Last updateTue, 21 Jun 2022 10am

Expert Witness Blog

Psychological legacy of scarring must be considered in damages

The press – and indeed the public – have been occupied recently with a sudden and huge increase in the number of so-called acid attacks, where a corrosive substance is thrown or squirted onto the victim, in particular the face. From being isolated cases, often where the victim is known to the perpetrator – who deliberately aims to disfigure – they now appear to be the weapon of choice of mugging gangs who are more and more likely to be caught if they carry other weapons.

A quick response is essential on the part of bystanders, as is the correct response. The British Association of Plastic, Reconstructive and Aesthetic Surgeons has launched a campaign to educate the public, around the slogan Report, Remove, Rinse.

In addition to the burns and disfigurement, such attacks can leave lasting scars. Living with those scars can have profound and debilitating psychological consequences in addition to the physical legacy. Indeed, scarring from any source, whether inflicted deliberately or the consequence of negligence or carelessness, can carry long-term psychological consequences.

That harm can be taken into account in the assessment of any award of damages. A number of factors come into play, such as age and, significantly, the sex of the victim.

While scarring from attacks is the result of deliberate action, and those resulting from road or workplace accidents are often clearly culpable, scarring can be the result of clinical action. Whether or not that is the result of negligence or the inevitable consequence of clinical procedure is less clear cut. Nevertheless, accidents do happen and the NHS spends an eye-watering amount on settling claims. The National Audit Office has revealed that spending on settling claims has quadrupled in only 10 years.

Dentists, meanwhile, are taking the lead in utilising modern techniques to ensure they are singing from the same hymnsheet when it comes to keeping records – a key starting point in clinical negligence defence. The initiative was launched at the Health and Care Innovation Expo in Manchester by the Chief Dental Officer.

It was one of a number of announcements made at the conference. Another was an initiative to integrate prevention and care of cardiovascular disease, which can lead to heart attack and stroke, by early diagnosis and community preventative efforts.

One area of clinical hiccup that is exercising Health Secretary Jeremy Hunt is that of errors in prescribing. According to Mr Hunt, one in 12 prescriptions contains an error of some sort. It is a truism that no-one can read a doctor’s writing and the move towards electronic prescribing, or EPS, will help to eliminate most problems. However, some prescriptions are still hand-written – mostly in situ in the home or social care setting – and these are the most vulnerable to errors.

There are medical conditions leading to claims that are not the result of clinical negligence, but negligence at work or in the community. One such is noise-induced hearing loss, and a working party of the Civil Justice Council seems to have pulled off the impossible by producing a report that pleases everybody. The report by Andrew Parker on improving claims management and costs has been applauded by the judiciary and lawyers alike.

Another of the senses that is vulnerable to the senseless is sight. The latest craze in that respect is to shine powerful lasers into people’s eyes – particularly airline pilots and emergency services personnel. A consultation is underway on whether it should be a specific criminal offence.