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Texas Gas Transmission Corporation v. Dabney8/2/2005
de during the course of the hospital stay since it is included in the discharge summary under the heading "Hospital Course" and is not included in the "History of Present Illness" which was taken upon admission. Nevertheless, whether the statement refers to complaints made at the time of admission or to complaints made during the course of Dabney's hospital stay is largely academic because, in any event, when Dabney was admitted to the hospital, he had already been bitten by the snake. Also Dr. Baxter's testimony makes it exceedingly clear that Dabney had not experienced any type peripheral neuropathy or neural problems prior to the snake bite.
. The separate opinion also makes the assertion that " espite what Dabney told Dr. Cape, the substantial medical evidence indicates that Dabney did not have leg numbness or neurological complaints to his lower extremities (other than ones already present) until Dabney started seeing Dr. Cape three and one-half years later in July 1995." Again, this statement is not an accurate reflection of what the record reveals. As we have already pointed out, the discharge summary indicates that Dabney was complaining of peripheral neuropathy-like symptoms during his hospital stay for the snakebite. Further, Dr. Baxter's medical notes of November 2, 1992, indicate that Dabney was seen for "follow-up with hypertension and cellulitis of his left lower leg." And again on November 13, 1992, Dr. Baxter's notes indicate "follow-up with hypertension and snakebite with secondary cellulitis of his lower leg. Leg is still draining." During Dr. Baxter's deposition, he made it clear that, in hindsight, he thought that Dabney's peripheral neuropathy began January 8, 1993, although at the time of the initial treatments he did not make that diagnosis. On this point, the record reflects the following:
Q: If we are talking about the same thing, I guess my question originally was what was the first incidence where you yourself diagnosed a - -
A: Peripheral polyneuropathy?
Q: - - peripheral polyneuropathy? Yes, sir.
A: I've got an office note here on December 4, '92, where he had rash on his arms and legs. I thought at that time, that was scabies, but that could have been an allergic reaction from the snakebite. He continued to have a cellulitis of his left lower leg on January 8, '93, so I would have to say - -
Q: Maybe my question is not clear or we are not communicating.
A: I'm calling it cellulitis, but it might have been the beginnings. That's what I would term the beginnings of this neuropathy.
Q: Let me try it one more time. Let's clear that up. What is the difference betweeen cellulitis and a peripheral polyneuropathy?
A: Cellulitis is an infection; and he had redness and swelling and heat, which is an indication of cellulitis. But that can also be the beginnings of a neuropathy.
Q: What did you diagnose on that day of December 2, 1992?
A: Scabies.
Q: Are you changing that diagnosis now?
A: No.
Q: Let me, again, I guess, repeat my question. Let me back up one more time. What was the first date, as his family physician, you diagnosed Mr. Dabney with peripheral polyneuropathy?
A: I would say it's not documented in the chart, but I would say the very beginnings of it was January 8, 1993. Looking at the chart and knowing his history and knowing all the circumstances, I would say that that was the beginnings; although, neuropathy was not mentioned in that note.
. The separate opinion also incorrectly asserts that "Dr. Cape testified that there were numerous medical textbooks which
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