In re Canavan12/1/1999
Suffolk.
September 9, 1999.
Workers' Compensation Act, Expert opinion, Proximate cause. Evidence, Expert opinion, Competency. Witness, Expert. Multiple Chemical Sensitivity.
Appeal from a decision of the Industrial Accident Reviewing Board.
The principal issue in this case is the admission in evidence of the opinions of the employee's medical expert on diagnosis, disability, and causation. The self-insurer, Brigham and Women's Hospital, claims that this evidence, under the test set forth in Daubert v. Merrell Dow Pharmaceuticals, Inc., 509 U.S. 579 (1993), and adopted by our Supreme Judicial Court in Commonwealth v. Lanigan, 419 Mass. 15, 26 (1994), should not have been admitted by an administrative Judge (judge) in a worker's compensation hearing to determine the self-insurer's request to discontinue compensation and the employee's request for payment of various medical expenses. Based on the testimony of the employee and her medical expert, the Judge ordered the insurer to pay medical expenses incurred by the employee under G. L. c. 152, Sects. 13 and 30, and denied the self-insurer's request to discontinue compensation. The Judge's decision was summarily affirmed by the Department of Industrial Accidents Reviewing Board (board), and the self-insurer filed this appeal.
The employee is a registered nurse. In September, 1983, she went to work as a staff nurse in the recovery room at Brigham and Women's Hospital (hospital). In July, 1990, she became an operating room nurse at the hospital. During her employment in the operating room, the employee was exposed to various chemicals such as ethylene oxide, formaldehyde, diesel fuel, and other chemicals used in cleaning solutions. On August 6, 1993, she worked a ten-hour shift in operating room sixteen. At the end of her shift on that day, she experienced a severe headache and nasal stuffiness. When she awoke the following morning, she had a fever, her nose was red, and her right cheek was swollen. She was seen by a physician at the hospital on August 9, 1993, who confirmed those conditions. The physician prescribed antibiotics. She was diagnosed as suffering from chronic sinusitis and was considered disabled. The self-insurer accepted her medical condition as work related and has been paying workers' compensation to date.
The employee was examined by Dr. LaCava in June, 1994. He is certified in pediatrics by the American Board of Medical Specialties and certified in environmental medicine by the American Board of Environmental Physicians, which is not recognized by the American Board of Medical Specialties. Dr. LaCava took a history from the employee, performed a physical examination, and conducted a number of diagnostic tests. In his opinion, the employee suffers from arthritis, paresthesias, organic brain syndrome, chemical induced headaches, immunodeficiency, and multiple chemical sensitivities secondary to chemical poisoning at the hospital. He defines multiple chemical sensitivity as a "systemic reaction of the body with multiple symptoms to multiple kinds of chemicals, which may be chemically unrelated, which are commonly present in the every day working and living environment where that environment has not been meticulously cleaned up and had the chemical sources removed." In Dr. LaCava's opinion, the employee's medical condition is directly caused by the multiple chemicals that she has been exposed to at the hospital during the course of her employment and renders her totally disabled. For the treatment of her medical condition, Dr. LaCava has prescribed intravenous infusions of multi-vitamins, in particular vitamin C, oral nutrient supplements, antibiotics, and heat and sauna therapy.
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