Opinion ID: 1161718
Heading Depth: 1
Heading Rank: 1

Heading: the causal nexus between the death-dealing fibrillation episode and the prior compensable heart injury

Text: An employer is liable for all legitimate consequences of a compensable injury. [3] Whether the decedent's death is causally connected with his 1972 cardiac episode is a question of fact that must be established by expert testimony. [4] Because this court's range of corrective power is Statutorily confined to reexamination of law questions, our sole task on review is to canvass the record and ascertain whether the award is supported by competent evidence. [5] We need only look to the claimant's medical proof, [6] the substantial part of which is in expert testimony given by deposition. According to the record, the 1972 injury caused damage to the right side of the decedent's heart. Although no active tissue deterioration had developed from it, and his heart was damaged as much as it was going to be, the decedent's adjudicated heart pathology was shown to have passively as well as actively contributed to the cause of his death. Chest pains (angina) brought the decedent to the hospital, where a diagnosis of bradycardia and rhythmic disturbances called for a pacemaker implant. During this procedure the pacemaker wire irritated the hyperexcitable tissue surrounding the area of the heart damaged by the prior accidental on-the-job injury. It is that physical contact which induced the fibrillation directly causing decedent's death. To a great extent death was attributed to the disease process (atheroschlerosis) on the left side of the heart. The damage to the right side sustained in 1972, which forced the left side to work harder, coupled with the advanced coronary disease, brought about both the angina and bradycardia. According to the claimant's medical expert, (a) the prior compensable injury increased the chances of death by 40 to 50 percent and, (b) although the decedent's preexisting disease process made it probable that the pacemaker would be needed even if his heart had not been damaged by the compensable accident of 1972, the death-dealing fibrillation episode probably would not have occurred in the absence of the previous on-the-job heart attack. When assessed by the standards of proof pronounced in Oklahoma City v. Schoonover, [7] the evidence viewed in its totality demonstrates the on-the-job heart attack's causal nexus with the subsequent death-dealing fibrillation. The latter episode cannot be viewed as a separate, disconnected, independent or supervening cause of death. The chain of causation is not deemed to be legally broken where, as here, the medical proof shows that, but for the prior on-the-job heart attack, fibrillation would not have occurred.