J.W. Rodney Peyton OBE

J.W. Rodney Peyton OBE is internationally regarded as an accomplished consultant trauma surgeon with a longstanding commitment to surgical education. He has been involved in medico-legal reporting and court appearances as an expert witness since 1983, and is a founding member of the Expert Witness Institute.

As well as his original medical degree, an MSc in Medical Education and a law degree, Mr Peyton is responsible for the development of appraisal and assessment workshops on behalf of the Royal College of Surgeons. He penned a best-selling book entitled Appraisal & Assessment in Medical Practice, and has an expanding role in providing independent expert opinion in cases of potential medical negligence. He stresses the importance of preliminary screening, as can be highlighted in his case work.

In one such case, a 72-year-old Alzheimer’s patient was admitted to a respite unit so that his wife could go on holiday. At home he would sleep in his own bed and was fairly self-sufficient, although occasionally he would get up and wander around. The respite unit was part of a more general ward, where he did not have bed rails. He got up, fell, and the noise attracted one of the nursing assistants in another bay. An X-ray confirmed a hip fracture, and the family instigated a medical negligence claim. The lawyers obtained reports from an orthopaedic expert and a geriatric specialist. The statement of claim indicated that the gentleman should have been more closely supervised, and that there should have been bed rails. Unfortunately, there was no initial liability and causation report, and no indication that he should have been subject to any special care. The case was easily defended at a preliminary stage, although the legal firm had already incurred expense in obtaining other reports, for which they were not able to recover costs.

This is an important lesson in case management. Any case that has a potential for a suit should have a preliminary screening to ensure that the elements of duty, breach and consequential damage are in place.

In another case, a barrister was presented with diametrically opposed views on the merits of a claim. It was decided there should be an experts’ meeting to establish common ground or highlight any disputes. Unfortunately for the plaintiff, the expert engaged on his behalf – an infectious disease consultant – conceded to a haematology expert and then signed off on a common report. The plaintiff’s expert stated to the plaintiff’s solicitor that they now wished to retract the statement he had signed, saying he had only done so under duress.

Evidence is normally shared before meetings of expert witnesses, and sometimes it is advisable for lawyers to engage their own expert to review opposing medical opinions. Had that action been taken, discussions could have occurred with their own expert prior to the meeting so that any discrepancies could have been addressed.

Less than one in six actions in medical negligence succeed, with the vast majority failing on the grounds of causation. Initial screening is, therefore, essential – as a means of managing client expectations at an early stage.

In order to discuss any screening requirements of benefit to your clients, contact Rodney at rpeyton@rpeyton.com.