D v. D (Unrep) 28.06.19
28 June 2019
A 48-year-old University Lecturer recovered £700,000 net of any of contributory negligence that may have been found at trial for failure to wear a cycle helmet in a negotiated settlement in respect of a concussive head injury sustained in a bicycle accident.
He fell from his bicycle at a speed of < 10 mph when a car pulled across his path. He landed on his back with the back of his head also striking the road. He was concussed but suffered no loss of consciousness and his GCS remained normal throughout and head scans were normal. However, there was evidence of PTA consistent with a mTBI on the basis of his experts’ evidence. He developed anxiety triggers fulfilling the diagnostic criteria of PTSD. Also, he sustained a thoracic compression fracture that was not a source of disability beyond the sub-acute phase of his recovery.
This apparently mild TBI had a marked effect on his ability to operate at a high intellectual level over sustained periods as a university lecturer and researcher. This was illustrated by the pattern of his neuropsychological test scores that indicated that he was operating in the ‘high average’ or ‘superior’ domains across all indices save for processing speed which was c. 40 points below his full scale IQ.
He struggled on in academia, attempting to buffer the physical, cognitive, behavioural and psychological changes brought about by the concussive head injury for a period of c. 3½ years before going off work and being forced out of his profession.
The Claimant’s experts explained this presentation as the neuro-psychiatric complications that sometimes accompany a small minority of mTBI patients throughout the chronic phase of their recovery leaving them with lasting disability. The mTBI in question was microscopic diffuse axonal injury.
The Defendant’s experts observed that the pattern of dysfunction, i.e.: subjective symptoms deteriorating over time, contraindicated any significant organic brain injury and considered the presentation was entirely psychologically mediated and contributed to significantly by stressors unrelated to the consequences of the accident.
The case settled at the above level 4 weeks before trial through negotiation.