Tan Yu Min Winston (by his next friend Tan Cheng Tong) v Uni-Fruitveg Pte Ltd

JudgeChan Seng Onn J
Judgment Date01 August 2008
Neutral Citation[2008] SGHC 123
Docket NumberSuit No 859 of 2004 (Registrar's Appeal No 195 of 2008)
Date01 August 2008
Published date04 August 2008
Plaintiff CounselRamasamy K Chettiar (Acies Law Corporation)
Citation[2008] SGHC 123
Defendant CounselMahendra Prasad Rai (Cooma & Rai)
CourtHigh Court (Singapore)
Subject MatterAssessment of damages,Whether to substitute exercise of discretion,Personal injuries cases,Whether component or global approach to assessment,Damages,Appeal from Registrar to judge in chambers,Head injuries from road traffic accident,Measure of damages

1 August 2008

Chan Seng Onn J:

1 The plaintiff sustained serious head injuries in a road traffic accident on 31 July 2003. Interlocutory judgment was obtained on 12 January 2005 against the defendant with damages to be assessed and costs to be reserved to the registrar.

2 The plaintiff was 13 years old at the time of the accident and a student in secondary 1. At the time of the assessment in May 2008, he was aged 17 and a student at Temasek Polytechnic.

3 The particulars of the personal injuries in the plaintiff’s claim were based on the medical reports of three doctors attached to the statement of claim:

(a) Dr Charles Seah, the Senior Consultant and Neurosurgeon, Department of Surgery at Changi General Hospital;

(b) Dr Ho Ching Lin, the Associate Consultant, Division of Ophthalmology at Changi General Hospital; and

(c) Dr Karen Chua, Consultant, Department of Rehabilitation Medicine, Tan Tock Seng Hospital.

Medical Report of Dr Charles Seah

4 In his medical report dated 5 September 2003, Dr Charles Seah stated that the plaintiff was admitted to Changi General Hospital after the accident with the following injuries:

(a) The left eye globe was ruptured with severe oedema surrounding tissue.

(b) There were multiple lacerations over the face with bleeding from the nostrils and mouth due to multiple nasal bone fractures and an orbital bone fracture.

(c) CT head scan showed a left temporal extradural haematoma with subdural and traumatic subarachnoidale haematoma and brain oedema and brain contusion.

5 An operation was done to remove the blood clot and the bone flap. Suture and toilet facial lacerations, packet nasal bleeding and repair of the ruptured left eye globe were done by the eye surgeon.

6 After the operation, the plaintiff’s condition improved gradually and he regained his consciousness. He was able to see but with blurring of vision. Occasionally, the plaintiff became violent and he developed some depression. Neurosurgically, the plaintiff required to be followed-up for 6 to 12 months and his bone flap needed replacement.

Medical Report of Dr Ho Ching Lin

7 Dr Ho Ching Lin in her medical report dated 31 October 2003 described her treatment and prognosis, and assessed the multiple injuries to both eyes sustained by the plaintiff to be as follows:

(a) Multiple lid lacerations were repaired on 31 July 2003. The plaintiff had visible scars as well as mild left lagophthalmos with no exposure keratopathy.

(b) Left globe was ruptured. There was a stellate corneal laceration with loss of a significant portion of the iris tissue in the left eye at the time of the injury. Prolapse of vitreous gel through the corneal wound was observed at the time of primary repair. Toilet and suture of the corneal laceration, as well as limited vitrectomy and anterior chamber reformation was performed on 31 July 2003. He has a left traumatic aniridia with only a residual stump of iris from 10 to 3 o’clock.

(c) There was a right traumatic optic neuropathy with optic atrophy.

(d) There was bilateral choroidal rupture with right vitreous haemorrhage and left sub-retinal haemorrhage. The right vitreous haemorrhage was still present in the inferior portion of the right posterior segment and was bleached. The left sub-retinal haemorrhage had resolved. Crescentric scars at the site of the choroidal ruptures were seen at the posterior pole of both eyes. A risk of later development of sub-retinal neovascular membranes associated with these ruptures exists.

(e) There was a right traumatic cataract. Anterior and posterior sub-capsular opacities of the right crystalline lens were seen secondary to the blunt trauma.

(f) At the last ophthalmic outpatient review on 17 October 2003, the plaintiff had unaided visual acuities of 6/18 in both eyes, which pinholed to 6/12p on the right and 6/9p on the left. There was no anterior segment inflammation and the intraocular pressures were normal. The left corneal sutures were intact. Bleached vitreous haemorrhage was seen in the right eye.

Medical Report of Dr Karen Chua

8 In Dr Karen Chua’s medical report dated 18 October 2004, she gave an overview of the injuries of the plaintiff, his treatment, rehabilitation and the progress he achieved in his recovery from the injuries, including the condition of the plaintiff as at 22 June 2004. She wrote:

The above named suffered severe traumatic brain injuries at the age of 13 on 31 July 2003 after being involved in a road accident as a front seat belted passenger. He had a left temporal extradural haematoma with craniotomy and evacuation, rupture of the left eye, tear of the right eye retina, multiple facial lacerations and multiple nasal bone fractures and orbital wall fractures.

He completed inpatient rehabilitation at TTSH rehabilitation centre from 22 August 2003 to 2 September 2003. He had emerged from post traumatic amnesia after 1 month duration and was discharged functionally independent with residual emotional liability.

I have reviewed him as an outpatient at TTSH rehabilitation centre on 30 September 2003, 22 December 2003, 30 March 2004, and 22 June 2004. He has returned to school (secondary 2 express stream) since January 2004 and has scored borderline results since his head trauma. He has functional vision with refractive glasses and has hypermmetropia. He had plastic surgery for facial scar reduction and eyelid repositioning, elective cranioplasty to replace his bone flap in December 2003.

He is independent in the community and has slowed processing and impaired memory retrieval. He requires anti-depressant therapy for agitated depression and anger management. He has responded positively to this medical management and psychological counseling. Detailed cognitive testing on 30 March 2004 using the Weschler Intelligence Scale for Children showed overall low average performance on all cognitive domains and this represents a significant reduction from estimated premorbid status. He has reduced insight into his deficits and problems with high level planning.

In summary, he has suffered residual cognitive and behavioural deficits following severe head injury in 2003 and has facial scarring and visual impairment from bilateral eye trauma.

He will continue to benefit from remedial tutoring at the school level, psychological counseling and psychiatric interventions at the Child Guidance Clinic at IMH. Please obtain detailed reports from his plastic and eye surgeons and psychiatrists.

Other Medical Reports

9 To help understand the extent and permanence of the plaintiff’s injuries, the progress of the plaintiff in his recovery from the severe head injuries and how the injuries affected the plaintiff, counsel for the plaintiff very helpfully summarised the other reports from various doctors in his submissions as follows, which I had carefully considered:

(d) PB10 – This report is dated 10.1.05 from Dr. Daniel Fung a Consultant Psychiatrist at IMH. Dr. Fung noted that the Plaintiff has poor anger control. Neuropsychological testing revealed below average function in memory and verbal skills. The poor anger management may be related to several factors, the serious brain injury to the temporal lobe which is associated with emotional control, the cosmetic injuries which make the Plaintiff the subject of teasing and ridicule, as well as his having to cope with educational demands, which is made difficult by missing half a year in school in 2003. The Plaintiff is diagnosed to have a head injury resulting in memory and temperamental changes. He is currently placed on medication at night to help control his anger and is being seen for individual counselling by a medical social worker. Due to the Plaintiff’s poor verbal memory, he has suggested to teachers that they employ new memory strategies using visual cues which can utilise his fairly intact visual memory and help him learn better.

(e) PB11-14 – This is the neuropsychological report done on 19.4.04 by Ong Li Min. Under opinion at PB14, it is reported that the test results indicated mild intellectual decline, particularly in verbal reasoning skills, as well as specific impairment in verbal memory and verbal fluency, with other aspects of cognitive functioning being generally consistent with pre-morbid intellectual and cognitive functioning. The Plaintiff’s parents and teachers will need patience and understand that he may currently have more difficulties in the areas of impairment which affect his academic performance. Stress and anger management skills may help the Plaintiff cope with his frustrations and adjust to the changes that he has to face after the accident.

(f) PB15 – This report from Dr. Por dated 29.6.05 shows that the Plaintiff sustained nasoethmoid orbital fractures. As of that date the Plaintiff had bone graft reconstruction of cranioplasty defect, frontal sinus, bilateral medial orbital walls and transnasal canthopexy. More treatment will be required for orbital deformity.

(g) PB52-53 – This is a memo from Ms. Judy Yap (psychologist). She noted that the Plaintiff has visual problems and has requested the school teacher to allow the Plaintiff to be seated at the front of the class so that he is able to see the blackboard. Ms. Yap also evaluated the Plaintiff for exam stress. She observed that the Plaintiff’s method of learning was by memorisation rather than meaningfully understanding the material. This could explain his difficulties in learning some of the subjects that require conceptual processing of the information.

(h) PB55 – This is a memo from Dr. Charles Seah dated 21.2.06. It is stated that the Plaintiff sustained a right eye traumatic cataract and vocal cord injury (one side not functioning). Dr. Seah asks that the Plaintiff be allowed an extra hour for all examinations as he requires a longer time to read and answer all questions on the paper.

(i) PB58 – This is a memo from Dr. Annette Ang dated 19.9.06. In this report it was noted that the Plaintiff had right...

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1 books & journal articles
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