Alan Leake v. City of Fulton

The first accident involving employee on April 30, 2006 was a three car accident on Business Loop 54 near the high school in Fulton. Mr. Moses responded at approximately 2:55 p.m. Mr. Moses observed that employee and other fire fighters were present at the scene. One of the cars involved in the accident was disabled and blocking the roadway. A severe rainstorm moved through the area soaking Mr. Moses and the other rescue personnel on the scene. After the rain cleared, the sun came out, creating a hot and humid climate. Employee assisted Mr. Moses and one other individual in pushing the disabled car off the roadway and into a parking lot. Mr. Moses and the other rescue personnel received a call for a second accident while they were still on the scene at this first accident.

The second accident occurred approximately one half-mile away on Highway 54 in Fulton and involved a vehicle that had flipped over a guardrail and rolled down a steep embankment into a ravine, ejecting the victim, who lay face up next to the vehicle at the bottom of the ravine in a concrete ditch. In Mr. Moses' twelve years of responding to traffic accidents, this was his most difficult and physically demanding rescue.

In order to reach the victim, it was necessary for employee and other rescue personnel to descend a steep embankment covered with tall, thick grass and mud. Employee was wearing his "turn-out" firefighting gear, which included a heavy insulated coat, heavy insulated pants, and large rubber boots. The grass was wet from the rainstorm and intertwined with vines, adding to the difficulty and physical exertion required to navigate the embankment. Employee first assisted in attempting to resuscitate the victim. The victim was a male and was at least six feet tall and weighed approximately two hundred and fifty pounds. The victim's large size made it more physically demanding to attempt resuscitation, as it was necessary to push harder on the victim's chest and to work harder to force air into the lungs. Employee was responsible for "bagging," a job ideally performed by two persons due to the physical exertion required. However, because the victim was situated tightly against the wrecked vehicle, there was insufficient space for the various emergency personnel involved to participate fully in the resuscitation attempt. The task of bagging involved manually compressing a bag of air in order to force air into the victim's lungs. The task was made more difficult in this instance because the air tubes were intermittently clogged with the victim's vomit.

The rescue personnel spent an unusually long time attempting to resuscitate the victim due to the difficulties involved. It may have been as long as thirty minutes that the rescue personnel, including employee, were working frantically around the victim. When it was determined that attempts at resuscitation were ultimately unsuccessful, employee assisted other rescue personnel in attaching the victim to a backboard and carrying him up the opposite hill to where an ambulance was waiting. This hill was not as steep as the embankment that employee and other rescue personnel descended initially, but was longer, and covered with the same tall, thick grass and mud. The size and weight of the victim combined with the slippery and unreliable footing caused considerable difficulty to the personnel involved in this task and employee slipped and fell at least once. After reaching the top of the hill, employee assisted in attaching the victim to a stretcher and then descended the hill into the ravine once again to collect his equipment. He then ascended the steep embankment on the opposite side of the ravine. Moments after reaching the top of the embankment, employee collapsed.

Enployee: Alan Leake, Deceased

- 3 -

Resuscitation efforts were unsuccessful and employee ultimately died. Employee was 51 years old.

Autopsy and Pre-existing Coronary Artery Disease

Dr. Adelstein performed an autopsy on May 1, 2006. The autopsy revealed a 95% occlusion of the left anterior descending artery, 95% occlusion of the right coronary artery, and 30% occlusion of the circumflex. Dr. Adelstein noted calcification around the aortic orifices, marked left ventricular hypertrophy, and an extensive remote infarct involving the left ventricle posterior and lateral area extending into the apex. Dr. Adelstein noted that Mr. Leake was 5'8" tall and weighed approximately 220 pounds. Dr. Adelstein opined that the cause of death was acute cardiac arrhythmia secondary to severe coronary artery disease.

Testimony of Ms. Leake

Employee is survived by his widow, Ms. Linda Ann Leake. She testified that she and employee were married August 8, 2005. She answered questions relating to whether employee had experienced any symptoms from his underlying coronary artery disease that caused difficulty in his activities at work or outside of work. We find her testimony to be credible.

Employee was not treating for any heart condition prior to his death. He experienced no symptoms that interfered with his work duties as a firefighter. Employee was physically active outside of work. His activities around the house included painting the trim, building a privacy fence, and cutting the grass. He also engaged in boating in his free time. Employee experienced no symptoms that interfered with his activities outside of work. The only medical issue was employee's high cholesterol. He was not taking any medication for this condition, but was advised to eat healthier.

Ms. Leake personally paid for employee's funeral and burial expenses. She was employee's sole dependent at the time of his death.

Opinion of Dr. Schuman

On behalf of the employee, Dr. Stephen Schuman reviewed the report of injury, police reports and eyewitness statements relating to the events of April 30, 2006, the employee's medical history as set forth in medical records going back as far as November 7, 1996, and the autopsy report of Dr. Adelstein.

Dr. Schuman noted that employee's medical history revealed that employee had no complaints of chest pain or other cardiac symptoms, and that he was not under any treatment for heart disease. Dr. Schuman noted employee smoked two packs of cigarettes per day for a period of approximately five or six years, that levels of employee's LDL cholesterol were high, and that employee was diagnosed as obese. Dr. Schuman's opinion after reviewing the autopsy report was that employee had severe double vessel coronary disease at the time of his death.

Dr. Schuman opined that the prevailing factor causing employee's death was the combination of physical exertion, emotional stress, and unfavorable environmental conditions stemming from employee's work activities of April 30, 2006. Dr. Schuman explained that the physical exertion required to reach the victim, perform resuscitation,

and carry the victim out of the ravine would have put an abnormal strain on employee's cardiovascular system. He further explained that the emotional stress involved in struggling to resuscitate a non-responsive victim of a car accident would add to the strain on the cardiovascular system. He further explained that the weather on that date put an additional extraordinary strain on employee's heart because when the weather is hot and humid, the body can't dissipate heat easily. As a result, more demand is placed on the heart because in addition to sending blood to the working muscles of the body, the heart also has to pump more blood to the skin to dissipate heat.

According to Dr. Schuman, all of these factors would have created a supply/demand imbalance. He explained that employee's heart was demanding more and more blood in order to allow employee to exert himself at the level required to respond to the work activities he was engaged in, but the supply of blood was not there due to employee's blocked arteries. This supply/demand imbalance led to the creation of an electrical instability that in turn led to the severe rhythm abnormality that directly caused employee's death.

Dr. Schuman testified that there are people with underlying coronary artery disease who never experience an acute cardiac event. Dr. Schuman opined that, were it not for the events of April 30, 2006, employee could have continued to go about the activities of normal living. He further opined that if employee could have stopped the work activities he was engaged in on that date, he would not have died.

Dr. Schuman agreed on cross-examination that individuals can die of sudden acute cardiac events without exertion. He further agreed that if employee's coronary arteries had not been blocked, and if his heart had been totally normal, employee would not have died of an acute cardiac event as a result of his work activities on April 30, 2006.

Dr. Schuman is board certified in cardiology and internal medicine and is currently engaged in the private practice of internal medicine and cardiology at St. Luke's Hospital in Chesterfield, Missouri.

On behalf of the employer/insurer, Dr. Jerry D. Kennett reviewed police reports and eyewitness statements relating to the events of April 30, 2006, the employee's medical history as set forth in