Reasons for judgement were published today by the BC Supreme Court, Vancouver Registry, assessing damages for personal injuries which included the successful recovery of money spent for CBD oil and medical marijuana to treat chronic pain.
In today’s case (Culver v. Skrypnyk) the Plaintiff was injured in two collisions. These resulted in partly disabling chronic back and leg pain. The treatments attempted over the years included the use of CBD oil and medical marijuana. The Court awarded recovery for the costs of these medications noting they were reasonably incurred special damages. In reaching this conclusion Mr. Justice Davies provided the following reasons:
Reasons for judgement were published today by the BC Supreme Court, New Westminster Registry, awarding damages, including a $12,000 future care award for the cost of medical cannabis, to a collision victim.
In today’s case (Carrillo v. Deschutter) the Plaintiff was involved in a 2011 collison. The Defendant admitted fault for the crash. The Plaintiff suffered a variety of injuries including a frozen shoulder, soft tissue injuries and went on to develop chronic pain with a poor prognosis for full recovery.
At trial, in addition to other heads of damages, the Plaintiff sought damages for the future cost of medical cannabis. The Defendant objected to this arguing that “conventional prescription drugs” should be adequate. The court was not persuaded by this defence and awarded $12,000 for the cost of medical cannabis. In reaching this conclusion Madam Justice Dardi provided the following reasons:
 I have reviewed all the authorities on medical cannabis relied on by both parties. The authorities establish that, in some cases, medical cannabis is compensable in a personal injury case: Wright v. Mistry, 2017 BCSC 239 at para. 84; Amini v. Mondragon, 2014 BCSC 1590 at paras. 133-136; Chavez-Salinas v. Tower, 2017 BCSC 2068 at para. 539.
 An important fact in this case, and one that distinguished this case from many of the cases relied on by the defence, is that Mr. Carrillo, after receiving Dr. Hershler’s recommendations, has been using cannabis balm, tincture oil and capsules. I accept his evidence, that he has found the cannabis products effective and, as a result of using the cannabis products, he has experienced some pain relief. There was no evidence that the consumption has produced any negative side effects. Notably, since the Accident, Mr. Carrillo has pursued the more traditional modalities of physiotherapy, chiropractic treatments, massage and injections without any significant benefit. Mr. Carrillo’s prescription pain medication provides him with some symptomatic relief but I do not accept that it controls his pain as is asserted by the defendant.
 With respect to the defence submissions on Mr. Carrillo’s mental health issues, I note that Mr. Carrillo’s medical condition is currently being monitored by his primary care provider, Dr. Sennewald. The six-month’s use of cocaine for pain was some six years ago and there is no evidence of any issue arising since that time.
 All things considered, I conclude that the medical cannabis program recommended by Dr. Hershler is medically justified within the meaning contemplated by the authorities and that it is reasonable to make an award for the costs of the cannabis as part of Mr. Carrillo’s future pain management plan.
 The evidence on the costs of the medical cannabis was thin but not so thin as to justify not making any award for Mr. Carrillo. There was no evidence as to what the cost would be through a Health Canada supplier. Those costs may be different from the costs Mr. Carrillo actually incurred purchasing them through other dispensaries. This is a significant shortcoming that I have taken into account in my assessment. I have also factored into my assessment that in his report Dr. Hershler did not say how long Mr. Carrillo should be on the medical cannabis program. It is uncertain how long he may continue using medical cannabis.
 In the result, and on the totality of the evidence and taking into account the relevant contingencies, I assess an award for medical cannabis in the amount of $12,000.
To date I am aware of two cases in British Columbia that have awarded damages for the costs of medical marijuana to treat personal injuries (these can be accessed here and here). Earlier this week reasons were released by the BC Supreme Court considering whether to award damages for the cost of medical marijuana cream to a Plaintiff who suffered from chronic pain following a vehicle collision. In rejecting this aspect of the claim Madam Justice Duncan provided the following reasons:
 In his May 2012, report Dr. Hershler noted that with 4.5 years having passed since the accident it was unlikely the plaintiff’s condition would improve. He classified the plaintiff as having a permanent partial disability with respect to his low back, which was likely to be symptomatic indefinitely. He recommended pulse signal therapy. He is one of only two service providers for this treatment. In a follow-up report dated October 11, 2012, he also recommended medical marijuana compounded in a topical cream. Dr. Hershler is aware of directives from the Canadian Medical Association and Health Canada about exercising restraint in prescribing medical marijuana. He views these directives to be aimed at smoked cannabis of a particular strain, not those he suggests as a cream or oral supplement. He agreed he is keen to use those types of applications of medical marijuana in the field to assist in the gathering of evidence about its efficacy and modality in pain management…
 I agree with the defendant that Dr. Hershler’s opinion should be given little weight. I find he seized on the May 2008 MRI as the source of the plaintiff’s discomfort whereas the other experts, both Dr. Helper for the plaintiff and Dr. Paquette for the defence, had a very different view of the plaintiff’s MRI history. Similarly, I place no weight on Dr. Hershler’s recommendations for pulsed signal therapy or medical marijuana cream. The former is a service for which he is one of the only providers and the latter is a treatment in its very early experimental stage with minimal empirical evidence to suggest it will assist the plaintiff, if it is even permissible under Health Canada’s medical marijuana exceptions.
With medical marijuana gaining more acceptance as a prescribed treatment for a variety of health conditions, costs associated with such treatments are receiving judicial consideration in personal injury litigation.
In what is at least the second decision in BC to do so (click here for the first) reasons for judgement were released today by the BC Supreme Court, New Westminster Registry, assessing damages for the cost of medical marijuana.
In today’s case (Amini v. Mondragaon) the Plaintiff was injured in a 2011 collision that the Defendant accepted responsibility for. The Plaintiff suffered various lingering injuries and a medical marijuana program was recommended to address some of the Plaintiff’s symptoms. Mr. Justice Greyell assessed damages of $6,500 to account for the cost of this recommendation and in doing so provided the following reasons:
 Dr. Hershler strongly recommended Ms. Amini be put on the Medical Marijuana Program to assist in controlling her pain so as to allow her to work on strengthening exercises for her neck and back. He was of the view this would allow her a “good chance for effective pain management”. I accept his recommendation as a reasonable one.
 Dr. Hershler recommended she be prescribed ten grams of cannabis per day to be used as an ointment. He recommended this be followed with 20 sessions with a physiotherapist to build core strength and range of motion.
 Dr. Hershler estimated the cost of a six month program using a dosage of 10 grams per day to be approximately $9,000. In cross-examination counsel suggested the ointment could be made at considerably less cost if the plaintiff, as a Nurse, made her own. Dr. Hershler did not disagree.
 I award the plaintiff $6,500 for a Medical Marijuana Program and $1,500 for the cost of 20 physiotherapy sessions (at $75 each) to follow the medical marijuana treatments.
While BC Courts do recognize that the cost of medical marijuana can form a basis for damages in a personal injury claim, one matter that, to my knowledge, has never been addressed is whether failing to take prescribed medical marijuana can amount to a failure to mitigate damages. This issue was dealt with in reasons for judgement released today.
In today’s case (Glesby v. MacMillian) the Plaintiff was involved in a 2009 collision. Liability was admitted. In the course of the claim a physician suggested medical marijuana. The Plaintiff did not follow this advice. The Defendant apparently argued the damages should be reduced for this failure to mitigate however Mr. Justice Baird declined to do so. The Court, despite having reservations about the Plaintiff’s credibility, accepted her explanation for not following the advice to try medical marijuana. In reaching this conclusion the Court provided the following comments:
 Dr. Hershler examined the plaintiff on May 2, 2013, some five months before trial. His diagnosis was much the same as Dr. Kleinman’s, but without discussion of a possible interrelationship of physical and psychological factors. Soft tissue injury and chronic pain were the culprits, he said, and echoed Dr. Kleinman’s recommendation that the plaintiff should embark upon a core strengthening program. He also encouraged the plaintiff to consider the use of medical cannabis to manage her pain. The plaintiff has not taken this advice, either. She has reservations about the legality of the acquisition and use of cannabis, and, in any event, she is a committed life-long abstainer from narcotics and drugs of all sorts…
 I decline to find that the plaintiff failed to mitigate her losses by not taking medical cannabis. Dr. Hershler’s advice came after the end of what, for the reasons just stated, I consider to be a reasonable recovery period. In any event, I accept as sincere the plaintiff’s reservations about the acquisition and use of cannabis.
As readers of this blog know, I often extract one point of interest when creating case summaries and when more than one point is noteworthy I create multiple point specific posts. I do this because it makes it easier to search archived posts by case specific topics.
Reasons for judgement were released this week with so many nuggets it would be too burdensome to address them each individually so please excuse the multi point summary. In short this judgement showcases video surveillance successfully attacking a claim, credibility findings, comments on self-serving medical appointments, claimed care costs for medical marijuana and other points of interest. The entire judgement is worth a read.
In this week’s case (Datoc v. Raj) the Plaintiff was involved in an intersection t-bone collision. Both motorists claimed they had a green light which simply could not be true. The Court found that despite credibility problems with the Plaintiff his account of the collision appeared more reliable and the Defendant was found fully at fault. The Plaintiff claimed damages of over $450,000. The Court rejected most of these claimed damages and in doing so illustrated the following points:
Video Surveillance Successfully Used
Video evidence was presented which documented inconsistent presentations of the Plaintiff in court versus out of court. Mr. Justice Sigurdson provided the following comments in finding the plaintiff was “significantly exaggerating” his claims:
 I was shown video surveillance evidence of the plaintiff taken over a number of days in the months shortly before the trial. These videos showed the plaintiff getting in and out of his car, driving his car and taking photographs as a real estate photographer. This included squatting, and holding a tripod above his head to take pictures. He moved fluidly, in and out of the driver’s seat, apparently without discomfort. He and his counsel acknowledge a dramatic difference between his presentation on the video and his presentation in court. The plaintiff explains the difference by saying that he is capable of doing what he does on the surveillance video only because of medical marijuana he takes in the morning and at the end of the day. However, the plaintiff introduced no medical expert report to support this contention, only his evidence that this was the effect on him of his taking medical marijuana. I did not find persuasive his evidence that marijuana would have the dramatic and persisting effect that he asserts. The video surveillance showed him during different times of the day, not simply in the morning (shortly after he would have ingested a marijuana cookie), but into the afternoon as well, and his condition appeared to be no different no matter what the time of day.
 Generally, surveillance evidence can be relatively unhelpful to assess the condition of plaintiffs as to whether they are performing activities without pain, or whether their ability to perform activities is because of use of pain medication, or stoicism, or other factors. However, the difference in this case between the manner in which the plaintiff presented himself in court and how he was shown on the surveillance video was dramatic. I did not find the plaintiff’s explanation persuasive that the dramatic difference was from his taking marijuana while working, and not taking it while in court…
 I have concluded, based on a consideration of all of the evidence, that the plaintiff is significantly exaggerating the extent of his injuries.
The Plaintiff claimed damages of $20,000 for the cost of medical marijuana. While damages for medical marijuana are not unprecedented in British Columbia, a common analysis involves a plaintiff’s recreational interest in marijuana. The defendant pursued such an analysis with apparent success. In rejecting these claimed damages the Court provided the following analysis:
 On cross-examination, the plaintiff was asked about his posting on the internet under the name Nismo200sx in light of his comment that he had only taken marijuana once or twice before. Although those postings suggested an interest in marijuana beyond simply as a treatment for his back pain, the plaintiff denied any recreational interest in marijuana…
 The plaintiff said that prior to his prescription for medical marijuana, he tried marijuana once or twice, but he did not care for it. However, there is evidence to suggest the plaintiff’s interest in marijuana is more than purely for medical treatment purposes. His internet postings suggest that. Given my concerns about the reliability of the plaintiff’s evidence, and in the absence of expert evidence, I am not persuaded that medical marijuana is required by the plaintiff to treat his injuries…
 The plaintiff seeks future care costs for medical marijuana of $200 per month or $2,400 a year for a suggested award of $20,000. The evidence does not support the claim that medical marijuana is reasonably necessary: see Milina v. Bartsch (1985), 49 B.C.L.R. (2d) 33 (S.C.). As such, I award nothing for the cost of future care.
Frequency of Doctor Visits
The last point of interest deals with the Plaintiff’s frequency of doctor’s visits I have canvassed this topic previously. In this week’s case the Plaintiff pointed to having 128 doctor visits as supporting his claim for injury. The Court, however, found that there was no reasonable justification for this and instead came to the conclusion that the Plaintiff was simply papering his claim. The following observation was made by Justice Sigurdson:
 Up to June 2012, the plaintiff saw Dr. Irene Chan, a general practitioner, 128 times for his injuries. From July 8, 2008 to June 2012, the complaints he made to her were virtually the same on each occasion. Dr. Chen was not called as an expert witness but testified simply with respect to some of the observations she made…
 It is difficult to know what to make of the fact that the plaintiff attended his general practitioner for 128 visits and appears to have repeated his symptoms almost without change on each visit. He explained in his testimony that he went to his doctor to report changes in his condition; however his doctor noted each of his attendances with the plaintiff reporting no changes. The evidence left me with the impression that the plaintiff was creating a record of his injuries for his claim as there appears to be no reasonable medical justification for the number of attendances before his family doctor. Rather than supporting his credibility, this evidence of the numerous attendances on his family doctor left me with the opposite impression.
In what I believe is the first award of its kind, damages of $30,000 were recently allowed in a BC personal injury claim for the purchase medical marijuana to help manage the consequences of chronic pain.
In reasons for judgement released earlier this month (Joinson v. Heran) the Plaintiff sued the Defendant surgeon for medical malpractice. The Plaintiff’s claim was in part successful and damages of just over $310,000 were awarded including a $30,000 cost of future care assessment for medical marijuana. Mr. Justice Brown provided the following reasons setting out his legal analysis in allowing this claimed damage:
 As a judge of the law, I cannot make orders that directly or indirectly endorse unsanctioned accessing of medical marijuana. At the same time, my role is now to assess medical needs and necessities. It is the responsibility of Dr. Surgenor and Dr. Bright, as Mr. Joinson’s treating physicians, to address professionally these medical questions and to ensure Mr. Joinson’s medical use of marihuana complies with the rules and regulations. Ultimately, however compensation claims for medical use of marihuana, either as a special damage claim or as a future cost of care claim, must be assessed based on recommended guidelines and on costs charged by legally authorized dispensaries. All said, the foundational principle for an award of a cost of future care is that the expense must be both medically justifiable and reasonable on an objective basis. It is not enough to show merely that it is beneficial; the medical evidence must show it is reasonably necessary:Andrews v. Grand and Toy Alberta Ltd.,  S.C.J. No. 6, at para. 120; Aberdeen v. Langley (Township), Zanatta, Cassels, 2007 BCSC 993, at para. 198; Strachan v. Reynolds et al., 2004 BCSC 915, at para. 632.
 There is no bright line distinguishing mere benefit and reasonable necessity in this case. But with basic reasoning and application of the above stated legal principles it can be drawn, if roughly. Pain control and its contribution to Mr. Joinson’s ability to function to his maximum potential are core considerations here. Without use of medical marihuana or a synthetic substitute, Mr. Joinson would have to increase his use of morphine, which is detrimental, particularly to his functioning: he does not function as well, physically or mentally, without use of medical marihuana. His treating physicians endorsed this treatment option, supporting him in his use of medical marihuana. Other physicians may disagree, but his family physician and psychiatrist see him on a regular basis and, in this particular instance, are in the best place to consider what is medically necessary.
 The issue remains controversial and is one which more research and clinical experience must ultimately decide, or at least reveal clearer parameters for the safe and effective use of medical marihuana or its synthetic derivatives. Meanwhile, I find the medical evidence supports a finding that compensation for some medical use of marijuana is reasonably necessary in this case. However, I cannot find for compensation based on the quantity used by Mr. Joinson in his claim for exemption or on amounts he has been paying to purchase products from the TAGGS dispensary. The award will based on a maximum of 5 grams per day, and priced as if purchased from a Health Canada legally authorized source, or, alternatively, at the cost of the medically equivalent amount of a synthetic substitute such as Cesamet.
 Ultimately of course, any award must make allowance for the fact Dr. Heran’s errant surgery is not responsible for providing Mr. Joinson with a lifetime supply of medical marijuana, certainly not for the portion Mr. Joinson would have used for recreational purposes, irrespective of any of his surgeries. Moreover, I need to account for the medically beneficial effects of his participation in a chronic pain program, notably anticipated benefits that should help reduce his need to use pain medications….
 Therefore, I award $30,000 for costs of medical marihuana.