And further:
"He obviously is going to have some difficulties due to his pre-existing literacy problems, but I don't see any related difficulties for him to enter the workforce." (transcript p 93, lines 39-41)
72 Dr Roldan in cross examination that in part his basis for his conclusion that there was no compelling evidence that the assault resulted in brain trauma, was that there was only a three to five minutes of unconsciousness prior to the arrival of the ambulance, and that the figures for the Glascow Coma Scale might not necessarily be a result of the infliction of serious pain on an unconscious patient. Dr Roldan said that he disbelieved the plaintiff was unconscious in the same way he disbelieved the plaintiff in his claim that he had lost vision in one eye.
73 Dr Roldan's evidence was that there was no physical and psychological evidence to support the claim of brain damage, although he agreed that a MRI scan did not necessarily indicate where there had been internal brain lesions. Dr Roldan said that the plaintiff is highly suggestible and that his mother plays an important role in the manifestation of these symptoms, and that he was sceptical about the accuracy and reliability of the reporting of various symptoms.
74 In a report of the clinical psychologist, Polly Pickles at the new children's hospital, dated 5 November 1996, the following opinion was offered:
"The results of intellectual testing are difficult to interpret; however there is evidence on testing of marked cognitive slowing, difficulties in sustaining mental effort and loss of cognitive efficiency, with limitations in the amount of information he is able to hold in mind, which are consistent with the aftermath of mild brain injury. It is clear that any formulation of David's current presentation must be multifactorial, drawing on recent literature on the persisting cognitive and neuro-behavioural effects of mild brain injury, the post concussive syndrome, the known high incidence of post traumatic stress disorder following minor brain injury and other psychosocial factors specific to David and his family's situation. Such a formulation would include recognition of David's premorbid strengths/weaknesses, some cognitive slowing, inertia and loss of efficiency attributable to the injury itself, which impacted on his ability to cope with the demands of High School and were inevitably exacerbated by David's experience of failure over succeeding months, involving as it did further changes of school and a number of disruptions at home. The likely scenario is of a vicious cycle of failure, frustration, loss of confidence, anxiety, depression and withdrawal, in turn impacting on family relationships. I understand that David and his family were offered no psychosocial support at this important time in their lives; there was no information provided to his school(s) about possible difficulties and hence appropriate expectations of David, and medical investigations have to some extent proved frustrating.
In summary, while the results of intellectual assessment are difficult to interpret, it is clear that an understanding of David's current presentation cannot rely on an explanation in terms of amnesic difficulties. The examples described as instances of forgetfulness are more likely to be attributable to difficulties in registering and in coding the relevant information, consistent with the processing limitations seen on testing today. It is likely that there has been a complex interactive process of some organically based damage exacerbated as time went on by inappropriate demands on David, inadequate information to David, his family and teachers and an escalation of stress arising from this and other causes affecting David and his family, and resulting in a functional level at present well below age expectations."
75 In the report of the South West Brain Rehabilitation Service, dated 5 June 1997, in discussing non-verbal tasks it was stated:
"[However], he had no difficulty switching from one way of thinking or 'mental set' when required, and demonstrated appropriate deductive reasoning skills for his age." And further said, "David's reported argumentative and disobedient behaviour at home would also be likely to be contributed by being constantly at home rather than school, with little structure in his lifestyle as a result, and apart from his mother, having little social contact."
76 The South West Brain Injury Rehabilitation Service admitted him to correct difficulties. Dr Steven Ring, consultant neurologist, opined that the plaintiff had suffered symptoms consistent with post-concussion head injuries syndrome, causing him to be groggy, confused with poor memory and sore muscles.
77 Dr James Middleton, a rehabilitation medicine physician, in his report of the 14 December 1998 was of the view that there was no guarantee of achievement of employability in the long term. Dr Middleton was also of the opinion that the plaintiff was not likely to hold a driver's licence, mainly for psychological reasons. Dr Middleton, in his report of 28 May 2001, expressed the opinion that:
"Certainly Mr Griffin currently continued to present as a person with very limited capacity to sustain himself as an independent functioning adult in the community and as being likely to need considerable support and assistance in structuring, organising and planning his life and also as a person likely to have extreme difficulty achieving transition from education to paid employment in any open labour market situation. Whether his capacities, in regard to those broad areas of functioning, could improve was not an issue that could be determined with certainty. There may be some further indication available through review of his progress at the Brain Injury Rehabilitation Unit and with any further more recent such inputs and it may, at some stage, be appropriate to consider referral to some transitional independent living service for further rehabilitation assistance, directed particularly at areas of independent living skills that he would to develop to be able to function effectively independently in the community if his family support ceased to be available for whatever reason."
78 Dr Clayton Barnes, in his report of 2 November 1998, explained the tests that were carried out on the plaintiff's eye, including a test, which shows conclusively, in his opinion, that the plaintiff could see out of his left eye and that he suggested to the plaintiff, that he could see. A further report of 13 November 1998, which was also admitted without challenge, Dr Barnes notes that the plaintiff has bilateral myopic astigmatism and that:
"He now accepts that he can see out of the left eye, and I have explained to him why the vision in this eye is not as good as the right eye, because as I have said before, he has chronic corneal scarring on this eye which dates back to before his assault."
79 Elizabeth Fagan, paediatric neurologist was of the view the neuropsych testing that she had carried out, had established a large number of difficulties for the plaintiff, with the possibility of some functional overlay.
80 The consultant child psychiatrist, Dr Brent Waters, in his report of 24 August 1999, opined the view:
"The neurological opinions also do not appear to provide a clear diagnosis of an underlying neurological disorder although I note that Dr Geoffrey Coffey is of the opinion that the head injury itself was of only mild to moderate severity which triggered significant behavioural disturbance and psychological upset. It is not clear whether he believes that there has been any permanent brain damage." Dr Waters further notes that, "David's relationship with his mother has a rather clinging quality. It is possible that she has over-protected him and that has led to some rather immature behavioural traits which he shows now, however she expresses considerable distress at these behavioural changes in him, so even though she may be promoting it to some degree, it is in my view that she in not reinforcing it to such a significant degree that her over-protectiveness is the major causative factor."
81 In relation to the medication (Epilim) that the plaintiff has prescribed for him is on, Dr Waters is of the view that:
"When off Epilim, he seems to become more irritable and aggressive, but it is difficult to tell how much of this is just a withdrawal phenomenon as he has not been off Epilim for very long and how much of it would represent a stable behavioural trait. In any event, it is my view that this as well is probably a manifestation of an atypical behaviour disorder resulting from dysfunction in the frontal and front-temporal area."
82 The plaintiff's behavioural difficulties, in Dr Waters' opinion is:
"…that it is more probable than not that one major determinant of David's behavioural and personality change is underlying subtle brain problems of an undisclosed nature. A second determinant is behavioural changes associated with Epilim. A third and minor determinant is a degree of over-protectiveness by the mother, perhaps associated with David's reaction to his parent's separation."
83 In relation to plaintiff's social relationships and activities of daily living, Dr Waters expressed the view that the plaintiff is grossly impaired. He goes on to note, that:
"He is dependent on his mother to a very significant extent and it is likely that unless there is a dramatic change, he will not be able to become fully independent. There is also no indication that he is going o be able to pursue any vocation which will render him employable. Finally, his immature social behaviour makes it unlikely that he will be able to form mature adult relationships and have an independent interpersonal intimate life."
84 The plaintiff also tendered a report of Dr Greta Goldberg, clinical psychologist, of 11 February 1999, in which it was opined:
"The assault injuries have aggravated pre-existing learning difficulties that he had begun to overcome with remedial help during his primary school education. The traumatic experience may have exacerbated psychological and social stresses in David's previous adjustment and in the stability of his family life. The injuries may also have aggravated his pre-existing medical problems with the right ear."
85 She further expressed her opinion in relation to his employability, in her report of 11 May 2001, that:
He will need continuing services of vocational counsellors and rehabilitation providers in order to help him choose, find and keep a permanent job suitable to his limitations and needs. He is now 19, not working and slowly obtaining literacy skills at TAFE. By the age of 23 he should expect to be suitably employed. He will therefore be likely to need ongoing vocational and rehabilitation counselling on a monthly basis for about 2 years. The cost of this, using the fee guide for fully trained psychologist provider, would be approximately 24 months @ $165 per month i.e. $3960.
86 Goldberg in relation to the plaintiff working with animals, is of the opinion that:
"His vocational preferences are for outdoor jobs involving animals and he may be able to be an assistant in a business of this kind. He does not want to work on a farm or with horses due to previous problems with those situations and this is a further restriction. If he were to work in a pet sop or any kind of retailing he would have difficulty with his numeracy. I tis unlikely that he will find work as a labourer due to the physical limitations of his knee and his fatigue."
87 As to the loss of eyesight in the left eye, Dr McMurdo, psychiatrist, whose report dated 26 July 2000, tendered by the defendant, examined the various reports and commented that the plaintiff was tidily and appropriately dressed, that he was clean and well groomed and that through the consultation was pleasant and co-operative, appearing to be in good spirits, smiling and laughing appropriately.
88 There was no evidence of a disordered pattern of thinking, or delusion ideation or any evidence of psychotic manifestations. He had no difficulty answering questions put to him and he understood normal vocabulary and style and had no problem communicating or hearing. He noted that the plaintiff's demeanour changed remarkably when he went into the waiting room to be with his mother and sister, although it was a relatively short observation, he seemed to slump in his appearance and to be sad in his facial expression whereas immediately before he had been standing erect and speaking and smiling appropriately with Dr McMurdo.
89 Dr McMurdo, commented on the Dr Geoffrey Coffey that it is unlikely that any brain damage in the assault would have caused loss of vision in the left eye, and noting that an ophthalmologist was unable to find any evidence of organic damage to the left eye, that the lack of vision does not appear to be organically determined but is almost certainly a psychological problem and falls under the diagnosis of hysteria or conversion disorder.