Michael Bean v. Reynolds Consumer Products

2022 Ark. App. 276, 646 S.W.3d 655
Court of Appeals of Arkansas·Decided June 1, 2022·Published·Cited by 2 cases

Opinion

Cite as 2022 Ark. App. 276 ARKANSAS COURT OF APPEALS DIVISION IV

No. CV-21-611

MICHAEL BEAN Opinion Delivered June 1, 2022 APPELLANT

V. APPEAL FROM THE ARKANSAS WORKERS’ COMPENSATION

COMMISSION [NO. G806384]

REYNOLDS CONSUMER PRODUCTS; INDEMNITY INSURANCE COMPANY OF NORTH AMERICA/SEDWICK CLAIMS MANAGEMENT SERVICES, INC.; AND DEATH & PERMANENT TOTAL DISABILITY TRUST FUND AFFIRMED APPELLEES

BART F. VIRDEN, Judge

Appellant Michael Bean was diagnosed with a rare condition: pauci-immune anti-

neutrophilic cytoplasmic autoantibody (ANCA) vasculitis, also known as granulomatosis with polyangiitis (GPA), or pulmonary vasculitis, and formerly known as Wegener’s disease. Bean alleged that the ANCA vasculitis, which caused damage to his kidneys and lungs, resulted from his exposure to silica dust while working for appellee Reynolds Consumer Products. The Arkansas Workers’ Compensation Commission denied benefits after finding that Bean failed to prove that he sustained a compensable accidental injury or that he sustained a compensable silicosis injury. Bean argues on appeal that (1) his accidental injury

is compensable; (2) his injury was not “legally idiopathic”; and (3) the Commission arbitrarily disregarded the opinion of his medical expert. We affirm the Commission’s decision.

I. Background

On May 3, 2018, then thirty-four-year-old Bean was referred by his primary care physician (PCP) to CHI St. Vincent with the chief complaint of abnormal lab results, which he had received earlier that day. Specifically, Bean sought an “evaluation of elevated creatinine and BUNs.” It was noted that Bean is a body builder who uses creatinine, protein supplements, and Aleve, along with other NSAIDs (nonsteroidal anti-inflammatory drugs) for his back pain. It was further noted that Bean drinks mostly energy drinks, rather than water, and that he had gone to his PCP that day complaining of indigestion issues. The medical records indicate, “Suspect patient’s symptoms are likely coming from his creatinine and protein intake as well as his NSAID abuse. Although intrinsic kidney function cannot be excluded.” Bean was admitted to the hospital with acute renal failure—it was noted that he had a gradual onset of symptoms and “duration: > 1 month.” The hospital gave him intravenous fluids and conducted studies. Bean was provided a gastroenterology consultation on May 4. Dr. Sanford Henry Benjamin noted that Bean had chronic back pain for which he took nonsteroidal medications several times a day and had developed epigastric pain two months ago. Bean was given a chest x-ray and CT scan on May 5 due to shortness of breath and coughing up blood. The impression was bilateral upper lobe and right lower lobe airspace disease consistent with pneumonia. Bean was ultimately diagnosed with acute renal failure, pulmonary alveolar hemorrhage, and “suspected vasculitis.”

On May 5, Bean was transferred to the University of Arkansas for Medical Sciences (UAMS) at his request. Dr. Devendra D. Patel noted the earlier symptoms Bean had described to doctors at St. Vincent, and she pointed out that “[Bean] has exposure to Aluminum as he has been working in Aluminum plant for 2–3 years.” Dr. Patel’s impression was acute renal failure “probably related to long term NSAID use vs vasculitis (with hemoptysis).” She diagnosed anemia, dyspepsia, and hemoptysis. A kidney biopsy was taken on May 7, the findings of which were consistent with an ANCA-associated disease. A chest x-ray was taken on May 8, and it was noted that Bean had “significant interval worsening of patchy consolidation within both lungs . . . this could reflect other hemorrhage versus multifocal pneumonia.” Bean was transferred to the MICU on May 9 due to “worsening hypoxic failure which is thought to be due to DAH secondary for vasculitis (pulmonary renal disease).” Bean was placed in a medically induced coma and later diagnosed with ANCA vasculitis.

On May 15, Dr. Manisha Singh, a board-certified nephrologist and internist, reported that Bean was critically ill. Referring to ANCA vasculitis, Dr. Singh wrote, “This is the one disease that can fully explain this clinical picture along with biopsy readings . . . The driver of his clinical condition has to be pauci immune crescentic GN [glomerulonephritis].” Bean was discharged from UAMS on May 23, 2018; however, Dr. Singh continued to see him for nearly a year. In late August, Dr. Singh reported that Bean’s renal failure had suddenly become worse over the last month.

In September 2018, Bean completed a Form AR-C describing an inhalation injury on May 1, 2018, that had damaged his kidneys and lungs. On a “Workers’ Compensation First Report of Injury or Illness” form prepared by Georgia Diemer, the same information from the Form AR-C was reported with additional information that Bean had last worked at Reynolds on April 18, 2018, and that his disability had begun April 19. It was also reported that the time of the occurrence could not be determined; that the injury, illness, or exposure did not occur on the employer’s premises, yet it did occur at the address for Reynolds; that the specific activity or work process that Bean was engaged in when the accident, illness, or exposure occurred was driving a forklift; and that he notified his employer of his injury on September 24, 2018.

Bean returned to work for Reynolds in January 2019, but his condition deteriorated, and he underwent a kidney transplant in March 2019. Bean again returned to work at Reynolds in March 2020.

On July 25, 2020, Dr. Singh was asked on a questionnaire whether she believed with a reasonable degree of medical certainty that the injuries/conditions for which she had treated Bean were caused by exposure to silica at his workplace. She stated, in part, that

It is difficult to say exactly what caused the [ANCA] GN, but in his history, the only thing that we were able to find is known to be associated with this condition – was the exposure to silica. This is a rare disease [so] not much is known about it. We concluded that this must be the inciting event.

Dr. William Banner, Jr., was asked to review the case for Reynolds. In a report dated October 14, 2020, he stated, in part, the following

The key question in this case is whether there is a causal relationship between Michael Bean’s exposure to silica while working at the Reynolds facility and his development of a pulmonary-renal syndrome. As can be seen in this case with conflicting results, testing for ANCA my yield some difficult to interpret results. Nevertheless, his kidney failure is consistent with a minimal (pauci) immune disorder. As stated in a recent article by Scott et al. (Scott, Hartnett, Mockler & Little, 2020), “Like many autoimmune diseases, the exact etiology of AAV (ANCA associated vasculitis), and the factors that influence relapse are unknown. Evidence suggests a complex interaction of polygenic genetic susceptibility, epigenetic influences and environmental triggers.” At this point causal links to these associated “triggers” have not been well defined and at this point remain associations . . . . A thorough evaluation of possible exposure in an individual patient would have to also consider the type of silica including particle size and structure.

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To assess the role of exposure time, it is important to consider the exposure times associated with the development of silicosis . . . . The term acute silicosis which can occur in shorter periods of time requires extremely high concentrations and produces severe symptoms. (Pollard, 2016) Mr. Bean by his deposition has indicated that he worked in this facility for two years. At no point in time did he complain of acute severe silicosis[,] and his chest CT did not at any point reveal chronic nodular inflammatory changes associated with silicosis.

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Michael Bean v. Reynolds Consumer Products, 2022 Ark. App. 276, 646 S.W.3d 655 (Ark. Ct. App. 2022).

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