821 N.E.2d 580 | Ohio Ct. App. | 2004
Lead Opinion
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[EDITORS' NOTE: THIS PAGE CONTAINS HEADNOTES. HEADNOTES ARE NOT AN OFFICIAL PRODUCT OF THE COURT, THEREFORE THEY ARE NOT DISPLAYED.] *621 {¶ 1} Linda Valentine appeals the trial court's summary judgment in PPG Industries Ohio, Inc.'s favor and various discovery orders. She contests the court's determination that she failed to establish a right to participate in the workers' compensation system for the death of her husband, David Valentine ("Valentine"). Specifically, she asserts that the court improperly found her experts' opinions regarding proximate cause to be unreliable and, thus, inadmissible. Without expert testimony, the court concluded that no genuine issue of material fact remained concerning whether Valentine's workplace exposure to various toxic substances proximately caused his brain cancer (glioblastoma multiforme) and subsequent death.
{¶ 2} She presents four arguments to support her contention that the court incorrectly determined that no genuine issue of fact exists regarding proximate cause: (1) the court failed to consider her three experts' affidavits, (2) the court wrongly concluded that her medical experts' opinions were unreliable and inadmissible, (3) the court improperly determined that her experts' testimony did not show general causation between the decedent's brain tumor and his exposure to carcinogens in the workplace, and (4) the court imposed an incorrect standard of causation under the workers' compensation statute to determine whether a claimant can establish an occupational disease.
{¶ 3} Initially, we conclude that the trial court properly applied traditional tort standards of proximate cause in analyzing the connection between workplace exposure and the occurrence of an occupational disease. Accordingly, we reject the appellant's contention that in order to establish causation, a worker need only establish that a workplace exposure increased the risk of contracting a disease above that of the general population. Furthermore, after carefully reviewing the legal landscape concerning the reliability of expert testimony and the scientific literature that formed the basis of her experts' opinions, we conclude that the trial court did not abuse its discretion by rejecting this testimony. Without their *622 opinions, appellant possessed no evidence to establish that Valentine's workplace exposure to toxic substances caused his brain tumor. Thus, appellant's failure to show proximate cause as an element of her workers' compensation claim is fatal to her claim, and the trial court appropriately entered summary judgment in PPG's favor. Because her remaining arguments are moot, we affirm the trial court's decision.
{¶ 5} In November 1999, Mrs. Valentine filed a claim for death benefits with the Bureau of Workers' Compensation. She claimed that Valentine's exposure to a toxic brew of chemicals throughout his career at PPG caused him to contract the glioblastoma multiforme that led to his death. Ultimately, the bureau denied the claim.
{¶ 6} In August 2000, Mrs. Valentine filed an administrative appeal in the common pleas court. After lengthy and contentious discovery, PPG filed a summary judgment motion, arguing that no genuine issues of material fact existed concerning whether Valentine's work environment proximately caused his brain tumor. Appellee insisted (1) that the opinions of appellant's experts (Drs. Miner and Newton and industrial hygienist Norman Brusk) were inadmissible because they were not scientifically reliable and (2) that without these opinions, appellant had no evidence regarding proximate cause. Appellee contended that the experts' testimony was unreliable because no scientific discipline has established that a specific chemical agent or combination of chemical agents can cause a brain tumor in humans. The trial court agreed and concluded that without their testimony, no genuine issue of material fact remained regarding proximate cause, so the court granted PPG summary judgment.
{¶ 7} Mrs. Valentine timely appealed the trial court's judgment and raises the following assignments of error: *623
First Assignment of Error. It was an abuse of discretion for the trial court to grant appellee's motion for summary judgment without examining and analyzing the affidavit evidence of appellant's three experts.
Second Assignment of Error. The trial court erred in holding that the opinions of appellant's medical experts were unreliable and therefore inadmissible pursuant to Rule 702.
Third Assignment of Error. The trial court erred in ruling as a matter of law that appellant's experts failed to establish general causation between David Valentine's exposure to carcinogens in his workplace and the development of his brain tumor.
Fourth Assignment of Error. The trial court erred in its assessment of the proof necessary to establish an occupational disease as defined by the workers' compensation statute.
Fifth Assignment of Error. The trial court erred in limiting appellant's discovery on the following matters:
A. Failure to order suspension of the appellee's "retention of records policy" so as to prevent destruction of relevant documents.
B. Limitation on production of exposure records, air sample tests, and ventilation records to only those records taken in the laboratories rather than the production areas.
C. Failure to order appellee to release patent information for materials manufactured during David Valentine's employment.
D. Denial of appellant's request for production of e-mail communications and any other written communications from the appellee's research and development department in Pennsylvania to appellee's industrial hygienists.
E. Denial of appellant's request for review of OSHA and EPA records pertaining to the operation of appellee's Circleville plant.
F. Failure of the court to order the completion of depositions of appellee's industrial hygienists, Lewis Jordan and Nick Cleary, to answer questions on the presence of a risk of cancer from chemicals in the appellee's workplace.
G. Failure of the court to order the release of the ENSR computerized data and imposition of a ten-day time limit for the appellant to commit to full payment of unspecified expenses.
H. Failure of the court to require the appellee to provide affidavits that identify the appropriate individuals with the corporation that carried out discovery searches and to document what efforts have been taken to find the documents ordered released. *624
{¶ 9} As a prelude to addressing appellant's contention that the trial court applied an improper legal standard of causation, we set forth some general principles governing summary judgment proceedings and the workers' compensation statutes.
{¶ 12} Although a court must liberally construe the workers' compensation laws in favor of the injured employee, a court may not "`read into the statute something which cannot reasonably be implied from the language of the statute.'" Phillips v.Borg-Warner Corp. (1972),
{¶ 13} R.C.
{¶ 15} In order to demonstrate that the employee contracted the disease while in the course of employment, the employee must prove that the occupational disease proximately resulted from employment. See State ex rel. Ohio Bell Tel. Co. v. Krise,
{¶ 16} "The proximate cause of an event is that which in a natural and continuous sequence, unbroken by any new, independent cause, produces that event and without which that event would not have occurred." Aiken v. Indus. Comm. (1944),
{¶ 17} To prove the proximate cause of a medical condition, here, a brain tumor, expert medical testimony ordinarily is necessary. See, e.g., Darnell v. Eastman (1970),
{¶ 18} Appellant cites Olinger v. Pretty Products, Inc. (Nov. 7, 1997), Coshocton App. No. 96-CA-29, as support for her argument that the burden of proof regarding causation in tort cases is not applicable to an occupational-disease claim in the workers' compensation context. In Olinger, the court stated: "Throughout its brief, appellant consistently misstates the law in Ohio concerning the of a [sic] cause of action for recovery of workers' compensation benefits for an occupational disease. Appellant cites cases concerning proof of causation in a tort action. The instant action is not based on tort. An occupational disease is compensable under R.C.
{¶ 19} Based on Ohio's unique statutory scheme, the Olinger
court went further and rejected the requirement that a claimant must establish both general and specific causation in order to participate in the fund. Unfortunately, Olinger is neither persuasive nor controlling in light of the Ohio Supreme Court's pronouncement that the definition and principles governing proximate cause in tort actions are equally applicable in workers' compensation cases. Murphy,
{¶ 20} Appellant construes the statutory requirement that a claimant must establish a risk of contracting a disease that is greater that that of the public generally as a liberalized causation standard. We disagree. The requirement dealing with comparative risk is simply a necessary predicate to participation in the worker's compensation system; it is a definitional component of the term "occupational disease" that is intended to ensure that the injury to be compensated is truly workplace-related. The Supreme Court's ruling in Murphy negates the contention that it is intended to abrogate the standard principles of proximate cause that require proof of both general and specific causation within a reasonable degree of expert certainty. While we concede that appellant's argument is *628 appealing, we cannot adopt it in light of Murphy.2 Appellant's fourth assignment of error is meritless.
{¶ 22} The trial court has broad discretion in determining the admissibility of expert testimony, and we may reverse only if the trial court abused its discretion. See Kumho Tire Co. v.Carmichael (1999),
{¶ 23} In general, courts should admit expert testimony whenever it is relevant and satisfies Evid.R. 702. State v.Nemeth (1998),
{¶ 24} In performing its gatekeeping function, the trial court's starting point should be Evid.R. 702, which provides that a witness may testify as an expert if all of the following apply: "(A) The witness' testimony either relates to matters beyond the knowledge or experience possessed by lay persons or dispels a misconception common among lay persons; (B) The witness is qualified as an expert by specialized knowledge, skill, experience, training, or education regarding the subject matter of the testimony; (C) The witness' testimony is based on reliable, scientific, technical, or other specialized information. To the extent that the testimony reports the result of a procedure, test, or experiment, the testimony is reliable only if all of the following apply: (1) The theory upon which the procedure, test, or experiment is based is objectively verifiable or is validly derived from widely accepted knowledge, facts, or principles; (2) The design of the procedure, test, or experiment reliably implements the theory; (3) The particular procedure, test, or experiment was conducted in a way that will yield an accurate result."
{¶ 25} Here the issue is whether appellant's experts' testimony "is based on reliable scientific, technical, or other specialized information." (Emphasis added.) Evid.R. 702(C). In general terms, the reliability of an expert's opinion depends upon (1) the validity of the underlying theory, (2) the validity of the technique used to apply that theory, and (3) the proper application of the technique on a particular occasion. InDaubert the United States Supreme Court identified a series of specific reliability inquiries that apply in the context of the "hard" or quantitative sciences. These factors include (1) whether a theory or technique can be and has been tested, (2) known error rates, (3) peer review and publication, and (4) general acceptance in the field.
{¶ 26} The court made it clear in Kumho Tire Co. that the reliability analysis adopted in Daubert for scientific experts also applied to experts with other types of technical or specialized knowledge. But it is critical to realize that the analysis of reliability is flexible and its indicators may vary from discipline to discipline. Daubert,
{¶ 27} In order to determine reliability, a court must assess whether the reasoning or methodology underlying the testimony is valid. Miller,
{¶ 28} A court resolving a reliability question should consider the "principles and methods" the expert used "in reaching his or her conclusions, rather than trying to determine whether the conclusions themselves are correct or credible." Nemeth,
{¶ 29} A trial court may not, therefore, exclude expert testimony simply because it disagrees with the expert's conclusions. Instead, if the expert followed *631
methods and principles deemed valid by the discipline to reach his opinion, the court should allow the testimony. See Paoli,
{¶ 30} In addition to being scientifically or technically reliable, expert testimony also must "fit" the case at hand; that is, the testimony must be "`relevant to the task at hand' in that it logically advances a material aspect of the proposing party's case." Daubert,
{¶ 31} In Cavallo v. Star Ent. (E.D.Va. 1995),
{¶ 32} Thus, an expert's opinion would not fit if sources relied upon by the expert did not actually support the expert's opinion. As the Paoli court more specifically explained: "[A]nimal studies may be methodologically acceptable to show that chemical X increased the risk of cancer in animals, but they may not be methodologically acceptable to show that chemical X increases the risk of cancer in humans. Daubert explains that `"[f]it" is not always obvious, and scientific validity for one purpose is not necessarily scientific validity for other, unrelated purposes.' Id. [509 U.S.] at 591 [
{¶ 33} In cases alleging that chemical exposure caused a plaintiff to contract cancer, the question whether the expert's testimony regarding general causation is reliable, or fits, looms large. This is so because in most cases, the only thing that scientists know for certain about the causes of cancer is the limited nature of their knowledge. See Michael D. Green, Expert Witnesses and Sufficiency of Evidence in Toxic Substances Litigation: The Legacy of Agent Orange and Bendectin Litigation (1992), 86 N.W.U.L.Rev. 643, 644, quoting Environmental DefenseFund v. Environmental Protection Agency (C.A.D.C. 1978),
{¶ 34} Nonetheless, in attempting to show that a chemical substance can cause a particular medical condition (general causation), the expert ideally proceeds in "a stepwise fashion." Federal Judicial Center, Reference Manual on Scientific Evidence (2000) 468. "In the first step the physician must establish the characteristics of the medical condition. Second, he or she carefully defines the nature and amount of the environmental exposure. The third step is to demonstrate that the medical and scientific literature provides evidence that in some circumstances the exposure under consideration can cause the outcome under consideration. This step is synonymous with establishment of general causation. As part of this step, the clinician attempts to establish the relationship between dose and response, including whether thresholds exist, ultimately defining the clinical toxicology of the exposure. The fourth step is to apply this general knowledge to the specific circumstances of the case at hand, incorporating the specifics of exposure, mitigating or exacerbating influences, individual susceptibilities, competing or synergistic causes, and any other relevant data." (Footnotes omitted.) Id. at 468-470.
{¶ 35} Because of the limitations of hard scientific knowledge, especially about the causes of cancer, experts commonly extrapolate from existing data. Extrapolation is a valid expert technique when properly performed and explained. "But nothing in either Daubert or the Federal Rules of Evidence requires a district court to admit opinion evidence that is connected to existing data only by the ipse dixit of the expert. A court may conclude that there is simply too great an analytical gap between the data and the opinion proffered." Gen. Elec. Co. v. Joiner
(1997),
{¶ 36} Several types of improper extrapolation commonly appear, "including extrapolating (1) from a structure analysis for similar compounds, (2) that a substance that causes one type of harm also causes a different type of harm, (3) upon the basis of methodology that is transposed from one area of inquiry to a completely different one, (4) from epidemiological studies with different exposures, and (5) when data regarding the plaintiff's exposure is unknown." (Footnotes omitted.) Judge Harvey Brown, Eight Gates for Expert Witnesses (1991), 36 Hous.L.Rev. 743 at 811, citing Capra, 32 Ga.L.Rev. 699, supra. *634
{¶ 39} While epidemiological studies can be "powerful evidence of causation," their absence "is not fatal to a plaintiff's case." Rider v. Sandoz Pharmaceuticals Corp. (C.A.11, 2002),
{¶ 40} However, extrapolating from epidemiological studies may not always be proper. See, generally, Joiner,
{¶ 41} The existence of an epidemiological study alone does not make expert testimony fit a plaintiff's case. "[A] claimant must do more than simply rely on epidemiological studies that show a substantially elevated risk. A claimant must show that he or she is similar to those in the studies. This would include proof that the injured person was exposed to the same substance, that the exposure or dose levels were comparable to or greater than those in the studies, that the exposure occurred before the onset of injury, and that the timing of the onset of injury was consistent with that experienced by those in the study." Merrell DowPharmaceuticals, Inc. v. Havner (1997),
{¶ 42} In reaching their causation opinions here, appellant's experts relied on epidemiological studies "suggestive" of a link between various chemical exposures and glioblastoma multiforme. However, none of the epidemiological studies concerned the same industry in which Valentine worked, and, more important, none of the studies could identify a chemical or group of chemicals that caused the brain tumor excess. Thus, extrapolation produced unreliable results because none of the epidemiological studies the appellant's experts relied upon could conclusively identify the cause of the brain tumor excess. See Bragdon v. Abbott
(1998),
{¶ 44} In Joiner, the court considered the reliability of an expert's opinion when the expert relied on animal studies to reach a causation opinion. The court noted: "The studies involved infant mice that had developed cancer after being exposed to PCB's. The infant mice in the studies had had massive doses of PCB's injected directly into their peritoneums or stomachs. Joiner was an adult human being whose alleged exposure to PCB's was far less than the exposure in the animal studies. The PCB's were injected into the mice in a highly concentrated form. The fluid with which Joiner had come into contact generally had a much smaller PCB concentration of between 0-to-500 parts per million. The cancer that these mice developed was alveologenic adenomas; Joiner had developed small-cell carcinomas. No study demonstrated that adult mice developed cancer after being exposed to PCB's. One of the experts admitted that no study had demonstrated that PCB's lead to cancer in any other species."Joiner,
{¶ 45} The Joiner court concluded that "[t]he studies were so dissimilar to the facts presented in this litigation that it was not an abuse of discretion for the District Court to have rejected the experts' reliance on them." Id.
{¶ 46} Here, appellant's experts have not sufficiently explained what enables them to extrapolate from the animal studies to humans. Moreover, the chemical exposures in the animal studies did not cause brain tumors to develop across *637
species. See Allen,
{¶ 48} Therefore, the trial court did not abuse its discretion in finding that Dr. Miner's reliance on his experience, including his observation of workers in the petroleum industry, does not sufficiently demonstrate the reliability of his opinion.
{¶ 50} Moreover, "substances are regulated because of what they might do at given levels, not because of what they will do." Wiley, supra fn. 1, Section
{¶ 52} Differential diagnosis6 can be a valid expert technique. See Hardyman v. Norfolk W. Ry. Co. (C.A.6, 2001),
{¶ 53} However, differential diagnosis alone does not always establish proximate cause, particularly when general causation evidence is lacking. "The process of differential diagnosis is undoubtedly important to the question of `specific causation.'"Cavallo,
{¶ 54} For example, in Cavallo, the plaintiff's expert used differential diagnosis to opine that the plaintiff's exposure to jet fuel caused her respiratory problems. However, the plaintiff presented no reliable evidence that jet fuel fumes could, in fact, cause such respiratory problems. See, also, Raynor v.Merrell Pharmaceuticals, Inc. (C.A.D.C. 1997),
{¶ 55} Compare Cavallo with Westberry, where the court found the expert's differential diagnosis reliable to prove causation when general causation already had been established. The court noted that "it was undisputed that inhalation of high levels of talc irritates mucous membranes." Westberry,
{¶ 56} Here, the cause of brain tumors is largely unknown (except for ionizing radiation). To state that nothing else caused the brain tumor is contrary to the medical and scientific fact that the cause of brain tumors is unknown. At this point, medical science does not enable physicians and other scientists to pinpoint a cause of brain cancer (except for ionizing radiation). Both Dr. Miner and Dr. Newton readily acknowledged the current status of medical and scientific knowledge in their depositions. Thus, under the circumstances of this case the trial court did not abuse its discretion in concluding that differential diagnosis is not a reliable technique for identifying causation.
{¶ 58} Based upon the foregoing reasons, we overrule appellant's first through fourth assignments of error.
{¶ 60} In this case, any error that the trial court may have committed in ruling on discovery matters is harmless. Civ.R. 61 provides: "No error in either the admission or the exclusion of evidence and no error or defect in any ruling or order or in anything done or omitted by the court or by any of the parties is ground for granting a new trial or for setting aside a verdict or for vacating, modifying or otherwise disturbing a judgment or order, unless refusal to take such action appears to the court inconsistent with substantial justice. The court at every stage of the proceeding must disregard any error or defect in the proceeding which does not affect the substantial rights of the parties." See, also, Siuda v. Howard, Hamilton App. Nos. C-000656 and C-000687, 2002-Ohio-2292, 2002 WL 946188, at ¶ 21, citing Meyers v. Hot Bagels Factory, Inc. (1999),
{¶ 61} "`In determining whether a substantial right of a party has been affected, the reviewing court must decide whether the trier of fact would have reached the same decision, had the error not occurred.'" Prakash v. Copley Twp., Summit App. No. 21057, 2003-Ohio-642, 2003 WL 294365, quoting Moore v. Univ. of Akron
(Aug. 1, 2001), Summit App. No. 20320, 2001 WL 866274. "`Generally, in order to find that substantial justice has been done to an appellant so as to prevent reversal of a judgment for errors occurring at the trial, the reviewing court must not only weigh the prejudicial effect of those errors but also determine that, if those errors had not occurred, the jury or other trier of the facts would probably have made the same decision.'Hallworth v. Republic Steel Corp. (1950),
{¶ 62} In this case, had the trial court ruled in appellant's favor regarding the various discovery requests, none of the requested material would have helped appellant establish the reliability of her experts' testimony. Therefore, no prejudice resulted from the court's discovery rulings.
{¶ 63} Accordingly, we overrule appellant's fifth assignment of error and affirm the trial court's judgment.
Judgment affirmed.
PETER B. ABELE, J., concurs.
Concurrence Opinion
{¶ 64} I reluctantly concur in both the judgment and opinion. I believe that the principal opinion accurately sets forth the current state of the law concerning the admissibility of expert witness opinions. I am troubled, however, with the application of the law to the facts of this workers' compensation case.
{¶ 65} Appellant asserts that the trial court improperly applied general tort law principles to this workers' compensation case. The principal opinion rejects this argument, and I agree with this conclusion. Although courts must liberally construe workers' compensation laws in favor of employees (see R.C.
{¶ 66} The results in this particular case are unfortunate. This case involved Valentine's prolonged exposure to chemical toxins, not a traditional workplace injury that involved machinery or other types of easily recognizable injuries. I fear that the instant case may very well be a situation in which medical science and the law are not currently equipped to adequately resolve this controversy.7 In light of the fact that this matter is in the context of a workers' compensation case, I do not believe that a relaxed causation standard is unworkable or far fetched. This, however, is a matter that is beyond our reach and must be addressed by the Ohio Supreme Court. As an intermediate appellate court, we are obligated to follow Ohio Supreme Court decisions. *643
{¶ 67} I recognize that Daubert and Kumho Tire stand for the proposition that "junk science" has no place in our courtrooms. I, however, question whether the expert opinions elicited in this case should be placed in that category.
{¶ 69} Appellant retained three expert witnesses: Valentine's treating physicians at OSU hospital, Dr. Newton and Dr. Miner, and industrial hygienist Norman Brusk. Drs. Newton and Miner opined that Valentine's work environment, specifically his exposure to various toxic substances, proximately caused his brain tumor.
{¶ 70} Appellee retained two expert witnesses: Dr. Darrell A. Bigner and Charles R. Buncher, a professor of Biostatistics and Epidemiology in the Department of Environmental Health University of Cincinnati College of Medicine who testified favorably for PPG.
{¶ 72} Dr. Miner readily admitted, however, that medical science has not yet proven a known etiology for glioblastoma multiforme. He qualified this statement by explaining: "I believe it's very difficult to prove what would or wouldn't cause brain tumors. One thing that seems to have been well proven is ionizing radiation. I believe there's other things that certainly contribute to formation of tumors, but it's difficult to prove in people that they are the cause of them."
{¶ 73} Dr. Miner stated that he did not agree with PPG's expert, Dr. Bigner, that "the only known cause of primary brain tumors * * * [is] ionizing therapeutic radiation." Dr. Miner believed Dr. Bigner's opinion to be "an overly dogmatic statement; and taken in the context of everything else he says, I would have trouble agreeing with." He explained his disagreement with Dr. Bigner: "Well, after reading [Dr. Bigner's opinion], you conclude that nothing else contributes to causing — I would come to the conclusion that he thinks that nothing else contributes to the cause of brain tumors besides essentially bad luck, your parents' genes and ionizing radiation, and I don't think that's true."
{¶ 74} He cannot state within a reasonable degree of medical probability which specific chemical caused Valentine's glioblastoma. He cannot state which chemical or group of chemicals caused Valentine's glioblastoma.
{¶ 75} He thinks that benzene, acrylonitriles, ethylene oxide, and toluene can contribute to glioblastoma: "[E]xposure to them increases the chances of people developing brain tumors or glioblastoma multiforme." He believes that exposure to toluene increases the risk of glioblastoma. "[L]ong-term exposure to benzene I believe within a reasonable degree of medical probability enhances the likelihood that you'll develop a glioblastoma."
{¶ 76} Appellant's counsel questioned him: "[W]hen you consider the totality of Mr. Valentine's exposure to the range of chemicals identified in Mr. Brusk's report, this would be exposure both through air contact and dermal contact and under situations where strict safety standards were not being applied and that this exposure to the range of chemicals taking place over approximately a 30-year period, do you have an opinion based on a reasonable medical probability as to whether Mr. Valentine was exposed to a risk of developing cancer, including brain cancer, that was greater than the public as a whole because of his employment at PPG?"
{¶ 77} Dr. Miner answered: "I think assuming the things that you said are true from what I glean from the Brusk report, that he was at an increased risk of developing a malignant brain tumor than the general population." Dr. Miner opined that Valentine's tumor was related to his employment and his total *645 exposure to various chemicals, not that any one specific chemical or group of chemicals caused the brain tumor.
{¶ 78} To support his opinion, Dr. Miner relied upon (a) epidemiological studies, (b) animal studies, (c) his prior experience treating patients with brain tumors, and (d) differential diagnosis.
{¶ 84} Dr. Newton opined that Valentine contracted the glioblastoma multiforme as a result of the risks he was exposed to at PPG. Dr. Newton believes that there is a suspicious proximate relationship between PPG and Valentine's brain tumor. Dr. Newton also stated that Valentine's employment as a lab technician and environmental specialist presented a risk of developing brain cancer greater than the risk presented to the general population.
{¶ 85} Dr. Newton stated that he agreed with Dr. Bigner that ionizing radiation is the only proven cause of primary brain tumors, but emphasized that Dr. Bigner discussed proven causes. Dr. Newton stated: "[T]here are many things that could be related that have not been proven yet. They may be part of a multiple causation of cancer, which is typical in most cases. If you really have the cancer, it's often not just one thing, it's numerous things that are involved in the cancer causation. It's not typically a single proximate cause disease."
{¶ 86} Dr. Newton stated that he could not identify the "exact single proximate cause of [Valentine's] glioblastoma, but [he] suspect[ed] there are numerous proximate causes like there typically are in most of these cases." Dr. Newton also explained that he is "suspicious that [Valentine's] exposures over 28 years at PPG were part of that list of potential proximate causes." Dr. Newton stated that he could not name a specific chemical that caused Valentine's brain tumor, but thinks "it might have been generalized exposure to probably more than one of those chemicals over time that could have acted as a proximate cause or one of the proximate causes."
{¶ 87} Dr. Newton stated that he was, within reasonable medical probability, "suspicious that [Valentine's employment] was possibly one proximate cause that contributed to his brain tumor development." Dr. Newton explained that his use of the word "suspicious" meant "[m]ore likely than not." Dr. Newton opined that Valentine's death was more likely than not contracted as a result of risks he was *647 exposed to in his employment. Dr. Newton gave the following reasons underlying his opinion: "Because of such intense constant exposure over a long number of years, which is the way cancer is often thought to develop. With environmental carcinogens, it's often long-term constant exposure to different agents that we feel lends to the initiation and promotion of a tumor."
{¶ 88} In Dr. Newton's August 29, 2000 letter that he sent to appellant's counsel, he more specifically explained his opinion as follows: "The etiology of PBT remains unclear, but most investigators agree it is a combination of familial genetic loading and endogenous metabolic processes and, less importantly, environmental exposures. However, some recent literature would suggest that exposure to environmental agents accounts for 60-80% of sporadic cancers, including PBT. It is important at this point to note that Mr. Valentine did not have a particularly strong family history of cancer, although there was some on his mother's side. Environmental carcinogens are suspected of acting as promoters, more so than as initiators, in the multistep process of neurocarcinogens and brain tumor development. In humans, cancer development is a long-term process that often evolves over decades. Several types of chemicals have been implicated as neurocarcinogens in animals and humans, including triazenes, hydrazines, vinyl chloride, pesticides, and others. Vinyl chloride, in particular, has been implicated in numerous studies as a potential neurocarcinogen in the work-place. Epidemiological studies are fairly consistent that industrial workers given long-term exposure to the above chemicals have an increased incidence of, and elevated odds ratios for, developing a brain tumor. Mr. Valentine was exposed to many of the above chemicals, as well as many others, over a 30 year career at PPG Industries. Although I agree with Dr. Bigner that the only proven exogenous cause of a brain tumor in humans is irradiation, I do not agree with his assessment concerning long-term exposure to neurocarcinogens in the work-place. I feel that long-term exposure to neurocarcinogens can add to the lifetime risk of developing a brain tumor and that they add to the intrinsic risk a person has from familial genetic loading for cancer. Considering that Mr. Valentine did not have a strong family history for cancer and that he was exposed to several types of neurocarcinogens over a 30 year period, I feel it is quite likely that his occupation contributed to the development of his brain tumor. This is supported by the fact that his co-worker, Harold McConnaughy, also had a similar exposure pattern to neurocarcinogens and also died of a glioblastoma multiforme. I conclude that Mr. Valentine's employment at PPG Industries constituted a risk for developing cancer that was greater than the public as a whole and that the exposure to neurocarcinogens in the workplace contributed to his contraction of the brain tumor." *648
{¶ 89} In reaching his opinion, Dr. Newton relied upon scientific literature, animal studies, and epidemiological studies.
{¶ 92} He stated that the animal studies showing a neurocarcinogenic effect would make one "suspicious for having that same effect in people." He further explained, however, that "we don't know the dosing, we don't know how long they need to be exposed, we don't know the details of any of that stuff because those studies can't be done [in humans]." Thus, Dr. Newton opined that "it's hard to say" whether the animal studies show that a specific chemical proximately causes brain tumors in humans.
{¶ 95} Brusk stated: "It is my professional opinion that Mr. Valentine's particular employment as a laboratory technician and environmental specialist subjected him to a risk of developing cancer from both respiratory and skin contact with the numerous carcinogens identified above that was substantially different from and greater than the risk of developing cancer faced by workers in general and/or the public as a whole." Brusk based his opinion "not only on the specifically identified chemicals, but also on the cumulative effect of Mr. Valentine's long term exposures to many toxic chemicals."
{¶ 96} Brusk opined that Valentine had "unquantifiable, but significant exposures to cancer causing and potentially cancer causing chemicals. His exposures would be from inhalation of vapors and from absorption of chemicals directly though his unprotected skin. He may also have had exposure from the transfer of chemicals from his hands to food or to his mouth by wiping."
{¶ 97} He reviewed the epidemiological study "A General Mortality Study of Production Workers in the Paint and Coatings Manufacturing Industry." He does not believe that it "reflect[s] the situation of Mr. Valentine during his work career at PPG. The study was considerably too broad to isolate the laboratory personnel. They were lumped in, if included at all, with the general work population. Therefore if there were an increase in brain cancers for the laboratory personnel, it would not show up in the study."
{¶ 98} Brusk refers to other epidemiological studies that linked employment and brain cancer: "Case-Control Study of Intracranial Tumors Among Employees at a Petrochemical Research Facility" and "Cancer Incidence Among Employees at a Petrochemical Research Facility." He recognizes that neither study could identify a specific agent, but the study concluded that the "`patterns suggest that the brain cancer excess resulted from occupational exposures.'" He also referred to "The Hazard of a Chemical Laboratory Environment — A Study of the Mortality in Two Cohorts of Swedish Chemists." The study concluded: *650 "`An increase in mortality due to leukemias * * * and possibly brain tumors was observed. It is probable that employment in a chemical laboratory, and particularly in organic chemistry, is associated to some extent with the increase.'" He also referred to a study entitled "The Cancer Mortality Among Swedish Chemists Graduated During Three Decades." That study concluded: "`[T]his study supports the suggestions that chemical exposure is a cause of both leukemic and hematopoietic tumors and brain tumors and thus indicates the occupational hazards in chemical work.'" Brusk also noted that the study "Brain Cancer in Petrochemical Workers: A Case Series Report" concluded, "`The information available indicates that the number of brain tumors is excessive in a population of this size, and that the tumors are likely to be occupationally related.'" Brusk also referred to the study "Occupational Risk Factors for Brain Tumors Among Women in Shanghai, China," which concluded that brain cancer "`[r]isks were significantly elevated in occupations thought to entail exposure to organic solvents.'"
{¶ 99} In his affidavit, Brusk stated: "Based on my assessment of Mr. Valentine's workplace, the above studies, my experience as an industrial hygienist as well as a chemist, and the occurrence of clusters of brain cancers in chemical related fields, it is my professional opinion that Mr. Valentine had a higher risk of developing brain cancer because of his position as a laboratory technician than of employees in the general workforce and of the population as a whole."
{¶ 101} Dr. Bigner's thus opined: "[T]here are no reliable or reproducible epidemiological studies that show that more likely than not any chemical or environmental agent has caused or contributed to the development of primary brain tumors in humans." Therapeutic radiation "is the only known and established cause of primary brain tumors in humans." "It is my opinion to a reasonable degree of medical and scientific probability and certainty that David Valentine's condition was not caused by exposure to chemicals or environmental agents in his work place."
{¶ 102} Dr. Bigner stated: "Plaintiff's contention that Decedent David Valentine was at an increased risk of developing a malignant brain tumor than the general population, that he had an increased risk of developing malignant brain tumor secondary to the exposure to the chemicals at PPG, and that his tumor was related to his employment and exposure to chemicals is not supported by any peer-reviewed medical or scientific literature or data in this specific case. There is no medical or scientific basis to determine what caused David Valentine's glioblastoma, and there is no medical or scientific basis to conclude that Mr. Valentine's glioblastoma was caused by any exposures at PPG." *652
{¶ 104} Buncher stated: "Based upon my experience and review of the medical and scientific literature there are no scientifically reliable or reproducible epidemiological studies that establish any chemical or environmental agent as a cause of a glioblastoma multiforme. There are no epidemiological studies that demonstrate that there is a statistically significant association between a specific chemical or environmental agent (with the exception of ionizing radiation) and contraction of glioblastoma multiforme in humans."
{¶ 110} The study also states: "A detailed literature search for compounds inducing brain cancer has identified 26 different chemicals from experimental animal studies, as shown in Table VI. Review of available epidemiological studies provided in Table VII offers several intriguing clues, but little solid documentation for occupationally related brain tumors, except in the case of vinyl chloride. Recent mortality studies of oil refinery workers in Canada and petrochemical workers in Texas suggest the possibility of an excess of brain cancer risk among these groups, although no specific causative agent has yet been identified." The study also reported: "A comparison of experimental studies, epidemiological data, and the plant chemical inventory shows that vinyl chloride and diethyl sulfate are possible suspect agents for inducing brain cancer in these workers. On the basis of prior knowledge from human and animal studies, and its presence in the work environment under poorly controlled circumstances in the past, vinyl chloride must be the first compound considered. However, to date, examination of the *654 work histories of the 18 cases does not support a significant positive association with vinyl chloride exposure, and other agents must therefore be carefully evaluated. The information available indicates that this number of brain tumors is excessive in a population of this size, and the tumors are likely to be occupationally related. There is no good evidence so far to implicate non-plant, general environmental factors. A very careful and thorough investigation of this situation must be completed, since a previously unsuspected chemical exposure may be responsible for this striking appearance of brain cancers among workers in a single petrochemical plant."
{¶ 112} The court also denied appellant's request for an order compelling the completion of Louis Jordan's deposition. "The Court agrees with [appellee] that [appellant] is asking Mr. Jordan to testify regarding a risk analysis that is the subject of expert testimony and clearly beyond the scope of Mr. Jordan's qualifications to answer." *655
{¶ 113} The court denied appellant's request to order Nick Cleary to appear for redeposition and specifically order him to answer all questions regarding increased risk of injury from chemical exposure at PPG. The court found that based upon Cleary's affidavit, he is not able to answer appellant's counsel's question whether someone working in a chemical plant like PPG would have a risk of exposure to harmful chemicals greater than the general public. Cleary swears that he is not qualified by education or training to do a comparative analysis between the risk of exposure to harmful chemicals in a paint plant and the risk of exposure to harmful chemicals to the general public.
{¶ 114} The court denied appellant's request for transmittal packages, messages, e-mails, and any other forms of communication sent from the Research and Development Departments in Pennsylvania to the Circleville plant's Safety Department or industrial hygiene specialist, from 1969 through 1996. The court found that it was too broad and unduly burdensome.
{¶ 115} The court denied appellant's request for PPG to produce "all product analysis prepared by process engineers to document by-products given off in the manufacturing process as discussed in Nick Cleary's deposition of December 20, 2002 at page 52." The court found appellant's request "overly broad and unduly burdensome."
{¶ 116} The court found that it already addressed appellant's request for the production of all ventilation test results and all problem analysis and memorandum accompanying such testing procedures that are described by Ralph Copeland in his deposition. The court previously ordered PPG to produce all existing documents relating to air sample testing performed from 1969 to 1996 at the Circleville facility in the labs where Valentine worked, and to produce documents relating to engineering controls or any problem analysis concerning ventilation problems at the labs where Valentine worked.
{¶ 117} The court denied appellant's request for PPG to produce all engineering and architectural designs to document the ventilation function for all of the buildings where Valentine worked from 1969 to 1996.
{¶ 118} The court denied appellant's request for all patent information to identify chemical processes and all products manufactured at the Circleville facility from 1969 to 1996. The court found that appellant's request seeking all patent information for a 30-year period is overly broad, unduly burdensome, and ambiguous.
{¶ 119} The court denied appellant's request for disclosure of the volume of every raw product purchased by the Circleville facility from 1969 to 1996. The court found appellant's request for the total volume of every raw product used by PPG's facilities over approximately 30 years to be overly broad. *656
{¶ 120} The court denied appellant's request for all OSHA and EPA records for inspection. The court noted that in its June 12, 2002 entry, it ordered PPG to produce all existing accident and/or injury reports from 1969 to 1996 related specifically to chemical exposure at the Circleville facility in the labs where Valentine worked.
{¶ 121} The court denied appellant's request to order PPG to produce an affidavit from appropriate PPG employees who have carried out the search to obtain the requested document information. The court found that it had already instructed PPG to supply an affidavit verifying the nonexistence of the items that the court had ordered PPG to produce and that it claims do not exist.
{¶ 123} "The first such study involved workers at an Italian capacitor plant who had been exposed to PCBs. Bertazzi, Riboldi, Pesatori, Radice, Zocchetti, Cancer Mortality of Capacitor Manufacturing Workers, 11 American Journal of Industrial Medicine 165 (1987). The authors noted that lung cancer deaths among ex-employees at the plant were higher than might have been expected, but concluded that `there were apparently no grounds for associating lung cancer deaths (although increased above expectations) and exposure in the plant.' Id. at 172. Given that Bertazzi et al. were unwilling to say that PCB exposure had caused cancer among the workers they examined, their study did not support the experts' conclusion that Joiner's exposure to PCB's caused his cancer.
{¶ 124} "The second study followed employees who had worked at Monsanto's PCB production plant. J. Zack D. Musch, Mortality of PCB Workers at the Monsanto Plant in Sauget, Illinois (Dec. 14, 1979) (unpublished report), 3 Record, Doc. No. 11. The authors of this study found that the incidence of lung cancer deaths among these workers was somewhat higher than would ordinarily be expected. The increase, however, was not statistically significant and the authors of the study did not suggest a link between the increase in lung cancer deaths and the exposure to PCB's.
{¶ 125} "The third and fourth studies were likewise of no help. The third involved workers at a Norwegian cable manufacturing company who had been exposed to mineral oil. Ronneberg, Andersen, Skyberg, Mortality and Incidence of Cancer Among Oil-Exposed Workers in a Norwegian Cable Manufacturing Company, 45 British Journal of Industrial Medicine 595 (1988). A statistically significant increase in lung cancer deaths had been observed in these workers. The study, however, (1) made no mention of PCB's and (2) was expressly limited *657
to the type of mineral oil involved in that study, and thus did not support these experts' opinions. The fourth and final study involved a PCB-exposed group in Japan that had seen a statistically significant increase in lung cancer deaths. Kuratsune, Nakamura, Ikeda, Hirohata, Analysis of Deaths Seen Among Patients with Yusho — A Preliminary Report, 16 Chemosphere, Nos. 8/9, p. 2085 (1987). The subjects of this study, however, had been exposed to numerous potential carcinogens, including toxic rice oil that they had ingested." Joiner,