Case Updates

This is primarily a case for cardiologists, cardiac nurses and anaesthetists with a learning point for psychiatric experts. Viewed from outside the jurisdiction the striking feature of the case is that the plaintiff’s general practitioner records documenting a previous psychiatric history, which she had denied when assessed by the two psychiatric experts, were not disclosed to the defendant until five days into the trial.

Tynan v Bon Secours Health System Company Ltd by Guarantee [2025] IEHC 81 

The detail of this judgment is for experts who conduct capacity assessments. Two points arise of more general interest.

First, the expert, who had been involved in the case for six years, changed her opinion. In the language of the court it was a 180^o degree change. The court thought that this called for a greater discussion in the analysis section of the report. This seems to have been that section of the report for which experts use the heading ‘Facts and assumed facts’ or ‘Factual analysis’. Second, the expert suggested that the issues, or some of the issues, in the case could be resolved by invoking the inherent jurisdiction of the court. But there had been no application for the exercise of the court's inherent jurisdiction, it was not referred to in the letter of instruction, and it might not – as a matter of law – have been available. This is a good example of the advice to experts to leave the law to the lawyers.  

Calderdale Metropolitan Borough Council v LS [2025] EWCOP 10 (T3)

This case has a number of important features of general interest. It illustrates the importance of assessing the reliability of a subject’s account. This is not the same as advising the court as to the reliability of the subject. It is the reliability of the account that is being assessed, not the reliability of the person giving the account. This is why it is good practice to open the Opinion section of an expert report with an introductory section sometimes headed ‘Evaluation of evidence’ or sometimes ‘Clinical plausibility’. That there was no challenge to the reliability of the experts’ evidence is not surprising. They explained how they assessed the appellant and the duration of the assessments.

ZA v Cornetu District Court, Romania [2025] EWHC 595 (Admin)

Mr Simon Britten, immediate past chair of the British Orthopaedic Association Medico-legal Committee, in his foreword to the forthcoming Expert Musculoskeletal and Orthopaedic Evidence, refers to how giving evidence one Monday in a case of tibial fracture, missed compartment syndrome and subsequent amputation, he was asked when he had last fixed a tibial fracture. Understandably, he said that the judge’s reaction to his answer ‘last Friday’ appeared to be a promising start. However, it is not a hard and fast rule that the healthcare expert should have experience, or recent experience, of performing the procedure or operation in issue. This case illustrates it.

Advanced Hair Technology Ltd v Revenue and Customs (VAT - whether hair transplants to treat androgenetic alopecia are exempt supplies of medical care) [2025] UKFTT 241 (TC) 

A common issue in personal injury orthopaedic cases is whether the damage of which the claimant complains is degenerative or traumatic in origin or a combination. This case illustrates for specialists in neurosurgery, orthopaedics, pain medicine and radiology how the court resolved conflicting expert evidence. It also illustrates the risks of reliance on the claimant’s self-reported history, especially if they have taken it upon themselves to research into areas of medical and legal expertise.

Rezmuves v Birney [2024] IEHC 592 

This is a case in which the tribunal was critical of an expert witness. One criticism was that he did not expressly acknowledge the guidance provided in the Ikarian Reefer in his declaration – “a step taken by many experts who prepare reports for this Chamber”.

UI2023005210 [2024] UKAITUR UI2023005210

This case illustrates how the Family Court depends on expert paediatric and radiological evidence to decide when and how a child’s fracture was sustained. This summary does not include how the court used the evidence. Suffice it to say that the expert evidence was only a part of the evidence before the court.  

C1 and C2 (Children: Fact Finding), Re [2024] EWFC 247 (B)

The issue in this judicial review did not turn on the expert evidence but the case illustrates the role of a medical reporting organisation (MRO) in a particular civil case and there are some general learning points.

Of note, the MRO did not arrange the correction of an erroneous date, it did not recognise how the evidence set out by the expert was seemingly insufficiently referenced and it did not recognise that there would be questions as to how some of the expert’s conclusions were reached.

Ivory, R (On the Application Of) v Welwyn Hatfield Borough Council [2025] EWCA Civ 21

This is a case which will assume much greater importance for the 15 points of practice and practical steps that the judge decided can help reduce the risk of well-meaning professionals falling into pitfalls that hinder the identification of safeguarding issues at an early stage than as a case with learning points for experts.

For some of the experts in the fields from which jointly appointed experts were instructed, it illustrates how their evidence is tested and applied in a case of suspected fabricated or induced illness (FII).

Re N (Children: Fact Finding - Perplexing Presentation/Fabricated or Induced Illness) [2024] EWFC 326

Any uncertainty as to whether a psychiatrist can provide an expert report as a paper-based assessment is answered by this case.

In this case the paper-based assessment was sufficient for the court to conclude that, having regard to the Mental Capacity Act 2005, s 48, there were "reasons to believe that the Appellant lacks capacity". However, the fact that the court did not make a finding of a lack of capacity and transferred the case to a Tier 3 (High Court) Judge of the Court of Protection in order to determine the matter of capacity indicates how the court recognises how much more difficult it is to make a finding when the report relies on a paper-based assessment compared to a consultation with the subject of the report.   

MacPherson v Sunderland City Council (Rev1) [2024] EWCA Civ 1579