Hopp v. Grist Mill, No. C5-93-219
| Decision Date | 14 May 1993 |
| Docket Number | No. C5-93-219 |
| Parties | Lisa HOPP, Relator, v. GRIST MILL and Kemper Insurance Company, Respondents. |
| Court | Minnesota Supreme Court |
Syllabus by the Court
The compensation judge's determination that certain medical treatment was reasonable and necessary to cure or relieve the effects of a compensable thrombosis had sufficient evidentiary support.
Charles M. Cochrane, Minneapolis, for appellant.
Jerry D. Van Cleave, Bloomington, for respondents.
Considered and decided by the court en banc without oral argument.
We review on certiorari a decision of the Workers' Compensation Court of Appeals reversing a compensation judge's determination that certain medical treatment, gastric bypass surgery, is reasonable and necessary to cure or relieve the effects of a compensable thrombosis. We reverse and reinstate the decision of the compensation judge.
Lisa Hopp worked on the production line for The Grist Mill which is located in Lakeville, Minnesota. On December 13, 1990, she sustained a compensable right knee injury which was initially treated as a knee strain; however, because of persisting complaints of pain, swelling and "heaviness" in the right leg, and because employee is morbidly obese and had a history of a superficial thrombophlebitis in the left leg, employee was referred to an orthopedic specialist who ordered an ultrasound venous doppler study. When the results of the ultrasound showed a deep venous thrombosis involving the right popliteal and femoral veins, employee was hospitalized and treated with "intravenous heparin and oral Coumadin (an anti-coagulant) * * * along with Ace wraps, elevation, and heat to the leg." Following the hospitalization, employee remained on anti-coagulant therapy.
Employee was eventually referred to the University of Minnesota for a "multi-discipline evaluation" of her right knee and leg problems. She was initially seen by Dr. Michael Caldwell, Director of the Wound Healing Program at the University of Minnesota and specialist in venous disease. Dr. Caldwell ordered another ultrasound which was followed by a venogram that suggested "a substantial amount of thrombus of the superficial femoral vein and incompetency of the deep valvular system above the thrombus on the right with an incompetent greater saphenous vein on the right." Dr. Caldwell felt this thrombus, which extended from the area of the knee up to the groin, was related to the injury employee received to her right knee. 1
Dr. Caldwell initially recommended conservative treatment with a Jobst pump, stockings and Coumadin. The record indicates that Dr. Caldwell ultimately felt that weight loss would be essential in the treatment of employee's injury-related thrombosis. He then referred employee to Dr. Buchwald, Professor of Surgery at the University for gastric surgery evaluation as employee had unsuccessfully attempted weight reduction through conventional diet control methods. Following his examination, Dr. Buchwald said obesity surgery was appropriate. Employee was also evaluated by Dr. Elizabeth Arendt, Orthopedic Surgeon at the University, and she believed the surgery would help to alleviate employee's knee problem.
Employee sought approval for the gastric bypass surgery pursuant to Minn.Stat. Sec. 176.135, subd. 1(a) (1990), 2 as reasonably required to cure or relieve the effects of the thrombus in her right leg. Grist Mill and its workers' compensation liability carrier, Kemper Insurance, then referred employee to Dr. James Finell, an internist, who examined her in April 1992. Dr. Finell believed employee's "thrombophlebitis" was due to her morbid obesity and not her knee injury; and he also believed the proposed gastric bypass surgery was related to her obesity and for the treatment of her health in general. Employer/insurer declined to authorize payment for the procedure.
The compensation judge determined employee's right knee and right leg venous conditions were causally related to the December 1990 work injury, that the proposed gastric bypass surgery was reasonably necessary to cure or relieve from the effects of the right leg venous condition, and that employee had therefore not attained maximum medical improvement. 3 On appeal, the Workers' Compensation Court of Appeals affirmed the determination that the deep venous condition was compensable but reversed the determination that the proposed surgery was also compensable, concluding that the gastric bypass surgery was not aimed at treating employee's deep venous condition, but "[r]ather, it...
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