Ankles and knee
35The primary judge found that, at the beginning of 2009, the respondent's ankles had been recovering well, that he "turned" his ankle in February 2009, that a "real deterioration" in the condition of the ankles and knee occurred thereafter and that this culminated in the respondent being advised in 2009 to consider further ankle surgery (ligament transplant surgery). The primary judge concluded (at [62]-[63]):
"that the facts material to the plaintiff's case in relation to his ankle injuries was [sic] not known to the plaintiff until the consequences of deterioration which first became apparent in [sic] his ankle turned in February 2009 were the subject of further complaint to his general practitioner in December 2009.
Accordingly, the plaintiff satisfies s 48(3a)(b)(i) of the Limitations of Actions Act 1936 (SA) and it is just in all the circumstances to grant the extension of time that the plaintiff seeks."
36The respondent's case was that, as regards his ankles and knee, he ascertained two facts material to his case between March 2009 and March 2010: first, that the condition of his ankles and knee had deteriorated; and, second, that he would require further significant surgery.
37The applicants submit that the evidence before the primary judge did not permit a finding that the respondent ascertained the fact of deterioration in his ankle injuries during the relevant period. It is accepted by the parties that the respondent had been having problems with his ankles since at least the time of the incident. The issue is whether the respondent's ankles had begun to improve by early 2009 and whether they deteriorated thereafter.
38The respondent deposed:
"I had an assessment by Konekt on 20 January 2009 as to my suitability for other jobs. They assessed me after asking me to perform a lot of physical tasks and were steering me in the direction of the types of work where I would be able to move around when needed to. I have had a look at the Konekt report as to the tests and movements which I performed when they were testing me and I agree that I could have done work where I did not have to stand for more than an hour or so or did not have to walk for more than about three quarters of an hour and could move my posture and so on. I had no problems with my upper limbs. I had no problems pushing or pulling and I was of the view that there was plenty of work that I could do.
The workers compensation insurer to my understanding used the Konekt information to terminate my workers compensation payments in mid 2009 because I was able to do various forms of work. I agree that at the start of 2009 when Konekt interviewed me there were many things that I could do but as that year went by things got worse and worse."
39The Konekt report dated 20 January 2009 states that, at the time of his assessment, the respondent was neither taking any medication nor undergoing any treatment for his ankle injuries; also, that he was able to perform most activities of daily living such as vacuuming, mopping and working on cars and was capable of lifting heavy items although avoided carrying them. The report also noted that the respondent was experiencing swelling and constant pain in his achilles tendons, albeit that the intensity of the pain varied. The report concluded that:
"RTW [I.e., Return To Work] Status
Mr Ollerenshaw is currently certified fit for permanently modified duties to work pre-injury hours with the restriction of no walking on uneven surfaces. Mr Ollerenshaw's pre-injury employer Alarm it, terminated his employment in February 2007 as they were unable to provide permanent suitable duties."
40The workers compensation insurer discontinued workers compensation payments in mid 2009 on the basis that the respondent was capable of returning to work full-time, provided that his duties could accommodate his physical limitations.
41The primary judge held that this evidence "paints a very clear picture of a young man recovering from his injuries and looking forward to a normal work life" at the beginning of 2009. The respondent submits that in reaching this conclusion the primary judge ignored clinical notes of Dr Susino that provide a record of the respondent's ongoing problems with his ankles just before the beginning of 2009.
42Dr Susino made the following note on 5 December 2008:
"R+L ankle painful
Both ankles feel unstable R+L
Ankles constantly painful
R ankle in particular ?? him with physio x3/night
not taking analgesics for pain;??
???
Requesting MRI both ankles
Requesting x-ray both ankles
m/c Mood 4/10 this week"
43Further, Dr Susino's note dated 12 December 2008 is as follows:
"Since injury of ankles, Damian's mood
has lessen significantly
Low pain, disability
...ed down life / unable to exercise
Gained weight
Boredom worthless
Agitation anger frustration
Mood ??? 6/10
Issued with WCC [ie, workers compensation cover] to cover depression caused by suffering and ankle pain"
44Dr Susino's note of 12 December 2008 does not tell against the respondent's contention that the condition of the ankles improved in early 2009. The Konekt report, the respondent's affidavit evidence and the fact that workers compensation payments were discontinued warrant a conclusion that, by early 2009, the condition of the ankles had improved to such an extent that the respondent was capable of returning to full time work provided that he was not required to be on feet for extended periods of time.
45The primary judge accepted a submission made on behalf of the respondent that he suffered further injury to his right ankle as a result of "rolling" it in February 2009. The respondent said in his affidavit:
"I was careful of both my ankles and I think I was proceeding well. Then I started to notice that my right ankle was rolling over again.
I can remember this happening in February 2009 and when the ankle rolled over I heard a loud popping noise in the joint."
46The applicants submitted in this Court that there was no medical evidence that supported this. However, the respondent's version of events is supported by Dr Susino's clinical note dated 17 February 2009, which is as follows:
"Whilst walking on even ground today rolled R ankle inwards
Now c/o pain R lateral ankle 'heard pop'
O/E swelling lateral ankle
INV pain dorsiflexion INV
Then CT + MRI R/L painful"
47Also, Dr Susino's report dated 28 September 2010 states that:
"Unfortunately Damian rolled his right ankle again 09.02.2009. He heard a definite pop during this injury. He was referred for an MRI scan but I have not viewed these results as yet."
48There is an obvious inconsistency between the recorded date of the injury in Dr Susino's clinical notes and the date Dr Susino later attributes to it in his report. Nevertheless, the primary judge found that the respondent rolled his ankle in February 2009. On the basis of this evidence, I also accept that, on the balance of probabilities, the respondent rolled his right ankle some time during February 2009 and that this followed the improvement in his condition that had been observed in late 2008.
49There is then the question whether the condition of respondent's ankles and knee deteriorated throughout 2009.
50The primary judge found that the respondent's injury in February 2009 caused him to become aware, for the first time, that the condition of his ankles had begun to deteriorate. On that basis, the respondent ascertained the fact of the onset of deterioration before the start of the period of twelve months made relevant by the closing words of s 48(3a)(b)(i) of the Limitation Act, that is, the period ending on 25 March 2010. However, the respondent maintains that the deterioration neither began in earnest nor was fully ascertained by him until later in 2009 when he was informed that further significant surgery was advisable. The primary judge accepted this. She said (at [51]):
"While this change appears to have started just outside the relevant period, the real deterioration, particularly in relation to his knee, occurred in April and December 2009, on which dates he received medical advice that he required a transplant (which he rejected) and then suffered a further injury."
51The only evidence that the respondent adduced in support of the proposition that the condition of his ankles and knee deteriorated after March 2009 was in his affidavit. He deposed that, throughout 2009, his ankles were getting "worse and worse" and that by September 2009 they were "very bad indeed." Further:
"By mid 2009 I would not have been able to work for anybody in ordinary paid employment. Not even in the sorts of employment which Konekt had assessed me as being able to do and in respect of which the insurance company stopped my payments. The reason for that was the greatly worsening condition of both my ankles and as well as this I started to have quite significant knee problems. Both my knees became painful and unstable because I was walking in a very unusual fashion where I was trying to keep my legs rigid as far as I could and trying not to bend my ankles and keep them straight so they would not roll over.
From mid 2009 my knees were very painful and swollen and I saw Dr Susino about that. They have never recovered."
52This evidence was unchallenged. The primary judge accepted the evidence and found that, compared with their condition in early 2009, the ankles and knee became worse in mid-to-late 2009. It is, however, difficult to know precisely what fact or facts the primary judge thought the respondent had ascertained during the relevant period. Her conclusion (at [62]) was that the facts material to the respondent's case which were not known to the respondent until the commencement of the relevant period were the "consequences of deterioration" which only became apparent after his consultation with Dr Susino in December 2009. Dr Susino's note from December 2009 is as follows:
"- both ankle painful at night painful if cold when starts, sits with pressure on feet pain better
- pain on lateral aspects of ankles worse if walks long distances and relates to achilles
- has used ?? + voltaren no relief
- R ankle > L ankle w/ 8/10 (on bad days) [Drawings of R ankle] [Drawing of L ankle]
Lax ligaments
Scars??
Lax ligaments ??
Start tramal SR Im (100mg) 100g"
53The respondent said in his affidavit that "[f]rom mid-2009 my knees were very painful and swollen and I saw Dr Susino about that. They have never recovered".
54It may be accepted that the state of the ankles and knee deteriorated during the first half of 2009. The primary judge so found. The question is whether the respondent thereby ascertained some material fact. It may well be the case that the improvement in his condition up to early 2009 temporarily changed the respondent's perception about the extent of his injuries and that, when he later came to be disabused of this optimistic perception, he learnt nothing about his injuries that he did not already know prior to the improvement of 2009 (this is, of course, subject to any new fact he may have ascertained regarding ligament transplant surgery). It is necessary to trace the clinical history.
55After his injury at the applicants' property, the respondent visited Dr Susino on 16 June 2004 and 9 August 2005. During the first consultation, he complained of an injury to his left ankle. During the second, he complained of right and left knee pain and left ankle pain. He was referred to Dr Kuo, a foot and ankle surgeon.
56On 18 October 2005, Dr Kuo diagnosed the respondent with "[t]orn lateral ligaments left ankle with instability? Loose body?" and referred the respondent for an MRI scan. On 28 November 2005, the respondent underwent an arthroscopic debridement and lateral ligament reconstruction surgery on his left ankle. Dr Kuo reviewed the patient on several occasions following his operation and found that he was recovering well. However, on 10 March 2006, he reported that the respondent had "rolled his ankle again the other day" and on 16 June 2006 that the respondent was "starting to get instability again which is requiring ankle strapping".
57On 14 June 2006, Dr Susino noted that respondent had torn the lateral ligament in his ankle again and could not work for six months. On 15 September 2006 Dr Susino referred the respondent to Dr Sullivan, a foot and ankle surgeon, for an MRI. On 9 October, Dr Sullivan advised that the respondent "requires revision of his ankle ligament reconstruction, possibly closing wedge osteotomy." The respondent underwent a closing wedge osteotomy of the left calcaneum and revision of the left ankle ligament reconstruction on 28 November 2011.
58On 7 February 2007, the respondent attended on Dr Susino and reported that he had rolled his right ankle on the previous day. He underwent an x-ray of his left calcaneus on 13 February 2007. On 15 March 2007, Dr Sullivan wrote to the respondent's workers compensation insurer that the respondent "had a fall an injured his right ankle". The evidence from around this time is the first that records any significant problem with the respondent's right ankle.
59The respondent had a third operation in May 2007 to have a screw removed from his ankle. On 15 June 2007 Dr Sullivan wrote to the workers compensation insurer to advise that the respondent had complained of "pain and instability of his right ankle". The respondent rolled his right ankle on 6 July 2007 and was kept off work thereafter.
60On 27 August 2007 the respondent underwent surgery on his right ankle. This was the fourth surgery that the respondent had had on his ankles and the second on his right ankle. The respondent returned to work on 20 October. On 20 December 2007, Dr Sullivan advised the workers compensation insurer that the respondent "has done extremely well after his right foot surgery and there is no need ... to review him again".
61Dr Susino's clinical notes dated 1 April 2008 state that the respondent's knees had been causing him pain since his ankle surgery on 27 August 2007 and his notes from 5 December 2008 record that the respondent had complained that he was experiencing pain in both his left and right ankles (see [#42] above). As mentioned at [45] above, the respondent then rolled his ankle in February 2009.
62This history makes it quite clear that the respondent was someone who had very significant and continuing problems with his ankles and knees from the date of his fall at the applicants' property until the beginning of 2009. His medical history refers to consistent and repeated complaints by him about pain he was experiencing in both his ankles and both his knees. He was referred to a number of specialists and underwent a variety of remedial treatments including surgery on his ankles on no less than four occasions. It cannot be doubted that the problems the respondent was experiencing were serious and that he had been informed of this by several doctors, including specialists. He also knew that his ankles would require ongoing revisionary treatment every ten years or so. Although there is evidence that the condition of his ankles and knees improved at times (including in late 2008), the problems he was experiencing with them can only be viewed as continuing and chronic.
63The evidence concerning ankles and knees in the period of twelve months ended 25 March 2010 is referred to at [#51] - [54] above. In essence, the respondent was experiencing pain and instability in the ankles and knees, these problems were significant and the condition deteriorated after the beginning of 2009. The respondent also gave evidence that his knees have not recovered.
64In my assessment, the respondent did not establish that he came to know within that period anything new about the extent of his injuries (again, I leave to one side, for the moment, the implications of the advice at [#67] that he should consider ligament transplant surgery). From May 2004 until early 2009, he knew that his ankles were painful and unstable, that his knees were painful and unstable and that these problems were serious - so serious, in fact, that they resulted in time off work, warranted specialist treatment, entitled him to workers compensation and, in the case of his ankles, required surgery on several occasions and would require ongoing revisionary surgery.
65A thing that the respondent did come to know within the relevant period of twelve months, however, was that the condition of his ankles and knee was worse at the end of 2009 than it was at the beginning of that year. Whether this is a material fact for the purposes of s 48 is addressed below at [#72] - [75].