Minute Maid Corp. v. Florida Indus. Com'n, Workmen's Compensation Div.

• Decision Date: 07 May 1958
• Docket Number: No. 226,226
• Parties: MINUTE MAID CORPORATION and Employers Mutual Liability Insurance Company, Petitioners, v. FLORIDA INDUSTRIAL COMMISSION, WORKMEN'S COMPENSATION DIVISION, and Charlotte H. Williams, Respondents.
• Court: Florida District Court of Appeals

Page 104

104 So.2d 104

MINUTE MAID CORPORATION and Employers Mutual Liability Insurance Company, Petitioners, v. FLORIDA INDUSTRIAL COMMISSION, WORKMEN'S COMPENSATION DIVISION, and Charlotte H. Williams, Respondents.

No. 226.

District Court of Appeal of Florida, Second District.

May 7, 1958.

Monroe McDonald, of Sanders, McEwan & Berson, Orlando, for petitioners.

W. C. O'Neal, Gray, Chandler, O'Neal & Carlisle, Gainesville, for respondents.

SHANNON, Judge.

This petition for writ of certiorari is seeking review of an order of the Full Commission of the Florida Industrial Commission, Workmen's Compensation, Division, which order sustained an award of compensation entered by a Deputy Commissioner in favor of the claimant. The order of the Deputy Commissioner made the following findings of fact:

'2. The decedent was a sixty (60) year old white male. On July 30, 1956 the decedent was employed as a laborer by Minute Maid Corporation, loading small pieces of scrap lumber onto a truck. He worked from 8:00 A.M. to shortly after 9:00 A.M., at which time he complained of being too hot, and sat down in the shade. Shortly thereafter he again complained that he was too hot and thirsty and went to the first aid room where he laid down on a cot. While at the first aid room he vomited and had a bowel movement. He complained of weakness in his arms and legs, and of being cold especially in his legs. He was sweating profusely. However, at no time while he was at the first aid room did he complain of any pain or pressure in his chest or arm. The temperature ranged from approximately 79 degrees to 84 degrees between 8:00 and 9:00 A.M., and from 84 degrees to 87 degrees between 9:00 A.M. and 10:00 A.M. The humidity ranged from 82 percent at 8:00 A.M. to 77 percent at 9:00 A.M., to 67 percent at 10:00 A.M.

'3. Decedent was admitted to the hospital at 10:50 A.M. At that time, in addition to the above symptoms he was now complaining of severe pain in the right side of his chest. His temperature was 98 degrees. The heart sounds were of poor quality. At that time his condition was diagnosed as heat exhaustion with possible coronary thrombosis and beginning cardiac failure. The decedent was placed in an oxygen tent and given a sedative. His condition then appeared to improve but at 2:05 P.M. his breathing became labored and at 2:15 P.M. he died. The immediate cause of death was a coronary thrombosis. An autopsy revealed that heart vessels were markedly atheromatous with 40 to 80 percent narrowing.

'5. Claimant contends that decedent's work caused him to have heat exhaustion which in turn triggered the coronary attack. The carrier contends that decedent suffered a coronary attack which was not causally connected with his work and that decedent did not have heat exhaustion. The question is a very close one and turns upon medical interpretation of the substantially undisputed facts.

'6. It appears that in 90 to 95 percent of cases of coronary thrombosis the victim has arm or chest pain or pressure at the onset of the attack. (See Page 9 of Dr. Evans' deposition.) This was absent. Except for this important exception, the decedent's symptoms were consistent with the onset of a coronary thrombosis (without heat exhaustion) and completely consistent with the onset of a coronary in the five percent (5%) to ten percent (10%) who do not have pain or pressure in the chest or arms. On the other hand decedent's symptoms were consistent with heat exhaustion except that his temperature was a little higher than usual. Also heat exhaustion often triggers a coronary, particularly in older persons like the decedent. On the other hand, the attack began in midmorning before the highest temperatures had been reached, but while the humidity was fairly high. There are a number of other troublesome evidentiary facts to be weighed both pro and con.

'7. I find that the moderate exertion of loading the truck under the conditions present resulted in decedent suffering heat exhaustion. This appears to be an unexpected or unusual result happening suddenly. I further find that the heat exhaustion triggered the coronary thrombosis which caused decedent's death. * * *'

The Full Commission approved this order with a dissent written by one member.

The petitioner submits nine questions for us to consider but, in view of our opinion, it will be necessary to pass on but two. The questions, in the petitioner's language, are:

'There is no competent substantial evidence to support the finding that such heat exhaustion 'triggered' the coronary thrombosis which caused decedent's death.

'Where the question of the causal connection between the death of an employee from a coronary thrombosis and his employment turns upon medical interpretation of substantially undisputed facts and the evidence as to such causal connection leaves the question within the realm of speculation it is error to award compensation.'

It will be necessary to set out certain portions of the testimony of the only doctor who testified favorably to the claimant, Dr. Benneveld. The deceased employee was seen by Dr. Benneveld, a general practitioner, at 10:50 A.M. on the day of his illness, who made a diagnosis as follows:

'Q. Would you tell us please of the objective findings on that initial examination? A. The patient was too ill to give much coherent information; a brief cursory physical examination revealed blood pressure to be 164/118, pulse 92, respiration 28 and temperature 98 degrees; the heart sounds were of very poor quality on the cardiac auscultation;

'An admitting diagnosis was made of heat exhaustion with a possible coronary thrombosis and beginning cardiac failure.

'Q. Now Dr. Benneveld tell us if you will the symptoms.

'The Commissioner: All right go ahead.

'Q. (By Mr. O' Neal) Tell us Doctor if you will the symptoms and the basis upon which you formed the diagnosis of heat exhaustion. A. The appearance of the patient and clinical findings.

'Q. What appearance was made? A. The patient was clammy, profuse perspiration, and heart sounds were of poor quality, pulse was not of good volume.

'A. I would have to base my findings on purely objective findings; when the man came into the hospital he was obviously in a state of cardiac failure. He was also in a state of heat exhaustion. May I transgress just a little here?

'Q. (By Mr. O' Neal) Then to, to summarize your testimony then Doctor would it, would it be fair to say then that in your opinion this man suffered initially from heat exhaustion? A. It is awfully hard to make a statement of what came first because we only saw the man and he was brought in in this particular state, now what came first it is impossible for me to say.

'The Commissioner: Well were all the symptoms he had as indicative of a cardiac failure as they were indicative of heat exhaustion? In other words are there some symptoms which are peculiar to heat exhaustion which are not peculiar to a cardiac failure, so that you could say he had heat exhaustion or cardiac failure?

'The Witness: No, no, no, it is awfully hard to make a delineating fact there.'

After the death of the employee, there was an autopsy made which gave the cause of death with the findings as follows:

'1. Thrombus with occlusion of anterior descending branch of left coronary artery, recent.

'2. Coronary athersclerosis, severe with 60% to 70% narrowing of either side.

'3. Acute passive congestion of spleen and kidneys.

'4. Petechiae of kidneys due to anoxia.

'5. Bilateral apical scarring and pleural adhesions suggesting old healed tuberculosis.

'Cause of Death

'It is felt that death in this instance is due to the thrombus demonstrated in the anterior descending branch of the left coronary artery. This thrombus is of recent origin as substantiated by the microscopic appearance and the fact that no myocardial changes could be identified.'

We have set out the attending physician's findings, as well as the autopsy report. While we deem it unnecessary to set out the opinions of the two doctors who testified for the employer, it will suffice to say that the identical symptoms, which were found...