Opinion ID: 71979
Heading Depth: 1
Heading Rank: 3

Heading: findings regarding krys's symptoms

Text: 23 Lufthansa also argues that the court below erred in finding that the plaintiff displayed the symptoms of a heart attack (as described by the American Medical Association and by Lufthansa's Manual) within the first one and one-half to three hours of the flight. According to Lufthansa's Operating Procedures Manual, the symptoms of a heart attack are as follows: The patient complains about feeling an ongoing pain and tightness in his chest, which may radiate into the neck area and the left arm. The patient shows a sudden paleness and is restless. The manual also provides the following rough distinction between angina and a heart attack: After administering [nitroglycerin], pain from angina pectoris disappears after 2 to 3 minutes at the most. In a heart attack, pain usually persists. The symptoms described by the American Medical Association are crushing pain in the center of the chest, pain in the chest, pain in the jaw, arms, tightness in the chest, bursting sensation in the chest, dizziness, shortness of breath, sweating, and nausea. 13 24 The federal rules provide that a district court's findings of fact in actions tried without a jury may not be reversed unless clearly erroneous. Fed.R.Civ.P. 52(a). A finding is clearly erroneous when the reviewing court, after assessing the evidence in its entirety, is left with a definite and firm conviction that a mistake has been committed. Anderson v. City of Bessemer City, 470 U.S. 564, 573, 105 S.Ct. 1504, 1511, 84 L.Ed.2d 518 (1985). As the Supreme Court has cautioned: 25 If the district court's account of the evidence is plausible in light of the record viewed in its entirety, the court of appeals may not reverse it even though convinced that had it been sitting as the trier of fact, it would have weighed the evidence differently. Where there are two permissible views of the evidence, the factfinder's choice between them cannot be clearly erroneous. 26 Id. at 573-74, 105 S.Ct. at 1511. The Supreme Court has further emphasized that where a trial judge's finding is based on his decision to credit the testimony of one of two or more witnesses, each of whom has told a coherent and facially plausible story that is not contradicted by extrinsic evidence, that finding, if not internally inconsistent, can virtually never be clear error. Id. at 575, 105 S.Ct. at 1512. 27 Keeping the Supreme Court's admonitions firmly in mind, we find no clear error in the magistrate judge's finding that Krys displayed the symptoms of a heart attack within the first three hours of the flight. Mr. Krys testified that he went to the lavatory about an hour and a half into the flight because his stomach was upset and he felt nauseous and that he returned to the lavatory thirty minutes later because he was feeling nauseous and dizzy. There, he began to feel a crashing, excruciating pain in [his] chest. 14 Krys also testified that he noticed his clothes were wet from perspiration. Josie Curry, a fellow passenger sitting in the row with Mr. Krys, testified that she observed him making these two trips and noticed that he was perspiring. Jan Holloway, another passenger, testified that she noticed the plaintiff returning from the lavatory: 28 The first thing I really noticed was just glancing up and seeing someone coming back from like the restroom area, the galley area, just looking like he was airsick, you know, just that flushed kind of white pasty look you-hope-you-never-get-it type.... [K]ind of washed out is what I really meant, just where you just are gray and you just don't feel good. 29 Holloway also noticed that Krys was perspiring. 30 After returning from the lavatory, Mr. Krys contacted the flight attendant, who made an announcement asking any doctors on board to identify themselves to the crew. Dr. Fischmann responded to the call. In the estimation of both Josie Curry and Jan Holloway, the flight attendant was contacted between an hour and an hour and a half into the flight; by Krys's calculation, this happened approximately two hours into the flight. Krys, Curry, and Fischmann all testified that Krys told the doctor at this time that he was suffering chest pains. Krys's testimony reflects that he told Dr. Fischmann that he had pain in his chest radiating into his arms, pain in his jaw, difficulty breathing, dizziness, nausea, and sweating. Josie Curry described the plaintiff's state this way: 31 He appeared to have difficulty breathing. He started to get pale. He appeared to be very uncomfortable, you know, with the movement within his seat. Made me notice that he was very uncomfortable. It was like this man is miserable. 32 Jan Holloway echoed this description: The man just was, I don't want to say in agony, but he was uncomfortable, couldn't sit still, couldn't stand, couldn't--just whatever position he tried to get into to get comfortable, it didn't last long. 33 In treating Krys, Dr. Fischmann administered two separate doses of nitroglycerin. 15 Curry testified that after the nitroglycerin was administered, it didn't appear [Krys] was getting better.... Even after the second administration of nitroglycerin, according to Josie Curry, He seemed miserable. He was pale-colored.... He looked ... about the same as he did before.... In Dr. Fischmann's assessment, there was no big difference in Krys following the administration of the nitroglycerin. As for the relevant time frame, Josie Curry estimated that the second dose of nitroglycerin was administered three hours into the flight. Jan Holloway similarly estimated that the events involving the summoning of the doctor, the administration of oxygen, and the dispensing of the nitroglycerin all occurred between like an hour and a half ... to two and a half, three hours [after leaving Miami]. 34 We are aware that there is contradictory evidence in the record. The purser on board the airplane, Jurgen Freund, estimated that the crew was not contacted until at least two and a half hours into the flight. Freund also claimed that at the time he first saw the patient, he did not see any of the following symptoms: sudden paleness, pain in the upper thorax radiating to the shoulder, and sudden perspiring. 16 Dr. Fischmann testified that Krys had chest pains, but they weren't severe. According to the doctor, Krys was complaining a little bit but not as a typical heart attack. Fischmann further testified that he did not observe a changed complexion or cold sweating in the patient until the flight was over Amsterdam and that he never observed the passenger having difficulty breathing to the point that he couldn't speak very well. The captain on board, Hans Schnabl, testified that he saw the patient while he was being attended by Dr. Fischmann and did not observe that Krys was suffering severe chest pains or that he was sweating profusely. 35 The magistrate judge could have credited either the testimony of Purser Freund, Dr. Fischmann, and Captain Schnabl or the testimony of Leonard Krys, Josie Curry, and Jan Holloway. The choice made between these two permissible alternatives is, almost by definition, not clear error. See Anderson, 470 U.S. at 575, 105 S.Ct. at 1512. The challenged findings of the court below are not clearly erroneous. 36