Lawyer Monthly Magazine - May 2019 Edition

What do you think makes a good expert witness? I believe that there are two key prerequisites: knowledge and experience. Knowledge is essential to understand the field and practice as a specialist, which is also a requirement for becoming an expert witness. Experience is also indispensable as, undoubtedly, an individual with many years of experience is likely to be a better expert witness than someone with less experience. However, there is a caveat in that senior clinicians are not always as up to date with the latest literature and advances in their field. Although medicine and technology continue to develop, the advantage of experience is that when confronted with difficulty, the years of experience allow one to navigate through the problem. Hence, in summary, a mixture of knowledge and experience will prove to be most beneficial. What are common cases ENT expert witnesses see? Two categories come to mind: the first group are patients with noise-induced hearing loss, and the second are those who have had complications following surgery. Noise-induced cases were prominent in the past as prior to the Noise Regulations in 1989, there were no requirements for employers to protect their workers from excessive noise. The cases from the 1960s and 1970s did not come to the legal field until a few decades later, so in the 1990s, there was an explosion of medicolegal cases, where previous employees A Fair Hearing in Healthcare Hard of hearing? What can the NHS do to avoid litigation and why are cases common? Dr Uddin treats ear, nose and throat conditions and speaks with us on his role as an expert witness. realised they could claim compensation for prolonged exposure to occupational noise damage. The current situation is much better. There is now legislation and all employers are required to provide protective measures. The second group of patients are those that undergo surgery where complications have arisen. The nature of surgery is that there are inherent risks, but doctors are dutybound to follow the guidelines set out by the general medical council. They must always ensure that patients have given informed consent and are aware of the potential risks and benefits of the procedure. There are two groups: common risks and significant risks. One of my areas of expertise is sinus surgery; the risk of breaching the thin bone that separates the sinuses from the eye or brain, for example, is very small. But it is so significant if it occurs, that it would be negligent not to mention it. Even though the consent process is rigorous, when rare complications arise, patients can and do complain and claim compensation; that is where an expert witness may get involved - to analyse where the complications arose and if these were potentially preventable and whether there is a case of negligence. In your opinion, do you think there is anything the NHS could change, in order to make medical-related disputes run smoother, or for them to be avoided? Due to the pressures within the NHS, a patient may see different medical professionals at different grades in one OTORHINOLARYNGOLOGY patient journey. They may meet a different doctor on each appointment and only see their consultant surgeon once – on the day of their operation. This is not ideal nor good practice. In the current climate, there are also many delays and long waiting lists, so the patient may already be frustrated with waiting times. In private practice, however, the doctor and patient build a unique relationship. The patient’s first appointment is followed through by the same professional that will conduct the surgery and review them following their operation. A level of trust is established, so that if a complication was to occur, the patient, possibly, may be less likely to complain. However, within the NHS, there is less of a rapport established with a particular doctor and patient, hence patients may be more prone to complain should there be an adverse outcome with their care. In order to avoid litigation, the NHS needs to look at this key aspect: continuity of patient care. Another factor to consider is that the younger generation is generally more aware of their rights, potentially more litigious and perhaps less accepting of mishaps. The key to avoiding legal disputes is good, safe medical practice and to keep the patient at the centre of what you do. It is acknowledged that there are challenges and pressures in the NHS, but every patient deserves nothing less than excellent care. I believe it is with this culture of excellence that the medical profession can minimise the risk of litigation. LM Mr F Javed Uddin, Ear, Nose and Throat Surgeon Contact Mr F Javed Uddin Ear, Nose and Throat Surgeon BSc(Hons), MB ChB(Hons), FRCS(Eng), FRCS(ORL-HNS) www.leicesterentsurgeon.co.uk Mr F Javed Uddin Javed Uddin is a consultant ENT surgeon in Leicester and has been practising as a consultant for 7 years and doing ENT since 2001. He was awarded theprestigious Gold medal from the Royal Society of Medicine for his performance in the national final surgical exams prior to his consultant appointment. MAY 2019 54 Expert Witness www. lawyer-monthly .com