Advanced medicolegal support for litigation professionals

Background:

A firm represented a client whose symptoms of cauda equina syndrome were misinterpreted as routine lower back pain by their GP and A&E clinicians, delaying emergency surgery.

Problem:

The legal team was overwhelmed by hundreds of pages of notes spanning multiple attendances and uncertain how to isolate the key decision points.

Our Input:

We produced a clinical timeline highlighting red flag symptoms (e.g., saddle anaesthesia, urinary retention) that had been recorded but not acted upon. We cross-referenced these against NICE guidance and standard neurological assessment protocols.

Outcome:

The solicitor quickly identified breaches and framed a compelling chronology. The case settled favourably prior to the first Case Management Hearing, avoiding unnecessary delay and cost.

Why it Matters:

Early pattern recognition in the notes allowed the legal team to frontload their case preparation—saving time and reducing costs.

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Background:

A pregnant woman with a history of gestational diabetes and pre-eclampsia attended hospital with reduced fetal movements. She was triaged as low priority, and there was a delay of over 6 hours before CTG monitoring was performed. An emergency caesarean was later carried out, but the baby was born with severe hypoxic injury.

Problem:

The solicitor team needed to understand whether the hospital acted within reasonable clinical expectations given the patient’s risk profile, and what monitoring protocols should have been followed.

Our Input:

Our Medicolegal Consultant reviewed maternity triage records, CTG strips, and obstetric guidelines. We created a risk escalation timeline and flagged key breaches in national and local triage protocols. We also offered commentary on care prioritisation and failure to escalate due to known red flag symptoms.

Outcome:

The firm adjusted their approach, dropping weaker allegations and focusing on failures in timely triage and monitoring. The streamlined argument resulted in early admission of breach and partial liability.

Why it Matters:

Clear medicolegal analysis helped the legal team isolate the strongest aspects of their case, enhancing credibility and accelerating resolution.

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Background:

A 62-year-old man with poorly controlled diabetes was admitted to hospital with a foot ulcer. Despite signs of infection and vascular compromise, there were significant delays in appropriate referral to a vascular surgeon. The patient ultimately underwent a below-knee amputation.

Problem:

The solicitors faced difficulty interpreting a large volume of complex hospital notes, conflicting wound care entries, and unclear timelines of decision-making. They needed support to determine the adequacy and timing of interventions, and whether earlier action could have prevented the amputation.

Our Input:

Our Medicolegal Consultant conducted a chronological mapping of care, isolating delays in key areas including vascular assessment, escalation of infection control, and referral pathways. We identified deviations from NICE and SIGN diabetic foot care guidelines and provided detailed insight on the likely impact of these delays on clinical outcome. We also suggested targeted Part 35 questions for the opposing party’s expert.

Outcome:

Following our input, the legal team narrowed the issues and strengthened their case strategy. The matter settled following a six-figure offer being accepted.

Why it Matters:

Timely medicolegal analysis can uncover missed opportunities in multidisciplinary care and clarify liability arguments in complex clinical pathways — all without reliance on expert testimony.

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Background:

A client developed a deep vein thrombosis (DVT) ten days after discharge from a knee replacement surgery. They had previously complained of calf pain during a post-op check but were told it was ‘normal post-surgical soreness’. A pulmonary embolism occurred shortly after.

Problem:

The legal team needed help understanding if the signs of DVT were adequately assessed and managed in line with national guidance and the patient’s personal risk factors.

Our Input:

We reviewed discharge documentation, pain assessment notes, and VTE prophylaxis records. Our Medicolegal Consultant identified missed documentation of calf swelling, no repeat D-dimer or ultrasound, and inconsistent pain descriptors. We provided an evidence-based narrative highlighting when a DVT should have been suspected.

Outcome:

Our input allowed the legal team to press for disclosure of guideline compliance records and escalate their inquiry around VTE protocols. The claim settled in a timely manner with a strong causation link established.

Why it Matters:

We enabled the legal team to uncover systemic monitoring failures and use that insight to drive negotiation strength.

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Background:

A surgical negligence claim arose following an operation for a chronic subdural hematoma. The patient re-presented days later with confusion and fever but was discharged without neuroimaging. He deteriorated rapidly and was later diagnosed with a subdural empyema.

Problem:

The legal team needed to understand whether signs of infection were clinically evident at the earlier presentation and if standard protocols for post-op complications were followed or deviated from.

Our Input:

Durey Solutions reviewed hospital records, A&E notes, and nursing observations. We mapped out the clinical trajectory and highlighted where guideline-based red flags were missed—specifically a raised temperature, altered mental status, and post-op history suggestive of complications. We provided a chronology with embedded clinical commentary and clarified key issues for counsel to probe during conference with an instructed expert.

Outcome:

Following receipt of our analysis, the legal team refined their expert instructions and obtained a supportive opinion. The case settled shortly after, avoiding lengthy proceedings.

Why it Matters:

Early, targeted medicolegal input sharpened the legal team’s clinical focus, helped refine pleadings, and supported cost-efficient litigation strategy. Without our input, the team may have pursued weaker avenues.

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Background:

A 72-year-old man was charged with arson endangering life. He denied intent and suggested confusion due to medication side effects and deteriorating cognition.

Problem:

With over 400 pages of medical records, care home logs, and hospital admissions, the solicitor needed help assessing whether confusion at the material time was clinically credible.

Funding:

The solicitor applied for prior authority citing our Medicolegal Consultant as a necessary preparatory step to control overall expert costs and clarify the need and scope of any further reports.

Our Input:

We reviewed the full set of care and treatment records, producing a narrative that identified patterns consistent with delirium. We recommended a sub-specialty expert instruction.

Outcome:

Our analysis led to tailored expert instruction. The psychiatric report led to charges being dropped.

Why it Matters:

Our input avoided scattergun expert commissioning, demonstrated proportionality, and justified our involvement as a disbursement within LAA parameters.

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Background:

A defendant was being prosecuted following the death of an individual while in police custody. The case involved large volumes of medical records and required careful analysis with a number of causative factors disputed

Problem:

The complexity arose from: (i.) a large volume of medical records (over 1000 pages); (ii.) multiple medical conditions and potential failures in monitoring and response; and, (iii.) medical terminology and complex interrelations between conditions and custodial oversight.

Our Input:

We assisted the prosecuting authority with understanding the medical and custodial complexities. We: (i.) reviewed all medical and custodial records to create a clear timeline of events; (ii.) identified key gaps and inconsistencies in the records; (iii.) provided a clear analysis of where custodial services appeared not to meet expected standards. (iv.) assisted the legal team with understanding the medical factors, avoiding unnecessary expert instruction at an early stage.

Outcome:

Upon review of the case, Durey Solutions’ input highlighted significant issues with the available evidence. The prosecution decided not to proceed to trial, concluding that there was insufficient evidence to support criminal charges. As a result, time and resources were saved for all parties involved.

Why it Matters:

Early-stage medicolegal input helps prosecuting authorities navigate complex cases. Clinical input can be justified as a cost-saving measure, particularly when dealing with large volumes of medical records, as it can provide early clarity on whether a case should proceed.

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Background:

A 28-year-old man was convicted of possession with intent to supply Class A drugs. Though he pleaded guilty, he later disclosed a history of paranoid schizophrenia, raising concerns that his plea may have been unsafe.

Problem:

The defence team at first instance did not investigate the client’s mental health history. A new solicitor, reviewing the case post-conviction, believed the client’s psychiatric condition at the time may have affected mens rea or ability to enter a reliable plea.

Funding:

A fixed-fee quote was provided, and prior authority from the Legal Aid Agency was secured in light of newly available evidence, case complexity requiring targeted medical insight and potential cost savings through focused triage before instructing an expert.

Our Input:

Our Medicolegal Consultant (i.) reviewed mental health records and summarised key events and diagnoses. (i.) identified missed opportunities to explore psychiatric input. (iii.) helped structure a focused expert referral to avoid delays or unnecessary cost.

Outcome:

Leave to appeal was granted based on the new evidence. A psychiatric report supported that the defendant’s condition was relevant to his plea.

Why it Matters:

We help criminal solicitors act swiftly when post-conviction evidence emerges, enabling fairer outcomes and improving the quality of applications made.

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Background:

A man in his 30s was charged with non-fatal strangulation under section 75A of the Serious Crime Act 2015. The complainant alleged that the defendant, her former partner, had placed his hands around her throat during an argument, causing her to lose consciousness. The offence was said to have occurred in a domestic setting. The defendant denied the allegation outright.

Problem:

The client solicitor instructed Durey Solutions due to the sheer volume of the complainant’s historical medical records — spanning over a decade and referencing multiple physical and mental health attendances. These records were believed to hold clues that might contradict or contextualise the allegation.

Funding:

A fixed quote was provided to the solicitor, who successfully applied to the Legal Aid Agency for prior authority under disbursements. The justification was: (i.) significant volume of medical records, (ii.) need for early filtering to determine if expert instruction was warranted, and (iii.) overall cost-effectiveness.

Our Input:

Our Medicolegal Consultant provided an early-stage review of the full set of medical records, flagging discrepancies in how the complainant described the incident to different professionals (e.g. first responder, A&E staff, GP). Notably, contemporaneous A&E documentation recorded a normal Glasgow Coma Score, normal oxygen saturation levels, and an unremarkable neck and airway examination — inconsistent with claimed loss of consciousness or neck compression injury.
We also noted previous documented injuries the complainant had attributed to unrelated causes, along with psychological history relevant to credibility. Our report allowed the defence to engage an appropriate expert on a narrower and clearer instruction.

Outcome:

The prosecution offered no evidence prior to trial, with the reviewing prosecutor concluding there was insufficient medical support for the alleged mechanism of injury.

Why it Matters:

Durey Solutions can help solicitors quickly sift through large volumes of medical records, saving critical time and ensuring public funds are used proportionately. Our input helps avoid unnecessary expert fees and can safeguard defendants from a trial based on contested medical claims.

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Background:

A single mother in her 40s was prosecuted for benefit fraud, alleged to have dishonestly failed to report an improvement in her medical condition while continuing to claim disability-related benefits. An overpayment of £27,000 over two years was alleged.

Problem:

The defence solicitor had obtained extensive medical records, including primary care, hospital and occupational therapy notes. However, inconsistencies and the sheer volume of entries made it difficult to quickly establish whether her functional difficulties had indeed improved. The solicitor needed early clarity to determine whether expert evidence was appropriate and to advise the client meaningfully.

Funding:

A quote was provided for our fixed-fee input. The solicitor secured prior authority from the Legal Aid Agency, citing: (i.) the complexity and volume of medical records; (ii.) the need for early triage to justify further expert costs, and (iii.) overall cost-effectiveness and time savings in preparing the case.

Our Input:

Our Medicolegal Consultant conducted an initial review of the medical records to determine the pattern and timeline of functional ability. We identified that the client’s condition — a progressive autoimmune disorder — followed a relapsing course. Periods of apparent mobility improvement, highlighted by the prosecution, coincided with brief improvements on high-dose steroids, not sustained recovery.
We also noted that the functional assessments lacked clinical context, and that fluctuations in reported symptoms were consistent with the natural history of her disease. Our findings helped the defence frame a sharply focused instruction to a consultant rheumatologist and saved the solicitor days of reading and summarising.

Outcome:

After representations were made to the prosecution the case did not proceed any further. The medical picture was more complex than first presented.

Why it Matters:

Durey Solutions helps defence solicitors challenge oversimplified prosecutions where disability or illness is involved. By clarifying the medical narrative early, we enable proportionate use of experts and better-informed client advice — key for busy lawyers under time pressure.

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Background:

A prisoner with a known diagnosis of paranoid schizophrenia was moved to a prison’s care and supervision suite after an altercation with another inmate. He remained there for 17 consecutive days, during which time he was kept in solitary conditions and given minimal access to structured activity or mental health care.

Problem:

His presentation deteriorated, with increased hallucinations, disordered thinking, and self-neglect. Despite his escalating symptoms, the rationale for his continued segregation was not clearly documented, and review mechanisms were poorly followed.

Our Input:

Our Medicolegal Consultant evaluated whether the client’s detention in the suite was appropriate, necessary, and proportionate. Segregation logs, healthcare notes, and mental health service entries were reviewed. We identified that the conditions breached principles laid out in the Nelson Mandela Rules, specifically Rule 45 (segregation as a last resort) and Rule 109 (adequate mental healthcare access). Instances were identified where there was a failure to provide appropriate mental healthcare, including failures to assess, review, or escalate concerns.

Outcome:

Soon after the prison service entered correspondence leading to settlement. The solicitor was better able to draft the claim.

Why it Matters:

This case highlights how prolonged segregation of mentally ill prisoners without adequate safeguards may give rise to human rights claims. Durey Solutions’ early input enabled the solicitor to identify key failings and proceed efficiently toward resolution.

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Background:

A vulnerable man with a known seizure disorder was arrested and placed in police custody. During his detention, he was found on the floor of his cell, reportedly after a fall. He was returned to custody after a brief hospital check.

Problem:

After release, the man was diagnosed with a subdural haematoma requiring neurosurgical intervention. The solicitors suspected failings in the initial assessment and ongoing monitoring under Code C of PACE.

Our Input:

Our Medicolegal Consultant conducted a structured review of custody records, CCTV footage logs, and hospital discharge documentation. We identified inconsistencies in risk assessment procedures and noted that red flags for traumatic brain injury were overlooked.

Outcome:

Our work enabled the solicitor to draft expert instructions with precision and proceed efficiently with a claim against the police. The case later settled following pre-action correspondence.

Why it Matters:

Quick insight into procedural failings in custody can front-load a civil claim. Our triage enabled targeted expert instruction and improved litigation economy

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Background:

A man arrested on suspicion of theft was detained overnight in police custody. He disclosed a longstanding heroin dependency during the risk assessment and repeatedly complained of withdrawal symptoms throughout his detention.

Problem:

Despite making multiple requests for medical attention, the detainee was not clinically assessed by a qualified healthcare professional until the final hours of his detention. His condition deteriorated, resulting in vomiting, diarrhoea, and a syncopal episode in the cell. Solicitors instructed to pursue a civil claim required a medicolegal overview to understand whether the delay in treatment constituted a breach of duty and whether it contributed to unnecessary suffering or harm.

Our Input:

Our Medicolegal Consultant conducted a detailed review of custody records, clinical notes, risk assessments, and internal use-of-force documentation. We provided a clear chronology of events, identified key omissions in clinical decision-making, and highlighted failures in escalation and observation protocols. We assisted the solicitor in formulating arguments that the threshold for neglect may have been crossed and helped shape the scope of expert evidence required.

Outcome:

Our input supported the solicitor’s application to instruct a forensic expert. The case proceeded with a narrowed and more cost-effective evidential focus. Settlement discussions began following a letter of claim, with the force accepting liability and agreeing damages shortly after.

Why it Matters:

Failings in the treatment of drug withdrawal are common and can lead to litigation if not promptly addressed. Our early involvement helped reduce unnecessary expert costs and allowed the solicitor to move swiftly toward resolution.

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Background:

A man with type 1 diabetes was arrested for alleged public order offences. While in custody, he became confused and aggressive. He was restrained using force and later found to have critically low blood sugar.

Problem:

Solicitors acting for him suspected a failure to recognise a medical emergency and needed to assess whether there was clinical negligence and/or assault in custody.

Our Input:

Our Medicolegal Consultant reviewed the custody records, use-of-force reports, and hospital admission documentation. They flagged inconsistencies in how staff interpreted the detainee’s confusion and identified missed indicators of hypoglycaemia.

Outcome:

Our work helped focus the legal claim and identify likely breaches. A diabetes specialist was instructed with tightly scoped questions, reducing delays and costs.

Why it Matters:

Medical emergencies like hypoglycaemia can be mistaken for intoxication or non-compliance in custody. Prompt medicolegal analysis ensured the solicitor had evidence of a lack of clinical oversight and causation. Our input supported a targeted claim — reinforcing our value as a cost-effective, responsive resource in technical cases.

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Background:

A detainee alleged they were physically assaulted by officers during a restraint episode in custody. Injuries were documented on the custody risk assessment but no hospital transfer occurred. The solicitor was preparing a civil claim against the police.

Problem:

There was uncertainty about the cause and extent of the injuries and whether they were consistent with the alleged conduct. The firm needed an overview of injury patterns, timelines, and clinical plausibility before commissioning a forensic medical expert. A quote was provided and the solicitor secured prior authority from the Legal Aid Agency, citing our input as a cost-saving measure to guide proportionate expert instruction and to reduce unnecessary expenditure on broad-ranging reports.

Our Input:

Our Medicolegal Consultant reviewed custody suite CCTV, force medical examiner notes, photographs, and contemporaneous risk assessments. We also examined body-worn video timestamps to correlate reported injury timing.

Outcome:

Our findings helped refine the instruction of a use-of-force expert and a forensic physician, limiting their scope. The solicitor was able to draft the claim with confidence in the underlying evidence base.

Why it Matters:

Where injury allegations arise during custody, Durey Solutions can help build a clear, time-efficient evidence base — preventing avoidable costs and positioning solicitors for early settlement discussions and appropriate expert escalation.

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Background:

An NHS consultant surgeon faced internal disciplinary proceedings after allegations of gross misconduct relating to their clinical decision-making in several high-risk surgical cases.

Problem:

The medical protection organisation instructed a solicitor to assist the surgeon in preparing a response. However, the solicitor encountered difficulties navigating the detailed operative records and understanding whether the allegations amounted to a lack of competence, misconduct or otherwise.

Our Input:

Our medicolegal consultant reviewed the relevant medical documentation and helped the solicitor distinguish between adverse outcomes and conduct breaches. The consultant provided structured insight into surgical risk, best practice, and thresholds for reasonable clinical judgment. The solicitor was then able to draft a cogent and clinically informed response.

Outcome:

The internal panel concluded the matter did not warrant escalation to the GMC or dismissal. The surgeon remained in post under informal supervision.

Why it Matters:

Disciplinary allegations against healthcare professionals often hinge on complex clinical judgments. Our input enabled a fairer and more clinically appropriate assessment of the surgeon’s conduct, supporting a solicitor working within tight deadlines and under intense pressure.

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Background:

A group of paramedics began experiencing stress-related illness and musculoskeletal disorders allegedly due to unsafe shift patterns, inadequate rest breaks, and prolonged exposure to manual handling risks.

Problem:

An employment solicitor instructed by a trade union was considering a group claim under the Working Time Regulations 1998 and Health and Safety at Work etc. Act 1974. However, the underlying medical issues varied significantly between individuals, and establishing causation and foreseeability across the group was challenging.

Our Input:

A Durey Solutions Medicolegal Consultant helped the legal team identify shared clinical themes across the workforce (fatigue syndromes, stress-related anxiety, repetitive strain injuries) and linked these to working conditions and breach of duty. We helped with causation strategy, helping the solicitor filter claims that were unlikely to succeed and refine the collective pleading.

Outcome:

The claim was drafted with a clear evidential and clinical basis, paving the way for a stronger negotiating position further down the track.

Why it Matters:

Large-scale claims can founder without early clarity. We help the legal teams triage issues and streamline claims, saving costs and strengthening prospects.

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Background:

A midwife employed by an NHS trust was dismissed following a series of formal complaints she made about chronic understaffing and patient safety risks on her unit.

Problem:

The midwife instructed a solicitor to bring an Employment Tribunal claim for automatic unfair dismissal under whistleblowing protections. The solicitor needed to understand the clinical implications of the concerns raised and how they affected care delivery.

Our Input:

Our Medicolegal Consultant helped with identifying how the reported safety concerns could reasonably be regarded as disclosures in the public interest under the Employment Rights Act 1996. We analysed rota gaps, patient safety incidents, and local governance issues to help inform the ET1’s factual matrix.

Outcome:

The ET1 was issued with well-reasoned and clinically grounded particulars forming a sound basis for a Scott Schedule further down the track

Why it Matters:

Our input gave the solicitor clinical clarity and confidence to pursue a legally and factually complex claim. We support ET strategy when things get technical.

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Background:

A primary care network approached a solicitor after a colleague raised concerns about a GP’s pattern of late diagnoses and missed referrals.

Problem:

The organisation sought legal advice on initiating formal capability proceedings but lacked clarity on whether the concerns crossed the threshold for a performance investigation or informal remediation.

Our Input:

Durey Solutions was asked to support the solicitor on a consultancy basis. Our MLC sense-checked the chronology of clinical incidents, helped frame the issues in light of General Medical Council guidance, and provided background on performance thresholds. We did not make judgments, but helped the solicitor prepare for their advisory conference with the client.

Outcome:

The organisation opted for a preliminary meeting with the GP under local governance arrangements, postponing formal proceedings.

Why it Matters:

Solicitors advising NHS clients must often weigh clinical subtleties. Our support helped this solicitor navigate grey areas, resulting in a proportionate and informed approach.

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Background:

A junior doctor was dismissed from their foundation training rotation following alleged unprofessional behaviour, including missed shifts and poor communication.

Problem:

The doctor’s solicitor was instructed privately and suspected that undiagnosed ADHD or another health issue might have contributed to the conduct. They sought clarity before drafting an appeal to the NHS trust.

Our Input:

A Durey Solutions MLC helped review occupational health records, shift data, and relevant medical literature on executive dysfunction and impulsivity. We helped the solicitor identify a medically grounded line of inquiry that could mitigate the doctor’s behaviour. Our Medicolegal Consultant’s time was billed with capped fees.

Outcome:

The solicitor was able to make a compelling case for reconsideration based on underlying health factors, resulting in reinstatement to a non-patient-facing role while further assessment was arranged.

Why it Matters:

We added clinical depth to a solicitor’s representation strategy, supporting a junior clinician who may have otherwise been unfairly excluded from training due to a health condition.

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Background:

A 6-month-old infant was brought to A&E with multiple bruises and a healing rib fracture. Care proceedings were initiated after social services raised concerns of non-accidental injury.

Problem:

The legal aid-funded solicitor representing the parents needed to make sense of the voluminous and technical paediatric records, which included mixed medical opinions about the injury mechanism and timing.

Funding

After providing a quote, the solicitor sought and obtained prior authority from the Legal Aid Agency to involve one of our Medicolegal Consultants, citing our input as a necessary cost-saving measure to shape expert instruction efficiently.

Our Input:

We reviewed the relevant records and imaging reports, helping the solicitor identify where the differential diagnoses hadn’t been adequately explored.

Outcome:

The solicitor used our insight to prepare a focused letter of instruction to a paediatric radiologist, ultimately showing that the injury was likely accidental. Proceedings were discontinued.

Why it Matters:

Care cases involving alleged NAI hinge on clarity of medical reasoning. Our triage enabled timely expert input, safeguarded public funds, and prevented unnecessary family separation.

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Background:

A mother alleged that her ex-partner strangled her during a custody handover. Children’s Services became involved, and the local authority considered issuing care proceedings due to perceived risk of harm to the children.

Problem:

The solicitor acting for the alleged victim needed to understand whether the medical notes supported the allegation and how to present this effectively in family court.

Funding:

The solicitor applied for prior authority to include our input under disbursements, justifying the request based on the case’s complexity and evidential importance.

Our Input:

We helped the solicitor interpret A&E and GP entries, identifying a delay in disclosure and an absence of consistent physical signs. Our Medicolegal Consultant flagged inconsistencies in the description of the mechanism of injury.

Outcome:

Our findings helped the solicitor shape a cautious and proportionate case strategy. The local authority was persuaded not to issue proceedings, opting instead for a child protection plan.

Why it Matters:

In high-stakes domestic abuse cases, distinguishing clinical fact from assertion supports more just and informed safeguarding decisions.

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Background:

Care proceedings were brought against both parents following emotional neglect and alleged exposure of their children to chronic parental conflict.

Problem:

The solicitor representing the mother needed to make sense of psychological assessments and mental health records, which were lengthy and inconsistent.

Funding:

After quoting for the work, the solicitor obtained prior authority to fund our input, citing both the complexity and the need to identify whether an expert in adult psychiatry was required, and, if so which sub-specialty.

Our Input:

We highlighted gaps in the chronology of mental health treatment and helped clarify the likely clinical impact on parenting capacity.

Outcome:

Our review informed a robust application to instruct an expert. The expert’s report contributed to a supervised reunification plan rather than permanent separation.

Why it Matters:

Unpicking psychological records can be overwhelming. Our support ensures solicitors have the insight to argue for or against expert instruction from a position of confidence.

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Background:

In private law proceedings, a father alleged that the mother was fabricating their child’s symptoms to justify excluding him from contact, raising concerns about emotional abuse.

Problem:

The child’s GP and outpatient notes were extensive and included multiple unexplained referrals. The solicitor needed assistance to assess whether a referral for an expert in fabricated or induced illness (FII) was justified.

Our Input:

We reviewed the full record set, identifying contradictory claims between reported and observed symptoms. We flagged that some diagnoses were based solely on parental report.

Outcome:

Our input supported a successful application to instruct an FII expert. The court ultimately ruled in favour of increased contact between the father and child.

Why it Matters:

In private law disputes, privately funding parties need efficient, credible guidance on whether expert instruction is warranted, especially when clinical records muddy the waters.

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Background:

The local authority issued proceedings after a hospital raised concerns that a mother may have induced or fabricated her child’s symptoms, leading to unnecessary interventions.

Problem:

The solicitor acting for the mother needed assistance identifying whether an expert opinion was even justifiable given the hospital’s findings were inconclusive.

Funding:

After providing a quote, the solicitor applied for prior authority to instruct us as part of the Legal Aid certificate, citing the need for clinical clarity before seeking expert opinion.

Our Input:

We helped review paediatric and mental health records, highlighting where diagnostic ambiguity had been misinterpreted as deliberate fabrication.

Outcome:

The solicitor used our input to argue that FII concerns were premature and the threshold for care proceedings was not met. The court allowed for ongoing monitoring rather than removal.

Why it Matters:

Timely clinical insight can prevent unwarranted escalation of proceedings and protect family cohesion without compromising child welfare.

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Background:

A solicitor acting for an asylum seeker facing deportation contacted Durey Solutions after their client, who had a history of complex PTSD and prior suicide attempts, was detained under immigration powers. Removal directions had been issued with little consideration of the client’s mental state.

Problem:

The solicitor needed to determine whether the threshold under Article 3 had been met but was struggling to piece together the fragmented medical history and assess whether expert evidence was warranted.

Funding:

A fixed quote was issued, and the solicitor sought prior authority from the Legal Aid Agency, citing the complexity of the records and our input as a time-saving and cost-effective measure compared to instructing a psychiatric expert prematurely.

Our Input:

We reviewed extensive medical records from both the UK and abroad and identified overlooked red flags, including hospitalisation for self-harm and withdrawal of psychiatric care while detained.

Outcome:

Our findings contributed to a successful deferral of removal and supported an application for bail. Expert psychiatric evidence was later obtained on narrower, better-focused terms.

Why it Matters:

Our involvement helped the solicitor act quickly in a high-stakes case and justify disbursement spending, ensuring the right expert was instructed, only when necessary.

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Background:

A client with advanced cancer was detained in an immigration removal centre. The Home Office maintained that they were fit to fly, despite visible clinical deterioration and concerns raised by detention staff.

Problem:

The solicitor needed assistance navigating the Home Office’s Adults at Risk policy and mounting a legal challenge to removal on medical grounds but lacked capacity to critically assess the medical notes in time.

Funding:

Prior authority for funding was obtained on the basis that the matter was urgent, our review was cost-effective, and a specialist expert opinion might be avoidable.

Our Input:

Our Medicolegal Consultant provided a time-sensitive review of hospital discharge summaries, palliative care notes, and in-detention records. We highlighted discrepancies between the client’s actual condition and the Home Office’s risk level categorisation.

Outcome:

Removal was deferred. The solicitor relied on our review to make representations challenging the assessment of risk and fitness to fly.

Why it Matters:

Rapid, clinically sound input helped prevent an inhumane and potentially unlawful removal, while keeping expert costs proportionate.

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Background:

A man detained for over five months without charge was later diagnosed with schizophrenia. His solicitor sought to challenge the lawfulness of his continued detention.

Problem:

Key medical assessments and internal Home Office records suggested early signs of mental disorder were ignored. The solicitor needed help establishing whether the detention had violated Home Office detention policy for mentally unwell adults.

Our Input:

We reviewed the available clinical material, identifying evidence that detention authorities had missed indicators requiring release or transfer. A quote was provided and accepted under the solicitor’s devolved powers; the matter was framed as a justified disbursement to clarify medical policy breaches quickly.

Outcome:

The judicial review succeeded. Damages were awarded based on policy non-compliance and breach of the client’s Article 5 rights.

Why it Matters:

We added immediate value by bridging the medical-legal gap, without delaying the solicitor’s urgent pre-action response.

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Background:

A client convicted of a serious offence faced deportation after serving their sentence. Their solicitor argued that removal would disproportionately interfere with their Article 8 rights, due to family ties and serious health needs requiring ongoing NHS care.

Problem:

The client’s conditions, including epilepsy and chronic kidney disease, were poorly documented and scattered across multiple Trusts. The solicitor couldn’t determine if these conditions met the Article 8 medical exception threshold.

Funding:

Prior authority was obtained by showing that our input narrowed scope, reduced expert fees, and supported the proportionality argument.

Our Input:

We reviewed the records, clarified treatment needs, and summarised the clinical trajectory. Our insights helped frame the case theory and shape a tightly focused letter of instruction to a consultant nephrologist.

Outcome:

The First-tier Tribunal accepted the medical evidence and allowed the appeal. The client remained in the UK under managed conditions.

Why it Matters:

We equipped the solicitor to challenge removal by ensuring complex medical needs were properly evidenced and aligned with human rights thresholds.

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Background:

A refugee claimant with visible physical scarring and a declared history of torture was detained by immigration officers without medical screening on entry. He was held for 38 days in poor conditions.

Problem:

A solicitor instructed to pursue damages under the Human Rights Act and common law (false imprisonment) required help establishing the extent of Home Office failures against their own policy and medical risk indicators.

Funding:

The solicitor, acting for a firm’s civil team, applied for prior authority under Legal Aid to fund our input — noting the likely savings and its role in helping evidence liability.

Our Input:

We analysed the scarring, history of pain management, and initial screening documentation. We cross-referenced clinical findings with the Adults at Risk in Detention policy.

Outcome:

Our input allowed the solicitor to plead with the benefit of clinical insight. Settlement negotiations were entered into soon after proceedings were issued.

Why it Matters:

Our involvement helped quantify failings, avoid lengthy litigation, and present a compelling case for resolution, faster and at lower cost.

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Background:

A claimant alleged long-term neck pain following a slip on council-maintained steps. The claim included ongoing physiotherapy and loss of earnings.

Problem:

The defendant local authority’s legal team had surveillance footage suggesting normal movement and no apparent impairment. The claimant’s disclosed GP records were sparse and inconsistent.

Our Input:

Our Medicolegal Consultant was engaged pre-litigation to critically review the disclosed medical evidence. They identified a lack of contemporaneous GP attendances and no objective clinical findings supporting ongoing impairment. Our Medicolegal Consultant highlighted inconsistencies between the claimed restrictions and routine activity descriptions in the notes.

Outcome:

The local authority relied on our report to challenge the claimant’s credibility during the pre-action protocol stage. The claim was withdrawn before proceedings were issued.

Why it Matters:

Timely, targeted input from Durey Solutions allowed the defence to mount a proportionate and cost-effective challenge without expert evidence. The claim never reached court—saving time and public funds.

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Background:

An insurer was defending a claim brought by a delivery driver following a low-speed rear-end collision. The claimant alleged PTSD and functional impairment.

Problem:

The medical evidence from the claimant’s GP and psychologist lacked specific diagnostic consistency. The defence solicitor wanted to avoid premature expert instruction while gathering further intelligence.

Our Input:

Our Medicolegal Consultant reviewed the claimant’s psychiatric records and highlighted the lack of documented symptoms in the six months following the incident. We also identified contradictory timelines in the therapy notes.

Outcome:

Our analysis was used to form the basis of a focused Part 35 letter of instruction. The expert ultimately concluded that the PTSD diagnosis was not sustainable. The claim settled for a nominal amount.

Why it Matters:

We helped the legal team focus their expert instruction and saved them time chasing unhelpful disclosures. Insurers value this type of early-stage clarity.

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Background:

Solicitors instructed by the NHS were defending a clinical negligence claim alleging chronic post-operative complications following routine hernia repair.

Problem:

The claimant asserted debilitating fatigue and bowel dysfunction. The defendant solicitor had concerns based on follow-up records and private healthcare use.

Our Input:

Our Medicolegal Consultant analysed the chronology of NHS and private records, identifying multiple gaps and inconsistencies. Our review questioned the credibility of the reported severity and frequency of symptoms.

Outcome:

This analysis was appended to internal instructions and helped justify a single joint expert approach, limiting costs. The case eventually settled on significantly reduced terms.

Why it Matters:

When dealing with ambiguous claims, our Medicolegal Consultants offer efficient, early insight that shapes litigation strategy, especially valuable in high-volume public body defence work.

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Background:

A travel insurer was defending a claim for cancelled flights and medical evacuation allegedly due to an acute cardiac episode abroad.

Problem:

The claimant had provided a medical certificate from a local clinic and an A&E note from after their return—but records were sparse. The insurer suspected the illness had been exaggerated to meet policy terms.

Our Input:

Our Medicolegal Consultant reviewed all available documentation and identified inconsistencies in the diagnosis chronology, language patterns suggesting template-based notes, and a lack of supporting diagnostic evidence (e.g. ECG, blood work). Our summary was appended to the insurer’s internal fraud investigation referral.

Outcome:

The claim was denied. No further action was taken by the claimant.

Why it Matters:

In claims involving cross-border records or questionable private documentation, Durey Solutions can quickly highlight red flags, freeing insurers to act decisively.

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Background:

A defendant PI panel firm was managing a multi-claimant case arising from a staged supermarket incident. Claimants alleged various soft tissue injuries.

Problem:

While surveillance and witness statements suggested collusion, the solicitors needed help tying medical inconsistencies to other lines of evidence without jumping to conclusions.

Our Input:

Our Medicolegal Consultant cross-referenced all five claimants’ medical histories and identified anomalies in reporting timelines, duplicated phraseology in independent medical assessments, and discrepancies between symptoms and declared activities.

Outcome:

The firm used our report to support an application for a strike-out. All claimant’s discontinued.

Why it Matters:

We offer value by equipping legal teams with structured, defensible material that helps them shape case strategy or justify expert spend.

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Background:

A man with known Type 1 diabetes died in police custody after being arrested for a public order offence. Officers believed he was under the influence of illicit drugs. He became unresponsive in his cell and died shortly afterwards.

Problem:

The family solicitor was preparing for an Article 2 inquest. Disclosure included confusing and fragmented medical records from police custody healthcare providers. The timeline of deterioration and the possibility of missed opportunities for intervention were unclear.

Our Input:

Our Medicolegal Consultant produced a detailed briefing note analysing custody logs, healthcare notes, and the ambulance service patient care record. We clarified the likely onset of hypoglycaemia and the inadequacy of the clinical observations recorded. We advised on key issues requiring expert instruction.

Outcome:

The solicitor used our note to frame questions for the pre-inquest review hearing, and successfully argued for expert evidence. Our input helped justify a Legal Aid prior authority application.

Why it Matters:

Accurately mapping the clinical picture in custody deaths ensures solicitors can fully engage with Article 2 issues and challenge institutional failings early.

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Background:

A 22-year-old woman died by suicide in prison. She had a history of depression, self-harm, and had been on an ACCT (Assessment, Care in Custody and Teamwork) plan. She was found dead less than a week after a cell move.

Problem:

The solicitor representing the family was unsure whether the standard of mental health care met the threshold for neglect and whether an Article 2 inquest was appropriate. Clinical records contained multiple references to referral pathways that were never actioned.

Our Input:

We provided an analysis tracing the failure to escalate her deteriorating mental state. We flagged apparent breaches of the Prison Service Instruction (PSI) and NICE guidance on suicide prevention in custodial settings, helping the solicitor identify causative omissions.

Outcome:

Our input contributed to a submission for an enhanced inquest. The coroner agreed to explore systemic failings. The Legal Aid Agency approved funding for expert psychiatric evidence, partly justified by our preliminary input.

Why it Matters:

Being able to distinguish between unfortunate events and potentially preventable deaths requires structured clinical interpretation that legal teams often lack.

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Background:

A man known to mental health services died by suicide within 48 hours of being discharged from a crisis resolution team.

Problem:

The solicitor acting for the family sought to understand whether his discharge met the relevant standards and whether the inquest could explore potential failings in continuity of care.

Our Input:

Our MLC reviewed the discharge summary, mental health risk assessments, and care plan. We identified inconsistencies with trust policy and national guidelines on discharge thresholds. We flagged these to the solicitor as areas requiring scrutiny.

Outcome:

Our briefing note helped the solicitor formulate written questions and challenge the proposed scope of the inquest. It also helped shape questions for NHS witnesses during the hearing.

Why it Matters:

Discharge decisions after a mental health crisis are high-risk and often under-scrutinised. We help solicitors understand whether standards were met and support a focused strategy.

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Background:

A child with epilepsy and respiratory vulnerabilities died following an out-of-hours triage by NHS 111 and a home visit by a locum GP. The GP declined to admit the child to hospital.

Problem:

The family solicitor needed to understand the clinical reasoning behind the decision and whether earlier hospitalisation would have changed the outcome. Disclosure was voluminous and inconsistent across services.

Our Input:

We reviewed the call transcripts, 111 disposition outcomes, and the GP’s consultation notes. Our analysis summary highlighted red flags that should have prompted escalation under NICE and RCPCH guidelines. We suggested that an expert in paediatrics and urgent care would likely be warranted.

Outcome:

This helped the solicitor prepare targeted questions for the article 2 inquest.

Why it Matters:

In complex community deaths, our structured input bridges clinical subtleties and legal relevance—helping solicitors form defensible strategies in emotionally charged cases.

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Background:

A man experiencing a mental health crisis died following physical restraint in a police custody suite. Initial reports framed the death as sudden and unexplained.

Problem:

The solicitor suspected positional asphyxia and raised concerns about the adequacy of medical supervision during and after the restraint. They needed a clinical perspective on whether restraint contributed to the death.

Our Input:

We analysed CCTV footage, use-of-force logs, and the paramedic care record. We outlined factors that may support a causal link between the restraint method used and the man’s collapse, drawing from College of Policing guidance and relevant medical literature.

Outcome:

The solicitor used our briefing note to support applications for independent expert evidence and to shape questions about restraint policy and medical oversight.

Why it Matters:

Deaths in custody involving restraint require close clinical scrutiny. We help solicitors identify when deeper questions are needed and guide funding applications accordingly.

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Background:

A community care solicitor acted for the litigation friend of a woman with dementia living in a residential care home. A DoLS authorisation had been granted, but the family believed the placement was overly restrictive and not in her best interests.

Problem:

The solicitor had received a large volume of records, including capacity assessments, mental health reviews, and safeguarding reports. There was conflicting information about the woman’s ability to consent to her care arrangements and whether less restrictive alternatives had been explored.

Our Input:

We reviewed the records and prepared a structured briefing note for the solicitor. This clarified (i.) the timeline and validity of capacity assessments; (ii.) the absence of any functional capacity test for specific decisions; and, (iii.) discrepancies between the clinical notes and the standard authorisation documentation

Outcome:

Armed with our note, the solicitor made a targeted application to the Court of Protection under s.21A MCA. The authorisation was ultimately set aside, and the court ordered a move to a supported living setting.

Why it Matters:

Our early analysis enabled the solicitor to act decisively and avoid spending public funds on unnecessary expert reports. The client’s Article 5 rights were protected through a cost-effective challenge.

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Background:

A local authority legal team sought advice in a case involving an adult with learning disabilities and a history of coercive control by family members. There were serious safeguarding concerns.

Problem:

The council’s internal capacity assessment had been challenged by the family’s independent psychiatrist. The solicitor needed help interpreting conflicting clinical documents and preparing a solid justification for bringing a s.16 application for welfare orders.

Our Input:

Our Medicolegal Consultant reviewed the psychiatric assessments, social work chronology, and safeguarding logs. We produced an analysis summary highlighting: (i.) how the family-supplied capacity assessment failed to meet the MCA’s functional criteria (ii.) concerns around undue influence not accounted for in the assessment (iii.) why best interests determinations required court input.

Outcome:

The local authority successfully applied for welfare orders and interim declarations. The Court of Protection found the family’s expert unpersuasive and approved protective measures for the adult.

Why it Matters:

Our input helped the solicitor shape their litigation strategy, identify weaknesses in the opposition’s clinical evidence, and meet procedural thresholds for court intervention.

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Background:

A specialist solicitor acting under public funding was instructed to challenge a local authority’s move to restrict an adult’s sexual contact due to capacity concerns.

Problem:

The medical records included outdated cognitive assessments and unclear documentation on how the diagnosis (autism spectrum disorder with intellectual disability) related to the adult’s capacity for intimate relationships.

Our Input:

Our Medicolegal Consultant provided a detailed briefing note to help the solicitor assess: (i.) whether a fresh expert assessment was required; (ii.) which aspects of the MCA and case law applied; and, (iii.) What questions a medical expert should be asked.

Outcome:

The solicitor secured prior authority for a specialist sexual health psychiatrist, using our note to justify the disbursement. The assessment ultimately supported the adult’s right to engage in consensual relations.

Why it Matters:

Targeted medico-legal consultancy can help solicitors secure funding for expert instruction and protect autonomy in sensitive cases.

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Background:

A Court of Protection solicitor was instructed to represent the family of a patient with a terminal illness who had rejected a proposed treatment plan. The hospital claimed the patient lacked capacity to refuse.

Problem:

There were inconsistencies in the medical records and mental capacity assessments. The solicitor needed help understanding whether the MCA test had been properly applied and how to frame the dispute for court.

Our Input:

We analysed the hospital’s notes and assessments, identifying: (i.) incomplete documentation on the patient’s ability to weigh information; (ii.) flawed assumptions conflating diagnosis with incapacity (iii.) the need for independent assessment before the court could make a best interests decision

Outcome:

Once furnished with our note, the solicitor submitted an urgent welfare application. The court ordered a stay of the treatment plan pending a new assessment. The patient was found to have capacity and allowed to make their own decision.

Why it Matters:

Ambiguity around complex end-of-life decisions can be clarified quickly with focused input, preserving autonomy and due process.

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Background:

A solicitor preparing a s.21A challenge had doubts about whether the adult actually lacked litigation capacity. The Official Solicitor had declined involvement, and the firm was unsure whether to proceed with the appointment of a lay litigation friend.

Problem:

Records from the care home and GP were ambiguous and lacked any formal capacity assessment for litigation decisions. The solicitor needed to decide whether to:
(i.) instruct an expert; (ii.) proceed under Rule 3A with participation directions; or (iii.) challenge the assumption of incapacity.

Our Input:

Our Medicolegal Consultant reviewed the available records and produced a short briefing note identifying the absence of a specific assessment of capacity to conduct proceedings, recommending interim procedural options under Part 17 of the Court of Protection Rules and suggesting targeted instructions for a capacity expert.

Outcome:

The solicitor applied for directions requiring the local authority to obtain a formal litigation capacity assessment. A lay litigation friend was appointed only after proper procedural steps were followed.

Why it Matters:

Solicitors sometimes face uncertainty in procedural matters linked to capacity. Durey Solutions helped the legal team avoid premature decisions and ensured compliance with MCA safeguards.

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Background:

A 32-year-old woman suffered soft tissue injuries in a low-speed road traffic accident. Months later, she reported persistent weakness, tremors, and episodes of non-responsiveness. The claimant’s solicitors struggled to identify causes of her symptoms.

Problem:

An orthopaedic expert had already declared the soft tissue injuries resolved. The psychiatric assessment was inconclusive. With rising costs and uncertain causation, the legal team needed clarity on whether further specialist instruction was justified.

Our Input:

Our Medicolegal Consultant was asked to review the complete medical file, including ambulance reports, GP records, A&E notes, and outpatient neurology letters. They identified early references to stress-related symptoms, inconsistencies in the presentation timeline, and prior mental health history not previously flagged. Our briefing note clarified that the clinical pattern aligned with a likely Functional Neurological Disorder (FND), recommending that a neuropsychiatrist be considered if causation remained disputed.

Outcome:

The solicitor used our analysis to refine the expert instruction and prepare a Part 35-compliant question set. The neuropsychiatric report ultimately supported a functional diagnosis with a guarded prognosis, allowing for proportionate valuation of quantum.

Why it Matters:

Where symptoms defy simple categorisation, structured analysis can prevent speculative expert spend and improve litigation outcomes.

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Background:

A builder sustained a knee injury in a workplace fall five years prior. The claim had been dormant while the client served a custodial sentence. Upon release, he re-engaged his solicitors, but records were fragmented, and his current complaints far exceeded the original documented injury.

Problem:

The solicitor needed to assess whether the claimed deterioration was credible. Multiple GP changes, missing physio letters, and poor record-keeping made expert instruction speculative and potentially wasteful.

Our Input:

We conducted a chronological analysis of available records and provided a summary of missing information likely to influence expert opinion. Our briefing note flagged a significant discrepancy between what the client now claimed and his early GP consultations. We suggested a joint instruction of orthopaedic and pain specialists, contingent on retrieval of key records.

Outcome:

The solicitor avoided premature expert instruction and obtained court permission for delayed disclosure. The final expert reports, guided by our summary, supported only partial ongoing disability.

Why it Matters:

Medical complexity, especially in disrupted records, can stall progress. Our input helps teams triage next steps with minimal cost exposure.

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Background:

An adult male claimant alleged ongoing pain and functional restriction following a crush injury to the hand at work. Surveillance evidence commissioned by the defendant’s insurers showed the claimant lifting weights at a gym and working without visible difficulty.

Problem:

The defence team suspected exaggeration but needed help integrating the surveillance footage with complex medical records, including pain clinic reports and inconsistent GP notes.

Our Input:

Our Medicolegal Consultant reviewed the pain management and occupational therapy records alongside the surveillance footage and highlighted key inconsistencies in the narrative. Our analysis supported a likely diagnosis of persistent pain with functional overlay, recommending consideration of psychometric testing before obtaining further expert evidence.

Outcome:

The solicitor used our briefing to instruct a psychiatrist with specific experience in pain-related factitious or somatoform disorders. The resulting report led to a revised settlement offer and favourable resolution.

Why it Matters:

Where symptom exaggeration is suspected, understanding what’s plausible within the medical evidence is crucial before challenging credibility.

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Background:

A cyclist involved in a hit-and-run reported confusion, memory problems, and concentration issues six months post-incident. A CT scan in A&E had been normal. The claimant had a history of anxiety.

Problem:

The solicitor was unsure whether to instruct a neurologist, psychiatrist, or neuropsychologist, and feared that the wrong instruction could result in wasted cost.

Our Input:

We reviewed the ED notes, GP records, and occupational health assessments, identifying a consistent pattern more aligned with PTSD than organic brain injury. We advised a phased approach starting with a neuropsychologist, with scope to escalate if necessary.

Outcome:

The solicitor secured prior disbursement authority for the recommended expert. The expert confirmed a PTSD diagnosis and ruled out cognitive impairment related to brain injury, saving considerable cost and time.

Why it Matters:

Matching the expert to the likely pathology reduces litigation risk and prevents diagnostic drift.

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Background:

A 50-year-old claimant pursued damages after a supermarket fall resulted in back pain. She had a prior diagnosis of degenerative disc disease but alleged the fall caused a significant deterioration in mobility and pain.

Problem:

Explain the challenge: “The solicitor faced contradictory reports from treating clinicians, which were confusing the narrative and causing delay.”

Our Input:

Durey Solutions reviewed the imaging reports, physiotherapy letters, and GP records and produced a comparative timeline showing symptom evolution before and after the fall. We clarified which symptoms were consistent with acute exacerbation and which were likely part of a chronic baseline.

Outcome:

The defence team used our structured briefing to instruct a spinal specialist with precise questions. The resulting expert report apportioned causation, significantly reducing the claimed value.

Why it Matters:

In cases involving pre-existing conditions, structured clinical analysis helps quantify claims more fairly and prevents over-inflated settlements.

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Background:

A prisoner with diabetes experienced multiple hypoglycaemic episodes while segregated in a Care and Supervision Suite. His condition deteriorated, but prison healthcare staff failed to escalate his care appropriately.

Problem:

A public law solicitor believed there were grounds to challenge the lawfulness of the segregation and the prison’s failure to provide adequate medical care, potentially violating Articles 3 and 8 ECHR. However, they needed clinical analysis to establish whether the threshold for a JR had been met.

Our Input:

Durey Solutions reviewed prison medical records and segregation logs. We provided a structured briefing note highlighting failures to follow NHS England’s Health and Justice Commissioning Intentions. We cross-referenced NICE guidance on diabetes management and identified missed red flags.

Outcome:

The solicitor incorporated our findings into the pre-action protocol letter. The prison service agreed to settle, providing compensation and committing to a healthcare policy review. No full judicial review was required.

Why it Matters:

By clarifying the clinical relevance of missed care, we enabled early resolution avoiding the need for expensive expert evidence or prolonged proceedings.

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Background:

An adult with complex mental health needs was discharged from an acute hospital to unsuitable accommodation without any safeguarding plan in place, despite a known risk of self-neglect.

Problem:

A Legal Aid solicitor sought to challenge the local authority’s failure under the Care Act 2014, but needed support understanding whether the medical records demonstrated that safeguarding duties had been triggered.

Our Input:

Our Medicolegal Consultant analysed clinical records and multidisciplinary meeting notes. We identified key indicators of likely self-neglect and contextualised them with statutory guidance (Care and Support Statutory Guidance, s.42 Care Act). We drafted a briefing note for the solicitor outlining potential breaches.

Outcome:

The analysis supported a successful pre-action protocol letter. The local authority re-engaged, offered a care plan, and the client was moved to supported accommodation.

Why it Matters:

Early medicolegal input helped clarify whether the safeguarding threshold had been crossed, ensuring accountability and improved client safety without the cost of a full JR.

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Background:

A patient detained under the Mental Health Act remained in hospital for several weeks after being clinically fit for discharge. The delay was due to commissioning gaps between NHS England and local housing services.

Problem:

The solicitor suspected the client’s ongoing detention was unlawful under Article 5 but needed clarity on the medical and procedural aspects of the discharge delay.

Our Input:

Our Medicolegal Consultant reviewed the patient’s care pathway, Mental Health Tribunal decision, and discharge summaries. We identified that clinical criteria for discharge had clearly been met, and further detention could not be justified under the Act.

Outcome:

Our insights formed the basis of an urgent application for judicial review. The court granted interim relief, requiring discharge within 48 hours. Damages were later awarded.

Why it Matters:

Medicolegal input can ensure timely intervention before harm escalates.

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Background:

An immigration detainee with cardiac disease and PTSD was scheduled for removal. His solicitor applied to defer removal, citing unfitness to fly, but the Home Office refused.

Problem:

The solicitor needed time-critical input on whether the Home Office had properly applied its Adults at Risk in Immigration Detention policy and whether the client’s condition made removal medically unsafe.

Our Input:

Our Medicolegal Consultant conducted an urgent review of medical records, highlighting inconsistencies in the Home Office’s clinical risk assessment. We cited key portions of the international guidance on medical fitness to travel.

Outcome:

Permission was granted. The removal was stayed, and the client was eventually released.

Why it Matters:

Our Medicolegal Consultants help ensure government bodies comply with their own policies, supporting access to justice for vulnerable clients.

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Background:

A patient discharged from hospital under a Community Treatment Order faced a six-week delay before community services provided medication and support, during which he deteriorated significantly.

Problem:

The solicitor queried whether the NHS Trust had breached its obligations under the Mental Health Act Code of Practice, but needed insight into the clinical and systemic failures behind the delay.

Our Input:

Our Medicolegal Consultant traced the care pathway, reviewed referral logs, and highlighted policy deviations, including missed mandatory post-discharge follow-up under NICE CG136. We drafted a structured analysis summary referencing relevant statutory duties.

Outcome:

The case settled pre-action. The Trust issued an apology and agreed to audit its CTO process.

Why it Matters:

Strategic medicolegal insight can strengthen legal arguments about systemic failure and help secure accountability.

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Background:

A solicitor acting for a consultant anaesthetist facing GMC investigation approached Durey Solutions. The case concerned allegations of incompetence during a high-risk obstetric procedure, where the patient had suffered unexpected complications.

Problem:

The solicitor was struggling to understand whether the clinical decisions made by their client deviated from accepted anaesthetic practice or were defensible given the presenting circumstances. They were keen to avoid instructing an expert, requiring medicolegal support to proceed effectively on representations alone.

Our Input:

Our Medicolegal Consultant provided a clinical issues briefing note, reviewing the operation records, anaesthetic chart, and contemporaneous notes. We highlighted the recognised emergency nature of the procedure, the limited options available to the anaesthetist, and key extracts from relevant guidance (AAGBI, RCoA).

Outcome:

Our input supported the solicitor’s decision not to instruct an expert at that stage. Instead, the case proceeded with robust written submissions, which ultimately led to no case to answer following the Rule 4 review.

Why it Matters:

In complex clinical cases, early medicolegal analysis can help avoid unnecessary expert expenditure and strengthen representations — particularly where time and funding are limited.

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Background:

An NHS paramedic was subject to an internal disciplinary process and concurrent referral to the HCPC following a delayed response to a category 1 emergency. The solicitor instructed by a trade union required rapid input to assess the clinical reasonableness of the crew’s actions.

Problem:

The Trust alleged gross misconduct. The solicitor was unclear in light of material disclosed whether the delay was as a consequence of incompetence, misconduct or whether systemic operational issues were more relevant.

Our Input:

Our Medicolegal Consultant analysed ambulance dispatch records, solicitors conference notes, the electronic patient care record (ePCR) and internal policy documents. The analysis demonstrated that a breakdown in CAD prioritisation and dispatch contributed significantly to the delay, rather than individual error.

Outcome:

The solicitor used our briefing to argue for mitigation and deflection of blame from the registrant. The internal disciplinary panel issued a written warning rather than dismissal, and the HCPC opted for no further action.

Why it Matters:

Where Trusts initiate internal proceedings focusing on adverse outcomes, clinical and operational context is key. Durey Solutions adds insight and clarity where legal teams face piecemeal disclosure and narratives that fly in the face of their client’s version of events.

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Background:

A midwife who had raised internal safety concerns about perinatal care standards was later referred to the NMC for alleged poor documentation and unprofessional conduct. A trade union solicitor sought our input to assess whether the clinical allegations had merit.

Problem:

The solicitor suspected retaliatory motives but needed a robust clinical review to determine if the midwife’s actions truly deviated from practice norms.

Our Input:

Our Medicolegal Consultant reviewed the patient records, MDT minutes, and Trust maternity escalation logs. We provided a clinical chronology and issues analysis, identifying that the midwife’s recordkeeping, while imperfect, did not pose risk to patient safety and was in line with wider systemic documentation issues.

Outcome:

The solicitor relied on our note to prepare comprehensive representations to the NMC. The case closed at the case examiner stage without further progression.

Why it Matters:

Professionals raising legitimate concerns often find themselves scrutinised in turn. Durey Solutions helps legal teams distinguish between genuine risk and background noise.

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Background:

A solicitor acting for a large GP partnership faced a CQC compliance visit, during which concerns were raised about one partner’s prescribing practices. The client wished to take early remedial action but needed to determine whether the concerns reflected poor practice or defensible variation.

Problem:

The solicitor needed a fast, informal clinical sense check to inform discussions with the client and avoid unnecessary self-referral to the GMC.

Our Input:

Our Medicolegal Consultant reviewed case summaries and prescribing logs. Our briefing note outlined that the deviations were consistent with local pathway adaptations for chronic pain management and were within BNF parameters, albeit with poor documentation.

Outcome:

Armed with our feedback, the solicitor advised internal retraining and recordkeeping review. No referral to the GMC was made, and the practice submitted an action plan that satisfied the CQC.

Why it Matters:

Durey Solutions offers pragmatic insight where solicitors or clients are unsure whether clinical issues rise to the threshold of regulatory concern.

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Background:

An NHS legal team contacted Durey Solutions during the early stages of preparing for a disciplinary investigation into a radiographer whose colleagues had raised concerns about abrupt communication during imaging procedures.

Problem:

The legal team wanted to determine whether the concerns had any clinical significance or risk to patient care, or whether the issue was purely interpersonal.

Our Input:

Our Medicolegal Consultant reviewed incident logs, feedback forms, and SOPs. Their analysis summary concluded that while communication was at times curt, it did not breach professional standards or impact patient outcomes. We also suggested evidence of good clinical performance the solicitor could draw on in mitigation.

Outcome:

The solicitor used our summary to support a proportionate outcome. A capability review and mentorship plan was undertaken, rather than referral to the HCPC.

Why it Matters:

Not every concern warrants regulatory escalation. Durey Solutions helps legal teams ground their advice in balanced clinical context, reducing the risk of overreaction.

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