Opinion
No. 32558
Decided November 14, 1951.
Workmen's compensation — Evidence — Proximate causal relationship between accident and physical condition — Testimony of lay witness without probative value, when — Medical testimony that causal relationship remotely possible — Not sufficient to present jury question.
1. A condition of bilateral cataracts claimed to have resulted from a small particle which blew into one of the eyes falls within the classification of industrial injury cases where the testimony of lay witnesses is without probative value to establish the probability of a proximate causal relationship between the accident and the claimed resulting physical condition, and in order to prove such relationship medical testimony is essential.
2. Where a claimant for compensation under the Workmen's Compensation Act is suffering from bilateral cataracts and claims that the condition in his right eye proximately and directly resulted from a small particle no larger than a pin head which blew into that eye, and where the most favorable medical evidence was testimony that a causal relationship between the particle which blew into the eye and the eye condition was remotely possible, there is no evidence sufficient to justify submission to the jury of the question of causal connection between the claimed accident and the eye condition. ( Drakulich v. Industrial Commission, 137 Ohio St. 82, approved and followed. Bowling v. Industrial Commission, 145 Ohio St. 23, distinguished.)
APPEAL from the Court of Appeals for Mahoning county.
The present cause arises from an appeal to the Court of Common Pleas of Mahoning County from an order of the Industrial Commission denying compensation to appellee, hereinafter designated plaintiff, for a claimed accidental injury received by him in the course of and arising out of his employment with appellant, hereinafter designated defendant, which was a self-insurer under the Workmen's Compensation Act.
In the Common Pleas Court the jury rendered a verdict in favor of plaintiff and judgment was entered thereon.
Defendant asked for an instructed verdict in its favor at the close of plaintiff's evidence and at the close of all the evidence and asked for a judgment notwithstanding the verdict. All the requests of defendant presented by motions were denied.
Upon appeal to the Court of Appeals the judgment of the trial court was affirmed.
The cause is before this court upon allowance of a motion to certify the record.
Plaintiff was an employee of defendant on July 26, 1944, and had been so for many years previous thereto. On that date he was working in a blacksmith shop of defendant and his duties consisted of heating and straightening iron for the purpose of making new sill steps for railway cars.
Plaintiff testified that on July 26, 1944, he was opening a window in the blacksmith shop and something was blown into his right eye. A fellow worker testified that plaintiff was closing a window at quitting time and when he closed it he rubbed his right eye; that witness asked plaintiff if he got something in his eye; and that plaintiff replied, "I don't know, it feels like it."
Plaintiff's wife testified that she noticed his right eye was a little inflamed when he came home on July 26, and that his eye continued to get worse.
On the day following the window incident, plaintiff went to defendant's hospital where a registered nurse in the employ of defendant put drops in his eye and gave him some dark glasses to wear, but she testified that with an ophthalmoscope she could detect no foreign substance in the eye.
Plaintiff continued to visit the nurse at defendant's hospital for three days, and thereafter he saw for some 21 times an eye specialist in the employ of defendant. The specialist testified that he found no foreign body or dust in plaintiff's right eye, and that there was no laceration or scarring therein or any bruises, abrasions or evidence of traumatic injury to the eyeball. He testified further that plaintiff had a mouthful of very bad teeth which upon an X-ray showed a marked aveolar absorption with numerous pus pockets.
The witness testified further that plaintiff's eye had a condition of beginning iridocyclitis; that it became progressively worse; that the iris became immobile; and that the condition was the result of a low-grade systemic infection due to the condition of plaintiff's teeth and with no traumatic causation.
On October 7, 1944, plaintiff went to Cleveland and saw a physician named Rolf, and, although that physician was not called as a witness, plaintiff's wife testified that he informed plaintiff and her that inflammation had caused a film or cataract to form on the pupil of plaintiff's eye; and that the physician advised that there be no operation for a year, that the eye be given a rest and that plaintiff report back to him after one year.
Plaintiff's wife testified further that on August 8, 1944, she and plaintiff together removed an object from plaintiff's eye, which object was a little smaller than the head of a pin and hard like a stone.
On October 4, 1947, plaintiff's eyes were examined by one Hart, an oculist and ophthalmologist, whom plaintiff called as a witness. Hart testified that plaintiff had bilateral cataracts in both eyes which were probably of the senile type; that the right eye, for practical purposes, was blind; and that the left eye had more than 50 per cent loss of vision.
Plaintiff's counsel asked Hart a hypothetical question in which he embodied all the evidence favorable to plaintiff, as follows:
That on July 26, 1944, plaintiff was a man about 62 years of age, employed with defendant as a blacksmith; that on the afternoon of that day plaintiff opened a window and a foreign body blew into his right eye which he immediately wiped or rubbed; that plaintiff's eye was inflamed and sore and the next morning he reported to the dispensary; that plaintiff's sight began to deteriorate and from August 16, 1944, to October 7, 1944, he could see nothing with his right eye; that when plaintiff reported to the dispensary on July 27, 1944, a nurse put some drops in his eye and gave plaintiff dark glasses to wear; that the nurse sent plaintiff to see defendant's eye specialist; that when plaintiff returned to work on July 31 his right eye was getting worse and seemed to continue to get worse; that plaintiff's wife bathed his eye with boric acid and water; that from August 2 to August 14 plaintiff remained away from work; that his eye was inflamed and bloodshot; that he continued to work but kept going to physicians where he had medical treatment until September 19; that on October 7, 1944, plaintiff went to Cleveland and was examined by Doctor Rolf who advised resting the eye for a year; that on March 13, 1947, the date of a rehearing at Youngstown upon plaintiff's claim for compensation, he was unable to see with his right eye two persons sitting within about five feet of him, and by that time he no longer read; and that before the episode of July 26, 1944, plaintiff had no trouble with his vision while at work and never wore spectacles.
Doctor Hart was asked by plaintiff's counsel whether, assuming all the information given him by the question to be true and accurate and taking into account the physician's own examination and findings, he had an opinion as to a causal connection between the entering of the foreign body into plaintiff's eye and the condition of ill-being which the doctor found in such eye. The doctor said he had such an opinion and he answered that there was a possibility of relationship. Thereupon plaintiff's counsel asked the doctor to tell the jury whether he thought, in his best judgment and opinion, that such a causal connection or relationship was remotely possible, very possible, highly possible, probable, or what, to which the doctor answered, "Remotely possible."
Plaintiff did not apply for compensation for temporary disability as the result of his claimed injury, continued working at and driving to and from defendant's plant for approximately eight months, and then retired as the result of heart trouble.
Messrs. Traxler Beil, for appellee.
Messrs. Manchester, Bennett, Powers Ullman, Mr. William T. Swanton and Mr. John Weed Powers, for appellant.
Two questions are presented to us in this case, the first, whether there was any substantial probative evidence that the condition of plaintiff's eyes resulted from an accident suffered while plaintiff was in the course of his employment with defendant and arising out of such employment, which justified the denial of defendant's request for a judgment in its favor, and, second, whether there was error committed by the trial court in sustaining objections to certain questions asked by defendant's counsel upon cross-examination of Doctor Hart.
In view of the conclusion at which we have arrived in reference to the first question, we do not reach a consideration of the second one.
Under the decisions of this court, where an issue in a case involves a question of scientific inquiry which is not within the knowledge of lay witnesses or members of the jury, expert testimony is required to furnish the answers, and, if the issue relates to a causal connection between an injury and a subsequent physical condition which involves only a scientific inquiry, such causal connection must be established by the testimony of medical witnesses competent to testify on the subject, and the proof in such case must establish a probability and not a mere possibility of such causal connection. Drakulich v. Industrial Commission, 137 Ohio St. 82, 27 N.E.2d 932; Aiken v. Industrial Commission, 143 Ohio St. 113, 53 N.E.2d 1018.
The syllabus in the Aiken case reads:
"To entitle the dependents of a deceased workman to participate in the state insurance fund upon a claim that the death of such workman from acute myocarditis was attributable to a compensable knee injury suffered six years before, the proof offered must show such injury was a proximate cause of death and must include evidence by competent medical witnesses that a probable relationship existed between the original accident and the myocarditis." See, also, Brandt, v. Mansfield Rapid Transit, Inc., 153 Ohio St. 429, 91 N.E.2d 1.
It follows that if the condition of plaintiff's eyes was such as to present only a scientific or medical problem as to the cause of that condition, plaintiff did not present evidence which entitled him to go to the jury in the trial of his case below.
Defendant's medical witness testified that in his opinion there was no traumatic cause of plaintiff's eye condition. Plaintiff's wife testified that Doctor Rolf of Cleveland had found cataracts in plaintiff's eyes and advised rest for a year before further treatment, but there was no expression from Rolf as to the cause of the cataracts. Plaintiff's only medical expert, in answer to a hypothetical question embodying all the evidence favorable to plaintiff, and as a result of the expert's own examination, testified that the accident which plaintiff claimed had caused his eye condition would have had only a remotely possible connection therewith.
There was no medical evidence which tended to establish any direct or proximate causal connection between any accident which plaintiff claimed happened and the condition of his eye for which he was claiming compensation.
However, plaintiff claims that his injury was such that lay witnesses, to wit, plaintiff and his wife, by their testimony produced evidence sufficient to submit to the jury the question whether the bilateral cataracts from which plaintiff was suffering resulted from the particle which plaintiff claimed blew into his eye.
Plaintiff, to substantiate his claim, relies upon the case of Bowling v. Industrial Commission, 145 Ohio St. 23, 60 N.E.2d 479. In that case it appeared that one Bowling sustained an injury in the course of and arising out of his employment when hot flux of 880 degrees Fahrenheit splashed into his right eye. He applied for and received workmen's compensation on a temporary basis, returned to work, and later filed an application for further compensation. It appeared that before his accident he had had some impairment of vision in his right eye, estimated to be 20 to 25 per cent, and that his vision had declined to an 80 per cent loss.
In the opinion in the Bowling case it is stated that, although the court was still committed to the pronouncements in the Drakulich and Aiken cases, in neither of those decisions was anything said that would lead to the conclusion that in every industrial injury case the claimant must produce medical testimony upon the subject of proximate causal relationship between the injury received and the result claimed.
The opinion states further that if a workman receives an injury resulting in amputation of his fingers, hand, arm, foot or leg, it would seem perfectly obvious that medical testimony is not absolutely essential to establish the proximate causal relationship between the injury and the result.
This court in that case came to the conclusion that, since it is a matter of common knowledge that any liquid heated to 880 degrees Fahrenheit and coming into contact with any part of the human anatomy, especially with the delicate membrane of the eye, would cause injury, the injury to Bowling's eye and the resultant loss of vision was within the class of cases where lay testimony does have some probative value in establishing the probability of proximate causal relationship and is sufficient to send the case to the jury.
However, the situation in the present case presents a quite different problem.
Plaintiff claims that some particle blew into his right eye. Thereafter both his eyes developed bilateral cataracts which even his own medical expert described as probably of the senile type.
No medical testimony tended to establish any probability of causal relationship between anything that entered plaintiff's eye and the cataracts from which he now suffers, and it seems fantastic to say that the cause of those cataracts was a question which did not present a field of scientific inquiry where expert medical testimony is required to furnish the answers.
The only evidence in the case which is claimed to have entitled plaintiff to have his claim submitted to the jury was that of plaintiff and his wife to the effect that one of his eyes became continually worse after a particle was alleged to have blown into it.
There are two types of industrial injury cases, one in which the testimony of lay witnesses does have probative value in establishing the probability of proximate causal relationship between accident and re-resulting injury, and the other where the testimony of lay witnesses is without probative value to establish a proximate causal relationship between the injury and the result claimed and where medical testimony is absolutely essential to prove such relationship. Each case must be decided upon its own facts in reference to this question.
We are of the opinion that whereas the Bowling case, supra, came within the first type of cases, the present one comes within the other type. Since the most favorable evidence in support of plaintiff's claim was that there was a remotely possible causal relationship between the accident he claimed happened and the bilateral cataracts from which he is now suffering, no evidence of probative value has been produced to entitle the jury to pass upon plaintiff's claim, and, therefore, the trial court should have directed a verdict in defendant's favor.
The judgment of the Court of Appeals is reversed and final judgment is entered for appellant.
Judgment reversed.
WEYGANDT, C.J., ZIMMERMAN, MIDDLETON, TAFT, MATTHIAS and HART, JJ., concur.