12.10.2010 The Sydney Pain Management Centre found that "on standing and walking it was noted that Mr McGiffen had his weight mostly on the right leg. Lumbar spine examination indicated spasm of the lumbar muscles aggravated by forward movements with pain maximum in the left knee."
DrWong recorded in her clinical progress notes: "pain upper right back 2-3 / 52. Increasing pain. Swollen."
14.10.2010 In a report of even date, DrWong noted: "Clinton has obvious muscle wasting of his left lower leg with deformity. He has altered sensation of his lower leg along with weakness. He requires use of walking stick and walks with a limp."
Under a heading, "Current injuries and disabilities", Dr Wong reported, "Clinton has persistent left leg pain and weakness since accident. He tried to avoid full weight bearing of his left side to reduce pain. This has resulted in constant back pain with frequent attacks of lower back muscle spasms."
The Plaintiffs medications were listed at that time as being "Oxycontin SR Tablet (Oxycodone Hydrochloride USP) 60mg divided doses per day", "Endone (Oxycodone Hydrochloride) 5mg as breakthrough medication if required", and "laxative medication for constipation (narcotic medication related) if required".
08.11.2010
to Medical reports of Gastroenterologist, Dr Choong, noted a history of increasing abdominal pain over previous two years. Dr Choong recommended a gastroscopy and colonoscopy.
30.11.2010
Dr Endrey-Walder reported that the Plaintiff had sustained, "at times quite debilitating, back pain as a consequence of his abnormal ambulation over the years."
He assessed the Plaintiff's injuries using the AMA Guide (Fourth Edition) as follows:
• 5% WPI for the back (DRE Thoracic Lumbar
28.03.2011 Category II);
• 3% WPI for loss of dors-flexion in the left ankle;
9 1 % WPI for restricted ability to invert the sub-talar joint at the left ankle;
9 1 % WPI for scarring.
Medical Assessor, Dr Edward Schutz, determined the following injuries were caused by the motor accident:
® Thoracolumbar spine
o "The lower thoracic symptoms may be a more recent symptom - but on the available information it seems more likely to be related to the 2008 accident." (Schutz p. 5)
23.11.2011 o "There is local pain at about the T7 or T8 spinal levels. The accident and injury were such that an occult (meaning not obvious) injury to the mid to lower thoracic spine was possible and indeed based on the clinical findings, seems probable." (Schutz p. 10)
• Digestive system
o "Evidently the CT abdomen performed around March 2010 showed features "suggestive of diverticular disease" but films were not available. Diverticular disease may be a constitutional condition but it more likely relates to constipation and in turn to analgesic medication he had been having." (Schutz p. 5)
Assessor Schutz declined to evaluate Whole Person Impairment for the above injuries as he did not think they had stabilised.