Tammy Louise Edgerton (Claimant), age 57 years, currently resides in Licking, Missouri, with her son and her daughter-in-law. Claimant graduated from Rolla High School in 1977. She became a respiratory therapist in 1980, and worked at Phelps County Hospital for four to five years. She would administer breathing treatments, EKGs, EEGs, PFT tests and run ventilators. She then worked for Texas County Memorial Hospital as a respiratory therapist in Houston, Missouri for approximately five years. When her husband at the time moved to Virginia, Claimant followed him and obtained a job as a respiratory therapist at the Woodstock Shenandoah Hospital. She maintained that position for more than four years.
Eventually, Claimant returned to Missouri. She was unable to find work immediately and accepted employment as a cook at the Rolla High School cafeteria. After about a year, she returned to work as a respiratory therapist at the Ozarks Medical Center in West Plains, where she remained employed for seven years. During this time she also obtained a two-year associate degree and passed state and federal boards to become certified in respiratory therapy. Her duties at the West Plains facility were much the same as previously described except that she also gave methalyne tests for asthma.
Claimant eventually quit work to care for her ailing parents. Her mother had end-stage renal failure and her father had undergone a triple heart by-pass. After her mother passed away, Claimant continued to care for her father for another five months, who then remarried. She then became a caregiver for her father-in-law.
While taking her father-in-law to Columbia, Missouri for some medical care, Claimant was hurt in a automobile accident near Freeburg, Missouri. She suffered whiplash injury and a bulging disc. Claimant said the pain from the injury and range of motion deficits never resolved. Still, Claimant continued to care for her father-in-law until he died in 1997.
Claimant said she was burned out from having worked as a respiratory therapist and from the stress of caring for her relatives for five years. She eventually returned to work in September 2000, accepting a cashier position with Pump N Pantry. In addition to running the cash register, Claimant was responsible for stocking a cooler and cleaning the counter and restrooms. It was this latter duty that gave rise to the instant claim.
She was employed at Pump N Pantry for only three days. Claimant understood, from another worker, Amy, that a certain cleanser was eating the finish from the bathroom fixtures, and she should not use the product. On September 5, 2000, however, a supervisor directed Claimant to use that particular cleaning product. While cleaning a second bathroom, Claimant contends that her lungs became tight, which she attributes to the cleaning product. Claimant does not know the name of the cleaning product. She does not have a picture of the label, nor any other identifying information as to its ingredients or their concentration. She only knows that it was a cleaner. Despite the alleged accident, Claimant did not seek immediate medical attention. She continued her shift and went to the emergency room for treatment the following day.
Records from Texas County Memorial Hospital verify that Claimant was admitted on September 7, 2000 and discharged the following day on September 8, 2000. She gave a history of have been "exposed to several cleaning chemicals in her new job." (Exhibit C). But she also gave a history of having cold symptoms the previous week with head congestion, fever chills, nonproductive cough and possibly some
wheezes. She further gave a history of having to walk one mile on September 6, 2000, because she had run out of gasoline and subsequently experienced a moderate to severe shortness of breath with wheezing. An x-ray report dated September 7, 2000 indicated moderate bronchitis.
Claimant remained in the hospital overnight and was discharged September 8, 2000. She was given several medications and treatments during her short stay at the Texas County Memorial Hospital. She was in an improved condition and not wheezing at all when she was discharged. In the discharge summary, the treating physician noted:
Patient had previously worked as an RT for approximately 23 years and reports that during that time she had had occasion to test herself with spirometry and states that she had noted lots of small airway obstruction.
(Exhibit C). This differs from comments Claimant had made to other physicians, in which she contended that she had no prior respiratory condition.
The treating physician, Dr. Linda Youngren, gave Claimant one day off work but released Claimant to work thereafter. Claimant, however, never returned to work at the Pump N Pantry.
On September 11, 2000, which was four days after her discharge from the Texas County Memorial Hospital, Claimant was admitted to the Ozarks Medical Center with a history of severe wheezing, dyspnea, and respiratory distress after being exposed to cigarette smoke. She reported a history of one episode of pneumonia and a diagnosis two years prior of croup. At the time of her discharge, Dr. A.N. Reddy believed Claimant had suffered acute bronchial restriction which was "probably on the basis of acute viral infection with bronchitis and bronchospasm" (Exhibit D). Claimant's chest x-ray was normal. Claimant contends she had to stay in the hospital two weeks, although medical records indicate her stay was only five days long. While she admits she was better after her discharge from the hospital, she avers that she was very weak, unable to do much, and relied on the kids to tend to her care. Dr. Reddy's discharge summary, however, indicates that Claimant's bronchospasm and respiratory distress was "much improved," and hypokalemia was resolved. The discharge diagnoses includes acute bronchitis and chronic rhinitis and sinusitis. During a follow-up with Dr. Reddy on October 13, 2000, both Claimant's lung examination and spirometry test results were normal.
Claimant testified that she returned several times to Ozarks Medical Center and that she had been in the hospital ten times within the first year. She has problems breathing particularly in the spring and fall due to allergies. She said avers that she never had any breathing problems before the exposure of the cleaning agent in September 2000.
In January 2001, about four months after the alleged bathroom incident at Pump N Pantry, Claimant went to work for Casey's making pizza. She was employed there three days when someone sprayed an oven cleaner. Claimant reacted to the oven cleaning and sought treatment to the Phelps County Regional Medical Center. Records from Phelps County Regional Medical Center reflect an emergency room visit on January 25, 2001. Upon admission, Claimant gave a history of having developed asthma in September of 2000 but did not know the etiology of her asthma (Exhibit E). She complained of an exacerbation after being exposed to cleaning chemicals at a new job in the last several days, and the use o cleaning chemicals at a different job. She was discharged with a diagnosis of acute extrinsic asthma with bronchospasm and hyperglycemia secondary to steroids.
She did not return to work for Casey's following this event. She had not filed a Claim for Compensation against Casey's. Claimant now uses breathing treatments as needed approximately six to eight times per week, Advair two times per day, an inhaler two times per day, A Combovent inhaler as well as Singulair, and uses oxygen at night. She has problems with her voice as it will come and go. She has a handicap parking sticker. She avers that she only can walk around her house to her recliner before being out of breath. She admits that her symptoms are triggered by pollen, cigarette smoke, perfume, aerosol cleaners, diesel fuels, humidity, and cold weather. Despite these triggering substances, Claimant uses a wood burning stove to heat her home even though doctors have advised her against this. She does see a doctor regularly. Prior to working at Pump N Pantry, she used to bowl, do crafts and play bingo. She no longer engages in these activities due to the presence of cigarette smoke or perfumes in the facilities.