Grace Sheldon REVLES, widow of John Vernon Revles, deceased employee, Petitioner,
INDUSTRIAL COMMISSION OF ARIZONA, Respondent.
Rehearing Denied June 28, 1960.
[88 Ariz. 68] Stokes, Bagnall & Moring, Coolidge, for petitioner.
Frances M. Long, Phoenix (Donald J. Morgan, James D. Lester, Phoenix, Edward E. Davis, Glendale, and C. E. Singer, Jr., Phoenix, of counsel), for respondent Industrial Commission of Arizona.
This is a certiorari proceeding to review an award of The Industrial Commission of Arizona denying death benefits (A.R.S. § 23-1046) to petitioner, Grace Sheldon
Revles, widow of a deceased employee of W. L. Eyer and Alice Pauline Eyer, d. b. a. Coolidge Sand and Rock Company. The employer makes no appearance; it carried insurance with the State Fund.
The widow's claim for death benefits was denied by the Commission and she timely filed for rehearing. A rehearing was held, after which the Commission entered its decision affirming the previous finding and award, i. e. denying relief to the widow. We granted certiorari.
The undisputed facts are these: John Vernon Revles, the decedent, was an employee of the Coolidge Sand and Rock Company (hereafter referred to as the employer). [88 Ariz. 69] On June 27, 1958, the date of the beginning of the events in question, he was 55 years old and had worked for the same employer for some 15 years. His work classification was 'crushing plant operator', i. e., he was an operating engineer whose duties involved the operation and maintenance of the machinery and equipment used to crush and grade gravel for commercial use.
During a lifetime of hard work he had experienced several injuries--broken bones, the loss of an eye, and, as a result of a compensated industrial accident in California, he had undergone the amputation of his right arm above the elbow. In 1951, while living in Coolidge, he was hospitalized with what was believed to have been a stroke. In spite of all these misfortunes, he was a strong and apparently healthy man, and a good worker. His superintendent at Coolidge said he was 'one of the best'. Revles lived in a ranch house outside of Coolidge with his wife, the petitioner. The evidence indicates that he was a vigorous man who enjoyed working around his home in the evenings and on off days, particularly in his garden.
On June 27, 1958, Arizona was suffering through an unusually early hot spell. On that date the temperature in Coolidge reached 114 degrees. Decedent spent several working hours on that afternoon repairing and patching a 'trammel screen', described as a long barrel or tumbler, approximately 4 to 5 feet in diameter and 27 feet long, made up of several sizes and layers of heavy steel wire screen. Revles worked inside the tumbler, cutting and placing the patches. He was cramped and worked in a crouching or recumbent position. Using a cutting torch, he would cut the steel wire patches to the proper size and then weld them in place with an electric welder. Both his working companion, Eleasar Marquez, and his superintendent, Ransom Stewart, who had performed the same job on occasion, testified that, because of the close quarters and the heat retained and reflected by the steel tumbler and the heat generated by the welding and cutting, it was considerably hotter where Revles was working than the 114 degree outside temperature.
Some thirty minutes to an hour before 4:30 p. m., the normal quitting time, Revles announced that he was getting sick, that it was 'just too hot', and that he was going home. Marquez testified:
'He told me he was sick, can't make it.
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'He looked--he got too, hot, you know.'
It is not clear whether Revles left the premises before 4:30, since he did not follow the usual procedure of going by the office and filling out his time card. The employer's report of injury, which was not [88 Ariz. 70] filed until September 17, 1958, states simply that at 3:30 p. m., June 27, 1958, 'Employee working as crushing plant operator in 114~ temperature, felt extremely ill, nauseated and dehydrated. Quit work at 4:30 p. m. and went home.' It does appear, from the testimony of decedent's daughter, that, feeling sick, he arrived home early that day.
Neither decedent's family nor his associates at work had heard him complain of illness prior to the date and the events above described. From that day forward, however, Revles never regained his health and strength, and on July 26, 1958,--some
thirty days thereafter--he died. As to this latter period, the following evidence was adduced: On the morning of June 28, 1958, the day following the initial illness, Revles telephoned Superintendent Stewart and said that he would not be to work, that he was ill. Stewart reported, 'He said he didn't feel like working, that his--he felt like his stomach was all full, and he could hardly breathe.' When asked whether Revles had said anything about being injured on the job, Stewart replied, 'The only thing he said to me was that he thought it might be too hot * * * that the thought he had gotten too hot' on the job.
During this last month before his death Revles led the life of an ambulatory semiinvalid. He spent much of the time in bed, or sitting or lying around the house in his pajamas. Occasionally his wife would drive him into town with her when she went shopping. On such occasions she would leave him at the home of one of their two daughters and then pick him up when she was ready to go home. Both daughters testified that he seemed to have undergone a sudden and profound change, that he was always tired and listless. Revles did not drive the car, and except for these excursions into Coolidge, rarely left the house. He stopped working in his garden. Through all this period he refused to see a doctor, insisting that he would soon get his strength back, that it was just a matter of time. He died at the end of the month.
The death certificate, prepared by Dr. David S. Burgoyne, who did not see decedent until after the death had occurred, attributed his death to two causes; the primary cause was stated to be 'congestive heart disease'; the secondary or antecedent cause, 'arteriosclerotic heart disease.' As to each of these factors the examining physician gave his estimate of the time intervening between the onset of the condition and the death. For the former, he estimated two weeks; for the latter, several years.
Shortly after Revles's death, an autopsy was performed by Dr. George Scharf, of Phoenix, a specialist in pathology and a diplomate of the American Board of Pathology. Dr. Scharf submitted his report and also was examined at the Industrial Commission hearing. Based on this autopsy [88 Ariz. 71] and on decedent's known physical history, the pathologist made certain findings, the gist of which is as follows: the arteries of decedent's heart were so clogged or 'hardened' that very little room was left for passage of the vital blood (coronary arteriosclerosis). In some areas the coronary arteries had been entirely stopped up (occluded). In the left side of the heart one area had--by the above process--been entirely cut off from blood and oxygen and had died (a myocardial infarction). In this same area a thick clot had recently formed on the heart wall (mural thrombus). The heart was considerably enlarged (cardiac hyperthrophy, 425 grams).
Upon these facts, Dr. Scharf constructed his theory of how Revles had died, viz.: Revles had a long standing heart condition, a coronary artery disease. However, up to June 27, 1958, his heart had somehow compensated for its defects, i.e., it had managed to do the work required of it in spite of the obstacles. From that date on, the heart failed to compensate, or, to use Dr. Scharf's term, a 'decompensation' set in. The result of this failure of the heart to overcome its deficiencies was a condition known as 'coronary insufficiency'. Symptoms of this deterioration were 'dyspnea' and 'edema', i. e., shortness of breath, and retention of fluids in the heart and elsewhere. Without medical treatment this condition ran on unchecked, ultimately causing death.
Dr. Scharf also gave his opinion as to what precipitated this 'decompensation'. The following appears in his autopsy report under the heading 'Comment':
'From the condition of the heart and coronary blood vessels, and the clinical story as given to the prosecutor, we would have to conclude that the patient died of cardiac failure secondary to coronary insufficiency. The question arises as to whether there might be any relationship between the precipitation
of this failure and the conditions existing immediately before the patient became ill. Again, referring to the condition of the heart and its blood vessels, we would have to conclude that the circulation of the heart was probably in a precarious state of balance, and that any conditions calling for additional blood flow, probably would result in acute coronary insufficiency. As noted in Bulletin No. 105 and the U. S. Dept. of Labor (1949), Dr. Arthur M. Master, reminds us that the first cause of acute coronary insufficiency would be anything that increases cardiac work. Among the variety of conditions listed are included extremes of temperature. We would therefore have to conclude that although the extremely high temperatures under which the patient was working certainly did not cause the [88 Ariz. 72] basic pathologic changes of the heart, it is very likely that the same conditions were strongly influential in precipitating the terminal cardiac failure.'
Of course Dr. Scharf did not insist that the theory set out above was the only possible explanation of the death. Under examination by the Commission's referee on rehearing, the following exchange took place:
'Dr. Scharf: With regard to the first part of your question as to what might have precipitated this, the autopsy itself gave us no direct information as to a precipitative factor, as far as the conditions under which this man lived.
'Q. You mean by that that you have no indication what precipitated it? A Not from the autopsy. We have to put the autopsy together with the information given to us about the clinical state of this man.
'Q. By 'clinical state,' now, what are you referring to? A. We mean the history in particular of his previous health, of his apparently becoming ill on a particular day under certain conditions, and of his condition after that illness. That is, that acute illness up to the time of his death.
'Q. And you say then that given that clinical history, it is possible that this precipitated the--A. Given that particular clinical history and knowing no other facts, it seems a good probability that the conditions under which he was working may very well have precipitated the cardiac decompensation that we have already referred to. We cannot prove it. It is matter of opinion.
'Q. And given other facts or given additional facts, your opinion might change; is that correct? A. My opinion might very well change.
'Q. Your opinion is based on this clinical history without any other evidence as to other activities and ...