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Igawa v. Koa House Restaurant2/2/2001
the right frontal lobe appears to be reasonable and necessary medical care which relates to said injury.
We credit Dr. Hosobuchi's reports of December 16, 1993 and September 12, 1994 in which he opines that claimant "had a small cavernous angioma in the right frontal lobe and because of the head injury it may have hemorrhaged causing headache and seizure problems." Further, Dr. Hosobuchi opines that surgery would eliminate claimant's headaches and seizures.
Dr. Pierce in his report of June 28, 1992 opines, "The headaches he describes took a rather dramatic change since his accident of October. I think the accident combined with the associated stressors are responsible for the majority of his headache problems now."
Dr. Nicholson states in his report of December 4, 1993 that "An arteriogram should be performed to diagnose whether or not there is an angioma."
Dr. Bergmanis, in his report of April 22, 1994, opines that "cerebral angiography is the only study that conceivably could throw some light on this problem, although some of the malformations are so small as not to be seen on any test."
Further, Dr. Hosobuchi opines in his report of September 12, 1994, "By nature of his anatomy, cryptic arteriovenous malformation or cavernous angioma cannot be demonstrated by the arteriogram."
Based on the aforementioned, any test conducted to diagnose angioma would not be appropriate since it would not show up on the test. Further, there is insufficient medical evidence to rebut Dr. Hosobuchi's opinion that claimant's headaches and seizures are not caused by the hemorrhaged angioma. Also, the medical evidence on file supports the fact that since said accident, claimant started having headaches and seizures. We note that claimant did have headaches prior to date of accident, but they had resolved before claimant had said work-related accident.
Thereupon the Director makes the following
DECISION
Pursuant to Sections 386-21 and 386-26,
[Hawaii Revised Statutes] HRS, said employer shall pay for such medical care, services and supplies as the nature of the injury may require, to include surgery to remove lesion from the right frontal lobe.
Pursuant to Section 386-31(b), HRS, said employer shall pay to claimant weekly compensation of $193.34 for temporary total disability from work beginning November 14, 1991 through November 17, 1991; April 5, 1992 through April 13, 1992; April 24, 1992 and terminating at such time as is determined by the Director that such disability has ended.
The matters of permanent disability and/or disfigurement, if any, shall be determined at a later date.
The Employer did not appeal the DLIR's November 15, 1994 Amended Decision and Order, even though the DLIR, in ordering the surgery and awarding Igawa temporary total disability benefits, concluded that the 1991 industrial accident had caused morbidity and disabling sequelae.
On December 2, 1994, the surgery was performed by Dr. Hosobuchi. About a week later, Dr. Hosobuchi reported to Dr. Nakano:
Finally Daryl Igawa won and the Workman's Compensation agreed to pay for the surgery so he underwent right frontal craniotomy and excision of a cryptic arteriovenous malformation and significant frontal gliosis. Thus whatever the caused avian bleed one will never know but certainly he had a very significant gliosis to explain for his seizure problem and this is cleanly excised. I hope this will certainly reduce his seizure frequencies. I saw him today on December 8th and we removed the staples and he has done quit well and I will keep you posted ab
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