Community Munchausen's by Internet (Malingerers, Munchies, Spoonies, etc) - Feigning Illnesses for Attention

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"I'm allergic to all pain meds except for this one that starts with a 'D'. I can't remember the name. Dol-...Dil-...Deluded?"

Just what the doctor ordered: a big shot of tar into the jugular, probably. I do find it pretty amusing that all of them totally think that they're the first person to come up with the idea of pretending to be allergic to everything but the good stuff.
This absolute piece of shit I’m related to by someone else’s marriage pulls this one all the time. He’s to the point where he’s collapsed all the common veins and had to have a jugular IV (idk if they call it carotid or jugular, I certainly didn’t bother to visit him in the hospital) the last time he was hospitalized.

In reality, he’s on pain pills (I THINK Dilaudid, something strong enough to require constant doctor signoffs on his prescription and dodging pain clinic referrals by doctor shopping) and supplements with IV heroin when the pills run out. But if you ask him, he’s just so sooper speshul that his body can’t ✨tolerate✨ any of that peasant shit like Vicodin.

If he posted more, I’d submit him to this thread because his occasional posts are great- extremely long-winded repetitions of “nobody loves me” and “I’m all alone and I’m so scared” complete with hospital selfies where he tries to force a single tear. But there’s like one per year so it’s not worth the trouble. Plus his family is completely normal and doesn’t deserve the embarrassment, to be honest. Some people truly are born wrong.

But yes. Coming into the ER with sneaky “rules” about what painkillers you will accept is a giant red flag and it warms my heart that so many medfags are on to it. Nothing pleases me more than hearing how the hysterics are ineffective, because people like that deserve to receive tenfold the misery they bring to their loved ones.
 
i’ve been following this chick chronically_ash on ig for a while now. she hasn’t been mentioned in this thread since 2019 - https://kiwifarms.net/threads/munch...ingerers-munchies-spoonies-etc.29936/page-199
she is now twice the size she was back then, has a power chair, frequently posts videos showcasing her “stridor” aka the fakest sounding breathing noises i’ve ever heard, and suicide baits ER drs to try to get admitted. she looks like a sad blowfish, and she’s a goddamn delight!
 
chronically_ash screenshots
 

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Despite all the tic faking on tiktok, I haven't seen a good seizure faker in a while. I did stumble upon a very obvious tic faking cosplayer who I'm keeping an eye on. This was too good not to share though. She even says it's FND and these are non-epileptic seizures. I love the eye contact with the camera.
 
Is she the exceptional one who was a social worker and her hair was so greasy that her coworkers had to sit her down and tell her she stank?
I'm not reading everything but one of the early screenshots back on p 199 shows this dated 19th March 2019:

Managed to bathe one dog and take a shower! People at work convinced me it was the right time to take a shower since people kept pointing out how my hair looked wet (oily despite my rinse free shampoo yesterday and dry shampoo this morning). Anyway I braved it and my heart rate didn't go too high. Still tachycardic but not extremely so.
 
Despite all the tic faking on tiktok, I haven't seen a good seizure faker in a while. I did stumble upon a very obvious tic faking cosplayer who I'm keeping an eye on. This was too good not to share though. She even says it's FND and these are non-epileptic seizures. I love the eye contact with the camera.
View attachment 2803073
I think I found another seizure faker for you!
 
Evie Toombes returned to Instagram on Tuesday as if absolutely nothing has happened and she hasn't caused undue stress for every doctor in the country (let alone the ones involved in her very frequent care). No mention of any hospital stay either but she won a prize at a showjumping event. Oh, she's been to London and went to Harry Potter Studios (didn't archive)...I wonder what else she got up to on her riveting trip there? Frankly if I were a follower I'd be a bit upset at her refusal to acknowledge the legal battle when the story's been published and republished across the entire Anglosphere but I'll watch and wait. There is no way she will be able to keep her mouth shut about it when she has such a salient need to share everything that happens to her online.
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It's mostly horse pics and a ton of sponsored posts that she refuses to label as such but there's a few interesting shots between the pony ones. She also posted a video yesterday of her Shetland pony and the person holding the pony both running but I can't tell if it's her or her brother/mother. Same outfit, but almost looks too chubby to be her. Speaking of that she posted some pictures of shopping for equestrienne jackets and you can see her vertebrae through the fabric as well as her TPN toob cutting across the bottom of the picture. I'd be inclined to suspect a body check if it wasn't for the box covering her legs (she did post another picture today repping some clingy black riding outfit, again refusing to highlight that it is a sponsored post).
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The most surprising story she posted was of a Clenil (beclometasone 100mcg) inhaler because never once have I seen her talk about breathing issues. How a standard steroid inhaler was the fifth one tried is beyond me as well as her explanation for requiring one.
I looked up her inhaler to try and identify it and this particular colour and cap was only a temporary batch of inhalers discontinued and replaced in July 2021. I don't know whether it is possible for these to have been issued after that point and maybe someone medical can make sense of that. Otherwise, is she using an old inhaler for photo ops? She makes it sound like this is recently prescribed.
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Meanwhile, the medical world is still seething at the judgement: just check out #IAmPhilipMitchell for their opinions. Yesterday I found out that Dr Mitchell will not appeal and the doctors in the comments section of the article are understandably very concerned and outraged. Lawyers from both sides, who seem fairly oblivious to the fact that doctors are usually busy during working hours, put on webinars to try and explain the implications to them. I'm upset it isn't being appealed mostly because I would have really liked to see her reaction to the loss, but the justification for it is at the bottom of the second spoiler. But it sounds like this is over now, so I probably won't have too much more to document about this one apart from her day to day life (I imagine the settlement will be undisclosed).

I didn't want to watch this one but Evie's team was first to post a recording so I thought it would be all I'd get. I did not enjoy listening to Susan Rodway QC and her bristlingly smug voice. She starts by reading "misconception tweets" with a laugh at all these stupid non-lawyer scum commenting so ignorantly on her winning landmark case she is so proud of. She's with a second lawyer, Victoria Butler-Cole QC - who isn't medicolegal (or insufferable) - who is interested in lay perception of law and is there to ask some questions about how it applies to the audience's lives. I've transcribed some of the legally interesting bits but the interesting comments are in bold. Quotes are mostly by Rodway unless stated otherwise.
"But we've had the trial and the facts, and of course, Evie Toombes herself is a very attractive person and a personality in her own right, and I think all of that together, as we will show you with some slightly misleading headlines, has caused perhaps a little bit of a storm, and we hope it's in a teacup."
"Those who are disabled take great offence to this judgement."
"This ended up being a case that was nothing to do with whether folic acid, if taken by this mother, would have prevented spina bifida in this claimant"
"I know that not only the claimant, but her family, have been quite nastily trolled on social media--she's a pretty available person, and so people have been able to get to her and say some pretty cruel and evil things, and even I have not been immune [...] it's interesting that there is that sort of venom out there."
"Conception occurred almost immediately, really, all the dates showed it was virtually as soon as the conception advice had been given."

"This action was brought by the claimant [Evie] and that's probably one of the first interesting issues because it's not a claim that was brought by parents, so it's not a claim for wrongful birth. And that as we know normally brings with it, the wrongful birth claims, are normally those cases where it is said that the disability could and should have been identified antenatally, and the parents then say that if that had been the case they would have opted for a termination - that was not the suggestion in this case [...] it was accepted that there was really no way that this particular disability could have been picked up antenatally so that was not part of the discussion. There was never any allegation concerning termination at all and certainly the claimant herself has never said I should have been terminated. And if she had said that, if that was the case, I'm afraid it would have-- it would have faulted at the first hurdle because there is a case, (those lawyers amongst you will know) called McKay which has been decided to many, many years ago and does not allow the claim for wrongful life which is what that would be."

VBC: [paraphrased] Could her parents have brought their own claim instead of her?
SR: "Yes, I think they could. It's an interesting one that I haven't explored with them. I think that the reason that they didn't bring the claim is that they, I think, tied it in with this idea of termination, and they didn't at any stage ever say 'We didn't want Evie; Evie's an absolutely fantastic daughter,' so there was an emotional element, I think, there. Time, I think, also went against them because by the time they really started thinking about it issues of limitation came into the picture. By the time the case came certainly to me, it was only the claimant who could bring an action on her own behalf because she was at that stage under the age of eighteen, and again one knows in common law *legalese word salad used as conversational filler* there is a preliminary period of three years but it's extendable if you're underage (so it only runs from the majority age 18 and can be extendable in other circumstances). It could have been brought as a claim for wrongful life; probably, however, would have ended up having the same issues.

Something she mentioned that I didn't want to transcribe but still found interesting: she did a lot of global research of other cases of wrongful conception looking at places like Australia, USA, Ireland, Netherlands where there's things like IVF and genetic disabilities that should have been known but this case is unique, i.e. nowhere and no-one else is this exceptional.

"I think the real interest in this case is, what would have happened if the non-negligent advice, if the correct advice had been given; and the argument (obviously at this stage we hadn't proved it, it was based upon assumed facts) but we argued that would have led to a delay in conceiving. And this then brings us to this very ethical, moral and difficult dilemma because there's no way-- obviously I as counsel-- everyone had to accept that a delayed conception would have meant that the child that would have been born would have been a genetically different individual."
VBC: "...Nothing that the doctor did here had any effect on the claimant except that if the doctor had done something differently she would have never been born.

"The [media] focus has wrongly been lasered onto this idea that 'I should not have existed" which is not what was being said. It was, as a matter of fact this is what would have happened, but forget that because the court looks at what has happened and what has happened, quite simply, a disabled child has been born."
[After talking about the very low probability of having a child with spina bifida] "It's a concept of balance of probabilities so is it more likely than not (and broadly we use a bar of 50%, so was it less than 50% likely) that the next pregnancy would have been one with spina bifida. The defendants were forced to have to agree that statistically, on the balance of probability, a later birth would have been normal." [note: they used the matter of fact that a later conception, i.e. brother Rocco, was healthy]
"There were investigations carried out, it wasn't a form of disability that was due to any genetic component in the parents so it was a stochastical one-off."

VBC: [paraphrased] very few conditions, even conditions with known genetic components like cystic fibrosis don't have more than a 50% chance of disability.
SR: "So that's perhaps a worry, isn't it, that's probably where the medical profession becomes concerned because of this point. But all I can say is I haven't seen this happening beforehand." *goes into legal hypotheticals* "No doubt there's someone clever in the audience will this think of a situation that's analogous [...] Another protection for the doctor, because there are going to be very narrow instances that conform to this."

She's got a slide that says "no genetic cause" but I don't think she fully understands that genetic =/= hereditary in all cases which is a bit of a mishap given she's devoted a number of years to this case. It's genetic because it's her genetic makeup that made it, not inherited from her parents' genetics technically, which would make it hereditary (and thus also genetic).

In regards to Lambert J (the preliminary trial, see earlier posts by me): "She said, claimant born disabled. The main thing that was very clever of her [the judge], and I give her the credit, not anything on my side, was that the 'occurrence' was sexual intercourse prior to conception [in a folic acid deprived state.] And then, D [doctor] answerable to C [Evie], and hence C's disability, actionable...She simplified it, as all very clever people do." The other lawyer notes here that in a future similar case a judge is not bound by this preliminary judgement.

"No one, not the parents, nor Evie, none of they say themselves, 'I should not have been born.' [...] She really is the most incredible young woman. She has never let this very, very, all-consuming disability in any way hamper her and when you see her, when she can't properly feel below her legs, she can't feel the legs or below the waist properly, she's doubly incontinent, she has to be tube fed. So she literally takes a backpack with her and what she has done in the world of showjumping is just quite incredible (it would beincredible for a completely able-bodied person let alone someone with her disability) and that's what she says, 'Find a way not an excuse.' So I do have to advocate strongly here that she is not, you know, saying she should not have been born."
VBC: "...She's obviously able to sort of separate those two things out and say, 'Well, I'm not saying I shouldn't have been but I am saying that the world should have been differently arranged, and my mother should have not conceived me' [...] fundamentally when it comes to the legal claim you are effectively saying 'I shouldn't be here.'"

Makes a point that in the nineties all this genetics stuff was very novel and wouldn't be in the forefront of parliamentarians/law advisors. Then goes into details on the law and talks about some more difficult scenarios and finishes it off with a haughty:
"Just keep a note. It is not that difficult. I mean, quite honestly, in giving evidence, and I'm not being unkind here but in giving evidence when Dr Mitchell was saying to Her Honour 'this is what my standard practice is' it took him about - well I took a note of what he said, it took me about one minute to write down what he was saying - and in doctors' notation [stammers] you have got time to do it as a doctor, you really have. [...] Have you discussed pros and cons, decided this or that was more preferable for reasons given, you know. Not that hard."

Did I mention how much I hate lawyers? I'm sure the doctors in the audience took this one well.
"To be honest I did not think that this would go to trial because it's a matter of factual issues, and the reason that I didn't think that is that, as you will see, the doctor's note was just-- it was-- the judge accepted it was absolutely inadequate [scoffs]."

VBC: [paraphrased] how was the conception date determined i.e. could Evie had been conceived before the doctor's appointment?
SR: "That was factually dealt with on a very simple basis because mother's evidence was supported by father, what they had done once [she] had come off the contraceptive pill is they just refrained from sex altogether. So there was no question-- it wasn't a question of-- it was a --it could have been sexual intercourse prior to the consultation but with conception afterwards, but the act/the occurence was not, not dependent upon the negligence. This was a point that [garbles] a lot was made of it with dates and timings et cetera because on a factual basis as soon as the judge believed the parents, that they had abstained, totally, that was proven. In any other situation I agree that could have been a very tricky one."
VBC: "As you said, when it fits into a whole narrative of 'I actually went to the doctor purely for the purposes of obtaining some advice about this question,' you can see why the judge believes that account."
SR "We were lucky because you don't always, you dont know which judge you're going to have. As we know in our, in our world we find out the judge who is going to try the case, almost literally the day before, or a couple of days before. We have no control over who the judge is. And we could have had a judge who completely took against the claimant's parents who didn't believe a word they said. So these things to some extent are to do with the way that the evidence comes out on the day."

"Dr Mitchell implied it was unusual [for Mrs Toombes to attend for preconception advice], but she wasn't coming to ask about that. Remember the impetus was she'd been on the contraceptive pill for a number of years. And she was most concern to know 'how long should I refrain from having sexual intercourse after I've come off the pill [...] and she was saying 'I've also heard something,' and she raised it, 'I've also heard something about folic acid so yes there's a lot of criticism of her, this silly woman that should have known - that's not really fair, because if you're coming specifically and you're saying, 'I've heard a few rumours about this and I could [research it]' but she's bypassing that and coming to the doctor. Why can she be blamed for that; she's doing better-- she's going to the gold standard rather than taking some sort of anecdotal."

"You needed to be at the the trial. I mean, mother was a relatively straightforward; she was cross-examined very skillfully, and the cross-examination certainly bamboozled her, let's put it that way, and the judge refers to there being areas of silence where she [filler words] was just unable to answer a question, but I'm afraid she, she did have the upper hand here for the very simple reason this was a unique situation for her she's coming specifically to the doctor before having her first baby. And it's the sort of situation that you can inderstand the courts sort of accept our submission: this is likely to stick in her mind it's something she's likely to remember. And, unfortunately, here we get the problem with this really poor note that Dr Mitchell made - I mean, the only reference was "folate if desired" which ironically fitted into mother's evidence that she asked about folic acid and was made to feel she was being a bit old fashioned because it's all-- that's all in the past, you don't need to take supplements now because if you have a good diet it is in your diet.

They talk about Dr Mitchell deviating from standard practice in 2001 by saying if you have a good enough diet folic acid isn't necessary:

SR: "Yes, and he had to accept that he had said in the witness box as well because he hadn't even asked about the diet properly *bursts out laughing* and he agreed during that it would be very difficult to ensure that you had sufficient, because you had to know exactly what the date was. So, he was decent enough, I think, good on him, to accept that frankly if he did in fact give what was his standard practice advice, it was negligent."
VBC: "So really this recent judgement just boiled down to who did the judge believe about what was said in conversation."
SR: Yes, it did. It did. And I think that's, yep, these were the facts that were obviously decided, um, and I think that's virtually, that that sums it up. So it, I suppose, in a way, this was meant, this was going to be the damp squib part of the case because it was, as you say, it's very factual, it's it was only to to do with an assessment of, effectively, two witnesses with two competing stories - what lawyers meet, day in, day out, what judges have to meet all the time. But of course the consequences of the decision have ignited these areas of concern and I think we've probably covered quite a few of them, I mean, the length of time after the event, you know what, sometimes you cannot avoid that, particularly if you have child injuries for the reasons I've said *gives example of kids with brain damage that become a protected class in law and therefore have no capacity and are entitled to sue the whole of their lives* And if you're a doctor that's one of the reasons that putting, keeping a good note is drummed into you at all stages and doctors--[garble] I think that's changing now because I think what I see doctors, and the computerised systems and they can, you can Dragon Dictate, you can just dictate, you know, sometimes doctors, I'm still sitting there, if I ever go to the doctor which is pretty rare, and they dictate it whilst I'm sitting there. So I don't think that's a real excuse." [note: this is a joke, half the country still runs on paper especially hospitals, and who is going to use Dragon Dictate for anything but a letter]

"Yes it looks like it's an assault on the medical profession but it's no more no less that the sorts where the medical profession has sadly failed the patient."
VBC: [paraphrased] suggests that there's still issues on the wider scale legally/this could be appealed - is it opening floodgates?
SR: "That's the final crumb of comfort because it is effectively not the end of the matter if, if another similar case comes along and the facts, support the argument this can go further"
Despite insulting doctors the whole way through, Susan finishes off with:
"That's part of the reason I wanted to have this webinar is, is to allay fears, quite frankly, is to say, if you do your job properly you don't have to fear the law *really condescending drop in her tone of voice at the end of the sentence*. We aren't out there to try and weedle in, this was in fact a pretty glaring case of a job not done properly when someone has specifically asked for a specific area of advice and it was not provided with care."

And finally:
"So those headlines and-- [stammers] We know what reporters do-- it certainly sold newspapers..."
Yeah, nice one coming from a lawyer, Susan.
I finally got a recording for the Clyde&Co (Dr Mitchell's lawyers) webinar which is good because I was much more interested in hearing what they had to say over Evie's legal team - if they had posted this sooner I likely wouldn't have bothered listening to the above but I guess you guys can celebrate at the extra content. It was very in-depth on the legal stuff and it doesn't really add much more than we already know but a few good comments. Despite my disdain for the legal profession I actually feel a bit bad for these guys.
Some direct quotes from the legal team but it was easier to copy stuff from their presentation as it was quite well made. View the presentation (instantly downloads a .pptx file). It starts with Ben Shoebridge talking about the preliminary issues and the story so far.
"I've put up some pictures of Evie. There's no doubt she's a very impressive young lady. She horserides, she's a showjumper, um, she wants to compete in the paralympics, she's met with Prince Harry and, and Meghan (you can see them there), and you know, by all accounts, she's making the most of her life and limitations. Uh, she has a blog, she does all sorts of things, she's written a book with her mum, um, so she really is, sort of, making the most, um, of her life, and you know, on account of her disabilities."
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"The claim has a very protracted history, and just to put the, the liability trial and the trial of the preliminary issue into context, I just want to run through that history."
  • 10 October 2006: Letter of Claim served on Dr M.
  • 7 May 2007: Letter of Response denying liability served on behalf of Dr M.
  • Claim then went dormant until 2010 when the C’s solicitors wrote to the MDDUS [Medical and Dental Defence Union of Scotland] (who were then assisting Dr M) inviting them to reconsider their position and indicating they had instructions to issue proceedings.
  • Nothing then heard until 2011 when C’s solicitors wrote to the MDDUS inviting them to exchange expert liability evidence. This was refused.
  • Between 2011 and 2014 there was correspondence between the parties in relation to exchange of expert liability evidence.
  • Claim then went quite for a number of years until 17 May 2018 when a “second letter of claim” was received.
  • The MDDUS wrote to C’s solicitors on 26 November 2018 to confirm that the position as set out in the LoR remained the same.
  • Proceedings served on 16 August 2019.
  • A Defence denying liability was filed and served on 18 October 2019.
  • Part of the original defence was that C had no valid cause of action as the claim was properly categorised as a claim for ‘wrongful life’ which are not actionable under the Congenital Disabilities (Civil Liability) Act 1976.
  • A trial of the preliminary issue took place on 9 and 10 November 2020. Judgment in favour of the Claimant was handed down on 21 December 2020.
    A Case Management Conference (CMC) took place on 29 July 2021 before Master Cook to set down Directions for a liability only trial.
  • Permission to rely on expert causation evidence sought by the Defendant but refused by Master Cook. Liability trial to proceed on the basis of the factual evidence only.
    "We sought permission to rely on causation evidence. It was agreed that GP expert evidence was not required because the claimant accepted that if the advice Dr M said he gave to the claimant was given then that was not negligent advice, that was reasonable. So it was agreed that GP expert evidence was not required but we wanted causation evidence, primarily to address the issue of whether Mrs Toombes, Evie's mother, was pregnant at the time she saw Dr Mitchell. Um, that was refused, unfortunately, despite our - I thought - very good submissions, uh, the judge refused permission to rely on any expert evidence. So the trial proceeded on the basis of the factual evidence - the liability trial, that is, proceeded on the basis of factual evidence alone."
  • Liability only trial heard at the High Court (RCJ in London) on 22 and 23 November 2021 before HHJ Coe QC.

Trial of the Preliminary issue:
  • C’s case was that the claim is not a claim for “wrongful life” and that to apply such a label here was to misunderstand what the Law Commission intended to convey by the term.
  • The claim is one which falls squarely within the scope of subsection 1(2)(a) of the Act which permits recovery by children born disabled as a consequence of negligence affecting a parent in his or her ability to have a healthy child.
  • C submitted that, on a proper reading of the Act, the LRCR and the judgment in McKay, “wrongful life” is restricted to tortious acts or omissions following conception but for which the pregnancy would have been terminated.
  • The judgment turned almost exclusively on the interpretation of section 1(2)(a) of the Act. Section 1(3) was also relevant to Lambert J's findings.

The "occurence":
  • Lambert J considered that a cause of action under section 1 of the Act involves three components: a “wrongful act”, an occurrence as defined in subsections 1(2)(a) or (b) and a child born disabled [at 41]
  • The “wrongful act” as alleged was accepted for the purposes of the preliminary issue trial. There was also a child born disabled.
  • Focus on what constitutes an “occurrence” under the Act.
  • D submitted that an occurrence means that there was an event or “something happened” and that, in the context of this claim, it means that something must have happened which affected the Claimant’s mother in her ability to have a healthy child.
  • D submitted that on the basis of the agreed facts, there was no change in the Claimant’s mother’s [physiological] state and so no occurrence which affected the Claimant’s mother’s ability to have a healthy child as required by subsection 1(2)(a).
  • Lambert J did not accept that that the Act requires there to be a change or alteration in the mother’s physiological state. Lambert J observed that at para 46 of the LRCR the Commissioners noted that one of the technical difficulties with claims derived from a duty owed to the mother is that a tortious act may not result in any actionable injury to the mother and that “an act or omission may cause physical injury to the child but leave the mother physically unaffected…” (as per section 1(3) of the Act) [at para 45]
  • Further, Lambert J found that the act of sexual intercourse itself may constitute an occurrence.
  • Consistent with the remarks of the Commissioners at para 91 that, where negligence actually causes the intercourse which results in the conception of a disabled child, there should be recovery (in this case the negligence being D’s “mis-advice” as to pre-conception folic acid supplementation).
  • Paragraph 55 of ruling: Evie Toombes’ disability resulted from the circumstances of her conception which took place in her mother’s folic acid deficient state.

Joanna Bower takes over to talk about the liability trial. Interestingly she keeps referring to Mrs Toombes as the claimant, technically incorrect but given what we know I also know this stems entirely from Mrs Toombes' intention to sue the whole of her daughter's life. She first makes a comment on the preliminary judgement:
"That was actually a very suprising ruling albeit a very intelligent judgement. However we must remember that this was decided on the basis of the claimant winning her factual case taken at it's highest. And we wholly disputed the claimant's factual case, which is why we then went on to fight the liability trial, uh, which Ben has explained was fought on factual evidence only.

C’s case:
  • with non-negligent advice, Mrs T would have delayed conception to take folic acid “for a time”
  • a genetically different foetus would have been conceived - born healthy.
D’s case:
  • Already pregnant on 27 Feb 2001
  • Dr M unable to recall consultation (20 years ago) - relied on contemporaneous note and usual practice – folic acid advised "and we said folic acid was appropriately advised. Now interestingly, the claimant said that if what was in Dr Mitchell's witness statement was accepted and the advice he gave was as he said he did then they said that that wasn't negligent. But they, of course, disputed that what he said was in fact what he advised at the time."
D’s main arguments:
  • C’s mother was probably already pregnant.
  • Change in C’s case over time in response to [expert] evidence that had folic acid been taken, there would be no difference in outcome "because the literature is clear that folic acid may prevent spina brifida but does not prevent LMM."
  • Dr M did give advice. [It was probable] that Mrs T did take folic acid – evidenced by maternity booking in form [about a month later], midwife recorded: “Current medication – Folic Acid”

Was mother already pregnant?
  • She stopped taking the pill on 11 Feb 2001 (16 days prior to Dr M).
  • LMP 13 Feb, 2 weeks before she saw Dr M.
  • EDD 20 Nov 2001 – 40 weeks from around 14 Feb (2 weeks before she saw Dr M; LMP was 13 Feb).
  • EDD confirmed on a scan (25 March).
  • EDD confirmed by fact C born on 19 Nov 2001( 40 weeks after 13/14 Feb).
  • Mother never challenged the inaccuracy of the EDD.

The evolution of C's claim
  • Oct 2006 LOC – 5 years after C was born – “it is clear that the C was conceived at about the same time she saw Dr M” - if properly advised, would have taken folic acid in critical weeks of pregnancy preventing NTD.
  • May 2007 LOR (MDDUS) – folic acid would not have prevented lipomyelomeningocele (LMM), a very rare form of neural tube defect
  • March 2011 – after 4 year silence - letter March 2011 – changed case:
  • With proper advice, C’s mother would have refrained from unprotected intercourse until a full regime of folate had been completed "Now initially, the claimant argued that the advice should have been to take folic acid three months prior to conception, but that wasn't in the literature, and that was actually subsequently dropped."
  • May 2015 – C’s sols states “had mother been properly advised conception would have been avoided until a much later date
  • May 2018 – draft POC: not had unprotected sexual intercourse between stopping pill and seeing Dr M
  • Sept 2021 – Mother’s WS – no sexual intercourse at all between ceasing pill and seeing Dr M
  • Sept 2021 - Addition of Father’s WS –no sexual intercourse at all
  • D argued case changed to make good the holes in their earlier case

  • Letter of claim
    • Clear conceived around same time and could not have benefitted from taking folic acid 3 months before, however, would have taken it during critical few weeks of pregnancy …
    • No suggestion that she would have delayed conception – rather it was suggested it was too late to do so.
LOC (former case): would have taken folic acid during first critical weeks of conception dropped
POC (changed to): now alleges would have delayed conception.

Why? [We say] Because avoids the causation argument that folic acid would not have prevented LMM (no causation [and the case would have failed])

Was she already taking folic acid?
  • Maternity booking-in form which was signed by the midwife on 25 March 2001 states: “Current medication: Folic acid”
  • D tried to call Midwife at trial – now elderly, refused to give evidence
  • D asserted records show she was already taking folic acid ["otherwise why would the midwife record 'Current medication: Folic acid'?"
  • C argued that she started taking it only when Midwife F advised her to do so "The claimant argued that this booking in form was filled in at different times, which we accepted. But we said that the bit that said current medication was related to the first booking in. The claimant argued that she only started taking folic acid at that time where the midwife had actually advised her to do so. And she also said at roughly the same time her sister was pregnant and her sister had been told to take folic acid so she thought she better do so, and the midwife had recorded that, because she had immediately went out and bought some folic acid. And because the sister was pregnant around the same time, the judge said that had a ring of truth about it."

"The crucial question at trial was: was the advice given negligent?"
  • Dr M no recollection of 27 Feb 2001 (20 years ago). Relied on [contemporaneous] note and usual course of practice in advising pregnant women regarding folate: “Preconception counselling. adv. Folate if desired discussed”
  • Usual practice [which the judge accepted wouldn't have been negligent] – advice as per BNF but also if patients question whether necessary, he would go on to say if very good folic acid intake from normal diet then supplementation is less important.
  • Literature BNF (and PGP): “Women who are planning a pregnancy should be advised to take folic acid as a medicinal or food supplement at a dose of 400 µg daily before conception and during the first 12 weeks of pregnancy"
"Now unfortunately the judge found Dr Mitchell didn't give the advice as per the BNF and found that his advice was actually negligent and in relation to him saying to the court what his usual advice was the judge said at paragraph 36 of her judgement: It is his assumption that he advised and discussed with her whether or not there would be sufficient folate in her natural diet because his note reads "Folate, if desired," rather than simply advising her to take folate. He confirms that ["this is what the judge said"]he would not have advised her to delay attempting to conceive. Such advice would not be in accordance with the applicable guidance at the time. Now I've highlighted the last sentence because that's debatable based on the guidance in my view, but Judge Coe was entitled to reach this decision in the absense of expert evidence on interpreting the guidance, and I think the problem was a lot sort of fell on the guidance also..."

"[The judge] found that it was Mrs Toombes and not Dr Mitchell that was telling the truth. And in fact the judge said, um, of Mrs Toombes, that she was careful and considered when she gave her evidence. And in fact there were pauses, and quite a lot of questions Mrs Toombes didn't even answer, um, and Judge Coe addressed that in her judgement and she said that was a reflection of the temperament of Mrs Toombes, that she was a careful and thoughtful witness."

[Judge] Found for the C on all points, ruling that Mrs T and not Dr M was telling the truth:
  • Mrs T’s main concern was whether there should be a gap in taking the pill and trying to conceive.
  • Dr M should have advised to take folic acid “prior to conception”; his note was wholly inadequate.
  • [his note] “gave the impression that she should only take folic acid if she wanted to” – not told about dose or reason why is recommended or that it should be taken before and during first trimester.

"Now oddly, the judge also found, in paragraph 72 of the judgement, that if Dr Mitchell had advised that she should have taken folic acid then Mrs Toombes would have followed that advice even without full explanation for the reasons. Well, I think, in my view, if Mrs Toombes was careful and thoughtful then why didn't she ask Dr Mitchell why she would-- he was advising to take folic acid or not? But in any events the judge made the finding and she did in fact refer to a note in the GP records two years after Evie was born, firstly in April 2003 which referred to inappropriate advice in respect of folic acid, um, and also this was recorded again when the parents requested the GP records in December 2003 where it was recorded that mum feels that she'd had inappropriate advice regarding folic acid in the preconception period. Now that record was found by the judge to be consistent with what the claimant had been saying all along. And I think that point could have gone either way, really, because one could question, why was the claim not pursued at that time when the GP records were being requested and mum was saying this, was it that the family had got legal advice at the time on the prospects of success [continued but I'll just drop the presentation paragraph]:
This point could have gone either way - why was the claim not pursued at that time when GP records were obtained? Legal advice - prospects? Why mum not bring wrongful birth claim? Claim not pursued until 5 years after C was born. Mrs T said was because she was too busy looking after Evie [who was clearly very disabled, but the judge used that entry in her records to assert that Mrs Toombes had not changed her story].

Judge concluded:
  • Mrs T was not pregnant.
  • She was not advised in accordance with guidance.
  • She was not advised of relationship between folic acid and NTD.
  • She would have delayed conception had she been adequately advised.
  • A later conception would have resulted in a normal healthy child.
"Now, the claimant then won on liability, so oddly, the law has now ruled that another child and not Evie should have been born, free of any diasability, and that's obviously cause a bit of a stir in the legal and medical communities. But, Evie is entitled by law to be compensated for the disability arising out of being born as her, and now the claim will be worked up to quantify how much compensation NHS Resolutions will be paying to Evie for her disability."

Hear that, Britbongs? Your taxes are going straight into Evie's pocket, which will likely come swiftly out of her pocket to buy a new horse.

"There was some factual evidence put before the court - it was a tweet by Evie saying her condition, uh, wouldn't have been impacted on by taking of folic acid supplementation, and that was put to the mum in the witness box, and she said she didn't agree with what her daughter was saying."

They start some Q&As:

Q2. Given that C was born exactly 37+6 weeks after her consultation with Dr M took place, would it not be possible to prove that her mother was indeed pregnant at the time assuming Evie was not born premature? If Evie was born at 40 weeks then this would be easy to prove by basic maths and common sense?

JB: "We did try to run this point but unfortunately we lost, unfortunately the judge found Mrs Toombes wasn't pregnant, she was not pregnant, and the judge took judicial knowledge rather than relying on expert evidence because that was disallowed by Master Cook. And the judge said: 'Calculation would still have been 40 weeks from the first day of last menstrual period whether she conceived as early as 13 February or as late as 14th March' and I'm afraid she was entitled to do that."
BS: "She was. We did have very good evidence, we thought. The only evidence was the claimant's mother. All the other evidence pointed to the claimant's mother being pregnant.

Q3. Patient’s have the autonomy to decide whether to take folic acid supplementation or not; the note written by the doctor was as follows: “Preconception counselling. adv. Folate if desired discussed”. Did the judge take issue with the phrase ‘if desired’ or was the description of ‘preconception counselling’ judged to not be comprehensive enough?

[,,,] "But in my view the word "discussed" that Dr Mitchell did record suggests the reasons were discussed. But the judge went on to say 'Dr Mitchell told her that if her diet was good enough, folic acid was not necessary. I find that that is the more likely meaning of his note, "Folate if desired“'. So actually, the "if desired" was really taken at face value by the judge, I think to justify her ruling that Dr Mitchell just said 'well, take it if you want to.' Obviously we would say that because we're defending Dr Mitchell and we know, you know, what his evidence was. I think that the note shows that it was discussed in greater detail. I think actually the issue we've got is the 'preconception counselling' and I think that swayed the judge in finding that mum wasn't pregnant at the time then everything else fell in place for the judge to find as she did."

"This is a question that so many people have written in to ask us - are you going to appeal? Well, it's very rare, Ben, as you know, it's very rare in the extreme for appellate courts to interfere with the judge's finding on the facts. And that's because appeal judges are unable to hear what the witnesses have said in evidence, or to assess their demeanour in the witness box. And so appeal judges tend to leave it to the trial judge to make findings on the facts. They only really interfere if the law was wrongly applied, or if the ruling is wholly irrational, but in this case the judge was actually entitled to prefer one witness' evidence over the other. And I'm afraid the judgement is unappealable and so NHS Resolution accept the findings of the Court and will be seeking to work constructively with the Claimant and her legal advisers to come to a final resolution of her claim."

"There is now a low bar as to whether a claimant can bring a claim [...] I can't understate that, this is a significant judgement, it does change the legal landscape because before this judgement the prevailing view was that it was a causation case, you wouldn't have been born at all, then you're not entitled to bring a claim. This does change that."
"Particularly to the GPs we appreciate that this case may be slightly disheartening to the profession [...] please continue to do your good work in primary care, andthe takeaway from this case it that your contemporaneous notes really are very important."
 
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World's not fair, If it's anything like here, it's up to the legislature to fix it going forward. In the US there would be legislation introduced in all 50 states and federally within a half hour of the judgement. Hope the girl can use the money to put some space between her and her psycho mom.

Consequences can be a bitch. NHS might section her for her eating disorder b/c it's the prudent thing to do. Mom might actually give a shit to be overbearing in that regard too now.

OMG megjacks - "Functional neurological disorder". I'm not just a pretty girl who shakes on camera. I'm a pretty girl who can also sit perfectly still on camera.
 
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This one seems spectacularly crazy. Self harmed in front of staff when told they were going to be discharged? And what's up with those super angry red stretch marks in the fifth picture? That only happens if the weight gain is dramatic and fast.
Did a little digging and the weight gain is absurdly fast. Steroid abuse, it looks like. Found them admitting it's iatrogenic cushings, which as far as I'm aware, is treated with immediate taper from the steroids that caused it so the adrenals can recover. By definition, that's cushings caused by overuse of steroids for asthma, allergies, etc, even overuse of inhalers. They claim having to be on the 'roids FOR that, but that is the opposite of what you'd do for that situation.

Looks similar to Bethany, with epipen and steroid abuse for claimed MCAS. Of course, this kind of self destruction takes effort in massive caloric intake alongside the drugs. It is like they can't grasp the effect of gaining that much weight that fast, of course they have breathing issues.
 

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I think we should euthanize Evie for being a conniving Jew and purposely undermining the NHS. I mean, her argument was basically that she should have not been born so perhaps this can legalize retroactive abortion? :smug:
This case is so terrible and insane. It would still be unreasonable in my view but it would make more sense if her type of spina bifida was actually caused by lack of folic acid in the mom. You could say, oh if my parents had fucked on a different day I would be a genetically different person for anyone. Trannies could say mom should have conceived me at a different time and then I might be the gender I want to be so imma sue her for transphobia!
 
You could say, oh if my parents had fucked on a different day I would be a genetically different person for anyone. Trannies could say mom should have conceived me at a different time and then I might be the gender I want to be so imma sue her for transphobia!
Yeah, exactly which is why this precedent is so weird to set. It's basically attempting to prove a counterfactual.

Anyone who provides preconception care for the NHS is opening themselves up to a whole lot of shit now. Imagine if it were the other way around and the doctor did strongly advise her to take folic acid so she delayed conception and then her baby came out 'tarded. Well they could use the exact same fucking argument in court that it wouldn't have happened if she did not delay conception. It's like...what the fuck.
 
I seem to have another raging munchie in my personal circle (not as interesting or amusing as Crazy Laura though).
There’s also a low effort but still munching munchie.
Have to be careful posting them though because I’m sure Laura is still occasionally lurking trying to figure out how she can prove I’m the infamous Alison.
Why does VBO come in contact with so many munchies?
Because when TMI TMI TMI you end up encountering these people by accident by proximity.
It’s honestly really frustrating because if someone is or has TMI there’s not really a community to be found without them for any medical condition.
The passive aggressive reactions munchies seem to have to people who are sick/disabled etc are very revealing.
Unless someone is really leaning into the never getting better philosophy there’s resentment, and god forbid someone try to improve their quality of life and not scream about those damn dirty doctors not listening to them.
 
Because when TMI TMI TMI you end up encountering these people by accident by proximity.
This thread is a valuable resource to me. Munch watching saves me a lot of effort in trying to support or comfort people. The initial MAID and VSED stuff was followed by wave after wave of "I can't live with x anymore.". Both online and in person. Some people are munchies/spoonies, but it's wild watching this stuff ripple through the people that are just straight up neurotic (health anxiety). "I might not be able to live with this my entire life" instantly tips to "I want to die now" b/c worst fears confirmed by some dumb munch faking.

Spoonies/dramatic teens and munch aside, a lot of people seeking a super trendy diagnosis have a lot of anxiety. There's just no reassuring them and I bet that's gotta be so damn frustrating from the perspective of the health people here.
 
Despite all the tic faking on tiktok, I haven't seen a good seizure faker in a while. I did stumble upon a very obvious tic faking cosplayer who I'm keeping an eye on. This was too good not to share though. She even says it's FND and these are non-epileptic seizures. I love the eye contact with the camera.
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She scratches her nose mid-"seizure", lol. Doesn't take an epileptologist to diagnose this one.

The entire episode looks like she's struggling to push out a massive dump.
 
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