There are two main areas of the work of the specialist in the accident and emergency department (casualty) of a hospital that may involve them in acting in an expert capacity in court: one is in the field of personal injury cases and the other is in criminal cases.
Personal injury cases
As far as personal injury cases are concerned, the most common arise from road accidents – where neck injury or 'whiplash' is most likely to have given rise to a claim – or accidents at work, where fractures and soft tissue injuries are most common.
Health and Safety Executive figures show that 137,000 injuries were reported under the RIDDOR regulations during 2007/8, the most recent period for which figures are available, while the Labour Force Survey for the same period shows 299,000 reportable injuries as occurring, a rate of 1,000 per 100,000 workers. Of those injuries, 229 were fatal.
While the number and rate of workplace fatalities and injuries is falling, there is a greater tendency among victims to sue for compensation. The same applies in other areas of life, including road traffic accidents. Soft tissue injuries and fractures sustained in such accidents are no longer seen as 'just one of those things'.
And most people who sustain injury through accidents of whatever kind are inevitably seen by the A&E specialist.
It used to be the case that witness statements and expert reports regarding non-serious injury were elicited from GPs, while reports dealing with more serious injuries were prepared by orthopaedic consultants. However, as pointed out by A&E consultant Colin Holburn in an article in The Legal Executive in 1997, most people who present to accident and emergency departments with such injuries are seen and discharged without being seen by an orthopaedic surgeon and rarely see their GPs for follow up.
Criminal cases
The second main area where the accident and emergency specialist may be called up to give expert evidence is in criminal cases. These are most commonly cases of assault or wounding.
Again, most such injuries are seen by an accident and emergency department and indeed it is common for the police investigating the incidents to take witness statements from the staff in the department during their investigations. While such statements are often accepted by the defence as to the facts of the injuries, there may be dispute as to their cause or the manner in which they came to be inflicted.
Again according to Colin Holburn, while there are some independent forensic examiners in these areas, their range of expertise in such injuries is not as extensive as those of the accident and emergency consultant: indeed, the experience of the A&E consultant in treating non-violent injuries and wounds puts them in a particularly advantageous position in assessing the probable cause of an injury where there is a dispute.
Negligence
There is a third, although thankfully rare, type of case where the accident and emergency consultant may be called upon to give expert testimony; that is in cases of claimed medical negligence cases.
The nature of the casualty department means it is particularly vulnerable to negligence claims as a consequence those departments are second only to obstetrics departments in attracting claims. Most claims are low-level and are dealt with out of court, but there are occasional high-level cases.