Court Opinion

ID: 9771955
Source: CourtListenerOpinion
Date Created: 2023-08-29 17:03:16.435045+00
Date Added: 2024-06-11T07:31:40.452087
License: Public Domain

HUGHES, Justice
(dissenting).
The Court correctly states the issue in this case as being whether the evidence supports the findings of the jury that the death of John B. Stroburg, Jr., resulted, directly and independently of all other causes, from bodily injuries caused by accident. This is the language of the policy and is the substance of the jury verdict on this issue. In connection with this issue and the issues inquiring whether the ulcer or emphysema suffered by Mr. Stroburg contributed to his death the jury was instructed: “You are instructed that in connection with special issues numbers 1, 2 and 3, that death may result ‘directly and independently of all other causes from bodily injuries caused by accident,’ even if there exists pre-existing conditions or disorders if those pre-existing conditions or disorders are so remote in the scale of causation, so dormant and insubstantial, or so temporary and transient that they do not materially contribute to the death.”
No exceptions or objections were made to the charge.
The Court, however, in its opinion, relying on the recitation in the death certificate that the bleeding ulcer of the deceased caused the car accident held that, “The death certificate established a defense of death due to a bleeding ulcer that produced fainting and resulted in the car wreck in which multiple injuries were sustained by the insured * * The Court further states, “The undisputed evidence shows that a pre-existing bleeding ulcer induced fainting or weakness to cause the accident. * * * ” The Court thereupon concluded, as to this phase of the case, that the bleeding ulcer contributed to the cause of death.
It is my opinion that the cause of the accident is immaterial to liability under this policy. The obvious reason for this opinion is that the policy is not so conditioned. The only issue here is as the Court states, the policy provides and the jury determined, whether the injuries sustained by Mr. Stroburg in the accident were the sole cause of his death.1
*408The Court also holds that there is no evidence to support the jury finding that emphysema was not a contributing cause of death. The extent of the injuries sustained by Mr. Stroburg as a result of the accident and the medical treatment to which he was subjected following the accident are not fully stated in the Court’s opinion and I will elaborate thereon on the theory that if Mr. Stroburg had been accidentally shot through the heart with a 45 revolver, dying instantly, the fact that he had emphysema would not have materially contributed to his death. This is not quite the case here, but it is a near approach.
When Dr. William Moskovitz, a surgeon, first saw Mr. Stroburg he was being treated by other doctors for facial lacerations and a fractured mandible (jaw bone). We quote the testimony of Dr. Moskovitz:
“Of course, by the time I saw Mr. Stro-burg, I had already been told by his physician that he had' vomited blood, and he had shown or told them he was having more abdominal pain; and had seen X-rays which showed that he had air under the diaphragm, which means that a hollow organ that contains air within the abdominal cavity had ruptured.
At the time, he was on the operating room table with a nasal gastric tube in place, which is a tube that is placed into his stomach through his nose, and bright red blood was coming out of this.
He had a board-like abdomen, which means that when you palpate it or examine it, it is like feeling a board, and this usually means that there is something catastrophic going on inside the abdominal cavity.”
X-rays showed that Mr. Stroburg had a fractured pelvis, a fractured acetabulum (perimeter of the pelvis) and fractured ribs.
Dr. Moskovitz had a study made of Mr. Stroburg’s blood in preparation for surgery at about 9:00 to 9:30 that evening. The hematocrit level at that time was found to be 26. As soon as blood was available, within an hour of Dr. Moskovitz first having seen Mr. Stroburg, surgery was begun. Upon entering the abdomen, he noted the presence of free blood. He noted that blood was coming from a one inch by three-quarter inch perforation in the stomach. Nearby this perforation he found, and ligated or sutured closed, a bleeding peptic ulcer. The perforation was a result of trauma, and was unrelated to the ulcer.
Additional internal injuries found were a lacerated liver, a laceration of the capsule of the spleen, and a rupture or tear of the large colon. All of these injuries, including the perforation of the stomach, were the result of blunt trauma to the abdomen, presumed by Dr. Moskovitz to have been suffered in the automobile accident.
Fecal matter was coming out of the ruptured colon, and Dr. Moskovitz initially used clamps to prevent further contamination of the abdominal area. He then removed the spleen, and took care of the laceration of the liver. An outside colostomy was then performed to permanently repair *409the rupture of the colon. The fecal material which had escaped into the body cavity had contaminated the omentum, or fat apron which covers the abdominal area, so it was removed so as to remove as much contamination as possible from the area. Since the stomach perforation was in the area of the pylorus, or junction between the stomach and the small bowel, Dr. Mos-kovitz peformed a pyloroplasty closure of the perforation so that the valve would continue to function. However, fearing that even with this the valve would cease to function, he performed a gastrojejunosto-my, which, in other terms, supplied an alternate route in case the pylorus became blocked. Drains were installed so as to allow drainage in the area of the spleen, along the liver, under the diaphragm on both sides, and in the area of the stomach. These drains were for control of infection or leakage through the closures made.
Finally, effort was made to clean out as much of the contamination as possible through irrigation, and closure was made of the surgical wound. Mr. Stroburg was then transferred to the intensive care unit for post-operative procedures.
Dr. Moskovitz testified that this had been “extensive surgery.”
After the surgery, Dr. Moskovitz testified that Mr. Stroburg “had a very stormy course, with one complication after another.” Soon after, Mr. Stroburg began to hallucinate, and had high fevers and a loss of blood pressure. One of two explanations for this was the development of gram negative septicemia, an infection of the blood due to gram negative bacteria from the colon. A later blood culture showed that there were gram negative bacteria in the blood stream.
Next, a fistula developed in the area of the stomach closure, which was first controlled with the catheters installed at the time of the first surgery. Later, a second surgical procedure was performed, called a “feeding jejunostomy,” by which a tube was placed into the small bowel below where the leakage was occurring so that he could be fed. From his observations during this second surgery, Dr. Moskovitz concluded that there was no bleeding from the ulcer or gastrointestinal tract after the original surgery.
Dr. Moskovitz continued to observe Mr. Stroburg until February 22, 1968, when death occurred.
As to the cause of death, he testified:
“Q When Mr. Stroburg finally died what caused his death, in your opinion, Doctor, in all reasonable medical probability?
A It is always difficult to say exactly why someone dies, because your vital functions of the heart and everything seem to be going on.
I would say that his cause of death was just the overwhelming infection and magnitude of the injuries that he received, and his body coped with it as long as he could, and then it couldn’t cope with it any more, and he died. * * *
Q And you believe that the overwhelming magnitude of his injuries from the car acccident killed him?
A That is right. * * *
Q Would you state for us, Doctor, in all reasonable medical probability what caused Mr. Stroburg’s death ?
A The overwhelming injuries he received at the time of his accident.
Q And those include the—
A The multiple facial lacerations and the fractures, the fractured pelvis, the ruptured colon, the ruptured liver, the ruptured spleen, the ruptured stomach.
Q All right, sir, in all reasonable medical probability, Doctor, did some other illness or disease contribute to Mr. Stroberg’s death?
*410A As far as I can say, at the time of his death there was no other reason for his death other than the overwhelming injuries that he had received. * * *
The cause of death is the injuries that he received. * * *”
In determining a no evidence point, “We may consider only that evidence, if any, which, viewed in its most favorable light, supports the jury findings, and we must disregard all evidence which would lead to a contrary result.” Biggers v. Continental Bus System, 157 Tex. 351, 303 S.W.2d 359 (1957).
This Court has not, in my opinion, followed this rule in this case. I would hold that the evidence, cited above, supports the jury verdict and would affirm the judgment of the Trial Court. I, therefore, respectfully dissent.

. The cited cases of American Casualty & Life Co. v. Morrison, 161 S.W.2d 796, Tex.Civ.App., Eastland, writ dismissed (1942) and Continental Casualty Company v. Fountain, 257 S.W.2d 338, Tex. Civ.App., Dallas, writ ref. (1953) are cited to sustain this holding. In Morrison the policy sued on provided, in part, “This policy insures against loss of life, limb, sight or time, resulting directly and independently of all other causes from bodily injuries sustained during any term of this policy through purely accidental means * * The Court stated, “ * * * the statement of facts presents no evidence of bodily injury of any kind received by the insured * * The Court then indulged in a fanciful pyra*408miding of presumptions which would have to be made in order to sustain a recovery, the fourth of which presumptions was that the presumed fall of insured “was not due to sickness or ill health.” This is the portion of the opinion deemed to support the Court’s holding in this case that if the ulcer caused the accident, there is no liability. It was quoted with approval in Fountain, supra. In that case the language of the policy was similar to that found in Morrison. The insured suffered a broken arm in an automobile accident. He died about three months later. Two doctors, including plaintiff’s, testified that insured died of cancer. Both doctors denied that the broken arm was the direct or sole cause of his death. The quotation from Morrison was to support the Court’s holding against piling presumptions. The decision of the Court was that there was no evidence to support the jury verdict that the insured died solely from accidental means. In neither of these cases, I submit, did the Court hold that the cause of the accident was relevant to liability under the policies.