Eva D. Brown v. Purodenso Company

This workers' compensation appeal has been referred to the Special Workers' Compensation Appeals Panel of the Supreme Court in accordance with Tennessee Code Annotated _ 5-6-225(e)(3) for hearing and reporting to the Supreme Court of findings of fact and conclusions of law. The employee tripped and fell on both knees while at work. The trial court dismissed the complaint after finding that the employee failed to prove by a preponderance of the evidence the injuries to both knees resulted in any permanent physical impairment or that her physical condition was caused or aggravated by her fall at work. The employee contends that the trial court erred in finding: 1) that her injuries were not caused by her work injury; 2) that she did not suffer permanent disability; and 3) that the employer complied with workers' compensation law since the employer failed to pay for necessary surgery and for her permanent disability. Tenn. Code Ann. _ 5-6-225(e) (1999) Appeal as of Right; Judgment of the Circuit Court Affirmed JAMES L. WEATHERFORD, SR.J., in which JANICE M. HOLDER, J., and JOE H. WALKER, III, SP.J., joined. Ruby R. Wharton and Cynthia A. Pensoneau, Memphis, Tennessee, for the appellant, Eva D. Brown. John D. Burleson and John D. Stevens, Jackson, Tennessee, for the appellee, Purodenso Company. MEMORANDUM OPINION Ms. Eva Brown was 45 years old at the time of trial. She has worked in factories since graduating from high school in 1975. She is divorced and the mother of 2 children over the age of 18. In October of 1996 she began working for Purodenso Company, a manufacturer of automobile air filters. Ms. Brown worked as a "panel pleater" operating a machine that folds the paper product used to make air filters. On January 4, 1999, while working at Purodenso, she tripped over a bin and fell onto the bare concrete floor landing on her hands and knees. After being helped up by another employee, she reported her injury. Later that same day she saw Dr. Gilbert Woodall, the company doctor, complaining of pain and swelling in both knees. He prescribed medication and a knee brace for her right knee. She returned to work and finished her shift. The next day she worked a regular shift doing light duty work. When she continued to complain of knee pain, Dr. Woodall referred her to Dr. Michael Cobb, board certified orthopedic surgeon. On February 3, 1999, Dr. Cobb diagnosed Ms. Brown as having a bruised right knee. He noted that Mrs. Brown reported diffuse tenderness during his exam: "She is tender everywhere." He found no effusion or swelling and no "localized tenderness to the joint lines that would indicate a cartilage problem." He prescribed exercises and released her. On February 24, 1999, Ms. Brown returned to Dr. Cobb complaining of right knee pain. He found "fine crepitance... [a] roughness feeling in her kneecap joint, but that was also present in her left knee." In his opinion, this common condition "had been there before" because it was present in both knees and was not caused by trauma or injury. He diagnosed a bruised knee with kneecap pain and gave her a cortisone injection. On March 1, 1999, Ms. Brown saw Dr. James T. Craig, Jr., board certified orthopedic surgeon, upon referral of her personal physician. She reported pain and grinding in both knees but the most pain in her right knee. He noted that "she did not have any swelling or any fluid in either one of her knees." He found that she did have "crepitation or grinding under the kneecaps on both knees when she flexed or extended her knees." He diagnosed early degenerative arthritis in both knees and chondromalacia of the patellae, a wearing of the cartilage behind the kneecap. He gave her a cortisone injection and recommended anti-inflammatories. On March 18, 1999, she returned to Dr. Cobb's office complaining of "diffuse ill-defined" right knee pain. Dr. Cobb found: "[N]o sign whatsoever of any fluid on the knee. She again was tender wherever I touched, not more so at the joint lines or other important landmarks. She had full range of motion. All ligaments again were stable. I again noted the kneecap crepitance." He reported: "I cannot correlate any of her subjective complaints of pain with any physical findings." He testified: "[W]hen they're tender everywhere [instead of more so at the source of the injury], that affects their credibility to me." Dr. Cobb found no sign of impairment or serious injury and did not assign permanent restrictions. In his opinion, it was possible but unlikely, that chondromalacia could be accelerated by a fall, but in Ms. Brown's case "she had no signs whatsoever that she had an injury in her kneecap area when I saw her on three visits." Ms. Brown then returned to Dr. Craig who found that an MRI did not reveal any cartilage tears, ligament or meniscal injury. Because of her continued complaints of pain, Dr. Craig recommended arthroscopic surgery. On October 12, 2, Dr. Craig performed an arthroscopy and found damage to the cartilage behind the knee cap called chrondromalacia. He performed a chrondoplasty to smooth the area down. He found she reached maximum medical improvement on 2