Williams v. Fuqua, 4761

• Decision Date: 20 January 1958
• Docket Number: No. 4761,4761
• Citation: 199 Va. 709,101 S.E.2d 562
• Parties: RUTH S. WILLIAMS v. FRED B. FUQUA, EMPLOYER, AND LIBERTY MUTUAL INSURANCE COMPANY. Record
• Court: Virginia Supreme Court

Page 562

101 S.E.2d 562

199 Va. 709

RUTH S. WILLIAMS v. FRED B. FUQUA, EMPLOYER, AND LIBERTY MUTUAL INSURANCE COMPANY.

Record No. 4761.

Supreme Court of Appeals of Virginia

January 20, 1958.

Basil G. Watkins (L. Bradford Waters, on brief), for the appellant.

James R. Caskie and William W. Sweeney (Caskie, Frost, Davidson & Watts, on brief), for the appellees.

JUDGE: SPRATLEY

SPRATLEY, J., delivered the opinion of the court.

This appeal brings up for review an award of the Industrial Commission refusing compensation to appellant on the ground that there was no causal connection between the death of her husband, John C. Williams, and the work he was doing for his employer.

Williams, 59 years old, was employed as a brickmason by Fred B. Fuqua. On May 7, 1956, while engaged in pulling a board, attached to a rope, up to a scaffold, he suffered a painful injury to his back. The board, 12 to 15 feet long, was made of oak and weighed approximately 30 pounds. He made no complaint of his injury on the above date, and continued to perform his work as usual for the remainder of the day. On the next day, May 8, he informed his fellow employees and his employer that his back was hurting him and that the pain was a result of his accident the previous day. He then consulted Dr. John Devine for treatment of the strain to his back. On May 11, Dr. Devine had Williams enter a hospital for treatment of his back injury. On May 12, five days after the date of his injury, Williams suffered a coronary occlusion. Dr. Devine, a surgeon and general practitioner, then called in Dr. Robert L. Brickhouse, who practiced internal medicine including cardiology, to treat his patient. Dr. Brickhouse consulted with Dr. W. S. Hooten, who specialized in cardiology; but Dr. Hooten did not treat Williams. Williams remained at the hospital until June 13, when he was allowed to return to his home for convalescence. On June 14, he died. His death certificate, issued after an autopsy was performed, listed the cause of death as acute myocardial infarction.

Williams, in a written statement of his injury, dated May 30, 1956, stated that 'During the time from when I hurt my back on 5-7-56, until the stroke on 5-12-56, I had no pains in any other part of my body at all but my back, and I had no spells of weakness or dizziness nor feeling of nausea, nor shortness of breath, and no other ailments of any kind. I felt well completely except for my back. * * *'

Evidence of the claim of Mrs. Williams for compensation was heard by Commissioner Evans. At that hearing, Dr. Brickhouse and Dr. Hooten, the consultant, testified that it was their considered opinion that the strain suffered by Williams in lifting the board on May 7, brought about the heart attack on May 12, which resulted in his death.

Dr. R. Earle Glendy, a cardiologist, was furnished a chronological history of the events leading up to employee's death, the clinical and pathological reports, and a report of the Veterans Administration Hospital. The hospital report showed that Williams, prior to his death, was receiving permanent total disability benefits based upon nonservice-connected conditions defined as: 'Valvular heart disease, myocardial damage, auricular fibrillation, Class III; Hyperthyroidism; Adenoma of the thyroid, operated, cured; Pterygium, left.'

Dr. Glendy made a written report in which he expressed, in part, the following opinion:

'After a careful review of your investigation and the clinical reports attached it is my opinion that the proximate cause of this man's death was myocardial infarction due to severe coronary atherosclerosis, and that the etiology of the heart condition is in no way related to the back condition for obvious reasons evident in the pathological protocol. Coronary atherosclerosis is an insidious, slowly developing condition unrelated to trauma or strain.

'Now the question as to whether the 'slight' exertion of lifting the board to the scaffold had any relation to the heart condition and the subsequent heart attack I would say first that it had no etiological relationship to the heart condition, which despite his denial of symptoms, undoubtedly existed before the strain occurred. The next question to be answered is: Can a strain precipitate thrombosis in a coronary vessel that is already atherosclerotic? In answer to this I quote directly from a chapter on Trauma and Heart Disease by Dr. Paul D. White and myself from Trauma and Disease edited by Brahdy and Kahn * * *. ' Probably yes, in infrequent cases. Certainly in the large majority of instances sudden occlusion of a coronary artery takes place when the patient is at rest, often at night, when the slowing of the blood stream may play a role. Occasionally, however, there appears to be a direct relationship between trauma and coronary thrombosis. A few minutes, a few hours, or a day or two after some fall or blow, or other physical strain typical coronary occlusion may set in. Of course it may be argued that this is merely a coincidence, but it has happened with enough frequency to make coincidence unlikely in the majority of such cases. A long time interval (in this case 5 days) between the trauma (or strain) and the appearance of the coronary thrombosis should rule out their relationship; arbitrarily one may set this interval at several days, certainly not more than one week; however, the interval may be extended to two weeks in cases in which coronary thrombosis develops following a severe injury, which confines the patient to bed for many days -- but even in such cases, coronary thrombosis that appears more than two weeks after the injury had better be regarded as a coincidence. The way in which coronary thrombosis is precipitated in a diseased vessel by trauma (or strain) is not known; perhaps an atheromatous abscess is ruptured, or a calsified plaque is broken.'

'In the light of the above quote, which is authoritative, I believe, I would regard the relationship between this man's physical strain of lifting the board to the scaffold and his coronary thrombosis as possible but tenuous, because his initial complaint did not appear to be cardiac in origin but rather related to a back strain. Furthermore, since he was not confined to bed after admission to the hospital it is unlikely that a heart condition (i.e. coronary thrombosis) was even considered until after his severe attack on May 12, 1956, five days after the alleged strain. Accordingly I am more inclined to feel that the coronary attack here was coincidental rather than related to or precipitated by the strain of lifting the board to the scaffold. However, the matter of aggravation of angina pectoris and other manifestations of coronary disease by trauma and mental and physical strain remains somewhat controversial and not always easy of interpretation.'

Commissioner Evans, on account of the conflict in the medical evidence, referred the file in the case to Dr. L. W. Hulley, Jr., Medical Advisor to the Industrial Commission, for his opinion as to the relationship between the injury of May 7, and the fatal heart attack. Dr. Hulley came to the conclusion that there was no causal relation. It...