Welch v. County of Essex

68 A.2d 787, 6 N.J. Super. 422, 1949 N.J. Super. LEXIS 1129
CourtNew Jersey Superior Court Appellate Division
DecidedAugust 5, 1949
StatusPublished
Cited by11 cases

This text of 68 A.2d 787 (Welch v. County of Essex) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Welch v. County of Essex, 68 A.2d 787, 6 N.J. Super. 422, 1949 N.J. Super. LEXIS 1129 (N.J. Ct. App. 1949).

Opinion

Welch, petitioner-appellant in this workmen's compensation appeal proceeding, a court attendant, *Page 424 attached to the Essex County Courts, was admittedly totally and permanently incapacitated by a cancer of the chest. This soon spread throughout his body, causing his death April 14, 1948. He filed a petition for compensation for his primary total incapacity, alleging that the cancer was aggravated by a blow he received in his chest December 23, 1946, when, while he was in his occupation as driver of the prison van, he was hit in the chest and knocked down by the swinging open of the heavy front door of the van. Before the hearing on this petition, he had become bedridden and in extremis, his testimony as to the accident and his symptoms thereafter, upon the basis of which the medical testimony was given, having been taken on deposition at his home. The court order, permitting the taking of this testimony, provided that it was to be "taken for all purposes as though it had been taken in open court."

Shortly thereafter, he died from this cancer. Thereupon the requisite petition was filed by his wife, as administratrix of his estate and as mother of his daughter. Since the main issue in both causes — the compensability of the cancerous condition, which first totally incapacitated him, and then killed him — was the same on both petitions, the causes were consolidated for hearing. The basic issue at this hearing was, of course, the medical fact question, whether this cancerous condition was aggravated by this accident, which clearly arose "out of and in the course of his employment." To this accident the only eye witness was the deceased petitioner, who described the occurrence in detail on his deposition under lengthy cross-examination. The other witnesses saw him pick himself up off the ground, but did not see the blow that knocked him to the ground.

As to his symptoms, it is undisputed that the petitioner was a particularly robust individual, apparently in perfect health previous to the above accident. He had had an earlier blow to his chest February 8, 1945, when, while driving the Essex County prison van in a snowstorm, he was thrown against the steering wheel, which hit him in the center of his chest also. But from this relatively minor *Page 425 injury, he recovered shortly, without any apparent continuing difficulty.

The above accident, in December, 1946, caused black and blue marks "all over my chest, and fractured a right lower rib." Within a week or two after this accident, he had a "terrific pain in my chest," which ran up from his left hip to his neck. He started spitting up blood within a couple of weeks after the accident. The physician in charge of the court attendants, Dr. Hanteman, treated him at first only for the fractured rib. However, when the symptoms, instead of abating, continued to increase, Dr. Martland, the Essex County Medical Examiner, was called in, and when a bronchoscopy was done, it was then for the first time suspected, in June, 1947, that Welch had a serious growth in his lung.

Thereupon, Welch was sent to the Memorial Hospital, in New York, where he was examined July 3, 1947, by Dr. Pool, one of the head men. Dr. Pool diagnosed the situation as critical, operated on Welch's left chest July 18th, and found a "mass in the immediate mid-portion of the left lung * * * diagnosis of lung cancer." The operation disclosed, however, that the cancer was too far advanced for removal, due to "widespread dissemination of the cancer throughout his body," and thereafter petitioner died from oatcell cancer April 14, 1948.

Such are the basic facts, lay and medical, on which this cause depends. The issue — one of medical fact — is whether this cancer, which admittedly pre-existed the accident of December, 1946, and which for the first time became known to Welch, and caused him increased suffering, immediately thereafter, was aggravated by this accident, or whether this suffering, which first became patent right after the accident, was entirely disconnected therefrom, and due solely to the normal progress of the pre-existing disease.

On this medical issue, for petitioner, appear not only both treating physicians, but as a consultant, Dr. Martland, the Essex County Medical Examiner, and Dr. Reilly, an expert. For respondent, appear two experts, one of whom had not *Page 426 seen the patient at all, another of whom had examined him but once, the day his deposition was taken.

Dr. Pool, of course, not only because of his experience, as one of the head men in the largest cancer institution in the country, but as the sole man who ever saw the cancer inside Welch's chest, is in a particularly advantageous position to advise the court as to the facts. Neither he nor anyone else considers the 1946 accident as the cause of the cancer. He says this blow was "an aggravating factor in the rapidity of growth of the lung cancer which was evidenced in March of the next year following the accident * * * the man reasonably and probably died of lung cancer, and it is my opinion that the aggravation by the trauma under the circumstances was probably under the circumstances an aggravating factor." It was his hypothesis that the "capsule or lymph node of the primary growth" was "stimulated by ripping or tearing" when Welch was "struck in the center of the chest;" that this caused "extravasation of blood or hemorrhage into the interior" of the man's body which "caused an acceleration of the growth." He of course did not see signs of this extravasation of blood, since the operation was "seven months following the trauma." In any event, he was visualizing a microscopic rupture, not one visible to his naked operating eye.

While Dr. Hanteman, Welch's original treating physician, is not a cancer specialist, it is his opinion too that the "trauma was a reasonable aggravating cause from the pre-existing condition" of cancer. He bases his answer on "clinical grounds," i.e., that while before the injury the man had been in apparent good health, immediately thereafter his symptoms rapidly increased till his death. Dr. Reilly, an expert, has the same opinion. And Dr. Martland, the Essex County Medical Examiner, says, "It is only fair to assume it [the trauma] might [have aggravated the cancer] but I don't know how you are going to prove it." Obviously, this is but Dr. Martland's well-known outspoken way of saying that you cannot demonstrate the connection, but that he considers the connection exists as a matter of sound medical theory.

Opposed to this united medical front of attending physicians, *Page 427 both specialist and otherwise, as well as experts, respondent produces two experts only. The one of them who did not see the petitioner at all, and treats the matter wholly hypothetically, persistently adheres to the theory that no trauma could possibly affect a cancer. "Question: It is your opinion that the harder you hit a cancer the sooner you will be rid of it? Answer: I don't think it makes any difference." He also says, "I do not know of any school that has seriously advanced the argument that trauma is an accelerating factor in carcinoma." And this, despite the fact that in this very case, one of the leading physicians in the largest cancer institution in the country has just opined, that he at least is a member of such a school. The other specialist produced by respondent, who examined petitioner but once, says he is not one of those doctors that thinks that trauma never aggravates cancer. However, in the next breath he says that the trauma would cause hemorrhage or infection, and that the increased symptoms thereafter would be due, not to the aggravated cancer, but to such hemorrhage or infection.

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Welch v. County of Essex
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Cite This Page — Counsel Stack

Bluebook (online)
68 A.2d 787, 6 N.J. Super. 422, 1949 N.J. Super. LEXIS 1129, Counsel Stack Legal Research, https://law.counselstack.com/opinion/welch-v-county-of-essex-njsuperctappdiv-1949.