Ruff v. DEPT. OF LABOR & INDUS. OF STATE

28 P.3d 1
CourtCourt of Appeals of Washington
DecidedJuly 17, 2001
Docket45095-6-I
StatusPublished
Cited by2 cases

This text of 28 P.3d 1 (Ruff v. DEPT. OF LABOR & INDUS. OF STATE) is published on Counsel Stack Legal Research, covering Court of Appeals of Washington primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Ruff v. DEPT. OF LABOR & INDUS. OF STATE, 28 P.3d 1 (Wash. Ct. App. 2001).

Opinion

28 P.3d 1 (2001)
107 Wash.App. 289

Sandra RUFF, Appellant,
v.
DEPARTMENT OF LABOR AND INDUSTRIES OF the STATE OF WASHINGTON, Respondent.

No. 45095-6-I.

Court of Appeals of Washington, Division 1.

May 21, 2001.
Publication Ordered July 17, 2001.

*2 Carol L. Casey, Casey & Casey, P.S., Port Orchard, for Appellant.

Anastasia R. Sandstrom, Asst. Attorney General, Seattle, for Respondent.

COX, J.

Two physicians diagnosed Sandra Ruff with porphyria, a rare, mostly hereditary disorder of blood enzymes. They testified before the Board of Industrial Insurance Appeals that the condition was caused by her workplace exposure to chemicals during a building remodel. On appeal to the superior court of the Board's adverse decision on the worker compensation claim, the trial court excluded evidence of the causal relationship between the diagnosis of Ruff's porphyria and her workplace chemical exposure based on Frye.[1] Because the testimony of the two doctors and the methodology of the blood test used to diagnose Ruff's alleged porphyria and the theory that porphyria is caused by short-term exposure to chemicals in the ambient air are not generally accepted in the relevant scientific community, we affirm.

In September 1992, Sandra Ruff was working at a Highline Community College building that was being remodeled. The remodeling included painting and carpeting. During the first few days of remodeling, Ruff experienced headaches, watery and burning eyes, nausea, and difficulty sleeping. On the fourth day, after smelling a strong chemical odor, Ruff felt as if she was going to "pass out" and was taken to the hospital emergency room. Upon arrival at the ER, Ruff immediately felt better. Ruff's blood tests were normal, and the ER doctor diagnosed Ruff's symptoms as an acute allergic reaction. Two days later, Ruff returned to work. But after two hours, she felt dizzy and weak. She also experienced numbness in her face and shortness of breath and left work early.

Prior to her workplace exposure to fumes, Ruff had a history of head injuries, headaches, depression, and anxiety. She saw a number of doctors for symptoms that included fatigue, sore throat, nausea, nasal congestion, cough, and vomiting. The doctors performed numerous blood, liver, and urine tests, as well as an Epstein-Barr virus test. Ruff's test results were all normal.

Ruff saw her physician, internist Dr. Bliss, regarding the cough, weakness, dizziness, and nausea she experienced shortly after her workplace exposure. Dr. Bliss performed a physical exam, which was normal. He opined that Ruff had a panic reaction.

During the next four months, Ruff saw several doctors, including an allergy specialist, *3 an ER physician, and a neurologist. The doctors examined Ruff, and she underwent pulmonary function tests, blood tests, urinalysis, EKG, and a MRI. The results of these tests were all normal, and the various doctors diagnosed her with panic disorder and depression.

In May 1993, Ruff saw Dr. David Buscher, who limits his practice to patients with allergies and chemical sensitivity. Based on Ruff's account of her medical history and an allergy test, Dr. Buscher diagnosed Ruff with multiple chemical sensitivity. Dr. Buscher also ordered a MRI for Ruff, which the neurologists interpreted as normal. Dr. Buscher later tested for porphyria[2] by sending Ruff's urine, stool, and blood samples to the Mayo Laboratory.

Ruff's stool test was normal and only one of the four enzymes tested for in Ruff's blood showed marginally abnormal levels. Ruff's urine test revealed only slight elevation of two enzymes—coproporphyrin and porphobilinogen—that would normally be increased dramatically in the urine of porphyria patients. Based on these tests, Dr. Buscher concluded that Ruff suffered from "toxic effects of chemicals resulting in a disorder of porphyria metabolism and multiple chemical sensitivities."[3]

Ruff also saw Patricia Sparks, M.D., MPH, an occupational medical specialist in chemical exposure and epidemiology. Dr. Sparks was the acting director for the Occupational Safety and Health Administration and was on the clinical faculty at Harvard Medical School and Harvard School of Public Health. Dr. Sparks works as a medical consultant for the State's Department of Labor and Industries (DLI). Dr. Sparks reviewed Ruff's extensive medical record and also examined Ruff. Dr. Sparks concluded that Ruff's symptoms were not typical for porphyria and that she did not meet even minimum clinical or laboratory thresholds for a porphyria diagnosis. Instead, she diagnosed Ruff with multiple chemical sensitivity, upper respiratory tract irritation from low levels of volatile organic compounds, panic disorder, and depression. Dr. Sparks did not believe these conditions were related to Ruff's workplace exposure.

Ruff then saw Dr. William Morton in April 1994. Dr. Morton is a professor of environmental medicine and epidemiology at Oregon Health Sciences University. He is Board certified in preventative medicine and occupational medicine and first became interested in "chemically activated porphyria" in 1992.[4] Dr. Morton has not published any papers relating to porphyria. He listened to Ruff's account of her medical history, tested her mental functions, and physically examined Ruff. The result of the mental function test was normal and the physical exam revealed pimples on Ruff's arm, lower abdomen tenderness, and diminished sensation in her feet and one cheek.

Dr. Morton also ordered red cell enzyme and stool tests from the Mayo Laboratory. The stool tests showed normal porphyrin excretion. The levels of three of the four red cell enzymes tested normal. One of the enzymes, coproporphyrinogen oxidize, was marginally below normal, but Dr. Morton did not repeat the test as the Mayo Laboratory recommends. Dr. Morton also reviewed the result of a urine test ordered by Dr. Buscher earlier. As a result of these tests, Dr. Morton diagnosed Ruff with "chronic porphyria [] activated by chemical exposure."[5]

Ruff applied for worker's compensation benefits based on her workplace exposure. *4 In a February 1994 order, DLI accepted her claim as a toxic reaction to gas and vapors and agreed to pay bills associated with that claim prior to June 21, 1993. But it denied responsibility for Ruff's depression, chronic fatigue syndrome, and somatization disorder, and closed Ruff's claim. Ruff appealed the order to the Board of Industrial Insurance Appeals (Board). At the proceedings before an Industrial Appeals Judge, Ruff offered the testimony of Dr. Morton and Dr. Buscher that her alleged porphyria was caused by her workplace exposure to chemicals. The judge issued a proposed decision and order rejecting the testimony and affirming DLI's order. On appeal, the Board affirmed DLI's order.

Ruff appealed the Board's decision to the superior court. Based on Frye, DLI moved to exclude Dr. Morton and Dr. Buscher's testimony regarding the Mayo Laboratory red cell enzyme test and the claimed causal relationship between Ruff's workplace exposure and her alleged porphyria. The trial court granted DLI's motion to exclude. Thereafter, Ruff moved to dismiss her appeal based on the exclusion of the above evidence and the lack of other evidence to establish a prima facie case.

Ruff appeals the orders excluding testimony and dismissing her case.

Preservation

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Bluebook (online)
28 P.3d 1, Counsel Stack Legal Research, https://law.counselstack.com/opinion/ruff-v-dept-of-labor-indus-of-state-washctapp-2001.