Featured Articles – Expert Witness Features – page 26

Problem Children

IN AN ARTICLE describing his student days, consultant child psychiatrist Dr Tim Hughes describes a cartoon in Private Eye which showed a male psychiatrist sitting behind his adolescent female patient who was lying on a couch. The patient is wearing Doc Martens, torn jeans, a tee shirt and a smug expression.

The psychiatrist is saying: “So, to recap, your parents are both tossers, your teachers are all idiots and I’m a four-eyed shirt-lifter whose car is being done over as we speak.”

Out of the mouths of babies... can come reliable evidence

ONE OF THE areas fraught with difficulty when dealing with the issue of fitness to give evidence is that of when a child is competent to give evidence in court. Earlier this year the decision of the Appeal Court in the case of R. v. Barker [2010] EWCA Crim 4, brought the issue to the fore.

In May 2009 Stephen Barker was convicted of anal rape of a girl – ‘X’ – who was less than three years old at the time of the offence. She was four-and-a-half years-old when she gave evidence.

Criminal cases help explain specialism

HIGH-PROFILE CASES in the media where people accused of crimes are said to suffer from mental illness were used as examples to explain the role a forensic psychiatrist plays within the legal system by Dr Gangopadhyay of the University of Aberdeen at a seminar in April.

He also provided a unique insight into the different elements of his occupation both at the university and in the NHS locally – which include support of prison health services and acting as an expert witness in court cases.

Sarcomas: early diagnosis is crucial

ONE OF THE most frequent types of compensation claim seen by medical negligence solicitors in the UK is the failure to diagnose cancer when it presents. Delayed diagnosis permits the tumour to advance and an advanced tumour will demand more aggressive treatment with the probability of additional complications.

Late diagnosis may also result in the tumour spreading into the rest of the body – known as metastases. These metastases are typically impossible to eradicate and frequently prove fatal.

Sarcomas are malignant tumours which arise from the connective tissues of the body: bone and cartilage or soft tissue and muscle. Unlike cancer of the breast, prostate or lung, sarcomas are rare. However, their rarity tends to lead to late diagnosis, so many patients present with a long history and a large mass.

Nephrologists: the kidney specialists

A PARTICULAR specialism within the discipline of urology is nephrology, which is concerned with issues related to the kidney. A consultant nephrologist deals with renal failure, glomerulonephritis, pylonephritis, renal dialysis, diabetic renal disease and kidney transplantation, as well as medication issues involved in kidney disease.

According to medicalcasenotes.co.uk, common issues that may lead to a claim of clinical negligence include medication causing kidney damage, delay in diagnosis of renal disease, mismanagement of renal failure and hypertension issues related to the kidneys.

An expert in the field is Dr Martin Mansell MD FRCP, who is the consultant nephrologist at the Royal Free and UCL Hospitals, London.