MARY HUNTER, Administratrix
of the Estate of PERCY HUNTER,
Deceased Employee,
Plaintiff,
v
.
From the North Carolina
Industrial Commission
I.C. File No. 847355
N.C. DEPARTMENT OF TRANSPORTATION,
Employer,
SELF-INSURED,
Defendant.
Scudder & Hedrick, by Samuel A. Scudder, for plaintiff
appellee.
Attorney General Roy Cooper, by Special Deputy Attorney
General Jonathan P. Babb, for defendant appellant.
GREENE, Judge.
The North Carolina Department of Transportation (Defendant)
appeals an opinion and award of the Full Commission of the North
Carolina Industrial Commission (the Commission) filed 22 December
2000 awarding Mary Hunter (Plaintiff), Administratrix of the Estate
of Percy Hunter (Hunter), workers' compensation benefits owed to
Hunter. Those benefits included: death benefits, all of Hunter's
unpaid medical expenses, reimbursement for past treatment relatedto Hunter's occupational disease, and partial funeral expenses.
The record reveals that from 1968 until 1985, Hunter worked
for Defendant in Hertford, Manteo, and at Mann's Harbor doing
various service and mechanical work on vehicles and equipment.
When Hunter worked in Hertford, he was blowing out dust and grime
from the hub housing of large wheels on motor graders using an air
hose. During the time Hunter was not blowing out various
particles, his co-workers were blowing out particles and he was
exposed to dust and grease particles, as well as carbon monoxide
fumes. When Hunter worked in Manteo, he continued working on
various equipment and blowing black dust particles which would get
into his mouth and nose and would remain there for two-to-three
days. Sometime between 1980 and 1981, instead of blowing out
equipment, Hunter began using Varsol and paint thinner to wash
fluids and grease from various parts. While in Manteo, Hunter
worked around men who ran large lathes and used torches to spray
chemicals on the shafts of ferries. Hunter was also exposed to
particles, including asbestos and other airborne particles,
generated from sandblasting various equipment.
After leaving his employment with Defendant in 1985, Hunter
began experiencing breathing problems in 1988 and was treated by
Dr. Robert Shaw (Dr. Shaw) who requested an open lung biopsy. Dr.
Shaw analyzed the tissue from the biopsy and made a diagnosis of
interstitial fibrosis which, at the time, he thought was
asbestosis. Dr. Victor L. Roggli (Dr. Roggli) examined the tissue
samples and determined the asbestos content of [Hunter's] lungtissue [was] unremarkable and diagnosed Hunter with idiopathic
pulmonary fibrosis. In 1989, Hunter filed a workers' compensation
claim citing asbestosis. Hunter's medical records and tissue
samples were subsequently reviewed by Dr. D. Allen Hayes (Dr.
Hayes) who noted abnormal chest x-rays dating back to 1980 showing
early evidence of interstitial lung disease. After reviewing
Hunter's tissue samples, Dr. Hayes determined asbestosis was not
present. Subsequently, Hunter voluntarily withdrew his workers'
compensation claim for asbestosis.
In 1992, Hunter's treating physicians sent him to Duke
University Medical Center to be evaluated for a lung
transplantation. Subsequently, in October 1994, Hunter underwent
a left lung transplant. After Hunter's lung was explanted, it
showed fibrotic disease as well as exogenous lipoid pneumonia. In
a letter dated 10 January 1995, Hunter told Dr. Victor F. Tapson
(Dr. Tapson) that he used fuel oil to clean parts and also sprayed
fuel oil and 10W motor oil on all snow equipment. Subsequently, in
a letter dated 4 April 1995, Dr. Tapson stated Hunter had sprayed
fuel oil/10W motor oil on equipment from 1968 until several years
ago. . . . It is possible that this activity may have contributed
to his lung disease. In May 1995, Hunter filed a claim alleging
his lung disease was caused by his exposure to asbestos and other
substances, including oil mist during his employment with
Defendant. Hunter died on 1 September 1995 as a result of his lung
disease.
In his deposition, Dr. Tapson testified that based on thehistory reported by Hunter, the exogenous lipoid pneumonia was
caused by Hunter's occupation. Defendant objected to the history
tendered by Plaintiff in Hunter's 10 January 1995 letter to Dr.
Tapson on the basis of hearsay. Dr. Tapson went on to testify that
to a reasonable degree of medical probability, Hunter's exposure to
dust and fuel oil contributed to his overall lung condition. Dr.
Tapson opined that the lipoid pneumonia caused Hunter's fibrotic
lung disease.
Dr. Gary N. Greenberg (Dr. Greenberg) testified that before a
diagnosis of environmentally triggered lipoid pneumonia could be
achieved, he would require evidence of exposure other than the oil
mist referenced in Dr. Tapson's letter. Dr. Greenberg had heard of
and read cases where mechanics had developed lipoid pneumonia. Dr.
Greenberg stated that if Hunter were exposed to aerosols of
petroleum products then that would certainly have increased his
risk of developing lip[o]id pneumonia.
Plaintiff's claim for compensation was denied by the deputy
commissioner on 19 April 1999. On appeal to the Commission, the
Commission reversed the deputy commissioner and overruled any
objections made in the deposition testimonies of Dr. Greenberg, Dr.
Tapson, and Dr. Roggli. The Commission found that:
4. . . . In Mann's Harbor, . . .
[t]here was . . . a lot of dust from
sandblasting and from removal of asbestos from
the boats.
5. During his work for [Defendant,
Hunter] was exposed almost daily to airborne
dust and greasy mist from blowing out brake
drums and other parts with a compressed air
hose and from the constant washing andspraying, by him and others in the facility,
of oil and oily mixtures on the vehicles and
equipment.
6. The dusts and mists contained
asbestos, motor oil[,] and other petroleum
products like [V]arsol or paint thinner that
were used on a daily basis to clean and
lubricate the pieces of equipment and parts.
. . . .
8. [Hunter] testified and the
Commission finds as fact that he used a
compressed air hose to blow off machinery and
black dust would get in his nose and mouth
and traces would remain [there] for
two[-]to[-]three days. After [Defendant]
stopped using compressed air to clean oily
dust and grease from machinery in the early
1980's, [Hunter] continued to clean large
machinery and equipment by spraying it with
[V]arsol chemicals.
. . . .
23. Dr. Tapson wrote a letter in April[]
1995 in which he stated that [Hunter] had
sprayed fuel oil/10W motor oil on equipment
from 1968 until several years ago and stating
that he thought it possible that the spraying
contributed to [Hunter's] lung disease.
. . . .
25. In his deposition [taken on] July
23, 1998, Dr. Tapson gave his opinion that
[Hunter] had exogenous lipoid pneumonia . . .
caused by something inhaled. Based on the
history that [Hunter] gave him, as
corroborated in the letter [Hunter] wrote
January 9, 1995, as well as the analysis of
the removed lung, Dr. Tapson's opinion was
that [Hunter's] exposure to oil mists at work
was the only factor in his history to have
caused the lipoid pneumonia. . . .
. . . .
28. The . . . Commission gives greater
weight to the opinions of Dr. Tapson because
he was in a better position than Dr. Roggli toexpress opinions on causation, because he was
a clinician treating [Hunter] and because the
entire lung was available as a sample for his
review. As such, Dr. Tapson based his opinion
upon a history of exposure obtained from the
patient and from looking at the whole
lung. . . .
. . . .
30. . . . [Dr. Greenberg] acknowledged
that . . . if he assumed a history of oil mist
exposure, that would very much support the
diagnosis of exogenous lipoid pneumonia. Dr.
Greenberg further stated that there is a well-
known connection in the medical literature
between lipoid pneumonia and interstitial
fibrosis and that there were connections in
studies of various types of mechanics. Dr.
Greenberg also opined that if [Hunter were]
exposed to aerosols of petroleum products at
work, that would certainly have increased his
risk of developing lip[o]id pneumonia.
31. . . . [T]he parties . . . deposed
Dr. Hayes . . . . Dr. Hayes was of the
opinion that . . . the occupational exposure
was[,] more likely than not, the source of
[Hunter's] lipoid pneumonia and the
interstitial fibrosis. Dr. Hayes was also of
the opinion and the . . . Commission finds as
fact that [Hunter's] exposure to oil mists at
work was the source of his inhaled exogenous
lip[o]id [pneumonia] and contributed to the
development of his pulmonary fibrosis and that
the treatment for his fibrosis, including the
transplant and immunosuppression medication,
most likely caused the cancer that [Hunter]
developed in his native right lung and which
resulted in his death.
. . . .
34. [Hunter's] occupational exposures to
oil mists and oily dust while in [Defendant's]
employ caused his lung condition to degrade to
the point of being unable to earn wages as of
Christmas 1987.
. . . .
36. Based on the greater weight of theevidence, the . . . Commission finds that
[Hunter's] exposure to oil sprays and mists,
as well as dusts, including airborne,
pressure-blown oil dust, in his employment
with [Defendant] was a significant
contributing factor in the development of his
exogenous lipoid pneumonia and interstitial
fibrosis and that his treatment for these
conditions caused his lung cancer and
subsequent death.
37. Based on the greater weight of the
evidence, including the opinion[s] of Dr.
Greenberg and Dr. Hayes, . . . the . . .
Commission finds that [Hunter's] job as a
mechanic with [Defendant] where he used
compressed air to blow oil dust, oily dirt[,]
and other oily substances from large pieces of
machinery and where he was constantly exposed
to airborne, sprayed oil mist used in cleaning
large equipment in enclosed spaces placed him
at an increased risk over the general public
for contracting exogenous lipoid pneumonia and
interstitial fibrosis over members of the
general public not so employed. The general
public, not so employed, would not be exposed
to airborne, pressure-blown oil dusts, oil
sprays[,] and other airborne oil substances
almost daily and in such an amount for such a
long duration of time as [Hunter]. Since
exogenous lipoid pneumonia is a rare or
uncommon disease that is difficult to diagnose
without studying a removed lung, the absence
of a significant number of documented cases in
the literature of exogenous lip[o]id pneumonia
and interstitial fibrosis contracted by
mechanics does not preclude a finding of
causation and increased risk in this case.
The Commission then concluded Hunter contracted an occupational
disease, namely exogenous lipoid pneumonia and interstitial
fibrosis, as a result of his exposures to and inhalation of mists
and oil dusts in his employment with Defendant.
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