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Mr Hamed was a prisoner at Belmarsh awaiting sentence. He had a history of poor mental health and had in the past made suicide attempts by jumping from heights. In 2017 he fractured his ankle after jumping off a fence. The fracture was fixed with a plate and screws. In the year leading up to March 2018, he had suffered 13 falls, during one of which he suffered a further ankle injury.
In March 2018 he fell from a top bunk in his cell at Belmarsh. No one witnessed this fall. Later that day he attended the nursing station, who recorded his complaint of an injury to his ankle and jaw but could not find any sign of redness bruising or swelling. At later medical appointments, he said that he had also injured his shoulder and back, but there was no record of this at the time.
He brought a claim against the Ministry of Justice. The claim was heard in the Cambridge County Court in June 2024. A consultant orthopaedic surgeon, Mr D, reported. His conclusions were based on Mr Hamed’s own account. He referred to Mr Hamed’s self-report of needing surgery to remove the metalwork following this fall, although there was no radiological evidence that the metalwork was broken or records to substantiate what he said. He concluded that Mr Hamid had suffered an exacerbation of pre-existing symptoms for 2 weeks, a soft tissue shoulder injury, a back injury and an ankle injury all of which would improve to their pre-accident state 4 months after physiotherapy.
The Defendant asked questions by way of clarification under Part 35 of the Civil Procedure Rules 1998 (CPR). In response he said that the fall may have resulted in a fractured screw and that the exacerbation of pre-existing symptoms had in fact lasted for 4 months, rather than 2 weeks. Commenting of the lack of any immediate complaint of shoulder or back pain, he said that this sort of injury could present late. He claimed that the literature supported him in this opinion but didn’t provide any.
The meeting of experts is a crucial part of the litigation process for medical expert witnesses. It can also be a very difficult and highly charged part of the process – where your views will be challenged. So, it’s vital that you prepare well for this meeting and present your opinions in a clear, reasoned way.
In this guide, we share our top tips for managing this meeting – drawing on insights from some of the UK’s most respected medical expert witnesses.
At trial, the judge was unimpressed by his evidence which was inconsistent, unsupported by the medical records or by the literature. The judge said:
‘It is not sufficient for an expert giving an opinion on which the court may rely to simply state what his/her opinion is without justification for that opinion…it is clear that this was a very weak report which failed to comply with the requirements of an expert report.’
He added, ‘I would urge Mr D to undertake some further training in expert medico-legal report writing to ensure that he fully understands the obligations of part 35 and his duties to the court.’
There are a number of lessons to take from this story:
Finally, don’t embark on medical expert work without having undergone training to understand your role, your duties and the Civil Procedure Rules.
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