Tag: pre-existing degenerative changes

$75,000 Non-Pecuniary Asssessment For Onset of Symptoms in Pre-Existing Degenerative Changes

Adding to this site’s archives addressing damages for collisions triggering symptoms in pre-existing degenerative changes, reasons for judgement were released last week by the BC Supreme Court, New Westminster Registry, dealing with such an injury.
In last week’s case (Savoie v. Williams) the Plaintiff was injured in a collision when the Defendant ran a stop sign.  Although fault was not admitted the Defendant was found fully at fault.  The 53 year old plaintiff, who was fit and active, suffered soft tissue injuries.  She also had degenerative changes in her neck which pre-existed the collision.  Following the crash these became symptomatic and the symptoms were expected to linger into the future.  In assessing non-pecuniary damages at$75,000 Mr. Justice Johnston provided the following reasons:
[34]         Dr. Maloon agreed that there was no indication that the plaintiff had any complaints arising from these areas of her body prior to the accident, and described as a “million dollar question” the reason some people with similar wear and tear will have pain or other symptoms from the wear and tear, whereas others will not.
[35]         Dr. Maloon also said that once there are wear and tear changes to the neck, nothing can be done to change the natural course of that condition; it is a mechanical problem and treatment is largely symptomatic.
[36]         At page 6 of his written opinion Dr. Maloon says:
It is possible that the soft tissue strain that she sustained initiated the symptoms of degenerative changes that have persisted to date.
[37]         I conclude that Ms. Savoie’s initial soft tissue injuries, which I consider moderate to severe, have plagued her from the time of the accident until the date of trial. I also find that these injuries precipitated symptoms from the pre-existing (but asymptomatic) degenerative state of her neck and upper back, that the combination of the injury and the degeneration has created more discomfort than either would alone, and that to the extent that the continuing symptoms come from the degenerative neck condition, it is unlikely they will ever completely go away.
[38]         I have reviewed the authorities tendered by each counsel and consider that the facts of this case more nearly approximate the facts in Ortega v. Pena, 2012 BCSC 1884, and Thomas v. Wormsley, 2009 BCSC 919.
[39]         In personal injury litigation there never are identical plaintiffs, circumstances or injuries and consequently authorities are, at the best, guidance on the question of damages.
[40]         On the evidence before me, I assess Ms. Savoie’s non-pecuniary damages at $75,000.

$60,000 Non-Pecuniary Assessment For Chronic Moderate Soft Tissue Injury

Adding to this site’s soft tissue injury damage archives, reasons for judgement were released earlier this year by the BC Supreme Court, New Westminster Registry, addressing damages for chronic moderate soft tissue injuries imposed on a pre-existing condition.
In the recent case (Graydon v. Harris) the 65 year old plaintiff was injured when his vehicle was struck by a large industrial garbage truck.  The Defendant was found fully at fault for the collision.  The Plaintiff suffered from pre-existing neck pain and headaches due to a degenerating spine.  The Collision resulted in soft tissue injuries which aggravated these issues.  In assessing non-pecuniary damages at $60,000 Mr. Justice Weatherill provided the following reasons:
 
[67]         Based upon the evidence before me, I find that the plaintiff is a very stoic and hardworking man who has suffered a moderate soft tissue injury to his neck, lower back and shoulders as a result of the October 25, 2007 accident.  I also find that, at the time of the October 25, 2007 accident, the plaintiff was suffering from pre-existing neck pain, headaches and a degenerative condition of the cervical spine.  That is why Dr. Koelink was continuing to prescribe Tylenol 3 for him.  The soft tissue injuries suffered during the October 25, 2007 accident exacerbated his pre-existing condition.
[68]         Despite some inconsistencies in his evidence, I find that the plaintiff’s injuries have had and will have a lasting effect on his work life and, to a lesser degree, on his home and recreational life.  He continues to be able to work but not without pain and discomfort.  He continues to have headaches which flare up when he is welding. 
[69]         He is able to travel both for vacation and work without adverse effects with the exception of occasional numbness in his left leg after sitting for prolonged periods of time.  However, as Dr. Craig testified, that discomfort can be eased by changing position.
[70]         The plaintiff was suffering from pain, headaches and a degenerative condition of the cervical spine well before the October 25, 2007 accident.  In my view, there is at least a 25% chance that the plaintiff’s pre-existing condition would have interfered with his work and other activities had the October 25, 2007 accident not occurred.
[71]         After considering all of the plaintiff’s circumstances, the principles set out in Stapley and the cases provided by counsel, and after applying a 25% contingency in respect of the plaintiff’s pre-existing condition, I find that an award of $60,000 for non-pecuniary damages is appropriate.

$75,000 Non-Pecuniary Assessment for Triggering of Pain in Pre-Existing Degeneration

As previously discussed, a common pattern following a motor vehicle collision is the onset of pain in a pre-existing but otherwise asymptomatic degenerative condition.  Reasons for judgement were released recently by the BC Supreme Court, Kelowna Registry, addressing such an injury.
In the recent case (Culos v. Chretien) the Plaintiff was involved in a 2006 pedestrian collision.  The Defendant motorist was found fully at fault.  The collision caused an aggravation of pre-existing low back pain and further caused chronic neck pain problems.  The latter problems were found to be due to pre-existing degeneration which became symptomatic as a result of the impact.  In assessing non-pecuniary damages at $75,000 Mr. Justice Rogers provided the following reasons:

[51] I find that the plaintiff accurately described his injuries and the symptoms he experienced after the accident. The fact that his left hip was sore when he went to see his physician several days after the accident and that his left thigh just above the knee was not bruised tell me that the defendant’s car hit him on his left hip, not his left thigh. I find that the impact gave the plaintiff a severe body-wide jolt. The impact caused the pre-existing but asymptomatic degenerative disease in his neck to become symptomatic. Absent the accident, the plaintiff may have lived out his entire life without any neck symptoms. The accident caused his neck to be painful, and the pain has persisted to this day. I accept Dr. Vallentyne’s opinion that the plaintiff’s neck symptoms are permanent.

[52] I find that the plaintiff’s memory of his pre-accident back function is faulty. The symptoms of pain that he felt in his lower back in the approximately one year before the accident must have been significant. I find that is so because the plaintiff is clearly not one to go running for medical treatment for minor or transitory complaints – the fact that he held off for five days after the accident before seeking medical help supports that proposition. For that reason, I accept Dr. Vallentyne’s opinion that even if the accident had not happened the plaintiff’s periodically symptomatic low back pain and his pre-existing degenerative disease in that region would have, as Dr. Vallentyne said, required him to “minimize heavy lifting/carrying as well as repetitive bending/twisting”. That said, I find that the accident accelerated and worsened the plaintiff’s low back symptoms; “accelerated” in the sense of causing the pain to be constant rather than periodic, and “worsened” in the sense that the low back pain prevented the plaintiff from participating in his usual activities to a much greater degree than before.

[53] I cannot accept Dr. Grypma’s opinion that the plaintiff’s present symptoms are not related to or caused by the accident. I find that the flaw in Dr. Grypma’s opinion is his dismissal without discussion of the indisputable temporal connection between the onset of the plaintiff’s neck and back symptoms immediately after the accident and his continuing symptoms throughout of pain in exactly those same regions. The link is, of course, the fact that those symptoms have persisted from then until now. The physicians agree that the accident did not accelerate the degeneration of the plaintiff’s neck and back – it follows that the plaintiff’s pains are not a result of increased degeneration. If the symptoms occurred after the accident, it is reasonable to conclude that they were caused by the accident, and the doctors agree on that as well. What Dr. Grypma does not explain is how it is that the plaintiff’s symptoms transitioned from pains caused by the accident to pains caused by his degenerative disease, and how it is that even without the accident, the plaintiff would nevertheless now be suffering from those symptoms. I find that there is a causal link between the accident, the onset of the plaintiff’s neck pain and the worsening of his low back symptoms, and the persistence of those symptoms through to the present day.

[54] Currently the plaintiff’s neck and back symptoms are present on a daily basis. They flare up when the plaintiff does anything strenuous. The symptoms aggravate, frustrate and tire the plaintiff out. They have reduced his enjoyment of recreational activities. The symptoms are a permanent feature of the plaintiff’s life. After discounting the plaintiff’s claim to account for the fact that absent the accident his lower back would have troubled the plaintiff periodically, I find that the proper award for non-pecuniary damages in this case is $75,000.

$100,000 Non-Pecuniary Assessment for Triggering Early Onset of Arthritic Symptoms

Reasons for judgement were released this week by the BC Supreme Court, Vancouver Registry, assessing damages for the triggering of arthritic symptoms in pre-existing asymptomatic degenerative joints.
In the recent case (Witt v. Vancovuer International Airport Authority) the Plaintiff was a fire-truck salesman.  Chalking this up to the ‘you learn something everyday’ category, this is apparently a lucrative career with the Plaintiff earning approximately $740,000 per year.  While at the Vancouver Airport the Plaintiff fell through metal plates “that were not secured by the long stakes that should have been used to secure the plates” creating “voids below the plates which allowed the plates to shift as vehicle traffic went over them“.  The Defendant was found fully liable for the incident.
The fall triggered symptoms of pain in the Plaintiff’s back, knee and hip.  He had pre-existing arthritis in these areas with the fall accelerating these conditions resulting in long-standing pain.  In assessing non-pecuniary damages at $100,000 Mr. Justice Burnyear provided the following reasons:

[59] Based on the conclusions reached by the medical experts, on the testimony of Mr. Witt and Ms. Witt, and on the testimony of those who knew him well, I conclude that Mr. Witt has considerable and continuing pain as a result of the Fall and that the pain that he has suffered has made his life less enjoyable.  I find that his inability to walk long distances, his inability to enjoy golfing, hiking and tennis, and his reduced sleep and energy levels have come as a result of the Fall.  I am satisfied that Mr. Witt should be compensated for that pain and suffering.

[60] Regarding the particular complaints of Mr. Witt, I make the following findings.  I find that Mr. Witt now suffers from chronic pain as a result of the Fall.  I also find that, as a result of the chronic pain, there have been negative changes to his disposition, a considerable reduction in his physical activity and capacity, and a significant negative effect on his marriage.

[61] Regarding the back pain experienced by Mr. Witt, I find that some but not all of the back pain experienced by Mr. Witt as a result of the Fall settled by the summer of 2010.  However, I also find that he is now more susceptible to develop spinal stenosis as a result of the Fall.

[62] Regarding the right hip of Mr. Witt, I find that he continues to have severe pain from time to time and discomfort when sitting.  As a result of the Fall, I find that osteoarthritis has become systematic and that this has become the case earlier than what would have occurred but for the Fall.  While I find that there was a degree of degenerative spondylosis and arthritis prior to the Fall, I find that the Fall produced severe pain in the right hip that would not have been experienced by Mr. Witt but for the Fall and which has produced early onset of degenerative spondylosis and arthritis.

[63] As a result of the Fall, I find that the pain and weakness being experienced by Mr. Witt in his right knee has accelerated the existing degenerative arthritis so that Mr. Witt now requires surgery.  I find that the presence of degenerative arthritis in the right knee of Mr. Witt was accelerated by the Fall…

[68] Taking into account the injuries caused by the negligence of the Defendants, the duration of the pain and suffering produced by the negligence, the likely future pain and suffering caused by the Fall, and by the early onset of arthritic problems caused by the Fall, I set the non-pecuniary damages available to Mr. Witt at $100,000.00.

The Court went on to note that the ongoing injuries and expected medical interventions will interfere with the Plaintiff’s career and assessed damages for diminished-earning capacity at $600,000.

$75,000 Non-Pecuniary Damages for Aggravation of Pre-Existing Knee Arthritis


A common issue courts have to address in injury litigation is the effect of trauma on pre-existing asymptomatic arthritis.  Often times after people are injured X-rays and other diagnostic tests reveal arthritic changes in joints which produced no pain prior to the trauma.  Often times accidents cause these pre-existing conditions to become painful.  A theme which usually comes up in these types of cases is whether the degeneration would have become painful at some point in time without the trauma.  Reasons for judgement were released today by the BC Supreme Court dealing with such an injury to the knees.
In today’s case (Michal v. Begg) the Plaintiff was injured in a 2003 motor vehicle accident.  The driver of the Plaintiff’s vehicle lost control and hit a concrete highway divider.  The crash was significant destroying the vehicle on impact.
The plaintiff sustained various injuries including the onset of pain in his knees.  The Plaintiff did not have pre-existing knee pain but on examination arthritic changes which would have pre-dated the accident were noted.  The accepted medical evidence was that even if the Plaintiff did not have the accident he would have likely eventually experienced pain in his knees but the trauma accelerated this.  Mr. Justice Curtis assessed the Plaintiff’s non-pecuniary damages at $75,000.  In arriving at this figure the court noted the following about the extent and effect of the accident related injuries:

[26] In summary, I find it proven on the balance of probabilities that as a result of the December 18, 2003 collision, Miroslav Michal suffered a whiplash injury aggravating a pre-existent mild recurrent neck pain, which is now continuing on about the same course as it would have had the 2003 accident not occurred, injuries to his head, right shoulder, right and left wrists, fingers and elbow strains, rib injury and a buttock contusion, all of which has resolved fairly quickly, and injuries which have produced symptoms persisting to the present time, namely to his right ankle, right foot and left and right knees.

[27] The right knee was clearly injured in the collision as is demonstrated by the immediate appearance of pain, swelling and stiffness.  That knee had pre-existing degenerative changes which were not symptomatic prior to the collision, but were clearly made symptomatic following it.

[28] There is no immediate medical record of Mr. Michal complaining about left knee problems.  That knee also had pre-existing degenerative changes which were not symptomatic prior to the accident.  I am satisfied, however, that the collision did aggravate the condition of the left knee and caused it to become symptomatic afterwards.  Mr. Michal has testified that was the case and his testimony is supported by the observations of Mr. Begg and his Aikido instructor.  Mr. Michal is clearly not a complainer and I accept that early left knee symptoms were simply overlooked in dealing with more urgent matters.

[29] Both knees were showing pre-existing signs of degeneration in all three compartments.  The outlook for his knees was that the degeneration could continue and would have at some point become symptomatic even if there had not been any December 18 injuries.  It is likely his knees would have got bad enough to affect his function even if he had not been injured.  How long that would have taken is not clear – Dr. Anton offers the opinion that “The pre-existing changes would probably have become symptomatic absent the accident but that could have taken five years or longer.”  Dr. Sovio in his report of March 6, 2006 was of the opinion that:

He, in all likelihood, had pre-existent degeneration which predisposed him to this problem and regardless he would have had some difficulties with his knees in the future. It is difficult to say when this would have shown up but it would likely have presented itself in the relative near future.

[30] On the evidence, I find it reasonable to attribute Mr. Michal’s knee symptoms to the date of his surgery in January and April of 2007 to the collision, but I find that, while the collision injuries remained a contributing factor, his failure to recover as expected from his knee surgery and his worsening condition from September 2007 onward was attributable to the fact that he had degenerative knees as well as the fact that they had been made worse by the collision induced injuries.  It is probable that Mr. Michal would have ended up having arthroscopic surgery to his knees even without his 2003 injuries but that surgery was probably significantly sooner because of the December 2003 injuries.

[31] The plantar fasciitis in his right foot has become chronic but the medical opinion is that it should be cured.  His right ankle does not show evidence of significant injury.  I accept that these have troubled him as he has described to the date of his trial, but I find that they remain treatable and should not pose a significant problem for him in the future.

[32] Considering the pain and suffering Mr. Michal has had from his injuries, and the significant loss of enjoyment of life they have caused him, in particular forcing him to forego his long time interest in martial arts, I assess Mr. Michal’s claim for general damages at $75,000.

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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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