Insurance Dept. of Miss. v. Dinsmore, 40790

• Decision Date: 19 May 1958
• Docket Number: No. 40790,40790
• Parties: INSURANCE DEPARTMENT OF MISSISSIPPI et al. v. Mrs. Alice DINSMORE.
• Court: Mississippi Supreme Court

Page 691

102 So.2d 691

233 Miss. 569

INSURANCE DEPARTMENT OF MISSISSIPPI et al. v. Mrs. Alice DINSMORE.

No. 40790.

Supreme Court of Mississippi.

May 19, 1958.

Butler, Snow, O'Mara, Stevens & Cannda, Dan McCullen, Jackson, for appellants.

Lipscomb, Ray & Barksdale, Jackson, for appellee.

LEE, Justice.

Mrs. Alice Dinsmore, in her claim for workmen's compensation benefits against the Insurance Department of Mississippi and its carrier, was granted an award by the attorney-referee. On successive appeals by the defendants, the award was affirmed both by the commission and the circuit court; and they have brought this appeal here.

In the meantime Mrs. Dinsmore died on November 1, 1957, and the action has been revived in the name of R. R. Dinsmore, the lawfully appointed administrator of her estate.

The claimant was sixty years old, and her weekly wage was in excess of $37.50. For many years she had been an employee of the Insurance Department, and had risen to the position of deputy commissioner. Her duties were both clerical and executive. It was shown that she was a perfectionist, loyal and very conscientious, but at the same time irritable, high tempered, highstrung, and not disposed to delegate these duties to others. In fact, she resented any effort to decrease her work. While her work load had been substantially reduced, still she kept just as busy as before. She was very exacting of her subordinates. The first four months of the year was the period of greatest activity in the office, with the consequent increased stress and strain.

The claimant had been afflicted with hypertension or high blood pressure for sometime. In fact, she suffered a mild stroke on February 27, 1951, and another on April 8, 1953. In spite of these attacks, she continued to work with little, if any, interruption. In the afternoon of May 4, 1955, she had been signing her mail. Either because she was going to be off the next day, or because Commissioner Davis would be working, she was seated at her desk trying to line-up the work, that is, making notes. While doing this, she became unconscious and suffered the disability for which claim was made.

Drs. L. T. Carl, Charles L. Neill, and John Gallogly were offered as witnesses by the claimant. Dr. Carl, who had treated Mrs. Dinsmore for several years, and who was present when she regained consciousness, made an elaborate report in which he included her history. The examination, following the April 1953 attack, showed her blood pressure was 225/115. His diagnosis as to the May 4, 1955, attack was as follows: '(1) Hemiplegia, left, due to (2) Thrombosis, right middle cerebral artery and (3) Hypertensive cardiovascular disease.' His opinion as to the relationship between her work and the attack was as follows: 'It is my impression that her job was a rather responsible one, and in a busy office surely carried with it a certain degree of tension and nervous strain. This probably contributed to the hypertension, which indirectly was one factor in the production of her attack of 4 May 1955. In this manner, it was, in my opinion, contributory. However, I would not state that it was responsible for the vascular changes which usually precede thrombosis.'

Dr. Neill, who also attended Mrs. Dinsmore, said that intense activity can aggravate hypertension, and that he did not know of any practitioner who, in view of her hypertension in 1953, would not have advised her to reduce her activity. He was submitted a hypothetical question, embracing the claimant's traits, the nature of her employment, and the manner in which she performed her duties, and was asked whether her attitude toward her work and her activity in the department contributed to the attack of May 4, 1955. His reply was, 'Yes, as long as you remember this could have happened anyway.'

Dr. Gallogly, who had been a consultant to her on August 1, 1955 and June 23, 1956, was of the opinion that the work load which Mrs. Dinsmore carried, coupled with her type of person, aggravated her hypertension.

Dr. S. H. McDonnieal, an internal medicine man, and Dr. William H. Rosenblatt, a specialist in the cardiovascular diseases, as witnesses for the defendants, discussed the difference between a cerebral thrombus and a cerebral hemorrhage. They attributed the thrombus to a disease known as arteriosclerosis, which, because of deposits of cholesterol, causes a decrease in the size of the arteries and diminishes the blood supply, thus increasing the chance of the formation in the blood of a clot, or thrombus. On the contrary, the elevated blood pressure speeds the flow of blood, thus reducing the chance of a clot, but increasing the chance of a cerebral hemorrhage. Dr. McDonnieal conceded that stress and strain in a pre-existing hypertensive can aggravate the patient's condition. He was of the opinion that, with a blood pressure of 225/115 in April 1953, Mrs. Dinsmore's activity should have been decreased; and that, to some extent, it was dangerous for her to continue her work. He admitted that loss of consciousness may occur either from a thrombus or hemorrhage, and that, although it was not done in her case, a spinal puncture is useful to determine which of these is the cause. While expressing the opinion that there was no connection between her work and the formation of a thrombus, he conceded that hypertension could possibly be a contributing factor in the end result of a thrombus, although unlikely.

Dr. Rosenblatt was of the opinion that in the absence of other impairment a curtailment of activities is unnecessary, and that there was no connection between what Mrs. Dinsmore was doing and the attack.

Neither Dr. McDonnieal nor Dr. Rosenblatt had seen or examined claimant. Their opinions were based on hypothetical questions. Dr. McDonnieal conceded that the attending physician is in better position to know what has happened to the individual patient, but Dr. Rosenblatt, because of his experience, thought that his opinion should not be discounted to any extent merely because he had not attended Mrs. Dinsmore.

The appellants contend that the relentless and inexorable march of a disease or condition of life is not a compensable injury arising out of and in the course of employment simply because the disability manifested itself during a period of employment. They say that the disability must result either from traumatic injury, or precipitation of a dormant condition by specific exertion, or from the special hazard of the work not experienced by the public generally. They contend that appellee's proof is insufficient to show a causal relation between her employment activity and her subsequent disability. They cite a...