SHUM TING YUK v. LAM KAM LUEN and Another

1988, No. A714

IN THE SUPREME COURT OF HONG KONG

HIGH COURT

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ASSESSMENT OF DAMAGES

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1. On 10th February 1987 the Plaintiff, Miss Shum, who was then aged 28, was travelling as a passenger in the back of a private car driven by the 1st Defendant, and owned by the 2nd Defendant, when it was involved in a head on collision with a light goods vehicle.

2. These proceedings were commenced on 27th January 1988 and the 1st Defendant indicated by his acknowledgement of service that he did not contest the claim. Judgment was accordingly entered against him on 25th April 1988 for damages to be assessed. The 2nd Defendant having put in a defence to the claim, the parties agreed to proceed with the assessment of damages against the 1st Defendant, and, subject to the damages being paid, not to proceed against the 2nd Defendant.

3. In the accident in February 1987 the Plaintiff suffered a number of injuries of varying severity which are set out in the Statement of Claim but may be summarised as follows:-

(a) loss of consciousness and a penetrating injury to the skull allowing air to enter the cranial cavity, although no fracture could be detected on X-rays;

(b) lacerations and bruising to the face and a laceration to the right hand ;

(c) extensive damage to the mouth resulting in the loss of six teeth and some of the supporting bone, requiring prolonged dental surgery;

(d) prolapsed intervertebral disc at L-4/L-5 level.

4. As a result of these injuries, the Plaintiff was admitted initially to Princess Margaret Hospital, transferred to Queen Elizabeth Hospital the next day, and discharged on 24th February 1987.

5. However, these are what might be described as the immediate injuries, it being contended by the Plaintiff that this was only the beginning of a number of physical and mental disorders arising from the accident which have prevented her from permanent employment since, and are continuing to this day. This contention is disputed by the Defendant who maintains that many of her subsequent complaints are not related to the injuries she received in the accident, and that she should, and could, have returned to work had not other, unrelated complaints not arisen. It will accordingly be necessary to look in some detail at the medical evidence, which has taken up a large amount of the unusually prolonged time this assessment has taken to complete, and the treatment which the Plaintiff has undergone.

6. The injuries and subsequent treatment which are not in dispute relate to the damage to the Plaintiff's mouth, and the lacerations and consequential scarring to the face and hand, although, as will be seen later, the psychological effects of the latter are part of the Plaintiff's case not wholly accepted by the defence.

7. The injuries to the mouth noted by the consultant oral surgeon at Princess Margaret Hospital on the day of the accident were loss of a number of teeth, derangement of the occlusion, i.e. inability to close the mouth properly, and a suspected fractured left mandible, although this was never confirmed. A more detailed report by Professor Robert Clark of the Prince Philip Dental Hospital following examinations on the 12th and 25th November 1987 noted in addition severe loss of alveolar bone, and bone supporting the teeth in the lower law, and recommended extensive restorative treatment. This was commenced in June 1988 and over the next twenty six months the Plaintiff attended at the Prince Philip Dental Hospital no less than 40 times for outpatient treatment, and was an inpatient at Tsan Yuk Hospital from 17th January 1990 to 25th January 1990, when a bone graft was taken from her right hip to replace some of the lost bone in her mouth. During this time dental implants were inserted in the bone of the jaw and implant-retained dentures fitted, in addition to numerous other procedures to correct the damage to her teeth, including root canal therapy, amalgam restorations, a ceramo-metal crown and partial upper and lower dentures. The upper dentures were replaced by the implant-retained dentures, and in April 1991, at the request of the Plaintiff, surgery was commenced again to replace the lower dentures with implants. This was completed finally in December 1992.

8. The Plaintiff therefore had to undergo extensive and major reconstructive surgery to her mouth over a period which lasted altogether nearly six years from the date the original injury was sustained.

9. As to the facial scarring, the initial injuries noted at Princess Margaret Hospital were a 5 cm. laceration across the right zygomatic region, a 2 cm. laceration above the nasal bridge, and a 1 cm. laceration over the submental region communicating with the oral cavity, although Dr. Otto Au, who was consulted by the Plaintiff in relation to the scarring in April 1987, noted a total of five scars on the face. Dr. Au carried out a total of six operations for scar revisions, scar excision and dermabrasion between April 1987 and September 1988 and, in a report of 16th July 1991 noted that the scars had all healed well and were practically invisible, except for that on the right cheek which was still slightly visible. The Plaintiff has chosen to try to conceal this scar with a flesh coloured sticking plaster which she wears permanently, and as a result, the skin adjacent to the scar is of a paler colour than the surrounding skin, making it even more conspicuous if the plaster is removed. It is noted by several of the doctors who have examined the Plaintiff over the years that she is excessively sensitive about her perceived facial disfigurement, and this has not assisted her psychological or psychiatric problems, which I shall deal with later, and, indeed, may at least partly have caused them. Having seen the Plaintiff at trial, and had an opportunity to see the facial scars close to, I am of the view that the disfigurement, if any, from these scars, is minor, and could easily be disguised by the use of cosmetics, in which the Plaintiff herself claims some expertise from one of her pre-accident occupations. There seems to be no further complaint regarding the scar on the right hand.

10. The Plaintiff also pleads continuing pain in the hip and weakness in her right hand. However, I can find nothing in the medical evidence to account for the hip pain, and the evidence with regard to the right hand does not reveal any connection with the accident. I therefore propose to ignore these.

11. The first matter in dispute regarding the medical evidence relates to the head injury and the degree of its severity. Mr. Pirie on behalf of the Plaintiff points to the evidence of air having entered the cranial cavity, caused almost certainly by a fracture, and the loss of consciousness and post-traumatic amnesia, as indicating that the injury was severe. The fracture, probably through a paranasal sinus, cannot have been more than very minor as it was not visible on any x-rays taken at the time. Dr. Shroff, in his report of 31st October 1994, refers to this as the Plaintiff's "biggest problem" with a risk of the introduction of bacteria and the possibility of meningitis, although in evidence he conceded that the risk now is very remote, and the air itself would have been absorbed. I accept that, while this injury may be some evidence of the severity of the blow she received to the head, it was in itself comparatively minor, and there is no, or no significant, risk to the Plaintiff as a result of it.

12. What then is the significance of the period of post-traumatic amnesia? The evidence of this is solely from the Plaintiff's account of waking up in Queen Elizabeth Hospital, where she had been taken the day after the accident, although the medical reports refer to her as being conscious with coherent speech when first admitted, giving rise to an assumption that she had amnesia for the period before she "woke up" in Queen Elizabeth Hospital. Unfortunately none of the hospital records were produced so we do not know what period of amnesia was noted by the doctors at the time. On the evidence available, I have to assume that the period was in the region of 24 hours.

13. Dr. Shroff referred to the Glasgow Coma Scale and the criteria laid down by Professor Jennett at the University of Glasgow in support of his contention that this indicated a "severe" head injury, on the basis that, under that scale, any period of post-traumatic amnesia between one and seven days indicated that the head injury was in the "severe" category. Dr. Brian Choa, called on behalf of the Defendant, disagreed with that proposition. He pointed out that there is a lot of difference between one day and seven, and while less than 24 hours post-traumatic amnesia was insignificant, seven or more days was very severe, so that 24 hours or a little more was probably not severe. He went on to say that post-traumatic amnesia was only a rough guide to severity, and when assessing severity retrospectively was not a major consideration, the intention of the scale being as a guide to management of head injuries at the time, so that conscious patients were not released too early when the injury may be quite severe. He said the duration of post-traumatic amnesia is a guide only, and now a number of years have elapsed since the accident, and it is known that other complications such as inter-cranial bleeding did not occur, the injury to the head could be assessed as significant but mild.

14. He also disagreed with the finding of Dr. Shroff that there had been diffuse damage to the white matter of the brain. This is a matter that Dr. Shroff deals with briefly in his report, and mentioned in his evidence, and said that it would account for the Plaintiff's slowness of thought. No other evidence of damage to the white matter of the brain was given, nor any other explanation by Dr. Shroff as to how he arrived at that conclusion. Dr. Choa, on the other hand, gave evidence that such damage would be extremely severe with the effects being obvious, and such was not the case here. To some extent, that is supported by Dr. Shroff's report of the C.T. scan of the Plaintiff's brain where he found that the ventricles were normal in shape and size, that there was no evidence of any abnormal space-occupying lesion or focal mass, and no evidence of any infarction.

15. I am bound to say that, where they disagree, I prefer the evidence of Dr. Choa to that of Dr. Shroff, and I find that the head injury sustained by the Plaintiff was, as Dr. Choa says, significant, but was not severe, and any damage healed completely within a comparatively short time. It is therefore unlikely to be the cause of the numerous complaints from which the Plaintiff still maintains she suffers and I do not consider that she now has any residual disability caused by that injury alone.

16. The next matter, where the dispute relates to the residual disability alone, is the injury to the Plaintiff's back. It is not disputed that the Plaintiff suffered an injury to her back for which she was treated by surgical excision of the disc at L4/L5 level in October 1988. Following this, it was reported by the orthopaedic surgeons under whose care she was, that although leg and ankle pain she had experienced was cured, back pain persisted in spite of physiotherapy and other treatment. However, it was noted in their reports in 1990 that there was then evident psychological and psychiatric disturbances which possibly aggravated the symptoms, and, until that was dealt with, her condition would not improve in the near future. The Plaintiff was examined by a medical board in August 1991, about a year later, which found that she had a sitting tolerance of about one hour, she had lumbar-sacral tenderness, full straight leg raising, mild decrease in flexion, but no neurological deficit, and gave as their view that she suffered from chronic low back pain with heavy psychological element. They estimated the permanent disability at 5%. Dr. Shroff examined the Plaintiff in October 1994 and found that there were degenerative changes in the L5/S1 region which were due to natural causes, but aggravated by the trauma, and gave evidence that it was this that was the cause of her current pain. Dr. Chun Siu-Yeung, called on behalf of the Defendant, agreed that this was probably caused by the accident, and while he thought that she had been exaggerating her symptoms during his examination, the limitation of lumbar movement amounted to an impairment of 19%, an assessment with which Dr. Shroff agreed.

17. It is clear from this that the Plaintiff did suffer an injury to her back in the accident which has caused continuing pain and discomfort, for which surgery was not a complete answer, and which has resulted in a disability which is likely to be permanent.

18. However, as has already been mentioned, the Plaintiff's difficulties are exaggerated and exacerbated to a marked degree by her psychological problems, which are noted in most of the medical reports produced and in the evidence of those doctors who appeared at the trial. It is clear from the evidence that she suffers from severe depression which itself is responsible for a number of other complaints, mainly of a psychological nature. When interviewed by Mrs. Shelley Chow, an occupational therapist, in August 1994 for the purpose of assessing her disability and employability, the Plaintiff listed some 37 complaints, many of which are clearly a result of her depression, such as loss of self-confidence, fear of going out or taking lifts alone, and some which cannot be accounted for by her documented injuries, such as pounding in the ears and painful ribs. Dr. Bernard Lau, in his report of 1st June 1988, was of the opinion that she was suffering from a depressive illness which was precipitated by and arose out of the accident. The main reason for this, apart from the natural shock of the accident, was, in his view, the immediate effect the injuries had on her facial appearance. I accept that, prior to the accident, she took a pride in her appearance, and, from the photographs she has produced of herself at that time, with some justification. One of her occupations was as a beautician, which she intended not only to continue but to build up as a career, and she felt that her appearance after the accident had now prevented that. It cannot be denied that she does now present an unprepossessing appearance. She is overweight, without apparently any attempt at cosmetic improvement to her facial appearance, and with the sticking plaster already referred to on her face which she believes looks better than the scar beneath it. She clearly believes that her appearance is a result of the accident and her injuries, but it is equally clear that her depressive state is now the prime cause of her lack of any attempt to improve her appearance or the quality of her life, or to attempt to return to the workforce, and while it persists, it is the principal reason she is now unemployed and likely to remain so.

19. Miss Sze on behalf of the Defendant contends that the depression was caused, or at least overtaken, by subsequent events unconnected with the accident. It is true that, shortly after the accident, the Plaintiff's boy friend broke off their relationship, and not long thereafter her father, to whom she was very close, died. She later entered into another relationship as a result of which she became pregnant, but had a miscarriage early on in the pregnancy and later that relationship also terminated. However, I accept that, to her, the effects of the accident were, as Dr. Lau says, catastrophic. The scarring, and the damage to her mouth until the completion of her dental repairs some years later, had taken away what she regarded as one of her main assets, her looks. The immediate result of this was the onset of depression which was aggravated by the other unfortunate events which subsequently occurred. Miss Shum might be forgiven for thinking that the hand of fate was very much against her. It is clear from the evidence that without help she had no prospect of regaining her self-esteem, her confidence or even her ability to face the normal events of everyday life, and certainly not to return permanently to any form of employment. To her credit, she underwent years of painful treatment for her scars and her teeth, and an operation on her back followed by months of physiotherapy. At the same time she had other medical problems unrelated to the accident, although I do not believe that any of these would have otherwise prevented her from working other than for short periods. But no one offered to her, or suggested that she needed, intensive psychiatric therapy, apart from Dr. Lee Wai-keung, the orthopaedic surgeon, who referred her to the psychiatric clinic in a Government hospital. It does not appear that this was a success, and in any event the Plaintiff stopped going to that clinic after a threatening incident involving another patient. After that it appears that all her medical examinations were for the purpose of these proceedings rather than to treat her complaints. It may be that she has not been well served by the medical profession, many of whom she has seen over the last few years, and possibly by the legal profession to whom the various reports on her condition were directed. Be that as it may, little treatment has been given prior to last year for her principal complaint now, which is her depressive state, which in turn is responsible for many of the debilitating symptoms from which she now suffers.

20. Miss Sze contends that the Plaintiff's present condition is not wholly caused by the accident, and that the subsequent events, the loss of her boy friend, the death of her father, the end of the second relationship and her miscarriage, all contributed to her mental state and may have caused it. She seeks to cast doubt on the existence of depression caused by the accident by drawing my attention to the Plaintiff's evidence that she had been hopeful that the treatment by Dr. Au would restore her looks, that she conscientiously attended all appointments for treatment for her scarring and her dental repair.

21. I accept that, on the authority of Jobling v. Associated Dairies [1981] 3 W.L.R. 155, if a supervening illness totally unconnected with the accident renders the Plaintiff disabled, then this cannot be disregarded in assessing general damages for pain, suffering and loss of amenities, and any loss of earnings would only fall to be awarded up to the date of the supervening illness. Equally, where there are a number of possible causes of an illness or disability, only one of which the Defendant is liable for, and the Plaintiff cannot prove the causative link between the Defendant's negligence and the disability, the Plaintiff must fail in seeking damages for that disability (Wilsher v. Essex Area Health Authority [1988] 1 All ER 871). However, the medical evidence here clearly points to the accident as being the prime cause of the Plaintiff's depression, whether as a result of the trauma itself, or the results of the injuries and the fear of the Plaintiff of the consequences. While there are a number of events which might have triggered that depression if the accident had not occurred, and it does appear that the Plaintiff was a young lady of fragile mental balance, the fact remains that it was the accident which triggered it, and the subsequent events aggravated it to the extent that, as the doctors largely agreed, she became totally unemployable until the condition should be successfully treated.

22. I am accordingly satisfied on the evidence that the Plaintiff's present condition is solely attributable to the accident and therefore to the negligence of the Defendant. Each of the physical injuries on their own would not have been extremely serious. Indeed, without the mental problems, the Plaintiff would probably have made a substantial recovery and returned to work some time ago, albeit with some continuing loss of earning capacity. The depression added to the other injuries has, however, as Dr. Choa concedes in his report, made her presently incapable of work at all.

23. Miss Sze further contends that the Plaintiff has failed to mitigate her loss by seeking treatment earlier than she has. Throughout her treatment over the years a number of the doctors who have seen her have commented on her mental condition, their opinions varying from " a heavy psychological overlay" to "post-traumatic depressive disturbance" and "very depressed and slow thinking". But I am satisfied that, although she was aware of her problems, she did not know precisely the sort of treatment that she should seek, as she knew what was needed for her scars and her teeth, and no-one until recently has offered it to her or urged her to undergo it.

24. Mr. Pirie has submitted that the Plaintiff's injuries fall within the "substantial injury" category as described by Cons J.A. in Lee Ting-lam v. Leung Kam-ming [1980] H.K.L.R. 657. He points out that the categorisation in that case is based on mobility and envisages damages to limbs and paralysis, and does not cover cases such as this where the injury is more generalised, and difficult to define, involving as it does a large psychological element. In Dominga Lakhan v. Wu Wing Tat and anor. HCA 3641 of 1983, Nazareth J, as he then was, considered this problem of adapting the guidelines for cases not involving loss of mobility and accepted that there can be factors, not in themselves disabling, but sufficient to take a case from one category to another. As in that case, the Plaintiff's physical injuries here would fit clearly into the lower category of serious injury. Her scarring is minor, her dental problems have been resolved through treatment, the pain from her back injury, though persistent, is not a major disability. However, the other factors present here, the lengthy painful treatment she has undergone, the depression to which she has been, and still is, a victim, and the change all this has wrought in the life of a young lady, described in one report as being, prior to the accident, sociable and outgoing, clearly warrant an award of damages within the "substantial injury" range.

25. The levels of damages in the various categories was last reviewed by the Court of Appeal in December 1994 in Chun Yat Nam v. Attorney General C.A. 92 of 1994, when the range in the substantial injury category was put at $335000 to $415000, to take account of inflation since 1988 when they were considered in Lau Che Ping, and I believe that I am entitled to take into account inflation since then in arriving at an appropriate figure.

26. I consider that a proper figure to award here for pain suffering and loss of amenities is accordingly $410000.

Loss of earnings

27. Prior to the accident the Plaintiff worked as a cashier in a bowling centre for which she earned an average of $25000 a year or $2083 per month. In addition to this she says that she worked as a free-lance beautician, at the same time selling beauty products to clients for which she also earned commission. In the statement of claim filed on her behalf in January 1988 it was pleaded that her earnings from this source were $2000 a month. This was amended in March 1995 to $3000 a month, in accordance with her claimed earnings in her witness statement filed in December 1994, and re-amended in September 1995 to $4945 a month, giving total earnings prior to the accident of $7028 a month. While the Plaintiff sought to justify the later figures by giving examples of the work she did in her beauty business and the number of clients she attended on average, I have to say that this part of her evidence was not convincing. On her own admission her memory is poor, and she could produce no records of customers or receipts for that period. I consider it safer to rely on her impressions of her overall income given to her instructing solicitors for the preparation of pleadings and her witness statement. Her first figure of $2000 may well have been given without much thought initially, and I am prepared to accept that the second figure of $3000, which after all is in her witness statement as her evidence in chief, and is more likely to be accurate. I therefore find that her earnings prior to the accident were $5083 per month.

28. The next question is what she would have been earning today had the accident not occurred. The Plaintiff maintains that she always intended to make the beauty business her principal full-time career, and a considerable amount of evidence has been adduced as to what a beautician earns at a high class beauty and fitness salon in Central in support of her contention that that is what she would be earning today. This, in my view, is departing too far from reality. The Plaintiff is, on her own counsel's description, from a poor socio-economic background, and probably of limited intelligence. She lives with her family in Government housing on Tsing Yi Island and left school after Form 1. Her training was by way of a course run by a local beauty parlour called "Tinny Beauty House" who granted her a certificate in 1980, since which time she had continued to work full time as a cashier in the bowling centre, doing her beauty work in her spare time. This is not the picture of someone who is likely to be appointed to a position in an organisation such as Phillip Wain, where the minimum educational requirements are Form 5, and where earnings are available of $12000 a month and upwards for a trained beautician. Indeed, it has not been the evidence of the Plaintiff that this was what she intended. The Plaintiff says that she was building up her client base to a point where she could give up her work as a cashier. However, she had been in the business for 7 years by the date of the accident, and was then only earning $3000 a month from this source, and there has been no evidence of the size of her client base nor the increase in it over the years.

29. I find it more likely that she would have continued as she had been prior to the accident, with a full time employment to give her a steady income, and her beautician business in her spare time to supplement it. If she had gone into the beauty business full time, I consider it unlikely in the extreme that she would have done so other than as an employee in a local small salon, or possibly as a free-lance in the area where she was known and had an established clientele, and her earnings would have reflected this. Whatever her ambition, I do not believe that she had the education or the ability to go further than this. Her earnings today, therefore, would not in my view be markedly different from those in 1987 apart from the increase following upon inflation over the years. Taking this at a fixed 10% a year since the accident, this would give her earnings from the bowling centre of $4465, which the Defendant is prepared to concede at $4900 including allowances plus one month's extra pay at Chinese New Year, giving a total of $5308.30 a month, which I accept as a accurate estimate, and in accordance with the evidence of present earnings in such an occupation.

30. As to her earnings as a beautician, in the absence of any reliable evidence of what someone in her position would earn today, I have no choice but also to apply the same rate of inflation to her pre-accident earnings of $3000, which I find comes to a figure of $6430.70 a month, giving a total for present day earnings of $11739.00 a month, and a median for the pre-trial period of $8411 (i.e. $11739 + $5083 ÷ 2).

31. From what I have said above regarding the Plaintiff's injuries, the effects of them on her over the whole of the period since the accident, and her present condition, it is apparent that she has been totally disabled from the point of view of employment and earning capacity, and I see no reason not to award her a total loss of earnings for the whole period, up to the conclusion of this trial, which itself has lasted over 10 months.

32. I accordingly assess the Plaintiff's pre-trial loss of earnings at $870538.50, being $8411 × 103.5 months.

33. As to her loss of future earnings, this clearly depends on the extent to which she will recover and how long that will take. Her principal disability now being the depression, from which so many of her other actual and imagined ailments spring, what are the present realistic probabilities? Dr. Bernard Lau was of the opinion that, with a course of intensive treatment over 6 to 12 months, there is a probability of modest improvement, following which she could return to part-time work with relatively few demands, with, however, occasional relapses, and a possibility of a complete recovery. It has to be borne in mind that she has suffered from depression now for some years, with little proper treatment until she was admitted to Kwai Chung Hospital about 10 months ago, and I do not know what treatment she is in fact receiving. Mrs. Hannah Chung agreed with the assessment of 6 to 12 months of treatment by way of psychotherapeutic counselling and psychiatric help to enable her to work part-time. It is bound to be speculative at this stage, depending as it does on the response of the Plaintiff to treatment, but both of these witnesses agreed that it is unlikely that the Plaintiff would ever be able to return to full-time work. The evidence of loss of earning capacity from the other medical witnesses, and the reports, varied in respect of the physical disabilities, notably the residual back pain, from a low of 5% by the Medical Board, to 20% by Dr. Chun Siu Yeung.

Doing the best I can on the wide divergence of medical views, I consider that the Plaintiff will be able to return to some employment within 12 months and will have a continuing loss of earning capacity from then of 50%.

34. Although it has been urged upon me by Miss Sze that the Plaintiff would have had a career as a beautician limited to age 40, in the area of such business that I have found it more likely she would have pursued her career, that is not in a top flight international beauty salon, I see no reason to place such a limit. In any event such a career may well have taken a different course with increasing age such as training others to do the work. I therefore propose to apply the same multiplier to the loss of earnings that I have found, rather than trying to forecast how long a particular career would have lasted.

35. Mr. Pirie has submitted that a multiplier of 12 is appropriate here. However, I cannot overlook the fact that it has taken some 7 and a half years to bring this matter to trial, although I make no criticism of that here, as there have been reasons for the delay. Whether they were justified or not may be a matter I have to consider at later stage. Be that as it may, if I were to accede to Mr. Pirie's suggestion, I would in effect be giving a multiplier of 19 and a half years from the date of the accident. The Plaintiff is now aged 37, and I think a proper multiplier would be 10.

36. I have already found that, had the accident not occurred, the Plaintiff would have been earning today the sum of $11739 a month. Her future loss in accordingly $140868 for the first year while she undergoes treatment, and $633906, being 9 years at $70434, reflecting 50% loss of earnings. From the first years' loss of $140868, I will make a deduction of $5900 being 4.2%, in respect of tax liability, reducing that figure to $134968.

Special Damages

37. A total of $204902.50 was agreed by the parties in respect of items 1 to 13 inclusive on the re-amended schedule of particulars of special damages, but items 14 to 17 are disputed by the Defendant.

38. The first of these relates to hospital fees from 2nd December 1994 to 24th September 1995. However, no receipts have been produced, and I have seen no evidence that they are in respect of the injuries the Plaintiff sustained in the accident. This item will therefore not be allowed.

39. The second is in respect of future psychiatric treatment by Dr. Bernard Lau which he has assessed at $40000. I consider it likely that, once these proceedings are concluded and damages awarded, the Plaintiff will wish to take advantage of such treatment to maximise her earning potential, and I see no reason why this should not be awarded in full.

40. The third is a sum of $145000 for future replacement dental bridges, on the basis that she will have them replaced every 10 years as advised by the doctors in their reports. I have to say that, in view of the comments by those dentists as to the Plaintiff's standards of dental care and hygiene prior to the accident, I am not satisfied that, having achieved a full repair of the damage caused by the accident, she would regularly return for replacement unless problems arose. If she did so, she would clearly have to pay private sector fees, as there is no reason for the Government to continue providing subsidised treatment other than in an emergency situation, and certainly not for might be classed as cosmetic work. I therefore consider it appropriate to allow for the paintiff to have the dental bridges replaced twice at a cost of $48400 each time, or a total of $96800.

41. As to the last item, the cost of occupational therapy, I agree with Miss Sze that there is no evidence that the Plaintiff will make use of it. The fact that treatment is available and may be useful is not enough on its own to award damages to cover its cost. In any event, Mrs. Chow, in a letter of 8th December 1994 recommends that provided in the public sector at a cost of $36 a visit. If the Plaintiff wishes to pursue this, I see no reason why she should not do so in the public sector, for which I assess the cost at $1872.

42. In addition to the agreed special damages therefore, I award the sum of $138672, making a total under this head of $343574.50.

Summary

Pain suffering and loss of amenities..........	$410000.00
Pre-trial loss of earnings....................	$870538.50
Future loss of earnings.......................	$768874.00
Special damages...............................	$343574.50
Total.........................................	$2392987.00
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43. I will hear the parties on the question of interest as they have indicated that there will be argument on this. There will be an order nisi for costs in favour of the Plaintiff with a certificate for counsel, and the Plaintiff's own costs will be taxed in accordance with Legal Aid Regulations.