I recently was asked to provide a report on a patient who developed a bowel rupture some 4 days after a Caesarean Section. She was an older mother on anti-depressants. On day 3 she developed right sided pain above her scar associated with abdominal distension. After she opened her bowels later that day she was discharged from hospital.

She was readmitted the following day with an obvious acute diaphragm and was found to have gas under her diaphragm on X-ray.

A general surgeon per...

An increasing number of recent requests for expert evidence seem to involve claims for brachial plexus palsy in babies as a result of shoulder dystocia. The definitions are as follows:

1. Shoulder Dystocia: (incidence 0.5-1.5% of deliveries a.Prolonged Head to Body Delivery Time >60 seconds
b. Resnik (1980) : Condition requiring special manoeuvres after failure to deliver the shoulders with downward traction
c. Arrest of spontaneous delivery due to impaction of the anterior...

One in 3 Australian women have been diagnosed with iron deficiency by age 50.This is largely caused by disorders of menstruation and pregnancy. In one study 11% of women (mostly premenopausal) without anaemia were nevertheless iron deficient. Menstrual loss of iron is approximately 1mg per day and a pregnancy, delivery and puerperium accounts for a loss of about 1000 mg.

The impact of anaemia in pregnancy includes higher rates of preterm delivery (Chinese study) spontaneous abortion, low b...

Recently I was asked to provide an expert opinion on the causation of a missing ovary discovered at  a third laparoscopy. It was alleged by another expert witness that this must have been surgically removed at one of the 2 previous laparoscopies, both of which were brief procedures. The witness stated that in his experience congenital absence of one ovary had never occurred. In fact there have been a number of case reports of just such congenital absence of only one ovary: in 1978...

Recently I was asked to provide medico-legal expert evidence in a case of digital sexual assault. It was pointed out to me by the Defence that one publication cited a detected genital injury rate after digital sexual assault of in excess of 80%.
However the American publication involved:

1. Colposcopic examination with tissue dyes such as toluidine blue (both of these techniques substantially increase the detection rate)
2. Short time periods before forensic examination (<72 hours aft...