Mitigation of Loss
4 The first ground of appeal was that the trial judge had erred in finding that Mrs Gumbert had mitigated her loss within the meaning of s 39 of the Motor Accidents Act 1998. The question is whether Mrs Gumbert took reasonable steps to mitigate her damages. The onus of establishing that lay on her: s 39(2).
5 At the trial, in the trial judge's understanding, the failure to mitigate argument centred on failure to seek specialist treatment of physiotherapy for back pain. That was certainly the main focus of the cross-examination on mitigation. The trial judge accepted Mrs Gumbert's evidence that she had had two courses of physiotherapy for a previous episode of back pain which she found unhelpful, and for that reason did not act on the suggestion that she have physiotherapy. He also accepted her evidence that she did not act on the suggestion of back surgery because she perceived this to have potential risks.
6 Mr Gumbert's argument on appeal centred on three matters. The first was that Mrs Gumbert was advised to have an X-ray of her sternum on 27 March 1995 by her treating doctor, Dr Goodall, but did not. Secondly, on the same day she was referred to physiotherapy for her shoulder injury by Dr Goodall, but did not seek physiotherapy either for her shoulder injury or her back pain. Thirdly, Mrs Gumbert failed to seek a referral to an orthopaedic surgeon for any of her injuries.
7 Whether these refusals or failures were reasonable depends on the medical advice given to Mrs Gumbert and all the circumstances known to her and affecting her.
8 On the question as to an X-ray of the sternum, the trial judge said nothing. However, immediately after the accident her sternum had been X-rayed. The X-ray revealed a depressed fracture of the mid-sternum. This healed with some difficulty and was pain free by November 1995. Mr Gumbert did not demonstrate what utility the diagnostic procedure of a further X-ray would have had, and how it would have reduced Mrs Gumbert's damages. Indeed, it was part of Mr Gumbert's argument for another purpose that by 27 March 1995 Mrs Gumbert had no ongoing problem with her sternum.
9 As to the failure to have physiotherapy, Dr Goodall's suggestion related to her shoulder injury. There is no ground for interfering with the trial judge's acceptance of Mrs Gumbert's evidence that she had had two previous courses of physiotherapy for her earlier back trouble which she found unsuccessful, and accordingly that she was sceptical about its utility. If she was sceptical about its utility in relation to her back, it was not unreasonable for her to be sceptical about its utility in relation to her shoulder. While some of the doctors did suggest that physiotherapy might be beneficial (e.g. Dr Glen and Dr Buckley), as did an occupational therapist, Ms Allan, the fact that the non-adoption of physiotherapy was not unreasonable is supported by the fact that her previous back pain had been resolved by bed rest and lifestyle changes. She adopted the same methods for her back pain after the car accident, and kept the pain under some control by that means. That type of treatment was regarded by Dr Berry as desirable. He did not recommend physiotherapy and neither did Dr Potter or Dr Price.
10 This part of the argument was put by Mr Gumbert on the basis that there was a "referral" for physiotherapy. There is no evidence to indicate that Dr Goodall's advice rose above a suggestion that she have physiotherapy. That was the way in which the matter was put, fairly, in cross-examination. There is no reason to interfere with the trial judge's view that this fell below the level of specific advice to have physiotherapy.
11 In all the circumstances there is no ground for interfering with the trial judge's conclusion that there was nothing unreasonable in her failure to have physiotherapy
12 On the question of orthopaedic surgery, there is no ground for disturbing the trial judge's finding that she had a very strong resistance to back surgery because of its potential risks. She was not advised to have it. Dr Carr opined in 1997 that she did not require surgical intervention. The trial judge's conclusion that she did not fail to mitigate her loss in this respect has not been shown to be wrong.