Skip to main content

$72,000 Non-Pecuniary Assessment for Chronic and Plateued Soft Tissue Injury

Reasons for judgement were released last month by the BC Supreme Court, New Westminster Registry, assessing damages for a chronic low back soft tissue injury with a pre-existing complicating factor.
In the recent case (MacIntosh v. Davison) the Plaintiff was involved in a rear end collision in 2009.  He had injuries from previous collisions which were recovered.  He also underwent back surgery many years prior.  Although he had no symptoms related to this his back was at risk of suffering exacerbation of back injuries.  The Court assessed non-pecuniary damages at $90,000 but then reduced these by 20% to account for the plaintiff’s original position.  In reaching this conclusion Mr. Justice Davies provided the following reasons:
On balance, having considered the totality of the evidence I consider reliable, I have concluded that after consideration of the measurable risk of future back problems inherent in Mr. MacIntosh’s “original” position but considering also the increased risk of further exacerbation of his present post-accident condition because of the defendants’ negligence in the 2009 collision, a reduction of 20% of the award of damages that would otherwise appropriately compensate Mr. MacIntosh for the injuries he has endured since October 2009 is necessary to ensure that he is only compensated for the difference between his “original” and his “injured” condition…
1)    Mr. MacIntosh’s testimony and that of the medical and lay witnesses establishes that although injuries arising from the collision other than his low back injuries were largely resolved within one year, the low back injuries suffered in the collision have continued with only limited and sporadic abatement over time.
2)    I accept the opinions of Drs. Kates, Quirke and O’Connor that Mr. MacIntosh’s condition has now “plateaued” and will not likely deteriorate further, except for occasional flare-up of more intense and debilitating pain.
3)    However, the “plateau” which Mr. MacIntosh has reached renders him a far different person than the one he was prior to the collision.
4)    Mr. MacIntosh’s life in the four years since the collision has been dominated by the effects of the collision as he has followed all of the medical advice he has received to attempt to regain his health.
5)    While he has continued to golf regularly, his enjoyment of the game is much lessened. He also now golfs at significant rehabilitative cost and discomfort requiring much ongoing physical therapy.
6)    In that regard, while I note Dr. MacPherson’s opinion that the golfing exacerbates Mr. MacIntosh’s condition, I also note that his treating physicians have encouraged him to attempt to golf and undertake therapy as necessary to alleviate more acute symptomology related to it.
7)    I accept that to be a reasonable course of both advice and treatment because if Mr. MacIntosh had to restrict his golfing more than he has done, the result would be a larger award for non-pecuniary losses related to his ability to enjoy that which he previously enjoyed before the collision.
8)    The medical “plateau” at which Mr. MacIntosh now finds himself and which will likely endure for the balance of his active life also includes an inability to exercise as rigorously as he once did or hike with the enjoyment he once had. He is also far more irritable due to sleep deprivation caused by his injuries. That has an impact on his social life as he has become more reclusive than before.
9)    All of those aspects of his present life significantly negatively impact his overall enjoyment of life not only physically but also socially and emotionally. Coping with and trying to ameliorate the lasting effects of those injuries now are the focus of his daily life in place of the healthy and well-rounded physical, emotional and social life he previously enjoyed.
[91]         In all of the circumstances I find that an award of $90,000 would appropriately compensate Mr. MacIntosh for his past, present, and future pain and suffering and loss of enjoyment of life. By application of the 20% reduction I have previously found to be necessary to compensate him only for the change from his “original” position that arises from the defendants’ negligence, I award Mr. MacIntosh $72,000 to compensate him for his non-pecuniary losses.

Paraplegia Claim Not Too Complex For Jury Trial

Reasons for judgement were released recently by the BC Supreme Court, Vancouver Registry, addressing a jury strike application in a paraplegia injury claim.
In the recent case (Laktin v. Vancouver (City)) the Defendants “were responding to a call that the Plaintiff might be suicidal” when one of the Defendant police officers “shot the plaintiff, rendering him paraplegic“.
The Plaintiff sued for damages and elected trial by Jury.  The Defendants brought an application to strike the jury notice arguing the trial was too complex for a jury to hear.  Mr. Justice Pearlman disagreed finding that despite the severe nature of the injury the matter was appropriate for jury trial.  In reaching this conclusion the Court provided the following reasons:
[35]         This is not a trial that involves multiple accidents or actions, or that raises complex issues of causation of the plaintiff’s physical injuries. The jury may have to determine the extent to which the  psychological injuries claimed by the plaintiff result from a pre-existing condition rather than the incident of January 21, 2006. That will involve the jury making findings of fact that are well within the capabilities of a modern jury.
[36]         The defendants have identified numerous issues of fact and law relating to issues of liability, the statutory and common law defences to the plaintiff’s claim of battery available to the defendants, the apportionment of fault, and damages.  It is the responsibility of the trial judge to instruct the jury concerning the legal principles that will apply to the facts as found by the jury.  The court will instruct the jury on the application and interpretation of the relevant provisions of the Police Act and the Criminal Code. 
[37]         The duties of care owed by the defendants to the plaintiff are a matter of law for determination by the trial judge rather than the jury. It will be the responsibility of the trial judge to determine whether the City of Vancouver owed a duty of care to the plaintiff, and whether, as a matter of law, there is any basis for the plaintiff’s claim against the City, other than its liability under s. 20 of the Police Act for the torts of municipal police officers.
[38]         Whether, as a matter of law, the application of the doctrine of ex turpi causa would be justified in the circumstances of this case is also a matter for the trial judge.
[39]          The defence correctly submits that the provisions of ss. 34 and 37 of the Criminal Code in force at the time of the incident that gave rise to this action add a level of complexity to this trial.   However, juries in criminal cases have been frequently called upon to apply those provisions, and with the assistance of instructions from the trial judge, have done so. I see no reason why a civil jury, properly instructed, cannot perform a similar task.
[40]         In my view, finding the facts regarding what occurred in the sequence of events that culminated in Constable Coulthard shooting the plaintiff, and determining whether the force used by the police was justified in all of the circumstances are tasks well suited to a jury composed of eight members of the community.

Facebook "Partying" Quote Impacts Personal Injury Trial

In another example of social media posts being used in personal injury litigation reasons for judgment were released today by the BC Supreme Court, Vancouver Registry, where a Facebook post impacted the trial of the 52 year old plaintiff.
In today’s case (Raikou v. Spencer) the Plaintiff was involved in a 2011 T-bone collision.   The Defendant admitted fault. The Plaintiff suffered various soft tissue injuries and had complaints lingering at the time of trial.  The court found some of these were related to the collision and some of these were due to pre-existing factors.  The Court also noted that the Plaintiff “had a tendency to overstate or exaggerate her condition somewhat“.  This finding was due in part to a Facebook update where the Plaintiff discussed “partying“.  In illustrating the use of this quote Mr. Justice Skolrood provided the following reasons:
3]         Before turning to that issue, I should note that while I found Ms. Raikou generally to be a credible witness, in my view she had a tendency to overstate or exaggerate her condition somewhat. This is particularly so in her description of her pain as being constant and unremitting.
[54]         By way of example, Ms. Raikou travelled to Greece in July and August of 2011. When she returned, she posted the following entry on her Facebook page on August 20, 2011:
From the airport to Eleni’s and Nick’s wedding. Missed the ceremony but made it to the reception. From the airport home to change and off to the reception. Made it through and had an awesome time. 48 hours without sleep, jet lagged and still partying.
[55]         I agree with counsel for Ms. Raikou that caution must be applied when considering the relevance and import of Facebook entries in that they are but a mere “snapshot in time” and do not necessarily shed light on a person’s overall condition or ongoing complaints: see Guthrie v. Narayn, 2012 BCSC 734 at para. 30.
[56]         Nonetheless, this particular snapshot is inconsistent with Ms. Raikou’s testimony that her pain condition is continuous and unrelenting and that it has effectively precluded her from enjoying any of her pre-accident activities.

Failure to Examine Patient Impacts Weight of Expert Report

It is well established that failure of an ‘independent medical examiner’ to physically examine a patient is not, in and of itself, a reason for an expert report to be inadmissible in the BC Supreme Court. However, when a litigant relies on such a report the weight the court attaches to it is often negatively impacted.  Reasons for judgement were released this week by the BC Supreme Court, Vancouver Registry, demonstrating this.
In this week’s case (Johal v. Meyede) the Plaintiff was injured in a 2010 rear end collision.  Fault was admitted by the Defendant.  The Plaintiff suffered injuries which were ongoing at the time of trial and expected to effect her well into the future.  In the course of defending the claim ICBC retained a neurologist who did not examine the Plaintiff and provided a more conservative opinion with respect to the plaintiff’s limitations and care needs.  In placing less weight on this opinion, in part for failing to examine the plaintiff, Mr. Justice Funt provided the following reasons:
[47] The defendants also called Dr. F. Kemble as an expert witness. He had been retained to provide a responding medical-legal report. He was qualified, without objection, to provide expert evidence with respect to neurology. Dr. Kemble concluded his October 22, 2013 report saying:
I do not feel that there is any indication for any thoracic outlet surgery. Ultimately, the probability is that she will be able to work full time although she will probably have minor difficulty in terms of using her arm and moving her neck. I am optimistic, that with the measures outlined by Dr. Travlos and Dr. Caillier, that the pain will significantly reduce.
[48] For two reasons, I have given less weight to Dr. Kemble’s report and testimony than the other medical experts. First, he did not meet or examine the plaintiff. Second, in cross-examination, Dr. Kemble conceded that the basis for his report could be incorrect to the extent it was based on the assumption that the plaintiff’s symptoms would become intermittent.

Double Costs Ordered After Baseball Brawl Lawsuit Dismissed

Earlier this year the BC Supreme Court dismissed a lawsuit following a fight between two adults at a Pee Wee baseball game.  Prior to trial the Defendant made several fairly modest settlement offers, one of which was a formal offer giving the Court the discretion to award double costs.  In finding it was unreasonable for the Plaintiff to reject the offer and proceed to trial Madam Justice Watchuk (Charland v. Cloverdale Minor Baseball Association) provided the following reasons ordering the Defendant to pay double costs:
[17]         Mr. Wheeler submits that the offers were offers which ought reasonably to have been accepted.  There is now general agreement on the law that, “in determining whether the offer to settle ought reasonably have been accepted the court does not consider the final result…  The reasonableness of a decision not to accept an offer must be assessed … [by] the circumstances existing when the offer was open to acceptance:” [Ward at para. 36]. 
[18]         The first offer of $3000, although not a formal offer under the Rules, was made on March 13, 2012.  It canvassed the minor injuries set out in Mr. Charland’s records, and noted that there was not the required supporting letter to substantiate the amount of an offer which had been made by Mr. Charland.
[19]         On June 8, 2012, a formal offer to settle in the amount of $5000 was served on counsel for Mr. Charland.  It was open until five minutes after the commencement of the trial.
[20]         Discoveries of Mr. Charland were held in late July 2012.  On August 2, 2012, counsel for Mr. Wheeler wrote to plaintiff’s counsel expressing reasons why Mr. Charland’s case was problematic.  Those reasons, the credibility of Mr. Charland and the nature and extent of his injuries, were later the subject of findings made at the trial which supported the position of Mr. Wheeler.
[21]         At that time, previous offers were retracted and a “nuisance offer” of $250 was formally made.
[22]         Mr. Wheeler submits that the fact that the final offer was reduced significantly following discoveries should have no effect on the determination of whether double costs are appropriate in this case.  I agree.
[23]         It was incumbent on Mr. Charland to “make a careful assessment of the strength or lack thereof of [his] case at the commencement and throughout the course of the litigation” [Hartshorne at para. 25].  Mr. Charland had knowledge, particularly after his Discovery, of the evidentiary problems in his case.  He chose to proceed to trial despite knowledge of those problems.  In light of that knowledge at the time the $5000 offer was made, and in light of the heightened knowledge at the time the nominal offer of $250 was made, his decision not to accept the offers was not reasonable.
[24]         As in Riley, Mr. Charland ought reasonably to have anticipated that his claim would be dismissed at trial.
[25]         With regard to the other factors listed in Rule 9-1(6), the relationship between the terms of settlement offered and the final judgment of the court may be considered by the court.  The second and final offers were more favourable to Mr. Charland than the decision of the court since his claim was dismissed with costs.
[26]         The court may also consider the relative financial circumstances of the parties.  Little is known regarding this factor.  It appears from the evidence that both parties have similar financial circumstances.  Both have legal costs arising from the litigation.
[27]         There are no other factors raised by Mr. Wheeler and, in the absence of submissions from Mr. Charland, no other factors that the court considers appropriate to take into account.
[28]         On consideration of the factors set out in Rule 9-1(6), I conclude that Mr. Wheeler is entitled to double costs from the date of the first formal offer, June 8, 2012. 
 

Court Orders Part 7 Action Discovery Transcripts Disclosable in Tort Action

Reasons for judgement were released recently by the BC Supreme Court, Vancouver Registry, allowing a Defendant in a tort action to gain access to a Plaintiff’s examination for discovery transcript from a related Part 7 action.
In the recent case (Gill v. Gill) the Plaintiff was injured in a 2009 collision and sued for damages.  She also sued ICBC for allegedly denying benefits owing under her own policy of insurance.  ICBC defended both actions but appointed separate lawyers to do so.  The Plaintiff was examined for discovery in both lawsuits.  Subsequent to this the Defendant in the tort action applied for a copy of the transcript from the Part 7 action discovery.  Madam Justice Adair held it was appropriate to lift the implied undertaking of confidentiality and ordered disclosure.  In doing so the Court provided the following reasons:
[20]         Ms. Simon is correct that the underlying causes of action in the Tort Action and the Part 7 Action are different.  In that sense, the issues are different.  She also points out, correctly, that the two actions cannot be consolidated for trial or heard together by virtue of s. 83(4) of the Insurance (Vehicle) Act, and Part 7 benefits are not to be referred to at the trial of the Tort Action.  Moreover, a determination with respect to entitlement to Part 7 benefits does not bind the court in the Tort Action.
[21]         However, there are, without any doubt, overlapping factual issues in the two actions, including:
(a)      was Ms. Gill injured in the accident and, if so, what injuries did she sustain as a result;
(b)      was Ms. Gill unable to work as a result of the injuries sustained in the accident; and
(c)      has Ms. Gill incurred expenses in relation to medical and rehabilitative treatment as a result of injuries sustained in the accident.
[22]         Although the causes of action are different, key factual issues will be the same in both actions.  Ms. Gill must establish injury, causation and loss arising out of the same event, namely, the accident on April 5, 2009.  If, in stating that “the issues are sufficiently different and discrete,” the Master was referring to factual issues in each action, then, in my opinion, the Master was clearly wrong, because many factual issues in the two actions are obviously very closely related, if not identical.
[23]         Ms. Gill, as the plaintiff in both actions, can be compelled to testify in both the Tort Action and the Part 7 Action about the same factual issues, so there is no privacy issue that needs to be protected.
[24]         On the other hand, there is a compelling public interest in getting at the truth.  As Mr. Justice Hood observed in Scuzzy Creek Hydro & Power Inc. v. Tercon Contractors Ltd. (1998), 62 B.C.L.R. (3d) 366 (S.C.), 1998 CanLII 5684, at paragraph 22:
[I]t is the possibility of there being inconsistent statements which triggers the special reason for the production of the discovery transcript.  The test over the years . . . has never been higher than “lets see what the witness had to say under oath before with regard to these or related matters”.  What [the witness] has said may be relevant to the evidence [the witness] gives in the second action.
[25]         Accordingly, here, the defendant has demonstrated the existence of a public interest of greater weight than the values (privacy, and the efficient conduct of litigation) the implied undertaking is designed to protect…
[31]         In summary, the defendant’s appeal is allowed and the defendant’s application to use the discovery transcript from the Part 7 Action in this action is granted.

Witness Name and Statement Ordered Disclosed

Reasons for judgement were released this week by the BC Supreme Court, Chilliwack Registry, ordering that the name and statement of a witness be disclosed in the course of litigation.
In this week’s case (Derksen v. Canada Safeway Limited) the Plaintiff alleged injury following an incident on the Defendant’s premises.  She sued for damages.  In the course of the claim a liability claims examiner retained by the Defendant obtained a statement from a witness who “claimed to have information regarding the plaintiff and her claim“.  The Defendant did not share this document claiming litigation privilege.  Master Caldwell disagreed finding the statement, along with the name of the witness, needs to be disclosed.  In reaching this conclusion the Court provided the following brief reasons:
[14]         The remaining issue involves a statement provided to Ms. Freestone by an unnamed individual on April 11, 2012. According to Ms. Freestone, she was contacted by this person who claimed to have information regarding the plaintiff and her claim. An interview was arranged and a transcript created. The defence now claims that the interview was done and the statement created solely for the purpose of litigation.
[15]         There is no property in a witness, particularly a lay witness. Based upon the material before me, the individual has potentially relevant, potentially controversial information, about the plaintiff and her claim. The statement provided by this lay witness may well form an important part of cross examination. Failure to disclose such a statement denies plaintiff the opportunity to investigate the allegations contained therein and to challenge the veracity and motives of the informant.
[16]         No authority was cited to me to support the defence position of privilege as regards the statement and the identity of the witness.
[17]         The defendants are ordered to produce to counsel for the plaintiff an unredacted copy of the statement dated April 11, 2012 which has been listed as privileged item 4.3 of the defendants’ List of Documents.

More on the Recovery of Disbursement Interest

Adding to this site’s archived posts addressing the recoverability of interest on disbursements, reasons for judgement were released last week by the BC Supreme Court, Vernon Registry, canvassing the evidence necessary to recover these expenses.
In last week’s case (Bodeux v. Tom) the Plaintiff was injured in a collision and the claim settled however the parties could not agree on various disbursements.  The Court concluded that the majority of claimed disbursements were reasonable along with interest charged on these.  In reaching this decision Master McDiarmid provided the following reasons addressing disbursement interest:
[68]         The defendants say that the plaintiff has not provided sufficient evidence for me to determine that interest was either necessary or proper. They submit that detailed financial information, such as was provided to me in a review of the plaintiff’s bill of costs in Franzman v. Munro, 2013 BCSC 1758, is required before I can conclude that interest is a disbursement which has been necessarily or properly incurred in the conduct of the proceeding. They point to the evidence presented to Registrar Cameron in Chandi v. Atwell, 2013 BCSC 830, where, in an appeal from the decision of Registrar Cameron, Mr. Justice Savage, at para. 14, summarizes a relevant fact as follows:
…In preparing for litigation, the plaintiff incurred disbursements in order to obtain necessary evidence on liability, the extent of injuries, and the quantification of damages. As the plaintiff and his family were of limited means, they required assistance in order to fund the disbursements.
[69]         Similarly, in the appeal from the decision of Registrar Sainty in MacKenzie v. Rogalasky, 2012 BCSC 156, Savage J. summarized the relevant facts in paras. 22-23 as follows:
[22]      However, due to his income loss, Mr. MacKenzie could not afford to pay for the expert reports and other trial expenses. He did not qualify for a loan from a bank or a similar institution, and his credit cards were maxed out. He had already borrowed from his family. The only source of funding available to him was a loan from Lexfund Management Inc. (“Lexfund”), a specialized disbursement lender.
[23]      Mr. MacKenzie obtained the loan from Lexfund on November 26, 2009, only two months before trial. The loan was for $25,000, plus a $1,250 underwriting fee, for a total of $26,250. Under the terms of the loan, Mr. MacKenzie could only use the funds to pay disbursements incurred in the course of litigation. The interest on the loan was 2% compounded monthly, representing an effective annual rate of 26.82%. The loan was secured by any proceeds of the litigation.
[70]         As is apparent from the materials I have reviewed, including the various medical/legal reports and the description of the accident contained in many of those reports and also contained in the affidavit of Mr. Yawney, this was a claim which, in order to be properly presented, required plaintiff’s counsel to obtain many expert reports. Those expert reports cost money. As I wrote in my decision in Franzman:
[28]      We are constantly hearing how difficult it is for ordinary people to afford access to our courts. The fee agreement entered into between the plaintiff and her lawyer facilitated her having access to the courts. …
[71]         Entering into a fee agreement in which the plaintiff’s lawyer agreed to incur the expense of necessary disbursements for the plaintiff and to finance them and charge the plaintiff for that result in the incurring by the plaintiff of a disbursement for interest which I find, on the uncontradicted evidence before me, to be both necessary and proper.
[72]         In Franzman, at para. 28, the balance of the paragraph is as follows:
The interest rate charged by the law firm, that being essentially the interest it was paying on its operating line of credit (a way in which many law firms finance their operations) is reasonable.
[73]         In Franzman, interest on disbursements was calculated at six percent simple interest.
[74]         The mere fact that the plaintiff entered into a fee agreement which provided for charging disbursements at a rate appropriate to be charged between the client and her lawyer, does not mean that that amount of the disbursement should be automatically passed on to an unsuccessful litigant.
[75]         For example, retainer agreements often provide that the law firm will charge its client photocopies at an agreed upon rate. A photocopy rate allowed by registrars is usually less than the rate agreed to as between the law firm and its client.
[76]         I am charged with assessing and allowing a reasonable amount for disbursements. The six percent allowed in Franzman was a reasonable amount; economic times have not changed since that decision was rendered in September 2013. I, therefore, allow the disbursement at six percent of the amount claimed, reducing the $2,730.81 claimed to $1,638.49.

Liability Findings in Tort Action Binding in Subsequent HCCRA Prosecution

Reasons for judgment were published this week by the BC Supreme Court concluding that a trial court’s findings of liability are binding in subsequent Health Care Costs recovery prosecutions undertaken by the Province.
In the recent case (British Columbia v. Tekavec) the Defendant owned an apartment building.  A guest fell from the balcony and sued for damages.  The Defendant was found liable and ordered to pay damages.  Prior to trial the Province initiated collateral proceedings under the HCCRA.  They did not participate in the tort trial.  After trial they continue the HCCRA prosecution against the Defendant. The Defendant brought an application to strike the Claim.  Mr. Justice Bracken held that the action can continue and further that Defendant cannot re litigate the issue of liability as it was fully canvassed in the tort trial.  In reaching this conclusion the Court provided the following reasons:
[42]         While the Province could have joined in the original action to fully advance its claim, it chose not to.  Perhaps that decision resulted from the conclusion in Gosselin that the Act did not apply to the injuries Mr. Jack suffered before the Act came into force so the Province concluded it could not take an active role in the original action and had to proceed with an independent action.
[43]         Whatever the reason, it seems clear that the court in the original action thoroughly canvassed the issues the defendant has raised in its Response to Civil Claim filed in this action.  I accept that the Province was sufficiently privy to the original action to engage the doctrine of issue estoppel.  The Province had a right to participate with the plaintiff and had a participatory interest in the outcome.  If the court had determined that the defendant was not negligent that outcome would have bound the Province for the purposes of this proceeding.
[44]         The defendant referred to MacIver v. The Queen, 2005 TCC 250, as support for its submission; however, that case is distinguishable on its facts and was not a case where conclusions were reached after a full trial on the very issues the defendant wishes to raise again in this action.  It is not appropriate to allow the same issues to be canvassed again in this action.
[45]         The issues of liability and contributory negligence were fully dealt with and the defendant has exhausted any rights of appeal.  I am satisfied that the defendant is prevented from raising any defence related to his liability or the plaintiff’s contributory negligence in this action.

$120,000 Non-Pecuniary Assessment for Chronic Rotator Cuff Injury


Adding to this site’s database of cases dealing with ICBC shoulder injury cases, reasons for judgement were released this week by the BC Supreme Court, Vancouver Registry, addressing such an injury.
In this week’s case (Hanson v. Yu) the Plaintiff was involved in a 2010 intersection collision which the Defendant was found 100% responsible for.  The Plaintiff was 43 years old and worked as a contract sales representative.  The collision caused a chronic rotator cuff injury which required two surgeries at the time of trial and was expected to have long term and deteriorating function in the future.  In assessing non-pecuniary damages at $120,000 Mr. Justice G.P. Weatherill provided the following reasons:
[4]             The plaintiff’s neck, upper back and headache symptoms settled in approximately four months. The most significant and far more serious injury was to his right shoulder, his dominant arm.
[5]             The plaintiff underwent two surgeries to correct the shoulder injury. Neither surgery was effective. He also had approximately six cortisone injections that provided some temporary relief, and he underwent nearly two years of physiotherapy treatments.
[6]             He has permanent pain and restricted function in his right shoulder. His ability to do physical tasks at work and at home is limited, and he relies on prescription pain medication to manage…
[170]     In this case, the plaintiff has a permanent and progressively deteriorating injury to the shoulder of his dominant arm. He is likely to face surgeries in the future that will have an uncertain outcome. Has chronic pain and is managing to function through the use of pain medication that he is now addicted to. Having considered the cases, counsel have referred to, the evidence , the permanent nature of the plaintiff right shoulder injury and the possibility that it will deteriorate in the future and require shoulder replacement and considering the principles that must be considered in awarding of general damages, I award $120,000 under this head.