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Forensic Healthcare Services

Est 1999.

FHC Experts for Law & Mediation is one of the leading providers of expert witnesses both in the UK and Internationally.

Since 1999 we have been providing a custom range of services within the judicial system for all criminal and civil practice, including the police, family courts, defence solicitors and barristers, inquests and medical negligence to name but a few.

We have one of the largest expert witness panels comprising of, but not limited to, medical, paediatric, psychological, psychiatric, technical and scientific experts

Types of Expert Witnesses
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Odontology
Odontology

An odontologist is a dentist with a particular interest in the anatomy, structure and disease of the teeth. Forensic odontologists may be asked to identify deceased individuals from teeth structure, or identify bite marks from teeth imprints. In the civil setting, expert odontologists may be required to review treatment and outcome of dental procedures.

Blood pattern analysis
Blood pattern analysis

Blood from bleeding injuries can transfer to clothing, footwear and other objects (eg carpet, ceiling, walls). The pattern of blood marks may assist in determining a number of factors such as movement of individuals during an assault, force and nature of assault , number of blows and type of weapon.

Police custody
Police custody

Individuals who have been arrested for an alleged offence will be taken into police custody. In England & Wales their care is governed by the Police & Criminal Evidence Act which ensures standards are applied in all aspects of detention. Breaches of those standards may lead to complaints, or at worst, deaths in custody. Review of such cases needs to be undertaken by those thoroughly familiar with the police custodial setting.

Torture
Torture

Torture is frequently complained of following detention in custody. Examinations for the physical and psychological effects of torture require detailed assessment according to the Istanbul protocol. Physicians and psychologists with experience of utilising the Istanbul protocol are essential in assisting courts and asylum tribunals in making correct determinations.

Substance misuse
Substance misuse

Understanding of the nature and effects of substance misuse (including drugs, illicit and lict, and alcohol) is crucial to ensuring that evidence is presented appropriately in courts and tribunals. Psychiatrists may be required to assess the degree of dependency and its effects on an individual whilst forensic physicians and emergency physicians may be required to describe the clinical effects of drugs on the body. Toxicologists and pharmacists may be required to analyse drug levels and interpret the findings in context of blood, urine or breath levels at particular rimes.

Accountants
Accountants

Fraud, financial irregularities in both criminal and civil settings may require accountants trained and experienced in reviewing and unravelling paper trails of transactions, accounting interpretation and company matters. The investigation of these and related matters is outwith the expertise of most accountants – we are able to locate those with special skills.

Epilepsy
Epilepsy

Epilepsy affects the brain and causes repeated seizures, also known as fits. Epilepsy affects almost half a million people in the UK. This means that about 1 in 130 people has epilepsy. Epilepsy usually begins during childhood, although it can start at any age. Seizures take a number of forms – some very obvious others not. Epilepsy may have no cause but it can develop after head injury or in association with drug and alcohol problems. Experts may required for a number of reasons, eg to determine causes of epilepsy, to describe the effects of epilepsy, to determine how it might affect behaviour or driving.

Driver Fatigue
Driver Fatigue

Driver fatigue is now a very well established contributory factor in road crashes.However, there are several issues which may contribute to the likelihood of a driver “falling asleep at the wheel”. These include sleep deprivation, length of time driving without a break and the time of day “circadian factors. Medical issues such as sleep apnea or narcolepsy may also be a factor. It is also well known that a driver’s propensity to fall asleep when driving varies enormously from one individual to another. In all such cases, therefore, it is advisable to seek expert forensic advice.

Acupuncture
Acupuncture

Acupuncture may be practised by trained acupuncturists, by medical practitioners and other trained healthcare professionals. It is important that certain standards and guidelines are followed by practitioners. Failure to do so, or to treat inappropriately may reflect fitness to practice issue, regulatory and Health & Safety matters. Poor practice can result in complications resulting in medical complications – such as nerve injury or infection (eg hepatitis). Each aspect may require expert review.

Rape
Rape

The examination, documentation, and forensic sampling of complainants and defendants in rape cases are crucial to the integrity of the case. Accepted guidelines are available to identify appropriate standards in these areas. Experts must be able to relate current known factors of findings after sexual assault to individual cases. Most frequently this is undertaken by forensic physicians.

Neuropathologists
Neuropathologists

A neuropathologist is a pathologist with a particular interest in the nervous system particularly the brain. Neuropathologists may be called upon to make or confirm diagnoses by review of histological material. Neuropathologists are frequently asked to give opinions on causes of death in cases where, for example, head injury and drug use are present.

Cancer
Cancer

The term cancer embraces a vast range of conditions that can affect the human body. In very general terms the body starts producing cells which are of no use to the body. Such cells create growths which can spread. All types of cell in the body can develop cancer (or disease equivalent to cancer) – such as bone, muscle, bowel, breast, lung, kidney, blood and lymph glands. Interpretation of possible causes, the appropriate treatment, the possible symptoms and likely prognosis requires specialists within the particular field.

Fibres
Fibres

Clothing and soft furnishings are made in a wide array of fabrics that come from all manner of sources. Natural fibres, such as wool, cotton and linen have been used for centuries and they are often combined with man-made fibres to improve their versatility. Within the types of fibre that is used there may be many different dyes used and other materials incorporated into them which give different properties to the finished garment. All of these characteristics enable the forensic fibre examiner to identify sources of fibres and compare them to fibres that have been transferred to other garments or furnishings. Identification of the fibres involves microscopic and analytical techniques and it is possible to use the results in tandom with the number and location of the recovered fibres to give an interpretation of the circumstances which caused the transfer to occur.

Psychology
Psychology

Psychology is the science of mind and behavior. Its main goal is to understand behavior and mental processes. Psychologists try to understand the role of mental functions in individual and social behavior, and explore the physiological and neurobiological processes that underlie certain functions and behaviors. Psychologists explore concepts such as perception, cognition, attention, emotion, phenomenology, motivation, brain functioning, personality, behavior, and interpersonal relationships. Some work in general clinical settings (clinical psychologists) and others work in the criminology setting (forensic pyschologists).

Post-mortem
Post-mortem

Post-mortem examinations for sudden, violent or unnatural deaths are undertaken by forensic pathologists. In England & Wales, the term Home Office Pathologist is used to identify those approved by the Home Office to undertake post-mortems where criminal acts are considered a possibility. The pathologist undertakes a physical examination of the deceased, internally and externally taking samples (under strict guidelines) for histology and toxicology in order to try and determine the cause of death.

Injuries
Injuries

Injury causation is a crucial element of many criminal and civil cases. The effects and prognosis from injury, and any alternative possibilities may require a range of experts including forensic pathologists, forensic physicians, emergency physicians and forensic scientists (to link weapons with specific injury).

Trauma
Trauma

Trauma is a broad term embracing all aspects if injury which may be accidental, non-accidental, major, minor or fatal. The specific nature of the trauma and the legal setting will determine the best type of expert to provide an appropriate opinion.

Glass
Glass

The analysis of glass, whether it is present, what it is made of, it’s type are some of the key factors that may be important in criminal investigation. Forensic scientists specialising in glass analysis may be able to identify or match glass pieces or fragments and relate them, or exclude them from criminal activities. The work of glass experts embraces the collection and identification, analysis and interpretation of glass at scenes of crimes. How glass performs, or is expected to perform, and why it fails is another area of glass analysis that may be relevant in civil cases.

A&E
A&E

Accident & Emergency Medicine, Emergency Medicine and Casualty Medicine refer to departments that deal with acute illness and injury. Expertise may be required to determine causation of injury in both civil settings (eg accident, personal injury) and in criminal settings. Opinions may be

Occupational Health
Occupational Health

Occupational health doctors and nurses are trained in the assessment and diagnosis of patients within an occupational setting and are able to identify risk factors for individuals, occupationally-acquired disease or illness, and advise on strategies to improve or remedy situations. Occupational health teams must work in close collaboration with human resource teams, and be aware of relevant law and regulations that impact on work practice. Occupational health opinions are often sought in employment tribunals or other settings where ability to carry out a job may be questioned.

Clinical Perfusionist
Clinical Perfusionist

Clinical perfusion scientists are highly skilled professionals who manage heart-lung machines and the patient’s physiological parameters during Cardiopulmonary Bypasses. They may be asked to determine causes of machinery malfunctions, circulatory support failure and the interpretation of blood gas and blood chemistry values.

Child abuse
Child abuse

Child abuse can embrace physical, emotional, sexual and neglect aspects. These may require a variety of experts to assess, interpret and advise on psychiatric, physical and pyschological issues. Such issues may all require comment in criminal, civil and family law matters.

Head injury
Head injury

Expertise required to assess injuries or diseases to to the head embrace a huge range of potential expertise, including maxillofacial surgeons, neurosurgeons, emergency physicians and forensic physicians and pathologists, dependent on the legal need. Determining the correct specialist is crucial in ensuring best suppor for a legal case.

Forensic Toxicology
Forensic Toxicology

Forensic Toxicology is primarily the involvement of drugs, alcohol and poisons in incidents from drink or drug driving through to rapes, murders, consumer terrorism and many others. Investigation of suspicious deaths is another important area. Thorough investigation, analysis and interpretation is paramount to avoid incorrect conclusions being reached. Toxicologists, Forensic Medical Practitioners and Pathologists can all play a part, and work together, to provide detailed comprehensive assessments.

Neuropsychologist
Neuropsychologist

Neuropsychology – often confused with neuropsychiatry – examines the structure and function of the brain related to specific psychological processes and behaviour. In clinical practice, neurospysychologists assess and treat those with neuropsychological problems. Examples of other settings include the forensic arena or in industry and employment when neuropsychological principals are applied to product design.

Communications
Communications

All aspects of communication may be explored in civil and criminal court cases. The interpretation, recovery and presentation of communications data (eg from cell phones and pagers) may often be bery relevant in such cases.

Medical records
Medical records

Documentation, storage and monitoring of medical records are all subject to laws and regulations. Access to such records is limited and defined. Breaches of the laws and regulations require identification. If medical records are being utilised in court cases, specialised personnel may be required to ensure that the lay out and format of the notes provided are consistent, so that relevant chronologies and actions can be easily identified by detailed pagination.

Osteoarcheology
Osteoarcheology

Forensic anthropologists specialise in the study of origins of individuals and can identify individuals (both living and dead), in particular from bone characteristics. Anthropologists may be asked to age bones and can apply these principles to both the living and the dead.

Cardio-thoracic
Cardio-thoracic

Cardiothoracic surgeons specialises in the surgical treatment of heart and chest disease and trauma (eg lung cancer, stab wounds, heart transplants, coronary artery bypass). Many surgeons sub-specialise in these areas and can give opinions on the most appropriate treatment and prognosis after surgical intervention.

Nursing Care
Nursing Care

As with medical specialties, there are a wide range of skill levels and expertise that apply to nursing care. Where questions about standards of care are raised, whether in hospital, in the community or in a nursing home, it is crucial to ensure that a nursing professional with the appropriate skills assesses the case in question.

Microbiology
Microbiology

Microbiology is the study of microorganisms, which include bacteria, fungi and prokaryotes. Viruses and prions, may also be studied by microbiologists although these mainly fall under the remit of virologists.. Medical microbiologists are doctors who specialise in identifying and treating infections, and how to prevent them or limit their spread using antibiotics and other pharmaceutical agents. There is considerable overlap between the work of immunologists, microbiologists and virologists.

Chemistry
Chemistry

Chemistry is the science of matter and the changes it undergoes. Chemistry is particularly concerned with the composition, behavior (or reaction), structure, and properties of matter, as well as the changes it undergoes during chemical reactions. It studies various substances, and their components such as atoms, molecules, crystals and other aggregates of matter whether in isolation or combination. Chemists may be required to determine why, or how a chemical reaction has taken place and assist, for example, in assigning causation in industrial accidents.

Schizophrenia
Schizophrenia

Schizophrenia is a mental disorder characterized, in its acute stages by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests as hearing voices, paranoid or bizarre delusions, disorganized speech and thinking, and it is accompanied by significant social or occupational dysfunction. Its diagnosis and management is generally within the realm of the psychiatrist, although if criminal behaviour is involved, forensic psychiatrists may have much contact. Determination of ability to form intent, of making a plea, and serving a sentence are all issues that may need to be decided, before, during or after criminal trials.

Firearm identification tool marks
Firearm identification tool marks

Microscopic comparison of tool marks on spent bullets and cartridge cases to determine whether they were fired in the same gun, and if so, whether that was the suspect gun.

Time of death
Time of death

The determination of time of death is not easily made (despite the appearances in TV programmes) such as CSI. Determination of time of death may often be a collaborative venture including forensic pathologists, forensic entomologists, anthropologists, forensic physicians and gastroenterologists, using features such as presence or absence of rigor, insect growth stages and stomach emptying rates.

Virology
Virology

Virologists are involved in the assessment and management of individuals with viral and related illness (eg hepatitis, HIV, post-viral fatigue). The spread and cause of viruses can be explored and the relevance of viral infection following contact with an infected person (eg HIV infection after unprotected sexual contact) may be relevant in both criminal and civil settings.

Complaints against police
Complaints against police

Complaints against police may relate to a wide variety of concerns such as unlawful imprisonment, use of excess force, deployment of devices such as handcuffs, incapacitant sprays, Viper restraints and Tasers. The appropriateness and the effects of the deployment of such techniques may be relevant in criminal and civil courts, disciplinary tribunals, IPCC inves

Age determination
Age determination

Age determination may be undertaken in the living and the dead. In the living this may most frequently be done in refugee, asylum or paediatric cases, and must be done appropriately and according to legal precedent (Merton compliance). Anthropologists can play a key role in age determination by assessing bones and X-rays together with other techniques such as odontology. Deceased individual’s age and sex can be determined by anthropological means.

Burns
Burns

Burns may be caused in a range of settings, by accident, deliberately, in industrial settings. Burns vary in severity and the severity will determine the nature of treatmemt and management. The interpretation of burn types (eg liquid, fire, chemical) and patterns (eg accidental, non-accidental) is essential in both criminal and civil settings.

Sleep disorder
Sleep disorder

There are many types of sleep disorder. Individuals may need to be investigated by sleep disorder specialistst to determine whether they have conditions which may account for abnormal behaviour. Sleep disorder may be raised as a defence in sexual assault and road traffic offences. It is essential that specific expertise is sought to elucidate any diagnoses that may exist.

Nephrology
Nephrology

Nephrology is the medical specialty which deals with diagnosis and treatment of kidney diseases, including electrolyte disturbances and hypertension (high blood pressure), and the care of those requiring renal replacement therapy (because of kidney failure), including dialysis and renal transplant patients. Many diseases affecting the kidney are systemic disorders not limited to the kidney itself. Surgical treatment of kidney and urinary tract pathology or trauma may be carried out by a urological surgeon.

Munchausen
Munchausen

Munchausen Syndrome is the condition by which individuals inflict harm on themselves in some way in order to fabricate illness. If such harm is done to another such as a child, the term Munchausen Syndrome by Proxy was used. This is now more often known as factitious (or fabricated) illness by proxy.

Epidemiology
Epidemiology

Epidemiology is the study of health-event patterns in a society. It is the cornerstone method of public health research, and helps inform evidence-based medicine for identifying risk factors for disease and determining optimal treatment approaches to clinical practice and for preventive medicine. Epidemiologists are involved in research of outbreaks of communicable and non-communicable disease and are involved in study design, data collection, statistical analysis, documentation of results and submission for publication.

Geriatrics (Care of the Elderly)
Geriatrics (Care of the Elderly)

Geriatrics is a sub-specialty of internal medicine that focuses on health care of elderly people. It aims to promote health by preventing and treating diseases and disabilities in older adults. There is no set age at which patients may be under the care of a geriatrician, or physician who specializes in the care of elderly people. Doctors and nurses within this field may be able to assess the standards of care and expectations of quality of life.

Alzheimers
Alzheimers

Alzheimer’s disease is a form of dementia where mental functioning deteriorates, sometimes at a very early age. Specialists in the care of the elderly may be required to make the diagnosis (and distinguish it from other causes of altered mental functioning), whilst psychiatrists and psychologist may determine the degree of impairment and its progress.

Sports injuries
Sports injuries

Previously the realm of emergency physicians, the development over the last two decades of sports medicine as a specific medical specialty means that the assessment and interpretation of sports injuries has become more defined. Sports injury may require the expertise of sports physicians, physiotherapists, emergency physicians or forensic physicians dependent on the injury setting.

Psychiatry
Psychiatry

Psychiatry is the medical specialty devoted to the study and treatment of mental disorders. These mental disorders include various affective, behavioural, cognitive and perceptual disorders. Psychiatric assessment typically starts with a mental status examination and the compilation of a case history. Psychological tests and physical examinations may be conducted, including on occasion the use of neuroimaging or other neurophysiological techniques. Mental disorders are diagnosed in accordance with criteria listed in diagnostic manuals such as the widely used Diagnostic and Statistical Manual of Mental Disorders (DSM), and the International Classification of Diseases (ICD).

Otorhinolaryngology
Otorhinolaryngology

Otolaryngology or ENT (ear, nose, and throat) is the branch of medicine and surgery that specializes in the diagnosis and management of ear, nose, throat, and head and neck disorders. Otorhinolarynologists’ workload may overlap considerably with maxillofacial surgeons and dentists and oncologist.

Child protection
Child protection

Most jurisdictions now have laws, statutes or codes in place aimed at protecting children and identifying those children at risk. It is crucial that every healthcare professional who has any contact with children is aware of their own duties and responsibilities towards children, whether identifying those at risk, or initiating further assessment by those with specialist skills

Voice recognition
Voice recognition

Voice analysis enable voices recorded in various media to be identified – individuall, regionally or by identifying other unique characteristics. Speech patterns and rhythyms may assist in identifying suspects or excluding individuals who may have been linked to a possible crime.

Non-freezing cold injury
Non-freezing cold injury

Non-freezing cold injury (NFCI) –

is an injury  injury of the hands or feet resulting from exposure to wet conditions and temperatures just above freezing, typically found in soldiers. NFCI is due to microvascular endothelial damage, stasis and vascular occlusion.

Veterinary
Veterinary

Veterinary surgeons/pathologists specialise in all areas of veterinary medicine and animal welfare including professional negligence, injuries, disease, transport, pre-purchase, loss, behaviour, and health management issues.

Automatism
Automatism

Automatism is a term used as one of the  mental condition defences that relate to the mental state of the defendant. Automatism may be described as a lack of voluntariness, lack of culpability (unconsciousness) or excuse.. Automatism means that the person was not aware of his or her actions when whatever the act or acts alleged were made.  There are a variety of medical and psychiatric conditions that may result in apparent automatism.  Such cases require review by relevant experts in the psychiatric or medical field relevant to the defence.

Rehabilitation
Rehabilitation

Rehabilitation involves the diagnosis management of disorders that alter the function and performance of the patient. Emphasis is placed on the optimization of function through the combined use of medications, physical modalities, physical training with therapeutic exercise, movement & activities modification, adaptive equipment and assistive device, orthotics (braces), prosthesis, and experiential training approaches. This is a multiprofessional areas with the skills of those trained in rehabilitation medicine, physiotherapy, occupational therapy and social care providing aspects of support. The assessment of skills and achievable aims post-injury is an important part of the role of rehabilitation.

Asylum
Asylum

The medical and psychological assessment of refugees and those claiming asylum is a complex area, requiring input of a range of specialists including forensic physicians, psychiatrists and psychologists, whose aim is to determine what features are as a result of the possible abuse suffered which has resulted in the individual having refugee or asylum-seeking status. The Istanbul Protocol is a useful guide in assessing such individuals.

Drug Driving
Drug Driving

Drug driving is an immensely complex subject. If a person drives after consuming drugs, either medicinal or illicit, they may be potentially charged under Section 4 of the Road Traffic Act 1988 as being unfit through drugs.

Such a charge requires that for the time being their driving is impaired. However the act does not define what is meant by being unfit or impaired.

Such cases therefore necessarily rely on expert opinion as to the effect of a given drug or drugs on a drivers ability to drive safely and this in turn relates to the concentrations of drugs involved, the time the drugs were taken, and any tolerance the driver may have developed towards the drugs, In all such cases it is very wise to seek expert forensic opinion on both the effects and the toxicology of the drugs invoved.

Legal Highs
Legal Highs

With the ever-changing world of novel drug substances, so-called legal highs pose a challenge to everyone in law enforcement. The delay in controlling mephedrone led to many users trying the drug, liking the effects and now seeking non-controlled alternatives. Consequently chemists, mainly in the Far East, are constantly designing new compounds which side-step controls, albeit often temporarily. Detecting the drugs and providing any interpretation requires detailed knowledge of the latest situation. Has the testing laboratory correctly identified any drugs present? Forensic Scientists can provide detailed assessments.

Vibration White Finger
Vibration White Finger

Vibration White Finger (VWF) –

Vibration white finger (VWF), also known as Hand-arm vibration syndrome (HAVS) or dead finger, is a secondary form of Raynaud’s syndrome, an industrial injury triggered by continuous use of vibrating hand-held machinery.

Fitness for court
Fitness for court

Determination of whether an individual is fit to attend court, to be interviewed, to be detained in custody, to make a plea and to be sentenced may require physical, psychiatric and psychological assessments. Individuals may be fit for some of the above but not all. For example an individual may be mentally fit to plead, but not physically fit enough to serve a prison sentence; or someone may be fit to be interviewed, but only in the presence of an appropriate adult. Forensic physicians, psychiatrists, and psychologist are frequently called upon to assess these and other matters, such as ability to form intent to commit a crime.

Section 12
Section 12

A section 12 approved doctor is a medically qualified doctor who has been recognised under section 12(2) of the Mental Health Act 1983. They have specific expertise in mental disorder and have additionally received training in the application of the Act. They are usually psychiatrists, although some are general practitioners (GPs) who have a special interest in psychiatry.

Drugs
Drugs

The acute or chronic intake of licit and illicit drugs may have great relevance to matters in civil, family and criminal courts. Interpretation of the acute and long-term effects of specific illicit drugs (eg crack cocaine, heroin, mephedrone, LSD. amphetamines, khat, marijuana) may require a range of specialists including forensic scientists and toxicologists (to determine levels in body fluids), the forensic physician (to describe possible clinical effects) and the forensic pathologist (if drugs or alcohol have been implicated in death). A clinical pharmacologist may be required to determine the types of possible interaction of a range of prescribed drugs.

Neonatology
Neonatology

Neonatology is paediatric subspecialty that consists of the medical care of newborn infants, predominantly those who are sick or premature. Neonates are cared for in neonatal intensive care units (NICUs) until fit enough fpt discharge. Examples of conditions or types of illness that may lead to illness or prematurity include intrauterine growth retardation, congenital malformations (birth defects), sepsis, or birth asphyxias (eg delayed labour, or umbilical cord compression). Neonates are treated by specialist nurses and specialist doctors – neonatologists.

Assault
Assault

The assessment, documentation and interpretation of the type and nature of assault is generally best done by forensic physicians, in the living and forensic pathologists, for the deceased.

Child neglect
Child neglect

Child neglect reflects a particular aspect of child abuse. is the persistent failure to meet a child’s basic physical or psychological needs, likely to result in the serious impairment of the child’s health or development. It may involve a parent or carer failing to provide adequate food, shelter and clothing, failing to protect a child from physical harm or danger, or the failure to ensure access to appropriate medical care or treatment. It may also include neglect of, or unresponsiveness to, a child’s basic emotional needs.

Physiotherapy
Physiotherapy

Physiotherapy is a health care profession which addresses the physical treatment and management of disease or condition which enables people to reach their maximum potential. Physiotherapist diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions, illnesses, or injuries that limit their abilities to move and perform functional activities.

Clinical forensic medicine
Clinical forensic medicine

Clinical forensic medicine is the term which describes the medical specialty which deals with matters where medicine and law interact. Forensic physicians are doctors who practice clinical forensic medicine (forensic medicine of the living) and may be involved in many areas including healthcare of detainees in police custody; sexual offence examination; torture; driving under the influence; child abuse; sexual assault; police complaints and deaths in custody.

Lung function
Lung function

Lung function is important in lung disease. Respiratory physicians will interpret reasons for, and causes of altered lung function which may be relevant in employment tribunals and industrial setting where claims may be need suggesting that work or environment precipitated or aggravated worsening of lung function. Respiratory or forensic physicians may be asked to determine whether an individual’s ability to provide an evidential breath specimen was impaired.

Geology
Geology

Geology is the science that comprises the study of the solid Earth and the processes by which it is shaped and changed. Geology provides primary evidence for plate tectonics, the history of life and evolution, and past climates. Geology is commercially important for mineral and hydrocarbon exploration and for evaluating water resources; is publicly important for the prediction and understanding of natural hazards, the remediation of environmental problem and plays an essential role in geotechnical engineering.

Cot death
Cot death

Sudden Infant Death Syndrome (SIDS) – also known as ‘cot death’ or ‘crib death’ -is still the most common cause of death in the post-perinatal period in countries with a relatively low infant mortality rate. SIDS has been defined as ‘the sudden unexpected death of an infant <1 year of age, with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation, including the performance of a complete autopsy and a review of the circumstances of death and the clinical history'. Investigation of such deaths may involve criminal, family and criminal courts, each requiring expertise from a range of experts including pathologists, paediatricians, neonatologists, safeguarding teams and forensic physicians.

Environmental health
Environmental health

Environmental health is the branch of public health that is concerned with all aspects of the natural and built environment that may affect human health. These include both the direct pathological effects of chemicals, radiation and some biological agents, and the effects on health and wellbeing of the physical, psychological, social and aesthetic environment which includes housing, urban development, land use and transport

Death in custody
Death in custody

Death in custody (whether police, prison, army or other security setting) is a very emotive subject. Review is often required of the cause of death, the events leading up to the death, restraint methods used, prior medical history and actions of those in contact with the deceased. Proper investigation may require a range of experts including forensic physicians, forensic pathologists, restraint trainers and toxicologists.

Tourettes
Tourettes

Tourette’s syndrome is a ‘tic disorder’ characterised by physical and vocal tics. A small number of individuals with Tourette’s have a vocal tic which may use offensive, obscene or socially inappropriate language. Most commonly though, tics such as eye blinking, coughing, and sniffing may be present. Determination of diagnosis may require psychiatrists, psychologists and neurologists to differentiate the condition from other causes such as personality disorder.

Thermal injury
Thermal injury

Thermal injury may be caused in a range of settings, by accident, deliberately, in industrial settings. Burns vary in severity and the severity will determine the nature of treatmemt and management. The interpretation of burn types (eg liquid, fire, chemical) and patterns (eg accidental, non-accidental) is essential in both criminal and civil settings.

Bombs
Bombs

Ballistics is the specialty which explores the nature and effects of explosive projectiles (eg bullets, bombs) and can help determine issues such as the type of gun or actual gun used, type and amount of explosive. The physical effects of such weapons can be assessed by forensic physicians or forensic pathologists.

Hepatology
Hepatology

Hepatology is the branch of medicine that studies the liver, gallbladder, biliary tree, and pancreas. It may be practised by gastroenterologists or hepatologists. In legal settings, experts may frequently be required to provide information on the effects and consequences of diseases and complications related to viral hepatitis and alcohol.

Forensic Fire Investigation
Forensic Fire Investigation

A detailed and meticulous investigation to establish where, when and how a fire/explosion was started. Each investigation follows a structured process to ensure that all possibilities have been considered.

Arson
Arson

Investigation of arson may require fire specialists to determine the nature of and origins of the fire.; to establish the seat of the fire; to determine what accelerants were used; and to determnine whether burn injuries (to victims and alleged perpetrators) are consistent with accounts given.

Anthropology
Anthropology

Forensic anthropologists specialise in the study of origins of individuals and can identify individuals (both living and dead), in particular from bone characteristics. Anthropologists may be asked to age bones and can apply these principles to both the living and deceased. Age estimation is increasingly used by courts in both criminal, family law, and refugee & asylum settings.

Hospital care
Hospital care

An individual patient’s care in the hospital setting has the opportunity of being below standard throughout the care pathway. It is essential that an appropriate expert is identified who can explore the particular area of concerns in detail. It is important to have experts in all aspects of hospital care, including nurses, paramedics, clinicians or managers and to ensure that the most relevant experts pass opinion on the case in question.

Fitness for interview
Fitness for interview

Determination of whether an individual is fit to attend court, to be interviewed, to be detained in custody, to make a plea and to be sentenced may require physical, psychiatric and psychological assessments. Individuals may be fit for some of the above but not all. For example an individual may be mentally fit to plead, but not physically fit enough to serve a prison sentence; or someone may be fit to be interviewed, but only in the presence of an appropriate adult. Forensic physicians, psychiatrists, and psychologist are frequently called upon to assess these and other matters, such as ability to form intent to commit a crime.

Wounding
Wounding

The nature, type and interpretation of wounding, and its causes, lies within the realm of forensic physicians and forensic pathologists.

Parkinson’s disease
Parkinson’s disease

Parkinson’s disease is a degenerative disorder of the central nervous system. It is caused by the death of dopamine-containing cells in part of the midbrain; the cause of cell-death is unknown. Initial symptoms are movement-related, including shaking, rigidity, slowness of movement and difficulty with walking and gait. Later, cognitive and behavioural problems may arise, with dementia commonly occurring in the advanced stages of the disease. Diagnosis and treatment may the realm of the neurologist or of specialists in care of the elderly (dependent on age at diagnosis).

Flammable liquid analysis
Flammable liquid analysis

Review and contextualisation of analytical results in relation to the analysis of flammable liquids from debris and items taken from potential arson scenes.

PAVA spray
PAVA spray

PAVA spray is one of the incapacitant sprays used by law enforcement agencies. There are a broad range of complications ot effects of the assorted types of control or restraint techniques (eg manual, batons. other incapacitant sprays (eg CS), restraint belts or devices (eg Viper), and controlled electrical weapons). These must be deployed appropriately or complications may develop, or their incidences increase. Forensic physicians and pathologists, law enforcement personnel and clinicians may be required to put the findings after deployment into context.

Rheumatology
Rheumatology

Rheumatology is a specialty concerned with the diagnosis and management of conditions and diseases affecting joints, muscles, and bones. Rheumatologists deal mainly with clinical problems involving joints, soft tissues, autoimmune diseases, vasculitis, and connective tissue disorders. There is considerable overlap with immunology and orthopaedic surgery.

CS spray
CS spray

CS spray is one of the group of incapacitant sprays (including PAVA) which may be used by police and security forces as part of the Use of Force continuum. There are short term effects (which incapacitate – causing streaming and painful eyes and nose, and blepharospasm) and longer term complications which may include skin, respiratory and psychological problems. Medical and psychological specialists may be needed to determine causation and prognosis and the appropriateness of use.

Forensic anthropology
Forensic anthropology

Forensic anthropologists specialise in the study of origins of individuals and can identify individuals (both living and dead), in particular from bone characteristics. Anthropologists may be asked to age bones and can apply these principles to both the living and the dead.

Urology
Urology

Urology is the medical specialty addressing disease or injury to the male and female urinary systems including the kidneys, bladder, ureters, and prostate. The nature of expert required will be determined by the nature of the case (eg medical negligence, trauma, assault).

Dermatology
Dermatology

Skin disease, marks, scars, tattoos or other skin diseases or abnormalities may require a dermatologist to determine the possible diagnoses and advise on management and prognosis. Skin disease mimicking injury (eg in the genital area) after sexual assault may require interpretation by forensic physicians, genitourinary medicine specialists and dermatologists, each contributing from their own perspective.

Domestic assault
Domestic assault

Domestic assault resulting in inter-personal violence may result in physical injury, or no injury. The interpretation of different accounts to assist the court in determining the facts of the case may require interpretation from a forensic physician, whilst the presence of drugs or alcohol and questions about causation of injury may require additional specialists such as toxicologists or general physicians.

Vascular
Vascular

The body’s blood supply flows through a series of arteries and veins of different sizes pumped by the heart. Damage to the blood vessels may be caused by trauma and disease. Medical assessment may be required to interpret damage to blood vessels. The nature of the case (eg assault. medical negligence) will determine the type of opinion required – eg vascular surgeon, forensic physician.

Medical records assessment
Medical records assessment

Documentation, storage and monitoring of medical records are all subject to laws and regulations. Access to such records is limited and defined. Breaches of the laws and regulations require identification. If medical records are being utilised in court cases, specialised personnel may be required to ensure that the lay out and format of the notes provided are consistent, so that relevant chronologies and actions can be easily identified by detailed pagination.

Alcohol back-calculations
Alcohol back-calculations

Often a requirement in cases involving post-incident drinking or unintentional consumption of additional alcohol in road traffic offences, such calculations can be very complex and require the services of experts in the field. Could the post-incident drinking or additional alcohol have made the difference between being above the prescribed limit (80mg% blood, 35ug% breath) at the time, with the motorist facing a 12-month or longer ban, or being below the limit? Forensic Toxicologists can provide this expertise.

STD
STD

The diagnosis and management of Sexually Transmitted Disease lies within the realm of the genitourinary medicine (GUM) specialist. Much assessment and management of complainants of sexual assault is now based in GUM centres – in special Sexual Assault Referral Centres (SARC). The relevance of STD findings may be significant in adults and children requiring the opinions of GUM physicians, forensic physicians, virologists and paediatricians.

Intensive care
Intensive care

The Intensive Care Unit (ICU) sometimes known as Critical Care or Intensive Therapy is the setting within hospital where seriously ill patients received the highest level of supportive nursing and medical care. ICUs are run by ICU specialists or anaesthetists drawing on the expertise of all other specialties. Because patients are so ill, deaths or complications are common, and it is important for families to be able to be reassured that care has been given appropriately, and when not, for this to be identified.

Intoximeter
Intoximeter

The term intoximeter generally refers to all devices that are used to determine an individual’s breath alcohol levels. Expertise may be required at a scientific level to ensure that the device used was functioning properly, and at a medical level, to identify whether any medical issues may have affected the results.

Accident investigation
Accident investigation

Determination of causes of road traffic collisions, industrial and factory accidents is a complex field. We are able to advise and locate the expert appropriate to the type of accident requiring investigation.

Stomach contents
Stomach contents

Post-mortem analysis of stomach contents may be useful in confirming an individuals previous movements and actions prior to death, or assist in providing a range of possible times of death. Such determinations may requires the skills of the forensic pathologist, forensic scientists and gastroenterologist.

Incapacitant spray
Incapacitant spray

The immediate effects of different types of incapacitant spray, the appropriateness of use, the legality of use are examples o issues that frequently arise whne such sprays are discharged, whether in private or law enforcement settings.

Orthopaedic
Orthopaedic

Orthopaedic surgery is the branch of surgery concerned the musculoskeletal system. Orthopaedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma, sports injuries, degenerative diseases, infections, tumors, and congenital disorders. Orthopaedic surgeons may undertake all types of joint replacement and spinal surgery. Many focus on one particular aspect of the musculoskeletal system, eg the hand.

Injury causation
Injury causation

Injury causation is a crucial element of many criminal and civil cases. The effects and prognosis from injury, and any alternative possibilities may require a range of experts including forensic pathologists, forensic physicians, emergency physicians and forensic scientists (to link weapons with specific injury).

Firearms/ammunition
Firearms/ammunition

The examination and classification of firearms and ammunition to determine whether they fall under the Firearms Acts; this includes rifles, pistols, revolvers, shotguns, machine guns, air pistols and air rifles, pyrotechnics, stuns guns, and chemical weapons (e.g. CS and pepper sprays), and improvised firearms

Entomology
Entomology

Forensic entomology is the use of insects to assist in legal investigations, the vast majority of which are suspicious deaths or murders. Insect analysis can assist in answering questions such as; the estimated post-mortem interval (PMI); whether or not a body has been moved from one location to another; whether a body has been moved between a concealed and exposed environment; issues of abuse and neglect and public health issues.

Refugees
Refugees

The medical and psychological assessment of refugees and those claiming asylum is a complex area, requiring input of a range of specialists including forensic physicians, psychiatrists and psychologists, whose aim is to determine what features are as a result of the possible abuse suffered which has resulted in the individual having refugee or asylum-seeking status. The Istanbul Protocol is a useful guide in assessing such individuals.

Footprints
Footprints

When footwear comes into contact with a surface it often leaves an impression.The resulting footwear impression can be photographed, lifted using a variety of mediums or it can be recovered whole, marks on paper for example, and submitted to a laboratory for some method of enhancement. When footwear contact is made with a person with a degree of force, by kicking or stamping, then skin deposits may be transferred to the inner surface of clothing whilst next to the skin.When forceful contact is made directly to the surface of the skin, it is possible that patterned bruising may be left on the skin forming a mark characteristic of the surface that made the contact. Footwear specialists can identify and relate patterns to marks seen, identifying or excluding certain individuals.

Dentistry
Dentistry

Dentists may be required to assess injury to teeth, or compare possible new injury to previous dental work, or to determine whether apparent injury is caused by natural disease (eg caries or gingivitis). Dentists may also be required to assess claims of personal injury or professional negligence for issue such as dental implants, tooth extraction and orthodontic treatments.

Taser
Taser

The increasing use of Taser as part of the Use of Force continuum results in increasing numbers of injuries or death associated with such use. The interpretation of causation of injury or death using a device with a number of well recognised primary (eg barb injury) and secondary (eg head injury, vertebral fracture) complications is one that may require the expertise of those including cardiologists, physiologists, toxicologists, forensic pathologists and forensic physicians.

Forensic pathology
Forensic pathology

Forensic pathology investigates causes of sudden, unknown, unnatural or violent death by undertaking post-mortems and taking relevant samples, including histology and toxicology. Many forensic pathologists have may have particular interests specific fields such as cardiac pathology, injury causation and time of death.

Devices
Devices

Examination and evaluation of petrol bombs and incendiary devices that are subject to the 1883 Explosive Substances Act, section 3b. Devices can be examined, reconstructed where necessary, and their viability assessed.

Post-Traumatic stress disorder
Post-Traumatic stress disorder

Posttraumatic stress disorder PTSD) is a severe anxiety disorder which may develop after exposure to any event that results in psychological trauma.This event may involve the threat of death to oneself or to someone else, or to one’s own or someone else’s physical, sexual, or psychological integrity. Diagnostic symptoms for PTSD include re-experiencing the original trauma(s) through flashbacks or nightmares, avoidance of stimuli associated with the trauma, and increased arousal – such as difficulty falling or staying asleep, anger, and hypervigilance.

Gas/Vapour Explosions
Gas/Vapour Explosions

Investigation of deflagrations such as mains gas and flammable liquid vapour explosions including those incidents associated with LPG.

Drink & drugs
Drink & drugs

The acute or chronic intake of both alcohol and other substances may have great relevance to matters in civil, family and criminal courts. Interpretation of the acute and long-term effects of alcohol and substances may be the role of a range of specialists including forensic scientists and toxicologists (to determine levels in body fluids), the forensic physician (to describe possible clinical effects) and the forensic pathologist (if drugs or alcohol have been implicated in death).

Endocrinology
Endocrinology

Endoctrinologists specialise in the study and treatment of organs in the body which produce physiologically active substances (hormones) that are vital to normal life. These include conditions of the thyroid, pituitary and adrenal glands. Endocrinologists identify disorders and manage treatment. These are complex areas, where missed or wrong diagnoses can have catastrophic consequences and as such may involve doctors in both criminal and civil courts related to medical negligence. Some endocrine disorders may affect individual’s behaviour and may provided defences or mitigation in criminal courts.

Expert opinion
Expert opinion

An expert witness is an individual who has specific areas of expertise in which he or she is able to give an opinion to a court or tribunal in order to allow the court or tribunal to come to an appropriate decision. There is no specific definition of an expert, but expertise develops variably from a range of factors such as practical experience in the field, a comprehensive understanding of the relevant literature, the publication of peer-reviewed research, publication of textbooks. An expert has a number of duties which have been identified in court cases, – a duty to the court (not to whoever is instructing and paying), a duty to be prepared to revise opinions if new, or different evidence becomes available and a duty to stay within his or her area of expertise.

Appliance Examination
Appliance Examination

Gas, electric and liquid fuel appliances are a potential cause of fire and sometimes need to be examined for evidence of faults or misuse.

Facial mapping
Facial mapping

There are a number of techniques if facial mapping which can assist in identifying individuals by analysing and comparing and comparison of two or more moving or still facial images and determining if they are the same individual. These may originate from a variety of sources including CCTV footage, digital or analogue photographs, and determining through the identified characteristics, similarities and resemblances. In criminal cases the technique can be used to identify individuals or eliminate them from enquiries.

Trichology
Trichology

Trichology is the study of hair. This may be undertaken by those solely trained in this specialty – who are not medical practitioners (although some medical specialists, eg dermatologists, may be skilled in certain aspects of trichology such as haire loss) and may include scientists who can analyse hair samples for the presence and timimg of drug and other substance intake. Concern should be raised about those who appear to be able to determine multiple characteristics from hair samples. This is an area rife with possible ‘pseudo-science and medicine’.

Handwriting
Handwriting

Questioned document examination (QDE) is the forensic science discipline relating documents that are (or may be) in dispute in a court of law. The purpose of questioned/forensic document examination is to answer questions about a disputed document using a variety of scientific processes and methods and the most common type of examination involves handwriting wherein the examiner tries to address concerns about potential authorship.

Asthma
Asthma

Asthma and other respiratory conditions may be relevant in many settings including, occupational health (eg cause of asthma, fitness to work) and criminal law (ability to provide an evidential breath specimen). The nature of the case may alter the type of expert required (eg respiratory vs forensic physician).

Psychotherapist
Psychotherapist

Psychotherapy, or personal counseling is an intentional interpersonal relationship used by trained psychotherapists to aid a client or patient in problems of living. Psychotherapists have a variety of backgrounds such as psychology, social work, general practice and psychiatry and work in a range of different problem areas. Regulation of psychotherapists is variable and may depend upon their professional background.

Forensic medicine
Forensic medicine

Forensic medicine embraces both clinical aspects and legal aspects of forensic issues related to medicine. Clinical aspects of forensic medicine include wound causation, sexual offences, child abuse and neglect, driving under the influence of drugs and alcohol, drug and alcohol misuse, fitness to detain in custody, fitness to interview and fitness to plead or serve a sentence.

Maxillo-facial
Maxillo-facial

Oral and maxillofacial surgery is surgery to correct a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. Many oral and maxillo-facial surgeons are dually qualified in medicine and dentistry.

Gait Analysis
Gait Analysis

Is the study of an individual’s gait. Identification of an individual can be determined from the characteristics of their gait.

Sperm count
Sperm count

Analysis of semen and sperm contained within may have relevance in many settings eg paternity suits, failed vasectomy, sexual assault allegation. Expertise that may be required may include that of the forensic scientist to physically identify specimens, do DNA analysis, and forensic physicians , urologists and fertililty experts to interpret the findings within the relevant setting.

Instanbul protocol
Instanbul protocol

The Manual on Effective Investigation and Documentation of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (known as the “Istanbul Protocol”) is the first set of international guidelines for documentation of torture and its consequences. It became a United Nations official document in 1999 and is available in a number of languages on the United Nations web site. The Istanbul Protocol provides a set of guidelines for the assessment of persons who allege torture and ill treatment, for investigating cases of alleged torture, and for reporting such findings to the judiciary and any other investigative bod

Computers
Computers

The analysis and interpretation of computer data are complex areas requiring those skilled in interrogating data from all computer disc sources. The recovery of hidden files and data are an important part of the role of the forensic computer specialist.

Bullet comparison/gunshot wounds
Bullet comparison/gunshot wounds

The examination of post-mortem evidence (gunshot wounds) and the examination of crime scenes, clothing, vehicles etc for gunshot damage and gunshot residues to determine how they occurred and from that reconstruct the shooting incident; this can involve ballistics and trajectory calculations.

Firearms legislation
Firearms legislation

Determine whether the article is a ‘firearm’ at all – is it capable of discharging a missile with lethal potential? – and if so, whether it is exempt from controls (is it an antique firearm) or whether it is a ‘prohibited weapon’ thus attracting a mandatory five year sentence.

Toxicology
Toxicology

Toxicologists study the effects of drugs (legal and illegal) and other chemicals, including poisons on the body. In the legal setting they may be asked a variety of questions – eg to determine the effect of a given amount of a drug at a given time, or the likely level of a drug at the time of an offence, or the effects of one drug upon another. These roles overlap and complement the roles of physicians and clinical pharmacologists.

Gynaecology
Gynaecology

Gynaecology is the medical practice dealing with the health of the female reproductive system (uterus, vagina, and ovaries). Gynaecologists may be required to explore questions of medical negligence (eg after treatment for uterine cancer, or a hysterectomy) or appropriateness of treatment. Some (forensic gynaecologists) have particular interests in examination and findings after sexual assault.

Neurophysiologist
Neurophysiologist

Neurophysiology is the specific study of physiological primciples applued to the nervous system. It is a medical specialty which investigates neurological diseases, in order to elucidate changes in nerve activity and neuromuscular damage and make diagnoses of conditions affecting the nervous system. Examples of conditions dealt with include neuromuscular diseases, epilepsy and peripheral nerve lesions (eg carpal tunnel syndrome).

Diabetes
Diabetes

The management of the diabetic patient, from initial diagnosis through to treatment and long-term management is a complex area. The effects of medications on diabetic status, and the effects of aberrant glucose levels (eg hypoglycemia or hyperglycemia) may have relevance in criminal case (eg driving under the influence) and on an individuals fitness to be detained or interviewed. Diabetic conditions may cause behaviour including apparent drunkenness or aggression that needs clinical assesment by a range of specialists.

Intermediary
Intermediary

The role of an Intermediary is to assist vulnerable people in the judiciary system and are allowed to explain the questions or answers so far as is necessary to enable them to be understood by the witness or the questioner but without changing the substance of the evidence.

Registered Intermediaries are not investigators and their role is not the same as appropriate adults, witness supporters or expert witnesses.

Driver Distraction
Driver Distraction

Driver distraction is an established contributory factor in road crashes. Factors such as mobile phone use, changing of CDs, eating or smoking while on the move can be an important causative factor in these cases. Such factors are often confused with “impairment” resulting from alcohol or drug use or driver sleepiness / fatigue. The mechanisms, duration and effects are however, very different and the seeking of forensic advice in such cases is very desirable.

Bones
Bones

Examination of bones and X-rays may be required to determine type and nature and causation of bony injury. This may require forensic physicians, or orthopaedic surgeons or radiologist dependent on the nature of information required. Forensic anthropologists may examine bones and X-rays to determine identification and age.

Emergency medicine
Emergency medicine

Emergency medicine (previously known as accident and emergency medicine, or ‘casualty’) is the hospital specialty that deals with acute medical and surgical emergencies and trauma. Most emergenct departments will have a substantial volume of patients presenting with conditions that should be dealt with by the family doctor. Emergency medicine specialists may be required to assess a variety of issues with regard to courts including appopriateness of treatment, missed diagnoses, injury causation, management and prognosis.

Engineering
Engineering

Engineering is a very broad area encompassing design, structure and function of materials and how they are used. Structural or material failure, design faults, industrial accidents are examples of areas where engineering opinion must be sought to establish causes and outcomes.

Neuropsychiatry
Neuropsychiatry

Neuropsychiatry is the branch of medicine dealing with mental disorders caused by diseases of the nervous system. It is a subspecialty of psychiatry and is related to behavioral neurology, which itself is a subspecialty of neurology which addresses clinical problems of cognition and behavior caused by brain injury or brain disease. Neuropsychiatric disorders may account for and act as defences, or mitigating factors for issues that arise in criminal and civil courts.

Acoustic
Acoustic

Determination of legally acceptable sound levels, the effects these may have on individuals and how they may be assessed may require scientists, audiologists and medical practitioners. It is important to know which of these specific specialists may be required to assist the case. We can identify the expertise required and provide an expert to provide reports.

Pharmacology
Pharmacology

Pharmacology is concerned with the study of drug action. It is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function. If substances have medicinal properties, they are considered pharmaceuticals. The field encompasses drug composition and properties, interactions, toxicology, therapy, and medical applications. The two main areas of pharmacology are pharmacodynamics and pharmacokinetics. The former studies the effects of the drugs on biological systems, and the latter the effects of biological systems on the drugs.

Cardiac
Cardiac

Cardiac experts may be needed in a variety of setting. These include making diagnoses, determining appropriate treatment for heart conditions, assessing treatment undertaken for heart conditions, determining whether collapse is caused by heart or other issues.

Fitness to sentence
Fitness to sentence

Determination of whether an individual is fit to attend court, to be interviewed, to be detained in custody, to make a plea and to be sentenced may require physical, psychiatric and psychological assessments. Individuals may be fit for some of the above but not all. For example an individual may be mentally fit to plead, but not physically fit enough to serve a prison sentence; or someone may be fit to be interviewed, but only in the presence of an appropriate adult. Forensic physicians, psychiatrists, and psychologist are frequently called upon to assess these and other matters, such as ability to form intent to commit a crime.

Aspergers
Aspergers

Asperger syndrome is one of the disorders which are part of the autism disorder spectrum (ASD). The assessment and management of those with possible or diagnosed Asperger’s or Asperger’s like syndrome may require psychiatric and psychological assessments, in addition to physical needs and abilities determinations. Assessmentts may need to determine issues such as fitness to carry out actions, ability to form intent and fitness to plead.

Carpel Tunnel Syndrome
Carpel Tunnel Syndrome

Carpel Tunnel Syndrome (CTS) –

CTS is a painful condition of the hand and fingers caused by compression of a major nerve where it passes over the carpal bones through a passage at the front of the wrist. It may be caused by continual repetitive movements or by fluid retention.

Restraint
Restraint

Many types of restraint are available in the law enforcement setting and represent part of the Use of Force continuum. Techniques to control individuals may include, verbal, manual, batons. incapicitant sprays, restraint belts or devices (eg Viper), and controlled electrical weapons (eg Taser). Each of these must be deployed appropriately. Forensic physicians and pathologists, law enforcement personnel and clinicians may be required to comment when any of these are deployed and complications of fatalities ensue.

Restraint injury
Restraint injury

There are a broad range of complications ot effects of the assorted types of control or restraint techniques (eg manual, batons. incapicitant sprays, restraint belts or devices (eg Viper), and controlled electrical weapons). These must be deployed appropriately or complications may develop, or their incidences increase. Forensic physicians and pathologists, law enforcement personnel and clinicians may be required to put the findings after deployment into context.

Medical records pagination
Medical records pagination

Documentation, storage and monitoring of medical records are all subject to laws and regulations. Access to such records is limited and defined. Breaches of the laws and regulations require identification. If medical records are being utilised in court cases, specialised personnel may be required to ensure that the lay out and format of the notes provided are consistent, so that relevant chronologies and actions can be easily identified by detailed pagination.

ENT
ENT

Ear, nose and throat (ENT) specialists (also known as otorhinolaryngologists) have specific interests in diseases and disordeds of ear, nose and throat which have close relationships anatomically. Conditions of these areas may mimic other disease and proper diagnosis and management of such diseases is essential for an individual’s well-being. Missed diagnoses can have severe long-term consequences. Tumours and trauma are frequently seen and the causation and treatment may need to be scrutinised to assist courts in coming to proper determinations.

Fingerprints
Fingerprints

The theory that fingerprints are unique to each person that enabled them to become one of the primary methods by which identifications of suspected offenders were made. Fingerprints have been used for many years to identify individuals, and, for example, have been known to confirm identity by the Chinese in the 3rd century. Interpretation of fingerprints is a mixture of science and art, and such evidence has been challenged in court. Fingerprint examiners may be required to review and interpret prints, partial prints and recovered prints to assist in identifying or excluding individuals linked to crime scenes.

Hand Arm Vibration Syndrome
Hand Arm Vibration Syndrome

Hand Arm Vibration Syndrome (HAVS) –

Otherwise known as Vibration White Finger (VWF) affects hundreds of workers every year.  Caused by over-exposure to vibrating tools, damage is caused to the nerves, blood vessels and joints of the hand, wrist and arm.  HAVS is preventable, but once the damage is done, it is irreversible. Over-exposure to vibrating tools and machines can also cause Carpel Tunnel Syndrome (CTS).

Water fluoridation
Water fluoridation

Water fluoridation (the introduction of fluoride to water supplies) is a public health measure designed to improved dental health and reducing dental caries. There is controversy as to whether this approach us correct and a number of groups campaign against it. Fluoride can cause tooth changes in growing teeth. Dentists or forensic odontologists may be asked to review or interpret abnormalities in teeth.

Surgery
Surgery

Surgery is the broad medical specialty that uses operative manual and instrumental techniques to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance, and sometimes for religious reasons. Experts may be required in the various surgical specialties to interpret injury, to determine whether surgery was necessary, or to determine whethre it was carried out appropriately.

Audiology
Audiology

Hearing loss may be caused by many factors, professional, industrial, traumatic and recreational (eg listening to heavy metal music). Assessments may determine causation and also allow a determination of what work or activities may be continued or avoided, and the severity and nature of the hearing loss.

CCTV
CCTV

The analysis and enhancement of CCTV images in order to undertake function such as identification of individuals or corroborating other evidence is an important one in many cases. The appropriate presentation and validation for court is crucial in determining proper outcome of cases.

Chest physician
Chest physician

A chest or respiratory physician specialises in the diagnosis and treatment of respiratory disease. They may assess lung function (for criminal or civil cases) and may be asked to determine causes of respiratory disease such as silicosis, asbestosis and asthma and whether they may be caused by occupational or industrial factors.

Multiple sclerosis
Multiple sclerosis

Multiple sclerosis is a progessive relapsing and remitting neurological condition generally resulting in progressive loss of function and movement and other neurological symptoms which may mimic other conditions . It is also associated with sensory changesm, such as numbness. Its diagnosis and management lies initially within the expertise of neurologists.

Whiplash
Whiplash

Whiplash injury is typically caused by direct impact car accidents as a result of rapid flexion/extension of the neck. Its assessment requires detailed examination and documentation. It is frequently claimed in car accidents. Assessments are best undertaken by orthopaedic surgeons, emergency physicians and forensic physicians.

Drug deaths
Drug deaths

Not all such deaths are straightforward and all should be thoroughly investigated. Testing may sometimes be done at non-accredited laboratories, sometimes not to a forensic standard and with minimal interpretation of results. Incorrect conclusions can be reached and crimes missed. Detailed analysis and interpretation can be supplied by Forensic Toxicologists and Pathologists and such cases can result in civil actions, for example where negligence may have contributed to death.

Head and neck
Head and neck

Expertise required to assess injuries or diseases to to the head and neck embrace a huge range of potential expertise, including maxillofacial surgeons, neurosurgeons, plastic surgeons, oncologists and forensic physicians and pathologists, dependent on the legal need. Determining the correct specialist is crucial in ensuring best suppor for a legal case.

Drink Driving
Drink Driving

Drink driving law is now well established. However, issues still remain which may benefit from forensic enquiry. The Government is considering scrapping the law which allows the motorist to opt to give an alternative blood or urine sample if an evidential breath test gives a reading below 50 micrograms per 100ml of breath. In addition, the seeking of expert forensic advice may be beneficial if a blood sample is required to be given in hospital or a sample is given some time after a road traffic incident, which then requires back calculation of a blood alcohol level.

Ophthalmology
Ophthalmology

Ophthalmology is the branch of medicine which deals with the anatomy, physiology and diseases of the eye. The term ophthalmologist refers to a specialist in medical and surgical eye problems. They may have to deal with congenital, and acquired and traumatic problems, including cataract, retinal tears, diabetic changes, penetrating wounds and glaucoma.

Non-accidental injury
Non-accidental injury

The determination of whether an injury or a scar, or group of injuries or scars, was as a result of accident, sport or play, or caused by another in an assaultative or abusive manner is a crucial element of many cases in criminal, family and other civil courts. Experts who determine such causation include forensic physicians and pathologists, and paediatricians.

Medical negligence
Medical negligence

Medical malpractice is professional negligence by act or omission by a health care provider in which care provided deviates from accepted standards of practice in the medical community and causes injury or death to the patient, with most cases involving medical error. Standards and regulations for medical malpractice vary by country and jurisdiction within countries. Key judgements refine and develop how medical negligence may be determined. The link between outcome and what was, or wasn’t done, are crucial elements in determining liability. It is essential that appropriate experts are identified relevant to the particular area of possible negligence.

Oncology
Oncology

Oncology is that branch of medicine which studies, diagnoses and manages cancers and other tumours (growths). Many cancers and other tumours may be treated by other specialties (eg colorectal surgeons). Oncologists tend to become involved either in those cases which are complex, or rare, or which are not amenable to simple surgical resection.

Immunology
Immunology

Immunology is the branch of biomedical science that covers the study of the immune system in all organism. It deals with the physiological functioning of the immune system in states of both health and disease; malfunctions of the immune system in immunological disorders (autoimmune diseases, hypersensitivities, immune deficiency, transplant rejection); the physical, chemical and physiological characteristics of the components of the immune system. Expertise may be required to determine whether immunological issues are present and whether these are caused by extraneous factors eg poisoning or exposure to radiation.

Ballistics
Ballistics

Ballistics is the specialty which explores the nature and effects of explosive projectiles (eg bullets, bombs) and can help determine issues such as the type of gun or actual gun used, type and amount of explosive. The physical effects of such weapons can be assessed by forensic physicians or forensic pathologists.

Haematology
Haematology

Haematology is concerned with the study of blood, the blood-forming organs, and blood diseases. Hematology includes the study of aetiology, diagnosis, treatment, prognosis, and prevention of blood diseases. Blood diseases affect the production of blood and its components, such as blood cells, hemoglobin, blood proteins, the mechanism of coagulation. Haematologists undertake the care and treatment of patients with haematological diseases.

Hospital procedure
Hospital procedure

An individual patient’s care in the hospital setting has the opportunity of being below standard throughout the care pathway. It is essential that an appropriate expert is identified who can explore the particular area of concerns in detail. It is important to have experts in all aspects of hospital care, including nurses, paramedics, clinicians or managers and to ensure that the most relevant experts pass opinion on the case in question.

Allergies
Allergies

Allergies to naturally occurring or other substances may result in many types of symptoms, often of the skin or respiratory systems. Other systems may be affected, such as the gastrointestinal tract. In some cases death may be caused by anaphylaxis. A range of specialists may be required to determine whether allergies have caused symptoms, what the long-term effects may be, and this may impact on work or sports or other activities. Dermatologists, respiratory physicians and general physicians may frequently see allergy symptoms. Immunologists may be required to determine the specific link between an agent and a response. Occupational health physicians may be required to give opinions on work-related issues.

Weapons
Weapons

Guns, baseball bats, knuckledusters, knives, controlled electrical devices are examples of weapons that may cause injury. Forensic physicians, forensic pathologists and emergency physicians have particularn skills in assessing, identifying a wide range of weapons capable of causing injury.

GMC
GMC

The General Medical Council is the professional body of registered medical practitioners (doctors) in the UK. Doctors against whom complaints of medical negligence are made or whose performance is questioned, may require expert professionals to review their actions within an appropriate context by doctors of similar experience.

Music piracy
Music piracy

The use of social media and the internet have increased the possibility of music piracy, which had already developed with the use of CDs and DVDs and memory sticks. Protection of copyright and proof of ownershop, permission status and related issues are complex areas of law. The interpretation of possible music plagiarism requires specialist musical knowledge.

Marine survey
Marine survey

Boats, yachts and other motor or sailing vessels need to comply with a variety of statutes and regulations dependent on the nature of their use (recreational vs business), their size and the area within which they work. Marine surveyors are able to determine whether such regulations and statutes are observed, and whether build standards are appropriate.

Penile dysfunction
Penile dysfunction

Penile (or erectile) dysfunction (impotence) is caused by a variety of physical and psychological factors. It may be caused by medical treatment, or disease such as diabetes, or advancing years. Assessment of such dysfunction may be undertaken by urologists, who can show that penile erection is possible, but cannot determine what the psychological effects may be. The issue is often used as a defence in sexual assault cases, and it is important that a full assessment of the relevant individual is undertaken in the context of their general health.

Forensic psychology
Forensic psychology

Psychology is the science of mind and behavior. Its immediate goal is to understand behavior and mental processes by researching and establishing both general principles and specific cases. Psychologists attempt to understand the role of mental functions in individual and social behavior, while also exploring the physiological and neurobiological processes that underlie certain functions and behaviors. Psychologists explore such concepts as perception, cognition, attention, emotion, phenomenology, motivation, brain functioning, personality, behavior, and interpersonal relationships. Forensic psychology is the intersection between psychology and the criminal justice system. It involves understanding criminal law in the relevant jurisdictions in order to be able to interact appropriately with judges, attorneys and other legal professionals

Sexual offences
Sexual offences

The examination, documentation, and forensic sampling of complainants and defendants in sexual assault cases are crucial to the integrity of the case. Accepted guidelines are available to identify appropriate standards in these areas. Experts must be able to relate current known factors of findings after sexual assault to individual cases. Most frequently this is undertaken by forensic physicians.

Animals
Animals

Animal expertise may be required in a wide range of civil and criminal cases and may involve both vets and doctors. Examples of areas where skills may be required include the determination of whether bites have been caused by a particular animal, the true identity of an animal, animal behaviour and mis-selling of animals, maltreatment of animals and doping in animals.

Personal injury
Personal injury

Personal injury is a legal term for an injury to the body, mind or emotions, in cod to an injury to property. The term is most commonly used to refer to a type of tort lawsuit alleging that the plaintiff’s injury has been caused by the negligence of another. The most common types of personal injury claims are road traffic collisions, accidents in the workplace, tripping accidents, assault claims, accidents at home, and product liability). The term personal injury also incorporates medical and dental accidents (which may be caused by medical or dental negligence claims) and diseases which may be classified as industrial such as asbestosis and mesothelioma, , emphysema, pneumoconiosis and silicosis. vibration white finger, deafness, repetitive strain injury (RSI) and contact dermatitis.

Colorectal
Colorectal

Colorectal surgeons specialise in the surgical treatment of diseases such as rectal or colonic cancer and conditions such as inflammatory bowel disease (Crohn’s disease, ulcerative colitis). As these may be treated in a number of ways, the appropriateness of such treatment may be relevant in cases where medical negligence is possible.

Paediatrics
Paediatrics

Paediatricians are involved in the study of, assessment, diagnosis and care of children. Many are based in the community and are linked closely to schoold. Paediatricians have a particular role in safeguarding children and may be asked to assess for neglect or non-accidental injury or child physical or sexual abuse. Paediatricians often work closely with forensic physicians on such cases, providing expert evidence for criminal, civil and family courts.

Temperature Measurements
Temperature Measurements

Electrical appliances produce heat that can be sufficient to cause burns. The temperature these and other appliances reach can be measured and this information passed to burns specialists to evaluate the potential effect on an individual.

Biochemist
Biochemist

Biochemists study chemical processes in the living body. In the legal setting biochemist may be required to assess effects of drugs on the body and how the body responds and interpret blood test results. There is considerable overlap with clinical toxicologists and clinical pharmacologists. Physicians may also be required to interpret the clinical effects of drugs and others substances.

DNA
DNA

DNA is a biological profile that can identify individuals. Analysis of biological samples (eg blood, semen) can identify if contact has taken place. When there is a partial profile, this can be used to compare with reference samples and a statistic can be provided as to the likelihood of a match with known people. Within most cells in the body there is the nucleus containing 23 pairs of chromosomes. Half of these are inherited maternally and half paternally. The same, or different form of each complementary area on each paired chromosome (with the exception of the sex chromosomes) may be inherited. DNA is also present on mitochondria within cells; this is inherited through the maternal lineage. Analysis may be need to be undertaken primarily or if results are questioned. The interpretation of the presence of DNA may require the expertise of forensic scientists, forensic physicians or forensic pathologists.

Telephones
Telephones

Analysis of usage of mobile phones and accessing of data stored on phones and SIM cards is often a crucial part of criminal and civil investigation. Specialists utilise software programs to access and extract relevant data such as contact lists, deleted texts, deleted voice messages and deleted usage histories.

RTA reconstruction
RTA reconstruction

Reconstruction of road traffic collisions has great relevance in determining causes of crashes and may have relevance to insurance claims and liability, determination of damages in civil settings and determination of pleas in criminal courts. Road traffic investigators are highly skilled, many working with, or having worked for police services.

Alcohol
Alcohol

The scientific determination of alcohol levels in biological samples, eg blood, urine and breath may be used widely in criminal investigations. Robustness of technique, quality assurances and scientific interpretation are crucial in cases. Backtracking techniques to determine alcohol levels at a previous time may be important in either proving or disproving Road Traffic Act cases. These require forensic scientists or toxicologists. The effects of alcohol on a person’s behaviour, and how it may be affected by other prescribed medication or illicit drugs, is an area interpreted by medical practitioners such as forensic physicians.

Critical care
Critical care

SIDS has been defined as ‘the sudden unexpected death of an infant <1 year of age, with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation, including the performance of a complete autopsy and a review of the circumstances of death and the clinical history

Forensic physicians
Forensic physicians

Forensic physicians practice forensic medicine embraces both clinical aspects and legal aspects of forensic issues related to medicine. Clinical aspects of forensic medicine include wound causation, sexual offences, child abuse and neglect, driving under the influence of drugs and alcohol, drug and alcohol misuse, fitness to detain in custody, fitness to interview and fitness to plead or serve a sentence.

Nurse/nursing home
Nurse/nursing home

As with medical specialties, there are a wide range of skill levels and expertise that apply to nursing care. Where questions about standards of care are raised, whether in hospital, in the community or in a nursing home, it is crucial to ensure that a nursing professional with the appropriate skills assesses the case in question.

Forensic psychiatry
Forensic psychiatry

Forensic psychiatry is a sub-speciality of psychiatry. It encompasses the interface between law and psychiatry. A forensic psychiatrist provides services – such as determination of competency to stand trial – to a court of law to facilitate the judicial process. Forensic psychiatrists work with courts evaluating an individual’s competency to stand trial, defences based on mental diseases or defects (e.g., the “insanity” defense), and sentencing recommendations. There are two major areas of criminal evaluations in forensic psychiatry. These are Competency to Stand trial (CST) and Mental State at the Time of the Offence (MSO).

Vehicles
Vehicles

Road traffic collisions may be caused by a number of factors – eg driver error, drugs and alcohol, mechanical failure, behaviour of other drivers. Assessments may need to be made by traffic investigators looking at the mechanics of the event. Medical opinion may be required to determine nature of injuries or infuence of factors such as disease, drugs or alcohol.

Respiratory medicine
Respiratory medicine

Respiratory medicine is a medical specialty dealing with the diagnosis and management of disorders of the lungs and associated respiratory tract. Respiratory medicine specialists may be required to determine, for example, whether respiratory disease has been caused due to environment or work place, or to determine whether lung function is adequate to produce an evidential sample of breath. Examples of diseases encountered include lung cancer, chronic obstructive pulmonary disease, asthma, tuberculosis and asbestosis.

Biology
Biology

Biologists study living organisms. In the forensc setting biological principles are applied to matters of law by examining and comparing samples of substances sucj as blood, semenm saliva, skin cells and hair. Much of this work may involve the analysis of DNA.

Elderly
Elderly

With an increasingly aged population conditions associated with ageing (eg Alzheimer’s disease, loss of mobility) may reqyuire assessment for issues such as care needs, or mental capacity. Many elderly adults are vulnerable, both mentally and physically, making them targets for neglect and abuse. A multiprofessional team (including nurses and doctors) may be required to determine their needs, and how (and if) they are being appropriately addressed.

Radiologist
Radiologist

It aims to increase the individual’s sense of their own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change that are designed to improve the mental health of a client or patient, or to improve group relationships (such as in a family).

Tissue viability
Tissue viability

Determination of tissue viability (the ability of tissue such as skin to remain healthy) depends on many factors. The development of skin ulcers and pressure sores are areas that are of great relevance in the care of the elderly and other vulnerable individuals. Development of such areas may be caused by medical issues, nutrition, medications or standards of care. Assessments may be required by physicians, nurses and others experienced in the care or treatment and management of such individuals.

Heat Damage to Clothing/Footwear
Heat Damage to Clothing/Footwear

Examination and evaluation of damage to a garment caused by the exposure to an undefined heat source. Differentiation between the heat damage caused by the ignition of a flammable liquid, manufacturer’s finish, tumble drying, hot working, cigarette burns, old and new damage.

Liver
Liver

The liver is the largest solid organ in the body. It is subject to trauma and disease. As the liver is a single organ, damage to the liver may result in significant morbidity, or death. Dependent on the nature of the case, a variety of specialists may be required to provide expert opinion.

Injury
Injury

Injury causation is a crucial element of many criminal and civil cases. The effects and prognosis from injury, and any alternative possibilities may require a range of experts including forensic pathologists, forensic physicians, emergency physicians and forensic scientists (to link weapons with specific injury).

Sexual assault
Sexual assault

The examination, documentation, and forensic sampling of complainants and defendants in sexual assault cases are crucial to the integrity of the case. Accepted guidelines are available to identify appropriate standards in these areas. Experts must be able to relate current known factors of findings after sexual assault to individual cases. Most frequently this is undertaken by forensic physicians.

DFSA
DFSA

What the media loves to call ‘date-rape’! Often portrayed as drinks spiking with ‘Rohypnol’, GHB and other sedative drugs in reality such cases are very rare. Most involve victims who have become intentionally intoxicated through binge-drinking and/or taking drugs and who are then taken advantage of by others. Consent is often the key issue with alcohol and drugs levels in the victim being important to evaluate. Such cases rarely proceed to criminal trial but there is scope for civil actions. Use of Forensic Toxicologists and Forensic Medical Practitioners together provides a powerful resource to evaluate any claims.

Fitness to detain/ plead
Fitness to detain/ plead

Determination of whether an individual is fit to attend court, to be interviewed, to be detained in custody, to make a plea and to be sentenced may require physical, psychiatric and psychological assessments. Individuals may be fit for some of the above but not all. For example an individual may be mentally fit to plead, but not physically fit enough to serve a prison sentence; or someone may be fit to be interviewed, but only in the presence of an appropriate adult. Forensic physicians, psychiatrists, and psychologist are frequently called upon to assess these and other matters, such as ability to form intent to commit a crime.

Elder abuse
Elder abuse

Elder abuse is more prevalent, with an increasingly aged population. Many elderly adults are vulnerable, both mentally and physically, making them targets for neglect and abuse. A multiprofessional team (including nurses and doctors) may be required to determine whether abnormal findings may relate to normal ageing, disease, or from some form of neglect and abuse.

Hands
Hands

Hand function is essential to normal every day life. Hands may be injured by trauma, or following surgery. Orthopaedic or plastic surgeons may be required to determine the nature or appropriateness of treatment, whilst forensic physicians may be required to interpret the causation of injury resulting in functional loss.

Life Assessments from Fires
Life Assessments from Fires

Endangering Life assessments from fires

A potential risk to life assessment for a person or people affected by a fire. Factors taken into account include: the location of the fire in relation to the victim, the presence/absence of a smoke detection system, the building design, any viable escape routes and the potential development of the pre-existing fire.

Autism
Autism

Autism is a disorder of neural development and causes difficulties in social interaction and communication. It often causes restricted and repetitive behaviour. Assessment of individuals is important to determine a management plan and to identify needs and capabilities. Determination of fitness to plead or form intent may be required in criminal trials.

Martial arts
Martial arts

Injury as a result of specific martial arts techniques occur frequently. In such cases it is important to ensure an appropriate expert in that martial art determines whether the technique used was correct and undertaken properly.

Plastic surgeon
Plastic surgeon

Plastic surgeons undertake reconstructive surgery for congenital disease (eg cleft lip) and acquired injury (eg burns) and in association with complex surgery (eg bone removal for tumour). Plastic surgeons may also undertake aesthetic surgical procedures. Each type of surgery is open to complications and review of treatment to determine its appropriateness and standard is often required.

Podiatry
Podiatry

Podiatry is a healthcare specialty (also known as chiropody) embracing the study, diagnosis, and treatment of disorders of the foot, ankle, and lower leg.

Police complaints
Police complaints

Complaints against police may relate to a wide variety of concerns such as unlawful imprisonment, use of excess force, deployment of devices such as handcuffs, incapacitant sprays, Viper restraints and Tasers. The appropriateness and the effects of the d

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We are unique in that we specialise in complex, high value cases and often multi-faceted cases where a range of experts are required. Because we are a one-stop personal service you do not have to search around for a variety of experts in different disciplines.

We have access to a complete range of experts to provide written reports and give live evidence in over 300 multi-specialty professional areas including criminal, healthcare, regulatory, scientific, clinical negligence, civil, family, non-recent (historic) and personal injury.

You can see examples of our extensive list of expert specialist areas here. If the one you seek is not on the example list, we will have access to whatever specialty you need.

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In many cases the FHC experts have specific experience in teaching, research and publication in their specified field (or fields) of expertise. All experts are expected to be conversant and adhere to the duties and role of an expert in court. Our experts are asked to confirm that they will conform to the Code of Practice of the Council for the Registration of Forensic Practitioners (CRFP).

If you wish to identify an expert for a case with which you are involved FHC will provide the name of a suitable expert, their CV, including range of expertise, current dates of non-availability, and a quote for the cost of the services, for report production and ( where applicable ) court attendance, within 2 working days.

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