Court rules against Capital Region Medical Center

Hospital owes worker's comp, death benefits to employee's family

Last week, the Missouri Court of Appeals in Kansas City ordered Capital Region Medical Center to pay Dorothy Smith, Jefferson City, more than $12,746 in burial and temporary total disability benefits, as well as weekly death benefits of $675.90.

The issue was workplace exposure to hepatitis C.

The appeals court's ruling Tuesday upheld payment amounts previously ordered by Missouri's Labor and Industrial Relations Commission. And last week's order was the second in a case that's continued for nearly nine years.

In March 2013, a different appeals panel sent the case back to the commission, saying the wrong legal standards were used in denying the Smiths' benefits claims.

"In "Smith I,' we held that (Mrs.) Smith was not required to present evidence of specific exposure to an occupational disease in the workplace; rather, she was required to submit medical evidence establishing a "probability' that working conditions caused the disease," Judge Gary D. Witt wrote for the three-judge panel that issued the new order.

The legal battle was based on Stephen Smith's more than 36 years as a medical laboratory technician for Capital Region and its predecessors.

After starting in 1969, Smith retired in March 2006 and, a month later, filed a Worker's Compensation claim for occupational disease, saying he contracted hepatitis C as a result of his exposure to it through his lab work.

He died Feb. 27, 2007, with hepatitis C listed as one of the causes of his death.

One of the hospital's arguments has been the Smiths never showed any Hep C patients had been treated at Capital Region while the Smiths worked there. (A registered nurse, Dorothy Smith was allowed to replace her husband as the claimant in the battle for benefits.)

But, both appeals court rulings have said the law in effect when Stephen Smith likely was exposed to the disease - or when his doctor first alerted him "to the possibility that his hepatitis C may have been contracted from his work at Capital Region on Dec. 5, 2005" - did not require proof of a direct connection between a job and a disease.

The appeals court's 20-page ruling last week noted that Dorothy Smith's expert in the case testified by deposition that Stephen's work for Capital Region was "more likely than not the cause of him contracting hepatitis C and that his work was the prevailing factor in causing him to develop hepatitis C." The expert saidl he likely contracted the disease by needle stick or by handling blood and bodily tissue.

The deposition noted Smith had worked for many years handling blood and body products at Capital Region before the health care industry began to pay attention in the mid-1990s to the risks from blood-borne pathogens.

The hospital's expert filed a report indicating Smith likely got the disease from a 1970 blood transfusion during emergency surgery following a hunting accident.

Several other hospital and medical groups - including SSM Health Care (St. Mary's), BJC Health Care, St. Luke's Health System Inc. HCA Midwest Health Care, the Missouri Self-Insurers Association, the Missouri Hospital Association and the National Federation of Independent Business - filed a "friends of the court" brief arguing the commission's award would "adversely impact these employers by expanding their workers' compensation occupational disease exposure far beyond its current parameter."

Capital Region could appeal the case to the state Supreme Court or ask the appeals court for another hearing.