Case Law[2023] ZAGPPHC 4South Africa
Jacobs v Road Accident Fund and Another (99830/2015) [2023] ZAGPPHC 4 (9 January 2023)
High Court of South Africa (Gauteng Division, Pretoria)
9 January 2023
Headnotes
of the treatment engaged as reflected in the hospital records as summarised in paragraph [6] above. In emphasising of the points agreed upon was that (i) the plaintiff had multiple consultations for septic non-union, a piece of bone was extracted from his right elbow where there was exorbitant puss …. That a certain Dr Morule at Klerksdorp Hospital stated … “double plaiting can be considered once ESR and CP are normal” this was after single plate had been inserted which had become septic. The plaintiff received Cloxallin, Flagyl and Augmentin. There is no proof that he was started with his regime from the beginning and he was only place on it and on Anti-bone (iii)…on
Judgment
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# South Africa: North Gauteng High Court, Pretoria
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## Jacobs v Road Accident Fund and Another (99830/2015) [2023] ZAGPPHC 4 (9 January 2023)
Jacobs v Road Accident Fund and Another (99830/2015) [2023] ZAGPPHC 4 (9 January 2023)
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# IN THE HIGH COURT OF
SOUTH AFRICA
IN THE HIGH COURT OF
SOUTH AFRICA
# GAUTENG DIVISION,
PRETORIA
GAUTENG DIVISION,
PRETORIA
CASE
NUMBER:
99830/2015
REPORTABLE:
NO
OF
INTEREST TO OTHER JUDGES: NO
REVISED:
NO
09
January 2023
In
the matter between:
E
S
JACOBS
PLAINTIFF
and
THE
ROAD ACCIDENT FUND
FIRST DEFENDANT
THE
MEC FOR HEALTH, NORTH WEST
SECOND DEFENDANT
PROVINCE
# JUDGMENT
JUDGMENT
TLHAPI
J
[1]
The plaintiff sued the first defendant in
terms of the
Road Accident Fund Act 56 of 1996
for bodily injuries and damages suffered in
a collision on 23 September 2013 on the N12 Highway in Stilfontein,
where the plaintiff
who was a pedestrian at the time was struck by a
truck while standing on the side of the road. The merits between the
plaintiff
and the first defendant were settled on 60/40 apportionment
in favour of the plaintiff.
[2]
The plaintiff also sues the second
defendant for damages arsing from further injuries and complications
sustained during the plaintiff’s
hospitalisation at the
Klerksdorp/Tshepong Hospitals which damages were caused by the
alleged negligence of the medical and nursing
practitioners in the
employ of the said second defendant. The plaintiff sued the second
defendant for an additional 50% for the
damages suffered as a result
of the negligence.
[3]
The plaintiff and the second defendant
reached settlement before the hearing in the sum of R2, 400,000.00
(two million four hundred
thousand).
[4]
The plaintiff was 59 years old and
self-employed since 1994 as a freelance assessor and also doing
reconstruction of motor vehicle
accidents and had been in this
occupation until the collision in 2013. He was engaged in his
freelance capacity by many firms of
attorneys, and confirmation on
this aspect is to be found as deposed to by the said attorneys in the
Rule 38
application. Prior to that he was employed by the Road
Accident Fund in the same position from 1978 – 1993.
[5]
It is common cause that after the collision
the plaintiff never returned to his occupation as a result of the
sequelae of the collision
and those suffered as a result of the
negligence of the employees of the second defendant. On the day of
the collision, 23 September
2013, the plaintiff was admitted to the
Tshepong Hospital where he was stabilised and transferred to the
Klerksdorp General Hospital.
Expert reports were compiled by experts
for the plaintiff, first and second defendants.
[6]
The following injuries as summarised by Dr
Birrel (for the plaintiff)
and
Dr Read (for the RAF), Orthopaedic Surgeons as gleaned from hospital
records:
a)
An open supra-condylar distal humerus
fracture of the right elbow;
b)
On
5 October 2013 the fracture was surgically managed by way of open
reduction and internal fixation; and the plaintiff was discharged
with an elbow back slab;
c)
At a follow up on 11 November 2013 the
plaintiff’s elbow was noted to be swollen with a restricted
range of extension and
X-rays revealed good alignment of the fracture
with loose screws and, the treatment plan included physiotherapy and
removal of
the hardware when fracture had healed; (the plaintiff
informed Dr Birrel that he did not have physiotherapy);
d)
On 13 December 2013 a septic wound
measuring 1,5cmx 2cm was noted over the right elbow and X-rays showed
an undisplaced fracture,
pus swabs were taken and removal of the
hardware was scheduled for January 2014;
e)
On 4 March the plaintiff a debridement and
removal of the hardware due to sepsis was performed in theatre;
X-rays showed that the
fracture had not united, there was still
ectopic bone of callus present and 2 screws floating loose; the elbow
was still in back
slab and there were surgical clips present);
f)
On 19 May 2014 a septic non-union fracture
was noted and replating was considered and he was referred to
Charlotte Maxeke for an
opinion;
g)
The X-ray dated 5 August 2014 show marked
distortion at the fracture site with total non-union, exuberant
callus and still the presence
of the two floating screws was noted;
h)
On 1 October 2013 there was plaiting of the
right distal humerus;
i)
The plate and screws were removed on 4
March 2014 due to sepsis;
j)
There were repeated visits for ‘non-union
of the right elbow’.
The plaintiff’s
pre-existing medical conditions were that he suffers from high
cholesterol, hypertension and epilepsy and
is on chronic medication
for these conditions. He also had ‘a basal cell carcinoma
removed from the right nostril’,
the latter has healed.
[7]
I rely on the submissions in the Heads of
Argument by Counsel for the plaintiff Mr van der Berg where he
addressed the opinions
of the experts in their joint minutes and the
individual report of the occupational therapist
## Orthopaedic Experts:
Orthopaedic Experts:
Dr Birrell (for
plaintiff) Dr Preddy (for second defendant):
Both doctors were in
agreement with the summary of the treatment engaged as reflected in
the hospital records as summarised in paragraph
[6] above. In
emphasising of the points agreed upon was that (i) the plaintiff had
multiple consultations for septic non-union,
a piece of bone was
extracted from his right elbow where there was exorbitant puss ….
That a certain Dr Morule at Klerksdorp
Hospital stated …
“
double plaiting can be considered once ESR and CP are
normal”
this was after single plate had been inserted which
had become septic. The plaintiff received Cloxallin, Flagyl and
Augmentin. There
is no proof that he was started with his regime from
the beginning and he was only place on it and on Anti-bone (iii)…on
10 February 2014. The x-rays showed that there was loosening of the
plate, Dr Preddy notes that the two bottom screws do not appear
to be
‘in bone’ the construct was unstable and there were two
floating loose screws.
## The doctors disagreed on
the following:
The doctors disagreed on
the following:
(i)
Dr Birrell was of the view that from the
beginning a potent cocktail of antibiotics covering a broad spectrum
should have been given
and that there was no evidence of what
anti-bone treatment was initially given. Furthermore, that an
external fixator should have
been applied after debridement with an
inspection 48 hours later and waited 4-6 weeks before applying a
double plating to the joint.
Dr Birrell was of the view that
treatment was substandard and negligent;
(ii)
Dr Preddy could not fault the plaintiff’s
treatment;
## Dr Birrell and Dr Reed
(for the first defendant)
Dr Birrell and Dr Reed
(for the first defendant)
Both doctors agree that
the plaintiff’s injuries were serious under the narrative test
and was entitled to general damages;
since there recovery was not
full, he was disadvantaged in the workplace. Dr Reed gauged
productivity between 20% to 100%. Dr Birrel
opined that the plaintiff
required two years early retirement, that in view of the proposed
series of treatment going back to work
was not feasible and the
plaintiff had to be considered as being 100% unfit for work.
## Plastic
and Reconstructive Surgeons
Plastic
and Reconstructive Surgeons
Drs P B White (plaintiff)
and L Berkowitz are in agreement that further treatment is warranted
and that the injury was serious and
there was permanent
disfigurement.
Clinical Psychologists –
Sam Mphuthi and Kobus Truter
Both clinical
psychologists agree that the plaintiff complains of pain and impaired
functioning of his dominant right elbow, no
longer engages in past
activities and hobbies, suffers from depressed mood and anxiety and
will require long term supportive psychotherapy
treatment; he remains
vulnerable.
Industrial Psychologists
– Mr C Schoombie and Ms C J Nel
Both took into
consideration plaintiff’s employment history; pre-accident
earnings to be quantified on earning at time of
accident, annual
inflationary be considered; they agreed that he sustained past loss
of earnings; based on information they were
agreed that it was
unlikely that the plaintiff could generate the income he was earning
at the time of the collision and that he
would remain unemployed.
Occupational Therapist –
Ms Greef
Ms Greef made use of
photographs to indicate the deformity to the elbow and several tests
and exercise were conducted to assess
the deformity and a
psychological assessment was also conducted. The plaintiff related
his daily activities and the effect of the
sequelae and the depressed
mood as opined by Dr Truter when he stated at paragraph [5.5] of the
report: “
Ek bly in die bed, wat moet ek doen? Alles
waarvoor ek gewerk het, het ek nou verloor; Alles
voel vir my
net so total sinneloos”
She opines as a result of the
degree of deformity that prospects of post-accident employment was
minimal if not non-existent and
together with opinion of Dr Birrell
and her findings she considered the plaintiff to be 100% unfit for
work.
[8]
While
it is so that the plaintiff and the second defendant have reached
settlement it is worthwhile to consider Mr van der Berg’s
submission with regard to the quantification of the plaintiff’s
damages. Of relevance is the understanding behind joint and
several
delictual liability where the first and the second defendant are
concerned and, where the plaintiff claims that the first
and second
defendant are jointly and severally liable for his damages while is
contended by Mr Joubert for the second defendant
that its liability
only on several liability. At Common Law a distinction was drawn
between joint and concurrent wrongdoers. “Joint
wrongdoers
(‘
persons
who, acting in concert or in furtherance of a common design….they
are jointly and several….
Concurrent
wrongdoers (
whose
independent combine to produce the same damage…..concurrent
wrongdoers are liable in solidum…….The distinction
between joint and concurrent wrongdoers is of course now largely
academic in view of the provisions of the Act which recognise
and
regulate a right of contribution between joint and concurrent
wrongdoers at common law.”
[1]
[9]
The plaintiff having conceded that there
was contributory negligence in the occurrence of the collision, this
has no relevance to
the negligence of the medical practitioners even
where Dr Birrell expressed a view that the degree of plaintiff’s
injuries
would have been 50% better if proper orthopaedic treatment
had been provided after the collision. It was contended that where it
concerned the second defendant negligence was either a 100% or not.
In considering the damages it is the totality of the quantified
damages, that the second defendant would be liable for 50% of the
total amount of damages as a result of the negligence and not
50% of
the 60% of the damages (contributory) attributed to the first
defendant. Counsel for the second defendant Mr Joubert submitted
that
it was as a result of the 50% view of Dr Birrell that settlement
negotiations were entered into with the plaintiff and, that
an amount
of R2,400,000.00 in damages was agreed upon. What must be understood
is that Dr Birrell does not say that the second
defendant was 50%
liable for the injury to the plaintiff but that if proper treatment
was given the injuries would have been 50%
better.
[10]
Concern
was raised by counsel for the first defendant Ms Gaokgwate of the
possibility of over compensation ; no heads of argument
were filed
but counsel relied upon discussions she had with the Claims Handler.
Concern was also raised regarding the
section 17(4)
certificate. It
was contended by her that the first defendant’s liability
regarding future medical expenses be reduced to
30% since the first
defendant was 50% liable for the injuries. This is not what Dr Birrel
said when he spoke about the 50%. The
negligence of the employees of
the second defendant cannot reduce or exculpate the driver of the
motor vehicle
[2]
, there is a
concession that the plaintiff 40% negligent. It was contended by
counsel for the plaintiff that the total common law
value of the
plaintiff’s damages as appear in paragraph [6] of the Heads of
Argument for the plaintiff are calculated as
follows:
a) Past Hospital and
Medical expenses
2 231.02
b) Future Hospital and
Medical and related expenses
1 170 805.00
c) Past Loss of
Earnings
1 993 283.00
d) Future Loss of
Earnings
2 204 641.00
e) General
Damages
750 000.00
Total
6 120 960.02
It was contended that the
totality of damages payable by both the first and second defendant
had to be determined from the above
with the necessary deductions
being made. The amount settled with the second defendant would be
deducted leaving the balance from
which the first defendant’
s
60%
liability would be determined.
[11]
It was submitted that the calculations
according to the plaintiff were determined as follows:
i)
An undertaking for future medical expenses
limited to 60% of all claims regarding treatment of the elbow,
occupational therapy and
psychological counselling;
ii)
60% past medical expenses limited to R1
338.60;
iii)
60% past and future net loss of earning:(R
4 197 923.00 x60%) =R2 518 754.00
iv)
60% of the General Damages: (R750 000.00
x60%)=R450 000.00
Payment by the first
defendant would amount to R2 979 092.60 plus costs.
## General Damages
General Damages
[12]
It
is trite that each case is to be decided on its own merits. Several
authorities were relied on by plaintiff and defendant as
guidelines
for General damages to be awarded for varied arm injuries, for the
loss of arm (amputation), elbow, limitation of an
elbow joint and
shoulder
[3]
The
first defendant had no objection to general damages proposed in the
amount of R750 000.00 and that the first defendant was liable
for 60%
of such damages.
## Past and Future Loss of
Earnings:
Past and Future Loss of
Earnings:
[13]
The plaintiff’s past and future loss
of earnings were calculated as at the time of the collision and
having regard to what
he earned in his freelance occupation. A
contingency deduction of 10% was deducted from past loss and 20% on
future loss. The actuarial
calculations made provision for three
scenarios at ages 62 and a half; 65 and 67 and a half. In as far as
his pre accident earnings
were concerned the recommendations of Ms
Nel and Mr Schoombee were considered. In as far as post accident
earnings were concerned
the recommendations of Mr Schoombie as a
paragraph 7.2.1 of the joint minute were considered.
The calculations also provide for the limit
on losses as shown before and after applications of the
section
17(4A)(a)
amendment, Road Accident Fund Act 19 of 2005 as amended.
[14]
Motivation for retirement at 67 and a half
years was that being self employed it was unlikely that he would
retire before 65 years
because of he was self -employed for at least
more than 10 years prior to the collision and confirmation is found
in the Rule 38
application, the confirmation of the attorneys who
engaged the plaintiff for services. Ms Gaokgatwe was of the view that
the pre-existing
medical conditions had to be considered. My view is
that the plaintiff’s pre-existing conditions were being
treated, was
under control and that there had not been a history of a
hinderance to him doing his freelance duties. I would therefore go
with
the view that retirement at 67 and a half years was possible and
that for purpose of calculating Past Loss and Future Loss scenario
3
of the actuarial calculations applying a 10% and 20% contingency was
applicable as recalculated on case lines 010-20 and that
the first
defendant’s liability was limited to 60%.
[15]
The order granted is according to the draft
order on CaseLines with the insertion of the following amounts and
the draft order is
to be completed accordingly including paragraphs
[1] to [5] and filed on CaseLines for signature:
a)
The amount of R2 400 000.00 (Two Million
Four Hundred Thousand) by agreement payable in full and final
settlement by the second
defendant
b)
The first defendant is liable to pay an
amount of R2 970 092.60 (Two Million Nine Hundred and Seventy
Thousand Ninety Two
and
Sixty Cents).
V.V.
TLHAPI
JUDGE
OF THE HIGH COURT
GAUTENG
DIVISION, PRETORIA
# APPEARANCE
APPEARANCE
HEARD
AND RESERVED ON
: 28 OCTOBER 2021
FOR
THE PLAINTIFF
: Adv J P Van Den Berg SC
INSTRUCTED
BY
: Adams & Adams
FOR
THE 2
ND
DEFENDANT
: Adv H P Joubert
INSTRUCTED
BY
: OFFICE OF THE STATE ATTORNEY
DATE
OF JUDGMENT
: 09 JANUARY 2023
[1]
The
Minister of Police v Underwriters at Lloyds of London (ZASCA)72
[2]
LST
Taljaard v Road Accident Fund (unreported judgement of Preller )
23520/04
[3]
M
v Road Accident Fund (08758/16) [2017] ZAGPJHC 201 -loss of arm in
2017 was for R650,000,00 which equates to R786 000.00 today;
Mulliner
v Bendix 1954 C&B 529 left shoulder joint and a permanent
nervous condition R3000.00 translates to R305 000.00 today;
Saayman
v Commercial Union Insurance Co. of 1972 (2) ECD painful shoulder
and a wrist operation R8 000.00 translates R478 000.00;
Laubsher
& Another v Commercial Union Ass
1976 (1) SA 908
ECD supra
condylar fracture right humerus, limitation of movement elbow joint
40 degrees R4000 translates to R155 000.00;
Lee
v Road Accident Fund [2010] ZAGPPHC 276 Fracture of Elbow R250
000.00 translates to R367 000 today;
Swanepoel
v Road Accident Fund 2008 5 QOD 40 (NC) head injury
-quadriplegic-before injury he was a farmer and professional hunter
; post accident he could no longer conduct his activities on farm of
hunt R800 000 translates of R1 313 000,00 today
sino noindex
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