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CASE STUDY 2: A man in his 40s attended his GP for syringing of the ears. Syringing of one ear was attended by pain, but the doctor persevered with syringing. Afterwards a perforation of the tympanic membrane was noted. There was pain and infection with discharge, and healing took several weeks. Subsequently, the patient complained of hearing loss in the ear, but it became apparent on medico-legal examination that he was feigning deafness in that ear. Cortical ERA testing (see tests of auditory and vestibular function, Chapter 3) did indicate some high-frequency loss in the ear but it subsequently became apparent there was a history of noise exposure. The patient complained of persisting tinnitus in the injured ear. The case came to trial, a small offer in settlement having been rejected. The judge found that the sensorineural hearing loss and mild tinnitus were due to previous noise exposure. He did, however, find that the perforation of the tympanic membrane during syringing was negligent, and he awarded a small sum in damages, which was, however, less than the sum previously paid into court.