WEAPONS OF MASS DISTRACTION: Personal Injury Photography Tips to Avoid Distracting Elements

Personal injury photography can often be comical in its acquisition. Check out the following examples of unusual personal injury photography....

 

All too often does an image of an injury detract from its primary purpose of providing an accurate depiction of severity to cause an unnecessary and sometimes comical portrayal of subject matter. 

In Personal Injury photography the subject being documented must capture the attention of the viewer by minimizing focus elsewhere and avoiding any comical aspects which may detract from its purpose. To achieve this one must control any distracting elements such as background, jewellery, clothing and client posture/expressions. The viewer is unlikely to want to see a clients book collection, floral sofa pattern, or pink new crocodile shoes and ‘I Love Jesus’ socks. Facial expressions and posture can also create a quite comical effect and detract from the importance of the image.


To avoid background distractions a clear, clean non reflective white, black, green or blue cloth should be used. (Other coloured backgrounds can reflect colour casts onto the subject and may often clash with skin tones)
All clothing and jewellery in the vicinity of the subject much be removed. This is important in portraying the location of the clinical subject in relation to an identifiable part of the body. A photograph of a scar on a clients thigh without the knee cap in shot (either covered by clothing or out of shot) may fail to portray prominence. 
All clothing and jewellery in the vicinity of the subject much be removed. This is important in portraying the location of the clinical subject in relation to an identifiable part of the body. A photograph of a scar on a clients thigh without the knee cap in shot (either covered by clothing or out of shot) may fail to portray prominence. 


Jewellery and clothing is one of the major contributors of distracting elements not only by distracting the viewer away from the subject but also in displaying an injury out of context.


Whilst avoiding distracting elements may not be the most important factor in accurate personal injury photography, it is largely overlooked in its ability to draw attention away from the subject in a sometimes comical way. This may also possibly lead to photographic evidence carrying less evidential weight in court. Clinical photographer's are trained to control distracting elements through the use of local and national standard operating procedures developed to ensure the subject being documented is the focus of attention at all times.


Disclaimer: To my knowledge the images used in this blog post were not taken by anyone in a professional capacity as part of a personal injury claim. Images used are to highlight similar true to life personal injury photography examples I regularly come across 

Image Sources:

http://www.everystockphoto.com/photo.php?imageId=867325&searchId=828de69a2994bdb482cecf9d10c7f5f2&npos=6

http://www.everystockphoto.com/photo.php?imageId=1095060&searchId=828de69a2994bdb482cecf9d10c7f5f2&npos=9

http://www.everystockphoto.com/photo.php?imageId=2661988&searchId=828de69a2994bdb482cecf9d10c7f5f2&npos=50

http://www.everystockphoto.com/photo.php?imageId=1160081&searchId=828de69a2994bdb482cecf9d10c7f5f2&npos=139

http://www.everystockphoto.com/photo.php?imageId=2713185&searchId=828de69a2994bdb482cecf9d10c7f5f2&npos=260

http://www.everystockphoto.com/photo.php?imageId=1172079&searchId=7ff983fb58f776769fdfdc8faa69662b&npos=134
http://www.everystockphoto.com/photo.php?imageId=9693515&searchId=828de69a2994bdb482cecf9d10c7f5f2&npos=1002

 

INSTRUCTING A PHOTOGRAPHER IN A PERSONAL INJURY CLAIM: EXPERT PRACTICE POINTS

Instructing a Photographer in a serious injury or clinical negligence claim:

Practice points from a Clinical Photography Expert

Tim Zoltie BA (Hons) PgC LBIPP RMIP MIMI

Director of Clinical Photography UK & Clinical Photographer at Leeds Teaching Hospitals

A photograph of an injury can be a powerful and effective tool in its ability to depict severity, and its subtle ability to evoke a sympathetic understanding of suffering and pain which would otherwise be difficult to portray verbally or in a written report. Unfortunately for many cases it can also be a hindrance. Poorly taken photographs can lead to inadmissible evidence which may in turn delay settlement. The demand for accurate photographic evidence has now meant many solicitors are turning to the instruction of a photographic expert, but who should be instructed for this work and why?

Any photographs taken are classed as evidence and therefore it is important that only a relevant expert is instructed. A Claimant’s photographs may be poorly taken and fail to depict the injury. They may also be photographed on a mobile phone and possibly manipulated using the many photo editing apps available as the Claimant has an obvious bias in the depiction of his or her injury in its worst state. A medical expert may also fail to adequately portray the injury due to lack of photographic knowledge and professional equipment. A clinical photography expert on the other hand, has knowledge of anatomy and an understanding of how best to portray injury.

Instructing the Right Expert

When enquiring about a possible instruction of an expert, a solicitor must be aware that photography is a relatively ungoverned area. Approach a photography expert with caution, as many photographers will offer to undertake a medico-legal photography report. Photography is a highly competitive industry, and there is little chance of a photographer turning any income source down unless against the law to do so. Ensure your expert is either a Registered Medical Illustration Practitioner (RMIP) or a Clinical Photographer working within a medical illustration department. The expert should have a basic understanding of CPR p.35 and a suitable declaration of compliance. Failure to instruct an appropriate expert may lead to the provision of inaccurate and illegitimate evidence, unethical and unapproved photographic techniques and may possibly result in a claim for negligence. Instructing a qualified Clinical Photographer provides confidence in the knowledge your expert has the ability and experience to document evidence legitimately and accurately following departmental, local and governmental standard operating procedures.

Accuracy and Legitimacy is Key

Up until now knowledge of photographic manipulation has been more relevant in criminal litigation. With the increase of photography to display a claimant’s injuries however, accuracy and legitimacy have had to be addressed. Whilst there is no immediate need to approach all medico-legal photographs with scepticism, a basic understanding of image manipulation techniques should be understood. Manipulation can take on many forms, from pre-photography by the pressure on a wound to cause redness or inflammation, to post-photography by editing images to extenuate severity. Not often is an image questioned as to its authenticity, but images can be highly misleading and a rise in questionable evidence will no doubt prevail with an increase in acceptance of claimant photographs. If an image seems inaccurate it should be questioned upon receipt and a relevant clinical photography expert instructed.

Can it be justified?

The Jackson Reforms have led to a heavy focus on costs. As such, the need for photographic documentation of an injury vs. the need to minimise litigation costs has led to an increased acceptance of a Claimants own photographs. Whilst this may suffice in displaying the scope of an injury it is not an accurate form of documentation and often refused by Counsel and Defendant solicitors, often delaying settlement. If expert photographs can avoid a costly medical report and possibly save time, then an early instruction may enable a more economic method of presenting a claim.

Most specialist clinical photography reports range from £100-£200, and as such can be justified against the value or importance of most cases from fast track to multitrack. As a commercial photographer may charge a similar cost, it creates questions as to whether the level of qualification of the expert is appropriate for the function instructed in the case.

Practice points for instructing a photography expert:

·         Instruct an expert early on in the process: this will avoid delays in settlement and provide immediate accurate documentation in order to determine valuation.

·         Choose your expert carefully, ensuring he or she is a specialist Clinical Photographer

·         If locating a Clinical Photographer proves difficult and time consuming, use an agency that specialise in instructions to qualified Clinical Photographers such as Clinical Photography UK (www.clinicalphotography.co.uk)

·         If instructing another medico-legal agency that offers a photography service, ensure they only outsource to clinical photography experts.

·         Be detailed in your instruction citing specific areas of interest to document and request scales where appropriate.

·         Request two copies of photographic prints, one for file and another for Counsel. Avoid photocopying or printing digital images

·         Be cautious of the various methods of photographic manipulation and do not hesitate to question authenticity.

·         Ensure all photographs received are accompanied with a declaration that the images have not been manipulated in a way as to deceive.

Tim Zoltie BA (Hons) PgC LBIPP RMIP MIMI

Director of Clinical Photography UK

Clinical Photography UK is the UKs premier agency specialising in personal injury photography by the sole use of qualified clinical photographers. 

IS EVERY MEDICAL EXPERT A DAVID BAILEY IN DISGUISE?!

Medical experts are increasingly including (and quite often charging) for photographs as part of their medico-legal reports. This is not only possibly damaging for the claimant in respect of accuracy in quantum assessment, but it is also having increasing cost implications for the solicitor. 

I am a specialist clinical photographer and director of Clinical Photography UK who provide national personal injury photography reports by qualified experts. This has led me to critically analyse the current contributors in photography for Personal Injury and Clinical Negligence claims. 

I predict many reading this have commonly been on the receiving end of poorly taken photographs by a claimant, commercial photographer or medical expert. Whilst most poor quality images are provided by the claimant themselves, medical experts are generally untrained in clinical photography and lack knowledge of specialist photographic techniques.

As many cases rely heavily on the physical appearance of an injury for either valuation, liability, or both, is an expert the right choice? 

To provide an example in context:

A plastic surgeons report on a rhinoplasty may state the Claimant has an obvious inverted V deformity as a result of an unnecessary excision of dorsal cartilage from the septum. An inferior or superior view would provide a more accurate depiction of the V deformity but is often overlooked by a commercial photographer. Whilst the medical expert may include an inferior view as part of his report, without the use of a fixed focal zoom lens the photographs would be shot at varying distances causing subject distortion. This would extenuate the shape and contours of the nose, leading to inaccurate and inadmissible photographic evidence (Please see my law gazette article on perspective distortion HERE).

For a case that relies heavily on photographic evidence of injury such as a subtle cosmetic or serious injury claim; clear and accurate photographs by a clinical photographer are vital.

Looking to the future

Basic training can provide a medical expert with knowledge on exposure, composition, and camera settings. Assuming the expert stores the images according to the DPA and relevant governmental protocols, there is no issue with experts including photographs as part of their report for reference purposes only. These images should not be relied upon for valuation or liability. If photographs are required to document severity or subtle deformity, a clinical photographer should be instructed. . Clinical photography is a specialist subject and also a profession, with hundreds of clinical photographers based at hospital sites around the UK, who are highly skilled and trained in photographing physical deformity and injury. Clinical photographers work on standardised procedures and can provide highly accurate results at roughly the same cost of an expert or commercial photographer. Post Jackson this is undoubtedly a more justifiable solution to documenting injury. 

IMI IMAGE OF THE MONTH

Institute of Medical Illustrators

• Sign in
• JOIN

Forgot password

IMAGE OF THE MONTH MARCH 2013

Pinguecula by Tim Zoltie

St James University Hospital Leeds

This Image was taken using a slit lamp camera with 40 degree cross light and Nikon D3x attachment. The vignetting was produced naturally with no after effects or manipulation. Image was not taken for a PI or Clin Neg case and is just documenting a clinical condition. It does however show the accuracy involved in photographing difficult subjects and the advantages a clinical photographer can offer when documenting lesions in difficult places. A slit lamp provides macro close ups almost similar to a microscope and can pick up changes on the cornea and external eye conditions difficult to see to the naked eye. 

To View the link:

http://www.imi.org.uk/document/image-of-the-month

WELCOME

I have to admit I am heavily biased in medico-legalphotography. I strongly believe ALL medico-legal photography should bestandardised by the use of qualified clinical photographers nationwide. Iam biased as I am a clinical photographer at Leeds Teaching Hospitals anddirector of the company Clinical Photography UK (www.clinicalphotography.co.uk), which is a medico-legalagency specialising in expert photography reports for Personal Injury andClinical Negligence claims.

My bias however, does not take away from the argument that aclinical photographer is the obvious expert witness choice to document aclaimants injuries, yet we remain relatively un-used.

Through a series of blogs and published articles, I hope to explainwhy this should not be the case, and campaign for the future standardisation of medico-legalphotography by qualified clinical photographers. I hope to provide insight into the current standard ofphotographic evidence in Personal Injury and Clinical Negligence claims, andhow it can be improved. 

If you have any comments, suggestions, or would like information on any of the subjects posted, please contact me via email: info@clinicalphotography.co.uk