High Court awards €90,000 for PTSD and physical injuries from a minor rear-end collision six years prior.

THE HIGH COURT

RECORD NUMBER 2019/5222P

[2025] IEHC 638

BETWEEN

KATARZYNA SYKULA

PLAINTIFF

AND

NOEL O'REILLY

DEFENDANT

JUDGMENT of Mr. Justice Cian Ferriter dated 21 November 2025

Introduction

1. The plaintiff’s car was the subject of a relatively minor rear-ending by the defendant’s car near a traffic lights in Finglas, Dublin on 9 December 2017. Six years on, the plaintiff says that she continues to suffer physical and mental injuries (including symptoms of PTSD) which she says have been caused by this accident. She says that she lost her job as a result of her inability to work arising from the injuries sustained by her, which led to her falling into financial difficulty which ultimately led to her being made homeless. She is now on long term disability benefit.

2. While the case came before me as an assessment only, the defendant’s insurers having accepted liability for the accident, the case presents issues of causation and remoteness, in particular whether the defendant can be held liable for PTSD alleged to have resulted from an otherwise relatively minor accident and if so the extent to which the plaintiff’s ongoing physical and psychological symptoms are properly referable to the accident.

3. Following the hearing which took place at a sitting of the High Court in Kilkenny in February 2024, I received helpful written and oral submissions from counsel on the issues arising.

Witnesses and agreed evidence

4. I heard from three witnesses: on behalf of the plaintiff, I heard from the plaintiff herself and from Dr Catherine Corby a consultant psychiatrist who specialises in liaison psychiatry. In her evidence, Dr Corby spoke to the contents of a written medical report following an assessment of the plaintiff on 30 November 2023. The defendant called Mr. Michael O’Riordan, a consultant orthopedic surgeon who retired from his practice in University Hospital Waterford in 2010 but who continued thereafter to engage in medico-legal work particularly for insurance clients. Mr O’Riordan had seen and assessed the plaintiff three times during the currency of the proceedings and he spoke to his reports of those assessments. As it happens, this case was Mr. O’Riordan’s last case and I might record for posterity that he quite properly gave his evidence in accordance with his overriding duties to the court.

5. In addition to hearing from the plaintiff, I received agreed medical reports on behalf of the plaintiff as follows:

(i) report dated 1 May 2018 from Heather MacInnis, a chiropractor who examined the plaintiff in January and May 2018

(ii) a PIAB medical assessment form report completed by Alan Laing, consultant orthopedic surgeon following examination of the plaintiff on 1 September 2020

(iii) Report dated 7 January 2022 from Catherine Cullinane, clinical specialist physiotherapist attached to University Hospital Waterford

(iv) report dated 30 November 2023 of Chee Gan of an MRI of the plaintiff’s cervical spine.

6. In addition, I received reports of the Plaintiff’s GP Dr Lach from May 2018 and September 2021 which were part of the material furnished to Dr Corby and which were admitted into evidence at the defendant’s request.

7. I received the plaintiff’s GP medical records and drug card records from January 2013 to the date of the accident which the defendant also requested be put in evidence.

8. Photographs of the vehicle produced by the defendant were put to the plaintiff in crossexamination and form part of the evidence.

Material facts and evidence

The Plaintiff’s evidence

9. On 9 December 2017, the plaintiff was driving alone, wearing a seat belt and was stopped at a red traffic light in Finglas, Dublin. The lights changed and the plaintiff started to move off when she was rear-ended by the defendant’s vehicle. She was thrown forward, with her movement arrested by the seat belt, and then thrown back against the headrest. The airbags did not deploy. As it happens, an ambulance was passing and it stopped to inquire as to how she was. While sore and suffering from a headache as a result of the collision, she did not feel she needed the ambulance and was conscious of the need to collect her daughter from the Polish school in Dublin which her daughter was that day attending. (At the time of the accident and at the time of the hearing the plaintiff was a single mother to her only child, her daughter. They lived at all material times in Carlow.) Later on that day, the plaintiff felt very unwell, was nauseous and vomiting and attended Care Doc. She was referred to Waterford University Hospital the following day where she was examined (including with scans) and diagnosed with soft tissue injuries to her neck, shoulder and right arm in the area where she was wearing her seat belt.

10. The plaintiff was at the time of the accident working as a pharmacy assistant in a busy pharmacy practice in Carlow. She was on sick leave from her job for some seven weeks or so until towards the end of January 2018 when she pushed herself to go back to work.

11. Her evidence was that she found it difficult to work as a result of her injuries. She became tired and had pain in her neck and shoulders and, as time passed, also in her left lower back. She continued to suffer headaches. She took painkillers and attended for acupuncture and physiotherapy.

12. She have evidence that in the period following the accident she experienced flashbacks to the accident and sleep disturbance. She became anxious and low in mood. She attended her GP in January 2018 and was prescribed paroxetine and alprazolam to help deal with her anxiety. While she returned to driving a couple of months after the accident, she had a fear of driving outside of Carlow town and wouldn't drive on the motorway.

13. She attended a counsellor for therapy some 8 times in 2019.

14. It seems that the plaintiff moved to a three day working week at the end of 2019. She also had to move accommodation around this time from Carlow town to Tullow, some

18 kilometers away. She remained in work until September 2020 when she went out on sick leave (she was not working from March 2020 to September 2020 because of Covid). The plaintiff’s employment was terminated at the end of December 2021. She began to receive invalidity pension in September 2022. She has not worked since.

15. She was subsequently referred to the public mental health service in August 2023.

16. At the time of the hearing, she was on a combination of quetiapine 25mg to help address her flashbacks and nightmares, Mirtazapine 30mg for anxiety and paroxetine 40mg.

She said that she continued to feel pain on a daily basis with some days being worse than others. She continued to suffer sleep disturbance, panic attacks and flashbacks although the panic attacks appeared to be infrequent.

17. At the time of the trial she said in her evidence that she was “still overthinking all the difficulties in her life” and she referred to matters getting “worse and worse”. She referenced in particular the stress and anxiety caused by her housing situation; she and her daughter were made homeless in March 2023.

Pre-accident medical history

18. The plaintiff experienced a difficult number of years not long before the accident. Her mother was diagnosed with breast cancer in May 2013. She took time off work to care for her mother who lived in Poland. That cancer spread and her mother ultimately died at the young age of 59 in March 2015.

19. In 2015, she was a manager of a coffee shop outlet and experienced difficulties with a colleague which led to her becoming very stressed. Her GP records for 24 June 2015 record that “for a long time - past two years approx. -working in very big stress…, poor appetites, poor sleep getting anxious very easily… scared re what was happening at work… had some sleep but disturbed… have been working with no problems for over 9 years” and records a diagnosis of, “adjustment reaction stress, risk of depression". The notes record Seroxat as being prescribed at that time in addition to anti-anxiety medication. The GP’s notes for August 2015 record that she continued to get counselling and that her mood had stabilised but that she had some elements of panic in addition to anxiety. It appears that she was out on sick leave from June to October 2015.

20. Her difficulties were compounded by the death of her father in November 2015. The notes also record that she was still taking Seroxat at the end of November 2015 some weeks after her father died. An entry in the GP records in April 2016 records her taking Seroxat 20 mg “with good effect”. Her GP records also record that she was prescribed Seroxat in September 2016.

21. The plaintiff gave evidence that the experience of anxiety and depression that she had in 2015 and into 2016 were largely related to the grief of the loss of her two parents within a short time of each other and the stress related situation in her workplace. She addressed the workplace situation by moving to a different coffee outlet in Carlow. She got a new job in a pharmacy in Carlow at the start of September 2017. Her evidence was that she was not experiencing any mental health difficulties at the time of the accident.

Cross-examination

22. The plaintiff was cross-examined on the basis that she had pre-existing mental health issues at the time of the accident and that her ongoing mental health issues were not caused by the accident. She accepted that the loss of her parents was worse for her although different to the reaction she had to the car accident.

23. The plaintiff was also cross examined about the fact that she did not disclose the fact that she had a prior relevant history of depression and anxiety and sleep disturbance, in the context of an adjustment disorder for which she was prescribed medication in 2015 and 2016, when specifically asked about that by way of a request for particulars delivered by the defendant. She only disclosed this prior history a short time before the trial. She answered on the basis that her prior history was a reaction to losing both her parents over a short period and also due to bullying at work which she did not think was relevant to her current claim.

24. While there was some confusion in the evidence as to whether the plaintiff finished her medication in April 2016 or April 2017, I take her evidence to be that she finished her medication in April 2017 which would be consistent with the GP records which notes a further prescription for Seroxat in September 2016. She was prescribed Xanax on at the end of August 2017 in the context of her starting a new job as a pharmacy assistant and it was put to her that this was evidence of her continuing mental health difficulties in the run up to the accident. The plaintiff said this prescription was related to the stress of starting a new job as a pharmacy assistant in early September 2017 but that she did not actually take the medication.

25. It emerged in cross-examination that the plaintiff attended a gym in 2018 “probably 3 times a week” where she was doing squats, stretching and some twisting and turning, she said this was on her physio’s advice. It is not entirely clear when she finished attending the gym and she said she said she could not remember precisely when that happened. She was cross examined on the basis that her principal complaints to her doctors and chiropractor were in relation to neck and upper back pain and not in relation to her lower back. It appears that she did not complain of lower back pain to her chiropractor although she did to the doctor who assessed her for PIAB. It was also put to her that Michael O’Riordan’s reports of a range of movement when she attended him were consistent with someone who was more or less normal. The essence of this line of cross examination was that the plaintiff had not suffered the serious level of injuries that she maintained she had.

26. The plaintiff accepted under cross examination that the circumstances of having to go to court to split up with her former partner, the father of her child, a process which concluded in 2020, was very upsetting for her.

27. The plaintiff was also cross examined as to her loss of earnings claim but I do not need to resolve that issue in circumstances where the parties have agreed loss of earnings (along with special damages) in the sum of €25,000.

28. It was not in terms put to the plaintiff that she was making up her injuries and symptoms and misleading her medical professionals; she was not cross-examined on the basis, for example, that she was capable of work when she was let go from work and ultimately ended up on disability pension. Rather, the thrust of the cross-examination was that the bulk of her problems were not truly referable to the accident.

Dr Corby’s evidence

29. Dr Corby assessed the plaintiff on 30 November 2023, which was almost 6 years after the accident. Dr Corby spoke to the contents of a report of that assessment during her oral evidence to the court.

30. Dr Corby in evidence gave her professional opinion that the plaintiff’s ongoing symptoms (flashbacks, reliving the accident, panic attacks) were consistent with a diagnosis of PTSD under DSM-V. When she was challenged in cross-examination about her PTSD diagnosis, principally on the basis that this relatively minor accident could not objectively be said to have involved threatened death or serious injury (which is specified in the DSM-V as being a precondition to a PTSD diagnosis), she explained her expert view that the key issue was how a particular patient internalized the trauma of the accident; in her view the plaintiff here developed a shock response to the accident which made it a traumatic event sufficient to induce PTSD in the plaintiff such that it could be said for DSM purposes that there was exposure to threatened serious injury;

and the plaintiff’s ongoing symptoms were consistent with that – flashbacks, low mood, depression. The medication that the plaintiff was on was also appropriate to the treatment of those symptoms.

31. Dr Corby fairly accepted that the plaintiff’s emotional and physical state had been influenced by multiple stressors including the road traffic accident. She expressed the view in her report as confirmed in oral evidence that “it would be implausible to attribute all of her difficulties in 2023 to the accident”, citing in particular the fact that the accident wasn’t responsible for the housing crisis which led to the plaintiff being made homeless or the poor accommodation conditions the plaintiff had to endure.

32. She expressed the view that the plaintiff should be able to return to work within one to two years with appropriate support meantime.

33. Dr Corby also expressed the view based on her review of the medical records and the evidence given by the plaintiff that the plaintiff, while vulnerable to psychiatric illness on the date of the accident, was not suffering from psychiatric illness on that date.

34. While the defendant made complaint in submission about the very late introduction of a PTSD claim to the case, and the fact that Dr Corby did not see the plaintiff until some

6 years after the accident, Dr Corby was not cross-examined on the basis that she was not in a proper position to express her expert view as to the plaintiff’s psychiatric state at the time of her assessment.

35. The defendant did call any contrary psychiatric evidence even though a psychiatrist had been scheduled by the defendant as a witness for the trial.

Mr O’Riordan’s evidence

36. Consultant orthopaedic surgeon Michael O’Riordan was called on behalf of the defendant.

37. Mr. O’Riordan in his evidence spoke to the three reports he had prepared in relation to the plaintiff. In his the first report following examination of the plaintiff on 28 November 2018 (just under 12 months after the accident) he found some restriction in left and right rotation of her neck. He recorded some mild disability as regards lifting and carrying and bending/kneeling and squatting. He concluded that the plaintiff had sustained strains to her neck and back and that in the natural course of events he expected the symptoms to resolve over a period of two to three years. He saw her again on 20 January 2020, just over two years after the accident. At this point she had been on sick leave for the previous six weeks. He noted a reported deterioration in her symptoms. On this examination, movements of these cervical spine both in flexion/extension and rotation were diminished by some 25%. He still believed that her prognosis was very good and believed that her symptoms would ultimately resolve entirely. His third and final examination of the plaintiff occurred on 26 January 2022, just over four years after the accident. This report noted that the plaintiff had continued physiotherapy, continued to take analgesics and painkillers, that she had recently had two MRI scans and that she was now complaining of pain radiating down her right upper limb and pins and needles in her right arm. He noted that she had been seen by persons in the orthopedic department of University Hospital Waterford and at that time was awaiting specialist injections to her cervical spine. She had ongoing pain in her neck and back. He noted that on examination she appeared to be able to move quite freely, that there was no tenderness in the spine but that she had some restricted range of motion in the cervical spine.

38. Mr. O’Riordan recorded in his report of this examination that he felt that there was a considerable mismatch between the apparent disability and the essentially normal clinical examination and the freedom with which the plaintiff moved. Again, he expressed confidence that the plaintiff’s symptoms would fully resolve.

39. Mr. O’Riordan accepted under cross examination that the plaintiff was symptomatic on each of her three visits to him and that there were no inconsistencies between her physical presentation and the accounts she gave to him during those examinations. He also fairly accepted that he had not been aware of the plaintiff’s psychological and psychiatric condition since the accident and he accepted that the existence of such a condition could impact on her recovery from her physical injuries.

Discussion

Causation – psychiatric illness caused by pre-accident condition

40. The defendant submitted that the accident was not causative of the plaintiff’s mental health problems which were in truth in existence at the time of the accident. The defendant submitted that the court should approach the plaintiff's claim to suffer from PTSD with a high degree of scepticism in light of the fact that this claim was introduced very belatedly into the case and the fact that the plaintiff improperly failed to disclose relevant prior mental health history until very shortly before the hearing.

41. The failure to properly disclose her prior mental health history until shortly before the trial was distinctly unimpressive. While I found the plaintiff to be generally a credible witness, and her account was broadly consistent with the contents of the medical records and reports, I believe that the plaintiff was inclined to overstate the severity of her symptoms; the suppression of her prior relevant medical history supports the view that she was of a mindset to put forward the worst of her mental health experiences in particular as entirely attributable to the accident. It emerged in cross-examination that she had been attending the gym for up to a year after the accident which she sought to explain as being part of her attempts to ameliorate her pain but which in my view was inconsistent with the level of physical discomfort she was complaining of at that time.

This inclination of the plaintiff to overstate the severity of her symptoms was echoed in Mr. O’Riordan’s evidence of a mismatch between her described physical symptoms and the range of movement he found on examination.

42. However, even allowing for a margin of exaggeration by the plaintiff of her symptoms, the medical evidence does not support the conclusion that the plaintiff continued to suffer anxiety and depression at the time of the accident. As it is supported by the objective record contained in the GP and drug card records, I accept the plaintiff’s evidence that she discontinued her anti-depressant medication by April 2017, that she had resolved her difficulties in her previous job, that she was enjoying her new job as a pharmacy assistant which she had started in September 2017 and that she had been relatively well for a prolonged period before the accident. I do not think that a prescription for Xanax on a once-off basis in August 2017, at a time when she had not been on any other mental health medication for some 4 months and over 3 months before the accident, in the context of the plaintiff starting a new job is evidence of a psychiatric illness at the time of the accident.

43. I found Dr Corby to be persuasive in her evidence and accept her expert view that the plaintiff, while vulnerable to psychiatric illness at the time of the accident, was not suffering from a psychiatric illness at that time.

44. The plaintiff had reacted to setbacks in life including the death of her two parents and workplace difficulties in 2015 by suffering an adjustment disorder but that disorder was not clinically present in December 2017.

Eggshell skull rule

45. While the plaintiff was undoubtedly a poor candidate for the accident in terms of her psychological vulnerability, the law requires the defendant to take the plaintiff as they find her. As explained by Clarke J (as he then was) in Walsh v Tipperary County Council [2011] IEHC 503 (“Walsh”):

“in the oft quoted case of the injured party with the so-called “eggshell skull”

it can, on occasion, turn out that, due to some weakness or predisposition, a particular injured party suffers much more severe consequences from a relatively innocuous incident than might be expected. However, it again remains the case that, if personal injury is a foreseeable consequence of whatever wrongdoing is concerned (say the negligent driving of a motor vehicle), then the fact that those injuries may, in the peculiar circumstances of the case, be much more severe than might have been expected, does not deprive the injured party from an entitlement to recover whatever may be appropriate for those injuries.

46. I note in support of this view that in Fletcher v Commissioner of Public Works [2003]

1 IR 465 (“Fletcher”), Keane CJ observed that the eggshell skull test “is applied routinely in personal injury cases in our courts: one is well familiar with minor soft tissue injuries which have, according to medical evidence, caused the plaintiff acute psychiatric injury which, one is assured, is of real significance to the plaintiff however surprising his or her reaction is to the objective finder of fact” (at page 480).

Causation – but for test

47. In my view, but for the accident, the plaintiff would not have suffered anxiety and depression and symptoms consistent with PTSD from January 2018 onwards. However, as I shall come to, there were undoubtedly a range of external factors not properly referable to the accident which contributed to the length and severity of her mental health symptoms and these will need to be properly factored into any fair assessment of damages.

48. Before coming to that assessment, I wish to deal with a submission on the part of the defendant that the plaintiff cannot recover damages for PTSD for the “nervous shock”- type symptoms she has suffered from on the basis that she does not satisfy the wellestablished criteria for recovery of such damages in Irish law as set out in Kelly v Hennessy [1995] 3 IR 253 and related authorities including most recently the Court of Appeal decision of Harford v ESB [2022] 2 IR 541 (“Harford”).

PTSD injuries not recoverable?

49. The defendant submitted in his written submissions that the requirement for recovery for damages for nervous shock-type psychiatric illness is that the shock is brought on by a sudden event which is “shocking, distressing, horrifying, terrifying or calamitous”

as expressed by Noonan J in Harford (at para 67). The defendant submitted that the plaintiff here was the victim of a relatively minor rear ending which could not on any objective view be described as a terrifying event. There was no exposure to actual or threatened death or serious injury; the event could in no circumstances be regarded as a horrifying event.

50. With respect, I believe the defendant’s submissions in this regard are misplaced and in fairness to counsel for the defendant the submission was not pressed in oral argument.

The Kelly v Hennessy line of authorities is predicated on claims for nervous shock alone unaccompanied by any physical injury. This is clear from the terms of Kelly v Hennessy itself and from the Supreme Court decision in Fletcher where Keane CJ (at 480)

described the central issue in the case as whether the claim by the plaintiff came within the category of nervous shock cases “in which the courts have awarded damages for such psychiatric injury even in the absence of any physical injury…”. In the next paragraph of his judgment, he stated that the authorities use the term “nervous shock”

to define “a set of circumstances which, when they give rise to a specific psychiatric disorder unaccompanied by physical injury that was the reasonably foreseeable consequences of a breach of duty on the part of the defendant, may lead to a finding of liability provided the conditions laid down in Kelly v Hennessy are met” (emphasis added). In Harford, Noonan J stated that psychiatric injury is not compensatable even though reasonably foreseeable unless it is accompanied by physical injury or alternatively is the result of nervous shock (at para 34). At para 67, he stated that “the requirement for the occurrence of a “sudden event be it described as shocking, distressing, horrifying, terrifying or calamitous has consistently been held in this jurisdiction to be a prerequisite to recovery for purely psychiatric injury” (emphasis added).

51. The undisputed expert evidence before me from Dr Corby is that the plaintiff suffered anxiety, depression and symptoms consistent with PTSD (including nightmares, flashbacks to the accident, panic attacks and disturbed sleep) arising from the accident.

These symptoms are broadly consistent with what the plaintiff described in her evidence and also what was contained in her GP reports from May 2018 and September 2021. These symptoms were in conjunction with physical injuries to her neck, shoulder and lower back.

52. On the authorities, as it was foreseeable that she would suffer some form of personal injury, the fact the she suffered psychiatric injury in addition to her physical injuries does not preclude her from recovering from the psychiatric injury; as she suffered from recognisable psychiatric injury in the form of anxiety, depression and symptoms which in Dr Corby’s view were consistent with a diagnosis of PTSD under DSM-V, she is in principle entitled to be compensated for same. She does not in my view on the current state of the law have to demonstrate that the psychiatric injuries accompanying the physical injuries were caused by an objectively terrifying event which exposed her to actual or threatened death or serious injury; applying the approach in Walsh, as some form of personal injury was foreseeable arising from the accident, the defendant cannot escape liability simply because the injuries in fact sustained (physical and mental) were much more significant than might reasonably have been expected.

Multi-factorial nature of symptoms

53. However, that is not the end of the matter. Both the plaintiff’s GP Dr Lach in her written reports and Dr Corby in her report and oral evidence referred to multiple stressors or factors other than the road traffic accident as contributing to her psychiatric state. It is clear that the plaintiff’s mental health situation had worsened considerably as a result of her homelessness by the time she was assessed by Dr Corby in November 2023. Dr Corby expressed the view in her medical report following a consultation an 30 November 2023 some six years after the accident that the plaintiff’s symptoms deteriorated “markedly” when she was made homeless that year.

54. Bearing in mind my finding that the plaintiff had a tendency to overstate her symptoms more generally, in my view it is appropriate to approach the assessment of damages for her psychiatric injuries on the basis her symptoms were at a moderate level following her homelessness in 2023 and were on the lower end of the moderate scale in the period up to 2023.

55. While I accept the plaintiff’s submission that the chain of causation was not broken by external factors such as to disentitle her to any damages for her psychiatric injuries, I do believe it appropriate to discount the damages she otherwise might have been entitled to for the level of psychiatric injury she suffered on the basis that there were a series of external factors not attributable to the road traffic accident which undoubtedly exacerbated her mental health situation at various times in the 6 year period between the accident. These are factors which in my view stem from the evidence and seek to explain Dr Corby’s assessment of the causes of her PTSD as being “multifactorial”.

56. These factors include, on the balance of probabilities based on my assessment of the evidence as a whole, her move to Tullow from Carlow at the end of 2019 owing to property pressures in Carlow; Covid and the related difficulties of social isolation stemming from the lockdown restrictions particularly in 2020 and 2021; the fact that the plaintiff was undergoing stressful litigation related to the break-up of her relationship, which litigation did not conclude until 2020; and, of particular significance, the fact that the plaintiff fell into rent arrears in December 2022 which coupled with a landlord's decision to sell the property she was in led to her being made homeless in March 2023 and spending six months in distressing emergency hostel accommodation with her daughter, being the six months immediately prior to her assessment by Dr Corby which Dr Corby viewed as having led to a “significant deterioration” in her condition. These factors are not matters which were caused by the accident or the fall-out of the accident (including her inability to work).

57. The defendant also referenced in submission the events in 2015 involving the death of the plaintiff’s parents and trouble at work as being other relevant external factors. While I am of the view that these factors contributed to her psychological vulnerability at the date of the accident, I do not believe I can rely on those factors as contributing to her post-accident mental state as they pre-dated the accident and did not feature in the plaintiff’s account of her worries or in the medical evidence subsequent to the accident.

58. I have relatively little evidence to go on in order to objectively assess the severity or otherwise of the plaintiff’s psychiatric state prior to her being made homeless. In her GP’s report of 21 May 2018 some six months after the accident her GP records the plaintiff as having said that her mental state deteriorated since the accident and that she had been suffering quite advanced anxiety having persistent high levels of stress and insomnia which required her to take medications. In a further report of 13 September 2021 the GP stated that since her report in 2018 the plaintiff’s main problems related to “emotional abnormalities” the main emotional issue relation to anxiety to drive her car, having nightmares and suffering with insomnia. She also complained of severe anxiety panic attacks and low mood. The GP reported that “the symptoms can vary from problems with sleep, permanently low mood, increased anxiety, bad emotional reaction like palpitation, chest and neck tightness, racing thoughts, sleeping abnormalities and broken sleep”. This report did note that from the GP's perspective that she understood the emotional and physical state of the plaintiff had been influenced by “multiple stressors” including her road traffic accident.

59. While it is of course difficult to approach the allocation of causative attribution to the accident on any mathematical basis, it seems to me that it would be fair to assess damages on the basis that 50% of her psychiatric symptoms in the period from the accident to the trial were attributable to the accident itself, and the balance from the external factors I have identified above.

Assessment of Damages

60. There is no real dispute between the parties as to the principles applicable to the award of damages in personal injuries cases generally, and the approach to multiple injuries cases in particular.

61. In O’Sullivan v Broxda [2022] IECA 163, Faherty J stated (at para 108):

“The principles that can be derived from the authorities can be summarised as follows:

- Fundamentally, the objective is to arrive at a figure for general damages which is fair and reasonable (as per O’Higgins C.J. in Sinnott v. Quinnsworth);

- The award must be proportionate, taking account of societal factors, bearing in mind the common good and ensuring fairness for the plaintiff and fairness for the defendant. (Denham J. in M.N. v. S.M. [2005] 4 IR 461, at p. 474);

- Proportionality must be assessed firstly against the yardstick of the cap (presently €500,000) set for the most serious personal injuries. Secondly, as a general principle, the award should reasonably align with awards given by the courts for similar injuries (M.N. v. S.M. [2005] 4 IR 461, at p. 474), always, however, bearing in mind that the award is personal to the particular plaintiff and that the overall objective is to provide that plaintiff with reasonable compensation for the pain and suffering that he or she has endured (per Irvine J. in Nolan v. Wirenski);

- Where applicable, regard should be had to the Book of Quantum.”

62. Useful guidance to the appropriate approach to take in cases involving multiple injuries, such as the case at hand, is found in the judgement of Noonan J in the Court of Appeal in Meehan v Shawcove [2022] IECA 208 (a Book of Quantum case). Having noted at para 35 that “All the authorities are at one in considering that a key aspect of the court’s approach is proportionality. Proportionality in this context means that the award of damages must be proportionate to the maximum that may be awarded in the most serious cases, €500,000, and must also be proportionate in the context of other awards of damages for greater, lesser or similar injuries. If an injury that is directly comparable to the one in issue has been the subject of a previous award, then it is legitimate and appropriate for the court to have regard to such award.”, Noonan J went on to discuss the role of proportionality in the case of assessment of damages for multiple injuries.

63. Noonan J noted at para 57 that the appropriate approach to the assessment of damages in multiple injury cases including those advocated in the Book of Quantum and the personal injury guidelines proceeds on the basis that the trial judge should identify the most significant injury of the plaintiff’s multiple injuries and then uplift the damages for that injury to properly compensate the plaintiff for the other lesser injuries suffered;

the concern otherwise is that if one were to take separately each injury and value it individually there would be a risk of overcompensation. As Noonan J said at para 64:

“whatever individual categories of injury a plaintiff may have suffered, and whatever the values attributable to those categories may be, the court must strive to take an holistic view of the plaintiff and endeavour to place the plaintiff’s particular constellation of injuries and their cumulative effect on the plaintiff within the spectrum in a way that is proportionate both to the maximum and awards made to other plaintiffs.”

64. In my view, the most significant injury to the plaintiff was her psychiatric injury. An appropriate level of damages for the plaintiff’s psychiatric injuries, on the basis of a six year period of a mild to moderate PTSD, on a pre-Guidelines basis (bearing in mind that the Book of Quantum did not address itself to PTSD or other psychiatric injuries)

would be a figure of €50,000 for past suffering and a figure of €10,000 for future suffering bearing in mind Dr. Corby’s view that with appropriate help the plaintiff’s symptoms should resolve within one to two years. The total of €60,000 needs to be reduced by 50% to take into account the various contributing and exacerbating external factors which are not attributable to the accident. Accordingly, I would give a figure of €30,000 to the plaintiff for the psychiatric injuries stemming from the accident.

65. Bearing in mind that the Book of Quantum suggests a range of €20,400 to €30,200 for moderate neck injury and a range of €21,400 to €30,200 for moderate back injury, I would uplift the figure of €30,000 by a further €35,000 in total for her neck, shoulder and back injuries (being €30,000 for past suffering and €5,000 for future suffering). In arriving at that figure, I have taken into account that her physical injuries were on the lower end of the moderate scale, bearing in mind her tendency to overstate her symptoms and the medical evidence which I heard, and bearing in mind that the recovery from her physical injuries was hampered by her psychiatric injuries which have already been the subject of an appropriate figure for compensation. I have also taken into account the temporal overlap between the plaintiff’s neck and back pain.

66. Stepping back and assessing the fairness and proportionality of the overall award on a holistic basis, it seems to me that a total figure of €65,000 for her injuries stemming from the accident is proportionate both to the maximum awards available for damages for personal injuries and awards made to other plaintiffs in the Book of Quantum era.

In relation to the latter consideration, while no specifically comparable awards were drawn to my attention by the parties, I draw on my general understanding of the award levels in the Book of Quantum era for mild to moderate PTSD and for mild to moderate neck and lower back injuries in arriving at my assessment. In my view, the award I am making for general damages is a proportionate award for the various injuries suffered by the plaintiff stemming from her accident, applying the principles set out in the authorities.

Conclusion

67. In summary for the reasons outlined in this judgment, I award the plaintiff general damages in the sum of €65,000. Special damages and loss of earnings are agreed at €25,000. I accordingly award the plaintiff the total sum of €90,000.

68. I will discuss the precise terms of the award with counsel before finalising my order.