Title: Ford Motor Co. v. Boomer

State: virginia

Issuer: Virginia Supreme Court

Document:

Present:  Kinser, C.J., Lemons, Millette, Mims, McClanahan, and 
Powell, JJ., and Koontz, S.J. 
 
FORD MOTOR COMPANY 
 
v. 
Record No. 120283 
 
WALTER E. BOOMER, ADMINISTRATOR 
 
 
 
 
 
 
 
 
 OPINION BY 
 
 
 
 
 
 
  JUSTICE LEROY F. MILLETTE, JR. 
 
 
 
 
 
 
 
   January 10, 2013 
HONEYWELL INTERNATIONAL, INC. 
 
v. 
Record No. 120299 
 
WALTER E. BOOMER, ADMINISTRATOR 
 
FROM THE CIRCUIT COURT OF ALBEMARLE COUNTY 
Cheryl V. Higgins, Judge 
 
These paired appeals arise out of a jury verdict against 
Honeywell International Incorporated1 and Ford Motor Company for 
the wrongful death of James D. Lokey, caused by mesothelioma 
resulting from exposure to asbestos in dust from Bendix brakes 
installed in Ford and other vehicles. 
On appeal, Ford assigns error to:  (1) the circuit court's 
jury instructions as to causation; (2) its admission of 
plaintiff's expert testimony; (3) the finding of evidence 
sufficient to show that Ford's failure to warn was the 
proximate cause of the harm; and (4) the finding of evidence 
sufficient to show proximate cause despite a more likely 
                     
1 Honeywell, the successor-in-interest to Bendix, is 
referred to herein as Bendix. 
 
2 
alternative.  Bendix echoes the first three arguments.  For the 
reasons stated herein, we reverse and remand. 
I.  Background 
 
Lokey was diagnosed with mesothelioma, a malignant cancer 
of the pleura of the lungs, in 2005.  He passed away in 2007 
due to complications related to his disease.  Lokey testified 
at trial via a de bene esse deposition taken prior to his 
death.  His son-in-law, Walter Boomer, is the Administrator of 
his estate.  The relevant facts as presented at trial were as 
follows: 
Lokey served as a Virginia State Trooper for 30 years.  
Beginning in 1965 or 1966, for approximately seven and a half 
to eight years, his duties required that he observe vehicle 
inspections wherein mechanics used compressed air to blow out 
brake debris (dust) to allow for a visual inspection of the 
brakes.  Lokey testified that, during these years, he observed 
vehicle inspections in approximately 70 garages a month, for 
five to six hours a day, ten days each month.  Lokey testified 
to standing within ten feet of the inspectors who were blowing 
out brake linings with compressed air, and that these blow outs 
were a fairly common practice in inspections at the time.  He 
also recalled breathing in visible dust in the garages, which 
to his knowledge had no specialized ventilation systems.  He 
 
3 
testified that he was not provided protective clothing or masks 
or warned that breathing brake dust was harmful to his health. 
Lokey testified that his rotations included supervising 
inspections at a Ford dealership and that he was sure he was 
present when this process was being done on Ford cars.  Due to 
the time period in which he inspected cars, he testified that 
the vast majority of the cars being inspected at the garages he 
visited were American-made cars.  He also specifically 
remembered Oldsmobile dealers on his rotation.  He testified 
that the garages he visited in these locations and others did 
both inspection work and regular mechanical work in adjacent 
bays, the details of which he was not aware. 
Lokey could not identify the type of brake linings being 
inspected.  The Administrator of Lokey's estate presented 
circumstantial evidence as to the likely manufacturer of the 
brake linings at trial based on the testimony of a former 
assistant factory manager for Bendix in charge of "organic 
products" (including asbestos products).  The witness testified 
that Bendix manufactured asbestos-containing friction products 
for brakes, including primary brake linings manufactured by 
Bendix that were approximately fifty percent asbestos material.  
He also testified that Bendix likely held one hundred percent 
of the market for Oldsmobile up to the late 1960s or early 
1970s, until front disc brakes were phased in.  He testified 
 
4 
that they also began providing materials for Fords in 1955 and 
had one hundred percent of the new Ford market share for the 15 
years prior to 1983.  He also stated that he believed they had 
one hundred percent of the replacement market for brake linings 
for Oldsmobiles and Fords in the late 1960s. 
Dr. John C. Maddox and Dr. Laura Welch, experts for 
Lokey's estate, testified that chrysotile asbestos, the type of 
asbestos found in brakes, can cause mesothelioma.  They opined 
that the exposure to dust from Bendix brakes and brakes in new 
Ford cars were both substantial contributing factors to Lokey's 
mesothelioma.  Maddox and Welch opined that the current medical 
evidence suggests that there is no safe level of chrysotile 
asbestos exposure above background levels in the ambient air. 
Lokey also testified that he worked as a pipefitter at the 
Norfolk Naval Shipyard for slightly over a year in the early 
1940s.  Lokey testified that his own work and the work of those 
immediately around him involved packing sand into pipes so that 
the pipes could be bent to fit the ships.  He had no personal 
knowledge of any exposure to asbestos in the shipyard.  Lokey 
admitted, however, that he worked in a large warehouse and was 
unaware of all the work done and products used in the 
warehouse, whether asbestos products were present, or whether 
there was any ventilation. 
 
5 
Dr. David H. Garabrant, expert for the defense, testified 
that people who work around asbestos-containing brakes are at 
no higher risk of developing mesothelioma than those who do 
not, but noted documented evidence of increased risk of 
mesothelioma for those who worked around shipyards, both 
directly with asbestos material and also in its vicinity.  Dr. 
Victor Roggli, a pathologist presented by the defense, 
testified that he found amosite asbestos fibers in Lokey's lung 
tissue.  Following his analysis of Lokey's lung fibers, he 
opined that Lokey's profile was more consistent with a person 
who had exposure to amosite asbestos at a shipyard sixty years 
ago than a person exposed to chrysotile brake products.  Dr. 
Roggli admitted, however, that his investigation did not 
include the pleura of the lungs and that he opined that each 
and every exposure to asbestos above background level 
experienced by an individual is a substantial contributing 
factor in the development of mesothelioma. 
The trial court instructed the jury on negligence and 
breach of warranty theories.  The jury found in favor of the 
estate as to negligence and awarded damages in the amount of 
$282,685.69.  The trial court denied Bendix' and Ford's motions 
to strike the expert testimony and their motions to set aside 
the verdict or for a new trial and entered final judgment for 
the estate.  Bendix and Ford have timely appealed. 
 
6 
II.  Discussion 
A.  Jury Instructions as to Causation 
The circuit court instructed the jury on proximate cause 
but also on five occasions instructed the jury to determine 
whether Ford's or Bendix' negligence was a "substantial 
contributing factor" to Lokey's mesothelioma.  Defendants 
challenge the use of the substantial contributing factor 
language as contrary to prevailing Virginia law as to 
causation.  The determination of whether a jury instruction 
accurately states the relevant law is a question of law that we 
review de novo.  Hawthorne v. VanMarter, 279 Va. 566, 586, 692 
S.E.2d 226, 238 (2010). 
The circuit court defined proximate cause in Jury 
Instruction 19 as follows: 
A proximate cause of an injury, accident, or damage is a 
cause which in the natural and continuous sequence 
produces the accident, injury, or damage.  It is a cause 
without which the accident, injury or damage would not 
have occurred. 
 
This is a plain-language adaptation of the long-accepted 
definition of proximate cause set forth by this Court in Wells 
v. Whitaker, 207 Va. 616, 622, 151 S.E.2d 422, 428 (1966):  
"The proximate cause of an event is that act or omission which, 
in natural and continuous sequence, unbroken by an efficient 
intervening cause, produces that event, and without which that 
event would not have occurred." 
 
7 
We said in Wells that the first element of proximate 
cause, causation in fact, is "often described as the 'but for' 
or sine qua non rule." 2  Id.  We explained that "[t]o impose 
liability upon one person for damages incurred by another, it 
must be shown that the negligent conduct was a necessary 
physical antecedent of the damages."  Id. 
The requirement of but-for causation came with a caveat, 
however:  "The 'but for' test is a useful rule of exclusion in 
all but one situation:  where two causes concur to bring about 
an event and either alone would have been sufficient to bring 
about an identical result."  Id. at 622 n.1, 151 S.E.2d at 428 
n.1 (emphasis added). 
In such a scenario, our law provides a means of holding a 
defendant liable if his or her negligence is one of multiple 
concurrent causes which proximately caused an injury, when any 
of the multiple causes would have each have been a sufficient 
cause.  Carolina, Clinchfield & Ohio Railway Co. v. Hill, 119 
Va. 416, 421, 89 S.E. 902, 904 (1916) (" 'To show that other 
causes concurred in producing, or contributed to the result is 
                     
2 We note that there are inconsistencies in the national 
legal nomenclature as to whether cause-in-fact is considered to 
be a subset of proximate cause or whether cause-in-fact, in 
addition to proximate cause (defined as additional legal 
restrictions as to liability), together create legal cause.  We 
opt for the former nomenclature as it is the more widely used 
terminology in Virginia as well as the terminology used by the 
circuit court in this case. 
 
8 
no defense to an action for negligence. . . .  Where the 
negligence of two or more persons acting independently, 
concurrently results in an injury to a third, the latter may 
maintain his action for the entire loss against any one or all 
of the negligent parties. . . .' ") (quoting 21 Am. & Eng. Enc. 
of Law 495-96).  This legal principle can be found today in the 
Virginia model jury instruction providing the definition of 
concurring negligence:  "If two or more persons are negligent, 
and if the negligence of each is the proximate cause of the 
plaintiff's injury, then each is liable to the plaintiff for 
his injury.  This is true even if the negligence of one is 
greater than the negligence of the other [or others]."  
1 Virginia Model Jury Instructions – Civil, No. 4.020, at 4-13 
(repl. ed. 2011).  The circuit court in this case gave almost 
an identical instruction in Jury Instruction Number 23. 
Causation in a mesothelioma case, however, presents a 
challenge for the courts beyond even our standard concurring 
negligence instruction.  Mesothelioma is a signature disease:  
it was uncontroverted at trial that the cause of mesothelioma 
is exposure to asbestos at some point during an individual's 
lifetime.  The long latency period of the disease, however, 
makes it exceedingly difficult to pinpoint when the harmful 
asbestos exposure occurred and, in the presence of multiple 
exposures, equally difficult to distinguish the causative 
 
9 
exposure(s).  See Locke v. Johns-Manville Corp., 221 Va. 951, 
957-58, 275 S.E.2d 900, 905 (1981) (discussing the latency 
period between the exposure to asbestos, the later onset of the 
"harm" in mesothelioma cases — the development of the cancer – 
and, finally, the development of noticeable mesothelioma 
symptoms); see also Symposium, A Tribute to Professor David 
Fischer:  The Insubstantiality of the "Substantial Factor" Test 
for Causation, 73 Mo.L.Rev. 399, 401-02 (2008). 
Further complicating the issue, although numerous 
individuals were exposed to varying levels of asbestos during 
its widespread industrial use before safety measures became 
standard, not all persons exposed developed mesothelioma.  
5 Richard M. Patterson, Lawyers' Medical Cyclopedia of Personal 
Injuries & Allied Specialties § 33.54, at 33-81 through 33-82 
(6th ed. repl. ed. 2011).  It is not currently known why some 
are more susceptible than others to developing mesothelioma, or 
why even low levels of exposure may cause mesothelioma in some 
individuals while others exposed to higher dosages never 
develop the disease.  See id. at 33-82, 33-84.  Thus, in the 
context of a lifetime of potential asbestos exposures, 
designating particular exposures as causative presents courts 
with a unique challenge. 
Despite this lack of certainty, we task juries with 
determining liability in multiple exposure mesothelioma cases.  
 
10 
Virginia statutory and case law makes clear that the 
Commonwealth permits recovery for parties injured by asbestos 
exposure, including those with mesothelioma, even when a jury 
must draw inferences from indirect facts to determine whether 
an exposure was causal.  See, e.g., Code § 8.01–249(4) 
(addressing the statute of limitations for latent mesothelioma 
cases); see also Owens-Corning Fiberglas Corp. v. Watson, 243 
Va. 128, 143-44, 413 S.E.2d 630, 639 (1992) (upholding a 
mesothelioma verdict against the manufacturer of Kaylo, an 
asbestos-containing product, despite only indirect evidence 
that the injured party worked with Kaylo).  The question before 
us is whether the Commonwealth's approach to proximate cause 
should be modified to allow such recovery in multiple-causation 
cases and, if so, how.  Certainly, if the traditional but-for 
definition of proximate cause was invoked, the injured party 
would virtually never be able to recover for damages arising 
from mesothelioma in the context of multiple exposures, because 
injured parties would face the difficult if not impossible task 
of proving that any one single source of exposure, in light of 
other exposures, was the sole but-for cause of the disease. 
The circuit court, in an admirable attempt to offer 
guidance to the jury as to this point, invoked a supplemental 
term in its jury instructions:  "substantial contributing 
factor."  For example, in Instruction 16, the court stated: 
 
11 
Before the plaintiff is entitled to recover from 
either defendant on the negligence theory, he must 
prove by a preponderance of the evidence each of the 
following elements against the defendant:  Number 1, 
exposure to asbestos-containing products manufactured 
and/or sold by defendant was a substantial 
contributing factor in causing plaintiff's injury; 
Number 2, at the time of Mr. Lokey's exposure, 
defendants knew or had reason to know that its 
products could cause injury to persons when the 
product was being used in a reasonably foreseeable 
manner; Number 3, defendant failed to adequately warn 
of such a danger; and Number 4, defendants' failure 
to adequately warn of the danger was a substantial 
contributing factor in causing plaintiff's injury. 
 
(Emphasis added.)  Similar language was used as to the 
instruction on implied warranty theory in Instruction 14 and in 
the court's description of the availability of damages in 
Instruction 30 ("To recover damages, the plaintiff must show 
that Mr. Lokey was injured as a result of the defendant's [sic] 
negligence and/or their breach of certain implied warranties 
and that the conduct of either or both defendants was a 
substantial contributing factor in his disease.").  (Emphasis 
added.) 
 
In the last several decades, with the rise of asbestos-
based lawsuits, the "substantial contributing factor" 
instruction has become prominent in some other jurisdictions.  
See, e.g., Lohrmann v. Pittsburgh Corning Corp., 782 F.2d 1156, 
1162-63 (4th Cir. 1986) (upholding Maryland's substantial 
contributing factor standard in an asbestosis case); Rutherford 
v. Owens-Illinois, Inc., 941 P.2d 1203, 1219 (Cal. 1997) 
 
12 
(approving the substantial contributing factor test in 
California); Borg-Warner Corp. v. Flores, 232 S.W.3d 765, 773-
74 (Tex. 2007) (permitting a substantial factor test in a Texas 
asbestosis case).  "Substantial factor" language was also 
utilized in the Restatement (First) and Restatement (Second) of 
Torts.  The phrase "substantial contributing factor" is not 
grounded, however, in the jurisprudence of this Court:  we have 
not, in the history of our case law, ever invoked this 
language. 
Considering it now for the first time, we find several 
problems with the substantial contributing factor instruction.  
As an initial matter, the circuit court in this case never 
defined the term "substantial contributing factor" in its jury 
instructions.  It is not clear whether it was meant to alter 
the proximate cause requirement in some way, such as reducing 
the cause-in-fact requirement by referring to a "contributing" 
factor rather than an independent but-for cause.  The term 
substantial contributing factor could be construed to mean any 
cause that is more than a merely de minimis factor.  
Conversely, the invocation of the term "substantial" could be 
interpreted to raise the standard for proof of causation beyond 
a mere preponderance of the evidence to some more elevated 
standard.  In sum, some jurors might construe the term to lower 
the threshold of proof required for causation while others 
 
13 
might interpret it to mean the opposite.  We do not believe 
that substantial contributing factor has a single, common-sense 
meaning, and we conclude that a reasonable juror could be 
confused as to the quantum of evidence required to prove 
causation in the face of both a substantial contributing factor 
and a proximate cause instruction. 
 
Our concerns are bolstered by the fact that variant 
definitions have arisen across those jurisdictions invoking 
substantial contributing factor language in their asbestos 
litigation.  Compare Lohrmann, 782 F.2d at 1163 (holding that 
Maryland's substantial contributing factor standard required a 
"frequency, regularity and proximity test" to protect asbestos 
defendants from being held liable on insufficient facts), with 
Rutherford, 941 P.2d at 1219 (defining substantial contributing 
factor in California to include exposures that increase the 
plaintiff's "risk" of developing cancer), and Flores, 232 
S.W.3d at 773-74 (holding that defendant-specific evidence 
relating to dose was necessary to determine whether exposure 
from a defendant was a substantial factor in causing the 
disease in Texas). 
Moreover, we agree with the explicit rejection of 
substantial contributing factor language in the recent 
Restatement (Third) of Torts:  Liability for Physical and 
Emotional Harm (2010).  The Restatement (Second) of Torts used 
 
14 
substantial factor language, stating that, absent an 
independent but-for cause, "[i]f two forces are actively 
operating . . . and each of itself is sufficient to bring about 
harm to another, [one] actor's negligence may be found to be a 
substantial factor in bringing it about."  Restatement (Second) 
of Torts § 432 (1965). 
The latest revision of the Restatement, however, 
deliberately abandoned this language, explaining: 
[T]he substantial-factor rubric tends to obscure, 
rather than to assist, explanation and clarification 
of the basis of [causation] decisions.  The element 
that must be established, by whatever standard of 
proof, is the but-for or necessary-condition standard 
of this Section.  Section 27 provides a rule for 
finding each of two acts that are elements of 
sufficient competing causal sets to be factual causes 
without employing the substantial-factor language of 
the prior Torts Restatements.  There is no question 
of degree for either of these concepts. 
 
Restatement (Third) of Torts § 26, cmt. j.  The comment also 
specifically references the tendency of courts to at times 
interpret the language as either raising or lowering the 
factual causation standard, leading to inconsistent and 
inaccurate statements of law.  Id.  If courts cannot be relied 
upon to consistently construe the language, we cannot expect 
lay jurors to accomplish the same task. 
The Restatement (Third) of Torts relies instead on the 
combination of sections 26 and 27: 
 
 
15 
§ 26 Factual Cause 
 
Tortious conduct must be a factual cause of harm for 
liability to be imposed.  Conduct is a factual cause 
of harm when the harm would not have occurred absent 
the conduct.  Tortious conduct may also be a factual 
cause of harm under § 27. 
 
§ 27 Multiple Sufficient Causes 
If multiple acts occur, each of which under § 26 
alone would have been a factual cause of the physical 
harm at the same time in the absence of the other 
act(s), each is regarded as a factual cause of the 
harm. 
 
This model, as explicated in the comments, is quite consistent 
with our statements in Wells regarding concurring causation.  
The rationale articulated in comment c of § 27 echoes the logic 
behind our long history of recognizing concurring causes:  
A defendant whose tortious act was fully capable of 
causing the plaintiff's harm should not escape 
liability merely because of the fortuity of another 
sufficient cause. . . .  When two tortious multiple 
sufficient causes exist, to deny liability would make 
the plaintiff worse off due to multiple tortfeasors 
than would have been the case if only one of the 
tortfeasors had existed.  Perhaps most significant is 
the recognition that, while the but-for standard 
provided in § 26 is a helpful method for identifying 
causes, it is not the exclusive means for determining 
a factual cause.  Multiple sufficient causes are also 
factual causes because we recognize them as such in 
our common understanding of causation, even if the 
but-for standard does not.  Thus, the standard for 
causation in this Section comports with deep-seated 
intuitions about causation and fairness in 
attributing responsibility. 
 
Restatement (Third) of Torts § 27, cmt. c. (emphasis added).  
The multiple sufficient cause analysis allows multiple 
tortfeasors to be found jointly and severally liable. 
 
16 
The Reporters Note to § 27, comment b, specifically 
observes that some jurisdictions use the term "concurrent 
causes" rather than multiple sufficient cause.  Indeed, 
multiple-exposure mesothelioma cases fit quite squarely with 
our line of concurring cause cases, "where two causes concur to 
bring about an event and either alone would have been 
sufficient to bring about an identical result."  Wells, 207 Va. 
at 622 n.1, 151 S.E.2d at 428 n.1 (emphasis added).  See also 
Schools v. Walker, 187 Va. 619, 629-30, 47 S.E.2d 418, 423 
(1948) ("It is not essential, therefore, for a plaintiff to 
show that an act, claimed to have been the proximate cause 
. . . was the only cause. . . .  Where the concurring 
negligence of the two produces a single injury and each is its 
proximate cause they are both liable.") (internal quotation 
marks and citation omitted); Carolina, C. & O. Ry., 119 Va. at 
420, 89 S.E. at 903 ("[W]here there are several concurrent 
negligence causes, the effects of which are not separable, 
though due to independent authors, either of which is 
sufficient to produce the entire loss, all are jointly or 
severally liable for the entire loss."). 
Unfortunately, our model jury instruction for concurring 
negligence invokes only general language that each is a 
"proximate cause" of the harm, rather than more specifically 
articulating the standard indicated in Wells.  The standard 
 
17 
that, in this case, exposure to the defendant's product alone 
must have been sufficient to have caused the harm is both an 
accurate articulation of our concurring cause law and perfectly 
plain to the average juror.  This standard constitutes the 
cause-in-fact portion of the proximate cause requirement in 
concurring cause cases.  The factfinder is left, having heard 
the nature of the exposures to each of the products at issue, 
as well as the medical testimony as to the requisite exposure 
necessary to cause mesothelioma, to determine whether the 
exposure attributable to each defendant was more likely than 
not sufficient to have caused the harm. 
While it might be clearly seen in a car accident or 
converging fires that both acts contributed in some degree to 
the harm, the nature of mesothelioma leaves greater uncertainty 
as to which exposure or exposures in fact constituted the 
triggering event.  This is, however, a distinction without a 
difference:  if the jurors, after hearing the testimony and 
evidence, believe that a negligent exposure was more likely 
than not sufficient to have triggered the harm, then the 
defendant can be found liable in the same way that a jury can 
conclude that a driver in a multiple-car collision or the 
negligent party in one of two converging fires is liable. 
Established Virginia law indicates that in order for acts 
of negligence to constitute concurring causes, it is not 
 
18 
necessary that concurring acts occur simultaneously.  Dickenson 
v. Tabb, 208 Va. 184, 193, 156 S.E.2d 795, 802 (1967).  This 
appears at first glance to be contrary to the language in the 
latest Restatement: 
§ 27 Multiple Sufficient Causes 
 
If multiple acts occur, each of which under § 26 
alone would have been a factual cause of the physical 
harm at the same time in the absence of the other 
act(s), each is regarded as a factual cause of the 
harm. 
 
Restatement (Third) of Torts § 27 (emphasis added).  We note, 
however, that the phrase "at the same time" is placed so as to 
modify "factual cause of the physical harm" rather than "acts 
occur."  We thus read this to be consistent with our precedent.  
The acts themselves do not have to be concurrent, so long as 
they are "operating and sufficient to cause the harm 
contemporaneously."  Restatement (Third) of Torts § 27, cmt. e.  
We have held, as to mesothelioma, that the "harm" occurs not at 
the time of exposure but at the time when competent medical 
evidence indicates that the cancer first exists and causes 
injury.  Locke, 221 Va. at 957-58, 275 S.E.2d at 905.3  
Recognizing that this date, if possible to isolate, may be 
decades after an injured party's exposure(s) to asbestos, id., 
                     
3 Although the General Assembly later established a 
discovery rule for asbestos-related diseases based on 
diagnosis, thus altering the statute of limitations, see Code 
§ 8.01-249(4), this does not redefine the definition of harm or 
injury for the Court. 
 
19 
it may often be the case that any exposure sufficient to cause 
harm that occurred prior to the development of the cancer may 
constitute one of multiple sufficient causes under the 
Restatement and a concurring cause in Virginia. 
The exposure must have been "a" sufficient cause:  if more 
than one party caused a sufficient exposure, each is 
responsible.  Other sufficient causes, whether innocent or 
arising from negligence, do not provide a defense.  Excluding 
other exposures from the pool of multiple sufficient causes 
will require competent medical testimony indicating whether the 
timing of exposure could possibly have caused the cancer.  
Defendants with sufficient exposures that occur after the 
cancer has already developed cannot be held liable. 
It must be noted that there is a separate comment under 
§ 27, entitled "Toxic substances and disease," that appears to 
offer an alternative approach to causation specific to disease.  
See Restatement (Third) of Torts § 27, cmt. g.  This approach 
allows for a finding of causation when multiple exposures 
combine to reach the threshold necessary to cause a disease, 
allowing parties who were responsible for some portion of that 
threshold to be held liable.  While it may be the case that 
this dose-related approach to causation is indeed appropriate 
for some cancers or diseases, we do not find it to be 
necessarily appropriate for mesothelioma, in light of the 
 
20 
current state of medical knowledge.  This comment assumes an 
identifiable threshold level of exposure triggering a disease.  
Given the current state of medical knowledge, we find the 
general approach described in comments a through e of section 
27 to be more helpful in mesothelioma and more consistent with 
our case law. 
Here, for the first time, we are called upon to rule 
explicitly as to the causation standard appropriate for 
mesothelioma.  We find that in concurring causation cases, the 
"sufficient"-to-have-caused standard as elaborated above is the 
proper way to define the cause-in-fact element of proximate 
cause.  We note that, while the Commonwealth currently only 
offers a model jury instruction as to concurrent negligence, 
concurring causes are not so limited:  use of the multiple-
sufficient-causes approach remains appropriate whether the 
concurring causes are all tortious in nature or whether some 
are innocent. 
While we reject defendants' strict interpretation of sole 
but-for cause argued to the circuit court at trial, we 
nonetheless conclude that the trial court erred in failing to 
sustain the defendants' objections to the substantial 
contributing factor jury instructions.  We remand for further 
proceedings consistent with the multiple sufficient cause 
analysis. 
 
21 
B.  Alternative Causes 
 
Ford alleges that the evidence presented was insufficient 
to establish that exposure to brake dust from Ford products 
proximately caused Lokey's mesothelioma when evidence 
demonstrated a more likely alternative cause (specifically, the 
earlier alleged exposure to amosite asbestos at the shipyard).  
Based on our holding above, the plaintiff must show that it is 
more likely than not that Lokey's alleged exposure to dust from 
Ford brakes occurred prior to the development of Lokey's cancer 
and was sufficient to cause his mesothelioma.  Given that this 
approach differs from that taken in the circuit court, we do 
not find it appropriate to rule on the sufficiency of the 
evidence at trial at this time. 
C.  Expert Testimony 
In light of our above holding rejecting substantial 
contributing factor causation, we also decline to reach the 
assignments of error relating to expert testimony. 
Bendix' assignment of error is worded as follows: 
2. The trial court erred in permitting the 
Administrator's experts to opine that "any exposure" 
to asbestos above background levels was a substantial 
contributing factor in causing the decedent's 
mesothelioma because the ["]any exposure["] theory 
was scientifically unreliable and was not based on an 
adequate factual foundation concerning the decedent's 
exposure to Bendix brakes. 
 
 
22 
As we have held that substantial contributing factor causation 
is not a permissible standard for causation in the 
Commonwealth, the above assignment of error is no longer 
applicable.  The circuit court now needs to consider the 
experts' opinions as to whether the exposures by Ford and 
Bendix were each more likely than not sufficient to have caused 
mesothelioma. 
 
Ford's assignment of error is worded slightly differently: 
4.  The Circuit Court erred in holding that there was 
sufficient foundation for the admission of the 
causation testimony of Plaintiff's expert witnesses 
Drs. Maddox and Welsh and in denying Ford's motion to 
strike the testimony. 
 
Despite the difference in language, Ford's assignment of error 
suffers from the same infirmity.  Ford alleges that the factual 
foundation upon which the experts' causation opinions were 
based was insufficient.  This causation testimony was 
inextricably linked to the substantial contributing factor test 
for causation.  The experts must opine as to what level of 
exposure is sufficient to cause mesothelioma, and whether the 
levels of exposure at issue in this case were sufficient.  The 
bases for the witnesses' opinions as to substantial 
contributing factor causation are now rendered moot. 
D.  Failure to Warn and Proximate Cause 
 
Both defendants allege that the plaintiff failed to 
present evidence sufficient to show that their failure to warn 
 
23 
was the proximate cause of Lokey's mesothelioma.  Specifically, 
they allege the absence of evidence sufficient to show that 
Lokey's behavior would have changed had the defendants offered 
sufficient warnings.  As a result, defendants argue that 
plaintiff lacks sufficient evidence to find Ford or Bendix 
liable.  As this issue is both independent of the multiple-
sufficient-cause proximate cause analysis addressed in Part 
II.A, supra, and would be dispositive if defendants were 
correct, we will reach this assignment of error. 
 
In his de bene esse deposition, Lokey was never asked if 
his behavior would have been changed had he known that he was 
inhaling a potentially fatal substance.  Lokey, deceased by the 
time of trial, was obviously unavailable for further 
questioning.  While Virginia does not observe a heeding 
presumption,4 we have clearly already ruled on this issue, 
stating: 
[The injured party], of course, was unable, because 
of his disability, to tell the jury whether, had a 
warning been provided, he would have heeded it in the 
manner suggested by [the expert witness].  Nor could 
anyone have spoken for [the injured party].  But 
frequently material facts are not proven by direct 
evidence.  A verdict may be properly based upon 
reasonable inferences drawn from the facts.  If facts 
are present from which proper inferences may be drawn 
this is sufficient.  Here, from the circumstances 
                     
4 A heeding presumption is "a rebuttable presumption that 
an injured product user would have followed a warning label had 
the product manufacturer provided one."  Black's Law Dictionary 
1305 (9th ed. 2009). 
 
24 
that were proven below, and according to the ordinary 
experience of mankind, the jury was warranted in the 
conclusion that [the] injury would not have occurred 
had [a warning] been given. 
 
Hoar v. Great E. Resort Mgmt., Inc., 256 Va. 374, 388, 506 
S.E.2d 777, 786 (1998) (internal quotation marks and citations 
omitted) (final modification in original). 
We find this case to be precisely on point.  Reasonable 
jurors are entitled to utilize their own experiences, as well 
as evidence as to the character of the injured party and the 
known asbestos dangers at the time the warning should have been 
given, in order to draw conclusions as to the content of an 
adequate warning and whether Lokey would have heeded such a 
warning. 
In this case, the plaintiff presented evidence through 
multiple expert witnesses of the dangers of asbestos exposure, 
as well as evidence that Ford and Bendix had internal corporate 
documents at the time Lokey was inspecting garages that 
indicated that asbestos exposure from brake linings had 
carcinogenic effects.  Lokey's son-in-law testified that Lokey 
was a "perfectionist," a "by-the-book guy.  Everything was to 
be done correctly."  The jury was provided with ample evidence 
to allow it to conclude that a reasonable person who was 
concerned for his or her safety and who, like Lokey, was 
 
25 
inclined to follow recommended procedures and guidelines, would 
have heeded a warning had one been given. 
Bendix and Ford emphasize the fact that boxes containing 
Bendix brakes were armed with warning labels during the final 
year of Lokey's employ as a garage inspector, and Lokey's 
behavior did not change.  They argue that this evidence shows 
that, even had an adequate warning been issued in the earlier 
years of Lokey's inspection work, the warning would have been 
ignored by Lokey and therefore could not have been the 
proximate cause of the harm. 
"At common law the liability of a manufacturer for failure 
to adequately warn of the dangers incident to the use of his 
product does not depend on whether the injury is to the person 
using the product . . . or to persons . . . other than those to 
which the product is to be applied."  McClanahan v. California 
Spray-Chemical Corp., 194 Va. 842, 853-54, 75 S.E.2d 712, 719 
(1953).  Considering that his employment with the Commonwealth 
required him to be present at inspections which included the 
blowing out of brakes, and testimony that defendants were aware 
at the time that compressed air was used to blow out brake 
dust, the jury was entitled to conclude that Lokey's exposure 
to asbestos was foreseeable by Bendix and Ford and that a 
person in his position should have been warned. 
 
26 
We have previously stated that "an insufficient warning is 
in legal effect no warning."  Id. at 852, 75 S.E.2d at 718 
(internal quotation marks omitted).  There was indeed evidence 
presented that the brake boxes eventually included a warning.  
There was no evidence presented, however, that Lokey knew of 
this warning or reasonably could have known of it:  the warning 
was present only on new boxes of Bendix brakes, which 
inspectors or supervisors of inspections might reasonably have 
never seen.  Indeed, Lokey himself testified that he was never 
warned.  A reasonable jury could thus have found, based on this 
evidence, that the warning on the boxes was inadequate as to 
Lokey.  If the warning on the boxes was inadequate, the jury 
would have correctly disregarded the fact that Lokey's behavior 
remained unchanged. 
The jury was then left with evidence of the known dangers 
of asbestos and could reasonably infer that Lokey, if properly 
informed of these dangers at the time, would have taken 
precautionary measures.  We therefore find no defect in the 
circuit court's conclusion that there was evidence sufficient 
for a jury to find that the failure to warn was the proximate 
cause of the injury. 
 
27 
 
III.  Conclusion 
For the foregoing reasons, we reverse and remand for 
further proceedings. 
Record No. 120283 – Reversed and remanded. 
Record No. 120299 – Reversed and remanded.