Liberty Nat. Life Ins. Co. v. Reid

Citation158 So.2d 667,276 Ala. 25
Decision Date30 May 1963
Docket Number4 Div. 120,4 Div. 122,4 Div. 116,4 Div. 115,4 Div. 118,4 Div. 121,4 Div. 119,4 Div. 117,4 Div. 123
CourtSupreme Court of Alabama

Apain, Gillon & Young and Ralph B. Tate, Birmingham, for appellant.

Robt. C. Reid, and A. R. Powell, Jr., Andalusia, and F. B. McGill, Opp, for appellee.

HARWOOD, Justice.

Suit below was for the recovery of double, or triple indemnities for accidental death under the provisions of nine life insurance policies issued by the appellant company on the life of Edward F. Reid. The case was tried before the Hon. F. M. Smith, Judge of the Circuit Court of Covington County, without a jury.

After hearing, the court entered a judgment in favor of Gladys M. Reid, wife of the deceased Edward F. Reid, the beneficiary under the policies. The appellant's motion for a new trial being overruled, an appeal was perfected to this court.

The company had paid the face amounts of the policies, but had refused payment of the multiple indemnities on the grounds that a disease or infirmity from which Mr. Reid was suffering at the time of the accident cooperated with the accident to bring about Mr. Reid's death, and was an efficient cooperating cause thereof.

The evidence presented below tends to show that in 1942 Mr. Reid developed a malignancy of the lower intestinal tract. He was operated on by Dr. Alton C. Ochsner, Sr., and what is designated as a permanent enterostomy was done, that is, an opening was made in the left side of the abdomen and the lower intestine routed to the opening. Thereafter Mr. Reid wore a ileostomy bag for the purpose of catching the discharge from the intestine. The operation, under the medical evidence, was completely successful in eliminating the cancer, and this condition does not enter into our consideration.

In 1952 Mr. Reid's records at Ochsner Clinic showed evidence of heart disease, and in December 1958, Dr. Estep, his physician, diagnosed his heart disease as being a partial heart block, which had become complete by October 1959. Dr. Estep's diagnosis was confirmed by heart specialists at Ochsner's.

A heart block was defined by Dr. Ochsner as follows:

'Well, normally the heart beat originates in the auricle. There are four chambers of the heart, two auricles and two ventricles. The so-called pacemaker, the mechanism by which the beat is set up, normally is in the auricle. This is transmitted through a nervous bundle, which is called the 'bundle of Hiss,' which is described by a man by the name of Hiss. It's an electrical conduction from the auricle to the ventricle. In persons, usually as a result arteriosclerotic disease, there is an interference with this, there are changes in this neuromuscular bundle, and as a result of this there can be partial or complete interruption in this conducting mechanism. In such an instance, if it is complete, then the ventricle has to take over its own pacemaker, and it sets up its normal beat independently of the original beat.'

One of the manifestations of a heart block is an Adams-Stokes syncope, which is defined as a fainting spell. Mr. Reid had suffered one or more fainting spells.

The evidence also shows however, that Mr. Reid, up until the day of his death engaged in a large and active law practice. He was president of the Covington County Bar Association. He participated in many civic enterprises and was widely known for his leadership in anti-cancer crusades.

It was Mr. Reid's habit to shave every morning while standing in a bath tub preparatory to taking a shower. While shaving he would hold his ileostomy bag in place with his one hand and shave with the other.

Mr. Reid's son testified that the tub was slippery and he himself had slipped in the tub several times while taking showers.

On the morning of the accident Mr. Reid and his son had slept the night before in the guest house on the Reid premises. His son occupied an upstairs bedroom, and Mr. Reid had slept downstairs.

At about 7:00 A.M., his son heard 'banging' noises downstairs and ran down to his father's room. He found Mr. Reid in the tub with his head under the faucets. There was quite a bit of hot water in the tub, the bathroom was warm, and the mirrors steamed up.

Mr. Reid had a bleeding gash over one eye, was 'red as a beet,' and in great pain, though conscious. Some of the skin had peeled off.

His son got Mr. Reid out of the tub, called Dr. Estep, and then called Mrs. Reid from the main house. Mrs. Reid testified she found pieces of skin floating in the tub water when she retrieved the ileostomy bag therefrom.

Dr. Estep arrived in a few moments, and gave Mr. Reid a shot for his pain, and then had him taken to the Andalusia Hospital. There medicines were applied to the burns and Mr. Reid was bandaged to the extent that he 'looked like a mummy.' Later in the day Mr. Reid was flown by an airplane ambulance to Foundation Hospital in New Orleans. There several doctors and surgeons attended him, including Dr. Ochsner. At about 11:30 that night Mr. Reid died.

Dr. Ochsner is in disagreement with the other doctors as to the efficiency of the heart disease in causing Mr. Reid's death.

Numerous medical records of Ochsner Clinic and Ochsner Foundation Hospital were received in evidence, and Dr. Moore, a cardiologist on the staff of each institution, and Dr. Ochsner, each testified by deposition, and testimony of Dr. Ochsner taken in another case was received in evidence by agreement.

Dr. Moore testified that he attended Mr. Reid from about 7:30 P.M., until he died. Asked the proximate cause of Mr. Reid's death, Dr. Moore stated: 'It would be impossibel to state a cause of death as far as I am concerned.' The record shows Dr. Moore further testified:

'Q Would you state what your judgment as to the causes of death is?

'A The burns that were present were very obvious, and the laboratory studies done on admission confirmed the severity of the burns. In addition the records indicate he had had progressively severe heart disease by electrocardiograms, this disease presumed to have been arterio-sclerotic. My feeling is that the alteration secondary to the burns, plus the alteration in his conduction system secondary to his previous disease was such that the two together made it impossible for his heart to function adequately.

'Q You say your feeling, that is your best judgment?

'A My best judgment.

'Q Is this a correct statement, you are saying or have said in your judgment and opinion Mr. Reid's heart condition and the burns to his body actively cooperated to produce death at that time?

'A I think the heart disease alone would not have killed him; I think the burns alone would not have killed him; and if this is to be construed that the two together cooperated, I would say yes.

* * *

* * *

'Q As to the cause of the death February 24 likewise the burns alone would have produced death?

'A I am not a burn doctor; don't get me in the position of saying I know how to treat burns, or that the burns alone would have killed him; I would not make a judgment as to the burns alone; I feel they would not have; but I do not feel able to render an honest opinion on that; that should be left to the surgeon.'

Dr. Moore executed proofs of death submitted in serveral of the claims submitted by the appellee. On these papers he listed the cause of death as follows:

'Cause of death--(a) Adams-Stokes syndrome.

Due to (b) Gastrointestinal hemorrhage.

Due to (c) 50% 1~ and 2~ burns.

* * *

* * *

'Patient suffered fainting spell in shower at home resulting in severe burns to upper part of body. This accident was not the direct cause of death.'

The defense also introduced a letter of Dr. Kenneth K. Meyer, a surgeon on the staff at Ochsner's. In this letter Dr. Meyer stated:

'* * * It was the impression of the pathologist that the burns were not a direct cause of Mr. Reid's death. It was felt that the basic significant factor was the defect in the conduction mechanism of the heart, mainly the complete atrial ventricular block with Stokes-Adams syndrome, which caused the fainting in the shower through which he received first and second degree burns. As you probably know, after he was here in the hospital, he had another attack of this AV block with complete stoppage of the heart beat, which was restored by massage and electrical cardiac pacemakers. However, as is usual at the agonal contractions at death, at the time this AV block occurred he aspirated gastric contents into the tracheo-bronchial tree. The third factor was the massive gastro-intestinal hemmorrhage that was found. There was blood along the entire length of the gastro-intestinal tract, which had apparently occurred sometime before death. The source of this bleeding could not be found at autopsy and it is impossible to state what its relationship could have been to the fall. It was felt that the burns themselves were not sufficiently severe to have caused his death, at least in this interval. It is unlikely that any single one of the conditions found, namely the defect in the conduction mechanism of the heart, aspiration of the gastric contents, massive gastro-intestinal hemorrhage, or the first and second degree burns, would of themselves cause death.

'Although the burns were not a direct cause of Mr. Reid's death, the physiologic changes due to burns were undoubtedly a factor in his death. I think it would be very difficult to assess the exact importance of these but they certainly were a factor. * * *'

We note that Dr. Moore testified that the doctors he remembered as being in attendance upon Mr. Reid at Ochsner's were Drs. McKee, Webster, Ochsner, and himself. We infer that Dr. Meyer did not attend Mr. Reid.

The defense also introduced into evidence the death certificate on Mr. Reid, executed by Dr. Brumfield, a resident physician on the staff at Ochsner's, and the...

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