Gopal Sri Ram JCA:

[1] There are two appeals before us here. They relate to a case of alleged medical negligence. It is a sad story. But it must be told. The plaintiff is a bright young lady. But she is confined to a wheelchair. This is how it happened.

[2] At about 10pm on the night of 11 July 1982, the motor car in which she was travelling as a passenger crashed into a tree. It was near the Assunta Hospital. The plaintiff displayed much courage. She helped the other occupants of the car. Soon after, she admitted herself into the Assunta Hospital. The plaintiff was injured in the accident. The injuries she suffered included a closed dislocation of the C4 and C5 vertebrae. She complained of pain in her neck when she moved her head. X-rays were taken. The plaintiff was attended to by a Dr. Pereira who fitted her with a surgical collar and advised her not to move her head. Dr. Pereira then communicated with Dr. Soo, the orthopaedic surgeon. Dr. Soo advised that the collar was continued to be fitted and that the plaintiff was to be kept in bed with sandbags around her head to minimise movement. This was to reduce the risk of paralysis.

[3] At about 8.30am on the following morning, Dr. Soo saw the plaintiff. After a brief physical examination, he placed the plaintiff on traction. There is a dispute about how long the traction lasted. But I do not regard this as of any great importance. What is certain is that on 13 July 1982, the plaintiff gave her consent for a closed reduction procedure. On 14 July 1982 Dr. Soo attempted closed reduction under general anaesthetic. Despite three attempts it produced no success.

[4] Then on 15 July 1982, Dr. Soo obtained the plaintiff's consent to perform an open reduction on her. That procedure was carried out on 19 July 1982. The nape of the plaintiff's neck was surgically opened. The dislocated vertebrae were moved to their original position. A wire was then inserted to lend stability to the cervical spine. Dr. Soo gave evidence that he inserted the wire under the laminar. According to Dato (Dr.) Arumugasamy, the expert called by the plaintiff, the correct procedure is to insert the wire in this fashion. X-rays were taken after surgery. They were not however produced at the trial with a consequence I will refer to later in this judgment.

[5] Unfortunately, the plaintiff became paralysed the day after this surgical procedure was performed on her. Dr. Soo obviously suspected that the paralysis was caused by vascular infarction because he prescribed a course of medication for it over four days. On the morning of 5 August 1982, a milogram was done by the late Dr. Mohandas. He found a block in the C4-C5 vertebrae. On the afternoon of the same day a second operation was performed on the plaintiff by Dr. Soo. The wire that had been placed below the laminar was removed. But the paralysis did not improve. The plaintiff did nothing for about five years. And it was only on 8 January 1987 that she caused a writ to issue against Dr. Soo and the Assunta Hospital claiming damages for negligently injuring her.

[6] The substance of the plaintiff's complaint appears from the particulars of negligence set out in her pleaded case. Since they are important I will reproduce them in full. This is what she says:

a) Failing to exercise a fair, reasonable and competent degree of care and skill in the performance of the said operation and the further operation;

b) Failing to exercise reasonable care and skill in the use of surgical instruments resulting in the severe damage to the Plaintiff's spinal cord;

c) Failing to exercise reasonable care and skill in the use of surgical instruments resulting in the severe damage to the Plaintiff's spinal cord;

d) Operating on the Plaintiff with such surgical methods and in such manners which resulted in the severe damage to the Plaintiff's spinal cord;

e) Wrongly advising the Plaintiff to undergo the said operation and the second operation, which no doctor of reasonable skill and comp