Prudhomme v. DeSoto Professional Home Health Services
| Decision Date | 08 May 1991 |
| Docket Number | No. 22331-CA,22331-CA |
| Citation | 579 So.2d 1167 |
| Parties | Alice PRUDHOMME, Plaintiff-Appellant, v. DeSOTO PROFESSIONAL HOME HEALTH SERVICES and Commercial Union Insurance Company, Defendants-Appellees. 579 So.2d 1167 |
| Court | Court of Appeal of Louisiana — District of US |
Brittain, Williams, McGlathery, Passman & Sylvester by J. Morgan Passman, Natchitoches, for plaintiff-appellant.
Lunn, Irion, Johnson, Salley & Carlisle by Julia A. Mann, Shreveport, for defendants-appellees.
Before LINDSAY, BROWN and STEWART, JJ.
On July 9, 1987 plaintiff, Alice Prudhomme, sued for worker's compensation benefits. She claimed to have been disabled due to a work-related injury that occurred on March 6, 1985. Plaintiff was paid worker's compensation benefits until May 13, 1986 when they were terminated by defendants after receiving medical opinions that plaintiff could return to work. Plaintiff named as defendants her employer, DeSoto Professional Home Health Services, (Health Services) and its insurer Commercial Union Insurance Company. After a lengthy trial on the merits, the court found that plaintiff's claims for disability benefits had prescribed but those for supplemental earnings benefits (SEB) had not. However, the court denied supplemental earnings benefits finding that plaintiff failed to prove a causal connection between the accident and her disability. Plaintiff then appealed the rejection of her claim for supplemental earnings benefits. The issue presented is factual and finding no manifest error, we affirm.
Plaintiff was 51 years old on the date of the accident and had been employed as a Licensed Practical Nurse since 1970. Prior to the accident in this case, plaintiff injured her back in 1974 while lifting a patient and eventually had surgery for a bulging disc. Plaintiff received worker's compensation benefits and returned to work approximately six months thereafter. In 1982 plaintiff had a minor automobile accident. Following the accident plaintiff experienced such back pain that she was unable to work for approximately one year.
Plaintiff was first hired in April 1981 by defendant, Health Services, but was voluntarily terminated in August 1982 after indicating she was unable to work. She was subsequently hospitalized and was found to have degenerative changes of the entire lumbar spine. Between 1979 and 1984, she was hospitalized on approximately five different occasions and was seen by numerous physicians regarding her back complaints. Plaintiff was rehired in July 1983 and returned to work on a part-time basis for approximately one month before returning to full-time status.
Plaintiff's job duties as a home health nurse included taking patients' vital signs, teaching the family how to care for the patient, caring for the patient's wound or bed sores, changing catheters if necessary and administering insulin for diabetic patients. Driving was required in order to visit the patients' homes, many of whom lived in rural isolated areas throughout Sabine and DeSoto parishes. She was required to carry nursing supplies, such as catheters, weighing approximately seven pounds. Plaintiff was rated by her employer as an above average nurse in the performance of her duties.
On March 6, 1985, plaintiff was at a patient's home and completed taking vital signs with a thermometer, blood pressure cuff and stethoscope. Although plaintiff gave several inconsistent versions, it appears that she then turned away from the patient and felt a burning pain in her back and right hip. Plaintiff completed her rounds, seeing three more patients. She returned home and called a neighbor to help get her into bed due to back pain. At trial, plaintiff complained of disabling chronic low back pain occurring since the date of the accident.
Following the 1985 accident, plaintiff was seen by a multitude of physicians for evaluation and treatment. She was examined immediately following the accident by Dr. Leigh Dillard, a general practitioner, who had treated her since 1978. Plaintiff was complaining of back and leg pain mainly on the right side. Due to plaintiff's previous history, Dillard felt hospital admission was indicated. Tests revealed the suggestion of a bulging disc at the L5-S1 interspace. Dillard continued to treat plaintiff based on her subjective complaints of pain and believed she would eventually get better. Plaintiff indicated on January 6, 1986 that she had injured her back with the minor trauma of reaching up to get some canned goods off the shelf. However, the examination showed no significant change. Dr. Dillard did not feel that plaintiff had sustained a new injury but rather only an exacerbation of her continued symptoms. By February 13, 1986, Dr. Dillard had become frustrated with plaintiff's progress and did not feel that there was any surgical solution. Dr. Dillard felt plaintiff had degenerative arthritis and disc disease with chronic sciatica. Dr. Dillard admitted plaintiff's stress seemed to play a large part in her physical condition as during a crisis plaintiff would come in with severe back pains. Dr. Dillard had previously treated plaintiff for back pain following the 1982 car accident and at that time felt she had a chronic low back syndrome which made her unable to work. Dr. Dillard felt that any exacerbation that plaintiff may have experienced due to the work-related injury had been resolved and he could not relate any of plaintiff's present complaints to her alleged work injury.
Dr. Jack Grindle, a general surgeon and family practitioner, had also treated plaintiff for a number of years. Dr. Grindle stated plaintiff had worked for approximately 12 years without any pain and was unaware of any back problems plaintiff may have had between 1974 and 1985. Dr. Grindle did not know why plaintiff had had continuing pain since March 1985 as normally the pain should have only existed for a short period of time. Dr. Grindle noted that other factors could have exacerbated plaintiff's condition after that time. Based on plaintiff's history and onset of chronic pain immediately after March 1985, Dr. Grindle believed that the incident had contributed to or aggravated plaintiff's condition as she became more symptomatic after that date.
Dr. William Bundrick, an orthopedic surgeon, examined plaintiff on February 17, 1986 at the request of the defendants. The neurological exam was normal and Bundrick found no evidence of any recent nerve root irritation. X-rays revealed narrowing of the L5-S1 disc space and some minimal changes at the L3/4 disc space. Dr. Bundrick's impression was that plaintiff had a chronic lumbosacral myoligamentous strain with no evidence of nerve root irritation. Dr. Bundrick recommended that plaintiff continue conservative treatment and did not see the need for surgical intervention. Bundrick felt that plaintiff could return to work as of March 1986 with a limitation of moderate to heavy lifting of 35 to 50 pounds. Given her history, Dr. Bundrick could not tell whether plaintiff's chronic back strain was due to degenerative disc disease or to her alleged injury. Dr. Bundrick stated it would be very difficult to determine the actual site of plaintiff's pain and when it originated.
Plaintiff was examined by Dr. Richard Gray, a neurosurgeon, on April 17, 1986 upon a referral by Dr. Grindle. Plaintiff complained of back and left leg pain and related her history of having a discectomy in 1974, being pain free for 12 to 13 years and reinjury in 1985. Plaintiff did not reveal any problems with her lower back during that interim. Dr. Gray felt plaintiff's examination was near normal and she could probably be successfully treated with conservative measures. Dr. Gray believed that most of her problems were the result of a lumbar sprain or strain and surgery was not indicated. The examination did not reveal an indication that plaintiff had a ruptured disc and Dr. Gray believed that plaintiff could go back to some type of work limiting her lifting to 10 pounds with minimal bending. Dr. Gray released plaintiff to return to work and stated she appeared to be in good health. Dr. Gray performed a myelogram and the comparison of that myelogram with one taken several years earlier showed no changes. The myelogram was normal other than for some post-surgical changes at the lower lumbar segment. There was no evidence of any type of disc bulge or impingement of nerve roots. Dr. Gray stated that plaintiff's initial accident was not the type of injury one would suspect would cause a ruptured disc and with plaintiff's history, he assumed plaintiff's "injury" was probably an exacerbation of her original problem of degenerative changes that occurred in 1974. Plaintiff's description of her onset of pain would be more a manifestation of her preexisting problem rather than a separate injury.
Plaintiff was then seen by Dr. Albert Dean, another orthopedic. Plaintiff related a history of back problems with pain and previous surgery in 1974. Plaintiff stated that she had done well following the surgery until the March 1985 accident. Plaintiff's x-rays and myelogram were unremarkable. Plaintiff had some narrowing of the L5-S1 disc indicating degenerative changes but Dr. Dean did not find any disabling condition or evidence of disc herniation or rupture. Plaintiff's myelogram showed a slight change at the L5-S1 disc space slightly to the left and a slight posterior bulge at the L4-L5 space. There was also scarring at the L5-S1 disc level. After completing his testing, Dr. Dean was convinced there were no objective symptoms or signs of injury. In August 1986, Dr. Dean was of the opinion that plaintiff could return to work but would not be able to perform any hard labor or heavy lifting. Dr. Dean did not believe plaintiff's twisting injury in March 1985 would have been a permanent aggravation of her condition. A patient with degenerative disc disease could have that condition aggravated with a simple...
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