“I am concerned that Dr McCrirrick [Marston’s expert in anaesthesia and intensive care] appeared to exceed his brief by engaging with questions of causation as to when the infection began and progressed. He did, however, make it clear that he deferred to the microbiologists on issues of the progress of infection.” ii) At para 20 of the Judgment, he said: “In so far as both [Dr Power and Dr McCrirrick] gave some evidence that deals with development of infection, I do not consider that it does anything other than provide me with factual information which relates to the evidence given by the microbiologists; it allows me a broader view of that evidence.”
“They disagree that the sepsis condition which Mr Price presented with on the20 February 2015 began with his accident on the 14 February. Dr McCrirrick considers that Mr Price was demonstrating symptoms of systemic illness on 15 February resulting in septic shock on 21 February and that those symptoms were not related to mechanical injuries. Dr Power relates symptoms to the accident. Both agree the infection was caused by staphylococcus aureus. Dr Power considers that the organism (which is generally harmlessly present on the skin surface of a proportion of the population) entered through a soft tissue injury to the skin caused by the fall.”
“Dr Power makes it clear that Mr Price was not particularly vulnerable to the risk of infection from this organism. He also indicates that the probable source of infection is a breach in the skin, this being the commonest means by which an organism invades a body, he does not find it surprising that no injury was identified because of the nature of symptoms being reported. Dr Power relies on the temporal relationship between the fall and the development of illness as indicative that there was infection through a relatively minor break in the skin, either abrasion or laceration, although he made it clear in cross examination his original instructions had not required him to concentrate on point of entry of the infection. He further conceded that entry via mucous membrane was a possible point of entry and the nose was the most obvious source through such membrane. He indicated that initially he was examining critical care and not considering the issue of the accident and emergency attendance on15 February 2015 . He told me that in 50% of cases during treatment of infection a portal of entry is not identified and that it was unsurprising that this was the case in respect of Mr Price.”
“Both Dr Teare and Dr Gray agree that the organism causing sepsis was staphylococcus aureus. They also agree that bacteria present in the bloodstream for long enough and in large enough numbers may result in sepsis. It is agreed that Mr Price was bacteraemic (bacteria in the bloodstream) 4 to 5 days prior to presentation on20 February 2015 . They further agree that there must have been a source for this infection and that the most likely original source of infection came from a site on Mr Price. There is further agreement that the organism is carried on the body without symptoms on the skin and mucus membranes. They also agree that no clear source of infection was identified during the time Mr Price was in hospital and frequently examined and tested.”
“In my judgment this back calculation does not assist as it relies on too many variables and is undermined for the very reason outlined by Dr Gray that it cannot be used to date the start of infection.”
“3. When did the Deceased likely develop Staphylococcus aureus bacteraemia? We agree: that evidence for Staphylococcus aureus being in the blood stream comes from the history given on 20.02.15: ‘started to feel feverish, hot and sweaty. 4 - 5 day history of fevers, general malaise and loss of appetite. Generally stiff all over, including neck.’ On the balance of probabilities therefore, the Deceased was bacteraemic 4 - 5 days before the history he gave on 20.02.15, i.e. by 15.02.15 or 16.02.15.”
“27. (…) [The experts] agreed there should be a reduction in the base figure because of obesity, but disagreed as to the correct reduction Professor Almond placing that at 8 years and Dr Bodansky putting it as a range between 8 – 10 rather than a fixed figure. The differences between them largely arise from the tables they have used. (…) 30. In cross examination Professor Almond was asked to explain his choice of a discount of 8 rather than 10 years when considering the impact of the known obesity of Mr Price. His answer that 10 years would be suitable where a person had been obese for the greater proportion of their life whereas a lower figure would be appropriate where someone had developed towards obesity as they aged. (…) 32. Dr Bodansky was asked about the depressive effect of obesity figures on life expectancy figures [sc. in tables] in any event given the high levels of overweight and obese males within the population. I was not clear what the purpose of this question was as both experts agreed there would be an impact and the marginal difference was reliance upon a range rather than the lower fixed figure. In any event I considered that this was a question that would apply to a statistician preparing tables as it required an analysis of base figures and their application to averages of life expectancy. 33. In addition, when Dr Bodansky was asked about the range he had given in relation to the gradual weight gain towards obesity rather than obesity from an early age, he told me he was not sure he could answer. He was not prepared to accept the argument but stated that he could understand the thrust of the argument. 34. Where I found Dr Bodansky’s evidence was much less persuasive was in respect of the reduction due to sleep apnoea (…) 35. (…) In my judgment there is nothing to choose between the physicians as to their choices of table (…) 36. Professor Almond, using Lancet information made a reduction in life expectancy of 8 years due to obesity. He concluded the 8 year figure out of the range was appropriate where obesity developed over time. Dr Bodansky, placing a range of 8 to 10 years, relied solely on statistics. I prefer the evidence of Professor Almond in this regard as he has advanced reasons for positioning at the lower end of the range to which Dr Bodansky did not have a detailed response. Similarly I prefer his evidence with regard to the impact of treatment on sleep apnoea. (…) DISCUSSION 45. Having concluded that the expert evidence of the Claimant’s witnesses is to be preferred I find the following: (…) 50. Given my view of the evidence of Dr Bodansky on sleep apnoea I would make no reduction from the baseline figure because of that. I have had much more difficulty with the question of obesity. In some ways obesity will form part of the overall population figures, however there is clearly a difference of some significance as both the Claim and Defence experts accepted. Providing a range, it seemed to me, was a more realistic approach on the part of Dr Bodansky but then he was not able to answer questions about the impact of when obesity began. Professor Almond was much firmer on eight years, but it seemed to me that was a rather dogmatic position. In the end I felt that a reduction at the middle of the range probably reflected reality. That was a period of 9 years leaving an age of 76.5 years as life expectation. (…)”
“JUDGE: Let me have a look and perhaps I can explain. It may be just a poor explanation of what I am trying to set out rather than a real discordance. I will look at these two paragraphs. MR HAINES [for Mrs Price]: Yes. JUDGE: (After a pause) Yes, I think I am dealing there specifically with the issue of obesity and my sense that in terms of the question of obesity there was a realistic approach on the part of Dr Bodansky, but had that difficulty in that he was not approaching things on the basis of your questioning with regard to the effect of a slowly increasing level of obesity and in the end what I am trying to convey is that although I preferred Professor Almond generally, on that obesity problem it seemed to me that he was being far more dogmatic. That may not have been explained in terms of the overall preference of evidence, but that was my explanation in para 50. I do not know if that satisfies you as clarification. MR HAINES: Your Honour, I just read-- It starts your analysis of the evidence in relation to life expectancy from para 30 to para 36 in which the evidence of Dr Bodansky is, frankly, criticised and then you prefer the evidence of Professor Almond unequivocally and then at para 50 Professor Almond is accused of being dogmatic, contrary to your earlier conclusions about his rational approach to it and you have then adopted the evidence of Dr Bodansky who you have said you did not---- JUDGE: I am not. I am choosing my own figure and if that is not clear to you, that is precisely what I am doing, based on my understanding of the evidence of both of them, because I thought in one aspect only that Professor Almond’s position was rather, shall we say, fixed.”
“…in the absence of some other identifiable error, such as (without attempting an exhaustive account) a material error of law, or the making of a critical finding of fact which has no basis in the evidence, or a demonstrable misunderstanding of relevant evidence, or a demonstrable failure to consider relevant evidence, an appellate court will interfere with the findings of fact made by a trial judge only if it is satisfied that his decision cannot reasonably be explained or justified.”
“A reduction at the lower end of the range of 8-10 years for the reasons given by Professor Almond moves Mr Price’s life expectancy down by 8 years, not 9 years, leaving an age of 77.5 years as life expectation.”
“50. Given my view of the evidence of Dr Bodansky on sleep apnoea I would make no reduction from the baseline figure because of that. I have had much more difficulty with the question of obesity. In some ways obesity will form part of the overall population figures, however there is clearly a difference of some significance as both the Claim and Defence experts accepted. Providing a range, it seemed to me, was a more realistic approach on the part of Dr Bodansky but then he was not able to answer questions about the impact of when obesity began. Professor Almond was much firmer on eight years. A reduction at the lower end of the range of 8-10 years for the reasons given by Professor Almond moves Mr Price’s life expectancy down by 8 years, not 9 years, leaving an age of 77.5 years as life expectation. (etc.)”
“It is assumed that the Deceased would have retired on5th June 2021 which would have been his 66th birthday. It is anticipated that upon his retirement the Deceased would have been paid in an equivalent sum to his pre-accident income and that upon her retirement the Claimant’s statutory income will be paid in an equivalent sum as her pension. The net equivalent annual loss will likely be£9,486.85 .”
“The defendant agrees the loss claimed of£59,814.59 .”
“m. Past loss of financial dependency is claimed in the sum of£71,458.15 inclusive of interest at half the special account rate. The calculation for loss of financial dependency should be based on the income of the Deceased and the income (from benefits) at the time of death. The Defendant agrees the previous figure for past loss of financial dependency but makes no admission in respect of interest. The Court is invited to award the full sum claimed of£71,458.15 for this head of loss. (…) o. Future loss of financial dependency is claimed in the sum of£122,949.58 . Within the corrected multiplier, this equates to£121,526.55 . The calculation for loss of financial dependency should be based on the income of the Deceased and the income (from benefits) at the time of death. The Defendant did not properly challenge the basis of the claim in cross examination. Within the Counter-Schedule of Loss the Defendant has failed to properly address this head of loss and should be deemed to have agreed the Claimant’s claim. The Court is invited to award the sum of£121,526.55 for this head of loss.”
“10. I accepted that Mrs Price was honest in her evidence about earnings and benefits, however I did consider that her evidence was given on the basis of approximations and estimates on the subject of her benefits. Mr Price, at that stage was earning approximately£350 per week net (this has been calculated as an annual figure of a little less than that amounting to£18,130.28 net). He was the main earner and was also a carer for his wife at the time of his fall. Mr Price, was expected to change employment before retirement at 66 but would have probably earned at a similar level because he was a Chef. Mrs Price told me that she thought that Mr Price, on retirement would earn a similar amount to when he worked because she expected that he would have earnings from a part time job along with receiving his pension. I am convinced that this was the intention and expectation given his work ethic. However, I consider that the general risks in life could have prevented these intentions reaching fruition. 11. Mrs Price had stopped work in 2014 due to her health and in 2015 she was in receipt of benefits amounting to approximately£300 per fortnight. In her evidence to me she indicated this this had now increased and approached£680 per fortnight in various benefits, this had changed approximately 2 years before the hearing.”
“51. There is a claim for financial dependency. The Defendant argues that the evidential basis for such a claim is not made out due to but the Claimant contends a level of loss can be quantified from other facts. I have found that in 2015 she had benefits of approaching£300 per fortnight, however this had increased to a figure close to£680 per fortnight a change approximately 2 years before the hearing. I am persuaded by Mr Payne that this is not a proper basis for an accurate quantification of financial loss as this is information that could have been accurately obtained from the DWP. However, equally common sense tells me that, as the Claimant has been in receipt of benefits and remains in receipt of benefits, there is an upper limit on how much she would receive in those benefits. That upper limit would not equate to the amount earned by Mr Price and as such she has proved that there is some loss. On that basis I consider that given the approximations involved in her evidence I should make some award. It seems to me that the best basis for making such an award is to begin with the current figure for benefit of approximately£340 per week because that is the figure in which I have most confidence in. That figure would mean a£10 difference or an annual figure of£520 . In my judgment, given that there would have been a period of lower benefits, and rates would have increased annually in any event, that figure is the best I can do in respect of annual loss of financial dependency both for past and future losses.”
“The Claimant is unsure how this figure was derived. As a point of principle, case law has established that the approach to be adopted is to look at the combined income (of the Deceased and the dependant partner) and not just the difference between the respective incomes; see Harris v Empress Motors Limited[1984] 1 WLR 212 and approved in Coward v Comex Houlder Diving Ltd (18 July 1988 , CA); see also the Schedule of Loss.”
“…it is not clear to the Claimant what loss is provided for from the Deceased’s 73rd birthday until his anticipated date of death at age 76.5 years, as he would still have been in receipt of his pension. The remaining multiplier for life would be 3.06 (This is derived using Ogden table 36, 76.5 years – 67.52 years – 8.98 years, which provides a multiplier of 9.08. Then the 5.48 multiplier for the period 67.52 years to age 73 years has to be subtracted, which – 3.60. This then is discounted by 15% as per paragraph 50 of the Judgment).”
“If you work on out the dependency based upon a financial dependency of£10 per week, the calculation would be: h. The annual loss becomes£520 net as set out at paragraph 51 of the Judgment. i. Past loss of financial dependency = (£520 x 6.12) + (£520 x 1.52 x 0.85) =£3,854.24 + interest @ 1.68% (£64.75 ) =£3,918.99 . j. Future loss of financial dependency = (£520 x 4.69) + any additional figure from age 73 years using the multiplier of 3.06. k. Total financial dependency becomes:£6,357.79 + any additional figure from age 73 years using the multiplier of 3.06.”
“However, that approach is only appropriate when the figures are ascertainable”
“23. There were no findings of fact on the figures, instead more of a ‘feel’ about what the figures indicated and what would be reasonable in the circumstances of evidential sufficiency. That should not be revised now. 24. There were findings of fact on the following: a. Life expectancy was 76.5 years. b. There was a chance (unquantified) that Mr Price would not have worked to age 66. c. He would not have worked beyond age 73. d. The change of him not working until 73 should be discounted by 15%. e. In any event there would have been winding down.” a. Life expectancy was 76.5 years. b. There was a chance (unquantified) that Mr Price would not have worked to age 66. c. He would not have worked beyond age 73. d. The change of him not working until 73 should be discounted by 15%. e. In any event there would have been winding down.”
“Judge Hickinbottom was right when he held that it was irrelevant that David and Sarah had made a success of the business. That was (…) because that financial benefit was irrelevant to the assessment of the dependency under section 3. He was correct when he said that nothing that a dependant (or for that matter anyone else) could do after the death could either increase or decrease the dependency. The dependency is fixed at the moment of death; it is what the dependants would probably have received as benefit from the deceased, had the deceased not died. What decisions people make afterwards is irrelevant. The only post death events which are relevant are those which affect the continuance of the dependency (such as the death of a dependant before trial) and the rise (or fall) in earnings to reflect the effects of inflation.”
“Yes. I am afraid nobody is going to feel very happy with me today. I am afraid, Dr Haines, that the reasons for me approaching matters as I did in those paragraphs was my level of discomfort with the evidence before me and it is on that basis that I came up with a figure that I thought I could come up with on the basis of the evidence that would reflect the evidence before me and what information was available. It is on that basis that I consider that I cannot really depart from that. I understand what you are saying about the case law, but it seems to me that this falls into the category of case which has an exceptional element to it and that exceptional element was the evidence that was provided. As such, it seems to me that if you have a point it is an appeal point and not one for me at this stage…”
“JUDGE: My position was that from 73 I had no real indication at all of what the loss would be. MR HAINES: Thank you. So it is nil. JUDGE: Yes. I have no evidence upon which I could come to a conclusion. I am sorry to put it as bluntly as that, but it seemed to me that is what it was.”
“In the course of time the courts have worked out a simple solution to the similar problem of calculating the net dependency under the Fatal Accidents Acts in cases where the dependants are wife and children. In times past the calculation called for a tedious inquiry into how much housekeeping money was paid to the wife, who paid how much for the children's shoes, etc. This has all been swept away and the modern practice is to deduct a percentage from the net income figure to represent what the deceased would have spent exclusively on himself. The percentages have become conventional in the sense that they are used unless there is striking evidence to make the conventional figure inappropriate because there is no departure from the principle that each case must be decided upon its own facts. Where the family unit was husband and wife the conventional figure is 33 per cent. and the rationale of this is that broadly speaking the net income was spent as to one-third for the benefit of each and one-third for their joint benefit. Clothing is an example of several benefit, rent an example of joint benefit. No deduction is made in respect of the joint portion because one cannot buy or drive half a motor car. Part of the net income may be spent for the benefit of neither husband nor wife. If the facts be, for example, that out of the net income of£8,000 p.a. the deceased way paying£2,000 to a charity the percentage would be applied to£6,000 and not£8,000 . Where there are children the deduction falls to 25 per cent., as was the agreed figure in the Harris case.”
“Where both are earning and pooling their net earnings, application of the same principle requires that one-third of the joint earnings be treated as spent for the benefit of each and one-third for their joint benefit; and the justification for that is that a couple living together as a stable family are likely to divide their common resources fairly and equally. As O'Connor L.J. pointed out, the principle is always capable of being displaced by evidence. If the joint income is low, it is likely that more than a third will be applied to joint benefit. Next, a husband or wife may have special needs, or make special demands, which in fact require a larger share than can also be applied to the sole benefit of the other spouse. Further, when the joint net earnings are substantial, as they are in this case on the judge's findings, part of the one-third proportion retained by either spouse for his or her sole benefit may in probability be retained for purposes which will eventually pass to the benefit of the other.”
“…the court’s task in any case is to examine the particular facts of the case to determine whether or not any loss in money or in monies worth has been occasioned to the dependants and, if it determines that it has, it must then use whatever material appears to best to fit the facts of the particular case in order to determine the extent of that loss.”
“I merely sound the cautionary note that where the court is invited to adopt an unusual or unconventional approach in a case of this kind, an additional burden is imposed on the judge to ensure that the more conventional approach would not provide the fairest way to do justice between the parties, and, even if he is satisfied that it would not, he should stand back from the figure to which the unconventional approach had led him and examine whether it fairly reflected the practical realities of the case.”