Case Name: Milton BERTRAND v. COAL OPERATORS CASUALTY COMPANY
Court: Louisiana Supreme Court
Jurisdiction: Louisiana
Decision Date: 1968-11-12
Citations: 253 La. 1115
Docket Number: No. 49065
Parties: Milton BERTRAND v. COAL OPERATORS CASUALTY COMPANY.
Judges: FOURNET, C. J., and BARHAM, J., dissent for written reasons assigned.
Reporter: Louisiana Reports
Volume: 253
Pages: 1115–1149

Head Matter:
221 So.2d 816
Milton BERTRAND v. COAL OPERATORS CASUALTY COMPANY.
No. 49065.
Nov. 12, 1968.
On Rehearng March 31, 1969.
Preston N. Aucoin, Ville Platte, Daniel J. McGee, Mamou, for plaintiff-appelleeapplicant.
Downs & Gremillion, Alexandria, for respondent.

Opinion:
SUMMERS, Justice.
Certiorari was granted to review a judgment of the Third Circuit which denied the workmen's compensation claim of plaintiff Milton Bertrand.
The employer, Courville Concrete Company, was engaged in the manufacture of concret culverts at Mamou in Evangeline Parish. Plaintiff, who was 57 years old in July 1964, had been employed with that firm for 16 years. As a principal part of his employment he was required to mix concrete, transport it by wheelbarrow, pour it into forms and otherwise perform heavy labor exposed to the heat of the sun in an unsheltered area of the manufacturing plant.
As related in part by Dr. B. J. Manuel, plaintiff's medical history discloses that Dr. Manuel performed surgery on him to repair bilateral herniae a number of years prior to July 9, 1964, at which time plaintiff's heart was thoroughly examined and found to be normal and sound. He next consulted Dr. Manuel on July 9, 1964 for an episode of weakness, dizziness or near fainting which occurred while plaintiff was doing heavy work as a laborer with Courville Concrete Company. Dr. Manuel examined him at the Savoy Hospital and made an electrocardiogram, which he read and from which he concluded that plaintiff had a nodal tachycardia, a conduction defect impairing the heart's response to impulses regulating its beat.
He was put to bed, but after overnight rest and medication plaintiff was discharged from the hospital and returned home. Upon advice of his doctor, he did not resume work that summer. In the fall of the year, about September 14, 1964, because he was feeling well and the weather was cool, plaintiff was permitted by his doctor to return to his job with Courville Concrete Company. He worked there at his usual tasks without incident until June 1, 1965.
. While at work on June 1, 1965 plaintiff's heart began to beat erratically and he almost "blacked out" and fell to his knees, but he did not lose consciousness. He returned to Dr. Manuel with essentially the same complaints made by him after the July 1964 episode. Another electrocardiogram was made in connection with his reexamination, medication was prescribed and he went home to bed. Two days later he again visited Dr. Manuel and reported he was feeling fine. At this time he was advised to stop working because Dr. Manuel thought the work with Courville was incompatible with his heart condition. The doctor felt that continued work in the hot sun might bring about a "full blown coronary" and plaintiff's death. This decision appears to have been influenced to some extent by a history of heart disease in plaintiff's family, a brother having died of heart disease some time prior to this latter episode, and it was known, too, that another brother had arteriosclerotic disease. Plaintiff has not worked since.
Suit was instituted by plaintiff on September 9, 1965 claiming compensation for total permanent disability, alleging that the episodes of July 9, 1964 and June 1, 1965 were both responsible for his condition. Courville Concrete Company's compensation insurer at the time of the episode of July 9, 1964 was Highlands Insurance Company; at the time of the June 1, 1965 episode its insurer was Coal Operators Casualty Company. Both insurers were joined as defendants in plaintiff's suit. In time, however, plaintiff and Highlands Insurance Company compromised the claim based upon the July 9, 1964 episode. Our only direct concern, therefore, is with the claim against Coal Operators Casualty Company and the episode of June 1, 1965.
In defense of the claim, defendant contends that on June 1, 1965 plaintiff suffered an attack of angina pectoris from which he recovered almost immediately with no residual ill effects, and the real cause of plaintiff's disability, if any, is a disease of long standing known as arteriosclerosis which has become progressively worse. This' condition, defendant contends, is neither caused nor aggravated by the episode of June 1, 1965 or by plaintiff's work at any time.
The central issue thus presented is whether there is any causal connection between the accident of June 1, 1965 and the disability of which plaintiff complains. It is substantially a factual question and depends, to a large extent, upon the testimony of the doctors who examined and treated plaintiff.
Since the writs were granted and the record has been made available for our review, we find we are in agreement with the Third Circuit. Plaintiff has failed to establish by a preponderance of the evidence that his alleged disability was caused or aggravated by the episode of June 1, 1965 and his claim for compensation must be denied.
Dr. Rufus Craig, of Alexandria, Louisiana, a specialist in internal medicine, examined plaintiff in October 1965 when plaintiff's counsel referred him to Dr. Craig. On this occasion plaintiff's medical history was taken, and a complete examination including blood count, urinalysis, chest x-ray and electrocardiogram was performed. Based upon the data obtained, Dr. Craig was of the opinion that plaintiff had arteriosclerotic heart disease with angina pectoris. In this written opinion he stated: "Even though both of Mr. Bertrand's episodes occurred while at work and while he was actively engaged in strenuous physical activity, I am unable to say that his heart disease was precipitated by his work since this was the usual effort that he was engaged in each day."
On September 21, 1966 Dr. Craig again saw plaintiff, this time at the instance of counsel for defendants. Another complete examination was performed and an interval history recorded. As a result of this examination, Dr. Craig confirmed his previous finding of arteriosclerotic heart disease. In giving his deposition, Dr. Craig stated that though the cause of arteriosclerosis is unknown, it is probably not a result of trauma, but is more likely, in part, a normal process of aging. We think the essence of the controverted fact of causal connection between the episode of June 1, 1965 and plaintiff's alleged disability is dealt with and satisfactorily explained in the following dialogue between counsel and Dr. Craig:
"Q. In this particular case did you see any indication of trauma or overexertion brought on this ultimate diagnosis that you described?
"A. The angina pectoris was precipitated by — if you consider physical exertion trauma, yes, in that during the effort that he was engaged in, the demand for blood for the heart was greater than these narrowed, sclerosed coronary arteries were able to provide at that particular time. Therefore, he had an inadequate oxygen supply to the heart muscle with resultant pain. When he ceased his activity the demand decreased, the supply caught up with the demand, the pain ceased. In other words angina pectoris is a syndrome which is completely reversible, once the episode is over with, the status of the heart is as it was preceding the attack of angina.
*
'Q. Doctor, in this case as in all compensation cases it's necessary to establish whether or not the disability the man is found to be suffering from is attributable to the trauma complained of. In this case apparently the trauma complained of was working in the hot sun, blacking out and falling to his knees. Did you find anything that will indicate to you to some degree of conclusiveness that this traumatic experience resulted in the disability that the man complains of?
'A. By history the first episode of angina pectoris which this man complained with occurred while involved in the activity of pushing his wheelbarrow at work. When he ceased pushing the wheelbarrow the attack ceased — to answer that, the attack could just as well have occurred had he been say shovelling dirt or doing some other physical activity at home and when this attack was over with there was nothing disabling there except he still had a basic underlying coronary artery disease which could lead to further attacks of angina pectoris on adequate effort or effort in overeating or effort in eating and emotion and so on.
"Q. Is it your opinion then that the underlying disease brought on the attack as distinguished from the pushing of the wheelbarrow ?
"A. Without the underlying disease he could not have had the attack — yes."
Dr. Craig testified that he could not determine whether plaintiff was disabled at the time of his examinations without subjecting him to a program of gradually increasing activity and observing the results. Moreover, he saw no reason why the episodes complained of would have any effect upon other episodes in the future.
Doctor Roderick P. Perron of Mamou examined the two electrocardiograms taken at the time of the episodes of July 9, 1964 and June 1, 1965. He also read the testimony of Dr. Manuel and Dr. Craig to learn the facts upon which they formed their opinions. In a question based upon a hypothesis, which was actually a recitation of the facts and circumstances of plaintiff's case, he was of the opinion that plaintiff had, and still has, arteriosclerotic heart disease. His testimony was that the episodes of July 9, 1964 and June 1, 1965 were true angina or possibly a mild coronary occlusion. Plaintiff's heart condition, he felt certain, was present before June 1, 1965, or, for that matter, before July 9, 1964.
Arteriosclerosis, in his view, is a disease which develops slowly over the years, and the attacks which plaintiff experienced at work were merely precipitated symptoms of an already existing condition. Arteriosclerosis, he explained, is a degenerative condition involving a hardening of the arteries which supply blood to the heart. Exertion, emotion and eating, he said, increase the demand for oxygen by the heart. Because the sclerosed or occluded arteries cannot supply the additional need for oxygen under these circumstances by increasing the blood supply, the lack of adequate oxygen-induces spasm of the heart muscles and produces coronary insufficiency or angina pectoris. This, according to Dr. Perron, was the cause of the episodes of July 9, 1964 and June 1, 1965 which plaintiff suffered; and these incidents neither caused nor aggravated the condition of arteriosclerosis but simply brought about a manifestation of symptoms that the disease was present in the patient. In summary Dr. Perron's testimony was that the episodes complained of had only a temporary effect, and plaintiff's heart was not injured or impaired thereby.
Thus it is seen that the testimony of Dr. Manuel differs from the testimony of Dr. Craig and Dr. Perron. Faced with these inconsistencies in the expert testimony, which is often the case, we have accepted the theories and opinions of Dr. Craig and Dr. Perron as being more probably correct under the facts and circumstances. The consequence is that plaintiff has not produced a preponderance of evidence in support of his claim; failing in the discharge of this burden which the law imposes, plaintiff cannot recover.
A like question was presented and disposed of by this court in Nickelberry v. Ritchie Grocer Co., 196 La. 1011, 1020, 200 So. 330, (1941) where we said:
"When the disease began, what was its origin, and the rapidity with which it has progressed, are all matters of pure speculation. The mere fact that a workman develops heart disease while employed by another does not entitle him to compensation. The employer is not the insurer of his employees. There must be an accident to furnish the basis of any such claim, that is to say, something sudden, undesigned or unexpected and that accident must either cause or aggravate the disease which is the cause of the disability."
See also Seals v. Potlatch Forests, Inc., 151 So.2d 587 (La.App.1963) ; Malone, Louisiana Workmen's Compensation Law and Practice, Sec. 256 (1951) and 1964 pocket part.
For the reasons assigned, the judgment of the Court of Appeal is affirmed.
FOURNET, C. J., and BARHAM, J., dissent for written reasons assigned.