Cooper v. Ami, Inc.

454 So. 2d 156
CourtLouisiana Court of Appeal
DecidedJune 26, 1984
Docket83 CA 0876
StatusPublished
Cited by17 cases

This text of 454 So. 2d 156 (Cooper v. Ami, Inc.) is published on Counsel Stack Legal Research, covering Louisiana Court of Appeal primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cooper v. Ami, Inc., 454 So. 2d 156 (La. Ct. App. 1984).

Opinion

454 So.2d 156 (1984)

Verna COOPER
v.
AMI, INC. and Ranger Insurance Company.

No. 83 CA 0876.

Court of Appeal of Louisiana, First Circuit.

June 26, 1984.
Rehearing Denied August 24, 1984.
Writ Denied November 9, 1984.

*158 Thomas B. Waterman, Ponchatoula, for plaintiff-appellee, Verna Cooper.

Alton B. Lewis, Jr. of Pittman, Matheny, Lewis & Moody, Hammond, for defendants-appellants AMI, Inc. and Ranger Ins. Co.

Before PONDER, WATKINS and CARTER, JJ.

PONDER, Judge.

In this worker's compensation case, defendants appealed a judgment awarding plaintiff unpaid medical expenses and an increase in compensation benefits, plus penalties and attorney's fees. Plaintiff answered, requesting an increase in the amount of attorney's fees.

The issues are: (1) whether plaintiff's injury was causally related to an accident arising out of her employment; (2) whether surgery performed to treat the injury was necessary; (3) whether defendants were arbitrary and capricious in refusing to pay the surgical expenses; (4) whether the amount of compensation benefits paid by defendants was incorrect; (5) whether admitting testimony on that issue was an improper expansion of the pleadings; (6) whether penalties were properly assessed against defendants for having paid the incorrect amount; (7) whether certain documentary evidence was improperly entered into the record; and (8) whether $3,500.00 in attorney's fees is excessive.

We amend and affirm.

There is no dispute that plaintiff suffered back injury during the course of her employment as a nurses' aide, which was diagnosed as acute lumbosacral strain. Dr. Ferachi, her initial treating physician, also diagnosed degenerative disc disease, revealed by x-rays showing a narrowing of the L5-S1 disc space. Plaintiff complained of low back pain but a straight leg raising test was negative and neurological examination was normal. When plaintiff continued to complain of pain, Dr. Ferachi, an orthopedist, sent her to a neurologist for an electromyelogram (EMG) and nerve conduction study. Both were negative and Ferachi eventually released her from treatment, six weeks after her injury.

About six weeks later plaintiff was examined by Dr. Llewellyn, a neurosurgeon, who observed muscle spasm, restricted range of motion in the lower back, weakness in the right leg and a positive leg raising test for both legs. Plaintiff complained of pain radiating from her lower back into her legs. On the basis of her history and complaints and his own observations, Dr. Llewellyn believed plaintiff had suffered a ruptured disc which might require surgery. However, to confirm his diagnosis, he scheduled her for hospitalization and testing.

Prior to the testing, defendants sent plaintiff to another neurosurgeon, Dr. Clifford. After conducting a physical examination, Dr. Clifford concluded that plaintiff's symptoms were hysterical in nature. He believed that neither degenerative disc disease nor a ruptured disc would have resulted in plaintiff's symptoms and reactions.

*159 When plaintiff subsequently entered the hospital for testing, an EMG, x-rays, CAT scan and nerve conduction study were performed. Only the CAT scan was positive. According to the radiologist who interpreted it, the CAT scan revealed bulging disc material at the L5-S1 site which directly impinged upon the dural sac which encompasses the nerve roots. He testified that in his opinion, the disc material was compromising the nerve roots themselves. Dr. Llewellyn agreed and scheduled plaintiff for surgery. At this time, plaintiff was also diagnosed as a diabetic.

Prior to the surgery, defendants sent plaintiff to yet another neurosurgeon, Dr. Levy, who examined her and took x-rays. He found the x-rays to be "virtually normal" and did not believe plaintiff's displayed symptoms were indicative of a ruptured disc. He recommended against surgery and suggested that a myelogram be performed to confirm the CAT scan results.

However, Dr. Llewellyn operated as scheduled, at which time he discovered and removed an irreparably torn portion of the L5-S1 disc, which he testified was positioned to compress the fifth lumbar nerve root. Plaintiff thereafter experienced general relief from her complaints, but at time of trial was still undergoing rehabilitative therapy. Defendants refused to pay the expenses of the surgery.

Defendants contend that plaintiff failed to carry her burden of showing that the ruptured disc was causally related to her on-the-job injury. They do not seriously contest the fact that she suffered a lumbosacral strain by lifting a patient in the course of her employment. However, they argue that plaintiff had recovered from that "mild" strain by the time Ferachi released her and that the subsequent manifestation of new symptoms could only mean that she suffered another, unrevealed, trauma to her back after her release. Defendants attack her credibility and rely upon the opinions of their medical experts that plaintiff's ruptured disc was not caused by the reported injury.

The plaintiff-employee in a workmen's compensation case bears the burden of establishing the causal connection between the disability and the employment accident by a reasonable preponderance of the evidence. Prim v. City of Shreveport, 297 So.2d 421 (La.1974). Furthermore, medical testimony must be weighed in the light of other credible evidence of a nonmedical character, such as a sequence of symptoms or events, in order to determine probability judicially. Schouest v. J. Ray McDermott & Co., 411 So.2d 1042 (La.1982).

Our perusal of the record does not convince us that the trial court was clearly wrong in concluding that plaintiff's ruptured disc was caused by her on-the-job injury.

Defendants next contend that the trial court erred in concluding that the surgery was necessary. LSA-R.S. 23:1203(A).[1] They base their argument upon the alleged inconsistency of plaintiff's symptoms, as manifested to the various physicians who examined her; the negative results of the EMG exams and nerve conduction studies; the alleged insufficiency of the CAT scan as a diagnostic device; and the relief of symptoms arguably unrelated to the surgery.[2]

Dr. Llewellyn found that the CAT scan showed impingement upon the nerve-containing dural sac at the L5-S1 disc space by a ruptured or torn disc. He testified that a diabetic will likely experience greater discomfort from nerve compression than those *160 without the disease. He believed that a myelogram was superfluous when a CAT scan was positive (an opinion shared by the consulting radiologist, Dr. Fortenberry); further, he testified that the risks involved in a myelogram are greater for a diabetic. Despite the negative results of the EMG exams and the nerve conduction studies, he believed that plaintiff's clinical symptoms, interpreted in conjunction with the CAT scan results, required surgery. He did in fact discover an irreparably torn portion of the L5-S1 disc and excised it. He testified that a torn disc, as opposed to a ruptured disc, will not respond to conservative treatment but instead requires surgery. The operation provided plaintiff with immediate relief from most complaints, including the low back pain.

There was a clear difference of opinion among equally qualified physicians; however, we do not feel the trial court was manifestly wrong in relying upon Dr. Llewellyn's testimony in making the determination that the surgery was necessary.

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454 So. 2d 156, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cooper-v-ami-inc-lactapp-1984.