The North Carolina Court of Appeals determined that the North Carolina Industrial Commission failed to address the cause of a worker’s aortic dissection. The commission had initially decided his heart injury that occurred hours after he was hit in the chest with a tire was not compensable but the appellate court reversed it.

David Holland worked as a truck driver for Parrish Tire Co. in Winston-Salem, NC. Part of his duties included loading and unloading tires that weighed between 100 and 200 pounds each.

On September 17, 2015 he was unloading tires for delivery and one fell from the stack and hit him in the chest, then bounced and hit him again. The owner of the tire store where the incident was said Mr. Holland became gray and was uncharacteristically slow after being struck with the tire, so he took him to an urgent care. He was sent to the emergency room from there and was diagnosed with an aortic dissection and a collapsed lung. He was admitted to the intensive care unit and underwent surgery. He was given a work restriction of being unable to lift more than 40 pounds indefinitely and was diagnosed with major neurocognitive disorder due to this open-heart surgery, adjustment disorder and depression. He was later rated permanently disabled and unable to work, and he was terminated in February 2016. He filed for workers’ comp and was denied.

The deputy commissioner said he had suffered a compensable injury, but Parrish appealed to the full commission who agreed that his testimony was inconsistent and that he failed to prove he sustained a compensable injury. The appellate court reversed the commission’s decision, saying the commission failed to consider testimony from physicians stating that aortic dissections could be caused by aneurysm, trauma, infection, inflammation and genetic predisposition. The physician who performed his open-heart surgery stated it could have been caused by trauma since there was no proof his dissection was due to an infection. Another physician had said the tire hit could aggravate or contribute to an aortic dissection.

The appellate court heard these medical testimonies and said the commission had erred by failing to evaluate the testimony of physicians and the cause of his aortic dissection.

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