A recent clinical negligence case illustrates numerous ways in which an expert witness can thoroughly lose the confidence of a judge, despite already being known to him as a reliable and professional expert.
In Liam Dickinson v Newcastle upon Tyne Hospitals NHS Foundation Trust [2026], despite describing one of the experts as an “undoubtedly eminent and experienced expert”, the judge, Charles Bagot KC, was unable to see past the expert’s handling of certain aspects of the evidence and his own errors.
This case shows that even experts of sound reputation and extensive experience cannot expect to escape criticism after a poor performance. Judges will respond only to the evidence in front of them and if it lacks credibility their judgment will reflect that no matter the standing of the expert.
What was the key issue in this case?
The issue in this case was whether the defendant’s self-confessed failure to administer intravenous thiamine (Pabrinex) had caused the claimant to develop Wernicke’s Encephalopathy (WE), leading to Functional Neurological Disorder (FND) and Functional Cognitive Disorder (FCD).
Despite admitting negligence in not administering Pabrinex to the patient, whose alcoholism indicated it was required, the defendant argued that the claimant had never developed WE and that the FND and FCD were either already present or developed independently to the index incident.
What were the main concerns with the expert evidence?
The defence relied heavily on questioning the findings of the clinical staff who had diagnosed WE. The judge felt that the defendant’s experts had pre-determined that WE had not been present and went on to interpret the evidence in that light.
Moreover, he pointed to factual errors in their reports. One such error was to mistakenly recall that the claimant “did not know who he was”, when in fact the evidence from his wife, Mrs Dickinson, had been that he did not know who she was and did not know where he was. The judge considered this was an important factual error that the expert “latched onto” and skewed their subsequent reasoning.
The judge was also concerned by the same expert’s ease at dismissing the contemporaneous evidence of various treating clinicians, including consultants, that diagnosed WE. He said the defendant expert showed “an excess of confidence in their ability retrospectively to second-guess the contemporaneous notes”.
In other words, they implied they knew better than all the doctors dealing with the patient at the time, with the judge saying the expert had given “an impression of loftiness” when contradicting medical evidence.
How should an expert respond when made aware of errors in their work?
The judge also commented on the difference between the ways in which the defendant and claimant experts responded to being made aware of errors in their work. He said: “It was not that surprising that all of the experts had made one or two errors.” He also highlighted where the experts on both sides had “overlooked or failed to mention entries which the other party thought significant”.
One of the claimant’s experts accepted he had not noted a GP entry for 1 June 2016. However, when it turned out one of the defendant’s experts had also not recorded it, the judge described their attitude to their errors as “less satisfactory”.
In one instance the judge said one of the defendant’s experts had been asked to clarify what the phrase “foredge waste” meant. While it was clearly an error, the expert did not apologise for it, he simply said: “I have no idea what that is.” The judge said he found it curious that his response was not to apologise for the error or recognise it as such, but to express his lack of understanding of it.
The judge pointed out that the defendant’s expert “had been uncharacteristically less careful than my previous experience of him, in the preparation and presentation of his evidence in this case”, emphasising that precision in previous court appearances would not override later carelessness in another.
Somewhat witheringly, the judge went onto say that their reaction to errors and omissions “gave me pause for thought about the cogency of their overall opinions”.
What was the outcome of the case?
The judge found that on the balance of probabilities the claimant did develop WE because of the required drug not being administered sooner.
His finding was ultimately based on the evidence and the confidence he had in the claimant experts’ analysis, he said: “In my judgment, there is a clear thread of cause and effect to be followed through the records in this period backed by the claimant’s experts’ opinions.”
How we can help
Bond Solon provides training covering all the core skills and knowledge expert witnesses require to fulfil their role compliantly and effectively, including our Clinical Negligence Essentials Part 1 and Part 2 courses, which are designed and delivered by a leading clinical negligence lawyer for expert witnesses working or wishing to start work in this field. We also offer university certified training programmes that are widely regarded as the industry gold standard by instructing parties.