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High Court of Ireland Decisions |
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You are here: BAILII >> Databases >> High Court of Ireland Decisions >> Whelan v. Mowlds [2000] IEHC 73 (12th October, 2000) URL: http://www.bailii.org/ie/cases/IEHC/2000/73.html Cite as: [2000] IEHC 73 |
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1. It
is not disputed that the Plaintiff in this case, on the 3rd of October 1996 was
accidentally kicked in the area of her coccyx while participating in a swimming
lesson at Glenalbyn Swimming Pool. She stated in evidence that she felt an
immediate severe pain in this zone of her body which made her gasp. A fellow
pupil assisted her in climbing the ladder out of the pool. Ice was applied by
a member of the Defendants staff, I assume to reduce any swelling, and this
induced a sensation of numbness in the affected area. She told me that she
felt very embarrassed.
2. On
the same day she consulted her General Medical Practitioner, Dr. Patrick Feeney
who recorded that on presentation the Plaintiff complained of pain in the
coccygeal and sacro-iliac zones. The Plaintiff states that she only ever had
pain in the right sacro-iliac zone. Dr. Feeney ascertained that she was tender
on palpation in the coccyx zone. X-rays subsequently taken showed no evidence
of bony injury to her pelvis, sacrum or coccyx. Dr. Feeney was of the opinion
that a referral to an orthopaedic surgeon was unnecessary. He recommended to
the Plaintiff that she adhere to good posture and he prescribed
anti-inflammatory medication. While not envisaging any long term sequelae, Dr.
Feeney noted that coccygeal pain can often be slow to resolve and that it was
impossible to give an exact prognosis in this regard.
3. Mrs.
Whelan considered that her condition was disimporving. She said that she was
unable to get through her household chores as well as she could prior to the
3rd of October 1996. She said that she was never without some pain at the base
of her spine and in the right hip area. She had, she said, a lot of discomfort
at night and had difficulty in sleeping. She took, “Solphadine”, a
non prescription analgesic with no anti-inflammatory activity, to relieve the
pain when, “the pain was particularly bad”.
4. Some
time before the 5th of November 1996 she decided to consult a firm of
Solicitors. This is her legal right and in my opinion she cannot justly be
censured in any way for so doing. This firm of Solicitors sent her to Mr.
Fergal McGoldrick, a Consultant Orthopaedic Surgeon.
5. On
examination of the Plaintiff on the 17th of December 1996, - about 11 weeks
after the incident in the swimming pool, - Mr. McGoldrick found that the
Plaintiff was tender to palpation over her right sacro-iliac joint and adjacent
secrum, and that spinal extension was sore particularly with reference to her
right sacro-iliac region. Mr. McGoldrick concluded that the Plaintiff had low
to medium grade discomfort probably due to soft tissue injury to her gluteal
muscle and sacro-iliac areas. He recommended physiotherapy and aqua aerobic
exercises.
6. He
saw the Plaintiff again on the 5th of August 1997. In the meanwhile she had a
number of physiotherapy sessions, - her recollection in evidence was five or
six, - and had undertaken aqua aerobics. She told me in evidence that while
she considered that the pool exercise aggravated her condition the
physiotherapy was of benefit and her condition had improved. However, she said
that she was not the same as she was prior to the accident.
7. Her
complaint to Mr. McGoldrick on the 5th of August 1997, - or ten months after
the incident in the swimming pool, - was of discomfort radiating into her
buttock and down her lateral thigh. Mr. McGoldrick obviously considered this
complaint to be genuine and formed the distinct impression that it was due to
iliotibial band irritation which physiotherapy would certainly help. While the
evidence is not altogether clear I gather that she had a further 14 sessions of
physiotherapy.
8. A
Bone Scan was carried out in March 1997 which disclosed no evidence of fracture
or disease. An MRI Scan was carried out on the 18th of May 1999 which showed
early degeneration of the L .2/3 dist and facet degeneration of the L. 4/5.,
and L.5/S.1., processes, which in the opinion of Mr. Robert McQuillan, FRCSed.,
“have no relationship to her symptoms”. She was seen by Mr. Robert
McQuillan on behalf of the Defendants on the 6th of October 1998. She
complained to him of low grade discomfort in all her right leg from the
lateral and posterior aspects of the hip to the medial aspect of the right
thigh. She said that symptoms were aggravated by sitting for more than half an
hour and by prolonged walking. She stated that she was unable to walk fast
since the incident in the swimming pool.
9. On
examination Mr. McQuillan found tenderness over the right sacro-iliac joint.
In view of the normal results from the radiography and the bone scan he felt
somewhat surprised that the Plaintiff should have such symptoms on such a
protracted basis but he did accept that sometimes sacro-iliac symptoms could
continue for quite a protracted period. In his opinion the Plaintiffs symptoms
at two years post the incident were quite minor and should not specifically
interfere with her activities. In his opinion, “there certainly would be
no long term complications”.
10. The
Plaintiff revisited Mr. McGoldrick on the 19th of April 1999 with essentially
the same complaints. On examination he found tenderness on palpation over the
right sacro-iliac joint and adjacent lumbo-sacral facet. He also found that
she was tender over the right gluteal muscle stretching in on to her greater
trochanter. He recommended the MRI Scan to which I have already adverted which
excluded any neurogenic component to her pain. He considered that her symptoms
were consistent with soft tissue injury.
11. She
was next seem by Mr. McQuillan and this was on the 16th of October 1999 or at
three years and two weeks post the incident. On examination he found tenderness
overlying the sacrum right sacro-iliac joint and right ischium and discomfort
in the adductor muscle on rotation and abduction of her right hip. Mr.
McQuillans’ diagnosis is of chronic pain syndrome with no physical
explanation the duration of which was therefore difficult to determine.
12. Finally,
the Plaintiff was seen by Mr. McGoldrick on the 10th of May 2000. The
Plaintiff stated in evidence that she was referred by Mr. McGoldrick to Dr.
O’Keeffe a specialist in pain management. I consider it essential to set
out the full text of Mr. McGoldrick’s report of this consultation which
text is dated the 12th of May 2000 and is as follows:-
13. Mrs.
Whelan told me she attended Mr. O’Keeffe and was about to undergo
diagnostic facet block injection but became distressed at the thought and was
reluctant to proceed. She has not followed through for any further treatment.
She continues to complain of right buttock discomfort radiating into her right
leg.
14. In
reply to Mr. Nugent in cross-examination the Plaintiff claimed that Mr.
O’Keeffe had told her that the purpose of the injection was to relieve
her pain, - that it was an injection for pain. She had earlier told Mr.
Fitzgerald that she did not want these injections. I greatly doubt if Mr.
O’Keeffe and in all probability Mr. McGoldrick, especially in these
litigious times, left the Plaintiff in any doubt as to the purpose of the
diagnostic facet block injection. If she believed that the purpose of the
injections,- and she did use the plural in her examination in chief, - was to
relieve pain, then I find her explanation, or rather her lack of explanation,
as to why she would not accept such rapid, minimally intrusive and non perilous
treatment very unconvincing. This attitude may be contrasted with her answer
to Mr. Nugent when he put to her that, “she had compensation on her mind
from the very start”, and she responded, “why should I be
uncomfortable for the rest of my life”.
15. The
Plaintiff asserted that there had been no change in her symptoms over the past
year. She said that on average she takes one or two “Solphadine”
tablets each week. She claims that she cannot sit on a firm surface, or drive
or stand for long, - which she did not define, - periods. She claims that when
she walks she does not lift her right leg properly and stubs her toes on the
ground. She says that carrying things up the stairs is difficult and she
avoids it. She says that she cannot walk as quickly as she did prior to the
3rd of October 1996. These are essentially the same complaints she made to Mr.
McQuillan on the 6th of October 1998. She told me that prior to the incident
in the swimming pool she and her husband were keen set dancers and that now she
has to dance more slowly, tires easily and has to sit down. I asked her to
describe the pain which she claims she suffers. She said that it was like a
drag at its easiest and like someone pulling the leg out of her at its worst.
Mrs. Whelan is 55 years of age with three children aged 31, 27 and 25 and two
grandchildren aged 2½ years and 8 months.
16. On
the basis of the foregoing in my judgment the Plaintiff suffered a moderate to
mild soft tissue injury as a result of the most unfortunate incident in the
swimming pool. This resulted in low to medium grade pain and discomfort in the
right sacro-iliac and coccygeal zones of her body. In my judgment this pain
and discomfort diminished with time until this pain and discomfort had become
quite minor and was not significantly interfering with her day to day
activities. I accept on the balance of probability that there were
intermittent episodes of increased pain and discomfort from time to time.
17. I
have no doubt that if the Plaintiff was suffering any significant pain or
discomfort she would not have rejected what she in her evidence said she
believed to be a course of pain relieving injections. One is tempted to make a
comparison with a case of an aching tooth. I do not believe that the Plaintiff
was deliberately exaggerating her symptoms. However in the absence of any
physical evidence or explanation for the continuance of these symptoms, and
having regard to the total absence of any medical treatment since October 1996
and any physiotherapy or other paramedical treatment since autumn 1998, I must
conclude that there is now and has been since at the latest October 1998 a very
large subjective element involved in the Plaintiff’s complaints. I
believe that the conclusion of these proceedings will unfocus the
Plaintiff’s attention from this most unfortunate incident in her life
with considerable benefit to her well being both physically and mentally.
18. I
do not accept that the Plaintiff now has or will have in the future any
significant pain or discomfort associated with the incident in the swimming
pool at Glenalbyn on the 3rd of October 1996. Accordingly, I assess general
damages in the sum of £10,000. I was informed that special damage has
been agreed in the sum of £1,394. The Plaintiff is entitled to a decree
in the sum of £11,394 with costs appropriate to such a decree and in the
exercise of my discretion I do not made an Order under Section 14 subsection 5
of the Courts Act 1991.