TELEPHONE/FAX: 01822 855471 (Home) [email protected] EDUCATION:
Secondary Education: The Kings School, Macclesfield, Cheshire.
Charing Cross Hospital Medical School, London.
Elective period in Radiotherapy at Centre Leon Berard, Lyon, France
Certificat de connaisance de La Langue Francais, Exeter University June 1982
The Society of Anaesthetists of the South Western Region
ACCREDITATION: May 1989 PRESENT APPOINTMENT Consultant in pain management and anaesthesia at Derriford Hospital Plymouth June 1994 to date MEDICO-LEGAL EXPERIENCE
a)Number of reports: Until earlier this year I have been writing in the region of 20 reports per year however my instruction rate has increased to about 30 per year. The ratio of claimant to defendant work has been roughly equal however more recently there has been an increase in defendant briefing. I am aware of the civil procedure rules and will accept instructions from claimant and defendant solicitors and joint instructions. I also accept medical negligence work in pain management and Anaesthesia. b)Court Attendance: I have attended court and given oral evidence on two occasions once for a claimant and once for a defendant. In the first case I was congratulated on the clarity of my evidence by the judge and the claimant was awarded £90,000. In the second case where I acted for the defendant at the end of my evidence the judge manually wrote a mutually agreed text on the salient issues. In his judgment he wrote “….I found Dr. Luscombe to be an impressive witness, who gave measured, compelling and consistent opinions based on long and relevant experience, and I have no hesitation in preferring his opinion in relation to the matters upon which they did not agree” c)Scope of expertise
All aspects of pain management and in particular chronic pain syndromes, intrathecal drug delivery and spinal cord stimulation. Medical negligence in pain management and anaesthesia. d)Lectures and educational meetings. I am available to lecture with notice on all aspects of pain management As a Houseman I worked at the Royal Devon & Exeter Hospital followed by the Greenbank Hospital, Plymouth. Having completed these posts successfully I returned to the Royal Devon & Exeter as a Senior House Officer before moving on to the extended Registrar Training Scheme based in Bristol. During this period of time I had six months absence to work in Chest Medicine and I gained experience and clinical expertise in all forms of anaesthesia including pain management. I passed my Fellowship whilst working in Bristol and after that had a one years’ leave of absence working in France at a Paris Teaching Hospital. My Senior Registrar years were spent in the Wessex Region and I then had a Consultant post in Truro for 4 years from 1990-94 before I moved to Plymouth EXPERIENCE IN PAIN RELIEF (training posts) My interest in pain relief began as a Registrar at Frenchay Hospital where I received tuition from Dr A Diamond in the management of a wide variety of referrals and the use of invasive methods of pain relief. Further similar experience was obtained at the Bristol Royal Infirmary from Dr R Johnson and Dr J Alexander. As a Senior Registrar I worked for ten months in the pain relief clinic at The Queen Alexandra Hospital, Portsmouth with Dr D Pounder and Dr P Rogers spending two sessions per week in the clinic. The clinic sees an average of 400 new patients per year. I regularly saw new patients and initiated treatment regimes in discussion with Dr Pounder. During this period I practised a wide variety of techniques such as facet joint, stellate ganglion and Guanethidine blocks and also epidurals and sympathectomies. I used the radio frequency lesion generator under supervision and conducted the clinic in Dr Pounder’s absence including carrying out sympathectomies and gaining experience in acupuncture and the use of transcutaneous nerve stimulation. The clinic had a Senior Lecturer in psychology attached and had access to full physiotherapy and hydrotherapy services. My position allowed me to utilise the above mentioned services so learning the importance of a multi disciplinary approach to pain relief. I spent a two week period in October 1989 in the pain relief clinic at the Walton Hospital, Liverpool with Dr J C Wells. Here for the first time I observed a Pain Management Programme in action and participated in teaching sessions for the patients. During this time I also observed and assisted Dr Wells with pain relieving techniques such as trigeminal ganglion blockade and cervical cordotomies. I attended the "Advanced practical course in clinical pain management" at the Pain Foundation, Liverpool in November 1989. EXPERIENCE IN PAIN RELIEF (Consultant Post)
I initially worked at the Royal Cornwall Hospital, Treliske a Consultant in Anaesthesia and Pain Management. During this time I set up the acute pain service at Treliske. I moved to Derriford Hospital in June 1994 and further developed my experience in chronic pain. In particular whilst in Cornwall and also now at Derriford Hospital, I have organised the Pain Management Programme for patients with chronic intractable plain and published the outcomes (Anaesthesia 1995, Feb). This is a behaviourally based approach to rehabilitation for which the outcomes are highly successful and have been validated. In addition to this I have developed a regional expertise in the use of intrathecal medications, in particular Baclofen for spinal cord injury leading to spasm as in multiple sclerosis and also the use of opiates for severe pain conditions. I receive referrals for this from many sources. In my time in Pain Management I have also co-produced with Dr Paul Griffiths, a video on Pain Management entitled “No Illusions” and I am now the President of the Neuromodulation Society of the UK and Ireland. I was formally the Treasurer. H. M. SERVICES
Commissioned June 1983 Surgeon Lieutenant RNR Surgeon Lieutenant Commander RNR 1994-97 My work within the Royal Naval Reserve allowed me to travel to places as diverse as Hong Kong, Gibraltar and the Arctic where I served for 5 weeks on the aircraft carrier HMS Illustrious. In Hong Kong I treated a diver with a severe bend within a decompression chamber. Meeting people from different professional backgrounds to medicine has also been refreshing.
Basic, uncomplicated infection with Borrelia burgdorferi-not too ill, respond readily to antibioticsDisseminated, symptomatic disease- usually present longer, and may Need higher doses, longer duration, and also may need IV treatmentsNeed complex antibiotic regimens of long durationChronic Lyme- Patients ill for > I year, with many complications possible:Immune deficiencies (the beginnings
REVIEW Care of HIV-infected patients in China 1The AIDS Research Center, Chinese Academy of Medical Sciences Peking Union Medical College, Beijing 100730, China2Department of Infectious Diseases, Shanghai/FuDan Public Health Center & Huashan Hospital, Fudan University, Shang-hai 201508, China ABSTRACT Compared with high infection areas of the world, the total HIV infection rate in