Adams v. New Orleans Public Service Inc.

• Decision Date: 28 September 1981
• Docket Number: No. 81-C-0784,81-C-0784
• Parties: Huey P. ADAMS v. NEW ORLEANS PUBLIC SERVICE INC.
• Court: Louisiana Supreme Court

Page 485

418 So.2d 485

Huey P. ADAMS v. NEW ORLEANS PUBLIC SERVICE INC.

No. 81-C-0784.

Supreme Court of Louisiana.

Sept. 28, 1981.

On Rehearing Aug. 4, 1982.

Dissenting Opinion Aug. 30, 1982.

Rehearing Denied Sept. 3, 1982.

Ronald L. Wilson, New Orleans, for plaintiff-applicant.

A. R. Christovich, Jr., New Orleans, for defendant-respondent.

Joel P. Loeffelholz, New Orleans, (Amicus Curiae).

DIXON, Chief Justice.

This is a workmen's compensation case involving a claim of disability from attacks of angina pectoris.

Recovery was denied by both the trial court and the Court of Appeal. The appellate court held that plaintiff's episodes of angina were due to arteriosclerosis and were not work related. 395 So.2d 470 (La.App. 4th Cir. 1981).

Plaintiff worked for over thirty years as an automotive mechanic for various employers. On April 3, 1978 he was hired as a mechanic by defendant New Orleans Public Service Inc. at an hourly wage of about $6.155. After working for approximately three months, plaintiff began experiencing shortness of breath and chest pains at work. Plaintiff testified that while repairing an exhaust system on one of the NOPSI buses, he began to feel hot and sweaty, short of breath, nauseated and as if he had "a heavy weight on my chest." When his wife picked him up from work, he told her of the dizziness and nausea.

Plaintiff continued working, attributing the episode to indigestion and exhaustion. About two weeks later, on July 1, plaintiff was working the night shift. He once again experienced pains in his chest, nausea, profuse perspiration and a heavy smothering in his chest. A co-worker, David Cornes, testified that plaintiff told him he felt as if he had indigestion and "was feeling real bad." Mr. Cornes agreed to do all of the more strenuous work, leaving plaintiff to simply drive the buses back and forth to be checked and refueled.

Upon reaching home the next morning, plaintiff related his symptoms to his wife. She convinced plaintiff to go to the hospital on the following day. On Monday, July 3, plaintiff was admitted to the hospital. An electrocardiogram, chest x-rays, blood tests and a stress test were run and normal results obtained. The treating physician, Dr. Oei, diagnosed plaintiff as having suffered angina pectoris due to arteriosclerosis.

Generally speaking, angina pectoris is pain located in the chest area. ¹ It is usually caused by an insufficient supply of oxygen to the heart muscle. ² Arteriosclerosis is a condition marked by a loss of elasticity, thickening and hardening of the arteries. Angina pectoris is often associated with arteriosclerosis because the thickening of the arteries results in a reduction of the blood supply to the heart which in turn causes pain or angina. ³

Dr. Oei advised plaintiff not to engage in any hard physical labor. Plaintiff asked to return to work for NOPSI on a light duty basis. NOPSI rejected plaintiff's request. According to NOPSI's maintenance manager plaintiff was still a temporary employee and NOPSI policy prohibited the transfer of temporary employees from regular duty to light duty.

Under our workmen's compensation law, plaintiff is entitled to compensation benefits if he has suffered "personal injury by accident arising out of and in the course of his employment." R.S. 23:1031. An "accident" is defined as "an unexpected or unforeseen event happening suddenly or violently with or without human fault and producing at the time objective symptoms of an injury." R.S. 23:1021(1). The statutory definition limits "injury" to "injuries by violence to the physical structure of the body and such disease or infections as naturally result therefrom. These terms shall in no case be construed to include any other form of disease or derangement, howsoever caused or contracted." R.S. 23:1021(6).

This court had occasion to discuss at length the meaning of these terms in Ferguson v. HDE, Inc., 270 So.2d 867 (La.1972). In Ferguson, the plaintiff had been working for the defendant employer about two weeks when he received his pay check. The check was for an amount much less than plaintiff had expected. He became enraged and went to the office to complain, during the course of which he felt a flash of pain followed by paralysis. We found that the plaintiff had suffered an injury arising out of and in the course of his employment. Although not subjected to any blow or trauma, nor injured due to physical stress or strain, he unquestionably suffered "violence to the physical structure of the body."

The Ferguson opinion referred to the workmen's compensation statutory scheme of Great Britain upon which the American workmen's compensation statutes are based. This court found that the British approach to determining whether a disability occurred "by accident" involves an examination of whether there is an accidental result or effect on the employee, rather than whether the disability had an accidental cause. Utilizing that approach, we held that where an injury occurs suddenly and unexpectedly, it is compensable despite the absence of any physical stress or exertion. Thus, we have held without hesitation that a heart attack is a compensable accident within the meaning of our workmen's compensation law. Roussel v. Colonial Sugars Co., 318 So.2d 37 (La.1975).

In the case before us, plaintiff's disability occurred by accident. Although not subjected to extraordinary stress or exertion at the time of the attacks of angina pectoris, the attacks themselves came suddenly and unexpectedly, causing violence to the structure of plaintiff's body. The episodes happened without warning and in the course of plaintiff's employment.

Defendant contends that plaintiff's claim is not compensable because the angina pectoris resulted from arteriosclerosis, a condition of the arteries which had gradually worsened over the years, rather than a sudden trauma. Defendant's position is untenable. The instant case is virtually indistinguishable from Bertrand v. Coal Operators Casualty Co., 253 La. 1115, 221 So.2d 816 (1969). In Bertrand, the plaintiff suffered an episode of weakness, dizziness or near fainting while working as a laborer. He was diagnosed as having had a nodal tachycardia. ⁴ About one year later, plaintiff's heart again began to beat erratically and he almost "blacked out," falling to his knees. Defendant denied plaintiff's claim for workmen's compensation, arguing that plaintiff suffered an attack of angina pectoris and that the real cause of plaintiff's disability was arteriosclerosis. The medical testimony revealed that the symptoms were due to a sclerosis or restriction of the arteries which fed the heart muscle so that an insufficient quantity of blood reached the heart during periods of exertion. Plaintiff was diagnosed as having suffered "either angina pectoris ('chest pain' from a coronary insufficiency) or possibly even a slight occlusion." 221 So.2d at 826. This court held that plaintiff had suffered a compensable injury by accident although the attack was precipitated by the gradual thickening of the vessel walls. We stated:

"... What has happened to the plaintiff, according to all of the medical testimony, is that his total physical being and capacity have so changed that because of the symptoms exhibited (tachycardia or angina pectoris) and the preexisting disease (defective atrioventricular node or coronary sclerosis) he cannot return to work of a character similar to that which he had successfully done without pain, complaint, or disability for 16 years before the first episode and for nine months after it...." 221 So.2d at 827.

It makes no difference that the claimant in Bertrand fell to his knees with pain. Both the plaintiff in Bertrand and plaintiff in the present case experienced an episode of angina pectoris with outward manifestations observable to those nearby.

Defendant seeks to distinguish Bertrand on the ground that the plaintiff in that case may have suffered a slight occlusion. This distinction lacks merit. The Bertrand opinion indicates that there was considerable doubt as to whether the plaintiff had suffered any occlusion at all. The wording of the opinion is that the plaintiff suffered either angina pectoris or possibly even a slight occlusion. It is evidence from this language that the court did not rest its decision on a finding that the plaintiff had experienced an occlusion.

It is well known in the medical field that arteriosclerosis may lead to various consequences including angina pectoris, heart failure, myocardial infarction and even sudden death. ⁵ If plaintiff had suffered a myocardial infarction ⁶ (one of several events commonly called a "heart attack") as a result of arteriosclerosis, there would be no question but that a compensable injury had occurred. Roussel v. Colonial Sugars Co., supra. Here, plaintiff suffered from angina pectoris while on the job, brought on by the failure of his heart muscle to receive an adequate supply of oxygen. Both heart attacks and episodes of angina pectoris may be caused by an inadequate oxygen supply to the heart muscle. Both are recognized by the same symptoms, the main difference being that the pain experienced during an infarction is generally more severe and of a longer duration. ⁷ Given these similarities, there is no justification for granting compensation in the first situation while denying plaintiff recovery.

The Court of Appeal held that plaintiff could not recover because no incident or series of incidents during plaintiff's employment caused the arteriosclerosis or the episodes of angina pectoris. That analysis of causation is faulty. Where there is proof of an accident and of a following disability without any intervening cause, it is presumed that the accident caused the disability. When dealing with a claim for workmen's compensation, we have repeatedly stated that it is irrelevant whether the accident might have occurred at another place and at another...