Monday, October 1, 2018

Maryland Court of Special Appeals Reviews Occupational Diseases

Baltimore County v. Michael Quinlan, No. 319, Sept. Term 2017 

            The Maryland Court of Special Appeals recently held that an employee presented sufficient evidence at trial to establish that the degenerative menisci tears he suffered were an occupational disease for which he may recover under the Labor & Employment Article § 9-502(d)(1)(i) of the Maryland Code.
            Michael Quinlan (“Quinlan”) filed a claim with the Workers’ Compensation Commission, alleging that he developed meniscal tears in his right knee due to his job duties as a paramedic/firefighter.  After a hearing, the Workers’ Compensation Commission determined that  Quinlan did not sustain an occupational disease arising out of, and in the course of, employment.  Quinlan appealed.

            The matter went before a jury in the Circuit Court for Baltimore County.  There, Quinlan testified that he worked for the Baltimore County Fire Department as a paramedic for twenty-four (24) years.  That job required Quinlan to work long shifts, in which there were between 26-30 calls per day.  During those calls, Quinlan often had to kneel, and when he did so, he knelt down on his right knee.  In 2005, Quinlan injured his right knee while assisting a patient at work.  In 2014, Quinlan returned to his doctor for further knee problems.  The doctor found tears in Quinlan’s medial and lateral menisci.  Quinlan underwent a partial meniscectomy, and then returned to work.

            Quinlan called Dr. Barbara Cochran (“Dr. Cochran”), a specialist in internal medicine, occupational medicine, psychiatry, and pulmonary medicine, to testify.  Dr. Cochran explained that tears of the menisci, as Quinlan suffered from, are part of the continuum of osteoarthritis, and that osteoarthritis is a cumulative injury.  Dr. Cochran further explained that understanding a patient’s job functions, shift work, and whether he or she takes breaks is vital to forming a reliable opinion relating to osteoarthritis.  Dr. Cochran also testified that medical literature showed that in general,  more physically demanding jobs and people who do more squatting and kneeling are at a greater risk for osteoarthritis and problems in their knees.  Finally, Dr. Cochran testified that Quinlan’s essential job functions, which included repetitive kneeling, bending, and stress on the knee, are the causes of Quinlan’s osteoarthritis.

            Baltimore County called orthopedic surgeon, Dr. Richard Hinton (“Dr. Hinton”) to testify.  Dr. Hinton performed an independent medical examination of Quinlan and found Quinlan to have a previous partial meniscectomy, lateral meniscectomy, early arthritis in the medial side of the knee, and mild arthritis behind the knee cap.  Dr. Hinton, however, claimed he could not relate the meniscus tears directly to Quinlan’s job because there were no specific incidents or cumulative symptomatic episodes on the job.  Dr. Hinton agreed that the medical literature showed that people in more physically demanding jobs and people who do more squatting and kneeling have a greater risk of osteoarthritis and problems in their knees.  In Dr. Hinton’s opinion, however, the medical research did not yet explain why that portion of the population was more at risk, but he speculated that it could be limited to more definable injuries, less access to health care, smoking, or weight.  Finally, Dr. Hinton described Quinlan’s occupational injury as a potential or arguable cause of his arthritis, though not the primary cause.

            The jury returned a verdict in favor of Quinlan.  Baltimore County appealed, arguing that both doctors’ testimonies made clear that osteoarthritis and degenerative knee tears are not diseases inherent in Quinlan’s employment, but rather, are diseases of life.  Baltimore County further argued that a disease cannot be occupational if it is wide spread in the population and is not inherent to the occupation.

            Quinlan countered arguing that the proper analysis is not whether a disease is labeled occupational or not, but rather if the basic job responsibilities exposed an individual to conditions that could lead to the disease.  Quinlan did not dispute that there were potentially other causes in addition to his work that could have led to his diagnosis because, by law, there can be more than one cause for the degenerative tears as long as his work contributed in part. 

            The Court of Special Appeals found that Quinlan presented sufficient evidence to prove that his menisci tears were an occupational disease.  The Court of Special Appeals further indicated that Baltimore County did not preserve its legal argument that Quinlan’s injuries were injuries of life.  Even if Baltimore County did preserve the argument, the Court of Special Appeals indicated that it would not find the argument convincing because it is the risk factors, not the disease, that must inhere in the nature of the employment.  Therefore, the judgment was affirmed.

-Ashley Bond, Associate Attorney