Martha Diana Rougeau v. St. Francis Cabrini Hospital

CourtLouisiana Court of Appeal
DecidedFebruary 6, 2013
DocketWCA-0012-0854
StatusUnknown

This text of Martha Diana Rougeau v. St. Francis Cabrini Hospital (Martha Diana Rougeau v. St. Francis Cabrini 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
Martha Diana Rougeau v. St. Francis Cabrini Hospital, (La. Ct. App. 2013).

Opinion

STATE OF LOUISIANA COURT OF APPEAL, THIRD CIRCUIT

WCA 12-854

MARTHA DIANA ROUGEOU

VERSUS

ST. FRANCIS CABRINI HOSPITAL

**********

APPEAL FROM THE OFFICE OF WORKERS' COMPENSATION - # 2 PARISH OF RAPIDES, NO. 11-05846 JAMES L. BRADDOCK, WORKERS’ COMPENSATION JUDGE

JOHN E. CONERY JUDGE

Court composed of John D. Saunders, Phyllis M. Keaty, and John E. Conery, Judges.

AFFIRMED.

Daniel Elmo Broussard, Jr. Broussard, Bolton, Halcomb Post Office Box 1311 Alexandria, Louisiana 71309 (318) 487-4589 COUNSEL FOR PLAINTIFF APPELLEE: Martha Diana Rougeou

John Chris Turnage Mayer, Smith & Roberts 1550 Creswell Shreveport, Louisiana 71101 (318) 222-2135 COUNSEL FOR DEFENDANT APPELLANT: St. Francis Cabrini Hospital CONERY, Judge.

In this workers’ compensation case, Defendant, St. Francis Cabrini Hospital,

(Cabrini) appeals a judgment of the workers’ compensation judge (WCJ) in favor

of its employee, Martha Diana Rougeou (Rougeou). For the following reasons, we

affirm and award Rougeou additional attorney fees.

FACTS AND PROCEDURAL HISTORY

Rougeou filed a LDOL-WC-1008 Disputed Claim for Compensation Form

(1008) against Cabrini on August 8, 2011, seeking to receive the cost of a surgical

procedure recommended by her neurosurgeon, Dr. Aril Nanda. Rougeou claimed

the need for surgery resulted from an incident which occurred on February 8, 2011,

while she was in the course and scope of her employment as a Registered Nurse

with Cabrini at Central Louisiana Imaging Center. Rougeou was assisting Dr.

William Long with a medical procedure on a patient who was undergoing a wrist

arthrogram. The procedure required the patient to sit on a low stool with her wrist

extended over the x-ray table. Dr. Long began to insert a needle into the patient’s

arm in order to inject dye required for an MRI when the patient fainted and began

falling from the stool. Rougeou and Dr. Long caught the patient and prevented her

from hitting the floor and sustaining injury. At the time of the incident, Rougeou

was wearing a twelve-pound lead-lined apron extending from her shoulders to her

knees. Rougeou began to experience symptoms of pain in her neck and shoulders

beginning that evening and becoming worse the next day.

The incident was reported and an initial report was made of the incident.

Three days later, on February 11, 2011, Rougeou was referred by the Cabrini

health nurse to her employer’s doctor, Dr. Gordon Webb at Louisiana

Occupational Health Services. Dr. Webb diagnosed Rougeou with neck and

shoulder strain. He prescribed Ibuprofen and Valium, restricted her from wearing the lead apron and transferring patients at work, and referred her to physical

therapy three times a week.

Rougeou’s symptoms persisted, and, after a month of conservative treatment,

Dr. Webb ordered an MRI of the cervical spine. Rougeou had previously

undergone an MRI in 2007 (2007 MRI) in connection with an anterior cervical

discectomy at C5-6. Upon review of the 2011 MRI, Dr. Webb observed that the

2011 MRI was significantly worse than the 2007 MRI at C6-7, and referred

Rougeou to Dr. M. Lawrence Drerup, a neurosurgeon. Rougeou, however,

preferred to return to Dr. Nanda, the neurosurgeon who treated her in 2007.

On May 24, 2011, Dr. Nanda advised Rougeou to continue her physical

therapy and also to undergo a series of epidural steroid injections (ESIs). He told

Rougeou that if her symptoms did not abate, he would recommend a surgical

intervention. Dr. Nanda’s recommended conservative treatment of physical therapy

and ESI injections provided only temporary relief. Rougeou sought the

recommended surgery by Dr. Nanda, but the request for surgery was denied by

Cabrini’s third-party administrator, FARA. 1

In her 1008, Rougeou sought penalties and attorney fees in addition to the

recommended surgical procedure by Dr. Nanda. Rougeou, however, had not

missed any work due to the February 8, 2011 incident, and thus did not seek past

indemnity benefits from Cabrini.

Cabrini answered and asserted the defense of fraud, pursuant to La.R.S.

23:1208. Cabrini claimed that Rougeou committed fraud during an April 1, 2011

telephone interview conducted by Joanne Cannatella of FARA on behalf of

Cabrini. Specifically, Cabrini claimed Rougeou was not truthful in her responses

to questions relating to Rougeou’s history of her cervical spine problems and her

previous cervical discectomy at C5-6 some twelve to thirteen years earlier. It 1 On September 19, 2011, the WCJ granted a joint motion to dismiss FARA, Cabrini’s third-party administrator, without prejudice. 2 should be noted that the telephone interview, on April 1, 2011, came well after Dr.

Webb’s treatment, which began on February 11, 2011 and continued for a month

thereafter.

In connection with the line of questioning involving Rougeou’s cervical

spine, Cannatella asked Rougeou whether she had “any other problems” with her

neck “since that time.” Rougeou replied, “No, not really.” This appears to be the

sole basis of the so-called “fraud” alleged by Cabrini. In its Answer, Cabrini

further claimed the need for the recommended surgery by Dr. Nanda was not

causally related to the February 8, 2011 incident, but was a pre-existing condition,

which was not aggravated by the on-the-job incident.

The matter was tried on February 29, 2012, and the parties were given an

opportunity to file post-trial briefs with citations to the pages in the record

supporting their positions. Additionally, counsel submitted Joint Exhibit 1

consisting of a timeline of Rougeou’s medical history dating back to 1997.

On April 30, 2012, the WCJ issued oral reasons for judgment. Counsel for

Rougeou was requested to prepare a written judgment in accordance with the

ruling of the WCJ in favor of Rougeou. The Judgment was signed on May 9,

2012, and ordered: 1) Cabrini to authorize the medical treatment recommended by

Dr. Nanda and to pay all past accident-related medical expenses that are

outstanding and unpaid at this time; 2) Cabrini to pay indemnity benefits for any

period of time Rougeou is required to miss her employment if, and when, surgery

should take place; 3) Costs in the total amount of $2,232.00 for deposition fees and

medical records; 4) $4,000.00 in penalties for Cabrini’s arbitrary and capricious

failure to authorize the medical treatment of Rougeou as recommended by her

treating neurosurgeon, Dr. Nanda; and 5) $7,500.00 in attorney fees for

prosecution of her claim, together with judicial interest on all amounts from date of

judgment until paid.

3 Cabrini now appeals, asserting the WCJ committed manifest error in: 1)

denying Cabrini’s defense of fraud pursuant to La.R.S. 23:1208; or 2), in the

alternative, finding Rougeou was entitled to medical benefits and/or treatment with

Dr. Nanda by meeting her burden of proof that she was injured or aggravated a

previous medical condition in the on-the-job accident; and 3) finding that Cabrini

was arbitrary and capricious in its denial of the recommended surgery, in awarding

penalties and attorney fees, and in determining the amount of penalties and

attorney fees.

DISCUSSION

“Factual findings in workers’ compensation cases are subject to the manifest

error or clearly wrong standard of appellate review. In applying the manifest error

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