Dr Allan Thomas Consultant Neuroradiologist

MB BS DM(Radiology) FRCR MSc(Diploma)

Medico-legal work (all enquiries/correspondence) to:

Medico-Legal Secretary, SM Legal Services, High Pines, 71 Walsall Road, Little Aston,

Sutton Coldfield, Birmingham, B74 3BA

Tel: 0121 352 0517 Fax: 0121 353 9408 E/m: mls@smlegalservices.co.uk Web: www.smlegalservices.co.uk

Registration details: General Medical Council Number: 4260002 (registered 19.12.95) Medical Protection Society Number: 294514 CCST Date: 4

th May 2003

University Education: 1988-1993 Faculty of Medical Sciences,

University of the West Indies

1988-1991 Pre-Clinical Studies and First Clinical Year, University Hospital of the West Indies, Mona Campus, Jamaica 1991-1993 Second and Third Clinical Years, Port of Spain General Hospital, Port of Spain, Trinidad Qualifications: February 1994 MB.BS

November 2001 DM (Radiology), U.W.I., Mona, Jamaica

November 2001 FRCR, London

December 2004 International Masters (MSc) in Neurovascular Diseases, Université Paris Sud-Faculté de Médecine de Bicêtre and Mahidol University, Thailand

Medico-Legal Profile Dr Thomas has previous reporting experience, and has given evidence in court. His specialist areas of interest include:

Vascular Diseases of the Brain and Spinal Cord including management of aneurysms, arteriovenous malformations and acute ischaemic stroke

Interventional Pain Management in the Spine

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Traumatic Brain Injury

Brain and Spinal Cord Tumours

Skull Base, Soft Tissue Neck and Temporal Bone Tumours

Tumours of the Orbits and Neuro-Ophthalmology related imaging

Imaging of the Brachial and Lumbosacral Plexus

Medical Experience: Current Post October 2008 to date

Consultant Neuroradiologist Queen Elizabeth Hospital, Birmingham Interbnship Posts Jan 1994 – Jun 1995 Jan – Mar 1994 Dr T Gopeesingh Mt. Hope Women’s Hospital, Mt Hope, Trinidad

Obstetrics & Gynaecology, Gynaecologic Oncology

Apr – Dec 1994 Port of Spain General Hospital, Port of Spain, Trinidad

Apr-Jun Mr T Ali Orthopaedics Mr K Fung Kee Fung General Surgery Jul-Sept Professor C Bartholomew Gastroenterology, General Medicine Oct-Dec Dr J Webb Paediatric Medicine Dr P Manning-Alleyne Neonatology

Jan – Mar 1995 Dr A Popplewell Community Medicine, County St Andrew/St. David

Apr – Jun 1995 Dr O Khan

Eric Williams Medical Sciences Complex, Mt Hope, Trinidad Internship Elective: Radiology and Nuclear Medicine

Junior Medical Officer Jul 1995 – Jun 1996

Eric Williams Medical Sciences Complex Mt. Hope, Trinidad

Jul – Sept 1995 Mr L Sawh Urology Mr R Moze Orthopaedics Oct 1995 – Mar 1996 Mr F Saa Gandi Urology and Vascular Surgery Apr – Jun 1996 Dr O Khan Dr P Maharaj Radiology and Nuclear Medicine

Junior Doctor Jul 1996 – Jun 1997 Radiology Department

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University Hospital of the West Indies, Mona, Jamaica Dr N Moule & Dr W West, Radiology

I was on call on a one in four rota for the last three months of this period.

General Radiology Training: Jul 1997 – May 2000 Doctor of Medicine (Radiology) Program University Hospital of the West Indies University of the West Indies Mona, Jamaica The radiology department at the University Hospital in Mona is the only 24-hour on-call service for the

island of Jamaica, serving a population of approximately 2.2 million. On average, I was on call on a one in

four rota for three years. I obtained experience in interpreting emergency and day-case plain films and

cross-sectional imaging studies using a GE CT Synergy and a GE Logiq 500 at this institution.

I rotated through Fluoroscopy, Ultrasound, Plain Film Reporting/Angiography and CT for three months at

a time over the three years. During the fluoroscopy rotations I performed over a hundred barium enemas

and meals and numerous biliary tract and urinary tract investigations in adults and children.

In ultrasound I performed hundreds of abdominal and pelvic studies. I became proficient at

transabdominal and transvaginal studies and hysterosonography as well. I also performed a number of

peripheral arterial and venous studies and imaging of small parts.

My CT experience included brain, CT angiography of the Circle of Willis, head and neck imaging,

thoracoabdominal aortography, CT pulmonary angiography and hundreds of abdominal studies for

trauma, GI and renal neoplasia.

There was limited opportunity for angiographic and interventional procedures. A list of the relevant

screening and interventional procedures performed and assisted in at the University Hospital of the West

Indies between June 1997 and May 2000 can be provided.

For my final year in the DM program I spent an elective year in the West

Midlands Training Scheme.

Jun 2000 – Oct 2001 West Midlands Training Scheme, UK WMD\080\601\F Jun – Sep 2000 Interventional Rotation

Birmingham Heartlands Hospital

One session per week of Neuro/ENT CT/MRI

Oct 2000 – Jan 2001 Cross-Sectional Rotation

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City Hospital

Two sessions per week of Neuro/ENT CT/MRI

Feb – May 2001 Neuroradiology SpR

Queen Elizabeth Hospital

Jun – Sep 2001 Cross-Sectional Rotation

Queen Elizabeth Hospital

Two sessions per week of ENT CT/MRI Oncology

Oct 2001 Neuroradiology and Interventional Rotation

Birmingham Children’s Hospital

Two sessions per week of Neuro/ENT CT/MRI

Three sessions p/w of Paediatric Head and Neck/Vascular intervention

A log of the General and Peripheral Vascular Intervention cases I was involved in during a 4-month

rotation at Birmingham Heartlands Hospital and for one month at the Birmingham Children’s Hospital can

be provided on request.

NEURORADIOLOGY TRAINING & POSTS:

Nov 2001 – Jun 2002 Neuroradiology SpR (THN\080\400\V)

National Hospital for Neurology and Neurosurgery, Queen Square,

London (with on-call commitment to Great Ormond Street Hospital for

Children)

Jul 2002 – May 2003 Fellow in Interventional Neuroradiology

(NOT\080\806\V)

Queen’s Medical Centre, Nottingham

May 2003–Oct 2008 Consultant Interventional Neuroradiologist and Head & Neck Radiologist

Queen’s Medical Centre Nottingham

NEURORADIOLOGY EXPERIENCE:

DIAGNOSTIC NEURORADIOLOGY AND HEAD & NECK RADIOLOGY

Cerebral and Spinal Angiography: Over 1500 examinations performed with a wide variety of catheters and guidewires.

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Craniospinal CT: My experience began with the on-call cases at the University Hospital in Jamaica as well as the use of 3D

CT angiography for the demonstration of aneurysms. This was reinforced by my exposure to acute

neurovascular disease, neuro-oncology and ENT oncology in the Birmingham centres. At the National

Hospital for Neurology we covered neurology and neurosurgery referrals from over 40 neurologists and 8

neurosurgeons as well as all the referrals from Moorfields Eye Hospital. At QMC I gained more experience

in trauma CT, CT angiography/venography and ENT oncology.

Craniospinal MRI: I have experience in conventional examinations of the neuraxis and the head and neck. I have also gained

experience in analyzing diffusion weighted imaging, time of flight and contrast enhanced MR angiography

of the circle of Willis and neck vessels. I also have experience in MR spectroscopy, MR perfusion imaging

and volumetric studies for neurodegenerative disorders and hippocampal sclerosis as well as diffusion

tensor imaging and tractography.

Myelography: My myelography experience was obtained mainly in Jamaica, as we did not have access to good quality

MRI. This continues today as there are many patients with non-MRI compatible pacemakers.

Videofluoroscopy: I have experience in analyzing video swallows in patients with post operative or neurological swallowing

abnormalities and globus symptoms both at the National Hospital and at the QMC.

Clinico-Radiological Meetings: At the National Hospital for Neurology I ran the Neurosurgical, Neuro-orthopaedic, Neuro-oncology,

Stroke meetings and bi-weekly Neuropathology meetings. At the QMC I ran regular Neurovascular,

Neuro-oncology, Neurology and Head & Neck Cancer MDT meetings. Now, at the QEH, I have been

integral to the running of the Neurology and Neuro-Oncology MDTs as well as the Neurovascular MDTs

and Stroke MDTs.

INTERVENTIONAL NEURORADIOLOGY

My formal training was acquired at the National Hospital for Neurology and Neurosurgery and

the QMC. It was in my Fellowship post at the QMC that I gained the most hands-on experience.

In the ten months at the QMC, as a Fellow, I participated in over 80 interventional procedures,

emergency and elective, and contributed to on-table management decisions. A summary of my logbook

for all the interventional procedures I have performed at all centres as a trainee and to date as a

consultant can be provided on request. In 35 of the cases I “assisted” in at the QMC I was the lead

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operator with a consultant supervising. As a consultant I have treated over 500 acute patients and 100

elective patients as a single operator since May 2003.

I have acquired experience in the use of many microcatheter and guiding catheter systems from

eV3/Covidien, Codman and Stryker Neurovascular. I have used the GDC, Cordis DCS, Microvention and

Cook coiling systems, remodelling balloons, detachable and temporary balloons as well as most

generations of the Angioseal closure device. I have also used the Onyx AVM embolisation system and

assisted in one Onyx aneurysm embolisation. I have experience with NBCA, PVA particles, Embospheres

and the LEO, Cerebrence, Neuroform, Enterprise, Solitaire, Pipeline and FRED/LVIS stents as well as the

new WEB DL, SL and SLS devices.

At the QMC, as a consultant, I had 2 designated sessions of intervention per week and 1 session for

diagnostic angiography. I also assessed acute and elective admissions for procedures, obtaining informed

consent and following their progress post procedure, on the wards and in clinic.

I managed a bi-weekly interventional outpatient clinic and ran the weekly Neurovascular MDT

and Morbidity & Mortality meetings. We had a quarterly Neurovascular Business meeting as well as a

quarterly Maxillofacial Vascular Malformation Clinic. I had been randomizing and following patients on the

INVEST Trial looking at vertebroplasty versus best medical management and I was the lead physician at

QMC for the ARUBA Trial looking at intervention versus best medical management for unruptured brain

AVMs.

QEH TO DATE…

I have settled in at the QEH, getting to know my referring Neurologists, Neurosurgeons and ENT

colleagues. I have been the neuroradiology clinical lead for stroke imaging and intervention at the QEH. I

contribute to the teaching of our SpRs as well as improving on our Neuro-oncology and Neurovascular

diagnostic and interventional services. I have been appointed the Neuroradiology Tutor with responsibility

for our Core and Specialist Neuroradiology trainees. I am also the nominated radiologist for a number of

oncology and stroke intervention trials such as RESTART, REDUCE, TICH, OPARATIC to name a few.

COURSES/CONFERENCES:

COURSES/CONFERENCES ATTENDED IN THE LAST YEAR eV3 Acute Ischaemic Stroke Workshop Stockholm, Sweden (23/3/2011) UKNG Education Course: DAVFs Paddington Hotel, London (25/5/2011) Eurostroke 2011 Hamburg, Germany (24 to 27/5/2011)

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Brainstorm Interventional Meeting Edinburgh (20 to 22/6/2011) BAYER Healthcare Update on Clinical Neuro MRI London (28/6/2011) Microvention Animal Lab California, USA (13 to 14/2/2012) ACINR 2012 Istanbul, Turkey (30/5 to 1/6/2012) Advanced Aneurysm/AVM techniques-Covidien Essen, Germany (20 to 21/9/2012) WEB Animal Lab Training Magdeburg, Germany (11 to 12/12/2012) FRED Animal Lab Training Gressy, France & Salzburg, Austria (19/12/2012 & 29/1/2013) UKNG Winter Meetings London (24 to 25/11/2012) Passionate about Stroke- Codman Neuro-DePuy Synthes Institute Manchester (14/5/2013) UKNG Summer Meetings Newcastle (14 to 15/6/2013)

AUDIT: Review of Patient Tolerance of Visipaque versus Omnipaque for Cerebral Angiography DA Yates, A Thomas presented to QEH Radiology Consultants on March 12

th, 2001

Audit of Catheter Complications in Neuroangiography A Thomas, C Soh, H Amstell presented June 13

th, 2002

CT & MRI Requests for Head & Neck Cancer E Jones, R Lenthall, A Thomas presented April 7

th, 2005

Abciximab Usage During Endovascular Treatment of Cerebral Aneurysms: Technical and Clinical Outcomes and Lessons Learned A.J.P. Goddard, G. Tan, R. Lenthall, A. Thomas, N.Mc-Conachie (Oral presentation at WFITN 2005, Venice, Italy) Endovascular Management of Giant Intracranial Aneurysms: A Single Centre Experience S Boddu, A Thomas, K Woon (Oral presentation at UKRC 2006, Birmingham, UK)

PUBLICATIONS:

Brain and Facial Trauma: A neuroradiology perspective M Varnamkhasti, A Thomas

Trauma 2011 13(4) 317–333 An unusual complication following translabyrinthine resection of an acoustic neuroma SO Ushewokunze, A Thomas, S Lamin et al British Journal of Neurosurgery 2011 April; 25(2): 303-5

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Alcohol-related head injury: Impact on acute CT workload in a major trauma centre T Taylor, J Mhlanga, A Thomas British Journal of Neurosurgery 2009 December; 23(6): 622-624 Chapter on “Brain Imaging” in the 5

th edition of “Radiological Procedures” by Stephen Chapman, being

edited by Frances Aitcheson. I am the sole author on this chapter. Intra-operative combustion of Onyx embolic material S Smith, A Thomas, R D Ashpole British Journal of Neurosurgery 2009 February; 23(1): 76-8 Non-sphenopalatine-dominant arterial supply of the nasal cavity-An unusual anatomical variation and a challenge for the management of epistaxis D Biswas, S K Ross, A Thomas, A Sama The Journal of Laryngology and Otology, 2008 June 25:1-3 The use of a commercial remote desktop program in the delineation of target volumes in radiotherapy K Langmack, A Thomas, D A L Morgan The British Journal of Radiology, 81(2008), 666-667 Cholangiocarcinoma in Association With Caroli’s Disease: The Role of Ultrasound and other Imaging Modalities P Maharaj, O Khan, A Thomas, R Naipaul The Journal of Diagnostic Medical Sonography, (March/April 1999); 15(2)

Posters: A Review of Ultrasound Requests for Cholelithiasis at the University Hospital of the West Indies W West, D Mitchell, P Johnson, A Thomas presented at Surgical Research Day UHWI – May 30

th, 1997

CT Cisternography: A Review of the Experience at the UHWI A Thomas, D Soares presented at the Surgery Research Day UHWI- May 12

th, 2000

Endovascular Coiling of Ruptured and Unruptured Intracranial Aneurysms: Technical Results and Clinical Outcomes after six months follow-Up in 206 aneurysms G.S. Tan, A. Goddard, A. Thomas, N.S.McConachie, R.K. Lenthall Presented at WFITN 2005, Venice, Italy

WORK IN PROGRESS/AWAITING PUBLICATION: 1. Endovascular therapy as first line treatment for ruptured cerebral aneurysms: comparison of the demographics and outcome data for patients treated within and post ISAT. A single center experience. AJP Goddard, A Thomas, T Jaspan, RK Lenthall, N McConachie, BD White 2. Dissecting aneurysm of the middle cerebral artery in a neonate: a case report A Thomas, T Jaspan 3. An Unusual Facial Vein in a VGAM Baby: case report A Thomas, H Alvarez, P Lasjuanias submitted to Interventional Neuroradiology 4. The Angioarchitectural features associated with haemorrhage, at presentation, in the Nottingham Brain AVM Cohort S Boddu, A Thomas, N McConachie, T Jaspan, R Lenthall: oral presentation at RSNA 2007 to be published in Radiology

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5. A Comparison of Multimodality and Single modality management outcomes of Brain AVMs in the Nottingham Brain AVM Cohort S Boddu, A Thomas, N McConachie, T Jaspan, R Lenthall: oral presentation at RSNA 2007 to be published in Radiology

PRESENTATIONS/LECTURES: BELOW IS A LIST OF THE FORMAL TEACHING AND LECTURE ASSIGNMENTS FOR THE LAST TWO YEARS. “Haemorrhagic Stroke” & “Vascular Intervention in Acute Stroke” Birmingham Neuroradiology Course for Stroke Physicians QEHB (4/2/2013) Interventional Neuroradiology Neuroanaesthesia SpRs and Consultants (2/3/2011 & 29/6/2011, 5/10/2011, 25/3/2013) Update on Microcatheter Technology-Workshop BSIR 2012, Bournemouth (15/11/2012) CNS Tumours FRCR 2A (17/11/2011) & Radiographers (26/4/2012) Essential Head & Neck Imaging First year FRCR SpRs (12/9/2011) Lecture on “Acute Cerebral Ischaemia: Beyond Non-Contrast CT” RCR Lecture Series Birmingham (11/4/2011) “Role of Radiology in Stroke Management” Neurology Calman Study Day (11/2/2011) “Diffusion Weighted Imaging” and “MRI of Intracerebral Haemorrhage & Subarachnoid Haemorrhage” Solihull Study Day (2/4/2011) CNS Tumour Imaging Oncology Year 4 trainees (24/3/2010) Film viewing FRCR 2B (29/7/2010)

TEACHING:

Formal weekly medical student teaching

University Hospital of the West Indies, QEH in Birmingham, National Hospital for Neurology and QMC

Formal and informal radiology trainee tuition

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University Hospital of the West Indies, City Hospital and QEH in Birmingham, National Hospital for

Neurology, QMC and QEHB: Salivary Gland Imaging, Neurotrauma, ENT Film viewing for FRCR 2B

Formal and informal neurology and neurosurgery registrar tuition as well as formal Neuroscience MSc

candidate tuition

National Hospital for Neurology

Formal radiographer tuition National Hospital for Neurology as well as CT Head reporting for radiographers at QEHB

POSITIONS OF RESPONSIBILITY AND MANAGEMENT:

At the National Hospital for Neurology and Neurosurgery I was responsible for the on call rota, assigning

the responsibilities for formal teaching, the neuropathology MDTs and Gowers Grand Rounds. I was also

responsible for ensuring that hot and cold films were appropriately separated and reported so as to

decrease wasted time in searching for films by radiology and clinical staff.

At the QMC I was a core member of the sub-directorate and I made contributions to the debates

surrounding the expansion of neuroimaging in Nottingham, the logistics of dealing with the workload

from out-sourced scanning, its quality control and its impact on our NHS service resources and patient

care. I was one of three Interventional Neuroradiologists in the Nottingham Trent region and I made

decisions on patient selection, treatments, equipment and consumables, stock and distribution of nursing,

radiography and medical resources. I was the local lead clinician for the randomization of patients to the

ARUBA Trial and I managed and randomized patients on the INVEST, HELPS and ISAT Trials.

At the QEHB I was the sole radiologist for the Neuro-Oncology MDT for my first 5 years. Lately I have been

given the responsibility for Neuroradiology Education and I have been making contributions to plans for

employing a Neuroradiology Specialist Nurse and improving the patient experience for our interventional

patients.

CAREER GOALS:

I would like to practice and teach Surgical Neuroangiography, Neuroradiology and Head & Neck Radiology

in an environment where most, if not all, patients with acute hemorrhagic and ischaemic stroke,

maxillofacial and peripheral vascular anomalies and ear nose and throat cancer as well as cancer of the

neuraxis receive the best care. I would like to be able to contribute in some way to the care of such

patients in the Caribbean and to support the instruction of local physicians there as well.

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I am developing my interest in medical legal work and embarking on refreshing my current bank of

knowledge and taking part in appropriate instruction.

PREVIOUS EXTRA CURRICULAR ACTIVITIES: 2011 Member of Harborne Hockey Club 2008 Cuban Salsa Dancing 2005–2007 Member of Basford Mill Cricket Club 1998 Captain of Mona Campus Indoor Hockey Squad 1996-1999 Sub-Warden, Irvine Hall 1992 Vice Captain of the Trinidad and Tobago Under 21 Hockey Team to Caracas,

Venezuela for the Caribbean U-21 Competition 1991- Present Member of Malvern Hockey Club, Trinidad 1991 Captain of Mona Inter-Campus Indoor Hockey Squad 1991,Inter-Campus Games

1991, Mona 1989-1990 Designer / Builder of 1

st Place Costume Culturama 1990

UWI, Mona Campus, “Come Rally Round the West Indies” Chief Organiser of Block Song and Carnival Costume Competition Culturama 1990 UWI, Mona Campus Designer / Builder of 4

th Place Costume Culturama 1989

UWI, Mona Campus, “Caribbean Unity” Member of Mona Inter-Campus Indoor Hockey Squad 1989, Inter-Campus Games 1989, St. Augustine

1989-1990 Member of Avis Raiders Hockey Club, Jamaica

REFEREES: 1. Dr Dougall McCorry Consultant Neurologist Neurosciences Department

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Queen Elizabeth Hospital Birmingham Edgbaston Birmingham B15 2WB Phone: 0121 371 2000 ext E-mail: dougall.mccorry@uhb.nhs.uk 2. Dr Roland Etti Consultant Neurologist Neurosciences Department Queen Elizabeth Hospital Birmingham Edgbaston Birmingham B15 2WB Phone: 0121 371 2000 ext E-mail: roland.etti@uhb.nhs.uk 3. Dr. Swarupsinh ChavdaNeuroradiology/MRI Dept., Queen Elizabeth Hospital, Edgbaston, Birmingham B15 2WB Phone: 0121 371 2000 ext 12307 E-mail: swarupsinh.chavda@uhb.nhs.uk 4. Dr. Norman Mc Conachie Consultant Neuroradiologist Radiology Department Queen’s Medical Centre Derby Road Nottingham NG7 2UH Phone: 0115 924 9924 ext 61949 E-mail: norman.mcconachie@nuh.nhs.uk 5. Mr. Donald MacArthur Consultant Neurosurgeon Neurosciences Division Queen’s Medical Centre Derby Road Nottingham NG7 2UH UK Phone: 0115 924 9924 ext 61103 E-mail: donald.macarthur@nuh.nhs.uk