PAN WA CHUN v. YUEN LONG MERCHANTS ASSOCIATION SECONDARY SCHOOL

HCPI 157/2008

IN THE HIGH COURT OF THE

HONG KONG SPECIAL ADMINISTRATIVE REGION

COURT OF FIRST INSTANCE

PERSONAL INJURIES ACTION NO. 157 OF 2008

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REASONS   FOR  DECISION

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1.  There are three matters at this Pre-trial Review:

(1) leave to adduce evidence of a pain expert;

(2) leave to call the respective orthopaedic experts;

(3) leave to call the respective psychiatric experts.

2.  The Plaintiff was a general worker with the Defendant school.  She was tasked to move a 50 lb metal desk with a colleague.  She alleged spraining the left wrist.  The accident occurred in April 2005.  She consulted various doctors successively because of persistent pain.  It was not until September 2005 that Triangular Fibro Cartilage Complex (TFCC) was diagnosed upon arthroscopy.  The tear was healed by then, but with remaining synovitis (inflammation).  Shaving of the inflamed tissue and searing of the scar was performed.  But pain persisted, allegedly diffusing to the left shoulder.  She was referred to the pain clinic and there is a suggestion of Complex Regional Pain Syndrome (CPRS).

3.  The respective orthopaedic experts are Dr Li Wing-kin and Dr Lam Yan-kit.  Dr Lam doubted whether that TFCC was caused by the index accident or another accident in July 2005.  He referred to the physiotherapist’s notes on 11 July 2005 in recording bruises over left hand and elbow contusion.  Dr Lam recognized signs of CPRS, but deferred to the opinion of a pain expert.

4.  The respective psychiatric experts are Dr Law Wun-tong and Dr K Singer.  Dr Law’s diagnosis was adjustment disorder with mild depression, the stressor being the injury.  Dr Singer did not make the diagnosis of adjustment disorder, but accepted symptoms of mild to moderate depression.  Dr Singer suggested exaggeration in the Plaintiff’s complaint of hallucination of being haunted a killer threatening her life.  Dr Law explained that hallucination of being accused of useless is only “pseudo-hallucination” and is consistent with adjustment disorder.

5.  Mr Hingorani, for the Plaintiff, pointed out that there is suggestion of diffusion of the pain to other parts of the body, and the Plaintiff was referred to pain specialists by his treating orthopaedist.  Literatures suggested investigative anaesthetic tests isolating sites of pain might identify the cause(s).

6.  I noted that shoulder pain and CPRS are matters the judge will have to deal with, and pirma facie the investigative tests may be helpful to the determination.  I suggested that the appointment of a single joint expert may be appropriate as the exercise is investigative in nature.  Both parties agreed to a SJE.

7.  On calling the orthopaedic experts, Mr Hingorani submitted that the Plaintiff will have an explanation on the July 2005 injury, to be supported by other medical records to be identified.  The purpose of calling Dr Lam for examination is to put to him the suggested explanation of the Plaintiff on a “what if” basis, to see whether he still has any doubt on causation.

8.  I observed that the clarification with Dr Lam on “what if” basis could be undertaken now before deciding whether to call him.  The Plaintiff is yet to make a witness statement on the point.  I suggested the Plaintiff to file and serve a supplemental witness statement, and solicitors for the parties to identify the medical records and frame the questions for consideration by Dr Lam.  They agreed.  They also agreed that there is no need for any joint report or comments by Dr Li.

9.  Counsel for both parties requested calling the respective psychiatric experts.  They accepted that both doctors are not far off on symptoms of mild depression.  Mr Hingorani agreed that adjustment disorder would not indicate hallucination of threats to life, and Dr Law’s suggestion of “pseudo-hallucination” did not deal really with that point.  As such, there is ample materials for the judge to resolve the psychiatric evidence without calling the doctors.  Counsel did not persist.

10.  In the premises, I ordered a SJE report by a pain expert to be filed within 3 months, and Dr Lam to submit a supplemental report in response questions agreed to be by the parties within that time.  The question of calling the orthopaedic experts may be revisited upon the filing of the supplemental report.

11.  I fixed a 2^nd PTR on 14 September 2009 at 2:30 pm to review the expert evidence, to be dealt with on paper if possible.

12.  I ordered costs in the cause with certificate for counsel and legal aid taxation.