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one-third of left leg medial lateral surface. Motion of ankle restricted in dorsiflexion and external rotation. Voluntary motion of left foot and ankle is normal in adduction and somewhat lessened in abduction. Muscle power is diminished in left foot and left lower leg 30 percent and patient walks with a limp and with left foot adducted. Does not bear weight on the ball of foot. Tendon achilles of left ankle appears to be somewhat shortened. Big toe is dorsiflexed normally, as is also plantar flexion. Remaining four toes appear to remain hyperextended when weight bearing is exerted. When weight bearing is not exerted on left foot toes are normal position. Power, of big toe is diminished between 20 to 30 percent of normal. There is no shortening of either leg either real or apparent. SLR normal both legs. Quadriceps function of left thigh markedly diminished, Weight bearing on left foot is out of natural line, being adducted about 15°. There is atrophy of both left foot and lower extremity, due probably to atrophy . of disuse. Reflexes of both lower extremities are equal and active. Both ankle jerks are active. X-rays reveal no bony pathology of left hip, pelvis, knee, tibia, or fibula. X-rays of left ankle reveal transverse fracture Chip of medial malleolus left ankle. Evidence of slight callus formation. Slight degree osteoporosis of bones of foot and ankle. Impression: (1) Atrophy from disuse, (2) peroneal nerve injury (left) with foot drop, (3) Chip fracture medial malleolus left ankle, (4) slight osteoporosis left foot and ankle."

The records of the War Department show that Miss Smith's automobile was repaired at a total cost of $428.96 ($433.96 actual cost of repairs, less $5 salvage of parts). The records contain bills showing that Miss Smith incurred medical and hospital expenses as a result of the injuries sustained by her in this accident in the aggregate amount of $772, as follows: Tobey Hospital

$15.00 St. Luke's Hospital, New Bedford, Mass.

110.00 Dr. H. G. Lee, Boston, Mass..

260.00 Dr. Thomas B. Horan, New Bedford, Mass.

174. 00 Dr. Raymond H. Baxter, Marion, Mass.

97.00 Dr. James B. Ayer, Boston, Mass...

20.00 Browne Pharmacy, Inc., New Bedford, Mass. (crutches).

2. 50 Visiting Nurse Association, Marion, Mass.

93. 50 Total.-

772 00 On November 28, 1942, Katherine Smith filed a claim with the War Department in the amount of $428.96 for damage to her automobile and her claim has been approved by the Department in the amount claimed. It is now in process for payment.

At the time of the accident Miss Smith was 32 years of age and was unmarried. She contributed the sum of $15 per week toward the support of her father, Frederick Smith, but had no other dependents. When she was injured Miss Smith was emploved by Hiller Co., Inc., Marion, Mass., as a bookkeeper, and her employer continued to pay her salary during the entire period during which she was unable to work.

The evidence clearly establishes that the accident and resulting personal injuries sustained by Katherine Smith were not caused by any fault or negligence on her part, but were caused solely by the negligence of the Army driver in failing to keep his vehicle under proper control as he approached a red traffic light so that he could stop without skidding into other vehicles lawfully stopped in obedience to the traffic signal. It is, therefore, the view of the War Department that Miss Smith should be reasonably compensated for the personal injuries sustained by her. Considering the heavy medical and hospital expenses which she has incurred, and as she appears to have sustained a serious permanent disability, the amount of the proposed award, $4,772, is believed to be fair and reasonable. The War Department, therefore, has no objection to the enactment of the bill.

The fiscal effect of the bill is manifest.

The Office of the Bureau of the Budget in a letter to the War Department, dated August 19, 1944, concerning the report on this bill, stated:

I am authorized by the Direcor of the Bureau of the Budget to advise you that while the payment of $4,772 to the claimant, as is proposed in H. R. 3890, appears excessive, there would be no objection to the enactment of legislation that would compensate the claimant commensurate with the injuries sustained by her." Sincerely yours,

HENRY L. STINSON,

Secretary of War.

STATEMENT

I, Katherine Smith, of Marion, Plymouth County, Mass., hereby certify that I suffered losses and personal injuries, including conscious suffering, as the direct and proximate result of an accident caused by Government vehicle W-427233 belonging to the Three Hundred and Sixty-ninth Coast Artillery (Antiaircraft), Camp Edwards, Mass., in Wareham, Mass., April 20, 1942; that at the present time my injured leg is much larger than the other, and my doctors advised me that I will never be able to walk right again; and that the value of my suffering and injuries, past and present, resulting from this accident is, in my opinion, $4,000.

KATHERINE SMITH.

OCTOBER 8, 1942. COMMONWEALTH OF MASSACHUSETTS,

Plymouth, 88: Personally appeared the above-named Katherine Smith and made oath that the foregoing statement by her subscribed is true, before me.

BARTLETT E. CUSHING, Notary Public. My commission expires April 15, 1949.

W. R. MACAUSLAND, M. D.
A. R. MacAUSLAND, M. D.
H. G. LEE, M. D.

Boston, Mass., August 25, 1948. Miss KATHERINE SMITH,

Marion, Mass.:
For professional services:
Apr. 1. Visit

$10 Apr. 15. Operation..

250

260

ST. LUKE'S HOSPITAL

NEW BEDFORD, MA88. Miss KATHERINE SMITH,

Marion, Mass.: Apr. 15, 1943. Urinalysis...

Operating room fee.

Leg culture.
Apr. 14 to Apr. 21, 1943. Services.-
Apr. 21 to Apr. 23, 1943. Services.

$2 15

3 70 20

110

Paid in full, April 23, 1943

ST. LUKE'S HOSPITAL.
M. A. G.

VISITING NURSE ASSOCIATION,

Marion, Mass., September 12, 1948. Statement of treatment of Miss Katherine Smith Bake and massage left leg daily per order of attending physicians:

103 visits from May 5 to Šept. 12, 1942, at 50 cents each visit.---. $51. 50 4 4-ounce bottles sweet oil, at 50 cents.

2. 00 Approximately 3 months' further treatment will be necessary, at 50 cents each visit, will amount to approximately -

40. 00 Total.

93. 50 THELMA B. SEQUEIRA, R. N.,

Marion Visiting Nurse.

THE BROWNE PAARMACY, INC.,
New Bedford, Mass., September 19, 1942.

Miss KATHERINE SMITH,

Marion, Mass.! 1942. 1 pair crutches..

$2. 50

JAMES B. AYER, M. D.,

Boston, September 1, 1948. Miss KATHERINE L. SMITH,

Marion, Mass.:
For professional services: Aug. 20, office consultation..

$20

TAE TOBEY HOSPITAL,

Wareham, Mass., May 20, 1948. Miss KATHERINE B. SMITH,

Marion, Mass.: X-ray of leg on Apr. 20, 1942.

$5 Received payment on behalf of the Tobey Hospital, May 25.

By DOROTHY V. BROWN.

THE TOBEY HOSPITAL,

Wareham, Mass., August 12, 1942. Miss KATHERINE SMITH,

Marion, Mass.:
X-ray of ankle and leg on Aug. 12, 1942..

$10 Received payment on behalf of the Tobey Hospital, August 15, 1942.

By A. E. MONAHAN.

RAYMOND HARDING BAXTER, M. D.,

Marion, Mass., October 1942. Miss KATHERINE SMITH,

Marion, Mass.:
Services rendered (U. S. Army accident, Apr. 20, 1942 at Wareham):
House call and Tobey Hospital, Apr. 20, 1942.

$15 House calls Apr. 23, 24, 26, 28, May 4, 8,'11, 18, 21, 27, June 5, 15, 25,

28, 29, 30, July 8, 10, 13, 23, 24; office calls July 25, Aug. 12; total.. 85

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RAYMOND HARDING BAXTER, M. D.,

Marion, Mass., May 1943. Miss KATHERINE L. SMITH,

Marion, Mass.:
Services rendered (U. S. Army accident, Apr. 20, 1942, at Wareham,
Mass.):
Bill rendered.

$87 Surgical assistance, operation, Apr. 15, 1943.

10

Total...

97

Dr. Thomas B. HORAN,

New Bedford, Mass., September 18, 1942. Miss KATHERINE SMITH,

Marion, Mass.:
To professional services:
May 20, 1942. Consultation in Marion, Mass..

$20 Aug. 12, consultation -

25

Total

45 Dr. THOMAS B. HORAN,

New Bedford, Mass., May 1943. Miss KATHERINE SMITH,

Marion, Mass.:
To professional services:
Bill rendered..

$65 Apr. 15, 1943, assisting Dr. Lee..

75 Apr. 16, 17, 18, 19, 20, 21, 22, 23, hospital visits, at $3.

24 May 1, 25, orthopedic examinations, at $5...

10

Total.

174

MAY 20, 1942. Re Miss Katherine Smith, Marion, Mass. Dr. RAYMOND BAXTER,

Marion, Mass. DEAR DR. BAXTER: I saw the above patient at her home today and I received a history of an automobile accident about 4 to 5 weeks ago, with an injury to her left leg.

At the present time on my examination I found that this patient had almost a complete foot drop due to injury to the common perineal nerve. In addition to this I found marked hemorrhage under the skin and in the soft tissues on the outer aspect of her leg.

The X-rays were reported as being negative for any fracture of the shaft of the fibula.

I instructed the nurse, who is attending the patient at the time of this examination, how to exercise the foot and how to stretch the heel cord. I also told her that I would speak to you on the advice of giving Miss Smith vitamin B1.

Now on this case I believe that the prognosis should be guarded. I do think there is a possibility of getting the return of complete power in the leg, without any residual paralysis. However, I believe that a period of convalesence will be at least 2 more months. Very truly yours,

T. B. HORAN, M. D.

RAYMOND H. BAXTER, M, D.,

Marion, Mass., October 10, 1942. To Whom It May Concern:

This is to certify that Katherine Smith is under my care and is still partially disabled due to her accident. She still has a marked limp which may be permanent.

RAYMOND H. BAXTER.

T. B. Horan, M. D.,

New Bedford, Mass., April 5, 1943. Miss KATHERINE SMITH, Marion, Mass.

My Dear Miss Smith: After consultation with Dr. Lee, it is my opinion that your leg is in a very serious condition. We believe that very marked damage has been done to the bellies of the muscles on the outer aspect of the leg. We believe that an operation should be done on the leg, but we do not guarantee any results. Very truly yours,

T. B. Horan, M. D.

Miss KATHERINE SMITH,

Marion, Mass.
April 16, 1943:

F. H.- Negative.
P. H.-See present illness.

P. 1.-This patient some months ago was involved in an automobile accident and as the result of this she received an injury to her left leg. It was very markedly swollen and in addition to this there seemed to be an injury to the nerve of the leg. She was treated by Dr. Baxter and Dr. Horan. Lately, she came in to see Dr. Horan, walking very lame.

After a consultation with

woman,

No spasm,

Dr. Lee it was thought that there was considerable muscle damage to the left leg which required an open operation of the leg. She was admitted to the hospital for same.

P. E.-On examination we have a well-developed and well-nourished
Head.-Negative. No lacerations. No contusions.

Eyes.-Pupils are regular, react to light and accommodation. No nystagmus.

Ears and nose.-Negative to external examination.

Mouth.-Negative. Teeth fairly good condition. Tongue protrudes in & median line.

Neck.–Cervical motions are free and unrestricted and not accompanied by any pain or discomfort.

No thickening.
Upper extremities.--Motions of the shoulder, elbow, and wrist joints are
free and unrestricted and not accompanied by any pain or discomfort.
Grasp is good on both sides.

Chest.-Expansion is good and equal.
Heart.- Within normal limits. Heart sounds are regular. No spasm.
Abdomen.-Negative. No masses felt. No hernias.

No spasm.; Back.—Negative. Forward, backward, and lateral motions of the spine are free and unrestricted and not accompanied by any pain or discomfort. No spasm over either sacroiliac or lumbosacral joints. Straight leg raising test is negative on either side. Lateral pressure to the pelvis does not cause any pain or discomfort.

Lower extremities.-Motions of the hip joints are free and unrestricted and not accompanied by any pain or discomfort. No areas of any thickening.

Left leg. —The patient walks with a marked limp on the left leg. There is, on feeling of this leg, a definite sulcus which appears to be a muscle-belly rupture.

Operation. An incision was made on the outer aspect of the leg. Skin and subcutaneous tissue was incised, then the pus exuted-a great deal of it. This was cleaned all out and culture was taken (Drs. Horan, Lee, and Baxter; ether, Dr. P. Wilde). April 16, 1943: The patient is doing very well. Her temperature is within normal limits.

April 18, 1943: The patient is doing well.
April 20, 1943: The patient is doing well.
April 23, 1943: All sutures have been removed.
The patient is discharged home under the care of Dr. Horan.

T. B. HORAN, M. D.
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