Opinion ID: 3010765
Heading Depth: 2
Heading Rank: 1

Heading: Mr. Murray's Prior Medical Condition

Text: Prior to his fall, Mr. Murray had been diagnosed with a significant number of medical problems; those from which he suffered at the time of his death are catalogued in the margin.1 He had coronary artery disease, a condition relatively common among older Americans, and suffered intermittently from atrial fibrillation. While Mr. Murray's heart was not fibrillating at the time he came into the hospital, he subsequently developed partial atrial fibrillation after the accident. He also had hypertension, which was elevated on the morning of April 11, prior to the accident. Still, Dr. Scotti, plaintiff 's expert, opined that there was no reason to believe that Mr. Murray was in any imminent danger of an acute heart attack. Moreover, the infarctions noted on his discharge summary, see n.1, supra, occurred after the accident, and, according to evidence adduced at trial, were caused by the fall. In addition, Mr. Murray suffered from renal disease, which had necessitated two earlier kidney transplants (the _________________________________________________________________ 1. The discharge summary prepared by the hospital after Mr. Murray's death lists fifteen conditions under the heading Final Diagnoses. That list includes: uremia; cellulitis of the left foot with gangrene; intertrochanteric and subtrochanteric fracture, right hip; peripheral vascular disease, severe; diabetes mellitus; end-stage renal disease, secondary to autosomal dominant polycystic kidney disease; status post kidney transplant; acute renal failure, secondary to sepsis; atherosclerotic heart disease; fever of undetermined origin; left pleural effusion; hepatocellular necrosis, idiopathic; fat emboli syndrome; pneumonia; acute, non-Q wave myocardial infarction. 5 first in the 1970s and the second in the 1980s) and required continuous medication to suppress his immune system and to prevent his body from rejecting the transplanted organ. As a result, he had some immune deficiency. Dr. Scotti testified, however, that Mr. Murray's kidney function was fine prior to the accident, and that he did not appear to be in any danger of imminent kidney failure at that time. Sometime after his second kidney transplant, Mr. Murray developed Diabetes Mellitus. According to Dr. Nasberg, an endocrinologist, this condition was also under control prior to the accident. Additionally, he suffered from peripheral vascular disease (i.e. the obstruction or narrowing of the blood vessels to the legs and feet), which led to the transmetatarsal amputation of his foot. Dr. Scotti nonetheless testified that there was no evidence that his foot was a problem after the amputation. Although Mr. Murray still suffered from peripheral vascular disease after the amputation -- which could have lead to complications if he was to suffer another similar injury -- he did not have any active gangrene or any specific symptoms prior to his fall. As noted supra, Mr. Murray also suffered from a fever of unknown origin while in the hospital for treatment of his foot. Although the defendant offered testimony at trial that this fever was indicative of pneumonia, and that it was that pneumonia that lead to Mr. Murray's death, Dr. Scotti testified to the contrary. In his opinion, Mr. Murray's clear chest and lack of cough prior to the accident would make the possibility of pneumonia highly unlikely. Furthermore, he had suffered from hepatitis for the fifteen-year period prior to 1992, and Dr. Scotti hypothesized that the most likely cause of the pre-accident fever was chronic active liver disease.