Case Law[2023] ZAGPPHC 1778South Africa
P.J obo A.J v Road Accident Fund (72576/2018) [2023] ZAGPPHC 1778 (3 October 2023)
High Court of South Africa (Gauteng Division, Pretoria)
3 October 2023
Headnotes
of his findings are that:
Judgment
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# South Africa: North Gauteng High Court, Pretoria
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## P.J obo A.J v Road Accident Fund (72576/2018) [2023] ZAGPPHC 1778 (3 October 2023)
P.J obo A.J v Road Accident Fund (72576/2018) [2023] ZAGPPHC 1778 (3 October 2023)
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sino date 3 October 2023
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REPUBLIC OF SOUTH
AFRICA
IN THE HIGH COURT OF
SOUTH AFRICA
GAUTENG DIVISION,
PRETORIA
CASE NO: 72576/2018
REPORTABLE:
NO
OF
INTEREST TO OTHER JUDGES:NO
REVISED:
NO
DATE:
3 October 2023
SIGNATURE
OF JUDGE
In
the matter between:
PJ
obo AJ
PLAINTIFF
and
ROAD
ACCIDENT FUND
DEFENDANT
JUDGEMENT
FLATELA
J
[1]
The Plaintiff instituted an action against the
Road Accident Fund (the defendant) on behalf of her minor son, AJ for
injuries sustained
by him in a motor vehicle-pedestrian (MVP)
accident that occurred on
20 October 2017. The claim is
pursued by the Plaintiff in her capacity as the mother and natural
guardian of the minor child. AJ
was hit by a taxi whilst crossing a
street with another child. He was 4 (four) years and 8 (eight) months
old at the time of the
accident.
[2]
The Plaintiff claims that the defendant is liable to
pay the minor an
amount of R5, 199 440 (five million, one-hundred and ninety-nine
thousand, four-hundred and forty Rand) for
future loss of earnings.
[3]
The merits and general damages have been settled between
the parties.
Merits were conceded by the defendant 100% in favour of the
Plaintiff’s proven damages. General damages were
settled in the
amount of R1, 000 000.00 (one million Rand) and the claim for
loss of earnings was postponed
sine die.
The agreement to
settle merits and general damages was made an order of Court by
Molefe J on 18 August 2020.
[4]
The Defendant was also ordered to provide the Plaintiff
with a
Certificate of Undertaking in terms of
section 17(4)(a)
of the
Road
Accident Fund Act, No. 56 of 1996
, for the cost of future
accommodation of the minor child in a hospital or nursing home, or
the treatment of or rendering of a service
or supplying of goods to
him arising out of the injuries sustained by the minor child in the
motor collision which occurred on
20 October 2017.
[5]
I am called to determine the loss of earnings claim.
The defendant
was not represented in this matter and the trial proceeded by
default.
Brief
Background
[6]
In terms of the amended particulars of claim, the Plaintiff
alleges
that on or about 20 October 2017 at approximately 11:20 near End
Street and Rocky Street, Johannesburg Central, Gauteng
Province, AJ
was hit by a motor vehicle with registration number XVM […]
(“the insured vehicle) driven by Really Ngika
Malembe (“the
insured driver”) whilst a pedestrian.
[7]
As a result of the collision, AJ sustained severe bodily
injuries,
more specifically:
·
Head injury
·
Injury of the right ankle and foot
·
As well as other bodily injuries more fully described in the hospital
records and medico-legal
reports.
[8]
The Plaintiff alleges that when she was called to the
scene, she
found AJ lying unconscious on the side of the road, and bleeding from
both nostrils. When the ambulance arrived, he
was put on a stretcher
and on an oxygen, mask was put on his nose. He was transported to
Charlotte Maxeke Hospital, Johannesburg.
The Plaintiff alleges that
AJ only regained consciousness upon his arrival at the hospital.
[9]
It is not clear who AJ was with when he crossed the street
but an
affidavit from Ms. Vuyelwa Kgasane states that AJ was with another
boy when he was hit by the motor-vehicle. Ms Kgasane
is the
Plaintiff’s friend who witnessed the accident and called the
Plaintiff.
Hospital
Records
[10]
Hospital records reflect that AJ sustained the following injuries:
10.1
A haematoma on the left side of the forehead.
10.2
A degloving injury over right ankle and foot over lateral malleolus
and lateral aspect
of foot, tendons and bone exposed.
[11]
In terms of the hospital records, AJ’s Global Coma Score (GCS)
was 15/15
when he arrived at the hospital, meaning that he was
conscious and fully alert on arrival at the hospital. Importantly,
the hospital
clinical records state that AJ was fully alert post
impact.
[12]
X-rays of the skull, right ankle and foot were taken, and no
fractures
were found on the skull. Analgesics were given and the
wound in the right foot was dressed. The following day, a wound
debridement
on the right foot was performed and AJ had several wound
debridement procedures in theatre. He was discharged towards the end
of
November 2017, and his mother continued wound dressing him at
home. He was readmitted in January 2018 for skin grafting and
discharged
5 (five) days thereafter.
[13]
This trial
proceeded by default and an
application was made in terms of Rule 38(2) of the Uniform Rules to
admit the expert evidence tendered
without oral testimony. I granted
the application.
[14]
The Plaintiff contends that the minor child suffered future loss of
earnings
caused by one or more of the injuries AJ sustained in the
accident. I now deal with the experts’ opinions.
Plaintiff’s
experts and their evidence
[15]
The Plaintiff was examined by the following experts:
a.
Dr B A Okoli- Neurosurgeon on 05 November 2018.
b.
Dr LF Oelofse-Orthopaedic Surgeon on 06 November 2018.
c.
Dr J. F Mureriwa -Clinical Psychologist on 08 November 2018.
d.
Dr L. Berkowitz – Plastic and Reconstructive Surgeon on 11
April 2019
e.
Amanda Peter – Physiotherapist on 11 April 2019
f.
Dr H.M Laauwen – Educational Psychologist on 20 January 2023
g.
Ms N Ndzungu – Occupational Therapist on 18 January 2023
h.
Mr B Moodie – Industrial Psychologist 07 November 2017, and
16
th
February 2023
i.
Munro Forensic Actuaries
Dr
B.A Okoli – Neurosurgeon – Report dated 05 May 2018
[16]
The primary report filed by the Plaintiff is the Neurosurgeon Report.
According
to Dr Okoli, AJ suffered a mild brain injury from the
accident. He came to this conclusion after having considered the
following
assertions and/or observations:
a.
Collateral information obtained from the mother
about AJ
psycho-social behavioural issues: violent behaviour and aggressive
short-temper; threats (and one attempt) to self-harm;
disobedience;
sleep disturbance, nightmares, and post-traumatic flashbacks of the
accident.
b.
Physical evidence of cranial impact:
AJ sustained a tender
swelling on the forehead and the mother reported that he had blood
coming from his nostrils.
c.
Acute clinical evidence of brain injury –
his mother’s
assertion that AJ was unconscious at the scene and that he only woke
up and started crying when they arrived
at the hospital.
d.
Reported poor scholastic ability.
The teachers complain that
he is not doing well at school, and that he is a slow learner.
e.
The reported loss of consciousness
by the mother and the
duration is consistent with a mild brain injury. However, he had no
secondary deterioration in his consciousness.
Otherwise, the presence
and duration of post-traumatic amnesia is difficult to determine at
his age group...
f.
Vulnerability –
since AJ was four at the time of the
accident, that’s an age of rapid neuronal development when new
nerve connections and
changes make the brain less physically stable
and is thus more vulnerable to physical injury.
Dr
JFL Mureriwa - Clinical Psychologist
[17]
The Plaintiff reported to Dr Mureriwa that since the accident, AJ’s
activities
of daily living have been impaired in that his functional
mobility is affected by the right foot injury and persistent pain.
Sleep
is disrupted by nightmares. Academic performance is impaired by
behavioural and cognitive problems (poor concentration and
forgetfulness).
Personal relationships are impaired by his
irritability and behavioural issues.
[18]
On Dr Mureriwa’s own examination some tests could not be
completed due
to behavioural problems. AJ was uncooperative and
fidgety. He did not listen to some instructions and was reluctant to
participate
in tests, despite his mother’s prompting.
[19]
AJ mental status examination revealed that his short-term memory
appears to
be mildly impaired and remote memory appears to be normal.
On the Junior South African Individual Scales (JSAIS) test, his
number
and quantity concepts, memory for digits, and copying are all
in the average range. In terms of the World Health Organisation for
Disability Schedule (WHODAS), his overall disability is moderate, but
performance of school activities is severely affected.
[20]
Dr Mureriwa also performed an Electroencephalography (EEG) test on AJ
and the
summary of his findings are that:
a.
EEG absolute power scores are within normal limits, but there is a
mild-moderate poor functional integration
between brain areas. The
normal EEG power and alpha peak frequencies reflects normal
pre-accident neurocognitive capacity. On the
other hand, the mild
moderate poor functional integration between brain areas reflects the
disruptive impact of early childhood
injury, and the accident-related
persistent pain, discomfort, and stress. The EEG feature of reduced
phase lag is consistent with
the reported symptom of irritability.
[21]
In conclusion, Dr Mureriwa concurred with Dr Okoli’s diagnosis
that AJ
sustained a mild brain injury. Furthermore, he commented that
AJ’s family history, EEG results, and performance on subtests
of the JSAIS all suggest that AJ was of at least average
neurocognitive capacity prior to the accident. The brain injury has
resulted
in a major behavioural disorder with reported symptoms of
irritability, aggression, poor concentration, forgetfulness,
impulsivity,
and distractibility. As a result of these symptoms, AJ
is unlikely to attain his full pre-accident educational,
occupational, and
social potential. Deference to an educational
psychologist was made to determine his current IQ and future
scholastic prospects.
[22]
Dr Mureriwa conducted a second assessment on AJ on 19 January 2023
and delivered
his report on 24 January 2023. At the time of this
assessment AJ was 9 (nine years and ten months). Much of his findings
remained
the same as in the initial report. However, this time AJ was
also tested on a supplementary Raven’s Coloured Progressive
Matrices (CPM) test. This is a nonverbal mental ability test that
requires solutions to problems. The CPM measures observation skills,
clear thinking ability, intellectual ability, intellectual capacity,
and intellectual efficiency. AJ’s score on the CPM test
showed
deficits in one or more of these tested areas. This suggests that he
may be intellectually below average.
[23]
Further EEG results featured symptoms typically associated with
tension, anxiety,
reduced cognitive capacity, and poor impulse
control (irritability). Dr Mureriwa comments that these are expected
outcomes from
a mild traumatic brain injury such as the one sustained
by AJ. Furthermore, poor performance on some tests implies
significant
impairment in completing tasks that are multi-stepped and
complex, as well as significant impairment in making quick and
accurate
shifts in mental processes.
Dr.
L.F Oelofse – Orthopaedic Surgeon
[24]
To Dr. Oelofse, it was reported that AJ still experiences pain in his
ankle
and foot. He continues to have trouble walking and standing for
extended periods. The pain in his ankle and foot is more pronounced
during inclement weather conditions. He complains of weakness in his
ankle joint. He experiences pain when ascending and descending
stairs. Walking on uneven surfaces aggravates the pain in his ankle
and foot. He has difficulty alternating from a sitting to a
standing
position. He continues to experience muscular spasms in his calf
muscles after strenuous activities. Pain medication only
offers
limited relief.
[25]
Radiological examination from Burger Radiologists Inc showed that on
AJ’s
right ankle and foot there is a mild soft tissue
prominence overlying ankle as well as some soft tissue architectural
distortion
of the right foot, and a slight sclerosis at the distal
articular margin of the calcaneus at calcaneal-cuboid junction
(frontal
study) but no significant abnormality seen on the lateral
assessment at this level. Dr Oelofse agreed with this report, and in
his opinion, he also believes that there is a small avulsion bone
fragment on the lateral view of the calcaneocuboid joint.
[26]
Dr Oelofse prognosis is that considering AJ’s degloving injury
of the
ankle and foot and radiological changes, he has a probability
to develop osteoarthritis of the calcaneocuboid joint. He also has
a
high possibility or probability to develop osteoarthritis of the
adjacent joints. The above is calculated over his total lifespan.
Thus, AJ’s occupational prospects are curtailed to
light/sedentary duty. Deference was made to an occupational
therapist
for further comment.
Ms.
Amanda Peter – Physiotherapist
[27]
Physically, Ms. Peter found that AJ has full active range of motion
in his
upper limbs, but he has limited inversion and eversion by half
a range on his right ankle joint. He has decreased sensation on the
lateral aspect of the right foot. Most gross coordination activities
were performed pain free, except discomfort reported during
running.
He has good muscle strength in his upper and lower limbs appropriate
for his age. He has good balance in standing both
static and dynamic
with symmetrical gait.
[28]
Ms. Peter also concurred with the opinion prognosis of Dr Oelofse as
stated
above.
Dr.
L Berkowitz, Plastic and Reconstructive surgeon
[29]
On examination Dr. Berkowitz’s findings were that AJ has:
a.
Minor post-abrasion marks on the lateral aspect of the distal third
of the left arm.
b.
Hyperpigmented skin graft donor site measuring 60mm x 30mm on the
anterior of the aspect of the right
thigh.
c.
A post abrasion scar measuring 90mm x 70mm on the lateral aspect of
the distal third of the right leg.
This scar extends onto the dorsum
of the foot.
d.
A depigmented thick scar measuring 110mm x 25mm lying along on the
lateral border of the right foot.
[30]
Because of the accident, AJ despite having reached maximum medical
improvement,
has been left with disfiguring, scarring and permanent
disfigurements of his right lower limb. Dr Berkowitz opined that the
deep
pigmented scar is likely to be exposed to a great deal of
sunlight during his lifetime. Depigmented scars of this nature are
particularly
susceptible to development of squamous cell carcinoma.
For this reason, he recommended that the scar be excised by means of
a thickness
skin graft. However, the surgery should not be performed
up until AJ has completed his growth at no less than the age of
seventeen.
Dr.
HM Laauwen – Educational Psychologist
[31]
School reports before Dr Laauwen showed that in 2020, AJ aged 6 (six)
years
and eleven months was enrolled at D[…] Primary School.
His marks rested mostly on the non-achievable level of performance,
and he was regarded as a slow learner by his educators due to his
inability to acquire language and writing skills. In 2021 he
was
condoned to grade 2 but was still regarded as a slow learner due to
his inability to read and write. In 2022 he proceeded to
grade 3 but
completing the year with all 4 (four) subjects on level 1 i.e.,
without a pass. His educators regarded him as a very
weak child who
forgot easily.
[32]
AJ was tested on all subtests of the Senior South African Individual
Scale-
Revised (SSIS-R) test. His tests results revealed that his
global intellectual ability measured in the borderline range at IQ
score
72. Dr Laauwen notes that his IQ score has basically remained
constant over a period of four years and three months. His scholastic
tests for reading, spelling, and comprehension were insufficient for
his age norm. His number problems in the IQ test were in the
below
average range as his mental arithmetic was also found to measure low,
thus both scores pointing to possible challenges with
his short-term
memory and working within a time factor.
[33]
Dr Laauwen postulated that pre-accident AJ was likely to have had the
potential
to pass grade 12 and possibly qualified for a Diploma (NQF
6) qualification. He draws this opinion from AJ’s developmental
milestones which were reported to have been normal and that both his
parents have a grade 11 exit pass.
[34]
Post accident, AJ has numerous cognitive, physical, and behavioural
challenges.
He is forgetful and struggles with concentration. Dr
Laauwen opines that If his emotional turmoil and physical challenges
were
to be left unattended, they are likely to affect his motivation,
stamina, and perseverance and would curtail the realisation of
his
residual and cognitive education potential. He would not be able to
achieve his pre-accident potential. Considering his current
complaints, current scholastic performance, and challenges, he would
with additional learning, remedial and therapeutic support,
at most
be able to achieve NQF level 1 which will allow him to qualify for a
skills programme in a special school with vocational
offerings.
Ms.
Ncumisa Ndzungu – Occupational Therapist
[35]
Ms. Ndzungu, an occupational therapist, assessed AJ on 18 January
2023 to determine
the residual problems following the accident and
their effects on AJ’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.
[36]
Ms. Ndzungu’s Report states that the following occupational
barriers
are anticipated when considering AJ’s residual
challenges:
a.
AJ suffers from persistent pain in the right ankle which is
exacerbated by strenuous physical activity.
b.
Poor self-confidence due to pain and unsightly scars that compromises
engagement in age-appropriate activities.
c.
Decreased physical endurance and pain with prolonged standing and
walking.
d.
Reduced work pace due to pain.
e.
Impairment with performing duties which require climbing and dynamic
posturing.
f.
Impairment with performing physical strenuous duties which requires
weight bearing and repetitive
lower limbs movements.
g.
Low self-esteem due to accident-related scars.
[37]
The abovementioned physical assessment finding concludes that AJ has
compromised
physical and functional capacity. After perusal of the
Plaintiff’s other medico-legal reports, Ms. Ndzungu opines that
the
noted neurocognitive and behavioural limitations would have a
negative impact to his future scholastic abilities, his day-to-day
interactions with his peers and future employment. His occupational
prospects will be directly linked to the level of education
he would
manage to achieve. Should he not be able to secure Grade 12 level of
education, he would be regarded as an unskilled worker
who would have
to rely on his physical fitness to fulfil the requirements of a job.
[38]
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 challenges, AJ’s
career or job options are likely to be curtailed as he will not
be
able to cope with physically 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
[39]
AJ is the second born of four children. He lives in Mbizana, Eastern
Cape with
his grandmother, aunts, and uncles whilst the mother lives
in Johannesburg. Their house is a four bedroomed house with
electricity.
There is no running water inside the house; they collect
rainwater from the outside tanks. AJ was in crèche at the time
of the accident. His father is a taxi driver and has a grade 11
education. His mother also has a grade 11 education. Describing
AJ’s pre-morbid personality, the Plaintiff reported that he was
an active and healthy child; respectful, cheerful, and disciplined
.
Post-morbid
profile of the minor
[40]
The Plaintiff reported to the various experts that as a result of the
accident,
AJ suffers from the following injuries sequalae:
personality changes in that he has major post traumatic behavioural
disorders
characterized by violence, rage, predisposition to
self-hurt, defiant behaviour, poor scholastic ability, post traumatic
anxiety
and features of post-traumatic stress disorder.
[41]
His grandparents have recommended that he should be taken to his
father in
Polokwane with the hope that his behavioural disorder will
get better. He now visits his father but there are no changes.
[42]
According to Dr Berkowitz,
AJ’s
Whole Person Impairment is 20%.
Ben
Moodie – Industrial Psychologist – Report dated 20
February 2023.
[43]
Mr. Moodie, postulated his hypothesis on AJ’s pre-accident
potential
based on Dr Laauwen’s (the educational psychologist)
opinion that pre-accident, AJ had the potential to pass grade 12 as
well as to further his education to an NQF level 6 (diploma studies).
Taking the aforesaid into consideration, Moodie is of the
opinion
that but for the accident, AJ’s career would have developed as
follows:
a.
Certificate – likely;
the writer postulates that AJ
could have decided to enrol or apply or a one-year certificate
course, either internally or externally,
with the aim to upskill and
prepare him for more advanced studies such as a 3-year diploma
course.
b.
Diploma- NQF 6 –
in an
optimal scenario
, after
completion of his certificate course, he could have applied to
further his studies, doing a diploma course at an academic
institution. His employer (assuming employment) at the time would
probably have subsidized his studies if the studies were to the
employer’s benefit. He probably would have engaged in part-time
studies, and it is likely that a 3-year diploma course would
have
taken him five to six years to complete. Further progression would
also be based on straight line increases to Paterson level
C3/C4
(median) total package by age 45. The writer is therefore of the
opinion that AJ’s pre-accident income potential would
have been
Paterson level C3/C4 by the age of 45 after which he would have
received inflationary increases until retirement age.
[44]
As to the post-accident postulation and noting that Dr Laauwen is of
the opinion
that AJ post-accident is, at most, likely to achieve an
NQF level 1 (grade 9) education, this means that for him to work, he
will
have to be reliant on his physical strength. Typically,
individuals with such a low level of education usually do not qualify
for
work which is sedentary to light in nature; they usually work in
the open labour marker doing work which can be classified as medium
–
heavy and very heavy in nature.
[45]
With regards to his future physical abilities, Moodie notes that from
the Occupational
Therapist report, AJ’s injuries will preclude
him from relying on his physical abilities to secure employment. He
will have
to be reliant on an understanding employer who would be
willing to accommodate his physical limitations. On the other hand,
Dr
LF Oelofse, the orthopaedic surgeon, concluded in his report that
AJ will only be capable to do work in sedentary to light work
in
nature. But since he will not progress beyond grade 9, this precludes
him from doing even the type of work concluded by Dr LF
Oelofse.
Moodie is therefore of the opinion that AJ will not be able to work
in a physical capacity due to the injuries sustained
in the accident.
So even if he were to apply for sedentary to light nature of work, he
will not qualify due to his limited level
of schooling. Thus, the
writer’s conclusion is that AJ is completely unemployable in
the open labour market.
Munro
Forensic Actuarial Report
[46]
Munro Forensic Actuaries reading of the IP’s report projected
two scenarios.
One, where AJ is likely to have obtained a certificate
in the uninjured and injured scenario. Second, where AJ in the
optimal scenario
he would have had the potential to obtain a diploma
for both uninjured and injured earnings. Their projections are that:
Scenario 1
a.
Certificate uninjured earnings
being R 7, 096 400 and
Certificate injured earnings
being R 1, 194 200.
Total loss of
earnings:
R 5, 902 200.
Scenario 2
b.
Diploma uninjured earnings
being R 8, 691 200 and
injured
earnings
being R 1, 194 200.
Total loss of
earnings:
R 7, 497 000.
No contingencies were
applied in either scenario.
Legal
principles – earning capacity.
[47]
The legal principles applicable to loss of
earnings and/or earning capacity are trite. E
arning 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
income value that one could have generated to their
estate is
depreciated because of the injury, then there has been a loss of
earning capacity.
[48]
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
[49]
The Defendant conceded merits 100% in favour of the Plaintiff’s
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. She must still
satisfy
the Court that
but for
the accident, AJ would not have
suffered the harm and injuries complained of; conversely, AJ’s
injuries and damages arose
from the accident.
[50]
In
Prince
v Road Accident Fund
[3]
,
at paragraph 9, Lowe J quotes Corbett in
The
Quantum of Damages in Bodily and Fatal Injury Cases: General
Principles
,
J.
J. Gauntlett
,
2008 where it is said at page 30 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...”
[51]
In
the recent decision of
Gumede
v Road Accident Fund
[4]
Bhoolah
AJ, concisely set out the requirements that a litigant must pass to
establish a delict against the Fund. Of the seven that
she stated, I
only concern myself with the causation aspect.
[52]
The court held as follows, with reference to
liability as contemplated in Regulation 2(d), framed under section 26
of the Act:
“
23.
By an analysis of the above section, liability of the defendant is
founded upon the principles of delict. Six jurisdictional
facts will
need to be proved by the plaintiff in order for the defendant to be
liable in each claim in respect of the Act and the
Amendment Act
added a seventh jurisdictional fact. These jurisdictional facts are
as follows:
…
23.4
Causality:
The plaintiff must allege and prove the causal
connection between the negligent act relied upon and the damages
suffered. The requirement
that there must be a causal link between
the conduct, the resulting injury or death and consequent damage is
expressed by the phrase
"caused by or arising from" as it
is found in section 17 of RAF Amendment Act. Grove v Road Accident
Fund [2017] ZAGPPHC
757 (28 November 2017). In determining the causal
nexus between the negligent driving of the driver of the insured
vehicle and
the injuries sustained by the plaintiff, Van Oosten J, in
Miller v Road Accident Fund
[1999] 4 All SA 560
(W), at p 565(i),
formulated the inquiry as follows:
“
Two
distinct enquiries arise, which were formulated by Corbett CJ in
International Shipping Co (Pty) Ltd v Bentley
1990 (1) SA 680
(A) at
700E–I as follows:
‘
The
first is a factual one and relates to the question as to whether
defendant’s wrongful act was a cause of the plaintiff’s
loss. This has been referred to as ‘factual causation’.
The enquiry as to factual causation is generally conducted
by
applying the so-called ‘but-for’ test, which is designed
to determine whether a postulated cause can be identified
as a causa
sine qua non of the loss in question… On the other hand,
demonstration that the wrongful act was a causa sine
qua non of the
loss does not necessarily result in legal liability. The second
enquiry then arises viz whether the wrongful act
is linked
sufficiently closely or directly to the loss for legal liability to
ensue or whether, as it is said, the loss is too
remote. This is
basically a juridical problem in the solution of which considerations
of policy may play a part. This is sometimes
called ‘legal
causation’.”
[53]
In the factual causation enquiry, the logical starting point is the
police
accident report which serves as evidence of the occurrence of
the accident. The second report to consider would be the paramedics’
report if the patient was transported to the hospital by ambulance.
Third, the primary hospital records of the receiving facility.
These
sets of documents constitute the core primary records of a
Plaintiff’s claim against the Fund as it is from them that
the
Plaintiff expands her case to the experts.
[54]
I accept that initial treatment records from a receiving facility are
not always
consistent with experts’ clinical findings about
injuries and the sequalae which may (or may not) have arisen from the
accident
in issue. I say this because in case of an accident arising
injury, notwithstanding the length of the admission stay of the
patient
at the receiving facility, the treatment received at that
facility is acute and meant to ameliorate in real time whatever
adverse
symptomology experienced by the patient and observed by the
attending clinicians. However, this does not mean that
post-treatment,
complications and a negative sequalae would not arise
simply because the patient was adequately treated at a clinic. As I
said,
clinical treatment is acute, whereas the sequalae of the
injurie(s) sustained may manifest much later post clinical treatment
and
admission.
[55]
However, the inverse is also true, whatever sequalae complained of
must stem
from the injuries which were and would have been recorded
in the receiving facility medical notes. A sequalae that is
farfetched
from one’s treated injuries triggers a legal
question of remoteness which may disqualify a Plaintiff’s claim
if it
established that the sequalae complained off is too off to have
been caused by the accident. This now brings me to the role of
experts’ services post-injury admission and clinical assessment
of the claimant.
Role
of experts
[56]
Attorneys litigating in the RAF space resort to private
medical
and other relevant experts for medico-legal reports. The
purpose of these reports is to furnish the Court with the sequalae
arising
from the accident in question to: a) prove that the claimant
had sustained the injuries complained of from the accident in issue;
b) the presenting sequalae arises from those injuries; and c) by
result of (a) and (b), the claimant suffered or will suffer loss
of
future earnings and/or earning capacity.
[57]
A mixed bag of the expert’s own examination of the patient, and
with
tests and other diagnoses deferred to and read from other
experts; then it is often found that in subsequent expert’s
“own
conclusion”, they typically have already
incorporated the opined conclusion of antecedent expert(s). The laden
risk of inadvertent
collusion here could not be more pronounced.
[58]
Furthermore, corroborated, and uncorroborated say-sos of the
Plaintiff complaint(s)
or allegations of some other kind are assumed
(in the latter, usually without veracity testing) and presented to
the occupational
therapist for determination of the complainant’s
vocational prospects. With the injuries and sequalae presenting in
the determination
of whether the claimant has any capacity to
undertake vocational prospects; and if so, which ones, the
occupational therapist then
forms an opinion with reference to the
open labour market as to what extent the claimant is limited from
attracting gainful employment.
[59]
The occupational therapist report, fed by all the other reports, is
then presented
to the industrial psychologist, and the industrial
psychologist’s own computations – in that order, is by
far the most
critical expert opinion to a Plaintiff’s claim.
[60]
An industrial psychologist must then compute from all the evidence
presented
about the claimant’s
but for
and
having
regard to the accident
futuristic career progressions regard
being had to the accident injuries and consequent sequalae. These
postulations can sometimes
range from speculations nothing short of
the most improbable scenario to realistic projections of the likely.
[61]
Finally, an actuary is called at the final stage to read the
industrial psychologist
report and therefrom quantify the losses of
the claimant.
Legal
principles applicable to expert evidence
[62]
I now discuss the legal principles applicable to experts’
opinion evaluation;
their ever seemingly ready acceptance of the
Plaintiff’s say-so without testing the veracity of that
information, and the
Court’s role in weeding out the objective
data from the subjective, and sometimes, not unheard of, the most
improbable of
allegations of which in the RAF space are a children’s
playing ground.
[63]
Vally J in
Twine
v Twine
[5]
at paragraph 18 succinctly formulated a helpful guideline with
necessary built-in checks and balances and safety precautions that
have been developed by local and international jurisprudence as to
how Courts should objectively evaluate the expert(s) opinion
whilst
paying due deference to expert opinion by virtue of their expertise
and valuable insights that they may bring to Court,
some of which
would have been beyond the Court’s scope of understanding but
for the expert opinion. Importantly, Vally J
put across that judges
should never abdicate their judicial responsibility of adjudicating
matters with an independent mind in
respect of the application of the
prevailing legal principles. This is a caution to just thumb-sucking
experts’ opinion for
judicial decisions. It is apt to extract
(without footnotes) some of his relevant formulations all found in
paragraph 18 of his
judgment.
“
Para
18
A.
The admission of expert evidence should be guarded, as it is open to
abuse.
H.
Expert witnesses should state all facts and the assumptions upon
which they base their opinions. The facts relied
upon:
“
must
be proved by admissible evidence. …:
Before
a court can assess the value of an opinion it must know the facts on
which it is based. If the expert has been misinformed
about the facts
or has taken irrelevant facts into consideration or has omitted to
consider relevant ones, the opinion is likely
to be valueless. In our
judgment counsel calling an expert should in examination in chief ask
his witness to state the facts on
which his opinion is based. It is
wrong to leave the other side to elicit the facts by
cross-examination.”
While
they are entitled to make assumptions, they should avoid basing their
opinions on conjecture or speculation for once they
do so they place
their evidence at risk of being disallowed.
R
.
A court is not bound by, nor obliged to accept, the evidence of an
expert witness:
“
It
is for (the presiding officer) to base his findings upon opinions
properly brought forward and based upon foundations which justified
the formation of the opinion.”
(my emphasis)
And
“
(A)
court should not blindly accept and act upon the evidence of an
expert witness, even of a finger-print expert, but must decide
for
itself whether it can safely accept the expert’s opinion.”
(my emphasis).
[64]
In
Ndlovu
v Road Accident Fund
[6]
Splig
J also penned some valuable insights
where
he firmly stated 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.
[7]
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.
[8]
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.
[9]
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.
[10]
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.
[11]
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).
[12]
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;
[13]
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.’
[14]
Evaluation
of evidence
[65]
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 AJ’s
purported loss of consciousness, especially since it was alleged that
he had been bleeding from both nostrils. In my mind, these
would have
been pertinent accident effect presentations for the trauma unit to
prudently record for their medical relevance. That
this information
was not recorded in the hospital records, but with AJ’s GCS
admission score recorded as 15/15 I decided
to call for the original
paramedics’ report.
[66]
On 27 June 2023 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.
[67]
On 29 June 2023 the Plaintiff’s attorneys responded and
attached a response
from Charlotte Maxeke Academic Hospital to the
attorney’s own request for a legible copy dated 24 October
(year illegible).
The hospital advised that the illegible copy of the
EMS was the only copy that it had from the EMS paramedics. However,
the Plaintiff’s
attorneys undertook to find a legible copy for
the Court. True to their word, on 10 July 2023 a legible copy of the
EMS report
was forwarded to me.
[68]
Upon reading of the EMS legible copy, I discovered that none of the
Plaintiff’s
allegations about how AJ was at the scene were
supported by the paramedics Patient Report Form filed.
[69]
On the 27
th
of July 2023 I issued directives calling upon
the parties, being the Plaintiff’s friend, Ms. Kgasane, the
Plaintiff, the
paramedics and one of the Plaintiff’s experts,
Dr Okoli, to come give oral evidence on this troubling aspect. I
canvass this
later when I discuss their evidence.
[70]
The hospital clinical records, as does the legible paramedics reports
discussed
hereunder, markedly differs with the Plaintiff’s
allegations on material aspects. But notably, throughout her account
of
the accident, not once did she contradict herself in the given
evidence regarding AJ’s state of consciousness, the oxygen
mask
and bleeding from both nostrils.
The
EMS Report
[71]
From the Patient Report Form of the EMS records, the following
appears:
a.
“
history / mechanism of injury:”
it is stated PVA
– which stands for pedestrian vehicle accident.
b.
“
chief complaint”
it is stated, ‘
open
wound (R) foot and head”.
c.
“
general comments”
in the same section it is
stated, ‘
on arrival we found patient holding by the
bystander with blood on the foot. Patient hit by the taxi. Patient
was on [illegible]
and stable”.
d.
“
examination”
notes, the paramedics recorded
that, ‘
airway is clear. Breathing self-maintained.
Circulation regular and clear. Air entry by lateral. Patient has open
wound on right
foot (ankle). Abrasions (R) head hematoma forehead.
Head to toe survey done. Open wound on the right ankle.’
e.
GCS scores were recorded as follows: motor- 6/6; visual-5/5; eyes-
4/4. This totals a 15/15 GCS score,
which means AJ was conscious.
[72]
The discrepancies between the Plaintiff’s allegations and the
paramedics
report were of great concern to me.
[73]
AJ’s injuries and sequalae can be distinguished in two
categories with
two sub-classes. The first category is the
orthopaedic injuries and their own subclass sequalae. The second
subclass is the sequalae
arising from the traumatic brain insult
category.
[74]
The first subclass is the easiest to deal with. Therefore, I start
with it
first.
Orthopaedic
injuries
[75]
AJ’s orthopaedic injuries and the sequalae complained of are
comprehensively
captured in the reports of Dr Oelofse, the
Orthopaedic Surgeon and Ms Peter, the physiotherapist. Repeating the
sequalae here would
be unnecessary repetitive. The fact is that over
AJ ‘s total lifespan, he is at risk of developing further
future medical
complications arising from these injuries. These
complications and anticipated surgeries he will need to treat. The
time off from
whatever vocational opportunities he maybe would have
been enjoying at the time, the potential loss of earnings and further
restrictions
to his vocational prospects and totality of the
limitation to his earning capacity, are all to be compensated for by
the Defendant.
[76]
In her report, Ms. Ndzungu concludes that considering AJ’s
physical impairments,
he would need an empathetic employer to
accommodate his limited physical capacity. As such, she says, he is
best suited to sedentary
to light work. However, Mr Moodie opines
that even here, AJ is non-suited for this type of work because
individuals with AJ’s
projected level of education are
typically found in occupations of medium-heavy and very heavy in
nature. The cause of this is
the neurocognitive, psychosocial, and
behavioural sequalae that AJ suffers from, of which I must say, I am
pressed to impute it
to the Defendant’s insured driver harm
causing conduct, but not without difficulty.
The
traumatic brain injury
[77]
Dr Okoli’s diagnosis is that AJ suffered
a mild traumatic brain injury. The traumatic brain injury that AJ
suffered from is
based on
inter alia
the Plaintiff’s allegations about AJ loss of consciousness, the
bleeding from the nostrils and the assisted breathing by
the oxygen
mask. Also considered were then the neurocognitive effects that AJ
suffered presented with.
Ms.
Vuyelwa Kgasane’s evidence
[78]
Ms. Kgasana testified that she was going on about her business when
she witnessed
two boys being hit by a taxi. She rushed over to the
scene and found that one of the victims was none other than M[…],
her
friends’ child. M[…] is AJ’s other name. She
testified that she found AJ unconscious. She called the Plaintiff
and
together they called the ambulance. She testified that AJ was
unconscious throughout this time.
The
Plaintiff’s testimony
[79]
The Plaintiff testified that she was called to the scene by Ms.
Kgasane. She
found AJ unconscious and lying on the side of the road.
When she arrived on the scene, there were people around AJ, and they
prevented
her from touching and holding him. He was unconscious. She
even thought that AJ had passed on. When the paramedics came, he was
still unconscious, and he was bleeding from nostrils. When the
ambulance arrived, the paramedics placed him on an oxygen mask.
She
accompanied him to the hospital. He remained throughout the way
unconscious. He regained consciousness sometime after being
admitted
at the hospital. She was informed and called by hospital staff that
AJ had woken up.
The
Paramedic’s testimony
[80]
Ms. Matabeng was one of the two paramedics who responded to the
scene. Her
partner, the driver of the ambulance was unavailable. She
testified that she was the one who wrote and recorded the patient’s
presentation in the Patient Report Form. I asked her to explain the
report.
[81]
On
GCS scores
she explained that AJ’s GCS score was
15/15, vital signs were checked and his motor- flex was 6/6 meaning
he could lift his
hands and could feel pain when pinched. His verbal
speech score was 5/5 meaning that he could talk. Visual scores of his
eyesight
were 4/4, meaning that he could clearly see. This totals a
15/15 GCS score, which means AJ was conscious and fully alert when
she
examined him.
[82]
She explained that SATS score entry is an evaluation of the Oxygen
Saturation
in the body. She testified that AJ’s oxygen 80% but
he was breathing on his own and unassisted.
[83]
Ms Matabeng testified that AJ had haematoma (a swollen lump
bruise) and
bruises on the left forehead. He was not bleeding from
the nostrils.
[84]
On questions arising from the Court, Ms Matabeng was asked if she
could state
whether AJ ever lost consciousness post impact, she
reiterated that she cannot say so, she can only state that AJ was
conscious
when she examined him upon her arrival.
Dr
Okoli
[85]
Dr Okoli’s confirmed that he prepared his report without having
considered
the paramedics and the hospital clinical records/reports.
He only considered the J88 form and the completed RAF 1 report.
Counsel
for the Plaintiff asked him to look at the EMS report and
point out to the Court anything that is of importance. He pointed out
the record score of AJ’s oxygen levels as reflected in the
legible EMS report. The score, somewhere under the section “SATS”
of the Patient Report records AJ’s oxygen levels as 80 over 92.
He says that this shows that the child was deprived of oxygen,
and he
suffered from hypoxia, meaning the oxygen levels in the body were
very low. He says there is no way that AJ could have been
conscious
because the minimum level of oxygen saturation in the body is 90 and
once the levels drop to 89 it is worrying. He testified
that one of
the easiest ways to boost the scores is by supplementing the oxygen –
here one can safely assume that what he
meant is by assisting the
patient with an oxygen mask for instance. He stated that at 80
percent, AJ was severely hypoxic. He stated
that for the oxygen
levels to have risen from 80 to 92 clearly shows that there was an
intervention. Therefore, the testimony of
the mother that AJ was
assisted by oxygen mask makes sense and he believed same to be true.
Boldly, he doubted the Paramedic’s
testimony on AJ’s GCS
score.
[86]
Dr Okoli also pointed out that the pulse score of 104 /140 is a sign
of instability.
The normal pulse rate of a 5-year-old is 80-120 beats
per minute. He also raised the time of the arrival of the ambulance.
The
ambulance arrived 26 minutes after the accident.
[87]
Plaintiff’s counsel asked Dr Okoli to explain to the Court the
meaning
of the GCS 15/15 score. Dr Okoli explained that the
relationship between the GCS score of 15/15 refers the level of
consciousness
and not the absence of head injury.
[88]
Regarding the clinical records, Dr Okoli pointed me to the illegible
hospital
copy where there’s an inscription which appears as
“L.O.C”. He stated that this is a clinical shorthand way
of
recording loss of consciousness. He stated that clearly there was
loss of consciousness post impact.
[89]
I directed Dr Okoli to the same clinical records and showed him that
few pages
down in the same records there was a “–
“(negative) sign appearing before the letters L.O.C. I put to
him that
according to my understanding this means that the attending
clinician, in shorthand, recorded that there was “negative”
loss of consciousness. Dr Okoli’s agreed that a negative sign
before “L.O.C means there was no loss of consciousness,
but he
stated that the notes were not written by the same person as the
latter were theatre notes. I further directed him to the
hospital
record’s triage form where it was recorded that AJ’s AVPU
(
an acronym for Alert, Voice, Pain, Unresponsive
) score was
“Alert” upon admission. I asked him what that tells us
about. He stated that triage examination in an emergency
informs the
clinicians the patient’s level of consciousness. It is only at
that stage that Dr Okoli conceded to AJ’s
state of
consciousness as being alert on arrival at the hospital.
[90]
I further note that the SATS score recorded in the triage form was
recorded
as 98%.
[91]
I enquired from Dr Okoli whether he would still maintain the TBI
diagnosis
if I were to reject the Plaintiff’s testimony about
AJ’s state of consciousness, the bleeding from the nostrils and
the oxygen mask account. He answered affirmatively. Dr Okoli
stated that even in the absence of the mother’s reported
loss
of consciousness he would still maintain the same TBI diagnosis of
the child because of the reported and clinically confirmed
neuropsychological sequalae. The sequalae complained of, even if the
Plaintiff’s evidence were to be rejected, in the absence
of any
other cause prior to the accident, supports a diagnosis that the
child sustained a mild TBI. Furthermore, the haematoma
and bruises on
forehead suggest that there was head trauma.
Discussion
[92]
[93]
On the first allegation that AJ was unconscious at the scene up to
arrival
at the hospital, the paramedics’ patient form says the
exact opposite. AJ’s GCS scores were as follows: motor- 6/6;
visual-5/5; eyes- 4/4. This totals a 15/15 GCS score which means AJ
was fully conscious and awake.
[94]
The Triage Form recorded AJ’S AVPU as alert and the SATS score
as 98%.
The hospital records reflecting the GSC was 15/15, the low
velocity PVA, the (-) LOC and AJ being alert post impact contradicts
the Plaintiff’s testimony in material respects. Furthermore,
when giving oral evidence, the Plaintiff completely forgot that
to
all the experts consulted, she consistently maintained that she found
AJ unconscious and that he had only woken upon arrival
at the
hospital -this is just pre-admission. In Court however, she
maintained that AJ had been unconscious for some time and only
woke
up after being admitted, whereupon she was alerted to him being awake
by clinical staff. So which one is it? The Patient Report
form,
supported by the triage hospital records are destructive to the
Plaintiff’s version. Even on her own version, she is
inconsistent. The Plaintiff’s allegations about how she found
AJ at the scene and his state of presentation is nothing short
of
being mendacious. I reject her version completely.
[95]
What about AJ’s consciousness prior to arrival of the
paramedics? Ms.
Kgasane testified that when she arrived at the scene,
she found AJ unconscious. The Patient Report Form from the paramedics
pertinently
says, ‘
on arrival we found patient [held] by
bystander with blood on the foot. Patient hit by the taxi. Was on
[illegible] and stable.’
This statement negates Ms.
Kgasane’s version and renders her account of AJ’s state
of consciousness improbable. It bears
to be noted that the statement
which says AJ was held by “bystander” is in most
probability, reference to her and not
the mother. I assume this
because it is Ms. Kgasane which arrived first at the scene, and the
called the mother; and on the mother’s
own version, she was
denied holding AJ,
[96]
On the Plaintiff’s second allegation, that AJ had been bleeding
from
both nostrils, there is no mention of this in the paramedics’
patient report from. Tied to this allegation is the third allegation
that AJ’s breathing was assisted by an oxygen mask. Here the
paramedics examination notes say: “
Airway is clear.
Breathing self-maintained, circulation regular and clear air entry by
lateral…”.
Therefore, the allegation that he was put
on an oxygen mask by the paramedics is rejected. AJ was breathing on
his own and unassisted.
If he was indeed bleeding from the nostrils,
this would have been noted in the airway entry observation and
examination findings.
[97]
Dr Okoli firmly believed that the EMS Report, regard being had
to SATS
score, AJ’s recorded oxygen levels score, cannot be
what it says it is. He insisted that AJ must have been unconscious at
the time of being attended to by the paramedics.
[98]
Dr Okoli tried very hard to poke holes in the EMS report.
However,
he could not go far with that as he had not considered the
hospital records and had not had any sight of the other primary
sources
like the Triage report. His testimony was far too partial to
the Plaintiff’s case.
[99]
Furthermore, on a closer look at the illegible and legible paramedics
report
forms, from the little that could be seen, one of them shows
that on the face of it, the SATS score of the legible report seems
to
have been tempered with.
[100]
On the illegible report, a sketch of the number “8” is
apparent. However, except
for a line just going a little below over
the block of the square where the numbers are recorded at, the number
after it is not
legible to read. But on the legible copy, there is a
very emphasised and bolded zero “0” next to the number
“8”.
This then becomes inconsistent with the illegible
copy in that illegible as it was, the sketch of “8” could
still be
made out. This being so, how then could this “0”
being the odd one out and made so by the emphasis, disappear?
Furthermore,
the drawing of this “0” becomes inconsistent
with but a very small vertical line crossing over the square block.
Upon
a closer look, it seems to me that the “0” is drawn
over a number “9”. This leads me to being of the view
that the true SATS was probably 89 over 92 rather than 80. In my eye
view, this report has been tempered with for whatever nefarious
reasons by whomever; I choose not to speculate for obvious reasons.
This view is further fortified by the fact that upon admission
at the
hospital, AJ’s SATS score was 98 percent. That is an eighteen
percentage points increase from when he was in the ambulance
to when
they handed him over to the receiving facility.
[101]
Having rejected the contention that AJ was assisted by an oxygen
mask, of which Ms. Matabeng
contends firmly that he was not, it is
improbable that AJ’s GCS scores could have been what both the
hospital triage records
and the paramedics report form record if
indeed that 80 percent with an oddly bolded zero next to the number
“8” were
true. Therefore, on a preponderance of
possibilities, I conclude that AJ’s oxygen saturation score was
89 over 92. It is
only on this version that the undisputable triage
records are to be true.
[102]
So, what to make of the contradictions?
After
certain tests, which indeed showed neurocognitive and other
psycho-behavioural and psychiatric impairments, Dr Mureriwa concurred
with the diagnosis of Dr Okoli.
In the absence of evidence of
some other cause, or the defendant’s opposition to the
contrary, it cannot be refuted that AJ’s
neurocognitive,
behavioural, and psychosocial sequalae impairments presented
themselves after the accident. Therefore, in the absence
of any other
reasonable explanation or cause to their manifestation, they must be
attributed to have been occasioned by the injury
of which Dr Okoli
diagnoses as a TBI.
[103]
As Vally J said in
Twine
and Another v Naidoo and others
[15]
‘
In
certain cases of neurological, psychological, and psychiatric
evidence the expert is dependent on the honesty of the person who
is
the subject of the assessment for their evidence to be of any
probative value to the court. This problem has manifested itself
many
times and the approach of the courts is succinctly captured in the
following
dictum,
which while dealing with the evidence of an
expert in psychiatry is no less applicable to an expert in the
sciences of neurology
or psychology:
“
The
weight attached to the testimony of the psychiatric expert witness is
inextricably linked to the reliability of the subject
in question.
Where the subject is discredited the evidence of the expert witness
who had relied on what he was told by the subject
would be of no
value.
Legal
principles applicable to quantification of loss of earnings or
earning capacity
[104]
In
Southern
Insurance Association v Bailie
[16]
Nugent
JA stated as follows:
‘
Any
enquiry into damages for loss of earning capacity is of its nature
speculative, because it involves a prediction as to the future,
without the benefit of crystal balls, soothsayers, augurs or oracles.
All that the court can do is to make an estimate, which is
often a
very rough estimate, of the present value of the loss. It has open to
it two possible approaches. One is for the Judge
to make a round
estimate of an amount which seems to him to be fair and reasonable.
That is entirely a matter of guesswork, a blind
plunge into the
unknown.
The
other is to try to make an assessment, by way of mathematical
calculations, on the basis of assumptions resting on the evidence.
The validity of this approach depends of course upon the soundness of
the assumptions, and these may vary from the strongly probable
to the
speculative.
It
is manifest that either approach involves guesswork to a greater or
lesser extent. But the Court cannot for this reason adopt
a
non
possumus
attitude and make no award.’
Likely
scenario on AJ’s loss of earnings and earning capacity.
[105]
I note that in Dr Laauwen Report, pre-accident,
AJ probably had the potential to pass grade 12 and qualify for study
towards an
NQF level 6 diploma qualification.
Dr Laauwen
postulated that post-accident, AJ would with additional remedial
learning, and therapeutic support, will be at most only
be able to
achieve an NQF level 1 which will allow him to qualify for a skills
programme in a special school with vocational offerings.
According to Dr Laauwen
the accident had an
impact on AJ’s pre-scholastic potential.
[106]
I accept Dr Laauwen's report.
[107]
Ms. Ndzungu’s report states that AJ’
p
hysical challenges preclude him from medium to heavy
occupations or any work duties which require prolonged standing,
walking, dynamic
posturing, climbing and driving. This is a live
complication because
according to Mr Moodie,
people with an NQF level 1 exit qualifications are usually not
employed in light to sedentary duty work.
And since this is the only
type of work that AJ could be fit for, he would nonetheless not be
employed in the work because of his
projected level of schooling. It
is therefore Mr Moodie conclusion that AJ is completely unemployable
in the open labour market.
Contingencies
[108]
The
Supreme Court of Appeal in the case of
Road
Accident Fund v Guedes
[17]
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...”
[18]
[109]
Nicholls
AJA in
RAF
v Kerridge
[19]
also
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 myriad 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.’
Methods
of calculation
[110]
Moosa AJ
in
O
v
Road
Accident Fund
[20]
endorsed Gaunttlet’s principle and said that it 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:
[21]
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)
[111]
Robert J Koch
[22]
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.
[112]
In
N.S
obo Minor v Road Accident Fund
[23]
Bhoola
J explained that
‘
In
quantifying such a claim an Actuary is often used to make actuarial
calculations based on proven facts and realistic assumptions
regarding the future. The role of the Actuary is to guide the court
in the calculations to be made. Relying on its wide judicial
discretion the court will have the final say regarding the
correctness of the assumptions on which these calculations are based.
The court should give detailed reasons if any assumptions or parts of
the calculations made by the actuary are rejected. It must
be borne
in mind that the actuary depends on the report of the Industrial
Psychologists, who in turn are dependent on the information
provided
by the claimant’
[24]
Munro
Forensic Actuarial Report
[113]
Munro Forensic Actuaries reading of the IP’s report projected
two scenarios. One where
AJ is likely to have obtained a certificate
in the uninjured and injured. Second, where AJ in an optimal scenario
would have the
potential to obtain a diploma, uninjured and injured
earnings. Their projections are that:
Scenario 1
Certificate uninjured
earnings
being R 7, 096 400; and
Certificate injured
earnings
being R 1, 194 200.
Total loss of earnings
–
R 5, 902 200.
Scenario 2
Diploma uninjured
earnings
being R 8, 691 200; and
injured earnings
being
R 1, 194 200.
Total loss of earnings
being R 7, 497 000.
No contingencies were
applied in either scenario.
[114]
The Plaintiff’s attorneys invited the
Court to approach the claim by applying the following contingencies
on scenario one:
a.
Uninjured future loss of earnings:
20%
b.
Injured future loss of earning:
60%
Uninjured earnings
R
7, 096 400 less 20% = R 5, 677 120
Less
injured earnings
R1,
194 200 less 60 % - R 477 680
Total
loss of earnings =
R 5, 199, 440.00
[115]
Before I come to quantification, I must address
Mr Moodie’s Report. In his
likely
scenario postulations, he says that AJ would have probably post
matric have studied towards a one-year certificate course with
an aim
to upskill to do diploma studies. Thereafter, he would find
meaningful employment. After some time, he would with a subsidy
from
his employer enrol for diploma studies if the chosen studied course
is to his employer’s benefit. I accept that this
is a summary
of AJ’s probable career projections. However, the difficulty
with this projected scenario is that it is not
founded on the expert
reports’ nor postulated by Dr Laauwen. This entire trail of
thought borders to being a hypothetical
speculation rather than an
informed assumption. This too I address with appropriate
contingencies.
[116]
On the question of contingencies, it is my
prerogative to decide depending on the circumstances of the case. The
Plaintiff’s
suggested contingency deductions are out of the
ordinary scales and there is no justification in the Plaintiff’s
heads of
arguments for such. This justification was without support
other than to say that the Court must apply the suggested
contingencies
with reference to certain case law which the attorneys
view to be comparable with the present matter. Having considered the
matter
as a whole, I am of the considered view that a 30% contingency
deduction in the pre -morbid scenario is fair and reasonable. A 20%
contingency deduction in the post-morbid scenario is fair and
reasonable in the circumstances.
[117]
The calculation on the likely scenario one
therefore is:
a.
Uninjured future loss of earnings:
30%
b.
Injured future loss of earning:
20%
Uninjured earnings
R
7, 096 400 less 30% = R 4 967 480.00
Less
injured earnings
R1,
194 200 less 20% - R 955 360
Total
loss of earnings =
R 4 012 120.00
The
attorney and client Fee Agreement
[118]
I
enquired from Plaintiff’s counsel about the absence of a
contingency fee agreement as the draft order stated that a
contingency
fee agreement is not applicable. I was informed by the
Plaintiff’s counsel that there is no contingency fee agreement.
Instead,
there is an attorney and own client fee agreement. Having
considered the overlaps between the attorney and own client fee
agreement,
I found that its clauses were alike to a both contingency
fee agreement like and an attorney and own client fee agreement. But
it does not end there. The fee agreement also stipulated a special
RAF fee clause. These clauses stipulate that in RAF cases, the
client
is billed 100% over the normal attorney and own client fee agreement.
The
matter just read too closely to
Majope
and Another v Road Accident Fund.
[25]
.
I
called the Plaintiff to address me on what fee agreement that she and
her attorneys agreed on. She testified to me that she understood
the
fee agreement to be one of a deduction of 25% from the award. In lay
terms, this shows that she understood or assumed that
the governing
fee agreement is a contingency fee.
[119]
I
directed the attorney, Mr Zangwa to address me on the validity of the
attorney and client fee agreement. Mr Zangwa filed an affidavit
and
conceded that in light of the SCA decision in
RAF
v MKM obo KM &TM
[26]
, the present attorney and
own client fee agreement must be declared invalid. I therefore order
that at the finalisation of this
matter, the Plaintiff’s
attorney must submit a Bill of Costs of their fees to the Taxing
Master of the High Court of Gauteng
Division, Pretoria.
ORDER
[120]
In the circumstances, I make the following order:
1.
The Defendant is to pay the Plaintiff an amount of
R
4 012 120.00
(Four million,
twelve thousand and one hundred and twenty rands) into the attorney’s
trust.
2.
Paragraphs 1.2 to 5 of the Draft Order are incorporated herein as
Orders of Court.
L
FLATELA
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 3 October 2023
Counsel
for Plaintiff:
PM
Leopeng
mleopeng@rsabar.com
pmleopeng@webmail.com
083 665
1466
Attorney
for the Plaintiff:
Ms.
NP Tshabalala
083 887
0890
012 323
130
godiattorneys@gmail.com
Date
of the Hearing
28
February 2023 ,1 March 2023
, 28 August 2023
Date
of the Judgement
3
October 2023
[1]
Dippenaar
v
Shield
Insurance Co Ltd
1979
(2) SA 904 (A)
[2]
Ibid, at 917 B – D.
[3]
(CA143/2017)
[2018] ZAECGHC 20
[4]
Gumede
v Road Accident Fund
[2021] ZAGPPHC 568 (24 August 2021) unreported decision
[5]
Twine
and Another v Naidoo and others
[2018] 1 ALL SA 297
(GJ) paras 18
[6]
Ndlovu
v Road Accident Fund 2014(1) SA 415 (GSJ)
[7]
Id, para 114.
[8]
Id. Para 115.
[9]
Id.
Para 116.
[10]
Id.
Para 117
[11]
Id, para 118.
[12]
Id,
para 119.
[13]
Id,
para 121.
[14]
Id. Para 121.
[15]
Twine
and Another v Naidoo and others
[2018] 1 ALL SA 297
(GJ) paras 18(t)
[16]
Southern
Insurance Association v Bailie
1984
(1) SA 98
(A) at 113 F – 114A
[17]
RAF
v Guedes
2006 (5) SA 583
(SCA)
[18]
Ibid,
para 9.
[19]
RAF
v Kerridge
(1024/2017)
[2018] ZASCA 151
[20]
O v Road Accident Fund (20976/2014) [2018] ZAGPJHC 419 (31 May 2018)
[21]
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
[22]
Robert J Koch, The Quantum Yearbook, 2009, p.100
[23]
N.S
obo Minor v Road Accident Fund (61470/2017) [2021] ZAGPPHC 558
[24]
Ibid, pra 33.
[25]
(308/2021,1309/20) [2022] ZAMPMBHC 37 (26 May 2022)
[26]
(1102/2021[2023] ZASCA 50
sino noindex
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