The Plaintiff's Injuries
135 When he was crushed by the collapsing girder the plaintiff sustained severe physical injury and was subjected to very considerable psychological trauma as well. He was in pain in many parts of his body. It was severe. In his evidence he said "the pain could not have been possibly worse". He hurt everywhere; legs, back, head, etcetera. He was conscious and aware of the fact that he was unable to feel or move his legs. He could not breathe because he was swallowing blood. He was absolutely terrified and thought he was dying. He then thought of his wife and family and that he was going to die there on the factory floor and never see them again.
136 The arrival of the paramedics and the administration of morphine did not help until he had been given a second dose. Even then he remembers screaming with pain as he was put on a stretcher and placed in the ambulance. He heard the paramedics express concern about the need to stabilise him and then arriving at the hospital and the doctors realigning his left foot, which despite the pain killing effect of morphine was still sufficiently painful to cause him to scream.
137 He was diagnosed as having suffered fractures to his face, fractures of the right and left orbits, lower ribs, transverse processes of both the lumbar and the thoracic spine, crush fractures of lumbar vertebrae L3 and L4, sub-capital fracture of the left femur, grossly comminuted bicondylar fracture of the right tibial plateau, comminuted bicondylar fracture of the right fibula, fracture of the right ankle, fracture of the third finger of the right hand, injury to his right wrist, fractures of the face involving both maxilla and teeth, lacerations to his nose, swelling of the abdomen and clinical ileus due to the presence of retroperitoneal blood as well as difficulties in breathing. In short his injuries were wide spread, serious and extremely painful.
138 He was taken by ambulance to Wollongong Hospital. On admission he was treated in the Emergency Ward and then taken quickly to surgery. He underwent open reductions and internal fixations of his left femur, right ankle and right tibia. Bone grafts were undertaken, the donor site for the grafts being the right iliac crest.
139 He remained in Wollongong Hospital until 20 October, 1994 when he was transferred to Port Kembla Hospital, although his condition was then such that he has no recollection until he was in Port Kembla Hospital.
140 Thereafter he underwent at least six further operative procedures between the end of October, 1994 and mid December, 1995. Whilst some of these involved removal of fixing screws and other internal support mechanisms, others involved open reduction and plating and reconstruction of the floors of the right and left orbits. The operative findings at, and procedures undertaken in the course of, surgery on 24 October, 1994 were:
"1. Comminuted fracture of the lower end of the fibula with disruption of the tibio-fibular syndesmosis. There was a transverse fracture of the medial malleolus of the ankle.
The fibular fracture was reduced and internally fixed with plate and screws. A diastasis screw was inserted across the tibio-fibular syndesmosis. The medial malleolus was not fixed because of significant fracture blisters and skin damage in the area.
2. Grossly comminuted by bicondylar fracture of the proximal tibia. The medial condyle was in many fragments and the articular surface was depressed. There was marked damage to the articular cartilage of the medial femoral and to a greater extent, the medial tibial condyle. The tibial tubercle was avulsed.
Through a midline straight anterior right knee incision the patellar tendon with attached bone was reflected superiorly. The menisco- femoral ligaments were divided laterally and medially and the menisci reflected superiorly for exposure. The medial condyle was elevated and bone graft inserted. The bone graft was harvested from the right iliac crest. Two "T" shaped plates were inserted to act as butress plates and multiple screws were inserted. The tibial tubercle was internally fixed. …"
141 During this initial phase of his treatment the plaintiff undoubtedly suffered a great deal of pain and was substantially immobile.
142 By early 1995 he was experiencing increasing back pain which mirrored his increase in mobility and activity. An MRI scan performed on 13 March 1995 revealed significant damage to his spine. There was a disc protrusion at C5/6, another at T11/12, yet another at L5/S1 and a canal stenosis at L3/4. Thus his neck, thoracic spine and lumbo sacral spine were all damaged in such a way as not only to cause pain and restriction of movement, but also such as to be likely to produce increasing symptoms and even the prospect of surgical intervention.
143 In mid-February, 1995 he returned to work on limited duties, working on only three days a week and effectively half time on such days. That he persisted with such work for some time is, in my opinion, the mark of the man. He was determined to get back to work even if doing so meant a great deal of pain, as proved to be the case. His attempted return to work proved unsatisfactory. He could not maintain even the limited duties over a shortened week of three days with only four hours per day being worked. Persistent pain, swelling and stiffness meant that he had to cease his light, part-time duties in June 1995.
144 Since that time the plaintiff has not been able to return to gainful employment and it was not contended that he was able to do either his former job (as was obviously the case), or cope with a real, as opposed to a made, job.
145 On one occasion he attempted a computer course. However, this was an unsuccessful experiment since, as he said and I accept, he is essentially a physical person, whose life has been one of working with his hands and using the strength of his body, a person who liked working outdoors and disliked office work. His educational qualifications, industrial experience and age do not engender confidence that he will ever be able to return to full time gainful employment. That he will not is supported by the medical evidence. I am satisfied that he will not.
146 In February 1999 he underwent a total left hip replacement; in August 1999 a total right knee replacement. It is virtually certain that further replacements will be necessary. The details of these will be considered under the particular headings relating to future operative treatment and care. His injuries have already produced crepitus in his shoulder. The injuries to his neck have left him with a substantial permanent impairment at that level and an even greater permanent impairment to his back at lower levels. His prognosis is poor. There is permanent loss of efficient use of the right leg as well as of the left leg. The prognosis is for gradual worsening of symptoms in the knee, back, hip and ankle. He experiences difficulty with any task that is physically demanding and his walking tolerance is limited to between 20 to 30 minutes; his sitting tolerance to between one and two hours. Pain in the neck, thoracic spine and lower back is of a reasonably high order. He also experiences intermittent pain in the right ankle and in the right wrist and hand. His sleep is fairly often disturbed by pain. In his daily life he is significantly impaired. For example he e is unable even to lift his children out of the bath. This makes him angry and no doubt contributes to feelings of depression. His injuries have led to his drinking, at time to excess, and the need to take analgesics fairly regularly. There are many barriers to his leading a normal life and to returning to paid employment. The view expressed by Dr Patrick, which I think is well founded in fact, sensible and probable, is that the plaintiff "may be regarded as being essentially incapacitated for all work." Because of the nature and extent of his injuries and the intervention of osteoarthritis he can only deteriorate.
147 Dr Dodd, an orthopaedic surgeon, not only negates his ability to return to his former occupation, but is of opinion that he "would have difficulty in performing many activities required of him around the house, such as lawn mowing, gardening and domestic maintenance. He could do light lifting of up to about 5 kilograms".
148 He is left with a limp, recurrent pain, a bad back and dramatically diminished endurance. Were he to apply for a job it is unlikely that he would be successful in obtaining it. His limp would undoubtedly raise questions in the mind of a prospective employer. Were he to reveal his accident and its sequelae, he would be likely to be seen as inappropriate for virtually any work, other than a made job or in sheltered environment. Dr Lewington, a rehabilitation physician thought that he was not even physically capable of working as a car park attendant. In my opinion the extremely limited physical capacity of the plaintiff to work is rendered even more significant by his background and the economic realities of the Australian workplace. His history, training and natural inclinations make him unsuited for clerical type activities and even if he wished to engage in such activities, his inability to sit for any real length of time would be a barrier to obtaining employment and an impediment to retaining it even in the unlikely event that he should get it. At most I assess him as being able to do light odd jobs on an intermittent basis and not predictable frequency, perhaps some light gardening, but not to do so on a regular or consistent basis. Were he able to earn on average $100 per week, I think he would be doing well. Although no submission was put on behalf of the defendant that the plaintiff had a working capacity that was measurable in economic terms, I think that it is appropriate to make a minor deduction of $100 per week for, say, the next 10 years, because of the likely effects in the future of the osteoarthritis he has.