Employee injured ankle: Will that lead to death benefits?
May 16, 2011 by Fred HosierPosted in: Bizarre Accident of the Week, Injuries, new court decision, Safety training, Special Report, Workers' comp
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Employee Michael Stokes suffered an ankle injury at work which required surgery. How did this lead to his widow requesting death and funeral benefits under workers’ comp? And did she get them?
After Stokes’ authorized surgery, his incisions didn’t heal. He received professional wound care and strong antibiotics.
According to court documents, Stokes wounds became “swollen, pus-filled, odorous and inflamed.”
While being attended to by a wound-care nurse, Stokes collapsed and died.
An autopsy revealed colonies of bacteria had formed in Stokes’ heart, causing acute inflammation of heart tissues.
The only source of infection on his body was his surgical wounds.
The medical examiner concluded Stokes’ cause of death was acute bacterial infection in the heart caused by the infection resulting from the ankle surgery. The M.E. ruled out all other possible causes of death.
Stokes’ widow filed for death and funeral benefits under workers’ comp. The employer and insurance carrier denied the claim on the basis that Stokes’ death wasn’t caused by the ankle infection.
Before a Judge of Compensation Claims (JCC), the company presented testimony from a toxicologist who said Stokes could have died from other causes, and that a link between the workplace injury and the cause of death couldn’t be made without culturing the ankle to match the bacteria found in the heart.
The JCC denied death benefits because no culture was taken of Stokes’ ankle wound, therefore no link could be drawn to the heart bacteria. Stokes’ widow took her case to a state appeals court.
Absolute or reasonable degree of certainty?
The appeals court said the essence of the toxicologist’s testimony was that there wasn’t absolute certainty that the bacteria found clumped in Stokes’ heart entered through the ankle wound.
However, Florida’s Workers’ Compensation Law states a reasonable degree of medical certainty, not absolute certainty, was needed to show an occupational link to injury or death.
The medical examiner’s expert opinion showed the occupational link, according to the court.
The appeals court reversed the decision and sent the case back to the JCC to determine proper death benefits.
Suggestion: This might be an interesting case for a safety meeting — not as a tutorial about workers’ comp, but as story for hard-to-reach workers who think they’ll never suffer a catastrophic injury at work.
(Stokes v. Schindler Elevator Corp., Dist. Crt. of FL, No. 1D10-1748, 5/9/2011.)
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Tags: ankle injury, bacteria, death benefits, Schindler Elevator, surgery, Workers' comp, wound care
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May 17th, 2011 at 7:42 am
It does appear to me the bacteria came from the ankle injury especially since the wound would not heal. His death is unfortunate but appears to be related to the surgery.
While I don’t know how he injured the ankle it appears the company did nothing wrong in terms of treatment and hopefully that would be taken into consideration when awarding benefits. This one was just a fluke
May 17th, 2011 at 8:36 am
This is a tough one, and honestly, am on the fence. Not being a doctor or having first hand knowledge of the specifics and testimony, I believe it would be very difficult to determine this case. On one hand, the employee was hurt at work, which led to surgery which appears to have led to the infection that caused his death. However, what is not apparent is how this employee took care of his wounds, followed doctors orders, living conditions, etc. So - this is definately one of those cases that one would have to trust the courts….
May 17th, 2011 at 10:12 am
An difficult and emotional case, indeed, but taking the emotional element down a few notches: What if the infection had not resulted in death, but only an additional 90 days of recovery? Would there have been any question who payed the bill? What if the IW’s initial injury had involved a laceration which itself resulted in an infection (that may or may not have moved to the heart and regardless of personal wound care, living conditions, etc.) and his subsequent death? There wouldn’t have been litigation over where the infection came from. The benefits would probably be paid.
If the infection could be directly attributed to OR negligence, that’s another thing, but with the details we’re provided I tend to agree with the appeals court.
May 17th, 2011 at 10:15 am
Uhh…isn’t this what ‘insurance’ is for? In case something unexpected happens? I think it was handled correctly. Cause and effect are fairly clear, according to the ‘common sense’ meter.
May 17th, 2011 at 10:26 am
This is a perfect case of an actual injury that went bad. This worker was under the care of a wound specialist and I dont think his personal hygien was any part of it. The courts did the right thing and this widow deserves her death benifits
May 17th, 2011 at 10:47 am
Actually I think that they argued this incorrectly. Was the ankle injury an open fracture??? If so then the bacterial infection could have been introduced at the time of injury. If not, then the bacteria was introduced in the hospital or during the surgery. If this is the case then it is not work related but was introduced due to poor sterile techniques in surgery or in the hospital, or perhaps even poor hygiene on the part of the individual at home post surgery. Without this added information it is difficult to call however, if we assume that it was not an open fracture then this is just another case of the courts making a poor decision.
May 17th, 2011 at 10:48 am
Frequently people during, after surgery and while hospitalized develop severe infections called nosocomial infections, pneumonia is very common as is staff and strep. In most cases the patient can be cured with the proper treatment however there are many infections that are antibiotic resistant. There are others that attack major organs some even cause what is called sepsis when the body poisons itself.
The comment about the care of the wound is something that should have been investigated as should how the heart got infected? There was also the surgery itself…..Was this a same day surgery? Was the patient hospitalized during the surgery and recovery period? Were the proper tests and cultures taken? Was the patient monitored properly? Etc.
The article states there were no cultures taken to ascertain if the heart infection was the same as the ankle infection. But from the description of the wound and subsequent wound infection after surgery this sounds like a nosocomial infection. As infections are opportunistic the surgery on the wound could have compromised this man’s immune system and the heart could have been attacked by other bacteria that could have caused another infection. The initial cause of both infections could be the same as it was the wound after surgery getting infected and that was resistant to treatment causing a severe strain on his immune system allowing infections to take hold easily.
May 17th, 2011 at 11:47 am
Adequate accident investigation material has not been provided to correctly evaluate the actual cause or root of the complication. It is that complication that appears to have caused death.
While the initial injury is identified, the events that followed do not appear to be the direct result of the work place. What appears suspect is either in the surgery or the extended treatment/care following the surgery. Only when this is evaluated, can the court make intellengent determination concerning the issue.
A driver driving a Ford is slightly injured in an accident and while being transported by ambulance, the ambulance (Ford) runs into a tree and kills the driver being transported. I doubt that that the auto manufacturer would be found as the cause of his death. Like the above, it sounds like subrogation.
May 18th, 2011 at 9:47 pm
WHO is footing the bill may vary from state to state depending on work comp laws. I know in my state workers comp picks up the bill. As for OSHA all states must report the same so the employer will be updating their 300 log to reflect the fatality.
See: http://www.osha.gov - OSHA Recordkeeping Handbook - Frequently Asked Questions: Section 1904.7 Question 7-3.
If an employee dies during surgery made necessary by a work-related injury or illness, is the case recordable? What if the surgery occurs weeks or months after the date of the injury or illness?
Answer:
If an employee dies as a result of surgery or other complications following a work-related injury or illness, the case is recordable. If the underlying injury or illness was recorded prior to the employee’s death, the employer must update the Log by lining out information on less severe outcomes, e.g., days away from work or restricted work, and checking the column indicating death.