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Notice how the adverse reactions experienced by this woman
are the same reactions that have been associated with Cipro. Yet
no one ever considered that she may or may not have been having a
reaction to the Cipro that was prescribed to her.
Plaintiff was diagnosed with folliculitis to the scalp secondary to
Nix, diabetes mellitus and hypertension. Plaintiff was prescribed
Cipro, Allegra and Natural Tears shampoo. On May 11, 2000, P.A. Ransom
wrote plaintiff out of work for "2-6 weeks due to multiple ongoing
medical problems." ie: Depression, stress ,anxiety, hypertension and
adult-onset diabetes mellitus, marked fatigue,
pain, sensitivity, continued weakness, paresthesias and numbness
involving both lower
extremities, some tingling paresthesias above in her arms and
shoulder, headache, paresthesias associated with a mixed headache-type
syndrome, complaints of paresthesia involving distal extremities, some
scalp pain and paresthesias, mild polyneuropathy and sleep
disturbance, primary complaints of right hip and SI joint pain,
sleep disturbance, scalp paresthesias, concern that her treating
physicians had misdiagnosed her condition and failed to note a stroke
that she believed had occurred; sleeping no more than five hours at a
time and waking tired and fearful;
Following a mental exam by a psychiatrist, Dr. Lamm, he
noted that plaintiff had a marked preoccupation with illnesses,
misdiagnoses, possible sequela and fears of medicine.
North
Carolina Workers’ Comp. Decisions
--------------------------------------------------------------------------------
GLUNT v. COLUMBUS CTY. SCHOOLS, 039675 (2-16-2005)
JOYCE GLUNT, Employee, Plaintiff v. COLUMBUS COUNTY SCHOOLS, Employer,
SELF-INSURED (KEY RISK MANAGEMENT SERVICES, Administrator), Defendant.
I.C. NO. 039675.
NORTH CAROLINA INDUSTRIAL COMMISSION.
Filed 16 February 2005.
OPINION AND AWARD for the Full Commission by DIANNE C. SELLERS,
Commissioner, N.C. Industrial Commission.
This matter was reviewed by the Full Commission on October 5, 2004
upon
the appeal of plaintiff from an Opinion and Award filed on March 18,
2004
by Deputy Commissioner J. Brad Donovan, who initially heard this
matter
on April 25, 2003 in Wilmington, North Carolina.
APPEARANCES
Plaintiff: Nexsen, Pruet, Jacobs, Pollard & Robinson,
Attorneys, Myrtle Beach, South Carolina; Steven
W. Williford, appearing.
Defendant: The Honorable Roy A. Cooper, Attorney General,
State of North Carolina, North Carolina
Department of Justice, Raleigh, North Carolina;
Dahr J. Tanoury, appearing.
***********
The undersigned have reviewed the prior Opinion and Award based upon
the record of the proceedings before Deputy Commissioner Donovan and
the
briefs and arguments of the parties. The appealing party has not shown
good ground to reconsider the evidence, receive further evidence,
rehear
the parties or their representatives, or amend the Opinion and Award.
***********
The Full Commission finds as a fact and concludes as matters of
law the following, which were entered into by parties as:
STIPULATIONS
1. All parties are properly before the North Carolina Industrial
Commission and the Industrial Commission has jurisdiction of the
parties
and the subject matter.
2. All parties have been correctly designated and there is no question
as to misjoinder or nonjoinder of parties.
3. The employee-employer relationship existed between the parties at
all relevant times.
4. North Carolina School Boards Association was the carrier for
defendant-employer at the time of the alleged incident. Key Risk
Management is now handling this claim.
5. The date of the alleged incident was March 3, 2000.
6. The parties were subject to the North Carolina Workers'
Compensation
Act at the time of the alleged accident, defendant-employer employing
the
requisite number of employees to be bound under the provisions of the
Act.
7. Plaintiff's average weekly wage is $593.83, yielding a compensation
rate of $397.24.
8. Plaintiff's alleged injuries include a bacterial scalp infection,
allergic reaction to treatment and psychological disorder.
9. The issues for determination are:
a. Whether plaintiff sustained a disability as a result of the injury
on March 3, 2000, and if so, to what benefits is she entitled?
b. What is the extent, if any, of plaintiff's disability?
c. Whether plaintiff is entitled to payment for past and/or future
medical treatment?
10. The parties stipulated the following documentary evidence:
a. Stipulated Exhibit No. 1 consists of plaintiff's medical records.
***********
Based upon all of the competent evidence of record the Full Commission
makes the following:
FINDINGS OF FACT
1. At the time of the hearing before the deputy commissioner,
plaintiff
was 60 years old. Plaintiff began her employment with defendant in
1996.
She was employed by defendant as a traveling English as a Second
Language
(ESL) teacher. Her duties included driving approximately 2000 miles
per
year to 19 different schools in southeastern North Carolina and
teaching
English to students ranging from kindergarten through grade 12.
Plaintiff
spent approximately two thirds of her time teaching and one third
coordinating.
2. On March 3, 2000, plaintiff was working at the Fair Bluff
Elementary
School in Columbus County, North Carolina, when she interacted with a
student who was infected with head lice.
3. On March 7, 2000, plaintiff presented to Calabash Medical Center
with complaints of postnasal drip, a sore throat and significant
pruritis
of her scalp (itchy scalp). She was diagnosed with pharyngitis (throat
inflammation), non-insulin dependent diabetes, allergic rhinitis
(nasal
inflammation) and lice. Plaintiff was prescribed Nix shampoo to treat
the
lice, and was given an out of work note to last until she was free of
lice.
4. Plaintiff returned to Calabash Medical Center on March 13, 2000,
with an allergic reaction to the Nix, but had no active lice at that
time. She was prescribed Gtaraz for the allergic reaction.
5. On April 6, 2000, plaintiff was evaluated by Amy Ransom, a
physician's assistant at G&G Healthcare. Plaintiff was diagnosed with
folliculitis to the scalp secondary to Nix, diabetes mellitus and
hypertension. Plaintiff was prescribed Cipro, Allegra and Natural
Tears
shampoo. On May 11, 2000, P.A. Ransom wrote plaintiff out of work for
"2-6 weeks due to multiple ongoing medical problems."
6. On May 16, 2000, Grand Strand Regional Medical Center pathology
results reported that plaintiff suffered from "acute bacterial
folliculitis."
7. Plaintiff's contract with defendant was year-to-year and expired in
June 2000. On or about May 17, 2000, plaintiff was notified by
defendant
that her contract would not be renewed. During her employment with
defendant, plaintiff never missed work due to stress or other
problems,
other than having the flu.
8. On June 13, 2000, plaintiff presented to Dr. Dennis J. Darcey at
Duke University Medical Center. Dr. Darcey opined that plaintiff
suffered
an allergic reaction to Permethrin and developed acute bacterial
folliculitis, which was treated with antibiotics. He further opined
that
the course of the illness and the multiple treatments took place over
a
period of two months. He diagnosed plaintiff with depression, stress,
anxiety, hypertension and adult-onset diabetes mellitus.
9. On August 2, 2000, plaintiff presented to Dr. Julian N. Hayes of
Strand Regional Specialty Associates with complaints of marked
fatigue,
pain, sensitivity and continued weakness. She also complained of
continuing scalp discomfort described as pain in the vertex and on the
left frontal and parietal regions. Plaintiff reported the pain as
increasing with stress, and variable at other times. She described the
condition to Dr. Hayes as a "very disagreeable sensation." Plaintiff
also
complained of some paresthesias and numbness involving both lower
extremities and some tingling paresthesias above in her arms and
shoulder. Dr. Hayes noted that plaintiff's family history was positive
for adult onset diabetes and that plaintiff had allergies or
sensitivities to approximately 37 medications. Dr. Hayes opined that
plaintiff's neuropathy may be based on adult onset diabetes, and that
her
headache and paresthesias are associated with a mixed headache-type
syndrome.
10. On August 8, 2000, plaintiff returned to Dr. Hayes with continued
complaints of paresthesia involving distal extremities, some scalp
pain
and paresthesias, mild polyneuropathy and sleep disturbance. Dr. Hayes
noted that while plaintiff was still bothered by the scalp discomfort,
her primary complaints were of right hip and SI joint pain, and that
the
neuropathic discomfort was consistent with the history of diabetes. He
prescribed Doxepin for the sleep disturbance with hopes that it would
also
help the scalp paresthesias and some of the neuropathic discomfort.
11. On August 15, 2000, plaintiff was evaluated by Dr. William M.
Simpson of the Medical University of South Carolina in Charleston, to
determine what, if any, side effects plaintiff might have experienced
as
a result of her exposure to Nix shampoo. Dr. Simpson examined
plaintiff's
scalp and found no inflammation and minimal scaling with normal
healing.
He also found no infection or infestation, no excoriation,
lichenification or evidence of persistent trauma. He opined that
plaintiff's symptoms might be the result of pyrethroid sensitivity,
which
should improve with time. He further noted that pharmakokinetics of
the
active ingredient indicate a brief course in the body and minimal
likelihood of prolonged effect in any body system.
12. In a letter dated August 25, 2000, Dr. Simpson again opined that
any likelihood that an application of a shampoo containing permethrin
could cause persistent dermatologic problems and systemic
manifestations
is time limited. He noted that a small portion of the population is
sensitive to permethrin and other pyrethroids, but this is primarily
limited to respiratory symptoms upon re-exposure. He also noted that
anxiety and stress might exacerbate many conditions, including
hypertension and diabetes.
13. On September 6, 2000, defendant filed a Form 28 Return to Work
form
with the Industrial Commission. On September 8, 2000, defendant filed
a
Form 60 accepting plaintiff's claim as compensable and agreeing to pay
temporary total disability compensation commencing on April 13, 2000.
14. On September 25, 2000, plaintiff presented to Dr. Renee Lamm of
Strand Psychiatric Associates. Dr. Lamm took a history in which
plaintiff
noted several stressors in her life including: (1) a series of
demoralizing and demeaning changes in her job which led to her
resigning; (2) concern that her treating physicians had misdiagnosed
her
condition and failed to note a stroke that she believed had occurred;
(3)
sleeping no more than five hours at a time and waking tired and
fearful;
(4) fear of being destitute; (5) fear of recurrent allergies; (6) fear
of
health care professionals who are unwilling to consider alternative
therapies that plaintiff wishes to pursue; (7) exposure to snakes,
insects and vermin; (8) her husband's disability; (9) a death in her
family; and (10) a pending law suit resulting from a motor vehicle
accident.
15. Following a mental exam, Dr. Lamm noted that plaintiff had a
marked
preoccupation with illnesses, misdiagnoses, possible sequela and fears
of
medicine. Dr. Lamm opined that until plaintiff obtained a single
primary
care physician and stabilized her medical conditions of diabetes
mellitus, her thyroid status and her allergies, plaintiff was not a
good
candidate for antidepressant therapy or sleep stabilization.
16. Plaintiff continued to treat with Dr. Lamm. On February 26, 2001,
Dr. Lamm noted that plaintiff was not compliant with diet, exercise or
other recommendations. Plaintiff continued to be stressed over an
impending court date for an auto accident, her workers' compensation
case
and her husband's illness. She was not taking prescribed medication.
Plaintiff complained of continuing feelings of hopelessness, anhedonia,
sleep disturbance, intractable pain in her legs, burning and numbing
consistent with neuropathy and generalized pain.
17. During subsequent visits, Dr. Lamm noted that plaintiff's status
remained unchanged due to her unwillingness to take medication.
Plaintiff's blood sugars fluctuated, worsening her neuropathy and
pain.
In August 2001, Dr. Lamm noted increasing problems with plaintiff's
husband, including suicidal ideations, and manipulative, controlling
behavior. Plaintiff failed to improve, and in October 2001 Dr. Lamm
opined that the reason was uncontrolled diabetes mellitus and sequela,
along with plaintiff's compliance issues.
18. During the next year, plaintiff experienced additional stressors,
including the deaths of two close friends and an additional motor
vehicle
accident wherein she lost consciousness and suffered lacerations and a
neck injury.
19. In Dr. Lamm's final note of March 4, 2003, she stated that
plaintiff had recently been placed on insulin and was beginning to
look at
some limited exercise such as walking. Plaintiff still reported some
intermittent depression.
20. There is medical evidence which shows that plaintiff is currently
disabled as a result of her depression and other conditions.
21. There is no medical evidence that relates plaintiff's current
depression and other conditions to the contracting of head lice in
March
2000 or the subsequent allergic reaction plaintiff had to Nix shampoo.
The medical evidence tends to show that plaintiff's scalp condition
was
essentially resolved within two months following treatment. There is
evidence of a significant number of other non-work related stressors,
which are responsible for plaintiff's depression and disability from
work.
***********
Based upon the foregoing stipulations and findings of fact, the
Full Commission concludes as follows:
CONCLUSIONS OF LAW
1. Plaintiff sustained an injury by accident on March 3, 2000, which
arose out of and in the course of the employment when she contracted
head
lice from a student. In addition, the treatment of plaintiff's
condition
caused an allergic reaction which resulted in her disability from work
beginning on March 3, 2000 and continuing through June 13, 2000, when
she
was examined by Dr. Darcey and her scalp condition was deemed
resolved.
N.C. Gen. Stat. § 97-2(6).
2. As a result of the compensable injury, plaintiff is entitled to
temporary total disability compensation at the rate of $397.24 per
week
for the period from on March 3, 2000 through June 13, 2000. N.C. Gen.
Stat. § 97-29.
3. There is no medical evidence that relates plaintiff's current
depression and other conditions to the contracting of head lice in
March
2000 or the subsequent allergic reaction plaintiff had to Nix shampoo.
There is evidence of a significant number of other non-work related
stressors, which are responsible for plaintiff's depression and
continuing disability from work. Accordingly, plaintiff is not
eligible
for further disability compensation after June 13, 2000. N.C. Gen.
Stat.
§ 97-29.
4. Plaintiff is entitled to have the defendant pay for medical
expenses
incurred or to be incurred as a result of the compensable injury until
and including the treatment provided by Dr. Darcey. N.C. Gen. Stat. §
97-2(19).
***********
Based upon the foregoing findings of fact and conclusions of law, the
Full Commission enters the following:
AWARD
1. Subject to a reasonable attorney's fee herein approved, defendant
shall pay temporary total disability compensation to plaintiff at the
rate of $397.24 per week for the period from March 3, 2000 through
June
13, 2000. As much of said compensation as has accrued shall be paid in
a
lump sum, and defendant shall be entitled to a credit for any
compensation already paid for this period.
2. A reasonable attorney's fee of 25% of the compensation awarded to
plaintiff in Paragraph 1 above is hereby approved to be deducted from
sums
due plaintiff and paid directly to counsel.
3. Defendant shall pay medical expenses incurred or to be incurred
which are related to plaintiff's compensable scalp condition when
bills
for the same have been approved, in accordance with the provisions of
the
Act.
4. Defendant shall pay the costs.
***********
This the 2nd day of February 2005
S/_______________
DIANNE C. SELLERS
COMMISSIONER
CONCURRING:
S/_______________
CHRISTOPHER SCOTT
COMMISSIONER
S/___________________
BERNADINE S. BALLANCE
COMMISSIONER
DCS/mb
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