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HomeMy WebLinkAboutMinutes - Oro Valley Public Library Review Committee - 11/19/2007 ORO VALLEY PUBLIC SAFETY PERSONNEL SYSTEM NOVEMBER 19, 2007 LIBRARY MEETING ROOM 1:30 p.m. ROLL CALL: Present: Mayor Loomis David Andrews Officer Kranz Officer Helvig Richard Tracy Sr. Staff: Alexa Mack, Legal Department Sandra Abbey, Human Resource Department Guest: Dr. Eskay-Auerbach, Independent Medical Examiner Mr. Stillman, Patrick Fojt's attorney OATH OF OFFICE Wes Helvig took the Oath of Office as the new member of the OVPSPRS Board. His term will expire November 2011. OLD BUSINESS None REVIEW ACCIDENTAL DISABILITY APPLICATION FROM PATRICK FOJT A. Independent Medical Examiner's Report/Dr. Eskay-Auerbach Dr. Eskay-Auerbach gave a summary of the medical exam she gave Patrick Fojt on July 31, 2007. Prior to his appointment, she had reviewed Patrick Fojt's medical records and felt that one or two of the independent medical exams were not sufficiently thorough for her to be able to make a determination, which is why she requested an appointment with him. Patrick Fojt presented with low back pain, left leg pain and neck pain and gave her a history; stating that he was involved in a chase at work and scaled a fence with his utility vest, he got stuck the first time and swung again and landed; initially he didn't have any pain, but subsequently developed back pain, which was progressive. He was treated by a number of physicians. At the time that she saw him, Mr. Fojt was more comfortable standing than sitting and stood during the entire interview, which was unusual as most people sit for the entire interview. He has not had any previous surgery. He had intalgigate, favoring the left side. He had some tenderness on palpitation of his OVPSPRS Minutes 11/19/2007 Page 1 of 4 back and a limited range of motion, which is not particularly specific. He didn't have any specific neurological findings. She went through his records from physical therapy, a number of physicians that had seen him and the opinions of those physicians. She reviewed his imaging studies,the most significant which was an upright MRI ordered by Dr. Dunn. She formed her opinions, which were that Mr. Fojt now has degenerative disc disease, which is symptomatic, by history, as a result of the injury that occurred at work. He also has a central disc herniation, which she could not say whether it existed before or after the incident, but clearly became symptomatic after the incident. His left leg pain was consistent with that. A central disc herniation is unusual and much more difficult to treat. He is now under the care of Dr. Gundanna who is a fellowship-trained spine surgeon in Texas that plans to evaluate him further with respect to surgical intervention, likely lumbar fusion. B. Questions from Board to Dr. Eskay-Auerbach The OVPSPRS Board members asked Dr. Eskay-Auerbach questions: The phrase that his injury was caused by his jumping the fence was questioned. Dr. Eskay-Auerach Response: What I said was that by history, what he reported to her was that his back pain was a result of the jump from the fence. In Dr. Eskay-Auerbach's report, she said that she thought another test might be advisable; a functional capacity evaluation. Dr. Eskay-Auerach Response: That really is. In general I prefer two-day tests although there are one-day tests and actually the person is seen by a physical therapist or an occupational therapist who does sort of work related tasks. In an hour at the office, I can't really accurately tell what somebody can lift, whether they can lift repetitively and so all those functional activities including sitting, standing are all measured in a functional capacity evaluation. And your analysis didn't determine that he had, that this was an aggravation of a previous injury or previous physical deterioration? Dr. Eskay-Auerach Response: Everyone by the time they are twenty or twenty-five has degenerative disc disease. So any of us, whether there is back pain or not could have findings of degenerative disc disease. So this could be aggravated by that jump? Dr. Eskay-Auerach Response: Correct. As far as I know, he wasn't symptomatic prior to this event. Are the injuries that you saw consistent with jumping a fence? Dr. Eskay-Auerach Response: I couldn't give a specific injury that would be consistent with that necessarily; although it is not unusual for people with an axial load to have back pain after an injury of that sort. So they are not inconsistent, but not specific for it. At this point with Mr. Fojt's history, are you happy with your recommendation here that the officer's not going to be able to return to duty in his current state and if he does OVPSPRS Minutes 11/19/2007 Page 2 of 4 additional items that Dr. Gundanna talked about that there may be some possibility of a return of function, but at this point without that process, he will be disabled and not able to perform the duties of a police officer? Dr. Eskay-Auerach Response: Correct. Another physician said he might be able to tolerate sedentary or light duty; he'd have to be able to change positions frequently. He really is not able to tolerate sitting, so I hesitate to recommend sedentary work. But assuming that his workup is as Dr. Gundanna described, he probably will be able to return to some form of work after surgical intervention, but at this point and time he is not able to. By surgical intervention does that include the epidermal injections? Dr. Eskay-Auerach Response: The epidural injections are really done to relieve the nerve root pain or the leg pain so they're not really surgical intervention. They are invasive, but they are not really considered surgical intervention. Surgical intervention would really be for this gentleman, most likely a fusion at L4, L5. Basically, you believe that the surgical intervention would be necessary for him to regain 100% capability? Dr. Eskay-Auerach Response: I don't think he'll be 100%, which disappoints him, he is very unhappy to be limited the way he is now. The epidural injections for some people, particularly if just a herniated disc on one side or the other, the epidural injections may be affective, but in this gentleman there is a large component of his pain is back pain from the central disc herniation; it is unlikely that the epidural injections would be sufficient. Are you saying that you think it is unlikely he'll ever return to duties of a police officer? Dr. Eskay-Auerach Response: I think if it is sort of an on the street field job, it is more likely than not that he will not be able to do that. However, there are people who do very well after a single level fusion and can return to regular activity. Unfortunately, I am not able to predict it, but I would say it is unlikely that he'll be able to do field work. An interjection was made by Mr. Stillman, Patrick Fojt's attorney, in reference to Dr. Gundanna being a fellowship-trained spine surgeon. He asked that Dr. Eskay-Auerbach explain what that means. Dr. Eskay-Auerach Response: I believe that Dr. Gundanna is an orthopedic surgeon, but either orthopedic surgeons or neurosurgeons can go on to do an extra year of training that specialized in dealing with problems that are lumbar and cervical spine, so this gentleman has that extra training. Also highlighted by Mayor Loomis was that if Mr. Fojt is able to recover due to additional medical treatment then the review of his disability can be done by the firm and it would come back to the local board as well as a possible rehearing. Basically, looking at the checklist, the accidental disability shall be considered to have ceased and an accidental disability pension terminates if the member has sufficiently recovered in the opinion of the local board based on medical evidence from a medical board appointed by the local board to be able to engage in a reasonable range of duties within his department and the member refuses an offer of employment by an employer in the PSPRS or refuses OVPSPRS Minutes 11/19/2007 Page 3 of 4 to undergo a medical examination requested by a local board, cannot be requested more than once in any calendar year. C. Review Medical Board Findings In reference to Patrick Fojt who was examined on July 31, 2007 the following questions were asked of Dr. Eskay-Auerbach: 1. Does the claimant have a physical condition which totally and permanently prevents him from performing a reasonable range of duties within his job classifications? Yes 2. Does the claimant's disability result from a physical condition or injury that existed or occurred before the claimant's date of membership in the PSPRS? No, accident while under employment of town. 3. Was the disabling condition or injury incurred in the performance of the claimant's duty as a police officer? Yes Richard Tracy Sr. MOVED to accept the accidental disability retirement questionnaire as signed by the physician and the case moved to the state for their consideration. Seconded by David Andrews. Discussion: Richard Tracy Sr. congratulated Dr. Eskay Auerbach on very comprehensive report. Motion unanimously carried. NEW BUSINESS None Troy Kranz MOVED to adjourn; Seconded by Richard Tracy Sr. Motion unanimously carried. Meeting adjourned. Respectfully transcribed and submitted by Diane Little. OVPSPRS Minutes 11/19/2007 Page 4 of 4