Areas of Expertise
Specialist neurosurgical knowledge applied to medico-legal proceedings
Clinical Foundation for Expert Opinion
Mr Richards' expert opinion draws on active consultant practice in paediatric neurosurgery at Alder Hey Children's Hospital and an international fellowship at SickKids Toronto. The areas described below reflect conditions he manages regularly in clinical practice and in which he is able to provide defensible, well-grounded independent opinion.
Hydrocephalus & Shunt Complications
Hydrocephalus management forms a core part of Mr Richards' day-to-day clinical practice. He undertakes the full range of CSF diversion procedures, including ventriculoperitoneal shunting, endoscopic third ventriculostomy, and shunt revision surgery.
In medico-legal proceedings, hydrocephalus cases commonly involve questions around delayed diagnosis of shunt malfunction or infection, the appropriateness of the chosen surgical strategy, timing of intervention, and the management of complications. Mr Richards is well placed to advise on the standard of care applicable at the time of treatment and whether any departure from that standard caused or contributed to the harm alleged.
Typical Case Types
- Delayed diagnosis of shunt malfunction
- Shunt infection — diagnosis and management
- Timing and appropriateness of shunt revision
- Complications of CSF diversion surgery
- Endoscopic third ventriculostomy — selection and outcome
Traumatic Brain Injury
Traumatic brain injury in children is a significant component of paediatric neurosurgical practice. Mr Richards manages both operative and non-operative paediatric TBI, including extradural and subdural haematomas, depressed skull fractures, and diffuse axonal injury.
In personal injury proceedings, expert opinion is commonly sought on the nature and severity of the injury, the appropriateness of initial assessment and management, and prognosis — including the likely functional, cognitive, and neurological consequences. Mr Richards is able to address these questions in paediatric cases.
Typical Case Types
- Paediatric head injury — operative and non-operative management
- Extradural and subdural haematoma
- Depressed skull fractures
- Delayed or missed diagnosis of intracranial injury
- Prognosis following TBI — functional and neurological outcome
Paediatric Spinal Disorders
Paediatric spinal neurosurgery encompasses a wide range of congenital and acquired conditions. Mr Richards manages spinal cases as part of his consultant practice, with experience across the spectrum of conditions encountered in a busy tertiary paediatric neurosurgical centre.
Medico-legal cases in paediatric spinal surgery frequently involve questions around delayed diagnosis of spinal cord compression or tethered cord, the management of spinal dysraphism, and the assessment of perioperative complications. Mr Richards can provide opinion on breach of duty, causation, and prognosis in these cases.
Typical Case Types
- Tethered cord — diagnosis, timing of surgery, outcome
- Spina bifida and spinal dysraphism
- Intramedullary spinal cord tumours
- Craniocervical junction abnormalities
- Spinal cord injury — causation and prognosis
- Perioperative spinal complications
Paediatric Brain Tumours
Paediatric neuro-oncology is a subspecialty area of Mr Richards' current practice at Alder Hey, where he holds a subspecialty neuro-oncology clinic. His operative practice covers the range of paediatric CNS tumours, including posterior fossa tumours, craniopharyngiomas, pineal region tumours, and high-grade gliomas.
His fellowship at SickKids Toronto provided further exposure to complex oncological cases, including MRI-guided laser interstitial thermal therapy and epilepsy surgery in the context of tumour-related epilepsy.
Medico-legal cases in this area commonly involve delayed diagnosis, the appropriateness of surgical decision-making, operative complications, and prognosis. These are technically demanding cases and Mr Richards advises potential instructing solicitors to contact him to discuss suitability before formal instruction.
Typical Case Types
- Delayed diagnosis of paediatric brain tumour
- Surgical decision-making and operative planning
- Posterior fossa tumours — surgery and complications
- Craniopharyngioma — management and prognosis
- Pineal region tumours
- High-grade glioma — treatment and outcome
Cerebrovascular Disease & Vein of Galen Malformations
Paediatric cerebrovascular disease, including Vein of Galen malformations (VOGM), forms part of Mr Richards' subspecialty practice at Alder Hey, which is the designated back-up unit for the nationally commissioned VOGM service. The unit manages approximately five to six of these children each year, and Mr Richards is directly involved in their neurosurgical care alongside the wider multidisciplinary team.
Medico-legal cases in this area commonly concern the recognition and timing of diagnosis, the coordination and timing of treatment, the management of associated hydrocephalus and neonatal cardiac compromise, and the assessment of neurological outcome and prognosis. Given the rarity and complexity of these lesions, Mr Richards advises instructing solicitors to contact him to discuss suitability before formal instruction.
Typical Case Types
- Delayed or missed diagnosis of Vein of Galen malformation
- Neonatal presentation with high-output cardiac failure
- Timing and coordination of treatment
- Hydrocephalus secondary to a vascular malformation
- Other paediatric intracranial vascular malformations
- Neurological outcome and prognosis
Is Your Case Within Mr Richards' Expertise?
If you are unsure whether a case falls within Mr Richards' area of expertise, please contact us with a brief summary of the clinical issues. Mr Richards will respond promptly to confirm whether he is able to assist, without any obligation on either side.
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