Case Law[2024] ZAGPPHC 559South Africa
D.X.R v Road Accident Fund (4809/21) [2024] ZAGPPHC 559 (14 June 2024)
Judgment
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# South Africa: North Gauteng High Court, Pretoria
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## D.X.R v Road Accident Fund (4809/21) [2024] ZAGPPHC 559 (14 June 2024)
D.X.R v Road Accident Fund (4809/21) [2024] ZAGPPHC 559 (14 June 2024)
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REPUBLIC
OF SOUTH AFRICA
IN THE HIGH COURT OF
SOUTH AFRICA
GAUTENG DIVISION,
PRETORIA
CASE NO: 4809/21
(1)
REPORTABLE: NO
(2)
OF INTEREST TO OTHER JUDGES: NO
(3)
REVISED: NO
DATE: 14 JUNE 2024
In the matter between:
D[…]
X[…]
R[…]
PLAINTIFF
and
ROAD
ACCIDENT FUND
DEFENDANT
JUDGEMENT
FLATELA
J
[1]
The Plaintiff instituted an action against the
Road Accident Fund for injuries sustained by him in a motor vehicle
accident that
occurred on
09 March 2020.
[2]
In terms of the amended particulars of claim dated 13 November 2023,
on 9
March 2020 at approximately 06:36 at or near
R-102, Southport, KwaZulu Natal Province, a collision occurred
between a motor vehicle
with registration numbers N[…] (the
insured vehicle) and a motor vehicle with registration numbers N[…]
P[…]
3[…], driven by the Plaintiff. The cause of the
accident was caused by the negligent driving of the insured driver.
[3]
As a result of the accident, the Plaintiff sustained laceration and
fracture left medial malleolus.
[4]
As a direct consequence
the Plaintiff, has
suffered, continues to suffer and will in future suffer the following
sequalae’s:
i.
The Plaintiff was forced to undergo and will in
future be forced to undergo hospital and medical treatment. The
Plaintiff has experienced
pain and suffering and will in future
experience pain and suffering;
[5]
I was informed by the Plaintiff’s counsel that the merits were
previously settled at 85% in favour of the Plaintiff. The
Defendant
had made an offer for general damages and loss of earnings, but the
Plaintiff rejected it.
[6]
The Plaintiff alleges that the Defendant is liable to pay him an
amount R3 164 760 made up as follows:
1.
Past. loss of earnings; R280-4810.
2.
Future
loss of earnings; R 2 079 950
3.
Loss
of future earnings. R 2 364 760
4.
General damages 800,000.
5.
Total
amount. R3 164 760
[7]
This Court was called to determine the General Damages, Loss of
earnings and Future medical expenses.
[8]
An application was made in terms of Rule 38 of the Uniform Rules to
admit the expert evidence tendered without recourse to oral
testimony. The order was granted.
[9]
With regards to general damages, counsel on behalf of the Plaintiff
has argued that an amount of R800 000 is an appropriate
amount.
[10]
I intend to deal first with the Plaintiff’s injuries and their
impact on the Plaintiff’s earning capacity.
Background
[11]
The Plaintiff is an unemployed major male born on 12 February 1974.
He was 46 years old at the time of the collision and is
now 50 years
old. He was employed as a truck driver at the time of accident and
was earning about R9 000 per month. The Plaintiff’s
highest scholastic achievement is grade 11. The Plaintiff was
diagnosed with HIV and was on ARV. The Plaintiff was diagnosed with
Pulmonary TB in 2012.
Plaintiff’s
injuries and impact to the Plaintiff’s earning capacity
[12]
The initial entry of the hospital records which describes the mode of
arrival and condition on arrival amongst other information
recorded
that on 9 March 2020, at about 8H30, the Plaintiff came in a
stretcher accompanied by paramedics from Med-Evac from the
scene of
the accident. It described the mechanism of injury as the frontal
impact, as a result he sustained laceration on the forehead,
neck
laceration and he was vomiting blood. The Plaintiff complained about
pain to the anterior chest/blunt chest trauma and painful
left leg.
His Global Coma Score (GCS) was 15/15 when he arrived at the
hospital, meaning that he was conscious and fully alert.
The clinical
findings were as follows:
a. Face- laceration on
forehead-7cm
b. Laceration on anterior
throat
c. He had no raccoon
eyes.
d. Blunt trauma chest-
Abrasion on chest
e. Swollen ankle
f. No loss of
consciousness
[13]
The Plaintiff received the following treatment –, ATT
injection, suturing of laceration, Neuro observation C-T Scan brain,
chest and abdomen were taken. X-rays of the skull, C-spine and foot
were taken. No fractures were found on the skull. C-spine cleared;
the left ankle had lateral malleolus. Pelvis was examined and found
inferior ramus. The X-Ray of the chest showed air under diaphragm
bilateral infiltrates. The Plaintiff was treated with analgesics and
antibiotic.
[14]
During follow up visits, the Plaintiff complained of a pain in the
left ankle. There was no mention of a back pain, the right
foot, the
left shoulder as it will be demonstrated hereinunder.
Experts
Report and Opinion
[15]
The Plaintiff was examined by the following experts:
a. Dr Mafeelane –
Orthopaedic surgeon
b. Dr Mazwi –
Neurosurgeon
c. Dr J. F Mureriwa –
clinical Psychologist
d. Dr Selahle –
plastic and reconstructive surgeon
e. Dr Nhlapho
-Ophthalmologist
f. Ms N Ndzungu –
occupational therapist – on 18 January 2023
g. Talifhani Ntsieni –
industrial psychologist
h. Munro Forensic
Actuaries
Dr.
Mafeelane – Orthopaedic surgeon
[16]
Dr Mafeelane examined the Plaintiff on 06 April 2021. He states that
from the hospital notes and from the RAF form,
the
Plaintiff sustained mild head injury with facial laceration, pelvis
injury, neck injury, back injury, chest contusion, left
shoulder
injury and left medial Malleolus fracture. At the time of
examination, the Plaintiff complained of backache, dizziness,
and
painful left shoulder.
[17]
On previous medical history, the Plaintiff enjoyed
good health prior to the accident and had never had any operation or
admission.
[18]
Physical examination-Dr Mafeelane examined the
Plaintiff and discovered tenderness on left ankle with swelling
measuring 27 cm v
25 cm on the right. Regarding the shoulder the
doctor noted severe tenderness with reduced range of motion due to
pain. Regarding
cervical spine and face, the doctor noted that here
was a 5cm scar on the forehead and 2cm scar on the forehead.
[19]
Radiological examination from Dr Mkhabele & Indunah Inc on 7
April 2021 revealed that
there is a fracture of
the distal fibula which is united with no displacement or angulation.
There is irregularity of lateral ankle
mortars with suggestion of an
old fracture of the lateral talar dome.
[20]
On pain and suffering, the doctor noted that the
Plaintiff suffered severe pain after the accident and continues to
suffer the inconvenience
and discomfort of chronic pain from the
injured areas. He has never been pain free since the accident.
[21]
As a result, the Plaintiff has great difficulty
with prolonged walking and standing. He has difficulty bending, he
has difficulty
carrying and lifting heavy objects and he has
difficulty doing overhead activities. He is unemployed. The injury he
sustained will
make it difficult for him to compete fairly in the
open Labour market. The doctor deferred to the occupational therapist
to comment
in more detail on the practical effect of his impairment
and ability to work in the open labour market. The injuries sustained
by the Plaintiff. Dr Mafeelane opined that the Plaintiff suffered a
serious long-term impairment and has 12% WPI calculated as follows:
a.
Ankle
-WPI 3%;
b.
Whiplash
-WPI 2%
c.
Pelvis
-3% WPI
d. Shoulder -4% WPI
Dr
Mazwi – Neurosurgeon
[22]
According to Dr Mazwi
the Plaintiff sustained mild
head injury. The Plaintiff experienced head trauma and also had
forehead lacerations, with the loss
of awareness. The Plaintiff had
brief loss of consciousness and amnesia with 15/15 GSC in keeping up
with the mild head injury.
The Plaintiff now presents severe
difficulty with concentration, significant permanent memory
disturbances, dizziness, recurrent
headaches, difficulty with
concentration, cervical neck pains, shoulder pains, forgetfulness,
poor memory, and poor recall. The
Plaintiff has combined WPI of 12%.
[23]
Regarding future medical expenses, The doctor
stated that the Plaintiff would need to consult an Orthopaedic
surgeon and physiotherapist
and he recommended an amount of R30,000.
Furthermore, the Plaintiff will also need to purchase analgesics. And
he recommended R10,000
and he recommended that provisions be made in
final settlement for these future medical expenses.
[24]
On retirement and employability. The doctor stated
that the Plaintiff is unemployed and the injuries he sustained will
make it difficult
for him to compete fairly in an open labour market.
He deferred to the occupational therapist to comment in more detail
on the
practical effect of this impairment and ability to work in an
open market.
Dr
Nhlapho: Ophthalmologist
[25]
Dr Nhlapho examined the Plaintiff on 12 May 2022. He stated that the
Plaintiff sustained direct trauma to the lower forehead
between the
eyebrows and that since the accident the Plaintiff complains of poor
vision of the left eye. He complains that the
eyes are painful,
tearful and photophobic and they have a foreign body sensation. After
clinical examination Dr Nhlapho stated
that the plaintiff has no
vision impairment and the scar on the left brow does not interfere
with visual function. The MMI has
been reached and visual acuity is
normal. Dr Nhlapho opined that the Plaintiff’s future
possibilities and loss of amenities
are not affected. Regarding a 4cm
horizontal scar between eyebrows, Dr Nhlapho stated that he could not
find any damage to the
external ocular adnexa, orbits and globes or
visual pathways as consequences of accident.
[26]
Dr Nhlapho opined that the Plaintiff is in Class 1 with WPI of 3%
according to Table 11 -5 Criteria for Rating Impairment due
to Facial
Scars and Disfigurements. Dr Selahle used the same table regarding
the scars, meaning that this WPI is duplicated as
far as the scars
and disfigurement.
Dr
Selahle – Plastic and Reconstructive Surgeon
[27]
On examination Dr. Selahle made these findings:
a.
Scar
1-6 cm scar on the forehead
b.
Scar
2-5 centimeters Scar on the anterior aspect of the neck.
c.
Scar
3-2cm scar on the left lateral aspect of the neck.
d.
Scar
4-Four cm abrasions scar on the anterior aspect of the leg.
[28]
Dr Selahle concluded that the Plaintiff’s
scars have no features, but they are cosmetically unsightly and
disfiguring, conspicuous
and difficult to conceal, particularly the
facial scar, permanent, with some prospects of scar improvement by
scar revision techniques.
The Plaintiff feels very uncomfortable with
these scars. He has suffered some considerable physical pain, and he
is still suffering
some emotional pain due to his cosmetically
disfigured scar. He has 7% WPI.
Dr
JFL Mureriwa – Clinical Psychologist – Report dated 12
April 2019
[29]
The Plaintiff reported to Dr Mureriwa that since the accident,
he
has the following challenges:
a.
The
Plaintiff misplaces objects. He has low motivation and no longer
enjoys previous enjoyed hobbies, struggles to come to terms
with
altered lifestyle, struggles with bending, kneeling and stopped doing
heavy duties. He has pain and discomfort when sitting
or standing for
a very long time, struggles to walk long distances or stand for
longer periods, performance at work deteriorated
and he could not
cope. As a result, he resigned from his job.
b.
The
Plaintiff is anxious about the future. He is concerned about poor
future employment prospects. The Plaintiff's relationships
are
affected by his impatience and irritability. He is separated from his
wife, he is socially withdrawn and prefers to be alone.
He has poor
sleep because of worrying about things, his sexual activity
negatively impacted. He has low libido and pain.
[30]
The Plaintiff has since been using ARVs for HIV.
[31]
The Activities of Daily Living Summary; functional
and community mobility, Sleep, and Sexual Activities are disrupted by
persistent
pain. Work capacity is affected by cognitive problems that
is forgetfulness and easily distracted, pain and fatigue.
Interpersonal
relationships are impaired by irritability and social
withdrawal. The Plaintiff requires more assistance when performing
heavy
task than he did before the accident.
[32]
Overall clinical impression client presentation.
The Plaintiff was
cooperative but easily
distracted, requires directions.
[33]
Remote memory and recent memory summary. Recent
memory summary appears to be severely impaired and remote memory
appears intact.
He appeared depressed and anxious.
[34]
Overall, very low below average test performance.
Scores were below average, low, average, and average. Visual memory.
The average
verbal memory was below average. Some tests of Speedway
within normal limits, others are below average. Injuries sustained
have
given rise to significant slowing of motor and all cognitive
responsive. Average estimated pre accident neurocognitive capacity
the below average test performance is significantly lower than the
estimated average pre accident capacity. Consistent with the
mild
traumatic head injury sustained, no brain injury, factors which
probably contributed to poor test performance.; persistence,
pain,
and discomfort. Reduced range of movement, fatigue, tiredness and
stressful life events. The Plaintiff sustained mild traumatic
head
injury with mild, mild to moderate anxiety and severe depression.
[35]
Qualitative EEG results summary: The Plaintiff’s
EEG profile suggest a slower than normal speed of information
processing
and chronic pain. These problems are consistent with the
history that the plaintiff sustained a traumatic head injury. The
slowness
is consistent with the reported symptoms of forgetfulness
and below average performance.
[36]
Taking all these factors into account. Referred to
Table 13.- 8, the alteration in MSCHIF, mental status, cognition, and
highest
integrative function., the clinical features summarized here,
placed the Plaintiff in Class 2(20% WPI). The Plaintiff experiences
persistent accident-related pain, discomfort, and emotional distress.
The pain is reportedly severe enough to interfere with his
ability to
work and to perform household chores. He rates his stress level as
high. And finds it more difficult than before the
accident, to
perform some activities of daily living.
[37]
Dr Mureriwa concluded that the symptoms and
accident consequences listed are potent sources of serious and long
term physiological
disorders, including depression, anxiety and
cognitive fallouts. Familiar and educational history suggests that he
was mostly likely
to average neurocognitive capacity prior to the
accident. His neurocognitive functioning appears to have dropped from
average to
below average. This means that he will probably not
realize the professional, financial, and social potential he would
have achieved
had he not been involved in this accident.
Ms.
Ncumisa Ndzungu – Occupational Therapist
[38]
Ms. Ndzungu, an occupational therapist, assessed the Plaintiff on 18
January 2023 to determine the residual problems following
the
accident and their effects on the Plaintiff’s independent
living; as well as his vocational potential before and after
the
accident, with estimations on potential loss of earnings. For
purposes of this judgment, it is the vocational assessment report
results and loss of earnings estimations that are relevant.
[39]
The presence of cognitive and psychosocial limitations may further
curtail his ability to be trained into sedentary or light
work in the
future. His injuries will make him a lesser competitor in the open
labour market compared to his peers. He would thus
require an
understanding employer who will be willing to accommodate his
physical limitations. Due to the accident-related challenge
the
Plaintiff’s job options are likely to be curtailed as he will
not be able to cope with physical demanding jobs. He does
not retain
enough physical vocational capacity to compete in the open labour
market. His physical challenges preclude him from
medium to heavy
occupations or any work duties which require prolonged standing,
walking, dynamic posturing, climbing, and driving.
Pre-morbid
profile of the Plaintiff
Personal
circumstances of the Plaintiff and family background
[40]
The Plaintiff has Grade 11 level of education with
Code 14 drivers’ license and worked as truck driver at Sunrise
Poultry
Farming at the time of the accident. Post accident, he
attempted to return to work in July 2020 and he was given light duty
to
drive, a small van. After a week he was expected to resume his
pre-accident job demands but he struggled. He resigned from his job.
At the time of the report, he was unemployed and without an income.
Post-morbid
profile of the Plaintiff
[41]
The Plaintiff
Demonstrated a compromised ability
in maintenance of some of postural positions on a frequent basis. He
presented with significant
limitation with crouching and repetitive
knees squatting. He presented some limitations with climbing stairs,
elevated work, standing
and walking. His limitations were observed by
sitting forward, bending and kneeling. The limitations are attributed
to the residual
pain in the left ankle, left scapula and left ribs.
Decreased weight bearing on the left lower limb was also noted. The
Plaintiff
worked from Monday to Saturday and his duties included
truck driving, loading chicken feet, operating feed processing
machine offloading
chicken feet. The job physically required
standing, walking, lifting, carrying heavy objects, forward bending
and climbing stairs.
The physical or psychological cognitive
requirements were attention and concentration, problem solving,
communication, and following
instructions.
[42]
The following occupational barriers are
anticipated when considering the climate's residual challenges,
residual left, ankle and
left ribs pain, antalgic gait, left ankle
swelling, decreased movements of the left ankle, headaches and
dizziness, compromised
ability in maintaining most of the postural
position. On frequent basis, limited ability for weight handling,
mild mood disturbances.
[43]
The claimant further presented with a restricted
ability to execute weight handling tasks following the accident.
Decreased weight
bearing was noted to the left leg, and he complained
of left lower limb pain during weight handling. He was therefore
concluded
to have limited ability to execute tasks that required
lifting and carrying heavy objects following the accident. According
to
the assessment of the post-accident, he retains the vocational
capacity to cope with the physical demand characteristics of work
of
mid ranges of light, physical demand level, in respect of
accident-related symptoms. It is noted that his pre- and
post-accident
occupation as a truck driver is classified as medium to
occasional heavy work.
[44]
Ms. Ndzungu is of the opinion that the Plaintiff
has been regarded as an unfair competitor in an openly below market.
His endurance,
work, speed and performance has been affected
following the accident.
Talifhani
Ntsieni – Industrial Psychologist Z
[45]
It was reported to Mr. Ntsieni
that after the
accident the Plaintiff stayed home recuperating for three months. He
also reported that he received his full salary
for March, April and
part of his salary for the month of May, in June he was not paid. He
also reported that he attempted to resume
work in July 2020, but he
struggled to climb onto the truck and to drive due to the pains, and
he stopped working in less than
a month. He is currently unemployed
with no income.
[46]
The Plaintiff has Grade 11 level of education and
the Code 14 driver’s license. Koch states that it is well
established that
for the purposes of the assessment of damages for
loss of earning capacity, the test is likely earnings and not what
the Plaintiff
could possibly have earned in an optimal scenario
(Quantum Year book. 2011/70. The best guide to likely earnings is
often what
the victim was earning at the time of the accident,
Quantum Year Book 2012:106. The Plaintiff reported that he was
employed as
a truck driver, and he was reportedly earning R9500 per
month.
[47]
It is evident that in this capacity he relied on
his physical health, strength and capabilities for gainful
employment. It is the
reality that people without Grade 12
qualification tend to work in the fields of high physical nature,
which demands less administrative
functions. They therefore rely on
physical strength for obtaining and sustaining employment. Same was
the case for the Plaintiff
as he was working. As a bus driver, packet
driver, driver, machine operator and truck driver. His reported
earnings at the time
of the accident were slightly above the lower
quantile of 2020 truck drivers earning scale within the non-corporate
sector.
[48]
The 2022 suggested earnings assumption for truck
drivers within the non-corporate sector are as follows, R72,100 to
R191 000 to
404,000 per year.
[49]
The Plaintiff resumed his work post-accident,
however stopped due to accident challenges. He is currently
unemployed. This is justified
as noted by the occupational therapist.
That he is pre- and post-accident occupation as a truck driver is
classified as medium
to occasional heavy work. This indicates that
his residual vocational capacity does not match his post-accident job
demands.
[50]
It is noted by the occupational therapist that the
residual pain and limitation has affected the Plaintiff’s
vocational and
functional capacity. The accident under review has
significantly curtailed the Plaintiff’s occupational choices
and placed
him in a position of an applicability in an open labour
market. Given the above writer is of the opinion that the Plaintiff
is
likely to experience difficulties securing employment and may be
faced with an extended period of employment.
Munro
Forensic Actuarial Report
[51]
Munro Forensic Actuaries prepared loss of earnings calculations based
on the bases that the Plaintiff received lower earnings
during
recuperation and has been unemployed and will only be able to find
lower paying job in future and is not expected to reach
his suggested
pre-accident career potential. The calculation was based on a monthly
income of R9500 and earning inflation until
retirement.
[52]
The capital value of loss of earnings is calculated as follows:
a. Past
R 299 800
b. Future
R 2 447 000
c. Total
R2 746 800
[53]
The contingency deduction of 5% on the past loss of earnings and 15%
on the future loss of earnings was applied. The loss of
earnings
totals R2 364 760.
[54]
The Plaintiff submitted that an amount of R3 164 760 is
fair and reasonable. It is made up of the following:
i.
Past. loss of earnings; 280-4810.
ii.
Future
loss of earnings; R 2 079 950
iii.
Loss
of future earnings. R 2 364 760
iv.
General damages R800,000.
v.
Total
amount. R3 164 760
Legal
principles – earning capacity.
[55]
The legal principles applicable to loss of earnings and/or earning
capacity are trite. Earning capacity refers to one's potential
and
prospects to generate future income using their skills, talents,
abilities, and experiences. Where this potential has been
diminished
because of the injury, and the quantum value income that one could
have generated to their estate is depreciated because
of the injury,
then there has been a loss of earning capacity.
[56]
The legal principles
applicable to restitution of loss of future earnings and/or earning
capacity have been firmly established.
In
Dippenaar
v
Shield
Insurance Co Ltd
[1]
where
Rumpf JA said that:
[2]
‘In our
law, under the
lex Aquilia
, the defendant must make good the
difference between the value of the plaintiff's estate after the
commission of the delict and
the value it would have had if the
delict had not been committed. The capacity to earn money is
considered to be part of a person's
estate and the loss or impairment
of that capacity constitutes a loss, if such loss diminishes the
estate. This was the approach
in
Union Government (Minister of
Railways and Harbours)
v
Warneke
1911 AD 657
at 665 where
the following appears:
‘In later Roman
law property came to mean the
universitas
of the plaintiff's
rights and duties, and the object of the action was to recover the
difference between the
universitas
as it was after the act of
damage, and as it would have been if the act had not been committed
(
Greuber
at 269)…’
Causation
[57]
The Fund conceded merits 85% in favour of the Plaintiff proven
damages. Concession of merits simply means that the Fund accepts
the
fault of the harm-causing conduct by the insured driver for the
Plaintiff’s proven damages. However, concession of merits
does
not rest the Plaintiff’s case. He still must satisfy the Court
that
but for
the accident he would not have suffered the harm
and injuries complained off; conversely, injuries and damages arose
from the accident.
[58]
Corbett
in
The
Quantum of Damages in Bodily and Fatal Injury Cases: General
Principles
,
J.
J. Gauntlett
,
2008 at page 30 states that:
“
Before damages
payable to the injured person can be assessed it is necessary that
the court should determine factually what injuries
were suffered by
the plaintiff as a result of the defendant’s wrongful act...”
[59]
In the factual causation enquiry, the logical starting point is the
RAF 1 form which deals with the general information regarding
the
accidentthe primary hospital records of the receiving facility, the
police accident report the paramedics’ report if
the patient
was transported by ambulance. . These sets of documents constitute
core primary records as it is from them that the
Plaintiff expands
his case to the experts.
Evaluation
of evidence
[60]
The Plaintiff’s injuries and sequalae can be categorised as
orthopaedic injuries and head injuries . I will deal with
the
orthopaedic injuries first.
Orthopaedic
injuries
[61]
The Plaintiff’s injuries and the sequalae complained is
comprehensively captured in the hospital report. The initial
entry
upon arrival is recorded as follows
“
Patient
came in casualty with a stretcher accompanied by Med-Evac paramedics,
from the scene. Patient is an MVA. Mechanism of injury
is frontal
impact, collided with the other vehicle. Common injuries sustained,
Forehead laceration and neck laceration patient.
Also, c/o(complains)
of pain on the anterior chest. But? Blunt chest trauma and painful
left leg. GSC 15 / 15. Vital signs done
and recorded. Hard cervical
collar. applied. Primary and secondary survey done. Patient received
by Doctor Ntlanti Currently is
awaiting to be seen@ ECG done and was
shown to Doctor Ntombela”
[62]
Dr Ntombela recorded provisional diagnosis to be:
a. Head injury.
b. Chest trauma? cardiac
contusion
c. C-Spine injury
d. Ankle injury
e. Pubic ramus
f. Lateral malleolus
[63]
Dr Ntombela recorded that the Plaintiff suffered no loss of
consciousness. Treatment plan was X-Rays and Neck collar, suture,
and
dressing, IV plus bloods and ECG.
[64]
The X-Rays revealed that the Plaintiff suffered laceration on the
forehead and anterior neck and the left ankle lateral malleolus
fracture. The Pelvis and C-spine were cleared. Black slab was applied
on the Plaintiff’s left leg. It was noted that there
was no
faecal neurological fallout, left ankle swollen tender on sight,
unable to flex or extend as the left foot painful.
[65]
The final diagnosis was lacerations and lateral malleolus fracture.
Loss
of Consciousness
[66]
Dr Mazwi diagnosed the Plaintiff as suffered a mild head injury. It
is recorded that the Plaintiff
experienced head
trauma, also had forehead laceration with loss of awareness. Dr Mazwi
states that the Plaintiff had brief loss
of consciousness and amnesia
with 15 / 15 GSC in keeping up with mild head
injury.
[67]
The paramedics’ patient Report form from the hospital records
was illegible and nothing could be read from it. I was
concerned that
the hospital’s trauma unit medical records did not record the
Plaintiff’s purported loss of consciousness,
that this
information was not recorded in the hospital records, but the
Plaintiff’s GCS admission score was recorded as 15/15,
I
requested the original paramedics’ report.
[68]
On 15 May 2024, I issued a directive to the Plaintiff’s
attorneys to obtain the original copy of the Paramedics Patient
Form
Report from the Emergency Medical Services (EMS) that attended to the
scene.
[69]
The Plaintiff’s attorneys filed a clearer EMS report, I found
that Dr Mazwi’s statements about the Plaintiff’s
loss of
consciousness were not supported by the EMS report. The EMS report
states that he was found lying on supine position alert
and oriented.
The hospital clinical records, as does the EMS report markedly
differed with the Plaintiff’s allegations that
he lost
consciousness.
[70]
Regard being had to the contradiction in Dr Mazwi’s report and
the EMS and hospital records. I am not satisfied that
the Plaintiff
lost consciousness after the collision. The next question to be
answered is whether the Plaintiff has suffered head
injury, if yes,
to what extent has the injury affected his ability to work.
[71]
After Dr Mureriwa conducted certain tests, which showed
neurocognitive and other psycho-behavioural and psychiatric
impairments,
I accept that the Plaintiff suffered mild traumatic
brain injury without any loss of consciousness. Dr Mureriwa opined
that the
below average performance on the neuropsychological test is
consistent with the mild traumatic injury.
[72]
I am of the view that Dr Mazwi was told by the Plaintiff that he had
loss of consciousness’ and amnesia. I am saying
this because it
does not appear on the EMS Report and on hospital Records.
[73]
Splig J also penned some
valuable insights regarding the value of expert witness in
Ndlovu
v Road Accident Fund
[3]
where he held that:
‘
If the patient is
the source of the information regarding the injury and the facts, he
or she supplies differ from those recorded
by the hospital or doctors
at the time of the accident or other primary source documents then
this should be clearly stated.
[4]
There remains a need for
the expert’s report to distinguish between the primary
extrinsic data used and the patient’s
comments. This is
necessary in order to maintain the requisite distinction between
opinion evidence, which is receivable (and which
may also include
reasons as to why the patient’s say-so is supportable based on
the practitioner’s field of expertise),
and an untested version
which amounts to an assumption. In the latter type of case, it should
be clearly identified as such, and
not masqueraded as factual
evidence, particularly where the very purpose of obtaining expert
testimony may have been to test the
veracity of the Plaintiff's
allegations.
[5]
’
The need for medical
experts to identify originating source data and at least identify or
raise concerns regarding their effect
on
quantum
if
there are discrepancies is also apparent when considering how a
failure to do so may result in prejudice, particularly for the
plaintiff.
[6]
The prejudicial
consequences of a medico-legal report failing to comply with the
basic requirement of identifying the underlying
facts and their
sources arises because in practice there can be a significant
difference in the consequences where a court does
the best it can
with available evidence and cases where the court finds that the
plaintiff has not been frank with it or with the
experts.
[7]
In the first mentioned
situation a court will utilise a contingency factor to cater for the
risk of a symptom or an event being
causally related or eventuating
in the future. In the latter case the court may reject the evidence
because it was presented as
a fact that was subsequently shown to be
incorrect, and not as an opinion thereby precluding the court from
adopting a contingency;
in short, a matter of irresoluble
imponderables is converted by the expert into a factual issue of true
or false.
[8]
Accordingly, much will
depend on how the experts distinguish between objective originating
data on the one hand and the patient’s
say-so or
unsubstantiated hearsay on the other. A court will readily be able to
do the best it can and apply contingency factors
in the first type of
case. However, if it rejects the plaintiff’s version or
considers that available evidence has been suppressed
it is entitled
to reject the version and adopt an alternative conclusion with or
without applying a contingency factor (compare
Harrington
NO v Transnet Ltd t/a Metrorail
2010
(2) SA 479
(SCA) at 494B-C).
[9]
In order for a
comprehensive medico legal report to continue being accepted as
complying with Rule 36(9) in modern practice, and
for the plaintiff
not to be potentially prejudiced by a failure to distinguish
assumptions from fact and opinion it appears that
the following
should also appear from its contents;
[10]
a. A clear distinction
between the primary source data relied upon, secondary sources and
the plaintiff’s say-so.
The primary source would
inevitably be the treating hospital’s records from the time of
the accident until discharge (including
paramedics’ records
where relevant). While it may also include follow ups, subsequent
surgical and medical intervention,
scripts and other actual
treatment, the originating source document upon which all else is
likely to be tested is the records of
the treating hospital from
admission until discharge. The medico-legal reports should therefore
clearly state whether the origins
of the symptoms and other
sequelae
relied upon by the plaintiff self-evidently appear from the
treating hospital’s records. Obviously if the patient was not
admitted to a hospital or otherwise received medical attention before
admission then the treating doctor’s records would also
constitute the primary source records, similar to the paramedics’
records if any.
b. The medico-legal
report should also clearly indicate whether the patient's assertions
are accepted or merely assumed. If the
expert accepts the patient's
contentions as to the injuries sustained and when, or their sequelae,
or as to other relevant assertions
in cases where they are not self-
evident from the primary documents then such acceptance itself
constitutes opinion evidence;
as such the expert should qualify
himself or herself as capable of providing such opinion and set out
the process of reasoning,
on medical grounds within the expert's
field of expertise, upon which the conclusion to support the
patient's assertions is made.
In this way a clear line
can be drawn between opinion evidence on the one hand and the
acceptance of the Plaintiff's mere say-so
on the other. Unless the
distinction is made between the Plaintiff's untested assertions and
an expert opinion of whether they
can be medically supported, and if
so whether on primary source documents or not, the report will
impermissibly encroach on the
judicial function of determining
fact.
[11]
[74]
While some of the injuries are mentioned in the hospital record, they
were provisional diagnosis not the final one. The Doctors
that
completed RAF 1 and RAF 4 clearly recorded the injuries suffered by
the Plaintiff as gleaned from the hospital records. Unfortunately,
Dr
Mafeelane, Dr Mazwi and Dr Mureriwa’s report did not
distinguish between the information received from the Plaintiff and
the information gleaned from the hospital records.
[75]
And now for the contingencies.
[76]
The Supreme Court of
Appeal in the case of
Road
Accident Fund v Guedes
[12]
at paragraph 9 referred
with approval to
The
Quantum Yearbook
,
by the learned author Dr R.J. Koch, under the heading
'General
Contingencies
',
where it states that:
“…
[when]
assessing damages for loss of earnings or support, it is usual for a
deduction to be made for general contingencies for which
no explicit
allowance has been made in the actuarial calculation. The deduction
is the prerogative of the Court...”
[13]
[77]
Nicholls AJA in
RAF
v Kerridge
[14]
pointed
to some general rules that have been developed over the years in
contingency applications. He said that:
‘
Some general rules
have been established in regard to contingency deductions, one being
the age of a claimant. The younger a claimant,
the more time he or
she has to fall prey to vicissitudes and imponderables of life. These
are impossible to enumerate but as regards
future loss of earnings
they include, inter alia, a downturn in the economy leading to
reduction in salary, retrenchment, unemployment,
ill health, death,
and the myriads of events that may occur in one’s everyday
life. The longer the remaining working life
of a claimant, the more
likely the possibility of an unforeseen event impacting on the
assumed trajectory of his or her remaining
career.’
[15]
[78]
Moosa AJ in
O
v
Road
Accident Fund
[16]
endorsed
Gaunttlet’s principle and said that i
t
is well established practice that where the plaintiff suffers a
permanent impairment of earning capacity, the proper and effective
method of assessing past and future loss of earnings is as
follows:
[17]
a) To calculate the
present value of the income which the plaintiff would have earned but
for the injuries and consequent liability.
b) To calculate the
present value of the plaintiff’s estimated income, if any,
having regard to the disability.
c) To adjust the figures
obtained in the light of all the relevant factors and evidence
obtained and by applying contingencies;
d) To subtract the figure
contained under (b) from that obtained
under (a)
[79]
Robert J Koch
[18]
has suggested that as a general guideline, a sliding scale of 0,5%
per year over which the applicable income must be calculated,
be
applied. For example, 25% for a child, 20% for a youth and 10% in
middle age.
Munro
Forensic Actuarial Report
[80]
Munro Forensic Actuaries calculated the capital value of loss of
earnings without contingencies as follows:
a. Past loss of earnings
R299 800
b. Future
R2 447 000
c.
Total
R2 746 800
[81]
The Plaintiff’s attorneys applied normal contingency deduction
of 5% and 15% resulting in the amount of R2364 760 (Two
Million three
hundred and sixty four thousand and six hundred rand only).
[82]
It is common cause that a number of issues are considered when an
actuarial assessment is done, including considerations of
early
death, promotion prospects, and taxes.
Having
considered the Plaintiff’s age, educational background, skills,
employment history, medical history, the injuries suffered
and all
the expert opinions, I am of the view that 5% contingences must be
applied to pre-morbid position and 25 % to the post
morbid position.
Therefore, the Capital value of loss of earnings will be calculated
as follows:
a. Past
R 284 810
b. Future
R 1835 250
c. Total
R 2 120 060
Less 15%
R 1 802 051
General Damages
[83]
Moseneke
DCJ in
Van
der Merwe v Road Accident Fund and Another
[19]
stated that:
“
non-patrimonial
damages, which also bear the name of general damages, are utilized to
redress the deterioration of a highly personal
legal interests that
attach to the body and personality of the claimant. However,
ordinarily the breach of a personal legal interest
does not reduce
the individual’s estate and does not have a readily
determinable or direct monetary value. Therefore, general
damages
are, so to speak, illiquid and are not instantly sounding in money.
They
are not susceptible to exact or immediate calculation in monetary
terms. In other words, there is no real relationship between
the
money and the loss.
In
bodily injury claims, well-established variants of general damages
include “pain and suffering”, “disfigurement”,
and “loss of amenities of life.”
[20]
(my emphasis –
and footnotes omitted)
…
.
it is important to
recognize that a claim for non-patrimonial damages ultimately assumes
the form of a monetary award. Guided by
the facts of each case and
what is just and equitable, courts regularly assess and award to
claimants’ general damages sounding
in money. In this sense, an
award of general damages to redress a breach of a personality right
also accrues to the successful
claimant’s patrimony.
After
all, the primary object of general damages too, in the
non–patrimonial sense, is to make good the loss; to amend the
injury.
(My
emphasis – and footnotes omitted)
[21]
[84]
I have considered the cases that the Plaintiff referred me to. I
agree that an award of R800 000 (Eight Hundred Thousand
Rand
Only) is fair and reasonable.
[85]
In the result I make the following order:
1. Amended order marked
“X” annexed hereto is made an order of court
FLATELA
LULEKA
JUDGE
OF THE HIGH COURT
GAUTENG
DIVISION, PRETORIA
This
Judgment was handed down electronically by circulation to the
parties’ and or parties’ representatives by email
and by
being uploaded to CaseLines. The date and time for the hand down is
deemed to be 10h00 on 14 June 2024
Counsel for Plaintiff:
Rhangani RJ
rhangani@gmail.com
Instructed by
Sotshintshi Attorneys
Attorneys for the
Defendant
Phokwane K.A
Date of the Hearing
14 November 2023
Date of the Judgement
14 June 2024
[1]
Dippenaar
v
Shield
Insurance Co Ltd
1979
(2) SA 904 (A)
[2]
Ibid, at 917 B – D.
[3]
Ndlovu
v Road Accident Fund
2014(1)
SA 415 (GSJ)
[4]
Id, para 114.
[5]
Id. Para 115.
[6]
Id.
Para 116.
[7]
Id.
Para 117
[8]
Id, para 118.
[9]
Id,
para 119.
[10]
Id,
para 121.
[11]
Id. Para 121.
[12]
RAF
v Guedes 2006 (5) SA 583 (SCA)
[13]
Ibid, para 9.
[14]
RAF v
Kerridge
(1024/2017)
[2018] ZASCA 151.
[15]
Ibid at para 44.
[16]
O v Road Accident Fund (20976/2014) [2018] ZAGPJHC 419 (31 May
2018).
[17]
The Quantum of Damages, vol 1, 4th edition by Gauntlett at page 68;
Southern Insurance
Association Ltd v Bailey
1984 (1) SA 98
(A) at
113 F – 114E
[18]
Robert J Koch, The Quantum Yearbook, 2009, p.100
[19]
(CCT48/05) [2006] ZACC 4
[20]
Ibid at para 39
[21]
Cf:
Sandler
v Wholesale Coal Supplie
s
Ltd
1941 AD 194
at 199 where the court held: “The amount to be
awarded as compensation can only be determined by The broadest
general considerations
and the figure arrived at must necessarily be
uncertain, depending upon the judge’s view of what is fair in
all the circumstances
of the case”.
sino noindex
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