Smith v. Capital Region Medical Center
2013 Mo. App. LEXIS 376
| Mo. Ct. App. | 2013Background
- Dorothy Smith appeals a decision denying workers’ compensation for her deceased husband Stephen Smith, asserting the commission erred in requiring a specific workplace source of exposure to hepatitis C and in credibility findings favoring the employer’s expert; case is remanded.
- Stephen Smith, 1969–2006 lab technologist at Capital Region Medical Center, worked with blood/blood products daily under unsafe conditions prior to safety measures; potential exposure included needle sticks, pipetting with a mouth on the pipette, lack of gloves/face shields.
- Smith diagnosed with hepatitis C in 1991; died 2007 from sepsis, hepatitis C, and acute tubular necrosis; claim filed April 28, 2006, later substituted by Smith’s wife as claimant.
- Two competing medical experts: Dr. Parmet (claimant) opined work exposure was the most probable source of hepatitis C; Dr. Bacon (employer) testified transfusion in 1970 was the likely source and that workplace exposure was hard to prove.
- ALJ denied the claim; Commission affirmed denial; the court reverses and remands for reconsideration under the proper causation standard for occupational disease claims.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Commission erred by requiring a specific exposure source. | Smith: exposure at work must be shown as cause. | Capital Region: no direct workplace exposure evidence; cannot prove causation. | Remanded for reconsideration under correct causation standard. |
| Whether claimant met the burden of production on causation. | Smith offered Dr. Parmet’s testimony linking work conditions to hepatitis C. | Bacon’s view that transfusion was the likely cause defeats causation. | Remand to apply proper burden of production standard; not decided on the record. |
| Whether credibility determinations should be revisited under the correct standard. | Credibility of medical experts should be evaluated under proper causation framework. | Credibility favored employer’s expert under current record. | Remand to reconsider credibility with correct standard. |
Key Cases Cited
- Vickers v. Mo. Dep’t of Pub. Safety, 283 S.W.3d 287 (Mo.App.2009) (causation proof for communicable disease in workplace context; medical evidence sufficient even if indeterminate sources)
- Simmons v. Bob Mears Wholesale Florist, 167 S.W.3d 222 (Mo.App.2005) (causation test for occupational disease; natural and reasonable connection required)
- White v. Director of Revenue, 321 S.W.3d 298 (Mo.banc 2010) (burden of production vs. persuasion explanation)
- Johme v. St. John's Mercy Healthcare, 366 S.W.3d 504 (Mo.banc 2012) (two-part burden of proof; medical testimony sufficiency standard)
- Lawrence v. Anheuser Busch Cos., 310 S.W.3d 248 (Mo.App.2010) (discovery and accrual in occupational disease limitations)
- Spencer v. Sac Osage Elec. Coop., Inc., 302 S.W.3d 792 (Mo.App.2010) (limitations applicable to occupational disease claims; discovery rule)
- Hampton v. Big Boy Steel Erection, 121 S.W.3d 220 (Mo.banc 2003) (standard of review for Commission findings; evidentiary weight)