Road Accident Fund v Klisiewicz (192/2001) [2002] ZASCA 57 (29 May 2002)

80 Reportability
Personal Injury Law - Road Accident Fund

Brief Summary

Road Accident Fund — Loss of earning capacity — Assessment of damages — Respondent, a neurosurgeon, injured in a road accident, unable to continue practice — Appellant liable for 75% of damages — High Court awarded R4 810 709 for loss of earning capacity — Appellant appealed against assessment and costs order, claiming trial court errors in admitting evidence and concluding respondent would have entered private practice — Court upheld trial court's findings, determining that the assessment of loss of earning capacity was reasonable and supported by evidence, including expert testimony on respondent's professional competence and earning potential.

Comprehensive Summary

Summary of Judgment


1. Introduction


The proceedings concerned an appeal and a cross-appeal to the Supreme Court of Appeal against a High Court award of damages arising from a motor vehicle accident, with the principal dispute relating to the quantification of loss of earning capacity and a further dispute relating to the appropriate scale of costs.


The appellant was the Road Accident Fund and the respondent was Roman Klisiewicz, a neurosurgeon who had practised until injuries sustained in a 1995 road accident rendered him incapable of working as a medical doctor. The parties had agreed that the Fund was liable to compensate the respondent for 75% of his proven damages.


In the High Court at Johannesburg (Goldblatt J), the respondent’s damages were assessed and awarded with costs. With leave, the Fund appealed (and the respondent cross-appealed) against the award insofar as it included R4 810 709,00 for loss of earning capacity. The respondent additionally sought leave in the Supreme Court of Appeal to cross-appeal against the High Court’s refusal to grant a special costs order, contending that the Fund’s conduct warranted costs on a punitive scale.


The general subject-matter was the monetary assessment of damages for a professional person who, because of accident-related injuries, lost the ability to continue in his specialised profession, and whether litigation conduct justified a punitive costs consequence.


2. Material Facts


It was common cause that the respondent, born in 1951 in Poland, was a qualified neurosurgeon with a PhD in neurosurgery, and that he emigrated to South Africa in 1991 with his family. He secured employment in the neurosurgery section at Johannesburg General Hospital, first temporarily and then on a full-time basis from 1 August 1991. The respondent later moved to Paardekraal Provincial Hospital in Krugersdorp, commencing there on 2 January 1995. Approximately seven months thereafter he was injured in the 1995 accident.


It was undisputed that, as a result of the accident and ensuing complications, the respondent became incapable of earning a living as a medical doctor of any kind. The quantification dispute therefore turned on what his likely career and earnings would have been but for the accident, and whether he retained any realistic residual earning capacity in his disabled state.


A central factual component concerned the respondent’s professional trajectory in South Africa. To enter private practice as a neurosurgeon in Johannesburg he needed specialist registration from the South African Medical and Dental Council (later the Health Professions Council). The Council required him to pass the relevant College examination (and also an examination in legal ethics and language). By the time of the accident he had not yet written these examinations. The High Court nevertheless found it reasonable, on the evidence, to conclude that he would have written and passed them, entered private practice, and ultimately earned at a level comparable to a practitioner in the middle echelons of private neurosurgical practice in Johannesburg.


The evidence relevant to those prospects included detailed letters written by Professor V J R Farrell (head of the Department of Neurological Surgery at Johannesburg Hospital and a College examiner) in support of the respondent’s application for specialist registration. Those letters strongly endorsed the respondent’s skill and attributes as a neurosurgeon in an academic setting. Evidence also addressed the deterioration of the working relationship between the respondent and Professor Farrell and the circumstances leading to the respondent’s transfer from Johannesburg Hospital to Paardekraal.


On residual earning capacity, the Fund sought to advance that the respondent was not totally disabled for work. The evidence the appeal court treated as material included that the respondent suffered hypoxic brain damage with a material memory deficiency and other problems affecting employability, and that no witness could provide a convincing basis for concluding that he was employable on the open labour market. Evidence about sleep apnoea was led to suggest a remediable condition affecting work capacity, but the appeal court regarded the thrust of the evidence as showing no such disabling ailment connected to the accident.


3. Legal Issues


The central legal questions were whether the High Court erred in its assessment of the respondent’s loss of earning capacity, including whether it was justified in finding that he would have entered private practice and how it quantified the likely earnings and contingencies, and whether it should have found a quantifiable residual earning capacity.


These questions involved, in significant part, the application of legal principles to fact and the exercise of a value judgment/discretion typical of damage quantification in personal injury matters, where the assessment turns on forecasts and contingencies rather than certainties.


In addition, the appeal raised evidentiary and procedural issues concerning whether the High Court correctly disallowed certain expert-type evidence from Professor Farrell due to non-compliance with procedural requirements, and whether the High Court erred in admitting certain evidence concerning private neurosurgeons’ earnings (though the appeal court ultimately considered the admission issue non-determinative because the judgment did not indicate reliance on that evidence).


A further issue was whether the Fund’s manner of conducting the litigation justified a punitive costs order (in particular, an attorney-and-client scale) for part of the trial, and whether the High Court’s refusal of such an order should be interfered with on appeal.


4. Court’s Reasoning


On the attempted evidence from Professor Farrell about the respondent’s professional competence and prospects, the Supreme Court of Appeal emphasised the procedural framework governing expert evidence. The respondent had complied with the rules applicable to expert witnesses months before trial. The Fund, by contrast, did not consult timeously with Professor Farrell, gave no notice that he would testify as an expert, and only at a late stage attempted to elicit opinion evidence concerning the respondent’s abilities and chances of passing the required examinations. The appeal court agreed with the High Court that the evidence was plainly expert in nature, and that the Fund’s contention that it was not expert evidence was correctly rejected.


The appeal court held that the High Court was justified, as an exercise of discretion, both in disallowing the questioning and in refusing a postponement sought to remedy the lack of notice. The Fund’s dilatoriness and failure to attend to procedural obligations were treated as decisive in upholding those rulings.


On the challenged evidence regarding earnings in private practice (obtained by an industrial psychologist, Ms Noble, from discussions with practising neurosurgeons), the appeal court reasoned that the record did not show that the disallowed later evidence was of the same nature as the admitted evidence, and, critically, the High Court’s judgment did not reveal that it actually relied on the disputed income figures in reaching its conclusion on quantum. For that reason, this complaint did not assist the Fund in overturning the award.


On whether the respondent would have entered private practice, the appeal court considered the evidence as a whole, including the respondent’s personal characteristics (ability, ambition, drive, courage), his decision to emigrate at the age of 40, his qualifications and experience, and Professor Farrell’s strong endorsements. Although Professor Farrell’s letters referred to academic neurosurgery and did not mention private practice, the appeal court noted that the respondent testified that private practice was his intention and that this was not put to him in cross-examination as being inconsistent with what he had told others. The respondent’s wife gave consistent evidence on his intention.


The appeal court also addressed the Fund’s submission that the respondent had to prove it was probable that he would have passed the examinations, entered private practice, and succeeded. It rejected this approach as inconsistent with authority in circumstances where it was already clear that the accident disabled him from working as a doctor; the task was not causation but quantification. In quantification, the court held, it is permissible and customary to take account of future possibilities even if they are not proved as probabilities, applying the approach in the authorities cited.


In assessing whether the High Court took too optimistic (as the Fund argued) or too conservative (as the respondent argued) a view of practice prospects, the appeal court evaluated how the High Court used comparator evidence (in particular, Dr Edeling’s income) and the timeline to parity. It held that the High Court did not improperly equate the respondent with Dr Edeling at the same level and time, because the High Court’s approach placed the respondent on a lower scale by projecting parity only by 2006 with Dr Edeling’s 2000 earnings. The appeal court considered that the High Court adopted a cautious approach and further relied on an assessment (which had not been challenged) that the respondent would likely inspire confidence in patients and the medical fraternity.


At the same time, the appeal court recognised and weighed countervailing considerations identified in the evidence: the respondent’s deficiencies in clinical examination and follow-up stemming from differences between Polish and British/South African training approaches, the need for improvement in patient communication particularly early in private practice, and the possibility that age might have affected patient choice in a competitive market. It also noted uncertainty about whether the respondent’s paediatric neurosurgery interest would have attracted work, treating it as a possibility without evidence pointing definitively one way or the other.


On residual earning capacity, the appeal court accepted that the medical evidence did not translate into realistic employability. Professor Vorster’s evidence that the respondent had residual abilities was regarded as insufficient without a realistic employment prospect, and she ultimately deferred to industrial psychology. Ms Noble’s evidence in court was that employment would be “onmoontlik” or “baie moeilik” to obtain and that retention prospects were “baie skraal”, particularly given memory and concentration problems and other constraints. The appeal court therefore upheld the High Court’s decision not to attribute any quantifiable residual earning capacity.


Regarding contingencies and the quantification methodology, the appeal court endorsed the High Court’s approach of identifying predicted income levels from 1995 to retirement and then applying a substantial contingency discount to reflect uncertainties (including delay in reaching private practice, the chance of never entering it, the risk of lack of success, and possible health curtailment), balanced against upward contingencies (including the chance of reaching upper echelons and earning beyond age 65). The net result was a 20% contingency deduction, which the appeal court considered within the wide discretion afforded to trial courts in such assessments.


The appeal court, however, identified an arithmetic error in the High Court’s calculation: applying a 20% deduction to the unadjusted loss of R5 930 014 should have yielded R4 744 011 rather than R4 810 709, a difference of R66 698. It corrected the award accordingly, describing the reduction as less than 2% and not warranting a special costs consequence.


On costs, the appeal court revisited the High Court’s refusal to grant a special costs order. It accepted the High Court’s strong criticism of the Fund’s conduct but held that it was insufficient to excuse that conduct merely as “excess caution and uncertainty” if it stemmed from unreasonable lack of preparation. Drawing on the notion of “vexatious” conduct in the cited authority (including conduct that puts the opponent to unnecessary trouble and expense), the appeal court concluded that the Fund was profoundly ill-prepared, pursued unnecessary issues, failed to take timeous and reasonable steps (including proper expert engagement and admissions), and thereby materially lengthened the trial. On a broad conspectus it found that the trial was extended from about seven to fourteen days due to the Fund’s fault.


The appeal court held that a special costs order was therefore appropriate and necessary, also emphasising the Fund’s public duty to administer funds with integrity and efficiency through thorough investigation and responsible litigation conduct. Nevertheless, it declined to order costs on the scale as between attorney and own client, noting the Supreme Court of Appeal’s expressed disinclination to make such awards absent fuller argument and forensic debate establishing a proper basis.


5. Outcome and Relief


The Supreme Court of Appeal dismissed the Fund’s appeal on the merits of the loss of earning capacity assessment, and also dismissed the respondent’s cross-appeal on quantum. The court corrected the High Court’s arithmetic error by reducing the total sum reflected in paragraph 1 of the High Court order by R66 698,00, substituting the amount R3 641 571,00.


The appeal was dismissed with costs (subject to the amended amount). Leave was granted to the respondent to cross-appeal against the High Court’s costs order, but the respondent was ordered to pay the costs of the application for such leave. The respondent’s cross-appeal on costs succeeded with costs, and the High Court’s costs order was supplemented to provide that, in respect of seven days of the trial, costs were to be paid on the scale as between attorney and client.


Cases Cited


Burger v Union National South British Insurance Co 1975 (4) SA 72 (W)


Blyth v Van den Heever 1980 (1) SA 191 (A)


Engineering Management Services (Pty) Ltd v South Cape Corporation (Pty) Ltd 1979 (3) SA 1341 (W)


AA Alloy Foundry (Pty) Ltd v Titaco Projects (Pty) Ltd 2000 (1) SA 639 (SCA)


Thoroughbred Breeders Association v Price Waterhouse 2001 (4) SA 551 (SCA)


Legislation Cited


No legislation was expressly cited in the judgment.


Rules of Court Cited


No specific rule number was expressly cited; the judgment referred generally to the procedural requirements governing the calling of expert evidence (notice and summary).


Held


The Supreme Court of Appeal held that the High Court did not err in its substantive assessment of the respondent’s loss of earning capacity, including its conclusion that the respondent would have written and passed the required examinations, obtained specialist registration, entered private practice, and earned at a level broadly consistent with a middle-tier neurosurgeon in Johannesburg private practice, subject to appropriate contingencies.


It held that the High Court properly exercised its discretion in excluding opinion evidence sought from Professor Farrell as expert evidence where the Fund had failed to comply with procedural requirements, and in refusing a postponement sought to cure that failure at a late stage.


It held that there was no basis to interfere with the High Court’s treatment of residual earning capacity, as the evidence did not support realistic employability on the open labour market given the respondent’s cognitive impairments and other constraints.


It held that an arithmetic error in the High Court’s application of the contingency deduction required correction, resulting in a modest reduction of the final amount.


It held that the Fund’s unreasonable lack of preparation and conduct of the defence materially and unnecessarily lengthened the trial, justifying a special costs order for part of the trial on an attorney-and-client scale, but not on the more punitive attorney-and-own-client scale.


LEGAL PRINCIPLES


The judgment applied the principle that, once it is established that an accident has rendered a plaintiff unable to work in their profession, the assessment of what would have been earned is primarily a matter of quantification, not causation, and that in quantifying future loss a court may consider future possibilities and is not confined to outcomes proved as probabilities.


It affirmed that trial courts enjoy a wide discretion and latitude in assessing damages for loss of earning capacity due to the inherent imponderables in forecasting future career trajectories and earnings, and that an appellate court will not readily interfere absent demonstrable misdirection, aside from correcting a clear arithmetic error.


It applied the procedural principle that expert opinion evidence must be introduced in accordance with applicable procedural requirements, including timely notice and summaries, and that a trial court may, as a matter of discretion, exclude such evidence and refuse postponements where a party’s non-compliance results from dilatoriness and unreasonable lack of preparation.


It applied the costs principle that litigation conduct may justify a punitive costs order where a party’s unreasonable conduct causes unnecessary trouble, expense, or prolongation of proceedings, and that a public body administering public funds bears a responsibility to litigate efficiently and responsibly; however, it recognised the Supreme Court of Appeal’s caution in granting the most punitive scale of costs (attorney and own client) absent fuller development of the jurisprudential basis for such orders.

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[2002] ZASCA 57
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Road Accident Fund v Klisiewicz (192/2001) [2002] ZASCA 57 (29 May 2002)

IN THE SUPREME COURT OF APPEAL
OF SOUTH AFRICA
Case No 192/2001
In
the matter between:
ROAD
ACCIDENT FUND
Appellant
and
ROMAN
KLISIEWICZ
Respondent
________________________________________________________________________
CORAM:
HOWIE,
SCHUTZ JJA et LEWIS AJA
________________________________________________________________________
Hearing
date:
6 May 2002
Date
delivered:
29 May 2002
Loss
of earning capacity -
Quantum
- Attorney-client
costs award.
________________________________________________________________________
J U D G M E N T
________________________________________________________________________
HOWIE JA
HOWIE
JA
[1]
The respondent is a neurological surgeon.
He followed that profession until he was injured in a road accident
in 1995. As a result
he is incapable of earning his living as a
medical doctor of any sort. By agreement between the parties the
appellant is liable
to pay the respondent 75% of the damages he has
suffered as a consequence of the accident. In a trial in the High
Court at Johannesburg
the damages were assessed and awarded, with
costs.
[2]
The assessment included an amount of R4 810
709,00 in respect of loss of earning capacity, which sum, subject to
adjustments, constituted
the major component of the total assessment
and the ensuing award. With the necessary leave the appellant
appeals, and the respondent
cross-appeals, against the award in so
far as the assessment, in that amount, of loss of earning capacity is
concerned. Furthermore,
having been refused leave by the trial
Court to cross-appeal against the costs order, the respondent now
seeks the required leave
from this Court, his proposed contention
being that the conduct of the appellant's case warranted an order
that it pay the costs,
or part of the costs, on the scale as between
attorney and own client.
[3]
The respondent was born in 1951 in Poland.
He emigrated from that country in 1991 and came to settle in South
Africa with his wife
and children. By then he was an experienced
neurosurgeon and the holder of the degree PhD in neurosurgery.
[4]
He qualified in neurosurgery in 1984. In
1985 he started practice. Predominantly his work was in Polish
state institutions but
he also practised privately on a part-time
basis. His special interest was paediatric neurosurgery, an area of
medical practice
quite well developed in Europe but hardly known in
South Africa, if at all.
[5]
Late in 1990, on his own, he came to South
Africa for the first time. His purpose was to investigate the
employment opportunities
here. A visit to the Johannesburg General
Hospital, a provincial institution, secured him virtually immediate
temporary employment.
The neurosurgery section had at that stage no
full-time specialist and no departmental head. His services in both
respects were
eagerly invited and accepted, in an acting capacity.
In due course he returned to Poland to fetch his family and came back
to South
Africa in July 1991 to become a full-time employee at the
hospital as a medical officer. His employment as such began on 1
August
1991, the same date, as it so happened, on which the new
permanent head of department took office. This was Professor V J R
Farrell
of the University of the Witwatersrand who became the
hospital's chief specialist in neurological surgery.
[6]
The respondent's career at the hospital
terminated at the end of 1994 when, on transfer, he became a medical
officer at Paardekraal
provincial hospital at Krugersdorp. The
reason for this change will be discussed in due course. His term
of office there started
on 2 January 1995 and was cut short by the
accident a mere seven months later.
[7]
It was the respondent's case that he would
eventually have entered private neurosurgical practice in
Johannesburg had he not been
injured. To do so he had to apply to
the South African Medical and Dental Council (now the Health
Professions Council) for registration
as a specialist neurosurgeon.
His application, early in 1991, was supported by Professor Farrell.
The respondent hoped that his
having the PhD degree would persuade
the Council to allow registration without his having to write any
examinations but the Council's
response was that he first had to pass
the special examination set by the College of Surgeons of South
Africa for doctors with overseas
qualifications. Accordingly, in
February 1991, the Council gave him permission to enter for that
examination and in November 1992,
in order to acquire the training
appropriate to registration, the respondent resigned from his
position as medical officer, which
was not a training post, and
became a neurosurgical registrar at a lower salary. Apart from the
College examination it would also
have been necessary for the
respondent to pass an examination in legal ethics and language set by
the Council.
[8]
By the time of the accident he had not yet
written the examinations but the learned trial Judge found
nonetheless that it was reasonable
to conclude that the respondent
would, on the evidence, have written and passed them, entered private
practice and eventually earned
an income comparable with that of
someone in approximately the middle echelons of neurosurgical
practice in Johannesburg.
[9]
The contentions advanced by the appellant are
that the trial Court erred in the following respects:
1. In disallowing Professor Farrell (called by the
appellant) to give certain evidence, as an expert, as to the
respondent's professional
competence.
2. By admitting certain evidence as to the earning
capacity of neurosurgeons in private practice.
3. In concluding that the respondent would have entered
private practice.
4. As to quantifying lost earning capacity,
(a) in taking too optimistic a view of the respondent's
practice prospects, and
(b) in not finding that he had a quantifiable earning
capacity in his disabled state.
[10]
The argument for the respondent on the
quantum aspect is that the trial Court's assessment of the
respondent's likely practice income
was so unduly conservative as to
warrant an increase in the amount I referred to earlier of R4 810
709,00.
[11]
As regards the exclusion of certain evidence
sought to be led from Professor Farrell, the respondent's compliance
with the rules
pertaining to the calling of expert evidence was
effected months before the start of the trial. It must always have
been obvious
that Professor Farrell was the person best qualified, in
every sense, to express an opinion on the respondent's prospects and
abilities
as a neurosurgeon and that the respondent was not going to
call him. The appellant omitted to consult with Professor Farrell
until
after the Court
a quo
refused the appellant a
postponement on the opening day of the trial. Notice that he would
give expert evidence on behalf of the
appellant was never furnished.
When, at an advanced stage of the proceedings, the appellant's
counsel called Professor Farrell
and attempted to elicit his views as
to the respondent's abilities and his chances of passing the
examinations necessary for registration
as a specialist neurosurgeon,
the respondent's counsel understandably objected. The justification
for the absence of notice, said
the appellant's counsel, was that the
evidence he aimed to lead was not expert testimony. This received
short shrift from the learned
trial Judge (Goldblatt J). Rightly
so. Only a qualified and practising neurosurgeon and College of
Medicine examiner (which Professor
Farrell also was) could give the
intended evidence. When the questioning was disallowed, the
appellant's counsel asked that the
trial be postponed so that the
requisite notice and summary of the proposed evidence could be given.
This request was refused.
In exercising his discretion to
disallow the questioning and to refuse the postponement, the learned
trial Judge, given the appellant's
dilatoriness in this regard and
its lack of attention to its procedural obligations, was undoubtedly
right.
[12]
The appellant's complaint as to the
admissibility of evidence concerning a neurosurgeon's earning
capacity is that the trial Court
erred in admitting evidence by an
industrial psychologist, Ms Esmé Noble, in which she confirmed
a pre-trial report in which
she said that she had spoken to three
practising neurosurgeons (two in Johannesburg and one in Pretoria)
and was told what they thought
an average neurosurgeon in full-time
private practice could earn. The Judge considered that her evidence
was admissible as constituting
the result of a survey, the
reliability of which would be determined at the end of the trial.
By contrast, said counsel, when the
respondent sought to recall Ms
Noble to testify as to conversations she had recently had with two
other neurosurgeons that evidence
was disallowed.
[13]
The answers to the appellant's argument in
the present regard are, firstly, that the record does not show that
the proposed, but
disallowed, evidence was of the same import as the
admitted evidence, in other words was also in the nature of a survey
rather than,
say, the recorded informants' assessment of colleagues'
relative merits or demerits. Secondly, although the Court's
judgment quotes
the contents of the report by Ms Noble, including the
portion which was challenged but admitted, there is nothing in the
judgment
which shows, even inferentially, that the Judge relied on
the income figures obtained by Ms Noble in arriving at any of his
conclusions.
[14]
Turning to the question whether the
respondent would have entered private practice, the conclusion on all
the evidence is compelling
that here was a man who arrived in South
Africa with conspicuous ability, ambition, drive, courage and special
neurosurgical skills.
A clear and telling pen portrait of the
respondent is presented by Professor Farrell in three letters to the
Registrar of the Council
concerning the respondent's application for
specialist registration. The first letter is dated 16 March 1992.
It contains the
following paragraphs:
'Doctor Klisiewicz did both his undergraduate and
post-graduate training in Neurosurgery in Poland and I am submitting
herewith his
detailed curriculum vitae. Kindly note that in 1988 he
was appointed Clinical Assistant Professor of Neurosurgery in Warsaw.

It is generally accepted in the International Neurosurgical
community that training and expertise of Polish Neurosurgeons is of
the
highest standard. Because of the high regard in which the
Polish counterparts are held the society of British Neurosurgeons
holds
regular combined clinical and research meetings with them.
Doctor Klisiewicz has worked in the Department of
Neurological Surgery at the Johannesburg Hospital as Principal
Medical Officer since
August 1991. I have therefore had the
opportunity of close assessment of his basic knowledge, his clinical
judgement and his ability
as an operating neurosurgeon. In all of
these areas he has met the very high standard which I have demanded
and I would find him
completely acceptable as a specialist
neurosurgeon in my department. He has shown an aptitude for
clinical research and indeed
has a doctorate for work that he did
while still in Poland. In my opinion Doctor Klisiewicz has all the
attributes required to
be a valuable member of the Neurosurgical team
in the academic setting.
He is firmly committed to a future in South Africa and
has been granted permanent resident status. He has brought to this
country
his family, his wife being an accomplished neurologist in her
own right. Both of his children are attending school locally and
have already in a few months shown themselves to be of high
intelligence and industry.
In my capacity as head of the Department of Neurosurgery
at Johannesburg Hospital, executive member of the Society of
Neurosurgeons
of South Africa and as examiner for the College of
Medicine of South Africa in Neurology and Neurosurgery, I have no
hesitation in
supporting the application of Doctor Klisiewicz that he
be given a Specialist registration.'
[15]
The second letter is dated 19 March 1992 and
sets out the following (I have corrected obvious errors in dates):
'The Department of Neurological Surgery was effectively
closed in August 1990 when the incumbent neurosurgical specialist
entered
private practice. Fortuitously Dr Klisiewicz was visiting
this country and when he expressed interest in visiting the
Department
of Neurological surgery he was immediately offered a post
by the Hospital Administrators who were naturally concerned about the
absence
of any neurosurgical service at the Johannesburg Hospital.
Dr Klisiewicz was employed from the latter part of November until the
end of April 1991 and during this five month period took full
responsibility for the department and the patients who required both
general and surgical management. Dr Klisiewicz was then given an
offer of permanent employment in the department and he returned
temporarily to Poland to fetch his wife and two children.
In August 1991 I was appointed as the Head of the
Department of Neurological Surgery and Dr Klisiewicz recommenced
employment in
the department at that time. As I indicated in my
earlier letter I have had the opportunity over an extended period of
time of
a detailed assessment of his capacity as a neurosurgeon. In
all regards he has measured up to the high standards that I would
require
of a specialist neurosurgeon in the academic setting and it
is important to note that this assessment has not only included his
clinical
judgement but has also afforded an opportunity of assessing
his surgical skill as well as his knowledge of the general body of
neurosurgical
literature.
As an examiner for the FCS Neurosurgery of the College
of Medicine of South Africa, I have had the opportunity over a number
of years
of assessing candidates who have presented themselves for
the final examination success in which has immediately permitted
specialist
registration and, if chosen, private practice. I
respectfully submit that the assessment that I have done of Dr
Klisiewicz over
many months is in fact more meaningful than the
one-off examination system and I have no hesitation in stating that
he is superior
to the majority of the candidates who have
successfully completed the College examination.
As I stated in my earlier letter Dr Klisiewicz has
committed himself to a future in this country and is anxious to
remain in the
academic neurosurgical environment.
I support his application for specialist registration
without question and believe that he has the qualities necessary to
make a
significant contribution to academic neurosurgery at the
Johannesburg Hospital.'
[16]
The third letter, dated 10 March 1993, says
this:
'Dr
Klisiewicz is currently employed as the Principal Medical Officer in
the Department of Neurological Surgery, Johannesburg Hospital
and is
making a very valuable contribution to this department.
He intends writing the final examination for the FCS SA
in Neurosurgery in the September examinations and if successful will
seek
registration as a specialist neurosurgeon. He has committed
his future to South Africa and at present is seeking citizenship of
the RSA having been granted permanent residence on the 2nd of January
1992.'
[17]
One notes in the letters the reference by
Professor Farrell to academic neurosurgery and no mention of private
practice. However,
the respondent's evidence was that he intended
to go into private practice and that was why he sought registration.
It was never
put to him in cross-examination that he had never
mentioned this topic to Professor Farrell or to anyone else. It was
also not
put that Professor Farrell would say that he was unlikely to
pass the examinations or that he was in any way ill-suited to private
practice. The respondent's wife testified before he did and it was
also her evidence that he intended to enter private practice.
All
that the appellant's counsel put to her was that Professor Farrell
would say that he was dissatisfied with the standard of
patient care
which the respondent rendered and therefore wanted him transferred to
Paardekraal. When the appellant's counsel did
challenge the
evidence that the respondent would have entered private practice it
was not on the basis of any foreshadowed criticism
by Professor
Farrell. It was founded on no more than a submission which counsel
said he was going to make at the end of the case.
It is not without
significance that Professor Farrell's only complaint when he gave
evidence was that the quality of the respondent's
work had declined
to the extent that he was no longer of sufficient value in an
academic department. The witness thought that this
decline was due
to what he called the Council's rejection of the respondent's PhD for
specialist registration. As against that,
however, the Council's
requirement that he write the examinations was known in February 1991
and in March 1993, according to Professor
Farrell's third letter, the
respondent was still intending to write the examination and still
making "a very valuable contribution"
to the academic
department.
[18]
The respondent's transfer to Paardekraal
came about because both he and Professor Farrell very much wanted
their respective ways to
part. The respondent was in various
respects unhappy with the Professor's attitude towards him and there
is the added factor that
his work schedule in the academic hospital
allowed him little or no time to prepare for the examinations.
Professor Farrell's disenchantment
with the respondent was best
explained by the evidence of Dr H Edeling, a practising neurosurgeon
in Johannesburg who had been a
fellow neurosurgical registrar with
the respondent under Professor Farrell. Dr Edeling was called as a
witness on behalf of the
respondent. He said that Professor Farrell
had been trained in Britain and was a rigid adherent to the ways of
British neurosurgical
practice. He would not brook any
inconsistency in the methods by which the registrars in the
Johannesburg General Hospital were
taught. As can be seen in
Professor Farrell's first letter, the standards of Polish
neurosurgical teaching were highly regarded
internationally and in
Britain. The essential difference between the British way as
followed, apparently, in South Africa, and
the Polish approach,
according to Dr Edeling, was that a Polish neurosurgeon's work was
very much confined to the operating theatre,
with little or no
pre-operative or post-operative clinical attention to the patient.
By contrast, the training implemented by Professor
Farrell involved
the neurosurgical registrars having to learn to consult with and
prepare their non-trauma patients pre-operatively
and to follow them
up clinically after surgery. (Obviously trauma patients by and
large had to be operated on urgently without
the opportunity for
clinical engagement.)
[19]
In the opinion of Dr Edeling the respondent
was far superior to the other registrars in knowledge and experience
of brain tumour
surgery, paediatric neurosurgery and surgical
technique. In terms of clinical judgment and integrity he was
comparable. Where
he was inferior was with regard to patient
examination and clinical "work-ups". He said that
Professor Farrell often
criticised the respondent "rather
viciously" on ward rounds leaving the impression among the
registrars that he disliked
the respondent or did not think much of
him. The respondent himself recounted in evidence Professor
Farrell's having asked on one
occasion whether he had to show him how
to hold a scalpel. This incident may well reveal Professor
Farrell's eventual intolerance
towards the respondent but in the
light of the clear evidence that the latter was an especially skilful
surgeon it must be interpreted
as no more than a sarcastic outburst
triggered by what the Professor saw as other shortcomings. Dr
Edeling said that the Johannesburg
General Hospital was inundated
with trauma cases and other cases referred from a large network of
provincial hospitals and the respondent
did a lot of these cases on
his own. Indeed, apart from doing them himself, he would teach and
guide other registrars in certain
types of surgery and surgical
techniques.
[20]
The fact that by the time he was injured the
respondent had not yet written the necessary examinations can, in my
view, easily be
explained. Reference has already been made to the
burden of surgical work he was faced with throughout his time at the
Johannesburg
General Hospital. In addition, its being a training
hospital meant there were many meetings and conferences which took up
the rest
of a working day. There were also several occasions when
he was away on leave or sick leave. On emigrating from Poland he
left
his parents behind. His mother died early in 1992 and his
father towards the end of that year. These bereavements involved
inevitable
distraction and the need to return to Poland for family
reasons.
[21]
As time went by the stresses of work at the
Johannesburg General Hospital, coupled with the unavailability of
time to attend to his
studies and the growing tensions between
himself and Professor Farrell, all contributed to the respondent's
suffering from hypertension.
From the latter half of 1993 until
early in 1995 he consulted a number of specialists at various times
to determine whether he
had a heart ailment. On a visit to Poland
late in 1993 he thought he had had a heart attack and was
hospitalised there for some
while. None of the investigations
established a heart defect or any related problem. By early in 1995
he would have known that,
and from then on would have been able to
pursue his examination preparation without the hindrance of health
worries and with more
time at his disposal at Paardekraal.
[22]
Dr Edeling mentioned the obvious fact that
the respondent had had, as an immigrant, to cope with a number of
circumstances new to
him. One was the use of English. The
respondent recognised his need to improve on this aspect especially
as the examinations
he was due to write involved what he said
amounted to essays. There is no evidence to suggest, however, that
apart from a noticeable
accent, the language factor was destined to
be a real difficulty either in the examinations or in private
practice. Obviously,
though, one must bear in mind the possibility
that South African private patients might have been more disposed to
choose a neurosurgeon
with whose approach and manner of speech they
would be more familiar.
[23]
It was argued for the appellant that the
respondent had to prove that it was probable that he would have
passed the examinations,
entered private practice and succeeded as a
busy practitioner. This submission is, of course, contrary to
authority in so far as
it invokes application of the
onus.
Once it is clear, as it is, that the accident has disabled the
respondent from working as a doctor of any kind, the ascertainment
of
his lost medical earning capacity (leaving aside for the moment any
possible residual earning capacity in his disabled state)
is a matter
not of causation but of quantification. That being so, the general
practice in this kind of case is to take into account
future
possibilities even if they have not been shown to be probabilities:
Burger v Union National South British Insurance Co
1975 (4) SA
72
(W) at 74A - 75H;
Blyth v Van den Heever
1980 (1) SA 191
(A) at 225G - 226B.
[24]
In my view it is highly improbable that,
having taken the daunting decision to leave the land of his birth and
come to a distant
continent at the age of 40, to a country which he
obviously saw as one of opportunity, the respondent would, with his
attributes,
have been content to remain in salaried provincial
employment. Even if it were for him to prove the necessary facts on
a balance
of probabilities I consider he succeeded in showing that he
would have written and passed the examinations necessary for
registration
and thereafter entered private practice.
[25]
In quantifying lost neurosurgical earning
capacity the trial Court considered that after entering private
practice in 2001 the respondent
would, by 2006, "have achieved
parity in regard to earnings with Dr Edeling's
present
earning
capacity" (I emphasise). When Dr Edeling testified in November
2000 he said his nett income was R90 000 per month.
The appellant's
counsel argued that the Judge had erred in equating the earning
capacity of the respondent with that of Dr Edeling.
It will be
clear, however, that in predicting that the respondent would earn in
2006 what Dr Edeling earned in 2000 the Court was
in fact placing him
on a lower "income scale". It is also apparent from Dr
Edeling's forthright and frank assessment
of his own abilities
compared with the abilities and incomes of people in the top strata
of Johannesburg's private neurosurgical
practice that the trial Court
adopted an understandably cautious approach to the quantification of
the respondent's loss of earning
capacity.
[26]
Moreover, in his deliberations the learned
Judge took into account a consideration of particular importance, the
merits of which
we, sitting as a court of appeal, are quite unable to
controvert. He said:
'The
Plaintiff, despite his deficiencies, gave me the impression of a man
who would have been able to inspire confidence in his patients
and in
the medical fraternity.'
The appellant's counsel did not
criticise that assessment or, for that matter, the respondent's
credibility.
[27]
The evidence justifies the conclusion that
the respondent was capable of working long, hard hours. In
addition, he was on his own
assessment able to complete operations in
a fraction of the time colleagues took to do them. That evaluation
was not challenged.
Coupled with those operating skills to which Dr
Edeling approvingly referred, there can be no doubt that the
respondent was, in
all the circumstances, a particularly fine
prospect for private practice in so far as the surgical aspect was
concerned. However,
whether his interest and ability in regard to
paediatric neurosurgery would have attracted work is a question in
respect of which
there is no evidence pointing one way or the other.
It is nevertheless a possibility to be weighed.
[28]
Against the respondent's favourable
attributes there is the consideration that his Polish medical origins
rendered him short of knowledge,
experience and skill when it came to
clinical examination, assessment and follow-up. Improvement on this
front would have been
crucial to successful doctor-patient
communication, particularly in the early years of practice. It was
a shortcoming which he
would have had to work hard to eradicate.
Alternatively, he would have been dependent on his surgical skills
building him such
a reputation that his clinical deficiencies became
effectively irrelevant. In addition, it has to be remembered that
he would have
been entering the competitive field of practice at an
age substantially nearer the end of the average professional working
life than
the beginning. The possibility must therefore be borne in
mind that his age might, from the patients' viewpoint, have tended to
detract from his getting work rather than attracting it.
[29]
If, of course, the bulk of his practice
would have lain in operating, as opposed to consulting and writing
medico-legal reports,
then the chances were, on Dr Edeling's
evidence, that he would have earned a much bigger income than
colleagues who operated less
than he even though they might be
consulted more.
[30]
In all the circumstances I disagree with the
appellant's submission that the Court took too optimistic a view of
the respondent's
earning prospects in private practice. I also
disagree with the respondent's submission that the Court was unduly
conservative.
[31]
As to residual earning capacity, the
appellant called Professor M Vorster of the University of the
Witwatersrand. She had
said in a pre-trial report that the
respondent 'is not totally disabled to work'. In evidence the most
she could say was that the
respondent has 'residual abilities' and
that it would be therapeutic for him to work even if not in a 'full
day job'. Correctly,
the Court pointed out to her that somebody had
to be prepared to employ him. She conceded that and said that she
had had in mind
part-time work in a medical library but she finally
deferred to the view of an industrial psychologist. The only such
witness was
Ms Noble whose evidence I shall deal with presently.
There is no realistic prospect of the respondent's employability in a
medical
library. As a result of complications during surgery
necessitated by the accident he suffers from hypoxic brain damage and
consequent
material memory deficiency. This is one of the
fundamental problems detracting from his employability. There are
others, including
depression, which it is unnecessary for present
purposes to detail. No witness was able to articulate any
convincing reason for
the conclusion, sought by the appellant, that
the respondent is employable on the open labour market. Ms Noble's
evidence was to
the contrary. The most that the appellant could
point to is a reference in Ms Noble's pre-trial report in which she
suggested the
possibility of employment at a certain salary scale.
However what she said there was this:
'Indien
dr Klisiewicz wel sodanige gerehabiliteer word dat hy weer sal kan
werk word gepostuleer dat hy waarskynlik in 'n pos sal
moet waar
- onafhanklike besluitneming beperk is,
- waar leiding beskikbaar is,
- waar daar nie aanhoudende druk en stres is nie,
- waar sy werk gekonroleer word om moonlike foute weens
sy geheue- en konsentrasieprobleme op te vang,
- waar die gevolge van moontlike foute klein is,
- waar hy nie op 'n gereelde basis met mense hoef te
werk nie,
- waar hy sedentêr werk en nie nodig het om bv
rond te ry nie,
- waar hy gereeld terugvoer kry en aangemoedig word, en
- waar hy nie teen spoed hoef te werk nie.
Bogenoemde vereistes sit waarskynlik ten beste om in
hoogstens
'n administratiewe pos op 'n Paterson C4-posvlak met
'n totale pakket van ongeveer R10 650 tot R14 225 per maand. Die
skrywer is
egter van mening dat Dr Klisiewicz kwesbaar is as 'n
werknemer as gevolg van sy neurosielkundige problematiek wat
waarskynlik die
beste by wyse van verhoogde postongelukse
gebeurlikheidsaftrekking aangespreek kan word. Laasgenoemde sal
waarskynlik in spanverband
gedebateer moet word.'
Patently, entry into the suggested
type of employment would be subject to what she refers to as the
respondent's 'neurosielkundige
problematiek' and here, again, there
is no evidence, for example, that changes of medication or any other
consideration will realistically
improve his chances of being
acceptable to an employer. In her evidence Ms Noble said it would
be 'onmoontlik', 'baie moeilik'
to find him employment and the
chances of retaining it if he found it, 'baie skraal'.
[32]
Evidence was led on behalf of the appellant
to bolster the suggestion that the respondent suffers from sleep
apnoea, a condition
which causes serious sleep disruption and
consequent impairment of one's ability to do a proper day's work but
which is nevertheless
remediable. The thrust of the evidence on
this aspect, properly analysed, shows that the respondent has no such
ailment and that
if he indeed does suffer from sleep apnoea now he
probably suffered from it before he was injured and nothing points to
his having
been disabled by it then.
[33]
Taking into account all the evidence, I am
not persuaded that the trial Court erred in ignoring any possible
chance of present and
future earning capacity.
[34]
As to his quantification of the damages
under this head the trial Judge, having predicted specific income
levels for the years 1995
to retirement in 2016, felt that a 'fairly
substantial' contingency discount (in other words a deduction from
the unadjusted loss)
had to be made for the possibility that the
respondent might have taken longer to reach private practice; that
he might never have
entered private practice; that he might not have
succeeded in private practice; and that health reasons might have
curtailed his
working life. On the other hand the Court made an
allowance the other way to take account of the possibility that the
respondent
might have reached the upper echelons of neurosurgical
practice and earned a far bigger income than that which the Court
predicted,
and the possibility that he might have continued earning
beyond 65 years of age. Setting off the respective negative and
positive
contingency allowances against one another the trial Court
concluded that it was appropriate to make a contingency deduction of
20%
from the unadjusted loss.
[35]
On the basis of the trial Court's findings,
what I have called the unadjusted loss was calculated by a consulting
actuary to be R5
930 014. The calculations are not in contention.
Applying a contingency deduction of 20%, the Court found the proved
loss to
be the sum of R4 810 709, to which sum I referred at the
beginning of this judgment. (I should point out, however, that a
20% deduction
from R5 930 014 in fact leaves R4 744 011. I shall
revert to the Court's calculation error.)
[36]
Save for that error I do not think that the
learned Judge erred in any respect in quantifying the respondent's
loss of earning capacity.
It is trite law that a trial court has
considerable latitude and discretion in the assessment of damages of
this kind especially
because of the many imponderables that
inevitably beset any attempt to be even remotely accurate. I
therefore see no basis to either
decrease or increase the
pre-contingency amount calculated by the actuary of R5 930 014.
[37]
It follows that, subject to correction of
the calculation error referred to, the appeal must fail. The same
fate must befall the
cross-appeal against the assessment of loss of
earning capacity.
[38]
Coming, lastly, to the cross-appeal on
costs, the trial Court said the following:
'The Plaintiff sought a special order for costs on the
basis that the trial was unduly extended and expenses incurred due to
the Defendant's
failure to admit facts where the Defendant was not in
a position to dispute the evidence which the Plaintiff intended
adducing and
which evidence had been made available to the Defendant
prior to the trial. Whilst the criticism levelled against the
Defendant
is fully justified and echoed my own anger and irritation
at the Defendant's manner of conducting the defence I, on considering
the
matter anew, am satisfied that it was due to excess caution and
uncertainty rather than to vexatious or malicious behaviour. I
have
accordingly, possibly erring to the detriment of the Plaintiff,
decided not to make any special order in regard to costs.'
[39]
As pointed out in
Engineering Management
Services (Pty) Ltd v South Cape Corporation (Pty) Ltd
1979 (3) SA
1341
(W) at 1344-5, with reference to the cases cited at 1344 E-H, a
party's conduct is "vexatious" when apart from the usual
meaning of that word, it puts the opposing party to unnecessary
trouble and expense which the latter 'ought not to bear'. And the
opposing party ought not to bear such trouble and expense where the
unsuccessful party has acted unreasonably in the conduct of the
case.
With respect to the learned Judge, it is not enough to absolve the
appellant on the basis that its conduct complained of
was occasioned
by excess caution and uncertainty if such caution and uncertainty
were the result of the appellant's having been unreasonably
unprepared for trial.
[40]
The respondent's case was stated in very
detailed particulars of claim, annexing a comprehensive actuarial
report, that he would
have entered private practice as a
neurosurgeon, that he had been rendered permanently unable to do so
and that he would earn no
future income in his disabled state. The
trial was set down to begin on 2 November 2000. But for Ms Noble's
report (filed in September
2000) the reports of the respondent's
other experts had been filed by mid-year. Knowing full well the
case it had to meet, the
appellant
(1) omitted to have the respondent examined or
interviewed by an industrial psychologist when the likelihood is the
adoption of such
course would have demonstrated the absence of any
real residual earning capacity;
(2) furnished particulars for trial dated 31 October
2000 in which it was denied that the respondent's right hand and arm
had lost
co-ordination and dexterity thereby disabling him form
performing any surgery;
(3) furnished later particulars dated 4 November in
which it refused to admit that disability;
(4) omitted to make proper and timeous discovery of
documents it sought to introduce, without notice, during the course
of the trial;
(5) omitted to consult timeously with Professor Farrell
so as to prepare properly to call him as an expert and have relevant
cross-examination
directed to the respondent and his witnesses;
(6) omitted to have the respondent timeously examined by
medical and/or surgical experts when such course would have revealed,
and
reasonably led to the pre-trial admission of his inability to
earn any living in the medical profession;
(7) pursued the issue of sleep apnoea when proper and
timeous investigation would have shown that this aspect advanced the
appellant's
case no further;
(8) took up trial time with the evidence of Ms Venter
and Ms Vorster when the essence of their evidence was covered by
the evidence
of Professor Farrell.
[41]
That list is not exhaustive. It conveys
enough, nonetheless, to show that the appellant was unreasonably, and
without any tendered
excuse, profoundly ill-prepared for trial. As
a result obstructive tactics were used and unnecessary lines of
enquiry pursued.
The upshot is that 15 witnesses were called in all
when, reasonably assessed, the respondent only needed the evidence of
himself,
his wife, Dr Frankish and Dr Edeling, and the appellant
possibly needed only Professor Farrell.
[42]
I agree with the submission for the
respondent that, on a broad conspectus, the trial was lengthened
through the appellant's fault
in the above mentioned respects from
about seven days to fourteen. A special costs order is therefore
not only appropriate but
necessary. The appellant exists to
administer, in the interests of road accident victims, the funds it
collects from the public.
It has the duty to effect that
administration with integrity and efficiency. This entails the
thorough investigation of claims
and, where litigation is responsibly
contestable, the adoption of reasonable and timeous steps in
advancing its defence. These
are not exacting requirements. They
must be observed.
[43]
Leave to cross-appeal on costs must
therefore be granted and from what I have said it follows that the
cross-appeal must succeed
in that regard.
[44]
The respondent's counsel has asked for an
award of costs on the scale as between attorney and own client.
Recent judgements have
indicated this Court's disinclination to grant
such awards until salient argument and sufficient forensic debate
have helped to establish
the appropriate judicial basis on which to
make them:
AA Alloy Foundry (Pty) Ltd v Titaco Projects (Pty) Ltd
2000 (1) SA 639
(SCA) at 648 E-I and
Thoroughbred Breeders
Association v Price Waterhouse
2001 (4) SA 551
(SCA) at 596 D-I.
[45]
The cross-appeal in so far as quantum is
concerned did not occasion prolongation of the appeal hearing to any
material extent and
I do not think that any costs order against the
respondent is warranted by reason of the failure of that part of the
cross-appeal.
[46]
Correction of the calculation error
mentioned earlier necessitates reducing the sum awarded in the trial
Court's order by R66 698,00.
It was not contended that this change
ought to carry costs. Nor can it. The reduction is less than 2%.
[47]
The following order is made:
1. Save that the sum reflected in para 1 of the order of
the trial Court is altered to R3 641 571,00, the appeal is dismissed
with
costs.
2. Leave is granted to the respondent to cross-appeal
against the costs order in para 3 of the order of the trial Court and
the respondent
is ordered to pay the costs of the application for
such leave.
3. The cross appeal succeeds, with costs. Paragraph 3
of the order of the trial Court is supplemented by the addition of
the following
sub-paragraph:
'3. In respect of seven (7) days of the trial hearing,
costs on the scale as between attorney and client.'
_____________________
CT HOWIE
JUDGE OF APPEAL
CONCUR
:
SCHUTZ JA
LEWIS AJA