EWJ FEB 59 2025 web - Flipbook - Page 74
An Eye for Detail: A Recent High
Court Judgment in a Claim Against
an Ophthalmic Surgeon Highlights
Why an Expert's Experience Matters
Expert evidence is crucial in almost every clinical negligence claim. The outcome of a case at
trial will often turn on which expert evidence the Judge prefers - the claimant's or the defendant's.
As we start the New Year, and perhaps whilst not a cause for 'fireworks' in the medical malpractice
world, the recent High Court Judgment of Lochrie v Edwards (Judgment handed down on
7 January 2025) serves as a stark reminder as to the importance of an expert's experience (or
rather lack of experience) when providing an opinion.
that she had in fact received it well in advance of
surgery.
What was the case about?
The Claimant, Rebecca Lochrie, brought a claim
against the Defendant, Mr Matthew Edwards, a consultant ophthalmic surgeon. It was alleged that the
Defendant failed to obtain the Claimant's consent for
laser-assisted in situ keratomileusis (“LASIK”) laser
eye surgery on 10 March 2016.
The issues for the experts
A key issue for the Judge to consider was whether the
Claimant should have been identified as a 'high risk'
patient. The Judge found that this was a matter for
expert evidence. Not surprisingly, the experts called
by each party had different opinions on this.
The Claimant's case on breach of duty focussed on an
allegation that the Defendant failed to adequately investigate her ophthalmic condition prior to the LASIK
surgery (the Claimant had an underlying dry eye condition, with meibomian gland disease). The Claimant
alleged that this had implications for the scope of the
information that had to be provided to her, and that
the Defendant had therefore failed to identify and
discuss the risk of permanent dry eyes before
undergoing LASIK surgery.
Notably, the Defendant's expert, Mr Morris, had
performed well over 10,000 LASIK procedures. In
support of the Defendant's denial of breach of duty,
he considered that the Claimant was a patient with a
low risk, due to her young age and the low eyesight
correction that was required. He did not believe
that her history of anxiety and depression was a
matter that necessitated special consideration by the
Defendant.
As a result of the surgery, the Claimant suffered with
dry-eye problems and developed chronic corneal pain
(corneal neuralgia, sometimes called corneal dysesthesia) which has had a substantial and disabling effect on her daily life. She described ongoing disruptive
dry eye symptoms, burning pain in the eyes, excessive
tears, visual disturbances and photophobia.
Conversely, the Claimant's expert, Mr Walker, was of
the opinion that the Claimant was a patient with a
higher risk of suffering complications than average
due to her underlying conditions and her history of
anxiety and depression. The Claimant's expert was
however somewhat lacking in experience in LASIK
surgery (to put it mildly). He had, in fact, performed
zero. Instead, he relied on his experience as a general
ophthalmic consultant and on his academic research.
This was, therefore, a case focussed solely on consent.
There was no allegation that the surgery was
performed negligently.
HHJ Baddeley, in dismissing the claim, specifically
referred to the experience of the Defendant's expert
as to why he preferred his evidence over that of the
Claimant's: "…. Mr Walker is not a laser eye surgeon
and has not conducted LASIK surgery. He was unable to opine based on his own personal experience."
The Defendant denied the allegations, on the basis
that he did advise the Claimant of these risks during
his initial consultation. He also relied on the consent
form and patient guide, which he maintained had
been given to the Claimant two weeks before surgery.
This included information on the risks of temporary
and permanent dry-eye problems. The Claimant alleged, however, that she did not read any information
on the risks contained in the consent form or patient
guide, and relied only on the discussion with the Defendant, who had played down these risks. The
Claimant initially alleged that she only received the
consent form on the day of surgery, but later conceded
EXPERT WITNESS JOURNAL
The Judge therefore did not accept the Claimant’s
case that the Defendant’s failure to take a more detailed history meant that he missed information that
would have necessitated a different explanation of
risk.
The Judge also preferred the Defendant's version of
events - that he did refer to the risk of the Claimant
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