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Supreme Court of the ACT |
Last Updated: 26 October 2009
CAROLYN DAPHNE BECKER v QUEENSLAND INVESTMENT CORPORATION
AND BOVIS LEND LEASE PTY LTD
[2009] ACTSC 134 (12 October
2009)
PERSONAL INJURY – liability admitted – dispute as to quantum of damages – whether pre-existing condition contributed to current incapacity and suffering.
Law Reform (Miscellaneous Provisions) Act 1955 (ACT), s 33
Civil
Law (Wrongs) Act 2002 (ACT), s 100
Court Procedures Rules 2006 (ACT), r 1616, Schedule 2
Australian Law Reform Commission, Community Law Reform for the Australian
Capital Territory, Second Report: Loss of Consortium; Compensation for Loss of
Capacity to
do Housework (AGPS, 1986) ALRC, Report No 32
Luntz H,
Assessment of Damages for Personal Injury and Death
(4th ed, LexisNexis Butterworths, 2001)
Livingstone v Rawyards Coal Co (1880) 5 App Cas 25
Nominal
Defendant v Gardikiotis [1995] HCA 56; (1996) 186 CLR 49
Skelton v Collins
[1966] HCA 14; (1966) 115 CLR 94
Young v Rothin [2009] ACTSC 71
MBP (SA)
Pty Ltd v Gogic [1991] HCA 3; (1991) 171 CLR 657
GMH Ltd v Whetstone (1988) 50
SASR 199
Koeck v Persic (unreported, ACTSC, Miles CJ, Gallop and
Foster JJ, 26 March 1996)
Todorovic & Anor v Waller [1981] HCA 72; (1981) 150 CLR
402
Griffiths v Kerkemeyer [1977] HCA 45; (1977) 139 CLR 161
Van Gervan v
Fenton [1992] HCA 54; (1992) 175 CLR 327
CSR Ltd v Eddy [2005] HCA 64; (2005) 226 CLR
1
Brown v Willington [2001] ACTSC 100
Davis v Grgic [2006]
ACTSC 14
Dennis v Australian Capital Territory [2005] ACTSC
118
Smith v Canberra Labor Club [2005] ACTSC 121
Grincelis v
House [2000] HCA 42; (2000) 201 CLR 321
No. SC 560 of 2005
Judge: Refshauge J
Supreme Court of the ACT
Date: 12 October 2009
IN THE SUPREME COURT OF THE )
) No. SC 560 of
2005
AUSTRALIAN CAPITAL TERRITORY )
BETWEEN: CAROLYN DAPHNE BECKER
Plaintiff
AND: QUEENSLAND INVESTMENT CORPORATION
ABN: 95 942 373 762
First Defendant
AND: BOVIS LEND LEASE PTY LTD
ACN: 000 098 162
Second Defendant
ORDER
Judge: Refshauge J
Date: 12 October 2009
Place: Canberra
THE COURT ORDERS THAT:
1. There be judgment for the plaintiff in the sum of $382,316.79
1. On 21 October 2002, the plaintiff, Mrs Carolyn Becker was injured when a
partition alongside the corridor she was using to walk
into the Canberra Centre
collapsed injuring her. She sues for damages for those injuries. The defendant
admitted liability for
the damages and this is an assessment of them.
The
facts and the evidence
2. Mrs Becker was 56 when she was injured. She is a
fairly slight woman of 5 feet 2 inches in height and 58 kilograms in
weight.
She was born in Queensland and still resides in Brisbane. She went to
school until year 10 and then commenced work as a secretary
for about three
years.
3. After that she travelled for a time and subsequently held various
jobs until she married in 1966. She has three children. All
her children are
now adults, but one son continues to live with her.
4. In October 1987 she
returned to work as a shop assistant in the Myers Department Store (Myers) at
the Carindale Centre in Brisbane.
She remained there until June 2006 when she
ceased work in circumstances to which I will later refer.
5. While with
Myers, she worked in various departments. Her hours were from 28 to
32 hours up to a full-time workload each week.
6. In 1999 she had a
problem with the joints in her thumbs for which she received some physiotherapy
treatment.
7. In December 2001, while working in the children’s
department at Myers, she had an accident. She twisted her back while putting
a
box on a trolley. She described this as a stinging pain with no numbing into
her legs. The stinging was evident in her right
leg. She saw her general
practitioner, Dr Tania Burgess, who referred her for physiotherapy treatment.
She tended to attend around
work hours, before work, after she went to work or
in her lunch hour. She says she may have taken one day off work (though her
physiotherapist
recorded four days off work), but otherwise continued working.
Mrs Becker remembered getting better quite quickly from this incident.
The
physiotherapist, however, reported that she attended for treatment from December
2001 to April 2002 though she then regained
a full range of motion. At this
time, she was working for four and a half days a week. She was not working at
weekends.
8. The physiotherapy treatment relieved her symptoms. Although she
cannot remember it, she now acknowledges that she had physiotherapy
treatment
until 24 April 2002.
9. She continued at her job and said before me that her
back was fine until she injured it again on 21 October 2002.
10. In 2002 she
was still working in the children’s department. Her work involved work on
the cash register but also some fairly
heavy stock work. She had to get stock
from the store’s loading bay, unpack it and generally look after
it.
11. In August 2002, her children gave her a gym membership, apparently
for her birthday and she enrolled. Before she actually started,
however, she
travelled to Canberra where her daughter lived. Her daughter was pregnant with
her second child and Mrs Becker
was going to provide some child minding and
other domestic assistance. She arrived the day after her daughter’s
second child
was born. Her daughter remained in hospital for about five to
seven days.
12. When her daughter was discharged from hospital, Mrs Becker
continued to provide domestic assistance, including driving her daughter
around
and bathing the children. She had no difficulty in undertaking these tasks.
She said her back was giving her no trouble.
13. On 21 October 2002, she was
with her daughter and the two grandchildren in the Canberra Centre. They had
been to the baby clinic
where the new-born child had been weighed. Part of the
building was being refurbished. Mrs Becker and the others were walking down
a
corridor in the Centre. The refurbishment was screened off from the corridor by
means of a long series of partitions that were
fixed to one another.
14. Mrs
Becker’s daughter was pushing the pram with the baby in it and the other
child had hopped onto the back of the pram.
They were going to Target for some
more shopping.
15. As they were walking along, Mrs Becker heard a crack and
looked up to see the partition starting to fall down on them. Mrs Becker
put
her hands up to try and hold the partition that was falling on them while Mrs
Becker’s daughter pushed the pram out of
the way. She described that
“it just knocked me flat down onto like a crouching position on the
floor”. Her daughter
and the grandchildren managed to get out of the way
unhurt, though the elder one was screaming.
16. Mrs Becker said that the
partition hit her on the head and shoulders and “went down – sort of
down on my hip”
on the left side.
17. Some workmen came over from where
they were working on the other side of the partitions and helped her and another
person who
had been knocked over by the falling partitions as well.
18. Some
immediate assistance was provided and Mrs Becker was advised to see a doctor.
Her son-in-law, having been phoned by her
daughter, arrived and they took her to
see Dr Mitar Milosevic. Dr Milosevic arranged for her to be x-rayed and that
took most of
the afternoon. The x-rays showed that she had suffered no
fractures.
19. Later in the afternoon, while waiting for the x-rays, Mrs
Becker started to feel pain. She experienced “the shakes”
and her
head was aching, her lower back was aching and her left shoulder was sore. She
took some Panadeine Forte which Dr Milosevic
had prescribed. She found herself
to be quite teary also.
20. A couple of days later, she returned to
Queensland. When she left the plane, she found she could not carry her suitcase
and burst
out crying when she saw her husband. She went straight home to
bed.
21. Soon after returning home, she went to see her general practitioner,
Dr Victoria Featherstone, because of continuing and worsening
pain. She also
found that she could not stop crying. She found she did not want to get out of
bed and every time someone spoke
to her she would burst into tears.
22. Dr
Featherstone found on examination that she had a limited straight leg raise on
her left side and continuing back pain. Mrs
Becker said she did not think she
could return to work. Dr Featherstone prescribed the analgesic Voltaren and
referred her to John
Perrier and Associates for physiotherapy. This was the
same physiotherapist she had been seeing in late 2001 and early 2002.
23. Her
first physiotherapy consultation was on 28 October 2002. She continued with
physiotherapy treatment for some time attending
about four or five times a
month, though initially at nearly twice that frequency.
24. Mrs Becker did
return to work but found she could not carry out her normal duties. She could
not fit shoes or do any lifting.
She could not climb a ladder to get stock or
hang merchandise. Anything involving lifting or bending was painful. She moved
to
cash register only work in the intimate apparel department. This involved
her serving customers, answering the phone, tallying the
tills and similar.
There was no lifting or bending required.
25. She continued to see Dr
Featherstone who also referred her to a clinical psychologist, Mrs Tracey
Howard, because of Mrs Becker’s
continued lachrymosity and depression.
She also commenced her on a course of Aropax which appeared to help after some
little time.
She continues to take that medicine, as she told me that when she
tried to stop taking it, she became quite anxious and felt she
could not leave
the house.
26. She felt, too, that she had lost her self-confidence. She
said in evidence that she had not felt like this before. She said
she used to
be a strong person and able to cope with most things. Indeed, she would help
others cope but now she finds it difficult
to cope herself.
27. She saw Ms
Howard on five occasions. The treatment consisted of cognitive behaviour
therapy, incorporating supportive counselling
and anxiety and depression
management techniques. She was recommended to have further treatment but did
not do so because of the
expense. She said she would have further treatment if
she could afford it.
28. Mrs Becker also said that Dr Featherstone had
prescribed an anti-inflammatory drug, though Dr Featherstone in her report does
not mention this specifically. Mrs Becker said she came out in a skin rash as a
result of the prescribed medicine. Dr David Champion,
consultant physician, to
whom Mrs Becker was referred for a medico-legal opinion, thought this may have
been a reaction to the Voltaren.
In any event, the rash was itchy and appeared
as bruise-like on parts of her body. Dr Featherstone referred her to a hospital
where
she was admitted overnight. She stopped taking the medicine as a result,
but the pain returned. The bruising went away.
29. Mrs Becker also
experienced interrupted sleep. She said she would lie awake at night and, if
she did fall asleep, would experience
“flashbacks” of the incident
and wake, often shouting, thus disturbing her husband’s sleep as well.
Although it
seems to have improved, she said her sleep remains erratic. She has
been prescribed an additional anti-depressant medication with
sedating
properties, Endep, which she takes every night.
30. She continues to take
Panadeine Forte on a regular basis, probably, she said, about two or three times
a week. She also takes
Panadol, up to six tablets a day when she does not take
Panadeine Forte.
31. Her work seemed to exacerbate her pain. The continual
standing in virtually the one position stressed her and worsened the lower
back
pain. After work, she tended to go straight home and then to bed for two or
three hours after taking some pain medication.
32. Although Mrs Becker was a
licensed driver, she has generally ceased this activity, she told a number of
doctors. She had two
minor motor vehicle accidents which she attributed to the
restriction on her neck rotation. No-one was injured in either
accident.
33. In June 2006, she resigned from work. She said she wished to
work until she was 65 as she and her husband were planning to build
a new house
and she wanted to earn money to pay for furnishings for it and to save money for
travelling in retirement. She said
that the pain was so bad that she had to
retire as she could not stand it any longer.
34. Her husband had retired a
few months earlier because of severe arthritis after an extended period of sick
leave, during which
he had hoped to be able to return to work. She said to me
in evidence that her husband’s retirement was not a factor in her
decision
to retire. A number of the medical reports tendered by the defendant refer to
Mrs Becker saying that she had retired because
of her husband’s illness,
or was influenced by it in making the decision. She denied in evidence that
this was a factor in
her decision to retire. It was put to her in
cross-examination that she wanted to do so and desired it. She rejected those
suggestions.
35. She said in evidence that her husband had been home on sick
leave for more than a year before she retired and had needed little
by way of
particular help. She said that she must have been misunderstood.
36. Her
husband and son have been doing most of the domestic chores since the 2002
incident. They have been doing the cooking and
her son particularly does the
heavier domestic work. She tried vacuuming but was unable to do it because of
pain. She does the
washing but her husband and son had to hang it out; if they
were not able to do so, she used the dryer for the first twelve months
or so,
though she became able to hang the washing out after that. They have also been
doing the shopping and much of the cleaning,
such as mopping. She estimated
that they would spend about four hours a day on domestic work initially, but
more recently, after
about twelve months, it had reduced to about two to three
hours a day. It was slightly decreasing. She said she was able to undertake
more tasks as time progressed, though mentally she found it difficult to do some
of the things around the house. She and her daughter,
who has now returned to
Brisbane, go shopping together.
37. She also experiences reduced
concentration. Her memory seems also to have been affected. She is prone to
irritability and impatience
as well as depression. These are attitudes that she
did not exhibit immediately prior to the accident, though she was depressed
following the death of some friends and family members some years before the
2002 incident.
38. She expressed to me also her concern at her inability to
be a good homemaker for her husband and at her loss of confidence, lack
of
energy and of motivation. She has also experienced a loss of libido since the
accident. She experiences anxiety when near building
sites and similar sites to
that where the accident happened and can no longer interact with her
grandchildren in the same way that
she used to do.
39. The notes from her
physiotherapist were put in evidence and used in cross-examination of Mrs
Becker. She accepted that they recorded
accurately what she had told the
physiotherapist for the most part, though there were at least two references
which she found quite
unlikely. She had, however, no present recollection of
any conversations with the physiotherapist.
40. The notes disclose reports of
continuing improvement in the pain reported by Mrs Becker, though there are
a number of lapses
where either the leg or back pain is reported as worse. In
one case, on 25 March 2003, she reports that her back was very sore
“because
carrying grandchild a lot” and on 2 April 2003
“continued aggravating after carrying baby”. Mrs Becker was
initially
confused about these references and said that she could not recall
picking up her grandchild; she suggested she generally just sat
and nursed the
younger one and did not pick up nor carry the older one.
41. The notes
recorded that on 26 November 2003, she had dropped a box on her left foot which
led to her taking some time off work
and caused her to feel shooting pain under
the top of her foot. She did not herself recall an incident with a box and
suggested
that she had only slipped over on her foot. She returned to work two
days later. No reference appears in the notes about back or
leg
pain.
42. The treatment by the physiotherapist continued fairly regularly
until October 2003, about twelve months. The entry, on 3 September,
records
“much better since last Rx – is also walking 4 x week with good
effect”. The entry on 17 September
records “still going [sic] bit
better” and on 1 October the last entry records “as good as she has
been”.
Her subsequent treatment in 2003 referred to the foot
injury.
43. In 2007, she returned to the physiotherapist where she complained
of arm pain.
44. Mrs Becker said that she ceased physiotherapy treatment
because of the cost.
45. I had in evidence a number of medico-legal reports.
Mrs Becker tendered a number of reports from Dr David Champion, consultant
physician in rheumatology, musculoskeletal and pain medicine. The defendant
tendered reports from Dr Ian Dickinson, orthopaedic
surgeon, Dr Neil
McGill, rheumatologist and Dr Robert Lewin, consultant
psychiatrist.
46. When seeing these medical practitioners, she was clearly
asked about her prior medical history. Regrettably, she did not report
to them
the existence or extent of her prior history. Dr Champion did not know of the
prior back injury at all, until he read Dr
McGill’s report.
Dr Dickinson, reports merely that:
She had had back pain early in the year prior to the accident when she twisted her back carrying a box. She had no treatment and the pain settled after a few days.
47. Mrs Becker acknowledged that, as a description of the 2001 incident and
treatment, this description was wrong. Dr McGill reported
a similar account by
her and, again, Mrs Becker accepted that it was wrong.
48. Mrs Becker
gave evidence that she had forgotten about the treatment she had received from
the physiotherapist. Dr McGill, in
his report, referred to clinical notes from
her physiotherapist. This caused her to make inquiry. She said in evidence to
me:
And do you recall seeing or having physiotherapy treatment to your back in the following year? That is January, February and March of 2002? - I don’t – I don’t recall it, but after seeing the physiotherapist’s report, I now know that I did.
When did you first realise that you did go during those months? – Only after I got a letter from my solicitor with a letter – a report from the doctor saying that I had treatment up until, I think it was April.
Yes, I think – was that a report of Dr McGill’s? – Yes, it was.
And when you read that report, how did you feel? – I was devastated. I just did not remember having that and so I immediately phoned the physiotherapist and she told me that that was so and so I asked her if I could come down and look at the records because I didn’t believe that I had had that treatment.
And did you do that? – I did, yes.
And you looked over the records? – I did.
And - ? – I asked her to go through them with me to make sure they were mine and not somebody else’s.
And you were satisfied they were yours? – Yes.
49. Mrs Becker was also challenged on what she had told the psychologist,
Ms Tracey Howard, about her physical symptoms. She
said, however, that she
did not generally discuss her physical problems with Ms Howard. I accept that
her consultations with Ms
Howard focussed on her depression, anxiety and
post-traumatic stress disorder.
50. While it may have been desirable for her
to have let Ms Howard know about the improvement in her physical symptoms, that
does
not seem to be the focus of her reason for seeking treatment from Ms
Howard. I do not think this adversely affects her credibility.
51. Two of
the three medical practitioners, whose reports were tendered by the defendant,
record, in different ways, a suggestion
that Mrs Becker retired from work in
order to assist her husband. Dr Dickinson wrote “[s]he gave up working
for Coles Myer
in June 2006, mainly to care for her husband”. Dr Lewin
wrote:
Mrs Becker reported that her husband retired about three years ago, after developing arthritis. He had been employed by a hire company as a repair man. He has continued to suffer from arthritis in the hands, knees and feet. Mrs Becker was initially quite worried about his condition. The need to care for her husband was one of the reasons she decided to stop working. She said that his treatment has included the use of anti-inflammatory medication and that he is under the care of a rheumatologist. Mr Becker’s arthritis has improved in response to treatment.
52. As I have noted earlier (at [34]), Mrs Becker denied that she had retired
because of her husband’s illness or that she
had told either of these
doctors that. Dr Dickinson but not Dr Lewin was called to give evidence and Dr
Dickinson was cross-examined
on this issue and referred to his contemporaneous
note of Mrs Becker saying her retirement was “mainly due to her husband
being
sick”. I find it difficult to assess whether there was a
miscommunication or whether Mrs Becker had erroneously said this to
those
doctors.
53. I accept that Mrs Becker has a poor memory. I did not form the
impression that she was lying to me when she denied saying such
things to those
doctors.
54. Mrs Becker was cross-examined at some length about the domestic
chores. She said that mentally she could not do many of them,
though it was
possible that she could have actually physically accomplished them. In this
category was cooking, dusting, light cleaning,
washing, some weeding and
pruning. She clearly stated she could not hang out the washing initially,
though this changed over time,
nor the vacuuming nor the heavier work in the
house or garden.
55. One of Mrs Becker’s work colleagues also gave
evidence. She had worked with her from 1998 to early 2003 in the
children’s
department. She described the work Mrs Becker
did:
I know exactly what [Mrs Becker] used to do, fit shoes for one, which is quite testing at times. It involves getting down on your knees to feel for room in children’s shoes for growth and what have you, getting up ladders in – in the shoe reserve – reserve to get down boxes, bringing out stock from the dock, unpacking stock, moving heavy shelving, moving racks, re-merchandising, serving behind the counter.
... if something new arrives we’re asked to feature it at the front and that involves moving clothes around, and at times it can be quite heavy because we go up to 16-year-old boys and their – their clothes are almost the – the size of men’s clothing, so – yes.
56. She described Mrs Becker as a “hard worker, a good team member and
always very hands-on”. She was unaware of any
physical problems prior to
the incident, the subject of these proceedings.
57. She also noted that after
the incident she was much restricted; she could not fit shoes because she could
not get onto her knees
and she was unable to climb ladders.
58. She
remembered the problem that Mrs Becker had earlier had with her hand and that in
about December 1999, she was not to climb
ladders. She did not recall the 2001
incident or any consequences of it. She did confirm that after the incident in
2002, her duties
changed and she was transferred out of the department.
The
other non-medical evidence
59. Mr Becker also gave evidence. He was aware of
the 2001 incident and of treatment for it. He suggested, however, that there
was
little change in her work as a result. He said:
Well, the best I can recall, life went on as usual. It was a busy time of the year for her and she just carried about [sic] her job and my job was pretty – I was on call 7 days a week, 24 hours a day, and that was a busy time for me and I’d always come home at night, meals were already done, washing was done, meals prepared and I was aware that she was having physio.
60. After the 2002 incident, however, he noticed a marked change. When she arrived home from Canberra she was very upset and could not lift her suitcase because of pain. She continued to be emotionally affected so that when he mentioned the incident she would weep, though she would have good days and bad days. She was, he said, also definitely not as active as before and has not returned to that pre-incident active life. He described her activity as:
Before she went to Canberra, when she went to Canberra she took an interest in all her gardening, sewing, had a good social life but when she came back she sort of withdrew into a shell, for a better word I can think of, and she still used to get a bit teary from time to time and – during that time.
...
I’d usually come home around about 5 o’clock, 6 o’clock and sometimes she’d come home about the same time as me and when she did come home she’d go straight to bed because she was just worn out, exhausted, complaining mainly about the pain and she just had to relax.
61. He repeated that she complained of pain in her back and that this lasted for years. He also said that when her job changed at Myers, she found it easier to cope, but still suffered. He added:
She’d come home still exhausted and suffering from the pain, but I think she could cope with the job easier during the day.
62. He recounted discussions he and Mrs Becker had had about retirement. She,
he said, had planned to work until she was 65. This
would, he said, provide
funds to help pay for the new house they were planning to build and to furnish
it.
63. He also said that her retirement in June 2006 was caused by her
continuing pain. He recounted her saying “I’m just
not putting up
with this any longer” and, as he said, “that was the end of the
story”. He said also that the suggestion
that she should retire to look
after him “never entered into the conversation at all”. His
evidence continued:
Do you need any looking after? ... Occasionally when I get a bad attack Carol’s got to help me with putting on socks and maybe doing my nails. I need a close shave and when I have a bad attack on my hands she might give me a close shave, but apart from that I can cope quite well by myself.
64. As to the assistance with domestic chores, his evidence was that he and his son took over a number of them. He said:
We had to get stuck down and help each other and mainly, like as I said before, making the beds and I had to turn the mattresses. Carol would come along and just tidy up some of the finishing touches. Taking out the washing with heavy loads. My son did the vacuuming and I’d assist with preparing the meals and cooking the meals.
65. He estimated that he would do about two to three hours every day and their
son would do an hour a day or perhaps more on weekends.
66. Mr Becker said
that after Mrs Becker retired, she was able to do a little more, some washing in
particular.
67. He also noted that Mrs Becker had lost confidence in driving
and would now only drive short distances. He also recounted an incident
where
she had had a serious anxiety attack in a building where renovations were being
undertaken.
68. He stated that Mrs Becker had talked in her sleep, sometimes
crying and saying things like “I’ll save you” or
“I’ll look after...”. He denied any similar kind of anxiety
prior to the 2002 incident.
69. In cross-examination, Mr Becker did confirm
that Mrs Becker received physiotherapy treatment for the 2001 incident and that
it
had improved her symptoms. He also confirmed that the physiotherapy
treatment after the 2002 incident did help her pain.
70. Mr Becker
emphatically denied that Mrs Becker retired because she wanted to do
so.
71. Mrs Becker’s daughter also gave evidence. She confirmed the
events of the actual incident. She also confirmed Mrs Becker’s
fitness
prior to the incident. She stated that in late 2001, Mrs Becker had visited her
and was in good physical shape and able
to take on active involvement with her
granddaughter.
72. She reported that Mrs Becker kept a tidy house and was an
active person. She noticed a considerable change when she returned
to live in
Brisbane in 2003. The house was messy, though not dirty and she provided some
assistance, helping to make the beds, hang
out the washing and mop and sweep the
floor. She confirmed that her brother does the vacuuming, cleaning the windows
and other heavy
chores. She said that her mother could shop but needed a break
when doing so.
73. She also noticed that her mother’s ability to retain
information was quite small and that her memory was poor. She noticed,
too,
that she had been quite teary since the incident, unlike her self
beforehand.
74. Mrs Becker’s daughter was not asked any questions about
Mrs Becker picking up or walking with her children, Mrs Becker’s
grandchildren.
The medical evidence
75. Reports were tendered by both
parties. Mrs Becker tendered:
(1) a report of Ms Tracey Howard, clinical
psychologist of Psychology Consultants;
(2) a report of Dr Victoria
Featherstone, general practitioner;
(3) a report of Dr Noela Whitby, general
practitioner;
(4) a report of Sharon Hennessy, physiotherapist of Physio
Works, John Perrier and Associates; and
(5) a detailed report and three
additional reports or letters of Dr David Champion, consultant physician in
rheumatology, musculoskeletal
and pain medicine.
76. None of the authors of
these reports were called to give evidence or were cross-examined.
77. The
defendant tendered:
(1) a report of Dr Ian Dickinson, orthopaedic
surgeon;
(2) a report of Dr Neil McGill, consultant rheumatologist;
and
(3) a report of Dr Robert Lewin, consultant psychiatrist in adult general
and forensic psychiatry.
78. Drs Dickinson and McGill were called to give
oral evidence and were cross-examined.
79. Mrs Becker adopted and relied on
Dr Lewin’s report.
80. Neither party tendered any report from or notes
of Dr Milosevic.
81. It is helpful to set out what were the contested issues
in this matter. Liability was not in dispute, and that the falling of
the
partition on Mrs Becker caused her injury was not contested. It was also not in
contest that Mrs Becker suffered ongoing pain
in her back which was to some
extent debilitating.
82. The defendants’ position was that Mrs Becker
had degenerative spinal problems which were the cause of her ongoing pain.
The
injuries from the incident would have caused an aggravation of this condition or
an injury which would have settled down within
no more than three months it was
said. Thus, her ongoing disabilities were caused by the degenerative changes in
her spine and not
the accident. Accordingly, the defendants submitted, her
retirement, if not to look after her husband, was not caused by the incident.
Her economic loss, therefore, was minimal. In addition, her claim for domestic
assistance was challenged on the basis that it was
provided either in response
to her degenerative spinal condition-caused impairments or as part of a family
interaction and not through
need.
83. Mr S E Torrington, who appeared for the
defendants, did not submit that Mrs Becker had deliberately misled the doctors
who examined
her on behalf of his clients, nor that she set out to deceive the
court or indeed anyone. The fact was, however, that the histories
given were
wrong.
84. I turn then to the medical reports.
Ms Tracey Howard
85. Ms
Howard is the clinical psychologist to whom Mrs Becker was referred by
Dr Featherstone. She saw her three times in 2002
and twice in 2003. She
was given a history of the incident and of Mrs Becker’s personal history
which was consistent with
the evidence given before me.
86. Ms Howard
reported that Mrs Becker continued to experience intrusive thoughts about the
incident, a situation that both Mrs Becker
and her husband said in evidence
continued to the time of the hearing. She also described other symptoms such as
anxious avoidance
of the scene of the incident and of anxiety generally. She
also described symptoms of depression, including frequent tearfulness,
diminished concentration, poor memory, and other similar feelings.
87. Ms
Howard diagnosed a post-traumatic stress disorder (PTSD) and a major depressive
disorder secondary to the PTSD. She noted
that the symptoms persisted over a
long period. She considered that these symptoms caused functional impairment
and were caused
by the incident.
88. She noted that the pain persisted and
interfered with domestic chores and her sexual relationship with her husband as
well as
her work.
89. Ms Howard would not provide a prognosis. She had
provided cognitive-behaviour therapy, incorporating supportive counselling and
anxiety and depression management techniques. She reported that there had been
improvement with a good initial response but that
she remained with functional
impairment.
90. Some issue was made by Mr Torrington of Ms Howard’s
description of “debilitating symptomatology” in the context
of
physiotherapy notes which disclosed, apparently at about the same time,
improvement in her levels of pain. When the whole paragraph
is read, however,
it seems clear to me that this refers to the psychological symptoms and not the
physical ones. The paragraph reads:
Although she has shown some improvement, Mrs Becker continues to experience debilitating symptomatology. On the basis of my sessions with Mrs Becker it is my opinion that she would likely benefit from ongoing professional psychological input to address her trauma and depressive symptoms. I consider treatment to be paramount to Mrs Becker’s recovery from this traumatic incident and the ongoing psychological disturbance, which would seem to have its basis in the traumatic event. My view is that treatment would likely include cognitive-behavioural and interpersonal therapy.
Dr Victoria Featherstone
91. Dr Featherstone is the general practitioner
whom Mrs Becker consulted when she returned to Brisbane. She noted that Mrs
Becker
had “reported lower back pain since the incident and poor
sleep”. She had limited straight leg raise on the left side
and was
tender over the L5 S1 region of her lower back. She prescribed physiotherapy
and Voltaren.
92. She saw her on 1 November 2002 (though typed 2003) when Mrs
Becker reported back pain with prolonged standing and pain lying in
bed and
rolling over. She was a little better a few weeks later, though the rash
referred to above (at [28]) had arisen. She also
recommended she see a
psychologist. On the next visit, after she had seen the psychologist, she was
feeling better and there was
further improvement a week later.
93. She last
saw her on 11 April 2003 when Mrs Becker was still not sleeping well and had no
libido.
94. Dr Featherstone’s summary was as follows:
My feeling is that this lady did suffer a reasonably serious soft tissue injury to her L shoulder and lower back as a result of the incident in Canberra. In the process of recovering from these injuries she developed a more serious complaint of anxiety that has continued through to now. She did have a pre-existing history of depressive illness, but had never experienced anxiety to this extent in the past.
I think her physical recovery is now static, in that her pain in [sic] now not as severe as it was in her lower back, but it has not gone away completely and I am not able to say if it will.
Her anxiety is reasonably well controlled with medication. It has been complicated to some extent by this rash that developed late last year and was presumably not related to the injury in Canberra. However she was certainly experiencing significant anxiety prior to the onset of the rash, and continues to have problems now despite clearance of the rash.
Mrs Beckers [sic] capacity for work has been complicated by her pre existing problems with her hands. This has been one of the factors that has made it necessary for her to change departments at work. However her back discomfort as a result of the injury has also made a contribution. She has needed time off work also during the time of the rash during its initial diagnosis and treatment. I do not have a record in my notes of any time taken off work specifically for this injury/complaint.
Dr Noela Whitby
95. Dr Whitby is a general practitioner who has recently
seen Mrs Becker. She reported that she continued to suffer neck and lower
back
pain, often severe enough to require Panadeine Forte and disrupted sleep. She
continued to feel depressed, lacking in confidence
and needing
antidepressants.
Ms Sharon Hennessy
96. Ms Hennessy appears to be a
physiotherapist with John Perrier and Associates. She noted that Mrs Becker
attended in December
2001 until April 2002 for treatment of a lumbar spine
injury at work but that she regained full range of motion and planned
commencement
of a regular fitness program.
97. As to the 2002 incident, Ms
Hennessy reported that subjectively Mrs Becker showed pain in her lower back
radiating into the posterior
left leg. Objectively she showed a 1/6 of normal
reduction in her lumbar spine flexion. Hip flexion was reduced to
120 degrees
on the left, but normal on the right. On palpation, she was
tender and stiff to palpation on L5 S1. Her left sacroiliac joint was
tender
and surrounded by muscle spasm. This led Ms Hennessy to suggest bruising with
likely lower lumbar disc and ligament strain.
98. The pain was shown
consistently in physiotherapy sessions and Ms Hennessy detected no abnormal
pain behaviours.
99. Ms Hennessy noted similar pain difficulties as had been
reported to Dr Featherstone. She suggested that she would always
suffer
low back pain following repetitive lifting and during physical activity such as
vacuuming or mopping and may require physiotherapy
intervention when the
condition flares up.
100. The notes of physiotherapy treatment were also
tendered. These showed periods of physiotherapy treatment between 3 December
1999 to 24 January 2001 (for her thumb), 13 December 2001 to 24 April 2002 (for
the 2001 incident), 28 October 2002 to 1 October
2003 (for the 2002 incident),
26 November 2003 to 28 November 2003 (for the work incident concerning her foot)
and 4 April 2007 to
16 April 2007 (when carrying a suitcase caused further
pain).
101. It is not necessary to analyse these notes in any detail. Mr
Torrington referred to a number of them in cross-examination and
assured me that
these were all that he considered relevant.
102. The notes showed
that:
(1) Mrs Becker consulted the physiotherapist on 13 December 2001 with
lower back and right hip pain after lifting at work.
(2) She had six further
consultations over the next eight days, with variable pain levels, and saw the
physiotherapist up to 2 January
2002 when she was noted to be continuing to
improve and managing a full day at work but a little sore.
(3) Mrs Becker
continued to see the physiotherapist during March 2002, where she made
complaints of right leg hip pain getting worse
with real restrictions (7 March),
moderate improvement with no leg pain (9 March), improvement (14 March),
continued improvement
(19 March), pain persisting (21 March) and
“good” except when rolling in bed (28 March).
(4) She also saw
the physiotherapist in April 2002 when she complained of sharp pain in her right
thigh and pins and needles in her
lateral three toes (4 April) and later
reported feeling very much better, having taken two days off work and tried heat
and stretching
(12 April); she was recommended strengthening
exercises.
(5) She saw the physiotherapist finally, in this period, on 24
April 2002 when she was very much better, she had done two days of
heavy working
which did not increase her pain, and was discharged from physiotherapy to cope
with HEP and self-massage.
(6) Mrs Becker returned to the physiotherapist on
28 October 2002, after the 2002 incident and saw her on 1, 5, 8, 12, 17, 20 and
26 November and 2, 10, 17 and 30 December 2002 and the treatment was really
helping.
(7) On 31 January 2003, the physiotherapist recorded that Mrs Becker
stated that she was overall improving well.
(8) On 10 February 2003, the
physiotherapist recorded that Mrs Becker stated that she was steadily improving
recently and on 18 February
2003, the leg pain was much better but the back pain
remained and on 22 February 2003, the back pain was showing slow
improvement.
(9) On 19 March 2003, the physiotherapist recorded that Mrs
Becker told her that her back was a little sore that day and a week later
on 25
March 2003 that the leg pain was “really good” but the back was
quite sore “probably because of carrying
grandchild a
lot”.
(10) On 2 April 2003, the physiotherapist recorded that Mrs
Becker had said that there was “continued aggravating” after
carrying the baby.
(11) Mrs Becker was still seeing the physiotherapist in
May and on 26 May 2003 told her that she was better overall but that pain
returned with activity of any sort.
(12) Mrs Becker was still having
treatment in June but the physiotherapist recorded that she told her on 23 June
2003 that her back
was “good” but her right leg was numb and ached
at night or after work.
(13) On 9 July 2003, the physiotherapist recorded
that Mrs Becker told her on 9 July that she was improving, on 11 August
2003
that her back had “seized up” and her right leg was numb and on
18 August 2003 that she was a bit better but her left
side was “catching
this?”
(14) On 25 August 2003, the physiotherapist recorded that Mrs
Becker told her that her back was “fairly good” as long
as she did
not sit for too long.
(15) On 3 September 2003, the physiotherapist recorded
that Mrs Becker told her that she was much better and was walking four times
a
week to good effect. In evidence, Mrs Becker also said that she was doing
exercises the physiotherapist had prescribed and that
they were
helping.
(16) On 17 September 2003, the physiotherapist recorded that Mrs
Becker had said she was “still going bit [sic] better”
and on 1
October 2003 she was “as good as she has been”.
(17) She
consulted the physiotherapist on 26 November 2003 about an incident at work
where it is recorded she dropped a box on her
foot. There was no reference to
back pain on that occasion and no reference to back pain in the next attendance
recorded on 28 November
2003.
103. These notes show, and this was accepted
by Mrs Becker, improvement in the level of pain although she had no independent
recall
at all of whether they would have been accurate. That, of course, does
not mean that the pain had disappeared or that she had resolved
all the pain
issues, only that it was better and that she had improved. There is, however,
no doubt that this record shows improvement,
though there had been a relatively
extended period of back and leg pain.
104. This does not seem inconsistent
with the physiotherapist’s report and, in particular, the prognosis of
ongoing problems
which led to restrictions. The notes are also not inconsistent
with the report that Mrs Becker had achieved a good result from treatment
for
the 2001 incident.
Dr David Champion
105. Dr Champion was asked to examine
Mrs Becker by her solicitors to provide a medico-legal report. In her
consultation with her,
she did not refer initially to the 2001 incident nor to
the physiotherapy treatment for it, though she later mentioned the incident
but
suggested it was “brief” and with no “leg radiation”.
This created a problem for me in the way I could
take his report into account.
It is clearly desirable, as Dr Champion himself noted, for lawyers in
personal injury damage
cases to review the pre-accident general practitioner
records and make them available on a medico-legal consultation. It would be
good practice for them to be obtained and submitted to any medico-legal
expert.
106. He had copies of the reports of Dr Featherstone, Ms Tracey
Howard and Ms Sharon Hennessy.
107. Dr Champion had the x-rays and noted
the degenerative changes in her spine. He noted that these showed that her
spinal changes
were asymptomatic before the accident or only mildly symptomatic
for several years. It is not clear whether these were the radiographs
arranged
by Dr Milosevic or those of 2004 and 2007 to which Dr McGill referred. It is
likely that they were one or both of the latter
since those ordered by
Dr Milosevic did not appear to include the spine. He noted, too, the post-
traumatic stress disorder
and that there was “wide acceptance” that
it “augments the pain experience”. He provided a number of useful
articles from serious academic publications in support of this
proposition.
108. He conducted a detailed examination, which was impressive,
and considered that spinal surgery may be required in the future.
His view,
apparently unchanged when the facts of the 2001 incident and subsequent
treatment were disclosed, had been that Mrs Becker
would never be “a
serious candidate for return to work”, as he maintained his view that she
continued to suffer pain
and disability.
109. Dr Champion opined that Mrs
Becker “presented in a genuine and honest manner without exaggerated or
inappropriate responses.”
110. Subsequently, Dr Champion became aware
of the 2001 incident and provided a revised report (his third
report).
111. Dr Champion expressed the view in his third report, after
becoming aware of the earlier injury, that the incident in 2001 had
made a
significant contribution to her “post subject accident disorder, pain and
disability” and that the “predisposing
back disorder should account
for some 30-50%” of it; he suggested 40%. He did note that the matter
left some questions about
Mrs Becker’s credibility.
112. He commented
on Dr Dickinson’s report (see [119] to [130]) and felt it recorded a
superficial examination and that he “sincerely”
believed the history
and examination reported in it to be “deficient”. He questioned the
lack of explanation that Dr Dickinson
had for suggesting that the symptoms
could not be related to the 2002 incident and his lack of evidence for finding
“abnormal
illness behaviour”.
113. He also commented on Dr
McGill’s Report (see [131] to [140]), and felt that his examination was
not complete, in that he
had only tested the modality of light touch for
“responses to cutaneous sensory testing” and that he did not
consider
the post-traumatic stress disorder, a view that Dr McGill ultimately
accepted.
114. Mr Torrington, in making his submissions, suggested that Dr
Champion, especially in his third report, showed a “flavour
of a treater
come qualifier dealing ... with the other medical opinion”.
115. In the
absence of cross-examination, I am not disposed to discount Dr Champion’s
opinion for this reason.
116. Mr Torrington further submitted that Dr
Champion did not take into account the fact that Mrs Becker improved after
treatment.
In a sense that could be said of Dr Dickinson, too. He does
not mention improvement in relation to her back. He does mention
it in relation
to her shoulder and neck, but these are separate sites from her lumbar spine.
Indeed, he clearly accepts that she
has significant symptoms of pain from her
lower back but attributes this now entirely to the degenerative changes. He
discloses
no reliance on any improvement in coming to his conclusion.
117. Dr
McGill, on the other hand, does note that treatment has led to improvement.
Unlike Dr Dickinson, he notes with apparent acceptance
that Mrs Becker still has
aching at the back of her neck, a problem that was not apparently linked by him
to the degenerative spinal
changes of the lumbar region. As to the improvement
through treatment, I found it curious that Dr McGill noted Mrs Becker’s
self-report of improvement in five months. This is consistent with the reports
in the physiotherapy notes where by March 2003 the
improvement had already
stabilised. This strongly suggests that, even on his thesis, Dr McGill’s
suggestion of a three month
period of the effect of the 2002 incident is
arbitrary and not based on the actual clinical situation.
118. Further, Dr
McGill does not refer to the improvement in her condition as relevant in his
summary and did not suggest how, if
at all, it influenced his opinion. Indeed
he accepted that Mrs Becker is significantly impaired in the tasks she can do
and his
prognosis was for “a continuation of the current
situation”.
Dr Ian Dickinson
119. Dr Dickson saw Mrs Becker on 24
May 2007 and subsequently received some x-rays dated 7 June 2007. He had
various reports, including
all those available to Dr Champion as well as
the clinical notes of the physiotherapist apparently and a report of Dr Stewart,
with which I was not favoured a copy. He also had Dr Champion’s
first report.
120. The history taken of the incident was generally consistent
with the evidence given before me, as was the history of the immediate
aftermath
and the difficulties Mrs Becker had with domestic chores.
121. He knew
of the earlier 2001 incident but was told, wrongly, that “the pain settled
after a few days”.
122. He found that Mrs Becker had considerable
anxiety and depression. He noted her pre-existing spondyliolisthesis of the
lumbar
spine and the prior treatment.
123. He expressed his finding as to
causation in a slightly curious way. He found:
The persistence of the symptoms is related to the accident. However, the underlying orthopaedic pathology (the spondylolisthesis) has been present long before the accident. The symptoms are complicated by the presence of the anxiety and depression and there is significant evidence of abnormal illness behaviour. While her symptoms have dated from the time of the accident, the persistence of them cannot be related to the accident.
124. The first sentence is directly inconsistent with the last sentence. I am
not sure what to make of that. Initially, I thought
that Dr Dickinson had left
out a “not” from the first sentence, but the use of
“however” in the second sentence
would be inconsistent with that.
It makes it difficult to see exactly what he is saying.
125. He found that
Mrs Becker was fit for work. In an unvarnished way, that is inconsistent with
all other medical opinion; even
Dr McGill found her to be unfit for a number of
the heavier tasks she used to perform and this would clearly restrict her work.
Dr Dickinson found, in contrast, that she needed no help as a result of her
injuries.
126. He advised that the impairment suffered by Mrs Becker was not
related to the 2002 incident but to her spinal condition. He found
that her
symptoms were related to her underlying condition, and her “ongoing
functional disorder” of the lumbar spine.
127. Dr Dickinson was
cross-examined. He was asked about the inconsistency to which I referred above
(at [124]). He said:
... you’re quite right, that appears to be at odds and what I’m trying to say there perhaps is that, in not a clear a way as I should’ve, is that I believe that the anxiety and depression and the illness behaviour related to this were the cause of the symptoms rather than the actual pathology.
I see so ...? So, I understand that that hasn’t been properly written.
128. He accepted that Mrs Becker had been legitimately complaining of back pain
since the 2002 incident. He also accepted that spinal
and related post-injury
pain disorders and post-traumatic stress disorders interact, the one tending to
worsen the other.
129. He thought, however, that a pain could have the
persistence of symptoms when there is no underlying pathology that would explain
the symptoms. He described this as an “abnormal illness behaviour
pattern.” He expressly deferred to Dr Champion’s
views in his
judgment on pain management. He did, however, feel that when the orthopaedic
cause of the pain had disappeared, that
any continued symptoms which were
perceived did not “augment” the pain, though he accepted that the
pain was real to
the sufferer.
130. Dr Dickinson also noted that his notes
recorded Mrs Becker had ceased employment “in June 2002 mainly due to
husband [indecipherable]
being sick” and that this is what he had been
told by her. He was cross-examined about this as I have noted above (at
[52]).
Dr Neil McGill
131. Dr McGill prepared a detailed and comprehensive
report. He had x-rays from 25 February 2004, 30 March 2007 and 7 June
2007.
132. He had progress notes from Mrs Becker’s general
practitioners, the report of Dr Featherstone, the notes of Dr Milosevic
(which were not in evidence before me), the notes of Ms Tracey Howard, a
referral letter from Dr Tanya Burgess, the first report
of Dr Champion and the
report of Dr Dickinson.
133. He found that Mrs Becker had “long
standing degenerative change in the lumbar spine, including spondylolisthesis at
L 4/5
and L 5/S1”, as well as in the cervical spine.
134. He noted that
Dr Milosevic did not think she had suffered a lower back injury and reported
that she did not seek treatment for
low back symptoms within a week. I am not
sure what to make of that for the history given to Dr Featherstone was that she
had suffered
“lower back pain since the incident”. Indeed, her
evidence was that she felt back pain on the day of the accident:
see [19]
above. That, rather than the time of seeking treatment, which may have been
delayed for a whole range of reasons, seems
the more important issue.
135. He
accepted that the 2002 incident “caused an exacerbation of symptoms
related to her long standing degenerative change
in the low back”. He
felt that these may have lasted for up to three months. It was not entirely
clear to me to what he was
referring here. Mrs Becker had apparently, on the
evidence of the physiotherapist, supported by Mrs Becker’s statement and
the evidence of Mrs Becker’s co-worker, no particular symptoms prior to
the incident and post April 2002 when she stopped seeing
the physiotherapist.
Even if, as I do, I have a concern about Mrs Becker’s memory, the other
evidence is relatively objective.
The degenerative changes were there prior to
the 2002 incident but appear, as Dr Champion said, to be
asymptomatic.
136. Dr McGill agreed that Mrs Becker was not fit for heavy
lifting or heavy manual activities and acknowledged she would experience
discomfort with vacuuming or sweeping for more than short periods. He did not
opine on whether she could work and whether standing
for long periods would
cause pain, though this might be inferred from his comments.
137. He accepted
that she would continue to have the pain she currently experiences and would be
likely to continue to experience
fluctuating low back pain and intermittent pain
radiating into one or other lower limb. He felt that surgery would not be of no
benefit to her. He did not recommend further treatment. He eschewed any
comment on the psychological symptoms Mrs Becker suffered.
138. Dr McGill was
also cross-examined. He initially accepted that his comment about the lack of
complaint at the time about her
lower back in the light of
Dr Featherstone’s report was odd, he said that he felt nevertheless
that the accident would
not have “been sufficient to cause a back
strain” because of the lack of complaint. I note that the transcript
actually
records Dr McGill saying the incident “would’ve been
sufficient” but the sense of what he actually saying was to
the
contrary.
139. He was asked about the finding that the effect of the accident
would have lasted for three months. He answered that this was
based on his
clinical experience and that the period was an outer limit. It seems
inconsistent, however, with the evidence from
the physiotherapist’s notes,
thus reducing the capacity for me to rely on his opinion.
140. He reaffirmed
the importance of a medical history of the patient but accepted that pain can
influence psychological symptoms
and psychological symptoms can influence pain.
He refused, however, to answer in regard to causation or effect of the suggested
post-traumatic stress disorder.
Dr Robert Lewin
141. Dr Lewin saw Mrs
Becker at the request of the defendant’s lawyers, though his report was
relied on by Mrs Becker as well.
He received “a dossier of medical
reports and other documents” which he listed in an index not available to
me.
142. I did ascertain that he had Dr Featherstone’s report as well
as that of Ms Tracey Howard, Dr Dickinson, Dr Milosevic (not
available to me)
and Dr Champion’s first report.
143. He noted a prior period of
distress as a result of bereavements in her family and which Dr Featherstone
referred to as “pre-existing
history of depressive illness”, though
with no symptoms of this in the months prior to October 2002.
144. The
history of the 2002 incident provided to Dr Lewin was consistent with that which
she gave in evidence before me.
145. Dr Lewin recounted the symptoms
experienced by Mrs Becker after the accident.
146. Dr Lewin accepted that Mrs
Becker suffered a post-traumatic stress disorder but was of the opinion that
this had resolved, though
with some lingering anxiety symptoms. His formal
diagnosis was of recurrent unipolar major depression. He then reported:
You asked me to consider the question of causation. Ms Becker’s psychiatric condition was precipitated by her emotional response to the events of 21/10/2002. A direct causal relationship exists.
147. He found that the earlier depression had resolved by the time he saw her in
September 2007, though it acted as a vulnerability
factor.
148. Dr Lewis
opined that there was no psychiatric basis for impairment in her capacity to
undertake domestic tasks, but a partial
impairment in her capacity to enjoy
social and recreational activities.
149. As to her employment, he found that
her psychiatric condition imposed a partial restriction regarding work. He
said:
There is no absolute barrier because Ms Becker is not suffering from morbid depressive symptoms, such as melancholic symptoms or psychotic symptoms. There is no distortion of the process of thinking. On the other hand, she experiences reduced motivation and lack of confidence which would impair her capacity to work, at least, to some degree.
150. His prognosis was that, should she receive treatment, there is a reasonable
likelihood that her condition would improve or remit.
He recommended referral
to a consultant psychiatrist for antidepressant medication and a programme of
cognitive behaviour therapy
for fifteen outpatient sessions, each likely to cost
$250.00. He thought medication at $60.00 per month for twelve months would
be
appropriate.
Conclusion on causation
151. I was impressed with the
comprehensive, thorough and helpful reports of Dr Champion and of Dr
McGill. Although Dr Champion
was initially given an inaccurate history for his
first report, before preparing his third report he did have a more complete
history,
including the comprehensive report of Dr McGill. Although this third
report was relatively brief, it built on what he had already
prepared and, for
example, he had seen the x-rays that Dr McGill had seen.
152. Dr
Dickinson’s report was quite detailed also, though I had the criticisms of
it by Dr Champion (his second report).
Dr Champion suggested that Dr
Dickinson’s examination was “superficial.” He also pointed to
the fact that Dr
Dickinson stated that, although the symptoms that dated from
the time of the 2002 incident have persisted, they could not be related
to it,
and posed the question: why? There was no answer to this either in Dr
Dickinson’s report nor in his oral evidence.
153. Dr Champion also
noted Dr Dickinson’s assertion of significant evidence of abnormal illness
behaviour and posed the question:
what evidence? It seems Dr Dickinson
identifies any psychological issues experienced by Mrs Becker as abnormal
illness behaviour.
This is contradicted by the evidence of Dr
Lewin.
154. Further, Dr Dickinson’s assessment of Mrs Becker’s
abilities are in conflict with the evidence of all other medical
reports. His
suggestion, for example, that Mrs Becker is fit for work is contradicted by all
others to some degree. He refers to
the “prior condition of her
spine” which might have made her less suitable for work, but that
condition was present before
the 2002 incident and yet she performed some
relatively heavy work with no symptoms.
155. Accordingly, I cannot accept the
report of Dr Dickinson where it conflicts with the reports of other medical
personnel.
156. Dr McGill’s position was that the 2002 incident would
have aggravated Mrs Becker’s back problems for three months.
He chose
that period based on his clinical experience as the outer limit. He has
accepted her current symptoms but asserted that
they are a reflection of
“long standing degenerative changes of her back”.
157. The
difficulty with that is that, while she had a problem flowing from the 2001
incident, the contemporaneous evidence of her
physiotherapist was that by the
end of April she was very much better and required no further
physiotherapy.
158. The lay evidence from her co-worker and husband was that
she continued to work and was asymptomatic. The work was described,
without
challenge, as heavy. In addition, Mrs Becker’s daughter’s evidence
was that prior to the 2002 incident, Mrs Becker
could manage the children
and do all needed domestic chores. Her evidence was that her mother was active
with aqua aerobics and
about to start a gym membership. Her house was tidy.
Her husband also gave evidence that she was active and did work in the garden
which Dr McGill accepted she could no longer do. The work colleague’s
evidence was that prior to the 2002 incident she could
do heavy work.
159. Dr
McGill seems either not to have known of or to have disregarded the period of
six months prior to the 2002 incident when Mrs
Becker was asymptomatic. The
2002 incident was the only cause of her pre-existing condition becoming a source
of pain.
160. I can accept that for about five months the specific physical
injuries from the 2002 incident were experienced by her but the
incident clearly
made her degenerative condition symptomatic. In this, the 2002 incident
thereby, on this scenario, caused the pain
which she now experiences, even if
that comes from the aggravation of the degenerative condition.
161. Of
course, with her spinal condition, some incident is likely to cause the problems
at some stage, as a result of the vulnerability
that this meant.
162. Dr
Champion estimated that the spinal condition was a contributor to the extent of
perhaps 30% to 50% and suggested 40%. This
would appear to suggest the 2002
incident contributed 60% of the symptomatic problems Mrs Becker currently
experiences. That does
not seem to me to be a legal, as opposed to medical,
approach to causation.
163. Accordingly, I accept that the 2002 incident was
the cause of the pain Mrs Becker currently experiences and also of her
psychological
impairment and the disabilities from which she now
suffers.
Damages
164. In assessing the damages to which Mrs Becker is
entitled, the principles on which courts act are well-known. Thus, Lord
Blackburn
said in Livingstone v Rawyards Coal Co (1880) 5 App Cas 25 (at
39):
I do not think there is any difference of opinion as to its being a general rule that, where any injury is to be compensated by damages, in settling the sum of money to be given for reparation of damages you should as nearly as possible get at that sum of money which will put the party who has been injured, or who has suffered, in the same position as he would have been in if he had not sustained the wrong for which he is now getting his compensation or reparation.
165. The principles have been summarised by McHugh J in Nominal Defendant v Gardikiotis [1995] HCA 56; (1996) 186 CLR 49 where his Honour said (at 54):
When a defendant has negligently injured a plaintiff, the common law requires the defendant to pay a money sum to the plaintiff to compensate that person for any damage that is causally connected to the defendant’s negligence and that ought to have been reasonably foreseen by the defendant when the negligence occurred. The sum of money to be paid to the plaintiff is that sum which will put the plaintiff, so far as is possible, ‘in the same position as he would have been in if he had not sustained the wrong for which he is now getting his compensation’.
166. Bearing these matters in mind, I then turn to the assessment of the
compensation to which Mrs Becker is entitled.
General Damages
167. As
Windeyer J pointed out in Skelton v Collins [1966] HCA 14; (1966) 115 CLR 94 (at 131), the
award of general damages is a monetary sum which:
... is not then a recompense for a loss of something having a money value. It is given as some consolation or solace for the distress that is the consequence of a loss on which no monetary value can be put.
168. Here, Mrs Becker suffered what must have been a quite terrifying event.
The falling of the partition on to her when she was
with her grandchildren who
could have been severely injured if not killed is explanation in itself for her
lachrymosity and anxiety.
169. The effects have been ongoing since then and,
subject to the recommended treatment which the award of damages may permit her
to undergo, will continue.
170. While the pain has, I have found, been partly
caused by the disturbance to the degenerative changes in her spine, the nature
of her psychological condition which was solely caused by the incident has, on
the evidence, somewhat magnified this.
171. I propose to award, as is
customary, a lump sum undifferentiated as to components, for the non-economic
loss she has suffered.
Having regard to all the facts and circumstances of the
case, to Mrs Becker’s past, present and likely future condition, I
consider that general damages should be awarded in the sum of $70,000.
172. I
consider that three-quarters of the factors under this head of damages refer to
the past and one-quarter to the future.
173. Interest on past general damages
at the rate approved in MBP (SA) Pty Ltd v Gogic [1991] HCA 3; (1991) 171 CLR 657 amounts to
$7,350.
Cost of medical treatment to date
174. Mr R E Mildren, who
appeared for Mrs Becker, included in his written submissions an amount for
treatment expenses to the date
of trial. It was, however, indicated by both
parties that they would attempt to agree upon an amount for this head of
damages.
175. By letter dated 18 February 2009, I was advised that agreement
had been reached and that the amount of those costs, as agreed,
was
$3,566.79.
176. I allow that sum.
Cost of future treatment
177. Mr
Mildren submitted that medication currently being taken by Mrs Becker totalled
$62.00 per month. Dr Lewin suggested anti-depressant
medication at $60.00
per month for twelve months.
178. It is difficult to assess how long Mrs
Becker will require the analgesic but I think that five years is a reasonable
estimate.
Given the depressive disorder, I also think that sleeping medication
is appropriate, though it is likely also to help in relation
to the pain and so
I allow that for five years also. Thus, an amount of $29.00 per month for that
period for the medication is reasonable.
179. Dr Lewin suggested that the
anti-depressant medication would be needed for twelve months. I assume this
will replace the Aropax.
Accordingly, I think $2,500.00 for future medication
is a reasonable allowance.
180. Dr Lewin also recommended fifteen sessions of
psychiatric treatment. He estimated the cost at $250.00 per session. That was
nearly two years ago. I consider $4,000.00 is a reasonable
allowance.
181. There will, of course, be continuing general practitioner
attendances both for referral to a psychiatrist and for prescription
of
medication. They are estimated to be $60.00 for each consultation. Allowing
three a year for the next five years is $900.00.
182. That totals $7,400.00
which is what I would allow for future treatment.
183. Dr Champion initially
recommended a spinal operation. This was, however, in his first report. Dr
McGill was clear that no such
operation was required. Dr Champion did not
mention it when he finally was given the full history. I am quite unable to say
whether
it will become necessary, at least as a result of the 2002 incident as
opposed, perhaps, to the degenerative changes to Mrs Becker’s
spine. In
my view, the best way to deal with that is to provide a buffer (Young v Rothin
[2009] ACTSC 71) in the sum of $20,000 which I allow.
Economic
loss
184. The significant consequence of the dispute between the parties as
to causation was the effect on Mrs Becker’s earning capacity.
185. In
one sense, this was easy, for Mrs Becker ceased working in June 2006. She
claimed that this was caused by the problems of
pain and psychological disorder
from the accident. Thus, her loss was the earnings she would have received in
the period from then.
This is quite an allowable method of calculating such
loss: GMH Ltd v Whetstone (1988) 50 SASR 199 (at 200).
186. There were,
however, two issues I had to resolve: did she cease work because of these
problems or because she had to look after
her husband? Was the pain and other
problems which caused her to retire caused by the 2002 incident?
187. Having
seen Mrs Becker in the witness box and also heard from her husband and having
considered the matter, I am satisfied on
the balance of probabilities, that
Mrs Becker retired because the pain and psychological problems were too
much for her. I
make this finding despite the evidence of Drs Dickinson and
McGill. I do not know whether she told them that she retired to help
her
husband or whether there was some miscommunication, but I am satisfied on the
balance of probabilities, that this was not the
reason she did so, after
considering all the evidence.
188. While it seems to me that the
post-traumatic stress disorder with its interaction with her pain was the
primary cause of her
retirement, I have found that there is likely to be some
residual pain from the incident.
Past economic loss
189. As a result of my
finding, Mrs Becker is entitled to recover her loss of earning capacity for the
period from June 2006.
190. The submissions of Mr Mildren were that her
weekly loss was $434.00 from 1 July 2006 to 1 July 2007 and then $438.00.
There
was no challenge to these amounts.
191. To date, that totals $73,376.00
which I round to $73,500.00.
192. Dr Champion suggested that 60% of her
disability was attributed to the 2002 incident and 40% to the degenerative
spinal condition.
That may be a medical view of causation but it does not
assist me to resolve any of the issues I have to resolve. I do not use
that for
any purpose of calculating damages.
193. That the 2002 incident caused the
pain she now experiences, in part by the immediate consequence of the incident
itself and in
part by causing Mrs Becker’s degenerative condition to
become symptomatic, exacerbated by the post-traumatic stress disorder
she
suffered, is sufficiently causative of her damages for which she is to be
compensated.
194. Accordingly, I do not propose to reduce these
damages.
195. Mrs Becker is entitled to interest on the past economic loss at
the prescribed rate of 9% per annum (see r 1616 of the Court Procedures Rules
2006 (ACT) (the Rules) and Schedule 2) over the period since the date of
the 2002 incident, namely seven years. I round this amount
and allow
$23,000.00
Future Economic Loss
196. Mrs Becker was clear that she
proposed to work only until 65. That is now two years away.
197. In my view,
based on all the evidence, I am satisfied that she is unlikely to work again.
She may well recover from her depressive
disorder within the twelve month period
referred to by Dr Lewin and this may make her able to work but somewhat less
than full-time.
In my view, this can be met by a higher than usual discount for
vicissitudes of life (see Koeck v Persic (unreported, SCACT, Miles
CJ, Gallop
and Foster JJ, 26 March 1996)).
198. The predisposing degenerative condition
also leads me to conclude that such a discount should be somewhat higher because
her
vulnerability as a result of this condition makes the likelihood of some
other cause for the condition to become symptomatic the
greater.
199. Applying then the pre-accident earnings, which is the only
evidence I have, of $438.00 per week, at 3% (Todorovic & Anor
v Waller
[1981] HCA 72; (1981) 150 CLR 402), with a discount of 25%, and rounding the result, the future
economic loss is $37,500.00.
200. In my view, that is a reasonable amount to
provide for Mrs Becker’s future economic loss in earning
capacity.
Gratuitous services
201. In Griffiths v Kerkemeyer [1977] HCA 45; (1977) 139
CLR 161, the High Court held that a plaintiff was entitled to recover the cost
of domestic assistance required as a result of disability
caused by the
negligence of the defendant, even when provided at no cost to the plaintiff. As
was held in Van Gervan v Fenton [1992] HCA 54; (1992) 175 CLR 327, the basis for the claim was
the need of the plaintiff for that assistance and that the plaintiff was not
required to show that the
need was or may be productive of financial
loss.
202. The principles in those cases have been somewhat extended by
subsequent decisions, but in CSR Ltd v Eddy [2005] HCA 64; (2005) 226 CLR 1, the High Court
rejected these extensions. Gleeson CJ, and Gummow and Heydon JJ restated (at
14-5) the extent of Griffiths v Kerkemeyer
as follows:
In short, as the appellants submitted, Griffiths v Kerkemeyer damages are awarded to plaintiffs to compensate them for the cost (whether actually incurred or not) of services rendered to them because of their incapacity to render them to themselves, not to compensate them for the cost of services which because of their incapacity they cannot render to others. In each instance there may be a ‘need’ for services, but it is a different kind of need, and the recipient of the services is different.
203. Nevertheless, the award of such damages remains a common feature of awards
of damages for personal injury. As Professor Luntz
remarked in his important
work, Assessment of Damages for Personal Injury and Death (4th Ed, LexisNexis
Butterworths, 2002) (at p
287), “so called ‘Griffiths v Kirkemeyer
damages’ constitute a separate head of damages, which in many cases exceed
the damages under all other heads” (citation omitted).
204. The
position in this Territory is, however, different because of legislative
intervention. Section 33 of the Law Reform (Miscellaneous
Provisions) Act 1955
(ACT) introduced a statutory regime for the payment of gratuitous services
following a law reform report of
the Australian Law Reform Commission, Community
Law Reform for the Australian Capital Territory, Second Report: Loss of
Consortium;
Compensation for Loss of Capacity to do Housework (AGPS, 1986) ALRC,
Report No 32. That provision is now to be found in s 100 of the Civil Law
(Wrongs) Act 2002 (ACT), which provides relevantly:
(1) A person’s liability for an injury suffered by someone else because of a wrong includes liability for damages for any resulting impairment or loss of the injured person’s capacity to perform domestic services that the injured person might reasonably have been expected to perform for his or her household if the injured person had not been injured.
(2) In an action for the recovery of damages mentioned in subsection (1), it does not matter –
(a) whether the injured person performed the domestic services for the benefit of other members of the household or solely for his or her own benefit; or
(b) that the injured person was not paid to perform the services; or
(c) that the injured person has not been, and will not be, obliged to pay someone else to perform the services; or
(d) that the services have been, or are likely to be, performed (gratuitously or otherwise) by other people (whether members of the household or not).
205. This provision, contrary to what was suggested in Brown v Willington [2001]
ACTSC 100 (at [109], [112]), does not overlap
with a common law claim for
damages: CSR Ltd v Eddy (at 26, 32).
206. In the Amended Statement of
Particulars, Mrs Becker claimed the following:
As a result of the plaintiff’s injuries and disabilities she has had to rely on home assistance from her husband and son. The duties undertaken by them include cooking, cleaning, dusting, mopping, vacuuming, washing and some gardening. In addition, they assist with any heavy duty cleaning or cleaning that requires any form of lifting, twisting or reaching. Additionally, the plaintiff requires assistance with undertaking the shopping.
207. The use of “include” is troubling for that suggests there is
some activity for which gratuitous services are sought
but which is not
particularised.
208. In any event, Mrs Becker gave explicit evidence which
was not inconsistent with these particulars. She was unable to do any
cooking
for a long time. After June 2006, she did some cooking. She felt that the
house had “gone backwards”, suggesting
that some of the chores were
not done as she would have done them.
209. Her son does the vacuuming. She
used to do it once a day, but according to Mrs Becker’s daughter, he
now does it
about once a week. To do it thoroughly takes about an hour. He
also cleans the bathrooms and the windows. He also does all the
gardening,
though Mrs Becker never mowed the lawns.
210. Mrs Becker does the washing
but, at least initially, needed assistance in taking the washed clothes to the
line. She also needed
assistance with shopping but her daughter now takes her,
though it is of shorter duration.
211. Mrs Becker’s husband helped by
sweeping and mopping though she accepted that she could do lighter work. Mrs
Becker’s
grandchildren were said to do the dusting.
212. She accepted
that she can physically do the cooking, dusting and washing and some pruning.
She needs help to change the beds.
213. It was clear, however, that at least
some of the disability in this area comes from her psychological disorder. If,
as Dr Lewin
said, that can be brought under control within about twelve months,
much of the future disabilities are likely to disappear.
214. Mrs Becker
suggested initially that these services were provided for four hours everyday.
She seemed to suggest that there was
after twelve months a reduction to about
two to three hours a day. Mr Becker suggested that he did about two to three
hours a day
and his son about an hour and more at weekends. He did not suggest
a reduction in his hours of assistance after twelve months, but
that is, of
course, a general estimate.
215. Such estimates are obviously just that. It
seems unlikely, given that some work was only done weekly or at least less than
daily
that the amount of time would be equal on each day.
216. Mr Mildren
submitted that I should allow the payment for these services at $17.00
per hour. There was no evidence before
me as to the precise cost that was
appropriate. Mr Mildren suggested this amount was regularly used by the
Master. Mr Torrington
made no challenge to this amount.
217. I note
that in Davis v Grgic [2006] ACTSC 14, Marshall J said (at [42]):
In her amended Statement of Particulars, Ms Davis claimed domestic assistance ... at a rate of $30 per hour, amounting to a total of $16,800. No authority was provided for this hourly rate and a review of recent decisions in this jurisdiction indicate that a rate of $17 per hour is more appropriate.
218. His Honour referred to cases such as Dennis v Australian Capital Territory
[2005] ACTSC 118 (at [39]) per Master Harper and Smith v Canberra Labor Club
[2005] ACTSC 121 (at [46]) per Connolly J. Though these are now slightly older
cases, I am prepared to accept this amount in the absence of other
evidence.
219. I am prepared to accept that over the first twelve months, Mr
Becker and their son provided gratuitous services for about twenty
hours per
week and that after twelve months that reduced to fifteen hours per week. That
amounts to $91,500 to date which I consider
to be a reasonable amount in all the
circumstances.
220. The High Court held in Grincelis v House [2000] HCA 42; (2000) 201 CLR
321 that interest accruing on these damages at the rate set out in the Rules
(see r 1616) should be awarded. In this case, I award $28,500.
221. As it
appears that some of Mrs Becker’s difficulty in not being psychologically
able to cope will disappear with the proposed
regime of treatment proposed by Dr
Lewin. That appears to be a regime that will last for about a
year.
222. Thereafter, while I cannot find that there will be no impairment
for Mrs Becker to carry out her household or domestic tasks,
it will be much
more limited. In my view an allowance of $20,000 as a lump sum rather in the
nature of a buffer would be a reasonable
amount for the damages payable for
future provision of domestic services.
Other matters
223. There was no
claim for loss of superannuation and I have not allowed for any amount in the
damages to be awarded.
224. There appears to have been no workers
compensation payments to be repaid and so no adjustment for any taxation
liability paid
on such payments.
225. There appears no other claim to be made
under any other head of damages.
Conclusion
226. The individual components
of the award of damages are:
General damages 70,000.00
- interest on past
component 7,350.00
Treatment expenses
- past treatment 3,566.79
-
future treatment 27,400.00
Loss of earning capacity
- past
loss 73,500.00
- interest on past loss 23,000.00
- future
loss 37,500.00
Gratuitous services
- past provision 91,500.00
-
interest on past provision 28,500.00
- future
provision 20,000.00
TOTAL 382,316.79
227. This total seems to me to
represent an appropriate reflection of the effects of the 2002 incident upon Mrs
Becker.
228. There will, accordingly, be judgment for the plaintiff in the
sum of $382,316.79. I shall hear the parties as to costs.
229. I sincerely
regret that the busyness of the court has delayed the delivery of judgment and
these reasons in this matter. Nevertheless,
I have read carefully the entire
transcript and the exhibits tendered at the trial as well as my contemporaneous
notes. These have
resulted in a good recall of the proceedings and of the
witnesses giving evidence, notwithstanding the passage of time.
I certify that the preceding two hundred and twenty-nine (229) numbered paragraphs are a true copy of the Reasons for Judgment herein of his Honour, Justice Refshauge.
Associate:
Date: 12 October 2009
Counsel for the plaintiff: Mr R J Mildren
Solicitor for the
plaintiff: Meyer Vandenberg
Counsel for the first and second defendants: Mr S
E Torrington
Solicitor for the first and second defendants: Ken Cush & Associates (as
agents for McCabe Terrill)
Dates of hearing: 29 May 2008 and 3 June 2008
Date of judgment: 12 October 2009
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