Case No. HQ12X01213

ii)If she did damage her neck, is that damage causally connected with the symptoms subsequently related by her and if so, to what extent?iii)If the Claimant had not damaged her neck in the accident then the what would have been her prognosis?7.With that brief introduction I turn now to the three issues with which this trial has been concerned and record that I have heard evidence from the Claimant herself and from two experts, Mr Kirkpatrick a consultant neurosurgeon instructed by the Claimant. Whose reports are dated 26th July 2007 ( page 166) 14th August 2008 ( page 202) 22nd June 2010 ( page 208) 7th December 2011 ( page 212) 28th March 2012 ( page 219) and 28th December 2012 ( page 246) and Mr Marks a consultant orthopaedic spinal surgeon whose reports are dated 15th November 2007 ( page 178) and 5th April 2012 ( page 224.) In addition the two experts have produced two joint reports dated respectively 9th March 2008 ( page 199) and January 2013 ( page 258(1) Did the claimant damage her neck in the accident on 10 th May 2004? 8.The Claimant was alone when the accident occurred and much therefore turns on her credibility and reliability as a witness. The Defendant has sought to test the Claimant’s credibility in cross-examination in particular by reference to the contemporaneous and near-contemporaneous records. The Defendant has itself called no evidence as to the accident circumstances.9.The Claimant’s account, which she did not depart from to any substantial effect in cross-examination, is contained in her second witness statement dated 25th April 2012 and was therefore made nearly eight years after the events with which it is concerned. She has also provided a diagram which she has exhibited to that statement. In short, she says that she was clearing away plates, standing between two trolleys, facing one trolley with a second, known as a bain-marie trolley, behind her. She attempted to lower the tray of dirty plates onto runners within the first trolley which was in front of her but she says that the tray came off the runners so she tried to pull the tray back out again but in doing so, and unbeknownst to her, she caused waste food located in a receptacle on a tray lower down the trolley to fall onto the floor and she slipped on that food and felt her feet go from under her. She landed on the base of her spine and as she fell backwards she struck the base of the bain- marie trolley with the back of her head and neck. Her recollection was that she immediately felt as if it had jarred and she felt pain but that that pain was dwarfed by the pain in her lower back. She was unable to get up, and remained on the floor for some twenty minutes before she crawled out of the room and obtained assistance, her alarm not having functioned properly or indeed at all. She was taken to A & E.10.She was challenged as to this account by reference to various contemporaneous or near contemporaneous documents which failed to record any reference to a neck injury. They include but are not limited to a Report of an Injury or Dangerous Occurrence Form ( page 906;) the A& E records ( page473 at 474) which is in these terms:“Slipped over whilst at work at 17.40 onto hard surface. O/A c/o severe pain to coccyx, sacral area and radiating to left and right 0 head injury, 0 LOC” (interpreted as no head injury and no lost of consciousness). 11.At page 629 there is a letter dated 11th May 2004 from A&E to the Claimant’s GP in these terms:“Your patient attended our A&E Department on Monday 10th May 2004 at 6:16pm referred by: Self. Their presenting complaint was: - back injury. On examination I found: - Fall. No focal neurology. Investigations: diagnosis: sprain, buttocks. Disposal: allowed home.”In addition, the GP note for the 10th May (bundle, page 478) contains the following:“Slipped over at work, fell on hard surface on coccyx, sacral. No other injuries”And at page 611 the following entry is to be found:“Unspecified disorder of the coccyx fall ++”12.Again there is no mention of any neck injury in the occupational health notes dated 12th May 2004 (bundle, page 798); the reference being to back problems and injury to coccyx or in a report to the Health and Safety Executive dated the 13th May 2004 (bundle, page 906).13.The Claimant’s explanation for the apparent absence of any reference to injury to the neck was that her main source of complaint was the lumbar spine from which she was in a great deal of pain and that was the focal point so far as she was concerned with regard to the early reports. She also made the point that so far as the A&E notes were concerned at the time she was vomiting and it was her husband who provided information.14.In fact, by the 21st May 2004 there is reference to injury to the neck. This is to be found in a physiotherapy note which is in these terms: “recent injury to back (fell at work) injury to coccyx but jarred entire back and involved neck” (bundle, page 833) On the 18th June 2004 the GP notes include the following reference:“Having physio – trapped nerves in neck and lower back”On the 24th June 2004 the initial assessment by an osteopath includes a reference to the Claimant having presented with pain in her neck accompanied by occipito-frontal headaches (bundle, page 835).15.The Defendant also prays-in-aid the absence of any reference to neck pain in the Claimant’s Letter Before Action which was sent on the 1st September 2004 (bundle, page 924) or indeed the Particulars of Claim (bundle, page 3) although to be fair to the Claimant there is a reference under Particulars of Injury to the Claimant having developed pain of the cervical spine shortly after the accident.16.In my judgment it is fair to say that the Claimant’s evidence as to the accident circumstances was clear, consistent and cogent and of course there was no direct evidence contradicting her account. Moreover, if in fact the Claimant did not suffer an injury to her neck, it is difficult to see why she should be complaining of symptoms to Occupational Health only eleven days post the accident and thereafter to her GP and to an Osteopath in circumstances where she says, and I accept, she was asymptomatic in the period immediately preceding the accident. To my mind, the absence of early reporting is eminently explicable, as indeed the Claimant sought to explain it, initially as a result of the pain she was in and her condition generally and the fact that overwhelmingly the main source of pain was in the lumbar spine and then by reference to the fact, accepted by both medical experts, that the insult to her lumbar spine was overwhelmingly the major element in her situation. I have no hesitation in concluding that the accident occurred in the way described by the Claimant and that, on the balance of probabilities, the Claimant did indeed suffer an injury to her neck on the 10th May 2004.