Title: Sharon Kahrar and Bernard Kahrar v. Borough of Wallington
Citation: N/A
Docket Number: a-68-00
State: new-jersey
Issuer: new-jersey Supreme Court
Date: February 27, 2002

(This syllabus is not part of the opinion of the Court. It has been prepared by the Office of the Clerk for the convenience of the reader. It has been neither reviewed nor approved by the Supreme Court. Please note that, in the interests of brevity, portions of any opinion may not have been summarized). STEIN, J., writing for a majority of the Court. The issue in this appeal is whether the plaintiff, Sharon Kahrar, has satisfied the threshold for awarding pain and suffering damages under the Tort Claims Act, N.J.S.A. 59:9-2d, based on a torn rotator cuff that was surgically repaired. Plaintiff, Sharon Kahrar, was injured on June 28, 1997, when she fell on an alleged hole in a road owned and/or maintained by the Borough of Wallington, adjacent to a market she had intended to visit. Following her fall, Kahrar noticed that she had sustained cuts and bruises to various parts of her body. Nevertheless, she did not seek medical treatment until the following day, when she went to the emergency room and learned that she had broken her right elbow and knee. After several weeks of treatment and physical therapy, Kahrar still was in pain and thus was recommended to an orthopedist. Kahrar was seen by Dr. Gary Savatsky, an orthopedist, in July 1997. Dr. Savatsky ordered an MRI, which revealed a massive tear of Kahrar's rotator cuff. He performed surgery the following month to repair the tear. Within three weeks of surgery, the doctor noted an improvement. However, two months after surgery, Kahrar was still experiencing pain and achiness. In addition, three months after surgery, Dr. Savatsky observed that he could rotate Kahrar's shoulder only twenty-five degrees, and subsequent post-operative reports described significant limitation in movement of her left arm. Dr. Savatsky's last report (rendered 227 days after surgery) describes Kahrar's range of motion in several respects in her left arm as measuring less than that in her right arm. A subsequent exam by a defense medical expert, approximately one year post surgery, confirmed that Kahrar had sustained substantial motion loss in her left arm as a result of the rotator cuff tear. After surgery, Kahrar began a course of physical therapy that continued for about nine months. She returned to work as a secretary approximately two months after her surgery and was noted to be performing her full duties without restrictions. However, Kahrar indicated that it took her longer to perform her normal job responsibilities and that she often required the assistance of others to complete some of her duties. In addition, Kahrar indicated that she experienced difficulty when performing normal household tasks, requiring her husband's or her children's assistance, and that she had difficulty driving, sleeping through the night without pain, reaching certain areas of her body, and continuing her hobbies. Kahrar and her husband filed suit under the Tort Claims Act against the Borough for the injuries and other damages she sustained. The Borough subsequently filed a motion for summary judgment, claiming that Kahrar's injuries did not satisfy the threshold requirement of permanent loss of a bodily function set forth in N.J.S.A. 59:9-2d. The trial court granted summary judgment for the Borough, observing that the Supreme Court's decision in Brooks v. Odom, 150 N.J. 395 (1997), required, as a predicate to recovery for pain and suffering, an injury that prevents a plaintiff from performing any or most of the tasks performed at work and at home prior to the injury. The Appellate Division affirmed the trial court's determination that Kahrar's injury was not permanent. The Supreme Court granted Kahrar's petition for certification to consider whether her shoulder injury constituted a permanent loss of a bodily function that satisfied the Tort Claims Act's threshold requirement. HELD: Plaintiff, who fell and was injured on property owned and/or controlled by the Borough of Wallington, has satisfied the Tort Claims Act's threshold for awarding pain and suffering damages based on a torn rotator cuff that required surgical repair and that resulted in a significant limitation in range of motion. 1. The Tort Claims Act limits recovery for pain and suffering damages to cases involving permanent loss of a bodily function, permanent disfigurement, or dismemberment where the medical treatment expenses are in excess of $3,600. That limitation is intended to ensure that such damages will not be awarded unless the loss is substantial. (pp. 9-10) 2. To recover under the Tort Claims Act, a plaintiff must prove an objective permanent injury and a permanent loss of bodily function that is substantial. (pp. 10-13) 3. The Legislature intended to include within the notion of aggravated cases for which one can seek damages for pain and suffering those cases involving permanent injury resulting in a permanent loss of normal bodily function even if modern medicine can supply replacement parts to mimic the natural function. (pp. 13-16) 4. The appropriate focus in applying the Tort Claims Act standard is on the degree of injury and impairment, and if the loss of bodily function is permanent and substantial, a plaintiff's eligibility to recover pain and suffering damages will not be defeated merely because he or she can perform some routine functions almost as well as he or she could prior to his or her injury. (pp. 16-17) 5. A determination of whether a claimant has sustained injuries sufficient to satisfy the threshold under the Tort Claims Act is fact sensitive and not conducive to per se rules, and based on the facts in this record, Kahrar has adequately demonstrated a permanent and substantial loss of a bodily function. (pp. 18-19) Judgment of the Appellate Division is REVERSED and the matter is REMANDED for trial to the Law Division. JUSTICE VERNIERO has filed a separate dissenting opinion in which JUSTICE LaVECCHIA joins. Justice Verniero did not believe that Kahrar's proofs satisfied the Tort Claims Act's high threshold for recovery of non- economic damages under Brooks. He further believed that the Court had altered the analysis used to evaluate claims for non-economic damages against a public entity under the Tort Claims Act and that the approach employed in Brooks was more in keeping with the Act. Thus, he would have affirmed the Appellate Division's judgment. CHIEF JUSTICE PORITZ and JUSTICES COLEMAN, LONG, and ZAZZALI join in JUSTICE STEIN's opinion. JUSTICE VERNIERO has filed a separate dissenting opinion in which JUSTICE LaVECCHIA joins. SHARON KAHRAR and BERNARD KAHRAR, Plaintiffs-Appellants, v. BOROUGH OF WALLINGTON, Defendant-Respondent. Argued September 25, 2001 -- Decided February, 27, 2002 On certification to the Superior Court, Appellate Division. James H. Cleary argued the cause for appellants. Brian R. Martinotti argued the cause for respondent (Beattie Padovano, attorneys; James V. Zarrillo, on the brief). The opinion of the Court was delivered by STEIN, J. The issue on appeal is whether plaintiff, Sharon Kahrar, has satisfied the threshold for awarding pain and suffering damages under the Tort Claims Act, N.J.S.A. 59:9-2d, based on a torn rotator cuff that was surgically repaired. The Appellate Division affirmed the dismissal of plaintiff's cause of action, concluding that plaintiff's shoulder injury did not constitute a permanent loss of a bodily function that was substantial, the standard adopted by this Court in Brooks v. Odom, 150 N.J. 395, 406 (1997). We hold that on the facts in this record the shoulder injury satisfies the statutory threshold requirement. The cuff tear was deemed too large to repair adequately with an arthroscopic assisted technique. Therefore, a traditional Neer skin incision was made from the coracoid to the anterolateral acromion. The skin and subcutaneous tissues were divided down. The deltoid was taken from the anterior acromion and then split distally for 3 cm. The coracoacromial ligament was divided. A formal Neer acromioplasty [surgical removal of the anterior portion of the acromion] was performed with the above noted findings. Significantly, Dr. Livingston noted that plaintiff had approximately forty percent loss of full motion in her left shoulder. Accordingly, both examining physicians agreed that plaintiff had sustained substantial motion loss in her left arm that apparently was attributable to weakness in the reattached tendon. After surgery, plaintiff began a course of physical therapy that continued for about nine months. By the time she returned to her employment, she had missed approximately 100 days of work. Plaintiff sustained approximately $6,225 in lost wages and approximately $25,000 in medical bills. Plaintiff returned to work as a secretary almost two months after her surgery and was noted to be performing her full duties without restrictions. Plaintiff's employment as a secretary includes typing on the computer and answering incoming telephone calls for a work force of twenty-two employees. She indicates that it takes her longer to perform her normal responsibilities and that she often requires the assistance of others to complete some of her duties. Plaintiff, who is left hand dominant, indicates that she has had to compensate for the weakness and loss of mobility in her injured arm by using her right arm more, which often causes the right shoulder to swell. She especially experiences difficulty when performing normal household tasks, requiring her husband's or her children's assistance to clean, vacuum or move furniture. In addition to the difficulty in performing normal household tasks, plaintiff also states that she has difficulty driving, sleeping through the night without pain, reaching certain areas of her body and continuing her hobbies that include woodworking and furniture stripping. In Brooks, supra, 150 N.J. at 400, the Court elaborated on the permanent loss of a bodily function requirement under N.J.S.A. 59:9-2d. There, a New Jersey Transit bus struck the open door of the plaintiff's car, knocking her back into the car. The plaintiff arrived at the hospital complaining of pain in her neck, back and head. X-rays were taken, and she was prescribed medication, fitted for a cervical collar and discharged. The plaintiff subsequently sought treatment from a physician who administered twelve heat treatments to her back. Finding those treatments ineffective, plaintiff then came under the care of a new doctor, complaining of headaches, dizziness, blurred vision, pain and stiffness in her neck, upper and lower back, and in her left shoulder. The plaintiff was diagnosed with 'residual of post-traumatic myositis and fibromyositis of the cervicodorsal and lumbosacral region and post-traumatic headache syndrome.' Id. at 399. Despite treatment with transcutaneous electrical nerve stimulation, the plaintiff's complaints of pain persisted. The evidence in Brooks included X-rays of the plaintiff's back that revealed small marginal spurs and spinal curvature. An EMG indicated elevated muscle activities in her neck. Ibid. We also considered the plaintiff's persistent complaints of pain, muscle spasms and limited motion when performing household chores. We concluded that [i]n reviewing the sufficiency of plaintiff's case, we accept that she experiences pain and that the limitation of motion in her neck and back is permanent. Id. at 406. We also explained that a partial, as well as a total, permanent loss of a bodily function would satisfy the statutory standard provided that the loss of bodily function was substantial. Ibid. Nonetheless, we held that the plaintiff's complaint reflected essentially a subjective claim for pain and suffering that did not rise to the level of a substantial and permanent loss of a bodily function. The Court noted that plaintiff was able to function both in her employment and as a homemaker, and concluded that she did not have a permanent loss of a bodily function within the meaning contemplated by the Legislature. We also reviewed the legislative history underlying the Tort Claims Act and concluded that the Legislature intended a chary interpretation of a public entity's exposure to liability. Id. at 402. We stated that '[t]o recover under the Act for pain and suffering, a plaintiff must prove by objective medical evidence that the injury is permanent. Temporary injuries, no matter how painful and debilitating, are not recoverable. Further, a plaintiff may not recover under the Tort Claims Act for mere 'subjective feelings of discomfort.' Id. at 402-03. The Court acknowledged, however, that certain types of permanent injury, such as permanent loss of eyesight, taste and smell, would satisfy the statutory standard. Id. at 403. Cases under the No-Fault Act also were considered in our analysis. We stated that [t]he No Fault Act manifests legislative recognition that something less than a 'permanent loss of the use of a body organ, member, function or system' would satisfy the verbal threshold. 150 N.J. at 406. We clarified that in the case of the Tort Claims Act, although the Legislature did not intend to require a total loss of a bodily function, it also did not intend that a mere limitation on a bodily function would suffice. Ibid. A two-pronged test emerged from our decision in Brooks. To recover under the Tort Claims Act, a plaintiff must prove (1) an objective permanent injury, and (2) a permanent loss of a bodily function that is substantial. Gilhooley v. County of Union, 164 N.J. 533, 541 (2000). Since our decision in Brooks, courts have attempted to apply correctly the substantiality requirement under the second-prong of Brooks. In Hammer v. Township of Livingston, 318 N.J. Super. 298 (1999), the Appellate Division ruled that a plaintiff whose fractures had healed did not demonstrate a permanent loss of a bodily function that was substantial. The sixty-four year old plaintiff was struck by a fire wagon and thrown into the air. She suffered severe lacerations to her knee, left elbow, right eye, nose and lip. She also sustained several fractures of her nose, elbow, and knee. Plaintiff underwent several operations, but her physician noted that within three months of the accident plaintiff was functioning well. Thereafter, plaintiff started to complain of pain in her right shoulder and was diagnosed with post-traumatic tendonitis. The court noted that plaintiff's gait was not limited by her injuries, and that plaintiff had acknowledged that her left fibula and left elbow had healed completely. On the issue of plaintiff's fractures, the court concluded that plaintiff had presented no objective medical evidence to satisfy the second prong of Brooks. Id. at 305. See also Dellisanti v. Harrison Hous. Auth, aff'd, 163 N.J. 61 (2000)(reaffirming need for objective credible evidence to satisfy the second prong of Brooks) In comparison, in Gerber v. Springfield Board Of Education, 328 N.J. Super. 24, (2000), the Appellate Division ruled that a plaintiff diagnosed with nasal fractures had demonstrated a permanent loss of a bodily function that was substantial. There, plaintiff, a high school student, was attacked by a classmate. She sustained multiple nasal fractures and underwent surgery for a 'closed reduction of nasal bone and septal fractures.' Id. at 31. After surgery, the plaintiff still had difficulty breathing through her nose. Her physicians concluded that her injuries were permanent, her symptomology would worsen, and that there was no possibility that she would ever breathe normally again. Id. at 32. The court held that a substantial loss of bodily function encompasses permanent and constant difficulty breathing. Id. at 36. More recently in Gilhooley, supra, 164 N.J. 533, we addressed the Brooks two-prong test. In Gilhooley, the plaintiff was employed as a clinical social worker for the United States Department of Veterans Affairs. While working in that capacity, plaintiff slipped and fell on an exit ramp as she exited the Union County jail. Doctors diagnosed a fractured nose and fractured right patella. They informed plaintiff that her knee fracture [had] resulted in the disruption of the extensor mechanism leaving her with a complete loss of quadriceps power. Id. at 536. Consequently, plaintiff underwent open reduction surgery, which required the restructuring of her patella with the use of pins and a tension band wire. Plaintiff remained in the hospital for five days and wore a leg brace for more than two months. The Appellate Division determined that because plaintiff had successful reconstructive surgery and had returned to work, her injury constituted only a temporary loss of a bodily function. Id. at 538. We reversed, holding that plaintiff's fractured patella was an objective permanent injury that caused the plaintiff to lose forever the normal use of her knee that, thereafter, could not function without permanent pins and wires to re-establish its integrity. Id. at 542. We also explained that the Legislature intended to include within the notion of aggravated cases those involving permanent injury resulting in a permanent loss of normal bodily function even if modern medicine can supply replacement parts to mimic the natural function. Ibid. Thus, we concluded that plaintiff had satisfied the Tort Claims Act threshold and reversed the grant of summary judgment for defendant. Our dissenting colleagues' reliance, post at __ - __ (slip op at 10-11), on this Court's 4-3 disposition in Dellisanti v. Harrison Housing Authority, 163 N.J. 61 (2000), is misplaced. The Court divided in Dellisanti on the issue whether objective evidence in the record was sufficient to sustain a causal connection between the plaintiff's wrist fracture and her subjective complaints. No such issue is presented by this record, it being undisputed that plaintiff's loss of motion in her left shoulder resulted from the massive tear of her rotator cuff. IV The judgment of the Appellate Division is reversed and the matter remanded for trial to the Law Division. CHIEF JUSTICE PORITZ and JUSTICES COLEMAN, LONG, and ZAZZALI join in JUSTICE STEIN'S opinion. JUSTICE VERNIERO has filed a separate dissenting opinion in which JUSTICE LaVECCHIA joins. SHARON KAHRAR and BERNARD KAHRAR, Plaintiffs-Appellants, v. BOROUGH OF WALLINGTON, Defendant-Respondent. VERNIERO, J., dissenting. Without expressly saying so, the Court has altered the analysis used to evaluate claims for non-economic damages against a public entity under the Tort Claims Act, N.J.S.A. 59:1-1 to 12- 3 (the Act). Because the approach employed in Brooks v. Odom, 150 N.J. 395 (1997), is more in keeping with the Act than the one used here, I respectfully dissent. NO. A-68 SHARON KAHRAR and BERNARD KAHRAR, Plaintiffs-Appellants, v. BOROUGH OF WALLINGTON, Defendant-Respondent. DECIDED February 27, 2002 Chief Justice Poritz