N C OBO N Z v Road Accident Fund (26302/15) [2018] ZAGPJHC 63 (4 April 2018)

80 Reportability
Personal Injury Law - Road Accident Fund

Brief Summary

Road Accident Fund — Damages — Future loss of earnings — Plaintiff, as guardian of minor child, claimed damages following a motor vehicle accident resulting in head injury — Defendant sought postponement of future loss assessment pending Health Professions Council of South Africa (HPCSA) findings — Court dismissed application for postponement, ruling that the issue of future loss could be determined without HPCSA input, emphasizing the court's role in assessing expert evidence and the absence of prejudice to the plaintiff.

Comprehensive Summary

Summary of Judgment


1. Introduction


The proceedings were a civil action for damages arising from a motor vehicle collision and brought under the Road Accident Fund Act 56 of 1996. The plaintiff, Ms N C, litigated in her capacity as mother and guardian of her minor daughter, Z N (born 12 June 2005), against the defendant, the Road Accident Fund.


The matter came before the Gauteng Local Division, Johannesburg. Prior to trial, the merits and liability were settled 100% in favour of the plaintiff, on the basis that the minor child had been a passenger in the minibus taxi involved in the collision. The defendant also provided a section 17(4)(a) undertaking for 100% of future medical expenses. There were no past medical expenses or past losses to be determined.


The dispute that remained for determination concerned the quantum of patrimonial loss, specifically damages for future loss of earnings / earning capacity / employability. The issue of general damages was not determined by the court because it had been referred to the Health Professions Council of South Africa (HPCSA) and was postponed sine die. At the start of the trial, the defendant brought an interlocutory application seeking to have the future loss issue likewise postponed pending the HPCSA process; that application was dismissed with costs, and the trial proceeded on future loss.


2. Material Facts


On 22 November 2013, between 06:30 and 07:00, the minor child (then eight years old) was being transported to school as a passenger in a minibus taxi when a collision occurred on Chris Hani Road, Dlamini, Soweto. The plaintiff pleaded that the child sustained a tongue laceration and a serious head injury with neurological and neuropsychological sequelae. It was common cause that the tongue laceration healed, and any sequelae from that injury were to be considered under general damages (which were postponed to the HPCSA process).


The hospital narrative relied upon by the court included that the child was taken by ambulance to Chris Hani Baragwanath Hospital, admitted at around 11:00, and later taken to theatre around 22:00 for suturing of the tongue under anaesthetic. In a pre-operative assessment, it was recorded (among other things) that there had been a head injury and neck pain, and a Glasgow Coma Scale (GCS) score of 12/15 was recorded. The court noted that, on the conventional categorisation, 9–12 is associated with moderate brain injury and 13–15 with mild brain injury. The evidence did not include any other GCS measurement.


The court further noted an absence of evidence in the hospital records (and the narratives summarised in expert reports) of loss of consciousness and an absence of evidence of post-traumatic amnesia (PTA). At most, there was hearsay reported by the child’s father to one expert psychologist that the child seemed confused at some stage.


A central factual dispute concerned whether the child sustained a traumatic brain injury with enduring neurocognitive sequelae capable of impairing educational progress and future earnings. The plaintiff’s neurosurgeon (Dr Lewer-Allen) accepted the presence of a brain injury and advanced an approach emphasising possible delayed or progressive effects (including what was described as a “sleeper effect”), with the severity of injury to be evaluated with reference to later neuropsychological outcomes. The defendant’s neurosurgeon (Dr Earle) disputed that approach, emphasising diagnostic reliance on recognised acute indicators (including GCS, loss of consciousness, and PTA) and contending that any injury, if present, was mild and not expected to cause enduring cognitive impairment affecting earnings.


During trial, the parties narrowed the issues and agreed a postulation for the actuarial computation: that the minor child would progress at the same rate as she would have absent the accident, but with a one-year delay. They agreed a pre-morbid contingency deduction of 20%, but did not agree on the post-morbid contingency, with the defendant contending it should be no more than 25%. The remaining controversy for determination accordingly crystallised into whether a post-morbid contingency higher than 25% should be applied, in light of the evidence and the court’s evaluation of the probability of future impairment.


3. Legal Issues


The first legal question, arising as a preliminary issue at the start of the trial, was whether the court should postpone the determination of future loss of earnings/earning capacity so that it could be considered later alongside the HPCSA determination relating to general damages under the statutory scheme. This question involved an issue of statutory interpretation and the proper delineation between the function of the court and the statutory role of the HPCSA in the RAF framework.


The central question on the merits was the appropriate quantification of damages for future loss of income, given the evidence and the parties’ agreed actuarial basis. This required the court to decide whether, and to what extent, the accident-related injury was shown to have a probable impact on future earnings capacity, and how that should be reflected through contingency deductions. This was primarily a matter of application of law to fact coupled with a discretionary/value judgment, because the assessment of future earning capacity is inherently speculative, and contingency selection depends on the court’s evaluation of risk and fairness on the evidence.


4. Court’s Reasoning


On the preliminary postponement application, the court rejected the defendant’s attempt to defer the future-loss enquiry to the HPCSA process. The court reasoned that, properly construed, section 17(1)(b) read with section 17(1A) of the Road Accident Fund Act addresses non-pecuniary loss and does not provide a basis for postponing or diverting the judicial determination of pecuniary loss such as future loss of earnings. The court was not persuaded that the Act authorised the postponement sought, and it regarded the defendant’s reliance on differences of expert opinion as insufficient to justify removing the issue from the court’s ordinary adjudicative function.


The court also rejected the premise that a divergence between neurosurgeons necessarily “compromised” the reports of other experts. It held that differences of expert opinion are not unusual and that experts in other disciplines are expected to report based on their own investigations and expertise, with their evidence either supporting or not supporting particular medical opinions. The court further considered the argument framed as being in the minor’s best interests and found no basis to invoke its role as upper guardian to order a postponement, particularly where the child was represented and had already been assessed by numerous experts over several years. The timing of the application, raised at what the court described as the “11th hour” despite the underlying expert divergence being apparent long before trial, also counted against the defendant. The postponement application was therefore dismissed with costs.


Turning to the quantification of future loss, the court evaluated the competing expert approaches. It identified that the plaintiff’s neurosurgeon’s conclusion on ongoing deficits was largely dependent on the neuropsychologist’s testing and the mother’s reporting, whereas the defendant’s neurosurgeon relied on recognised acute diagnostic criteria (including the absence of documented loss of consciousness and PTA and the context of the GCS score). The court accepted that a GCS score is a monitoring tool but assessed the overall evidentiary picture as not establishing, on a balance of probabilities, the asserted nexus between accident-related brain injury and the minor’s cognitive profile in a manner that justified the plaintiff’s more pessimistic future-loss scenario.


In this context, the court held that the neuropsychological evidence did not, in its view, establish the necessary link between the accident and enduring neurocognitive impairment affecting future earnings. The court emphasised that, on the facts of this case, it was not for the neuropsychologist to establish pathologically the existence of a brain injury, and it concluded that the evidentiary chain relied upon by the plaintiff did not prove the required connection. It was not persuaded by the plaintiff’s submission that the minor faced a “long and unsure future” warranting a substantially higher post-morbid contingency.


At the same time, the court treated the enquiry into loss of earning capacity as inherently speculative and reaffirmed that actuarial computations are a useful basis but not determinative, with the trial court retaining a wide discretion to make a just award. It referred to authority on judicial discretion in the quantification of earning-capacity loss and on contingencies for children. The court also took into account that, despite rejecting the plaintiff’s broader causal case, the defendant had nonetheless conceded a degree of connection sufficient to justify at least a differential between pre- and post-morbid contingencies.


The court reasoned that, in circumstances where the defendant’s concession implicitly recognised some accident-related vulnerability, and given the child’s young age and the limited nature of available evidence at the time of assessment, it would be inappropriate to confine the differential to what the court regarded as an inadequate margin. The court considered that the agreed one-year delay in educational progression was itself a meaningful concession by both parties. It further noted the possibility, accepted as a possibility rather than a proven probability, that even mild injuries might manifest difficulties as academic demands become more complex. These considerations led the court to increase the post-morbid contingency beyond the defendant’s proposed ceiling.


Accordingly, exercising its discretion, the court adopted a 15% differential between pre- and post-morbid contingencies, applying a 20% pre-morbid deduction (agreed) and a 30% post-morbid deduction (determined by the court). It then accepted the undisputed actuarial computation placing the capital value of the loss at R708 249.00 as at 1 October 2017, on the agreed postulation of a one-year delay.


5. Outcome and Relief


The court granted judgment for the plaintiff for R708 249.00 in respect of the minor’s future loss of income. The issue of general damages was postponed sine die because it had been referred to the HPCSA for determination.


The court ordered that the awarded amount be paid into the trust account of the plaintiff’s attorneys, to be held in an interest-bearing account pending the creation of a trust and the issuing of letters of authority. It ordered that the defendant furnish, if it had not already done so, an undertaking in terms of section 17(4)(a) of the Road Accident Fund Act 56 of 1996 for 100% of specified future medical-related costs (including costs connected to the creation and administration of the trust).


A trust was ordered to be established for the benefit of the minor child on detailed terms regulating trusteeship, security, administration, investment powers, audit, amendment, and potential termination (including an assessment after the child attains 21 years to determine capacity to manage the award). The defendant was ordered to pay the plaintiff’s taxed or agreed party-and-party costs on the High Court scale, including the costs of numerous expert reports and qualifying fees, counsel’s costs for specified trial dates, actuarial report costs, travel expenses for medico-legal appointments, and related preparation costs. The earlier application for postponement was dismissed with costs (as recorded in the court’s ex tempore ruling).


Cases Cited


JD Botha v The Road Accident Fund 2015 (2) SA 106 (GP).


Yvonne De Bruyn v Road Accident Fund (case number 29608/2014 RTS/B30/B39) (Gauteng Local Division, Johannesburg) (unreported).


Road Accident Fund v Guedes 2006 (5) SA 583 (SCA).


Carstens v Southern Insurance Association Ltd 1985 (3) SA 1010 (C).


Goodall v President Insurance Company Limited 1978 (1) SA 389 (W).


Nonkwali v Road Accident Fund (771/2004) [2009] ZAECMHC 5 (21 May 2009).


Southern Insurance Association Ltd v Bailey 1984 (1) SA 98 (A).


Mashaba v Road Accident Fund (15683/04) [2006] ZAGPHC 20 (2 March 2006).


Legislation Cited


Road Accident Fund Act 56 of 1996, section 17(1)(b).


Road Accident Fund Act 56 of 1996, section 17(1A).


Road Accident Fund Act 56 of 1996, section 17(4)(a).


Attorneys Act 53 of 1979, section 78(2A).


Rules of Court Cited


No specific rule of court was cited in the judgment.


Held


The court held that the statutory referral mechanism associated with the HPCSA process for non-pecuniary loss (general damages) did not justify postponing the court’s determination of pecuniary loss in the form of future loss of earnings, and it dismissed the defendant’s postponement application with costs.


On the merits of future loss, the court held that the plaintiff did not establish, on a balance of probabilities, the asserted nexus between the accident-related brain injury and enduring cognitive impairment to the extent contended for. Nevertheless, taking into account the speculative nature of the enquiry, the child’s circumstances, and the defendant’s concession, the court exercised its discretion to apply a 30% post-morbid contingency (against an agreed 20% pre-morbid contingency), resulting in an award of R708 249.00 for future loss of income, with general damages postponed sine die and costs awarded to the plaintiff.


LEGAL PRINCIPLES


A court retains responsibility for determining patrimonial damages such as future loss of earnings in Road Accident Fund matters, and the HPCSA process referenced in the statutory scheme is concerned with non-pecuniary loss; it does not, on the judgment’s construction of the Act, provide a basis to postpone or shift the adjudication of future loss of earnings to the HPCSA.


Differences between experts, including differences between medical specialists, are not unusual in litigation and do not, without more, justify postponement. Experts in different disciplines are expected to provide opinions grounded in their own investigations, and the court must evaluate the evidence and determine what is persuasive.


The assessment of damages for loss of earning capacity is inherently speculative. Actuarial calculations provide a useful basis for quantification, but the trial court retains a wide discretion to award what is fair and just on the evidence. The selection of contingency deductions is a discretionary evaluative process aimed at reflecting uncertainties and risks in future outcomes, particularly in claims involving children where future educational and employment pathways cannot be known with precision.


Where parties agree an actuarial postulation and certain contingencies, the remaining dispute may properly be resolved through judicial evaluation of the evidence and by fixing an appropriate post-morbid contingency. Even where a claimant fails to prove the full extent of asserted sequelae, the court may consider concessions made and the overall circumstances in exercising its discretion to ensure a just outcome within the proven and conceded parameters.

About SAFLII
Databases
Search
Terms of Use
RSS Feeds
South Africa: South Gauteng High Court, Johannesburg
SAFLII
>>
Databases
>>
South Africa: South Gauteng High Court, Johannesburg
>>
2018
>>
[2018] ZAGPJHC 63
|

|

N C OBO N Z v Road Accident Fund (26302/15) [2018] ZAGPJHC 63 (4 April 2018)

SAFLII
Note:
Certain
personal/private details of parties or witnesses have been
redacted from this document in compliance with the law
and
SAFLII
Policy
IN
THE HIGH COURT OF SOUTH AFRICA
GAUTENG
LOCAL DIVISION, JOHANNESBURG
CASE
NO: 26302/15
In
the matter between:
N
C
Plaintiff
o.b.o.
N Z
and
ROAD
ACCIDENT
FUND
Defendant
JUDGMENT
WILLIS
A.J.:
Introduction
1.
This is an action for damages
brought by Ms C N (“the plaintiff”).  The plaintiff
sues in her capacity as mother
and guardian of her daughter Z N born
on 12 June 2005 (“the minor child”).
2.
Between 06:30 and 07:00 on 22
November 2013 the minor child, eight years old at the time, was a
passenger in a minibus taxi being
driven to school when a collision
occurred with another vehicle on Chris Hani Road, Dlamini, Soweto.
3.
The plaintiff claims against
the defendant in terms of the
Road Accident Fund Act 56 of 1996
as
amended (“the RAF act”).
4.
The merits and degree of
liability of the defendant was settled 100% in favour of the
plaintiff inasmuch as the minor child was
a passenger in the motor
vehicle accident.
5.
Counsel for the parties
confirmed that the defendant had provided the plaintiff with a
section 17(4)(a)
undertaking covering 100% of her future medical
expenses.  There were no past medical expenses or losses.
6.
The issue and quantum of
general damages did not fall to be decided by me as it had been
referred to the Health Professions Council
of South Africa (“the
HPCSA”) for determination and was accordingly postponed
sine
die
.
7.
The plaintiff pleaded that as
a result of the collision, the minor child sustained a laceration of
her tongue and a serious head
injury with neurological, neurophysical
and neuropsychological fallout.
8.
The tongue laceration
suffered by the minor children has on all accounts healed and the
sequelae resulting therefrom will be considered
under the head of
“General damages” by the HPCSA.
9.
What is left for my
determination in this case is the quantum of damages under the head
for future of losses (of: earnings, earning
capacity and
employability) which the plaintiff claims on the minor child’s
behalf in the amount of R7.5 million.
Preliminary
Issue
10.
At the commencement of the
trial action the defendant made application that the issue of future
of losses be postponed and dealt
with by the HPCSA in the same manner
and at the same time as the referral of general damages pursuant to
section 17(4) of the RAF
Act and its Regulations.  The timing of
the application was ascribed to the joint minute only being received
from the experts
on or about the preceding Wednesday 4 October 2017.
Pursuant to argument I gave an
extempore
ruling that the application be dismissed with costs, for the
following reasons.
11.
The grounds for the
application were three fold.  Relying essentially on the grounds
in the rejection letter and the joint
minute of the expert reporting
neurosurgeons, and while it was common cause between the
neurosurgeons that the minor child sustained
a brain injury, mild in
nature (described in different terms by each report), the first basis
was that there is what counsel called
a “fallout between the
neurosurgeons” i.e.  a difference of opinion with regard
to the
sequeli
of the injury.  It was argued that this difference of opinion
impacted the reports of the numerous other experts who reported
on
the
sequeli
from the perspective of their fields of expertise, such as the
educational, industrial and clinical psychologists, who were
allegedly
compromised by the difference of opinion.
12.
Accordingly, so it was
argued, this difference of opinion was best considered and resolved
with the assistance of a third investigation
and report.  It was
argued was that such third investigation and report ought or might as
well be by the panel of doctors
appointed by the HPCSA to deal with
the seriousness of the injury when considering the seriousness of the
injury.
13.
The second basis is better
described as the motivation for the application.  It was argued
that the approach contended for
by the defendant was in the best
interests of the minor child in light of the prejudice she may suffer
if the difference of opinion
between the two Neurosurgeons was not
properly and further investigated.  Counsel specifically alluded
to the court’s
duty as upper guardian of the minor child to
protect her interests.
14.
The third basis was that
there could be no prejudice to the plaintiff if the matter were
postponed.
15.
Counsel for the plaintiff
opposed the application disavowing all grounds and arguments. Four
primary arguments were advanced.
16.
Firstly that it was the role
of the court to consider the expert oral evidence to be tendered and
whether or not objective and persuasive.
Put differently that it is
not the role and function of the HPCSA to inquire into the evidence
in relation to future loss of income,
and for me to refer or defer
this matter as contended for by the defendant would amount to the
HPCSA usurping the function of the
court.
17.
Secondly the seriousness of
an injury is not a pre-requisite for the determination of future loss
of income.
18.
Thirdly the difference of
opinion expressed in the joint minute was identifiable as far back as
9 March 2016 when the report of
the defendant’s expert became
available.
19.
Fourthly there was no
prejudice to the plaintiff in the matter proceeding but definite
prejudice to the plaintiff if the matter
was dealt with as the
defendant contended for.
20.
Regarding prejudice to the
minor child.  In my view, it is not for the defendant to dictate
what the best interests of the
plaintiff are.  In this case the
minor child was represented by her mother, attorneys and experienced
counsel.  I neither
identified nor could I conceive of any sort
of prejudice to the minor child that ought in a proper exercise of my
discretion, to
invoke my duties as the minor child’s upper
guardian, and order a postponement.  The minor child was 12
years of age,
had been assessed by approximately 19 experts in the
approximate four years since the motor vehicle accident and injury
and there
was no good reason to postpone the assessment of whether or
not the minor child would suffer a future loss of income.
21.
Properly construed the
argument advanced by the defendant was more why the plaintiff needed
or ought to have the benefit of a postponement,
or put differently
that the court ought to order a postponement in the best interests of
the plaintiff.   I could discern
no basis for why the
defendant in fact needed and would otherwise be prejudiced in the
absence of a postponement.
22.
It is disconcerting that the
defendant raised these grounds underpinning its application at the
11
th
hour.  Apart from the fact that the defendant’s expert
reports had been available since approximately 9 March 2016,
this
approach could have been adopted at trial certification stage.
23.
I did not understand counsel
for the defendant to be advancing the proposition that as a rule
damages for loss of future earnings
had to be deferred until the
determination of the HPCSA had been received.  The defendant’s
contention as I understood
it was that in the circumstances arising
namely the nature of the expert opinions and the joint minute, the
postponement sought
was justified.
24.
In my view section 17 (1)(b)
read together with (1A) of the RAF Act clearly deals only with
non-pecuniary loss.  There is no
basis to read pecuniary loss in
the form of future loss of income into the wording.  I was not
persuaded that there was any
basis in the Act for the postponement
sought.
25.
As to the difference of
opinion between the neurosurgeons as expressed in their reports and
joint minute, this is nothing new or
extraordinary.   On
the contrary a difference of opinion is often the case if not
expected.  I asked counsel for
the defendant for reasons why the
opinions of the other experts were compromised by the difference in
opinion between the neurosurgeons.
Counsel’s point made
was that these other experts defer to the opinion of the other
experts.  Indeed that may
be so, but those experts are expected
to report on their own investigations and opinions of what they find
in their fields, which
will either support or not support one or more
of the neurosurgeon reports.
26.
I considered two judgements
in this division on substantially the same issue albeit that the
issue arose on a different basis.
I was in full agreement with
these decisions in which I found support for my views.  The
first is by Victor J in JD Botha
v The Road Accident Fund
2015 (2) SA
106(GP)
and the second is by Sutherland J in Yvonne De Bruyn v Road
Accident Fund case number 29608/2014 RTS/B30/B39.
27.
In the result the application
for a postponement of the issue pending the HPCSA’s findings on
the seriousness of the injury
in the context of general damages was
dismissed with costs and the trial continued on the issue of future
of loss.
The
Evidence
28.
The plaintiff called three
experts namely Dr. M. Lewer-Allen, a Neuro-Surgeon; Ms R. Hovsha, a
Neuro Psychologist; and Mrs M. Scott,
an Educational Psychologist.
29.
The defendant called Dr J.
Earle, a Neuro-Surgeon; Ms L Swart, an Educational Psychologist; and
Mr L Roper, a Clinical Psychologist.
30.
All experts gave evidence in
line with their reports and joint minutes.
31.
The narrative in the reports
of some of the expert witnesses called, which was not in dispute
between the parties, was that the
plaintiff mother was called to the
scene of the collision. From there she travelled with the minor child
per ambulance to Chris
Hani Baragwaneth Hospital and the minor child
was admitted sometime around 11:00.  The minor child’s
father also attended
at the hospital in the course of the morning.
The tongue laceration required suturing under anaesthetic for which
the minor
child was eventually taken to theatre at around 22:00 that
night.
32.
In a pre-operative assessment
signed off by the anaesthesiologist it was recorded
inter
alia
that the minor child
had sustained an isolated tongue laceration, head injury and
experienced neck pain.  Of particular interest
was that a glasco
coma scale (“GCS”) reading of 12/15 was measured and
recorded.  It appeared that the minor child
had been
hospitalised for some ten hours prior to the measurement of this
GCS.  Drooling and the swollen tongue were also
recorded. There
was no recordal or evidence of any other GCS measurement.
33.
It is well known that the GCS
severity categorization scale of severity of brain injury rates
severe to lie between 3/8; moderate
between 9/12; and mild between
13/15.
34.
There was no evidence in the
hospital records or narratives recorded by the experts that the minor
child lost consciousness at any
stage.  At best there was
hearsay evidence of the father reporting to Mr L Roper, the
defendant’s Clinical Psychologist,
that the minor child seemed
confused at a stage in the day. There was also no evidence whatsoever
of post-traumatic amnesia (“PTA”).
35.
The plaintiff’s case as
introduced by Dr Lewer-Allen was that the GCS, while a monitoring
indicator and useful to neurosurgeons
and traumatologists to assess
potential severity of brain damage due to a head injury, was merely
an indicator of potential severity
and did not rule out long term
sequelae
after even a mild head injury.  He indicated that while in
general terms GCS scores may be correct in approximately two thirds

(depending on the sample substrate) of mild trauma brain injury
(“MTBI”) cases, there remained one third of MTBI’s

who suffer long term
sequelae
.
Dr Lewer-Allan adopts the view that GCS does not recognise the
diffuse axonal shear type of brain injury where there is
a delayed
loss of cerebral function as the trauma-induced chemical cascade of
axonal degradation and destruction develops in the
hours after the
patient has left casualty.
36.
Dr Lewer-Allan holds that the
true severity of the brain injury is to be measured against the
severity of the neurocognitive and
neuropsychological deficiencies
ultimately proven to exist after maximum medical improvement (“MMI”),
rather than exclusively
according to the criteria as assessed in
casualty by GCS measurement.  Dr Lewer-Allan divides the issue
of severity of a brain
injury into two concepts namely injury
diagnosis (the severity of the injury at hospital level –
accident/casualty diagnosis)
on the one hand, and the outcome
diagnosis (the severity of the outcome after MMI) on the other.
Thus according to Dr Lewer-Allen
the key to understanding whether or
not a given patient has sustained a brain injury depends heavily on
demonstration by psychometric
testing by the Neuro Psychologists, for
the presence or otherwise of neurocognitive and neuropsychological
shortcoming.  Where
such testing confirms deficit and
malfunctioning, if that deficit is shown not to have been present
prior to the accident, and
not to have been caused by any
non-accident related factor, then the damage could be attributable to
the accident.  This was
whether or not one could prove the
natural nature or mechanism of the injuries, and whether or not the
patient complied with the
stereotyped expectation that such patient
must have had a significantly long PTA or reduced GCS before such can
be considered a
candidate for brain damages.  Accordingly the
severity of the demonstrated changes to the patient would describe
the severity
of the outcome diagnosis.
37.
Dr Lewer-Allen explained this
continuous progression of fallout sustained in a brain injury leading
to long-term neuropsychological
difficulties as the “sleeper
effect”.  It was ultimately the defendant’s case
that the only way to deal
with this unknown, taking into
consideration the requirements of the once and for all rule, was to
apply positive contingency deductions
that would not negate these
possibilities and not deny the minor child just compensation.
38.
Ultimately Dr Lewer-Allen’s
conclusions were based on the report of Dr Hovsha the
neuropsychologist who relied on the plaintiff’s
mother’s
reporting (who did not give evidence in the trial) and analysis by
means of psychometric testing.
39.
In so doing Dr Lewer-Allen
concluded that the minor child is shown to be suffering from mild to
moderate neuro cognitive deficits
as well as neuro psychological
deficits in keeping with her being included in the group of MTBI’s
with sequelae.  He
also referred to the educational
psychologist’s reporting and industrial psychologist’s
reporting for an assessment
of the impact of the head injury on the
minor child’s educability and ultimate earning capacity.
In the joint minutes
Dr Lewer-Allen stated that he expected the
aforementioned psychologists to bear in mind possible compromise of
her scholastic abilities
by virtue of the “
sleeper
effect”
.
40.
In the result the evidence of
Dr Lewer-Allen was clearly to lay the foundation and understanding
for why and the degree to which
the plaintiff’s case ultimately
fell to be assessed on the evidence of Ms. Hovsha and to a lesser
degree that of Ms Scott,
the educational psychologist.
41.
Dr Earle on the other hand
testified that the approach of Dr Lewer-Allen and others who
subscribed to this approach, was novel but
not mainstream medical
science.  He testified that brain injuries were diagnosed on
three primary characteristics namely:
loss of consciousness (“LOC”),
PTA and the GCS measurement.
42.
Dr Earle testified that the
probabilities were that the minor child’s GCS was taken when
she was already prepared for theatre
by which stage a sedative had
already been administered and on this basis he concluded the reading
to be inaccurate of her actual
level of consciousness i.e. she had
been more conscious before that.  In other words her true GCS
reading was above 12.
Dr Earle doubted the minor child suffered
a brain injury at all but if anything, it was mild and there was no
basis on which to
expect intellectual or cognitive impairment or
anything that would affect her schoolwork or sustain a claim for loss
of earning
potential.  Dr Earle confirmed his report that

Should any further
tests be done and these do show some impairment of intellect it is
absolutely not possible to relate it to this
accident.”
(sic)
43.
Dr Earle takes the position
that applying the results of psychological tests randomly after the
head injury, can in no way supersede
the diagnosis of severity of
brain injury according to primary characteristics as laid down by the
World Health Organization Task
Force on brain injuries.  He said
this is so because no similar prior tests were done on the individual
and secondly similar
tests applied to non-injured piers all show
similar results not distinguishable from those with mild head
injuries.  He opined
that accepting these sorts of statistical
comparisons as modifying severity means relinquishing the scientific
basis of brain injury
totally and leaving the final diagnosis to a
psychologist.
44.
Dr Earle confirmed what he
sets out in the joint minute with Dr Lewer-Allen namely that he
regards the sleeper effect to be a myth
dreamt up by psychologists
which has absolutely no neuropathological basis for its existence.
45.
There was some reference and
discussion around a report by Dr Peché on an EEG test.
Indeed Dr Earle signed this report
by Dr Peché but the report
gives no neuropsychological assessment and in my view took the issues
nowhere.
46.
There was also some debate in
cross-examination of Dr Earle relating to certain collateral
information obtained by Mr Roper (the
defendant’s
neuropsychologist) from the minor child’s father who noted that
he saw his daughter a few hours after the
accident and she seemed
confused and in shock.  In counsel for the plaintiff’s
heads of argument she sought to criticize
Dr Earle and the
reliability of his evidence.  The argument in the heads of
argument did not weigh against my assessment of
Dr Earle as an expert
witness.  Dr Earle indeed testified as an experienced expert
witness but that in my view did not weigh
against him.  On the
contrary he was a calm and collected witness unhinged by fairly
assertive and competent cross-examination.
Dr Earle’s
evidence was quietly assertive, informed and in my view did not fall
to be criticized.  At this juncture
I may also point out that Dr
Lewer-Allen was also competently cross-examined on the issues and
like Dr Earle testified earnestly
and in accordance with his report
and the neuro surgeons’ joint minute.
47.
During the course of the
trial counsel for the parties reached agreement on narrowing the
issues and resolved the dispute in relation
to possible postulations
in respect of the minor child’s future loss of earning
capacity.  The agreed postulation was
to the effect that the
plaintiff would have progressed at the same rate as she would have
progressed had the accident not occurred,
but with a one year delay.
Counsel agreed on a pre-morbid 20% contingency but did not agree on a
post-morbid contingency
above 25%.  Accordingly it fell to me to
consider whether a post morbid contingency higher than 25% falls to
be applied.
48.
As reported in the various
experts’ pre-trial minutes, limited premorbid information on
the minor child was presented at the
hearing.  Non contentious
collateral information from the plaintiff to the experts was as
follows.  Her pregnancy with
the minor child was normal and
without complications.  The minor child was born via natural
vaginal delivery and was healthy
at birth.  All developmental
milestones were within normal limits.  The minor child was in
Grade 3 when the accident
occurred and had passed every grade up to
that point.
49.
Ms Hovsha was of the opinion
that the minor child was of at least average cognitive functioning
pre-morbidly while Mr Roper noted
that given her age at the time of
the accident it was difficult to make any comment on her pre-morbid
level of cognitive functioning,
particularly given that there were no
school reports available to compare her pre and post-accident
academic performance.
He concluded that the available
information did not evidence any obvious pre-morbid cognitive
difficulties.
50.
As recorded in their joint
minute both neuropsychologists deferred to the opinion of the neuro
surgeons with regard to the presence,
nature and severity of any
traumatic brain injury sustained by the minor child.
51.
Based on Ms Hovsha’s
interview with the minor child and the plaintiff, she reported
post-accident complaints of headaches,
neck pain, difficulty with
mathematics at school, impaired memory and concentration, a change in
personality, anhedonia and travel
related anxiety.  As a result
of her investigative assessment, Ms Hovsha opined mild to moderate
cognitive deficits in the
areas of orientation, attention and
concentration, processing/motor speed, visuopraxis, memory and
executive functioning.
In her opinion these deficits are in
keeping with those found in individuals who have suffered a traumatic
brain injury.
52.
Based on his interview with
the minor child, plaintiff and the father, Mr Roper noted the reports
that the minor child is short
tempered and moody and physically
aggressive, suffers from headaches, irritability and impaired memory
and that her teachers reported
that her concentration was poor.
In his assessment Mr Roper found symptoms of increased anxiety
related to walking near vehicles
and concluded that the minor child
has been suffering from mild symptoms of post-traumatic stress
disorder.  Mr Roper found
poor working memory and double
tracking abilities, difficulty distinguishing between different sets
of rote verbal information,
poor forward planning and problem solving
abilities as well as two-dimensional non-verbal reasoning abilities.
Mr Roper was
of the opinion that her mild symptoms of posttraumatic
stress disorder could have impacted negatively on her overall
cognitive
test results.  He was further of the opinion that her
increased anxiety related to her post-traumatic stress disorder and
her ongoing headaches may have contributed to some attention and
concentration difficulties.  Difficulties with attention and

concentration could in turn be expected to have contributed to her
reported forgetfulness in her day to day functioning.
Mr Roper
concluded that the minor child suffered a mild to moderate head
injury due to the accident however given the relative
lack of
severity of her symptoms, any impact in this regard would be
considered fairly insignificant.  He conceded that while
it was
possible for a head injury of this severity to bring about subtle,
but ongoing neuropsychological difficulties, no enduring
cognitive
difficulties were usually expected.  Mr Roper opined nonetheless
that the minor child may be vulnerable to experiencing
some future
academic difficulties as her work becomes more complex.  It
falls to be noted that both experts noted that the
minor child’s
mother did not report that she was experiencing difficulties at
school at present, with the exception of mathematics.
Both
experts deferred to the opinions of the educational psychologists.
Ms Hovsha reported that the plaintiff reported that
while having
difficulty with mathematics at school her marks had not
deteriorated.  Furthermore they both also agreed that
the minor
child would benefit from psychotherapy for her emotional and
behavioural difficulties.
53.
It was argued for the
plaintiff that Ms Hovsha’s findings determined a nexus between
the accident and the minor’s psychological
profile.
However Ms Hovsha said the following:

The cognitive deficits
found on the neuropsychological assessment are in keeping with those
found in individuals who have suffered
a traumatic brain injury.
The deficits are in keeping with a mild to moderate traumatic brain
injury.  The writer defers
to the opinion of a neurosurgeon to
give a final opinion as to the presence, nature and severity of any
traumatic brain injury
sustained by Ms N in the accident.”
Discussion
54.
The educational psychologists
were agreed in evidence that presently there are no real indicators
of scholastic performance pre
and post-accident.
55.
In my view of the
circumstances of this case, it was not for Ms Hovsha to establish
pathologically the existence of a brain injury.
Ms Hovsha
looked to Dr Lewer-Allen for this.  Her evidence and the results
of her testing, do not in my view establish a nexus
between the
accident and brain injury on the one hand and the minor child’s
psychological profile and cognitive functioning
on the other.
56.
In the result the following
was apparent from the evidence of the neurosurgeons.  Dr
Lewer-Allen’s opinion was largely,
if not entirely, dependent
on the evidence of the neuropsychologist Ms Hovsha.  Dr Earle on
the other hand was of the opinion
based on recognised criteria for
the assessment of a brain injury and possible sequelae to conclude no
sequelae pursuant to what
could best be described as a mild brain
injury.
57.
I am not persuaded by the
plaintiff’s case against the defendant’s evidence and
argument that the deficits found by
Ms Hovsha and Mr Roper can be
present in individuals who have not suffered a traumatic brain
injury.
58.
In my view Dr Earle and Mr
Roper’s evidence adequately and persuasively dealt with Ms
Hovsha’s findings.
59.
Taking all the available and
presented evidence into consideration, and on a balance of
probabilities, I do not agree with the submission
on behalf of the
plaintiff that the minor child faces a long and unsure future
regarding her studies and subsequent employment
and as such a much
higher post morbid contingency should be applied to allow for just
compensation keeping in the mind the once
and for all rule.
Conclusion
and Order
60.
I do however consider
that given the young age of the minor child at the time of the
accident (keeping in mind children recover
better from brain injuries
than adults do) as well as her young age at the time of assessments
for the trial, the evidence available
to the plaintiff is limited.
While my finding is that the plaintiff failed to establish the
requisite nexus the agreed postulated
delay of one year to conclude
her studies was in my view in and of itself a concession by both
sides.
61.
Indeed the possibility exists
that even the mildest of brain injuries could found difficulties that
could progress as time goes
on.  In
Road
Accident Fund v. Guedes
2006 (5) SA 583
(SCA) 587 A – B
the Supreme Court of Appeal addressing the assessment of compensation
and a Trial Judge’s discretion stated:

The court necessarily
exercises a wide discretion when it assesses the quantum of the
damages due to loss of earning capacity and
has a large discretion to
award what it considers right.  Courts have adopted the approach
that to assist in such a calculation,
an actuarial computation is a
useful basis for establishing the quantum of damages.  Even
then, the trial court has a wide
discretion to award what it believes
is just.”
62.
By agreement between the
parties I was placed in possession of a series of actuarial
calculations by the plaintiff’s actuary
Mr G A Whittaker of
Algorithm Consultants and Actuaries CC.  No part of this report
is in dispute.  Nonetheless it remains
my discretion and
responsibility to decide whether the results of these calculations
and evidence accord with what is a fair and
just award in each
particular case.  See
Carstens
v. Southern Insurance Association Ltd
1985 (3) SA 1010
(C) at 1021
B.
The premorbid
contingency has been agreed at a deduction of 20% the oft resultant
allocation of 20% for a child.  See
Goodall
v. President Insurance Company Limited
1978 (1) SA 389
(W)
and
Road Accident Fund v.
Guedes (
supra
)
at 588 D – C
, also
Nonkwali v Road Accident
Fund (771/2004) [2009] ZAECMHC 5 (21 May 2009)
.
Counsel for the defendant submitted the post morbid deduction ought
to be no more than 25%.
63.
An enquiry into damages for
loss of earning capacity is of its nature speculative.  See
Southern Insurance
Association Ltd v. Bailey
1984 (1) SA 98
(A) at 113 H – 114 E.
64.
Notwithstanding my findings
that the plaintiff failed to persuade me on a balance of
probabilities of a nexus between the brain
injury and the minor
child’s cognitive function, the defendant has conceded some
connection between the brain injury and
the minor child’s
psychological profile and cognitive functioning.  The concession
of a 25% deduction is still a 5%
differential.  Arithmetically,
it makes no difference whether the contingency exercise involves
higher or lower contingencies,
as along as the difference remains the
same.  See
Mashaba v.
Road Accident Fund (15683/04)
[2006] ZAGPHC 20
(2 March 2006)
.
Inasmuch as the defendant concedes fallout to the extent it has and
if I am not to be remiss in my duty and not discount
the evidence on
which the defendant based its concession then in order to ensure
justice and that the minor child is not prejudiced
in all the
circumstances of her case, to conclude a higher contingency.
Especially in light of the evidence of Mr Roper that
notwithstanding
his other findings, the minor child may be vulnerable to experiencing
some future academic difficulties as her
work becomes more complex I
am of the view that a 10% differential may be inadequate.
65.
Accordingly I find for a 15%
differential and that a 30% contingency be applied to the value of
future injured earnings.  The
calculation by the actuary on the
capital value of the loss of income sustained by the minor child as a
result of the motor vehicle
accident on 22 November 2013 is R708
249.00 as at 1 October 2017.
66.
I note that counsel for the
parties handed me a draft order with terms I assume were agreed to,
but omitting aspects I was still
to find on.   In the
result I make the following order:
1.
Judgment is granted in favour
of the plaintiff in the amount of R708 249.00 in respect of future
loss of income.
2.
The issue of general damages
is postponed
sine die.
3.
The amount referred to in
paragraph 1 above shall be paid into the trust account of the
plaintiff’s attorneys of record with
the following details:
Rene Fouche Inc, Standard Bank/Trust Acc. Nr: 032956 630, Branch
code: 004305, Ref: N[…]/RM/N203,
who shall, after deduction of
agreed attorney’s fees, costs and disbursements, retain same in
an interest bearing account
in terms of section 78(2A) of the
Attorneys Act, pending the creation of the trust referred to in
paragraph 4 and 5 infra and the
issuing of letters of authority.
4.
In so far as the defendant
has not already done so the defendant shall furnish to the plaintiff
within 14 days of the granting of
this order, an undertaking in terms
of
section 17(4)(a)
of the
Road Accident Fund Act 56 of 1996
, for
100% of the costs of the future accommodation of Z N (“the
minor child”) in a hospital or nursing home or the
like for
treatment or rendering of a service to the minor child or supplying
of goods to the minor child arising out of the injuries
sustained by
the minor child in the motor vehicle collision which occurred on 22
November 2013, after such costs have been incurred
and upon proof
thereof, including the costs of the administration  of a trust
referred to hereinafter, which shall include:
a.
the reasonable costs of the
creation of the trust referred to in paragraph 4 above and the
appointment of the trustees;
b.
the reasonable costs of the
furnishing of security by the trustees;
c.
the costs of the trustees in
administering the minor child’s estate.
5.
A trust shall be established
and administered on behalf of the minor child, to administer the net
proceeds received from the defendant
(after deducting attorney and
client fees), which shall be paid over to a special trust to be
created with the following provisions:
a.
the minor child is the sole
beneficiary of the trust;
b.
the trustee(s) to provide
security to the satisfaction of the master;
c.
the trust property vests in
the trustee(s) of the trust in their capacity as trustee(s);
d.
at least two (2) but not more
than three (3) trustees will be appointed of which one will be an
independent professional trustee;
e.
the trust will have the
purpose of administering the funds in a manner which will best take
into account the interests of the minor
child;
f.
trust property will be
excluded from any community of property or accrual in the event of
the marriage of the minor child;
g.
the trustees will have the
right to purchase, sell and mortgage immovable property, invest and
reinvest the trust capital and to
pay out so much of the income
and/or capital as is reasonably required to maintain the minor child
(with due regard being had to
the obligations of any person having a
duty to support the minor child, the requirements of the minor child
and the purpose of
the award of damages);
h.
the powers and authority of
the trustees shall not exceed those usually granted to trustees or
special trusts;
i.
procedures shall be set out
to resolve any potential disputes, subject to the review of any
decision made in accordance therewith
by this court;
j.
the composition of the board
of trustees and the structure of the voting rights of the trustees
should be such that the independent
trustee cannot be overruled or
outvoted in relation to the management of the trust assets by any
trustee who has a personal interest
in the manner in which the trust
is managed;
k.
the amendment of the trust
instrument be subjected to the leave of this court;
l.
the termination of the trust
upon the death of the minor child in which event the trust assets
shall pass to the estate of the minor
child;
m.
the minor child shall after
attaining the age of 21 years be assessed by appropriate experts with
a view to determining whether
the minor child is capable of managing
the fund award and, if so, the trust will be terminated and the
trusts assets shall pass
to the minor child;
n.
the trustees shall as far as
possible recover the costs of the creation and administration for the
trust from the defendant in terms
of
section 17(4)(a)
undertaking;
o.
that the trust property and
the administration thereof be subject to an annual audit.
6.
The defendant shall pay the
plaintiff’s taxed or agreed party and party costs of suit on
the High Court scale, such costs
including but not limited to:
a.
The costs of the expert
reports (including RAF4 forms and addendum reports, if any) of Prof.
L.A. Chiat, Dr A.P.J. Botha, Dr C.
Kahanovitz, Dr L Fine, Ms R.
Hovsha, Dr. Lewer-Allen, Ms M Scott, Dr O Guy, Dr A Peché, Dr
J Goosen, Ms A Reynolds, C &
N Diagnostics, Ms N Kotze and Mr
Lottering;
b.
The qualifying and
reservation fees, if any, of Dr Lewer-Allen, Ms R Hovsha and Ms
Scott;
c.
The preparation, qualifying
and attendance fees of Dr Lewer-Allen, Ms R Hovsha and Ms M Scott;
d.
The qualifying fees of all
experts who attended to the preparation of joint minutes;
e.
The costs of counsel for 9
th
,
10
th
,
11
th
,
12
th
,
13
th
and 27
th
October 2017;
f.
The costs of the actuarial
reports of Mr G Whittaker (Algorithm Consulting Actuaries);
g.
Plaintiff’s reasonable
travelling expenses to and from medico legal appointments;
h.
The costs of the preparation
and perusal of the six bundles;  and
i.
The costs of the assessor’s
reports.
7.
In the event that the costs
are not agreed, the plaintiff’s attorney shall serve a notice
of taxation on the defendant’s
attorneys of record.  The
defendant shall be granted a period of 14 days post taxation to pay
the taxed costs.
_______________________
R
S WILLIS
ACTING
JUDGE OF THE HIGH COURT
Date
of Hearing: 27 October 2017
Judgment
Delivered: 4
th
April 2018
APPEARANCES
On
Behalf of the Plaintiff: M Letzler
Instructed
By:
Rene Fouche Inc
35
Keys Avenue, Rosebank
Tel:
(011) 484-4950
On
Behalf of the Defendant: F Magano
Instructed
By:
Kekana Hlatshayo
Radebe Attorneys
31
Princess of Wales Terrace, Parktown
Tel:
(011) 848-4114