This is an important judgment for experts instructed in cases where there is an issue as to whether thrombolysis should have been carried out following a stroke. The court considered a number of relevant publications.

For experts in psychiatry and psychology, it is important as it illustrates how the court tests evidence in cases involving performance validity testing.

Hakmi v East & North Hertfordshire NHS Trust [2025] EWHC 2597 (KB) 

One of the important differences between Ireland and other British Isles jurisdictions is in the procedures followed in personal injury litigation. This case is illustrative. If the plaintiff had brought his case in England or Wales, how would this case have progressed?

Keogh v O'Keeffe [2025] IEHC 26

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The Claimant alleged that an accident five years earlier was the cause of the amputation of his lower leg. The judge criticised the Claimant’s orthopaedic expert, Professor H, for demonstrating at times a rather ‘loose approach’ to his expert evidence and a closed mindedness towards his evidence.

Following last month’s case update by Professor Keith Rix of Brown v Morgan Sindall, several experts have offered further reflections on the use of validity testing in medico-legal assessment. Commentaries from Professor Michael Kopelman (neuropsychiatry), Dr Karen Addy (neuropsychology), Mr Daniel Friedland (neuropsychology) and Dr Kathryn Newns (clinical psychology) were published in the MAEP Expert Witness Healthcare Matters newsletter, coordinated by Professor Rix.

This follow-up brings together the key points emerging across disciplines. It also clarifies several areas regarding the early learning points given in the September case update. The discussion in this article refines those conclusions and reflects current multidisciplinary consensus. 

Familiar to all experts, this case illustrates how personal injury claimants can attempt to maximise their claim by dishonestly reporting symptoms and disabilities. There are few honest and experienced experts who can say that they have never been deceived by a personal injury claimant. The more experienced will avoid saying that the claimant appeared genuine, that they had no reason to doubt their account, or that they appeared to be honestly reporting their difficulties.

What assisted the court in this case was the findings of the experts that the claimant’s presentation was not supported by the objective findings.

This case has a more important message. An expert, having given an opinion that he has no reason to doubt a claimant’s veracity (not just a conclusion on the balance of probabilities, but beyond reasonable doubt), when he comes to change his mind, is under a duty to the court positively to make clear that he no longer holds that opinion. It is not sufficient to leave the judge to read between the lines. 

Debbie O'Connell v The Ministry of Defence [2025] EWHC 2301 (KB)

The person insured by the defendant drove his motorcycle into the pursuer’s parked lorry causing the pursuer, who claimed he was standing on the steps of the lorry on one foot and leaning on the cab, to allegedly lose his balance and suffer injuries. The defendant led an expert witness, Mr H, who presented himself as a Forensic Engineer, and the pursuer an Orthopaedic expert, Mr S. 

The Sherrif concluded that he could not afford Mr H’s conclusions more than minimal weight because of a failure of methodology. Mr H had also expressed his conclusions in terms that gave the appearance that he was the decision-maker and made concessions during cross-examination. The Sherrif found Mr S to be a credible and reliable witness overall but noted that he was not clear when describing his fee arrangements. 

This is an important judgment for obstetricians as it shows in precise detail how the court, relying on not just the experts’ evidence but a critical analysis of the literature on which they relied, decided whether the claimant would have avoided developing HELLP had she been advised to take 75 mg aspirin at 12 (or 14) weeks instead of at 23. Twelve publications were put under the microscope and considered also in the light of research concerning the relative value of aggregate data and individual participant data.

Although the issue in this case was the prevention of HELLP, it may be an important judgment to consider in pre-eclampsia cases.

De Francisci v Hampshire Hospitals NHS Foundation Trust (County Court, Basingstoke sitting at Southampton, 9 May 2024) Case No: F16YM828

The detail of this judgment is for the specialists. It illustrates the challenges of proving that an infection has been caused by food poisoning at a hotel, and specifically the relevance of evidence as to other outbreaks in the area, trips out of the hotel, the records of illnesses suffered by other residents and audits of hotel food standards. The two learning points are oft-repeated ones and in this case of particular importance as some of the judge’s decisions depended on which expert’s evidence to accept.  

Rawson v TUI UK Ltd [2025] EWHC 2093 (KB) 

The Claimant sought damages for clinical negligence from the Defendant who, she asserted, failed to diagnose red flag symptoms of cauda equina syndrome at a face to face consultation. The Claimant’s neurorehabilitation expert prepared his reports, engaged in an expert discussion, and signed the Joint Statement, without having seen the Claimant’s witness statement or the reports of other relevant experts.