Missouri: Lab Tech Proves a Work-Related Hep C Infection

Missouri: Lab Tech Proves a Work-Related Hep C Infection

What does the widow of a deceased hospital employee have to prove to make a submissible case when the claimant worked around blood during his career and many years later develops hepatitis? In a March 26 decision, Smith, dec. v Capital Region Medical, No. WD75078 (Mo Ct. App 2013), the court of appeals tries to answer that question.

Claimant worked as a lab tech at the hospital from 1969 to 2006. He was diagnosed with hepatitis in 1991. He died in 2007 from sepsis, hep c and acute tubular necrosis. He alleged in April 2005 he developed an occupational disease when he was diagnosed with hepatic encephalopathy.

Claimant, in this pre-reform case, had the burden of production in an occupational disease case to establish a recognizable link between distinctive features of his job as a lab tech and exposure and must establish through expert evidence the probability that working conditions caused HCV even though the specific causes of the disease may be indeterminate. Claimant’s expert indicated that claimant’s job as a lab tech exposed him to blood splatter which might have been infected. He testified that claimant did not use early in his career protective devices such as gloves and face shields which are more common now. Smith’s expert further relied upon a history that claimant reported multiple needle sticks in his career. The Commission denied benefits and found that claimant never established that HCV was ever present in the hospital, or that claimant ever handled any blood tainted with HCV or that he ever had an actual exposure. In Vickers v. Mo. Dep't of Pub. Safety, 283 S.W.3d 287, 291 (Mo. App. 2009); in which benefits were awarded, the claimant established that patients with an infectious disease had been admitted where the claimant worked handling laundry. The Court of Appeals, however, concluded that claimant established a prima facie case because claimant does not have to prove causation with medical certainty.

The Commission in a 2-1 decision concluded that claimant also failed in his burden of persuasion because the majority concluded that his expert lacked credibility. 2012 MO WCLR Lexis 57. The employer’s expert was more credible and he concluded that the most likely cause of claimant’s disease was a non-occupational blood transfusion. The majority felt claimant’s expert misinterpreted and disregarded medical records and used a timeline to prove causation inconsistent with the treating records. The court of appeals remanded the case for the Commission to re-evaluate its finding on credibility. Since the original decision, the Commission now has a vacant seat and the remaining two commissioners reached opposite conclusions on the original decision.

A different commission previously awarded disability benefits to a lab tech alleging hep c exposure without evidence of a specific accident that he cut himself where the virus could have entered his body. Simburger v Barnes Hospital, 1997 MO WCLR Lexis 38.

Source: Martin Klug, Huck, Howe & Tobin. Read Martin Klug's Mo. Workers' Comp Alerts.

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