Tag: Lim v. Anderson

Failure to Obtain Injections and Mitigation of Damages


Reasons for judgement were released recently by the BC Supreme Court, Vancouver Registry, discussing whether the failure to follow through with steroid injections to treat a shoulder injury should result in mitigation of damages in a personal injury claim.
In the recent case (Lim v. Anderson) the Plaintiff suffered an impingement syndrome following a rotator cuff injury sustained in a collision.  In the course of recovery she had a steroid injection which provided temporary relief.  Her surgeon suggested that the Plaintiff could have further injections although she chose not to follow through with this advice.  The Defendant argued the Plaintiff’s damages should be reduced due to this choice.  Madam Justice Fenlon rejected this argument and provided the following reasons:
[18] A preliminary issue I must decide before assessing damages is whether the plaintiff has failed to mitigate her damages. The defendants must prove that the plaintiff failed to follow recommended treatment by a qualified practitioner that could have overcome or reduced her current or future problems: Papineau v. Dorman, 2008 BCSC 1443. The applicable standard is reasonableness. The defendants must demonstrate that the plaintiff unreasonably refused to follow the practitioner’s recommendations…

[23] Here too, while Dr. Yu listed further injections or surgery as possible further treatments, he did not opine that they would fix the plaintiff’s problems with her shoulders. The injections offered at least temporary relief. The first and only one the plaintiff underwent gave her two months without pain. The plaintiff described the pain relief as “like a miracle”.

[24] It can be implied from the location of the space into which the steroid medication has to be injected, from Dr. Yu’s evidence and from Ms. Lim’s decision not to repeat it every two months despite the relief that followed, that the needle itself is unpleasant. Further, Dr. Yu acknowledged that injections are not always successful and that patients have to balance the pain of the injection against the pain without it. Surgery carries with it risks and time off work.

[25] A plaintiff is only required to do what is reasonable, and I do not find to be unreasonable Ms. Lim’s decision to decline further injections and surgery and to instead use pain medication to control her symptoms.

This judgement can be contrasted with this 2010 decision where a Plaintiff’s damages were reduced by 30% for choosing to follow naturopathic treatment instead of injections/surgery to treat a shoulder injury.

$55,000 Non-Pecuniary Damages for Rotator Cuff Impingement Syndrome


Reasons for judgement were released yesterday by the BC Supreme Court, Vancouver Registry, assessing damages for a rotator cuff injury caused by a motor vehicle collision.
In yesterday’s case (Lim v. Anderson) the Plaintiff was injured in a 2008 collision when the Defendant ran a red light.  Fault was admitted by the Defendant.  The Plaintiff suffered an impingement syndrome in her shoulder due to a rotator cuff injury caused by the crash.  She had some ongoing symptoms of pain and limitation at the time of trial.  In assessing non-pecuniary damages at $55,000 Madam Justice Fenlon provided the following reasons:
[7] There was a difference of opinion between Dr. Christian and the plaintiff’s treating orthopaedic surgeon, Dr. Yu, as to the cause of the plaintiff’s ongoing shoulder pain. Dr. Yu attributes it to calcific tendonitis caused by the soft tissue injuries. In his view, with the injury there was bruising and swelling or hemorrhage into the rotator cuff giving rise to pain or an abduction and impingement syndrome. In this condition the tendon is pinched between the under surface of the acromion and the humeral head, resulting in pain on movement…
[9] While it is not really necessary to choose between the opinions on causation, given the agreement on ongoing residual pain in the shoulder, I prefer Dr. Yu’s diagnosis…
[10] I accept his finding that the plaintiff’s response to an injection into the subacromial space of her right shoulder, (temporary relief from pain), confirmed his diagnosis…

[38] The biggest impact on Ms. Lim in terms of loss of enjoyment of life is her inability to cook using a wok, to do the vacuuming and heavy housework she used to do to keep her home in the meticulous order she enjoyed and to do her own gardening and yard work. Her co-workers describe a woman who is less cheerful than she used to be and is often sore and uncomfortable at work. She can no longer pour tea when they go for dim sum together, something she always did before the accident.

[39] There is medical evidence that suggests that the plaintiff’s soft tissue injuries may further improve with exercise over time, although the evidence supports a finding that her shoulders will not likely improve in future.

[40] Taking into account all of the Stapley factors, I find that an award of $55,000 for pain, suffering and loss of enjoyment of life is appropriate.

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ERIK
MAGRAKEN

Personal Injury Lawyer

When not writing the BC Injury Law Blog, Erik is the managing partner at MacIsaac & Company, based in Victoria, B.C. He is also involved with combative sports regulatory issues and authors the Combat Sports Law Blog.

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