MEMORANDUM OPINION AND ORDER
Plаintiffs in this action are suing the defendant (hereinafter “Ashland”) for injuries allegedly caused by toxic substances contained in pollution released by Ashland into the air, water and ground in the vicinity of its Catlettsburg, Kentucky refinery. They allege that exposure to those toxic substances causes damage to the human body, both immediate and latent. Such latent effects can include cancer and other life-threatening diseases. In their complaint, the plaintiffs assert that they require, now and in the future, special medical monitoring “in order to detect the early onset” of such latent diseases which they purportedly have an increased risk of incurring because of Ashland’s polluting activities. Plaintiffs seek from Ashland, among other things, a monetary award as compensation for their present personal injuries and the establishment of a fund to pay for the future medical monitoring to diagnose potential latent injuries. Plaintiffs define a claim for medical monitoring as “a claim for the costs for reasonable diagnostic medical examination [to provide early diagnosis of cancer and other diseases] which are a proximate result of defendant’s tortious polluting activities.” Plaintiffs’ Surresponse, Court Document 117, at 2-3.
Ashland has moved to dismiss all claims for future medical monitoring for failure to state a claim upon which relief can be granted. Fed.R.Civ.P. 12(b)(6). It asserts that the claim for future medical monitoring is simply a claim for damages for future medical expenses. Defendant argues that under Kentucky law, which governs this action, 1 a plaintiff must show a present, demonstrable physical injury and a reasonable likelihood of future complications of such injury in order to recover future medical expenses. Ashland contends that the plaintiffs can be divided into two groups; one group consisting of persons alleging a present physical injury and a second comprising those of persons whо allege only exposure to purported toxic substances without any demonstrable physical injury. It is Ashland’s position that under Kentucky law the second group of plaintiffs do not have a claim for future medical expenses, i.e., future medical monitoring, until such time as a physical injury manifests itself. In other words, the second group of plaintiffs do not have a claim against Ashland to pay for medical monitoring to detect the onset of a latent disease caused by exрosure to toxic substances until such time as the latent disease manifests itself or unless the exposure causes some presently discernable physical injury. Defendant insists that to allow future medical monitoring costs in any other circumstances would amount to allowing speculative damages for a possible increased risk that plaintiffs might suffer future harm. 2
Plaintiffs have put forward alternative arguments against dismissal of their medical monitoring claims. First, they argue that Kentucky would allow such a claim upon proof of exposure to toxic substances, even without a physical injury. They contend that a claim for medical monitoring is analogous to or a corollary of a claim for enhanced risk of future injury, which the Kentucky Supreme Court recognized in
Davis v. Graviss,
The plaintiffs’ second, fallback argument is that if this court holds that Kentucky requires proof of a present physical injury in order to recover for future medical monitoring then they have alleged such injury. They posit that under Kentucky law all that is needed to establish physical injury is some physical impact and that they have sufficiently pleaded such physical impact. 3
Ashland’s motion to dismiss for failure to state a claim 4 is based upon its contention that Kentucky law does not recognize claims for medical monitoring.
A complaint should not be dismissed under Rule 12(b)(6) “unless it appears beyond doubt that the plaintiff can prove no set of facts in support of his claim which would entitle him to relief.” Conley v. Gibson,355 U.S. 41 , 45-46,78 S.Ct. 99 , 101-02,2 L.Ed.2d 80 (1957). Dismissal can be based on the lаck of a cognizable legal theory or the absence of sufficient facts alleged under a cognizable legal theory.
Balistreri v. Pacifica Police Department,
The parties agree that Kentucky does not have any statutory or decisional law concerning the question presented to this court or regarding the issue of medical monitoring in general. Therefore, the matter is one of first impression.
In cases where the state’s highest court has not considered the precise question to be answered, the federal court is called upon to predict how the state court would resolve the issue should it be called upon to do so.
In making such predictions we recognize that “[t]he state’s highest authority is the best authority on its own law” and that “if there be no decision by that Court then federal authorities must apply what they find to be the state law after giving ‘proper regard’ to the relevant rulings of other courts of that state.” ... Our role is not to form or create statе law but to decide the case as we believe it would have been decided by the state’s highest court had the ease arisen in the state court system.
Robertson v. Allied Signal, Inc.,
When faced with an unsettled issue of state law, a federal court should not decline to exercise its jurisdiction to decide a case____ A federal court “may not give up — lost in darkness” in such a situation. ... [I]f a state’s supreme court has not yet decided an issue, a federal court should look to available data and adopt the rule that it believes a state’s supreme court would adopt.
Heinhold, v. Bishop Motor Express, Inc.,
This court, with the assistance of counsel for the parties, has found a limited number of cases dealing with future medical monitoring related to toxic pollution. A majority of the courts in these cases has allowed recovery of such costs upon proof of exposure to the toxins without requiring proof of a physical injury also.
In re Paoli Railroad Yard PCB Litigation,
1. Plaintiff was significantly expоsed to a proven hazardous substance through the negligent actions of the defendant.
2. As a proximate result of exposure, plaintiff suffers a significantly increased risk of contracting a serious latent disease.
3. That increased risk makes periodic diagnostic medical examinations reasonably necessary.
4. Monitoring and testing procedures exist which make the early detection of the disease possible and beneficial.
In re Paoli,
In a second group, thе courts have allowed recovery of future medical monitoring costs as an element of future medical expenses only upon proof of some physical injury.
Hagerty v. L & L Marine Services, Inc.,
In
Hagerty,
the court found “[djizziness, leg cramps, and a persistent stinging sensation in feet and fingers” after the plaintiff had been drenched by a toxic chemical as “suggestion] [of] some harm or injury”,
Judge Hallanan of this court, in the
Ball
ease, held that a plaintiff must show a present, demonstrable injury caused by the exposure to a toxin before he or she may recover the costs of future medical monitoring.
The issues facing this court are threefold: first, would Kentucky recognize a claim for recovery of the costs of future medical testing to detect possible diseases caused by toxins; second, would Kentucky require proof of a present physical injury from, or *536 merely exposure to, the toxin before entertaining such a claim; and third, would a plaintiff have to be prosecuting a claim for compensation for present injuries in order to recover for future medical monitoring? Although there is no decisional law in Kentucky on point, this court believes that there are cases which indicate the position that stаte’s courts would take on these issues.
First of all, the Kentucky Supreme Court has held that a plaintiff who has suffered a physical injury because of the negligence of a tortfeasor may recover for the increased risk of future harm that might result from that injury.
Davis v. Graviss,
This court believes that Kentucky’s recognition of an enhanced risk claim is significant because two of the courts which have allowed recovery for future medical monitoring costs have expressly rejected recognizing claims for enhanced risk.
In re Paoli,
[t]he enhanced risk claim seeks a damage award, not because of an expenditure of funds, but because plaintiffs contend that the unquantified injury to their health and life expectancy should be presently compensable, even though no evidence of disease is manifest....
By contrast, the claim for medical surveillance does not seek compensation for an unquantifiable injury, but rather seeks specific monetary damages measured by the cost of periodic medical examinations.
Ayers,
[t]he injury in an enhanced risk claim is the anticipated harm itself. The injury in a medical monitoring claim is the cost of the medical care that will, one hopes, detect that injury. The former is inherently speculative because courts are forced to anticipate the probability of future injury. The latter is much less speculative because the issue for the jury is the less conjectural question of whether the plaintiff needs medical surveillance.
Given that the Kentucky Supreme Court has taken the broader step of allowing recovery of damages in enhanced risk claims,
Davis, supra,
it is far easier to predict that that court would take the lesser step of allowing recovery in so-called medical monitoring claims. The court reaches this conclusion because an award for future medical monitoring is essentially an award for medical costs which
will be
incurred in an effort for early detection of latent diseases which a plaintiff has an enhanced risk of suffering. It is no more speculative than the recovery allowed in
Maresz.
A plaintiff seeking such medical monitoring costs in a toxic pollution ease of course would have to present substantial evidence оf the need for such monitoring.
See Davis,
Most of Ashland’s argument for dismissal has concerned itself with the second inquiry; whether a plaintiff must allege a present physical injury before he or she may seek to recover medical monitoring costs. To support its contention that Kentucky courts would require a present, demonstrable physical injury, Ashland relies heavily on the statement by the Kentucky Supreme Court that “[t]he right of action for negligence causing injury or death ... requires more than mеre conduct before recovery can be attempted. Recovery is not possible until a cause of action exists. A cause of action does not exist until the conduct causes injury that produces loss or damage.”
Saylor v. Hall,
In the case of
Deutsch v. Shein,
The ease of
Deutsch v. Shein,
That does not mean that Kentucky would allow recovery of medical monitoring costs on proof of exposure alone however. It is apparent that the Kentucky Supreme Court requires proof of some present physical harm, however slight, before a plaintiff may recover compensation. See Deutsch, supra. Proof of such harm, as well as' proof of the need for future medical monitoring as discussed supra at 536, could likely be made by showing that:
1. Plaintiff was significantly exposed to a proven hazardous substance through the ... actions of the defendant [;]
2. As a proximate result of exposure, plaintiff suffers a significantly increased risk of contracting a serious latent disease [;]
3. That increased risk makes periodic medical examinations reasonably necessary [; and,]
4. Monitoring and testing procedures exist which make the early detection and treatment of the disease possible and beneficial.
In re Paoli,
*538 Ashland’s final contention is that each plaintiff seeking to recover the costs of future medical monitoring must be currently prosecuting a claim for compensation for present injuries. In other words, defendant asserts that there cannot be an award for future damages without a concomitant award of damages for present injuries. Presumably such a requirement is intended to prevent an award of speculative claims.
This court has not found any Kentucky law establishing the requirement proposed by Ashland. Kentucky already allows the recovery for enhanced risk of future injury, Davis, supra, and the future medical expenses a plaintiff with such an increased risk might incur. Maresz, supra. That state’s courts apparently do not consider such claims too speculative. Given the level of proof this court has predicted Kentucky courts would require in order to establish harm from toxic exposure and the enhanced risk created thereby and to establish the necessity of future medical examinations, this court cannot discern the purpose for requiring a plaintiff to also be seeking compensation for present manifest physical injuries. The very essence of toxic exposure cases is the contention that physical injuries therefrom are presently indiscernible; instead the effects are latent. To require a plaintiff to assert a potentially nonviаble claim to recover for such presently indiscernible injuries in order to be able to assert a claim for future medical monitoring would amount to elevating form over substance.
For the reasons set forth in this memorandum opinion, it is ORDERED that the defendant’s motion to dismiss plaintiffs’ claims for medical monitoring as a matter of law be, and the same hereby is, OVERRULED and DENIED.
Notes
. This case involves interstate pollution because the alleged source of the pollution is situated in Kentucky while аll the plaintiffs are residents of Wayne County, West Virginia. The parties have agreed, and the court concurs, that in cases involving interstate pollution the substantive law of the state in which the source of the pollution is located governs common-law tort claims.
See International Paper Co. v. Ouellette,
. In materials submitted to the court after it had heard oral arguments on this motion, Ashland honed its position by asserting that not only should a plaintiff have to show a present injury but he or she should also have to be currently рrosecuting an action for compensation for such injury in order to recover future medical monitoring costs.
. In their post oral argument submissions to the court, plaintiffs assert that exposure itself to toxic substances is physical impact. Presumably their argument is that exposure causes subcellular changes which create an enhanced risk of future harm and that such subcellular changes are physical impact and physical injury.
. Plaintiffs, in post oral argument briefs to the courts, have asserted that the defendant convertеd the motion to one for summary judgment, Fed.R.Civ.P. 56, by submitting certain documentary evidence to the court at oral argument. Fed.R.Civ.P. 12(b). As a consequence, plaintiffs have themselves submitted materials outside the pleadings in order to show that genuine issues of material fact exist which preclude a grant of summary judgment.
However, the documents submitted by defendant's counsel during oral argument to the court were simply four sheets of paper which highlighted the salient points of counsel's argument. Suсh materials were nothing more than demonstrative aids, and like counsel’s statements themselves, are not evidence of facts. Because the issue before the court is purely one of law, the court sees no relevance to the materials submitted by plaintiffs’ counsel and has completely disregarded them in deciding this motion. Therefore, this Rule 12(b)(6) motion has not been converted to one for summary judgment.
.
Potter v. Firestone Tire & Rubber Co.,
.
Friends for All Children, Inc. v. Lockheed Aircraft Corp., 587
F.Supp. 180 (D.D.C.1984),
modified,
Schweitzer v. Consolidated Rail Corp.,
In
Morrissy,
the issue before the Appellate Court of Illinois was the рropriety of a trial court's refusal to certify a class.
. The United States District Court for the Western District of North Carolina applied the same reasoning when it refused to recognize a claim in any form for future medical monitoring.
Carroll v. Litton Systems, Inc.,
Civ. No. B-C-88-253,
. Long ago, the Kentucky Supreme Court, in discussing the term “injury”, said that "[a] legal injury must be a violation of some legal right, and is distinct in meaning from the damage that may flow from the injury ...
'injury' means a wrong or a tort,
and that ... may arise by nonfeasance or failure to perform a legal obligation or duty.”
Combs v. Hargis Bank & Trust Co.,
. This court in principle generally agrees with the authorities cited in this opinion which do not permit recovery of damages for so-called medical *538 monitoring rather than with those who do so. However, for the reasons stated in this opinion, this court feels itself well-nigh ineluctably constrained to predict that the Kentucky Supreme Court would permit recovery of such damages if that court was called upon to decide this issue raised herein.
