MEDICO LEGAL M A G A Z I N E
INTERVIEW WITH AN EXPERT WITNESS By Mr Aruni Sen MS, FRCS, FRCEM, DipMedEd, Consultant in Emergency Medicine, Princess Elizabeth Hospital, Guernsey and Grosvenor Medical Clinic, Croesnewydd Hall, Wrexham with over 20 years experience in medico-legal work. Please give us a short background of your own specialties and current medical practice? My professional training consists mainly of General Surgical specialities, Orthopaedics and Accident & Emergency (since 1992). I moved to Guernsey as a lead consultant in 2015.
When and why did you decide to start a medico-legal practice? I have been involved in medico-legal work since 1992, earliest as a senior registrar in the Emergency departments of Glasgow. I had to write numerous “pre-cognition” reports for the Procurator Fiscal in Scotland, which taught me how to adhere to facts and justify one’s opinion. During this time, I also attended the City Sheriff, Magistrate and High Court as a crown professional witness.
How did you go about setting up your first ML practice and how did you source clients? The bulk of the medico-legal work started since my consultant appointment at Wrexham in 1996. I have worked in this busy DGH catering for 70,000 patients annually. I established my contacts with the local solicitor network in Wrexham, Liverpool and nationally in the UK. I have done so in Guernsey and enjoy a good relationship. I attended relevant training courses, networked with agencies and solicitors to receive regular instructions from the national medicolegal agencies, Welsh Risk Pool, UK solicitors and the GMC for professional negligence reports. This includes mediation, joint expert meetings and Court appearances.
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Does ML work fit well with your other professional commitments? Indeed, it does and actually enhances my clinical and professional practice. Because of clinical and medico-legal work, I am obliged to keep up to date with current evidence and standards of practice. I can bench mark my own practice with another clinician in negligence claims. The practice of precision in comments and having to justify my opinion enforces a discipline I benefit from.
What kind of cases do you come across most often – can you give us an example of a ‘typical’ case? Most of the personal injury report instructions are related to whiplash and workplace accidents. Contrary to the recent Government regulations around MedCo, I have not come across any fraudulent claimants. This might be because the solicitors who instruct me possibly vet the claimants before asking me for a report. I do not write large volumes of reports in one sitting. Most workplace injury claims reveal unsafe work environments or a lack of apology from management after an unfortunate accident. The clinical negligence claims of course vary. Most of the consequences are tragic and cause suffering. A typical claim will arise from missed diagnosis of Cauda Equina Syndrome due to central disc prolapse. The history and examination are often incomplete, urinary retention (commonest) is overlooked while looking for incontinence (rare) and patient returned home as they managed to walk. I am still impressed how often, despite glaring and indefensible omissions in clinical management (not doing a CT scan after a head injury presenting with
