MS Worker’s Staph Infection Was Causally Connected to Epidural Injections for Back Injury

Stressing that the weighing of expert medical evidence is the province of the state’s Workers’ Compensation Commission—and not the appellate courts—the Court of Appeals of Mississippi affirmed a decision awarding workers’ compensation benefits for a worker’s staph infection that the Commission found was causally connected to epidural injections the worker received as treatment for a work-related back injury [Lowe’s Home Ctrs., LLC v. Scott, 2017 Miss. App. LEXIS 618 (Oct. 31, 2017)]. Observing that the Commission had been presented with “dueling expert opinions,” the appellate court indicated the Commission was entitled to give more weight to the testimony of one physician over that of another.

Background

Scott injured his back while unloading a heavy appliance and was subsequently treated with, among other things, a series of epidural steroid injections. Several weeks thereafter, Scott was found to have an epidural abscess in the lower back, a staph infection caused by methicillin-resistant staphylococcus aureus (MRSA) bacteria. The infection necessitated several serious surgeries. The factual dispute in this case was causation, i.e., whether the injections led to the staph infection.

Employer’s Expert: No Causative Relationship

The employer’s medical expert testified that infections rarely resulted from epidural injections and that Scott, a diabetic, was especially vulnerable to “spontaneous” infections. He noted that Scott had had two staph infections in the past two years in other parts of his body. The doctor concluded that the injections were not the cause of Scott’s infection.

Employee’s Expert Tells a Different Story

The employee’s expert, an infectious disease specialist who actually treated Scott, testified that he believed the infection was caused by the injections. He based this finding on the timing of the injections and their location, which was a few centimeters from the infection. The doctor noted that “spontaneous” infections did not appear from nowhere, but required staph bacteria to have entered the blood somehow. He opined that the bacteria could have entered Scott’s body from the needle punctures. Alternatively, bacteria already present in the blood could have infected the spine because of inflammation from the injections. While the employee’s expert acknowledged that it would be unusual for an infection to result from an epidural infection or for such an infection to progress in some of the ways Scott’s did, nevertheless, in his judgment it was still more likely than not that the infection was caused by the injections.

Third Expert Opines

Another expert, a specialist in anesthesiology and pain management, also treated Scott. He testified that while he could not say the injections caused the infection, he disagreed with the employer’s expert’s opinion that one could say with any confidence that they had not.

Appellate Court May Not Reweigh Evidence

The Court indicated that the employer’s contentions appeared to be an attempt to reweigh the various facts that were considered by the employee’s expert. The record, however, reflected the fact that the employee’s expert had considered all the factors deemed relevant by the employer’s own expert. The Commission had acknowledged that it had relied upon the professional judgment of the employee’s physician; it was in no position to second-guess the opinion after finding it most credible. While there was certainly a conflict in the medical testimony, the Commission had exercised its role in determining what evidence was more credible.