Mr Simon Fulford FRCS

Contact Number: 07855 312901
When it comes to medical negligence and personal injury claims it is vital for those in the legal sector to seek the independent, unbiased advice from a professional Surgeon. When it comes to court cases for compensation for Spinal Injury, Head Injury, pelvic fracture & Urological medical negligence cases, Simon Fulford FRCS (Urol) has become recognised as a leading provider of Expert Witness Reports in to the consequences of such injuries on bladder, bowel and sexual function for Barristers and Lawyers on both sides of the case, as well as for law enforcement agencies.Simon qualified as Bachelor of Medicine & Surgery from London University in 1987 and he trained in general surgery becoming a fellow of the English Royal College of Surgeons and Urology in 1992. He then chose to specialise in Urology gaining his FRCS (Urol) in 1999. During his training he worked in many Urology units around the UK and the Princess Royal spinal injury Centre Sheffield.

He has been Consultant Urological Surgeon at James Cook University Hospital, Middlesbrough for the past 22 years and has a wealth of experience in many aspects of Urology. He is one of twelve consultants in a very busy department of Urology serving a population in the Tees Valley of over a million. He is also Consultant Urologist to the regional spinal injuries unit based at James Cook University Hospital which provides acute and long term care to patients with spinal cord injury from the whole of the North of England. In addition he runs a busy private and medico legal practice based at Woodlands Hospital.

His primary interest within Urology is the care of the neuropathic bladder in patients with spinal injuries or neurological disease. He sees and manages large numbers of patients with spinal cord injury, Multiple Sclerosis, Parkinsons disease and many other neurological conditions. He regularly performs urodynamic investigations on such patients and offers a full range of management options ranging from ongoing surveillance to major urinary tract reconstructive procedures.

Holding Membership to a number of major quality organisations including BMA; GMC; RCS; MPS and BAUS, Simon is also an active Member of the uro oncology MDT, and as such he regularly undertakes radical cystectomy with either ileal conduit or orthotopic bladder formation for bladder cancer, pelvic exenteration for gynaecological and colorectal cancers.

A great deal of Simon’s medico legal work involves patients with Cauda Equina Syndrome (CES). The Cauda Equina is a bundle of nerves that lie within the spinal canal below the termination of the spinal cord from the level of the first or second Lumbar Vertebra to the coccyx. It is vulnerable to injury by compression. Most commonly this will be caused by a prolapsed inter vertebral disc but can also be the result of spinal fracture, tumours of the spine, congenital or degenerative spinal conditions or complications of procedures such as lumbar puncture or spinal anaesthetic.

CES is the combination of low back pain, sciatica, saddle anaesthesia (loss of sensation around the anus and over the buttocks), motor weakness in the leg(s) combined with bladder and bowel disturbance (retention and / or incontinence) and loss of sexual function.

Forming part of the Cauda Equina, the Sacral nerves supply the bladder, bowel, urethral sphincter, anal sphincter and the sexual organs. All of which can be affected by CES. Patients with established CES should be referred to a Urologist with an interest in Neuro Urology to be assessed and helped with their pelvic organ dysfunction. Unfortunately many cases of CES result in litigation for alleged negligence in relation to diagnosis or treatment. It is important that in these cases expert opinion from a Urologist with an interest in Neuro Urology in regard to pelvic organ dysfunction is sought in order to ensure appropriate assessment of ongoing disability, treatment and prognosis.

In a similar way spinal cord injury inevitably affects pelvic organ function that requires highly specialised management and is of course highly relevant to a personal injury compensation case. Pelvic organ function can also be adversely affected by other injuries including pelvic fractures and Traumatic Brain Injuries and Simon believes that the expert reports ha has prepared in such cases have been important in reaching appropriate settlement.

On his medico legal work, Simon had this to say: “I have been preparing expert witness reports since shortly after appointment and have attended training courses in medico legal report writing. Having appeared in court as an expert witness for both claimant and defendant, as well as receiving joint instructions, I currently receive instructions for approximately six to ten cases per month. The cases I have reported on include spinal injury compensation claims, accidental injury compensation claims, head injury compensation claims, along with urological medical negligence cases and criminal injury cases.

As you would expect from such a dedicated professional, Simon is committed to research and development as a means of introducing new techniques: “I have run audits on several new techniques and procedures which include artificial sphincter insertion, Botox injection and implantation of Invance and Advance male slings. I was a major contributor to the MASTER trial comparing AUS to Slings in Post Prostatectomy Incontinence. These results have been presented at local, national and international meetings and in some cases published. Within Urology we have become aware of a new syndrome called Ketamine Induced Cystitis. This is an exciting research opportunity as understanding it may well improve our understanding and management of other painful bladder syndromes. I have supervised a clinical research fellow working between York University and JCUH, working with other urologists, epidemiologists, public health doctors, drug abuse experts and basic scientists to study of these patients and this new condition.