American General Insurance Company v. Barrett

• Decision Date: 07 February 1957
• Docket Number: No. 6920,6920
• Citation: 300 S.W.2d 358
• Parties: AMERICAN GENERAL INSURANCE COMPANY, Appellant, v. Suwillow BARRETT et al., Appellees.
• Court: Texas Court of Appeals

Page 358

300 S.W.2d 358

AMERICAN GENERAL INSURANCE COMPANY, Appellant, v. Suwillow BARRETT et al., Appellees.

No. 6920.

Court of Civil Appeals of Texas, Texarkana.

Feb. 7, 1957.

Rehearing Denied March 7, 1957.

Second Motion for Rehearing Denied April 4, 1957.

Vinson, Elkins, Weems & Searls, Thomas B. Weatherly, Sam W. Davis, Jr., Gaius G. Gannon, Jr., Houston, for appellant.

Henry E. Doyle, Houston, for appellees.

CHADICK, Chief Justice.

This is a compensation case appealed from Harris County and transferred from the First Supreme Judicial District to the Sixth by an equalization of dockets order of the Supreme Court. The case is affirmed for the reasons hereinafter stated.

Eddie Barrett, Sr., a Negro man 60 years of age, had been employed by Brown & Root, Inc., regularly for several years and was seldom absent from his employment. Barrett, in apparent good health, was leaving that firm's job on the premises of Humble Oil & Refining Company at Baytown on the afternoon of July 14, 1954, immediately after the four o'clock quitting whistle sounded. Along with other workmen, he was walking down a road composed of gravel and shell, and described by witnesses as hard-surfaced, from the vicinity of his immediate duties to the clock-house for the purpose of checking out. During the day, the group Barrett worked with had been engaged in checking leaks around pipes, back-filled some pipe ditches, and washed down some drums with a water house. It was a normal summer day, the maximum temperature 92 (F.).

As Barrett approached the clock-house he suddenly stopped and said he was going to 'black out.' As he fell back, he made no attempt to break the fall with his hands, and one witness said he appeared to be unconscious and was red in the face. He fell backwards, completely limp, his head striking the hard street. He was unconscious when his fellow-workmen reached him.

In a matter of a very few minutes, he was carried to the Humble First-Aid Station and there examined by a nurse. No lacerations, abrasions or bruises were then or later visible on his head. Shortly after reaching the First-Aid Station he regained consciousness, refused aid or medication and left for his home by his usual conveyance. On the way home, he was met by his wife who had been informed of the occurrance, and without aid changed to her car and continued home.

On reaching home he indicated that he did not want to talk about his injuries and wanted to get out and do his evening chores. He sat in a chair for a time while his wife bathed his face. He then went to take a bath and get ready for supper, and while bathing complained that his head had started hurting and did not finish his bath. Putting his clothes on, he lay down and did not attempt to eat supper. At this show of debility, a doctor was called and administered a hypodermic. The next morning, July 15th, the doctor ordered him to a hospital. This doctor did not testify.

At the hospital Barrett was first treated for heat exhaustion. On the 17th an X-ray of Barrett's head was made and a fracture of the skull discovered. Other doctors were called in. A lumbar puncture at the third interspace was made and fluid in two specimens was grossly bloody. Barrett died about 11 o'clock on the morning of July 18, 1954.

Medical testimony of three doctors is in the record. One, the appellees' medical expert witness, was a general practitioner; and the appellant's two medical witnesses were specialists, that is, neuro-surgeons.

The medical testimony may be fairly summarized by stating that each of the three doctors testifying at the trial gave it as his opinion that Barrett died as a result of a subarachnoid hemorrhage and that death was from a natural cause as distinguished from one of traumatic origin. However, in their examination and cross-examination, other opinions were given which were at variance with these final conclusions.

Illustrative are these questions and answers:

'Q. Let me ask you, if he had fallen with force sufficient to cause a fracture of the skull, could that have been a producing cause of the subarachnoid hemorrhage you are talking about? A. Yes, he could have fallen from any other cause and fractured it, yes, it could cause it.

'Q. So, then, it is your testimony, while you are not saying what caused him to fall, that if he did fall, and in the course of falling it fractured his skull it is possible that could have produced the subarachnoid hemorrhage? A. That is right.

'Q. You are naturally puzzled as to what might have caused him to be in the condition he was in? A. Yes, sir.

'Q. And one of the conclusions you had was that a fracture of the skull caused it? A. Yes sir.

'Q. The history did not tell you what caused him to fall and pass out? A. No, it does not tell me that. It just says he had the headache.

'Q. Will you testify that the hemorrhage could have been caused by a fall which was of sufficient force to fracture his skull? A. A man who has a weakened blood vessel, an aneurism can rupture spontaneously without injury, and it can rupture from a minor injury and it can rupture from a serious injury.

'Q. It is your testimony it could have ruptured as a result of this fall? A. If there was nothing wrong with the patient before the fall, if he had no symptoms before the fall, then I would say yes.

'Q. Is a fall sufficient in force to cause a fracture sufficient to cause an aneurism, whether he had anything wrong with him or not? A. I would say yes.

'Q. What is your opinion as to the fracture? A. From the history I would say the man had the initial hemorrhage which caused him to lose consciousness, then he fell, he apparently fell backward and struck the occipital portion of the skull against the pavement he was walking on and that caused the fracture.

'Q. This history that was given about how he fell, suddenly falling and fainting, is that compatible with the diagnosis you gave? A. Yes. That would be the first thing you would think of in a case like that. I think probably the most common thing is that a spontaneous hemorrhage causes a loss of consciousness.

'Q. What happens to a person when they have these blood vessels burst in the brain, do they become unconscious immediately? A. Yes, maybe and maybe not. It depends on the severity of the hemorrhage and how long it lasts. I would rather suspect from the history that was an initially small hemorrhage. It was enough of a shock to produce pressure to the brain and cause a loss of consciousness, then apparently he came out and was able to be taken to the dispensary, and they took him home; then he became drowsy and his speech became thickened. I believe his wife and one member of the family stated he went in and laid down on the bed and they tried to arouse him but couldn't. That indicates to me that the man had some more hemorrhages. A spinal puncture was performed and that showed blood, which appeared as a consequence.

'Q. That day he died what was the condition? A. He was deeply comatose, had a lot of edema in the lungs due to the fact that the pressure or swelling in the brain affected the respiratory center, and they do not breathe and cough and the secretions are not coughed out or swallowed as in a normal person, and they fill up with mucous, and he probably died with pneumonia and a lack of oxygen to the brain.

'Q. In your opinion was the cause of death in this case due to natural causes as distinguished from a traumatic origin? A. I have no way of knowing this man was not hit in the head, but I assume that this was the consequence of it, and that would be a very natural consequence.

'Q. Assuming that Doctor-let's say for the sake of the hypothetical question, just say he was seized with an aneurism to cause him to slump, if he had not fallen with such force that he fractured his skull, is it possible that he still might be alive today? A. Yes, I think it is possible. I don't think there is any way you can answer that question.

'Q. What I am trying to get at is this: Isn't it a fact that the seizure of this aneurism, whatever it is in itself might not have been fatal but for his striking his head against a paved or hard surfaced road and developing a skull fracture? A. Well, I think that could have contributed-could have been a contributing factor, but I think what you are trying to ask me is if he had not fallen he might not have died. There is no way of knowing. An aneurism does not ordinarily produce a lot of hemorrhage, because when you cut open the skull there is very little bleeding. I think this bleeding was from a hemorrhage of the blood vessel. He could have had a small fracture and then later a larger one. There is no way of knowing those things.

'Q. Isn't it true that a blow sufficiently hard to cause a fracture could have been a contributing cause to the hemorrhage? A. Yes, I think it could.'

Appellees' doctor filed a death certificate on the standard form provided by the Texas Department of Health, Bureau of Vital Statistics. This certificate under a heading 'Cause of Death' has a sudbivision 1(a) with a heading 'Disease or condition directly leading to death' and an instruction in connection with it that 'This does not mean the mode of dying, such as heart failure, asthenia, etc. It means the disease, injury or complication which caused death.' In answering this subdivision 1(a), the doctor inserted 'Fracture of skull.' Subdivision 1(b) deals with antecedent causes and defines them as 'morbid conditions, if any, giving rise to the above cause (a) stating the underlying cause last.' In subdivision 1(b) the doctor inserted, 'Subarachnoid hemorrhage.' This certificate was admitted in evidence as original evidence without objection.

The family not being agreeable, no post mortem examination was made.

The parties and the court laudably kept the issues and the testimony simple, clear and direct. By stipulation counsel agreed to limit trial to these issues: '(a) Did Eddie Barrett, Sr., die as alleged...