Interview With an Expert Witness

Please give us a short background of your own specialties and current medical practice?

‍My professional training consists mainly of General Surgical specialities, Orthopaedics and Accident & Emergency (since 1992). I moved to Guernsey as a lead consultant in 2015.

‍When and why did you decide to start a medico-legal practice?

‍I have been involved in medico-legal work since 1992, earliest as a senior registrar in the Emergency departments of Glasgow. I had to write numerous “pre-cognition” reports for the Procurator Fiscal in Scotland, which taught me how to adhere to facts and justify one’s opinion. During this time, I also attended the City Sheriff, Magistrate and High Court as a crown professional witness.

‍How did you go about setting up your first ML practice and how did you source clients?

‍The bulk of the medico-legal work started since my consultant appointment at Wrexham in 1996. I have worked in this busy DGH catering for 70,000 patients annually. I established my contacts with the local solicitor network in Wrexham, Liverpool and nationally in the UK. I have done so in Guernsey and enjoy a good relationship. I attended relevant training courses, networked with agencies and solicitors to receive regular instructions from the national medico- legal agencies, Welsh Risk Pool, UK solicitors and the GMC for professional negligence reports. This includes mediation, joint expert meetings and Court appearances.

Does ML work fit well with your other professional commitments?

‍Indeed, it does and actually enhances my clinical and professional practice. Because of clinical and medico-legal work, I am obliged to keep up to date with current evidence and standards of practice. I can bench mark my own practice with another clinician in negligence claims. The practice of precision in comments and having to justify my opinion enforces a discipline I benefit from.

‍What kind of cases do you come across most often – can you give us an example of a ‘typical’ case?

‍Most of the personal injury report instructions are related to whiplash and workplace accidents. Contrary to the recent Government regulations around MedCo, I have not come across any fraudulent claimants. This might be because the solicitors who instruct me possibly vet the claimants before asking me for a report. I do not write large volumes of reports in one sitting. Most workplace injury claims reveal unsafe work environments or a lack of apology from management after an unfortunate accident.

The clinical negligence claims of course vary. Most of the consequences are tragic and cause suffering. A typical claim will arise from missed diagnosis of Cauda Equina Syndrome due to central disc prolapse. The history and examination are often incomplete, urinary retention (commonest) is overlooked while looking for incontinence (rare) and patient returned home as they managed to walk.

I am still impressed how often, despite glaring and indefensible omissions in clinical management (not doing a CT scan after a head injury presenting with confusion, blaming the same on alcohol/drugs), the negligence claims are defended until almost a week before the court date. Unfortunately, all prolonged NHS legal action comes at a price to the tax payer.

Have you undertaken any medico-legal training over the years and do you find it helpful?

I trained with SpecialistInfo and Bond Solon. A lot of training is now available on-line.

I am a member of:

SpecialistInfo’s Faculty of Expert Witnesses (FEW), Association of Personal Injury Lawyers (APIL) database, Law Society Member, Society of Expert Witnesses Member,

Expert Witness Directory, Registration Council of Medical Experts Member, Waterlow Solicitors & Barristers Directory.

I find all the training invaluable and would suggest that all medical experts undertake at least ONE yearly update or attend a conference.

What advice would you give colleagues who are thinking of starting a medico- legal practice?

‍Please do NOT start any practice without suitable training. It helps to network with local, regional and national solicitors or MRO. You should prepare a brief medico-legal CV to highlight experience, credibility, training and accreditation. Solicitors prefer to know your terms and conditions and payment arrangements. Membership of accrediting bodies, often after suitable training or online courses, help. Advertising in medico-legal magazines will help – but best not to overstate the case. A sample report, best vetted by a reputable solicitor/barrister, will help receive instructions.

Finally, how do you think the industry has changed since you began your ML practice and how do you think it will evolve in the future?

When I started, there were many solicitors and MROs instructing me. Over the years, the number of claims have fallen. Solicitors are now selective on which claim they take on, especially for clinical negligence. I often get asked to comment on whether there is a case worth pursuing at all. More training is now available leading to accreditation. Annual conferences are of educational value.

Although I write fewer reports, the quality and thoroughness have improved.

I prefer this to the past.

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