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Dean v. Industrial Com.

OPINION FILED APRIL 3, 1986.

JOHN DEAN, APPELLEE,

v.

THE INDUSTRIAL COMMISSION ET AL., APPELLANTS.



Appeal from the Circuit Court of Winnebago County; the Hon. John C. Layng, Judge, presiding.

JUSTICE BARRY DELIVERED THE OPINION OF THE COURT:

Rehearing denied June 9, 1986.

The petitioner, John Dean, filed a claim under the Workers' Compensation Act (the Act) (Ill. Rev. Stat. 1981, ch. 48, par. 138.1 et seq.) for injury he sustained while an employee of the respondent, Commonwealth Edison and Nuclear Installation Service Company, a/k/a NISCO (the company). The company and the Commission appeal from a judgment of the circuit court which set aside and remanded the Industrial Commission's denial of benefits.

After employing the petitioner as a boilermaker, in March of 1980, the company promoted him to job superintendent at the Braidwood Nuclear Plant. One year later, when the petitioner was transferred to the Byron nuclear plant (the plant), his additional responsibilities included supervising laborers, carpenters, and iron workers, as well as scheduling and meeting deadlines for the work in units one and two (the site), a multilevel area equivalent to at least 10 football fields.

Each work day, the petitioner drove 64 miles to the plant. At approximately 7:30 a.m., the petitioner commenced his daily routine by conferring with the site manager about contracted and extra work scheduled for completion that day, and then meeting with the craft foremen prior to inspecting the work at the site.

The petitioner began a tour of the site by ascending a 45°, 100-yard incline and then descending a 50- and a 10-foot ladder to inspect the integrated heads. To inspect the fuel transfer installation site, the petitioner next climbed those ladders, descended another 50-foot ladder and walked on scaffolding. Thereafter, the petitioner inspected the revision of unit one by crawling through the transfer tube. Occasionally, the petitioner climbed out of that tube, climbed the ladder, and descended the ramp back into unit one. After descending at least 40 feet into the reactor, the petitioner ascended and completed the tour by returning to his office to check material listings or to discuss questions. Daily, the petitioner spent six hours walking seven to 10 tours; one hour scheduling; and, sometimes, worked overtime.

Prior to May 18, 1981, even though the petitioner was overweight, smoked at least one package of cigarettes daily, and did not exercise, he had no difficulty climbing and descending inclines, ladders and stairways. However, when the petitioner climbed during his rounds on May 18, he intermittently experienced shortness of breath, pain in his chest and left arm, and nausea. When the petitioner left work later that day, he was lethargic and still had throbbing arm pain, "gas pains" and indigestion. The petitioner rested that evening. Between May 18 and May 20, the petitioner was involved with the boilermaker's union dispute.

Although the petitioner felt slightly better when he went to work on May 19, when he walked or climbed he again experienced shortness of breath, gas and left arm pain. His symptoms continued as he rested that evening.

The following day, the petitioner was nauseous when he arrived at work. Later, his arm pain became more severe; his gastric distress became unbearable; and he experienced grasping chest pains. The petitioner was driven home, and never returned to work.

Prior to being admitted to the hospital on May 20 for the purpose of ruling out coronary insufficiency, the petitioner consulted by phone with Dr. Charles Kanakis, Jr., a Board Certified cardiologist and internist, author and lecturer. Based on the petitioner's symptoms, rather than his denial of heart problems, Dr. Kanakis suspected that the petitioner was experiencing angina pectoris and advised him to report to the nearest hospital. Dr. Gallagher treated the defendant during that hospitalization and consulted by phone almost daily with Dr. Kanakis. The petitioner's May 20 EKG was normal. The May 21 EKG revealed nonspecific abnormalities in the anterior septal area. Even though the next day's EKG revealed more pronounced T wave changes consistent with myocardial ischemia and/or damage, Dr. Gallagher advised the defendant to limit his activities and discharged him with medication. The petitioner still doubted that he had a heart problem but agreed to submit to the arteriogram which Dr. Kanakis planned to evaluate. Dr. Kanakis diagnosed the petitioner's chest discomfort as pre-infarctional angina pectoris.

The petitioner rested at home but his arm and chest pains continued. Very early on May 25, when his pains became severe and radiating, the petitioner's wife phoned Dr. Kanakis. The petitioner was again hospitalized. During his two-week stay, the petitioner was treated with therapy and medication; his EKG and enzyme changes were indicative of a heart attack; and the chest X ray revealed moderate vascular congestion. Dr. Kanakis supplemented his and Dr. Gallagher's conclusion that the petitioner had experienced a myocardial infarction, with his opinion that the heart attack occurred in the petitioner's anterior septal area.

At the arbitration hearing, the petitioner introduced Dr. Kanakis' evidence deposition which set forth the following. Dr. Kanakis explained his early diagnosis of the petitioner's condition as atherosclerotic heart disease with coronary artery disease, status post-myocardial infarction, and mild chronic obstructive pulmonary disease. Dr. Kanakis stated that exertion, climbing and rushing caused the petitioner's more frequent pains in mid-May of 1981. The overexertion, instead of solely precipitating the heart attack, produced an oxygen imbalance which caused recurring pain to result from increasingly less exertion. The petitioner's coronary arteries were unable to meet the increased demands on his heart. The petitioner's symptoms indicated the onset of the petitioner's pre-infarction syndrome and preceded the ongoing process of the work-related myocardial infarction which actually occurred when the petitioner's left coronary artery became totally obstructed. Dr. Kanakis concluded that since May 20, when the petitioner collapsed while exerting himself at work, the petitioner has been totally disabled.

Dr. Kanakis based his opinion on his knowledge of the petitioner's activities on the three work days the petitioner noticed chest pressure and on his August 1981 examination of the petitioner, when he discovered that the left anterior descending branch of the petitioner's left coronary artery was completely blocked and the ramus branch of the left coronary artery was obstructed.

Dr. Kanakis further explained that during the petitioner's hospitalizations he relied upon Dr. Gallagher's data interpretations; that the petitioner could have had some degree of coronary disease prior to the infarction; and that the petitioner's arteriosclerosis could have been caused by numerous factors such ...


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