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Complex Regional Pain Syndrome – A Judicial Review

Ruffell v Lovatt – HHJ Hughes QC 4 April 2018

In a recent judgment handed down by HHJ Hughes QC at Winchester County Court the issue of damages for Complex Regional Pain Syndrome (“CRPS”) was considered. Shaun Ferris was instructed by Liddell & Co on behalf of the Defendant.

The Claimant sought damages in excess of £1,600,000 as a result of CRPS that she alleged had been caused as a result of a road traffic accident.

HHJ Hughes QC held that:

  • CRPS is a controversial diagnosis that is medically untestable. There are no diagnostic tests and doctors have to rely on subjective observation;
  • Limb disuse can present a picture similar to that of CRPS;
  • It would be a “fundamental error” to proceed on the basis that a correlation in time represents causation;
  • The fact that a claimant complains of certain symptoms after the index accident does not prove that the same were caused by the index accident;
  • It is necessary to analyse the pre accident history which, in the present case, established that all symptoms had manifested themselves at some time prior to the index accident (with one exception which was not proved to be a true symptom at all);
  • The Claimant had a long and complex medical history prior to the index accident and that she was suffering from a number of discrete and significant physical and psychological disabilities pre accident;
  • As a result of these disabilities the Claimant was physical disabled, socially isolated and substantially dependent on others;
  • Prior to the accident the Claimant had a long history of unexplained pains, social anxiety, panic attacks, long standing serious psychological problems and recurrent depression;
  • The Claimant’s pre accident condition was at odds with her own description of her pre accident levels of function and that presented by her expert pain management expert, which accounts were rejected;
  • The learned judge expressed criticism of the approach taken by the Claimant’s pain management expert and rejected his evidence.

The Claimant was awarded general damages of £12,500 and past losses of £350. There was no award for future loss.

For the full judgment, please click here.



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