SUPERIOR COURT OF NEW JERSEY
APPELLATE DIVISION
A-3593-97T1
SUSAN HAMMER and ALAN HAMMER,
her husband,
Plaintiffs-Appellants,
v.
TOWNSHIP OF LIVINGSTON and
CRAIG D. DUFFORD,
Defendants-Respondents.
________________________________________
Argued December 8, 1998 - Decided February 18,
1999
Before Judges Muir, Jr., Eichen and Coburn.
On appeal from the Superior Court of New
Jersey, Law Division, Essex County.
Stephen S. Weinstein argued the cause for
appellants (Mr. Weinstein, attorney; Gail S.
Boertzel, of counsel and on the brief).
Thomas D. Robertson argued the cause for
respondents (McCarter & English, attorneys;
James H. Keale, of counsel; Christopher R.
Carton, on the brief).
The opinion of the court was delivered by
EICHEN, J.A.D.
In this New Jersey Tort Claims Act case, N.J.S.A. 59:1-1 to -12-3 (the Tort Claims Act), plaintiffs Susan Hammer and Alan
HammerSee footnote 1 appeal from a dismissal of their complaint following a
successful motion for summary judgment by defendants Township of
Livingston and Craig D. Dufford, the Chief of the Livingston Fire
Department. The motion judge concluded that plaintiff had not
demonstrated she sustained a "permanent loss of a bodily function"
or a "permanent disfigurement" that is substantial under N.J.S.A.
59:9-2(d). We reverse.
The underlying relevant facts are not in dispute. On October
27, 1994, at approximately 8:00 a.m., plaintiff, then age sixty-four, was crossing West Northfield Road in Livingston on foot when
she was struck by a red fire chief station wagon operated by Fire
Chief Dufford. The vehicle hit plaintiff on the left side of her
body, and she was thrown, landing on her right side. The collision
was of sufficient force to cause substantial damage to the station
wagon.
Plaintiff was taken to Morristown Memorial Hospital where she
underwent immediate surgeries to repair a severe laceration of her
left knee that had penetrated into the knee joint; a soft tissue
laceration of the left elbow involving the olecranon bursa; a
laceration of the iliotibial band, vastus lateralis muscle and
suprapatellar bursa; and numerous facial lacerations, including a
one-centimeter laceration near the tear duct of plaintiff's right
eye, a 0.5-centimeter laceration over the bridge of her nose, and
a laceration of the lower lip approximately three centimeters long.
In addition, plaintiff sustained fractures of both nasal bones, a
non-displaced fracture at the top of her left fibula, and an
avulsion fracture of her left olecranon bone (i.e., elbow)
requiring removal of the displaced bone fragment. Following the
surgeries, plaintiff was hospitalized for eight days and discharged
on November 4, 1994.See footnote 2
Dr. Robert J. D'Agostini, plaintiff's treating orthopedic
surgeon, noted as early as three months after the accident that
plaintiff had "regained full knee motion and ... had excellent
lateral stability." On May 15, 1995, he opined in his final report
that "[she] should have excellent elbow and knee function." On
April 26, 1997, Dr. Alan Tillis, a second treating orthopedist,
concurred in part, observing that "[plaintiff] probably has healed
the lacerations to the left side of her body fairly well."
Plaintiff's deposition, taken September 27, 1996, also reflects
that she had no discomfort in her left elbow or left leg and that
her left fibula had healed.
Nevertheless, plaintiff complains of pain on the right side of
her body. Specifically, she says she has pain in her right
shoulder, elbow and ankle. Plaintiff maintains that since the
accident she cannot walk with or lift her grandchildren, she cannot
swim anymore except for the breaststroke, and she can no longer
dance or play tennis. Plaintiff also alleges that, as a result of
the accident, she no longer has sexual relations with her husband
and that she suffers from permanent post-traumatic stress disorder.
On January 5, 1995, Dr. D'Agostini examined plaintiff's right
elbow and reported "no swelling, no tenderness" and "a full and
painless range of motion and good strength," concluding that from
his perspective, "nothing [was] wrong." In April 1996, Dr. Tillis
diagnosed post-traumatic tendinitis in plaintiff's right shoulder
and ankle. Both doctors noted full range of motion in plaintiff's
right shoulder. In November 1994, Dr. D'Agostini observed
plaintiff had "excellent motion and gait," while Dr. Tillis noted
in April 1996 that plaintiff walked with a "moderately antalgic
gait."See footnote 3 X-rays were negative as reflecting any objective basis for
plaintiff's right-sided complaints.
Beginning in November 1994, plaintiff was examined and
diagnosed by Dr. Charles D. Semel, a psychiatrist, as suffering
from post-traumatic stress disorder with severe phobic elements.
In June 1996, Dr. Semel reported that although the condition "ha[d]
moderated," it appeared to be "chronic" and "partially disabling."
Several months later, on October 23, 1996, he described plaintiff's
post-traumatic stress disorder as "characterized by elements of
anxiety and depression" and that her "current level of distress ...
[fell] into the mild range." He noted that "[p]rogress [was]
evident[, but a] full resolution ha[d] not been achieved." In his
final report, on July 29, 1997, Dr. Semel opined that "[w]ithin
reasonable medical probability, [plaintiff] will remain as she
is[,] less than fully recovered." He concluded that "[t]his
partial disability appears to be permanent and ongoing." His
report makes no mention of plaintiff's claimed sexual dysfunction
except to reiterate her complaints. The only other reference to
this allegation in a doctor's report is Dr. D'Agostini's
observation on January 5, 1995 that he perceived no reason why
plaintiff should not resume sexual activities with her husband.
Professional-quality color photographs, allegedly taken in
January 1998, reveal residual scarring and swelling including a
scar on plaintiff's left leg, a small scar on plaintiff's elbow,
swelling around her nose,See footnote 4 and some facial scarring. Specifically,
the photographs show a thin diagonal scar extending from her right
lower lip to her chin and a vertical scar extending from the corner
of her right eye to her nose. The scar on her left leg appears to
be at least fifteen centimeters long and runs the length of her
knee cap, ending in an indentation near the bottom of the scar that
is discolored and mottled. The scar on her elbow is shaped like an
inverted "V." Dr. D'Agostini opined in his final report that
"[plaintiff] will have a permanent disfiguring scar on her knee and
a smaller but still permanent scar on her left elbow." In
addition, the photographs reveal a scar on Mrs. Hammer's abdomen
approximately two inches in length which resulted from the excision
of a mass discovered after the accident. Mrs. Hammer's doctor
concluded that the accident caused the mass to form.
Defendants moved for summary judgment, asserting that
plaintiff's claim for pain and suffering did not meet the threshold
established by the Tort Claims Act, particularly N.J.S.A. 59:9-2(d), to permit her to recover against a public entity or its
employee. On February 6, 1998, the motion judge rendered the
following brief opinion from the bench:
After reviewing the moving papers, as well as
the opposing papers and the arguments of
counsel, this Court is of the view that -
first of all, that the scarring does not
constitute permanent disfigurement that is
substantial.
This Court further finds that this case is,
indeed, distinguishable from Collins[ v. Union
County Jail,
150 N.J. 407 (1997)] and that the
finding by Dr. Semel does not bespeak of a
permanent bodily function. This Court further
finds that the healed fractures do not
constitute, individually, a permanent bodily
function that is lost. And combined in all -
with all of them, the plaintiff is not within
the statute according to Brooks[ v. Odom,
150 N.J. 395 (1997)]. The motion is granted.
Plaintiff contends that the judge erred in granting defendants
summary judgment on her claim for pain-and-suffering damages
because she has suffered injuries that constitute "permanent loss
of bodily function" as well as "permanent disfigurement."
Plaintiff maintains that her fractures, pain on the right side of
her body, and post-traumatic stress disorder, individually or taken
together, constitute "a permanent loss of a bodily function."
Additionally, she argues that the scars from her surgery and the
swelling and disfiguration of her nose are "permanent
disfigurements." Plaintiff also asserts that "looking at the
totality of her injuries and the manner in which she was injured,
... the circumstances of her case are sufficiently aggravating to
meet the criteria set forth in N.J.S.A. 59:9-2(d)." Defendants
counter that summary judgment was proper because plaintiff failed
to meet the threshold requirements of N.J.S.A. 59:9-2(d).
N.J.S.A. 59:9-2(d) of the Tort Claims Act governs claims for
pain-and-suffering damages arising from personal injuries caused by
public entities and their employees. That section establishes
certain threshold injury requirements for recovery, providing in
part:
No damages shall be awarded against a public
entity or public employee for pain and
suffering resulting from any injury; provided,
however, that this limitation on the recovery
of damages for pain and suffering shall not
apply in cases of permanent loss of a bodily
function, permanent disfigurement or
dismemberment where the medical expenses are
in excess of $1,000.00.
[N.J.S.A. 59:9-2(d).]
The Act was intended to re-establish the Legislature's
overriding philosophy that immunity for public entities is the
general rule and liability is the exception. See Pico v. State,
116 N.J. 55, 59 (1989); see also Brooks, supra, 150 N.J. at 402
(discussing the legislative history and intent of N.J.S.A. 59:9-2(d)). The comment to N.J.S.A. 59:9-2(d) explains that:
The limitation on the recovery of damages in
subparagraph (d) reflects the policy judgment
that in view of the economic burdens presently
facing public entities a claimant should not
be reimbursed for non-objective types of
damages, such as pain and suffering, except in
aggravated circumstances....cases involving
permanent loss of a bodily function, permanent
disfigurement or dismemberment where the
medical treatment expenses are in excess of
$1,000.
Brooks clarified the standard necessary to meet the threshold
under N.J.S.A. 59:9-2(d). There, the Court held that in order to
recover under the Tort Claims Act a claimant must sustain "a
permanent loss of the use of a bodily function that is
substantial." Brooks, supra, 150 N.J. at 406 (emphasis added).
We have carefully reviewed the record and the arguments of the
parties and are persuaded that there is a total absence of
objective medical evidence in the record of any permanent loss of
bodily function resulting from the fractures or lacerations
plaintiff sustained in the accident. Indeed, plaintiff concedes
that her left fibula and left olecranon have healed completely, and
she claims no loss of bodily function from her fractured nasal
bones. Additionally, both of her treating orthopedists confirmed
that her lacerations have healed nicely.
Similarly, plaintiff failed to present any objective medical
evidence of an injury to her right elbow, shoulder or ankle that
meets the requirements of N.J.S.A. 59:9-2(d) despite her subjective
complaints of pain. Dr. D'Agostini examined plaintiff's right
elbow in 1995 and saw "nothing wrong." When Dr. Tillis examined
plaintiff in April 1996, he did not indicate any objective medical
abnormality with respect to her right elbow. Absent objective
medical evidence, plaintiff cannot recover pain-and-suffering
damages for her right elbow. See Brooks, supra, 150 N.J. at 403.
Plaintiff's complaints of pain in her right shoulder and right
ankle were also unsupported by objective medical evidence that
either condition constituted the permanent loss of a bodily
function that is substantial. Both Dr. D'Agostini and Dr. Tillis
noted that, despite plaintiff's tendinitis, her shoulder did have
a full range of motion. As for her ankle, although Dr. Tillis
observed that "[plaintiff] walk[ed] with a moderately antalgic gait
on the right," she nevertheless was able to walk. See Brooks,
supra, 150 N.J. at 406 (observing that as long as plaintiff could
still function in her employment and as a homemaker, her loss was
not substantial). Furthermore, despite Dr. Tillis's conclusion
that plaintiff's tendinitis was "post traumatic," he did not state
whether the trauma that caused the tendinitis was the collision of
October 27, 1994, nor did he explain why he believed the tendinitis
resulted from some trauma. In any event, there is no other
evidence in the record to show that the collision caused the
problems with plaintiff's right ankle. To the contrary, on
November 17, 1994, only three weeks after the collision, Dr.
D'Agostini examined plaintiff and observed that "she ha[d]
excellent motion and gait."
We are convinced that none of plaintiff's subjective
complaints regarding the right side of her body are supported by
objective medical evidence; therefore, they cannot constitute a
permanent loss of a bodily function that is substantial.
We are also satisfied that plaintiff's post-traumatic stress
disorder claim was properly rejected because plaintiff has not
demonstrated that her allegedly debilitating psychological disorder
constitutes a permanent loss of a bodily function that is
substantial. See Collins, supra, 150 N.J. at 423.
In Collins, our Supreme Court held that "an aggravating and
intrusive assault" that causes a victim to sustain a permanent
psychological injury may be sufficient to qualify as a "permanent
loss of a bodily function" under N.J.S.A. 59:9-2(d), id. at 420,
provided the loss is substantial and the claimant has met the
$1,000 medical expense requirement, see id. at 413, 423. Stated
differently, Collins requires "sufficiently aggravated"
circumstances before liability will attach under the Tort Claims
Act. Id. at 413.
We need not determine whether this case presents "sufficiently
aggravated" circumstances to entitle plaintiff to recover pain-and-suffering damages for her psychological disorder because we
conclude that plaintiff failed to produce prima facie proof that
her psychological disorder was substantial. According to Dr.
Semel, plaintiff's psychiatrist, her "current level of
[psychological] distress" only falls into the "mild range."
Although plaintiff initially suffered from flashbacks and
nightmares, those conditions have "moderated." Indeed, Dr. Semel
indicated in his two most recent reports that plaintiff's only
permanent psychological injury is a mild level of anxiety and
depression. Moreover, the record does not reflect that plaintiff
is prevented by her disorder from carrying out her ordinary day-to-day functions or that she cannot live a normal life. In fact, her
psychiatrist noted that she "has returned to driving and also
riding as a passenger in vehicles."See footnote 5 Further, although plaintiff
claims that she cannot engage in regular sexual relations with her
husband, neither she nor her psychiatrist assert that her alleged
sexual dysfunction is the result of her post-traumatic stress
disorder. In any event, there is no evidence in the record of any
physical impediment to plaintiff's engaging in sexual relations.
Indeed, Dr. D'Agostini assured her there was no reason why she
could not resume sexual activities with her husband. In short,
plaintiff has failed to demonstrate by credible, objective medical
evidence that her permanent psychological disorder is a
"substantial" loss of a bodily function.
Our view is different, however, with respect to plaintiff's
claim of "permanent disfigurement" under N.J.S.A. 59:9-2(d). As a
threshold observation, we agree with the motion judge's conclusion
that plaintiff was required to demonstrate not only that she
sustained a "disfigurement" but that the disfigurement is both
"permanent" and "substantial." Cf. Brooks, supra, 150 N.J. at 406.
To determine whether a scar constitutes "disfigurement," we
apply the definition used in Falcone v. Branker,
135 N.J. Super. 137 (Law Div. 1975). That case recognized an objective standard
for determining whether a scar is a "permanent significant
disfigurement" under New Jersey's original "no-fault" statute,
N.J.S.A. 39:6A-8a (1972). See Falcone, supra, 135 N.J. Super. at
152. That standard informs our decision here. See Brooks, supra,
150 N.J. at 403-04 (citing Thorpe v. Cohen,
258 N.J. Super. 523,
526 (App. Div. 1992)) (observing that "[i]n some respects the
threshold issue in actions against public entities is similar to
the verbal-threshold issue in no-fault cases.").
In Falcone, the trial court stated that to be a
"disfigurement" a scar must "impair[] or injure[] the beauty,
symmetry, or appearance of a person or thing ... render[ing its
bearer] unsightly, misshapen or imperfect, [or] ... deform[ing her]
in some manner." Falcone, supra, 135 N.J. Super. at 145 (quoting
Superior Mining Co. v. Industrial Comm'n,
141 N.E. 165, 166 (Ill.
1923), an out-of-state workers' compensation case). Building on
Falcone, in Puso v. Kenyon,
272 N.J. Super. 280 (App. Div. 1994),
we observed that to qualify as a "disfigurement" under the current
no-fault verbal threshold statute, N.J.S.A. 39:6A-8a, a scar must
be "objectively significantly disfiguring." Puso, supra, 272 N.J.
Super. at 292.
In assessing the severity of the disfigurement, the Falcone
court listed a number of objective factors the court should
consider, namely its "appearance, coloration, existence and size."
Falcone, supra, 135 N.J. Super. at 152. In Puso, we expanded these
factors to include the "shape, characteristics of surrounding skin,
the remnants of the healing process" and any other factors that
might be "develop[ed] as being cosmetically important on a case-by-case basis." Puso, supra, 272 N.J. Super. at 291. There, we
acknowledged with approval the Falcone court's observations that
not every mark or scar will be compensable as a "disfigurement."
Id. at 289 (quoting Falcone, supra, 135 N.J. Super. at 145).
Compensability depends on the severity of the disfigurement.
We accept the definition of disfigurement applied in Falcone
and Puso and employ the same objective factors utilized there to
assess whether the disfigurement meets the verbal threshold under
the No-Fault Act, N.J.S.A. 39:6A-8a. We hold, however, that, in
addition, under the Tort Claims Act, a disfigurement must be
"substantial" to satisfy its verbal threshold requirement, N.J.S.A.
59:9-2(d). Cf. Brooks, supra, 150 N.J. at 406.
We infer from the record that the motion judge reviewed the
recent photographs of plaintiff's scars and considered the relevant
legal principles we have discussed. Regrettably, he did not
articulate his reasons for concluding that plaintiff had failed to
demonstrate a prima facie case of permanent disfigurement that is
substantial. Without explaining the basis for his determination,
he simply stated that the scar did not meet the threshold
requirements of N.J.S.A. 59:9-2(d). In doing so, he made no
mention of the numerous surgeries plaintiff had undergone to repair
her face, leg and elbow. Nor did he mention Dr. D'Agostini's
opinion that plaintiff would have "a permanent disfiguring scar on
her knee," or comment on its appearance or its size. That scar is
fifteen centimeters long and runs the length of plaintiff's knee
cap ending in a discolored and mottled indentation near the bottom.
The judge also did not refer to the swelling of plaintiff's nose,
the facial scars extending from her right lower lip to her chin and
from the corner of her right eye to her nose, or the scar on her
elbow which is shaped like an inverted "V." In fact, the judge did
not make any findings of fact or conclusions of law, or provide any
reason for his decision. As we noted in In re Will of Marinus,
201 N.J. Super. 329, 338-39 (App. Div.), certif. denied,
101 N.J. 332
(1985), the failure of the judge to find facts and state
conclusions of law pursuant to R. 1:7-4 constitutes a disservice to
the litigants, the attorneys and the appellate court. Although we
could remand the matter to the motion judge to make the required
findings, we have exercised our original jurisdiction to make our
own independent determinations based on the record before us. See
R. 2:10-5.
We cannot conclude, as the motion judge apparently did, that
the scars, as depicted in the photographs, are so insubstantial
that no rational fact-finder could determine that one or more of
them "impair" plaintiff's appearance, rendering her "unsightly,"
"misshapen," or "imperfect," Falcone, supra, 135 N.J. Super. at
145. To withstand a motion for summary judgment, the non-moving
party need only present "competent evidential materials ...
[which], when viewed in the light most favorable to [that] party,
are sufficient to permit a rational factfinder to resolve the
alleged disputed issue in [that party's] favor...." Brill, supra,
142 N.J. at 540. Here, at the very least, the record raises a
factual dispute concerning plaintiff's claim that her scars
constitute permanent and substantial disfigurements. In such a
case, it is not the judge's function to weigh the evidence and
determine the truth of the matter but only to determine whether
there is such a dispute. See Brill, supra, 142 N.J. at 540. It is
only when the evidence is so one-sided that a judge may decide that
one party should prevail as a matter of law. Id. at 536.
Consequently, the judge erred in concluding as a matter of law that
plaintiff did not suffer a permanent disfigurement that is
substantial. Accordingly, we reverse and remand for trial.
Defendants concede that once plaintiff demonstrates a prima
facie case of either a permanent loss of a bodily function or a
permanent disfigurement that is substantial, then the limitation on
the recovery of pain-and-suffering damages under N.J.S.A. 59:9-2(d)
does not apply and plaintiff may present evidence relating to all
of her alleged permanent injuries to the jury. Cf. Puso, supra,
272 N.J. Super. at 293. In light of this concession, while we take
no position on its correctness, on remand plaintiff may present
proof of the nature and extent of all of her injuries to the trier-of-fact. Further, because we remand for trial on plaintiff's
alleged pain-and-suffering damages, we need not address or resolve
plaintiff's alternative argument that, even if no single injury is
found to satisfy the threshold requirements of N.J.S.A. 59:9-2(d),
the totality of plaintiff's injuries may constitute sufficiently
"aggravated circumstances" to justify the recovery of pain-and-suffering damages. See N.J.S.A. 59:9-2 Task Force Comment.
Reversed and remanded for trial in conformity with this
opinion.
Footnote: 1 References to plaintiff in the singular refer to plaintiff Susan Hammer. Plaintiff Alan Hammer, Susan's husband, asserted a per quod claim. Footnote: 2 It is not disputed that plaintiff's medical expenses exceeded $46,000. Footnote: 3 "Antalgic" means "[a]cting to allay or prevent pain." J.E. Schmidt, Attorneys' Dictionary of Medicine and Word Finder A-213 (1962). Footnote: 4 Plaintiff contends that the fracture of her nasal bones caused her nose to swell and appear wider and that the swelling makes her right nostril look different from her left one. Footnote: 5 Plaintiff disputed this in her deposition on September 17, 1996.