Tia Galloway, Claimant, is 37 years old. She is married and raises six children. She also bore a child while she was a teenager whom she gave up for adoption. Claimant had a tumultuous childhood, being a victim of abuse and sexual assault. She has had an extensive history of mental illness, including schizophrenia and bi-polar disorder, for which she was hospitalized for several months. She left treatment against medical advice. According to one of Claimant's experts, Dr. Norbert Belz, Claimant's pre-existing mental condition was severe and included self-mutilation. Through it all, she managed to graduate from high school. She has no post-secondary education.
Claimant held a job at Shoney's Restaurant, but experienced problems working with others. She also worked in a day care and in customer service for AT\&T from 1994-1995 before
marrying David Galloway. He served in the armed forces, during which time Claimant did not work. Claimant indicated that she had suffered anxiety at being left alone while her husband was training in the military.
After David Galloway's military discharge, Claimant and her spouse engaged in illegal drug activity which led to their imprisonment. While in prison, Claimant received substance abuse and psychological counseling. She was placed on medications which helped stabilize her mental condition.
Upon the couple's release from prison, Claimant obtained a job in a group home for mentally challenged individuals. Claimant's spouse came to live with her, but Claimant eventually quit that job to obtain other employment that would allow her to reunite with her children. She found a job working at Pennington Seed through an employment agency.
The job at the seed company was very repetitive in nature. David Galloway testified that Claimant often called him during the day, apparently seeking reassurance. Once a month, she would have to take a day off from work to travel to Kansas City to have her psychiatric medications monitored and adjusted. The seed company job ended in 2004, however, when she was injured at work. A drug test was administered during treatment. Claimant was not thereafter allowed to return to work. Claimant indicated that she preferred to stay at home in the summer months anyway.
In 2005, Claimant went to work for the Petit Jean poultry plant. The job was highly repetitive in nature; she worked on a line sorting and cutting chicken parts. Claimant expressed some anxiety about the job, and again called her husband frequently for reassurance. But, she eventually was successful in her position.
The plant was quite cold in order to keep the chicken from spoiling. Claimant worked on one of several processing lines. Claimant wore her own clothes to work, but she was required to put on an apron, gloves, and a plastic smock over her clothing. This protective clothing, however, did not prevent Claimant from becoming wet. The processing line was chest high. Claimant was splashed with water as she grabbed the chicken to pull it toward her. Within a couple of hours of her 8 -hour shift, Claimant said she would be soaked through her clothing, despite the protective smock and apron. Even when she could change gloves and smocks at break time her t-shirt and undergarment were wet. At the end of her shift, Claimant changed all of her clothes except her bra. She would then travel home. She showered after she arrived home.
Claimant testified that in June 2006, she felt a knot on her breast. Her husband thought it was a pimple, but Claimant said it did not feel like that. She applied heat and ice, but when the knot began to grow she showed it to a co-worker who had had breast cancer. The co-worker indicated that the area did not resemble cancer, and suggested that Claimant see the company nurse. The plant nurse immediately referred Claimant to a physician. Claimant then saw Drew Shoemaker, M.D.
Regarding the onset of Claimant's condition, Drew Shoemaker, M.D., made the following notation on June 29, 2006:
This is a 33-year-old, African-American female who presented [at] the office yesterday with complaint of having had some pain in her left breast which had been going on for approximately the last day or so. She states she has had numerous small lesions on her breasts and she had picked those but she has had those get a little bit infected in the past but those had easily transiently gotten better. Yesterday, she presented with her breast being more tender than usual. She was given a gram an Ancef last evening and Augmentin 875 po bid. She has taken both of those. She presents today with her breast simply not improved at all.
(Exibit Q). Dr. Shoemaker referred Claimant to the hospital.
At Citizens Memorial Hospital in Bolivar, Dr. Linda Milholen noted on June 29, 2006:
This lady is a 31-year-old African-American female who presented to Dr. Shoemaker's office the day prior to admission with pain in the left breast. This had been going on, the history on the History and Physical, says about a day or so. It has actually been going on for 10 days. She says she had numerous small lesions on her breasts. She has picked them and they "got infected."
(Exhibit D). Dr. Milholen said Claimant's left breast "is erthematous and discolored with pururic lesions inferolaterally. These are purplish in color. There is no particular heat or erythema." (Exhibit D). Dr. Milholen believed Claimant suffered from cellulitis, possibly associated with toxic shock syndrome, with strep as the etiology.
Dr. William Donnell also reported on June 29, 2006 that Claimant's condition was unstable. He noted that Claimant was at risk for septic shock and renal failure.
Claimant thereafter was transported by air to St. John's Medical Center in Springfield, Missouri. The St. John's medical transfer record notes that Claimant had a three day history of not feeling well "and longer history of cellulitis to left breast." (Exhibit Q)
Claimant saw a number of physicians upon her arrival at St. John's Medical Center in Springfield. The admitting physician, Dr. Robert P. Saylor, ordered an ultrasound, which was performed on June 30, 2006. The ultrasound, read by Dr. Kathleen Gafarian, noted severe swelling and warmth in the left breast. There was an "oval area which had a very deep purple hue to the skin and extended over predominantly the lateral aspect of the left breast from the 2 to 5 o'clock location." Dr. Gafarian suggested that Claimant had "liquefactive necrosis of tissue." Dr. Gafarian "strongly recommended" a surgical and/or infectious disease consultation (Exhibit Q).
Dr. Saylor referred Claimant to Dr. John Bumberry. Dr. Bumberry reported on June 30, 2006, that he could see "no obvious drainage or source for this cellulitis or infection." He reported "No bulla, pustules or drainage appreciated." (Exhibit Q). He believed that Claimant suffered from necrotizing fasciitis and he recommended emergent mastectomy.
Claimant then was referred to Dr. Eric J. Fulnecky, who likewise diagnosed necrotizing fasciitis of the left breast requiring mastectomy. Regarding the onset of Claimant's symptoms, Dr. Fulnecky reported:
Per the husband's report the patient had developed small area of redness on her left breast that she had been scratching in the days leading up to the swelling in her breast. This apparently progressed and was noted both in Bolivar and here on admission and has now advanced significantly in size.
(Exhibit L). Claimant's left breast was then removed. She eventually was diagnosed with community acquired MRSA (Methicillin-resistent Staphylococcus aureus).
Claimant does not recall being flown on a helicopter to the hospital in Springfield. Her last memory prior to the mastectomy was on June 28, 2006, when she showed a red bump on her breast to a friend because she was concerned it might be cancer. Claimant required numerous surgeries to reconstruct her breast following the MRSA infection. She never returned to employment.
Claimant's mental health deteriorated after the MRSA infection. She now has increased anxiety with fear of germs. Her fear of public situations was aggravated. She now spends her days at home, takes the children to and from school and visits her husband at work during the day. She keeps her bedroom extremely clean and has a fear of becoming sick again.