Expert Witness Journal Issue 64 December 2025 - Flipbook - Page 43
of the terms “stricture”, “stenosis” and “narrowing”
which led to him lacking a coherent basis for the
position he adopted. He sought to add that C’s
symptoms could be alternatively explained by
dysmotility, but ultimately conceded that narrowing
was top of the list of possibilities.
Learning points
1.
D argued that the barium swallow did evidence
stenosis, as supported by the opinion of his expert
Upper GI/Bariatric Surgeon. D’s expert was
praised by the Judge for his careful and intelligible
explanation of what was encompassed by “stricture”,
“stenosis” and “narrowing”, and made clear in his
opinion that the evidence of stenosis made the
performance of the balloon dilatation reasonable.
A Claimant need not be found dishonest
for their evidence not to be accepted. The
Claimant’s credibility was not criticised by the
Judge (or indeed the Defendant) at trial, but
the Judge acknowledged it would be surprising
if the passage of time and traumatic nature of
the events did not have a detrimental impact on
her recollection. This goes to show that factual
evidence can be challenged on reliability,
without having to pursue any allegations of
dishonesty.
2. It is important to evidence how a clinical team
can work together, not just as individuals, to
support a patient’s journey. Having a robust
MDT model in place, and calling other members
of the MDT as witnesses, can help to prove the
level of support provided to patients.
Judgment was reserved and handed down in
October 2025.
Outcome
3. Finally, it is crucial that a party’s expert is able to
demonstrate an adequate understanding of the
Bolam test and justify their evidence with clarity,
being able to explain complex terminology as
necessary.
The Claimant’s claim was dismissed. HHJ Simon
acknowledged the extremely serious consequences
that C su昀昀ered as a result of the sleeve leak, and
expressed the Court’s every sympathy for C’s serious
and continuing health challenges. However, he
concluded that the claim against D was simply not
made out, even on the more limited basis advanced
at trial.
The Judge was not persuaded that the support
o昀昀ered by the team to C was anything other than
a reasonable equivalent of what would be o昀昀ered
in the NHS. It was improbable that D or his team
would not have documented communications
from C concerning highly relevant and important
information such as her di昀케culties with vomiting
or food progression, and D’s MDT working model
was found to be a perfectly proper system for
sharing expertise and being patient-focussed. The
Defendant and his clinical team were found to be
credible witnesses and their evidence was reliable.
Mr James Manson
Consultant Surgeon
BSc, MBChB, FRCS, ChM
Mr James Manson qualified from St Andrew’s, Scotland and Manchester, underwent post
graduate training in the north west of England as well as two years in Harvard Medical
School, USA. Gained fellowship of the Royal College of Surgeons in 1982, followed by a
higher degree by thesis in 1989. Appointed consultant to Neath Hospital in 1993 and later,
moved to Swansea, where worked in Morriston and Singleton Hospitals until 2021.
Initially a general surgeon, Mr Manson has become a specialist in upper gastrointestinal
surgery, particularly surgery of the oesophagus, stomach and gallbladder. He has extensive
experience of laparoscopic cholecystectomy (over 2000 procedures) and minimally invasive
anti-reflux surgery (over 300 procedures), also performing 400 oesophageal and gastric
resections for malignancy. Audited and presented outcomes in all these areas compare
favourably with results produced anywhere in the world. In addition, over 20,000 upper GI
HHJ Simon accepted D’s evidence that the holistic
picture was highly suggestive of narrowing in the area
of the GOJ. Further, he found that the Defendant’s
expert had considered the relevant literature
thoroughly, roundly undermining the explanations
put forward by his counterpart. The Claimant’s
expert was criticised for not clearly having at least
a basic understanding of the legal parameters
within which he was asked to express his opinion,
for his evidence being di昀케cult to understand due
to his inconsistent use of terminology, and for not
responding adequately to cross-examination. This
was contrasted with the evidence of the Defendant’s
expert, who was entirely coherent and supported his
opinion by reference to the medical literature.
endoscopies carried out, both diagnostic and therapeutic, including dilatation, stenting,
ablation, endoscopic mucosal resection.
With 40 years experience on the emergency rota as a general surgeon Mr Manson can provide
expert opinion on any case relating to a general surgical emergency.
Mr Manson has prepared over 400 reports in cases of alleged clinical negligence, both for
the defendant and claimant. In addition he provides Condition and Prognosis reports
(following consultation) in appropriate cases of Personal Injury (largely abdominal injury).
Extensive experience in conference with Counsel, expert’s meetings and Court appearances.
Mr Manson continues to teach, examine at intercollegiate level (the most senior general surgical examiner in the British Isles), has a licence to practice, and is subject to regular appraisal
and revalidation by the GMC.
Instructing solicitors include Hempsons, Ward Hadaway, Lees & Partners, Pannone, Gadsby
Wicks, Thomson Snell Passmore (lead expert in a class action), Slater and Gordon, Campbell
Smith, Graystons, Williamsons, Kingsley Napley, Admiral Law, Moonerams, Alsters Kelley,
Drummond Miller and Jones Whyte (Scotland), Cian O'Carroll, McNally & Co, Carson
McDowell and Lynch Solicitors (Ireland).
Tel: 07989 436 722
Email: mansonj363@gmail.com
Website: http://mansonugisurgeon.co.uk
Address: Brenwyn, 30 Maes-y-Cncwe, Newport, Pembrokeshire, SA42 0RS
Area of work: Nationwide and worldwide
EXPERT WITNESS JOURNAL
40
DECEMBER/JANUARY 2025-2026
