Interpreting Expert Joint Statements in Cardiology Negligence

In civil cardiology clinical negligence claims, the joint statement process is a procedural stage designed to narrow issues in dispute. When cardiology experts, initially instructed by opposing parties, enter into discussions under Civil Procedure Rules (CPR) Part 35.12, the primary objective is to identify clear areas of agreement and fundamental points of clinical disagreement. For instructing solicitors, understanding the nuances of these statements is essential for evaluating the strength of a claim or defence before trial.

The Clinical and Evidential Framework

The joint statement process often requires experts to address complex clinical pathways, such as the interpretation of troponin trajectories in chest pain triage or the clinical classification of myocardial infarction. Cardiology experts may be asked to consider whether the index clinical event represents an identifiable breach of the duty of care or a known complication of a procedure, such as coronary artery dissection following percutaneous coronary intervention. Experts must frame their discussion within the Practice Direction 35 requirements, which demand that the discussion focus on the expert’s own professional opinion.

Procedural Distinction Between Evidence and Negotiation

Solicitors should recognise that a joint statement is not a platform to re-litigate the entirety of clinical records. Instead, it serves to focus the court’s attention on specific, material clinical questions by providing clarified clinical positions for the court where experts have previously reached conflicting views on causation or the standard of care. It is important to distinguish this process from the appointment of a Single Joint Expert, which is a court-directed appointment under CPR 35.7, with instructions governed by CPR 35.8, rather than a voluntary discussion between party-appointed experts. The joint statement process frequently highlights where disagreement arises from differing interpretations of the facts or where the clinical evidence base remains open to legitimate debate.

Common Pitfalls in Cardiology Joint Statements

A frequent error in the medico-legal process is the failure to explicitly define the basis of an expert’s disagreement. In cardiology, this often arises when experts cite different clinical standards or apply diverging interpretations of established frameworks. To be effective, a joint statement should:

• Identify which clinical facts are agreed upon and which remain in dispute.
• Specify the precise clinical reasoning for any difference in opinion, referencing relevant evidence.
• Address the legal components of the claim, such as the causation threshold, without straying into the role of the court in deciding factual issues.
• Maintain a neutral, clinical register, avoiding emotive language regarding the index events or patient outcomes.

The Role of the Consultant Cardiologist

The expert’s overriding duty remains to the court, as stipulated by CPR 35.3. When participating in discussions under CPR 35.12, the consultant cardiologist acts as a specialist advisor to the court. If the experts reach a stalemate, the joint statement must clearly set out the reasons for this divergence. In cases involving catastrophic outcomes, such as sudden cardiac death or undiagnosed aortic dissection, this clarity is essential for legal teams to assess whether the case satisfies the Bolam/Bolitho test—namely, whether the actions taken were supported by a responsible body of professional medical opinion and whether that opinion withstands logical scrutiny.

Practical Guidance for Instructing Solicitors

Solicitors should ensure that instructions provided to experts ahead of the joint statement process are focused and proportionate under CPR 35.6. Providing an expert with an extensive, unfocused list of questions can undermine the effectiveness of the statement. Instead, identifying the core clinical questions that determine breach of duty or causation allows the experts to produce a document that is beneficial to the court. Where a claim involves highly specialised areas—such as complex inherited cardiac conditions or electrophysiological interventions—instructing a consultant with specific subspecialty expertise is often necessary to ensure the joint statement reflects robust clinical practice.