Mr Marco Scarci Consultant Thoracic Surgeon · Expert Witness Discuss a case

Areas of expertise

Where a thoracic surgical opinion is the right one

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I am a Consultant Thoracic Surgeon. My evidence covers surgery of the lungs, pleura, chest wall, mediastinum and diaphragm, and the injuries and diseases treated by that surgery. Below is what I can properly opine on, and where the boundary of my expertise sits.

Getting the right expert

Thoracic surgery sits next to several specialties

Instructions are regularly sent to the wrong one. As a rough guide:

Surgery on the lungs, pleura, chest wall, mediastinum, diaphragm Thoracic surgery — mine
Surgery on the heart, valves, coronary arteries, aorta Cardiac surgery
Medical management of asthma, COPD, pneumonia, interstitial disease Respiratory medicine
Whether a lesion was visible on a chest radiograph or CT and should have been reported Thoracic radiology
Chemotherapy, immunotherapy, radiotherapy decisions Medical or clinical oncology
Abdominal and oesophageal surgery Upper GI surgery

Many lung cancer cases need two or three of these. If yours does, I will say so on the merits call, and I will tell you which order to instruct them in — it is often cheaper to establish the radiology point before commissioning a surgical opinion that depends on it.

The eight areas

What I can properly opine on

Lung & mediastinum

Clinical negligence in thoracic surgery

Breach of duty and causation in lung resection, pleural procedures, chest wall surgery and mediastinal surgery. Consent, surgical technique, intraoperative decision-making, recognition and management of complications.

 Lung & mediastinum

Delayed and missed diagnosis of lung cancer

What the stage was at the missed opportunity, what surgery would have been available then, and what difference the delay made to treatment options and outcome.

 Pleura

Mesothelioma and asbestos-related disease

Diagnostic pathway, pleural biopsy and drainage procedures, and the surgical management of malignant pleural disease.

 Pleura

Pneumothorax and chest drain complications

Drain insertion injury, misplacement, failure to recognise a tension pneumothorax, and management of persistent air leak.

 Chest wall & trauma

Chest trauma, rib fractures and flail chest

Management of blunt and penetrating chest injury, indications for surgical rib fixation, and the long-term consequences of chest wall injury.

 Chest wall & trauma

Chest wall deformity and post-surgical outcome

Pectus excavatum and carinatum surgery, chest wall reconstruction, bar displacement, and outcomes of cosmetic and functional chest wall procedures.

 The whole claim

Personal injury and road traffic chest injury

Condition and prognosis reports in chest injury, including seat belt injury, chronic chest wall pain, and effects on function, work and care needs.

 The whole claim

Criminal cases and coroner’s inquests

Mechanism of penetrating and blunt chest injury, survivability, and whether different management would have altered the outcome.

Not sure it’s thoracic?

Call and find out

Fifteen minutes, no charge. If it is not my field, I will tell you which specialty you need.

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