Cortez v. East Jefferson General Hospital

7 So. 3d 707, 8 La.App. 5 Cir. 653, 2009 La. App. LEXIS 69, 2009 WL 91112
CourtLouisiana Court of Appeal
DecidedJanuary 13, 2009
DocketNo. 08-CA-653
StatusPublished
Cited by5 cases

This text of 7 So. 3d 707 (Cortez v. East Jefferson General Hospital) 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
Cortez v. East Jefferson General Hospital, 7 So. 3d 707, 8 La.App. 5 Cir. 653, 2009 La. App. LEXIS 69, 2009 WL 91112 (La. Ct. App. 2009).

Opinion

MADELINE JASMINE, Judge Pro Tempore.

|2The appellant/employer, East Jefferson General Hospital, has appealed the trial court judgment in favor of claimant, Trudy Cortez. For the reasons that follow, we affirm the award of medical payments and compensation benefits and reverse the award of penalties and attorneys fees.

FACTS

On September 25, 1998, the claimant was working as a medical technologist at East Jefferson General Hospital, when she injured her back while in the course and [709]*709scope of her employment. She sought medical treatment from Dr. Ralph Gess-ner, who performed lumbar surgery on her in July 1999. Ms. Cortez testified that following this procedure her back pain improved for a short time, and she returned to work at regular duty on a full time basis. She explained that in November 1999, her pain increased and a few months later she was put on light duty work. She continued on light duty work until 2002. She received | ^compensation payments until December 20, 2002. Those payments and medical treatment are not at issue in this appeal.

In 2002, Ms. Cortez moved to north Louisiana and sought treatment from Dr. Pierce Nunley, an orthopedist in Shreveport. In February 2003, Ms. Cortez went to work as a medical technologist at a hospital in northern Louisiana. Her back pain continued and she experienced pain in both of her legs making it difficult to walk or stand. She testified that in December 2003, she began walking -with a cane for support because her leg gave out at times. Ms. Cortez testified that she visited Dr. Nunley regularly and underwent numerous injections, nerve blocks and physical therapy. Her back pain and leg pain continued.

Ms. Cortez testified that in July 2005 while walking down a flight of stairs, her leg gave out and she “kind of bounced downstairs.” In August 2005, Dr. Nunley performed a discogram, which reproduced the pain she was experiencing. On October 25, 2005, Dr. Nunley performed an anterior lumbar interbody fusion at the L4-5 and L5-S1 disc spaces. Ms. Cortez testified that this procedure significantly reduced her pain allowing her to work full time including 15 hours per week overtime. She no longer has to take medication.

On July 2, 2004, Ms. Cortez filed a second disputed claim for compensation seeking additional workers’ compensation benefits for the September 1998 accident. It is these benefits and medical treatment that are the subject of this appeal. East Jefferson answered claiming that benefits for this accident had been paid and denied that further benefits were due. The defendant paid for the initial medical treatment from Dr. Nunley. However, when Dr. Nunley recommended a discography in anticipation of surgery, the defendant refused payment. Ms. Cortez underwent the discography and surgery, which were paid for by her private health insurer, Health Plus.

LLori Francis testified that she was a claims adjuster for the defendant and was assigned to Ms. Cortez’ claim. Ms. Francis testified that she denied payment of the discogram because this procedure was not recommended by Dr. Gordon Mead, who examined the claimant at the request of the defendant, or Dr. Bilderback who examined the claimant after being appointed by the Office of Workers’ Compensation Administration pursuant to defendant’s request. Ms. Francis admitted that Dr. Nun-ley’s office contacted her to request authorization for the discogram, but denied that her office was contacted for authorization for the surgery. She testified that she was notified of the surgery after the procedure took place. Ms. Francis acknowledged that authorization for a myelo-gram and CT scan were denied because there was a pending IME. She denied receiving further requests for these procedures until after they were performed.

On cross-examination, Ms. Francis admitted that she no longer has access to her file in this matter, but had reviewed her notes prior to trial. She was presented with the motion for IME filed by the defendant, which states there had been a request for discography before proceeding with surgery. Ms. Francis denied that [710]*710anyone in Dr. Nunley’s office had called requesting authorization for surgery.

The deposition of Dr. Nunley was admitted into evidence. Ms. Cortez’ medical records were attached to the deposition. Dr. Nunley testified that he is board certified in orthopedic surgery with a specialty in spinal medicine and spinal surgery. Dr. Nunley testified that he first saw Ms. Cortez on January 31, 2003 at which time she was complaining of back and leg pain. He recommended an MRI and EMG. The MRI performed on February 14, 2003 showed significant disc disease at the L4-5 and L5-S1 levels. The EMG results were negative. Dr. Nunley explained that the initial injury caused pain from the disc and the nerve root. The first surgery performed in 1999 decompressed the nerve root, but did not address |»the discogenic low back pain. He recommended conservative treatment including physical therapy, non-narcotic pain medication, and nerve blocks. Ms. Cortez’ pain continued to increase and in April 2004, he recommended discography in anticipation of a spinal fusion. Authorization was refused by Ms. Cortez’ former employer. Eventually the procedure was authorized by Ms. Cortez’ private health insurer and the dis-cogram was carried out on August 16, 2006. Dr. Nunley explained that this procedure reproduced the concordant pain that Ms. Cortez experienced on a daily basis. The spinal fusion was performed on October 25, 2005. Ms. Cortez was unable to work from this surgery until January 26, 2006 at which time she was released to light duty work. She returned to full duty work on April 19, 2006. Dr. Nunley further testified that he recommended a mye-logram and CT scan be performed prior to surgery and these tests were denied by the defendant as well. He explained that these tests showed blunting of the SI nerve root.

Dr. Nunley testified that the July 2005 fall did not aggravate or accelerate Ms. Cortez’s condition.

Dr. Nunley compared his experience to that of Drs. Mead and Bilderback. Dr. Bilderback is a fellowship trained spine surgeon who performed spine surgery for three years then did a fellowship in hand surgery. He no longer does spinal surgery. Dr. Mead is not a spine surgeon and does not perform spinal surgery.

The deposition of Dr. Mead was admitted into evidence. Dr. Mead testified that he is an orthopedic surgeon and performed spine surgery from the time of his residency until the early 1990s. He sees 10 to 15 patients per week who complain of back pain some of which are candidates for back surgery. Dr. Mead first examined Ms. Cortez on October 1, 2003 at the request of her former employer. Dr. Mead testified that while Ms. Cortez had marked limited motion in her low 1 ^back, the physical exam showed her reflexes to be intact, she had good strength and sensation, and her neurological exam showed no evidence of nerve root impingement. He testified that he reviewed the MRI reports of February 14, 2001 and the EMG/ nerve conduction studies of February 19, 2003. Dr. Mead concluded there was no objective evidence to support the severity of her complaints. He opined that Ms. Cortez had degenerative disc disease and scarring around her nerve roots. He did not feel that an IDET (Intradiscal Electrothermal Therapy) procedure or discogram would benefit Ms. Cortez.

On May 24, 2004, Dr. Mead examined Ms. Cortez a second time at the request of defendant. Ms. Cortez reported that her pain had increased in the last year and she had sought treatment from two pain specialists. Dr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Villatoro v. Deep South BH & R Enterprises, LLC
206 So. 3d 428 (Louisiana Court of Appeal, 2016)
Leidelmeijen v. Ferncrest Manor Nursing Home Luba Workers' Comp.
191 So. 3d 38 (Louisiana Court of Appeal, 2016)
Baker v. Harrah's
190 So. 3d 379 (Louisiana Court of Appeal, 2016)
Soniat v. Crown Buick & Risk Management Services
166 So. 3d 278 (Louisiana Court of Appeal, 2014)
Bell v. Mid City Printers, Inc.
54 So. 3d 1226 (Louisiana Court of Appeal, 2010)

Cite This Page — Counsel Stack

Bluebook (online)
7 So. 3d 707, 8 La.App. 5 Cir. 653, 2009 La. App. LEXIS 69, 2009 WL 91112, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cortez-v-east-jefferson-general-hospital-lactapp-2009.