City of Owensboro v. Adams

136 S.W.3d 446, 2004 Ky. LEXIS 141, 2004 WL 1361482
CourtKentucky Supreme Court
DecidedJune 17, 2004
Docket2003-SC-0097-WC
StatusPublished
Cited by9 cases

This text of 136 S.W.3d 446 (City of Owensboro v. Adams) is published on Counsel Stack Legal Research, covering Kentucky Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
City of Owensboro v. Adams, 136 S.W.3d 446, 2004 Ky. LEXIS 141, 2004 WL 1361482 (Ky. 2004).

Opinion

Opinion of the

Court by Justice COOPER.

Upon reopening a previously settled award in this workers’ compensation case, KRS 342.125(l)(d), the administrative law judge (ALJ) found that Gary Dewayne Adams was totally disabled as a result of a work-related injury, and awarded benefits under KRS 342.730(l)(a). Both the Workers’ Compensation Board and the Court of Appeals affirmed. The primary issue on appeal is not the extent and duration of Adams’s disability, but its cause. The employer asserts here as it did below that the ALJ based his decision that Adams’s disability was work-related on expert medical evidence that was unreliable and thus inadmissible under KRE 702, and the principles enunciated in Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579, 113 S.Ct. 2786, 125 L.Ed.2d 469 (1993). We affirm.

I. FACTS.

On May 15, 1987, Adams, then age twenty-one, and a co-worker were cleaning a section of sewer line for their employer, the City of Owensboro. Adams’s co-worker descended into the manhole and almost immediately collapsed, overcome by methane gas. After radioing for help, Adams attempted a rescue but was also overcome by the gas and fell, striking his head. Rescuers eventually arrived and began pumping oxygen into the manhole. Although Adams later regained consciousness and was taken to safety, his co-worker died from methane inhalation. At the *448 time of his initial application for benefits, Adams had returned to work but still suffered from a sore neck and intermittent pain above his right eye and along the right side of his face. In July 1989, he settled his claim for $6,125.00, representing a lump sum payment for a 9.5% occupational disability.

Although Adams’s neck pain abated, episodes of facial pain persisted. He testified upon reopening that he first experienced intermittent episodes of sharp pain that began over his right eye and spread to his face. In 1994, the episodes became more frequent and severe, and he was diagnosed with bilateral trigeminal neuralgia. Eventually, even morphine faded to control it. He underwent fourteen facial surgeries in an attempt to treat the condition but had obtained only temporary relief. Since the May 17, 1987, injury, he had also been treated for meningitis, an abscessed tooth, and shingles. He quit working in September 2000 due to the severity of his facial symptoms. He filed his motion to reopen on December 12, 2000.

II. MEDICAL EVIDENCE.

The record contains medical reports and records prepared by numerous physicians, only a few of whom rendered opinions as to the causation of Adams’s bilateral trige-minal neuralgia. The only medical expert who actually testified was Dr. Harry R. van Loveren, a neurosurgeon affiliated with the Mayfield Clinic and the University of Cincinnati. Dr. van Loveren, who began treating Adams in 1994 and was the first physician to diagnose his condition as trigeminal neuralgia, testified that he had treated approximately 1,000 trigeminal neuralgia patients. According to Dr. van Loveren, the ailment is a very rare and specific condition that is typically sudden in onset. It affects the areas of the face controlled by the trigeminal nerve and its three branches, and is characterized by intermittent episodes of very sharp facial pain, followed by remissions and exacer-bations. It is also typically undetectable by X-ray and laboratory studies. The immediate cause of the condition is a deterioration of the myelin sheath that encases the trigeminal nerve, which can result from a number of factors, including abnormal blood vessel growth around a nerve, a tumor, multiple sclerosis, trauma, and exposure to toxic chemicals. Dr. van Lover-en ultimately opined that Adams’s condition was caused by his 1987 exposure to toxic methane gas.

Dr. Harold Moses, Jr., a neurosurgeon affiliated with the Vanderbilt Medical Center, filed a report in which he noted that most individuals with trigeminal neuralgia suffer from multiple sclerosis, and diagnosed Adams’s condition as probable relapse-remitting multiple sclerosis. Dr. David H. Mattson, a neurologist affiliated with the Indiana University Multiple Sclerosis Center, filed a report in which he agreed with Dr. Moses but admitted that he found no clinical evidence that Adams suffered from multiple sclerosis. Dr. Stephen Kirzinger, a Louisville neurologist, reported that he was unable to determine the etiology of Adams’s condition but noted that there was no evidence in Adams’s history or medical records to confirm the possibility of demyelinating disease (multiple sclerosis). Dr. Kirzinger did not relate Adams’s condition to the 1987 accident because he believed that the trigeminal neuralgia had not manifested itself until 1994. However, Dr. van Loveren testified that Adams gave him a history in 1994 of suffering from facial pain since shortly after the 1987 accident.

Dr. Elizabeth A. Shuster, a neurologist with the Mayo Clinic in Jacksonville, Florida, examined Adams in September 2000 and conducted extensive diagnostic testing *449 over several days. She acknowledged in her report that his atypical facial pain raised questions concerning multiple sclerosis and noted that his maternal aunt suffered from it; yet no information obtained during her clinical examination supported that diagnosis, and a magnetic resonance imaging (MRI) test failed to reveal any brain lesions characteristic of multiple sclerosis. She noted other potential causes of trigeminal neuralgia including Lyme Disease and toxic brain injury, which would not be structurally apparent. However, Adams’s Lyme serology test was negative. Dr. Shuster also mentioned that temporomandibular joint malfunction can cause facial pain and that herpes simplex may also be associated with facial palsy and possibly with trigeminal neuralgia. However, she did not opine that either of these ailments caused Adams’s condition.

Dr. van Loveren testified that the onset of Adams’s condition was gradual rather than dramatic. When he failed to respond typically to treatment and when the condition became bilateral, also atypical, Dr. van Loveren attempted to determine causation by a process of elimination. The surgeries revealed no tumor or blood vessel abnormality, and seven years of repeated radio-graphic studies and spinal fluid analyses had failed to confirm the presence of multiple sclerosis. Although acknowledging that multiple sclerosis was the only well-documented cause of trigeminal nerve dysfunction, Dr. van Loveren stated that the repeated diagnostic studies and the lack of any neurological deficits outside the facial area led him to conclude that Adams did not suffer from multiple sclerosis. According to Dr. van Loveren, approximately one in 4,000 persons suffers from trigemi-nal neuralgia but only approximately one person in 400,000 suffers from the bilateral form; and in perhaps only four or five cases per year is the onset gradual. He admitted that he had seen only one other such case, and there, the patient was diagnosed with multiple sclerosis.

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Cite This Page — Counsel Stack

Bluebook (online)
136 S.W.3d 446, 2004 Ky. LEXIS 141, 2004 WL 1361482, Counsel Stack Legal Research, https://law.counselstack.com/opinion/city-of-owensboro-v-adams-ky-2004.