The high court of south africa (western cape division, cape town)

Gross Motor Function Classification System Expanded and Revised 2007. Palisano et al are attached to the CanChild Centre for Childhood Disability Research, McMaster University. They appear to be the founders of the GMFCS (see p 292 of the article by Wood et al, exhibit “ZZ”, handed up during Ms Jackson's re-examination). Pages 5-6 of exhibit "AH" is a separate document from the same authors. Since the expanded and revised GMFCS (pp 1-4) is said to include a new age band (age 12-18) and since pp 5-6 does not include this new age band, I infer that pp 5-6 sets out the original 1997 GMFCS (it is this version which is quoted in the Would article, exhibit “ZZ”). During oral evidence the pages were referred to without drawing this distinction.

21 He referred in this regard to a paper of which he was the lead author, Strauss et al Life Expectancy of Children with Cerebral Palsy (1998) Pediatr Nerol [exhibit "G"]. See Table 2 read with the text at p 1107. The proportional hazard ratios for tube-feeding and no self-feeding ability were 3,85 and 2,01 measured against a value of 1 for some self-feeding ability. This indicated that being fed by others 'doubled the risk'.

22 He referred in this regard to a 2014 paper of which he was a co-author, Brooks et al Recent Trends in Cerebral Palsy Survival, Part II, Individual Survival Prognosis (2014) Developmental Medicine & Child Neurology [exhibit "K"].

23 6/527-528.

24 6/358.

25 6/376-377.

26 6/406.

27 6/407.

28 See exhibit "P".

29 Exhibit “AT” Himmelmann and Sundh Survival with Cerebral Palsy over Five Decades in Western Sweden Dev Medicine & Child Neur 2015.

30 K1 - K6 in his 2014 Quantum Yearbook were handed in as exhibit "H". All that would have changed in subsequent years are the income brackets. For reasons that will become apparent, these income brackets are not relevant.

31 In context, this is a reference to K1. The trial judge applied K2.

th This was explained in Prof Dunn's evidence with reference inter alia to exhibit “AD” pp 7-8.

32 Exhibit “AE” pp 1-2.

33 Exhibit “AF” pp 1 and 2 (left) and pp 3-4.

34 Exhibit “AF” pp 1 and 2 (right) and p 5.

35 Exhibit “LL”.

36 These two lines are known as the inter-crystal line and the Helgenreiner line respectively. I drew them in accordance with the witness's description on p 4 of exhibit “AF”.

37 Ms Bawa objected to evidence of this examination on the basis that the plaintiffs had been in possession of Prof Dunn's report since 18 April 2016 and that no supplementary report by Dr Versfeld dealing with the further examination had been served. Following brief submissions I allowed the evidence to be led subject to the defendant's right to take time for further instructions if necessary. In the event Ms Bawa did not seek time for this purpose.

38 A simple screening test for scoliosis is to place the child in the Adams position in order to measure the angle between the shoulder blades (the Bunnel angle) using a scoliometer. A Cobb angle of 30° would translate into a Bunnel angle of between 7° and 12°. Prof Dunn explained these tests with reference to pp 3-6 of exhibit "AD”.

39 Balmer et al The Incidence and Treatment of Scoliosis in Cerebral Palsy (1970) Journal of Bone and Joint Surgery [exhibit "JJ"].

40 Rosenthal et al The Occurrence of Scoliosis in Cerebral Palsy (1974) Develop Med Child Neurol [exhibit "KK"].

41 The authors discuss two illustrative cases out of ten children treated with Harrington rods. One of these two cases was a boy with athetoid CP and a scoliotic curve of 127°. It is not clear whether the children treated with Harrington rods were part of the group of 100.

42 Using the PubMed search engine.

43 Cogill et al Do Lycra Garments Improve Function and Movement in Children with Cerebral Palsy? (2010) Arch Dis Child (University of Warwick) [exhibit "S"]. It is unclear whether the document handed in is complete since the caption I have cited as the title is described as ‘Question1’.

44 Garland The Effect of Dynamic Elastomeric Fabric Orthoses on Upper Extremity Function of Children with Cerebral Palsy: Systematic Review of the Literature (2012) ACPOC News.

45 See Table 3 (Bailes; Flangahan; Corn; Rennie). Of these the Bailes research is probably the most important since the study method was reasonably strong. Garland classified the level of evidence in the various studies as I, II, III or IV, with I being the best. The Bailes study was level I.

46 Exhibit “AP”.

47 Exhibit “AQ””.

48 See photograph at 12/221.

49 See invoice at 9/54.

50 7/55.

51 There is an image of the buggy under consideration at 11/94.

52 7/215.

53 If the chassis now costs R10 000 inclusive of VAT, the ex-VAT price is about R8772 as against R6 413 in the invoice at 9/54.

54 R18 480 and R25 440 [6/625].

55 See the CE Mobility quotation at 11/312.

56 R1092 and R195 inclusive of VAT– see invoice at 9/54.

th Exhibit AO”.

57 Exhibit “XX”.

58 Exhibit AN”.

th This is based on the Ottobock quote, exhibit "R".

59 Exhibit "AC", an affidavit which was handed in by agreement.

60 See image at 12/193.

61 This is the VAT-inclusive sum of the first two items listed on the quotation, exhibit "R".

62 See Mygo brochure at 12/204-217.

63 In the images at 12/194 and 12/205 the Mygo seat is mounted on a different kind of base (four legs with castors). My understanding is that the cost for the Mygo contained in the quotation, exhibit “R”, does not include this (or any) base.

64 12/214.

65 See 12/215-216.

66 Code EC12 in the code list.

67 Exhibit “R” refers to a product code 414P88=50000_K which is the standard Mygo seat shown at 12/194.

68 See brochure, exhibit “U”.

69 Exhibit “AM” p 4 (R40 388 excluding VAT).

70 R63 024 excluding VAT.

71 Exhibit “AB”.

72 11/311-316. I do not recall these being adduced as exhibits through Ms Scheffler.

73 12/211-212.

74 12/215.

75 For the B400, see “U”.

76 See 11/97e.

77 See 11/316 and 11/312.

78 Exhibit “AM” p4.

th 11/311.

th R46 043 as against R69 941.

th 6/605-606. See also 12/245.

79 For an image of the Flux, see 12/246.

80 Images of the type of rollator she had in mind are at 12/247-249.

81 11/248-250.

82 See image at 6/602.

83 11/304-310.

84 See image at 6/603.

85 See invoice at 9/50.

86 “DH14” para 157.

87 At 6/350.

88 See the images at 6/611.

89 At 7/137.

90 See 6/161 – ‘up to’ R920 excluding VAT.

91 Exhibit “AN” p 80.

92 Exhibit “YY”.

93 See pp 16-17 of the exhibit.

94 In argument I was referred to Dr Marus’ report where he said that recent literature indicates that intellectual abilities in patients with kernicterus-induced CP are often in the normal range [6/17]. He annexed a chapter by Shapiro et al from Pediatric Life Care Planning and Case Management 2^nd Ed where the authors say that intellect in these children is ‘almost always in the normal range’ [6/29]. In the absence of expert evidence on the point, I do not think I can have regard to this material.

95 At 7/146.

th McDermott et al A Population-based Analysis of Behavior Problems in Children with Cerebral Palsy (1996) Journal of Paediatric Psychology [exhibit “GG”].

96 Item 6.

97 Item 102.

98 Stein et al Lifetime Prevalence of Psychiatric Disorders in South Africa British Journal of Psychiatry (2008) [exhibit "HH"].

99 Table 2 (second column, first row) indicates, on my understanding, that women are 1,78 times more likely than men to suffer from depression.

100 The questionnaire was designed to generate diagnoses according to the criteria of the ICD-10 and DSM-IV diagnostic systems [pp 112-13].

101 File11/297-298.

102 File 11/304

103 File 9/177.

104 Exhibit “W”.

105 “W” p 4.

106 “W” pp 5-6.

107 “W” p 7.

108 “W” p 8.

109 The extracts relevant to Ms Auret-Besselaar's model were handed in as exhibit "X".

110 This was set out in an addendum handed up during the course of her evidence on 10 March 2016. The relevant pages, including the attached extracts from bargaining council wage determinations, were inserted in the defendant's expert bundle as 7/246A-G.

111 These figures are arrived at by multiplying by 12 the monthly figures furnished by Ms Auret-Besselaar in para 2.2 of her addendum. Mr Donaldson was satisfied that Ms Auret-Besselaar had correctly translated the prescribed wages into monthly remuneration figures, taking into account Ms Auret-Besselaar's assumptions.

112 Arrived at by multiplying by 12 the two monthly figures furnished by Ms Auret-Besselaar in para 2.4 of her addendum and then taking the average of the two annualised amounts.

113 Arrived at by multiplying by 12 the monthly range furnished by Ms Auret-Besselaar in para 2.5 of her addendum.

114 “X” at p 128.

115 Joint minute para 1.3.

116 Exhibit “AV”.

117 She assumes a progression R83 755 – R149 599 – R150 017.

118 The Electrical BC progression is R64 680 – R76 574 – R85 084. The Building BC progression is R83 430 – R91 430 – R125 445. The median is R74 055 – R84 002 – R105 265.

119 R128 818 – R252 790.

120 R150 017 – R292 702.

121 R85 084 – R170 180, based on an annualisation of Ms Auret-Besselaar’s monthly figures.

122 R125 445 – R175 307.

123 R105 265 – R172 744.

124 R216 905 – R312 185 (10^th). R252 790 – R379 722 (lower). R292 902 – R429 793 (median).

th Exhibit “H”. The cohort at age 7 comprises 98 448 lives. The reduced cohort is 91 084 at age 45, 83 741 at age 56 and 67 006 at age 65.

125 Exhibit “J”. The table reflects a cohort of 100 000 at age seven, with 42 189 deaths to age 55 and 44 254 deaths from age 55 – 80.

126 See Dr Lofstedt’s report at 6/239. Impairment (dysplasia) of dental enamel is a known effect of kernicterus.

127 Singh (1) [2010] 3 All SA 187 (D).

128 Clause 19.2.

129 Clause 22.9.

130 Regulation 8(3) of the regulations promulgated under s 130 of the Administration of Estates Act 66 of 1965.

131 “DH15” para 82.

132 Full heads para 4.7.