What is a Medical Negligence Duty of Care Case?

What is a Medical Negligence Duty of Care Case?

A medical expert plays a critical role in a clinical negligence case, providing key evidence and opinion that can make or break a case. These attributes will apply to a medical expert whatever type of case, from cancer misdiagnosis to a cosmetic procedure that’s gone wrong. Surgeon expert witnesses are medical professionals with extensive experience in surgical procedures. They are called upon to provide great insight in cases where surgical procedures, malpractice, or other healthcare-related matters exist. Mr Rakesh Bhardwaj - MBChB (Bristol), FRCS (Eng), FRCS (Ed), MD (London), FRCS (Gen Surg), LLM and Leading Consultant General and Colorectal Surgeon explains.

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The role of the Consultant General and Colorectal surgeon expert witness extends to advising solicitors, insurers, and leading counsel on all aspects of causation and condition involving individuals suffering afflictions to the abdomen, particularly the lower part of their gastrointestinal system. 

As an expert in General and Colorectal surgeon Mr. Rakesh Bhardwaj trained at Bristol University (1988-1993) and undertook a Research Higher Degree in the field of Colorectal Surgery at University of London and was awarded an MD. He undertook Higher Specialist Training in London and South-East England.

He completed his training with Specialist Surgical Fellowships at St Marks Hospital and with Ethicon Endosurgery. He is a Fellow of the Royal College of Surgeons of England and currently examines for the College. He developed an interest in Medical Law and recently obtained the award of LLM with a focus on clinical negligence.  Although he deals with conditions of the abdomen and has extensive experience in elective and emergency abdominal surgery, his main interest is in the field of colorectal surgery. This includes diagnosis and treatments for colorectal cancer, inflammatory bowel disease, functional bowel disease and anorectal pathology.  

Please introduce yourself to the readers of Lawyer Monthly and what is your professional background and education? 

My name is Rakesh Bhardwaj. I currently work in the NHS as a Consultant General and Colorectal Surgeon and have been in this position for fifteen years. 

I trained in medicine at Bristol University and graduated as a Bachelor of Medicine and a Bachelor of Surgery in 1993. I undertook by basic surgical training in Manchester and achieved admission as a Fellow of both the Royal College of Surgeons of England and Edinburgh in 1998. I then undertook a period of surgical research in colorectal surgery with the University of London and was awarded a higher degree by research, becoming a Doctor of Medicine. My Higher Specialist Surgical Training was undertaken in London and the Southeast of England and achieved entry to the Specialist Register along with an award of an FRCS in General Surgery.

After this I undertook a specialist fellowship at St Mark’s Hospital. This was followed by a sponsored laparoscopic fellowship with Ethicon Endosurgery in Plymouth. I joined the staff at Darent Valley Hospital as a Consultant Surgeon in 2009. I am currently Lead Clinician in Colorectal Surgery. 

I have chaired the Colorectal Cancer Multidisciplinary Meeting for twelve years and recently became an Examiner for the Royal College of Surgeons of England. I have a mature medicolegal practice and in order to improve my practice I studied medical law and achieved in 2023 the award of LLM with an interest in medical negligence. I have published several articles in the Expert Witness Journal in the fields of Consent and Gross Negligence Manslaughter.  

What are your areas of expertise and professional experience as a General and Colorectal Consultant Surgeon? 

Most of my practice centres around the diagnosis and treatment of Colon and Rectal Cancer. However, I have extensive experience in inflammatory bowel disease and benign colorectal disorders. I also have a commitment to general abdominal conditions such as hernias. As part of my emergency surgical commitment, I undertake all forms of emergency abdominal surgery.  

How did you become an expert witness specialising in General and Colorectal Surgery? 

I always had an interest in medical law. As I became more interested, I naturally fell into becoming an expert witness. I find it challenging but enormously rewarding. I find it also very useful in my current working life as a surgeon to have such exposure. 

Most of my experience is self-taught, but I find the support from medicolegal organisations very helpful. I try and keep up to date by attending medicolegal conferences and refreshing my skills with courses. Working towards legal deadlines with a current busy surgical practice keeps me very busy.  

What type of services do you provide? 

Most of my work consists of reports related to Medical Negligence. I accept instructions from Solicitors directly and Companies that are engaged by solicitors. I also work with NHS trusts and with NHS resolution. I thus conduct Screening, Breach of Duty, Causation and Condition and Prognosis Reports. I am happy to look at Medical Records alone or see patients directly in Harley Street, London or by video consultations when appropriate. I have recently expanded my practice and now consult in Manchester.  

What types of organizations or cases have you provided services to or assisted and in which areas? 

I have provided services for NHS Resolution, UK expert Medical, e-medical, Doctors Chambers, Medreport, UK independent Medical, S K Medical Practice and Bodycare Clinics.

I have assisted in the field of General and Colorectal Surgery. Specifically, I have dealt with the diagnosis and treatment of Colon and Rectal cancer and Emergency Surgical Conditions. I have also dealt with many Personal Injury cases causing abdominal injuries.  

What do you have to do as part of this role? 

I review medical records predominately and try and sift out the features that are salient to the legal instructions. I occasionally see patients in my chambers to assist in this process.  

What are the challenges with providing expert medico legal opinion on matters involving General and Colorectal Surgery? 

It is essential to provide a balanced opinion. I think clinical experience is essential but also understanding the nuances of modern medicine is vital. An academic background helps to provide supportive evidence. Ultimately, providing a sound opinion is the aim, and this can take considerable thought. Each case is unique.  

The working relationship between an expert and their instructing solicitor is a significant one. What are the challenges that experts face when working with instructing solicitors, and how do you overcome these? 

Communication is the key. All medicolegal work is about providing high quality reports within the terms that are agreed. I find it helpful to speak to the instructing solicitors sometimes get a deeper understanding of the instructions. Most instructing parties are understanding that medicolegal experts also have busy clinical commitments and are accommodating regarding looming deadlines. Time management is an essential skill.  

What is the most interesting case you have worked on? 

I find delays in cancer diagnosis specifically during the pandemic period some of the most interesting cases I have worked on. The pandemic created an extra-legal dimension to the cases.  

What do you consider the essential elements for a top-rated expert report? 

I find that the essential elements for medicolegal experts are discipline and organisation. I find that it is very useful to set aside protected peaceful time away from a busy clinical practice to write and more importantly think about what is required in each case. Extensive experience in inflammatory bowel disease and benign colorectal disorders. I also have a commitment to general abdominal conditions such as hernias. As part of my emergency surgical commitment, I undertake all forms of emergency abdominal surgery.  

How did you become an expert witness specialising in General and Colorectal Surgery? 

I always had an interest in medical law. As I became more interested, I naturally fell into becoming an expert witness. I find it challenging but enormously rewarding. I find it also very useful in my current working life as a surgeon to have such exposure.  Most of my experience is self-taught, but I find the support from medicolegal organisations very helpful. I try and keep up to date by attending medicolegal conferences and refreshing my skills with courses. Working towards legal deadlines with a current busy surgical practice keeps me very busy.  

What type of services do you provide? 

Most of my work consists of reports related to Medical Negligence. I accept instructions from Solicitors directly and Companies that are engaged by solicitors. I also work with NHS trusts and with NHS resolution. I thus conduct Screening, Breach of Duty, Causation and Condition and Prognosis Reports. I am happy to look at Medical Records alone or see patients directly in Harley Street, London or by video consultations when appropriate. I have recently expanded my practice and now consult in Manchester.  

What types of organizations or cases have you provided services to or assisted and in which areas? 

I have provided services for NHS Resolution, UK expert Medical, e-medical, Doctors Chambers, Medreport, UK independent Medical, S K Medical Practice and Bodycare Clinics. I have assisted in the field of General and Colorectal Surgery. Specifically, I have dealt with the diagnosis and treatment of Colon and Rectal cancer and Emergency Surgical Conditions. I have also dealt with many Personal Injury cases causing abdominal injuries.  

What do you have to do as part of this role? 

I review medical records predominately and try and sift out the features that are salient to the legal instructions. I occasionally see patients in my chambers to assist in this process.  

What are the challenges with providing expert medico legal opinion on matters involving General and Colorectal Surgery? 

It is essential to provide a balanced opinion. I think clinical experience is essential but also understanding the nuances of modern medicine is vital. An academic background helps to provide supportive evidence. Ultimately, providing a sound opinion is the aim, and this can take considerable thought. Each case is unique.  

The working relationship between an expert and their instructing solicitor is a significant one. What are the challenges that experts face when working with instructing solicitors, and how do you overcome these? 

Communication is the key. All medicolegal work is about providing high quality reports within the terms that are agreed. I find it helpful to speak to the instructing solicitors sometimes get a deeper understanding of the instructions. Most instructing parties are understanding that medicolegal experts also have busy clinical commitments and are accommodating regarding looming deadlines. Time management is an essential skill.  

What is the most interesting case you have worked on? 

I find delays in cancer diagnosis specifically during the pandemic period some of the most interesting cases I have worked on. The pandemic created an extra-legal dimension to the cases.  

What do you consider the essential elements for a top-rated expert report? 

I find that the essential elements for medicolegal experts are discipline and organisation. I find that it is very useful to set aside protected peaceful time away from a busy clinical practice to write and more importantly think about what is required in each case. 

 

Email: lindsaymedicolegal@protonmail.com 

Tel: 07388 187231 

Published by: www.lawyer-monthly.com – July 2nd, 2024

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