Taking an all-round approach to excellence
Often, being a specialist in a clinical field gives a medicolegal expert insight into a particular case that matches their training and everyday practice.
However, a medical professional with a more general background can be more in demand as they are able to help on a wider number of cases.
Dr Nicolas Samaniego is a good example. A consultant at Sheffield Teaching Hospitals NHS Trust, he also takes on 40 medicolegal cases a year and has a waiting list of 10.
In his daily practice, Dr Samaniego regularly receives unselected general medical patients and is experienced at managing all common medical emergencies and performing emergency practical procedures.
A lot of his work involves the care and management of the full range of medical illnesses which affect the elderly including patients with Parkinson’s disease, other movement disorders and dementia.
“The frail and elderly tend to have several things wrong with them at the same time, which have to be accounted for and balanced” he explains.
The idea of being a generalist stretches back to the time when he was training. “When it was coming to the point where I needed to start specialising, a lot of the specialties were retreating away from the general side of the job so that put me off. I wasn't bad at certain procedures but I didn't want to focus on one area to the exclusion of everything else.
“It was really finding a way of being able to carry on being a generalist and at that time, care of elderly was the way.”
Dr Samaniego is an Educational and Clinical Supervisor for junior doctors and trainee specialists teaching medical students on the wards and in clinic. He teaches staff of all disciplines on aspects of Parkinson’s disease, including GPs, and mentors community nurses and pharmacists. He is also a mortality assessor for the Trust, working with the Medical Examiner Service.
Dr Samaniego has been involved in medicolegal work since 2014, having found visits to coroners’ courts interesting.
“Most of my colleagues were rather nervous about the concept but I enjoyed the whole process of fact finding, working through a case from start to finish and seeing what happened, what could have been done better and so on,” he says.
“Then a colleague who was in the process of retiring told me that he was a fairly established medical legal expert and asked if I would be interested in looking at some of the cases he wasn't going to take. He put me forward, showed me his structure and introduced me to the world of medicolegal.
“One of the law firms decided to give me a go, liked what I did and I suppose they told their friends!
“I enjoy it because It's almost like detective work. I like going through the files and working out what actually happened as opposed to what a claimant or defendant says happened,” he says.
“Because none of these things are black and white and if it's genuinely not a medicolegal problem so much as bad luck, that in itself is interesting and satisfying if you can explain it wasn't actually negligence.
“It's often not so much that that the medical professional did anything terribly wrong in their practice but they didn't know how to explain it. It highlights the importance of good communication at every step.”
He has written medical expert witness reports in cases of alleged clinical negligence in hospitals and care homes, including neglect, drug and prescribing errors, life expectancy calculations, falls, pressure sores, missed diagnoses and dementia care.
He adds: “I do a lot of clinical negligence and I'm receiving more cases where condition and prognosis are the focus. I’m seeing more cases of trauma where the focus is: how were they before, what is their condition now, what difference it has made to their living circumstances and their life expectancy.”
Dr Samaniego has worked with TLA for many years and he describes it as “one of the best” consultancies in the business.
He says: “The team respond very quickly, their pagination is good and their instructions are clear. They know what they want and what they don't want so it just makes the whole process flow nicely.”
Like many medical professionals, outside practice, Dr Samaniego also keeps busy.
“I've played guitar since I was 12 – I grew up on a diet of Kiss, Van Halen and Iron Maiden and I still listen to all that sort of stuff and their modern equivalents and play it as well as I can. One of my kids is a professional drummer and all three of my children are musical in some way.
“I’m also a high diver. Sheffield is one of the national dive centres and my kids all did it when they were younger. I became fed up sitting on the sidelines and discovered there were lessons for older people.
“I started when I was 38 and now my children have all stopped and I'm still doing it. I was at the Masters Nationals in April and I was at the Croatia Open recently.”
Please email Senior Case Manager Kelly Booker on kelly@tla-medicolegal.com for Dr Samaniego’s CV and further information.