
    STEWART & COMPANY, Employer, and THE TRAVELERS’ INSURANCE COMPANY, Insurer, vs. CORA L. HOWELL et al.
    
      Workmen’s Compensation Act — Cause of Death — Evidence— Medical Testimony — Burden of Proof.
    
    On an issue as to whether an aneurism which resulted in death was caused by a blow received by deceased in the course of his employment, his widow was properly allowed to testify in regard to his feelings as expressed by him on his return home after the receipt of the blow.
    That, on an issue as to whether an aneurism which resulted in death was caused or increased by an injury received in the course of decedent’s employment, a question asked of a medical expert called for a speculative opinion as to what might have been the effect of the injury rather than for his judgment as to what its effect really was, is not cause for reversal, the witness having answered as if asked the latter question.
    That a question asked of a medical expert was leading is not cause for reversal, if it merely embodied what 1he witness had said in his answer to the preceding question.
    On an issue as to whether an aneurism which resulted in death was caused or aggravated by a blow received by deceased, it was proper to allow a medical expert to be asked what effect a blow inflicted on deceased would have upon hastening the trouble, assuming that there was a pre-existing aneurism,
    In the case of a claim on account of a death alleged to have resulted from a blow which was received in the course of the deceased’s employment, held that it was proper to refuse to direct a verdict for defendants, in view of testimony by the widow as to the difference between his apparent physical condition before the receipt of the blow and that thereafter, and the testimony of the physician who attended him that his death was duo to the blow, and of another physician that a forcible blow, which the evidence showed this to be, would aggravate an aneurism of the aorta, which malady was apparently the immediate cause of death.
    On appeal from a decision of the State Industrial Accident Commission, the defendants were given all they were entitled to on the question of burden of proof by an instruction that the Commission determined that the death of claimant’s decedent-was not due to an accidental injury arising out of and in the course of his employment, and for that reason disallowed the claim; that said decision is prima facie correct, and the burden is upon the claimant to shoAv by a preponderance of the evidence that death was due to an accidental injury arising out of and in the course of his employment, and if the minds of the jury are in a state of even balance upon this question, the Arer-dict must be for the defendants.
    Code, Art. 101, Section 56, providing that the decision of the Commission shall be prima facie correct for the purpose of a court proceeding and the burden of proof shall be upon the party attacking it, does not mean that additional testimony must be offered on appeal from the Commission, or that even as much testimony need be offered by the party taking the appeal as he produced before the Commission, the statute merely leaAring upon the claimant, when he appeals, the burden previously Upon him, and shifting the burden to the defendant on an appeal by him.
    The refusal of a prayer as to the comparative value of testimony, or as to a proper differentiation between certain kinds of testimony, held proper in vieAV of the fact that the granted prayers fully and fairly instructed the jury as to the laAv of the case.
    
      Decided June 16th, 1920.
    
    Appeal from, the Baltimore City Court (Dubty, J\).
    The prayers granted and refused were as. follows:
    
      Plaintiff's First Prayer. — The jury are instructed, at the request of the claimant, that if they shall find from the evidence in this case that Adam J. Howell died on or about the 26th day of May, 1917, and that his said death was due to accidental injuries received by him, on or about the 4th day of March, 1917, arising out of and in the course of his employment by Stewart and Company, one of the defendants in this caso, then the verdict of the jury must be in favor of the claimant. (Granted.)
    
    
      Plaintiff's Second Prayer.- — The jury are instructed, at the request of the claimant, that if they shall find from the evidence in this case that Adam J. Howell, while in the employ of Stewart and Company, one of the defendants in this, case, received injuries on or about the. 4th day of March, .1917, arising out of and in the course of his said employment, and that said injuries produced or caused a rupture of the aorta or large blood vessel leading from, the heart resulting in his death on or about tbe 26th day of May, 1917, if the jury shall so find, then the verdict of the jury must he in favor of the claimant, even though the jury may believe from tbe evidence in this case that said Adam J. Howell was suffering prior to and at the time of receiving said injuries with an aneurism or weakened condition of said blood vessel. (Granted.)
    
    
      Defendants' First Prayer. — The defendants, pray the Court to instruct the jury that there is no evidence in this case legally sufficient to entitle the plaintiff to recover, therefore, the verdict of the jury must be for the defendants. (Refused.)
    
    
      Defendants’ Second Prayer. — Tbe Court instructs the jury that there is no evidence in. this case legally sufficient, to show that the death of the deceased Adam J. Howell was, dne to an accidental personal injury arising out of and in the course of his employment, therefore, the verdict of the jury must be for tbe defendants affirming the decision of the State Industrial Accident Commission. (Refused.)
    
    
      Defendants? Third Prayer. — The Court instructs the jury that the decision of the State Industrial Accident. Commission, dated December 20th, 1917, disallowing the claim of Cora L. Howell for compensation in this case is prima facie 
      correct, therefore, the burden is-upon the plaintiff, Cora L. Howell, to show by a preponderance of the evidence that said decision is not correct and if the minds of the jury are in a state of even balance as to the correctness or incorrectness of said decision, then the verdict of the jury mnst be for the defendants affirming said decision of the State Industrial Accident Commission. (Refused.)
    
    
      Defendants’ Fourth Prayer. — The Oourt instructs the jury that the State Industrial Accident Commission by its order dated December 20th, 1917, determined that the death of Adam J. Howell was not due to an accidental injury arising out of and in the course of his employment, and for that reason the said State Industrial Accident Commission disr allowed the claim of the claimant in this case, Cora L. Howell, and that said decision is prima facie correct, and the burden is upon tbe said claimant, Oora L. Howell, to show by a preponderance of the-evidence that the death of Adam J. Howell was due to an accidental injury arising out of and in the course of his employment, and if the minds of the jury are in a state of even balance as to whether or not the death of said Adam J. Howell was or was not due to an accidental injury arising out of and in the course of his employment, then the verdict of the jury must be for the defendants, affirming said order of the State Industrial Accident Commission. (Granted.)
    
    
      Defendants’ Fifth Prayer. — The Court instructs the jury that notwithstanding they may find from the evidence that Adam J. Howell, the deceased, met with an accident to his shoulder on or about March 4th, 1917, while employed by Stewart & Company, one of the defendants, and notwithstanding they may further find that the said Adam J. Howell died on or about the 26th day of May, 1917, nevertheless, the jury cannot find for the plaintiff, Oora L. Howell, his widow, unless the jury shall further find that the said Adam J. Howell’s death was due to said injury arising on or about March 4th, 1917, and that of this there is no legally sufficient evidence. (Refused.)
    
    
      
      Defendants’ Sixth Prayer. — The Oourt instructs the jury that notwithstanding they may find from the evidence that Adam J. Howell, the deceased, met with an accident to his shoulder on or about March 4th, 1917, while in the employ of Stewart & Company, one of the defendants, and notwithstanding they may further find that the said Adam J. Howell died on or about the 26th day of May, 1917, nevertheless, •the jury canno-t find for the plaintiff, Cora L. Howell, widow of the said deceased, unless, the jury shall further find that the said Adam J. Howell’s death was a result of said injury. ( Granted.)
    
    
      Defendants’ Seventh Prayer. — The Court instructs the jury that there is no evidence in this ease legally sufficient to show that the death of Adam J. Howell was; due to the injury which he sustained on or about March 4th, 1917, while in the employ of SteWart & Company; therefore, the verdict of the jury must be for the defendants, affirming the order of the State Industrial Accident Commission. (Refused.)
    
    
      Defendants’ Eighth Prayer. — The Court instructs the; jury that the burden, of proof is upon the plaintiff, Cora L. Howell, widow of Adam J. Howell, to prove by a preponderance of the evidence that the said Adam J. Howell’s death on or about May 26th, 1917, was due to the accident which he sustained to his shoulder on or about March 4th, 1917, while in the employ of Stewart & Company, and if the minds of the jury are in a state of even balance as to whether or not said death was, due to said injury, then the verdict of the jury must be for the defendants, affirming the order of the State Industrial Accident Commission. (Granted.)
    
    
      Defendants’ Ninth Prayer. — The defendants pray the Oourt to instruct the jury that medical expert testimony to the effect that the accident happening to Adam Howell on March 4th, 1917, might possibly have some connection with the death, is not equivalent to; evidence that said accident either actually caused or hastened the death of Adam Howell, and they are further instructed that their verdict should be for the defendant unless they axe satisfied from all the testimony that said accident actually caused or hastened the death of Adam Howell. (Refused.)
    
    The cause was argued before Boyd, C. J., Briscoe, Thomas, Pattison, Hrner, 'SItockbridoe and Adkins, JJ.
    
      George Weems Williams and D. Vernon Miller, for the appellants.
    
      RobeH Biggs and O. Arthur Bby, for the appellees.
   Adkins, J.,

delivered the opinion of the Court.

Adam J. Howell, husband and father of appellees, while working for 'Stewart & Oo. in their building, at the corner1 of Howard and Lexington Streets, Baltimore, on March 4th, 1918, was struck by a heavy board which slipped while being drawn up by another workman. The board was caught by the foreman but he could not hold it and the end struck Howell in the chest between the shoulder and the heart. The immediate effect of thei blow was to cause him to stop work that afternoon for a time variously estimated at from twenty minutes to two hours, at the expiration of which time he returned to, work and continued to work the rest of that afternoon and through the night.

When he returned to his home on the morning' after the accident he showed his wife the place where he was injured. There wasi a bruise on his left side just above the heart. He told her “he was in great pain, and he was very sick, and that he was injured, and that he never could get over it, he says ‘I can never live.’ ”

The widow further testified that her husband was perfectly healthy prior to the accident, and was never sick; that he had never had any doctors and worked every day; that he was always strong and healthy, and could work in any kind of weather; never made any complaint, but would eat three meals a day and sleep, well at night; that he had been well all the time until he was injured, but after the injury he suffered a great deal; that he could not sleep at night at all; could not sit still or lie down but just a short time. This was all the time for the last week before he died; prior to the last week he suffered a great deal, could, not, sleep; his ap>peitite was poor, and he was complaining all the time; that, after the accident he went back to Stewart’s and worked there for about two weeks, and after that worked a few days at other places, the last place being on Baltimore Street, where he was taken sick the last time. He died at the University Hospital on Mlay 26th.

Mrs. Elizabeth Francois, a nurse at Stewart and Gompany’s testified that Howell came to, her before the accident “complaining of a pain in the side, right through, his back and chest, and had a very bad cough”; he was coming up to her about three weeks before the accident.

Several doctors testified that Howell died of an aneurism of the aorta, and that in their opinion the aneurism was present before the accident, and that the accident had practically nothing' whatever to do with the rupture so far1 as they could see from its description, and judging from the time of the accident to the time of death.

It is not perfectly clear, however, from their testimony that the blow might not have hastened the result.

Dr. L. B. Evans, who treated Howell after the accident, testified that his examination showed that the disease! from which Howell died was not of long standing, but was! the result of the blow which he had received on the chest; that it was a traumatic aneurism, assuming the correctness of the medical chart offered in evidence showing aortic aneurism to have been the cause of death.

The decision of the Industrial Accident Commission on. practically the same testimony as wasi offered on the appeal to the Baltimore City Court was against the claimants,, which decision was reversed by the Oity Court, from which this appeal was taken.

There are twelve hills of exceptions!. The first six are to the overruling1 of objections to questions and refusal to strike .out answers of the widow of Howell in regard to his feelings as expressed by him to her on his return home after the accident. We find no error in these rulings.

The seventh was to the following question propounded to ;Dr. L. B. Evans: “Keeping in mind your physical examination of Howell, when you saw him professionally, when you made the. extensive physical examination of hisi body, and knowing now what the chart gives you of his death and the causes which led immediately to his death, I would like you to tell the jury whether or not in your opinion a traumatic aneurism could have resulted from that injury?”

Assuming the question to be open to' the objection that it .asks for a speculative opinion asi to what might have been the effect of the injury rather than the doctor’s judgment as to .what its effect really was, such error was cured by the answer-of the doctor which was as follows: “Of course, it was .the only conclusion that could be drawn. The man gave a ■.negative history of any of the diseases that produce pathological. aneurismsi Therefore I could not assume that he had pathological aneurisms from diseases which did not exist, ■never existed. H'e gave the history of an injury which was capable of producing a traumatic aneurism by the force being transmitted to the chest in sufficient volume to produce rupture of one' or more of the coats of the artery, giving rise to this particular type of aneurism, a traumatic aneurism. It was the only conclusion I could draw.”

• ' The answer shows that the' doctor thought he was being asked what in his judgment caused the aneurism, and not what the question really asked. As understood by him the ■question-was unobjectionable, and therefore there was no reversible error.

The eighth exception was to -the question immediately following the above. It was leading, but did no harm as it practically embodied what the doctor had said in his previous answer. Of course the practice of repeating testimony of witnesses, by counsel isi not to be .encouraged, but there was no reversible error here.

The tenth exception is, to the refusal of the Court to permit a witness to answer a question, the substance of which was embraced in a later question, objection to which was overruled — consequently no harm was done.

The eleventh exception is to the overruling of defendants’ objection to the following question asked Dr. L. B. Evans in rebuttal: “There seems to be, Doctor, some difference of opinion among the doctors here representing the defendants on the question. Assume that the man did have a pre-existing aneurism and received the blow1 which Mr. Howell is said to have received, what effect would that blow have upon hastening the trouble, with the patient?”

We think the objection was properly overruled.

This brings usi to the twelfth exception, it being to the rulings of the Court on. the prayers, all of which will be set out by the Reporter.

Plaintiff offered two, both of which were granted, and defendants nine, of which the fourth, sixth and eighth were granted and the first, second, third, fifth, seventh and ninth were refused.

The plaintiff’s prayers were properly granted. The only objection urged to them, apart from special exceptions which will be considered in connection with defendants’ prayers, is that they assume certain facts. We do not find this objection to have been well taken. Defendants’ first, second, fifth and seventh prayers ask for an instructed verdict in favor of defendants on the following grounds:

That there is no evidence legally sufficient to entitle plaintiff to recover.

That there is no evidence legally sufficient to show that the death of the deceased was due to an accidental pectoral injury arising out of and in the course of his employment.

That there is no evidence legally sufficient to show that the death of the deceased was due to an injury.

It is difficult to understand how these prayers could have been granted, or the special exceptions to plaintiffs prayers could have been sustained, without entirely disregarding the • positive testimony of the widow and of Dr. L. B. Evans and ,of Dr. Kirby, all of which, of course, must be taken to be true, and as if uncontradioted, in considering these prayers and exceptions. Dr. Evans’ testimony and that of the widow ■has already been referred to'. Dr. Kirby testified, in answer ■ to the question: “Assuming that this aneurism was of old . standing and progressive, what effect, if any, would the blow .•upon the shoulder and upper part of the chest likely have upon that in hastening the time of death?” “It would increase the existing conditions if the blow was sufficient to cause that change.” There was abundance of testimony as to the force of the blow.

It will, be noted that the testimony of Dr. Evans is, not .that death might have been due to the blow, but that in his .opinion it was due to’ the blow.

Also that the testimony of Dr. Kirby isi, not that the blow might have increased existing conditions1, but that it would increase them if of sufficient force.

This testimony takes this case out of the principle governing the following English cases relied on by appellants, viz: Barnabas v. Beisham Colliery Co., 3 Butterworth’s Workmen’s Compensation Cases, 216; Maxwell v. Ruabon Coal and Coke Co., Ltd., 10 B. W. C. C. 138; Hawkins v. Powells Tillery Steam Coal Co., Ltd. (1911), 1 K. B. 988.

The principle underlying all the above oases is that it is not sufficient to show that death may have resulted from the accident; or that the accident was one of several possible causes of death.

On a careful examination of the other cases cited by appellants we find:

All that Knight’s Case, 231 Mass. 142, decides is that there was evidence from which the lower Court could find as it did, and that the appellate Court could not say as a matter of law that the finding of the board was unwarranted.

Taylor v. Bolckow, Vaughan & Co., Ltd., 5 B. W. C. C. 130, decides nothing except that the reasons' given, by the trial judge for his judgment are not in accordance with the evidence. Thei ease was sent back for another trial.

The facts in Palon v. William Dixon, Ltd., 6 B. W. C. C. 882, are different, and the decision has no bearing on the case at bar*.

Clover, Clayton & Co. v. Hughes, 3 B. W. C. C. 275, is* authority for the submission of the present cas© to the jury. See also Fisher’s Case, 220 Mass. 581; Madden’s Case, 222 Mass. 487.

We find no error' in the ruling on these prayers and on the special exceptions to plaintiff’s prayers.

Defendant’s third prayer asserts the proposition that the burden is upon the plaintiff to show that the decision of the Industrial Accident Commission is not correct.

The .form of this prayer was disapproved in the case of Jewell Tea Co. v. Weber, 132 Md. 178, though the granting of the prayer was held not to have been a reversible error. It was there said by Judge Thomas, speaking for the Court, referring to a similar' prayer: “While it states! a correct legal proposition, and could not have misled the- jury in this case, we cannot approve the form adopted. Prayers should instruct the jury in regard to the law applicable to certain facts to be found by them. An appeal from a decision of the Commission may present questions of law as well as questions of fact, and an instruction as to the burden of proof should be confined to the issues of fact to be decided by the jury.”

We think defendants’ fourth prayer, which was granted, gives the defendants! at least as much as they were entitled to> in the matter of burden of proof.

As we understand Section 56 of the Workmen’s Compensation Law (Code, Art. 101, Sec. 56), it does not mean that there must be additional testimony offered on appeal from the Commission; or that even as much testimony need bo offered by the party taking the appeal as be produced before the Commission, in order to discharge the burden put upon him by that section. But it simply puts the burden of proof upon the party taking’ the appeal, whether he be plaintiff or defendant. In other words it establishes no new rule when the plaintiff happens to be the party appealing, as the burden was always upon the plaintiff to prove his case. But it shifts the burden from the plaintiff to the defendant where the defendant loses before the Commission and desires to appeal from its decision, requiring the defendant in such a case to satisfy the jury by a preponderance of testimony that the plaintiff is not entitled to the award made -by the Commission.

This prayer was properly refused.

The ninth prayer asks the Court to instruct the jury as to the comparative value of testimony; or as to a proper differentiation between certain kinds of testimony. As a rule such prayers should not be granted; at any rate there was no error in- refusing an instruction of that sort in this case as the granted prayers fully and fairly instruct the jury as to the law of the case.

Binding no reversible error in any of the rulings of the trial Court, the judgment will be affirmed.

Judgment affirmed, with costs, to appellee.  