EWJ 60 April 2025 web - Journal - Page 44
Medical Tattooing in the Medico-Legal
World: An Expert Witness Perspective
on Negligence
by Rae Denman, Medical Tattoo & Expert Witness Ltd
months old. While flat, white scars can be considered
even if they are relatively new, red or raised scars require additional healing time or alternative treatments
before they can be addressed with tattooing.
Introduction
Medical tattooing is increasingly recognised as a
valuable treatment in medico-legal cases, particularly
those involving negligence claims. As a specialist in this
field, I am called upon as an expert witness to assess
cases where patients have suffered scarring or pigment loss due to cosmetic procedures, laser treatments, or surgical complications. My role involves
evaluating the extent of the damage, determining
whether medical tattooing is a viable corrective option, and providing detailed reports for legal
proceedings.
• Skin Texture and Thickness - Some scars, particularly those with very thin or fragile skin, may not respond well to medical tattooing.
• Healing Factors – Underlying conditions such as
diabetes, autoimmune disorders, or certain medications can affect healing and pigment retention.
Psychological Impact
Beyond the physical damage, scarring and pigment
loss can have profound psychological effects. Many
claimants struggle with self-image, particularly when
the affected area is highly visible. The emotional toll of
an altered appearance is often a significant component of negligence claims, and medical tattooing can
play a crucial role in alleviating this distress.
Negligence cases often arise when a patient
experiences an unexpected or severe outcome following a treatment. Whether due to laser burns,
chemical burns, surgical errors, or improper aftercare,
the resulting scarring or pigment loss can have significant physical and psychological consequences. Medical
tattooing offers a means of addressing these concerns,
helping to restore a more natural appearance and
improving the individual’s overall well-being.
My Role as an Expert Witness
As an expert witness, my primary role is to provide
professional assessments of a claimant’s condition and
the potential for medical tattooing as a remedial
treatment. My reports typically include:
• An objective evaluation of scarring or pigment loss
- Assessing the size, location, and severity of the
damage.
Scarring and Pigment Loss
A significant proportion of negligence cases involve
scarring or pigment loss that was not anticipated or
adequately disclosed as a potential risk. Patients may
undergo a procedure expecting only minimal side effects, only to be left with extensive damage. In cases involving laser treatments or chemical peels, improper
use of equipment or incorrect product application can
lead to burns, leaving behind areas of hypopigmentation (loss of pigment).
• Suitability for medical tattooing - Determining
whether the claimant is a good candidate for
treatment.
• Expected outcomes and limitations - Medical
tattooing can significantly improve the appearance of
scarring, but results vary based on individual factors.
When assessing such cases, I consider:
• Scar Type and Maturity - Medical tattooing is
generally suitable for scars that are at least 6–12
EXPERT WITNESS JOURNAL
42
APRIL 2025
