William Riley v. City of Liberty

involving outsourcing billing to a private company. Employee was the liaison between the firefighters and city management which placed him on the front lines of disputes involving the firefighters' attempt to organize with a local union. Employee worked with third-party consultants on expanding an existing emergency operations plan for the City of Liberty. Employee was also in charge of monitoring severe weather and operating the public warning systems.

In addition to the foregoing administrative and managerial duties, employee's job involved responding to fires and emergencies. Employee was required to respond and assist at all fires in the City of Liberty. Employee also responded to emergencies such as traffic accidents. For example, on September 24, 2004, employee was on the scene of an accident wherein a driver crashed into a house. While checking the vital signs of the driver, employee suffered injury to his leg when he fell through the floor of the house, which had been rendered unstable. Employee's duties as Deputy Chief were to take command of the emergency scene if necessary, but he was also required to assist with the actual physical work in responding to emergencies.

Employee's considerable duties with employer kept him essentially on-call twenty-four hours per day and seven days per week. Employee kept a dispatch radio on nearly the entire time he was at home. Employee also had a pager that would regularly require his attention. Employee took all of his duties extremely seriously and his home life and his sleep at night were often interrupted by a need to respond to some emergency or other pressing issue for employer.

We acknowledge the conflicting evidence provided by the parties with respect to employee's work duties and activities on October 5, 2004. We find most persuasive the testimony from Vicki Riley, Chief Gary Birch, Captain Michael Compton, and Captain Richard Cunningham. From their credible testimony, we derive the following findings.

On October 5, 2004, employee reported to work at his normal time. Employee was jovial and cheerful and nothing appeared to be the matter with him. Later, however, employee got upset about some administrative or personnel issues, including a disagreement involving a police dispatcher, and a feeling that Chief Birch (who was also a longtime coworker and friend of employee) had questioned his judgment. Captain Michael Compton discussed these issues with employee and observed that employee was so upset that his face was red and the veins in his neck were sticking out.

Later that day, employee responded to an emergency at a private residence to assist an EMS crew. The patient had fallen down a staircase. Employee helped treat, package, and carry the patient up the stairs and into the ambulance. Due to the small area within which employee and the EMS crew had to work, and the large size and weight of the patient, the task was extremely difficult and required very strenuous exertion on employee's part. The task was made even more difficult by the fact employer was short-staffed. Ideally, as Chief Birch testified, six people would assist in carrying a patient on a stretcher, but there were only five on the scene that day. After the task had

Enployee: William Riley, deceased

been accomplished, employee commented to his coworkers and to Chief Birch about how difficult and physically taxing the work had been.

Employee tried to work out on a treadmill at some point in the late afternoon, as was his custom. Afterward, employee's coworkers noticed that he didn't look well. Employee told coworkers who inquired that he didn't feel well and that he thought he'd eaten something that wasn't agreeing with him. Captain Richard Cunningham observed that employee was a pale or ashy gray color and that he was sweating profusely.

Employee called his wife from work to tell her that he would be home late because he was dealing with some bad personnel issues. When employee arrived home, his wife observed that he didn't look well. Employee was pale and upset. Employee's wife had cooked his favorite dish for dinner, but employee didn't eat any of it. Instead, he told her that he'd had an argument or altercation at work, that he didn't want to talk about it, and that he just wanted to sit. Employee's quiet and subdued demeanor was a significant departure from normal. Later, employee said he was tired and went to lie down. On October 6, 2004, at around 4:00 to 4:30 a.m., employee's wife woke up to discover employee sitting in a chair in their bedroom holding his head. Employee said he had a bad headache and his throat hurt.

Employee's wife went to make him some tea. When she returned, employee complained again about throat pain, then suddenly went into a seizure and stopped breathing. He died soon after from a ventricular fibrillation, a severe form of cardiac arrhythmia. Employee's wife called Chief Birch and told him what had happened. Chief Birch left for employee's house immediately and arrived while paramedics were still on the scene.

Employee married Vicki Riley in 1982. They had two children, Diane Riley, age 34 at the time of the hearing, and Landon Riley, age 14 at the time of the hearing. Landon Riley's date of birth is March 3, 1996.

Claimants provided evidence of their funeral expenses in the amount of $\ 2,360.90 owing to D.W. Newcomer's Sons Floral Hills Funeral Home and \$8,086.60 owing to Speaks Memorial Chapel, Inc. We find that the total of claimants' funeral expenses is $\ 10,447.50.

Employee was diagnosed with sleep apnea in 1998 and used a CPAP machine thereafter. Employee was evaluated for a heart condition in 1999 after he experienced a funny feeling in his chest; his heart checked out fine. Dr. Francis, employee's primary care physician since 2001, never initiated a cardiovascular workup on employee because employee didn't have any symptoms suggestive of heart problems. Employee treated with Dr. Francis for high cholesterol and took medication for this condition. Employee had high blood pressure during some of his examinations with Dr. Francis, but employee told Dr. Francis he regularly took his own blood pressure at home and gave Dr. Francis the last five readings he'd taken; all of them were within normal range,

Improve: William Riley, deceased

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and Dr. Francis attributed employee's high blood pressure during the examination as an instance of "white coat syndrome."

At the time of his death, employee was 46 years of age. Employee did not smoke cigarettes or drink alcohol. Employee was moderately overweight, but ran for exercise on a daily basis.

**Expert medical testimony**

Claimants allege that the physical and emotional stress employee endured in his work caused his death, and provide testimony from three medical experts in support of their claim: Dr. Lee, Dr. Gill, and Dr. Schuman. Employer provides testimony from Dr. Thompson. All of the doctors agree that, although employee was not known to have heart disease and had never been diagnosed as having a cardiovascular event in his lifetime, the autopsy revealed that employee suffered from concentric left ventricular hypertrophy, a serious underlying heart condition that made it more likely employee would die from a sudden cardiac event. The doctors disagree, however, whether employee's work on October 5, 2004, was nevertheless a substantial factor in causing employee's death.

Dr. Schuman opined that employee's work activities on October 5, 2004, were the prevailing factor in his cardiac arrest. Dr. Schuman explained that work tasks such as responding to the emergency call and assisting packaging and lifting the patient involved both physical and emotional exertion, and that such stress resulted in an increased demand on employee's heart with the heart beating harder and faster for a long period of time, which eventually caused the ischemia, which in turn culminated overnight in cardiac arrest. Dr. Schuman also believed that employee's work with employer contributed to cause his underlying left ventricular hypertrophy. Dr. Schuman reasoned that employee was experiencing intermittent sustained hypertension which his doctors missed because employee's blood pressure wasn't checked at work but instead at home or in the doctor's office.

Dr. Lee opined that physical and psychological stress on the job with employer on October 5, 2004, and probably in the weeks before that day, were the substantial causes of a cardiac rhythm disturbance evolving into sudden cardiac death. Dr. Lee explained that mental and physical stress cause an increase in adrenaline which in turn causes an increase in blood pressure, pulse rate, and an increase in cardiac work. Dr. Lee opined employee's underlying concentric left ventricular hypertrophy was the result of intermittent episodes of hypertension, which Dr. Lee opined employee must have been suffering from for a number of years, despite employee's normal blood pressure readings at home.

Dr. Gill performed the autopsy and opined that employee died from ventricular fibrillation. Dr. Gill opined that the stress employee experienced at work several hours prior was a substantial cau