and, in his own mind, may mean thereby that a pre-existing pathological condition was the overwhelming factor in bringing about the attack and that the part played by the work was insignificant. But, while it may be sound medically to say that the work did not cause the attack, it may be bad law, because, an [sic] general, existing law treats the slightest factor of aggravation as an adequate cause. Id. at 410, 495 P.2d at 1167 (emphasis added; citations and internal quotation marks omitted). Since Akamine, the supreme court has held that “the slightest aggravation or acceleration of an injury by the employment activity mandates compensation.” Van Ness, 131 Hawai'i at 562, 319 P.3d at 481 (citing De Fries v. Ass’n of Owners, 999 Wilder, 57 Haw. 296, 309, 555 P.2d 855, 862 (1976) (<HOLDING>)). In Van Ness, claimant alleged that the
holding a person commits aggravated dui when his or her driving under the influence was a proximate cause of the injuries  citation not the sole and immediate cause of the victims injuries emphasis omitted holding that claimant was entitled to recover for injuries resulting from a stumble that aggravated or accelerated the arthritic condition of his knee holding that homeowners policy precluded coverage for injuries resulting from intentional acts holding that rico claims were personal and plaintiffs were therefore entitled to sue on their own because their injuries were distinct from the injuries to creditors in general resulting from the diversion of corporate assets holding that a right of action for personal injuries resulting from negligence cannot be assigned absent statutory law