Messier v. United States (962 F. Supp. 2d 389, 2013)

OPINION, FINDINGS OF FACT AND CONCLUSIONS OF LAW

HAIGHT, Senior District Judge:

I. INTRODUCTION

This action within the Court’s admiralty jurisdiction arises out of a collision on July 2, 2008 in Block Island/Rhode Island Sound between the United States Coast Guard Cutter MORRO BAY and the ferry boat BLOCK ISLAND, owned and operated by Interstate Navigation Company. When the collision occurred, the BLOCK ISLAND was engaged on a voyage from Point Judith, Rhode Island, to Block Island. Plaintiff Renee Messier was a passenger on board the BLOCK ISLAND. She claims that the impact of collision caused her to suffer injuries.

To recover damages for those injuries, Plaintiff filed a complaint in this District against Defendant United States (“the Government”), the owner and operator of the MORRO BAY, and against Defendant Interstate Navigation Company (“Interstate”), the owner and operator of the BLOCK ISLAND. Subject matter jurisdiction is founded upon the general maritime law, 28 U.S.C. § 1333; the Suits in Admiralty Act, 46 U.S.C. §§ 30902-30918; and the Public Vessels Act, 46 U.S.C. §§ 31101-31113.

On February 4, 2013, following discovery, the ease was called for trial before this Court, sitting without a jury. At the beginning of the trial, counsel for the parties presented and the Court endorsed a Joint Stipulation as to Liability [Doc. 36 & 38]. All three parties stipulated that the two Defendants, the Government and Interstate, “are each fifty percent liable for the vessel collision” in suit. Doc. 38 at ¶ 1. The stipulation further provided that the Defendants “reserve the right to contest the medical causation and the nature and extent of the Plaintiffs claimed injuries at trial.” Id. at 2. In these circumstances, the trial focused principally upon the issues of whether the collision between the vessels caused Plaintiff any injury, and if so, the nature and extent of that injury. The trial began on February 4, 2013, and concluded with the oral summations of counsel on February 6. Plaintiffs theory of the case is that the collision between the MORRO BAY and the BLOCK ISLAND caused her severe and permanent injury. The Government’s and Interstate’s theory of the case is that the collision between the vessels did not cause Plaintiff any injury— or, perhaps to put the point more precisely, Plaintiff did not prove a causal connection between the collision and any injury or adverse physical condition. If Plaintiff succeeds on that core issue, any amount of damages awarded will be divided equally between the two Defendants, in accordance with the stipulation as to liability.

The Court, having considered all the evidence and the able summations of counsel, enters the following Findings of Fact and Conclusions of Law, in accordance with Rule 52(a) of the Federal Rules of Civil Procedure.

II. FINDINGS OF FACT

1. Plaintiff Renee Messier was born on June 3, 1963. At the time of the trial (February 2013) she was 49 years of age; she has since attained her 50th birthday. Renee Messier has been married to Gregory Messier for 29 years. They have one child, a daughter Jessica, now a college student. The Messiers live in Danville, Connecticut.

2. On July 2, 2008, Renee and Gregory Messier traveled by car from Danville to Point Judith, Rhode Island. They planned to board the ferry boat BLOCK ISLAND for a passage from Point Judith to Block Island, in order to spend the Fourth of July weekend as guests on the boat of friends, George and Cheryl Carpenter. The ferry BLOCK ISLAND was owned and operated by Defendant Interstate Navigation Company.

3. The Messiers boarded the BLOCK ISLAND during the morning of July 2, 2008. The ferry departed Point Judith for Block Island at approximately 11:55 a.m. Visibility was reduced by fog.

4. The ferry has two passenger decks: the main deck and an upper deck, above the main deck. These two decks are connected by stairs enclosed in stairwells. Below the main deck there is a cargo space where vehicles are stowed. The Messiers did not take their car on board the ferry.

5. When the ferry began to move, the Messiers were sitting on a bench in the covered and enclosed main deck area. The ferry passed through the Point Judith breakwater and into the open water of Block Island Sound. Renee Messier is prone to seasickness, and accordingly she left the passenger sitting area, walked aft on the starboard side of the ferry, through a doorway, and into a passageway which ran fore and aft along the starboard side, with open window spaces along the side, admitting the fresh air she sought to ward off seasickness. Gregory Messier accompanied his wife, and they both stood in this new area.

6. Shortly after the Messiers moved to this starboard side passageway on the BLOCK ISLAND, the ferry collided with the Coast Guard Cutter MORRO BAY. The MORRO BAY was owned and operated by Defendant United States of America. The Defendants have stipulated that the collision was caused by the fault of those navigating both vessels, with the proportion of fault divided equally between them. In consequence, these Findings of Fact do not describe in any detail the maneuvering and navigation of the colliding vessels. Instead, these Findings focus initially upon what happened to Renee Messier, on board the ferry.

7. Two disputed issues of fact are central to the case. First, at the time of the collision between the ferry BLOCK ISLAND and the Coast Guard Cutter MOR-RO BAY, was Plaintiff Renee Messier holding on to a railing on the ferry with her right hand? Second, did the impact of collision cause any injury to Messier’s right shoulder? These two questions, while separate, are also interdependent, much as the inner structure of a human body’s shoulder is made up of separate but interdependent parts.

8. The parties’ contentions in respect of these two questions are diametrically opposite. Plaintiffs theory of the case is that when the impact of collision occurred, she was holding onto a railing on the ferry with her right hand, and in consequence suffered a traction injury of her right shoulder. Defendants’ theory of the case is that the Court should not credit Plaintiffs claim of holding onto a ferry railing, and any pain or discomfort she has felt after the collision is the result of preexisting physical conditions, for which Defendants bear no liability.

9. As for Messier’s asserted holding on to a ferry railing, the parties’ disagreement is clearly expressed in their Proposed Findings of Fact at the beginning of the trial, and in counsel’s summations at its conclusion. Plaintiffs Proposed Findings of Fact [Doc. 35] state in ¶ 2: “At the time of the collision, Renee Messier was holding on to a rail with her right hand.” Defendants’ Proposed Findings of Fact [Doc. 34] state in ¶ 4: “While Mrs. Messier alleges that she was holding onto a rail under the window with her right arm, in fact there is no handrail there.” In his summation after all parties rested, counsel for the Government said: ‘While Mrs. Messier’s recollection is that she was holding on to a rail at the time of the collision, there is no handrail where she was standing.” Tr. Vol. 3 at 23. Counsel for Plaintiff said in summation: “Ml of the credible evidence, your Honor, is that she was holding on to a rail or holding on to something with her right arm and that the force of the impact between these tremendously heavy vessels caused her to stretch her arm and to twist around ...” Tr. Vol. 3 at 48. I will consider in detail the trial evidence on this question of fact.

10.Plaintiff Renee Messier testified at trial concerning the relevant events. Prior to that time, she had given accounts of the incident to two treating physicians: Heather Sullivan, M.D., a family physician, board certified in family medicine, who is Plaintiffs primary care physician; and Ammar Anbari, M.D., a board certified orthopedic surgeon, who operated on Plaintiffs right shoulder. These physicians testified at the trial: Dr. Sullivan in person, Dr. Anbari through the medium of a previously videotaped deposition, which was shown in the courtroom during the trial. Relying on contemporaneous notes in their medical files and upon memory, Dr. Sullivan and Dr. Anbari described what Plaintiff recounted to them with respect to the impact between the vessels and its effect upon Plaintiff.

11. The collision occurred on July 2, 2008. On October 17, 2008, Plaintiff was examined at Dr. Sullivan’s office. Dr. Sullivan testified that during the period between July 2 and October 17, Plaintiff “had been seeing a physical therapist and a chiropractor who did just gentle manipulation, trying to improve her shoulder pain.” Tr. Vol. 1 p.m. at 81. Dr. Sullivan then testified with respect to Plaintiff:

She right away came in and described for me what had happened when the Block Island and the Coast Guard collided. That she had been holding on to the rail with her right hand, to keep balance. And when they collided, she was thrown. She did not hit the ground, but only because she held on so strongly with her right hand. And as a result, she developed pretty severe right shoulder pain.

Id. Dr. Sullivan’s diagnosis at that time was that “the description and her symptoms were consistent with a traction injury to the right shoulder.” Id. at 33.

12. On March 24, 2011, Plaintiff on her own initiative, without being referred by another physician, obtained a consultation with Dr. Anbari to consider the possibility of surgery to relieve continuing right shoulder pain. With respect to that initial consultation, Dr. Anbari testified:

Renee presented to see me specifically for her right shoulder pain. In her intake history, which [sic ] I saw her the first time, she stated that she was on a ferry boat going to Block Island. .There was a collision between that boat and another boat. Renee was standing in the back of the boat, from my understanding. She was holding onto the railing.

She’d had a very extensive history of things going on in her lower extremities, so her leg is weak. She lost her footing and she ended up grabbing the railing really hard from the impact of the injury [sic ] and she sustained a traction injury to her right shoulder.

Deposition Tr. 11-12. I take the medical use of the noun “history” to indicate that this is the account of events Renee Messier gave verbally to Dr. Anbari at their first meeting. I am confirmed in that impression by this exchange during the defense cross-examination of Dr. Anbari: “Q. Now, you related these diagnoses to the July 2, 2008 ferry collision based on a history that was given to you by Renee Messier; is that correct? A. Correct.” Deposition Tr. 42. Amplifying on that point, Dr. Anbari testified later in his cross-examination:

A more minor impact can cause her to lose her balance more easily. And I think at least from her description on multiple occasions, is that she was holding onto the railing so she does not fall down. So as a result, the body weight was being pulled away — My interpretation of it was, her body was being pulled away from the railing and she held on with her right side to the railing to prevent herself from falling.

Deposition Tr. 43-44. Dr. Anbari’s “interpretation” of the events was based upon what Messier told him.

13.Thus, the evidence shows that Plaintiff told both treating physicians that when the impact of the collision manifested itself on the ferry boat, she was holding onto a railing with her right hand. I may consider Plaintiffs statements, testified to by Drs. Sullivan and Anbari, as evidence of the truth of the matters asserted in Plaintiffs statements. Those statements fall within the exception to the hearsay rule found in Fed.R.Evid. 803(4), which excepts a statement that “(A) is made for — and is reasonably pertinent to — medical diagnosis or treatment; and (B) describes medical history; past or present symptoms or sensations; their inception; or their general cause” (emphases added). The Advisory Committee Notes to Rule 803(4) recite the general principle that statements of present condition are admitted “if made to a physician for purposes of diagnosis and treatment in view of the patient’s strong motivation to be truthful,” and continue:

The same guarantee of truthfulness extends to statements of past conditions and medical history, made for the purposes of diagnosis or treatment. It also extends to statements as to causation, reasonably pertinent to the same purposes, in accord with the current trend. Statements as to fault would not ordinarily qualify under this latter language. Thus a patient’s statement that he was struck by an automobile would qualify but not his statement that the car was driven through a red light.

(citations omitted). In the case at bar, Plaintiffs statements to her physicians that she was holding on to a railing when the collision impact was felt is directly pertinent to the doctors’ medical diagnoses, since the statements enable the doctors to understand the mechanics of the injury and the forces to which Plaintiffs body was subjected. Plaintiffs “strong motivation to be truthful” is found in the obvious proposition that a patient wants her physician to know everything that might assist him in arriving at an accurate diagnosis and then fashioning effective treatment.

14. I turn now to the testimony of the only two lay witnesses with direct knowledge of the facts relevant to the question of whether the collision impact had any effect upon Renee Messier. Those witnesses are Plaintiff Renee Messier herself, and her husband, Gregory Messier. At the moment of collision, the Messiers were standing together in an aft covered area of the ferry, on the starboard side.

15. Renee Messier testified on direct examination that she gets seasick easily, and continued:

So, when the boat started to leave and we left about 10 minutes late, not too long after we got out the breakwall, I got up and went out back further to the open window. It helps for me to be in the open air.

We walked through a doorway where all the benches were like inside. When you go out the doorway and there was a stairwell where you could go upstairs to the open part of the ferry. And there were a couple like cut-out open windows with no glass or anything. And I was just standing there and Greg was leaning up against the stairwell.

Q. Were there railings there where you were standing?

A. (after Court overruled objection to the question): Yes.

Q. And describe the railings for the Court as best you can, Renee.

A. They were like tacked against the underneath of windows were they were [sic] in various places throughout the boat.

■ Q. Can you describe how long they were, what they looked like, anything like that?

A. I don’t remember exactly how long they were. At some spots, they went for a few feet. I don’t exactly remember.

Q. And do you recall approximately where you were on the ferry boat in terms of front to back or side?

A. It was more — it wasn’t in the middle. It was — I wasn’t at the way back, but I was more towards the back of the boat.

Q. All right. And assuming the front of the boat was going forward, were you on the right or the left of the boat?

A. On the right.

Q. On the right. So, tell us what happened.

A. It was very foggy. Like I said we were — I got up from inside, we both went out to stand in the open air. And the — and we noticed it was very foggy. And you could — from all our years going back and forth to the island, we kind of understood a little bit of boating from our friend, Woody.

So, the fog horn was going on and off periodically and it was a steady routine they were doing. And then all of a sudden, they got on the fog horn and didn’t stop. So, I had turned to look to my husband. And then when I did, out of the left of my eyes, I could see it was like a beige color. And I couldn’t make out what it was or if it was a person or anything. I just remember seeing that. And then I had just said to my husband, Somebody must be in the way. And that’s when we got hit.

Q. At the time that you got hit, were you holding onto anything?

A. Yes.

Q. What were you holding onto?

A. I believe it was a railing.

Q. And with what were you holding on, with your arms?

A. My right arm.

Q. Your right arm. And can you describe for the Judge as best you can, Ms. Messier, what the impact felt like to you?

A. It was like a big thud. I mean, it threw my balance way off. And my balance isn’t perfect to begin with. So, I went — I grabbed — whatever I was holding onto, I grasped it. And then it jerked all my body weight to the left and then back.

Q. Did your right hand ever let go of the rail?

A. No.

Q. Did you fall to the ground?

A. I did not.

Q. Why not?

A. Because I was holding onto that railing very tightly. And that’s my biggest fear, to fall. So, I did everything I could to not fall.

Q. Did you have any idea that there was going to be an impact?

A. No.

Q. I forget, I’m sorry, did you say you lost your balance?

A. I did.

Q. Describe that for us.

Q. When the collision occurred, my body weight went flying to the left as I held onto the railing. And I came a couple of inches close to the floor, but I did not fall.

Tr. Vol. 1 a.m. 56-60. Counsel for the Defendants did not cross-examine Renee Messier with respect to this account. Their examination was confined to her very considerable medical history, before and after the incident in suit.

16. Gregory Messier testified on direct examination:

A. We left Point Judith, headed out, fifteen, twenty minutes later. Well, the day was pretty foggy and very tough to see. Fifteen minutes or so past the brake wall [sic ], the sound of the horn of the ferry boat was on for quite a bit of time. And before that it had come on periodically, I believe, 'because of the fog and the weather.

We were slowed down abruptly and hit the Coast Guard boat. And it kind of launched us forward a little bit. And from that point on, it was maybe forty-five minutes before they even came on the intercom to even tell us what was going on with the collision.

Q. Do you recollect where you and Renee were situated just before the collision?

A. Yes, near the mid-ship area, facing the front of the boat. We were on the right side of the boat. There was an opening. It was like a window opening in the boat.

Q. And were you standing?

A. I was standing, yes.

Q. Were you attached to anything?

A. I was somewhere near the stairwell to the rear of Renee. Q. Was Renee standing or sitting?

A. She was standing.

Q. And did she have hold of anything?

A. She was near the window opening. I believe she was holding on to a rail or something near the window opening.

Q. Did you have any idea that there was going to be a collision?

A. I didn’t know what was happening, but as far as the long sound of the horn was different than what it was previously. You had short blasts of the horn. And the boat slowed down quite a bit. We were all wondering what happened and the collision happened soon after.

* * * * * *

Q. Would you describe the impact for us, please, Mr. Messier?

A. Yes. Like I was saying, it was slowing down quickly and then came to an abrupt halt. I wasn’t ready for it, but I mean it definitely launched it forward and it was nothing we felt on one of the ferry boats before.

Q. Was it to you a big impact, a medium impact or a small impact?

A. I would say it was a medium to large impact.

Q. Were you — did you have any trouble keeping your balance?

A. I didn’t fall down or anything, but like I said, I believe I was leaning against somewhere near the stairwell. But yes, it definitely caught me off guard and launched me forward.

Q. Did you have your eyes on your wife when the impact occurred?

A. I was looking towards the window and yes she was in my line of view.

Q. Did you see what happened to her?

A. Yes, like I said, it came to an abrupt halt. It launched her forward. And where she was holding on, she kind of turned to the left and twisted while she was holding on to where she was holding.

Q. Did she fall to the ground?

A. No, she didn’t.

Tr. Vol. 1 p.m. 71-74. On cross-examination, counsel for the Government elicited from Gregory Messier testimony that at the time of collision he was leaning against the stairwell, did not see anyone fall, and did not see anybody get injured. Id. at 82.

17. Defendants argue that the Court should not credit the Messiers’ testimony that at the moment of collision impact, Renee Messier was holding on to a rail with her right hand. If Defendants are correct, the Messiers’ testimony that Renee Messier was holding on to a rail is the result of either mistaken recollection or deliberate perjury. Defendants do not go quite so far as to claim the latter. My impression of Renee and Gregory Messier is that they were credible witnesses, in the sense of testifying on the basis of honest recollection rather than making up falsehoods. Having considered all the evidence on the point, I find that at the moment of collision between the ferry boat and the Coast Guard vessel, Renee Messier was in fact holding on to a ferry boat railing with her right hand. I make that finding for several reasons.

18. The Defendants’ contention that Renee Messier was not holding on to a railing depends principally upon a color photograph of the area in question on board the ferry that was admitted at trial as Def. Exhibit 523. That photograph shows a section of an interior passenger walkway on the BLOCK ISLAND which her captain, Steve Alan Kimball, testified was “the starboard catwalk.” Tr. Vol. 2 a.m. 69. It is undisputed that this is the location on the ferry to which the Messiers proceeded in search of fresh air, as Renee Messier described in her testimony quoted in ¶ 15 of these Findings. The picture is taken facing forward on the ferry. A line pf window-like apertures appears along the right-hand side of the picture. The seasick-prone Renee Messier sought these openings as a source of fresh air. The left side of the picture shows an interior wall (a mariner would probably say “bulkhead”) running fore and aft and up to the ceiling, and terminating close to the bottom of the stairwell leading from the ferry’s main deck to the upper deck. A handrail runs along the side of that wall, and bends to the left and disappears from the picture when the wall reaches the stairwell.

19. Def. Exhibit 523 is one of several photographs of the same area on the ferry, clearly taken at the same time. The other photographs in the series were premarked Def. Exhibits 524, 525 and 526. The Pre-Trial Order recited that all these photographs were admissible without objection. During the trial, only Exhibit 523 was shown to a witness, testified about, and separately received into evidence by the Court, but the entire series is useful in making these Findings of Fact, and in the circumstances I commit no impropriety in considering Exhibits 524, 525 and 526 as part of the trial record.

20. What these additional pictures show is the manner in which the railing running along the interior (or inboard) wall (or bulkhead) turns 90o to the left, as the wall itself turns away from paralleling the starboard side of the ferry and proceeds toward the vessel’s center line. Exhibit 526 is particularly vivid in that regard. In addition, Exhibits 524 and 525, taken as the photographer approached and then arrived at the bottom of the stairwell from the upper deck, are useful because they reveal how narrow and confined these spaces on the ferry really are. Looking at Exhibit 523, Captain Kimball’s attention was called to a structure running fore and aft just below the windows depicted on the starboard side. “That’s a flat bar,” Captain Kimball testified. “It’s used to — it’s a stiffener for the hull, so the hull doesn’t warp. It’s approximately an eighth of an inch thick, probably three inches wide and maybe about 10 feet long.” Tr. Vol. 2 a.m. 72. He further testified that one could not grasp the stiffener and hold onto it.

21.I accept Captain Kimball’s testimony that no one could hold onto the flat bar under the windows for support. I also accept his testimony that the bar is only three inches wide. That latter dimension, when viewed in its setting on the starboard side of the catwalk, furnishes rather dramatic evidence of how narrow a passage the catwalk is. For example, Exhibit 526 is a view looking aft along the catwalk from the bottom of the stairwell. The three-inch-wide flat bar consumes a discernible portion of the catwalk’s total width. More of that width is consumed by a series of vertical beams or structures which appear to be twice the width of the flat bar, or about six inches wide. Captain Kimball aptly referred to this passageway as a “catwalk.” Three cats could walk abreast along the passageway if they were house cats, but they would not fit if they were tigers. Three human beings, even the non-obese, would be hard pressed to stand abreast in this confined space.

22. These spatial reflections are relevant to the issues because Government counsel argued in summation that “[w]hile Mrs. Messier’s recollection is that she was holding on to a rail at the time of the collision, there is no handrail where she was standing.” The evidence allows that argument if the phrase “where she was standing” is interpreted to mean a position in immediate proximity to the starboard side windows. However, the pictures in evidence show a handrail running along the inboard bulkhead forming the other side of the confined space where Renee Messier was standing, having left the covered upper deck to obtain fresh air from the open windows. Presumably Government counsel had in mind Renee Messier’s testimony that the railings in question “were like tacked against the underneath of windows,” which does not accord with the photographic evidence. Gregory Messier testified that Renee Messier “was near the window opening. I believe she was holding on to a rail or something near the window opening.” That testimony is not necessarily inconsistent with the photographic evidence; given the narrow confines of the space where Renee Messier was standing, it can fairly be said that she was holding on to a rail “near the window opening.”

23. I find that just before and at the moment of the collision, Renee Messier, whose balance was compromised by her pre-existing condition, and concerned by the sudden and persistent sounding of the BLOCK ISLAND’S fog horn, reached out with her right hand and held on to the railing depicted in the photographs in evidence, while facing toward the open windows across the narrow catwalk. I base the finding of the direction Renee Messier was facing upon her testimony, which I credit, that she caught a glimpse of the other vessel “out of the left of my eyes,” which is the line of vision that would result if she was facing out to starboard and the collision occurred at the ferry’s bow. Renee Messier’s recollection that the handrail “was tacked against the underneath of windows” is inaccurate, but I think represents an error of recollection understandable in the circumstances, and does not preclude the finding recited in this paragraph, which I make on the basis of all the trial evidence.

24.The trial evidence probative of this issue includes the testimony of Dr. Heather Sullivan, quoted in ¶ 11. Dr. Sullivan had been Renee Messier’s primary care physician for a number of years. The first time Messier saw Dr. Sullivan after the collision was October 17, 2008, three and a half months after the incident. Dr. Sullivan testified that at the beginning of that office visit, Messier told Dr. Sullivan that when the vessels collided, “she had been holding on to the rail with her right hand, to keep balance. And when they collided, she was thrown. She did not hit the ground, but only because she held on so strongly with her right hand.” I accept Dr. Sullivan’s description of what Messier told her during that consultation. Dr. Sullivan was an articulate, impressive, non-partisan professional witness. Every trial judge becomes familiar with the board-certified, highly qualified, bespoke-clad physician who testifies forcefully as a medical expert at the behest of one party, only to have it made plain on cross-examination that the physician makes most of his or her living as an expert witness at trials, rather than practicing medicine in office, hospital or operating room. Dr. Sullivan is not one of those; neither, I should add, is Dr. Anbari or Dr. Alleyn, the other physicians who testified at this trial. So I accept that on October 17, 2008, Renee Messier related to Dr. Sullivan the account whose substance Dr. Sullivan described in her testimony.

25. Moreover, I may and do consider Messier’s account to her physician as non-hearsay evidence of the truth of the facts asserted in that account, for the reasons stated in ¶ 13. The consultation was close enough in time to the collision to leave Messier’s recollection unimpaired; Messier’s only discernible motive was to give an accurate description of events to her physician, in hopes of an accurate diagnosis and effective treatment; and there is no reason to suppose that Messier deliberately gave a false account to Dr. Sullivan in order to enhance or support a possible future lawsuit against the vessel owners for personal injuries. These factors enhance the trustworthiness of the account Renee Messier gave to Dr. Sullivan about how her injury came about: specifically, that she has holding on to a ferry handrail when the collision occurred.

26. The conditions for which Messier was subsequently treated may also be probative of whether the collision caused her any injury, and if it did, the nature and extent of that injury. On these issues the parties are sharply divided, and it is necessary to consider the medical evidence in detail.

27. Renee Messier has contended with serious medical and physical conditions. She described her medical history in her trial testimony, and the subject is also treated in detail in the Stipulated Uncontroverted Facts appearing in ¶¶ 27-41 of the Joint Trial Memorandum [Doc. 33]. Those Stipulated Facts are one of the sources of the Findings that follow.

28. When she was seven years old, Renee Messier was diagnosed with Ewing’s Sarcoma, a bone cancer centered in the left pelvis. She underwent surgery to remove the tumor and part of the bone, followed by radiation. The cancer metastasized to Messier’s spine, and in late 1971 or early 1972, while she was either sevén or eight years old, Messier underwent spinal surgery to remove the affected areas of bone, followed by further radiation.

29. This spinal surgery left Messier a paraplegic, and her physicians indicated to her parents that she might never walk again. Messier engaged in intense physical therapy, with the assistance and support of her parents (her father got down on the floor with her for push-ups and situps). She also went to the hospital for out-patient hydro tub treatments, and did swimming, “any kind of movement I could.” Responding to this dedicated protocol, Messier’s paraplegia receded, and after a year or year and a half she could walk again, albeit with assistance, holding on to someone’s hand “for a little while.”

30. In 1978, Messier had to undergo a surgical spinal fusion. The prior cancer surgery had removed so much bone and tissue that Messier developed scoliosis, or curvature of the spine, which caused back pain and affected the use of her legs. During this procedure, the surgeons rebuilt some vertebrae in the spine. Following this surgery, Messier resumed intensive physical therapy. She was by then “a freshman in high school.” The third surgery helped Messier; she “felt much straighter and stronger” and her balance was better. But she would tire easily and it “took more work for me to get around,” so in 1980, during her junior year in high school, Messier underwent a fourth surgical procedure: a surgical muscle transfer in her left hip, in medical parlance “a modified Sharrod iliopsoas transfer surgery.” Tr. Vol. 1 a.m. 29-30; Joint Trial Memorandum, p. 18, ¶ 27. She reached a plateau in her overall recovery and condition about a year after that fourth surgery, “almost to the end of my senior year.” She testified at trial:

Q. And at that time, Ms. Messier, can you tell the Judge how you were doing with your walking and balance and all that sort of thing?

A. I was doing pretty well. I did as well as I could be from what I’d dealt with my whole life. I mean, I tried to do as many normal things and physically, to my ability, what I could do. I went out with my friends and went to dances, and parties and social events.

Tr. Vol. 1 a.m. 31.

31. Based upon Renee Messier’s trial testimony, demeanor and the medical evidence, I find that she is a determined and courageous woman who throughout her life has refused to surrender to significant physical impairments or to self-pity, but instead strives through the efforts of physicians and physical therapists (and with family support) to live as full a life as the hand she was dealt will allow. That finding is relevant to additional findings I will make in the case.

32. Ever since her first surgery as a child for Ewing’s Sarcoma, Messier has walked with a limp, caused by pain and instability in her left leg. She walks with a limp today; it was noticeable in the courtroom, and one must conclude the condition is permanent. Over the years, Messier has experienced a series of additional medical and physical conditions and problems, and undergone a variety of treatments. They are summarized in the immediately following paragraphs of these Findings: a summary derived principally from ¶¶ 28^1 of the Stipulated Uncontroverted Facts, at pp. 18-21 of the Joint Trial Memorandum, as amplified or clarified by Messier’s trial testimony.

33. After graduating from high school, Renee Messier attended community college and then found employment as a bookkeeper and accountant. She met her husband, Gregory Messier, at work and they have been married 29 years. She was employed from 1984 through 1999, at which time the Social Security Administration (“SSA”) determined that she was disabled and entitled to benefits retroactively beginning on February 11, 1999. In connection with the SSA proceeding, Messier presented medical evidence establishing that she had chronic scoliosis and a gait disorder rendering her unable to perform sedentary work. The SSA relied upon a physician’s opinion that, because Messier’s upper and lower extremity functions were affected by her impairment, her abilities to climb, balance, stoop, kneel, crawl, reach, push, pull and bend were either precluded or limited.

34. In 1987, Messier injured her neck, shoulder and back in a motor vehicle accident, suffering whiplash injury when the car in which she was riding was rear-ended by a car going over 50 mph. Messier was diagnosed with chronic right para-thoracic pain and chronic right sub-scapular pain following the accident. She complained'of and received treatment for those injuries for years following the accident.

35. Shortly before and after the birth of her daughter in 1989, Messier was treated surgically for the removal of a small wire, installed during the original operation for Ewing’s Sarcoma, which had disintegrated and begun to penetrate the skin: a procedure that seems to have totally alleviated that problem.

36. Renee Messier was followed continuously throughout the 1980s and 1990s for back pain, right scapula pain, and neck pain. She was diagnosed with degenerative spinal disk disease in the 1980s. Between 2001 and 2004, Messier complained of, and received treatment for, shoulder pain and right upper extremity numbness. Also between 2001 and 2004, she complained of neck pain, and received treatment for her cervical spine. Messier experienced a fall in November of 2004, and immediately complained of pain in the right neck, shoulder, back, and radiating symptoms in her upper right extremity. Since the 2004 fall, but prior to the 2008 ferry incident, Messier complained of, and received treatment for, right shoulder pain, numbness, tingling, and pain in her right upper extremity, and neck pain, and received cervical spine treatment.

37. In March 2005, Messier had an MRI of her cervical spine for neck and right arm pain that showed very mild cervical degenerative disc disease and degenerative disc disease in the upper thoracic spine. In June 2007, Messier complained to Dr. Frederick Barkes, a chiropractor, that her chronic back pain had worsened and that she was concerned about persistency of her pain and its effect on her future. She had recently undergone an MRI and CT scan of her lumbar spine on account of pain in her low back and left leg; they showed moderate to severe spinal stenosis and degenerative joint disease in her lumbar spine. In August 2007, Messier reported to Dr. Sullivan that she was experiencing severe episodes of pain and wanted stronger medication. On July 11, 2007, Messier saw Dr. Thomas Arkins, a neurological surgeon, due to increased back pain. Her mobility was significantly limited at that point, and while she had been getting around with a manual wheelchair, she was in the process of applying for a motorized wheelchair. On her patient intake form, when asked by Dr. Ar~ kins’s office to describe the areas of her body in which she was experiencing pain that day, Messier identified her posterior neck, shoulders, mid and lower back, lower extremities, and her anterior forearms. In response to those complaints and following his examination, Dr. Arkins recommended treatment by spinal injections.

38. From at least 2002, Messier had complained of left leg swelling during and due to humid and wet weather during the summer. In 2003, she stated that prolonged wet weather affected her hip and that her left leg swells with dampness. In 2007, Messier complained of left leg swelling, and again of left lower extremity swelling a few days later. And on June 11, 2008, less than a month before the ferry collision on July 2, Messier complained of left leg swelling due to the humid weather.

39.. Between 2001 and the first months of 2008, prior to the collision, Renee Messier underwent frequent sessions with physical therapists, principally Crossroads Physical Therapy, L.L.C. of Columbia, Connecticut. Crossroads’ voluminous records concerning Messier constitute Defendants’ Exhibit 506 at trial. For the most part, these documents consist of daily treatment records, which are single-page forms containing body sketches, and entries under several captions (“Subjective Report”; “Objective”; “Comments — Results of Rx Session”; “Pt. Prognosis from Rx Session” and the like). The handwritten notations on these forms, added by a physical therapist, are not self-explanatory, at least to a lay reader, and no testimony was offered to explain them. In ¶¶ 44-49 of their Proposed Findings of Fact and Conclusions of Law [Doc. 34] Defendants’ Counsel undertake to interpret the Crossroads therapists’ notations describing Messier’s “comments” on that day (counsel describe them as “complaints”), as in: “Mrs. Messier has complained of, and/or received treatment for, right shoulder pain numerous times” (¶ 47), followed by a series of references to daily treatment records. For a fact finder, the more useful parts of the Crossroads records are found in the intermittent typed status reports which Crossroads sent to Messier’s family physicians’ office. The first of these reports in Ex. 506 is dated May 16, 2003; the last is dated December 6, 2007. Each report begins, under the caption “Subjective,” with a summary of how Messier described her own current condition. These self-evaluations evidence an overall improvement, albeit with set-backs interspersed. I will quote the last two reports. September 25, 2007: “Renee has reported that she has been doing well with decreased complaints of low back pain and increased ability to perform AJDL’s. She has stated that she wants to get back to the gym.” December 6, 2007: “Renee has reported that her right-sided low back pain has been doing better.” The record contains no further letter report prior to the ferry collision on July 2, 2008.

40. I find that notwithstanding this decidedly difficult and challenging medical past, by the end of June 2008, just before the vessel collision in suit, Renee Messier had through determination and hard work improved her condition in striking ways. Dr. Heather Sullivan, Messier’s primary care physician, gave persuasive evidence on these points. As I have previously observed, Dr. Sullivan was an impressive witness. She is board certified in family medicine, joined a family medicine practice in Putnam, Connecticut in 1986, and took on Renee Messier as a patient in 1988, when Messier was 24 years old. Dr. Sullivan interrupted her practice during the years 1995 through 2003 to work as a hospice physician, then returned to that practice and resumed her care of Messier (who in the interim had been cared for by other members of the family practice group). Dr. Sullivan clearly admires and cares about Renee Messier, as well as cares for her, but Sullivan’s testimony on medical issues was dispassionate, professional, articulate, well-reasoned and entirely credible. Asked by Plaintiffs counsel for her impressions of Messier from the beginning of their physician-patient relationship, Dr. Sullivan responded:

A. She has always walked, since I’ve known her, with a significant limp because of all of the ramifications of her cancer and then the radiation. A lot of muscle weakness in the left leg. She really has no quadriceps strength to lift her left thigh. So her gait, her walk is asymmetric. It’s not even keeled.

She had a good attitude. She was remarkably positive about life. She didn’t seem to feel that she’d been a victim. She just kept going. And what I was impressed by at the time was that she worked very hard at keeping her health, having worked her way back from this paralysis and from being so young and having so many treatments.

Tr. Vol. 1 p.m. at 26. Asked by counsel about Messier’s capabilities in “the first part of 2008,” “what she could do and not do,” Dr. Sullivan replied at some length and I will quote it at that length, because I think this testimony is important:

A. Well, she certainly still has and will always have the limitations of her spine and her left lower extremity. But in spite of that, she had really worked herself into good condition. She had really been purposefully doing a lot of things at the gym, things that maybe you and I would think were not that impressive, but for her background are.

And she’d had to retire a few years before that. I think about seven years before that because her job was too rough on her back pain. But she, I think, took that chance to really maximize her health.

So at that point, she still had the limp but she was pretty strong. She was lifting her scooter in and out of the car, which for her was key, because she can’t be on her feet for more than about fifteen, twenty minutes most of the time. And to get around and be independent, she had to be able to do that. So, she was doing that.

She was lifting, you know, pretty decently heavy bars, upper body weight, which has always been what she depends on because of her lower extremity problem. So, she’s dependent on upper body strength.

She was very positive. And one of the physical therapy notes talked about that she was probably in the best condition in terms of balance and strength that she’d been since they had seen her.

Tr. Vol. 1 p.m. 27-28.

41. Renee Messier gave a similar account of her pre-collision physical and medical condition. Asked on direct examination to describe her “medical condition in general between 2001 and the summer of 2008,” Messier testified that “I was fairly healthy. I just had mobility issues,” her symptoms being: “My low back would hurt. My legs would bother me, strength-wise.” Tr. Vol. 1 a.m. 36. During this period Messier consulted Dr. Sullivan, her family doctor, and a chiropractor. At their recommendation she had “physical therapy consistently between the beginning of 2000 and the middle of 2008,” the purpose of the therapy being “for me to get — strengthen my core, try to get my muscles back looser and stronger, and try to reduce the spasms and all the effects from having a very strict schedule.” Tr. 37. Messier’s condition improved over time. With respect to the physicians and therapists treating her, Messier testified on direct examination:

Q. What was your purpose at this time in seeing these folks, Ms. Messier?

A. My purpose was to keep mobile and be as healthy and strong as I could be to keep carrying out my daily activities.

Q. Okay. That leads us right to our next area. Around the middle of 2008, let’s say for the whole first half of 2008, how was your mobility?

A. I was actually at the most strongest I’ve felt in years. I was doing very well.

Q. Okay. And follow up on that. What do you mean by that?

A. I had — for about a year, year and a half, I went to our local gym and I was doing classes. And I was working out in the gym as well. So, I had really strengthened my core. So, I was feeling very stable and very strong.

Tr. 42. Messier’s self-appraisal echoes that of Dr. Sullivan, quoted supra: that by mid-summer in 2008, Messier “had really worked herself into good condition,” prompting a notation by one of her physical therapists that Messier “was probably in the best condition in terms of balance and strength that she’d been since they had seen her.”

42. That improvement in Messier’s overall condition by the beginning of July in 2008 was manifest, although during the several previous years she required the assistance of different devices in walking distances. She testified:

Q. How did you get around in the first half of 2008, Ms. Messier?

A. Over the previous years, it was getting harder for me to walk any distance. And I don’t remember the year, but I had to get a manual wheelchair. So, then I would use my wheelchair to go to the malls, or if we went to take a walk, if we went down to the park for a walk, anything with a long distance.

If we went, like, to a concert or something, you had to park, I would use my wheelchair. And then after that, the wheelchair got to be a burden. So, I got a motorized scooter. So, it gave me more independence.

Tr. 45.

43. Defendants’ theory of the case is that Renee Messier did not suffer any injury as a result of the collision between the ferry and the Coast Guard cutter, and accordingly is not entitled to recover any damages from them. In making that assertion, Defendants place an unsurprising and entirely reasonable emphasis upon Messier’s several prior surgeries and the assorted aches, pains and limitations she has endured since childhood. However, based upon a review of all the evidence in the record, I find that the vessel collision did in fact cause Messier an injury which can be identified and, to some degree at least, quantified.

44. The first time Dr. Sullivan saw Messier after the July 2, 2008 collision was on October 17. Dr. Sullivan testified that during the October 17 office visit, Messier said of the collision: “She did not hit the ground, but only because she held on so strongly with her right hand. And as a result, she developed pretty severe right shoulder pain.” Tr. Vol. 1 p.m. 41. According to Dr. Sullivan, during the weeks prior to the October 17 visit Messier “had been seeing a physical therapist and a chiropractor who did just gentle manipulation, trying to improve her shoulder pain.” Id. That represented a new sort of therapy for Messier; Dr. Sullivan testified:

Q. As her primary care physician, Dr. Sullivan, in your mind, what was the purpose of the physical therapy that she was going through immediately preceding July 2, 2008? What was all that about?

A. That was to maintain — it was really maintenance. This was not for treating injuries. It’s something that Renee had done for a long time. She had always had a few groups that she pulled in, like, Therapeutic Enterprises, occupational therapists and the physical therapy groups.

She fried to improve her balance, improve her strength, be able to live life in a somewhat normal fashion, and be part of life, and she’d been doing that for a long time. So, that’s really probably going to be her whole life, she’s going to need that kind of thing just to maintain.

Q. Okay. And so the new physical therapy, how is that different?

A. They were specifically working on the right shoulder pain, trying to reduce pain, increase movement.

Q. Different from the maintenance that you had just mentioned?

A. Yes, oh, yes. I don’t think she’d ever had a right shoulder joint injury. She had had neck trouble, low back trouble. But I don’t have any record of her having a right shoulder injury at all.

Tr. Vol. 1 p.m. 34-35. This is credible testimony, and I accept its accuracy.

45.Renee Messier testified that prior to July 2, 2008, she had had “issues back around my shoulder blades, muscular and aches, and depending on my activities and what I’ve done. My actual shoulder joint, neither one of my shoulders have ever bothered me.” Tr. Vol. 1 a.m. 55. That changed after the vessel collision. On September 16, 2009, Messier was seen by David LaChance, an Advanced Practice Registered Nurse in the office of Dr. Biren Chokshi, an orthopedic surgeon. She returned to Dr. Chokshi’s office on October 29, 2009, and again on November 17, 2009. On October 12, 2009, Messier saw Dr. Anthony Alessi, a neurologist. On January 23, 2011, Messier saw Dr. Stephen Searangella, a sports orthopedic physician, who had treated Messier previously for unrelated tendinitis. Several MRIs and other tests and procedures were performed during these consultations. Messier testified at trial: “Q. What was the circumstances that you went to see them? A. I was trying to find out why I was still having extreme pain in my limbs, especially my right arm.” Tr. 75.

46. In March of 2011, Messier was still suffering from pain in the right shoulder. On her own initiative, she consulted Dr. Anbari. Dr. Anbari first saw Renee Messier on March 24, 2011.

47. In ¶ 12 of these Findings, I quoted Dr. Anbari’s account of what Messier told him about the vessel collision and how it caused her injury. It is now necessary to consider in detail Dr. Anbari’s testimony, by videotaped deposition shown at trial, with respect to his treatment of Messier.

48. Dr. Anbari treated Messier’s right shoulder by operating on it. After examining Messier and taking her history, Dr. Anbari suspected that “she may have had a tear in the labrum,” soft tissue “that surrounds the [shoulder] socket” which “works deep in the joint and to provide more stability in the joint.” In Messier’s case, Dr. Anbari testified, “I suspected from her injury that — from history and physical exam — she may have had a tear there.” Dep. Tr. 16. Dr. Anbari’s diagnosis was “a labral tear of her right shoulder, and impingement,” which occurs if “the ball of the joint ends up articulating or touching or hitting hard against the roof of the shoulder.” Dep. Tr. 18. In his testimony, Dr. Anbari described the reason for and nature of the surgery he performed on Renee Messier:

Q. And so what did you do to go about treating these two things, Dr. Anbari?

A. She had already done physical therapy, from her history intake, when she saw Dr. Chokshi and Dr. Scarangella, which are two surgeons who saw her two years before I saw her.

She did physical therapy, but she did not improve well with it. Typically speaking, when somebody presents with symptoms like that, you try things like physical therapy. I offered her cortisone injections, which is sometimes a way to help mitigate some of the symptoms. She did not want it.

She came to really see me to have her shoulder fixed because she was having a hard time using it and she pretty much was having pain constantly for two years after the injury from her history intake.

Q. What did you do to treat it?

A. I did an arthroscopic surgery on her. Arthroscopic surgery means using small little holes in the joint and putting a camera about the size of this pen into the joint. And using that, I did cleanup of the tear that she had that was inside her joint. And then I went to the bone under the roof of the shoulder called the acromion and I shaved it down so it’s flat.

Q. And did you find a labral tear?

A. I did. It was — There’s several different types of labral tears. She had a type one. Which basically means a tear that does not go all the way through, but a piece of it can catch inside the joint and cause pain.

Dep. Tr. 19-20.

49.Since the main thrust of Messier’s claim against Defendants for personal injury relates to her right shoulder and Dr. Anbari’s corrective surgery upon that joint, it is not surprising that Defendants culled the Crossroads records, referred to in ¶ 39 of these Findings, for daily therapists’ reports that Defendants interpret by saying: “Since the 2004 fall, Mrs. Messier has complained of, and /or received treatment for, right shoulder pain numerous times.” Defendants’ Proposed Findings of Fact [Doc. 34] at ¶ 47. That paragraph of Defendants’ Proposed Findings contains references to 36 separate therapy sessions Messier underwent at Crossroads, all prior to the vessel collision. The earliest session was on December 1, 2004. The latest was on February 18, 2008 (over four months before the ferry collision). Arranging these sessions by calendar year, the following breakdown results: 2004: 6 physical therapy sessions purportedly for “right shoulder pain”; 2005: 17 sessions; 2006: 9 sessions; 2007: 3 sessions; 2008: 1 session. This pattern of physical therapy sessions does not support Defendants’ theory of the case that Messier was suffering from severe and chronic pain in her right shoulder at the time of the collision on July 2, 2008. On the contrary: the pattern supports the inference, which I draw, that Messier’s fall in 2004 caused temporary pain to her right shoulder that had largely abated by July 2008. The pattern is also consistent with the testimony of Messier and Dr. Sullivan, that by the beginning of July in 2008 Messier had improved her overall physical condition in significant ways. The apparent diminishing of discomfort in the right shoulder by July 2008 may be contrasted with the surgeon, Dr. Anbari’s examination of Messier in March 2011: “I could tell based on her presentation exam that her right shoulder was definitely painful, very painful for overhead type activities and lifting activities ...” Dep. Tr. 28.

50. As recited in ¶48 of these Findings, in March 2011 Dr. Anbari found and repaired a “type one” labral tear in Messier’s right shoulder. During the medical evidence adduced at trial, that condition was also referred to as a “SLAP tear.” During his testimony, on cross-examination by counsel for the Government, Dr. Anbari described the nature of a Type I (or “one”) SLAP tear:

A. I think the best way I would describe it is it’s not a full thickness tear. The labrum, it’s like a gasket that goes around the socket. You think of the socket as pretty much like a circle. Where my finger is is where the gasket goes around it. It surrounds the entire socket. That helps stabilize the shoulder. It deepens the socket with soft tissue that makes it more stable.

When you have a full thickness tear, meaning the tissue can slide back and forth, that would be Grade II or III or IV. Grade I is when you have a tear that does not make it all the way to the end where you actually have to reattach it back in place.

# ❖

Actually, the photograph I have just shows a piece of tissue that was actually cut off — not cut off, but actually draping into the joint.

They’re all considered a Type I SLAP tear. I may have just said it was frayed, but actually it was — it was — it’s sort of an incomplete tear that goes across the tissue.

Q. Being Type I, that would be the most modest type of tear that you would typically deal with?

A. Yes.

Dep. Tr. 41-42. On direct examination, Dr. Anbari had explained what we may call the causal mechanics of the vessel collision and Messier’s shoulder injury:

A. When somebody develops a traction injury — And to the best of my understanding, she was holding onto the railing to prevent herself from falling. The impact of the injury basically pulled her body weight away from the railing and her arm pulled back. That’s her right arm. That’s usually consistent with an injury inside the shoulder complex, the shoulder joint, and I suspect she may have had a tear in the labrum.

Dep. Tr. 15-16. And, as the subsequent surgery revealed, Messier did indeed have a Type I SLAP tear in the labrum of her right shoulder.

51. Dr. Anbari’s surgery on Renee Messier was successful. He testified:

Q. What did you have her do after the surgery, if anything?

A. She did physical therapy. Everybody after shoulder surgery undergoes physical therapy. And she did well with the surgery, she did well with the physical therapy. She ended up recovering a lot of the function she had in her shoulder prior.

She continued to have this vague pain going down her arm, which, again, she’s had a very long history of cervical and thoracic spine. Cervical meaning the neck and thoracic spine meaning the back of the thorax. And I think that’s probably just residual from previous to the injury. But the shoulder pain ended up doing really well.

Dep. Tr. 23-24. Asked on direct examination whether in his opinion “the injuries for which you treated Renee Messier will be permanent, Dr. Anbari responded in the negative: “I do not believe they will be permanent,” adding: “I do believe that her treatment for shoulder was successful, she did great with it.” Id. at 31.

52. That favorable evaluation echoes that of Dr. Sullivan, Messier’s primary care physician, who testified on direct examination:

Q. In regards to Ms. Messier, is it accurate to say that before the ferry collision on July 2, 2008, medically you established a baseline for what her condition was and what she could and couldn’t do?

A. Yes.

Q. This may be an impossible question, but if returning to baseline would be like 100 percent recovery, whereabout is she, would you say? And if you can’t say, I understand.

A. I would estimate 85.

Tr. Yol. 1 p.m. 42-43. Dr. Sullivan attributed the amount of time required for Messier’s recovery to these factors:

A. She’s done much better. She has improved over the years. But it was two years before she even had the right shoulder repaired. So all of that time her other muscles were not getting used as well. So they had atrophied and her sense of balance was not as good. And that takes a long time to get back. It takes a long time to get the strength of the right arm back after the shoulder surgery. Everyone is different. But certainly someone who has had Ewing’s sarcoma and radiation and had all those changes in their body is going to take a little bit longer.

Id. at 43. Asked on redirect examination whether she had an opinion if Messier “will ever be able to reach her baseline,” Dr. Sullivan responded: “I would say I’m 75 percent sure she will.” Id. at 54.

53.In these Findings, where I quote the testimony of witnesses, lay or medical, I do so because I assess those witnesses as credible and accept their testimony as accurate and truthful. Based on the trial evidence, and the findings stated or implicit in the preceding Findings, I find that the impact of the collision on July 2, 2008 between the ferry BLOCK ISLAND, on which Messier was riding as a passenger, and the Coast Guard Cutter MORRO BAY caused an injury to Messier’s right shoulder, the principal feature of which was a SLAP Type I partial tear of the labrum. Several aspects of the evidence require that finding.

54. First, that particular injury is consistent with the mechanics of the collision impact, as reve