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England and Wales High Court (Queen's Bench Division) Decisions |
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You are here: BAILII >> Databases >> England and Wales High Court (Queen's Bench Division) Decisions >> Hindson v Pipe House Wharf (Swansea) Ltd. [2007] EWHC 273 (QB) (21 February 2007) URL: http://www.bailii.org/ew/cases/EWHC/QB/2007/273.html Cite as: [2007] EWHC 273 (QB) |
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QUEEN'S BENCH DIVISION
Strand, London, WC2A 2LL |
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B e f o r e :
____________________
ELLIS HINDSON |
Claimant |
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- and - |
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PIPE HOUSE WHARF (SWANSEA) LIMITED |
Defendant |
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Mr Charles Feeny (instructed by Cartwright Black Solicitors) for the Defendant
Hearing dates: 29th – 31st January 2007
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Crown Copyright ©
The Honourable Mr Justice Wyn Williams:
"He continues to experience angina. He describes chest pain on lifting heavy items, for example on lifting a heavy drill and walking 20 yards. He also experiences angina during sexual intercourse. On the flat, he experiences angina on walking at a quick pace at approximately 200 yards……. On the stairs he only experiences angina, if he goes up and down the same several times."
"It appears that his coronary disease was essentially one major vessel, i.e. left anterior descending artery, with a lesion in a tiny non-dominant right coronary artery considered irrelevant. Subject to any view which might be expressed by a cardiologist, if a report is obtained from such an expert, I would refer to Brackenridge and Elder Medical Selection of Life Risks which suggest with the onset of symptoms of coronary disease at age 55, following angioplasty for single vessel disease a mortality ratio increment of plus 100 should be accorded and this translates to a reduction in life expectancy of 6 years at his age."
"8. Dr Rudd's report of 9th October 2003 emphasises the importance of categorising this man's coronary artery disease. The anatomy of a coronary artery is subject to congenital variation. The norm is for there to be three equally important vessels, the left anterior descending, the left circumflex and the right coronary artery. There is a close interrelationship between the right coronary artery and the left circumflex vessel and in practice there is a wide spectrum of anatomical balance between these two vessels. When the right coronary artery is large and supplies the inferior lateral walls of the left ventricle the left circumflex branch is correspondingly small. By contrast in the case of Mr. Hindson, when the left circumflex artery is large, the right coronary artery is small and was described by the interventional Cardiologist Dr. Gunn as being "tiny."
It is clear that in this case Mr Hindson has had only one severe stenosis in his left anterior descending artery treated on a single occasion. I therefore agree with Dr Rudd's categorisation that this man has essentially single vessel coronary disease. The stenosis in his tiny right coronary artery will have no impact on his life expectancy, a small distribution of the artery being of far greater importance than the severe narrowing within the vessels.
Dr Gunn has published a number of papers in the literature on interventional cardiology, and if in his opinion the angiographic findings in the left circumflex vessels are spasms rather than of atheroma then I would take this as good evidence that the large circumflex vessel is not significantly diseased."
"I would be grateful if you could take on this gentleman for angioplasty for his LAD. I think that his RCA is too small. There was diastolisation on injection using a 4F catheter as I suspect a guiding catheter is going to choke it completely. I would be interested in your views."[1]
On the 25th November 2003 Dr Gunn replied. His short letter was headed: -
"Diagnosis: 1. Two Vessel Disease
Many thanks for your referral of 18th November 2003. As usual I entirely agree with your assessment that the LAD and RCA may well be suitable for PCI."
Following the carrying out of the angioplasty Dr Gunn wrote a discharge summary to Dr Payne.[2] In that discharge summary he wrote:
"we did not attempt the tiny non-dominant RCA."
The contemporaneous notes of the angioplasty are also before me. In relation to the right coronary artery the following appears:-
"RCA artery viewed. Decision taken not to proceed"[3]
"On the basis of his reported symptoms and objective findings especially on the exercise test both expert agree that he has a good exercise tolerance and on the balance of probabilities will be able to continue to work until he has either another coronary event or other serious medical condition which affect his exercise capacity."[6]
General Damages
(a) the existence of the pleural plaques and his anxiety about what the future might hold; and
(b) the risk that he will actually develop the malignant and non-malignant diseases specified by Dr Rudd.
"I would suggest that the bracket for the usual range of cases should be £4,000 to £6,000 but the Judge should feel free to go outside that bracket for particular reasons."[7]
"The effects of asbestos exposure and smoking on the risk of lung cancer are multiplicative…….. I estimate that the asbestos exposure which he has sustained has increased his risk of lung cancer by a factor of 2.5 fold increasing his risk of lung cancer from 10% as result of smoking alone to 25% as a result of both hazards combined."
Financial Loss
(1) the Claimant's undoubted motivation in relation to work;
(2) the likelihood that he would continue to earn at a high level in the absence of an asbestos related illness until he ceased to work;
(3) the possibility that he will continue to work beyond the age of 65 and the greater likelihood that his business will continue when the Claimant was beyond that age and
(4) the risk that an illness related to his coronary condition will intervene to prevent his working.
In truth, my award represents no more than a comparatively small percentage of the Claimant's current annual net wage. Standing back, as I am required to do, that seems to me to reasonably reflect the risk to the Claimant that he will suffer wage and/or pension loss.
Note 1 Bundle 3 page 353 [Back] Note 2 Bundle 3 page 538 [Back] Note 3 Bundle 3 page 579 [Back] Note 4 See Bundle 5 Divider 46 [Back] Note 5 See Bundle 5 Divider 45 [Back] Note 6 Bundle 2 page 491a [Back] Note 7 See Paragraph 162 of the Court of Appeal Judgment [Back]