(1) The "chameleon" submission
74 Mr Colefax submits that in the assessment of the plaintiff's general damages for her physical injuries, the notional trial judge would have had considerable reservations about the plaintiff which would have been likely to have limited the damages awarded. These reservations would not have, in general terms, cast doubt on the physical symptoms experienced and described by the plaintiff, but rather would have cast a reasonably substantial doubt as to whether all the symptoms were attributable to the back injury arising from the collapse of the chair.
75 These doubts would have been engendered by an adverse view of the plaintiff centred upon, so it is alleged, her emphasising from time to time certain matters concerning her disability and minimising others depending upon the particular claim being pursued. Counsel for the defendant would accept, I believe, that it is not unfair to say that some of the instances of the material relied upon to support this submission are more significant than others. Notwithstanding, reliance is placed on each of the illustrations and on the cumulative effect they may have had on a trial judge in the notional trial for damages.
76 The first illustration of the alleged tendency arises out of the plaintiff's evidence in these proceedings that her back pain has been a continual problem for her since the fall from the chair. She agreed that this was what she had sought to convey in her evidence to the Court. It was then put to her in cross-examination (T 75-76) that she had told Dr Patapanian at an examination on 7 November 1994 that "she was better for about three months after surgery". She agreed that this was quite possible. The letter of 10 November 1994 in which this statement, along with a general history and other matters, was admitted as exhibit 4.
77 The submission is made that she has informed this court that there has been a continual problem with the back since the fall from the chair but that she sought to convey to Dr Patapanian in November 1994 (not long after her first car accident) that her back condition improved for a period of about three months after surgery at Bankstown Hospital.
78 It must be remembered that the significance of the allegations made against the plaintiff in this regard resides in the fact that she had been injured in a motor car accident on 24 October 1994. The defendant's assertion is that when she saw Dr Patapanian on 7 November 1994, she was, in effect, making less of her injuries as a result of the 1987 fall knowing that she would shortly be prosecuting a claim for damages for injuries sustained in the 1994 motor vehicle accident. I do no think this assertion can be made out when a careful analysis of Dr Patapanian's report is made. It may be accepted that the plaintiff maintains in these proceedings that her back pain has been a continual problem for her since the fall from the chair and she agreed that this was the factual situation she wished to convey in her evidence in these proceedings. At p 76 of the transcript she said that her back was probably better after Dr Sheehy performed the laminectomy "but it has never been right". She disagreed that it was considerably improved following the operation but agreed that it was quite possible she told Dr Patapanian that she was better for about three months after the surgery.
79 It will be immediately apparent that the statement to a doctor enquiring for the history of symptoms following an injury may legitimately note a short term improvement followed by a relapse. The actual expression in Dr Patapanian's report of the version given to him by the plaintiff is in these terms (Exhibit 4): -
"She had a very severe reaction to lumber myelography at Bankstown Hospital and she remembers this quite vividly. She was better for about three months after surgery, but has since had severe low back pain."
80 Later in his report Dr Patapanian noted that her history was that she was suffering from increased pain, functional impairment at home and "is now complaining of increasing pain in the thoracic and cervical spines". To my mind, a reading of the whole of exhibit 4 paints a picture of a woman who gives a history that she has, despite the occasional short term period of relief, continually suffered pain from back injury since the 1987 fall. The history is not inconsistent with her evidence in these proceedings.
81 More significantly, the plaintiff does not mention (at least so far as Dr Patapanian's version of her history is concerned) the 1994 car accident at all. In my opinion, the Patapanian illustration does not support the defendant's contention. It is also to be noted that in the subsequent proceedings commenced by the plaintiff to recover damages arising out of the whiplash injury caused in the car accident, no reliance was placed on Dr Patapanian's report. Exhibit "Q" is a list of the plaintiff's medical reports to be relied on for the purpose of those proceedings. The list does not include any reports from Dr Patapanian.
82 As a second illustration, the defendant also referred me to the report of Dr Sheehy on 5 February 1990 (Exhibit 9), the report of 7 September 1990 (Exhibit 7) and portion of some notes kept by Dr Sheehy relating to attendances with the plaintiff in April and November 1991 (Exhibit 8). There is no need for me to set out these in detail. It is sufficient to say that the defendant claims that these various notes and reports paint a picture of a plaintiff who is from time to time improving and whose back pain is at times not her major problem. I think it is necessary to take a broader view of these medical reports rather than to focus on particular sentences or portions. It must be remembered that Dr Sheehy was not required to give evidence before me. More importantly, it is necessary to read these medical reports and notes as part of a broad and ongoing history and commentary. I give a couple of examples. First, in February 1990 Dr Sheehy described the plaintiff as having had "an excellent result" following her operation in September 1989. This was no doubt his honest view but whether it proved to be an overly optimistic view of the plaintiff can only be determined by examining her following history month by month and year by year. When this is done, for example, noting the many complaints she makes, for example, to her general practitioner of continued pain in either her back, neck or limbs (Exhibit 3), Dr Sheehy's enthusiasm for the success of his operation, although understandable, is not justified.
83 Secondly, even in the letter of 5 February 1990, Dr Sheehy suggests, in the last paragraph, that some physiotherapy has been suggested for the plaintiff's cervical symptoms. He says that "she is keen to start exercising and feels confident that this will help the lower back problem to ease". It is quite apparent that the back problem is still there even a short time after the operation has been performed.
84 The next matter relied upon by the defendant as supporting the "chameleon tendency" relates to the questionnaire (Exhibit E) to which I have already made extensive reference.
85 It was put to the plaintiff in cross-examination that when she answered a number of questions in this document, she was wishing to convey the impression that her back condition was significantly worse after each of the Depo Medrol injections. She agreed with this although she made the point that her back was not getting better at the time and that is why she agreed to have the injections.
86 Again, I do not think that the admission made by the plaintiff during cross-examination carries with it the necessary result contended for by the defendant. It would be unrealistic to assume that a plaintiff who has seen a television programme which offers her the prospect of compensation in a possible medical negligence action would not embrace the possibility with at least some enthusiasm. Secondly, as I have already said, the plaintiff was adamant in her evidence before me that it was her view that her back was not getting better and that is why she had the two injections in March and September 1990. Thirdly, it is very important to note, that quite apart from the plaintiff's own evidence in these proceedings, there can be little doubt that it was the view of her neurosurgeon that she required an injection in March of 1990; and required a second injection some seven months later.
87 At p 60 of the transcript she was asked specifically by counsel for the defendant whether she was intending, as she had with the earlier answers in the questionnaire, to convey the impression that there was really not much wrong with her before the administration of Depo Medrol. She firmly denied this and I accept her denial. It is amply borne out by the fact her treating surgeon required her to undergo the injections.
88 The fourth matter relied upon by the defendant in this context is the manner in which she has emphasised the neck injury she received in the 1994 motor vehicle accident for the purposes of those proceedings whereas, in this action, she points to her neck problems as being associated with the 1987 fall. This, it is said, is a further demonstration of the tendency of the plaintiff to act in a "chameleon" style to maximise compensation opportunities as they arise. The sequence of events relied upon by the defendant is as follows: -
(a) Issue of the District Court Statement of Claim on 8 September 1995. This asserted an injury to the neck, and an aggravation of prior injury to the lower back. This was accompanied by the claim for loss of wage earning capacity "arising from the separate neck injury and the aggravation of the plaintiff's prior low back injury". (Exhibit 5)
(b) A history was given by the plaintiff to an acupuncture practitioner, Mary Lu which ultimately found its way in a report (Exhibit 6) to the plaintiff's general practitioner Dr Vij. In this report (a copy of which apparently was directed to the NRMA Insurance) Ms Lu described the cervical symptoms detailed by the plaintiff as having been experienced, "only following the motor vehicle accident on 24 October 1995." (Presumably, this is a reference to the 1994 accident).
(c) On 15 May 1995 the plaintiff's solicitors in the District Court personal injury claim wrote to the Claims Manager NRMA Insurance Limited stating : -
"The motor accident has stirred up the low back pain and caused separate neck injuries, from which she did not suffer before the motor accident." (Exhibit 10)
(d) The particulars of injury filed in the District Court proceedings on 12 March 1996 referred to an injury to neck, and minor aggravation of prior injury to low back. The same distinction was made in relation to the particulars of loss of wage earning capacity as had been made in the 1995 Statement of Claim. (Exhibit 13)
89 It will be seen that this submission centres mainly upon differing histories that the plaintiff has given to medical or health practitioners from time to time; and from certain aspects of the manner in which the litigation, following her 1994 motor vehicle accident, was conducted by her solicitors.
90 As to the first, there is no doubt that the plaintiff's 1987 fall essentially occasioned an injury to her lower back. An examination of her medical treatment over the next five years shows, in general terms, a gradual worsening of the lower back condition together with sporadic pain and discomfort in other parts of her back as a consequence of the worsening condition itself, day to day vicissitudes, and painful reactions to aspects of the medical treatment. The latter aspect includes both physiotherapy, traction, cortisone injections, exercise and the more invasive type of procedures such as the myelogram, the discectomy and the Depo Medrol injections themselves. As a generalisation, it may be observed, from an analysis of all of the medical reports in Exhibit "B", that the plaintiff's early back problems were accompanied by pain and loss of movement in the lower limbs to a varying degree from time to time. The period following the myleogram and discectomy seemed to result in an improvement to the situation so far as the plaintiff's leg pain was concerned but, overall, a continuance of lower back pain and pain in other parts of the back including the neck. Since that time, there appears to have been a slow and steady worsening of the condition exacerbated no doubt by the 1994 accident.
91 As far as neck pain is concerned, there is no doubt that the plaintiff complained to Dr Patapanian (Exhibit 4) that she had a very severe reaction to the lumbar myleogram and remembered this quite vividly. She complained to him of increasing pain in the thoracic and cervical spines. She complained of neck pain to her general practitioner Dr Vij (Exhibit 3). She also complained of neck stiffness to Dr Sheehy on 5 February 1990. He noted that there was some postural disturbance when she tilted her head back and suggested some physiotherapy for these cervical symptoms. She gave a history to Dr Champion on 14 November 1990 which suggested that she was suffering from pain in the neck in August of that year.
92 The point to be made is that it is clear from the whole of the medical evidence, the evidence of the plaintiff herself and her husband and daughter that the predominant problem arising out of the 1987 accident was her back disability. She walked with a observable limp in court and had difficulty in sitting in the one position for any length of time while giving her evidence. Notwithstanding this, the material to which I have made reference does record instances of neck pain after the 1987 accident and prior to the whiplash injury she sustained in the 1994 motor vehicle collision. The plaintiff's daughter said at T 162 line 15 that she also had problems with her neck and her hip but predominantly her back seemed to be the worst.
93 It is also of significance to note the course of the conduct of the District Court action commenced on 18 September 1995. On or about 16 March 1995, nearly six months earlier, the plaintiff completed and posted a claims form to the NRMA Insurance Limited in relation to the motor car accident. It was accompanied by a medical certificate completed and signed by her general practitioner. In this claim form, at p 3, she makes it clear that she had suffered prior injuries or disabilities to the same parts of her body (lower back, neck etc) when she fell off the banana lounge in November 1987. She also refers to the injury at that time to the lower back and to her subsequent operation. It is not consistent with the allegation now made against the plaintiff arising out of the material furnished by her solicitors, that she would so readily disclose to the insurer of the vehicle at fault that she had sustained both back and neck injuries in the 1987 fall. In addition, on 16 February 1996 her solicitors wrote to Abbott Tout, the solicitors for the NRMA (Exhibit "S") providing particulars in the proceedings relating to the motor car accident claim. These particulars make it clear that her case was that she had been unable to continue in her employment with the plumbing business due to the effects of her prior back injury and that this claim (so far as it related to the neck injury resulting from the whiplash) effectively removed any remaining earning capacity that she may have had following her back injury. Moreover, the particulars which were given identified the nature of the 1987 accident and its consequent effect on the plaintiff. The particulars identified these very proceedings and indicated their current status in the Supreme Court lists. Finally, the particulars also identified the motor car accident which occurred on 18 June 1995 and noted that, although a claim had been lodged to protect the plaintiff's position, it was unlikely that the claim would be taken any further. It was said that the second motor car accident "resulted in a temporary and minor aggravation of neck injuries sustained in the motor vehicle accident on 25 October 1994 and that any aggravation resolved after a short time."
94 On 18 July 1996 the plaintiff's solicitors had written to Dr Caspary with a view of obtaining a report from him which was to be utilised in relation to the District Court proceedings. A subsequent report was obtained. The significance of the letter to Dr Caspary (Exhibit "T") is that it precisely and fairly informed the Doctor of the three incidents including the 1987 fall and attempted, in a general way, to "scale" the effect of these incidents particularly in relation to her back injury.
95 The combined effect of each of these matters is to demonstrate the plaintiff and her solicitors (presumably in accordance with her instructions) placing before the NRMA and the medical profession material to enable a fair assessment to be made of the consequences of not only the 1994 motor car accident but also the disabilities associated with the 1987 accident. When the plaintiff's conduct is seen in this light, it further deprives the attack on her credit and reliability of any real force in relation to this submission.
96 Finally, Ms Lu was not required to attend for cross-examination and did not give evidence. It is not unimportant to note that although the defendant has conceded that the plaintiff was examined by Dr Isbister on his behalf, no report has been served in relation to the examination. Moreover, the fact that there was to be an attack upon the plaintiff's credit in cross-examination was not heralded, prior to the commencement of the trial, by the service of any medical evidence challenging her claim as to injury or the opinions expressed by any of the medical experts whose reports were tendered on her behalf. In all the circumstances, I am not prepared to find that Ms Lu has necessarily reported precisely the history which would have been given to her by the plaintiff. Alternatively, I am not prepared to give any significant weight to one sentence appearing in this report as demonstrating an attempt by the plaintiff to maximise her compensation opportunities arising out of the 1994 car accident.