H v. A (Unrep) 04.07.19
4 July 2019
A 46-year-old driver recovered £1.46m gross of a 25% reduction for contributory negligence in a negotiated settlement in respect of a concussive head injury sustained in a bicycle accident.
His bicycle was struck from behind by a car travelling in excess of 50 mph causing him to be thrown into an embankment, rendering him unconscious for c. 15 minutes and leaving him with a reduced GCS of 13/15 for the first 45 minutes after the accident
He was left with a syndrome of physical, cognitive and behavioural symptoms that his expert team attributed to microscopic diffuse axonal injury to the white matter pathways within the brain, leaving him, inter alia, with a damaged judgment centre and acute cognitive fatigue. Also he sustained damage to his balance apparatus leaving him with enduring impaired balance and intermittent vestibular migraines. He also suffered mild PTSD and depressive symptoms, all of which remitted with in vivo exposure therapy and CBT.
His case was advanced on the basis that he would never work again and that he would need light touch case management and some support worker assistance to cope with independent living. He lived with his retired parents since the accident.
The Defendant’s experts were more cautious about a diagnosis of diffuse axonal injury in the absence of macroscopic corroboration on MRI and rejected any suggestion of brain injury. They considered that his enduring subjective cluster of symptoms was attributable in part to pre-morbid vulnerability and personality traits and in part were being maintained by psychological factors, and that any damage to his vestibular system was amenable to treatment, such that with the litigation behind him he would be able to live independently with external support and may even achieve some residual earning capacity.
The case settled through negotiation against that evidential matrix.