Mr Niall Craig is a Consultant Orthopaedic Spinal Surgeon and Expert Witness specialising in complex spinal cases. He tells us about his professional journey and shares his advice for being cross examined, writing Reports, and getting referrals.  

 

I first got into Expert Witness work back in 2001.

I was a senior trainee in the NHS and my boss said, “I've got medical reports. I haven't got time to do them. Do you fancy doing some?” I worked on some simple reports before I went on fellowship. When I came back as a consultant in 2004, I started getting some referrals from solicitors locally and built it up from there.

 

Being an Expert Witness is a great way of reading around cases.

I work full-time as a surgeon in the NHS, so my Expert Witness work – as well as being very interesting – is a good way to keep up with CPD. It forces me to read!

 

I typically work on two Expert Witness cases per week.

Some cases have thousands of pages of documents to read through, so it can be time consuming. I dedicate one day a week to case work and usually allow 2 hours for appointments with clients or solicitors. I get started writing my Expert Report straight away, because I don’t like going back to them weeks afterwards.

 

My area of expertise is complex spine cases.

Anything from spine trauma, spine fractures, disc prolapses, or somebody who has had surgery on the spine. Around 85% of my work is for the pursuer and 15% of it is for the defender. I don’t have a preference either way; it just depends what comes in.

 

Whether I’m appointed by the pursuer or the defender, my Reports are the same.

I will always just give my honest Expert opinion. Having confidence in your own opinion is something that comes with age and experience.

I remember a case when I’d just started out and the Expert Witness on the other side was a very eminent, senior professor. But the court found in favour of my opinion, in part because it was well-reasoned and researched. That was a big confidence boost.

 

As an Expert Witness, it's important to stick to your own area of expertise.

I've participated in general orthopaedics trauma for years, so if there's another injury along with the spine – known as a polytrauma case – I will comment on that. But if it's very complex, I'll defer to somebody else's opinion.

 

I’m based in Scotland, where the concept of a Single Joint Expert doesn’t exist.

There are always separate Experts appointed by each side. I never sit down with the other Expert – all feedback is done online. You might have points of contention for both sides in England and Wales. That doesn't happen Scotland: instead, we're asked to comment indirectly on the other side’s report.

I am sometimes asked to comment on defender reports and will always identify points of agreement and focus on any points of disagreement, especially if there are imminent settlement meetings scheduled.

 

I always write my Expert Report, read it, and dictate it.

I ask myself, “can I defend this opinion in in court? What's the evidence I can use to support this? Can someone else refute it?” My reports are the same whether I’m giving evidence for the pursuer or the defender. It’s important to be impartial for the courts, remembering you are not acting for the pursuer or defender or their legal counsel. Your duty is to the court.

 

Being cross examined is about sticking to your guns.

My cases normally settle before they reach court. But when I have had to go to court, the advocates [barristers in England and Wales] are always trying to score points off each other and you're in the middle. I’m of the opinion that once you've adopted a position, it's reasonable to continue that argument. Having confidence in your well-researched opinion is important.

 

Some of the cases I get involved in are very high value.

Particularly cases involving spinal cord injuries, where the claimant requires lifelong care. But as Expert Witnesses, we rarely find out the outcome in terms of what's actually happened with the case.

 

I get the majority of my Expert Witness work through referrals.

I work with Resolve Medicolegal, a corporate partner of the EWI that links solicitors with Medical Experts in Scotland. I was asked if I wanted to join because they didn't have many spinal experts.

To begin with, it was all unnamed referrals and now I'd say it's probably 70% named and 30% unnamed. If you build a reputation for preparing good, detailed reports, then solicitors will come back to you again.

 

Being an Expert Witness isn’t without its challenges.

There is a lot of paperwork to read, though thankfully most of it is digital now. I think the most I've had was 4,300 pages for a case involving a devastating spinal cord injury, involving two years of rehabilitation and various rehab centres – with documentation for every day of that.

Dealing with solicitors can also be challenging. Some are very good; some are not so careful and attentive.

 

AI is being used more and more in Expert Witness work.

I was halfway through reading those 4,300 pages of records when somebody suggested using AI. I can definitely see how it could be very useful for interrogating documents and pulling out information. I have not used AI yet. but can understand its use particularly for very complex cases where the medical records are huge. Asking specific questions may be of use, but whatever platform is used must comply with GDPR rules.

 

My advice for new Expert Witnesses: set out clear terms from the outset.

In particular, state that any lengthy documents will be charged at a certain hourly rate. I charge a set fee, which includes up to 300 pages of documents to be reviewed. Any more than that, I refer to my terms and conditions to establish the extra charge.

Make your terms and conditions clearly visible for instructing agents. Also, make your late cancellation fees very visible. Many cases will go to the wire and settle a day or two before court. You have to change your plans or put work on hold, which isn’t always appreciated by the legal profession.

 

I always tell the end client what I'm going to say in my Report.

It avoids too many follow up queries from pursuers: If I explain what I’m going to put in my report, they’re far less likely to come back saying they don’t understand what I’ve said.

 

Occasionally, I will meet someone that I believe has been misdiagnosed and mis-treated.

In those cases, I suggest that they take their report to their GP and ask for more appropriate treatment. This is, of course, up to the Expert and you need to be careful not to blur the lines between being an independent expert and a treating clinician. But as far as I am concerned, once the client has seen my report, they can use it as they see fit.

 

I like interacting with people.

If I need to get their consent to access their medical imaging from them, I’ll take the opportunity to go over it with them. Often, they’re really grateful. It’s not in my remit as an Expert Witness, but as a surgeon I’m able to do it and I think they find it useful.