oct ewj 24 online - Flipbook - Page 63
complaint of mild stress incontinence. It indicated that
those symptoms had persisted following the initial
implantation of the tape.
Discrepancies in Medical Records
It is not uncommon that we find inaccuracies in the
medical records or that the medical records do not
directly accord with the claimant’s recollection of the
case or indeed a defendant’s recollection of a case.
None of the other records preceding that indicated
that there was any ongoing stress incontinence and
between the last record made before the urodynamic
studies and the urodynamic studies being undertaken
and reported upon, there had been no further communication with the claimant which could have given
rise to such a report.
However, that is usually because the medical records
are lacking in detail and, with the passage of time, a
witness’s recollection may become hazy and attempt
to fill in gaps in memory, particularly where a defendant may have to draw on his or her usual professional practice where detail in the contemporaneous
note is lacking.
The question of whether stress incontinence had been
reported by the claimant became central to the issue of
whether a colposuspension should have been offered
or not. In the absence of features of stress incontinence, the procedure would not be indicated. The
Judge considered all of the evidence and concluded
that the annotations had not been made contemporaneously or near contemporaneously as claimed but
had more likely been added at a later date to provide
retrospective justification for the procedure and to
support the second defendant’s defence. The judge
stated at paragraph 355:
However, it is highly unusual to find a scenario such as
this where medical records positively purport to describe a clinical picture which cannot be accurate.
Like many clinical negligence cases, this is a particularly interesting example of the importance of careful
examination of the factual evidence, not only that contained in documents but also in the evidence given by
all witnesses.
There is a significant difference between the honest
but mistaken witness who is genuinely trying to assist
the court, and the scenario that we find here.
“…I reject [the second defendant’s] evidence that her
annotated note is a true or contemporaneous record
of any discussion there might have been between
them. I find it to be a contrived and false piece of evidence. Its purpose is to support the second defendant’s Defence and provide retrospective justification
for performing the colposuspension.”
* Disclaimer: The information on the Anthony Gold website
is for general information only and reflects the position at
the date of publication. It does not constitute legal advice
and should not be treated as such. It is provided without
any representations or warranties, express or implied.*
Author
Dr James Piers
jpi@anthonygold.co.uk - 020 7940 4060
www.anthonygold.co.uk
Dr Mona Ghadiri-Sani
Mr Filippo Di Franco is a Consultant Upper Gastrointestinal and Laparoscopic Surgeon at the
Consultant Neurologist with
specialist interest in headache disorders
North West Anglia NHS Foundation Trust and also Director for the Division of Surgery at
MBBS, BSc, MRCP
North West Anglia NHS Foundation Trust.
Dr Mona Ghadiri-Sani is a Consultant Neurologist and the clinical and educational
lead for headache at The Walton Centre.
Mr Di Franco specialises in General Surgery and all aspects of benign upper gastrointestinal
surgery and emergency general surgery, including laparoscopic/open surgery for gallstones
Dr Ghadiri-Sani qualified from Bart’s and the London Medical School of Medicine
and Dentistry. She undertook her core medical training also in London, before
relocating to The Walton Centre to accomplish higher neurology training.
(cholecystectomy), groin hernias, abdominal wall hernias, hiatus hernia, acid reflux
(gastro-oesophageal reflux disease) and acute intra-abdominal conditions such as peptic
ulcer disease, bowel obstruction and perforation, appendicitis, cholecystitis, pancreatitis,
peritonitis and trauma. He is also a JAG accredited upper gastrointestinal endoscopist.
Her main areas of expertise are headaches, inlcuding migraines, hormonal headaches,
idiopathic intracranial hypertension and facial pain. Since being appointed as service
lead, she has expanded the service to include four headache specialist nurses, a
headache coordinator and admin support. She has since established the biggest
anti-CGRP MAB treatment centre in the UK and continues to expand the service to
accommodate the most up-to-date treatments in management of headache disorders.
As an expert witness, Mr Di Franco can be instructed to provide an honest and reliable expert
witness report on issues within a General Surgery context and in relation to trauma, personal
injury and clinical negligence including breach of duty, causation, condition and prognosis.
In addition to desktop reports and/or remote consultation, Mr Di Franco is prepared to
undertake medical examination where it is necessary.
Mr Di Franco has undertaken specialist expert witness training and holds the Cardiff
She also has an expertise in neuro-Behcet and leads the neuro-Behcet clinic at the
national Behcet centre in Aintree hospital.
University Bond Solon (CUBS) Expert Witness Civil Certificate (2021). To complete the CUBS
(Civil) he has undertaken the following Bond Solon Expert Witness training courses:
Dr Ghadiri-Sani undertakes medico-legal work, she has 18 months experience of
Medico-Legal report writing.
Reports carried out May - Dec 2022: 8
Reports carried out Jan – July 2023: 12
Estimate annual turnaround: 24 reports.
Current Claimant/Defendant ratio: 100/0
No Clinical negligence experience or Court Attendance as yet.
Willing to undertake home visits for Clinical Negligence cases and defendant
instructions
- Excellence in Report Writing (2019)
- Courtroom Skills (2020)
- Cross-Examination Day (2020)
- Civil Law and Procedure (2020)
Mr Di Franco has been awarded three Clinical Excellence Awards and has been a member of
the “Q” (quality) initiative of Health Foundation since 2018 and Fellow of the Royal College of
Surgeons since 2001. As Divisional Director for Surgery at North West Anglia NHS Foundation
Trust, he is responsible for the overall performance of the Division of Surgery which includes 15
Departments. He has published some 22 papers in peer-reviewed journals on topics in general
Appointment wait is 2-4 weeks and delivery of report is just 2-4 weeks post
appointment, this is very quick for a consultant report with full med records review.
Dr Ghadiri-Sani has maintained this efficiency since she started 18months ago.
surgery. The majority of these papers relate to laparoscopic surgery and emergency surgery.
Correspondence to: MSS, PO BOX 1460, Cambridge, CB1 ONS
Tel: 07984 185 295 - Email: admin@mgsneurology.com
Address: 4 Bempton Road, Liverpool, L17 5BB
Contact: Mr Filippo Di Franco Tel: 01223 479 024 - Fax:01223 755125
Email: info@fdifranco.com - Alternate Email: fildifra@gmail.com - Web: www.fdifranco.com
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