Baltimore & Ohio Railroad v. Brooks

Pattison, J., delivered the opinion of the Court. On September 17th, 1925, the appellee, Lilly Brooks, then Lilly Zake, widow of Arthur Zake, filed her claim for compensation with the State Industrial Accident Commission on account of the death of her husband, who died on the 18th day of September, 1924. In her claim so made, she alleged that Arthur Zake, a machinist, died “as a result of injuries sustained on the seventh day of March, 1923, in the employ of the Baltimore and Ohio Railroad Company,” the appellant. ¹⁵¹ Upon the request of the appellee, a hearing was had on May 17th, 1926, before the commission, to determine the following issues: First: “The deceased, Arthur Zake, committed suicide.” Second, “The death of said Zake did not result from accidental personal injuries sustained by the said Zake arising out of and in the course of his employment.” The commission found for the appellant on both issues and disallowed the claim of compensation. An appeal was thereupon taken to the Baltimore City Court, where the case was. heard and determined by a jury; the issues there being the same as those heard and decided by the commission, that is, first, did the deceased Arthur Zake commit suicide ? and second, did the death of said Zake result from accidental personal injuries sustained by him arising out of and in the course of his employment?

The answer of the jury to each of these issues, was “Yes,” thereby reversing the decision of the State Industrial Accident Commission. Upon the verdict so rendered, a judgment was entered in favor of the claimant for costs. It is from that judgment that the appeal in this case was taken. In the trial of the ease, eight exceptions were taken to the rulings of the court.

Seven of these exceptions were upon the admission of testimony and the other upon the prayers. The evidence discloses that Zake was hurt on March 7th, 1923. After the accident he was carried to the office of a physician, where he was examined, and from there he was taken to his home, where he remained until March 12th, 1923, when he went to the hospital. There he remained for some weeks and returned to his home, but visited the hospital at intervals for examination until August, 1923, when he returned to his work, and thereafter continued to work until April, 1924, when it is claimed he was no longer able to work.

In May, thereafter, it was said by his physician, Dr. Kitsch, that he was suffering with tuberculosis of the lungs, also had some mental derangement. Upon the advice of his said physician, he was sent to his father’s in the mountains of Pennsylvania, that his condition might be ini ¹⁵² proved. It was while at the home of his father that he> in June thereafter, shot and killed himself. The main contention of the appellant is upon the court’s refusal, in the sixth exception, to strike out certain testimony of Dr. Freedom, an expert witness, who was allowed to state, from all the evidence then offered, that in his opinion the insanity of Zake resulted from the injury received by him, without which the appellant’s second prayer, as claimed, should have been granted, asking that the jury be instructed that there was no evidence legally sufficient to show that the insanity of Arthur Zake resulted from accidental personal injuries arising out of and in the course of his employment. ■ The appellee’s witness, Dr. Freedom, was asked: “What, in your opinion, and basing that opinion on the testimony and evidence given in this case, which you say you have heard, was the probable and proximate cause of the insanity from which Arthur Zake was suffering according to your opinion at the time he took his own life ?” This question was objected to, but the witness was allowed to answer it.

In his answer he said: “When a case is sent to me for diagnosis and for treatment, and this patient is suffering from a very obvious mental disturbance, we always try to determine, if possible, some cause for their mental disturbance. That cause may be due to disease of the brain, or it may be due to disease elsewhere in the body. In questioning the patient, we look first for the presence of venereal disease; we look secondly for the presence of injury or for the history of injury. Bow, then, here is a man who up to the time of his accident was perfectly healthy.

After his accident he was in the hospital for a certain length of time, came home, and continuously complained. There is absolutely no doubt in my mind but that this man complaining while in the hospital showed some evidence already of a beginning mental disease. * * * Immediately after coming back from the hospital, going home, he was irritable, morose, dangerous, delusions of persecution, people trying to harm him, and people trying to take his wife and harm his children. Bow, then, if I had seen him while he ¹⁵³ was in the hospital, I possibly would not have known this man was insane. If I had seen him generally from day to day and observed him carefully, the time he was in the hospital and after he got home, possibly with each day I would not be able to say this man was insane.

But, observing him from day to day and taking a longitudinal section of the man’s life, I could have said very definitely that this man is insane, and, with the history of injury and nothing else, T would have been forced, absolutely forced, to base my opinion on the fact that he has been injured, and, as the result of that injury, now suffers from mental symptoms. That is a very frequent thing in the hospital. It is not at all unusual. We are always seeing cases of individuals who have been hurt, either to their head, or otherwise.

We examine those patients, go into the history very carefully, and we find that there is some evidence of injury. And so it was with this poor man, the story of his having been hurt — Mind you, minor injuries do not cause such things. Here is this man caught beneath a half ton boiler, and this half ton boiler very near crushed the life out of him, was prevented from so doing by the fact that there was a block which kept the boiler from actually crushing the life out of him, and you can appreciate not only the actual organic injury which he must have suffered, but also the terrible mental anguish which this man must have suffered until this thing was taken off of his chest, and so it continued up to the time of his death, one mental symptom after another, irritability, people trying to harm him, and on several occasions he actually tried to murder his wife and his children, certainly without cause. We examine different people, we try to determine a cause, if possible.

Delusions of persecution like that are exceptionally frequent without cause, that is, as far as we are able to determine; that is, on an unfounded basis. And so it was with him up to the time of this death, up to the time he committed suicide. I am forced to say, since I can find no other reason for his mental symptoms and for his mental malady, I am compelled to say that injury must have been the cause of it.” To this action of the court, in allowing this question to be ¹⁵⁴ asked and answered, the defendant excepted and, the objection being overruled, an exception was noted, which riding forms the second exception. He was then asked: “The only testimony of injury here is the injury which happened on March 7th, 1923.

Is that the injury which you say was the cause of it, and would you say that was the probable and proximate cause of his mental condition ?” This question was objected to, but the witness was allowed to answer it, saying: “Yes, sir.” To this action of the court, in allowing the question to be asked and answered, the third exception was taken. In the course of Dr. Freedom’s cross-examination he was asked: “In this history and in this assumption that you made, that it must have been the injury that caused this derangement, what concretely was the injury that you assumed occurred and on which your testimony is based ? A. I assume that this man was caught under this half ton boiler, and that his chest and his abdomen, of course his back too, because he was squeezed in this thing, not that he was necessarily crushed, as far as his tissues were concerned — that is, his bones were not broken, nor his muscles torn, nor lacerated, but this thing caught him and squeezed him * * * Q. What is the kind of squeezing you mean ? A. A squeeze that came with a good deal of suddenness, sufficient to cause a very rapid and severe increase in inter-thoracic and inter-abdominal pressure.” When asked to explain his answer, he went to the black board and attempted to illustrate what he meant and, at the conclusion of his answer, he said to the counsel for the defendant “Does that answer it ?” and was told by him it did not.

Whereupon the witness was asked: “Do you assume in your testimony that this man’s chest was squeezed ? A. I would assume so; yes, sir. Q. I am asking you to answer that yes or no? A. Yes, sir.

Q. What change was made by the squeeze that affects the brain ? A. That is very simple affair. Any very sudden extensive increase in inter-thoracic pressure, the venous blood, that is, the blood from the right side of the heart, is suddenly sent back through * * * its venous tree, sufficient to cause numerous small extravasations of blood ¹⁵⁵ out of the smaller blood vessels and so called peri-vascular hemorrhages. Q. Therefore, you tell this jury that the reason you connect the injury as the cause of Zake’s mental derangement is because he had a squeezing of his body, particularly of his chest, sufficiently great to force the circulation, that is, to force the blood up into his brain * * * sufficient to cause a breaking of the blood vessels in his brain ?

That is true, isn’t it ? A. Yes, sir.” The evidence which had been given at the time Dr. Freedom was upon the stand, in any way bearing upon the character of the injury suffered by Zake, and the manner in which it was inflicted, was first, the testimony of Zake’s wife, who said he told her “he was working underneath a smoke box and he was on the frame of the engine with an air hammer working under this smoke box, and one of the men on the other side of this engine moved the blocks, and when they moved the blocks, this smoke box and the frame of the engine caught him, doubled him up like that (indicating) and one of the workmen pulled him out with this part of his body first and this smoke box was crushing him on his back and the last place it struck was on top of his head.” Second, the statements made by Zake as disclosed by the hospital charts. In the first of these, made upon his admission to the hospital on March 12th, 1923, it is said “Injury being due to a boiler falling on him” and that “he was caught between a boiler and disc plate injuring his back,” and in a later chart, that “he sustained a crushing injury on March 7th, 1923.” Third, the testimony of Grimes, who did not see the accident but was told that “it was the outer tongue frame of a key wound engine, I j udge it would weigh around half a ton, from what 1 was shown. I didn’t see it, but from what they told me it was cut loose and lying up on top of the cylinder, and he was taking the cylinder ends off the cylinder and he happened to be laying across it and something occurred that one end jumped up,” and they “claim there were some small blocks that laid across it and kept from catching him between the boiler and crushing him to death.” Fourth, the testimony of Bowena O. Harrison, director of claims of the State Indus ¹⁵⁶ trial Accident Commission, in which she testified that Zake filed his claim for compensation “and was awarded eighteen dollars per week from March 11th, 1923, to August 4th, 1923,” and that in his claim, he, speaking of his injury, said it occurred while “taking cylinder off engine, engine tilted and wedged me under engine, contusing my back.” After the plaintiff had concluded her testimony, James P. McCann, a helper to Arthur Zake at the time of the injury, who was along side of him, about a foot from him, the only person who saw the accident, and consequently the only one able to explain just how it occurred, was asked: “Now, will you, in your own way, tell the jury just what happened ?

A. If you understand the workings of the engine I can easily explain it. We were taking the bolts out that go through the smoke box and the cylinder; he was on the frame tongue which rests on top of the frame back of the cylinders and goes over the top of the cylinders to the front, or what we call the deck. He was sitting on the frame tongue