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Bocalbos v. Kapiolani Medical Center for Women and Children3/9/2000
om October 21, 1987 until March 21, 1992, Jou continued to act as Bocalbos's primary care physician. During this time, Bocalbos also sought treatment from Alan Becker, O.D. (Becker), an osteopath.
In November 1989, David Kimura, M.D. (Kimura), an orthopedist, conducted another IME of Bocalbos at Employer's request. He examined Bocalbos on November 24, 1989, and in his December 1, 1989 report, noted that Bocalbos "denie having problems with TMJ syndrome in the past." While " he saw [Kamisugi] from 1973 to 1978 for . . . orthodontic treatment[, s]he apparently did not have TMJ pain at that time." Kimura stated that " s far as [Bocalbos's] TMJ problem is concerned, she is still undergoing treatment for this area and is not stable and stationary as far as the TMJ syndrome is concerned. . . . I would recommend continued follow-up and treatment by [Wong] for her TMJ problem . . . ." (Emphasis added.)
On April 5, 1991, Richard Courson, D.D.S. (Courson) performed a further independent medical examination of Bocalbos at Employer's request. In his April 11, 1991 report, he stated:
f it is determined that the [TMJD] is related to the [work accident], then splint therapy and reconstruction of the teeth would be a necessary part of [Bocalbos's] total rehabilitation. . . .
Definitive occlusal rehabilitation and reconstruction should be accomplished only after the occlusion is stable and the muscle tenderness has subsided. (Emphasis added.)
On April 16, 1991, Becker issued a "projected treatment plan" in which he recommended "manipulative therapy to areas of dysfunction." He stated that the "goal" of the treatment plan was "to improve ROM [(range of motion)] of back and neck, correct TMJ mis- alignment [and to] alleviate pain and discomfort in areas affected."
Bocalbos relocated to Philadelphia in March 1992 and began to receive treatment for her TMJD from Terry McRoberts, D.D.S. (McRoberts) on August 5, 1992. In an August 25, 1993 letter, McRoberts wrote, "I saw [Bocalbos] in my office on 8/5/92, and she was experiencing TMJ symptoms, balancing interferences[ ] and Class II malocclusion[ ] due to heavy, wet ceiling tiles falling on her head and shoulders while working at [Kapiolani] on 7-25-86." (Emphasis added.) McRoberts recommended the following treatment:
I saw [Bocalbos] on 8/5/92, and began treating her for the TMJ symptoms with exercises, soft diet, and the wearing of a soft mandibular orthotic splint.
After an orthodontic work-up was completed on 8/18/92, I determined that in order to correct [Bocalbos's] Class II maloclusion, balancing interferences, and uprighting of her molars, orthodontic treatment was the correct way to proceed in order to help her maintain a normal level of life. (Emphasis added.)
Bocalbos also began treatment for her cervical injuries with Walter Ehrenfeuchter, D.O. (Ehrenfeuchter), an osteopath, on September 19, 1992. Ehrenfeuchter wrote on November 18, 1992 that " here is undoubtedly TMJ dysfunction present with a very restricted range of motion at the temporomandibular joint." Further, Ehrenfeuchter opined, "Bocalbos['s] current condition is a direct result of the injuries she sustained when the ceiling fell on her." (Emphasis added.)
On September 26, 1992, Bocalbos was also seen by Walter Knouse, D.D.S. (Knouse), a prosthodontist, who was recommended to her by McRoberts. In a November 2, 1992 letter to Employer's attorneys, Knouse explained:
[Bocalbos] is presently experiencing many dysfunctional symptoms and pain due to her crainiomandibular misfunction. It is difficult for us to present an exact treatment plan, as she needs to hav
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