Waldron v Joondalup Hospital Pty Ltd

1. [1]

   McCOLL AP: I agree with Sackville AJA’s reasons and the orders his Honour proposes.

2. [2]

   MEAGHER JA: I agree with the reasons and proposed orders of Sackville AJA.

3. [3]

   SACKVILLE AJA: This is an application for leave to appeal from a decision of a Judge of the Common Law Division (Harrison AsJ). The primary Judge dismissed an application by the present applicant (the plaintiff in the Common Law proceedings) seeking an extension of time to file proceedings against the respondent (the first defendant in the Common Law proceedings). [1]

4. [4]

   The respondent (Joondalup Hospital) is located in Perth, Western Australia. In early July 2011, the applicant visited Perth by air from her home in Sydney. In her amended statement of claim (ASOC), the applicant alleges that she attended the Emergency Department of Joondalup Health Campus on the night of 2 July 2011 because she was experiencing extreme pain in her right foot. She claims that Joondalup Hospital was negligent in its treatment, in that it failed to assess her condition adequately or to make the inquiries reasonably necessary to make a proper diagnosis. In consequence, so the applicant alleges, she was allowed to return to Sydney on 6 July 2011 notwithstanding that she was still in extreme pain.

5. [5]

   In Sydney the applicant consulted a general practitioner (the second defendant in the Common Law proceedings) and attended Sutherland Hospital (for which the third defendant is responsible). She was subsequently transferred to St George Hospital where she underwent a series of procedures. Unfortunately these procedures culminated in an operation in St George Hospital on 26 July 2011 to amputate the applicant’s right leg below the knee.

The proceedings

1. [6]

   The applicant commenced the Common Law proceedings on 24 February 2017 by filing a statement of claim. The statement of claim alleged that each of the three defendants had been negligent and that by reason of their negligence the applicant was required to have her leg amputated and suffered psychiatric and emotional injury. The ASOC was filed on 11 May 2017.

2. [7]

   The applicant filed a notice of motion in the Common Law proceedings on 29 March 2017 seeking an order extending the time until 14 April 2017 for commencing the proceedings. This date was apparently chosen because it was three years from 14 April 2014, the date of the final version of an expert medical report prepared by an emergency physician, Dr Vinen, which addressed the conduct of Joondalup Hospital. (Dr Vinen had prepared an earlier draft report in late 2013.) On 5 April 2017 the applicant was granted leave to file a summons in court that was presumably intended to replace the notice of motion. The summons did not specify a particular date for which the extension of time was sought.

3. [8]

   On 25 May 2017, Joondalup Hospital filed a notice of motion seeking summary dismissal of the proceedings.

4. [9]

   It was common ground before the primary Judge, as in this Court, that although the proceedings were commenced in New South Wales, Western Australian law determines the limitation period applicable to the applicant’s cause of action against Joondalup Hospital. [2] It was also common ground that the effect of s 14(1) of the Limitation Act 2005 (WA) (WA Limitation Act) is that the limitation period expired (unless extended) on 26 July 2014, three years after the applicant’s leg was amputated, that being the date her cause of action accrued. For this reason, the applicant’s summons sought an extension of time pursuant to s 39(3) and (4) of the WA Limitation Act.

5. [10]

   Section 39 of the WA Limitation Act relevantly provides as follows:

6. [11]

   The primary Judge heard the applicant’s motion on 23 and 31 October 2017. Her Honour delivered the Primary Judgment dismissing the motion on 13 December 2017. The primary Judge directed the applicant to file submissions as to why, having failed to be granted an extension of the limitation period, the proceedings should not be dismissed. It appears however that no further steps have been taken in relation to Joondalup Hospital’s motion for summary judgment pending determination of the proceedings in this Court.

7. [12]

   Much of the argument before the primary Judge revolved around the significance of Dr Vinen’s final report. [3] The report was received by the applicant’s then solicitors and was the subject of correspondence between the solicitors and the applicant prior to 26 July 2014 (the date the limitation period expired). Joondalup Hospital contended that in these circumstances the applicant must have been “aware that [her injury] was attributable to the conduct of [Joondalup Hospital]” before the limitation period expired. Accordingly, so Joondalup Hospital argued, the applicant was unable to satisfy the threshold requirement in s 39(3)(b) of the WA Limitation Act for an extension of time, namely that the applicant was not aware, prior to the expiration of the limitation period, that her injury was attributable to the conduct of Joondalup Hospital.

8. [13]

   The primary Judge rejected Joondalup Hospital’s contention. Her Honour was not satisfied that the information made available to the applicant before 26 July 2014 was sufficient to make her aware that her injury was attributable to the conduct of Joondalup Hospital. The applicant was therefore able to satisfy s 39(3)(b) of the WA Limitation Act.

9. [14]

   However, the primary Judge held that there was a second hurdle which the applicant had not overcome. On her Honour’s construction of s 39(4)(b) of the WA Limitation Act, the applicant had to establish when she had become aware or ought reasonably to have become aware that her injury was attributable to the conduct of Joondalup Hospital. Her Honour considered that the evidence was insufficient to enable her to make a finding on this issue. Since the applicant could not satisfy s 39(4)(b) of the WA Limitation Act her application to extend the limitation period beyond 26 July 2014 had to be dismissed.

10. [15]

    Both the applicant’s summons seeking leave to appeal and draft notice of appeal identify Joondalup Hospital as the sole respondent. The draft notice of appeal contains a single ground, namely that the primary Judge erred in finding that the applicant had not satisfied s 39(4)(b) of the WA Limitation Act. The applicant’s written submissions contend that the primary Judge should have found that the applicant ought reasonably to have become aware on 22 October 2017, or shortly thereafter, that her injury was attributable to the conduct of Joondalup Hospital. It was on this date that the applicant’s current solicitors received a report from Dr Flecknoe-Brown, a consultant physician, which addressed the causal relationship between the alleged negligence of Joondalup Hospital and the subsequent amputation of the applicant’s foot. The curious feature of this submission is that the solicitors did not receive Dr Flecknoe-Brown’s report until the day before the hearing of the applicant’s motion for an extension of time in which to commence proceedings. This was eight months after she had commenced the Common Law proceedings.

11. [16]

    Joondalup Hospital filed a draft notice of contention seeking to uphold the primary Judge’s decision on grounds other than those relied on by her Honour. The notice of contention includes the following grounds:

12. [17]

    The application for leave to appeal and the substantive argument on the appeal were heard concurrently.

Legislation

1. [18]

   Sections 5 and 6 of the Choice of Law (Limitation Periods) Act 1993 (NSW) (Choice of Law Act) provide as follows:

2. [19]

   Limitation of actions legislation differs considerably among Australian jurisdictions. The author of a leading textbook on the subject has observed that “[a]s law reform has progressed, uniformity has declined”. [4] The provisions in the WA Limitation Act relating to the limitation period and the extension of that period have no precise counterpart in any other Australian jurisdiction. [5]

3. [20]

   Section 14(1) of the WA Limitation Act provides that:

4. [21]

   Section 39 of the WA Limitation Act empowers the Court to extend time to commence actions for personal injury in certain circumstances. The relevant provisions of s 39 have been extracted earlier in this judgment. [7]

5. [22]

   Section 43 of the WA Limitation Act relevantly provides as follows:

6. [23]

   Section 44 of the WA Limitation Act specifies matters for the Court’s consideration on an extension application:

7. [24]

   Section 79 addresses the burden of proof when a question relating to the limitation period arises, as follows:

Leave to appeal

1. [25]

   As was pointed out in argument in this Court, success by Joondalup Hospital on the appeal does not necessarily mean the end of proceedings against it. If Joondalup Hospital succeeds on Ground 1 of its notice of contention, the applicant has not satisfied s 39(3) of the WA Limitation Act and thus the Court lacks power to extend time for the commencement of the proceedings against Joondalup Hospital. However, it is presumably still open to the other defendants in the proceedings, if so advised, to file cross-claims against Joondalup Hospital.

2. [26]

   If Joondalup Hospital fails on its notice of contention but the appeal is dismissed, the applicant is not necessarily precluded from instituting fresh proceedings against Joondalup Hospital. As noted above, the primary Judge found that the applicant had not proven when she first became aware or ought to have become aware that her injury was attributable to the conduct of Joondalup Hospital. If that finding is upheld, it may be open to the applicant to file fresh proceedings and adduce evidence as to the date she first became aware or ought to have become aware of “attributability” for the purposes of s 39(4)(b). If the fresh proceedings are filed within three years of that date, she may satisfy the Court that it has power under s 39(3) and (4) to extend time for the commencement of the fresh proceedings.

3. [27]

   Despite the possibility that dismissal of the appeal will not necessarily preclude the applicant from instituting fresh proceedings, Joondalup Hospital did not oppose the grant of leave to appeal. In its written submissions, Joondalup Hospital stated that if the appeal is allowed it will not advance any argument based on s 44 of the WA Limitation Act [8] against the grant of any extension of time to the applicant as sought by her.

4. [28]

   It is appropriate that the Court grant leave to appeal to address the substantive issues that have been debated between the parties.

Background

1. [29]

   In order to explain the issues arising on the appeal it is necessary to set out the background facts and explain the history of the proceedings.

2. [30]

   The significance of Dr Vinen’s final report was a key issue in the proceedings. The report incorporated a detailed record of the applicant’s medical history and the treatment she received not just at Joondalup Hospital, but at Sutherland and St George Hospitals. The report was based on the records of the three treating hospitals and of the medical practitioners involved in treating the applicant. The length of the report was partly due to the numerous questions Dr Vinen was asked to answer, which he did in considerable detail.

3. [31]

   The section of the report dealing with the conduct of Joondalup Hospital included the following:

4. [32]

   Dr Vinen stated that Joondalup Hospital should have considered the “possibility of an acute ischaemic or thrombotic event” followed by referral/transfer for further investigation and treatment. He did not say that the failure of Joondalup Hospital to consider these matters contributed to the need for the applicant’s right leg to be amputated below the knee. Indeed, Dr Vinen expressed no opinion as to the relationship, if any, between Joondalup Hospital’s lack of due care and the subsequent amputation.

5. [33]

   Dr Vinen was particularly critical of the treatment the applicant received at Sutherland Hospital. According to Dr Vinen, when the applicant presented at Sutherland Hospital a doctor made a correct diagnosis. Yet the Vascular Surgery Registrar and the Vascular Surgeon at Sutherland Hospital concluded that the applicant did not need to be admitted because there was no evidence of ischaemia and the applicant’s presentation was not typical of DVT. In Dr Vinen’s view, this conclusion was “inexplicable [as] there was more than enough evidence at the time to clearly indicate that [the applicant] had acute ischaemia”.

6. [34]

   Dr Vinen stated that on 10 July 2011, when the applicant first attended Sutherland Hospital, four of the six characteristics of acute ischaemia were present. By 12 July 2011, when she attended Sutherland Hospital for the second time, all six characteristics were present. In Dr Vinen’s opinion, the situation became “out of hand” when the Vascular Registrar reviewed the applicant’s condition and it was the “failure to recognise that [the applicant] had an ischaemic foot [that] led to subsequent events and contributed to the eventual outcome”. Dr Vinen expressed no similar opinion in relation to the failure of Joondalup Hospital to administer the correct tests.

7. [35]

   Dr Vinen also opined that thrombus was present when the applicant was admitted to St George Hospital and was the cause of her ischaemic symptoms and signs. Dr Vinen thought that:

8. [36]

   In about November 2011, some few months after her leg was amputated, the applicant retained solicitors (Beilby Poulden Costello) to act on her behalf.

9. [37]

   On 18 December 2013, two years after they had been retained, the solicitors wrote to the applicant as follows:

10. [38]

    On 7 May 2014, the solicitors emailed the applicant as follows:

11. [39]

    The primary Judge recorded that Dr Vinen’s report identified three acts of negligence by Joondalup Hospital. However, her Honour also observed that: [9]

12. [40]

    On 19 May 2014, the applicant saw a psychologist. The psychologist’s notes included the following comment:

13. [41]

    On 12 June 2014 the applicant’s solicitor advised her by email as follows:

14. [42]

    The applicant saw another psychologist on 18 June 2014. The notes of that consultation record the following:

15. [43]

    On 23 June 2014, the applicant asked the solicitor “how it’s all going” and when the deadline was for filing. The solicitor replied on the same day as follows:

16. [44]

    The reference to “discoverability” in the solicitor’s reply appears to be to ss 50C and 50D of the Limitation Act 1969 (NSW) (NSW Limitation Act). Section 50C(1) relevantly provides a cause of action relating to the personal injury of a person is not maintainable if brought after the expiration of “the 3 year post discoverability limitation period”. Section 50D(1) provides that a cause of action is discoverable on the first date a person knows or ought to know of the following facts:

17. [45]

    As already noted, the limitation period under the WA Limitation Act expired on 26 July 2014.

18. [46]

    On 19 August 2014, the applicant attended a conference with her solicitor and a barrister (Mr McGillicuddy). She was told that there were difficulties with her case and that although the barrister had conferred with a surgeon, the surgeon was unable to provide a supportive report on causation. The applicant instructed her solicitor to pursue the matter and obtain further medical reports.

19. [47]

    The applicant’s solicitor prepared a file note on 20 August 2014 concerning a 50 minute telephone call with the applicant’s mother. The file note recorded the following:

20. [48]

    The reference to s 5O of the Civil Liability Act 2005 (NSW) in the file note is to a provision dealing with the standard of care owed by professionals. [11] There was no evidence as to whether a report was ever obtained from Dr Fisher.

21. [49]

    In May 2016, the applicant’s solicitors advised her that they were not able to continue to act on her behalf. The solicitors advised that if the applicant engaged new solicitors she should ensure that her statement of claim was filed before 14 April 2017.

22. [50]

    The applicant engaged her current solicitors on 18 December 2016. She provided the new solicitors with a copy of Dr Vinen’s report.

23. [51]

    The primary Judge found that the new solicitors, upon reviewing Dr Vinen’s report, formed the view that a case in negligence existed and that further investigations should be made. [12] The solicitors offered to fund the conduct and preparation of the applicant’s case.

24. [52]

    In January 2017, the new solicitors prepared a draft statement of claim and on 7 February 2017 they briefed counsel. On 15 February 2017 counsel advised that the applicant had a “potential cause of action” against Joondalup Hospital and gave advice as to the limitation issues that needed to be addressed. [13]

25. [53]

    The statement of claim alleging causes of action against Joondalup Hospital and the other two defendants was filed on 24 February 2017. The statement of claim incorporated a certificate signed by the applicant’s solicitor as follows: [14]

26. [54]

    The applicant’s notice of motion seeking an extension of time for the commencement of proceedings was supported by an affidavit sworn on 3 April 2017 by the applicant’s solicitor, Mr Moran. The affidavit makes it clear that until counsel’s advice was sought in February 2017, the applicant’s solicitors thought that the limitation period for the applicant’s action against Joondalup Hospital was governed by the NSW Limitation Act. Mr Moran’s affidavit included the following:

27. [55]

    It is not clear why Mr Moran thought that this evidence supported the applicant’s contention that she satisfied the requirements of s 39(3)(b) of the WA Limitation Act. To do so she had to show that as at 26 July 2014 she was not aware that her injury was attributable to the conduct of Joondalup Hospital. The affidavit suggests that the applicant was aware of this fact by 14 April 2014.

28. [56]

    The applicant’s motion was listed for hearing on 15 June 2017. Written submissions were filed on the applicant’s behalf on or about 2 June 2017. The submissions asserted that the applicant was aware that her injury was attributable to the conduct of Joondalup Hospital when she was informed of the contents of Dr Vinen’s report. The submissions also stated that although it was uncertain when the applicant received the report, it must have been after 14 April 2014. It followed, so it was submitted, that pursuant to s 39(4) of the WA Limitation Act the limitation period expired on 14 April 2017:

29. [57]

    It is therefore not surprising that the applicant’s submissions did not address the obvious problem that at this point she had not put on any evidence to show that she was not aware, prior to 26 July 2014, that her injury was attributable to the conduct of Joondalup Hospital.

30. [58]

    Joondalup Hospital filed written submissions in response on 13 June 2017. Joondalup Hospital pointed out that the limitation period had expired on 26 July 2014 and that the applicant had not even attempted to prove that she was not aware at that time that her injury was attributable to the conduct of Joondalup Hospital. The submissions noted that the applicant’s written submissions actually asked the Court to assume that she became aware that her injury was attributable to the conduct of Joondalup Hospital on 14 April 2014.

31. [59]

    The hearing scheduled for 15 June 2017 was adjourned on the application of the applicant’s representatives. Counsel representing the applicant said that the reason for the adjournment was that the applicant’s solicitors had only recently received the file from their predecessors.

32. [60]

    On 21 July 2017, the applicant swore an affidavit which included the following:

33. [61]

    The applicant filed further (undated) written submissions prior to the resumption of the hearing before the primary Judge which contended that she was unaware as at 26 July 2014 that her injury was attributable to Joondalup Hospital’s conduct. The submissions relied on the opinion of the applicant’s previous solicitors that she did not have a viable cause of action and the insistence by Dr Vinen that the opinion of a vascular surgeon had to be obtained. The submissions made no reference to s 39(4) of the WA Limitation Act (beyond asserting that the plaintiff was a person not aware or ought reasonably to have become aware that the injury was attributable to the conduct of a person). Nor did they explain the apparent inconsistency with the earlier submissions made on behalf of the applicant.

34. [62]

    Joondalup Hospital filed its written submissions in response on 4 September 2017. Joondalup Hospital maintained its argument that the applicant had not satisfied s 39(3)(b) of the WA Limitation Act. Joondalup Hospital also submitted that the applicant could not satisfy s 39(4) because she had failed to address when she became aware of the matters identified in that provision. The submissions relied on the decision of the Western Australian Court of Appeal in AME Hospitals Pty Ltd v Dixon [15] (Dixon) for the proposition that the applicant had to prove when she became aware of the matters in s 39(4) in order to gain an extension of the limitation period.

35. [63]

    The hearing of the applicant’s motion resumed on 23 October 2017. The primary Judge also had before her a motion filed by Joondalup Hospital seeking an order for summary dismissal of the proceedings against it.

36. [64]

    After the applicant’s cross-examination concluded, the applicant’s counsel tendered Dr Flecknoe-Brown’s report which he said he had seen for the first time the previous day. The purpose of the tender was not made entirely clear, although the applicant’s counsel observed that Dr Flecknoe-Brown found “quite a bit of causation, although not on everything one would have liked”. The report was admitted into evidence over the objection of Joondalup Hospital’s counsel.

37. [65]

    In his final oral submissions the applicant’s counsel characterised Dr Vinen’s report as “impoverished on the question of causation”. Counsel submitted that the absence of a clear medical opinion on the issue of causation justified the primary Judge finding that the applicant was not aware by 26 July 2014 that her injury was attributable to Joondalup Hospital’s conduct. This submission was consistent with the applicant’s undated further submissions, but was apparently inconsistent with the earlier written submissions of 2 June 2017.

38. [66]

    It is not clear that the applicant’s counsel advanced any submission as to the operation of s 39(4) of the WA Limitation Act, beyond observing that the applicant’s solicitors could not have commenced proceedings without a “proper report” since they had to certify that there were reasonable grounds for believing that the applicant’s claims had reasonable prospects of success.

39. [67]

    Dr Flecknoe-Brown’s relatively brief report was dated 14 October 2017. It addressed a series of questions directed to the acts or omissions of all three defendants. The section addressing the actions of Joondalup Hospital is as follows:

Primary Judgment

1. [68]

   The primary Judge referred to the applicant’s evidence that she had been told in June 2014 by her then solicitors that they were still pursuing evidence to establish a causal link between the negligence identified by Dr Vinen and the subsequent amputation of the applicant’s leg. [16] Her Honour observed that Dr Flecknoe-Brown’s report was the first medical report to identify a causal link between Joondalup Hospital’s negligent conduct and the amputation of the applicant’s leg. [17]

2. [69]

   Her Honour identified three issues that had to be addressed: [18]

3. [70]

   The primary Judge referred to the passages in the applicant’s cross-examination addressing the contents of the psychologists’ clinical notes. [19] In the course of her cross-examination the applicant agreed that her understanding of the advice she had received from her then solicitors was that they could not run the case unless they could legally prove causation. Her Honour accepted that as at 18 June 2014 (the date of the consultation with the second psychologist), the applicant: [20]

4. [71]

   The primary Judge referred to the conference that took place on 19 August 2014 and to the solicitor’s file note concerning the conversations with the applicant’s mother. [21] Her Honour noted the applicant’s affidavit evidence that at the date the limitation period expired, she was unaware that she had a cause of action because the solicitors had been unable to uncover evidence that Joondalup Hospital was responsible for the loss of her leg. Her Honour had previously found that the applicant gave truthful evidence. [22]

5. [72]

   The primary Judge concluded that the applicant satisfied s 39(3)(b) of the WA Limitation Act, for the following reasons: [23]

6. [73]

   On the second issue, the primary Judge noted that the applicant had not given evidence that she had read Dr Flecknoe-Brown’s report. Her Honour: [24]

7. [74]

   On the third issue, the primary Judge observed that on the second day of the hearing (31 October 2017) the applicant’s counsel stated in the applicant’s presence that there was “quite a bit of causation” in Dr Flecknoe-Brown’s report, but not as much as one would like. Nonetheless, her Honour said she was unable to say when the applicant became aware or should have become aware that her injury was attributable to Joondalup Hospital’s conduct: [25]

8. [75]

   The primary Judge concluded as follows: [26]

9. [76]

   The primary Judge dismissed the applicant’s motion to extend the limitation period and stood over Joondalup Hospital’s motion seeking summary judgment.

Notice of contention

1. [77]

   It is convenient to deal first with Ground 1 of Joondalup Hospital’s notice of contention challenging the primary Judge’s finding that the applicant was not aware, as at 26 July 2014, that her injury was attributable to the conduct of Joondalup Hospital. If this ground succeeds, there is no prospect that the applicant could commence fresh proceedings against Joondalup Hospital.

2. [78]

   Mr Kulevski, who appeared with Ms Lindeman for Joondalup Hospital, submitted that the applicant was “aware” of matters for the purposes of s 39(3) of the WA Limitation Act if her solicitors had knowledge of the relevant matters. Mr Kulevski accepted that this Court would follow the construction given to s 39(3) by the Western Australian Court of Appeal in Dixon. However, he contended that the judgments in Dixon left open the question of whether awareness included “imputed” rather than “constructive” knowledge. If this submission was accepted, so Mr Kulevski argued, the solicitor’s knowledge of the contents of Dr Vinen’s report could be imputed to the applicant in order to determine whether she was aware prior to 26 July 2014 that her injury could be attributed to Joondalup Hospital’s conduct. The submission assumed that the contents of Dr Vinen’s report indicated that the applicant’s injury was attributable to the negligence of Joondalup Hospital.

3. [79]

   In Dixon, the parents of a child born in August 2001 learned in 2003 that the child had cerebral palsy. In 2006 the parents sought legal advice about the prospects of suing the hospital where the child had been born. The solicitors obtained an expert medical report which stated that the doctor and nursing staff of the hospital had acted appropriately at the birth. Nothing further of significance occurred before 15 November 2011, the date on which the limitation period for an action against the hospital expired under the WA Limitation Act.

4. [80]

   In August 2012 the parents sought further advice and obtained a second medical opinion from an expert, Professor Dekker. His report concluded that the child had suffered hypoxic ischemic encephalopathy caused by intrapartum events. These events included lack of appropriate foetal monitoring during the birth, resulting in the hospital staff’s failing to recognise the deterioration of the foetal condition.

5. [81]

   In July 2013 the child, by her next friend, applied under s 39 of the WA Limitation Act for an extension of the time to commence proceedings against the hospital. The Master granted the application and the Court of Appeal affirmed the Master’s decision. McLure P, with whom Newnes JA agreed, summarised her reasons as follows: [27]

6. [82]

   In the course of her judgment McLure P addressed the meaning of “aware” for the purposes of s 39(3) of the WA Limitation Act: [29]

7. [83]

   Mr Kulevski submitted that McLure P left open the possibility that actual awareness of a duly authorised agent such as a solicitor might be sufficient to constitute awareness by the principal (the client). However, all that her Honour did (at [35]) was to note that the hospital had not relied on “imputed” awareness. Her Honour’s reasoning gives no support to the proposition that a plaintiff’s solicitor’s knowledge of matters can be “imputed” to the plaintiff so that he or she can be regarded as “aware” of those matters for the purposes of s 39(3) of the WA Limitation Act.

8. [84]

   The lack of support for this proposition can be seen from McLure P’s citation of Harris v Commercial Minerals Ltd, [30] a case also cited by Buss JA in his judgment. [31] In that case the High Court construed s 60I(1) of the NSW Limitation Act. Section 60I(1)(a) prevented a court extending the limitation period for a cause of action founded on negligence for personal injury damages unless it was satisfied (relevantly) that the plaintiff, at the expiration of the limitation period:

9. [85]

   The High Court in Harris applied what had been said in an earlier decision about the meaning of the words “first becomes aware of” in a Queensland statute: [32]

10. [86]

    The judgment of Buss JA in Dixon also gives no support to Mr Kulevski’s submission. His Honour contrasted the terms “aware” and “not aware” in s 39(3) and (4) of the Limitation Act with the phrase “ought reasonably to have become aware”. [34] Having regard to the context, Buss JA said that s 39 was concerned with whether the person had or did not have “actual awareness or knowledge” of the relevant matters. [35] In his Honour’s view, the term “aware” did not refer to “reasonable belief” or constructive awareness or knowledge. Rather it meant: [36]

11. [87]

    For these reasons I do not accept Joondalup Hospital’s submission that the applicant’s solicitor’s awareness of relevant matters can be imputed to the applicant, regardless of her actual or awareness or knowledge of those matters.

12. [88]

    The Ipp Committee Report recommended that a cause of action for damages for personal injury should accrue on the date of “discoverability”, being the date:

13. [89]

    Oddly enough, the WA Limitation Act does not adopt the “date of discoverability” as the date a cause of action for personal injury damages accrues. However, the language of s 39(3)(b) of the WA Limitation Act follows, with some adaptation, par (b) of the Ipp Committee Report’s proposed definition of the “date of discoverability”.

14. [90]

    The primary Judge quoted at length McLure P’s analysis in Dixon of the phrase “attributed to”. McLure P said this: [39]

15. [91]

    The passage from Basten JA’s judgment in Commonwealth v Shaw to which McLure P referred is as follows: [40]

16. [92]

    Joondalup Hospital submitted that even if its contentions on “imputed” awareness are rejected, the primary Judge’s finding that the applicant satisfied s 39(3)(b) of the WA Limitation Act should be set aside. Mr Kulevski accepted that a plaintiff might be able to prove lack of awareness of a matter at a particular date without necessarily proving the date on which he or she in fact became aware of that matter. But he submitted that on the principles laid down by McLure P in Dixon, the primary Judge should have found that the applicant was actually aware, prior to 26 July 2014, that her injury was attributable to the conduct of Joondalup Hospital.

17. [93]

    Mr Kulevski pointed out, correctly, that the submissions filed in support of the applicant’s motion in the Common Law proceedings suggested that she was aware prior to the expiration of the limitation period that her injury was attributable to Joondalup Hospital’s conduct. He submitted that the applicant’s “bare assertion” in her affidavit of 21 July 2017 concerning her lack of knowledge of a causal relationship between Joondalup Hospital’s negligence and the amputation of her leg was not enough to discharge the burden of satisfying s 39(3)(b) of the WA Limitation Act. In the circumstances of the present case, the inability of the applicant to identify the time at which she did become aware that her injuries could be attributed to the negligence of Joondalup Hospital counted against her claim of lack of awareness at 26 July 2014.

18. [94]

    In his oral submissions Mr Kulevski contended that although the primary Judge did not misstate the test enunciated by McLure P in Dixon, her Honour had not applied the principles correctly. According to Mr Kulevski, the primary Judge equated the (correct) question of whether the applicant was aware that there was a connection between Joondalup Hospital’s conduct and her injury with the (incorrect) question of whether the applicant was aware that she had reasonable prospects of succeeding in a claim against Joondalup Hospital.

19. [95]

    Mr Kulevski emphasised Dr Vinen’s view that if Joondalup Hospital had administered a D-dimer blood test, it is very likely that the test would have indicated either VTE or thrombosis, thus identifying the cause (thrombosis) of the amputation. Dr Vinen had opined that in view of the uncertainty as to the cause of the applicant’s symptoms, referral to a larger emergency department for specialised assessment was needed. It was also clear that Dr Vinen’s report was the sole basis on which proceedings were ultimately commenced on 24 February 2017.

20. [96]

    Early in his oral submissions Mr Kulevski expressly eschewed a submission that receipt of the solicitor’s letter of 23 June 2014 [41] was sufficient to establish the applicant’s actual awareness that her injury was attributable to the conduct of Joondalup Hospital. Later in his submissions Mr Kulevski seemed to reverse his position and place considerable significance on the letter. He accepted that the letter revealed that the solicitor was labouring under a misapprehension as to the relevant law, but relied on the statement in the letter that the applicant became aware that she had an “actionable right in negligence” on the date she received an expert report stating that there had been a breach of duty.

21. [97]

    The applicant submitted that her affidavit evidence was sufficient to establish her lack of awareness that her injury was attributable to the conduct of Joondalup Hospital. In any event, the applicant submitted that the claims in her affidavit evidence were supported by her oral evidence which was not seriously challenged. Moreover, there was no evidence that the respondent had been given a copy of Dr Vinen’s report prior to 26 July 2014. The only information she had as to the contents of the report was in the emails from her then solicitors. That information made it quite clear that the issue of attribution had not been addressed.

22. [98]

    Mr Beale, who appeared for the applicant, contended that Dr Vinen’s report provided evidence that Joondalup Hospital had breached its duty of care but the report had simply not addressed the issue of factual causation. The mere fact that Dr Vinen thought that the applicant should have been referred to a qualified specialist did not address the issue of whether the injury she sustained could be attributed to Joondalup Hospital’s negligence.

23. [99]

    In any event, so Mr Beale argued, the only information the applicant had prior to the expiry of the limitation period was provided by her solicitors. The letter of 23 June 2014 was in response to an inquiry made by the applicant. The letter made it quite clear that an essential precondition for a claim had not been met by Dr Vinen’s report. The letter stated that “causation evidence” was required and that a report would be needed from a vascular surgeon “to say that earlier intervention would have saved your leg”.

24. [100]

    It is fair to say that there were a number of significant deficiencies in the way the applicant’s case was analysed by her former solicitors and presented in the Supreme Court proceedings. But the issue the primary Judge had to address was whether she was satisfied that the applicant did not have actual knowledge by 26 July 2014 that the amputation of her leg was attributable to the conduct of Joondalup Hospital. Her Honour was not precluded from being so satisfied by any misconceptions entertained by the applicant’s previous solicitors as to the applicable limitation legislation or any ill-conceived submissions made on her behalf during the Supreme Court proceedings.

25. [101]

    The applicant’s solicitor gave evidence in his affidavit of 3 April 2017 that he was unaware of the date that Dr Vinen’s report or the information therein was provided to the applicant by her previous solicitor, but that “it was some time after 14 April 2014”. The applicant said in her affidavit of 21 July 2017 that she could not recall when she saw Dr Vinen’s report or read its contents, but that her previous solicitors did not provide the report to her.

26. [102]

    The primary Judge recorded a submission made on behalf of the applicant that she did not receive Dr Vinen’s report until after the previous solicitors ceased to act for her. However, her Honour did not make a finding as to when the applicant first saw the report itself, as distinct from being informed of its contents in correspondence from the previous solicitors. Instead, the primary Judge found that even if the applicant read Dr Vinen’s report before 26 July 2014, she could not have been aware that her injury was attributable to the conduct of Joondalup Hospital. [42]

27. [103]

    The applicant gave evidence as to the state of her understanding at 26 July 2014. In her affidavit she said that she was unaware at that date that she had a cause of action because the “solicitors … were unable to find evidence that the actions or failure to act of any individual or hospital, was responsible for the harm that [she] suffered”.

28. [104]

    The applicant’s oral evidence expanded somewhat on this rather formulaic statement. In her evidence in chief, the applicant’s attention was drawn to the contents of the solicitor’s letter of 23 June 2014. The following exchanges then took place:

29. [105]

    The applicant was asked questions on cross-examination about the notations in the psychologists’ clinical notes but was not pressed about her understanding of the relationship between Joondalup Hospital’s negligence (as reported by Dr Vinen) and the amputation of her leg and in particular whether if Joondalup Hospital had acted appropriately her leg would have been saved. The cross-examination concluded as follows:

30. [106]

    The applicant knew by 26 July 2014 that Dr Vinen had compiled his detailed expert report. She also knew that Dr Vinen had expressed the opinion that Joondalup Hospital breached the duty of care it owed to her. Regardless of whether the applicant had actually read Dr Vinen’s report by this time (as to which there is no evidence) the solicitors’ letter of 23 June 2014 recorded Dr Vinen’s opinion as to the breach of duty quite accurately.

31. [107]

    Otherwise the letter was hardly a model of clarity. Its reference to “discoverability” was based on a misconception as to the applicable law. Unsurprisingly the explanation of the term did not accurately reflect the requirements of the relevant legislation. The letter advised that the date of discoverability was the date of receipt of Dr Vinen’s report, since that was when the applicant learned that she had an “actionable right of negligence”. The letter then contradicted itself by asserting that “causation evidence” was crucial to the applicant’s case and would not be available until a vascular surgeon was prepared to opine that earlier intervention would have saved the applicant’s leg.

32. [108]

    A client without experience in personal injuries litigation would be likely to read this letter as conveying that there was no evidence available to show that there was any causal relationship between Joondalup Hospital’s negligence and the need to amputate the applicant’s leg. That was precisely the thrust of the applicant’s evidence. As far as she was concerned, there was “nothing to go on with … it wasn’t viable”. The primary Judge interpreted this evidence to mean that the applicant, having read the letter of 23 June 2014, was not aware that her injury was attributable to the negligence of Joondalup Hospital.

33. [109]

    The primary Judge expressed her finding in the language of s 39(3)(b) of the WA Limitation Act. There is no basis for concluding that the primary Judge misunderstood the import of the words “attributable to”, given that she quoted the relevant paragraphs from the judgment of McLure P in Dixon. Her Honour considered that the applicant’s understanding, based on her solicitor’s advice, was that the expert opinion was not capable of establishing that there was an “element of a causal relationship” between Joondalup Hospital’s negligence and the amputation of the applicant’s leg.

34. [110]

    Mr Kulevski placed some reliance on the observation of McLure P in Dixon that a person will be aware of a matter requiring expert knowledge and experience if he or she is aware of an expert opinion which is reasonably capable of being accepted and capable of establishing that the physical cause of the injury is attributable to the conduct of an identified person. [43] There are two answers to this contention.

35. [111]

    First, the primary Judge found that Dr Vinen’s report did not address the relevant “matter” and I am not persuaded that that finding was wrong. Dr Vinen’s opinion that the applicant should have been referred to a specialist did not address the critical question of whether that intervention was likely to have changed anything, particularly having regard to Dr Vinen’s firm opinion that the conduct of staff at Sutherland Hospital was inexplicable and causative of the trauma suffered by the applicant.

36. [112]

    Secondly, I do not understand McLure P to say that a person’s awareness of the existence of a report establishes the person’s awareness of the contents of that report, regardless of the person’s understanding of the contents or any explanation by his or her solicitor of the significance of the report. McLure P’s comments were directed to a situation where only one of two expert reports could have provided a basis for the plaintiff’s awareness of the relevant matter [44] and where there was no suggestion that the plaintiff had misunderstood anything about the contents of that report.

37. [113]

    For these reasons the primary Judge did not err in finding that the applicant was not aware by 26 July 2014 that the amputation of her leg was attributable to the negligence of Joondalup Hospital.

Section 39(4)(b) of the WA Limitation Act

1. [114]

   The applicant’s written submissions contended that the primary Judge should have found that the applicant “ought reasonably to have become aware … that [her] injury was attributable to the conduct of [Joondalup Hospital]” for the purposes of s 39(4)(b) of the WA Limitation Act on 22 October 2017. This was the date the applicant’s solicitors received Dr Flecknoe-Brown’s report. Even in the absence of direct evidence from the applicant, so Mr Beale argued, the inference was clearly available that at that point she ought to have become aware that Dr Flecknoe-Brown had linked the negligence of Joondalup Hospital to the need for her leg to be amputated.

2. [115]

   In the alternative Mr Beale submitted that the primary Judge misconstrued s 39(4) of the WA Limitation Act insofar as she held that the applicant could not satisfy the sub-section unless she affirmatively proved when she ought reasonably to have become aware (relevantly) that her injury was attributable to the conduct of Joondalup Hospital. Mr Beale submitted that s 39(4) merely marked out the maximum extension for the commencement of proceedings that a court could order. The effect of s 39(4), so he argued, is that the Court cannot exercise its power to extend time beyond three years from the date the plaintiff became aware or should have become aware of all three matters identified in the sub-section.

3. [116]

   Mr Beale accepted that by instituting proceedings within three years of the expiration of the limitation period a plaintiff would not necessarily satisfy s 39(4) of the WA Limitation Act. If, for example, the plaintiff ought reasonably to have become aware of the three matters in s 39(4) at the end of the first year after the injury occurred, s 39(4) prevents an extension of the limitation period beyond the end of the fourth year after the injury occurred (that is, one year after the expiration of the three year limitation period). In the present case, however, the applicant established that she ought not reasonably have become aware that her injury was attributable to the conduct of Joondalup Hospital at any time prior to 24 February 2014, three years before the proceedings were commenced. Dr Vinen’s final report had not even been obtained by then and, in any event, the applicant acted reasonably in leaving the matter in the hands of her solicitors.

4. [117]

   Joondalup Hospital submitted that it was not open to the applicant to contend that the first date on which she was aware or ought reasonably to have become aware that her injury was attributable to its conduct was after the proceedings had been commenced. Mr Kulevski argued that it would be a “perverse result” if the applicant could say that she was justified in commencing the proceedings, yet claim that she did so at a time when she was not aware and ought not reasonably to have been aware of attributability. Mr Kulevski pointed out that on the applicant’s argument she had commenced the proceedings before the three year period specified in s 39(4) of the WA Limitation Act had started to run. The correct construction of s 39(4), so Mr Kulevski contended, was that a plaintiff had to show that he or she became aware or ought reasonably to have become aware of all three specified matters before the proceedings were commenced.

5. [118]

   Mr Kulevski submitted that the judgment of McLure P in Dixon authoritatively decides for the purposes of the law of Western Australia that a plaintiff seeking the indulgence of the Court to extend the limitation period must affirmatively prove the date or dates he or she first became aware or ought reasonably to have become aware of all the matters specified in s 39(4) of the WA Limitation Act. It is not enough, so Mr Kulevski argued, for the plaintiff to show that the date on which he or she became aware or ought reasonably to have become aware of the last of the matters had to be a date no earlier than the three years before the commencement of proceedings. The actual dates must be established by evidence.

6. [119]

   Mr Kulevski submitted that not only was the judgment of McLure P authoritative on the point, it was clearly correct. He relied on s 79(3) of the WA Limitation Act which imposes the burden of proving that a court should extend the limitation period upon the plaintiff. He also contended that s 39(4)(b) requires the order extending time to specify a date which in terms is less than three years from the date on which the plaintiff became aware or ought reasonably to have become aware of the last of the three matters identified in s 39(4).

7. [120]

   Mr Kulevski described the applicant’s submission that she ought reasonably to have become aware that her injury was attributable to Joondalup Hospital’s negligence only after the proceedings had been instituted as an “Alice in Wonderland” argument. [45] He submitted that on its proper construction, s 39(4) required the applicant had to have the relevant awareness or means of awareness before the proceedings had been instituted. Otherwise the solicitor could not properly have filed the initiating process and the applicant could not have given the necessary instructions to do so.

8. [121]

   Although there was discussion in argument about the circumstances, if any, in which this Court would decline to follow a decision of the Western Australian Court of Appeal construing Western Australian legislation, in the end neither party submitted that Dixon should not be followed. However, before turning to the statements in Dixon relied on by Joondalup Hospital, it is convenient to consider the statutory language uninstructed by authority.

9. [122]

   Section 39(1) of the WA Limitation Act permits a plaintiff to apply to a court for leave to commence an action for personal injury damages even though (as in the present case) the limitation period has expired. The extension application may be made in the jurisdiction in which the existing action, if any, has been brought (s 43(1)). Thus the extension application may be made in proceedings that have already been commenced (as occurred in the present case), even after close of pleadings (s 43(5)). Although the defendant bears the burden of proving that the action cannot be commenced because the limitation period has expired (s 79(1)), the plaintiff in an extension application bears the burden of proving that “the court should extend the limitation period” (s 79(3)). When deciding whether to extend time for the commencement of an action, a court is to have regard to specified matters, including the prospects for a fair trial and any prejudice to the defendant (s 44).

10. [123]

    As has been seen, s 39(3) of the WA Limitation Act empowers the court to extend the time in which an action can be commenced if the court is satisfied that when the limitation period expired, the plaintiff (relevantly for the present case) was not aware that his or her injury was attributable to the conduct of the defendant. This requires proof by the plaintiff of a negative: the plaintiff’s lack of awareness at a particular time of attributability.

11. [124]

    Section 39(4) does not grant the court power to extend time; that is the function and purpose of s 39(3). Section 39(4) defines the temporal extent of the power conferred by s 39(3). If the Court is satisfied of the matters in s 39(3), it may extend the time in which the action can be commenced up to three years “from when [the plaintiff] became aware, or ought reasonably to have become aware” of all three matters specified in s 39(4). Section 39(4) does not say that a plaintiff seeking an extension of time must prove the precise date when he or she became aware of each of the three specified matters. The provision requires the Court be satisfied that the extension that is sought does not extend beyond three years from when the plaintiff became aware or ought reasonably to have become aware of all three matters.

12. [125]

    No doubt in the usual case a plaintiff will seek to satisfy the requirements of s 39(4) of the WA Limitation Act by proving the dates on which he or she became aware or ought to have become aware of each of the three specified matters. But this may not be necessary in every case. For example, a plaintiff may not be able to establish precisely when he or she became aware or ought to have become aware of the last of the three matters, but the evidence may make it quite clear that the plaintiff must have become aware of the matter at some time within the three years immediately preceding the commencement of proceedings.

13. [126]

    As I understand his argument, Mr Kulevski relied on the “general observations” made by McLure P in Dixon for the proposition that a plaintiff must prove with a degree of precision when he or she became aware or ought to have become aware of the matters specified in s 39(4) of the WA Limitation Act. Her Honour said this: [46]

14. [127]

    I do not read McLure P’s observations as meaning that it is always necessary for the plaintiff to identify with precision the time at which he or she became aware or ought to have become aware of each of the relevant matters. Her Honour’s observations are consistent with a plaintiff establishing that the time for which an extension is sought is not beyond the three year period, without necessarily proving precisely when he or she became aware or ought to have become aware of each of the relevant matters.

15. [128]

    The primary Judge did not rest her decision on the inability of the applicant to establish precisely when she became aware or ought to have become aware of the three relevant matters. Her Honour effectively found that the applicant had not established that she had ever become aware or ought to have become aware that her injury was attributable to the conduct of Joondalup Hospital, even during the hearing itself. This might be thought to be a surprising finding, given that the applicant’s solicitor certified in the statement of claim filed on 24 February 2017 that he believed that the applicant’s claim had reasonable prospects of success. Neither the solicitor nor the applicant gave evidence that she had been advised before the filing of the statement of claim that the proceedings had reasonable prospects of success. Nonetheless, her Honour might have been invited to infer that the solicitor believed that the applicant had an arguable case on the available evidence, including on causation, and that the solicitor must have given the applicant that advice prior to filing the statement of claim.

16. [129]

    It is clear, however, that no such submission was made to the primary Judge. The applicant’s case on s 39(4) of the WA Limitation Act relied squarely on the applicant’s awareness or means of awareness of Dr Flecknoe-Brown’s report. Indeed her counsel explicitly acknowledged that the proceedings were commenced on the basis of Dr Vinen’s report without further evidence of causation. So much appears from the following submission to the primary Judge:

17. [130]

    Although there were brief references on the appeal to advice that may have been given to the applicant prior to the filing of the statement of claim, her argument on appeal, as in the Common Law Division, rested on her awareness or means of awareness of Dr Flecknoe-Brown’s report. The applicant contended that the primary Judge should have found that the applicant became aware or should have become aware that her injury was attributable to the conduct of Joondalup Hospital on 22 October 2017, the date Dr Flecknoe-Brown’s report was received by the solicitors.

18. [131]

    This raises the question of whether sub-ss 39(3) and (4) of the WA Limitation Act permits the Court to extend time where the plaintiff becomes aware or ought reasonably to have become aware of the relevant matters for the first time after the proceedings had already been commenced. It will be recalled that Dr Flecknoe-Brown’s report was not received until nine months after the applicant commenced proceedings against Joondalup Hospital.

19. [132]

    There is some force in Mr Kulevski’s submission that the power to extend time conferred by s 39(3) of the WA Limitation Act cannot be exercised if the plaintiff did not become aware or ought not to have become aware of all three matters specified in s 39(4) until after the proceedings were commenced. Each of the three matters has its counterpart in s 39(3). Unless the plaintiff has evidence of all three (the physical cause of the injury, attributability and identity) no claim for personal injury damages can succeed.

20. [133]

    As has been seen, an application for an extension of time may be made after proceedings have already been commenced. The maximum extension permitted is “up to 3 years from when [the plaintiff] became aware, or ought reasonably to have become aware” of all three matters. On one view, however, the language can be read as contemplating that the plaintiff’s awareness or means of awareness of the relevant matters must precede the commencement of the proceedings.

21. [134]

    As Mr Kulevski pointed out, legal practitioners have a responsibility not to commence groundless proceedings or those inevitably doomed to failure. Western Australia, unlike New South Wales, has not imposed a statutory duty on practitioners to certify that they believe proceedings commenced on behalf of clients have reasonable prospects of success. But independently of statute, legal practitioners have obligations to the Court to give consideration to whether there is an arguable basis for the claim before commencing the proceedings. The obligations may be enforced in a variety of ways, for example through the principles governing abuse of process and the powers of courts to impose costs sanctions, or ethical rules. [47] In Western Australia, for example, the Ethical and Practice Guidelines issued by the Law Society of Western Australia make explicit the responsibilities of practitioners: [48]

22. [135]

    These considerations perhaps lend support to Mr Kulevski’s contention that it would be odd (if not “perverse”) to construe s 39(3) and (4) to permit an extension of time to commence litigation already on foot, where the evidence shows that the proceedings must have been commenced when the plaintiff was neither aware nor ought reasonably to have been aware that it was or might be possible to establish each of the elements essential to the success of his or her claim. [49] It is also necessary to bear in mind that practitioners must have proper instructions to commence proceedings. If a client of full age and capacity is unaware or does not have the means of becoming aware that an essential element in his or her cause of action might be established, it is not easy to see how the client can give proper instructions to commence the proceedings.

23. [136]

    Despite the force of these considerations, I do not think that s 39(4) should be read in the way Mr Kulevski suggested. As I have noted, the function of s 39(4) is not to grant the Court power to extend time, but to mark out the temporal limits of the extension that can be granted where a plaintiff satisfies the threshold requirements of s 39(3). The power to extend time may be exercised after proceedings have been commenced. If the evidence demonstrates that the plaintiff became aware or should have become aware of the relevant matters only after the proceedings were commenced, an extension of time to the date of commencement is consistent with the language of s 39(4). In this situation the court is not asked to extend time beyond three years from when the plaintiff became aware or ought reasonably to have become aware of the relevant matters. I should add that if Joondalup Hospital’s construction of 39(4) is correct, it would mean that a plaintiff who relied on awareness or means of awareness arising after the proceedings commenced would have to discontinue the existing proceedings and start afresh. No good purpose would be served by such a multiplicity of proceedings.

24. [137]

    Where proceedings are commenced without the plaintiff becoming aware or having the means of becoming aware of elements essential to the success of his or her claim or without proper instructions from the plaintiff, there might be consequences for the legal representatives who institute the proceedings. But in my opinion a breach of duties owed by legal representatives does not mean that s 39(3) and (4) of the WA Limitation Act should be construed to deny the court power to grant the plaintiff an extension of time to the date the proceedings were commenced.

25. [138]

    It follows that if the primary Judge had found that the applicant became aware or ought to have become aware on or about 22 October 2017 that her injury was attributable to Joondalup Hospital’s negligence, her Honour had power to extend the time for commencement of proceedings until 24 February 2017, being the date that they were commenced. Since the primary Judge declined to make such a finding, the next question is whether the power to extend time was dependent on the applicant proving that she had indeed become aware or ought to have become aware of attributability on or about 22 October 2017.

26. [139]

    In the absence of authority, there is something to be said for the proposition that it is not necessary for a plaintiff to prove that she had ever become aware or ought reasonably to have become aware of attributability. It is arguable that the statutory language is satisfied provided the plaintiff proves that she was neither aware nor ought to have become aware of attributability at any time prior to three years before the commencement of proceedings. As a matter of logic, in those circumstances the proceedings could not have been commenced more than three years from when the plaintiff became aware or ought reasonably to have become aware of attributability.

27. [140]

    However, the passage in McLure P’s judgment in Dixon relied on by Mr Kulevski [50] clearly states that the plaintiff seeking an extension of time must establish when he or she became aware or ought reasonably to have become aware of all three matters in s 39(4), including attributability. Since Mr Beale did not challenge the correctness of Dixon, this Court should follow McLure P’s observations as to the construction of s 39(4). Accordingly, unless the primary Judge should have found that the applicant became aware of attributability on or about 22 October 2017 (as she alleged), her Honour lacked power to extend the time for the commencement of the Common Law Proceedings to 24 February 2017. I therefore turn to that question.

28. [141]

    It must be said that remarkably little attention was given in the applicant’s final submissions to the primary Judge to the significance of Dr Flecknoe-Brown’s report. To the extent that the submissions referred to the report it seems to have been assumed that the report addressed the issue of causation without any real attempt to explain how it did so. Despite an eight-day gap between the first day of the hearing (23 October 2017), when Dr Flecknoe-Brown’s report was tendered, and the second day (31 October 2017), when the parties made final submissions, the applicant was not recalled to give evidence about her understanding of the significance of Dr Flecknoe-Brown’s report.

29. [142]

    When the report was tendered the applicant’s counsel said that Dr Flecknoe-Brown found “quite a bit of causation, although not on everything one would have liked”. This Delphic utterance was presumably a reference to the brief passage in the report where Dr Flecknoe-Brown expressed the view, based on Joondalup Hospital’s clinical records, that when the applicant was assessed “the arterial and small vessel perfusion of the foot was intact and the limb was salvageable at that point”. The primary Judge accepted that Dr Flecknoe-Brown’s report “state[d] that the injury was attributable to the conduct of Joondalup Hospital”. [51]

30. [143]

    The applicant’s counsel did not return to Dr Flecknoe-Brown’s report until the close of his submissions to the primary Judge. At that point counsel responded to a submission that there was no real difference between the report of Dr Vinen and Dr Flecknoe-Brown:

31. [144]

    Although the evidence is hardly satisfactory, it seems clear enough that the applicant’s advisers took the view that Dr Flecknoe-Brown’s report was sufficient to constitute evidence that Joondalup Hospital’s breach of duty was causally related to the loss of the applicant’s leg. Despite the absence of direct evidence, it is scarcely conceivable that the representatives would not have conveyed that assessment to her shortly after Dr Flecknoe-Brown’s report was received. If it were necessary to do so, I would infer that the applicant must have been told of the contents of Dr Flecknoe-Brown’s report and that it provided evidence of a causal relationship between her injury and the negligence of Joondalup Hospital. Thus, I would infer that the applicant became aware on or shortly after 22 July 2017 that her injury was attributable to the conduct of Joondalup Hospital.

32. [145]

    In any event, I would conclude on the basis of receipt of Dr Flecknoe-Brown’s report that the applicant ought reasonably to have become aware that the injury was attributable to the negligence of Joondalup Hospital. The primary Judge evidently accepted that the applicant was aware of the existence of Dr Flecknoe-Brown’s report. Her Honour’s observation that the applicant “may have understood that Dr Flecknoe-Brown ‘finds quite a bit of causation’” [52] indicates that the applicant was in court when her counsel tendered the report. If the applicant was not told by her legal representatives of the significance of the report, she had only to ask. It was reasonable to expect the applicant, who had known for years that causation was the critical issue in her case against Joondalup Hospital, to make that simple inquiry. Had she done so she would have been told that although the report was not ideal from her point of view it was evidence that the negligence of Joondalup Hospital was causally related to the amputation of her leg.

33. [146]

    The primary Judge’s concern as to the lack of direct evidence on these matters is entirely understandable, particularly given that it would have been very easy for the applicant to address. Nonetheless, the evidence is sufficient to conclude that as a consequence of receipt of Dr Flecknoe-Brown’s report, the applicant ought reasonably to have become aware that her injury was attributable to the conduct of Joondalup Hospital.

Orders

1. [147]

   The following orders should be made:

2. [148]

   The applicant has sought an indulgence from the Court in the form of orders extending time for the commencement of the proceedings. For that reason and also because of the lack of precision and clarity in the presentation of the applicant’s case at first instance she should pay the costs of Joondalup Hospital in the Common Law Division proceedings. However, Joondalup Hospital should pay the applicant’s costs of the appeal including the application for leave to appeal. Thus these additional orders should be made: