Stephen Smith, Dorothy Smith v. Capital Region Medical Center

458 S.W.3d 406, 2014 Mo. App. LEXIS 1453, 2014 WL 7342509
CourtMissouri Court of Appeals
DecidedDecember 23, 2014
DocketWD77043
StatusPublished
Cited by6 cases

This text of 458 S.W.3d 406 (Stephen Smith, Dorothy Smith v. Capital Region Medical Center) is published on Counsel Stack Legal Research, covering Missouri Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Stephen Smith, Dorothy Smith v. Capital Region Medical Center, 458 S.W.3d 406, 2014 Mo. App. LEXIS 1453, 2014 WL 7342509 (Mo. Ct. App. 2014).

Opinion

Gary D. Witt, Judge

Stephen Smith (“Stephen”) 1 worked as a medical laboratory technician at Capital Region Medical Center (“Capital Region”) from 1969 until March 2006. In April 2006, Stephen filed a claim with the Division of Workers’ Compensation alleging that he had contracted the occupational disease of hepatitis C as a result of occupational exposure. Stephen was diagnosed with hepatitis in 1991. He died from complications of the disease on February 27, 2007. The cause of death was sepsis, hepatitis C and acute tubular neurosis. Stephen’s wife, Dorgthy Smith (“Smith”) was substituted as a party and proceeded with the claim. The claim was denied by the Labor Industrial Relations Commission (“Commission”) and Smith appealed. This court reversed the Commission’s decision and remanded for “further proceedings consistent with th[e] opinion.” Smith v. Capital Region Med. Ctr., 412 S.W.3d 252, 254 (Mo.App.W.D.2013) (hereinafter “Smith I”).

Following remand, the Commission, without taking additional evidence and following its review of all of the evidence, applied the correct legal standard and issued its decision awarding Smith burial expenses of $2,897.58, temporary total disability expenses of $9,848.83 and weekly death benefits of $675.90. Capital Region now appeals. 2 For reasons explained more fully below, we affirm.

*409 FACTS AND PROCEDURAL HISTORY 3

Stephen worked for Capital Region from 1969 until March 2006 as a laboratory technologist. In this position, Stephen drew blood from patients, and worked with blotjd, human tissue and blood products every day. Stephen worked for Capital Region for a number of years before safety measures to protect people working with blood products were put into effect. 4 For several years, Stephen and his co-workers did not wear gloves while working with blood or tissue. Moreover, for many years, Stephen and his coworkers prepared blood slides by use of a “pipette,” which is essentially a narrow glass straw. The lab technician would place one end of the pipette into a tube of blood and then place his or her mouth on the other end of the pipette to suction some of the blood into the pipette, creating the substantial possibility of accidentally suctioning blood into his/her mouth. For several years, Stephen and his co-workers were not provided with face shields. As a result, the possibility existed of blood being splattered into Stephen’s face, particularly when blood was being centrifuged. Further, the possibility of a needle stick or a blood coming into contact with a cut or sore on Stephen’s hands was present during Stephen’s entire tenure with Capital Region, especially before gloves were worn when handling blood or tissue. Stephen never reported a needle stick to his employer, but his employer also did not require the reporting of such incidents until sometime in the 1980s or 1990s.

Smith, who was a registered nurse and also worked for Capital Region, and Stephen’s co-workers all testified that they came into contact with blood on their skin regularly. Stephen’s co-workers performed the same job duties as Stephen and said that they had gotten blood in their mouths while pipetting. One of Stephen’s co-workers and Smith also said that they had experienced needle sticks during their careers. Smith said that she had experienced numerous needle sticks and had blood of patients or bodily fluids of patients upon her person several times a week. Smith also testified that she had observed cuts or bandages on Stephen’s fingers. Stephen’s co-workers and Smith on occasions noticed spots of blood on Stephen’s protective lab coat or clothing, but none of them testified that they ever personally witnessed blood on Stephen’s face, witnessed him ingest blood by pipetting, or witnessed him suffer a needle stick.

Smith testified that Stephen was wounded with a shotgun in a hunting accident in 1970. As a result of the gunshot wound, *410 Stephen underwent surgery and was given a blood transfusion, with six units of blood. Other than the blood transfusion from this surgery, Smith testified that Stephen did not engage in any type of activities away from work where he could come into contact with other humans’ bodily fluids. Stephen did not use intravenous drugs; he did not have tattoos; and he was not a member of the military, all of which have been shown to increase the risk of contracting hepatitis C.

Stephen was first given the diagnosis of hepatitis in 1991, when he was hospitalized for abdominal pain and blood tests revealed elevated liver enzymes. The hepatitis was later typed as hepatitis C. 5 On April 20, 2005, Smith brought Stephen to the emergency room because he was confused and lethargic. 6 At that time, Stephen was diagnosed with hepatic encephalopathy. His treating physician, Dr. Arthur Dick, first alerted Stephen to the possibility that his hepatitis C may have been contracted from his work at Capital Region on December 5, 2005. Stephen continued to try- to work for Capital Region after this time, but, due to health problems associated with his disease, Stephen was unable to work after March 2006. Thereafter, Stephen filed his claim for workers’ compensation. On February 27, 2007, while his claim was pending, Stephen died. His cause of death was sepsis, hepatitis C, and acute tubular neurosis, all complications of his disease. After Stephen’s death, Smith was substituted as a party to the claim. While there is no dispute that hepatitis C caused Stephen’s death, how and when he contracted the disease is disputed.

At the hearing, Smith and Capital Region presented competing expert medical evidence on the issue of causation of Stephen’s hepatitis C. Smith presented the testimony of Dr. Allen Parmet through deposition, who opined that Stephen’s work for Capital Region was more likely than not the cause of him contracting hepatitis C and that his work was the prevailing factor in causing him to develop hepatitis C. According to Dr. Parmet, Stephen likely contracted the disease by needle stick or by handling blood and bodily tissue. Dr. Parmet noted that Stephen worked for Capital Region for many years handling blood and body products before the health care industry began to pay attention in the mid-1990s to the safety risks posed by blood-borne pathogens. Dr. Par-met identified the risk of blood splashing into Stephen’s eyes, nose, and mouth and opined that needle sticks were a very significant risk factor for phlebotomists and laboratory personnel and occurred quite frequently prior to the institution of OSHA safety standards. Indeed, Dr. Parmet found that Stephen’s job placed him in the highest risk group for hepatitis C infection. Dr. Parmet stated that Stephen reported that he suffered multiple needle sticks while working. Dr. Parmet further testified that fifteen percent of patients coming into a hospital in an urban setting have hepatitis C and one percent of the total population has hepatitis C. There was testimony that Capital Region was located in what is considered an urban setting.

Dr.

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458 S.W.3d 406, 2014 Mo. App. LEXIS 1453, 2014 WL 7342509, Counsel Stack Legal Research, https://law.counselstack.com/opinion/stephen-smith-dorothy-smith-v-capital-region-medical-center-moctapp-2014.