Medical negligence and healthcare disputes

An adverse outcome or a complication does not in itself mean that the healthcare provided was professionally inadequate. In a forensic medical assessment, I evaluate whether the care complied with the professional standards applicable at the time, whether the necessary examinations were carried out, whether the condition was recognised in time and whether the patient received appropriate treatment.

A forensic medical opinion may be requested where the professional assessment of a diagnosis, treatment, surgical intervention or complication is disputed. The assessment also considers whether there is a causal link between the healthcare provided and the resulting harm.

What questions can I address professionally?

Below I summarise the most common questions that may arise in a forensic medical assessment in this field.

Was the applicable standard of care breached?

An adverse outcome or complication may prompt concern about the care provided. The reality is considerably more complex. A complication alone does not mean that the healthcare provided was professionally inadequate. In a forensic medical assessment, I evaluate whether the care complied with the professional standards and guidelines applicable at the time and with the state of medical knowledge then prevailing.

Could the complication have been avoided?

Not every complication can be prevented. The expert assesses whether it was a known and accepted risk or whether it would probably have been avoided with appropriate care.

Was the condition recognised in time?

Early recognition of certain conditions can be crucial to the prospects of recovery. A forensic medical assessment can determine whether the reported complaints, symptoms and test results should have led to a different diagnosis or further examinations at an earlier stage.

Were the appropriate examinations carried out?

The medical records can be used to assess which examinations were professionally indicated in the circumstances, whether they were performed and whether their omission may have affected the patient’s condition or subsequent treatment.

Was treatment started too late?

The timing of treatment is critical in many conditions. The expert examines whether there was an unjustified delay in making the diagnosis, referring the patient or initiating the necessary treatment.

Did the patient receive appropriate treatment?

When preparing the opinion, I work with an appropriately qualified collaborating expert to compare the treatment actually provided with the professional guidelines, methodological recommendations and generally accepted medical practice applicable at the time.

Is the resulting harm causally related to the medical care?

Not every complaint that develops later can be attributed to the healthcare provided. The expert’s task is to assess whether there is a causal link between the care and the resulting harm.

Could the lasting impairment have been prevented?

This is often a central question in compensation claims. The expert assesses the likelihood that permanent harm could have been prevented by timely diagnosis and appropriate treatment.

Was the surgery clinically indicated?

The indication for surgery must be assessed against the clinical circumstances and standards applicable at the time. The assessment considers whether the intervention was genuinely necessary, whether it was performed at the appropriate time and whether another professionally acceptable treatment option was available.

Was the patient adequately informed?

The clinical documentation may also record the information provided to the patient. Where relevant, the documentation can be assessed to determine what information was documented as having been provided about the purpose, expected outcome, risks and possible complications of the intervention.

Was the care documented properly?

Medical documentation is more than an administrative obligation. Incomplete or inaccurate records can make it difficult to establish what occurred during treatment. I also assess the significance of any such deficiencies in the forensic medical review.

Is an adverse outcome enough to establish a breach of the applicable standard of care?

No. Even care provided to the highest professional standard may be followed by complications, unsuccessful treatment or an unfavourable course of disease. The medical assessment considers any departure from the applicable standard of care and whether it contributed causally to the harm. Legal liability is for the court to determine.