David Rhoades and Tracy Myatt (Raleigh) prevailed at the Deputy Commission level in a case involving a plaintiff who was working in the saw mill department. While working on February 27, 2015 the employee’s glove caught in a saw mill and caused a significant laceration to his right middle finger pad. Plaintiff received treatment by an internist and followed up 4 times or so over the next two and a half weeks. During the treatment for the finger plaintiff showed no signs of infection. On March 17, 2015, two and a half weeks after the injury, plaintiff was found intoxicated, passed out on the porch of a house where he was living with some friends, and covered in urine and feces. Plaintiff had a history of alcoholism and alcohol related conditions including liver cirrhosis which put him at a immunocompromised position with respect to fighting off infections. He was taken by EMS to the hospital where he was diagnosed with sepsis and a group B strep bacteremia. Plaintiff was hospitalized for a significant period of time and the infection led to diskitis in his neck and ultimately resulted in the need for a multilevel fusion. The issue presented was whether the portal of entry of the strep B infection was the finger laceration, the GI tract or an excoriated rash on plaintiff’s inner thighs. Group strep B is an organism that tends to live in the lower GI tract as well as the GU tract and all physician agreed that someone with cirrhosis has a more difficult time clearing certain organisms from the blood, including group strep B. The treating infectious disease physician at the hospital opined that the most likely portal of entry through which the group strep B bacteremia entered the bloodstream was the finger laceration and therefore plaintiff claimed all treatment and disability for the infection and cervical fusion were related to the finger laceration. Defense retained an infectious disease expert who testified the most likely portal of entry was either a tear in the GI/GU tract or the rash on the inner thighs. The Deputy Commissioner afforded more weight to the defense expert and found that the most likely portal of entry was a tear in the GI tract or the rash on the thighs and not the finger laceration.
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