Plaintiff Not Catastrophically Injured Where Two GCS Readings Below 10/15 in First 30 Minutes after Accident

UPDATE: this decision was reversed by the Court of Appeal on July 17, 2009. The reasons of the Court may be accessed here. The panel agreed that, the plaintiff having had a Glasgow Coma Scale reading of 9/15 within a reasonable time after the accident, even though his readings rose quickly after that, he nevertheless still met the statutory definition of “catastrophic impairment”. The subsequent higher GCS readings were held to be irrelevant.

In brief reasons, Mr. Justice Blenus Wright of the Ontario Superior Court disallowed a jury’s award of $865,000 for future care costs. Liu v. 1226071 Ontario Inc. required the court to determine whether or not the plaintiff had “sustained a catastrophic impairment” as a result of an auto accident. This requirement previously appeared in s. 267.5(3) of the Insurance Act. It has since been repealed but the former wording will continue to affect pending cases for a while yet. A regulation to the Insurance Act provided that a catastrophic impairment included “(i) a score of 9 or less on the Glasgow Coma score…according to a test administered within a reasonable period of time after the incident by a person trained for that purpose.” 

(The Glasgow Coma Scale (“GCS”) is a rough and ready 15 point scale used to measure levels of consciousness.) 

In this case, the plaintiff was involved in an accident on April 9, 1999. Sixteen minutes afterwards, he was tested and registered a GCS of 3/15. Another test was administered 29 minutes after the accident, yielding a reading of 8/15. A third test, done 40 minutes after the accident, resulted in a reading of 12/15. 

At trial, the jury awarded to the plaintiff damages of $865,000 as compensation for future care costs. The question for Wright J. was whether the above readings represented “a score of 9 or less on the Glasgow Coma score…according to a test administered within a reasonable period of time after the incident”. While there is no doubt that the first two readings were scores of “9 or less”, His Honour said: “In this case I find that the GCS scores were 9 or less in less than 40 minutes, which was a reasonable period of time after the incident.” In other words, the plaintiff was not catastrophically injured. 

In coming to this conclusion, Justice Wright rejected a DAC (“Designated Assessment Centre”) report, whose authors had said that “Mr. Liu would appear to meet Catastrophic Impairment status based upon this criterion, as he clearly demonstrated a GCS of less than 10 as ‘administered within a reasonable period of time after the accident by a person trained for that purpose.’”  This brief ruling was an expensive one for the plaintiff. It demonstrates that the mere fact that a GCS reading taken at the scene of an accident produces a reading of less than 9/15 will not necessarily mean that the injury is catastrophic.      

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