Road Accident Victims Research Articles

Modelling the costs of pre-hospital transport service for victims of road accidents in TDABC

The pre-hospital transport of victims of road accidents in Morocco by basic ambulances concerns the majority of the population of victims requiring urgent care. It also constitutes the common service that benefits the entire population of victims, in terms of pre-hospital care. The objective of this contribution is to develop a model for calculating the costs of pre-hospital transport of road accident victims using Time-Driven Activity-Based Costing (TDABC). This model could be effective in better understanding how consumption occurs and how resources are administered and distribut-ed within the pre-hospital care service portfolio. The qualitative research approach that we have adopted in the con-text of this study has enabled us to map and identify all the activities and tasks carried out in the process of pre-hospital transport of road accident victims. The model obtained is flexible enough to adapt to the various situations of pre-hospital transport of road accident victims by basic ambulances. The application of this model in the Moroccan context, delimited in a well-defined round trip (civil protection - accident site - hospital - civil protection) demonstrates that the said model is valid for cost calculation. The calculations made (217.47 MAD, 224.31 MAD, 225.45 MAD and 226.59 MAD) allow us to identify the possible cases of victims transported by basic ambulance. However, the TDABC, applied to the pre-hospital transport of road accident victims, has some limitations, in particular the estimation of time which is the main key to the allocation of the consumed resources. The results show that the TDABC promotes a better knowledge of all the processes related to the pre-hospital transport service. It allows making visible the value of the costs of the victims of road accidents in the selected patient population. Indeed, when the model is used in the set of routes (black points), decision makers are able to see, on the one hand, the variation of costs between similar pre-hospital transport services and different routes for the same transport services and, on the other hand, the value of the costs of each category of road accident victims' population.

The historical example of economic effect resulted from complex interagency interaction in pre-emergency medical care for injured in traffic accident

The work emphasizes the urgency of this problem, the importance of timely and high-quality pre-hospital assistance to victims of road accidents. The purpose was to show the importance of complex, interagency interactions in helping victims on motorways. The existing different tactical schemes to assist victims at the pre-hospital stage were analyzed. The success of the European countries in reducing the level of road accidents has shown their negative consequences compared to the Ukrainian current indicators. Also, the historical example of the constitutional result from the introduction of several provisions and actions in 1985 and 1986 in the USSR to improve pre-emergency care for the injured on the highways. As a result of the introduction of the provisions, the savings from pre-hospital losses amounted to 96.85 % of the total loss of fatalities on motorways. These data show the need to improve the universal organizational scheme of assistance to victims at the pre-hospital stage in Ukraine, which requires significant attention from state structures of different levels.

Підвищення безпеки автомобільних перевезень автошляхами Черкаської області

The problem of ensuring the safety of movement on the Cherkasy region roads is being studied. The need to improve transportation safety and study the factors affecting it arose with the development of market-based methods of transport management, changes in the structure and management system of the transport industry of Ukraine. Such qualitative changes have led to the development in this field of new models, methods, methodologies of transportation safety management capable of comprehensively solving the problems of transportation organization, their legal, financial, and information support. In order to identify methods of improving road safety in the region, an in-depth analysis of the state of accidents in the territory of the General Directorate of the National Police in Cherkasy Region was conducted by types, causes, days of the week, time of traffic accidents, number of victims, number of dead, etc. Dangerous sections of highways were identified and an experimental study was conducted to identify the causes of traffic accidents. In the course of the experimental study, measurements were made that allow to calculate the speed of vehicles that, violating traffic rules, were overtaking on sections of highways with blind turns. From the obtained results, it can be concluded that the main causes of traffic accidents are the violation of traffic rules, which is caused by the difference in traffic speeds in the flow and the unconscious attitude of drivers to the corresponding traffic situation. As a result of the conducted research, recommendations were provided for optimizing the organization of traffic on dangerous sections of highways. Namely, it is proposed to use the methodology of experimental research on other dangerous sections of the country's highways and to install dynamic traffic signs that will allow regulating the maximum permissible speed depending on the selected factors on the relevant sections, thereby reducing the speed difference in the flow of traffic and punishing violators for exceeding the speed limit. In addition, a very important element of improving safety on the country's highways is the dissemination of information programs on compliance with traffic rules among the country's youth. The proposed method is recommended to be used to reduce the number of road accidents, and accordingly, to reduce the number of victims of road accidents in the territory of Ukraine.

Design and Implementation of a Vehicle Tracking Mechanism using Wireless Network Infrastructure

This study presents the design and implementation of a vehicle tracking system with the goal of assisting victims of road accidents in obtaining prompt assistance from the rescue team. This is accomplished by sending tracking data to the rescue team's mobile equipment. The system was developed utilising available electronics components, installed in a vehicle. Accident situations were recreated by dropping loads of different sizes from a height and loads linked to a rope to shatter the glass on the automobile in order to determine the minimal impart energy necessary to break the glass and the likelihood of a catastrophic accident. If an accident occurs, the GPS engine sends the coordinates of the crash site to the rescue team's mobile equipment through the SIM900 module's GSM engine over a GSM frequency for tracking. The system's tracking accuracy was determined using a standard GPS device, the GERMIN GPSMAP78s, to get the GPS coordinates of the scene and tracking them using the Google map API. When tracked using Google map, the tracking information obtained, when compared with the GARMIN GPSMAP78s, were exact, indicating that proposed device is capable of transmitting accurate tracking information in a short period of time, thereby saving lives.

Low-cost test setup for motorcycle protective clothing abrasion examination

The personal protective equipment and protective clothing for motorcyclists reduce physical injuries to victims of road accidents. Therefore, it is important that the protective clothing complies with a number of test standards, which must be taken into account during the manufacturing process. However, the EN17092-1 to 6 standard does not necessarily correspond to a real accident situations and these testing procedures are time consuming. In this study, a simple and inexpensive self-constructed device for testing the abrasion resistance of motorcycle protective clothing was developed and evaluated. Different types of textiles and leather with and without coating were tested and compared. According to the results of this study, not only leather but also textiles offer good abrasion resistance results. The results show that the strength of an impact significantly changes the abrasion resistance. The developed test method can provide a good alternative as a low-cost and simple test method of abrasion resistance of motorcycle protective clothing.

Опыт применения телемедицинских технологий в работе Воронежского областного клинического центра медицины катастроф

The purpose of the study is to determine the role of telecommunication technologies in increasing the efficiency of Voronezh Regional Clinical Center for Disaster Medicine. Materials and methods of research. The data contained in analytical reports and other documentation of the Center for 2018-2020 in terms of identifying patterns of their change with the introduction of telecommunications technologies were analyzed. Results of the study and their analysis. Introduction of telemedicine technologies in the work of the Center resulted in increase of volume of rendering of medical care by its specialists. The neurosurgeons were the most demanded specialists, who performed telemedical consultations, which is mostly related to the necessity of performing consultations for the doctors of trauma centers of the II and III levels, engaged in treatment of victims of car accidents. Voronezh Regional Clinical Center for Disaster Medicine plans to further expand the use of telecommunication technologies not only in treating victims of road accidents, but also victims of other man-made and natural emergencies.

Структура інвалідності серед постраждалих унаслідок дорожньо-транспортних пригод в Україні

Статтю присвячено проблемі інвалідизації постраждалих внаслідок дорожньо-транспортних пригод (ДТП), проаналізована структура інвалідності в аспекті клініко-епідеміологічних характеристик та за ознакою участі в дорожньому русі. Проаналізовано 140 випадків первинної інвалідності, яку постраждалі отримали внаслідок дорожньо-транспортних пригод.

Клініко-нозологічна характеристика постраждалих, інвалідизованих внаслідок дорожньо-транспортних пригод в Україні

Статтю присвячено проблемі інвалідизації постраждалих внаслідок дорожньо-транспортних пригод, проаналізована структура інвалідності в аспекті клініко-нозологічних характеристик пошкоджень. Розглянуто 219 випадків первинної інвалідності, яку постраждалі отримали внаслідок травм, що сталися в рамках дорожньо-транспортних пригод.

Дорожная сочетанная травма органов мочевыделительной системы: организационно-клиническая тактика в многопрофильном стационаре

INTRODUCTION Damage to the organs of the urinary system (UMS) in road trauma (DT) is 4%, of which multiple and combined - over 70%. The aim of the study is to determine the main organizational and clinical directions for improving the EMC in case of trauma OMS in a trauma center of the 1st level. MATERIAL AND METHODS For the period from 2017 to 2020. 508 injured with road polytrauma were admitted to the hospital. Of these, trauma and secondary injuries were diagnosed in 108 people (21.3%), which were divided into three groups: the first - 73 (67.6%) victims with the injury of the OMVS, the second - 25 (23.1%) with secondary damage kidney, the third - 10 (9.3%) patients with neurogenic bladder with spinal trauma. The assessment of the severity of damage was carried out using the ISS scales and tables of the IH P and IH C. RESULTS It has been shown that the introduction of an interdisciplinary approach to the organization of in-hospital routing and differentiated algorithms of medical and diagnostic tactics based on the concept of traumatic disease, led to the establishment of a final diagnosis in every third victim in the early stages, as well as to a decrease in the overall mortality rate by 3.7%, the overall mortality rate was 12,2%. The key directions for improving the efficiency and quality of care in case of dominant and concomitant trauma of the urinary system have been identified, based on the tactics of programmed multistage surgical treatment (Damage Control Urological). CONCLUSION In the FSBI 3CVKG A.A. Vishnevsky developed, organized and implemented a system and algorithm for the provision of specialized medical care for trauma to the Ministry of Railways, including high-tech assistance to victims of road accidents, associated with the regional and federal services of disaster medicine.

Прогностичні критерії судово-медичної оцінки ступеня тяжкості тілесних ушкоджень при закритих переломах кісток нижніх кінцівок

Currently, to determine the severity of injuries in case of adverse effects of subcutaneous fractures of the lower extremities, several forensic examinations are conducted at the stage of treatment, which may lead to loss of confidence in the results of forensic expert opinion of the victims, accompanied by economic losses. Therefore, predicting the consequences of such injuries is an urgent scientific and practical problem of forensic medicine. The purpose of the study is to develop prognostic criteria for forensic assessment of the severity of injuries in fractures of the femur and tibia. Materials and methods. The object of the research was 180 "Expert conclusions (examination of the case file)" with the establishment of the severity of injuries in victims of road accidents: subcutaneous isolated and fractures of the femur (24; 13.3%), tibia – (64; 35.6%); fractures of these bones as the leading injury in polytrauma – (92; 51.1%). In 120 (66.7%) expert opinions the average degree of severity of bodily injuries was established as favorable consequences of road accidents (main sample). In 60 (33.3%) cases, adverse effects of injury were observed with the establishment of severe injuries (a control sample). Research methods which were used are expert examination of the victim with anthropometric studies; radiation diagnostics; alternative computational forecasting. Results and discussion. According to the results of retrospective analysis of the results of treatment, 25 risk factors for adverse effects of subcutaneous fractures of the femur and tibia were identified. The main ones are: passive participation in a road traffic injury as a pedestrian (87.5% in the main sample and 91.7% in the control); combined trauma (70.8% and 75.0%, respectively), multifracture (66.7% and 95.0%, respectively); age >41 years old (48.3% and 81.7%, respectively) and a frontal collision with a car (51.7% and 70.0%, respectively). Risk factors such as intraoperative misalignment of the fragments of the femur and violation of the terms of postoperative X-ray control (23.8% in the main group and absence in the control group) were relatively uncommon. Conclusion. Numerical values of prognostic coefficients of the most probable factors potentiating adverse effects of subcutaneous fractures of long bones of the lower extremities are established. The most informative are: intra-articular multifracture fracture (prognostic coefficient equals -9; I=1.44); multifragmental diaphyseal fracture (prognostic coefficient equals -7; I=1.20); non-elimination of intraoperative displacement of long bone fragments (prognostic coefficient equals -6; I=1.04); discrepancy of the sizes of a clamp to anatomic sizes of the damaged bone (prognostic coefficient equals -6; I=1,04); violation of the terms of postoperative X-ray control (prognostic coefficient equals -4; I=0.50)

Analysis of features of frontal collision of class D cars

Currently, there is a significant increase in road accidents, which can be associated with an increase in the number of cars, the condition of roads in the country and compliance with road discipline by road users. Modern automotive industry pays great attention to road safety. This is ensured by changes in the design of car interiors, which significantly affects the nature of injuries to victims of road accidents. That is why the solution of this issue has become extremely relevant for forensic expert practice.
 Aim of the work. To establish the characteristic injuries of the driver and passenger in the cabin of class D cars in a frontal collision.
 Material and methods. The analysis of road accidents from 2008 to 2021 in Zhytomyr, Rivne, Volyn regions of Ukraine is carried out. Cases of a fatal head-on collision with a driver and passenger in the front seat of a car with an engine capacity of 2-2.5 liters up to 4.7 meters long and 1.81 meters wide were considered. General and special methods used: system-structural analysis, observation, comparison, description. In addition, a forensic examination of the damage was conducted. Statistical analysis included primary data processing by descriptive statistics methods and null hypothesis testing by multifactor analysis.
 Results. A number of new features have been identified, which are inherent in the damage received in the cabin of a class D car, which can help to identify during the forensic examination. In particular, you should pay attention to the presence of neck injuries. According to the literature, injuries of the cervical spine are among the key and include: rupture of the atlanto-occipital ligament, dislocation and subluxation of the atlanto-axial joint, damage to the spinal cord and its membranes.
 Conclusions: The location and morphological features of spinal injuries can be used as diagnostic criteria in determining the location of the victim in the cabin of a mobile car class D in a frontal collision. The most informative is the analysis of injuries of the cervical spine of the driver and front passenger.

The effectiveness of the AEB system in the context of the safety of vulnerable road users

Abstract According to the analysis by the National Police Headquarters, roughly 40% of all road accident victims in Poland are vulnerable road users (VRU), i.e. pedestrians and cyclists. Their protection has become one of the priorities for action regarding road safety. For this purpose, various activities are carried out aimed not only at human behaviour or the development of modern and safe road infrastructures but also at the development of modern vehicles, including advanced driver assistance systems (ADAS). In order to identify the limitations of the currently available driver assistance systems, designed to respond to VRU, research was carried out under the project name, “PEDICRASH: Safety aspects of VRU in CAD automated vehicles.” The project was aimed at increasing users’ awareness (both pedestrians and drivers) of the limitations of ADAS by analysing barriers and indicating recommendations allowing for more effective protection of pedestrians and cyclists due to the identified operating limitations of these systems. The research focused on the autonomous emergency braking (AEB) system and its potential impact on the level of road safety, with particular emphasis on VRU.

A situational analysis of the care of road traffic victims in Burkina Faso: a challenge to achieve sustainable development objectives

Introduction The aim of this study was to assess the capacity of Burkina Faso’s health services to care for road accident victims, from the crash site up to their recovery and rehabilitation. Methods We performed a situation analysis rooted in the literature findings, an overview of administrative documents, followed by the analysis of pre-hospital, hospital and post-hospital care. We also performed monitoring visits and interviewed a number of stakeholders, aiming to understand the current situation and identify the most important knowledge gaps, required for the development of policy and implementation of the holistic intervention plan. Results The study identified numerous and strong deficiencies across the total care of road accident victims management spectrum. The results suggest that a broad-scope intervention is needed, although even smaller-scale effects on elements of total care may yield improvements in specific areas. We also detected a substantial need for more primary studies that can provide relevant data for policy. Conclusion This study identified numerous problems, which need to be further explored and quantified, before a more systematic intervention can be applied across the country, aiming to reduce the negative health consequences of road accidents.

Дорожньо-транспортна травма на фоні алкогольної інтоксикації (клініко-епідеміологічний аналіз за ознакою участі в русі)

Статтю присвячено проблемі дорожньо-транспортних пригод (ДТП), які сталися на фоні алкогольної інтоксикації. Із розвитком техніки і науки протягом останнього десятиріччя в усіх країнах світу зросла кількість постраждалих із тяжкими полісистемними пошкодженнями. Найбільш частими причинами пошкоджень є ДТП. Дорожньо-транспортна травма, згідно з висновками Всесвітньої організації охорони здоров’я, є однією з основних причин смертності населення працездатного віку. Десятиліття безпеки дорожнього руху (2011–2020рр.), що було проголошено Організацією Об’єднаних Націй, вказало на те, що саме медична безпека дорожнього руху є найбільш наболілою і складною для вирішення проблемою. Мета дослідження: вивчити вплив алкогольної інтоксикації на обставини отримання пошкоджень за ознакою участі в русі в постраждалих із полісистемними пошкодженнями внаслідок ДТП. Матеріали та методи. Проведений науковий ретроспективний аналіз 312 випадків полісистемних пошкоджень у постраждалих внаслідок ДТП, які перебували на лікуванні у відділенні політравми Київської міської клінічної лікарні швидкої медичної допомоги в період 2018–2019 рр. Результати. Пошкодження внаслідок ДТП виникають у 46 % осіб, які перебувають у стані алкогольного сп’яніння. Існує вірогідна залежність постраждалих внаслідок ДТП від ознак наявності алкогольної інтоксикації та участі в русі. У стані алкогольної інтоксикації водії отримають травму в 46,43 % випадків, пішоходи— у 52,53 %, пасажири— у 31,43%. Порівняльний аналіз ризику виникнення летального результату в постраждалих внаслідок ДТП з алкогольною інтоксикацією та без неї і за ознакою участі в русі довів, що ризик виникнення летального результату у водіїв із наявністю алкогольної інтоксикації більше ніж у 2 рази вищий, ніж у водіїв без неї, і становить 0,49. Висновки. Найбільші клінічні результативні ризики виникнення летального результату перебігу травматичного процесу в постраждалих внаслідок ДТП, незалежно від наявності або відсутності алкогольної інтоксикації, мають пішоходи. Такі ризики мають критичне або катастрофічне значення. Алкогольна інтоксикація підвищує ризик виникнення летального результату перебігу травматичного процесу в активних учасників дорожнього руху (водії та пішоходи) та не впливає на такий результат у пасивних учасників руху (пасажири).

Оrganizational aspects of primary health care for personal skeleton damage caused by road traffic accidents

The purpose of the study. Study the organizational aspects of providing primary health care for victims with the facial department of the skeleton as a result of traffic accidents. Materials and methods. To achieve this goal, a retrospective study was conducted. The work included victims of road accidents with damage to the facial part of the skull between the ages of 18 and 70 years. In total, 150 victims were included in the study between 2000 and 2019. Results of the study and their analysis. The study shows that injuries to the facial skeleton as a result of traffic accidents are relevant. As a result of the study, it was found that as a result of an accident, there is approximately the same number of closed and open injuries. At the same time, open injuries, which could be regarded as medium and severe, were identified in 45 (30%) cases. In addition, data analysis showed that in 30,7% of observations, first aid was provided by random witnesses and/ or relatives of victims who did not have the skills and necessary knowledge to provide such assistance. In addition, an additional 19,3 per cent of first aid was provided by staff of various services who have some knowledge and skills in first aid. This is due to the fact that in the first group, first aid was provided faster than in the second group. The lack of the necessary skills to provide first aid to victims with such an injury can be explained by the rather high percentage of errors, which in the first group amounted to 18,7%, while employees of various services showed good results in providing such assistance and errors were not noted. Key words: primary health care, damage to the facial skeleton, traffic accident.

Effectiveness of a holistic neuropsychological rehabilitation program using virtual reality

Acquired brain injury (ABI) is associated with severe functional consequences at several levels: personal, psychological, social, physical, economic, and systemic. The main objective of the present study is to show the potential of applying virtual reality (VR) in neuropsychological rehabilitation and the consequent psychological and cognitive improvement of the person with ABI. A total of 27 participants of both sexes with moderate or severe ABI participated in an investigation in a clinical trial-type design with pre-test and post-test. Participants in the experimental group (n = 8) underwent a remote holistic neuropsychological intervention program supported by a VR platform: the Virtual Centre for the Rehabilitation of Road Accident Victims (VICERAVI). The experimental group results were compared with a first control group (n = 10) that underwent a conventional holistic neuropsychological intervention face-to-face program; and with a second control group that did not have any neuropsychological intervention (n = 9). We conclude that the VR-based neuropsychological rehabilitation program (NRP) at a distance produces better cognitive results in general cognitive functioning, learning, memory, and executive functioning than the conventional face-to-face NRP. Still, at the psychosocial level, the conventional NRP obtained results similar to those of the VR-based NRP, which did not produce significant improvements. Thus, the study results suggest that the development of VR-based holistic NRPs may benefit the autonomy of people with ABI.

Self-reported Motorcycle Riding Behavior in Southeast of Iran

Background: Motorcyclists are among the greatest vulnerable individuals of road accident victims. Their behavior has a significant correlation with increased injury and mortality rate. Determining the risky and unsafe behaviors of motorcycle drivers is necessary for preventing riders and other citizen from potential accident risks. Objectives: The aim of this study was to determine the risky driving behaviors of motorcyclists in Iran. Methods: A cross-sectional study was done in 2019 in Sistan and Baluchestan Province as the second widest province of Iran. Using randomized sampling method, we included 613 motorcyclists from the province. To collect data, the Persian version of Motorcycle Riding Behavior Questionnaire (MRBQ), as a standard questionnaire, was used. For data analysis, descriptive and analytical statistics such as one-way analysis of variance (ANOVA), t-test, and linear regression were used by SPSS software version 21. Results: The age range of 57% of the motor riders was 15 - 30 years, and 50% of them did not use any safety equipment. About 58% of the subjects had started motorcycle riding under 18 years old, and 73% of them did not have a motorcycle riding license. Moreover, more than 50% of motorcyclists used mobile phones while driving. The mean score of driving behavior (106 ± 22) was desirable. Based on multivariate analysis, job, average amount of riding, lacking a riding license, type of motor, alert from police, non-fasting helmet band, exceeding speed limits, fatigue, and hand-free riding were the main predictors of risky riding score (P < 0.05). Conclusions: According to our results, the riding behavior of motorcyclists was desirable; however, many people used motorcycles without a license and safety equipment, which increases high-risk behaviors. Considering the potential dangers of motor riders, it seems necessary to hold training courses to obtain motorcycle certification and how to use safety equipment.

Modelling transport time to trauma centres and 30-day mortality in road accidents in Switzerland: an exploratory study.

Rapid access to a trauma centre for severely injured road accident victims, conceptualised as the Golden Hour, links access time to definitive treatment within 1 hour of trauma with reduced risks of morbidity and mortality. Access times have not been studied in Switzerland. The aim of this work was to model the transport time by ambulance of seriously injured road traffic accident victims to one of the 12 trauma centres in Switzerland and to investigate whether this time influenced mortality. Isochronous travel curves in 10-minute increments were modelled around each of the 12 Swiss trauma centres to assess travel times at the Swiss national level, based on the shortest travel time from the location of a serious road accident to the nearest trauma centre. We used the national database of the Federal Roads Office, which provided the geolocation of these accidents occurring between 2011 and 2017. The association between mortality and transport time to the nearest trauma centre was then analysed. The current distribution of trauma centres allowed access time within the Golden Hour for accidents occurring on the Swiss plateau, but the time was more prolonged in the Alps or the Jura. An association existed between mortality and prehospital transport time from the site of an accident to the nearest trauma centre. For each additional 10-minute isochrone, an average increase of 0.4% in mortality was observed. This work showed an adequate distribution of trauma centres in Switzerland and suggests a positive relationship between transport time to the nearest trauma centre and mortality. The numerous confounding factors not systematically collected in publicly available databases limit the robustness of our results. This study confirms the importance of having a national trauma registry to allow quality analyses to guide public health decisions.

Main factors that cause negative complications of foot function after receiving mechanical traumatic injuries

The article is devoted to an important and relevant area of ​​forensic and clinical research to clarify and implement in medical theory and practice the main factors that cause negative complications of lower extremity function after fractures and other injuries due to mechanical trauma during traffic accidents ( further - road accident) and lead to permanent disability of more than 33%. Therefore, the aim of the study was to identify the criteria that indicate the occurrence of severe consequences of mechanical injury in the form of permanent disability of more than 33%, and to determine the value of these prognostic criteria.
 The material of the study was 180 forensic examinations and tests and medical records of victims of road accidents. Of these, 120 examinations and research - the main group, and 60 - control. A number of current legal documents describing the concepts and types of disability have also been studied.
 The methods were scientific analysis of legal sources and methods of descriptive statistics of medical and forensic documentation.
 The results of the study allowed us to identify 8 groups of symptoms that cause the negative consequences of post-traumatic changes in the form of permanent disability of more than 33%. Based on the study of these signs, prognostic criteria for modern forensic assessment of the severity of injuries burdened with loss of general ability to work in the above range were developed.
 The ranking of these prognostic criteria in the main group (voters) was carried out.
 A number of clinical and forensic features of modern forms and types of mechanical trauma of the lower extremities during an accident and the consequences of such injuries have been identified.
 A number of inconsistencies of by-laws regulating forensic medical examination in the field of glossary on permanent disability are shown.
 Conclusions and recommendations for improving the theory and practice of forensic determination of the degree of disability are given.

SUPERFLUOUS LITIGATION, IN A WRONG FORUM ABOUT NOTHING: WHEN LAWYERS AND EXPERTS COLLUDE Motswai v RAF 2012 SA (GSJ) Case No: 2010/17220

The case of Motswai v RAF (2012 SA (GSJ) Case No: 2010/17220, not yet reported) is a clear indication of how lawyers and experts should not act in a case against the Road Accident Fund (RAF). From the facts of the case it is clear that there was no need to institute an action, yet the lawyers proceeded and experts even wrote lengthy opinions on a bruised ankle. The only inference the judge drew from this was that the lawyers (and experts) were only concerned about being paid even if it meant being paid from the funds intended to compensate road accident victims. Satchwell J therefore after analysing all the evidence made a cost order that neither the plaintiff’s nor the defendant’s attorneys should receive any fees at all in respect of this claim or litigation. The expenses incurred in respect of “experts” should not be a burden on the public purse and therefore the attorneys should meet these disbursements de bonis propriis. She further stated that counsel should be paid only on a scale of the Magistrate’s Court and it should not include trial fees.