal medicolegal reports including Medical Negligence, Personal Injury and Causation and Prognosis Reports. Mr Heaton has been instructed by both claimant and defendant solicitors, is a recognised expert witness for the General Medical Council and provides opinions and reports for the Welsh, Scottish and English Public Health Service Ombudsmen. Mr Heaton is able to offer opinions on General Plastic Surgery, including scars, outcomes following repair, acute hand surgery and trauma etc as well as in his specialist fields of skin cancer, reconstruction and head and neck surgery. With nine yearsâ&#x20AC;&#x2122; experience as a Consultant Plastic and Reconstructive Surgeon, Mr Heaton has a wealth of experience when dealing with contentious matters. Having graduated from The University of Nottingham Medical School in 1992, he became a Fellow of the Royal College of Surgeons in 1996 and subsequently obtained a doctorate (MD) from the University of Sheffield for research into reconstructed skin.
Mr Heaton passed the Intercollegiate Specialty Board examination in 2006 and was added to the GMC specialist register in the specialty of plastic surgery in 2008. A consultant appointment at the Leicester Royal Infirmary followed in January 2009 with a specialist interest in breast reconstruction. Since July 2010 Mr Heaton has been a consultant plastic surgeon at the Norfolk and Norwich University Hospital Foundation NHS Trust.
• Areas of expertise: • Assessment and management of scars and complex wounds. • Reconstruction of post-traumatic and post treatment tissue defects of all parts of the body using the full range of plastic surgery techniques including microsurgery. • Management of head and neck and skin cancer.
Scope of Practice:
Mr Heaton works entirely within the NHS. He has considerable experience of head, neck and skin cancer, reconstruction of posttraumatic and post-treatment defects of all parts of the body using the full range of plastic surgery techniques including microsurgery. Mr Heaton is able to advise on those aspects of aesthetic surgery that until recently were available on the NHS. This includes breast augmentation, breast reduction, abdominoplasty, liposuction and fat transfer.
Presentations:
I have presented, chaired sessions and been invited faculty at a variety of plastic surgery, head and neck and skin cancer meetings.
Expert Witness Experience:
Mr Heaton has attended the Bond Solon ‘Excellence in Report Writing, course. Mr Heaton has prepared Personal Injury and Causation and Prognosis Reports for both claimant and defence solicitors. Mr Heaton is an approved expert witness for the General Medical Council (4 – 5 expert witness reports per annum) and regularly prepares reports for the Scottish Public Health Service Ombudsman and the Parliamentary and Health Service Ombudsman (10 – 15 cases per annum). Mr Heaton is a member of the National Expert Witness Association and The Federation of Forensic and Expert Witnesses.
Contact Details 01603 288543 07946 486857 mjheaton@doctors.org.uk martin.heaton@nnuh.nhs.uk Norfolk & Norwich University Hospital Dept of Plastic Surgery Colney Lane NORWICH
Mr Mike Perry FRCS, FDSRCS, FRCS(OMFS), BSc
Consultant Oral and Maxillofacial Surgeon & Facial Plastic Surgeon
(London)
Mr Perry is a Consultant Oral and Maxillofacial Surgeon who is on the GMC Specialist list in Oral and Maxillofacial Surgery and registered with both the GMC and GDC. He is a fellow of the Royal College of Surgeons of England. Previously listed in The Times Magazine as one of the countryâ&#x20AC;&#x2122;s 50 top surgeons. Mr Perry has extensive experience in the management of diseases of the face, jaws and mouth, (Oral and Maxillofacial surgery and Oral surgery). He is qualified in both medicine and dentistry and trained as a surgeon before specialising in surgery of the head and neck. He has particular expertise in the management of craniofacial trauma, facial deformity and skin cancer and is the clinical lead in facial trauma at both the Regional Maxillofacial unit and Major Trauma Centre, serving the North west of London. He also sees and treats diseases of the mouth, temporomandibular joint, salivary glands and teeth. He is an enthusiastic teacher and has taken on various educational roles over the years (nationally and internationally), including the conception and design of several trauma related course, some one of which have been held at the Royal College of Surgeons and Royal Society of Medicine. He has published extensively in this field, including several text books.
MEDICOLEGAL PRACTICE
Mr Perry has considerable experience in both clinical negligence and personal injuries and regularly provides reports for several large national law firms.
Clinical negligence
These include:
(both for Claimant and Defendant)
Personal injury reports
(Injuries to the face, nose, jaws, teeth, orbits and jaw joints, including facial lacerations). All reports are detailed, comprehensive and non biased, and can address specific issues if requested. Rapid turn around (often within 3-5 days once all information received). Also available to provide desk top reviews and formal / informal preliminary analysis of any potential claims (non disclosure reports or telephone discussion). Will consider pro bono analysis of simple (quick) cases.
Mr Perry specialises in the following areas: Facial injuries Post traumatic craniofacial deformity ( Fracture and scars) Serious infections to the teeth and supporting bones Skin cancer /Oral disease
Reports available
Personal injuries to the face and teeth Clinical negligence (claimant or defendant ) Missed diagnosis Failure to treat Consent issues Breach of duty / causation / condition and prognosis Desktop / Claimant examination reports Very quick turnaround Northwick Park Hospital Department of Maxillofacial Surgery Watford Road London HA1 3UJ
020 8869 3141 020 8235 4282 michaelperry@nhs.net www.facialsurgery.center
Dr Anjani Prasad BSc (Hons), MBChB, FRCP
Consultant Respiratory & General Physician
Expert Witness in Respiratory Diseases
Areas include:
• • • • • • • •
Respiratory diseases. Asthma and occupational asthma. COPD. Asbestos related lung disease. Road traffic related breathing problems. Lung functions including spirometry. Interstitial lung disease. Pulmonary embolism.
For further information please contact Dr Anjani Prasad
0330 053 8151 admin@liberatehealthcare.co.uk. www.liberatehealthcare.co.uk
Allan R Thom
LLM (Medical Law), BDS, FDS (Eng & Edin), D'Orth, M'Orth (Eng), MFGDP, MEWI.
Consultant Orthodontist
• Dental negligence • Orthodontic negligence • Personal injury • Dental trauma • Cleft lip & palate Allan Thom was an accredited teacher at the University of London and an Honorary Senior Lecturer at Guy's Hospital. He is experienced in all aspects of orthodontic treatment, orthodontic surgery, cleft lip and palate, facial deformity and dental trauma. Allan has lectured and taught internationally. He has co-authored and edited orthodontic books. He is the President of the World Federation of Orthodontists and a past President of both the British Orthodontic Society and the European Federation of Orthodontists. Disclosure and Barring Service checked for minors Allan Thom is trained in report writing and cross examination. LLM (Medical Law and Ethics).
n
t tac
Co
Mr
m
o Th
T: 01892 528915 | M: 07808 596119 | E: arthom@hotmail.co.uk
w
no
Mr Imran Liaquat MBChB, BSc, MedSci, FRCSEd (Neuro.Surg) Med
Consultant Neurosurgeon I have been a Consultant Neurosurgeon for 5 years and have a long established track record in head injury/ traumatic brain injury management and research. Roughly 50% of my workload is with management of spinal problems such as back pain, neck pain, sciatica and arm pain (brachalgia). In addition, I am the clinical lead for adult neuro-oncology/brain tumours and the National Lead for the Scottish Neuro-oncology Network. I am an active member of the Scottish Adult Brain Injury Network (SABIN) and responsible for reconfiguring the rehabilitation of mild to moderate head injury patients.
Areas include: • Head injury and neurotrauma. • Back and neck injury. • Sciatica and radiculopathy. • Leg pain and arm pain. • Spinal injury. • Spinal injuries. • Neuro-oncology and brain tumours. • Cauda Equina Syndrome (CES). • General neurosurgery.
07812 010633 07380 273655 (PA) imranliaquat@nhs.net www.scottishneurosurgeons.co.uk
Spire Murrayfield Hospital Contact Address: 122 Corstorphine Road EDINBURGH
Dr Russell Keenan MB ChB, PhD, MRCP, MRCPath
MB ChB, PhD, MRCP, MRCPath
Consultant Paediatric Haematologist A Consultant Paediatric Haematologist with over twenty years experience, Dr Russell Keenan can act as an expert witness, including the preparation of medicolegal reports and appearing in court, in child protection cases, clinical negligence cases and relating to all aspects of paediatric haematology.
His specialist areas of expertise include: • Haemophilias and other bleeding disorders. • Thrombophilias. • Haemoglobinopathies. • Thalassaemias. • Sickle cell disease. • Benign haematological disease. • Malignant haematology. • Leukaemia. • Transfusion medicine. Dr Keenan's reports have covered cases of medical negligence relating to paediatric haematology and child protection in relation to the presence or absence of a bleeding disorder. He has experience of working with barristers and being cross examined in court. He keeps his reports relatively short, focused on the legal instructions, with all scientific and medical language and the basis of any opinions explained and referenced as required.
Dr Keenan can take instructions on behalf of either claimant or defendant. Alder Hey Children's Hospital | Eaton Road | West Derby | Liverpool | L12 2AP 07753 807611 | russelldavidkeenan@gmail.com
2019 winner T Specialist Training p AWARD FOR Total Train Ltd
Award for Specialist Training provider of the year 2019-2020 It gives us great pleasure to announce that the Federation of Forensic and Expert Witnesses has announced this years Independent Awards and has profiled one of its members and her training company Total Train for their outstanding work with in their chosen specialty in this case Joanne Caffrey a dedicated training expert witness based in Cumbria but covering the whole of the UK Total Train provides expert witness work and is supported via the specialist training to try to develop organisations to prevent the legal cases occurring. Their multi disciplinary team combines the legal, therapeutic and medical models to deliver a holistic approach suitable for police, prison, security, mental health, education and all care sectors. This is for the hard work and development of services given to the field of training and prevention methods provided to their clients and to the training and expert witness industry. The Awards are independent to the Federation and are designed to raise the profile and highlight in our opinion the best experts in their given fields of expertise . The Federation hope to bring this to the attention of the lawyers and barristers that follow them on linked in and who visit their site and read their E-mag that can be viewed at https://www.forensicandexpertwitness.co.uk
You can Instruct Joanne and Total Train now:
Joanne with her award
TotalTrain Helm Bar, Melmerby, Penrith, CA101HF 07528 800 720 joanne_caffrey@sky.com www.totaltrain.co.uk
Forensic & Expert witnesses
Federation of
Award
Federation of
2019
Total Train ltd provider of the year. The Award winning training includes: • • • • • • • • • • • • • • • • •
Managing Challenging Behaviour Minimising Use Of Force Physical Intervention & Restraint Safe Use Of Restraint Equipment Safe Use Of Isolation And 'Calming' Rooms Person Centred Behaviour Management Plans Stop, Search And Confiscate Managing Ligature Risks - Preventing Death By Hanging Mental Health First Aid Managing Suicide And Self Harm Safer Custody Tactical Communications Safer Management And Administration Of Medication Personal And Intimate Care Sensory Integration Restraint Specific First Aid And Medical Emergencies Working With Aces (Adverse Childhood Experiences)
• Safeguarding Joanne Caffrey and Total Train are happy to assist with any of the above.
Along with her awards for: 2018 winner Forensic & Expert Witness Award Outstanding Legal Services to Safer Custody 2019 winner Total Train ltd Specialist Training provider of the year. Joanne was awarded the 2012 British Excellence Award from the British Association of Women in Policing. This was heavily biased by her design and delivery of the initial Safer Detention and Handling of Persons in Custody programme.
Award winning training, consultancy and expert witness service.
Joanne Caffrey is available to speak at your conference
Please contact Joanne for further information: 07528 800 720 joanne_caffrey@sky.com www.joannecaffreyexpert. com Or totaltrain@sky.com www.totaltrain.co.uk Helm Bar Melmerby Penrith CA10 1HF
Safeguarding vulnerable people through health, safety and care.
Dr Abbas Lohawala Consultant Neuropsychiatrist
Dr Lohawala has practised as a psychiatrist for 15 years and as a Consultant Neuropsychiatrist for the last 7 years. He works across the spectrum of NHS, Independent sector and Expert Witness fields in Neuropsychiatry. He has a unique blend of qualifications and experience with Postgraduate Diplomas in Neuropsychiatry and Holistic psychotherapies . He was the Medical Lead for St Andrews Brain Injury Services and has worked for major Neuropsychiatry providers including Cambian, Huntercombe and BIRT groups.
He runs an outpatient Neuropsychiatry clinic in the NHS in Birmingham and acts as a Visiting Consultant Neuropsychiatrist at PJ-Care, providers of specialist Neurological care in addition to Expert Witness work. His skills stand out in being able to work with Complex Care clients with combinations of physical, psychiatric and cognitive disabilities.
He works in the Personal Injury and Clinical Negligence fields with 50:50 Claimant and Defendant instructions.
Areas of Expertise • • • • • • • •
Brain Injury- causation, severity and Post Concussion Syndrome. Dementia -Early and Late Onset and Memory disorders in adults Alcohol induced Brain Injury and Korsakoff’s syndrome. Somatisation, Conversion Disorders including Non Epileptic Attacks. Huntingtons Disease Epilepsy and Sleep Disorders General Adult Psychiatric Disorders with combination of Physical, psychiatric and cognitive issues. Capacity assessments for all above areas.
194 North Road Stoke Gifford South Gloucestershire BS34 8PH
0117 979 3773 07709 911052 abbas.lohawala@neurochambers.com www.mss-medicolegal.co.uk
Dr Alfred White MD MBBS LRCP MRCS DPM FRCPsych Consultant Psychiatrist r Alfred White has over 35 years' experience acting as an expert witness including extensive court experience. He undertakes approximately 200 cases per year, taking instructions on behalf of both claimant and defendant and as a Single Joint Expert.
D
Dr White prepares reports on most aspects of psychiatry (excluding learning disability and child psychiatry) but specialises in:
• Trauma (personal injury) • Medical Negligence • Employment issues • Brain injury • Medically unexplained symptoms • Liaison Psychiatry (Hospital Conditions) His interest in trauma began with a research project in burns and other accidents (MD 1981) followed by research on the Birmingham pub bombings. His wide ranging experience also includes eating disorders, brain injury rehabilitation and liaison psychiatry.
Dr White is an examiner for the royal college of psychiatrists. Dr Alfred White MD MBBS LRCP MRCS DPM FRCPsych Consultant Psychiatrist 17 Portland Road Edgbaston B16 9HN T: 0121 454 2217 07985 882 603 F: 0121 454 2217
Dr Anantha P P Anilkumar MBBS, MRCPsych, CUBS (Civil & Family)
Consultant Psychiatrist I am Dr A.P.P. Anil Kumar, Consultant Psychiatrist at the Maudsley for the last thirteen years. I have more than twenty one year’s experience in psychiatry, have been approved under section 12 of the mental health act and a member of the Royal College of Psychiatrists since July 2000. I am included in the GMC specialist register, with general psychiatry as my speciality, and substance misuse psychiatry as my sub speciality. I accept instruction on Civil and Family cases only. I have researched at the Institute of Psychiatry, Psychology and Neuroscience, King's College London for the last 17 years on clinically relevant areas. I have been a Royal College examiner, an interview panel member for CT and ST doctors and am a honorary clinical senior lecturer at IoPPN.
Federation of
Forensic & Expert witnesses
I have a wide range of experience in medico-legal work commencing from 2003. The cases I have undertaken (approximately 30-50 per year) have been in family proceedings, personal injury cases, housing related matters assessing in relation to the disability discrimination act, immigration cases, mental capacity assessments and employment tribunals. I have been awarded the Cardiff University Bond Solon Civil Expert Witness Certificate in April 2017 and the Family Expert Witness Certificate in October 2017. I have recently been appointed as a Fee-paid Medical Member of the First-tier Tribunal Health, Education and Social Care Chamber (Mental Health).I also have an Honorary Clinical Senior Lecturer post at Institute of Psychiatry, Psychology and Neuroscience, since January 2016 and am the firm head for the Longitudinal Mental Health Placements for Medical Students at GKT School of Medical Education.
My areas of expertise include: • Psychosis- Schizophrenia, Acute Psychosis, First episode psychosis, Delusional Disorder • Substance misuse and Dual Diagnosis • Dissociation disorders, Post Traumatic Stress Disorder( PTSD) and Complex PTSD • Personality disorder. • Anxiety and phobic disorders. • Depression and other mood disorders. • Adjustment disorder. • Factitious illness. • Impact of mental illness on parenting. • Chronic pain. • Bipolar disorder. • Abuse and domestic violence.
For Further Information plase contact Dr Anilkumar
46A Selborne Road | Park Hill | CROYDON | Surrey | CR0 5JQ Mani - 07533268342 | Susan - smurchison@nhs.net | Nora - nora.roberts@slam.nhs.uk
www.dranilkumar.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
Dr Lars Davidsson MRCPsych,MEWI, Accredited Mediator (LSM).
Medico legal work.
with Dr Lars Davidsson Lars Davidsson is a Consultant of almost 30 years standing, who for the last ten years, on a regular basis, has provided more than 2,000 medico legal reports. Lars attends the Courts as an expert witness on a regular basis. With almost 10 yearsâ&#x20AC;&#x2122; experience from his local Criminal Justice Mental Health Team, Lars has a special interest in anxiety and trauma (including road traffic accidents). However, over the last years Lars has written an increasing amount of reports for the employment tribunals. Lars attends most Courts including the Magistrates Court, Crown Court, County Courts (mainly family matters) as well as Military Tribunals. He also attends professional hearings as an expert witness for GDC, NMC and GOC. and has also been instructed by a number of reputable solicitor firms including Mills and Reeves, Keeble Hawson, Government Legal Department etc. Clients can usually be seen within two weeks after having received instructions. The reports are usually provided after another two weeks, provided all the necessary paperwork is available. Clients can be seen in Lars' office at Southend on Sea, Essex or in his consulting room at Suite 4, 7 Harley Street, London.
Areas of expertise include Adult ADHD, Anger Management, Anxiety, Bipolar Disorder, Complex Phobias, Depression and recurrent Depression, Post Traumatic Stress Disorder, Stress and Worry, Low Self Esteem and more. Fees are based on an hourly rate for all time spent on the case. This fee is flexible depending upon the amount of credit needed.
For an informal discussion please call 01702 464 099 / 07969 181936 or email Lars Davidsson directly lars.davidsson@angloeuropeanclinic.co.uk
Our practice clinics Anglo European Clinic Prittlewell House 30 East Street, Southend, Essex, SS2 6LH Anglo European Clinic Suite 4, 7 Harley Street, London, W1G 9QY
Dr Lucinda Cockayne
Consultant Psychiatrist Dr Cockayne currently works part time as a Consultant in Liaison Psychiatry for NHS Lothian, having recently retired from her full time post. She has a wealth of experience working in General Adult Psychiatry, and Substance Misuse. She was Lead Clinician for the Fife Substance Misuse Services prior to her retirement. Her work in treating drug and alcohol misuse and dependence was based in both community and inpatient settings. The scope of her work has also included liaison psychiatry and Perinatal psychiatry.
Dr Cockayne is a Designated Medical Practitioner for the Mental Welfare (Scotland) Commission (MWC). She prepares reports for the Nursing and Midwifery council on fitness to practice, and has taken similar instructions from the GMC and RPS. She has worked on a range of matters including medical negligence, personal injury, criminal cases and assessments for guardianship. She has also been instructed by the Forces to provide assessments of the mental health of veterans.
Her specialist interests include: • Treatment Of Opioid And Alcohol Dependence • Use Of Opioid Antagonists • Detoxification • Adhd, Add And Management Of Dual Diagnosis. • General adult psychiatry, liaison psychiatry, guardianship issued For further information please contact Dr Cockayne by e mail - pr4ultd@gmail.com
Dr Naresh Buttan MBBS, DPH, DPM, DNB (Psy), CESR,Sec 12 (2) AC
Consultant Psychiatrist Tenacity Consulting Service Ltd PO Box 295, Glenfield Road, PLYMOUTH Devon PL5 9DB www.nuffieldhealth.com/consultants
Areas of Expertise:
I specialise in general adult psychiatry and have been working a consultant in NHS since February 2008. I previously worked in Australia and India as a Consultant Psychiatrist and Clinical Director since 2001. My special interest areas are in transcultural psychiatry, asylum seekers and refugees’ mental health, impact of war, trauma and physical, emotional and sexual abuse on mental health, bullying and harassment at work and impact on mental health. Also specialise in diagnosing and treating common and severe mental disorders such as: • ADHD. • Schizophrenia and psychoses including drug induced psychosis. • Depression, bipolar mood disorders. • Anxiety spectrum disorders including GAD, phobias, OCD and PTSD. • Dissociative conversion disorders. • Eating disorders including anorexia nervosa, bulimia nervosa and binge eating disorder. • Psychosexual disorders such as erectile dysfunction and impotency. • Self-harming or suicidal behaviours. • Personality disorders. • Alcohol and drugs dependence. Areas of Expertise: I’ve been working as a full time substantive Consultant Psychiatrist in NHS since Feb’08. Previously, I worked as a Consultant, Clinical Director and Deputy Medical Superintendent in various hospitals in India & Australia since 2001. I also specialise in using psycho-pharmacological (antidepressants, anti-psychotics, mood stabilizers) and psychotherapeutic treatments including CBT for mental illnesses. I have provided Medicolegal Expert Witness Psychiatric Reports for over 50 cases to various legal firms and other organizations with high success rates. I’m able to see clients at mutually convenient places and times and provide time efficient high quality expert reports”. I currently work in NHS contracted organization and also see patients privately at Harley Therapy Ltd, London and Nuffield Health Plymouth Hospital by appointments in my private time. For medico-legal cases, please contact me by phone or email to arrange appointments.
Dr Nikki de Taranto MBBCh LLM MRCPsych
Consultant Forensic Psychiatrist NHS consultant forensic psychiatrist with more than twenty years' experience of medico-legal work in the civil courts including medical and clinical negligence, compensation for abuse and neglect including sexual abuse, personal injury, risk assessments and capacity assessments. Nikki is based in Hertfordshire but will travel anywhere for assessments
Dr Nikki de Taranto holds a Masters Degree in Medical Law from the University of Cardiff.
• • • • • • • • • • • • • • •
Mental health. Mental illness. Psychiatric. Post traumatic stress disorder. PTSD. Adjustment disorder. Trauma. Mental trauma. Child abuse. Negligence. Medical negligence. Psychosomatic. Suicide. Psychosis. Forensic psychiatry.
For further information please contact: Karen Lock - 020 8702 6055 | nikkidt@protonmail.com
Dr Pravir Sharma
FRCPsych DPM MSc MBBS Consultant Psychiatrist • 0121 227 0785 • 0121 227 0786 • 07747 563631 •info@privatepsychiatristbirmingham.co.uk • www.privatepsychiatristbirmingham.co.uk Dr Pravir Sharma specialises in mental health disorders in the elderly although he also has extensive experience of general adult psychiatry. He is experienced in assessing memory problems comprehensively and in the treatment of Alzheimer’s disease and difficult behaviours associated with it and other dementias. He also has a special interest in treatment resistant anxiety and depressive illnesses. Dr Sharma can act as an expert witness, including the preparation of medico legal reports and appearing in court, in personal injury and clinical negligence cases relating to these areas of expertise. He can prepare medico legal reports for road traffic accidents and other accidents in the work place as well as reports for employment tribunals. Mental capacity: Dr Sharma has extensive experience of assessing capacity in complex cases where mental illness or memory disorders affect the person. He has prepared reports for the court of protection on matters concerning mental capacity, lasting power of attorney, testamentary capacity, capacity to make decisions concerning money affairs and care arrangements, and fitness to stand trial or follow court proceedings. He has extensive experience of the use of the Mental Health Act and is Section 12(2) approved. Clinical negligence: Dr Sharma has experience of producing causation and condition reports in clinical negligence cases with respect to psychological injury and psychiatric illness. He does not take on paediatric cases involving children below 18 years of age and does not see clients for criminal court reports or forensic cases. Dr Sharma can act on behalf of either claimant or defendant or as a Single Joint Expert. He is able to offer quick appointments and usually provides reports within 2-4 weeks of assessment.
Dr Sharma has consulting suites at: • Spire Little Aston Hospital, Little Aston Birmingham B74 3UP • Sutton Medical Consulting (Ashfurlong Surgery) 233, Tamworth Road, • Sutton Coldfield, Birmingham B75 6DX He can also see clients for medico legal report assessment at their homes. Dr Sharma offers home visits for patients in the Midlands who are unable to travel.
Dr Nireeja Pradhan MBBS, FRCPsych, MA Medical Ethics & Law
Consultant Psychiatrist
Dr. Pradhan assesses clients nationally and normally provides reports one to two weeks from assessments (urgent reports in 2 -5 days). She is regarded as a leading Expert witness in Psychiatry and assists lawyers nationally with free expert medico-legal advice and by making referrals to fellow high quality psychiatrists and other medical specialty experts based on draft letter of instructions. (Please email draft letter of instruction to info@drpradhan.co.uk for appointments and quotes).
Expert Witness Awards Winner:
Consultant Psychiatrist of the Year 2017
Lawyers can submit case details online for instant appointments and quotes on her website www. drpradhan.co.uk Telephone Dr. Pradhan on 0800 161 3395 for free medico-legal advice and appointments.
Dr. Pradhan has extensive experience in provision expert witness reports across all areas of law for over 15 years. She has earnt a strong reputation with leading barristers for her comprehensive reports and court attendances. She has vast experience in Fast Track and Multi Track Personal Injury cases involving assessing psychiatric injuries in historic child abuse, clinical negligence Inc. Birth Injuries, personal injury cases Inc. catastrophic RTAâ&#x20AC;&#x2122;s, complex cases and equality act assessments.
Dr. Pradhan was awarded as Consultant Psychiatrist of the Year at Expert Witness Awards 2017. Dr. Pradhan was also awarded the Fellowship of the Royal College of Psychiatrists for her expert witness services and excellence in psychiatry. Working in the inner-city area of Birmingham as the lead Consultant Psychiatrist Dr. Pradhan has extensive clinical experience in patients with a range of complex mental health issues often precipitated by social factors. This highly relevant clinical expertise ensures that she is considered an appropriate psychiatrist to assess the General Adult population who may have suffered from sudden or past traumatic events whether mental, physical or emotional in civil and criminal matters.
Dr. Pradhan has been appointed on numerous panels in high profile cases as an expert and in high value and contentious cases involving numerous experts and court attendances where clients had been awarded record compensation. Expert Witness Training: Dr. Pradhan has completed a comprehensive professional course in Medical Report Writing and Giving Expert Evidence in Court. References from lawyers in Personal Injury, Clinical Negligence, Abuse, Employment Family Cases available upon request.
PERSONAL INJURY & MEDICAL NEGLIGENCE CASES : • Birth Injuries • Road Traffic Accidents • Workplace Accidents • Trauma Sequelae • Post-Traumatic Stress Disorder • Psychosomatic Disorders/ Munchausen / Malingering – fraudulent simulation or exaggeration of symptoms assessments • Psychopathology / Psychiatric Disorders • Anxiety Disorders / Depression / Stress Disorders • Psychiatry Injury due to Medical Negligence / Clinical Negligence • PTSD, Post-Traumatic Stress Disorder • Criminal Injuries : Victims • Victims of Abuse including childhood abuse • Employment Tribunals / Equality Act / DDA • Medical Negligence / Clinical Negligence Inc. catastrophic injuries • Fitness to work/ Return to Work • Sexual Harassment, Bullying, Racial Discrimination • Psychiatric Injury ; Depression, Anxiety , enduring personality change • Trauma Sequelae • Psychosomatic Disorders/ Munchausen / Malingering • RTA’s and Accidents at work • Psychopathology / Psychiatric Disorders • Anxiety Disorders / Depression • Psychiatric Injury / Stress Related • Medical Negligence / Clinical Negligence • Military Claims : PTSD, Bullying, Abuse • Catastrophic Injuries • Assessment of Adults who suffered Childhood Injury
CRIMINAL LAW : • Pre-sentencing reports • Fitness to Plead and Stand trial • Risk assessments including Arson • Pre-sentencing Reports • Suggestibility • Loss of control • Hospital Orders • Diminished Responsibility / Intent • Sexual / Violent crime • Parole Board Assessments • Mental Health Review Panels • Personality Disorders • Personality Disorders/Psychoses • Dangerousness/Risk Assessment • Violence/Self Harm/Suicide • Offender Assessment • Witness Assessment/ Testamentary Capacity • Abnormal Behaviour • Mental Disorders • Psychiatric Rehabilitation • Rape / Sexual abuse • Crime Victims / Torture Victims • Child Abuse • Section 18, Section 37 • Arson Cases • Murder Cases
Expert Witness Consultant Psychiatrist of the Year 2017
Dr Nireeja Pradhan receives her award
Consulting rooms nationwide Contact: Dr. Pradhan Tel: 0800 161 3395 E: contact@drpradhan.co.uk W: www.drpradhan.co.uk
Psychiatry Experts Chambers House 75 Harborne Road Birmingham B15 3DH
EMPLOYMENT LAW :
• Work Related stress • PTSD • Fitness to Work / Return to Work • Employment Tribunals / Equality Act • Psychiatric Injury: Depression, Anxiety, • Sexual Harassment • Bullying • Racial Discrimination
FAMILY LAW :
• Assessment of parents in child contact and custody cases • Parental Psychiatric assessments • Risk Assessments / Domestic Violence • Mental Capacity Assessments
IMMIGRATION & ASYLUM CASES : Training Extensively trained and experienced in CPR quality Expert Witness Reports Expert Training Expert Witness Training Membership Sweet & Maxwell Checked, Expert Witness Institute, Society of Expert Witnesses, Medico-Legal Society and APIL, Member of European Society for Traumatic Stress Studies, The Federation of Forensic and Expert Witnesses.
Dr. Pradhan offers free medico-legal advice and screening
Q/A Dr Sohom Das h
Wit
Consultant Forensic Psychiatrist Expert Witness How did you become an expert witness? I was fortunate enough to undergo forensic psychiatry training, as opposed to general psychiatry. Criminal Court report writing is our bread and butter, and I was encouraged as a Specialist Registrar to take on as many cases as I could. I was also fortunate enough to work for some encouraging consultants, who taught me and critiqued my work thoroughly; this allowed me to absorb the relevant legal knowledge and sharpen my medico-legal skills. From my very first case, I developed a passion for this work and knew it would be my area of expertise. I then attended multiple renowned courses, seminars and conferences, over a couple of years, before branching out into any other medico-legal opportunities I could find; from Civil Court Work, to Family Law to Coronerâ&#x20AC;&#x2122;s Cases, to Employment tribunals.
What has been your most challenging expert witness types of cases? For Civil cases, it is when there already is a longterm or complex psychiatric history. It takes skill and patience to sift through the medical records and pull out symptoms that existed before the trauma or clinical negligence and differentiate them from symptoms that have surfaced after this event. For Criminal cases, it is when I feel the Defendant is not fully cooperating or is exaggerating or fabricating symptoms (e.g. in the hope that they may be found unfit to plead to subvert the system). Again, it takes skill and patience, but also persistence in questioning to reveal the real truth.
I know that you deal with a range of cases, but can you specify a common case that you tend to deal with on a regular basis? My specific area of interest is high value claims related to trauma; whether it be clinical negligence, personal injury or historical sexual assault. I feel there is an honour in fighting the corner of those that have been wronged and psychiatrically harmed by others. I have developed skills in extracting the relevant symptoms and formulating the right diagnoses.
What is your average turnaround time for a report? I am in a unique position of working for the NHS for 2 days per week (in two Criminal Court Liaison and Diversion schemes). This means I can dedicate a minimum of three days a week for my medico-legal practice, Sigma Delta Psychiatry Expertise. Generally, I am able to turn around reports relatively quickly; usually within a week or two of being instructed. I am also able to turn reports around rapidly if needed. On one occasion, when there was an extremely urgent deadline for a deportation case, I was instructed one evening, and managed to assess the client in an Immigration Centre forty miles away and finish a full medicolegal report the next day.
Dr Sohom Das (MBChB, BSc, MSc, MRCPsych) Consultant Forensic Psychiatrist
Expert Witness (Section 12 Approved)
How often would you say your critical analysis the game changer in a claim? I actively obtain feedback for my reports for my Continued Professional Development. This is from peers (I am the co-founder of the North London Medicolegal Forum, where a group of expert psychiatrists regularly critique each others’ reports). It is also from judges and solicitors. For every piece of feedback I’ve been given, I’ve been told that my evidence (particularly on the psychiatric consequences of clinical negligence or personal injury) has been critical in gaining a sizeable compensation for the client. I do not take on work that I do not think will have a favourable outcome.
What do you feel is key to being an effective expert witness? Decisiveness. In my view, the actual science behind extracting information from the notes and assessing a patient is relatively straight forward, especially after some experience (I have authored several hundred in my career). In my view, the most impotent and helpful quality of an expert is being decisive about opinions. This might involve taking a risk on making a definitive decision. However, in my opinion, although sitting on the fence might feel safer, it is not helpful for the Court, the client or the profession.
What makes you the go to expert witness in your specific field? I have actively been honing my skills to get the right balance of writing very detailed reports that can withstand crossexamination yet are not over-burdened with irrelevant facts. This comes from having written several hundred court reports in my career, actively obtaining feedback from my reports and critiquing other expert psychiatrists’ reports regularly, as well as having them critique mine. I am able to turn reports around quickly as I dedicate a minimum of three days a week for my medico-legal practice. I also believe I am very strong under crossexamination. In fact, contrary to most of my colleagues, I very much enjoy this aspect of my work. I feel it is a cognitive challenge. I am able to think quickly on my feet and find the process of my opinions being contested to be quite exhilarating.
Is there any aspect of expert witness that you feel would surprise someone who was considering adding this to their CV? Whilst the majority of solicitors are a pleasure to work with, some can be difficult (as can some other experts!). In my career, I have experienced solicitors who have been very pushy (as they are clearly hoping for a certain opinion) and do not seem to appreciate than an expert witness has to be neutral and objective. Obviously, this will impact my willingness to work with them in future cases. In addition, many new experts might not appreciate how volumous the medical notes can be in some cases; sometimes several thousand pages. This obviously takes significant time to analyse.
Please contact me to discuss potential work. enquiries@sigmadeltapsych.co.uk | sohom.das@nhs.net
Dr Sohom Das MBChB, MRCPsych, BSc, MSc Consultant Forensic Psychiatrist
Looking for a medico-legal expert? Dr Sohom Das has extensive experience in undertaking medicolegal assessments. He regularly prepares high-quality reports on a number of psychiatric issues for a variety of courts, including the Criminal Court, Civil Court, Immigration Tribunals and Mental Health Review Tribunals, and has authored in excess of 500 reports in his career.
His specialist areas of expertise include: Civil court work • • • • • •
High value and complex personal injury cases High value and complex clinical negligence cases - including Breach of Duty, Causation, and Prognosis and Condition Historical sexual abuse Psychiatric consequences of a wide range of incidents and accidents - including post-traumatic stress disorder, issues at work and physical disability Recommendations for psychiatric treatment AvMA approved expert
Criminal court work • • • • • • •
Fitness to plead Defendants’ mental state at the time of offences Mental health disposals - including hospital orders, restriction orders and community orders Mental health defences - including not guilty by reason of insanity, diminished responsibility and automatism Capacity to form intent / mens rae Risk assessments - including violence, sexual offending and risk of reoffending Assessments carried out on male, female and adolescent defendants in secure hospitals, prisons and court
Other areas of expertise • • • • • • •
Mental health review tribunal reports Parole Board reports - including giving oral evidence Immigration tribunal reports Family court reports Employment tribunal reports - including grievance investigation assessments Formal capacity assessments Psychiatric assessments for housing issues
Dr Das can take instructions on behalf of either claimant or defendant or as a Single Joint Expert. He offers unlimited free telephone consultations to solicitors about any medicolegal case. His consultation rooms are based in North London, though he is able to travel to assessments.
sohom.das@nhs.net | www.sigmadeltapsych.co.uk
Dr Sunkanmi Osunsanmi Child/Adolescent Psychiatrist
MBBS, MSc, MRCPsych, Certificate in Family Law, Section 12 approved.
Dr Osunsanmi is a Consultant Psychiatrist based in Gloucestershire, his specialised area is Child and Adolescent Psychiatry. His duties involve providing psychiatric leadership and input to a specialist Child and Adolescent Mental health team. He also provides psychiatric input to a countywide Neurodevelopmental Clinic and a Schoolbased Learning Disability Clinic. In his role as a clinician, he has extensive experience of a broad range of psychiatric and Neurodevelopmental difficulties in both in and out-patient settings.
His experience includes; • Expertise in psychopharmacology • neurodevelopmental disorders such as ADHD and ASD. • Cognitive Behavioural therapy • Behavioural modification and therapy • Medico-legal writing for MHA tribunals and the court systems • Assessment of capacity and consent • Use of standardised Continuous Performance tool for assessing ADHD in children, adolescents and adults •Ffitness to plead/stand trial assessment.
Dr Osunsanmi has published a number of book reviews relevant to child and adolescent psychiatry and articles in relevant scientific journals on ADHD and learning disability in the child and adolescent population. He has also presented (both Oral and Poster presentations) at a number of national and international conferences. Training
Completed the Cardiff University Bond Solon Certificate course on Family law and procedures, British Association for Psychopharmacology scholarship award to attend the European College of Neuropsychopharmacology- was one of 3 selected candidates across the UK for the 1st school of Child/ Adolescent psychopharmacology- 2012. Fully up to date with CPD activities with the Royal College of Psychiatrists.
Membership
Member of the Royal College of Psychiatrist, membership awarded following success in the membership examinations (stages 1 and 2) in 2006. Registered with the General Medical Council, UK with full registration and on the specialist register of Child and Adolescent Psychiatrists. Section 12 (2) approved since 2006 and an Approved Clinician since 2010
The Devereux Centre Barton Road. Tewkesbury Gloucestershire GL20 5GJ 07785 785 647 osunsanmi@doctors.org.uk enquiries@edcapelimited.co.uk www.edcapelimited.co.uk
Dr Nick Cooling Consultant Psychiatrist 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 some of the 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 Redness Board was particularly challenging.
My Experience of the Interface Between Serious Personal Injury Cases and Psychiatry:
Lessons Learnt in Twenty-Five Years 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. My work as a Panel Member for The South East Fermanagh Foundation, providing support and treatment for victims of terrorist events has provided me with further insights into the longterm social and community impact of such events.
2.
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.
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.
4.
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.
5.
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 expertâ&#x20AC;&#x2122;s curriculum vitae to ensure that they have the relevant expertise and up-to-date practice is very important. In my opinion a particular thing 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. My long involvement in medico-legal psychiatry has given me a particular interest in social history. My book Twelve Shaldon People was published last year. This year I am working on Twelve Teignmouth People and Twelve St Davidâ&#x20AC;&#x2122;s People. Publishing local social history can have a powerful influence on community cohesion and understanding. 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 19 March 2018
01626 873 466 | 07976 797 017 | nickcooling4@aol.com
Dr Tinnevely Ananthanarayanan MBBS FRCPsych DPM(Lond) DPM(RCSI)
Consultant Psychiatrist Dr Ananthanarayanan is a Consultant Psychiatrist with extensive experience in the NHS, treating various types of mental illnesses for 22 years, from 1981 to 2003. He was a Specialist Medical Visitor for the Lord Chancellor's Department from 2003 until June 2014. This work mainly involved Mental Capacity, Cognitive Assessment, Memory problems etc. due to organic brain conditions, such as Alzheimer's and other dementias, head injury and alcohol related brain damage. He was also a Medical Member of the Mental Health Tribunal from 1998 until June 2015, where he performed Mental Capacity Assessments and Mental Health Act Assessments during this period. Over the years Dr Ananthanarayanan has given Independent Psychiatric Reports on Mental Capacity for the Court of Protection and other bodies, including giving opinion on patientsâ&#x20AC;&#x2122; fitness to plead in court. His experience has involved, mainly Mental Health Act Assessment for detained patients, also assessment of patients' Mental Capacity, to appear before the Tribunal, and understand the proceedings. Mostly he deals with civil cases involving capacity. Dr Ananthanarayanan also appears in criminal cases, both for defence and prosecution in which mental capacity is an issue. In addition to this he attends court to provide expert evidence in criminal cases both defence and prosecution. He has extensive experience in clinical and medico-legal aspects of Mental Health and given frequent independent psychiatric reports on patients appearing before for the Mental Health Tribunal. Special expertise in Mental Capacity, Cognitive Assessment, and memory problems, primarly due to organic and functional mental disorders. Training Dr Ananthanarayanan has attended various courses over the years, as part of his continuing professional development and continues to do so. These courses were organised by the NHS, Royal College of Psychiatrists, British Medical Association (BMA), Court of Protection, Mental Health Tribunal and various other bodies. Throughout the year Dr Ananthanarayanan also attends medico legal courses which keep him up to date with relevant issues. Membership He is a member of the British Medical Association, Royal College of Psychiatrists, Royal Society of Medicine and was a Medical Member of the Mental Health Tribunal for sixteen years, until June 2015. He is a member of the expert witness panel for the Medical Protection Society.
15 De Burgh Gardens, Tadworth. Surrey. KT20 5LU. 07921 299110
Tully Forensic Psychology was set up in 2012 by HCPC Registered and BPS Chartered Forensic Psychologist Dr Ruth Tully (BSc(Hons), MSc, DForenPsy, CPsychol, EuroPsy, AFBPsS, CSci, MAE, AFHEA). We expanded from there and are now a team of over 30 specially selected expert forensic and clinical psychologists who provide assessment, treatment, training, and consultancy services. Dr Tully is the Clinical Director of services, and she oversees the whole team of consultant, senior, associate, and assistant clinical and forensic psychologists nationwide. We are proud to be based in Nottingham, but with associates based throughout the UK, so that we can deliver services and take instructions nationwide. We specialise in providing independent forensic psychology expert witness services in relation to a range of clients. These include clients who may be at risk of committing (or who are alleged to have committed), a criminal offence. Clients may be victims of crime or abuse themselves. Examples of expert witness services include assessments for life/indeterminate (IPP) sentence/ recall parole purposes, Category A review panels, as well as for Court (criminal, family, civil), within care proceedings, Mental Health Review Tribunals (MHRT/MHT), immigration/deportation cases, and Local Authority (LA) commissioned family or individual assessments. We frequently undertake legal aid funded work. We provide expert psychological assessments for religious organisations and sporting organisations in relation to safeguarding, risk, and other matters requiring psychological expertise. We are on the National Crime Agency (NCA) list of expert advisors, providing reports instructed by the Police and Crown Prosecution Service (CPS) as well as instructed by the defence. We also provide therapy and treatment services to a wide range of people.
Dr Ruth Tully
Consultant Forensic Psychologist and Clinical Lead BSc(Hons), MSc, DForenPsy, CPsychol, EuroPsy, AFBPsS, CSci , MAE, AFHEA Our team provides training to individuals and large services such as the NHS and private service providers, and are proud to also offer treatment that impacts positively on peopleâ&#x20AC;&#x2122;s lives. The training and consultancy that we provide covers many areas of clinical forensic psychology, as well as us offering training that is relevant to areas wider than forensic psychology. Ruth has provided training nationally and internationally to hundreds of professionals in various areas including risk assessment and sexual offending. Between the team, our range of expertise lends to us being able to provide a range of bespoke training. Dr Tully is a Forensic Psychologist and Director of Tully Forensic Psychology Ltd. She is an expert in forensic risk assessment and is the clinical lead of the team, supervising all of the work of our expert psychologists. Ruth is Chartered by the British Psychological Society (BPS), Registered as a Forensic Psychologist with the Health and Care Professions Council (HCPC), an Associate Fellow of the BPS, and she holds a European standard qualification in psychology. Earlier in her career, Ruth was nominated for, and was then awarded, the BPS Division of Forensic Psychology Junior Award in Forensic Psychology 2013.
This BPS award focuses on the production of work of outstanding quality and innovation, and Ruth was awarded the prize for her ‘notable contribution to the field‘. Ruth is an accredited Full Practicing Member of The Academy of Experts. Following her extensive work in prisons and clinical forensic NHS settings with clients who have enhanced rehabilitation needs in relation to mental health, personality, learning disability and risk, Ruth moved to provide similar services in a private hospital as a Consultant Forensic Psychologist and senior manager. It was following setting up and watching this service flourish that she moved to The University of Nottingham. Dr Tully is regularly invited to act as peer-reviewer for respected journal publishers and she is also regularly requested by the media as an expert speaker in relation to Forensic Psychology. Ruth’s special interests are in prison and court risk assessment and treatment, especially relating to sexual and violent offences. She has worked on various high profile cases and is particularly proud of the rapport and understanding she is able to achieve with those who she is assessing/treating and professionals alike, regardless of outcome of the independent assessment. Ruth undertakes assessments in Family Court or care proceedings, such as assessments of young people and their carers. Alongside providing expert independent psychological services, Ruth gives workshops and lectures at various Universities, following her past role as Assistant Professor at The University of Nottingham. Ruth is registered with the BPS as an approved supervisor (RAPPS).
Ruth has an active research portfolio including: • Risk Assessment • Sex Offending • Learning Disability • Revenge Pornography • Road Rage • Psychometric Test Development • Internet Sex Offending.
The Team: Our team members, over 30 forensic and clinical psychologists, are friendly and approachable and so if you have any queries, or the particular issue surrounding your client’s case is not listed in the examples of work we engage in, please click through to the contact page to get in touch via email or phone. Upon request we promptly provide enquirers with an estimate of fees that you can easily use to apply for or request funding (e.g. Legal Aid Authority [LAA] applications, or within your organisation), and timescales are discussed in advance as part of this transparent process. We pride ourselves in completing on time and in our clear communication with the referrer. Along with an estimate of fees you will be provided with the psychologist’s up to date expert witness CV to view in order to ensure that you are well informed and fully content prior to the work proceeding. You will be able to feel safe in the knowledge that all of our psychologists have up-to-date DBS/CRB checks, professional indemnity insurance, and appropriate professional registration (e.g. British Psychological Society Chartered and Health and Care Professions Council Registered) alongside other professional training and expertise.
Our Psychologists and Practice Team: We specialise in providing high quality psychological services, specialising in expert witness reports for court and prison proceedings. Our team is detailed on this link http:// tullyforensicpsychology.com/practice-team/ If you are a legal professional, or other interested agency, please contact us for further details or to instruct one of our experts.
Tully Forensic Psychology
enquiries@tullyforensicpsychology.com 07779 907198 tullyforensicpsychology.com
Meet some of our dedicated team Dr Jill Peters Consultant Clinical Psychologist BSc(Hons), DClinPsy, CPsychol, AFBPsS Dr Peters is an extremely experienced Consultant Clinical Psychologist, particularly specialising in trauma, personality disorder, and offending. She is Chartered member and Associate Fellow of the British Psychological Society (BPS) and is Registered as a Clinical Psychologist with the Health Care Professions Council (HCPC). Since qualifying in 2004, Dr Peters has spent time working with individuals who have multi-faceted difficulties across a multitude of settings including the NHS, independent hospital sector and working as an independent psychologist. Many people Dr Peters has work with have traumatic histories often characterised by abuse and neglect, in addition to their complex presentations. She has also dedicated a large proportion of her career to working with offenders. Dr Peters has worked with numerous high-risk offenders within community settings and in secure inpatient and prison environments. She has experience in assessing risk of violent crimes, sexual offending, extremist violence, and stalking. This has included individuals whose offending has included extremely serious contact and noncontact sexual offences involving both adults and children, as well as the extremes of violence including arson, murder and Terrorism Act offences. Dr Peters has a particular interest in risk assessment, management and treatment and is skilled at building rapport with complex individuals who may be difficult to engage. She has experience of working with both adult male and female offenders, as well as with young people who have committed offences or have been involved with the criminal justice system. As well as her direct client work, Dr Peters is a dynamic and competent trainer and has taught a range of individuals from service users, unqualified staff, and qualified professionals in the workplace through to undergraduate and postgraduate students and she is skilled at moderating her approach to make the material accessible to all. She has previously worked as a tutor on the Coventry and Warwick Clinical Psychology Doctorate. Through her broad experience, Dr Peters is confident and competent communicator who has provided evidence in a variety of environments, including for Mental Health Act review tribunals, parole hearings, and Court. She is also experienced in supervising a wide range of other professionals and in the development, delivery, and supervision of treatment programmes offered to offenders. Dr Peters enjoys and is competent in undertaking a wide range of assessments and giving consideration to mental health problems, personality issues, cognitive ability, and risk related issues using a range of methods including professional liaison, psychometric assessment, and direct clinical interview. She has been privileged enough to work with and to have supported individuals across various parts of their treatment pathway and is equally as confident making recommendations regarding risk for individuals within the community or within a secure setting. Dr Peters also has extensive experience of conducting assessments relating to personal injury (trauma) and clinical negligence cases. She enjoys diversity in her work and continues to undertake Court and Prison assessments in addition to providing consultation, training, and treatment options.
Claire Illingworth Senior Psychologist BSc(Hons), MSc, CPsychol Claire Illingworth is a Senior Psychologist in our team. She is BPS Chartered and HCPC Registered as a Forensic Psychologist. Previously working for over 14 years within HM Prison Service, she has gained extensive experience in assessing and treating the full range of offender types, specialising in the assessment and treatment of high risk violent and sexual offenders, and individuals with cognitive functioning deficits. Claire has extensive knowledge in the prison accredited offender behaviour programmes. Claire has experience in working with and completing risk assessments for clients with a range of psychological difficulties including personality disorder and cognitive functioning deficits. Claire provides services nationwide and is able to complete a range of psychological assessments that explore risk and functioning for young and adult male and female offenders.
Dr Jennifer Bamford Senior Psychologist BSc(Hons), MSc, DForensPsy, CPsychol Dr Jennifer Bamford is a Senior Associate Psychologist in our team. She is BPS Chartered and HCPC Registered as a Forensic Psychologist with vast experience of working with male and female offenders in prisons, secure hospitals, and community settings. Jennifer has experience in working with and completing risk assessments for clients with a range of psychological difficulties including mental illness, personality disorder, cognitive functioning deficits and developmental disorders, such as ASD. Jenniferâ&#x20AC;&#x2122;s clinical work has included working with women using a Dialectical Behavioural Therapy (DBT) approach. She was awarded the BPS Division of Forensic Psychology Junior award in in 2015, having been nominated in relation to her academic work and clinical practice, recognising her notable contribution to the field of Forensic Psychology. Jenniferâ&#x20AC;&#x2122;s area of specialism is sexual offending; she is highly competent and experienced in delivering sex offender treatment programs (SOTPs) and in assessing risk and treatment progress of sexual offenders. Jennifer has completed a doctoral thesis on the assessment and treatment of multiple perpetrator sexual offenders, and has published articles in this area. Jennifer is trained in assessing men at risk of offending in a family context. In her Senior role she enjoys supervising other psychologists in our team and she is on the BPS register of supervisors (RAPPS).
Meet some of our dedicated team Dr Natalie Brotherton Associate Clinical Psychologist BSc(Hons), DClinPsy, CPsychol Dr Natalie Brotherton is a HCPC Registered and BPS Chartered Clinical Psychologist. She currently leads the psychological provision within an acute mental health service and is involved in the strategic management and development of psychology provision for the wider hospital, which includes secure services. Her experience includes working with adults within low and high security psychiatric services with a range of complex needs and presentations including intellectual disability, mental illness, personality disorders, autism spectrum disorder, and neurological conditions. She has also worked within the community, within NHS services, charitable organisations and privately with clients across the full developmental range. She is a qualified therapist in approaches such as EMDR and DBT and is currently working towards certification in Schema therapy. She also has experience of developing and providing individual and group offence-focused interventions. Additional areas of experience include providing supervision, training, consultation, reflective practice and service development. Dr Brotherton is experienced in a number of formal assessments such as assessments of violence (HCR20-v3), sexual risk (RSVP), personality disorder (IPDE), psychopathy (PCL-r), autism spectrum disorder (ADOS, ADI-r), and cognitive functioning (WAIS-IV), alongside a number of neuropsychological functioning measures.
For any further information on the diversity of the experts in our team, to discuss your requirements or to instruct any member of our team please contact:
Tully Forensic Psychology
enquiries@tullyforensicpsychology.com 07779 907198 tullyforensicpsychology.com
Bernard J. B. Kat
BA, MSc, DipClinPsychol, CPsychol, FBPsS PROVIDING PSYCHOLOGY, PSYCHOTHERAPY & EXPERT WITNESS SERVICES Registered as both a Health and Clinical Psychologist, Bernard Kat worked as a clinician and manager in the NHS for 28 years. In 2005 he formed his own company Psynapse (Psychological Services) Limited based in Newcastle upon Tyne. He provides services as a Psychologist, a cognitive behavioural psychotherapist and as an Expert Witness throughout what he calls “the true North of England” i.e. from Northumberland down to Teesside in the East, across to Cumbria in the West. A Cardiff University / Bond Solon certificated Expert Witness, Bernard is able to draw on the extensive 7 year training undergone by all clinical psychologists which includes the study of normal human development and functioning as well as specialist knowledge concerning mental health, disabilities and the problems of children and young people. Bernard told us: “The philosphy component of my undergraduate degree has been particularly useful and taught me how to approach and write about complex problems. The psychology component emphasised the scientific and statistical skills on which my work is still based.” As an NHS clinician Bernard specialised in work with general practitioners and community teams. This wide experience enables him to offer a rounded service as an Expert Witness.
He explained: “Throughout my career, in both my clinical and managerial responsibilities I was responsible for psychological services for clients of all ages and disorders. My own cases were mainly working age adults. Many of my patients suffered from psychological disorders resulting from traumatic events and experiences. I was also involved with psychological aspects of primary health care, general medical services, acquired brain damage services, systemic approaches to relationship and organisational problems, as well as public health psychology.” Bernard has seen many changes in Expert Witness work since 2005 owing to Government policies concerning funding: “I used to be instructed in criminal, family, personal injury and clinical negligence cases and I had Court experience in all of them. At present my Expert Witness work is primarily reports for the Court in criminal cases, initiated by the Defence. However Expert Witnesses do not act for either side. Psychologists’ reports are addressed to the Court and will very likely say the same whomever commissioned the report in the first place, so my reports are often accepted by the Prosecution and there is no need for me to attend Court. But I am fully aware of the formalities required when attending Court, which I do perhaps a couple of times a year on average.”
FOR MORE INFORMATION PLEASE CONTACT: Bernard Kat Psynapse (Psychological Services) Ltd Churchill House, 12 Mosley Street Newcastle upon Tyne NE1 1DE Tel: 0191 230 6461 Email: b.kat@psynapse.co.uk Website: www.psynapse.co.uk
The Need for Psychology in Child Protection By
Dennis Trent Chartered Clinical Psychologist
hartered Clinical Psychologist and an Associate Fellow of the British Psychological Society, Dr Dennis Trent, provides expert reports in the field of Child Protection/Custody issues, Pre-Sentence Reports, Risk Assessments, Fitness to Plead, Learning Disabilities and other court related psychological assessments, via his private psychology practice Midlands Psychological Services, based in Birmingham in the West Midlands.
C
Boasting over 20 years experience in providing Psychology Services throughout the U.K. and abroad, Dr. Trent outlined in a recent interview the need for psychology in child protection: 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 would not understand that and it would appear that 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,
Anyone who has worked with abused children will recognise such statements as,
“I deserved it”, “if I hadn’t....”, and “it was my fault”.
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 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 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. 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. 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 childrenâ&#x20AC;&#x2122;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, 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.
In conclusion Dr. Trent went on to say:: "Psychologists are best placed to help tease out that level of appropriateness. We can also assist Social Services in assessing the appropriateness of potential foster carers and support social workers in working with both children and adults. Most importantly, we 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."
Dr. Dennis Trent, (0121) 224-3051, (0121) 224 3252, mps@midpsych.co.uk www.midpsych.co.uk
Phil has been director of Psychologica Ltd for over 20 years. He is a Chartered Occupational Psychologist with considerable experience addressing a range of human factors, within organizations of all types and sizes. These include issues such as: • bullying in the workplace; • stress management, • leadership coaching and development; • staff assessment and selection; • and facilitation of organizational change. Phil has been Managing Director of both large and small commercial companies before developing an interest in Organizational Development. Gaining a PhD in Psychology and Marketing – in the area of Service Quality and Leadership Style. He is actively involved in research, and has published various articles and papers in respected journals and presented findings at international conferences, relating to the unique Psychologica Model™ which forms a basis for much of his work. Psychologica works with both commercial organizations and private individuals, focusing on maximising effectiveness and well being in the workplace. The company offers a range of tools and services and have the capacity to manage projects of all sizes, using our partners and associates and drawing on the Psychologica Practitioner network and their diverse range of professional skills and expertise.
• • • • • • • •
Coaching Stress Management Bullying & Harassment Staff Selection Leadership Development Research Expert Witness work and reports GDPR Compliant
Dr Phil Bardzil “Over the years the Psychologica ModelTM and associated tools and techniques, have been used in a wide range of organizations of all kinds”
0161 883 2879 info@psychologica.co.uk www.psychologica.co.uk 26 Albert Street Ramsbottom Bury Lancs BL0 9EL
DR. DAWN BAILHAM MSc Forensic Psychology, DClinpsych (Doctorate in Clinical Psychology), BSc (Hons) Psychology, AFBPS, CAT Practitioner
Consultant Clinical Psychologist & Expert Witness 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. 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 selfharm, 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. 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).
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.
Mobile Tel: 07801 266 010 / Email: dawnbailhan@icloud.com
Dr Sue O’Rourke
AFBPsS
Consultant Clinical Psychologist
High quality and timely reports with 20 + years of experience of: • Criminal Cases: Fitness to plead
• Personal injury:
Specialist in trauma/historical abuse - EMDR trained
• Family Proceedings:
Assessment of adults in proceedings.
• Mental HealthReview Tribunals: Assessment of risk
Specialist in Deafness
2019
Federation of Federation of
Expert witnesses Forensic Forensic & Expert&witnesses
07875 358574 | sueorourke@btinternet.com | www.deafexpert.co.uk
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).
U
p until recently the determination of a defendantâ&#x20AC;&#x2122;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 defendantâ&#x20AC;&#x2122;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 Commissionsâ&#x20AC;&#x2122; 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.
Dr Sarah Burnett MB BS, MRCP, FRCR, MBA, MA
Consultant Radiologist Expert Dr Sarah Burnett studied Medicine at Westminster, qualifying in 1985. She did ‘Golden Circuit’ jobs before becoming a registrar at the Mayday. In 1988 Sarah started training in Radiology at Bart’s, and became a Consultant at St Mary’s and the Royal National Orthopaedic in 1993. She was also Admissions Tutor for Medicine at Imperial. In 2001 she left the NHS to continue in full time independent practice. Dr Burnett specialises in treating needle-phobic patients, and is a Master Practitioner of NeuroLinguistic Programming.
Areas included are medical negligence and personal injury comprising of the following modalities and speciality areas:
General radiology - plain film. Musculoskeletal, trauma and injury - plain film, MRI, CT. Please note that the majority of the reports in the 7 500 reports over the last 3 years are PI cases, with a negligence figure of 150 in the last three years. I charge £300.00 an hour (VAT is not applicable) and most cases are done in an hour. Generally I can turn round a report within two weeks of receiving the bundle and I do not charge for email exchanges or minor amendments. I am ICO registered for data and a trained Civil and Commercial Mediator.
Radiology Expert Witness
Dr Sarah Burnett | 07776 183099 | drsarah@me.com
Dr Robert Campbell MBChB, DMRD, FRCR
Consultant Musculoskeletal Radiologist Dr Campbell is a specialist Consultant Radiologist with expertise in musculoskeletal imaging. His practice is based in Liverpool, providing imaging services to the Royal Liverpool and Broadgreen University Teaching Hospitals, a renowned centre for orthopaedics, rheumatology and related specialities. He has over 20 years of experience in writing medico-legal reports for medical negligence cases. He also provides imaging services for personal injury cases, including, x-ray, MRI, CT and ultrasound, for clients based in the North West of England.
Areas include:
• Trauma. • X-rays. • Magnetic Resonance Imaging (MRI). • Computed Tomography (CT). • Ultrasound. • Orthopaedics, spine and rheumatology imaging. • Sports medicine imaging.
R&M Campbell Ltd 10 Kingsmead Road North PRENTON Merseyside CH43 6TB
0151 706 2915 (NHS PA) 0151 200 1184 (Med-legal PA) 07940 537903 rob.campbell@rlbuht.nhs.uk medlegalreporting@gmail.com
Medical Expert Report Writing Emma Ferriman has been a Consultant Obstetrician since 2001. She graduated from Liverpool University in 1990 and is dually accredited in both Obstetrics and Gynaecology and is subspecialty trained in Fetal and Maternal Medicine. Emma Ferriman worked at The Leeds Teaching Hospitals NHS Trust as a Consultant Obstetrician and Fetal Medicine specialist from 2001 to 2015. In November 2015 she was appointed as a Consultant Obstetrician with a special interest in Fetal Medicine at The Jessop Wing, The Royal Hallamshire Hospital, Sheffield. Emma Ferriman has a private practice in antenatal ultrasound and first trimester screening at Thisismy Health and Ultrasound Screening Centre in Leeds. Emma Ferriman is a member of the British Maternal and Fetal Medicine Society (BMFMS), British Association of Perinatal Medicine (BAPM) The British Medical Ultrasound Society (BMUS) . She is listed on the UK register of expert witnesses and is a member of The Society of Expert Witnesses (SEW). Emma Ferriman undertakes medical negligence and personal injury reporting within the United Kingdom. Currently cases are split approximately 50/50 between plaintiff and defendant. Areas of special interest include prenatal diagnosis, first trimester screening, multiple pregnancy and high risk obstetrics including intra partum complications and asphyxia. Fees are charged at ÂŁ200 per hour or part hour of medical time, ÂŁ500 for a screening/desktop report and six hours work for a full report. Electronic records accepted. Simple reports vary from 2 to 4 hours work whereas more complex reports may be 7 to 8 hours work. The time for completed reports is usually four to six weeks from the date of receipt of the full medical records.
To enquire about instructing Emma Ferriman, solicitors and medico-legal agencies should first contact emmaferriman@doctors.org.uk or call on 0113 262 1675 to request a copy of the Terms and Conditions. Please note that all fees are payable within 56 days of receipt of the completed report.
Dr Julian Harriss MD, MSc, BSc
Consultant in Rehabilitation Medicine (PM&R, Physiatry)
Rehab Medicine Areas of Expertise:
Dr Harriss has served in many senior clinical and academic positions, including Clinical Lead in Rehabilitation Medicine at the Lane Fox Clinic, Guyâ&#x20AC;&#x2122;s and St Thomas Hospital and Frank Cooksey Rehabiliation Unit, KCH, and Honorary Senior Lecturer in Medicine at Kingâ&#x20AC;&#x2122;s College London. He is Director of IRMA: Independent Rehabilitation Medicine Assessment, and a trustee of UKABIF and the BSRM.
Areas include: * Rehabilitation medicine. * Neuro-rehabilitation. * MSK rehabilitation. * Paediatric rehabilitation. * Amputee rehabilitation. * Specialist orthotics. * Post polio syndrome. * Personal injury, clinical negligence and medical malpractice medical reports. * Spasticity management. * Brain injury rehabilitation.
Federation of
Forensic & Expert witnesses
10 Oakway, BROMLEY. Kent. BR2 0LJ 07533 149796 jharriss@doctors.org.uk
Professor Ali Ghoz
MB BCh, FRCS(Tr. & Orth.), MSc(Oxon), MRCS(Eng), MRCS(Ed), Fellowship(AOA)
Consultant Trauma & Orthopaedic Surgeon Honorary Professor of Trauma and Orthopaedic Surgery
Specialist Hip and Knee Surgeon Professor Ghoz is a Trauma and Orthopaedic surgeon specialising in minimally invasive hip and knee surgery in London and Berkshire.
Medicolegal Expertise As one of the leading surgeons in his field Professor Ali Ghoz is able to deliver professional and expert opinion and testimony, provide medical reports in a timely manner and explain the intricacies of trauma and orthopaedic medicine. Areas of Medicolegal expertise include personal injury, road traffic accidents and medical negligence.
Professor Ali Ghoz is available for criminal cases and personal injury cases â&#x20AC;&#x201C; as well as media and public relations work. Ali Ghoz is an Honorary Professor of Trauma and Orthopaedic Surgery. He specialises in trauma and orthopaedic surgeons specialising in cutting edge, minimally invasive hip and knee surgery. He has a specialist interest in custom made bespoke hip and knee surgery with an emphasis on computer guided surgery. Education and Training Professor Ghoz completed his basic surgical training at the Yorkshire School of Surgery progressing to a National Training Number for Specialist Registrar training at the Yorkshire Deanery. He obtained a Specialist Fellowship FRCS in Trauma and Orthopaedic Surgery in 2011 from the Royal College of Surgeons of England. In 2013, Ali completed a Fellowship in Adult Hip and Knee Reconstructive surgery at the Royal Berkshire Hospital.
In 2014, he completed the Australian Orthopaedic Association accredited Adult Hip/Knee Arthroplasty, Knee Arthroscopy and Sports Medicine Fellowship at the Mater/Prince of Wales Hospitals, Sydney. Professor Ghoz holds a Master of Science degree from Oxford University specialising in Musculoskeletal Sciences Specialist Interests Knee arthroscopic 'key hole' surgery | Primary hip replacement | Muscle sparing minimally invasive anterior hip replacement | Anterior Cruciate Ligament Reconstruction | Knee Ligament and Cartilage Reconstruction | Custom made Partial knee replacement | Custom made Total knee replacement | Computer aided surgery | Patellofemoral “knee cap” replacement | Soft tissue knee reconstruction surgery | Trauma Surgery | “Redo” revision hip and knee surgery | Carpal tunnel surgery | Trigger finger surgery | Ankle | Lower Limbs Professional memberships British Orthopaedic Association | British Trauma Society | Wolfson College, Oxford University | Academy of Experts | UK Register of Expert Witness | Royal College of Surgeons of England | Royal College of Surgeons of Edinburgh | American Academy of Orthopaedic Surgeons | Royal Australian College of Surgeons | Fellowship of the Australian Orthopaedic Association Personal Ali enjoys spending time with his family and regularly plays football with his son and also takes part in various sporting activities with his daughter. Languages: English, French, Arabic and partial Spanish and Italian Professor Ali Ghoz has a wide range of expertise and conforms fully to the Ministry of Justice Standards delivering honest, clear, unbiased and high quality report assessments with timely turnaround of report writing.
• Minimally invasive surgery • Hip replacement: anterior & posterior • Hip resurfacing • Soft tissue hip disorders • Knee arthroscopy (key-hole surgery) • Knee replacement • Knee anterior cruciate ligament reconstruction • Knee ligament reconstruction • Knee high tibial osteotomy • Knee joint preservation surgery • Sports injuries • Carpal tunnel release • Trigger finger release • Major trauma • Minor trauma • Advanced trauma • Life support Professor Ali Ghoz offers his services across the UK. He speaks French and Arabic. He offers expertise for claimants and defendants and as a Single Joint Expert*. Professor Ghoz has attended court multiple times and has written well over 200 reports. Professor Ghoz also offers skype examination appointments, prison visits, paediatrics/minors consultations. *A Single Joint Expert (SJE) is an expert instructed to prepare a report for the Court on behalf of two or more of the parties (including the claimant) to the proceedings.
Professor Ali Ghoz 02039 186747 | m. 07871 334929 ali@professoralighoz.co.uk | www.ghozmedicolegal.co.uk
DR IAN STARKE MD, MSc, FRCP. (Lond)
Consultant Physician Dr Starke has been a Consultant Physician in General Medicine, Medicine for the Elderly and Stroke Medicine at University Hospital, Lewisham and Guy’s, King’s and St Thomas’ School of Medicine since 1988.
Medico-legal Dr Starke provides expert reports in stroke medicine and geriatric medicine for medical negligence and fitness to practice cases and carries out examinations where required. He has provided reports for immigration cases and for fitness to stand trial. He is happy to assess clients within or outside London.
Memberships: Royal College of Physicians British Geriatrics Society British Association of Stroke Physicians Federation of Forensic and Expert Witnesses
For Further Information Please contact: Dr Ian Starke University Hospital Lewisham, Lewisham High Street. London. SE13 6LH 0208 333 3379 | 0208 333 3381
Dr Kalman Kafetz BSc, MB BS, FRCP
Consultant in Geriatric Medicine
All Aspects Of Geriatric Medicine. Dr Kafetz writes reports for solicitors on all aspects of the clinical medicine of old age including, but not confined to, falls, causes of fractures, pressure sores, confusion, cognitive issues, dementia, capacity, Parkinsonâ&#x20AC;&#x2122;s disease in older people, rehabilitation, disability and appropriate care of older people in hospitals, care homes and in their own homes. He advises for claimants and defendants and as a single joint expert and for the prosecution and the defence in criminal work. He advised the Crown Prosecution Service in the case of Ezekiel McCarthy, one of the oldest people to appear at the Old Bailey charged with murder. He has attended the 2 day Royal Society of Medicine/BPP School of Health expert witness masterclass and the 2017 BMA medico-legal conference and obtained the Bond Solon Civil Procedure Rules for Expert Witnesses certificate. He is a member of the clinical forensic and legal medicine section of the Royal Society of Medicine and the Faculty of Expert Witnesses.
07908 904462 | kalmankafetz@hotmail.com 22 Offham Slope LONDON | N12 7BZ
Mr. Ralph Graham FCPodS, FCPodM, BSc(Hons)
Consultant Podiatric Surgeon I have been a Consultant Podiatric Surgeon in Essex and Kent since 1985. I have now retired from the NHS but continue to offer care and surgery in private practice. I have reported for both claimants and defendants in cases involving podiatric surgery, diabetes foot treatment, general podiatry and biomechanics of the foot.
Areas of expertise include; •
•
Hallux valgus ('bunion') • Plantar fasciitis • Shock wave therapy • Foot surgery • Forefoot surgery • Neuroma Bunion surgery for younger patients. • The diabetic foot
I am happy to work within NHS Resolution report fees guidelines for short reports.
Training
Hons degree, Clinical Fellowship, 40 years practice
Expert Training
Trained in report writing, court appearance
Membership
Society Chiropodists & Podiatrists, College of Podiatry
Mr Ralph Graham M: 07850 898 385 E: ralph@ralphgraham.org Phoenix Hospital West Hanningfield Road Great Baddow Chelmsford Essex CM2 8HN
Mr Zak Rahman MBChB FRCS(GenSurg) MD
Consultant General and Laparoscopic Surgeon
Consultant HPB, Upper GI / Bariatric And Advanced Laparoscopic Surgeon - Trust Specialty Training Director In Hpb Surgery & Transplantation Mr Zak Rahman has been an expert witness since 2009. He reports on over 100 clinical negligence cases per year involving his specialist areas of expertise.
Dr Rahman’s Areas of Expertise Include: • • • • • • •
General Surgery (Elective and emergency) Bile Duct Injury Gastro-oesophageal Surgery – Benign (hiatal hernia, reflux, achalasia), Malignant (Gastric) HPB Surgery (Pancreatic disease, cancer, bile duct injuries, cholecystectomy, trauma) Hernias – Open and Laparoscopic surgery – inguinal, femoral, umbilical, incisional Bariatric surgery – Gastric banding, Sleeve Gastrectomy, Gastric Bypass Laparoscopic Surgery
Mr Rahman can act on behalf of either claimant or defendant (ratio 50:50) and has experience acting as an expert for the General Medical Council (UK) , the Medical Defence unions and NHS Resolution. He has extensive court room experience.
He has undergone the following training: • • • • •
Cardiff University (Bond Solon) Expert Witness Certificate Expert in Report Writing Cross Examination & Court Room Skills Civil Procedures & Law Invited speaker – AvMA, APIL, and Inspire MediLaw
Report turn-around time is 4-6 weeks from receipt of full instruction. Mr Zak Rahman Royal Free Hospital Pond Street London NW3 2QG 02077940500 extn 34512. zak.rahman@nhs.net
AWARD NEWSLETTER 2019 Award for General Surgery Expert of the year 2019-2020
Mr Ashok Bohra
It Gives us great pleasure to announce that the Federation of Forensic and Expert Witnesses has announced this years Independent Awards and has profiled one of its members for their outstanding work with in their chosen specialty in this case Ashok Bohra General and Gastrointestinal surgeon from the Midlands. This is for the lifetime of commitment he has given to the field of General and Gastrointestinal surgery to his patients and to the expert witness industry.
Please visit our brand new site
The Awards are independent to the Federation. They are designed to raise the profile and highlight in our opinion the best in their given fields of expertise. The Federation hopes to bring this to the attention of the lawyers and barristers that follow them on linked in and who visit their site and read their E-mag that can be viewed at www.forensicandexpertwitness. co.uk. Mr Bohra has been working in the NHS since 1995. As a Consultant Surgeon he has interest in all aspects of General Surgery including surgical aspects of trauma, emergency surgery, hernias, minor operations, with special interest in key hole surgery, Bariatric and Upper Gastro Intestinal Cancer Surgery.
www.surgeonexpertwitness.co.uk/
He was a member of NICE Quality Standards Advisory Committee, Instrumental in drafting quality statements for 23 guidelines.
The OPD | Derby Private Health | Royal Derby Hospital | Uttoxeter Road | Derby DE22 3NE
Mr Ashok Bohra MBBS, MS, MPhil, MFSTEd, PG Dip (Clin Edu), FRCSEd FRCS (Gen Surg)
Consultant General, Laparoscopic & Upper GI Surgeon Mr. Bohra has an active interest in medico legal work. He is based in Midlands and sees clients in Birmingham, Halesowen and Derby. He is aware of the requirements of Part 35 and Practice Direction 35, the Protocol for the Instruction of Experts to give Evidence in Civil Claims and the Practice Direction on pre-action conduct. He obtained the ‘Bond Solon Civil Procedure Rules for Expert Witnesses Certificate’ to evidence his understanding and compliance with the above requirements. He has undertaken numerous courses and attended relevant conferences to keep himself updated in the field. He has been providing medical expert witness reports over the last 8 years for law firms and agencies across the country. He is a member of the BMLS (Birmingham Medico Legal Society) and the National Expert Witness Agency (NEWA). He has also worked for NHS LA and has been an invited speaker for NHS LA in the past.
Federation of
Forensic & Expert witnesses
Award 2019
Federation of Clients can be seen within a week and a detailed
He provides reports for a variety of General and Gastrointestinal Surgical cases, Accident claims, and Negligence claims. He has experience of providing report for claimants, defendants and joint representation and joint reporting.
report with a summary will generally be prepared Forensic & Expert witnesses
The medico legal interest in surgical issues includes medico legal reports, case management reporting, injury or trauma including hernia, accident claim, emergency surgery, medical errors, medical negligence, clinical negligence and accident claims pertaining to general health care, symptoms, major and minor general surgical procedures and complications, and subspecialty issues related to abdominal, laparoscopic, bariatric and gastrointestinal surgery.
within 2 weeks or sooner if required, after receiving all relevant documents and information following the instruction. Reports will be addressed to the court. No conditional cases (where fee is dependant on outcome) are undertaken. He regularly works with some of the top solicitors across the country and also with medico-legal companies. For further information, ’Terms and Conditions’ and medicolegal appointments, please contact him directly through email, or the enquiry form on his website for his services as a medical expert witness.
To Instruct Mr Ashok Bohra please contact: 07812 112820 | 01332 783423 | enquiries@ashokbohra.co.uk | natalie.brealey@nhs.net Or visit the website at www.surgeonexpertwitness.co.uk/ BMI The Priory Hospital | Priory Road | Birmingham | West Midlands | B5 7UG
York YO19 6DN 07726 592 728 ridingforrehab@gmail.com www.ridingforrehab.com
EXPERT WITNESS Elizabeth is the UK’s only physiotherapist working in hippotherapy to have qualified as an expert witness. She’s an active member of the Medico Legal Association of Chartered Physiotherapists (MLACP), demonstrating that she’s educated, trained and competent in the relevant justice standards, qualified in medico-legal report writing and maintaining CPD relevant to hippotherapy and riding therapy practice at the highest level. Able to advise for both claimant and defendant, Elizabeth’s expert witness work includes short advice notes, desktop reports, condition and prognosis reports (Quantum) and physiotherapy needs reports in relation to hippotherapy and riding therapy. Recent cases include adults with spinal cord injuries, children with cerebral palsy, victims of road traffic accidents and people with musculoskeletal conditions.
Riding for Rehab was founded by Elizabeth Beckerlegge, to provide a physiotherapy service to riders with a disability
Equine Facilitated Physiotherapy Does your client want to ride again after a serious injury? Have you a client who needs hippotherapy to improve posture, balance or coordinated movement? Do you have a client who has aspirations to become a paradressage rider?
Horse + Specialist Physiotherapist = A Succesful Combination!
TREATING THERAPIST
WHERE DO WE WORK?
After a thorough assessment, we’ll put together a bespoke riding or hippotherapy programme, with frequent reassessment and resetting of aims and goals plus regular updates to the case managers and solicitors involved.
Although based in Yorkshire, we have undertaken medico-legal work all over England, from Brighton and Dorset in the south to Lancashire and Northumberland in the north.
We accept instructions as treating therapist for clients requiring hippotherapy or riding therapy during the litigation process and provide treatment post settlement of a compensation claim. Clients are typically seen at a riding facility convenient to their own home. This is often a Riding for the Disabled Association group but can also be a commercial riding establishment or with a private riding instructor.
WHAT PEOPLE SAY “You have made a very positive impression on AD and he is very enthusiastic and confident to pursue riding therapy further” Occupational therapist for young man with C6 SCI, Leeds
“We made very substantial savings. Your input was invaluable in respect of that element of the claim” Solicitor for defendant following out of court settlement, Manchester
“It is great that Luke is responding and engaging so well with his hippotherapy” Case manager for 3 year old with cerebral palsy, Lancashire
Mr Jack Lancer
A Consultant Surgeon with a special interest in otology and rhinoplasty, MR JACK LANCER is able to deploy the vast experience he gained over the 35 years he worked within the NHS, to provide a professional and knowledgeable service as an Expert Witness; dealing with cases involving otology (ear disease), rhinoplasty including â&#x20AC;&#x2DC;nose jobsâ&#x20AC;&#x2122;, and most other aspects of general and routine ENT. Mr. Lancer's comprehensive training in the NHS saw him accepting posts in Sheffield, Cambridge and Zurich, as well as in Rotherham and Doncaster, where he worked as Consultant Surgeon. Appointed as a Consultant ENT Surgeon in 1988, Mr. Lancer held the position of Senior ENT Consultant in South Yorkshire prior to retiring from the NHS in 2013.
With 26 years experience of medico-legal practice, Mr. Lancer has written many hundreds of reports each year, as well as attending court approximately 4-6 times a year. Practicing mostly at Thornbury Hospital in Sheffield and Park Hill Hospital in Doncaster, Mr. Lancer strives to offer a short waiting time for an appointment.
Since his retirement from the NHS, Mr. Lancer has been able to concentrate on his Private Practice, as well as accepting instructions for medico-legal work, the majority of which relates to noise induced hearing loss (NIHL).
Cases for which Mr Lancer has accepted instructions in the main involve individuals that have operated in and around 'high noise levels' for much of their working life.
When a claim is made, the Solicitor will conduct checks to ensure the claim is genuine and that the defendant company or insurance policy still exists. Medical records are then checked and, if no previous issues are raised and there is a reasonable likelihood of success in the case, an expert in noise-induced hearing loss is instructed. If requested to take the case, Mr Lancer will make an appointment with the individual, in order to conduct a hearing test and write an independent report. If areas of contention can be agreed with the defence, should one be instructed, the case may be settled out of court by means of compensation, but if not, the case may proceed to court.
Some cases involve personal injury claims as the result of an accident, for instance, car accidents where an individual has resulting deafness, nasal facial injuries or whiplash, which can lead to other ear problems such as tinnitus (noises in the ears and/or head). In many cases, defendants may deny either the facts of the hearing loss and tinnitus or its causation, and therefore examination by an expert is essential. It is possible to claim many years after the noise exposure was first experienced, although this will be subject to limitation issues, where an individual is expected to make a claim within 3 years of the date of knowledge, i.e. making the association with, for example, hearing loss and noise exposure.
ENT Consultant & Expert Witness
Whist many of the cases for which Mr. Lancer has provided a medico-legal report have resulted in a settlement, around 5-10% of cases of NIHL will fail due to well-preserved hearing, or other disease processes having been responsible for the symptoms. Mr. Lancer also assesses investigations and writes medico-legal reports where negligence has been alleged in everyday clinical practice, especially with regard to operations and their complications relating to ear, nose and throat conditions, and how these problems affect the individual.
Predominantly providing his services as an Expert Witness within Rotherham, Doncaster and Sheffield, Mr. Lancer is also prepared to travel for prearranged industrial deafness case appointments within a 150 mile radius.
THE IMPORTANCE OF DIRECT INSTRUCTION? Other intermediates and agencies that collaborate with solicitors on the need for Expert Witnesses do exist, and do serve a useful function. Solicitors will pay fees to these agencies which offer their own advantages aside from instructing directly through solicitors. Each solicitor will decide on the most appropriate method of instruction depending on the circumstances of individual cases.
INDUSTRIAL DEAFNESS: With the exception of the music and entertainment sectors, Controls of Noise at Work Regulations are in force to ensure the hearing of those working within a noisy environment is protected. Despite this, there continues to be a steady flow of cases regarding noise-induced hearing loss caused by noise at work. Noise induced hearing loss is usually described as 'damage to the inner ear structures due to repeated exposure to loud noise over a period of time.' It occurs when the sensitive hair cells inside the cochlea become damaged, resulting in a sensorineural hearing loss. The cells will not usually repair or replace. Problems usually develop gradually but are most severe following exposure to high frequency sound. The resulting hearing loss, centred mostly at the frequencies of 3, 4,and 6 KHz, tends to be similar in each ear and will inevitably get worse if the individual continues to be exposed to the noise. Individuals can also experience sudden hearing loss due to exceptionally loud noise, such as an explosion, which is known as acoustic trauma. Exposure to sudden and continuous noise can cause tinnitus, which results in the individual hearing sounds such as ringing, buzzing or whistling - the common link being that the sounds perceived do not have an external source. Tinnitus can occur suddenly or very gradually. For some, the condition can be temporary, for example after a music concert, however, continued exposure to loud noise may make it permanent. Although symptoms can take several years to develop, legal action should be taken swiftly once a problem has occurred as individuals will have limited time to make a claim (3 years to the date of knowledge that hearing problems are linked to an industrial career in noise).
MR. JACK LANCER T: 01777 817 160. E:jacklancer88@gmail.com
Mr Andrew R H Grace MB BS, FRCS, FRCSLT (Hons), PGCME
Consultant Otolaryngologist I have over 30 years experience in medico-legal work as Consultant ENT Surgeon working in York. Widely experienced in personal injury cases involving the head and neck. Particular interests in rhinology and laryngology including voice and swallowing problems.
Professional Memberships • • • • • • • •
GMC Revalidation 19th February 2023 MDDUS Medical Protection (No: M225880) Fellow Royal College of Surgeons of England member of the federation of forensic and expert witnesses member expert witness institute Cardiff University Expert Witness Certificate in Law 2018 Member association of personal injury lawyers Member UK register of expert witnesses
Medico-legal
With over 3 decades of experience in medico-legal work as a consultant ENT surgeon working in York, Mr Andrew Grace is widely experienced in personal injury cases involving the head and neck. He has a particular interests in Rhinology and Laryngology including voice and swallowing problems. Mr Grace is available to work throughout the United Kingdom and produces approximately 25 reports per year. He is willing to act as a Single Joint Expert with his workload is currently split at a ratio of 70% claimant; 20% defendant; 10% joint, Mr Grace is willing to attend court and offers a 15 minute, free of charge, Lawyer consultation.
Nuffield Hospital York Haxby Road. YORK North Yorkshire YO31 8TA 01904 715000 07710 646209 andrew.grace1@nhs.net www.medicolegalent.co.uk
Mr Brian Leatherbarrow BSc MBChB DO FRCS FRCOphth
CONSULTANT CONSULTANT OPHTHALMIC, OPHTHALMIC, OCULOPLASTIC OCULOPLASTIC & & ORBITAL ORBITAL SURGEON SURGEON Mr Brian Leatherbarrow was a consultant ophthalmic and oculoplastic surgeon at Manchester Royal Eye Hospital specialising in this field from 1992 to 2014. He is now in full time private practice. He has over 84 publications in the medical literature, 5 book chapters and is the single author of the textbook Oculoplastic Surgery (2nd Edition published by Informa in Dec 2010). Mr Leatherbarrow has been preparing specialist expert witness reports since 1994. He prepares 75-100 reports per year, for both Claimants and Defendants. Reports are produced within 4-6 weeks of receipt of all relevant information
Medico Legal enquiriesplease contact Mrs Stephanie Mallon (PA) 07854 629 527 Or Visit
www.faceandeye.co.uk
EYELID SURGERY
ORBITAL SURGERY
EYELID & ORBITAL DISORDERS
Specialist in: Eyelid Surgery / Orbital Surgery / Eyelid & Orbital Disorders
Mr Leatherbarrow has specialist expertise in: • Complications of cosmetic eyelid surgery (blepharoplasty) • Eyelid reconstructive surgery • Ptosis surgery • Eyelid and orbital tumours • Eyelid and orbital trauma • Loss of an eye / socket reconstructive surgery • Thyroid eye disease • Watering eye problems
Memberships: • Fellow Royal College of Surgeons of Edinburgh (FRCSEd) • Fellow Royal College of Ophthalmologists (FRCOphth) • Member and President of the British Oculoplastic Surgery Society (BOPSS) • Interspecialty member of the British Association of Anesthetic Plastic Surgeons (BAAPS) • Member of the European Society of Ophthalmic Plastic & Reconstructive Surgery (ESOPRS) • Member of the American Academy of Ophthalmology (AAO) • Member of the Federation of Forensic and expert Witnesses
Ophthalmic Surgeon & Paediatric Ophthalmologist Mr Ian Simmons has been involved in medico-legal work since 2000 for both claimant and defendant and can also act as a Single Joint Expert.
His specialist areas of expertise include: • • • • • • • • •
General ophthalmology Neuro-ophthalmology Cataract Surgery Ocular Trauma Personal injury to the eyes Paediatric ophthalmology (any aspect) Adult squints & molitity problems Ophthalmic neuro-oncology Strabismus
Mr Simmons write between 150 and 200 personal injury and clinical negligence reports per year. His Claimant:Defendant split is approximately 60:40. He has acted as a SJE in complex multi-disciplinary trauma cases and children suffering peri-natal or birth-related injuries. He regularly attends meetings with counsel and appears in court between 4 and 6 times per year.
Mr Ian Simmons MBChB BVSc FRCOphth
Instruct Ian now: Spire Leeds Hospital Tracey Horne (Secretary) 0113 218 5940 i.simmons@nhs.net
Consultant Physician in General and Geriatric Medicine Dr Solanki is a part time NHS Consultant Physician based at Taunton and Somerset Foundation Trust, Musgrove Park Hospital and has 25 years experience as a Consultant Physician in Geriatrics and General Medicine. He has been a Clinical Director at his NHS Trust and set up and led the osteoporosis service for Somerset. He was instrumental setting up and leading an award winning orthogeriatric (orthopaedic medicine for older people) service. After initial training he specialised in geriatrics and completed a Master’s degree in Gerontology at King’s College London. His research interest is in vitamin D and bone disease. In addition to his interest in bone disease, Dr Solanki also manages general medical and geriatric conditions such as falls and funny turns, TIA’s, strokes, Parkinson’s disease and memory problems. As a geriatrician he has an expertise in managing complex patients with multiple organ diseases.
Dr Tarun Solanki MBBCh MRCP MSc FRCP
Dr Solanki is passionate about patient safety and quality and has been a member of the Trust’s Quality and Safety steering group. He is Chair of the England Council the British Geriatrics Society. He is keen on education and training and has been responsible for training specialist registrars in geriatrics and is an examiner for the Royal College of Physicians. Dr Solanki has been undertaking expert witness work, including the preparation of medico-legal reports and appearing in court for the past 10 years.
2019
Federation of Federation of
Expert witnesses sic Forensic & Expert&witnesses 07568 907 192 | 0300 1311418 | taunton.enquiries@nuffieldhealth.com
Dr Katharine Winstone PHD, BDS
Expert Witness Qualifications: PHD (Doctorate - London University 1986), BDS (Batchelor of Dental Surgery London University 1980)
Details: I have been in general practice for 38 years and have a PhD in the Faculty of Medicine, London University. I have regularly run courses for postgraduate dentists on Treatment planning and composites. I have provided reports over 450 reports for both Claimants and Defendants for about 12 years; worked as a single Joint Expert, been involved in case conferences on many occasions, and given evidence at both the GDC and in the High Court in Dublin.
Training: Bond Solon Court Skills - 2009 London Bond Solon - Writing Expert Witness Reports - Manchester 2008 Cross Examination Skills â&#x20AC;&#x201C; Bond Solon 2011 Certificate in Civil Procedure Rules - Bond Solon 2011 Bond Solon Expert witness Conference 2012, 2013, 2015 The Dental Protection Conference 2017
Membership: Royal College of Surgeons â&#x20AC;&#x201C; Faculty of General Dental Practitioners British Society of Periodontology Vice-Chair Board of Trustees of Gravesend Grammar School Trust Trustee of the Kent Cancer Trust
Dr Katharine Winstone katharinewinstone@mac.com
Dr B David Cohen Specialist Endodontist and Accredited Expert Witness
PhD MSc BDS MFGDP LDSRCS CUEW MEWI CertMR
I have now been preparing expert witness reports for over 20 years, having prepared over 1000 of them. Most of these have been completed in the last 7-10 years since the Woolf reforms, and following my formal training on the Cardiff University Expert Witness Certification course. I am trained to be involved in acting as an expert witness on behalf of the court, appointed by either claimant or defendant, and as a single joint expert. My training and experience also include court/ tribunal procedures, and cross examination. Endodontics clinical negligence My specific area of expertise in clinical negligence cases is that of endodontics (root canal treatment/ therapy). I have prepared reports for both claimants and defendants
Personal Injury Cases
Dr Cohen prepares condition and prognosis reports for facial and dental injuries caused by:
• Accidents • Slip and trips • Road traffic accidents • Accidents at work • Sports accidents • Endodontic problems inc. clinical negligence DENTO-LEGAL SERVICES 122 Hilton Lane Prestwich Manchester M25 9QX dento-legal@endodontistmanchester.co.uk www.endodontistmanchester.co.uk Phone: 07000 665277
Mr. Robert Hensher FRCS FDSRCS
Consultant Oral & Maxillo-Facial Surgeon
Mr. Robert Hensher has undertaken broad training in orthopaedics, casualty, general and vascular surgery and held Senior Registrar positions at Westminster & Queen Mary’s Roehampton Hospitals, and Great Ormond Street Hospital for Sick Children together with University College Hospital. He was employed in the role of Consultant Oral & Maxillo-Facial (OMF) Surgeon to Gloucester Cheltenham & Cirencester Hospitals in 1986 – 2000. Whilst in this role, Mr. Hensher had a special interest in jaw surgery and pioneered TMJ Replacement, for which he now has a national and international reputation. Mr. Hensher has written chapters in standard text books and numerous professional papers and was one of the first non-American Surgeons to be invited to join the American Society of TMJ Surgeons. In a recent interview, Mr. Hensher explained that: “experience is vital as one’s advice and opinions improve in depth and veracity with repetition and learning. Qualifications give access to posts in the training grades and indicate the level of professional education obtained; however they do not indicate the experience an individual has gained.” Mr. Hensher attends court as an Expert Witness relatively infrequently at present, about once or twice a year, although this is increasing. He accepts instructions which require him to examine and report on patients about equally for prosecution, defence and on a single expert basis. “Early engagement of an expert usually saves time and money,” explained Mr. Hensher. “Of course, discussion may subsequently take place, but a senior opinion at the outset sets the tone and (should raise) the relevant points.”
As an expert, Mr. Hensher has received instructions and reported on the following example cases: • • • •
Failed TMJ Prostheses; joints were constructed by the inserting surgeon. Failed bone grating and TMJ prosthesis post trauma. Death by post operative haemorrhage (HM Coroner’s Inquest). Death post cancer resection (HM Coroner’s Inquest, scheduled for Dec 2015).
Mr. Robert Hensher is a founding member of The Association of Dental Implantology and The British Association of TMJ Surgeons. He is also a member of The American Association of TMJ Surgeons and a Fellow to The British Association of Oral and Maxillofacial Surgeons.
The Hospital The King edward vii Beaumont Street London W1G 6AA 02074673236 For further information, please call Mr. Robert Hensher on 02074673236, email medico legal enquiries to roberthensher@kingedwardvii.co.uk / jackiesorrell@kingedwardvii.co.uk
Professor Paul Tipton B.D.S., M.Sc., D.G.D.P., UK Specialist in Prosthodontics & Expert Witness London | Manchester
Professor Paul Tipton is a leading authority in UK Dentistry. Regularly featured in the Dentistry’s Top 50 Most Influential People in Dentistry, he has been a pioneering figure in the industry. In addition to being a specialist in Prosthodontics since 1999, he has been in private practice for over 30 years and is currently Clinical Director of T Clinics in Manchester and London. A keynote speaker at dental conferences around the world, Professor Tipton has lectured at home and abroad throughout his professional life including Australia, the US, Dubai, South Africa, Singapore and India. He is the founder of Tipton Training Ltd which has seen over 3500 UK dentists pass through many of his one year courses in Restorative, Aesthetic and Implant Dentistry. Professor Tipton has assembled a team of dental expert witnesses who work with him at T Clinics nationwide. All areas of Dentistry are covered including General Dentistry, NHS and Private, Cosmetic and Restorative Dentistry, Implantology, Oral Surgery, Orthodontics, Periodontics and Endodontics. Experts range from experienced Private Practitioners to those with Masters degrees that limit their practice to special areas of Dentistry, to Specialists, Consultants and Professors and span across the whole of the UK. All experts write the highest quality of reports in all fields ranging from Personal Injury to Road Traffic Accidents to Clinical Negligence.
07786327978 | becky@drpaultipton.co.uk www.drpaultipton.com | www.tclinic.co.uk 1. Throughout your years of experience as an expert, what common mistakes do other dental professionals make which does have the potential to lead to losses: Most of the common negligence cases that we see in dentistry are to do with periodontal disease and lack of diagnosis and lack of treatments which has in turn led to tooth loss and then the need to replace the teeth, usually with dental implants. Dental implants are a very costly treatment and usually not available in the health service and often should the negligence have led to loss of many teeth then treatment cost can be in the region of £50,000 in order to replace these missing teeth with implants. The second most common cause of negligence is then due to tooth extraction where it has not been explained to the patient that there are other options which could lead to the tooth being saved. The patient is then not fully informed of other treatment options and if they had been fully informed they would have taken another route which would have led to the tooth being treated. Again, once the tooth has been removed the usual replacement is with the dental implant and a single tooth replacement is often in the region of £3,000 to £4,000. The newer types of dental negligence which we are seeing more and more is to do with complex treatments for which the dental practitioner is either inadequately trained or he has not given the patient a reasonable estimate of the costs and the outcome together with the pros and cons of such treatment. Here the more expensive treatments include dental implants, cosmetic dentistry with veneers, etc., and also short-term orthodontics.
Patients are very often disappointed when having veneers or crowns placed that the end result does not match their expectations which can again then lead to a claim. Most dentists often do not complete enough diagnostic work in advance of treatment so that the end result can be easily previewed by patients and amended as required. Dental implants have a failure rate and this is often overlooked when placing dental implants. The expected failure rate has always been in the region of 5% in the lower jaw and 10% in the upper jaw. More recently, however, there is peri-implantitis disease which has led to an increase in the failure rates in some patients. Again this is often overlooked during the treatment planning stage. The patients are on the assumption that their implants will last them a lifetime. Short-term Orthodontics can not only improve the patientâ&#x20AC;&#x2122;s appearance but can also provide problems with the patientâ&#x20AC;&#x2122;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 dentistâ&#x20AC;&#x2122;s part which can be reflected in the quality of treatment that is provided.
3. How would you deal with negligence, whiplash and general accident cases differently? Do any of those have different requirements when producing a medicolegal report? Negligence cases take the most amount of time and are often very, very complex involving multiple dentists over a period of time during which the patient was treated. This is especially so in the area of periodontal disease where lack of care, lack of treatments and diagnoses may have been going on for a decade or more and the patient has seen multiple dentists or who have continued to non-diagnose the disease process and to not treat it which is kind of complex then to apportion the negligence percentage to each of the dentists involved in the case. The most important factor which is often overlookedby some experts is the issue of causation and understanding that it is then not enough just to deal with liability for the case to have merit. General whiplash and accident cases are far more easy and are reflected in the fact that the reports are cheaper to produce and are often of a more factual nature.
4.
What advise do you have for solicitors when choosing dental experts?
The choice of dental expert should be based on the understanding and knowledge of their field and certainly, expertise should be of a minimum an established private practitioner who has over 10 years of general dental practice. Alternatively, dentists who have gone on to have further education in a particular field, such as 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.
5.
Tell me about your specialism of Prosthodontics.
I am a Specialist in Prosthodontics and also a Professor of Restorative and Cosmetic Dentistry in the City of London Dental School. Prosthodontics is that speciality which deals with the replacement of teeth and this can be via crowns, veneers, bridges and implants. Restorative dentistry entails not only prosthodontics but also periodontics, prosthetics and endodontics and cosmetic dentistry includes aesthetic dentistry and again veneers, crowns, implants, bridgework, all of a cosmetic nature. Prosthodontics would also include treatment of the temporomandibular joints and bite. This treatment is often wholly performed by dentists who have inadequate training in the field of occlusion(bite). Being a specialist in Prosthodontics and a Professor of Restorative and Cosmetic Dentistry gives me an overall view of all the fields involved in Restorative, Cosmetic and General Dentistry which is essential when writing reports and coming to opinions as to plans and treatments.
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
Dr Megan Emma Smith LLB, MBBS, FRCA, Barrister
Consultant Anaesthetist Dr Megan Smith is a Consultant Anaesthetist at the Royal Free London NHS Foundation Trust, one of the UKâ&#x20AC;&#x2122;s leading major teaching hospitals. Dr Smith qualified as a doctor in 2003 and began her career in anaesthesia in 2006. She has been a consultant anaesthetist since 2015. She specialises in Regional anaesthesia (in particular, single shot peripheral nerve blockade and peripheral nerve infusion catheter insertion), trauma and orthopaedics, hand trauma, general and colorectal surgery, vascular surgery, renovascular (in particular arteriovenous fistula formation), renal surgery (including renal cancer and transplants), laparoscopic surgery and robotic surgery.
LEGAL EXPERTISE Prior to studying medicine, Dr Smith was a practising barrister. She gained a Bachelor of Laws degree (LL.B) in 1993 for which she was awarded First Class Honours. She attended the Inns of Court School of Law in London between 1993 and 1994 where she completed her Bar examinations. She was called to the Bar of England and Wales in October 1994. Dr Smith has been awarded a number of scholarships and prizes by The Honourable Society of Lincolnâ&#x20AC;&#x2122;s Inn for both her pre-pupillage and pupillage years. These include the Thomas More, Hardwicke and Shelford Scholarships. She also received numerous subject prizes during her LL.B (including for Medical Law and Ethics) as well as prizes for overall excellence in Part I and Part III examinations. Dr Smith practised as a barrister specialising in property, contract, commercial, landlord and tenant and insolvency law. In addition, she acted for plaintiffs and defendants in professional negligence cases. She appeared regularly in the County Court and High Court. She is entirely comfortable taking responsibility for the conduct of cases with serious outcomes for clients/patients and is highly skilled in relation to the following:
* Rapid, forensic analysis and assimilation of complex subject matter * Public speaking and thinking quickly on her feet, particularly in court * Assessment of likely examination and cross examination subject matter * Clear, accurate written presentation including the drafting of witness statements, affidavits, legal opinions and pleadings, as well as investigation reports * Time management: prioritisation of tasks, working under pressure of time and working to strict deadlines * Client communication and management and conduct of client consultations * The conduct of formal negotiations on behalf of clients 19 Meynell Gardens LONDON E9 7AT
Dr Smith retains a keen interest in medical law and is a member of the Medicolegal Society. She is a member of the Royal Free Hospital’s Serious Incident Review Panel and has conducted investigations into serious incidents that have occurred within the Trust.
Areas of Expertise: • General anaesthesia for major adult surgery. • Regional anaesthesia (peripheral nerve blockade incl use of peripheral nerve catheters). • Orthopaedic anaesthesia. • Neuraxial anaesthesia for adults (spinal, epidural, combined spinal and epidural). • Anaesthesia for plastic surgery. • Anaesthesia in trauma patients. • Airway management and problems with airway management (incl dental damage). • Acute pain management. • Care of the acutely unwell adult surgical patient. • Awareness under anaesthesia. • Allergy and anaphylaxis. • Intra-operative care (incl patient positioning). • Law and practice relating to anaesthetic consent. • Invasive monitoring (incl arterial line insertion and central venous cannulation).
020 3663 3367 | 07525 432915 | megan.smith16@nhs.net | www.drmegansmith.com
Dr Piotr Buczkowski FRCA, FFPMRCA
Consultant in Anaesthesia and Pain Medicine Consultations in English and Polish.
• • • •
Dr Buczkowski works as a Consultant in Anaesthesia and Pain Medicine at:
Nuffield Derby Hospital Nuffield Leicester Hospital Spire Leicester Hospital Spire Nottingham Hospital.
Specialising in the diagnosis and treatment of spinal (neck and lower back) pain including neck injury related headaches. His clinical interest also includes: • • • • • •
Chronic pain management Pain after injuries and RTA's Whiplash Complex regional pain syndrome (causalgia, RDS) Neuropathic pain, Pain after limb injury - including hand and foot injuries.
Training: • Medical Degree from the Medical University Gdansk, Poland 1992, • Full Anaesthetic and Pain Medicine training in the UK, • FRCA (London) 2002, FFPMRCA 2007
Memberships include: • International Spinal Intervention Society • International Association for the Study of Pain • Royal College of Anaesthetists
Dr Piotr Buczkowski
Spire Leicester Hospital | Gartree Road | Leicester | LE2 2FF Secretary Tel: (0116) 265 3656 | admin@dr.buczkowski.co.uk
