Insurance Disputes





Involnert v Aprilgrance [2015] EWHC 2225 (Comm)


Construction, Design and Management (CDM) Regulation Changes 2015 – ABI’s guidance


The Insurance Act 2015

The Insurance Act 2015

Click to access Willis%20Technical%20Insight%20-%20Insurance%20Act%202015.pdf

Consumer Insurance (Disclosure and Representations) Act


Fatal claims

Deborah Blake (Executrix of the Estate of Paul Nigel Blake, Deceased) v Mad Max Limited [2018] EWHC 2134 (QB)

The jurisprudential basis for Regan v Williamson damages


Bereavement damages

08/05/2019, 14:36

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 #Fairness4families





Asbestos Disease: Cosmetics

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:-


Clinical negligence 2018

Asante v Guy’s and St Thomas’ NHS Foundation Trust [2018] EWHC 2570 (QB) (05 October 2018) 9:10 AM – 10 Oct 2018. 2 Likes; rob …
YAH v Medway NHS Foundation Trust [2018] EWHC 2964 (QB)

Brayshaw v The Partners of Apsley Surgery & Anor [208] EWHC 3286 (QB) (30 November 2018)

Surrogacy costs as an item of special damages

XX v Whittington Hospital NHS Trust [2018] EWCA Civ 2832



Liberty (@libertyhq)22/11/2018, 14:50The new draft of the  political declaration 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  


Asbestos Disease 2018

Asbestos Campaign (@TheJUAC)22/11/2018, 22:43BBC News – #Jersey to introduce mesothelioma compensation scheme 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 [2019] EWHC 335 (Ch)

EMA cannot get out of lease because of Brexit:

Canary Wharf -v- EMA




SCCO costs guidance:

Senior Courts Costs Office Guide 2018 is published

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 ->

Yirenki -v- Ministry of Defence [2018] EWHC 3102 (QB)




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 




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 […]



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  


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


ARAG joins SCIL calls for fixed recoverable costs rethink



Myotonic Dystrophy

“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:”

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).

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.

DM1 Guidelines

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

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|| 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.


Protected: NIHL Claims: A Skeleton Argument

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NIHL claims: Chronology of Potentially Relevant Cases, Regulations & Publications etc


Factories Act 1961 s29

Factories Act 1961 – legislation


Noise and  the Worker

Noise and the Worker 1963


Noise and the Worker (updated)

Stokes v Guest [1968] 1WLR 1776

Stokes v Guest

Stokes v Guest Keen and Nettlefold (Nuts and Bolts) Ltd: QBD 1968

Click to access PW-Asbestos-Bussey-article.pdf

  • Ratio of Stanwick J applied in Baker v Quantum (below)


Noise and the Worker (updated)


Code of Practice

Code of Practice 1972


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 [1984] QB 405

Thompson v Smiths Shiprepairers (North Shields) Ltd: QBD 1984

  • Mustill J placed limits on the ratio of Stanwick J in Stokes v Guest [1968]


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

Black Book


Larner v British Steel [1993] 4 All ER 102

Nash & Others v Eli Lilly & Co & Others [1993] WLR 782

Nash v Eli Lilly and Co: CA 1993


CLB Guidelines

Holtby v Brigham & Cowan (Hull) Ltd [2000] ICR 1086

ISO7029:2000 2nd edition Acoustics – Statistical distribution of hearing thresholds as a function of age

ISO7029 2000

David Anthony Wright v Canadian Pacific (UK) Ltd (2000)

David Anthony Wright v Canadian Pacific


Bracknell Forest Borough Council v Adams [2004] 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 [2007] Unreported (Nottinghamshire textile litigation (27/04/07 HHJ Inglis)


Furniss v Firth Brown Tools Limited [2008] EWCA Civ 182

Cain v Francis [2008] EWCA Civ 1451

Teague v Mersey Docks [2008] EWCA Civ 1601

A v Hoare & Others [2008] 1 AC 844

John Field v British Coal Corporation (Department for Business Enterprise and Regulatory Reform) [2008] EWCA Civ 912


Keefe v The Isle of Man Steam Packet Co Ltd [2010] EWCA Civ 683


Baker v Quantum Clothing Group Limited & Others [2011] UKSC 17; [13/04/11, Supreme Court]


Johnson v MOD, Hoburn Eaton Limited [2012] EWCA Civ 1505

AB and Others v Ministry of Defence [2012] 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) [2012] EWCA Civ 1380

Davies v Sec of St

Hughes v Rhondda Cynon Taf County Borough Council

John Cran v Perkins Engines Company Limited



Platt v BRB (Residuary) Limited [2014] EWCA Civ 1401


Holloway v Tyne Thames Technology Limited (2015)

Hinchcliffe v Six Continents Limited and Cadbury UK Ltd (2015)

Click to access Hinchcliffe.pdf

Briggs v RHM Frozen Food Limited (2015)

Click to access Briggs-v-RHM-published.pdf


04/02/16 Inaugural NIHL Symposium: Medico-legal Advancements in Noise Induced Hearing Loss Cases – included Professor Lutman introducing “the LCB Guidelines”

2016 Inaugural NIHL Symposium

LCB Guidelines


Click to access The%20LCB%20Guidelines%20-%20A%20BC%20Legal%20Guide.pdf

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

ISO7029 2017

Stephen Lovatt v Secretary of State for Energy and Climate Change & Another (2017)

Lovatt Order and judgment

David Evans v Secretary of State for the Department of Energy and Climate Change & JJ Maintenance Ltd (2017)

David Evans



Legal Update Links

@PiKS Hub

Civil Litigation Brief – Gordon Exall:

Fatal Accident Law  – Gordon Exall

Accidents at Work and Loss of Earnings Claims – Gordon Exall



Asbestos Disease Case Law 2018


Case Name and link


Brief Summary of the Decision / Comments /Misc

Who Won?


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

Hawkes v Warmex Ltd [2018] EWHC 205 (QB) (08 February 2018)



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) [2018] EWHC 2134 (QB)

High Court Quantum in fatal meso case













Civil Procedure Rules


Court Addresses and Fees

Court and Tribunal Finder

Court Fees

Court Fee Remission



SRA Code of Conduct

SRA Warning Notices

Insights (e-mail updates)


Disability Living by Emma Lyons

Disability Living

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.


Notable Bloggers & Blogs

Civil Procedure:

Gordon  Exall

Clinical Negligence:


Simply Emma | One of the UKs Leading Disability Travel Resources


Inner Temple Library:


FTP Organisations: Clinical Negligence


Health & Safety Executive


FTP: Political Parties

The Green Party

The Labour Party

Socialist Party


2020 Labour Party report into anti-semitism


FTP Organisations: Green



FTP Organisations: Personal Injury


FTP Organisations: Asbestos

Asbestos Victims Support Groups Forum UK

GMAVSG – Greater Manchester Asbestos Victims Support Group

SARAG South Yorkshire Asbestos Victim Support Group

Merseyside Asbestos Victim Support Group

June Hancock

Cumbria and Lancashire Asbestos Support Advice Group




FTP Organisations: Human Rights



Amnesty International UK

Unicef UK


Medical records: organising and understanding

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.

Suggested sections

  1. Computer records
  2. Treatment summary cards
  3. Lloyd George records
  4. Vaccination and immunisation history
  5. Clinical data (eg x-ray results, scan results, blood test results)
  6. 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:

# Fracture

++ Much/many

0 Nil/nothing/none/no

Δ Diagnosis

ΔD Differential diagnosis

ΔΔ Differential diagnosis

↑ Increasing

→ Constant, normal or lateral shift

↓ Decreasing

⊥ Central

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

add Adduction

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

Applic Applications

aq Water

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

A/V Anteverted

bd Both

BJ Biceps jerk

B.S. British Standard

BO Bowels open

BP Blood pressure

BS Breath sounds; bowel sounds; blood sugar; British Standard

c With

Ca Carcinoma/cancer; calcium

Caps Capsules

CAT scan Computed axial tomograph

cp Compare

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

Cx Cervix

CXR Chest x-ray

D Diagnosis

DIC Disseminated intravascular coagulation – a condition in which blood clots form throughout the body, blocking small blood vessels.

dil Dilute

DNA Did not attend; Deoxyribonucleic acid

D&V Diarrhoea and vomiting

DOA Dead on arrival

DOPA Dopamine

DVT Deep vein thrombosis

D/W Discussed with

Dx Diagnosis

ECG Electrocardiogram

ECT Electroconvulsive therapy

EDD Expected date of delivery

emf Electromotive force

EM Electron micrography

emp Emplastrum –  a plaster

enem Enema

EOG Electrooculogram

ER External rotation

ERCP Endoscopic retrograde cholangiopancreatography

ERPC Evacuation of Retained Products of Conception

ERG Electroretinogram

ESR Erythrocyte sedimentation rate

Ex Extension

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

Flex Flexion

FMF Foetal movements felt

FSE Foetal scalp electrode

FSH Family/social history; follicle-stimulating hormone

GA General anaesthetic

garg gargles

glc Gas liquid chromatography

GTT Glucose tolerance test

GFR Glomerular filtration rate

GIT Gastrointestinal tract

GM Geiger Muller

GUT Genitourinary tract

Hb Haemoglobin

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

Hx History

ICF Intracelluar fluid

ICS Intercostal space

IgA, IgB, IgG, IgM Immunoglobulins

IJV Internal jugular vein

IM Intramuscular

Implant Implantation

In aq In water

Inj Injections

IP Intraperitoneal

IR Internal rotation

Irrig Irrigations

K Potassium

KJ Knee jerk

KPa Kilopascal, approx 7.5 mm Hg

L Litre

LA Local anaesthetic

LATS Long acting thyroid stimulator

LFT Liver function tests

LH Lutenizing hormone

LIH Left Inguinal Hernia

Lin Liniments

Linc Linctus

Liq Liquid/solutions

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 Mix

M Intravenous infusion

mane In the morning

mcg Microgram

MCL Mid clavicular line

mg Milligram

mmHg A millimeter of mercury is a manometric unit of pressure

ml Millilitres

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 Nanogram

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

of Daily

OD Outside diameter

OE On examination

OM Every morning

OP Every evening

PR Pulse rate

Pa Pascal

PAS Periodic acid – Schiff reaction

pc After meals

PCG Phonocardiogram

PCV Packed cell volume

PERLA Pupils equal, react to light and accommodation

PE Pulmonary embolism

pes Pessaries

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 Rhesus

rh Relative humidity

RIA Radioimmunoassay

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

S/D Systolic/diastolic

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

Ung Ointments

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

The Skeleton

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

Template Report

Claimant’s name:

Claimant’s DOB:

Claimant’s age:

Claimant’s occupation:


1 or 2 paragraphs summarising the claim.

Records received

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
  • Limitation
  • Identity of potential Defendants
  • Breach
  • Causation
  • 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.


First impressions (punctuation: use of apostrophes)

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 [1] 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).


It’s, Its

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 [2] 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.