Clark County v. Patrick Mcmanus

CourtCourt of Appeals of Washington
DecidedMay 11, 2015
Docket72437-1
StatusPublished

This text of Clark County v. Patrick Mcmanus (Clark County v. Patrick Mcmanus) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Clark County v. Patrick Mcmanus, (Wash. Ct. App. 2015).

Opinion

IN THE COURT OF APPEALS FOR THE STATE OF WASHINGTON

CLARK COUNTY, No. 72437-1-1 Respondent, DIVISION ONE

PATRICK J. McMANUS, PUBLISHED OPINION !=o 2C Appellant. FILED: May 11. 2015 m

Spearman, C.J. — Patrick McManus appeals the trial court's judgmei

and order reversing an award of benefits under the Industrial Insurance AcLJ^y ^s the Department of Labor and Industries (Department). He claims the trial court **" improperly admitted hearsay evidence through the testimony of his treating

physician. He also contends that the jury was improperly instructed. We agree

with McManus, reverse the judgment, and remand for a new trial.

FACTS

Patrick McManus is a former Clark County employee. Between 1999 and

2011, he worked full-time for the County operating a street sweeper. He stopped

working in April 2011 because of debilitating, degenerative spinal disease, which

he attributes to his work as a street sweeper operator. Shortly after leaving work, No. 72437-1-1/2

McManus filed a claim for workers' compensation under Title 51 RCW, the

Industrial Insurance Act (Act).

In reviewing the claim, the Department considered deposition testimony

from several witnesses. McManus testified that he began experiencing pain that

radiated across his low back and down his left leg in early 2010. He attributed

this pain to the cramped confines and bumpy rides of the street sweepers he

operated for the County. In particular, he claimed that, while the first two street

sweepers he operated had adjustable air ride seats and relatively ergonomic

cab-designs, the third and final machine he operated, which he was assigned in

either 2008 or 2009, had an uncomfortable cab layout and a negative air ride

seat that, according to McManus, felt like a block of concrete whenever he hit a

bump.

McManus also testified regarding a preexisting back condition and other

possible causes for his pain. He testified that his weight had hovered around the

330 pound mark for the past 30 years and that he had used tobacco products

regularly until 2011. He acknowledged sustaining a low back injury at age 19,

which resulted in flare-ups of pain in his low back and legs. McManus also

conceded having been on prescription medication for pain in his lower back,

buttocks, and left leg since 2001, approximately nine years before the onset of

the symptoms he alleged were work-related.

The sole medical expert to testify on behalf of McManus was Dr. Paul

Won, who is board certified in preventative and family medicine. In his

deposition, Dr. Won testified that he began treating McManus in January 2005 No. 72437-1-1/3

following a low back injury unrelated to the condition alleged in his workers'

compensation claim. After this initial treatment, McManus had continued to work

his regular job as a street sweeper operator. According to Dr. Won, McManus

had a gradual increase in low back pain during this time. On June 25, 2010, Dr.

Won obtained a magnetic resonance imaging (MRI) scan of McManus' back. The

scan showed various spinal changes as compared to a prior study, including a

central disc protrusion at the L2-3 vertebra. Based on this scan, Dr. Won

diagnosed McManus with displacement of a lumbar intervertebral disc at L2-3.

Dr. Won next treated McManus on April 11, 2011, at which time McManus

complained about low back pain due to a poor quality seat cushion in his street

sweeper.

On direct examination, Dr. Won acknowledged a November 14, 2011

letter to McManus' claims representative, in which Dr. Won had opined that the

cause of McManus' lower back condition was his work as a street sweeper

operator. Dr. Won testified that his opinion had not changed since writing the

November 14 letter. He opined, that "driving trucks with jarring and bouncing has

made a major material contribution to [McManus'] lumbar condition." CABR

(Won) at 30-31. According to Dr. Won, this opinion was based on his

understanding of McManus' medical history and the physical forces McManus'

spine endured during his street sweeping work.

On cross examination, Dr. Won testified over McManus' hearsay objection

that he was aware a consulting neurosurgeon, Dr. Wrobel, had opined that it was

unknowable whether or not the disc protrusion at L2-3 was related to McManus' No. 72437-1-1/4

employment. Dr. Won also stated he was aware of Dr. Wrobel's opinion that "no

one could relate the protrusion at 23 [sic] and the stenosis to the work activities

with Clark County." CABR1 (Won) at 39. While Dr. Won conceded that a

neurosurgeon would likely have greater expertise than him in determining the

etiology of degenerative disc disease such as McManus', he ultimately did not

agree with Dr. Wrobel's opinion and testified that his own initial opinion that

McManus' low back condition arose from the conditions of his work as a street

sweeper was still valid based on his knowledge of McManus' medical history.

The County offered the deposition testimony of two experts, Dr. Thomas

Dietrich and Dr. James Harris. Dr. Wrobel did not testify. Dr. Dietrich, a board

certified neurosurgeon, stated that he had rendered an opinion based on a July

14, 2011 examination of McManus. Dr. Dietrich concluded that McManus' low

back condition did not arise naturally and proximately from the distinctive

conditions of his employment, however he acknowledged that the repetitive

bouncing up and down McManus endured over a period of years as a street

sweeper operator likely played a role in the rate of degenerative change in his

condition.

Dr. Harris, a board certified orthopedic surgeon, testified that he

conducted a review of McManus' records at the request of Clark County. Dr.

Harris compared a December 14, 2005 computed tomography (CT) scan of

McManus' lumbar spine with the June 25, 2010 MRI ordered by Dr. Won and

1 "CABR" refers to the Certified Appeal Board Record. Deposition transcripts within the CABR are cited by parenthetical reference to the deponent's last name. No. 72437-1-1/5

concluded that the 2010 imaging showed a new central disc protrusion at the L2-

3 level. Dr. Harris' initial report indicated that McManus' employment could be a

possible cause of the abnormalities visible in the imaging scans. However, Dr.

Harris testified that his initial conclusion was speculative, rendered with

insufficient information on his part. He testified that, after additional research, his

ultimate conclusion was that McManus' low back condition was not the result of

an industrial injury. Dr. Harris attributed the injury to the normal aging process.

He noted that, by age 50, about half the population would experience similar

degenerative changes. He also recognized the role of obesity and heredity in

such degenerative changes. While acknowledging that the conditions of

McManus' work may have contributed to symptoms of this underlying condition,

Dr. Harris maintained that McManus' work did not cause the condition.

At the close of evidence, an industrial appeals judge determined that

McManus' injury was work-related, awarded him compensation under the Act,

and issued a proposed decision and order, which included the following findings

of fact:

1.

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