Post-accident
1. On 20 October 2018, following the accident, the plaintiff was taken by ambulance to Concord Hospital with a history of having injured her head and her right hip in a fall. She underwent x-rays of her chest and her right femur, which revealed a mildly displaced sub-trochanteric fracture with 9mm of lateral displacement of the femoral shaft. Her fracture was treated surgically by the insertion of intramedullary hardware. She was discharged to St Joseph's Hospital, on 24 October 2018: Exhibit "A", pp 75 - 85;
2. On 24 October 2018, the plaintiff was admitted to St Joseph's Hospital for rehabilitation therapy, whilst there, she was diagnosed with vasovagal syncope, deranged liver function test results, and musculoskeletal de-conditioning. She was discharged from that hospital 26 days later on 21 November 2018: Exhibit "A", pp 86 - 88;
3. On 25 October 2018, the plaintiff underwent a physiotherapy assessment whilst in St Joseph's Hospital, at which time it was determined that she would need continuing physiotherapy treatment post-discharge: Exhibit "A", pp 315 - 317;
4. On 8 November 2018, the plaintiff underwent an occupational therapy assessment at St Joseph's Hospital which resulted in her being provided with a range of assistive devices for various tasks: Exhibit "A", pp 97 - 106;
5. On 19 November 2018, the plaintiff underwent an occupational therapy home risk assessment before she was discharged from St Joseph's Hospital: Exhibit "A", pp 107 - 111;
6. On 21 November 2018, the plaintiff was discharged from St Joseph's Hospital: Exhibit "A", pp 86 - 87;
7. On 27 November 2018, the plaintiff underwent an x-ray of her right hip joint which revealed correct placement of hardware without complication: Exhibit "A", p 88;
8. On 30 November 2018, the plaintiff was assessed 6 weeks post-operatively by an orthopaedic registrar. She was found to have been progressing well, using a walker and a walking stick for mobility: Exhibit "A", p 89;
9. On 2 December 2018, the plaintiff was reviewed by Dr De Neptune, an orthopaedic registrar for Dr Paul Della Torre at Concord Hospital. She was walking well with the aid of a walker and was progressing to a walking stick under the supervision of a physiotherapist. Ongoing physiotherapy, hydrotherapy and bicycle exercises were prescribed. On x-ray examination the fracture was noted to be healing well : Exhibit "A", pp 89 - 92;
10. On 10 January 2019, the plaintiff underwent an x-ray of her right femur which revealed that the intramedullary nail was in situ as expected. It was noted that healing was progressing: Exhibit "A", p 91;
11. On 10 January 2019, the plaintiff was reviewed again by an orthopaedic registrar who noted she was progressing amazingly well, and was still using mobility aids: Exhibit "A", p 90;
12. On 26 June 2019, the plaintiff commenced a physiotherapy programme or referral from St Joseph's Hospital. The initial objective of that treatment was to assist her with bed mobility, sitting balance, independent standing, and some outdoor mobility. It was noted the plaintiff was fearful of falling, and had decreased balance with gait abnormality: Exhibit "A", pp 93 - 94;
13. On 15 July 2019, the plaintiff completed her physiotherapy programme. As a result, she was able to drive again, she was able to walk on all surfaces, unaided, and was able to walk up and down 3 steps, unaided. The assessment was that her balance and her mobility had improved significantly: Exhibit "A", pp 95 - 96;
14. On 2 December 2019, at the request of her solicitor, the plaintiff was examined by Dr Drew Dixon, a consultant orthopaedic surgeon whose report of that examination was dated 9 December 2019: Exhibit "A", pp 36 - 47. An x-ray taken on that date showed a healed fracture: Exhibit "A", p 92. He noted that despite treatment, the plaintiff had a residual limp on the right with pain in the lateral right hip region. He also noted the plaintiff's complaints of difficulty standing on her toes and difficulty with prolonged walking for more than 15 minutes, with reduced sitting and standing tolerance, and residual weakness in the right leg, with an associated fear of falling. He noted unsightly hypertrophic pigmented surgical scarring to the right leg and painful movements and stiffness in the right hip;
15. On 13 February 2020, at the request of the solicitor for the first defendant, the plaintiff was examined by Dr Robin Chase, an occupational physician. This resulted in a report dated 21 February 2002. Dr Chase noted the plaintiff had right thigh wasting, with a restricted range of motion in the right hip compared to the left. Dr Chase made a diagnosis of mild right trochanteric bursitis, and noted there was a long-term increased risk of osteoarthritis in the right hip: Exhibit "A", pp 327 - 334;
16. On 18 March 2021, at the request of the solicitor for the first defendant, the plaintiff was examined by Dr Roger Rowe, an orthopaedic surgeon. Dr Rowe noted the plaintiff's "current status" or symptoms as being unable to cross her legs when seated, difficulty washing her right foot and cutting her toenails, difficulty putting on and removing the sock on her right foot, difficulty squatting, difficulty reaching into a low cupboard, difficulty remaining squatting such as when weeding the garden, poor balance with the right leg, aching in the right thigh in cold weather or in winter, and anxiety around trolleys being used in a supermarket. He also noted the plaintiff was fearful of falling when walking in the street. He noted the plaintiff's residual restrictions were consistent with her history of injury, and considered the prognosis would remain as she is at present. He considered the plaintiff would not need future treatment nor would she need domestic assistance. He disagreed with Dr Dixon's opinion that the plaintiff might need removal of her indwelling hardware as it remained securely in place. He disagreed with Dr Dixon's suggestions for rehabilitation as she was functioning satisfactorily, he disagreed with Dr Dixon's prognosis for probable development of arthritic change in the right hip, and he described the prospect of a need for a right hip replacement as highly unlikely: Exhibit "A", pp 335 - 345;
17. On 17 March 2021, at the request of the solicitor for first defendant, the plaintiff was assessed at her home by Ms Di Owens, an occupational therapist. Her report on that assessment was dated 31 March 2021: Exhibit "A", pp 346 - 396. Her analysis will be considered in connection with the plaintiff's claim for damages for domestic assistance;
18. On 3 June 2021, the plaintiff was re-examined by Dr Dixon. He noted the plaintiff's symptoms essentially remained the same as when he last examined her but there had been some slight improvement in her standing tolerance, now 20 minutes rather than 15 minutes. He noted the plaintiff still felt residual weakness and instability of the right leg, especially after walking for half an hour. He considered the plaintiff had a guarded prognosis for returning to heavy household chores, heavy grocery shopping, yard work and gardening: Exhibit "A", pp 42 - 47;
19. On 9 June 2021, at the request of her solicitor, the plaintiff was assessed in her home by Ms Jacqueline Scott, an occupational therapist, whose report is dated 21 June 2021: Exhibit "A", pp 48 - 74. That report will be analysed in connection with the plaintiff's claim for domestic assistance;
20. On 22 July 2021, Dr Dixon and Dr Rowe met in a conclave and produced a joint report of that meeting: Exhibit "A", pp 394 - 396. These experts agreed that the plaintiff had received reasonable and necessary treatment and that she needs some assistance with household chores, a situation which is unlikely to change. They agreed she had residual restriction in the movement of her right hip joint. They also agreed that it is unlikely there will be significant improvement or deterioration in the plaintiff's condition. In addition, Dr Dixon considered the plaintiff had retro-patellar crepitus, whereas Dr Rowe found the right knee to be normal. Whilst they agreed no further rehabilitation should be needed, Dr Dixon considered she may need a cortisone injection if there was a flare-up in the plaintiff's trochanteric bursitis. The experts also agreed that it was possible the internal fixation device may need removal if loosening occurred;
21. On 26 July 2021, an occupational therapy conclave proceeded between Ms Owens and Ms Scott: Exhibit "A", pp 397 - 422. The products of that meeting will be examined in connection with the plaintiff's claim for domestic assistance.
- The results of those examinations, and the matters canvassed in the plaintiff's evidence, will form the basis for findings on the plaintiff's ongoing disabilities.