1. ) Kerajaan Malaysia v BHASKARAN A/L P. BALAKRISHNAN (BA-12B-27-04/2023)

DR NOOR ILIATI IBRAHIM …PERAYU-PERAYU DAN BHASKARAN A/L P. BALAKRISHNAN (NO. K/P: 591129-08-5103) …RESPONDEN [Dalam Mahkamah Sesyen Di Selayang Dalam Negeri Selangor Darul Ehsan, Malaysia Guaman No.: BD-B53KP-1-03/2021 Antara Bhaskaran a/l P. Balakrishnan (No. K/P: 591129-08-5103) …Plaintif

Dan Kerajaan Malaysia

Kementerian Kesihatan Malaysia

Pengarah Hospital Selayang

Dr Gearge Choo Eang Leng

Dr Fong Voon Yen

Dr Arun Arunasalam

Dr Nurul Athirah Mohd Zulkifli

Dr Noor Iliati Ibrahim ...Defendan-Defendan Yang diputuskan oleh Hakim, Tuan Osman Affendi Bin Mohd Shalleh pada 20 haribulan Mac 2023] JUDGMENT Introduction [1] The Respondent (Plaintiff in the Sessions Court), who now suffers from retrograde ejaculation due to surgery, sued the Appellants (Defendants in the Sessions Court) for medical negligence. With liability admitted by the Appellants, the Sessions Court awarded damages under various heads and costs to the Respondent. [2] This appeal by the Appellants is against the award on quantum and costs made by the Sessions Court on 20 March, 2023. The appeal as to quantum is further restricted to three specific heads of damages, that is, (i) general damages for pain and suffering and loss of amenity; (ii) future general damages; and (iii) aggravated damages. The Core Issues [3] The pertinent issues raised by the Appellants in their Memorandum of Appeal are:

whether the learned Sessions Court Judge had erred in fact and/or in law when he awarded RM150,000 as general damages for each of the following, namely, (i) Kesakitan dan Penderitaan dan Kehilangan Keselesaan Hidup”; and (ii) Kecacatan Kekal “Retrograde Ejaculation” dan Komplikasi “Major Depressive Order”.

Whether the learned Sessions Court Judge had erred in fact and/or in law when he awarded future general damages of RM7,610; and

Whether the learned Sessions Court Judge had erred in fact and/or in law when he awarded RM200,000 as aggravated damages. The Parties and the Background Facts [4] The Respondent, Bhaskaran a/l P Balakrishnan, is the Plaintiff whereas the Appellants are the Defendants at the Sessions Court (trial court below). [5] The Appellants are the Government of Malaysia, the Ministry of Health, Malaysia, the Director of Selayang Hospital, Dr Gearge Choo Eang Leng, Dr Fong Voon Yen, Dr Arun Arunasalam, Dr Nurul Athirah Mohd Zulkifli and Dr Noor Iliati Ibrahim. [6] The background facts that led to the filing of the suit by the Respondent against the Appellants in the Sessions Court can be gleaned from the following paragraphs [1](a) – (o) of the learned Sessions Court Judge’s grounds of judgment. [1] Tindakan ini adalah suatu kes tuntutan gantirugi oleh Plaintif terhadap Defendan-Defendan yang berpunca daripada kecuaian perubatan, di mana latar belakangnya adalah seperti berikut:

Plaintif telah dirawat di Hospital Selayang dan telah didiagnos oleh doktor bertugas bahawa Plaintif mempunyai bengkak yang kecil di kelenjar prostat. Plaintif kemudiannya telah dirujuk kepada Jabatan Urologi Hospital Selayang;

Defendan Keempat yang merupakan pakar urologi Hospital Selayang, telah memeriksa Plaintif dengan memasukkan satu tiub di bahagian uretra Plaintif dan memaklumkan kepada Plaintif bahawa pembedahan “transurethral resection of the prostate” (TURP) (Pembedahan) harus dijalankan;

Pada setiap masa yang material, Plaintif tidak dimaklumkan mengenai risiko yang telibat dalam Pembedahan tersebut mahupun kepentingan Pembedahan tersebut. Plaintif juga tidak berikan apa-apa kaunseling mahupun dimaklumkan bahawa ini adalah suatu pembedahan elektif untuk membenarkan Plaintif membuat sebarang keputusan sendiri atau pilihan untuk membuat rawatan yang lain yang kurang invasive;

Plaintif juga tidak dijelaskan mengenai risiko lazim yang bakal dialami terutamanya risiko “retrograde ejaculation” dan suatu persetujuan termaklum (informed consent) tidak diperolehi daripada Plaintif sebelum Pembedahan tersebut dilakukan;

Plaintif telah menjalani Pembedahan tersebut yang dilakukan oleh Defendan Keempat dan Plaintif telah mengalami “burning sensation” di bahagian zakarnya selepas Pembedahan tersebut. Plaintif telah dilihat oleh Defendan Keempat dan telah dimaklumkan bahawa perkara tersebut adalah perkara biasa selepas Pembedahan;

Plaintif kemudiannya telah discaj daripada Hospital Selayang dan selepas itu Plaintif sering menghadapi “burning sensation” di bahagian zakarnya dan ketika Plaintif sedang membuang air kecil di rumahnya, beliau mendapati dua ketulan daging yang tebal telah keluar daripada uretranya. Plaintif juga telah mendapati bahawa tiada aliran air mani di bahagian zakarnya (Komplikasi);

Plaintif mengalami kebingungan dan kerisauan selepas kejadian itu dan telah menunggu untuk berjumpa dengan doktor pada temujanji seterusnya. Malangnya, Plaintif telah dimaklumkan oleh Defendan Kelapan bahawa Komplikasi tersebut adalah perkara lazim selepas Pembedahan tersebut dan tiada sebarang ubat-ubatan untuk Plaintif;

Plaintif kemudiannya menghubungi Bahagian Perhubungan Awam di Hospital Selayang untuk membuat aduan mengenai perkara tersebut dan Plaintif telah dirujuk kepada beberapa doktor-doktor yang bertugas di mana Plaintif hanya dimaklumkan oleh doktor-doktor di Hospital Selayang bahawa tiada sebarang rawatan mahupun ubat-ubatan untuk memperbaiki keadaan Plaintif;

Ketidakupayaan Plaintif untuk mengeluarkan air mani telah menyebabkan Plaintif tidak berpotensi bagi menghasilkan sebarang zuriat. Plaintif yang tidak dapat menjalinkan hubungan intim dengan isterinya telah menyebabkan Plaintif menghadapi masalah dengan isteri dan keluarganya yang melabelkan Plaintif sebagai “mandul”;

Hakikat bahawa Plaintif tidak lagi berupaya dan berpotensi untuk menghasilkan sebarang zuriat sering bermain di fikiran beliau sehingga kini. Kesemua perkara ini sedikit demi sedikit telah menyebabkan Plaintif untuk mengalami perasaan rendah diri, tekanan emosi dan tekanan mental yang amat serius sehingga Plaintif tidak dapat untuk berkongsi dengan sesiapa pun akibat daripada gelaran ‘mandul’ yang diberikan oleh keluarganya sendiri;

Plaintif telah cuba secara kendiri untuk membuat aduan dan meminta penjelasan daripada Hospital Selayang berkenaan Pembedahan tersebut dan suatu Mesyuarat Jawatankuasa Penyiasatan Bebas telah diadakan pada 13.09.2017 (Penyiasatan Bebas);

Plaintif juga melalui peguamcaranya telah menghantar surat bertarikh 2.1.2019 kepada Defendan Kedua untuk meminta suatu penjelasan yang bertulis mengenai keputusan Penyiasatan Bebas tersebut tetapi tiada jawapan memuaskan yang diberikan;

Tambahan pula, peguamcara Plaintif juga telah memohon laporan perubatan daripada Hospital Selayang, tetapi tidak dibekalkan sehingga Plaintif memulakan tindakan ini dan setelah Plaintif mendapatkan perintah penzahiran dokumen terhadap Defendan-Defendan;

Plaintif telah kemudiannya didiagnos oleh Dr Susan Woo Yoke Yin (Dr Susan), doktor pakar konsultan Urologi di Hospital Kuala Lumpur dan telah mengesahkan dalam laporan pakarnya bahawa Plaintif mengalami komplikasi “retrograde ejaculation” akibat daripada Pembedahan tersebut di mana komplikasi tersebut tidak dapat dipulihkan kepada keadaan asal; dan

Plaintif juga dirawat oleh Dr Sapini binti Yacob (SD1), pakar psikiatri di Jabatan Psikiatri dan Kesihatan Mental Hospital Kuala Lumpur dan telah mengesahkan bahawa Plaintif mengalami “Major Depressive Disorder with Anxious Distress”. The Decision of the Sessions Court [7] Based on the background facts and findings by the learned Sessions Court Judge as outlined in the preceding paragraphs, the Sessions Court decided as follows: [5] Ringkasan keputusan Mahkamah ini adalah seperti berikut (Keputusan): LIABILITI [1] Liabiliti telah dipersetujui pada 8 Mac 2022 seperti berikut: Defendan-Defendan bertanggungan sebanyak 100%. KUANTUM [2]

Kecacatan kekal “retrograde ejaculation”: RM150,000.00; dan

Komplikasi “major depressive order”: RM150,000.00. Jumlah: RM300,000.00 [3]

Kos Konsultasi Dengan Pakar Psikologi Bagi “Major Depressive Disorder” dan “Temporary Memory Loss” RM210.00 setahun x 11 tahun (multiplier) = RM2,310.00

Kos Kemasukan Hospital Selama 2 Minggu Untuk Rawatan Electro Compulsory Therapy (ECT) RM300.00 sehari x 14 hari = RM4,200.00

Kos Perjalanan Untuk Konsultasi Dengan Pakar Psikologi RM100.00 setahun x 11 tahun = RM1,100.00 Jumlah: RM7,610.00 [4] Gantirugi Khas Jumlah: RM340.00 [5] Gantirugi Teruk Jumlah: RM200,000.00 [6] Kos Jumlah: RM40,000.00 Kos Perbelanjaan Hangus sebanyak RM6,066.55 hendaklah ditaksirkan di hadapan Penolong Pendaftar. [7]

Faedah 5% ke atas ganti rugi am dari tarikh pemfailan Writ Saman (10.2.2020) sehingga tarikh pengakuan liabiliti (8.3.2022);

Faedah 4% ke atas ganti rugi khas dari tarikh pemfailan Writ Saman (10.2.2020) sehingga tarikh pengakuan liabiliti (8.3.2022); dan

Faedah 5% ke atas jumlah penghakiman dari tarikh pengakuan liabiliti (8.3.2022) sehingga tarikh penyelesaian penuh. The Parties’ Contentions [8] On the award of general damages for pain and suffering and loss of amenity amounting to RM300,000 for “kecacatan kekal ‘retrograde’ ejaculation dan komplikasi ‘major depressive order’”, the Appellants argued that the sum awarded was excessive. The Appellants had submitted before the Sessions Court that it ought to be less than RM50,000. [9] The Appellants’ main bone of contention on this head is that the learned Sessions Court Judge had relied on Hasniyati binti Hassan & Anor v Kerajaan Malaysia [2022] 3 AMR 726; [2022] 7 CLJ 565; [2022] 10 MLJ 469; [2022] MLJU 376; [2022] 5 MLRH 675 (“Hasniyati”) when that case is clearly distinguishable from the present case. According to the Appellants, learned Sessions Court Judge should not have considered the amount of damages awarded in that case. [10] Concerning the award for “major depressive disorder” the Appellants submitted that: … keadaan “major depressive disorder” yang dialami oleh Responden adalah diakui oleh Saksi Pakar Defendan. Namun, Perayu juga berhujah bahawa berdasarkan keterangan Saksi Pakar Perayu bahawa Plaintif mengalami mental depression namun tahao kemurungan berdasarkan pemeriksaan beliau adalah di tahap sederhana atau moderate dan ianya boleh dirawat. It was pointed by the Appellants that their Expert Witness had testified that the “major depressive disorder” can be treated using antidepressant medication, psychotherapy or combination of antidepressant medication and psychotherapy. [11] The Appellants further argued as follows: Perayu berhujah bahawa Hakim Mahkamah Sesyen telah terkhilaf apabila memutuskan bahawa gantirugi di bawah tajuk ini dibenarkan sebanyak RM150,000.00 kepada Responden atas sebab Plaintif masih lagi mengalami ‘major depressive order with anxious distress’ in kerana merujuk kepada keterangan yang diberikan oleh SP1 rawatan yang diterima sebaik menjalankan pembedahan juga mengambil masa dan boleh menyebabkan keadaan Responden menjadi lebih buruk kerana tempoh masa yang lama dan SD1 Saksi Pakar Psikiatri juga mengesahkan bahawa keadaan Responden mungkin tidak boleh disembuhkan sepenuhnya namun rawatan yang diberikan boleh membantu Responden untuk masalah ini. [12] Based on the above assertions, the Appellants argued that the award of general damages for pain and suffering and loss of amenity “haruslah dikurangkan berdasarkan fakta kes di dalam rayuan ini dan dibezakan dengan fakta kes Hasniyati”. [13] As for the future general damages, the Appellants’ contention was that damages under this head should not be allowed. The twin reasons advanced by the Appellants are that “Electro Compulsory Therapy” treatment is only needed in the event that the present treatment proves to be ineffective in the future and such treatment is nevertheless available in the “Hospital Kerajaan”. [14] In relation to aggravated damages, the Appellants’ disputation was that the elements justifying the award of RM200,000 as aggravated damages were not present in this case. The cases relied by the Appellants include Sambaga Valli a/p K R Ponnusamy v Datuk Bandar Kuala Lumpur & Ors [2018] 4 AMR 745; [2017] CKHY 500; [2018] 1 MLJ 754; [2018] 3 MLRA 488[2017] MLJU 557 (“Sambaga Valli”), Thompson v Commissioner of Police of the Metropolis; Hsu v Commissioner of Police of the Metropolis [1997] 2 All ER 762, Dr Hari Krishnan & Anor v Megat Noor Ishal bin Megat Ibrahim [2018] 1 AMR 209; [2018] 3 CLJ 427; [2018] 3 MLJ 281; [2017] MLJU 2093; [2018] 1 MLRA 535 and Tan Harry & Anor v Teo Chee Yeow & Anor [2003] SGHC 275. [15] The gist of the Appellants’ submission is that “kes ini hanya difailkan oleh Responden pada tahun 2020 dan mengambil kira pada tahun tersebut negara telah dilanda dengan wabak COVID 19 menyebabkan berlakunya kelewatan dalam pihak Perayu mengakui liability, namun liability akhirnya telah diakui dan telah menjimatkan masa pihak-pihak terlibat dan Mahkamah dalam menentukan isu kuantum”. [16] Finally, on the issue of costs, the learned Sessions Court Judge had awarded RM40,000 as costs for getting up plus disbursement to be assessed by Registrar. The Appellants reasoned that the amount for costs should be reduced to RM5,000. [17] The Respondent argued that the learned Sessions Court Judge did not err in law and/or in fact in awarding RM300,000 as general damages for pain and suffering and loss of amenity to the Respondent and therefore the intervention of this Appellate Court is not warranted. [18] On future general damages, the Respondent had submitted in the Court below that RM13,820 should be awarded as future general damages. The Respondent accepted the award of RM7,610 made by the learned Sessions Court Judge for future general damages as reasonable and averred that the award does not warrant the intervention of this Appellate Court. [19] The Respondent also agreed with the award of RM200,000 as aggravated damages and costs of RM40,000 at the court below. The Law and Principles on Appellate Intervention [20] The Appellants referred this Court to the decision of the Federal Court in Gan Yoke Chin (P) & Anor v Lee Ing Chin @ Lee Teck Seng & Ors [2005] 2 MLJ 1, specifically to paragraphs [11] and [14], where the Federal Court remarked as follows: 11 In gist, the pivotal question raised by the appellants was whether the term ‘insufficient judicial appreciation of the evidence’ used by the Court of Appeal constituted a new test for appellate intervention. We think it is important to examine this proposition in the light of what the Court of Appeal had said in its judgment beginning from para 27 which we have reproduced earlier but repeated herein for the purpose of emphasis. It states: … Suffice to say that we re-affirm the proposition that an appellate court will not, generally speaking, intervene unless the trial court is shown to be plainly wrong in arriving at its conclusion. But appellate interference will take place in cases where there has been no or insufficient judicial appreciation of the evidence. It is, we think, appropriate that we say what judicial appreciation of evidence involves. … 14 In our view, the Court of Appeal in citing these cases had clearly borne in mind the central feature of appellate intervention, ie to determine whether or not the trial court had arrived at its decision or finding correctly on the basis of the relevant law and/or the established evidence. In so doing, the Court of Appeal was perfectly entitled to examine the process of evaluation of the evidence by the trial court. Clearly, the phrase ‘insufficient judicial appreciation of evidence’ merely related to such a process. This is reflected in the Court of Appeal's restatement that a judge who was required to adjudicate upon a dispute must arrive at his decision on an issue of fact by assessing, weighing and, for good reasons, either accepting or rejecting the whole or any part of the evidence placed before him. The Court of Appeal further reiterated the principle central to appellate intervention, ie that a decision arrived at by a trial court without judicial appreciation of the evidence might be set aside on appeal. This is consistent with the established plainly wrong test. [21] The above case was concerned with the validity of a will. The overarching principle propounded by the apex court is that an appellate court must determine whether or not a trial court had arrived at its decision or finding correctly on the basis of the relevant law and/or the established evidence. If a trial court had arrived at a decision without judicial appreciation of the evidence, that decision ought to be set aside on appeal. [22] It is granted that this Court is bound by the above principle. However, the present appeal relates solely to the issue of quantum. Hence, the more apposite authorities would be United Plywood & Sawmill Ltd v Lock Ngan Loi [1970] CLJU 164; [1970] 2 MLJ 237; [1970] 1 MLRA 57, which propounded the “good gracious test”. [23] In addition, this Court would refer to: • Ong Ah Long v Dr S Underwood [1983] CLJ Rep 300; [1983] 2 MLJ 324; [1983] 1 MLRA 154 and Inas Faiqah Mohd Helmi (A child suing through her father and next friend; Mohd Helmi Abdul Aziz) v Kerajaan Malaysia & Ors [2016] 2 AMR 217; [2016] 2 CLJ 885; [2016] 2 MLJ 1; [2016] 1 MLRA 647 on the underlying rationale behind the granting of an award of damages, that is, “to compensate” and “not to punish”; • Topaiwah v Salleh [1968] CLJU 161; [1968] 1 MLJ 284; [1968] 1 MLRA 580 – where the Federal Court had made clear that it would be disinclined to reverse the finding of a trial judge as to the amount of damages merely because they think that if they had tried the case in the first instance they would have given a lesser sum. In order to justify reversing the trial judge on the question of the amount of damages it will generally be necessary an appellate court should be convinced either that the judge acted on some wrong principle of law, or that the amount awarded was so extremely high or so very small as to make it an entirely erroneous estimate of the damages to which the plaintiff is entitled. The assessments which the courts have made over the years form some guide to the kind of figure which is proper and which an appellate court will follow in the light of the special facts of each particular case; • Jamiah bt Holam v Koon Yin [1982] CLJU 89; [1983] 1 MLJ 103; [1982] 1 MLRH 775 – in an appeal on quantum, unless it can be shown to the satisfaction of the appellate court that the award is extremely inconsistent with the discernible trend or that the award was made on some misapprehension of facts or some erroneous assumption of law or fact, the appellate court should not interfere; and • Meccilect Sdn Bhd v Petrosab Petroleum Engineering Sdn Bhd & Anor [2002] AMEJ 1890; [2023] 2 CLJ 255; [2023] 2 MLRA 111; [2022] MLRAU 281 – which states the qualification to the principle of non-intervention: “… unless the trial court is shown to be plainly wrong in arriving at its decision. A plainly wrong decision happens when the trial court is guilty of or insufficient judicial appreciation of evidence”. The Decision of this Court [24] This Court is guided by the principles as propounded by the courts as outlined paragraphs [20] – [23]. [25] For the avoidance of doubt, it should be emphasized that it is not an absolute principle that an appellate court cannot reverse a decision on quantum. [26] To justify reversing the trial judge on the question of quantum, this Court must generally be convinced either that the trial judge had acted on a wrong principle of law or that the amount awarded was so extremely high or so very small as to constitute an entirely erroneous estimate of the damages to which the plaintiff is entitled. [27] This Court is cognizant of the principle laid down by the Federal Court in Topaiwah v Salleh, which states that assessments made by courts over the years provide guidance on the appropriate figures to be followed, considering the special facts of each particular case. It is on this basis that the appeal on quantum under the various heads is considered. [28] On the issue of the award of RM300,000 for pain and suffering and loss of amenity, it must be remembered that the Respondent's claim in the Court below is the very first case involving a claim for damages against "retrograde ejaculation" together with "Major Depressive Disorder" injuries. In this regard, it is apt that precedents involving injuries on “inability to produce offspring” as well as precedents which have more or less the same facts as the Respondent's claim are taken into account. [29] The following body of cases serve as fitting guidance. • Gurmit Kaur a/p Jaswant Singh v Tung Shin Hospital & Anor [2012] 4 AMR 532; [2013] 1 CLJ 699; [2012] 4 MLJ 260; [2012] MLJU 348 – where the Kuala Lumpur High Court awarded general damages of RM120,00 for loss of uterus, inability to conceive, injury caused by surgery as well as pain and suffering; • Norizan Bte Abd Rahman v Dr Arthur Samuel [2013] 1 PIR 59; [2013] 4 CLJ 275; [2013] MLJU 81; [2013] 2 MLRH 658 – where the Kuala Lumpur High Court awarded general damages of RM120,000 for laparotomy injuries, hysterectomy, loss of right ovary, inability to conceive and for pain and suffering suffered by the Plaintiff. The High Court also awarded general damages of RM80,000 for emotional distress and loss of sexual intimacy between the Plaintiff and her partner as a result of the Defendant's medical negligence. • Turkyah Abdul Rahman Assiri v Dr Seri Suniza Sufian & Anor [2014] 1 PIR (66); [2014] 1 LNS 812; [2014] MLRHU 411, the High Court awarded general damages of RM200,000 to the Plaintiff for loss of uterus and inability to conceive. The Plaintiff in this case did not suffer any psychiatric injuries. • Muhamad Mustaqim bin Jidin v Mohd Zulfadhli bin Radzali & Ors [2017] AMEJ 0679; [2017] 1 LNS 919; [2017] MLJU 862; [2017] MLRHU 591 – where the Plaintiff who is an air force officer was injured by his colleague which caused the loss of his left testicle. The Plaintiff was also suffering from "post-traumatic stress disorder. The High Court of Kuching awarded general damages of RM100,000 for pain and suffering. In that case, the Plaintiff's psychiatric injury was not a permanent injury. • Hasniyati – where the Plaintiff suffered reproductive organ injury and "Major Depressive Disorder" as a result of the Defendant's medical negligence. In that case, expert witnesses have confirmed that the Plaintiff had recovered from psychiatric injuries. However, the Penang High Court awarded general damages of RM300,000 to the Plaintiff even after the expert witnesses confirmed that the Plaintiff had recovered from psychiatric injuries. [30] It is evident from the above cases that the scale for general damages for pain and suffering awarded by the courts over the last decade is in the range of RM100,000 – RM300,000. [31] The learned Sessions Court Judge did refer to the above decisions (see paragraph [8] of the Grounds of Judgment). [32] The learned Sessions Court Judge in paragraphs [10] and [12] of his Grounds of Judgment had also taken into account the fact that the Plaintiff in Hasniyati’s case has recovered from “Major Depressive Disorder” whereas the Respondent in our case here is still suffering the same. [33] Based on the existing applicable and guiding principles, this Court is of the considered view that the RM300,000 awarded under the head of pain and suffering and loss of amenity by the learned Sessions Court Judge should be maintained. [34] On future general damages, reference can be made paragraphs [13] – [16] of the learned Sessions Court Judge’s Grounds of Judgment. He opined as follows: [13] Bagi tuntutan untuk Gantirugi Am Masa Hadapan, Mahkamah ini mendapati Plaintif berhak untuk mendapatkan rawatan di hospital swasta, dengan syarat jumlah gantirugi yang dituntut adalah munasabah. Mahkamah ini merujuk kepada kes INAS FAIQAH BT MOHD HELMI (AN INFANT SUING THROUGH HER FATHER AND NEXT FRIEND, MOHD HELMI BIN ABDUL AZIZ) V KERAJAAN MALAYSIA & ORS [supra] yang telah memutuskan seperti berikut: “[36] … In determining a claim for future medical treatment, be it at a private, or at a public hospital, the question of reasonableness in making such a claim should always be the paramount consideration. The plaintiff not only needs to justify, for instance, why he chooses treatment at a private hospital over a public one, but he must also show that the amount claimed for such treatment is reasonable. Of course this can be satisfied by the production of compelling evidence for that purpose. It is to be noted that in claiming for the cost of future damage in Gleneagles, evidence was led as to the cost of rehabilitation care of the first respondent and the costing was obtained from the private hospitals/centres. [37] Nevertheless, in the present case, we found that the learned trial judge had considered the reasons advanced by the appellant in claiming for the cost for future medical treatment at the private hospital and was not persuaded to award the full cost claimed by the appellant. The learned trial judge had given her reasons for awarding only one-third of the amount claimed by the appellant. We affirm the award made by the learned trial judge in this respect, but on a different ground. We found that the amount awarded by the learned trial judge was fair and reasonable, and we do not find any justification to disturb the same.” [14] Mahkamah ini juga merujuk kepada kes HASNIYATI [supra] yang memutuskan seperti berikut: “[109] D did not dispute the need for such therapies or its frequency, They did not challenge Dr Kavitha as regards the cost of each of the items of private medical treatment, therapies and medicines which she had recommended. Their only point was simply that all these therapies are available for free at the Penang Hospital. D submitted that P2 should not get a single cent as damages because all the medical treatment, therapies and medicines that he will need in the future can be obtained for free at Government hospitals. However, I cannot compel P2 to seek treatment, therapies and medicines for the rest of his life in the Penang Hospital or any other Government hospitals because:

damages can be awarded only in monetary terms;

it is not possible for me to make an order, which can properly and conveniently be enforced, by which the Government is to provide treatment and therapies at the recommended intensity and frequency, and for free;

it would be difficult to supervise the performance of such an order;

non-performance or unsatisfactory performance of the order would lead to the Plaintiffs seeking damages and therefore lead to continuing litigation; and

the Government’s policies for free medical treatment and therapies are not cast in stone and may change at any time. [112] … The test is whether it was “reasonable” for the claimant to seek private medical care.” [penekanan ditambah] [15] Dalam kes ini, dengan berlandaskan keterangan SD1, DefendanDefendan berhujah bahawa Plaintif boleh mendapatkan kesemua rawatan tersebut di hospital Kerajaan, sama seperti yang dihujahkan dalam HASNIYATI [supra]. Walau bagaimanapun, berdasarkan keterangan Plaintif, setelah apa yang berlaku kepada dirinya akibat kecuaian oleh Defendan-Defendan, Plaintif mempunyai masalah kepercayaan terhadap doktor. Plaintif juga hanya menghadiri sesi temujanji bersama Dr Susan dan SD1 setelah diberikan keyakinan oleh peguamcara Plaintif. Keterangan Plaintif dalam WS-SP1 adalah seperti berikut: Q4: Kindly explain to this Honourable Court on what are the complications that you have been having since the surgery was conducted on you till date? … I have also experienced anxiety and trauma towards the entire incidents that caused me to no longer trust the doctors for any medical treatments even for a slight fever. In fact, I was extremely hesitant to attend the appointment with Dr Susan Woo Yoke Yin and Dr Sapini Binti Yaacob and only after repeated convincement from my solicitor, did I agree to attend the appointments. [16] Oleh yang demikian, berdasarkan alasan-alasan yang disenaraikan dalam HASNIYATI [supra] seperti dalam perenggan [14] di atas, dan juga berdasarkan Komplikasi yang dihidapi oleh dan keadaan mental Plaintif, Mahkamah ini berpendapat adalah wajar untuk membenarkan Plaintif mendapatkan rawatan-rawatan tersebut di hospital yang menjadi pilihan Plaintif, dengan syarat jumlah Gantirugi Am Masa Hadapan yang dituntut tersebut adalah munasabah. … [35] This Court is of the considered view that the learned Sessions Court Judge has not erred in law and/or in fact when he awarded RM7,610 as future general damages to the Respondent. [36] As for the award of RM200,000 as aggravated damages, the principle is trite. Aggravated damages are a form of compensatory damages. As explained in Thompson v Commissioner of Police of the Metropolis, compensatory damages are of two types, that is: (a) ordinary damages (which English Court of Appeal suggested should be described as basic damages); and (b) aggravated damages. The Court of Appeal further explained that aggravated damages can be awarded where there are aggravating features about the case which would result in the plaintiff not receiving sufficient compensation for the injury suffered if the award were restricted to a basic award. For purposes of this present appeal, aggravating features can include the way the litigation and trial are conducted. [37] The learned Sessions Court Judge explained and justified this sum that he has awarded to the Respondent at paragraphs [18] – [20] of his Grounds of Judgment. [38] It should be noted that the learned Sessions Court Judge had considered the line of cases that have awarded damages under this head and the cases are Nur Syarafina bt Sa’ari v Kerajaan Malaysia & Ors [2018] AMEJ 1023; [2019] 9 CLJ 246; [2019] 12 MLJ 741; [2018] MLRHU 1949, Yap Sao Leong & Anor (Both Suing as Administartors to the Estate of Yap Yi Hong, Deceased) v Kerajaan Malaysia & Ors [2021] AMEJ 0064; [2021] C;KI 33; [2021] MLJU 86; [2021] 3 MLRH 242, Ahmad Radhiq Arbee bin Ahmad Rejal Arbee (as a Husband and Defendant of Sharifah Shalihah bt Sayed Abdullah, Deceased & Ors v Kerajaan Malaysia & Ors [2020] AMEJ 0571; [2020] CLJU 702; [2020] 10 MLJ 459; [2020] MLRHU 573 and Irwanbudiana bin Amsah (Suing as the Administrator of the Estate of Muhammad Uwais bin Irwanbudiana, Deceased) v The Government of Malaysia [2022] AMEJ 1705; [2023] 3 CLJ 526; [2022] MLJU 3207. [39] No doubt the circumstances and factual matrix of each case differ. However, what is important is that the learned Sessions Court Judge considered the elements required to warrant an award for aggravated damages and, crucially, identified the "aggravating features" in the present case. This is evident from the following paragraphs in the learned Session Court Judge’s Grounds of Judgment.’ [18] Bagi tuntutan untuk Gantirugi Teruk, Mahkamah ini telah mendapati dua fakta yang dibuktikan dalam tindakan ini berkaitan dengan tuntutan bagi Gantirugi Teruk adalah seperti berikut:

Penyiasatan Dalaman telah diadakan pada 5 Mei 2017, dan Plaintif telah memohon untuk mendapatkan laporan tersebut tetapi tidak dibenarkan. Laporan tersebut hanya dikemukakan kepada Plaintif setelah diperintahkan oleh Mahkamah melalui perintah bertarikh 25 Jun 2020 (Kandungan 14); dan

Walaupun kecuaian Defendan-Defendan telah pun diketahui sejak tahun 2017, pengakuan liabiliti hanya direkodkan pada 8 Mac

Kronologi bagi perkara-perkara dalam perenggan (a) dan (b) di atas boleh dirujuk dalam perenggan 80 Hujahan Bertulis Plaintif. Mahkamah ini bersetuju dengan hujahan-hujahan pihak Plaintif seperti yang boleh dirujuk dalam perenggan 81 – perenggan 95 Hujahan Bertulis Plaintif. … [20] Sebagaimana yang dinyatakan dalam perenggan [18] di atas, dapatan-dapatan yang telah dibuat oleh Mahkamah ini adalah seperti berikut:

Walaupun Penyiasatan Dalaman telah diadakan pada 5 Mei 2017 di mana Defendan-Defendan telah pun mengetahui dan mendapati bahawa Defendan-Defendan memang telah melakukan kecuaian yang menyebabkan Komplikasi terhadap Plaintif, dan laporan bagi Penyiasatan Dalaman tersebut sememangnya telah disediakan, Defendan-Defendan tidak mendedahkannya kepada Plaintif walaupun permohonan telah dibuat. Laporan Penyiasatan Dalaman tersebut hanya dikemukakan kepada Plaintif setelah diperintahkan oleh Mahkamah melalui perintah bertarikh 25 Jun 2020. Ini bermakna tanpa perintah Mahkamah sedemikian, Defendan-Defendan langsung tidak berniat untuk memaklumkan Plaintif status sebenar bagi kejadian yang berlaku, yang tentunya amat memprejudiskan Plaintif. Tempoh masa antara Penyiasatan Dalaman dijalankan dan laporannya dikemukakan kepada Plaintif (yang hanya dibuat atas perintah Mahkamah) adalah melebihi tiga tahun; dan

Selanjutnya, walaupun kecuaian Defendan-Defendan telah pun diketahui sejak 5 Mei 2017, Defendan-Defendan hanya memaklumkan Mahkamah bahawa suatu pengakuan liabiliti boleh direkodkan pada 8 Mac 2022, iaitu tarikh yang telah ditetapkan untuk perbicaraan penuh. Ini bermakna tempoh masa yang diambil untuk pengakuan DefendanDefendan diberikan bagi kecuaian yang dilakukan yang menyebabkan Komplikasi terhadap Plaintif adalah selama lebih kurang empat tahun dan sepuluh bulan. Oleh yang demikian, berpandukan kepada nas-nas duluan seperti dalam perenggan [19] di atas, dan tindak-tanduk Defendan-Defendan dalam tindakan ini, Mahkamah ini berpendapat bahawa Gantirugi Teruk sebanyak RM200,000.00 adalah wajar dan munasabah untuk dibenarkan. [40] This Court does not think that the learned Sessions Court Judge has erred in law and/or in fact in awarding the Respondent RM200,000 as aggravated damages. [41] The answers to the questions posed in paragraph [3](1), (2) and (3) above are all in the negative. [42] As for Costs, the learned Sessions Court Judge made reference to Order 59 rules 8 and 16 of the Rules of Court 2012. These provisions provide as follows: Special matters to be taken into account in exercising discretion (O. 59, r. 8)

The Court in exercising its discretion as to costs shall, to such extent, if any, as may be appropriate in the circumstances, take into account —

any offer of contribution or offer of settlement under Order 22B;

the conduct of all the parties, including conduct before and during the proceedings;

the conduct of the parties in relation to any attempt at resolving the cause or matter by mediation or any other means of dispute resolution; and

in particular, the extent to which the parties have followed any relevant pre-action protocol or practice direction for the time being issued by the Registrar. Basis of assessment (O. 59, r. 16)

16.

In assessing the costs payable in relation to any item, the Court shall have regard to all relevant circumstances, and in particular to —

the complexity of the item or of the cause or matter in which it arises and the difficulty or novelty of the questions involved;

the skill, specialized knowledge and responsibility required of, and the time and labour expended by, the solicitor or counsel;

the number and importance of the documents, however brief, prepared or perused;

the place and circumstances in which the business involved is transacted;

the importance of the cause or matter to the client;

where money or property is involved, its amount or value;

any other fees and allowances payable to the solicitor or counsel in respect of other items in the same cause or matter, but only where work done in relation to those items has reduced the work which would otherwise have been necessary in relation to the item in question. [43] While the conduct of the Appellants in this case, including those conduct before and during the proceedings, are relevant for purposes for the exercise of the trial judge’s discretion when awarding costs, this Court is of the considered view that that feature had already been factored into the equation when the Sessions Court decided to award aggravated damages. Hence, the costs of RM40,000 awarded by the Sessions Court is reduced to RM20,000. [44] Except on costs, the decision of the learned Sessions Court Judge on quantum is upheld and this appeal is dismissed. [45] The Appellants to pay costs of RM10,000 to the Respondent for this appeal. Dated: 7 July, 2024 sgd [CHOONG YEOW CHOY] Judicial Commissioner High Court of Malaya Shah Alam Counsel: Natrah binti Mazman for the Appellants (Jabatan Peguam Negara, Putrajaya) Ganaesh Rau a/l B. A. Ramarau for the Respondent (Messrs. The Chambers of Ganaesh Rau)