Using the case of Jones v Portsmouth Hospitals NHS Trust to demonstrate the role of an Orthopaedic expert witnesses

Demonstrating the role of an Orthopaedic expert witnesses

Orthopaedics is a specialism that looks after the spine, limbs and joints of adults, children and babies. Claims of negligence in this clinical field may arise if the patient received negligent treatment when they were assessed, during their treatment or when receiving post-surgical care.  Somebody might receive care from the Orthopaedic team (which could be surgeons, nurses, consultants or other Orthopaedic professionals) for a number of reasons, including following a road traffic accident, trauma related incident or workplace accident.

Given that orthopaedic surgery claims make up 11% of the total 10,062 claims that went into the NHS in 2022/23 (Resolution NHS), it’s important that any medical negligence cases are backed up by experienced medico-legal expert witness who has in-depth knowledge on bones and joints.

In this blog post, we will introduce the case of Jones v Portsmouth Hospitals NHS Trust (2008) to demonstrate the role of the Orthopaedic expert witness.

Jones initially presented at Queen Alexandra Hospital in Portsmouth, and it was determined that she had a rare condition called Necrotising Myositis in her right thigh.  Jones had two operations to minimise the spread of the infection before her leg was amputated approximately two weeks later.

Jones’ claims 18 allegations of negligence relating to delays in getting to theatre, inadequate remedial surgery in the first two operations and negligent advice regarding reconstructive options once the infection had been successfully treated.

Demonstrate the role of an Orthopaedic expert witnesses

Role of an expert witness

The role of the medical witness for court in this type of case was to establish whether the Orthopaedic team were negligent in their treatment of Jones.

The expert witness used the Bolam and Bolitho test to determine whether the Orthopaedic doctor acted in accordance with a reasonable body of medical opinion.   They reviewed the evidence, which includes medical records, clinical reports, scans, x-rays and ultrasounds which both the prosecution and defence would have provided. They would have prepared a legal medical testimony that was compliant with part 35 of the Civil Procedure rules.

In this type of case, the court required medico-legal report services to determine whether the treatment Jones received was reasonable and looked at a number of factors:

  • Had the Senior House Officer discharged their duty of care by seeking the advice of the consultant?
  • Were the blood tests done at the right time?
  • Should a microbiologist have been consulted for expert opinion during Jones’ treatment?
  • Was it reasonable that the Senior House Officer didn’t make the connection of Necrotising Myositisis when Jones presented with a sore throat?

The prosecution raised these challenges to the defence as reasons why Jones’ leg was amputated. The Orthopaedic expert witness needed to determine whether there was any fault from the Orthopaedic team in relation to Jones’ case, or whether any reasonable changes to Jones’ treatment would have prevented the limb from amputation.

The ruling went in favour of the Trust; the Orthopaedic team were not negligent in getting Jones to theatre and that the remedial surgery carried out during the first and second operations were not inadequate. The evidence showed that the claimant had been informed of the options and that the through-knee amputation was necessary in order to preserve Jones’ life.

In many cases, there is likely to be a long-term impact for the claimant, such as loss of earnings, adaptation for the home to make adaptions for the disability and any ongoing disability aids. There is also a cost relating to the social and psychological trauma that an amputation can cause.

Despite the impact that the amputation will have on Jones’ life, if the ruling confirms that no party was negligent, it isn’t possible to make a claim for the losses.

How to choose the right medico-legal expert for your personal injury claim?

To match you with the most suitable Orthopaedic Expert Witness for your particular case, it’s helpful to know some basics about it. This includes the type of case (personal injury or criminal injury), the current status of the patient and any medical notes. Witness statements, relevant dates and timescales are also useful at this stage.

A clinical negligence medical expert typically requires 14 days to turn around the injury claim medical report.

If you would like to learn more about how our Orthopaedic Experts can assist in your legal matter, please call us on 01865 587865, email, or request a call by completing our online form.