71 Van Natta 506 (2019)
In the Matter of the Compensation of JACK L. EDWARDS, Claimant
WCB Nos. 18-01621, 18-01119
Oregon Worker Compensation
May 7, 2019
Dibartolomeo Law Office PC, Claimant Attorneys
Wallace Klor Mann Capener, Defense Attorneys
Reviewing Panel: Members Lanning and Curey.
ORDER ON REVIEW
The
self-insured employer requests review of those portions of
Administrative Law Judge (ALJ) Somers’s order that: (1)
found that claimant’s disputed medical services were
directed to his accepted right hip fracture/prosthesis; and
(2) awarded contingent penalties, attorney fees, and costs.
On review, the issues are medical services, penalties, and
attorney fees.[1] We reverse in part and modify in
part.
FINDINGS
OF FACT
We
adopt the ALJ’s “Findings of Fact” with the
following summary.
In
1980, claimant sustained a compensable right hip injury when
he had a logging accident. (Ex. 1). The claim was accepted
for a dislocated right hip and pelvis fracture, among other
conditions. (Ex. 45).
In
1983, claimant underwent a right hip fusion, which required
further surgeries. (Ex. 10-6-8). In the mid-1990s, he had the
right hip fusion converted to a total arthroplasty (total hip
replacement). (Exs. 10-2, -9, 11-1).
[71 Van
Natta 507] In September 2017, claimant sought treatment for a
two-week history of flu-like symptoms, a heart murmur, and
right hip pain. (Exs. 16A, 17). Blood cultures confirmed the
presence of streptococcus that “could have led to a
strep endocarditis and seeding his right hip.” (Ex.
23). Dr. Askew, an orthopedic surgeon, opined that emergency
debridement of the right hip prosthesis was indicated due to
the increasing risk of a “chronic devastating infection
of his implant.” (Ex. 21-2). Claimant wanted to proceed
to prevent damage to his hip arthroplasty. (Id.) Dr.
Askew surgically irrigated and debrided the right hip
prosthesis. (Ex. 22). Post-operatively, claimant was placed
on intravenous antibiotics. (Exs. 23, 25). The discharge note
detailed that claimant had “sepsis with bacteremia due
to streptococcus viridans” treated with IV ceftriaxone
and a “right septic hip prosthesis infection”
treated with irrigation and debridement of the prosthesis
with drain. (Ex. 28-1).
In
October 2017, Dr. Nanson, an orthopedist, diagnosed a right
hip infection and inflammatory reaction “due to
internal right hip prosthesis,” and referred claimant
to Dr. Crislip, an infectious disease specialist. (Ex. 30-3).
In
November 2017, Dr. Crislip opined that the infection was
likely endocarditis that “seized”
claimant’s hip. (Ex. 32-2). He based his opinion on
claimant’s symptoms of fatigue that preceded his hip
symptoms “by a significant period of time.”
(Id.)
In
December 2017, claimant requested that the employer modify
its acceptance to include new/omitted medical conditions of:
(1) septic arthritis of the right hip; (2) leukosytosis due
to sepsis and right hip infection; (3) acute right hip
infection; (4) septic right prosthetic hip associated with
streptococcal septicemia; (5) infected right total hip
arthroplasty, acute; (6) hematogenous spread of streptococcus
to the right hip; and (7) right infection and inflammatory
reaction due to internal right hip prosthesis. (Ex. 34).
Claimant also requested that the employer pay for medical
services related to the claimed conditions and his
compensable injury. (Id.)
In
January 2018, Dr. Leggett, an infectious disease...
