Injured Worker’s Death Due to Overdose of Medication: Breaking the Chain of Causation

April 12, 2017 (3 min read)

Key takeaways from a recent Tennessee case for both injured workers and employers

When do an injured worker’s actions, which led to a tragic overdose of opioids in the Kilburn case, constitute an independent intervening cause and thereby release the employer of liability for subsequent injuries or death? The Supreme Court of Tennessee recently reversed a decision of a state chancery court that had found an injured worker’s death due to acute oxycodone overdose, coupled with alcohol use, to be compensable. The Supreme Court of Tennessee held instead that the actions of the worker, in taking more of his opioid medication than prescribed and consuming alcohol while taking the pain medication—both specifically against his physician’s orders—amounted to an independent intervening cause, severing the causal connection to the original injury.

Quoting Larson’s Workers’ Compensation Law, § 10.01, the Court acknowledged that “all the medical consequences and sequelae that flow from the primary injury are compensable,” but, again quoting Larson, held there could be no compensation where the result was shown to have been “produced by an intervening nonindustrial cause.” The Court also rejected the widow’s contention that only reckless or intentional misconduct could constitute an intervening cause. It indicated that negligence was the appropriate standard for determining whether an independent intervening cause relieved an employer of liability for a subsequent injury purportedly flowing from a prior work-related injury. See Kilburn v. Granite State Ins. Co., 2017 Tenn. LEXIS 198 (Apr. 10, 2017).

We’ve asked Fredrick R. Baker at Wimberly Lawson Wright Daves & Jones, PLLC, about the Court’s decision.

LexisNexis: How does the Court’s decision square with prior case law in your state on this issue of opioids and independent intervening causes?

Baker: The Kilburn decision is consistent with prior Tennessee case law on the subject. Indeed, this case cited two prior decisions, Simpson v. H.D. Lee Co. and Guill v. Aetna Life & Cas. Co., which both held that taking or administering medication in contravention to doctor’s orders constituted independent intervening causes.

LexisNexis: What are the key takeaways of this decision for both injured workers and employers in your state?

Baker: For injured workers, the key takeaway is clearly to follow doctor’s orders when taking or administering prescribed medication. Failure to do so can not only result in serious bodily injury, if not death, but it can also break the chain of causation between the work injury and the further injury/death.

For employers in Tennessee, the Kilburn decision provides affirmation of the concept that an employee’s negligent activities in the context of his medical treatment for a work injury can, under the right circumstances, constitute an independent intervening event – thus releasing the employer from liability under the workers’ compensation law for subsequent injuries or death. However, it is important for employers to take some small degree of caution, because the court in Kilburn was very careful to say that it was not creating an across-the-board rule on overdoses. To the contrary, the Kilburn court stated in a footnote that it was not concluding that an individual can never prove that an overdose is the direct and natural result of the original compensable injury when a dependency or addiction to narcotics develops. The court merely concluded that the specific facts and testimony presented in the Kilburn case failed to establish that link. So the Kilburn decision does leave that door open in future cases, e.g. where an employee overdoses but there is no showing that doctor’s orders were violated.

It is also important for Tennessee employers to note that the Kilburn case was decided under pre-July 1, 2014 law by applying pre-July 1, 2014 precedent. To the extent that pre-July 1, 2014 law and precedent may be contrary to the Tennessee workers’ compensation reform law enacted for injuries on or after July 1, 2014, the Kilburn case would have limited precedential value. However, it could still be used as persuasive authority for a court deciding a similar case for an injury on or after July 1, 2014. Since the “new” law actually has a stricter causation standard than the “old” law that Kilburn was using, it might actually be harder now for an injured worker to prevail on this issue.