How physiotherapists can assist in expert witness work

Congratulations to Somek and Associates’ physiotherapist expert witness and associate trainer, Sara Dickinson, who has had the following article published in Your Expert Witness magazine (issue no. 49):

Many experienced physiotherapists undertake expert witness work related to their area of clinical practice. Physiotherapists are experts at assessing, treating and preventing musculoskeletal problems, i.e. those related to human movement. The problems may be insidious in their onset, or related to accidents, sporting injuries or the workplace.

Physiotherapy expert witnesses undertake two types of assessment reports: face-to-face assessments of the claimant for quantum purposes and desktop reports for liability purposes. Other reports include fitness to practice (FtP) reports, usually at the request of the Health and Care Professions Council – the profession’s regulatory body. Occasionally, there are requests for reports which will form part of a criminal case.

Liability reports may be in the form of a non-CPR compliant screening report, which provides the solicitor with an overview of the physiotherapy-related issues in the case. They may assist in formulating a Letter of Claim or Response.

Full liability reports are more detailed and include the relevant chronology, a statement of the standards expected and a discussion of the material event, with clear conclusions articulating the physiotherapist’s opinion. Full reports will be CPR compliant. 

Increasingly in clinical practice, a physiotherapist may be the first clinician to assess or triage a patient. Some examples of issues that may present as a case against a physiotherapist include:

• Possible breaches during assessment and treatment in an outpatient setting, such as a failure to act upon so-called ‘Red Flag’ signs and symptoms. This is commonly seen in patients presenting with spinal conditions, and in particular those with suspected cauda equina syndrome.
• Missed diagnosis of a fracture, for example of the scaphoid bone in the wrist, or other soft tissue injuries such as ruptured tendons or ligaments.
• Whether or not the physiotherapy treatment was too intensive resulting in injury or re-injury.
• Falls or injury on hospital wards and during inpatient rehabilitation: it may be alleged that the physiotherapy contributed to the fall or injury, that treatment was negligent or there was use of inappropriate equipment.

For physiotherapists who are expert witnesses, it is a very different challenge to that of their clinical practice and requires an analytic approach to the forensic nature of the work.   

Sara Dickinson (Grad Dip Physiotherapy) MCSP is a senior physiotherapist with expertise in trauma, orthopaedics, cauda equina, chronic pain, elderly care and general surgery. She is an associate trainer for physiotherapy experts at Somek and Associates.

To read Sara Dickinson’s full profile, please click here.

To read the article in Your Expert Witness, please click here and turn to page 32.