Case Title: IN THE MATTER OF THE DEATH OF GRAY

Citation: 

Docket Number: 98237

State: oklahoma

Court: Oklahoma Supreme Court

Date: 2004-07-06T00:00:00Z

Document:
IN THE MATTER OF THE DEATH OF GRAY  IN THE MATTER OF THE DEATH OF GRAY 2004 OK 63 100 P.3d 691 Case Number: 98237 Decided: 07/06/2004 THE SUPREME COURT OF THE STATE OF OKLAHOMA In the Matter of the Death of: JOE LUTHER GRAY, deceased, CATHY L. GRAY, Petitioner, v. ULTRAMAR DIAMOND, SHAMROCK CORPORATION and THE WORKERS' COMPENSATION COURT, Respondents, AMERICAN HOME ASSURANCE COMPANY, Insurance Carrier. CERTIORARI TO THE COURT OF CIVIL APPEALS, DIVISION I Honorable Gene Prigmore, Workers' Compensation Judge ¶0 Joe Gray (employee/injured worker) sustained a back injury which undisputedly arose out of and in the course of employment. He was scheduled to undergo back surgery as a result of the injury. The back surgeon, apparently concerned about the employee's twenty-year-old pacemaker and whether he would survive the back surgery, referred the injured worker to a doctor to perform a pre-surgery screening of the pacemaker. Ultimately, the doctor recommended that the pulse generator of the pacemaker be removed and replaced before the back surgery occurred. The employee died while undergoing the pacemaker procedure. The employee's wife filed a notice of death and claim for compensation in the Workers' Compensation Court. After a hearing, the trial judge, Honorable Gene Prigmore, denied the claim for death benefits. A three-judge panel of the Workers' Compensation Court affirmed. The Court of Civil Appeals sustained the panel's decision. We hold that the surviving spouse is entitled to death benefits because the unrefuted facts show that the work-related back injury necessitated the pacemaker operation as a precursor to the back surgery. CERTIORARI PREVIOUSLY GRANTED; COURT OF CIVIL APPEALS OPINION VACATED; ORDER OF THE THREE-JUDGE PANEL OVERRULED; TRIAL COURT OVERRULED; CAUSE REMANDED. G. Todd Ralstin, Oklahoma City, Oklahoma, for Petitioner, John S. Oldfield, Jr., Oklahoma City, Oklahoma, for Respondents. KAUGER, J: ¶1 The question presented is whether, pursuant to FACTS ¶2 On May 15, 2000, Joe Gray (employee/injured worker) hurt his lower back while carrying insulation for his employer, Total Petroleum a/k/a the Ultramar Diamond Shamrock Corporation (employer) in Ardmore, Oklahoma. ¶3 On May 23, 2000, after continuing to experience significant discomfort to his lower back, the occupational doctor ordered a scan of his lower spine. The scan revealed that the employee had a herniated disc. The occupational doctor continued the medications, modified his work duty, and recommended that the employee see a neurosurgeon to treat the disc. On July 13, 2000, the employee saw a neurosurgeon in Oklahoma City, Oklahoma, who recommended that a spinal diagnostic procedure be performed if his symptoms continued to worsen. The procedure was performed on July 26, 2000, and it confirmed a bulging disc with restrictions of the spine. On December 11, 2000, the neurosurgeon recommended surgery. ¶4 On January 29, 2001, the neurosurgeon, apparently concerned that the injured worker had a twenty-year-old pacemaker and that, consequently, he might not be able to handle an extensive and lengthy back surgery, sent the injured worker to another doctor for consultation and pre-surgery screening. ¶5 On February 6, 2001, the employee went back to the doctor for a screening of the pacemaker. The screening showed that, although the pacemaker appeared in good shape, it was capable of pacing at times when it should not, thus raising the possibility of triggering an abnormal heart rhythm. Ultimately, the doctor recommended that the pulse generator of the pacemaker be removed and replaced in order to perform the back surgery. ¶6 On February 21, 2001, the employee died while undergoing the procedure to replace the pulse generator of his pacemaker. On August 3, 2001, the petitioner, Cathy Gray (wife/surviving spouse), filed a notice of death and claim for compensation in the Workers' Compensation Court, seeking surviving spouse death benefits. ¶7 A hearing was held on April 3, 2002, at which the employer denied that the death arose out of and in the course of employment. The wife was the only witness present at the hearing. She testified that: 1) prior to the accident, the employee had not experienced any problems with his pacemaker; 2) he routinely had the pacemaker checked; and 3) it was recommended that the battery in the pacemaker be changed prior to the back surgery. ¶8 The wife also included in her exhibits, letters and medical records which tracked the injured workers' medical treatments back and forth between the various doctors, documenting concerns about the pacemaker and its effect on the back surgery. Among the exhibits was a letter from the injured worker's doctor who did the pre-surgery screening in which he stated that the direct cause of death was an event which occurred during the pulse generator replacement. The doctor also recognized that "the only relationship that I can see is the fact that his referral risk assessment was made because of his back surgery" and that the employee may well have gone on for a period of time before any investigation was made into the functioning of the pacemaker. ¶9 The employer did not call any witnesses, but offered a report of a doctor who had never seen the patient and who had formed his opinion based on medical records and who misstated the evidence. He thought that the employee's death had no connection to the back injury at all because the pacemaker was old and had not been checked in 5 years. ¶10 The court, in an order filed April 12, 2002, denied the wife's claim for death benefits. It found that the husband's death did not result from an accidental personal injury arising out of and in the course of employment. On April 19, 2002, the wife appealed to a three-judge panel of the Workers' Compensation Court; and on August 27, 2002, the three-judge panel affirmed the trial court. On September 12, 2002, the wife appealed to the Court of Civil Appeals; and on December 5, 2003, the Court of Civil Appeals, in an unpublished opinion, sustained the order of the three-judge panel. We granted certiorari on February 17, 2004, to address whether the wife is entitled to death benefits. ¶11 THE SURVIVING SPOUSE IS ENTITLED TO WORKERS' COMPENSATION DEATH BENEFITS BECAUSE THE UNREFUTED FACTS SHOW THAT THE WORK-RELATED BACK INJURY NECESSITATED THE PACEMAKER OPERATION AS A PRECURSOR TO THE BACK SURGERY. ¶12 The wife argues that: 1) the death of the employee was a direct result of an admittedly compensable low back injury or, in the alternative, a consequential injury which directly flowed from the back injury; and 2) there is no competent evidence to support either the trial court's decision or the Court en banc's ruling. The employer concedes that the employee did indeed sustain a back injury arising out of and in the course of employment. However, it insists that: 1) the injured worker died as a result of a long standing cardiovascular condition and a pacemaker failure; and 2) the evidence produced at trial clearly established that the death of the injured worker had no connection to the back injury he sustained or the work he was required to perform. ¶13 Title ¶14 Stroer involved the question of whether death benefits were available when an injured worker commits suicide after incurring a work-related injury. The Court adopted the chain of causation test as the criteria for determining if an employee's death by suicide is compensable if the original work-related injury resulted in the employee's becoming dominated by a disturbance of the mind directly caused by the injury and its consequences. The Court held that the act of suicide is not an intervening cause of death and the chain of causation is not broken in cases where the incontrovertible evidence reflects that, but for the injury, there would have been no suicide. ¶15 The Stroer Court recognized that the burden is on the claimant to prove by a preponderance of the evidence that there was an unbroken chain of causation between the compensable injury, the disturbance of the mind, and the ultimate suicide. It also determined that: 1) although compensation will be denied if the suicide was caused primarily by non-work connected problems, the work-connected injury does not have to be the sole cause of the suicide; and 2) expert testimony is not absolutely indispensable -- if the facts and circumstances are sufficiently persuasive, they may carry the burden of establishing the requisite causal nexus. ¶16 Although Stroer involved suicide, it illustrates how a causal nexus can exist between an event that occurs after a work-related injury and a resulting death ----- without breaking the chain of causation. The same rationale is applicable here. When an injured worker dies during an operation made necessary by a work-related injury, the operation would not be an intervening cause of death and the chain of causation would not be broken in cases where the incontrovertible evidence reflects that, but for the injury, the worker would not have had to have the operation. ¶17 An example of this rationale under even more tenuous facts than the present cause, is illustrated in Randall v. Mihm, 84 Ohio ApP.3d 402, 616 N.E.2d 1171. In Randall, an injured worker suffered a back injury while working. After two back surgeries failed to alleviate all of the pain and other symptoms associated with the injury, the worker's doctor ordered a CAT scan to detect any remaining pathology associated with the back injury. However, because the worker weighed in excess of three hundred pounds, the radiologist could not perform the scan because the worker was too heavy for the machine. ¶18 After many attempts to lose weight through various means failed, the worker decided to undergo gastric plication surgery or "stomach stapling". The surgery was successful in allowing the worker to lose the weight for the CAT scan, but resulted in numerous medical complications which eventually led to his death. Ultimately, the question regarding causation of the worker's death and the claim for benefits hinged on whether the evidence established with a reasonable degree of medical probability that "but for" the decedent's industrial back injury he would not have had the gastric plication which caused him to aspirate and die. The Randall court determined that the chain of events beginning with the back injury led to the order for a CAT scan and the gastric plication surgery, which led to the worker's death. ¶19 When reviewing resolutions of fact on non-jurisdictional issues from the three-judge panel of the Workers' Compensation Court, we do not re-weigh the evidence, but instead look for any competent evidence to support the trial court's findings. ¶20 We find that the order of the Workers' Compensation Court trial court and Court en banc sustaining the trial court's denial of death benefits is unsupported by any competent evidence. The incontrovertible evidence and undisputed facts reflect that: prior to the back injury, the employee had never suffered any significant problems with his pacemaker; the need to check the pacemaker and remove and replace it appeared only after the disabling back injury and because of the back injury; and the replacement of the pacemaker was a necessary precursor to the operation for the back injury and would not have occurred but for the injury. ¶21 The question at issue is not whether the back injury somehow caused the pacemaker to malfunction or whether the pacemaker was old and would have needed replacing anyway. Nor is our decision based on whether the weight of the evidence reflects those issues. Rather, the determinative issues here are: 1) whether the surgery for the work related injury caused the need for the pacemaker surgery which ultimately led to the employee's death; and 2) whether any competent evidence exists to support a finding that the back injury was not causally connected to the death. ¶22 Dr. Young's statement offers nothing more than an opinion that the employee died while on the operating table for the pacemaker surgery and that the pacemaker was old. Dr. Young's opinion provides at page 72 of the record that: ". . . In my opinion, this person's death was unrelated to his injury of May 15, 2000, as this person's pacemaker had gone past the normal life expectancy of a pacemaker and it had been (5) years since it had last been checked. . ." Nevertheless, it speaks nothing to the decisive issue in this cause -- whether the pacemaker surgery would have occurred "but for" the back injury, ie., whether the pacemaker surgery was made necessary at that time because of the back injury. The employee's cardiologist, Dr. Hauser recognized that the employee had the pacemaker surgery because of the back injury and that he may have gone on for a long period of time with the same pacemaker. His report at p. 66 of the record provides: ". . .The only relationship that I can see is the fact that his referral for perioperative risk assessment was made because of his back surgery. Without this referral, and based on his past habits, it may well be that a period of time would have gone by before any formal interrogation was done. . . ." The employee's expert witness recognized, and the medical records reflect, that the pacemaker procedure was brought about as a means of covering the back surgeon's exposure to liability if he died during the back surgery. ¶23 The dissent's objection to the application of the "but for" analysis to acts which are not a superceding cause of death, but which are part of the unbroken chain of causation to a work related injury is nothing new. The author was in the minority when the Court decided In the Matter of Death of Stroer, CONCLUSION ¶24 When reviewing resolutions of fact on non-jurisdictional issues from the Workers' Compensation Court, we do not re-weigh the evidence, but instead look for any competent evidence to support the trial court's findings. CERTIORARI PREVIOUSLY GRANTED; COURT OF CIVIL APPEALS OPINION VACATED; ORDER OF THE THREE-JUDGE PANEL OVERRULED; TRIAL COURT OVERRULED; CAUSE REMANDED. WATT, C.J., HODGES, HARGRAVE, KAUGER, BOUDREAU, EDMONDSON, JJ., concur. OPALA, LAVENDER, WINCHESTER, dissent. FOOT