Medico-Legal Magazine - Articles

Medico-Legal News, Issue 26

Secondary victim claims after the Supreme Court decisions in Paul, Polmear and Purchase

The Supreme Court Judgment in Paul and another v Royal Wolverhampton NHS Trust; Polmear and another v Royal Cornwall Hospitals NHS Trust...

The Intersection of PTSD, Chronic Pain, and Personal Injury: Navigating the Complexities of Treatment and Litigation

The intersection of post-traumatic stress disorder (PTSD), chronic pain, and personal injury presents a complex landscape with significant implications for both medical treatment and the medicolegal process.

A Case Report from the Medical Protection files, discussing how an Anaesthetic Error During Breast Surgery Resulted in a Clinical Negligence Claim for Psychiatric Injury

A 41-year-old project manager, Mrs F, underwent breast uplift surgery, performed on a private basis.

“Just Sign Here” – Thoughts on Consent in the Post-Montgomery Era

The Consent process is a vital part of the patient pathway and is far more than just getting the patient to sign on the dotted line.

Medico-Legal News, Issue 25

Churchill v Merthyr Tydfill: Integrating dispute resolution into the management of clinical claims

The recent decision of the Court of Appeal in Churchill v Merthyr Tydfill County Borough Council [2023] EWCA Civ 14161, confirmed...

Cyber insurance: Enabling the future of healthcare

Over the last 30 years, healthcare has undergone nothing short of a technological revolution...

The New Intermediate Track – Practical Points to Consider for Experts

Many readers will no doubt be familiar with the court tracks in civil litigation...

Non-Surgical Cosmetic Procedures: is Time Running out for Unlicensed Practitioners?

Called to the Bar in 1997, appointed a KC in March 2023, Sarah Prager has been listed in the legal directories as a Band 1 practitioner in travel and cross border work for many years....

The Leading Provider of Independent Medical Reports

Premex Services Is No One-Trick Pony...

Medico-Legal News, Issue 24

Aortic Dissection and Inquests

Following any tragic death there will be many questions which arise and many potential areas...

How to Expect the Unexpected by Kit Yates - Book Review

The science of making predictions and the art of knowing when not to...

All Aboard The Nihl Omnibus

Prior to being called to the Bar in 2015, Max Melsa worked with Gerard McDermott KC on all aspects of high-value...

Navigating Claims under The Equality Act: A guide for Medical Professionals

Claims under the Equality Act 20101 arising out of clinical care are increasing in frequency and are often made wholly without merit.

Medico-Legal News, Issue 23

Confidentiality & Consent: What is expected, and when is it safe to override them?

Patient consent and confidentiality are at the heart of every clinician’s day-to-day practice.

Whistleblowing in an NHS in crisis

The NHS has suffered from the perfect storm of more than a decade.

Reducing misdiagnosis of Aortic Dissection

Currently 4,000 patients a year in the UK suffer AAD.

A Taste of Ophthalmology Litigation

The annual clinical negligence bill against the National Health Service (NHS) in England has increased considerably from £0.3 billion in 2004 and 2005 to £2.3 billion in 2019 and 2020.

Unlocking the Potential: How AI can Transform the Medico-Legal Sector

While AI has yet to make significant inroads in our field, its potential applications hold promise for streamlining processes and improving outcomes for both patients and defendants.

Medico-Legal News, Issue 22

Noise Induced Hearing Loss

Without doubt the most preventable occupational health disorder is that of noise induced hearing loss (NIHL).

Clinical Negligence in Otorhinolaryngology

I have been writing reports on clinical negligence and clinical performance since 1989.

The world of the expert witness – are you ready to join it?

Dr Whiticar discusses the expert witness role and the need for more doctors to take it up.

Many are called - few are chosen: Celebrating 10 years of The Faculty of Expert Witnesses

It was the summer of 2012. The Olympic Games and for me, more importantly, as a barrister dealing with complex personal injury, particularly those with a military element, the Paralympic Games were in full swing.

A Risk Management Toolkit – Should I Have One and How can I get it?

You are a clinician with perhaps few or many years of experience, or you may be just starting out in your career. 

Medico-Legal News, Issue 21

Medical Negligence: Individual Error or System Failure?

A few years ago, I spent part of an enjoyable summer holiday reading two similar but different books.

The Role of Expert Witnesses in Consent Cases

When the court is considering whether a doctor’s treatment of a patient was negligent, it will of course apply the Bolam test.

New Guidelines on Aortic Dissection Diagnosis: A Cure or a Cause for Defensive Medicine?

This article explores whether the new best practice guidelines (RCEM, 2021) on the diagnosis of aortic dissection are more of a hinderance than help.

Medical Protectiom Society Case Report - Learnings from a Death Resulting from Anaphylaxis

Mr M, a 38-year-old financial adviser, was an existing patient of Dr V, a dermatologist...

Medico-Legal News, Issue 20

Pickering V Cambridge University Hospitals NHS Foundation Trust: Where Expert Witnesses Make All The Difference

Whilst instructing solicitors need to bear some responsibility for this, more work needs to be done by the experts giving evidence.

Assisting The Coroner - Understanding the Inquest Process and Potential Outcomes.

The following article will explain the role of the Coroner, the process of an inquest and the obligations and responsibilities of a doctor involved in a professional capacity.

Eight Top Tips for Medico-Legal Experts

Whether you are just starting out as an expert witness, or you are a veteran report-writer with hundreds of cases under your belt, it is always good to have the fundamentals of medico-legal work firmly in mind.

Reflections on Dispute Resolution: Mediation and Education

In my experience of conducting numerous mediations, it seems that disputes of any type can be driven by three main issues: perception, personality and communication.

Dental Practice and Responsibility for Claims

Dentolegal work and cases are not in essence any different to medicolegal work in general.

VAT Liabilities – An Introduction To The Understanding of The Correct VAT Liability

Since 2007, the medical VAT exemption no longer applies to certain “non-therapeutic” reports

GMC Publish Draft Guidance for Cosmetic Procedures

In 2015 the General Medical Council (‘the GMC’), the regulator for all medical doctors working in the UK, announced the development of new ethical guidance for those doctors who carry out cosmetic procedures.

Vascular Surgery - A Medico-Legal Overview

The speciality of vascular surgery is concerned with the diagnosis, assessment and treatment of all conditions of the arteries, veins and lymphatics.

NHS England Reveals That Over 1,000 Patients Have Suffered ‘‘Never Events’’ In The Last Four Years

‘Never events’ are serious, preventable patient safety incidents that should never happen. 

Making Medical Record Collation Cost Effective For Law Firms

The tough economic climate, matched with recent changes in the rules governing the recovery of costs, brings mounting pressure on law firms to reduce overheads and maximise profit costs. 

The Perils of Prescription Medication

Most of us have been to our GP at some point complaining of pain. It’s not uncommon – back pain or a persistent neck pain following a bad night’s sleep. 

Quantification of Noise Induced Hearing Loss – A Game Changer?

“Guidelines on the diagnosis of noise-induced hearing loss for medical legal purposes” has become the definitive paper on which the diagnosis of noise induced hearing loss (NIHL) in compensation cases is made.

Contributing to Paradise Lost

Bermuda has many things. Elbow beach. The Kite festival. Scuba diving. And the highest numbers of lawyers per head of population on the planet. 

Mend It Like Beckham – Anterior Cruciate Ligament (ACL) Reconstruction

The ACL is a band of dense connective tissue which runs diagonally in the knee and contributes significantly to stability, particularly during twisting and turning activities. 

Gait Analysis for Assessment of Lower Limb Function After Injury or Surgery

One of the challenges for assessing function of the foot and lower limb, especially in medico-legal examinations, is determining normal function.

What A Difference A Year Makes!

One year on from the implementation of MedCo it appears the medical legal sector is yet to come to terms with the changes.

Medico-Legal News, Issue 19

What Now: Vaccination as A Condition of Deployment

On 31 January 2022, Sajid Javid announced a reversal of government policy to implement mandatory vaccinations throughout much of the health and social care sectors.

Hughes V Rattan [2022] EWCA CIV 107: Non-Delegable Duties and Vicarious Liability: A Case Summary to Sink Your Teeth Into

‍The Defendant was a dental practice owner who owed the Claimant a non-delegable duty of care in respect of the treatment provided to her by self-employed Associate Dentists.

Maternity Risk Management – Missed Learning Opportunities

‍On a worldwide scale, the UK is a safe place to have a baby and recent data suggest a welcomed reduction in the stillbirth rates

A New Approach to Causation in Clinical Negligence Claims

This medical negligence case explores the cause or causes of the above-knee amputation of the claimant, Mr John Raggett (deceased), arising from the failures of three medical professionals.

Whistleblowing in The Healthcare Sector

The role of whistleblowing to highlight issues within organisations has become increasingly common in recent years, especially within the healthcare sector. What are the key lessons learnt?

Prognosis of Chronic Whiplash – Is The Evidence Convincing?

Whiplash claims cost the country about £2billion every year and motorists collectively pay about £1billion more than they need to because of high levels of claim. 

Litigation Culture Under The Microscope

Do you honestly understand microbiology? Few do, and the same applies in litigation. 

Endocrine Aspects of The Traumatic Brain Injury: Medico-Legal Implications

Traumatic brain injury (TBI) is a very common injury, particularly among children and young adults. The commonest causes of TBI are: falls (28%), traffic accidents (20%), struck by/against (20%), assaults (12%).

Medico-Legal VAT Liabilities – Further Details to Explore The Correct VAT Liability

In the introductory article on this subject in Issue 1, I explained some basic rules about the VAT treatment of “medico-legal” services. This follow-up article covers some of these issues in more detail.

An Infinite Capacity for Courting Disaster – The Mental Capacity Act

A person lacks capacity in relation to a matter if at the material time he is unable to make a decision for himself in relation to the matter because of an impairment of, or a disturbance in the functioning of, the mind or brain

Interview With an Expert Witness

‍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.

Vascular Surgery – A Medico-Legal Overview Part II

This article will concentrate on conditions of the venous and lymphatic systems.

SRA Proposed Change to The Definition of What is Client Money. Who Benefits?

The SRA recently launched a consultation on changes to the Solicitors Accounts Rules. Of particular significance to medico-legal organisations and solicitors is the proposed way that professional disbursements will be dealt with.

Medico-Legal News, Issue 3

A Revolution for Medico-Legal Experts?

In 1966 Robert F. Kennedy delivered a speech that included a passage: there is a Chinese curse which says “May you live in interesting times.” He could hardly have contemplated the rise of President-Elect Trump or Ambassador Farage 

Factual Witnesses and Expert Advisors – Lessons Learnt From Recent Trial Wins

We all know the importance of testing your evidence throughout a claim, before deciding whether to progress to the next step. 

An Industrial Toxicology Case Study

As Expert Witnesses we all see cases that we think are interesting. We would not take them on if they were not of interest to us personally, and within our compass of expertise to deal with. 

Mediation Within The NHS in Scotland

The use of mediation within the NHS in Scotland is proving to be a slow burn. 

Psychiatric Assessment of The Effects of Historical Child Abuse

The recent public focus on historical child abuse has led to an increasing number of personal injury claims. 

Patient Consent for Aesthetic Treatments – More Than Merely Cosmetic?

It’s been over three years since the Government Committee chaired by NHS Medical Director Sir Bruce Keogh published its final report into the regulation of cosmetic interventions. 

Whiplash Numbers – Fact or Myth?

Statistics have a wonderful ability to be manipulated to prove almost anything. 

Medical Reporting in 2017, The Year of Innovation?

MedCo has seen little evidence of the mature, fit for purpose Medico-Legal sector that industry has spent so many years portraying to both government and the market in general. 

Medico Legal News, Issue 4

A Perfect Storm – The Spiralling Cost of Claims

When a patient receives a multi-million pound compensation claim, it often makes headlines. But few of us stop and think about the effect the rise in such claims is having on NHS finances.

Mediation in Clinical Negligence Claims The New NHS LA Scheme

The NHS Litigation Authority (now renamed NHS Resolution from April 2017) recently launched its new Claims Mediation Service following a successful pilot and a public tender.

Robotics and Artificial Intelligence in Healthcare

The idea of ‘robotic surgery’ is not a new one. The first robot assistant for surgery, the Arthrobot, was developed in the early 1980s and first used in 1984, in an orthopaedic procedure. 

An Invitation To Mediate? Accept!

change is on the horizon. In 2014, the NHSLA published “Mediating claims in the NHS”. It runs to four pages, in which the NHSLA states its commitment to mediation 

Medico-Legal Aspect of Hand Arm Vibration Syndrome

Hand Arm Vibration Syndrome (HAVS) is a medical syndrome of symptoms and signs affecting the vascular, neurological and musculoskeletal systems

New Industry Body Launched to Represent Medical Reporting Organisations

The Confederation of Medical Agencies, launched in March, aims to offer a true voice and representation for the smaller Medical Reporting Organisations

Understanding The Unsaid Signals

There is an old saying, "It's not what you say, it's the way that you say it" and, like many old things, it has become hackneyed and overlooked with time

Medico Legal News, Issue 5

Short Term Pain From New European Data Regulations Will Lead To Long Term Gain in Digital Health

Damaging as it was, the WannaCrypt ransomware attack earlier this year made one thing very clear to everyone who heard about it: the UK’s health comms are broken.

Claimant Interview Tips for Experts

Five years ago, when I set up my own boutique personal injury firm, I wrote a blog entitled ’What to expect at a personal injury medical appointment’. 

Common Medico-Legal Issues in Facial Trauma (part one)

The treatment of facial injuries has evolved considerably over the last 30 or so years and many injuries can now be reliably repaired to a reasonable level of precision. 

Update in Selected Gynaecology Medico-Legal Aspects

Endometrial ablation has now firmly established itself as an excellent surgical option to treat heavy periods.

About The Parliamentary and Health Service Ombudsman

The Parliamentary and Health Service Ombudsman (PHSO) makes final decisions on unresolved complaints about the NHS in England

Medico Legal Agencies: The Good, The Bad and The Ugly. How to Choose?

When choosing and negotiating with medico-legal agencies, you need to consider a number of different factors.

Facilitate Expert Solutions Takes the Stress Out of Running Your Business

Running a business is hard, not least having to learn a whole new skill set to stay on top of the paperwork and ensure the smooth running of a medico-legal practice.

Medico Legal News, Issue 6

Medical Experts’ Tips for Lawyers

 I can offer a few thoughts to the legal profession that crop up regularly in the course of my own many years of medico-legal practice

The Primacy of Independence and Objectivity in Expert Evidence – A Review of EXP V Barker [ 2017 ] EWCA CIV 63.

the Court of Appeal decision in EXP v Barker [ 2017] EWCA Civ 63 is a salutary read reinforcing the principles of independence and objectivity in the provision of expert evidence

Common Medico-Legal Issues in Facial Trauma (part two)

I will discuss the impact of NHS targets on treatment of facial trauma, as well as other issues such as patient consent

The Loneliness of The NHS Whistleblower

Where are we now with whistleblowing in our health services?

How Virtual Reality Software Could Begin to help Injured Accident Victims Deal with Life Debilitating Chronic Pain

It is estimated that 28 million people in the UK suffer from some form of Chronic Pain. 

Medico Legal News, Issue 7

About The Association of Personal Injury Lawyers (APIL)

A group of barristers and solicitors founded APIL in 1990 to give a voice to those injured through no fault of their own.

Childbirth and Oasis - What is New?

Childbirth is exceptionally safe in United Kingdom, thanks to the progress made over decades in safety and quality of care.

Experts and Fixed Costs Extension

Lord Justice Jackson’s report – Review of Civil Litigation Costs: Supplemental Report: Fixed Recoverable Costs 

Accidental Awareness During General Anaesthesia (AAGA)

Two fears almost universally expressed by patients before surgery are first that they might die during the operation, and secondly that they may wake during the procedure unable to alert anyone to their plight.