MEDICO LEGAL REPORT!

! Your Honour,! !

! As per requested by the Toronto Courthouse at 311 Jarvis St, Toronto ON, this report states the incidence of injury, resulting conditions sustained, necessary treatment, and summary/conclusion of the condition of the claimant, Mrs. Emma Doyle. This report is required as an expert examination to provide evidence regarding the matter of compensation to Mrs. Doyle for sustaining the medical condition of Post Traumatic Whiplash as a result of the actions of the alleged persons at fault. !

! My name Cassidy Peplinskie of Toronto, Ontario. I am a practicing Registered Massage Therapist and owner of a private Massage Therapy clinic within downtown Toronto. I have been certied by the College of Massage Therapists of Ontario for four years, all of which have been as an active registrant and in good standing with the College. As a Registered Massage Therapist I am a member of the Registered Health Practitioners Act (1991) and under the rule of the Massage Therapy Act (1991). I am a graduate of Humber College Institute of Technology and Advanced Learning as well as the University of Ontario Institute of Technology with a Bachelor of Allied Health Sciences (Honours). I understand the the Court is expecting me to comply with their request to provide an expert evaluation on this case, and I will do this to the best of my abilities.!

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! In this report, the patients Past Health History, current Physician Diagnosis, and current Registered Massage Therapy Treatment Plan are referenced to compile accurate and up to date information for the purpose of this case and evaluation. Mrs. Doyle has given her express, informed, written consent to the use of these les.! ! Previous to this incidence, my patient has had no related neck injuries. Mrs. Doyle has been receiving massage treatment at my clinic for muscle relaxation, as well as trigger point release therapy (release of taut bands of muscle causing pain) in her upper back and neck regions (trapezius, rhomboids, levator scapulae, and scalene muscles). Mrs. Doyle suffers from hypertension, and is taking daily hypertensive medications (Thiazide diuretics and Metoprolol [Beta Blocker]). !

! In the incidence of the injury, Mrs. Doyle was in the drivers seat wearing her seatbelt in her own vehicle, and halted at a red trafc light. While she was stopped, another vehicle hit hers from behind at an approximate speed of 50 km per hour. Mrs. Doyles head was unexpectedly thrown backwards at a high velocity. Mrs. Doyle states that as a result of the shock of the accident, she cannot remember exact details, but reports feeling a deep pain in the front of her neck. Mrs. Doyle was transported by ambulance to Toronto General Hospital.!

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! After her examination by the hospitals emergency doctor, Dr. Doe, Mrs. Doyle was diagnosed with a grade II Whiplash via physical examination and x-ray. ! As a result of this diagnosis, Mrs. Doyle was referred by her physician to seek aid by way of alternative health care, as there was no fracture or disc dysfunctions present. ! ! Mrs. Doyle decided to continue to receive care in my practice, and came in for an assessment appointment the second day after her injury. !

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! Mrs. Doyle presented to my clinic with symptoms such as stiffness and limited movement in her neck and shoulders, pain in her neck and shoulders, pain radiating up and around her ear into her temple region, and headaches. ! ! After taking a verbal assessment regarding her pain, I concluded that an Active Range of Motion Assessment was unnecessary due to the degree of the pain Mrs. Doyle was experiencing with movement. A Passive Range of Motion Assessment did not indicate any severe connective tissue trauma or dysfunction. No further pathologies or conditions were indicated and I concluded that the injury was based around multiple muscle strains and ligament sprains.!

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! An assessment by palpation indicated a guarding tightness in the muscles of Mrs. Doyles anterior neck (mainly Sternocleidomastoid, also including Longus Colli, and Anterior Scalene). Fascial restrictions were noted in both the anterior and posterior regions of Mrs. Doyles neck.! ! The Treatment Plan that I prepared for Mrs. Doyle includes ve treatments of sixty minutes each, once a week. During treatment, my focus will be to to employ Myofascial techniques and Friction techniques to release scar tissue and fascial adhesions in Mrs. Doyles neck, to release the resting tension and tightness of the muscles mentioned, and to treat any identied trigger points (likely cause of radiating/referred pain, and headaches) by means of Muscle Stripping and Specic Compression techniques. Along with the physiological healing and benets Mrs. Doyle will obtain from massage, she will also benet from the psychological effects massage has on the brain, as her injury and experience were traumatic to her.!

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! To summarize, Mrs. Doyle is in need of a doctor referred massage therapy treatment to aid her healing of the Whiplash we received in a rear-ending car motor vehicle accident. Mrs. Doyles condition will worsen and likely become chronic if she does not receive treatment, and may be unable to resume normal daily activities. Her treatment consists of ve separate treatments totalling ve weeks duration at a once per week frequency. ! Sincerely,! Cassidy Peplinskie (RMT)