Mr R McLaughlin FRCSI FCEM MMedSci CFEU

Consultant in Emergency Medicine

 

 

Appointments:  Tel 07799147477  

Email vivhastings1066@gmail.com

 

 

Our ref:  RMcN/VH

 

John Radcliffe Solicitors

27 West Street

Belfast

BT12 7XY

 

Re: Percy Jones  27 West Nile Street  Belfast

 

Date of Birth: 7 May 1955

 

Date of Incident:  1 February 2012

 

Date of Medico-Legal Report:  27 April 2012

 

 

I, Russell McLaughlin am a Consultant in Emergency Medicine at the Royal Victoria Hospital.  I possess the qualifications FRCSI FCEM MMedSci CFEU.  I examined your client on 27 April 2012 as requested.  

 

History:

 

Your client is a 57 year old Plumber who tells me that he sustained injuries in a road traffic collision on 1 February 2012.  The history provided by your client indicates that he was the driver of a car that was stopped at a set of traffic lights and struck from behind by a van.  Your client describes the immediate evolution of neck pain and paraesthesia radiating into his right upper limb. 

 

Your client tells me that he was transported by ambulance to the Emergency Department of his local hospital.  Examination of the clinical records of this episode dated 1 February 2012 indicate that your client attended the Emergency Department of his local hospital and was examined by Dr P Smith.  Dr Smith has noted the history of your client being involved in a road traffic collision.  Your client was noted to have tenderness in the upper trapezius fibres on the right side of his neck.  X-ray was performed which was reported as normal.  Your client was discharged with painkillers and advised to keep his neck moving.

 

Your client tells me that his pain worsened in the days following the subject incident and he attended his General Practitioner who prescribed further painkillers which he required to take regularly and daily for approximately 6 weeks and on an as needed basis thereafter.  Your client tells me that he is currently awaiting a physiotherapy referral.  

 

Past Medical History:

 

Your client tells me that he sustained whiplash type symptoms in a road traffic collision in 1979. Your client recalls that these symptoms lasted approximately 1 year and have not troubled him in the interim.  Generally your client enjoys good health.  

 

Social History:

 

Your client tells me that he missed 2 weeks of work as a result of his injuries. Your client tells me that upon returning to work his symptoms were exacerbated by stooping and heavy lifting.  

 

Your client tells me that he enjoys playing golf to a handicap of 13.  Your client tells me that he missed approximately 6 weeks of golf as a result of his injuries. Your client tells me that upon his return to regular golf he has found himself to be quite sore the morning after a game of golf. 

 

Current Status:

 

Currently your client reports intermittent and slowly improving symptoms affecting the right side of his neck with some intermittent paraesthesia affecting his right upper limb.  Your client tells me the he requires painkillers on an alternate daily basis. Your client continues to await his physiotherapy referral.  Your client reports discomfort associated with reaching, stooping and playing golf.

 

In addition to your client’s physical symptoms, your client tells me that he has lost confidence with regard to driving and feels particularly nervous when driving in built up areas and when stopped at traffic lights.

 

Examination:

 

On casual observation your client appeared to be well and walked with a comfortable gait.  Your client tells me that he is 5 ft 8 inches in height and 11 stone in weight.  

 

Examination of your client’s spinal column revealed a normal spinal contour and good spinal movement with the exception of approximately 2/3rds of normal the ability to turn his head to the right. The end point of this manoeuvre caused your client considerable discomfort.  There was no evidence of mid line bony spinal tenderness. I was able to elicit tenderness of the right upper and middle trapezius fibres.  Neurological examination of the upper limbs was unremarkable.  

 

Diagnosis

 

  • Musculo ligamentous injury to cervicothoracic region.

 

Prognosis & Discussion:

 

Your client has made a functional recovery as evidenced by his return to work, driving and golf.  Your client has symptoms that continue to improve.  Your client has some residual symptoms and stiffness and I believe he would benefit from a completed course of physiotherapy with a view to preventing the evolution of chronic symptoms.

 

On balance I believe your client’s symptoms will continue to improve and should be largely settled within then next 12 – 14 months.    

 

I believe your client will experience a prolonged recovery phase as detailed earlier as he experienced immediate pain and he also experienced paraesthesia radiating into his right upper limb. Both of these factors are associated with prolonged symptoms.  

 

In terms of your client’s symptoms relating to a loss of confidence and nervousness associated with driving, it is my understanding that in the majority of cases these symptoms are settled within 1 year of the subject incident. Should your client exhibit symptoms that are progressive in nature of persist beyond the timeframe described, then a report from a Consultant Psychiatrist may be value. 

 

 

Practice Statement:

 

  • I understand that my primary duty in furnishing written reports and giving evidence is to assist the court and that this takes priority over any duties which I may owe to the part or parties by whom I have been engaged or by whom I have been paid or am liable to be paid.  I confirm that I have complied and will continue to comply with this duty; 
  • I have endeavoured in my reports and in my opinions to be accurate and to have covered all relevant issues concerning the matters stated, which I have been asked to address, and the opinions expressed represent my true and complete professional opinion; 
  • I have endeavoured to include in my report those matters of which I have knowledge and of which I have been made aware which might adversely affect the validity of my opinion;
  • I have indicated the sources of all information that I have used; 
  • I have were possible formed an independent view on matters suggested to me by others including my instructing lawyers and their client; where I have relied upon information from others, including my instructing lawyers and their client, I have so disclosed in my report;
  • I will notify those instructing me immediately and confirm in writing if, for any reason, my existing report or opinion requires any correction or qualification;
  • I understand that:
  • My report, subject to any corrections before swearing as to its correctness, will form the evidence which I will give under oath or affirmation;
  • I may be cross-examined on my report by a cross-examiner assisted by an expert;
  • I am likely to be the subject of public adverse criticism by the judge if the court concludes that I have not taken reasonable care in trying to meet the standard set out above.
  • I confirm that I have not entered into any arrangement whereby the amount or payment of my fees, charges or expenses is in any way dependent upon the outcome of this case. 

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Mr R McLaughlin FRCSI  FCEM MMedSci CFEU

Consultant in Emergency Medicine