200 A. 224 | Pa. Super. Ct. | 1938
Argued April 19, 1938. Claimant filed a petition for compensation on behalf of herself and two minor children under sixteen years *268 of age. She averred that her husband, Rodger Johnson, died as the result of an accident in the course of his employment with defendant on July 20, 1934. From an award in her favor defendant's insurance carrier appealed unsuccessfully to the Workmen's Compensation Board and the court below.
On its appeal to this court, we are urged to reverse the judgment entered on the award for the following reasons: (1) That there was not sufficient competent evidence to sustain the finding that deceased suffered an accidental death as the result of the inhalation of ammonia fumes; (2) that expert testimony was necessary to establish a causal connection between the alleged inhalation of the ammonia fumes and deceased's death, and that such testimony was lacking.
Unless it can be said that there was no competent evidence to support the findings and conclusions of the referee and board, they cannot be disturbed (Petrovan v. Rockhill Coal Iron Co.,
The accident seems to have occurred between 3 and 4 o'clock P.M. The only eyewitness to the events culminating *269 in the demise of the deceased was H.E. Anderson, an electric welder, also employed by defendant employer. He testified that on the day in question he was called to make some repairs to the ammonia coils, located on the second story of one of employer's buildings, which were covered by a cone-shaped roof. When he arrived at the coils, deceased was already there, and was engaged in knocking the rust scale from the coils with a hammer, and standing between several sets of coils about three feet from Anderson. The two men were conversing, when deceased slumped down suddenly and tried to catch himself by the pipes. Anderson reached over and asked him what was wrong. Receiving no answer he called for help, and deceased was taken to the hospital. He testified further that later he returned to the place where deceased had been working, and found a hole in the pipe, the size of a little finger, from which ammonia fumes were escaping; that he was strangled by the fumes, and had to rush away to recover his breath. He explained that he did not notice the fumes when deceased was present because the leak was above the level of the head, and when deceased sat down the ammonia fumes would not be noticeable at that level. Furthermore, there was a breeze at that point blowing from Anderson toward deceased, and the fumes were not detected until he was within a foot of the hole from which they were escaping. Concerning the effects of inhaling ammonia fumes from the coils, Anderson said: "It gags you. You can't breathe, or talk, or anything. It shuts off your wind. . . . . . . You can't cough, or talk at all, you just have to get into the air until it wears off." Another employee testified similarly. Witnesses who helped remove deceased from between the coils or accompanied him to the hospital testified that "his condition was blue," and that "his color was very flushed and his throat was open, and it seemed to be blue (indicating on both sides)." *270
At the hospital Dr. W.F. Pohl examined deceased, and found that his heart had stopped. He testified that "he had more an ashen, or cyanotic color, but there was nothing else particular about him much, except that he had some odor of ammonia about him then," and that the odor of ammonia must have been on his body or clothes, or both. The undertaker testified that it was very difficult to prepare the body for burial; it was dark, especially the face, and very much congested; "his veins were swollen and his condition was about (indicating large neck)."
Dr. Pohl, who testified for claimant, expressed no opinion as to the cause of death; in fact, careful reading of the testimony discloses that he was not asked for one. The only other physician called by claimant was Dr. M.E. Headland, coroner of Butler County. He examined the body of deceased at the hospital, and testified, over objection of defendant, that "after investigation, and hearing the witness, and seeing the place where death occurred, it was my decision he was asphyxiated from ammonia gas." He so certified to the Bureau of Vital Statistics, and this certificate, offered in evidence by claimant, over objection of defendant, read: "Accidental death — asphyxiation from inhaling ammonia fumes while working at the Valvoline Oil Company." Plainly, the opinion of Dr. Headland was based on facts elicited by his investigation and inquiry. He was the first witness called by claimant, and neither stated the facts upon which his opinion was founded, nor had any of the circumstances surrounding the death of deceased been developed, so that it was a manifest impossibility for him to rely on anything then in the record. At that time it was barren, except for his own testimony. Consequently, his testimony, considered as that of a mere expert, was inadmissible. In Howarth et ux. v. Adams Express Co.,
We have held that certified copies of death certificates issued under Section 21 of the Act of June 7, 1915, P.L. 900,
These conclusions deprive claimant's case of any competent medical testimony concerning the cause of death, and if she were confined to such method of proof her cause would fail. In Bunnellv. State Workmen's Insurance Fund et al.,
We are of the opinion that there was sufficient competent evidence in this case to warrant the finding of the referee and board that deceased died as the result of the inhalation of ammonia fumes, because his death was "so immediately and directly, or naturally and probably, the result of the accident." Proof of causal connection did not depend solely on the testimony of professional or expert witnesses.
Prior to the fatal occurrence, deceased was to all appearances a healthy, robust man. Except for a trifling interruption, he worked steadily and without difficulty. He performed manual work in connection with his supervisory duties, and engaged in athletics. The testimony of Anderson furnishes sufficient basis for an inference that deceased inhaled fumes of ammonia escaping from the hole in the coils. See Nesbit v. Vandervort Curry etal.,
Claimant's evidence did not reveal the intervention of any other agency to which his death could be attributed. Cf. Morrisv. Lehigh Valley Coal Co.,
Defendant's case consisted of the testimony of Drs. Ingram and Berg, who performed an autopsy on the body of deceased four days after it had been embalmed. *275 Dr. Ingram said that "death was due to a pulmonary occlusion, primarily; secondarily to a coronary occlusion." He testified that deceased had a "degeneration of the heart muscle," and "that meant a weak heart." The coronary occlusion was "in the right lung extending over into the right chambers of the heart. A mass of hard, black, blood clots. . . . . . . The nearest thing we could arrive at was this degeneration of the heart on account of interfering with the circulation allowing blood to coagulate in the pulmonary veins, more pronounced in the right side of the heart which propels the blood through the lungs."
In the opinion of Dr. Berg, death was due to "coronary occlusion and anemia of the brain, which caused paralysis of the fourth ventricle, causing death."
Both doctors said that deceased was afflicted with hardening of the coronary arteries, and that his death was not occasioned by inhalation of ammonia. On the other hand, they were in substantial accord that inhalation of ammonia fumes impedes the respiratory process. Dr. Ingram said that it "causes spasm immediately almost of the muscle coat or middle coat of the respiratory tube and that produced immediate spasm. Nature tries to shut off that ammonia from getting down in the lung." Dr. Berg described the effect as "a spasm of the epiglottis, which is nature's protective measure to prevent any irritating gas entering the lungs." Dr. Ingram testified: "Q. Would that spasm that you speak of, would the secondary effect of that be extra requirement of the heart? A. If a man had a weak heart it might. Like any extra work would do but those symptoms would have to be present before I could attribute it to the ammonia gas. If this man gave symptoms of choking and all that, I would have taken that all into consideration but he had no symptoms as far as I know. All I know is he died. . . . . . . Q. If there was that spasm in the throat and *276 upper tubes, it would put an extra pressure on the heart? A. It would if present sufficient. If momentarily for 1/2 minute or so a weak solution less than 1 percent 1 1/2 percent is usually enough to take a man." It will be remembered that claimant's witnesses said that one affected by the fumes could not choke. In addition, the doctors ruled out this possibility because they found no evidence of ammonia in the body.
Opposed to this testimony is that of Anderson, referred to previously, who said that when he returned to repair the hole at the place where deceased had been ". . . . . . I got a whiff of ammonia fumes, and it strangled me."
The admission drawn from Dr. Ingram may explain why deceased could not escape, although Anderson and the others always did. Assuming that the weakened condition of deceased's heart contributed to the fatal result, claimant is still entitled to compensation. Lafferty v. Carbo-Oxygen Co. et al.,
Dr. Ingram's conclusion seems to be that the lungs were occluded by blood clots due to the inability of the heart to maintain the proper circulation, and Dr. Berg apparently held this view also. In other words, they believed that death was due to deceased's inability to get air into his lungs, but attributed that inability to the fact that the lungs were filled with blood, rather than to constriction of the respiratory tube. However, the significance of these blood clots was dissipated by Dr. Pohl, who testified: "Q. Doctor, a man who has been embalmed for four days, and then an autopsy is performed, state what your experience is, as to blood clots in the organs that long after embalming. A. Regardless of the cause of death, there are always blood clots in a body, or practically always, and it would be impossible to embalm a body and get all the blood clots *277 out. Q. Would these blood clots appear in the heart and lungs and different arteries? A. They might. Q. Is that usual? A. It is usual. . . . . . . Q. Would an examination, or post mortem that is held four days after death, would it be difficult to detect a condition at the time of death? A. I think it would be very difficult with these clots, because they are common, as I said, and after any embalming, because an undertaker uses a blood solvent to try to get the clots out, but they never get the clots out, and it would make no difference whether an autopsy was done four days, or one day after embalming. . . . . . . Q. You would have no trouble in determining between blood clots that were there before the man died? A. I think it is very difficult very often. Q. But doctors do make that distinction, don't they? A. Sometimes. Q. They do it regularly in autopsies, don't they? A. I think in the majority of cases, it would be hard to tell the difference. It would be impossible to tell in a great many cases. Q. In some cases? A. In a majority of cases, the blood is drained out and coagulates — coagulation of a great part of blood has already taken place, before perhaps, even the undertaker has drained the blood from the system."
Appellant (insurance carrier) contends that the testimony of the expert witnesses was conclusive upon the compensation authorities because based upon an autopsy, and cites Burrell v.State Workmen's Ins. Fund et al.,
"But, notwithstanding these observations, judgment n.o.v. could not be entered on the strength of defendant's oral testimony. There was sufficient evidence in appellee's case to go to the jury. The strength of appellant's oral evidence was for them. We said in Shaughnessy v. Director General of Railroads,
In a compensation case the appellate court's power of review is even more restricted. And, although we may feel that the weight of the evidence as a whole is against a finding of fact of the compensation authorities, such finding may not be disturbed if it is supported by legally competent evidence. Paulin v. Williams Company, Inc., et al.,
It is the prerogative of the compensation authorities to give the testimony of witnesses such consideration as it may deserve, and to accept or reject it in whole or in part accordingly.Zbirowski v. John T. Lewis Bros. Co., supra.
Finally, relying upon Gausman v. R.T. Pearson Co.,
The second assignment of error is sustained, although, for the reasons above set forth, it does not affect the result we have reached. The other assignments of error are overruled, and the judgment is affirmed.