Cаtherine Turner Fulk (“Fulk”) filed a claim for damages against the Illinois Central Railroad Company (“Illinois Central”) under the Federal Employers Liability Act (“FELA”), 45 U.S.C. § 51
et seq.
Fulk alleged that various acts of negligence by Illinois Central caused the death of her late husband, Larry D. Turner (“Turner”). In particular, Fulk’s Amended Complaint raised four separate charges of negligence.
1
The
I.
In their briefs, both parties presented encyclopedic recitals of the facts adduced at trial. We reproduce here only those facts necessary to set the context and decide the issue before us.
At the time of his death on November 19, 1990, Larry Turner had been employed as a switchman for the Illinois Central Railroad for almost twenty years. As a switchman, Turner’s daily routine required him to walk several miles a day over rock ballast and to throw perhaps as many as fifty switches, some of which were difficult to thrоw because of their age or state of disrepair. In short, his job often involved long hours and strenuous work.
Turner’s medical records indicate that he suffered from high blood pressure throughout his career. Periodic physical examinations from 1972 through 1982 revealed a few temporarily disabling ailments, but Turner’s blood pressure apparently was under control as it never caused him to be disqualified from work. On July 25, 1983, however, Dr. J.R. Mallory examined Turner on behalf of Illinois Central and found him to be “moderately overweight and hypertensive.” Dr. Mallory notified Illinois Central that Turner could be continued in service, but required Turner to submit a status report in two weeks regarding his weight and blood pressure. Illinois Central then sent a letter reflecting Dr. Mallory’s directive tо Turner. Just over a month later, Turner was re-examined by Dr. Mallory (this time as Turner’s private physician) who found improvement in Turner’s blood pressure and weight. Dr. Mallory prescribed medication and requested another status report in six months. Once again, Dr. Mallory transmitted his findings to Illinois Central, which, in turn, sent a letter to Turner imparting the doctor’s orders. After the six month interval had passed, Dr. Mаllory examined Turner and reported to Illinois Central that Turner’s hypertension and weight were under satisfactory control. The doctor told Turner that he should continue follow-up with a private doctor, but no longer required status reports. Illinois Central again sent Turner a letter memorializing Dr. Mallory’s findings.
At trial, Dr. Dettro testified that he, in fact, believed he was examining Turner for work as a brakeman, a job which he understood to require “low to medium physical exertion.” Dr. Dettro further testified that, in view of Turner’s high blood pressure, he would not have approved Turner for continued service if he had appreciated the distinction between a brakeman and a switchman. Dr. Dettro was certain that he communicated to Turner the seriousness of his condition and the need to continue taking his medicаtion and schedule periodic check-ups. Dr. Dettro also testified that Turner failed to schedule a return visit within sixty days, or at any time prior to his death. After Turner neglected to appear as requested, Dr. Dettro did not attempt to contact Turner. Further, the record discloses no evidence of Turner visiting any doctors after his September 29, 1989, examination.
On November 19, 1990, Turner suffered a fatal ventricular arrhythmia while on the job. At trial, Dr. Stuart Frank, a cardiologist, testified for Fulk. According to Dr. Frank, an autopsy of Turner showed evidence of congestive heart failure that had been present for “weeks, months, or even longer, possibly.” In Dr. Frank’s opinion, this condition could have been diagnosed if Turner had been seen by a physiсian “certainly in the few days or few weeks prior to his death.” Dr. Frank believed that Turner should have been examined frequently enough to ascertain whether his blood pressure was under control, but Dr. Frank could not say precisely how often. If Turner’s blood pressure had been treated regularly, and if he had lost weight and stopped smoking, Dr. Frank testified that Turner probably wоuld have lived out the normal life expectancy for a man his age.
Although Dr. Frank testified that the autopsy report showing excessive heart weight revealed a “gross discrepancy” with Dr. Det-tro’s clinical finding of a normal heart size, Dr. Frank had no criticism of Dr. Dettro’s September 1989 examination of Turner. Dr. Frank testified that while Dr. Dettro’s examination could not have determined the size of the heart, it could have determined whether Turner had congestive heart failure at that time.
Dr. Gerry Smyth, a cardiologist, testified as an expert for Illinois Central. It was Dr. Smyth’s opinion that Turner could not have been in congestive heart failure at the time of Dr. Dettro’s examination. In Dr. Smyth’s view, Turner’s congestive heart failure and heart disease could nоt have been discovered unless Turner had submitted to an examination within a month or so of his death. Thus, Dr. Smyth did not believe that Turner’s death would have been avoided even if Illinois Central had required regular examinations as frequently as every six months “unless the examination happened to have just occurred within a month prior to his death.”
II.
Fulk contends that she is entitled to a nеw trial because the district court erred in granting judgment as a matter of law to Illinois Central on the allegations raised in paragraph 12(d) of her Amended Complaint. We review a district court’s decision to grant judgment as a matter of law
de novo. Harrison v. Dean Witter Reynolds, Inc.,
974
We are, of course, mindful that Fulk’s case arises under the FELA, a broad remedial statute that is to be construed liberally in order to effectuate its purposes.
Kulavic v. Chicago & Illinois Midland Ry. Co.,
The district court granted Illinois Central’s Rule 50(a) motion only as to paragraph 12(d), which read as follows:
The Defendant with knowledge of decedent’s high blood pressure and hypertension should have had him examined more frequеntly with more detailed examinations to determine his physical ability to perform his switchman’s job without danger to his life.
Relying on a recent First Circuit case,
Moody v. Boston and Maine Corporation,
the Court declined to submit paragraph 12(d) to the jury because the FELA imposes no duty on a railroad to perform periodic physical examinations on its employees.
Fulk maintains that Dr. Dettro’s September 29, 1989, examination of Turner may have imposed on Illinois Central various duties. In suppоrt of this argument, Fulk first attempts to distinguish
Moody
on its facts. Fulk asserts that
Moody
is inapposite here because there were no prior physical examinations performed on the decedent in
Moody
and the railroad knew little, if anything, of the decedent’s deteriorating physical condition. Then, drawing on
Fletcher v. Union Pac. R. Co.,
We disagree. First, we note the division of labor between judge and jury in a tort case based on a negligence theory. “Duty is an essential element of negligence,”
Homer v. Pabst Brewing Co.,
We now turn to whether the district court erred in entering judgment as a matter of law on the basis that Illinois Central owed Turner no duty of the kind alleged in paragraph 12(d) of the Amended Complaint. As noted above, Fulk calls our attention to
Fletcher
and
McGuigan
in support of her contention that the court did so err. Like
Moody, Fletcher
expressly states that a railroad has no general duty to ascertain whether an employee is physically fit for his job.
We are not persuaded by Fulk’s argument that Fletcher and McGuigan compel a different result in this case. Fulk presented no evidence from any physician establishing that Dr. Dettro negligently performed his September 29,1989, examination of Turner, and, in fact, Fulk’s medical expert, Dr. Frank, conceded on cross-examination that he had no criticism of Dr. Dettro’s examination. Fletcher and McGuigan are relevant to this case insofar as they establish that once an employer undertakes to provide medical attention it must do so in a non-negligent manner. While this general duty to provide competent medical carе may include, in an appropriate case, a specific duty to advise an examinee that further medical supervision is necessary for his well-being, it has never been thought to require that an employer compel a 'competent adult patient to submit to further treatments or examination. Nor should it. Fulk submits that Turner may have ignored his doctor’s advice and decided to аwait orders from his direct employer before proceeding with any further treatment. That is his prerogative, but requiring an employer to oversee an employee’s compliance with doctor’s orders is too paternalistic a mandate for a court to impose, even under the liberal strictures of the FELA. We emphasize that this is not a case whеre an employer at all interfered with an employee’s doctor-patient relationship; here, rather, the employee independently expected his employer’s direction at every turn. This he may do, but, having done so, we hold that he cannot blame Illinois Central for the result.
Finally, we consider Fulk’s argument that Illinois Central’s continued monitoring of Turner’s condition pursuant to Dr. Mallory’s orders following the 1983 examination gave rise to a duty to follow a similar monitoring regimen following Dr. Dettro’s 1989 examination. This “estoppel” theory sounds in contract, not in tort, and while we may think that undertaking such a monitoring practice might be enlightened self-interest on the part of a business, at least to the extent that healthy employees are productive employees, we cannot agrеe that prior monitoring gives rise to a legal duty of the kind claimed by Fulk.
III.
Paragraph 12(d) of Fulk’s Amended Complaint simply alleged that Illinois Central should have examined Turner more frequently and in more detail. We have examined the few cases that address the scope of a railroad’s duty to examine its employees and we conclude that the FELA imposes no such duty on Illinois Central. We hold therefore that the district court properly granted judgment as a matter of law pursuant to Fed. R.Civ.P. 50(a). 4 Furthermore, we find that the exclusion of paragraph 12(d) did not prevent the jury from making the connection between Turner’s death and Illinois Central’s alleged negligence as to paragraphs 12(a), (b), and (c). Fulk received a fair trial and thе district court properly denied her motion for a new trial under Fed.R.Civ.P. 59. Accordingly, the judgment and order of the district court are Affirmed.
Notes
. Paragraph 12 of the Amended Complaint reads as follows:
12. The death of the decedent was directly and proximately caused by the negligence of the Defendant in the following particulars:
(a) Defendant provided decedent with an unsafe place in which to work.
(b)Defendant, through а medical doctor hired by Defendant to examine the decedent, had knowledge that the decedent was suffering from high blood pressure and hypertension and knew that he was and could be in danger of a ventricular arrhythmia attack in the event of physical stress brought on by working long hours over a long period of time and/or insufficient help and/or having to exert great physical force to throw the switches. That even though the Defendant, its agents, servants, employees and the doctors Defendant hired to examine the decedent had knowledge of this fact, nevertheless it negligently caused the decedent to suffer physical stress by requiring him to work more than an 8-hour shift for an unbroken string of three days prior to his death оn November 19, 1990, by failing to provide a third man for his switching crew as aforesaid, and by causing him to use great physical strength in order to throw the switches in his job as aforesaid.
(c) That the Defendant had knowledge of decedent's hypertension and high blood pressure and knew or should have known he was suffering from heart disease and had a duty to assign decedent to work for whiсh he was reasonably well-suited; which duty it breached by negligently assigning decedent to perform work as a member of a yard switching crew, the performance of which was dangerous to his health and his life because of his hypertension and high blood pressure, and heart disease.
(d) The Defendant, with knowledge of decedent’s high blood pressure and hypertension, shоuld have had him examined medically more frequently with more detailed medical examinations to determine his physical ability to perform his switchman's job without danger to his life.
. As noted above, the district court acknowledged this duty and concluded that Fulk had
. We think it clеar that Dr. Dettro was an agent of Illinois Central with respect to the September 29, 1989, examination of Turner in that the examination was ordered by Illinois Central.
Cf. Fletcher,
. Because we decide that the FELA imposed no duty on Illinois Central to examine Turner more frequently and in more detail, we need not reach Illinois Central’s argument that Fulk failed to present evidence that the failure to monitor proximately caused Turner's death.
