Jury’s Award to MS Victim Fuels Debate

An Orange County jury’s $1-million award to a former surveyor who claimed a job-related accident almost six years ago brought on multiple sclerosis has highlighted a medical controversy about whether trauma or stress triggers symptoms of the crippling disease.

But the award to John Merle Waterman will not quiet the controversy among neurologists, according to Dr. Stanley van den Noort, dean of the UC Irvine College of Medicine and a neurologist who has studied multiple sclerosis and its symptoms for 30 years.

“This . . . is not a landmark decision,” van den Noort said in an interview, but it is “another record case to be considered” in future litigation.

Waterman, who was 51 at the time of the 1979 accident, was a healthy man who walked 10 to 15 miles a day as a land surveyor. He was active in sports, often playing on the beach near his Surfside apartment.

On June 11, 1979, he punctured a lung in an accident at work. He soon developed multiple sclerosis, a condition that left him confined to a wheelchair 90% of his “waking hours.” MS, a disease that strikes one in every 1,000 Americans, attacks the central nervous system and affects muscular coordination.

“I had an active physical life for a man in his 50s (before the accident),” Waterman said recently. He now lives in Los Osos, near San Luis Obispo.

$1.06 Million Award

His award from the Orange County Superior Court jury, which reached its verdict May 6, totaled $1.06 million. The jury found that the MS symptoms he developed after the accident at a construction site in Escondido were triggered by the trauma of his injury.

At the time of the injury, Waterman was on a job for RGB Surveyors, a subcontractor at a construction site being supervised by John Martin Co. of Los Angeles. Waterman, walking on an unstable surface at the site, tumbled over a retaining wall and fell on a reinforcement bar that punctured his lung.

Almost a year after the accident, Dr. Robert A. Rose of Santa Ana diagnosed Waterman as having MS. Rose suspected that the trauma of the accident had contributed to the MS symptoms he had developed and testified to that at the trial.

Waterman, who sued John Martin Co. after the diagnosis, said his condition began deteriorating almost immediately after the accident.

“I tired easily and sometimes I’d get dizzy. It got progressively worse . . . that by the end of 1980 I had to use a cane and by the end of 1981 I was using a wheelchair most of the time,” Waterman said after the two-week trial.

No Decision on Appeal

William Rohr, the attorney representing John Martin Co., said the company has not decidedif it will appeal the verdict. At one point, according to Waterman’s attorney, the company wanted to settle out of court for $40,000, but Waterman rejected the offer and pushed for the trial.

Jerome L. Ringler, a Los Angeles attorney who represented Waterman in the trial, did not argue that the trauma caused the MS, only that it contributed to the onset of the symptoms.

Some doctors, he said, “have seen a relationship between MS in its dormant state and then an onset of the symptoms after there has been trauma.”

Rohr, the defendant’s attorney, called two neurologists to challenge Rose and another doctor who testified the trauma of Waterman’s injury triggered the MS symptoms and eventually left him an invalid. One of the defense witnesses, Dr. William Sibley, a professor at the University of Arizona Medical School, conducted a 1981 study that concluded there is no relationship between trauma and MS.

In an interview, van den Noort said there is no scientific evidence to link trauma and stress to MS, but, he added:

“MS textbooks, in the cause section, say there is no scientific evidence that stress causes MS,” he said. “But in the treatment section, it says MS victims should avoid stressful situations. This is internally inconsistent.”

‘It’s Very Convincing’

Van den Noort said situations like Waterman’s case cannot be overlooked by the medical professionals who deal with MS and its causes. He pointed to a rare case he handled 10 years ago.

He said his patient sat down one night to look over his bills when he noticed a bill for a pregnancy test his wife had undergone. The patient, having had a vasectomy 10 years previously, became very distressed.

“Within 48 hours, he was paralyzed from the waist down,” van den Noort said. Such an incident and be “very convincing,” he said.

Gayle Swift, director of patient services for the Orange County MS Foundation, said a man who was among the 52 Americans held hostage in Iran for 444 days developed MS symptoms during the long siege.

“The situation did not cause the disease in the man, but the stressful situation allowed the symptoms to surface. He might not have ever suffered the symptoms the rest of his life if he had not been in that stressful situation,” Swift said.

Van den Noort, however, said that despite those isolated cases where trauma appears to be connected to MS symptoms, neurologists will still adhere to the majority opinion.

“We stand by the dogma that there is no scientific evidence that stress precipitates or aggravates MS symptoms,” he said. “I would think that many more are likely to lose than to win (in future court cases).”