Ramesh s/o Ayakanno (suing by the committee of the person and the estate, Ramiah Naragatha Vally) v Chua Gim Hock

• Jurisdiction: Singapore
• Judge: Kan Ting Chiu J
• Judgment Date: 29 February 2008
• Neutral Citation: [2008] SGHC 33
• Court: High Court (Singapore)
• Year: 2008
• Published date: 11 March 2008
• Plaintiff Counsel: Renuka Chettiar (Karuppan Chettiar & Partners)
• Defendant Counsel: Faizal Mohamed and Amy Lim (B Rao & K S Rajah)
• Subject Matter: Damages
• Citation: [2008] SGHC 33

29 February 2008

Kan Ting Chiu J:

1 This case arose from a road accident on 9 March 2001 in which Ramesh s/o Ayakanno, a 26-year-old lorry driver suffered severe head injuries. As a result of the injuries, he has been declared to be mentally disabled and his mother Ramiah Naragatha Vally was appointed his committee. While his mother brought the action on his behalf, he was referred to in the assessment hearing as the plaintiff, and I shall refer to him as such.

2 In October 2002, interlocutory judgment was entered in his favour with liability agreed at 95% and damages to be assessed.

3 The assessment hearing came before an Assistant Registrar in 2007 who made the following awards:

1	Damages for pain and suffering and loss of amenities					$170,000-00
2	Future medical and transport expenses
	(i)		cost of hospitalization at $6,000-00 per year for 10 yrs		$60,000-00
	(ii)		cost of replacement of VP [ventriculo-peritoneal] shunt and insertion of tracheostomy and gastrostomy feeding tube
	(iii)		cost of medication at $105-00 per month for 10 years ($105 x 12 x 10)		$12,600-00
	(iv)		cost of medical consultation with doctors at $240-00 per year for 10 years
	(v)		Transport expenses by ambulance for medical consultations at $210-00 per year for 10 years		$2,100-00
	(vi)		Cost of replacement of wheelchair		$3,000-00
	(vii)		Cost of replacement of hoist
	(viii)		Cost of diapers and wipes at $324-00 per month for 10 years ($324 x 12 x 10)		$38,800-00	$122,400-00
3
	(i)
		(a)		Plaintiff’s mother’s care at $400-00 per month for 3 yrs	$14,400-00
		(b)		Cost of maid at 70% of $667-50 per month for 3 yrs	$16,821-00
	(ii)	Nursing care at a Nursing home for 7 years at $2,100-00 per month plus $900 one time fee ($2,100 x 12 x 7 + $900)
	(iii)	Plaintiff’s mother’s transport expenses to visit Plaintiff at nursing home in the future			NIL __________
4	Plaintiff’s Loss of future earning & CPF (at a multiplier of 14 years) as follows:-
	(i)	1-3 years [$2,300 x 114.5% x 12 x 3]			$94,806-00
	(ii)	4-7 years [$2,500 x 114.5% x 12 x 4]			$137,400-00
	(iii)	8-14 years [$3,000 x 114.5% x 12 x 7]			$288,540-00	$520,746-00
5	Plaintiff’s Pre-trial loss of earnings & CPF as follows:-
	(i)	May to September 2001 at $600-00 per month [$600-00 x 116% x 5 months]			$3,480-00
	(ii)	October 2001 to September 2003 at $1,800-00 per month [$1,800 x 116% x 24 months]			$50,112-00
	(iii)	October 2003 to January 2004 at $1,800-00 per month [$1,800 x 113% x 4 months]
	(iv)	February 2004 to January 2007 at $2,000-00 per month [$2,000 x 113% x 36 months]
	(v)	February 2007 to June 2007 at $2,300-00 per month [$2,300 x 113% x 5 months]
	(vi)	July 2007 at $2,300-00 per month [$2,300 x 114.5%]			$2,633-50	$158,716-50
6	Pre-trial maid expenses
	(i)	Cost of employing maid (agreed)
	(ii)	Cost of part-time maid at 70% of $800-00 for 46 months			$25,760-00
7	Medical expenses, airfare expenses and ambulance expenses in respect of Plaintiff’s treatment in India
8	Massage expenses (past and future)
9	Singapore medical expenses (agreed)					$131,959-50
10	Transport expenses incurred in Singapore by Plaintiff (agreed)					$2,675-10
11	Transport expenses incurred by the Plaintiff’s mother to visit the Plaintiff whilst he was hospitalized					NIL
12	Miscellaneous expenses
	(i)	Cost of medical equipment			$24,889-44
	(ii)	Cost of health supplements			NIL
	(iii)	Cost of renovation of home			NIL __________	$24,889-44
13	Plaintiff’s mother’s pre-trial loss of salary at $400-00 per month for 71.5 months					$28,600-00
14	Plaintiff’s sister’s pre-trial loss of salary					NIL __________ $1,395,409.54

4 Both parties appealed against the Assistant Registrar’s awards. I shall deal with each head of appeal in turn.

The plaintiff’s appeal

Pain and suffering and loss of amenities

5 The plaintiff suffered the following injuries and disabilities:

- Severe head injuries to both sides of the brain, requiring bilateral craniectomies, shunting defects requiring VP shunting, refractory seizures and sepsis trachypnoea;

- Bilateral cord palsy requiring tracheostomy;

- Difficulty in swallowing requiring PEG tube insertion;

- Deranged liver functions and sepsis;

- Left iliac bone fracture;

- Disc protrusions at different levels of the dorsal spine causing cord compression, for which laminectomy was performed; and

- Contractures of the lower limb requiring tendo archilles lengthening.

and he is unable to move or talk and will require life-long medication for epileptic seizures.

6 The Assistant Registrar in making the awards acted on the evidence of neurosurgeon Dr Keith Goh that the plaintiff is likely to succumb to the injuries in ten years. It was not clear whether the ten years were to run from the date of injury, or the date of the assessment, and the Assistant Registrar proceeded on the basis that it was ten years from the date of assessment, and neither party took issue with that.

7 The plaintiff referred to several precedents in this appeal:-

(i) Mohamed Fami Hassan v Swissco Pte Ltd [1984-1985] SLR 675 in which an award of $180,000 was made to an injured workman who became a quadriplegic and was incapable of taking care of himself. However, little is known of the facts. Neither the age of the workman nor his injuries was disclosed. Counsel also informed me that the award was reduced on appeal to $100,000 after the workman died after the appeal was heard but before judgment was delivered. There was no written judgment for the reduction, and it is not known if it was made on account of grounds raised before the workman’s death, or on account of his death, or both.

(ii) Toon Chee Meng Eddie v Yeap Chin Hon [1993] 2 SLR 536 (“Toon”). The plaintiff, a boy of 7½ years suffered severe brain damage. He was paralysed on the right side and had intermittent involuntary movements of the right hand and right leg and the head, neck and body, and needed to take anti-epileptic drugs for life. He was unable to speak, and needed assistance to micturate and defecate, and had the intellectual ability of a six-month to one-year-old child and was wheelchair-bound. He was awarded $160,000 for pain and suffering and loss of amenities of life.

(iii) Fumihiro Hori & Anor v Singapore Bus Service (1978) Ltd & Anor, Suit No 2558 of 1982 (“Hori”). The plaintiff, a man aged 34, was awarded $125,000 in 1984 for unspecified brain injury, epilepsy, eye injury, loss of smell and loss of amenities.

(iv) Chen Qingrui v Phua Geok Leng, Suit No 937 of 2000 (“Chen”), the injured was an 18-year-old female. She suffered severe traumatic brain injury with generalised spasticity and minimal awareness. She was awarded $165,000 for the brain injury in 2001.

(v) TV Media Pte Ltd v De Cruz Andrea Heidi & Anor [2004] 3 SLR 543 (“De Cruz”), a more recent and better known case. The plaintiff, Andrea de Cruz was a television artiste. She was 27 years old, and she lost the use of her liver and had to undergo a liver transplant. At the first instance, the trial judge awarded her $250,000 for pain and suffering and loss of amenities, but on appeal, the Court of Appeal reduced that to $150,000. In coming to its conclusion, the Court of Appeal took into consideration awards in brain damage and cases of other injuries.

(vi) Tan Hun Hoe v Harte Denis Mathew [2001] 4 SLR 317 (“Harte”) where the plaintiff, aged 37, who was having fertility problems, underwent botched medical treatment which resulted in his testes being atrophied, and made it very unlikely that he would father any children. The trial judge assessed the damages for the injuries suffered at $50,000. On appeal, the Court of Appeal increased the general damages to $120,000. (The plaintiff recovered $72,000 only as liability was fixed at 60%).

8 Of the cases cited, Hori, Toon and Chen are brain damage cases. Hori offers little guidance as the extent of the brain damage is not described. The injuries suffered in Toon and Chen, although not identical to those suffered by the plaintiff here (such injuries are rarely identical), are comparable in that they left the subjects in a semi-vegetative state, dependent on the assistance of others. While De Cruz and Harte are not brain injury awards, they are relevant as indicators of the levels of severity of injuries and disabilities for which awards of $150,000 and $120,000 have been made by the Court of Appeal. They are also recent awards of 2004, whereas the brain damage awards are older.

9 Reviewing the cases, I am of the view that the $170,000 award is low, being only $5,000 higher than the 2001 award in Chen, and $10,000 higher than the 1993 award in Toon, and when compared with the awards of $120,000 and $150,000 for the testicular injury in Harte and liver injury in De Cruz respectively which are significantly less severe than the injuries suffered by the plaintiff. I will increase this award to $185,000. (All references to increases are stated on a 100% basis, and are to be adjusted to 95% to accord with the interlocutory judgment.)

Future medical expenses

10 The plaintiff’s counsel submitted that there should be an award for future medical expenses that the plaintiff may incur if complications such as chest infections, bed sores or VP shunt infection set in, which require hospitalisation. Dr Keith Goh was of the view that the plaintiff had at least a 50% chance of developing these complications within a year of the assessment and that he would require two to three hospitalisations a year with the cost of...