Goldmann, Foley and Molineux. Goldmann, S.j.a.d.
Respondent employer appeals a County Court judgment awarding petitioner compensation for an injury to his hands sustained out of and in the course of his employment. The Workmen's Compensation Division had earlier dismissed the claim petition.
The question here, as in the Division and the County Court, is whether the condition of petitioner's hands, known as Dupuytren's Contracture, was the result of a single traumatic incident.
Petitioner was employed by respondent county as a jail guard. He was 42 years old and weighed about 240 pounds at the time of the accident on August 16, 1957. He testified that as he was hurrying up the stairs in the jail he tripped and fell forward. The top of his fingers on both hands hit the edge of a step and his hands came to rest with the fingers bent backwards against the vertical riser, the heel of his palms resting on the tread below. He saw the jail physician, Dr. Hayden, the same day. The doctor died before the hearing in the Division. His jail record book contained a notation dated August 17, 1957 reading:
"Franklin Hall, jail guard, sprained palmar tendons, both hands today. Soak in hot Epsom Salts every hour for one-quarter of an hour."
Petitioner said that his hands swelled and became discolored. After a time the swelling subsided and finally disappeared. He saw Dr. Hayden five or six times in all and did not require the help of any other physician. He lost no time from work.
Petitioner testified he had worked at the jail for some four years. Prior to that time he drove long-distance busses for some nine years, his work week being 48 hours. The busses weighed 15 to 18 tons and did not have power steering. Petitioner said he experienced no difficulty with his hands while driving the busses, nor at any time before the accident.
Petitioner's medical expert, Dr. David J. Graubard, a traumatic and orthopedic surgeon, had examined him on October 6, 1959. The history he obtained was essentially the same as that testified to by petitioner. His examination revealed that petitioner had a thinning of the palmar fascia with nodular formation, skin contraction and restriction in the mobility of the metacarpal phalange joints of the index, middle, ring and little fingers of the right hand, and the same type of pathology (but to a lesser degree) involving primarily the ring and middle fingers of the left hand. Because of the nature of the fall and the history of discoloration of the hands, it was his opinion that petitioner had suffered a tear in the palmar fascia, resulting in the Dupuytren's Contracture. In response to a hypothetical question reciting a history of no disability in the hands prior to the fall, the details of the fall and the jail physician's record -- but containing no reference to petitioner's bus driving experience -- Dr. Graubard gave the following opinion:
"This individual had an inherited predisposition and * * * the trauma that he sustained produced the Dupuytren's contraction that I found on October 6, 1959."
The deputy director said he was "intrigued" by the statement that petitioner had an inherited predisposition and inquired of the doctor whether he so concluded by reason of the results of the fall or tests performed. His answer was, "By the results." He explained that his opinion as to causal connection was based on the fact that petitioner allegedly had no physical disability prior to the accident, "the rapidity of development of this condition in his hands in which there was evidence of trauma with swelling in the palm, and subsistence of swelling to the formation of nodules." On cross-examination Dr. Graubard rejected the suggestion that petitioner's nine years of bus-driving would predispose him to Dupuytren's Contracture, his reason being
that there was no evidence to show that petitioner had the condition ...