Lead Opinion
Certiorari directed to the Industrial Accident Commission. The return of the respondent commission reveals the following facts:
The proceeding was instituted by an application for benefits under the Workmen's Compensation Act, (Stats. 1917, p. 831), presented by the guardian ad litem and trustee of the incompetent wife and minor child of John Caffrey, deceased, whose death was alleged to have been caused by an injury received in the course of his employment and arising out of the employment. It appears that on Friday, July 26, 1918, Caffrey sustained a contused wound on the great toe of his right foot while engaged in the service of the petitioner. He continued at his work on Saturday and also on the following Monday. On Monday he had the toe dressed by Dr. Marvin at the emergency hospital of the Union Iron Works. On Tuesday, July 30th, the foot was so painful that after starting to work he returned home and undertook to treat the toe himself. He first complained of a swelling of the face on August 1st. On the following day, the symptoms of the face becoming alarming, Caffrey was removed to a hospital, where it was discovered that there was a streptococcic infection of the injured toe. The skin surrounding the toe was in an erysipelatous condition and there was a development of erysipelas on the face. The facial infection resulted in septicemia, from which Caffrey died on August 8, 1918.
The commission found that the germs which caused the facial infection were carried from the toe to the face by *Page 502 external means and that Caffrey's death was proximately caused by the original injury. It is contended on behalf of petitioner that these findings are not justified by the evidence.
The medical testimony upon which the commission based its finding that the germs which caused the facial infection were carried from the toe to the face by external means was, in effect, that such a method of transfer was exceedingly common, the transmission of the germs being very readily accomplished, that there was no reason to suppose that the infection had come from another source than the toe, and that, while it was within the realm of possibility for the infection to have come from another source, such hypothesis was so very much the least probable that it seemed useless to theorize as to such possibility in the face of facts indicating that the germs "certainly must have been carried" from the foot.
[1] It is contended on behalf of petitioner that this evidence shows that the opinion of the experts that the infection of the face was due to germs carried from the toe was pure "guess-work." The testimony shows, however, that the experts were not indulging in mere conjecture or speculation. They were giving what, on the facts before them, and in the light of medical science, appeared to be the most probable explanation of the event. The theory that germs were carried from the toe to the face was "guess-work" only in the sense that there was no direct evidence of the source of the facial infection. In the view of the experts, other admittedly possible causes were so far excluded by the conditions which were shown as to make the one which they advanced by far the more probable one. As stated in Santa v. Industrial Acc. Com.,
Petitioner, however, insists that, even if it be assumed that the facial infection was caused by germs carried from the toe by external means, the chain of causation was so *Page 503
broken that the original injury of the toe could not reasonably be said to have been the proximate cause of Caffrey's death. The rule of law which must guide us in the determination of the question thus presented is stated in Head Drilling Co. v.Industrial Acc. Com.,
The rule announced in Head Drilling Co. v. Industrial Acc.Com., supra, is well established in all cases where it becomes necessary to determine whether or not there is evidence to justify a finding that a subsequent injury or disease is part of the proximate consequences of an injury for which the defendant is responsible. In Dickson v. Hollister, 123 Pa. St. 421, [10 Am. St. Rep. 533, 16 A. 484], erysipelas followed a flesh wound received in the course of a fall occasioned by the defendant's negligence. At the time of the decision, the causes of erysipelas were not understood, but the mere fact that it frequently developed from personal injuries was held to warrant an instruction that the disease might be regarded by the jury as part of the injury itself. To the same effect is Houston T. C. Ry. Co. v. Leslie,
[2] It only remains to apply the above reasoning to the facts of the instant case. In the light of medical knowledge properly presented, to the commission that such a transfer of a streptococcic infection from a discharging wound as that found to have taken place in Caffrey's case is not only possible, but highly probable, we are of the opinion that the fact that the germs reached the face by external means and not through the system cannot, as a matter of law, be said in itself to have broken the chain of causation. But petitioner contends that Caffrey's conduct was such as to require a finding of negligence on his part. Caffrey was, of course, under a duty to use reasonable care to restore himself to health. [3] But if he conducted himself as would a reasonably prudent person in his situation and circumstances, and innocently enhanced the original injury, it was within the province of the commission to find that the original cause continued to the end and accomplished the final result, and was, therefore, the proximate cause, (Dunham v. Clare [1902], 2 K. B. 292; Hodgson
v. Robins, 7 B. W. C. C. 232, 233; Bailey v. Industrial Com.,
It appears that when the toe first troubled him, Caffrey had it dressed by Dr. Marvin at the emergency hospital at the ship-building plant. When called as a witness, the doctor did not recollect the case, but the hospital record as explained by him indicated that the toe was not in a very serious condition, that Caffrey was given no special warning, and that he was told to go to another hospital in a day or two when the dressing needed to be changed. The next day he started to work, but, on account of the pain in the foot, he returned home. He might have had free treatment *Page 506 at the hospital maintained by petitioner for its employees, but he chose instead to remain at home and treat the foot himself with witch hazel and iodine. In the light of subsequent events, this was an unfortunate decision. We are, however, unable to say as a matter of law that the commission was bound to find that, under all the circumstances appearing at the time, it was a decision so unreasonable and imprudent as to amount to a breach of his duty to use due care to restore himself to health. There is no further fact in the case upon which negligence can be predicated. It is not suggested that Caffrey failed to use due care in his own treatment of the foot. It was not until the third day of his absence from work that he first noted a swelling of the face, which he at that time attributed to a cold in the head. The toe, however, was improving, and he wrote to his foreman on that day that he was a little better and that he would try to return to work as soon as possible. Serious symptoms first developed on the face on the following day and without further delay he was removed to a hospital for treatment.
The facts of the case are not such as to warrant the conclusion that the commission was bound to find that the transfer of the germs from Caffrey's toe to his face was due to his own negligence. It follows that we cannot disturb the finding that his death was the natural consequence of the original injury.
The award is affirmed.
Wilbur, J., Melvin, J., Lawlor, J., Olney, J., and Angellotti C. J., concurred.
Dissenting Opinion
I dissent. Caffrey, while at work for his employer, had an accident which abraded the skin of his toe. From that abrasion natural causes which he could not control brought on an infection in the toe. The infection and consequent diseased condition of the toe were the proximate results of the abrasion and of the accident. But the infection did not reach his face by the operation of natural causes. The commission so found. It reached the face by being subsequently carried there, either from some other source, or by some agency entirely disconnected with the infected condition of the toe, or by his own act in *Page 507 carelessly or accidentally touching his face with something which had been in contact with the infection in the toe. Any one of these causes would be an independent intervening cause and not a cause arising proximately from the injury.
It makes no difference, with respect to this question, whether the act of Caffrey which carried the infection to his face, if it was so carried, was negligent or merely accidental; in either event it was a cause independent of the original injury and intervening it and the deposit of the infection on the face. The opinion of the majority appears to assume that an act of the injured person cannot be an independent intervening cause unless it is a negligent act. This, of course, cannot be correct. The question whether or not it is negligent has no place in an inquiry whether or not it is an independent intervening cause.
The decision and the reasons therefor stated in Head DrillingCo. v. Industrial Acc. Com.,