Expert Insight. Unbiased Testimony.
Expert Witness in Non-Surgical Cosmetic Procedures
Nurse Julie has extensive knowledge about all aspects of non-surgical cosmetic procedures, assisting law firms and offering specialised testimonials and credible evidence in malpractice lawsuits by dissatisfied patients. With a special interest in medical negligence and personal injury, her areas of expertise are:
BOTULINUM TOXIN A FOR COSMETIC USE | BOTULINUM TOXIN A FOR MEDICAL INDICATIONS
HYALURONIC ACID DERMAL FILLERS | TEAR TROUGH FILLERS | LIP FILLERS
CHEMICAL PEELS | FIBROBLAST TREATMENT | LASER DEVICES | TATTOO REMOVAL
MANAGING COMPLICATIONS | NON-SURGICAL FACIAL AESTHETICS | LIPOLYSIS MACHINE
Key areas of expertise include:
Threads: Investigating complications such as infection, suboptimal results, or technical issues.
Vascular Occlusion: Evaluating dermal filler cases involving occlusion, causation, and duty of care breaches.
Delayed Reactions to Dermal Fillers: Addressing immune or inflammatory responses, including nodules and swelling.
Breast and Vaginal Dermal Fillers: Assessing off-label use, risks, and regulatory compliance.
Illegal Botulinum Toxin: Investigating harm from unlicensed products and practitioner responsibility.
Breach of Duty and Causation: Analysing whether accepted standards of practice were met and linking actions to outcomes.
Duty of Care: Examining failures in patient assessment, consent, and aftercare.
Julie welcomes new instructions from a variety of sources including independent solicitors. Appointments are usually available for clients requiring a condition and prognosis report in Bristol and Cardiff within two weeks of instruction. A completed report is returned within a further four weeks. Clinical negligence (breach and liability) reports are completed within a similar time frame.
Julie is also happy to provide a screening report prior to engagement as a Part 35 Expert.
“A doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that particular art.” McNair J in Bolam v Friern Hospital Management Committee [1957]
Relevance: This quote introduced the Bolam Test, setting the standard for medical negligence by linking it to professional opinion.
Legal Standards Across the UK & Ireland
Ireland – Medico-Legal Test
Dunne v. National Maternity Hospital [1989] IR 91
The Dunne Principles govern medical negligence in Ireland and state the following:
A practitioner is not guilty of negligence if they act in accordance with a practice accepted as proper by a responsible body of skilled medical professionals in that field, even if others disagree.
The court must be satisfied that the practice relied upon has a logical and rational basis.
An error in diagnosis or treatment is not necessarily negligent if it is one that a competent practitioner could make. However, negligence arises if no competent practitioner would have made the same error.
If there is a general and approved practice that is not followed, the practitioner must justify why they departed from it.
Summary: Similar to Bolam and Bolitho in England, but explicitly stated through Dunne v NMH.
Scotland – Medico-Legal Test
Hunter v. Hanley [1955] SC 200
The Hunter v. Hanley test is applied in Scotland to assess professional negligence, including medical cases. It requires:
There must be a usual and normal practice.
The practitioner did not adopt that usual practice.
The course of action taken is one that no professional person of ordinary skill would have taken if acting with ordinary care.
Summary: while Hunter v. Hanley is broadly similar to the Bolam test, it is specific to Scotland and focuses on deviation from standard practice in a way that no reasonable practitioner would.
Comparison with England & Wales
England & Wales: Uses the Bolam and Bolitho tests (Bolam v Friern Hospital; Bolitho v City & Hackney HA) which establish that negligence occurs if a practitioner’s actions are not supported by a responsible body of medical opinion or lack logical defensibility.
Ireland: The Dunne Principles (Dunne v. NMH, 1989) function similarly to Bolam and Bolitho but are expressly established under Irish law.
Scotland: The Hunter v. Hanley test (Hunter v. Hanley, 1955) requires proof of usual practice, deviation from that practice, and that the deviation was unreasonable.