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White v. Conagra Packaged Foods, LLC

Court of Appeals of Missouri, Western District, Second Division

September 27, 2016


         Appeal from the Labor and Industrial Relations Commission

          Before Karen King Mitchell, Presiding Judge, Cynthia L. Martin, Judge and Gary D. Witt, Judge.

          Cynthia L. Martin, Judge.

         Patricia White ("Patricia") appeals from the Labor and Industrial Relations Commission's ("Commission") decision denying compensation for the death of her husband, Ulysses White ("Ulysses").[1] Patricia asserts that the Commission erred in concluding that she failed to sustain her burden to prove that Ulysses's work environment was the prevailing factor in causing her husband's death at work because: (1) the Commission improperly applied the prevailing factor test to her entire case and not just to the issue of injury; and (2) the Commission arbitrarily ignored lay testimony that would have coupled with credible expert testimony to establish that Ulysses's death came from a hazard or risk of employment. Because the issue to be determined in this case was whether Ulysses's death came from a risk or hazard unrelated to employment, and not whether work conditions were the prevailing factor in causing Ulysses's death, we conclude that the Commission committed legal error. We affirm in part, reverse in part, and remand for further proceedings.

         Factual and Procedural History

         Ulysses worked for ConAgra Packaged Foods, Inc. ("ConAgra") for twenty-four years in Marshall, Missouri. At the time of his death, Ulysses worked in ConAgra's machine shop making parts for the facility's production line. The machine shop did not have air conditioning but did have windows and fans to help cool the building. Ulysses's job required him to use machinery such as mills and lathes, and required him to wear a long-sleeved uniform and hard hat. Ulysses's typical work schedule was from 5 a.m. to 3:00 p.m., six to seven days per week.

         On June 30, 2012, Ulysses reported to work for his usual shift. Ulysses was wearing a leg brace due to a tendon injury in his foot. When Ulysses arrived at work, he spoke with his supervisor, Abraham Sellers ("Sellers"). Sellers warned Ulysses about the forecasted heat that day and asked Ulysses to watch for signs of heat stress. Sellers informed Ulysses that there would be a scheduled power outage that morning and instructed Ulysses to ensure that the waste water system's pumps restarted following the outage.

         Ulysses began his work day in the machine shop making parts. Following the scheduled power outage that occurred sometime between 9:00 a.m. and 9:30 a.m., Ulysses walked from the machine shop to the waste water system pumps to ensure they had restarted. Ulysses then walked back to the machine shop, where he continued his work until taking a thirty-minute break for lunch at 11:00 a.m.

         One of Ulysses's co-workers found him collapsed on the floor in the machine shop at approximately 11:45 a.m. Despite receiving medical attention, Ulysses died the same day. An autopsy revealed that the cause of Ulysses's death was "a cardiac arrhythmia resulting from severe coronary artery disease." The autopsy noted evidence of pericardial adhesions, coronary artery disease, and emphysema.

         Patricia filed a claim for compensation in January 2013, alleging that Ulysses suffered a "[h]eat stroke and/or cardiac injury resulting in death" while he was working in ConAgra's machine shop. During a hearing in front of an Administrative Law Judge ("ALJ"), Patricia and ConAgra each presented expert witness testimony about the cause of Ulysses's death through deposition testimony and written reports.

         Patricia's expert witness, Dr. Stephen Schuman ("Dr. Schuman"), specializes in internal medicine and cardiology. Dr. Schuman opined that the "work activities of 06/30/12 were the prevailing factor causing [Ulysses's] cardiac arrest and death." Dr. Schuman explained:

I would say the physical work he was doing [was the most important factor that caused Ulysses to have a cardiac event on June 30, 2012]. When you're operating a lathe, you're using the upper extremities to some extent. There's some isometric component to that effort. He was doing that in a hot environment, and that is a type of pathologic stress on the cardiovascular system that could cause ischemia, electrical instability, cardiac arrest. It can cause infarction, a rise of troponin, those sort of problems. And if you add in the additional problems, ambulating with a brace on his leg and whatever discomfort he was having in the foot and ankle, then that would add to additional stress, additional increased heart rate, blood pressure, coronary, tone, et cetera, on his cardiac work, basically on his cardiovascular system.
. . . .
He was in an indoor environment where it was probably hotter than outside, the environmental temperature, plus he was working. He was doing physical effort. There was a component with his arms working on the lathe. And he would have been more overheated than the average person with a brace on his leg, a long-sleeved shirt and a hard hat.
. . . .
[Y]ou dissipate heat from your head. About 25 percent of heat loss from the body is from the head of the top of the head.
. . . .
[H]e had long pants and long sleeves, and you put that all together, and he's going to get a little hotter than the average person in Marshall, Missouri that day who might not have been dressed -- might have been dressed more for the weather and might not have been doing physical work.

         Dr. Schuman acknowledged on cross-examination that Ulysses had high cholesterol and hypertension. He also acknowledged that Ulysses had an 80 percent occlusion in the left descending coronary artery and a 75 percent circumflex occlusion. Dr. Schuman noted that an occlusion increases the risk of ischemia if the heart is required to work harder, demanding more blood flow. However, Dr. Schuman opined that Ulysses's ischemia was not caused by his pre-existing conditions, but was instead caused by the stress imposed on Ulysses by the conditions of his work on the day of his death.

         ConAgra's expert witness, Dr. Michael Farrar ("Dr. Farrar"), is an adult cardiologist. Dr. Farrar opined that Ulysses "died of sudden cardiac death related to the prevailing causes of underlying severe coronary artery disease and hypertensive heart disease, caused by traditional risk factors." He explained:

[Ulysses] almost certainly died from ventricular fibrillation (sudden cardiac death) due to a combination of severe coronary artery disease and hypertensive heart disease with consequent left ventricular hypertrophy. Myocardial ischemia secondary to the above would have resulted in the arrhythmias. No thrombus was noted in the coronary arteries, indicating absence of acute plaque rupture and subsequent myocardial infarction, but this is the case in about 50% of cases of sudden cardiac death. The finding at autopsy were caused by traditional risk factors of hypertension, dyslipidemia, prior cigarette smoking and lack of regular physical exercise. His poor functional capacity on stress testing indicating an increased risk of future adverse cardiac events. His cardiac enlargement and left ventricular hypertrophy also increased his risk of sudden cardiac death. Sudden cardiac death is the initial manifestation of coronary artery disease in about 15% of patients with coronary artery disease and is certainly common.

         Dr. Farrar dismissed the possibility of heat as a factor in Ulysses's death because Ulysses had worked in similar conditions for many years and was likely acclimated to the heat.

         In addition to this expert testimony, Patricia testified about the extreme heat during the week of Ulysses's death. She testified that the temperature reached 96 degrees at 11:00 a.m. the day before Ulysses died. Numerous exhibits were admitted, including the depositions of Sellers, Patricia, and other workers--Pedro Estrada, Jose Sanchez, and Charles Vandiver. United States Government Weather Station information regarding the temperature in the area on the day of Ulysses's death indicated a high of 100 degrees and a low of 76 degrees.

         The ALJ denied compensation. The ALJ concluded that Patricia "failed to sustain her burden of proof that [Ulysses] sustained an accident or occupational disease." The ALJ observed that both Dr. Schuman and Dr. Farrar "agree that the mechanism of death was ischemia or lack of blood flow to [Ulysses's] heart which caused ventricular fibrillation and cardiac death." And the ALJ observed that "[b]oth physicians also agree that the coronary artery could not supply adequate blood to [Ulysses's] heart." The ALJ then concluded:

While Dr. Farrar does not believe that the temperature was a factor in the sequence of events leading to Mr. White's death, Dr. Schuman opines that the physical work at the lathe in a hot environment could cause ischemia, electrical instability, cardiac arrest, infarction and a rise of troponin. However, Dr. Schuman concedes that the prevailing factor was [Ulysses's] heart having to work harder than the severely compromised left anterior descending coronary artery would allow. In other words, [Ulysses's] heart needed more blood than the left anterior descending coronary artery which had a blockage of 80 percent could deliver. Even Dr. Schuman agreed that there was nothing unusual or different about [Ulysses's] work on June 30, 2012, only that the heart needed more blood than the artery could supply. Dr. Farrar and Dr. Schuman's opinion is supported by the autopsy report which also refers to cardiac arrhythmia caused by the severe coronary artery disease.

         Patricia appealed the ALJ's decision to the Commission. The Commission affirmed the decision of the ...

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