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Plaintiff unsuccessful in proving QAS psychiatric injury liability

James v State of Queensland [2018] QSC 188

Henry J. Supreme Court (Cairns).

10 December 2018


The plaintiff was a paramedic with the Queensland Ambulance Service ('QAS'), based in Far North Queensland. He allegedly developed a psychiatric injury arising out of three incidents which he attended as paramedic at Doomadgee.

The incidents were:

  • First Incident – He attended a boy who had been mauled by dogs and subsequently died.
  • Second incident – He transported a young child who had been raped.
  • Third incident – He attended another girl who had been raped and injured.

The three incidents occurred within a few weeks of each other. Between the second and third incident, when attending a training course in Mt Isa, the plaintiff reacted badly in response to correction by a trainer ('the training incident').

At all relevant time times, QAS provided a system of psychological support for the benefit of paramedics and other personnel, called Priority One. The services offered by Priority One included peer support, counselling and Critical Incident Stress Debriefing ('CISD').

Priority One has previously been recognised by the Queensland Court of Appeal as an adequate response to the risk of psychological injury from exposure to trauma by ambulance officers: Hegarty v QAS [2007] QSC 36.

Liability and quantum were both in dispute for the purpose of the trial.


At trial, the main focus of the plaintiff's case were allegations that the employer, QAS had:

  • Failed to activate a CISD after the first incident;
  • Failed in light of the plaintiff's unusual behaviour at the time of the training incident to refer him for treatment and remove him from Doomadgee.

Paul Scully, a former QAS employee who had been instrumental in establishing and overseeing the Priority One system for many years, gave evidence as to the history and development of the program, and how it operated at the time of the three incidents.

The Court affirmed that the Priority One system was an adequate and sufficient general response to the risk of psychiatric injury. His Honour Justice Henry J also found that from his QAS training, the plaintiff knew how to recognise signs of psychological stress, and how to access the support services of Priority One in order to receive assistance.

His Honour rejected the plaintiff's argument that QAS should have taken steps to ensure he received assistance following each of the incidents, rather than leaving it to him to make a choice whether he needed to access assistance. He pointed out the importance of individual dignity and privacy in this context.

Evidence from Mr Scully showed that in the late 1990s, a trial program involving mandatory follow up of paramedics following critical incidents was discontinued after a few months, for various reasons including significant staff resentment at the intrusive nature of this process.

The Court noted that the only part of Priority One which may entail automatic implementation, regardless of the wishes of staff, was CISD. However, as the Court also found, CISD was always intended as a group intervention, and was not suitable for use in the cases of individual officers. As the plaintiff had attended each of the three incidents as a solo paramedic, CISD was not an appropriate response in this case.

The Court also rejected the plaintiff's argument that QAS was on notice after the training incident that his behaviour was so unusual, it should have been recognised he required psychological support, and that he should not return to Doomadgee. As Justice Henry noted, the plaintiff's behaviour at the training could readily be explained on the basis he had told other staff at the training he feared he was not going to pass.

Additionally there was no evidence that the plaintiff himself subsequently identified any link between his behaviour at the training incident, and the first and second incidents. Rather, he saw it as an industrial issue; he lodged a grievance against the trainer who he felt had treated him unfairly. The grievance document contained no reference to either of the subject incidents.


The Court concluded there was no basis for the employer to have identified that the plaintiff required psychological treatment, or that he should not return to Doomadgee.

On many important points of evidence, the plaintiff was found to be unreliable, and the recollection of other witnesses was invariably preferred where their versions contradicted his evidence. In particular, there were important discrepancies between the evidence the plaintiff gave at trial, and written statements he had prepared soon after the events occurred.

As the Court had found there was no breach of the employer's duty of care, it was unnecessary to determine whether any alleged breach of duty had caused the plaintiff's psychiatric injury, nor was it necessary to assess the likely quantum of damages that might have been awarded in a successful claim.

His Honour briefly commented that he had certain concerns about the proper proof of causation in this case, which would have required further submission even if he had concluded there had been a breach of duty by the employer.

In summary, whilst the case was decided on the particular circumstances of the events in Doomadgee and Mount Isa, the Court's ruling can still be seen as a further endorsement of the QAS' Priority One system of psychological support.