@DrBridgetDolan 01/02/2019, 08:16 “New damages case this week for COP practitioners. High Court AWARDS (not just approves) damages of £4000 per month (plus aggs) for wrongful detention of an incapable patient after several breaches of the MCA by an NHS Trust. Esegbona v Kings College Hospital  EWHC 77 (QB).”
Recommended reading: Pleadings Without Tears – A guide to legal drafting under the Civil Procedure Rules by William M Rose, Blackstone Press Limited (5th edition, 1990)
Pleading in the alternative: Binks v Securicor Omega Express Ltd  EWCA Civ 993
Importance of pleading facts clearly:
Involnert v Aprilgrance  EWHC 2225 (Comm)
Construction, Design and Management (CDM) Regulation Changes 2015 – ABI’s guidance
The Insurance Act 2015
Consumer Insurance (Disclosure and Representations) Act
Deborah Blake (Executrix of the Estate of Paul Nigel Blake, Deceased) v Mad Max Limited  EWHC 2134 (QB)
Breaking news: The Government has published an order to allow bereavement damages to be awarded to people who have cohabited with the deceased for at least 2 years prior to their death. A long overdue step in the right direction bit.ly/2JaAUgL #Fairness4families
FATAL ACCIDENTS: PROPOSED AMENDMENTS TO BEREAVEMENT PAYMENTS : ADVANCE NOTICE FOR LECTURES LATER IN THE YEAR (AND A NEW EDITION OF A BOOK…)
Asbestos Victims Support Groups Forum UK press release 21/05/18: Asbestos in childrens products sold in UK:
Hidden for decades: Johnson & Johnson may have known about carcinogens in baby powder since 1971:
Sri Lanka bans imports of Johnson baby powder due to concerns that it may contain asbestos:-
ACTION SHOULD NOT HAVE BEEN STRUCK OUT: DENTON PRINCIPLES NOT ENGAGED IN FAILING TO SERVE PARTICULARS OF CLAIM AND MEDICAL REPORT by G Exall:
Mark v Universal Coatings & Services Ltd & Anor  EWHC 3206 (QB)
Mr Justice Martin Spencer allowed an appeal against an action being struck out. Case shouldn’t have been struck out for failure to serve POC and medical report.
ANOTHER CASE OF SERVICE OF THE CLAIM FORM GOING WRONG: GO ON – DICE WITH PROCEDURAL DEATH: WHAT COULD POSSIBLY GO WRONG by gexall When lecturing at the Zenith Chambers personal injury course this Thursday I only offered one prediction for civil procedure: “I’ll be here next year talking about claim form cases reported over the previous 12 months where things have gone wrong.” Less than 24 hours later (and from a court 500 yards away) I was – […] Read more of this post
Griffin Underwriting Ltd v Varouxakis (Free Goddess)  EWHC 3259 (Comm).
SERVICE OF THE CLAIM FORM: WHERE THINGS CAN GO WRONG FOR THE DEFENDANT: RELIEF FROM SANCTIONS REFUSED by gexall There are numerous cases reported on this blog where issues relating to service of the claim form have gone wrong for claimants. However, as we have recently seen, a failure to respond accurately and timeously to claim form issues can give rise to real difficulties for defendants (and most probably their lawyers). Certainly if I […]Read more of this post
LATE SERVICE OF THE PARTICULARS OF CLAIM AND ACCOMPANYING DOCUMENTATION: IT MAY STILL BE DANGEROUS – AND HERE’S WHYby gexall We have looked twice already at the judgment in Mark v Universal Coatings & Services Ltd & Anor  EWHC 3206 (QB). One of the key findings in that case was that the claimant, who had served the particulars of claim, medical report and schedule late, did not require relief from sanctions to serve because there was […]Read more of this post
BACK TO BASICS 18: WHEN IS A GOOD TIME TO APPLY TO EXTEND THE CLAIM FORM? NEVER, JUST NEVERby gexall An enquiry today related to service of the claim form. What was the best way to get at extension of time. My answer was short. Applying to extend claim forms is a form of (basically reckless) gambling. Defendants can always apply to set extensions of time aside. APPLYING FOR AN EXTENSION OF TIME TO SERVE […]
NON-SERVICE OF THE CLAIM FORM: MORE CLAIMANTS DICING WITH PROCEDURAL DEATH (AND LOSING): JUDGE REFUSES TO PUSH THE ENVELOPE by gexall I am grateful to David Turner QC for sending me a copy of the judgment in HHJ Klein (sitting as a High Court judge) in Capital Alternatives Sales and Marketing Ltd v Nabas & Ors  EWHC 3345 (Comm). This is a case that is very difficult to summarise. Essentially it is about errors by the […]
THE CONSEQUENCES WHEN SERVICE OF THE CLAIM FORM GOES WRONG: SOLICITOR’S LIEN OVERRIDDEN: NOT KNOWING THE RULES IN RELATION TO SERVICE AMOUNTS TO “MISCONDUCT”by gexall The judgment in Higgins & Ors v TLT LLP  EWHC 3868 (Ch) shows another case that has been made problematic because of basic errors in failure of service of the claim form. The errors made by the solicitors in that case were so great that they amounted to “misconduct” and overrode their claim to a […]Read more of this post
Brayshaw v The Partners of Apsley Surgery & Anor  EWHC 3286 (QB) (30 November 2018)
Surrogacy costs as an item of special damages
XX v Whittington Hospital NHS Trust  EWCA Civ 2832
Liberty (@libertyhq)22/11/2018, 14:50The new draft of the political declaration https://twitter.com/search?q=%23PoliticalDeclaration&src=hash contains a severely weakened commitment to the European Convention on Human Rights. The ECHR is a crucial tool for defending our human rights. The Government must ensure we can protect our rights and freedoms after #Brexit https://twitter.com/libertyhq/status/1065618555566211078/photo/1
Asbestos Campaign (@TheJUAC)22/11/2018, 22:43BBC News – #Jersey to introduce mesothelioma compensation scheme https://www.bbc.co.uk/news/world-europe-jersey-46282665. We commend the work of our #asbestosinschools colleague June Summers Shaw 👏
MOD: Sea king helicopters
A twitter post “Brexit timeline” by theNabster (@meNabster):
Canary Wharf v EMA  EWHC 335 (Ch)
EMA cannot get out of lease because of Brexit:
The Speaker has announced the results for today's #IndicativeVotes: (B) – Ayes 160 Noes 400 (D) – Ayes 188 Noes 28… twitter.com/i/web/status/1…—
UK House of Commons (@HouseofCommons) March 27, 2019
SCCO costs guidance:
Slade (t/a Richard Slade and Company) v Boodia & Anor [Court of Appeal]
re: status of interim statute invoices. The judge ruled that the fact various bills rendered by the London firm included only profit costs or disbursements, but not both, did not prevent them from being interim statute bills. Newey LJ said it would be impractical to rule otherwise and would have ‘unsatisfactory implications’. A solicitor would not be able to raise a statute bill until they had been invoiced for all disbursements incurred during the relevant period, leaving the solicitor dependent on the cooperation of third parties. “Full Story -> https://www.lawgazette.co.uk/law/solicitors-win-on-appeal-over-status-of-costs-bills/5068475.article#.W_8DoE1Yq9Y.linkedin
Yirenki -v- Ministry of Defence  EWHC 3102 (QB)
COST BUDGETING: THE PARTIES MUST KNOW WHERE THEY STAND: LEAVING HOURLY RATES “OPEN” IS INAPPROPRIATE
BACK TO BASICS 17: WHEN SHOULD A COST BUDGET BE FILED: WHERE THINGS GO WRONG by G Exall
This may appear very basic. However I have seen both sides falling foul of this very recently. In particular the fact that the budget has to be filed with the directions questionnaire when the claim is limited to £50,000. THE RULES The rules are simple. Filing and exchanging budgets and budget discussion reports 3.13 (1) […]Read more of this post
BACK TO BASICS 19: COSTS BUDGETING WHEN CASE IS MORE THAN £25,000 BUT LESS THAN £50,000 by G Exall
There are special rules governing budgets in cases where the claimant claims more than £25,000 but less than £50,000. Firstly the budget has to be filed much earlier. Secondly the budget “must” only be the first page of Precedent H. These are rules that are easy to overlook. In particular it is very easy to […]
COSTS WHERE A PARTY SUES A NUMBER OF DEFENDANTS: DEFENDANTS ORDERED TO PAY SUCCESSFUL DEFENDANT’S COSTS: HIGH COURT APPEAL by G Exall
I am grateful to Thomas Riis-Bristow, Associate Solicitor at Irwin Mitchell, for sending me a copy of the judgment of Mr Justice Lavender in McDermott -v- Inhealth Limited (19/07/2018), This deals with the issue of the appropriate costs order when a claimant is successful against some, but not all, defendants. THE CASE The claimant […] Read more of this post
A STRATEGY WHEN SETTLEMENT IS REACHED WITH SOME, BUT NOT ALL, DEFENDANTS by G Exall
An earlier post dealt with the judgment in McDermott -v- Inhealth Limited (19/07/2018) in relation to costs liability when a claimant settled against some, but not all, defendants in a clinical negligence case. That judgment was sent to me by Thomas Riis-Bristow, Associate Solicitor at Irwin Mitchell. Thomas was also kind enough to send me his “anecdotal tips” […] Read more of this post
The HSE state that asbestos can be found in any building built before 2000 (houses, factories, offices, schools, hospitals etc) and causes around 5,000 deaths every year – this is more than the number of people killed on the road.
When materials that contain asbestos are disturbed and damaged, fibres are released into the air. When these fibres are inhaled they can cause serious disease. The diseases often take many years to develop.
B. WHAT IS ASBESTOS?
Asbestos is a naturally occurring fibrous mineral which comes in several forms and each form is dangerous.
It is used worldwide and mined in many countries such as Canada, Russia, South Africa, India and parts of South America.
Asbestos used to be thought of as a wonderful material. Asbestos fibres are:
- Resistant to heat and fireproof
- Resistant to many chemicals
- Strong: stronger than steel
- A good insulator against heat, frost and noise.
Asbestos has widely been used as a cheap filler for building materials, brake linings, clutches, gaskets and seals.
There are different types of asbestos. It is a generic term used to describe 6 different varieties of fibrous mineral silicate which can be divided into 2 groups:
- Amphibole asbestos: including Crocidolite (blue), Amosite (brown), Tremolite, Actinolite and Anthrophylite; and
- Serpentine asbestos. The only type of Serpentine asbestos is Chrysotile (white) but this accounts for 95% of the world’s asbestos production. Serpentine asbestos is softer and more flexible than amphibole asbestos.
|Mesothelioma UK (@Mesouk)|
|01/11/2018, 12:04||Figures from the Health & Safety Exec show an increase #mesothelioma deaths from 2015 to 2016. twitter.com/H_S_E/status/1…|
Control of Asbestos at Work Regulations 2002
“Myotonic dystrophy is part of a group of inherited disorders called muscular dystrophies. It is the most common form of muscular dystrophy that begins in adulthood. Myotonic dystrophy is characterized by progressive muscle wasting and weakness.
People with this disorder often have prolonged muscle contractions (myotonia) and are not able to relax certain muscles after use. For example, a person may have difficulty releasing their grip on a doorknob or handle. Also, affected people may have slurred speech or temporary locking of their jaw. Other signs and symptoms of myotonic dystrophy include clouding of the lens of the eye (cataracts) and abnormalities of the electrical signals that control the heartbeat (cardiac conduction defects).
In affected men, hormonal changes may lead to early balding and an inability to father a child (infertility).
The features of this disorder often develop during a person’s twenties or thirties, although they can occur at any age. The severity of the condition varies widely among affected people, even among members of the same family.
There are two major types of myotonic dystrophy: type 1 and type 2. Their signs and symptoms overlap, although type 2 tends to be milder than type 1. The muscle weakness associated with type 1 particularly affects the lower legs, hands, neck, and face. Muscle weakness in type 2 primarily involves the muscles of the neck, shoulders, elbows, and hips. The two types of myotonic dystrophy are caused by mutations in different genes. A variation of type 1 myotonic dystrophy, called congenital myotonic dystrophy, is apparent at birth. Characteristic features include weak muscle tone (hypotonia), an inward- and upward-turning foot (clubfoot), breathing problems, delayed development, and intellectual disability. Some of these health problems can be life-threatening.”
Myotonic Dystrophy Support Group
Muscular Dystrophy UK
“Myotonic dystrophy About 9,500 people in the UK have a form of myotonic dystrophy. It is a group of inherited conditions that show muscle weakness and myotonia. We at Muscular Dystrophy UK want you to know you’re not alone. If you’d like to meet other families living with myotonic dystrophy, just to talk, share experience or get some advice, we can put you in touch. Our helpline team is also here for you to offer support and advice. Read more:” https://www.musculardystrophyuk.org/about-muscle-wasting-conditions/myotonic-dystrophy/
DM1Research (@DM1research) 08/03/2019, 03:12 Doing the math, this study indicates there are over 100,000 people with myotonic dystrophy type 1 in the U.S. Over 300,000 in the U.S. and EU combined. Yet there is only one drug in the clinic for DM1.
Disease burden of myotonic dystrophy type 1 Published: 24 February 2019
Disease burden in myotonic dystrophy type 1 (DM1) covers multiple domains and correlates with CTG repeat length, the DM1 genetic defect. Read our new paper by @drnicolenko and Erik Landfeldt, which used INQoL to assess burden on affected adults.
Nikoletta Nikolenko and Erik Landfeldt have published a new study on the impact of myotonic dystrophy type 1 (DM1) in the Journal of Neurology. They use a questionnaire-based method, the Individualized Neuromuscular Quality of Life Questionnaire (INQoL), to assess the burden of this condition on affected adults. The study provides further evidence of the wide range of domains affected in this multisystem disease. They are also able to show that INQoL scores correlate with the severity of the underlying genetic defect, linking CTG expansion with burden of illness.
The study provides important baseline data for healthcare and for clinical research in myotonic dystrophy. The full publication is available to read at the journal’s website here (open access) Disease burden of myotonic dystrophy type 1 Landfeldt, E., Nikolenko, N., Jimenez-Moreno, C. Cumming, S., Monckton, D.G., Gorman, G., Turner, C.,Lochmüller, H. J Neurol (2019). https://doi.org/10.1007/s00415-019-09228-w
Abstract Objective The objective of this cross-sectional, observational study was to investigate the disease burden of myotonic dystrophy type 1 (DM1), a disabling muscle disorder.
Methods Adults with DM1 were recruited as part of the PhenoDM1 study from Newcastle University (Newcastle upon Tyne, UK). Disease burden data were recorded through the Individualized Neuromuscular Quality of Life (INQoL) questionnaire. Results were examined by sex and clinical variables [e.g. the six-minute walk test (6MWT), the Mini Mental State Examination, and estimated progenitor and modal allele CTG repeat length].
Results Our sample consisted of 60 patients with DM1 (mean age: 45 years; 45% female). Muscle weakness and fatigue constituted the two most common disease manifestations, reported by 93% and 90% of patients, respectively, followed by muscle locking (73%). Most patients (> 55%) reported feeling anxious/worried, depressed, frustrated, and/or having low confidence/self-esteem, 23% and 33% indicated substantial impairment of daily and leisure activities, respectively, and 47% did not work as a consequence of the disease. Estimated progenitor CTG length corrected by age correlated surprisingly well with INQoL scores. Differences by sex were generally minor.
Conclusion We show that DM1 is associated with a substantial disease burden resulting in impairment across many different domains of patients’ lives, emphasizing the need for a holistic approach to medical management. Our results also show that the INQoL records relevant information about patients with DM1, but that further investigation of the psychometric properties of the scale is needed for meaningful interpretation of instrument scores.
DM1Research @DM1research · Jan 28 2019 MDF’s consensus care recommendations published a few months ago, now the Spaniards publish their guidelines: Clinical guide for the diagnosis and follow-up of myotonic dystrophy type 1, MD1 or Steinert’s disease https://www.ncbi.nlm.nih.gov/pubmed/30685181
Exercise in DM1 patients
Chronic exercise mitigates disease mechanisms and improves muscle function in myotonic dystrophy type 1 mice Alexander Manta , Derek W. Stouth , Donald Xhuti , Leon Chi , Irena A. Rebalka , Jayne M. Kalmar , Thomas J. Hawke , Vladimir Ljubicic First published: 10 January 2019| https://doi.org/10.1113/JP277123| Cited by: 1 Edited by: Scott Powers & Troy Hornberger
Abstract Key points Myotonic dystrophy type 1 (DM1), the second most common muscular dystrophy and most prevalent adult form of muscular dystrophy, is characterized by muscle weakness, wasting and myotonia. A microsatellite repeat expansion mutation results in RNA toxicity and dysregulation of mRNA processing, which are the primary downstream causes of the disorder. Recent studies with DM1 participants demonstrate that exercise is safe, enjoyable and elicits benefits in muscle strength and function; however, the molecular mechanisms of exercise adaptation in DM1 are undefined. Our results demonstrate that 7 weeks of volitional running wheel exercise in a pre‐clinical DM1 mouse model resulted in significantly improved motor performance, muscle strength and endurance, as well as reduced myotonia. At the cellular level, chronic physical activity attenuated RNA toxicity, liberated Muscleblind‐like 1 protein from myonuclear foci and improved mRNA alternative splicing.
Abstract Myotonic dystrophy type 1 (DM1) is a trinucleotide repeat expansion neuromuscular disorder that is most prominently characterized by skeletal muscle weakness, wasting and myotonia. Chronic physical activity is safe and satisfying, and can elicit functional benefits such as improved strength and endurance in DM1 patients, but the underlying cellular basis of exercise adaptation is undefined. Our purpose was to examine the mechanisms of exercise biology in DM1. Healthy, sedentary wild‐type (SED‐WT) mice, as well as sedentary human skeletal actin‐long repeat animals, a murine model of DM1 myopathy (SED‐DM1), and DM1 mice with volitional access to a running wheel for 7 weeks (EX‐DM1), were utilized. Chronic exercise augmented strength and endurance in vivo and in situ in DM1 mice. These alterations coincided with normalized measures of myopathy, as well as increased mitochondrial content. Electromyography revealed a 70–85% decrease in the duration of myotonic discharges in muscles from EX‐DM1 compared to SED‐DM1 animals. The exercise‐induced enhancements in muscle function corresponded at the molecular level with mitigated spliceopathy, specifically the processing of bridging integrator 1 and muscle‐specific chloride channel (CLC‐1) transcripts. CLC‐1 protein content and sarcolemmal expression were lower in SED‐DM1 versus SED‐WT animals, but they were similar between SED‐WT and EX‐DM1 groups. Chronic exercise also attenuated RNA toxicity, as indicated by reduced (CUG)n foci‐positive myonuclei and sequestered Muscleblind‐like 1 (MBNL1). Our data indicate that chronic exercise‐induced physiological improvements in DM1 occur in concert with mitigated primary downstream disease mechanisms, including RNA toxicity, MBNL1 loss‐of‐function, and alternative mRNA splicing.
Factories Act 1961 s29
Noise and the Worker
Noise and the Worker (updated)
Stokes v Guest  1WLR 1776
- Ratio of Stanwick J applied in Baker v Quantum (below)
Noise and the Worker (updated)
Code of Practice
Hatra Research Report: Noise in the Knitting Industry – a factual survey
Limitation Act 1980
- Section 11(4)
- Section 14(1)
- Section 14(2)
- Section 14(3)
- Section 33
WIRA report – partial copy:
Thompson v Smiths Shiprepairers Ltd  QB 405
- Mustill J placed limits on the ratio of Stanwick J in Stokes v Guest 
Noise at Work Regulations 1989
- Came into force on 01/01/1990
Assessment of Hearing Disability: Guidelines for medicolegal practice by PF King, RRA Coles, ME Lutman and DW Robinson
Larner v British Steel  4 All ER 102
Nash & Others v Eli Lilly & Co & Others  WLR 782
Holtby v Brigham & Cowan (Hull) Ltd  ICR 1086
ISO7029:2000 2nd edition Acoustics – Statistical distribution of hearing thresholds as a function of age
David Anthony Wright v Canadian Pacific (UK) Ltd (2000)
Bracknell Forest Borough Council v Adams  UKHL 29
The Control of Noise at Work Regulations 2005
- Came into force on 06/04/06 replacing the 1989 Regulations
Parkes v Meridian & Others  Unreported (Nottinghamshire textile litigation (27/04/07 HHJ Inglis)
Furniss v Firth Brown Tools Limited  EWCA Civ 182
Cain v Francis  EWCA Civ 1451
Teague v Mersey Docks  EWCA Civ 1601
A v Hoare & Others  1 AC 844
John Field v British Coal Corporation (Department for Business Enterprise and Regulatory Reform)  EWCA Civ 912
Keefe v The Isle of Man Steam Packet Co Ltd  EWCA Civ 683
Baker v Quantum Clothing Group Limited & Others  UKSC 17; [13/04/11, Supreme Court]
Johnson v MOD, Hoburn Eaton Limited  EWCA Civ 1505
AB and Others v Ministry of Defence  UKSC 9
Davies & Others v The Secretary of State for Energy and Climate Change (As Successor in Title to the Liabilities of the British Coal Corporation)  EWCA Civ 1380
Hughes v Rhondda Cynon Taf County Borough Council
John Cran v Perkins Engines Company Limited
Platt v BRB (Residuary) Limited  EWCA Civ 1401
Holloway v Tyne Thames Technology Limited (2015)
Hinchcliffe v Six Continents Limited and Cadbury UK Ltd (2015)
Briggs v RHM Frozen Food Limited (2015)
04/02/16 Inaugural NIHL Symposium: Medico-legal Advancements in Noise Induced Hearing Loss Cases – included Professor Lutman introducing “the LCB Guidelines”
Wignall v The Secretary of State for Transport (in substitution for BRB (Residuary) Ltd) (2016)
ISO7029:2017 3rd edition Acoustics – Statistical distribution of hearing thresholds related to age and gender
Stephen Lovatt v Secretary of State for Energy and Climate Change & Another (2017)
David Evans v Secretary of State for the Department of Energy and Climate Change & JJ Maintenance Ltd (2017)
Case Name and link
Brief Summary of the Decision / Comments /Misc
Bussey v Anglia Heating Limited
For the full judgment, please click here
|Court of Appeal||Low level exposure; TDN13 isn’t determinative of liability; Williams remains good law (ie C needs to establish a reasonably foreseeable risk of injury)
|C – case remitted back to Trial Judge|
Hawkes v Warmex Ltd
For the full judgment, please click
|High Court QBD||Low level exposure; would have been in breach of the common law duty of care and s.47 of the Factories Act in the 1940s.
Deputy High Court Judge Peter Marquand held that the Deceased had not been exposed to asbestos while making electric blankets at a factory in the late 1940s.
|D – case failed on facts|
Cape Intermediate Holdings Ltd v Mr Graham Drting (for and on behalf of the Asbestos Victims Support Group)
|Court of Appeal||Disclosure
Heynike v Birlec & MOD
|High Court QBD||
Duty to avoid substantial dust under s63 survives the 1969 Regs
|08/08/18||Blake v Mad Max Ltd (Rev 1)  EWHC 2134 (QB)||High Court||Quantum in fatal meso case
SRA Code of Conduct
SRA Warning Notices
Insights (e-mail updates)
Thousands of people in the UK suffer with a disability. The common misconception is that a disabled person is in a wheelchair. So if somebody asks me ‘What is a disability?’ My answer is ‘a condition that makes everyday activities difficult that able bodied people do without a thought.’ Such as walking, talking, eating, washing, dressing yourself etc.
Even though public places are trying to be more disabled friendly, are they doing enough? Some non-disabled people complain about there being too many disabled spaces in car parks. Some might say that there are more than enough facilities to accommodate a disabled person’s needs. From the point of view of a disabled person such as me, more could be done.
I suffer from a medical condition called Myotonic Dystrophy. Never heard of it? It’s a hereditary condition that gets progressively worse the older I get. Some people aren’t even aware they have it. Myotonic Dystrophy is a form of Muscular Dystrophy, a disease that affects all the muscles in the body including the heart. I thought that my muscle spasms were normal. When I couldn’t release my grip or my tongue went stiff whilst reading aloud in class, making my speech unintelligible I thought it happened to everyone. When walking to school one morning my ankle gave way causing me to fall. I used to fall a lot as a child, once when I was ill, the doctor noticed all the cuts and bruises on my legs. He thought I was being physically abused by my parents. I have frequent falls, some of which have been potentially serious. Once in Manchester city centre I fell over backwards and banged my head on the pavement. Two women I’d never met helped me up and took me to a nearby cafe.
Throughout my 39 year life I’ve had these problems. I now walk with a stick. Before that I was walking home from college one evening and I decided instead of the tram to take a taxi home. As I got in the driver said ‘you’ve had a good drink love.’ I was completely sober having had no alcohol that day. Another time I was walking out of a disabled toilet and an old man said ‘you’re not disabled.’
I am very lucky in some ways I have very caring and helpful family and friends. I also have a carer who is also my boyfriend. He accompanies me to medical appointments and takes me out in the car. He works full-time as a Fee Earner at Woodward Solicitors, then comes home and looks after me. He takes care of most household chores leaving me to do the less demanding jobs. Without him I wouldn’t have been able to do a degree at university or visit lots of great places. Carer is definitely the right word for him, he cares not just for me but for people in general. He wants to do everything to the highest standard and is a bit of a perfectionist.
So next time you see a person staggering down the street or somebody seemingly able bodied walk out of a disabled toilet, don’t judge. Spare a thought, that person might be disabled.
Emma Jane Lyons BA (Hons)
Emma graduated from Manchester Metropolitan University in 2013 having completed her creative writing degree after 6 years of part-time study. She was diagnosed as suffering from myotonic dystrophy in 2003 whilst working at Withington Hospital.
Inner Temple Library: http://www.innertemplelibrary.com/
Asbestos Victims Support Groups Forum UK
SARAG South Yorkshire Asbestos Victim Support Group
Merseyside Asbestos Victim Support Group
Cumbria and Lancashire Asbestos Support Advice Group
Amnesty International UK
Paralegals and Trainee Solicitors should be taught how to handle and consider documents effectively early in their career. When dealing with personal injury, clinical negligence, illness or disease claims this may include sorting and considering medical records.
When handling a claim where there is a large volume of medical records it is wise to sort the records into sections. This makes it easier when considering the records and when locating relevant records.
- Computer records
- Treatment summary cards
- Lloyd George records
- Vaccination and immunisation history
- Clinical data (eg x-ray results, scan results, blood test results)
- Correspondence & miscellaneous
Additional sections can be created if there are a lot of pages of a particular type of record or to have a particular type of record grouped together and easily accessible. Eg, in a NIHL claim it may be convenient to have a section headed “Audiology” or “ENT records.” One needs to think about what sections are needed.
Individual sections should be sorted into chronological order.
After the records have been sorted, they should be paginated in the top right corner (not in the bottom right corner because the records may form part of a Trial Bundle at a later date and need to be paginated in the bottom right corner then). The records should be scanned into the case management system.
A chronology should be prepared summarising the key records and noting their page number. The Paralegal or Trainee Solicitor may also prepare a brief report or a file note outlining what the Claimant claims and the extent to which their account is consistent with the records. Research about the medical problems suffered may also be attached to the brief report or file note. A template report is at the bottom of this blog.
Abbreviations within medical records may include:
ΔD Differential diagnosis
ΔΔ Differential diagnosis
→ Constant, normal or lateral shift
1/7 1 day
2/52 2 weeks
3/12 3 months
T-2/40 or 2/52
Term (ie the baby due date) less 2 weeks
T+3/40 or 3/52 Term plus 3 weeks
aa Of each
AAL Anterior axillary line
ac Before meals
ACTH Adrenocorticotrophic hormone
ad Up to
ADH Antidiurectic hormone
ADL Activities of daily living
ad lib To the desired amount
ADP Adenosine diphosphate
AE Air entry
AFB Acid fast bacillus (TB)
AFP Alpha-fetoprotein(α-fetoprotein; also sometimes called alpha-1-fetoprotein, alpha-fetoglobulin, or alpha fetal protein) is a protein that in humans is encoded by the AFP gene. The AFP gene is located on the q arm of chromosome 4 (4q25).
AID Artificial insemination – donor
AIDS Acquired Immune Deficiency Syndrome
AIH Artificial insemination – husband
AJ Ankle jerk
alt dieb Every other day
Al S Alimentary system
Anti-D A medication called anti-D immunoglobulin which can help prevent rhesus disease. It helps avoid sensitisation, which is when a woman with RhD negative blood is exposed to RhD positive blood and develops an immune response to it.
Agpar Apgar score is a method to quickly summarize the health of newborn children against infant mortality
aq dest Distilled water
aq ster Sterilised water
AR Analytical standard of reagent purity
ARC Aids related complex
ARDS Adult respiratory distress syndrome
ARM Artificial rupture of membranes
ASD Atrial septal defect
AST Aspartate aminotransferase
ATP Adenosine triphosphate
aurist Ear drops
BJ Biceps jerk
B.S. British Standard
BO Bowels open
BP Blood pressure
BS Breath sounds; bowel sounds; blood sugar; British Standard
Ca Carcinoma/cancer; calcium
CAT scan Computed axial tomograph
CIN Cervical intraepithelial neoplasia, also known as cervical dysplasia, is the abnormal growth of cells on the surface of the cervix that could potentially lead to cervical cancer.
CMV Cytomegalovirus is a common virus that is part of the herpes family of viruses.
CNS Central nervous system
CO Complaining of
COETT Cuffed oral endotracheal tube
comp compounded of
COT Cuffed oral tube (used for ventrilating a patient who can’t breathe unaided)
CPD Cephalopelvic disproportion – occurs when a baby’s head or body is too large to fit through the mother’s pelvis
crem A cream
CSF Cerebro-spinal fluid
CTG Cardiotocography – a technical means of recording the fetal heartbeat and the uterine contractions during pregnancy. The machine used to perform the monitoring is called a cardiotocograph, more commonly known as an electronic fetal monitor.
CVA Cerebrovascular accident
CVS Cardiovascular system
CXR Chest x-ray
DIC Disseminated intravascular coagulation – a condition in which blood clots form throughout the body, blocking small blood vessels.
DNA Did not attend; Deoxyribonucleic acid
D&V Diarrhoea and vomiting
DOA Dead on arrival
DVT Deep vein thrombosis
D/W Discussed with
ECT Electroconvulsive therapy
EDD Expected date of delivery
emf Electromotive force
EM Electron micrography
emp Emplastrum – a plaster
ER External rotation
ERCP Endoscopic retrograde cholangiopancreatography
ERPC Evacuation of Retained Products of Conception
ESR Erythrocyte sedimentation rate
FB Finger’s breath
FBC Full blood count
FBS Foetal blood sampling
FH Family history
FHH Foetal heart heard
FHHR Foetal heart heard regular
FHR Foetal heart rate
FMF Foetal movements felt
FSE Foetal scalp electrode
FSH Family/social history; follicle-stimulating hormone
GA General anaesthetic
glc Gas liquid chromatography
GTT Glucose tolerance test
GFR Glomerular filtration rate
GIT Gastrointestinal tract
GM Geiger Muller
GUT Genitourinary tract
HCG Human chorionic gonadotrophin
HCO History of present complaint
hn Tonight (hac nocte)
hs At bed time (hora somni)
HS Heart sounds
HSA Human serum albumin
HVS High vaginal swab
ICF Intracelluar fluid
ICS Intercostal space
IgA, IgB, IgG, IgM Immunoglobulins
IJV Internal jugular vein
In aq In water
IR Internal rotation
KJ Knee jerk
KPa Kilopascal, approx 7.5 mm Hg
LA Local anaesthetic
LATS Long acting thyroid stimulator
LFT Liver function tests
LH Lutenizing hormone
LIH Left Inguinal Hernia
LMP Last menstrual period
LN Lymph node
LOA Left occiput anterior
LOC Loss of consciousness
LOL Left occiput lateral
LOP Left occiput posterior
LSCS Lower segment Caesarean section
LSK Liver, spleen, kidneys
M Intravenous infusion
mane In the morning
MCL Mid clavicular line
mmHg A millimeter of mercury is a manometric unit of pressure
mp Melting point
MSH Melanocyte-stimulating hormones
MSU Midstream specimen of urine
N&V Nausea and vomiting
NAD Nothing abnormal detected
NBM Nil by mouth
Neb A nebulizer/nebuliser is a drug delivery device used to administer medication in the form of a mist inhaled into the lungs; a spray
NG Nasogastric; Neoplastic growth
NGT Nasogastric tube
NMCS No malignant cells seen
NOF Neck of femur
N/S Normal size
Occulent Eye ointment
OA Occipitoanterior position
OD Outside diameter
OE On examination
OM Every morning
OP Every evening
PR Pulse rate
PAS Periodic acid – Schiff reaction
pc After meals
PCV Packed cell volume
PERLA Pupils equal, react to light and accommodation
PE Pulmonary embolism
PET Pre-eclampsia toxaemia
ph Acidity/alkalinity scale
PH Past history
PID Pelvic inflammatory disease; prolapsed intravertebral disc
PMH Past medical history
PN(R) Percussion note (resonant)
PNS Peripheral nervous system
PO By mouth
PR Per rectum
PRN As required
PV Per vagina
RBC Red blood cells
rh Relative humidity
RIH Right inguinal hernia
ROA Right occipito anterior
ROL Right occiput lateral
ROM Range of movement
RPF Renal plasma flow
RQ Respiratory quotient
RS Respiratory system
RT Reaction time
RTI Respiratory tract infection
S/B Seen by
SEM Scanning electron microscope
SH Social history
SOA Swelling of ankles
SOB Shortness of breath
SROM Spontaneous rupture of membranes
SVC Superior vena cava
SVD Spontaneous vaginal delivery
TCI 2/52 To come in 2 weeks time
TGH To go home
THR Total hip replacement
TID 3 times a day
TJ Triceps jerk
TFTS Thyroid function tests
TSH Thyroid stimulating hormone
U&E Urea and electrolytes
UG Urinogenital system
URTI Upper respiratory tract infection
VE Vaginal examination
VF Ventrical fibrillation
VT Ventrical tachycardia
V/V Vulva and vagina
WBC White blood count
Carpals: Wrist bones
Clavicle: The collarbone
Femur: The thigh bone
Fibula: The calf bone; the outer and smaller bone of the leg below the knee
Humerus: The bone between the shoulder and elbow
Illium: The large broad bone forming the upper part of each half of the pelvis
Ischium: The curved bone forming the base of each half of the pelvis
Metacarpals: Bones in the hand
Metatarsals: Bones in the feet
Patella: The kneecap
Phalanges: Bones in the fingers and toes
Radius: The bone on the outer side of the forearm
Sacrum: A large, triangular bone at the base of the spine
Scapula: The shoulder blade
Skull: Head bone
Sternum: The breastbone
Tarsals: Ankle bones
Tibia: The inner and larger bone of the leg below the knee
Ulna: The inner and larger bone of the forearm
Vertebra: Any one of 33 bones of the spinal column
1 or 2 paragraphs summarising the claim.
Bundle A – GP records up to (date)
Bundle B – Name of Hospital/Trust records up to (date)
Bundle C – Name of Hospital/Trust records up to (date)
|Date||Type of Record||Entry||Page Number|
Where appropriate, include comments about:
- The extent to which the records are consistent with instructions received detailing inconsistencies
- Identity of potential Defendants
- Speciality of experts who may need to be instructed and the reasons why and likely cost (consider consulting your firm’s expert database and attaching CV’s)
- Questions that may need to be put to experts
- Questions that may need to be put to the client
- Missing records or other records that need to be applied for
State your opinion about the prospects of success (or if that isn’t possible, what is needed to be able to assess prospects).
List sources of information and, where appropriate, attach copies of research.
*Thank you to the team at Alexander Harris (now part of Irwin Mitchell LLP), who in the mid to late 1990’s, taught me how to sort and analyse medical records.
One doesn’t get a second chance to make a first impression. Grammatical errors can leave a poor impression and make one appear unprofessional. I wasn’t taught about when and how to use apostrophes during my schooling and I have reason to suspect that I’m not alone. An article by Nick Daws  in Writers’ Monthly in May 1994 taught me when and how to use apostrophes and this is summarised below.
Apostrophes are always required in:
Contractions (can’t, shouldn’t)
Expressions showing possession or association (David’s football, the girl’s book)
Apostrophes are needed even if the noun is inanimate or abstract (the table’s legs, 20 years’ service).
Not required in:
Plurals (tables, books, people).
Nick Dawes stated “Even professional writers are confused at times by where they should place the possessive apostrophe…”
“Its” is the possessive form of “it”
“It’s” means “it is” or “it has.”
The University of Bristol agree that “it’s” and “its” cause all sorts of problems and it takes just 2 minutes it takes to learn the difference between them. On their website  they give the following examples:
“It’s been a long time since we spoke,” he whispered (it has).
“Come on,” he shouted, “it’s a lovely day!” (it is).
“There is no way it’s going to be ready on time” (it is).
“It’s been ready for weeks!” (it has).
“Its,” without an apostrophe, is a possessive form, where an apostrophe is usually required. It is similar to words like his and hers, neither of which needs an apostrophe.
The building was missing its doors and windows.
The tree had lost all of its leaves.
Has your chewing gum lost its flavour?
Madrid is famous for its art galleries.
To figure out which is correct for your sentence, just swap in “it is” and then “it has.” If the sentence makes sense with either of those substitutions, use it’s. If the resulting sentence doesn’t make sense, use its.