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Jul 29, 2019

Iowa Worker Fails to Tie Legionnaires’ Disease to Workplace

Where an Iowa claimant’s expert medical witnesses appeared to be unaware of the procedures followed by the employer to prevent contamination of its water supply, the commissioner could reasonably conclude that their medical opinions were entitled to less weight than those of the employer’s experts and also conclude that the claimant had failed to prove the required causal connection between his Legionnaires’ disease and the workplace, held an Iowa appellate court [McDonald v. EZ Payroll & Staffing Solutions, 2019 Iowa App. LEXIS 687 (July 24, 2019)]. The appellate court acknowledged that the deputy commissioner had sided with the claimant, but the court observed that in Iowa, it was within the commissioner’s authority to reconsider and modify issues on inter-agency appeal, since the commissioner’s reviews the case on a de novo basis.

Background

McDonald was hired by EZ Payroll, who assigned him to ALPLA, a plastic fabrication company. He began working there on August 20, 2012, cleaning molds used in the production of plastic bottles. As part of this process, McDonald used pressurized air to blow debris and water out of the molds, leading McDonald to get misted water droplets in his face. During the same period, McDonald was also working at Proctor & Gamble, where he swept the floors, cleaned public areas, and mopped floors. On August 27, McDonald was injured at ALPLA while attempting to catch a large cutting blade that had fallen from its sheath. He need surgery, which was scheduled for August 31. However, on August 31, McDonald had a fever when he reported for surgery and surgery was rescheduled.

On September 3, 2012, a neighbor looked in on McDonald and noticed he was ill and confused. McDonald was taken by ambulance to an emergency room and he was transferred to the intensive care unit where he underwent testing. McDonald was diagnosed with Legionnaires’ disease, pneumonia, respiratory failure, and a brain lesion that was thought to be secondary to Legionella. He sought workers’ compensation benefits, asserting his Legionnaire’s disease arose out of and in the course of his employment with ALPLA.

Expert Opinions

McDonald submitted the opinion of Dr. Stapleton, who opined that based on the history and the epidemiology and given the exposure to mists-sprays and mists of water at ALPLA, the most likely course of McDonald’s Legionella was the water mist at work.

ALPLA submitted the affidavit of its Environmental Health, and Safety Manager, who indicated that one of his responsibilities was to mitigate risks in order to prevent contaminants from entering ALPLA’s facility or interfere with its manufacturing process. He averred the water within the facility contained several additives to control microbes and bacteria and that ALPLA utilized a highly-controlled, closed-circuit water system chemically treated to control any biological issues. He noted that ALPLA had no reported cases of Legionella, pneumonia, or other related conditions.

Dr. McKinsey, an infectious disease specialist, reviewed the safety manager’s affidavit and opined that McDonald’s Legionnaire’s disease could not be attributed to exposure to water at ALPLA.

Deputy Commissioner and Commissioner’s Findings

As noted above, the deputy commissioner found in favor of McDonald, indicating the opinion of Dr. Stapleton, McDonald’s expert, was the most convincing. The commissioner reversed the ruling and found that McDonald had failed to prove causation for contracting Legionnaire’s disease. Specifically, the commissioner indicated that Dr. Stapleton and another of claimant’s experts—an occupational health physician—appeared to have been entirely unaware of the procedures followed by ALPLA to prevent contamination of the water supply. According to the record, indicated the commissioner, those experts had not been provided with such information. The commissioner, therefore, found their opinions to be unconvincing.

Appellate Court

Noting that it was within the power of the commissioner to review the case on a de novo basis, the appellate concluded that substantial evidence supported the commissioner’s findings. The court acknowledged that this was a close case, but noted ALPLA’s evidence referenced the efforts made to mitigate risks of contaminants in the water at ALPLA and the fact that McDonald’s experts were unaware of those efforts. The commissioner determined that this was crucial information and therefore concluded that ALPLA’s experts were entitled to more weight than those presented by McDonald.