Case Updates

If, which is not clear, medical evidence that assists in the application of the adult dependent relative provisions as to entrance clearance for dependent adults to enter the UK is usually provided by doctors in the country in which the dependent relatives reside, this judgment may be of little interest to healthcare experts in the UK. However, it makes a very basic point about the format of an expert report and it illustrates how important it is to know and understand the particular test or rule that is applicable.

Ali v Entry Clearance Officer [2024] UKAITUR UI2024000707

This was a significant and well reported patent case which was determined in the Intellectual Property List within the High Court last autumn.   

The technical aspects of the case required significant expert input from the panel involved.  The cross-examinations performed by leading Counsel for the parties were lengthy and complicated.  This led to confusion over what evidence was given when the transcripts were re-visited on subsequent trial days. The case shows how consideration should be given to experts who are being cross-examined so not to overload them with questions and information on the stand.

Experts are advised, if possible, to avoid expressing opinions on the basis of possibility. The usually applicable stand of proof is the civil standard – the balance of probabilities or more probable than not. The criminal standard of proof is beyond reasonable doubt (and not beyond all reasonable [sic] doubt as it is sometimes misquoted). In this case it was submitted that the expert used the terms "possibility", "high possibility" and "extremely high possibility" interchangeably and that this was insufficient to satisfy the criminal standard of proof. However, when the court analysed the expert’s report as a whole, it was clear that a tribunal of fact could safely conclude that the criminal standard of proof was satisfied.

Government of Japan v Chappell [2025] EWHC 166 

The detail of this case is of relevance to dental experts and attention is drawn to the clarity and particularity with which Professor Harding set out the instances of treatment of the Claimant which was below the standard she could reasonably have expected and then identified the consequences thereof. There is a gastroenterological and pharmacological dimension to the case because it was alleged, and found, that the pain resulting from the negligent dental treatment necessitated treatment with NAISDs which caused ischaemic colitis. 

Bailey v Bijlani [2025] EWHC 175 (KB)

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)

The expert paediatrician in this case misidentified and confused twins when reading the primary medical disclose. This fundamental error was of seminal importance in this case because the twins had very different birth and post-birth experiences, with one being much weaker and more vulnerable than the other.  The judge noted that the cross-examination of the expert was nothing short of a demolition of the expert’s evidence.

LB Croydon v D (critical scrutiny of the paedeatric overview)

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) 

The judge determined that the proposed expert evidence, to support the existence of a money laundering scheme, was not admissible and, even if admissible, was neither necessary nor of assistance to the court.