Wilson v. Shady Grove Adventist Hosp.

• Decision Date: 31 March 2010
• Parties: Shannon M. WILSON v. SHADY GROVE ADVENTIST HOSPITAL, et al.
• Court: Court of Special Appeals of Maryland

993 A.2d 120

191 Md. App. 569

Shannon M. WILSON v. SHADY GROVE ADVENTIST HOSPITAL, et al.

No. 2588 September Term, 2008.

Court of Special Appeals of Maryland.

March 31, 2010.

Ari N. Laric (Chasenboscolo, Injury Lawyers, on the brief), Greenbelt, MD, for Appellant.

Jeffrey W. Ochsman (Todd S. Sapiro, Elizabeth B. Fisher, Friedlander Misler PLLC, on the brief), Washington, DC, for Appellees.

Panel: DAVIS, JAMES R. EYLER and MATRICCIANI, JJ.

DAVIS, Judge.

Appellant, Shannon Wilson, appeals from the judgment of the Circuit Court for Montgomery County in favor of appellees, Shady Grove Hospital and Sisco Insurance Company, finding that his left knee condition was not causally related to an earlier work-related accidental injury, reversing the decision of the Workers' Compensation Commission (WCC). On appeal, appellant presents this Court with two questions, which we have rephrased as follows:

I. Did the trial court err in instructing the jury on the law of proximate cause in a workers' compensation case?

II. Did the trial court err in submitting to the jury the issue of whether the left knee condition was proximately caused by a pre-existing back injury?

For the reasons that follow, we answer the first question in the affirmative and decline to reach the merits of the second question. Accordingly, we reverse the decision of the circuit court.

PROCEDURAL AND FACTUAL BACKGROUND

Appellant worked for appellee, Shady Grove Hospital, as a psychiatric technician. His duties included monitoring psychiatric patients, recording their vital signs and progress and, from time-to-time, restraining the patients for their safety. On July 14, 2006, while restraining a patient, appellant fell to the ground and injured his right knee. Accordingly, appellant sought and obtained treatment from Dr. James Weiss, an orthopedic surgeon. Pursuant to Dr. Weiss' recommendation, appellant underwent surgery on his right knee in November 2006 and again in June 2007. In May 2007, appellant began complaining of pain in his left knee and Dr. Weiss ordered an MRI of the left knee.

Appellant sought approval of the MRI of the left knee from the Workers' Compensation Commission. A WCC hearing was held on March 31, 2008 on the issue of whether appellant's left knee injury was causally related to the work-related injury that occurred on July 14, 2006.¹ Before the WCC, appellant testified that, after both of the surgeries to his right knee, he was required to wear a leg brace that immobilized his right leg which, he testified, caused him to favor his left leg, ultimately producing pain in his left knee due to overuse. Appellant also submitted the deposition testimony of Dr. Weiss, which we shall highlight infra. On April 22, 2008, the WCC issued an Order, finding that "the disability of appellant's left knee and medical treatment is causally related to the aforesaid July 14, 2006 accidental injury." Accordingly, the WCC authorized the MRI of the left knee.

Appellees appealed the decision of the WCC to the Circuit Court for Montgomery County. A two-day trial was held from December 18, 2008 to December 19, 2008. The crux of appellees' case in the circuit court was that appellant's left knee injury was not causally related to the July 14, 2006 injury. In their opening argument, appellees asserted that appellant had suffered an earlier back injury in 2004 for which appellant had been receiving treatment from Dr. Weiss through 2008. As a result of that injury, appellant experienced numbness and pain running down his right leg and foot and, occasionally, his left leg. Appellees presented the expert testimony of Dr. John O'Donnell,² an orthopedic surgeon, who had examined appellant on multiple occasions. Dr. O'Donnell's opinion was that appellant's left knee pain was not causally related to "overuse" as a result of his compensation for his right knee injury. He testified, in pertinent part, as follows:

Appellees' counsel: And Doctor, based upon your experience, your review of the medical records, the diagnostic studies, your physical examination of appellant, do you have an opinion within a reasonable degree of medical probability as to whether the left knee complaints are causally related to the July 14, 2006 work injury involving a (unintelligible)?

Dr. O'Donnell Yes.

. . . .

That they are not related.

. . . .

He wasn't—he didn't injure himself. He didn't injure his left knee on July 14, 2006. And he had, to my knowledge, no history of an injury on or about that time.

Appellees' counsel: And doctor, again,. . . do you have an opinion as to whether or not appellant's left knee complaints are causally related to overuse after having surgery on the right knee, putting more pressure on the left knee, and that's the cause of his knee complaints?

Dr. O'Donnell: Yes, I do. . . . I don't believe it has anything to do with his right knee.

Dr. O'Donnell further testified that, in his opinion, due to appellant's right knee pain, appellant was more likely to have reduced his amount of physical activity in general. But he further testified that, even assuming that appellant did not decrease his activity, there was "no evidence in orthopedic literature that increasing activities is bad for you," and that orthopedists routinely send their patients to physical therapy post-surgery for the very purpose of increasing physical activity in order to strengthen muscles. Thus, Dr. O'Donnell concluded that he did not "believe that favoring the left knee because you can't put weight on the right would have any influence on this particular problem."

By contrast, appellant's expert witness and treating physician, Dr. Weiss, testified that appellant's left knee pain was causally related to the July 14, 2006 injury. Dr. Weiss testified, in pertinent part, as follows:

There's a couple of reasons. One is appellant has no known history of knee problems, at least none I've ever seen documented prior to his injury. And he developed left knee problems without any change in the status of his left knee problems without any change in his left knee, meaning there was no interceding injury to his left knee that I've ever seen documented. And that he has significant problems with his knee which has forced him to use his left knee to substitute for the function of his right knee to a significant extent and so the only conclusion I can come to is that he never had a problem with his knee before. He did not specifically have an interceding injury to his left knee, and he began to get symptoms in his left knee while he was favoring or trying to recover from his right knee.

So to me, the cause and effect is . . . in that he has consistently complained of the transferring of stress to his left knee and resulting symptoms from his inability to use his right knee.

At the conclusion of the evidence, the parties disagreed as to the proper instruction to be submitted to the jury on causation. Over appellant's objection, the trial court instructed the jury as follows: "In this case causation means that appellant's work related injury of July 14, 2006, to his right knee, is a cause of the condition of his left knee." The jury then began its deliberations with a verdict sheet that posed a single question: "Is the disability of the claimant's left knee causally related to the July 14, 2006 injury?" The jury returned a verdict in favor of appellees. Appellant noted a timely appeal to this Court. Additional facts shall be supplied infra as warranted.

STANDARD OF REVIEW

In addressing the standard of review that we shall apply in this appeal, we initially observe that this case reached the circuit court in the form of an appeal from the decision of the WCC. We have previously recognized that appeals from the decisions of the WCC may be reviewed by circuit courts through two different modalities:

"The practice is that appeals are presented to trial courts in one of two fashions: (1) the submission of the case to the judge on the basis of the record made before the Commission; or (2) a de novo evidentiary hearing before the court sitting with or without a jury."

Bd. of Educ. v. Spradlin, 161 Md.App. 155, 167, 867 A.2d 370 (2005) (quoting R.P. Gilbert and R.L. Humphrey, Maryland Workers' Compensation Handbook, § 17.4, p. 342 (2d ed. 1993)). The appeal in this case proceeded before the circuit court by way of the latter modality with a jury, which has come to be known as an "essential trial de novo." Id. at 189, 867 A.2d 370 (explaining that "the reason for these differences between an essential trial de novo and a true trial de novo is to be found in the provisions of Md.Code (2008 Rep. Vol.), Labor and Employment, L.E. § 9-745(b)").³

"The de novo jury does not, as might an ordinary jury, render an ultimate verdict but only makes specific findings of fact on specific issues that are carefully framed and submitted to it." Id. at 190, 867 A.2d 370. On appeal in this Court, we do not disturb the jury's determinations of fact.

L.E. § 9-750 provides for appeal to this Court "as provided for other civil cases." . . . Thus:

`The verdict of a jury on a question of fact is conclusive on appeal.' Fowler v. Benton, 245 Md. 540, 545, 226 A.2d 556 (1967). It is not our function to inquire into the weight of the evidence, rather, we determine only whether there was legally sufficient evidence to support the jury verdict. Temoney v. State, 290 Md. 251, 261-62, 429 A.2d 1018 (1981); Gray v. Director, Patuxent Inst., 245 Md. 80, 84, 224 A.2d 879 (1966).'

Keystone Masonry Corp. v. Hernandez, 156 Md.App. 496, 506, 847 A.2d 493 (2004) (quoting Fraidin v. Weitzman, 93 Md.App. 168, 193-94, 611 A.2d 1046 (1992)). By contrast, when presented with questions of law, we engage in a de novo review. Barnes v. Children's Hosp., 109 Md.App. 543, 553, 675 A.2d 558 (1996) (citing Heat & Power Corp. v. Air Products & Chemicals, Inc., 320 Md. 584, 591, 578 A.2d 1202 (1990)). See also Wholey v. Sears Roebuck, 370 Md. 38, 48, ...