A primary judge who accepts lay testimony over the evidence of multiple medical practitioners must engage expressly with the contemporaneous medical records and the testimonial evidence of each practitioner individually, rather than conflating their evidence or dismissing it in a single sentence. Where the accepted evidence is inconsistent with other findings made by the judge, the inconsistency must be addressed in the reasons. Statistical data correlating tumour thickness with survival rates may be used to establish causation (whether metastasis had occurred by a particular date) in medical negligence cases, notwithstanding that the data was collected for prognostic rather than causal purposes.
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