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Adams v. Metals USA2/15/2005
d at 916.
In Holley, our Supreme Court discussed expert testimony which it found insufficient to establish causation because such testimony suggested "that a causal connection between plaintiff's accident and her [injury] was possible, but unlikely." Holley, at 233-34, 581 S.E.2d at 753-54. Holley involved an employee who felt asudden pain in her left calf after twisting her leg at work. She was subsequently diagnosed with a pulled calf muscle. Id. Approximately six weeks later, the employee developed a painful, swollen leg. She was diagnosed with deep vein thrombosis ("DVT"),a condition caused by a blood clot in a deep vein that obstructed blood flow and caused inflammation. Id. at 233, 581 S.E.2d at 751. The issue presented to the Court was the sufficiency of the evidence regarding the cause of the employee's DVT. Id. Although two physicians testified that it was possible that her DVT was caused by her earlier accident, neither physician could testify to a reasonable degree of medical certainty that a plaintiff's injury had been caused by an accident at work. Id. One doctor testified that he thought there was a "low possibility" that the plaintiff's injury had been caused by the accident at work, that the plaintiff could have been developing the problem prior to the incident at work, and that, given plaintiff's medical history, the cause of the plaintiff's injuries was "just a galaxy of possibilities." Id. The other doctor stated the following on cross-examination: "I don't really know what caused the [injury]." Id. Given this equivocal expert testimony and evidence that plaintiff's medical history made her susceptible to developing DVT in the absence of the accident at work, the Court concluded that causation had not been established. Id.
Following Holley, this Court decided the case of Hodgin, which involved a carpet layer who alleged that he suffered a paraesophageal hernia as a direct result of lifting an unusually heavy chest of drawers while at work. Hodgin, 159 N.C. App. at636, 583 S.E.2d at 363 There was evidence before the Commission that plaintiff had experienced possible symptoms before the incident at work. Id. One physician testified that the episode at work "could have been related to the plaintiff-employee's paraesophageal hernia," but noted that paraesophageal hernias can be asymptomatic for extended periods and chest pains are only symptomatic of the condition. Id. at 641, 583 S.E.2d at 366. Another doctor testified that paraesophageal hernias can be asymptomatic for some time such that there was no way of knowing exactly when the plaintiff-employee's paraesophageal hernia appeared without X-rays taken before and after the appearance of symptoms. Id. at 642, 583 S.E.2d at 366-67. Because the medical testimony before the Commission tended to establish that a paraesphogeal hernia is difficult to diagnose, that it was possible that plaintiff already had such a condition and that, at best, plaintiff's hernia could possibly have been caused by the incident at work, we reversed the Commission's award on the ground that causation was lacking. Id. at 642, 583 S.E.2d at 367. In reaching this decision, we observed that, while speculation may play an important role in patient diagnosis, it is not alone sufficient to establish legal causation: "Our Supreme Court has recognized that although physicians "are trained not to rule out medical possibilities no matter how remote[,] . . . mere possibility has never been legally competent to prove causation." Id. at 640, 583 S.E.2d at 366 (quoting Holley, 357 N.C. at 233, 581 S.E.2d at 751).
In the instant case, the only medical deposition testimony offered into evidence was the testimony of Dr. Kritzer taken on 7March 2002. Dr. Kritzer's
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