Ohio: Trauma Induced Stroke Sustained In Fall From Wheelchair Is Not Compensable Aggravation of Original Injury

A worker, who lost the use of his legs in 1965 in a work-related accident, and who was thereafter confined to a wheelchair, is not entitled to additional workers compensation benefits related to a trauma induced stroke that he sustained when, as he was being moved from his wheelchair by a home health aide, he fell, struck his head on a table, and sustained a right parietal bleed or hemorrhagic stroke, held a divided Ohio appellate court recently in Toth v. United States Steel Corp., 2012 Ohio 1390, 2012 Ohio App. LEXIS 1198 (Mar. 30, 2012). The majority held that the worker failed to show anything other than that his stroke was caused by the intervening act of being mishandled by the aide.  


Toth worked for U.S. Steel from 1946 until 1965 when he lost the use of his legs due to an injury at work. In April 2004, a nurse’s aide lifted his legs unexpectedly during a transfer, causing him to fall from his wheelchair and strike his head on a table, resulting in a right parietal bleed or hemorrhagic stroke. Toth moved to amend his claim allowance to include coverage for treatment of his head injury as flowing from his original industrial injury suffered at U.S. Steel. A hearing officer denied the additional allowance, after finding that the fall from the wheelchair was caused by a home health aide who created an intervening superseding cause, breaking the chain of causation set in motion by the 1965 compensable injury. Toth appealed to the Industrial Commission, which vacated the hearing officer’s order and granted the motion for the additional allowance of the new condition as a “flow-thru injury.” Upon further appeal, the trial court determined that U.S. Steel was entitled to judgment as a matter of law because Toth’s head injury was not a residual injury resulting from his compensable workplace back injury.

Issue: Causal Relationship Between the 1965 Injury and the Fall

The appellate court stated that the only question was a legal one: Whether Toth presented evidence of a causal relationship between his 1965 back injury and his 2004 fall sufficient to create a genuine issue of material fact regarding whether his back injury was a proximate cause of the stroke. U.S. Steel argued that the fall was caused by the independent negligence of the nurse’s aide, creating an intervening superseding cause that broke the chain of causation between the back injury and the head injury. Toth argued that he would not have struck his head and suffered a stroke if he had not been confined to a wheelchair due to injuries received at U.S. Steel.

Two Somewhat Similar Earlier Cases: Iiams and Kenyon

U.S. Steel cited Iiams v. Corporate Support Inc., 98 Ohio App. 3d 477, 648 N.E.2d 902 (3d Dist. 1994), where the trial court determined that the claimant was not entitled to compensation from the Fund for a neck injury that she suffered when her hospital bed collapsed while she was recuperating from work-related injuries. According to that trial court, the neck injury was not causally related to her original work-related injuries because it did not arise in a natural and continuous sequence, unbroken by any new independent cause, without which it would not have occurred.

Toth cited Kenyon v. Scott Fetzer Co., 113 Ohio App. 3d 264, 680 N.E.2d 1034 (8th Dist. 1996). There a worker suffered work-related injuries that required surgical replacement of both hips. After the second surgery, the worker was transferred to a rehabilitation center. As he was being moved, the attendants dropped his gurney and one hour later, he was diagnosed with a heart attack. Before the incident, the worker had no cardiac difficulties. An expert cardiologist testified, however, that the worker’s heart attack was a “direct result” of the work-related hip and groin injuries through a series of factors including decreased mobility, ulcers, and pain. The cardiologist testified that the multiple surgeries and recovery periods required to treat the allowed conditions aggravated and accelerated Mr. Kenyon’s coronary disease. Moreover, while the fright caused by being dropped while strapped to a gurney triggered the heart attack, the court determined that it did not cause the underlying coronary disease.

The Kenyon court considered and distinguished Iiams, noting that in the latter there was nothing demonstrating a connection between the allowed injury and the new injury apart from the claimant’s being in the hospital bed recuperating from the allowed injury at the time of the collapse. In Kenyon, on the other hand, there was expert testimony tending to show that the allowed conditions and the treatment of them over time aggravated an underlying condition of coronary disease, which first manifested itself with a heart attack triggered by being dropped by ambulance attendants.

Instant Case More Like Iiams

In the instant case, the appellate court indicated the situation was much more like Iiams than Kenyon. The court said the tipping of the wheelchair was an unforeseeable act of a negligent third-party, similar to the collapse of the hospital bed in Iiams. The evidence tended to show that the nurse’s aide’s negligent act was an independent superseding cause of the stroke.

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