Court Opinion

ID: 9514468
Source: CourtListenerOpinion
Date Created: 2023-08-06 22:49:46.93572+00
Date Added: 2024-06-11T09:06:18.115210
License: Public Domain

SABERS, Justice
(dissenting).
[¶21.] I dissent. Connie Hanten should not be punished simply because her doctor did not test her for de Quervain’s until long after her employment ended. There is substantial evidence in the record to indicate that her carpal tunnel symptoms, and treatment, effectively masked any sign of de Quervain’s. The diagnosis in June of 1992 does not mark the beginning of the symptoms. Reports of Connie’s pain, swelling, and loss of motion in her hand can be traced back to 1990. Carpal tunnel syndrome and de Quervain’s are closely associated anatomically and involve the same nerves, tendons, and muscle tissue.
[¶ 22.] Following surgery for carpal tunnel syndrome, Connie began what was supposed to be a six-week therapy program. Because of her continuing problems and pain, the program continued for nearly seventy-five weeks. The majority opinion dismisses Dr. VanDemark’s statement that Connie contracted de Quervain’s due to her employment because he was purportedly relying upon the rehabilitation consultant’s report naming the condition as tendonitis, a diagnosis supposedly unsupported by medical records. However, there is evidence in the record that the report’s use of the term “tendonitis” was derived from statements made by Dr. VanDemark. The rehabilitation consultant accompanied Connie to her appointments with Dr. VanDemark. It is unlikely she would independently begin to refer to “carpal tunnel syndrome” as “tendonitis.”
[¶ 23.] The pain in Connie’s hand and wrist was at times unbearable, driving her from sleep nightly; yet employer’s expert (Toun-tas) opined, after a five-minute examination and a review of her records, that there was no evidence in the record of de Quervain’s prior to the jar-opening incident in March of 1992. Tountas’ opinion should not be granted much credence in this case in light of his statements regarding de Quervain’s, which are contrary to a study reported in the Journal of Hand Surgery, a journal Tountas conceded was authoritative in his field.
[¶ 24.] The Journal reported data concerning women with de Quervain’s. Sixteen postoperative cases involved women ranging in age from 24 to 53 years. Fifteen were employed and were workers’ compensation cases. Eleven preoperative cases involved all working women between the ages of 36 and 51 years and seven were workers’ compensation eases. No mention of pregnancy as a related condition appears in the report, yet Tountas states that de Quervain’s is associated with pregnant women.
[¶25.] Although Tountas stated that de Quervain’s would not be a difficult diagnosis in the presence of carpal tunnel syndrome, the Journal points to misdiagnosis as a primary problem in the treatment of de Quer-vain’s, and that a fallacy in thought concerning the condition is that it is an “isolated anatomical problem.” The report repeats the conclusion of one physician, “de Quer-vain’s disease is an acute episode superimposed on a chronic condition.” The study also recognizes the coexistence of, among other conditions, carpal tunnel syndrome, tennis elbow, and trigger digits. Only two of the sixteen postoperative patients could trace their de Quervain’s to a specific incident or direct injury, all had multiple complaints, and three had carpal tunnel syndrome. Three of the eleven preoperative cases also had carpal tunnel syndrome.
[¶26.] The trial court is not supposed to look for reasons to reverse the Department, nor are we, even if we would not have made a *82similar decision. Fenner v. Trimac Transp., Inc., 1996 SD 121, ¶ 15, 554 N.W.2d 485, 489 (citation omitted). The circuit court’s review, and ours, is limited to a determination of whether the record contains substantial evidence to support its decision. We review the administrative agency’s decision without any presumption that the circuit court’s decision was correct. Nilson v. Clay County, 534 N.W.2d 598, 600 (S.D.1995). It is not Connie’s fault that she developed a condition which is difficult to diagnose in the presence of carpal tunnel syndrome. The study reported in the Journal and Dr. VanDemark’s ultimate conclusion that her de Quervain’s is work-related provide the substantial record evidence to support the Department’s decision.