Thavani A/p Kaliaperumal (Mendakwa Sebagai Ibu Sah Dan Orang Tanggungan Sah Bagi Komathi A/p Chellamuthu (Si Mati)) v KERAJAAN MALAYSIA (AA-21NCvC-18-11/2020)

1.

KLINIK KESIHATAN HUTAN MELINTANG 20

3.

4.

MOHAMED FAEZ ABDULLAH 30

HOSPITAL TELUK INTAN 35

DR. AYUNNI NAZIRAH BT ABDUL RAZAK 15/01/2025 16:57:16 AA-21NCvC-18-11/2020 Kand. 134 Pegawai Perubatan UD48, Hospital Teluk Intan

DR. MUTHULAKSHMI A/P MOULEESWARAN 40 Pegawai Perubatan UD53, Hospital Teluk Intan

DR. SITI NURFAZZILAH BT RUSLAN Pegawai Perubatan UD44, Hospital Teluk Intan 45 10. DR. LEE ANJILINE Pegawai Perubatan UD44, Hospital Teluk Intan 11. DR. SARAH HANI BINTI JOHAR HOW Pegawai Perubatan UD44, Hospital Teluk Intan 50 12. DR. REEYANA SYAKILA BINTI AB RAHMAN Pegawai Perubatan Siswazah UD41, Hospital Teluk Intan

DR. KARTHIKEYAN A/L KALIMUTU Pegawai Perubatan Siswazah UD41, Hospital Teluk Intan 55 14. DR. KOH YING - PEI Pegawai Perubatan UD44, Hospital Teluk Intan

DR. DHEEVIA BALAGURU Pegawai Perubatan Siswazah UD41 Hospital Teluk Intan 60 16.

DR. SITI HAFIZAH BINTI MOND ISMAIL PAKAR PERUBATAN AM UD52, Hospital Teluk lntan

DR. SHUKUR BIN AHMAD 75 Pakar Orthopedik UD54 Hospital Teluk Intan ….DEFENDANTS GROUNDS OF JUDGMENT Introduction 80 [1]. The case involves Thavani A/P Kaliaperummal, the lawful mother and dependent of the deceased Komathi A/P Chellamuthu, who tragically passed away on 5 July 2018. Komathi sustained a right knee injury from a motorcycle accident on 4 May 2018. She received 85 initial treatment at the 2nd defendant clinic, where she was diagnosed with a soft tissue injury and discharged with painkillers. Despite multiple subsequent visits to the clinic and the 6th defendant hospital, Komathi's condition was consistently misdiagnosed as a soft tissue injury without adequate investigation for potential Deep 90 Vein Thrombosis (DVT). [2]. Her condition worsened over several weeks, leading to severe pain and swelling in her right lower limb. Despite repeated complaints and multiple hospital visits, proper diagnostic tests, such as ultrasound for DVT, were not performed. Only on her final visit, after 95 persistent family requests, was she admitted for further investigation. Unfortunately, by then, the condition had worsened, and she was discharged without a correct diagnosis or appropriate treatment for DVT. [3]. Komathi's condition deteriorated rapidly after her discharge, leading 100 to her sudden collapse and death at home. A post-mortem revealed the cause of death as pulmonary thromboembolism due to right deep femoral vein thrombosis, highlighting the failure of the medical professionals to diagnose and treat her condition appropriately. [4]. The plaintiff, Thavani, argues that the defendants, including the 105 Government of Malaysia, the clinic, and the hospital, owed a duty of care to Komathi A/P Chellamuthu and were negligent in failing to provide adequate medical care, leading to her untimely and preventable death. The plaintiff alleges that repeated failures by medical personnel to properly diagnose and manage DVT, despite 110 multiple visits by the deceased to the clinic and hospital, resulted in prolonged pain and suffering and, ultimately, a fatal pulmonary embolism. Liability was admitted by the defendants on 1 November 2022; however, the case highlights significant delays and inadequacies in medical diagnosis and treatment. The plaintiff 115 seeks damages for pain and suffering, dependency losses, and aggravated damages under Sections 7 and 8 of the Civil Law Act 1956, emphasising the tragic and preventable loss caused by these breaches of duty. The Plaintiff’s claim compensations for the following: 120 a) Special Damages: i) Fee for Police Report ii) Fee for Medical Reports from Hospital Teluk Intan iii) Post Mortem Report from Hospital Teluk Intan iv) Payment at Hospital Teluk Intan 125 v) Payment at Hospital Anson Bay vi) Fee for Medical Report from Anson Bay Medical Centre vii) Funeral Expenses viii) Fee for Orthopaedic Specialist Opinion ix) Travelling Expenses of deceased and Plaintiff & Family 130 x) Loss of Dependency at RM 600/- per month xi) Loss of E.P.F. (Employers Contribution) at RM 130/- per month b) General Damages for Pain and Suffering of the deceased c) Aggravated Damages of the Deceased for failure to diagnose, 135 treat, manage, and care and for failure to advise of risks to the Plaintiff d) Vindicatory/Exemplary Damages for the outrageous conduct of the defendants e) Costs and interest 140 [5]. The total sum claimed under various heads includes specific amounts for special damages, general damages, aggravated damages, and exemplary damages, highlighting the extensive impact and the gravity of the negligence that led to the tragic death 145 of Komathi A/P Chellamuthu. I shall deal with them respectively. Special Damages Item (a)(b)(c)(d): Police Report and Medical Documents [6]. The claim includes fees for obtaining a police report and medical 150 documents, guided by official circulars such as the "Surat Pekeliling Ketua Pengarah Kesihatan Bil 16/2010," establishing standard charges for these services. Despite the absence of receipts, the Court can take judicial notice of these established fees, with the police report fee being RM4.00. The defendant agrees to the 155 standardised cost structure for medical reports and post-mortem documentation, making the claim for these fees reasonable and justified. As such, I allow claims in items (a), (b), (c) & (d) as claimed by the plaintiff. Item (e)(f): Allowance of claim for payment at Hospital Anson Bay 160 and medical report fee [7]. The plaintiff substantiates the claim for expenses incurred at Hospital Anson Bay and the fee for obtaining a medical report from Anson Bay Medical Centre through documented invoices and bills, serving as evidence of the costs. Despite the defendants’ argument 165 that these expenses are unrelated and thus not their responsibility, the Court finds the claims valid based on the provided proof. Therefore, the total sum of RM1,296.95 for these expenses is allowed. 170 Item (g): Allowance of Claim for Funeral Expenses [8]. In line with the authority in Azizah Abdul Manan & Ors v. Dr Norlelawati Ab Latip & Ors [2014] 2 CLJ 44; [2013] MLJU 1614; [2013] MLRHU 1412;, funeral expenses are recognised as a reasonable claim that should be awarded to the dependents of the 175 deceased. The plaintiff has claimed a total of RM5,450.00 for funeral expenses and, despite only providing a receipt for RM450.00, has reasonably itemised the remaining costs. Although the defendants contested the claim due to the lack of additional receipts, the detailed itemisation by the plaintiff substantiates the overall 180 expenses as customary and necessary for a funeral. Therefore, the Court allows the plaintiff's claim by rounding up to RM5,000.00. Item (h): Fee for Orthopaedic Specialist Opinion [9]. The plaintiff claims RM3,500.00 for the orthopaedic specialist's opinion, substantiated by the confirmation of payment to Dr. K.S. 185 Dhillon. This expense is considered essential to support the claim regarding the injuries suffered. Despite the defendants’ arguments that the specialist report was not used in the trial and that the plaintiff did not call the specialist as a witness, the payment confirmation demonstrates that the plaintiff incurred the cost. Additionally, while 190 the defendants point out that the claimed amount exceeds the recommended fees in the MMA Schedule of Fees, the complexity of the case may justify a higher charge, as outlined in the MMA guidelines. Given that expert medical opinions are crucial in substantiating medical negligence claims, the plaintiff’s claim is 195 reasonable, and the Court allows the sum of RM3,500.00. Item (i): Allowance of deceased and plaintiff's claim for travel expenses [10]. The plaintiff claims a total of RM500.00 for travelling expenses the deceased and the plaintiff's family incurred for trips to the hospital 200 and clinic. During cross-examination, it was confirmed that these trips were made by taxi, as outlined in the statement of claim on specified dates. Although the defendant argued against the deceased's claim, stating family members facilitated transportation and receipts were not provided, the incurred costs for necessary 205 travel are evident. A reasonable sum of RM50.00 per return trip for 10 trips is fair and reasonable. Therefore, the Court allows a total of RM500.00 for these travelling expenses. Item (j): Allowance of plaintiff's claim for loss of dependency based on a reasonable sum 210 [11]. The plaintiff claims a loss of dependency at RM600 per month, totalling RM82,800.00. However, based on the available evidence, the Court acknowledges that the deceased, Komathi, earned a monthly basic salary of RM1,035.00. The plaintiff failed to call the deceased's parents to testify regarding the alleged monthly 215 contribution of RM600.00. Therefore, the Court cannot accept the exact amount claimed but will consider a reasonable contribution to the parents. Given Komathi’s salary, a sum of RM400.00 per month is deemed a reasonable contribution to the family. Calculation for Loss of Dependency: 220 Monthly Contribution: RM400.00 Multiplier: According to Section 7(3)(iv)(d) of the Civil Law Act 1956, for a deceased aged 32 at the time of death: 55−32=23÷2=11.5 years. 225 Annual Contribution: RM400.00 × 12 = RM4,800.00 Total Loss of Dependency: RM4,800.00 × 11.5 = RM55,200.00 Thus, the Court allows the plaintiff's claim for loss of dependency, awarding a sum of RM55,200.00. 230 Item (k): Allowance of plaintiff's claim for loss of EPF (employer’s contribution) [12]. The plaintiff claims a loss of EPF employer's contribution at RM136.00 per month, totalling RM45,696.00, based on the deceased's basic salary of RM1,035.00. According to the EPF 235 scale, the employer’s contribution for this salary is RM136.00 per month, which would have accumulated until the deceased reached the age of 60. Despite the defendant's contention that the deceased’s actual EPF contribution averaged only RM86.00 based on the documents presented, the Court takes judicial notice of the 240 official EPF scale published by a government body. Furthermore, the Court acknowledges in Noor Azahar Habin v Rajaswari Sithampara Pillai & Anor [1991] 3 CLJ (Rep) 339; [1990] MLJU 10; [1990] 3 MLRH 559, where the loss of EPF contribution by the employer was recognised as a valid claim. 245 [13]. The plaintiff’s claim is deemed reasonable given the deceased's salary of RM1,035.00 and the EPF contribution scale. The Court allows the claim for loss of EPF contribution as follows: Calculation for Loss of EPF Contribution: Loss of EPF (Employer's Contribution) 250 @ RM130/- per month (RM130 x 12 x 11.5) Pre-Trial: RM9,792.00 Post-Trial: RM35,904.00 Total : RM45,696.00 255 Therefore, the Court allows the plaintiff’s claim for loss of EPF in the sum of RM45,696.00. General Damages Principles on General Damages in Medical Negligence and Personal Injury 260 [14]. In assessing general damages in medical negligence cases, the Court of Appeal in Dato' Dr. v. Thuraisingam & Anor v. Sanmarkan Ganapathy & Anor [2015] 6 MLRA 261; [2016] 3 MLJ 227; [2015] 8 CLJ 248; [2015] 6 AMR 417 (refd), emphasised that medical negligence must be evaluated differently from ordinary 265 negligence due to its unique complexities. This distinct approach requires the Court to consider case law advancements in medical negligence jurisprudence. The Court of Appeal states: “[21]….the principles of negligence related to medical negligence are not based on the same criteria as ordinary negligence cases. This distinction 270 must be kept in mind to appreciate the distinction, approach and compromises case laws from time to time advance in relation to medical negligence jurisprudence.” [15]. In addition, the Compendium of Personal Injury Awards 2018 275 serves as a guideline for damages but does not restrict the Court’s discretion. Judges and lawyers can depart from the compendium based on case law or the specific facts of the case. Furthermore, the Court must take inflation and the increased cost of living into account when assessing damages, as affirmed in Raji Transport 280 Sdn Bhd & Anor v. Idayu Zulkafli [2004] 5 CLJ 479; 2004] 1 MLRH 552; [2004] AMEJ 0087, ensuring that awards reflect current economic realities. Justice Low Hop Bing states this: “The considerations of inflation and enhanced cost of living over a period of more than two decades since the decision in 285 Lau Ee Ee, supra, should be given proper weight in the assessment of quantum of damages in personal injury litigation. Indeed, it is instructive to note that our courts have also moved ahead with the times in these areas. Chan Shick Chin, a very senior member of the Bar, in his concise and 290 well-researched book on “Personal Injury, Law, Practice and Precedents” published by MLJ in 2001 at p. 47 wrote: vii Fall in value of money The fall in the value of money must be taken into account in the use of comparables so that an award which is eventually given would be reflective 295 of the current value of money: 162: Abdul Ghani Hamid v. Abdul Nasir Abdul Jabbar & Anor [1995] 4 CLJ 317.” [16]. General damages for pain and suffering are assessed based on the nature and duration of the injuries, as well as precedents set by 300 similar cases. Courts typically favour a global award for injuries arising from the same incident, as demonstrated in Muhamad Qamarul Munsyiaqbal @ Yusri v. Md Nor Md Zain & Anor [2020] MLJU 106; [2020] CLJU 476; [2020] AMEJ 0089; [2020] MLRHU 121, where the Court upheld a single award for injuries affecting the 305 same body part. Similarly, the assessment should not be punitive but should aim to provide fair, just, and reasonable compensation for the plaintiff’s suffering. Factors influencing the award include the duration of hospitalisation, the plaintiff's personal circumstances, and previous awards in comparable cases, as outlined in Sam Wun 310 Hoong v. Kader Ibramshah [1981] 1 MLJ 295; [1980] 1 MLRA 712; [1981] 1 LNS 103, which states: “Under the heading of pain and suffering and loss of amenities, the quantum is mainly assessed on the nature of injuries sustained and the period of hospitalization, and in 315 arriving at a figure, the court is guided by previous awards in cases involving similar types of injuries with allowances being given as to the plaintiff’s age, marital status, his special position socially or in business, depreciation or appreciation of money value, and other relevant circumstances” 320 Global award for pain & suffering of the deceased [17]. After reviewing the submissions and evidence presented, the Court finds that the plaintiff’s claim for separate awards for pain and suffering for the deceased and the plaintiff lacks merit. It is 325 established jurisprudence that pain and suffering is a singular category of general damages, which encompasses the entirety of the injuries and consequences arising from the same set of circumstances, rather than being bifurcated into separate awards. [18]. The plaintiff presents evidence from Dr. K.S. Dhillon, Consultant 330 Orthopedic Surgeon, detailing the pain and suffering endured by Ms. Komathi following a motor vehicle accident on 04/05/2018. Despite numerous visits to clinics and hospitals, critical injuries, including quadriceps tear and lateral meniscus tear, remained undiagnosed for nearly seven weeks. This oversight led to a 335 pulmonary embolism from DVT, ultimately causing her death. [19]. This position aligns with the principle set out in Tan Cheong Poh & Anor v. Teoh Ah Keow [1995] 3 MLJ 89; [1995] 3 CLJ 665; [1995] 3 AMR 2733, where the Court held that when all injuries stem from a single source or event, a singular award should be granted rather 340 than separate assessments for different injuries or claims. Furthermore, the High Court in Muhamad Qamarul Munsyiaqbal @ Yusri v. Md Nor Md Zain & Anor (supra) reinforced the doctrine of a global award, emphasising that separate computations for each injury are unwarranted when the injuries pertain to the same part of 345 the body or result from the same source of negligence. [20]. Additionally, the Federal Court in Tay Tong Chew & Anor v Abdul Rahman Bin Haji Ahmad [1984] 2 CLJ 227; [1984] 1 MLRA 276; [1985] 1 MLJ 50, echoed this principle, stating that the quantum for pain and suffering must consider the injuries collectively when they 350 arise from the same incident or function, and separate awards would result in unjust overcompensation. [21]. While the plaintiff has itemised awards for each injury, the principle of a global award, as established in Tay Tong Chew (supra), dictates that such injuries should be considered collectively rather 355 than individually. Ms. Komathi’s injuries and the associated pain and suffering were concentrated in her right leg, resulting in similar degrees of physical and emotional distress. [22]. Taking into account the severity of her suffering, the failure of diagnosis, multiple hospital visits, the plaintiff's expert opinion, past 360 awards, and inflation, a global award is more appropriate. Therefore, a reasonable and just global sum for pain, suffering, and loss of amenities is RM100,000.00. Aggravated Damages of the Deceased [23]. The plaintiff claims aggravated damages for the pain and suffering 365 endured by the deceased, Ms. Komathi, arguing that it was "caused or exacerbated by the exceptional conduct of the defendants." According to Sambaga Valli a/p Kr Ponnusamy v. Datuk Bandar Kuala Lumpur & Ors [2018] 3 MLRA 488; [2018] 1 MLJ 784; [2019] 4 AMR 745; [2017] 1 LNS 500, aggravated damages serve 370 as additional compensation where there is an intangible injury resulting from the defendant's conduct. The Court states: “[32] Now aggravated damages are classified as a species of compensatory damages, which are awarded as additional compensation where there has been intangible injury to the 375 interest of personality of the Plaintiffs, where this injury has been caused or exacerbated by the exceptional conduct of the defendant” [24]. In this case, the defendants failed to diagnose DVT as the cause of 380 Ms. Komathi's swelling and pain in her right leg for almost seven weeks, despite multiple visits to Klinik Kesihatan Hutan Melintang and Hospital Teluk Intan. The plaintiff’s expert, Dr. K.S. Dhillon, emphasised that timely diagnosis and treatment would have prevented the pulmonary embolism and subsequent death. This 385 prolonged neglect and improper management of her medical condition amounts to a gross failure in duty of care, which goes beyond mere negligence. [25]. Further, based on Thompson v Commissioner of Police [1997] 2 All ER 762, aggravated damages are determined by the harm 390 suffered and the conduct of the defendants. The plaintiff satisfies this test by presenting evidence that: a) The medical staff at HTI failed to suspect or investigate DVT when Ms. Komathi presented symptoms on her first visit, which would have required admission, testing, and 395 appropriate treatment. b) DVT is a preventable condition, and its mismanagement by the medical staff at both KKHM and HTI deviated from acceptable medical practice, leading to Ms. Komathi's untimely death. 400 [26]. Despite being admitted to the hospital on 25 June 2018 due to the family's insistence, the deceased received no appropriate investigation for DVT until her discharge on 27 June 2018. The plaintiff submits that the defendants' negligence was evident and 405 that aggravated damages should reflect this failure in care and management. [27]. Given the medical negligence and the aggravating conduct of Dr. Shukur and his team at HTI, I have no doubt in awarding aggravated damages. 410 [28]. The plaintiff initially sought RM500,000.00 (as per the statement of claim) in aggravated damages based on cases such as Suzana Md Aris v. DSP Ishak Hussain & Ors [2010] 1 MLRH 936; [2010] 6 CLJ 712; [2009] AMEJ 0230 (refd) and Dato' Stanley Issacs v. The Government of Malaysia & Ors [2019] 8 MLJ 331; [2019] 1 415 CLJ 626; [2018] MLRHU 1385 (refd), where similar awards were granted. However, relying on a more recent case, Navin Sharma Karam Chand & Anor v. Bukit Tinggo Hospital Sdn Bhd & Anor [2023] CLJU 2099; [2023] MLJU 2370; [2024] 1 MLRH 679, which set a new benchmark, awarding RM700,000.00 for a delay in 420 treatment and unprofessional management which caused the life of a patient. The plaintiff, via their submission dated 10 June 2024 and 19 August 2024, submits for an oral amendment to the statement of claim to increase the claim from RM500,000.00 to RM700,000.00, in line with the latest decision. This Court, however, cannot accede 425 to this request; there is no authority cited to support an amendment in such an instance. The plaintiff’s claim remains within the four corners of the pleading, and therefore, following Suzana Md Aris v. DSP Ishak Hussain & Ors (supra) and Dato' Stanley Issacs v. The Government of Malaysia & Ors (supra), I award 430 RM500,000.00 in aggravated damages. Vindicatory and exemplary damages [29]. The plaintiff’s claim for vindictive and exemplary damages is not 435 allowed as it fails to meet the legal requirement of proving the defendants’ conduct to be outrageous, oppressive, malicious, or unconstitutional. Vindictive and exemplary damages are awarded only in exceptional circumstances where the defendants’ behaviour demonstrates deliberate or egregious wrongdoing, aimed at 440 punishing and deterring such misconduct. In the present case, there is no evidence to support that the defendants’ actions were motivated by malice, oppression, or an intentional disregard for the rights of the deceased or the plaintiff. The allegations revolve around medical negligence, which, although serious, does not rise to the 445 level of "outrageous" conduct required for such damages, as established in cases such as Rookes v. Barnard [1964] AC 1129 and Dr. Hari Krishnan & Anor v. Megat Noor Ishak Megat Ibrahim & Ors [2015] MLJU 1857; [2015] CLJU 1476. [30]. The Defendants have demonstrated that the deceased received 450 continuous medical attention from both the Klinik Kesihatan Hutan Melintang and Hospital Teluk Intan. The defendants’ witness, Dr. Shukur Ahmad, testified that the medical staff provided treatment to the deceased to the best of their ability, based on the information available at the time. There was no evidence of 455 deliberate neglect or ill intent by the medical professionals involved. The defendants also highlighted that, although the diagnosis of DVT was delayed, the failure was unintentional and arose due to the challenges of diagnosing such conditions, particularly in the absence of apparent symptoms at the initial stages. This supports 460 the defendants’ argument that the negligence, while unfortunate, was not intentional or motivated by malice. [31]. Furthermore, the Court must consider the policy implications of awarding vindictive or exemplary damages in medical negligence cases without clear evidence of bad faith. Such awards are intended 465 to address deliberate or oppressive conduct, as seen in cases like Mohd Ridzwan Abdul Razak v. Asmah Hj Mohd Nor [2016] 4 MLJ 282; [2016] 4 MLRA 614; [2016] 6 CLJ 346; [2016] 4 AMR 256, where the Federal Court emphasised that punitive damages require proof of egregious conduct. The defendants have shown 470 that the medical staff acted in good faith and within the scope of their duties to treat the deceased, and there were no aggravating features, such as intentional harm or oppressive behaviour, to justify an award of exemplary damages. [32]. I am of the view that while the prolonged neglect and improper 475 management of the deceased's medical condition amount to a gross failure in the duty of care, which is beyond mere negligence, compensation in this regard is adequately addressed through the award of aggravated damages. This reflects the gravity of the defendants’ failure to meet the required standard of care. However, 480 I find no evidence in this case of intentional acts by the defendants to harm, nor of oppressive behaviour, that would justify the imposition of vindictive or exemplary damages. As such, the plaintiff’s claim for vindictive and exemplary damages is dismissed. 485 Costs Awarded [33]. The defendants are ordered to pay the plaintiff costs amounting to RM25,000.00. This sum is awarded in recognition of the legal expenses incurred by the plaintiff throughout the proceedings. The Court deems this amount as reasonable and proportionate. 490 Interest Awarded [34]. The defendants are also ordered to pay the plaintiff interest as follows: a) Interest at the rate of 4% per annum on Special Damages from the date of the accident (4 May 2018) until the date of 495 Judgment (29 October 2024). b) Interest at the rate of 8% per annum on General Damages and Aggravated Damages from the date of the filing of the Writ (10 November 2020) until the date of Judgment (29 October 2024). 500 c) Interest at the rate of 5% per annum on the total Judgment sum, inclusive of costs, from the date of Judgment (29 October 2024) until full settlement. Allocatur Fee [35]. The Court further declares that this Judgment is not subject to the 505 payment of the allocatur fee. Date : 14 January 2025 Moses Susayan 510 ------------------------------------------- MOSES SUSAYAN Judicial Commissioner High Court in Malaya 515 at Ipoh, Perak Counsel: For the plaintiff : Ranjit Singh 520 (together with Harveynder Singh Tyndall) Advocates and Solicitors [Messrs Ranjit Singh & Co.] Ipoh, Perak 525 For the defendant s : Fariza Amira bin Azman Federal Counsel [Civil Division Government Contract and medical negligence Unit] 530 Attorney General Chambers Malaysia, Putrajaya [Notice: This Grounds of Decision is subject to official editorial revision] Headnotes 535 Damages — Assessment — Medical negligence — Misdiagnosis of Deep Vein Thrombosis (DVT) — Failure to provide adequate treatment — Plaintiff claimed against defendants for medical negligence — Defendants admitted liability — Quantum of damages to be awarded. Damages — Special damages — Fees for medical and police reports, 540 funeral expenses, and travel costs — Claims substantiated by evidence — Court allowed reasonable and justified claims Damages — Loss of dependency — Calculation based on reasonable monthly contribution — Adjustments made based on evidence — Award for dependency and EPF contribution granted 545 Damages — General damages — Pain and suffering of deceased — Global award granted — Assessment based on medical expert opinion, inflation, and precedents Damages — Aggravated damages — Exceptional negligence by defendants — Failure to diagnose and treat DVT — Award granted for 550 prolonged pain and suffering Damages — Vindicatory and exemplary damages — Claim dismissed — No evidence of malicious or oppressive conduct by defendants Costs and interest — Costs awarded to Plaintiff — Interest granted on special, general, and aggravated damages — Judgment exempted from 555 allocatur fee