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Dennis O'Brien v. ConAgra Foods Packaged Foods, LLC

Decision date: October 27, 2016Injury #12-08627225 pages

Summary

The Commission reversed the administrative law judge's decision and awarded workers' compensation benefits, finding that the employee's occupational exposure to aerosolized toxic chemicals in the boiler room was the prevailing factor in causing his cardiac arrest on November 4, 2012. The employee, who had prior cardiac conditions from histoplasmosis-related fibrosing mediastinitis, suffered cardiac arrest after working two days in the contaminated boiler room at ConAgra's food processing facility.

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Caption

FINAL AWARD ALLOWING COMPENSATION (Reversing Award and Decision of Administrative Law Judge)
Employee:Dennis O’Brien
Employer:ConAgra Foods Packaged Foods, LLC
Insurer:Old Republic Insurance Company
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund
This workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by § 287.480 RSMo. We have reviewed the evidence, read the briefs, heard the parties’ arguments, and considered the whole record. Pursuant to § 286.090 RSMo, the Commission reverses the award and decision of the administrative law judge.
Preliminaries
The parties asked the administrative law judge to resolve the following issues: (1) whether employee sustained an accident or occupational disease arising out of and in the course of the employment on or about November 4, 2012; (2) whether the accident or occupational disease is the prevailing factor in the cause of any or all of the injuries and/or conditions alleged in the evidence; (3) employer’s liability, if any, for permanent partial disability benefits; (4) employer’s liability, if any, for temporary total disability benefits for the period of November 5, 2012, through April 12, 2013; (5) employer’s liability, if any, to reimburse employee for past medical expenses; (6) employer’s liability, if any, for any future medical benefits pursuant to § 287.140 RSMo; and (7) the liability, if any, of the Second Injury Fund for permanent partial disability benefits.
The administrative law judge concluded as follows: (1) employee’s occupational exposure was not the prevailing factor in the cause of employee’s cardiac arrest; and (2) employee did not sustain a compensable accident or a compensable occupational disease.
Employee filed a timely application for review alleging the administrative law judge erred because the overwhelming weight of the evidence supports a finding that employee’s occupational exposure was the prevailing factor in causing his cardiac arrest.
For the reasons set forth below, we reverse the award and decision of the administrative law judge.
Findings of Fact
Employee works in employer’s food processing facility performing mechanical and electrical maintenance duties. He seeks workers’ compensation benefits in connection with a cardiac arrest he suffered at employer’s facility on November 4, 2012, after working for two days in a boiler room where a toxic chemical had been aerosolized from a leaking pipe.

Employee's date of birth is November 30, 1968. Employee smoked about a pack of cigarettes per day for 23 years. In September 2003, employee sought treatment for progressively worsening shortness of breath on exertion. A CT scan suggested employee was suffering from superior vena cava syndrome. ${ }^{1}$ An interventional angiography of September 11, 2003, revealed an occlusion of the superior vena cava; subsequent CT and ultrasound studies of the chest confirmed this diagnosis. On April 21, 2004, Dr. Imad Shawa diagnosed possible fibrosing mediastinitis ${ }^{2} related to histoplasmosis, { }^{3}$ and prescribed Sporanox.

On October 19, 2005, Dr. Richard Schmaltz performed a superior vena cava venogram in an attempt to place a stent at the area of obstruction, but this procedure was not successful. So, on November 8, 2005, Dr. Normand Caron performed an open heart surgery including a superior vena cava bypass with saphenous vein graft. For about a year after the surgery, employee took Plavix, a blood thinning medication. Thereafter, employee took no prescription medications for his heart. Employee returned to his fullduty, full-time work with employer, but was unable to qualify for the hazmat team, ${ }^{4}$ because he failed the lung function portion of the physical examination.

In April 2009, employee went to the emergency room complaining of left-sided chest pain, shoulder pain, nausea, weakness, and shortness of breath. An ECG revealed a left bundle branch block. ${ }^{5}$ In February 2011, employee again sought treatment for a history of shortness of breath and chest pains. A cardiac MRI revealed a severely dilated left ventricle with a 30 to 35 % ejection fraction. ${ }^{6}$ In contrast, a subsequent heart catheterization of March 2011 suggested a 53 % ejection fraction. ${ }^{7}$

Occupational exposure

On November 2, 2012, employee's coworker, Loren Kidder, noticed a strong, unusual smell while running conduit in employer's boiler room, so he called a boiler mechanic to help locate the origin. The mechanic found a leaky valve in a pipe, through which the industrial chemical Coravol 1973 (hereinafter "coravol") was spraying into the room. Coravol is composed of 20 % cyclohexamine, 5 to 20 % morpholine, and water, and is used by employer to prevent corrosion within the boiler systems. The Material Safety

[^0]

[^0]: ${ }^{1}$ The parties did not ask their medical experts to explain vena cava syndrome. As best we can determine from the record, this condition appears to have involved an occlusion of an artery located in employee's chest.

${ }^{2}$ Mediastinitis is an inflammation of the mediastinum, i.e., the center of the chest, and involves narrowing or occlusion of blood vessels preventing the flow of blood from the head and upper torso back to the heart, resulting in swelling and headache.

${ }^{3}$ The parties did not ask their medical experts to explain histoplasmosis. As best we can determine from the record, this condition appears to involve pulmonary inflammation, possibly linked to employee's childhood exposure to chickens.

${ }^{4}$ Employer's hazmat team responds to chemical spills in the facility, repairing leaks and rescuing any individuals exposed to toxic materials.

${ }^{5} \mathrm{~A}$ left bundle branch block is an abnormal finding indicating that the electrical impulses regulating the contraction of the heart muscles have been compromised, typically owing to underlying heart disease.

${ }^{6}$ Ejection fraction refers to the amount of blood that is pumped out of the heart with each contraction, or beat of the heart. A normal ejection fraction is 55 to 70 %.

${ }^{7}$ The medical experts who testified in this case generally agreed that the prior cardiac MRI may have been the more accurate study.

Employee: Dennis O'Brien

Data Sheet (MSDS) for coravol warns against inhalation of the substance in vapor or mist form; states that the substance is corrosive to the respiratory system and can burn the respiratory tract; recommends the use of protective equipment, including an appropriate respirator; and recommends immediate medical attention if inhaled. In addition, the medical experts who testified in this case agreed that the cyclohexamine contained in coravol has a stimulant activity upon the heart that can cause elevated heart rates and arrhythmia.

The mechanic who responded to Mr. Kidder's inquiry on November 2, 2012, turned off the valve through which the coravol was leaking. However, when employee joined Mr. Kidder in the boiler room at about 8:30 a.m. on November 3, 2012, the two immediately noticed a strong, pungent smell. ${ }^{8}$ They investigated and discovered that the valve had begun leaking again, producing a constant spray of mist and liquid. An electrical panel had been blackened by exposure to the leaking coravol, and the concrete floor under the leak had been pitted and burned. Mr. Kidder again called a mechanic to address the issue. The mechanic put a bucket under the leak, then left to find parts to fix it.

Employee and Mr. Kidder had to perform much of their work within close proximity to the leak, as they were running wires to the unit that regulated the flow of coravol into the steam system. It was over 100 degrees Fahrenheit in the boiler room that day, and the work of running conduit and pulling wires was rather strenuous. While performing these duties on November 3, 2012, Mr. Kidder began to experience a headache, burning sinuses, and a raw/scratchy throat. Employee also suffered from a sore throat and burning sinuses, as well as an upset stomach. Owing to these symptoms and the strong and unpleasant smell of the coravol fumes, the two took a number of short breaks to go outside and get some fresh air. (These breaks were in addition to the two 15 minute breaks and 30 minute lunch break employer typically allowed.) At some point later in the day, a mechanic returned and shut off the valve supplying coravol to the steam system, but this did not occur until long after employee and Mr. Kidder had felt the effects of the fumes. Mr. Kidder and employee finished their work in the boiler room between 8:00 and 8:30 p.m. on November 3, 2012.

That night, employee was unable to eat his dinner owing to an upset stomach. The next morning, employee felt a little better, but his throat was scratchy and his sinuses remained sore. Though employee and Mr. Kidder had reported the leaking coravol, employer did not provide them with respirators, as recommended by the MSDS, or any other protective equipment to minimize the effects of the coravol fumes. Nor did employer send them to receive immediate medical attention, as recommended by the MSDS. Nor did employer have anyone fix the valve from which the coravol was leaking. Instead, employer sent employee and Mr. Kidder back into the boiler room.

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[^0]: ${ }^{8}$ We find the consistent testimony from employee and Mr. Kidder regarding their start time on November 3, 2012, to be more persuasive than any contrary indication from Exhibit 18, which appears to consist of computerized time records from employer. There was no testimony from any custodian of such records or any other witness to explain how Exhibit 18 was created, stored, or retrieved.

On November 4, 2012, employee and Mr. Kidder resumed their work in the boiler room at about 8:30 a.m. About three hours later, the strong smell of coravol returned. Once again, Mr. Kidder called a mechanic, who determined the leak was too serious to fix without shutting down the entire boiler system. For unknown reasons, this was not immediately done. Instead, employee and Mr. Kidder continued to work in the boiler room near the coravol leak. They again took periodic breaks to leave the boiler room and get fresh air, but continued to suffer the symptoms they'd experienced the previous day. Employee additionally developed a headache. At some point, the leak got worse and began spraying about 15 feet into the air. Because of this, and because the two felt they could no longer withstand the symptoms they attributed to inhaling the coravol fumes, they stopped working around 6:00 p.m., and left the boiler room, returning only briefly to retrieve their tools. ${ }^{9}$

It is unclear what employee did in the period between 6:00 p.m. and 8:40 p.m., as he has no memory of this time period, and there is no other evidence on the record to establish his whereabouts or activities. At approximately 8:40 p.m., employee appeared in the nurse's station on employer's premises, and asked to see the MSDS for coravol. He also requested Tylenol for his headache. Thereafter, employee visited a coworker, Chris Townlain, who had asked employee to show him something on the computer. Employee sat down in an office and waited for Mr. Townlain to return from other duties. At some point, employee fell out of the chair, and at around 9:00 p.m., his coworkers discovered him on the floor. Employee was not breathing, and had no pulse. Fortunately, there was a defibrillator machine available on employer's premises, and through the efforts of employee's coworkers, who performed CPR and administered the defibrillator, employee's heart started beating again before emergency medical personnel arrived.

Medical treatment

Emergency personnel first transported employee to Fitzgibbon Hospita

Full decision text continues in the plain-text archive copy.

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