When a patient dies in hospital and nutrition may have been a factor, a dietitian expert witness can assist the coroner in determining whether nutritional care met an acceptable standard and whether it contributed to the outcome. A practical guide for legal professionals and coroners.

When does nil by mouth status become negligent in hospital litigation? A dietitian expert witness explains how courts assess prolonged NBM, escalation, and nutritional risk.

Refeeding syndrome is frequently alleged in hospital malnutrition litigation. However, biochemical disturbance alone does not establish negligence. The legal analysis turns on whether risk was identifiable, whether preventative measures were taken and whether monitoring was appropriate. Refeeding syndrome negligence depends on foreseeability, documentation and whether the metabolic disturbance materially contributed to harm.

Ketone meter showing elevated ketone levels illustrating starvation ketoacidosis and metabolic acidosis risk in hospital patients.

Hospital malnutrition negligence claims often arise from poor documentation. Learn the five most common failures in hospital nutrition records reviewed by dietitian expert witnesses.

Learn why discharge nutrition after brain injury is critical, including risks, planning requirements, and medico-legal considerations.

Learn about refeeding syndrome after brain injury, including risks, symptoms, prevention, and clinical management.

Learn how nutrition is managed in ICU patients with brain injury, including feeding methods, challenges, and risks of inadequate support.

Learn when a dietitian should be involved after brain injury and how delayed referral may impact nutrition, recovery, and clinical outcomes.

Learn how aspiration pneumonia occurs after brain injury, the role of dysphagia, and how feeding decisions impact patient safety.

Learn how patients may be eating but still not meeting nutritional needs after brain injury, and how this impacts recovery and clinical outcomes.

Malnutrition in hospital patients may become legally significant when analysing whether nutritional decline materially contributed to death.

Enteral feeding supports children with complex medical needs. Learn when feeding errors may become significant in paediatric negligence cases.

Hospital malnutrition can occur when children’s nutritional needs are not recognised during admission. Learn when hospital nutrition care becomes legally significant

When should a child be referred to a paediatric dietitian? Learn when delayed referral becomes clinically or legally significant in paediatric negligence cases.

Refeeding syndrome is a preventable complication of severe malnutrition. Learn when failure to follow NICE nutrition guidelines may constitute clinical negligence.

Growth charts allow clinicians to identify faltering growth and monitor a child’s development over time

Rick Miller is a UK Registered Dietitian providing independent expert witness evidence in clinical nutrition and hospital malnutrition negligence cases.

Dietetic referral timing is one of the most common points of dispute in hospital malnutrition litigation. Allegations are frequently framed around delay — particularly where referral was triaged as routine rather than urgent. However, dietetic referral negligence does not arise simply because a patient was not reviewed immediately. The legal analysis is more structured. Hospitals triage referrals based on screening scores, intake, nil-by-mouth duration, metabolic stability

Malnutrition Universal Screening Tool (MUST) used in hospital nutrition screening to assess risk of malnutrition based on BMI, weight loss and acute disease effect.