Opinion ID: 198766
Heading Depth: 3
Heading Rank: 1

Heading: Search for a Fair Standard

Text: 23 In conducting our own analysis, we first observe that we have been pointed to no Rhode Island jurisprudence involving latent and delayed cancer resulting from prolonged smoking. We begin with an analysis that leads us to the conclusion that Rhode Island would not follow such a draconian slight injury concept of accrual as was reflected in Joyce. 24 It bears noting that, strictly, this proposition is not disputed. The district court, as we have observed, while mentioning this concept, did not adopt it as a ground for decision. Defendants have similarly refrained from arguing that the earliest respiratory ailments suffered by plaintiff signaled the accrual of her cause of action. Indeed, they distinguish both asbestos and non-asbestos cases cited by plaintiff as involving relatively minor injuries and argue that by 1989 plaintiff knew all she needed to know to bring suit -- that she might have a claim against the Manufacturers for totally disabling respiratory harm. 25 Nevertheless, the authority of the cases tracing accrual of all causes to an initial minor injury seems to survive in some of the argument on appeal. In any event, were such a rule applied to a latent, long-delayed cancer case, it would place, as other courts have observed, a victim in an impossible position. If he did not sue at the earliest onset of breathing difficulty or emphysema, he would risk being barred from pursuing a remedy for a cancer condition discovered much later. If, on the other hand, he brought suit at such an early stage he would not be able to come forward with the proof of sufficient likelihood of damage from cancer to sustain his cause of action. As for the courts, such a rule would unnecessarily thrust them into obviously premature litigation. As then-Judge Ginsburg wrote in Wilson v. Johns-Manville Sales Corp., 684 F.2d 111 (D.C. Cir. 1982): In latent disease cases, this community interest [in balancing the interests of the parties and producing a fair resolution] would be significantly undermined by a judge-made rule that upon manifestation of any harm, the injured party must then, if ever, sue for all harms the same exposure may (or may not) occasion some time in the future. Id. at 119. 26 Moreover, a strict initial-though-slight injury rule would not be consistent with the approach of the Rhode Island Supreme Court in the discovery rule cases that have been cited. For example, in Wilkinson, the court was concerned with the manifest unfairness of barring the enforcement of injury claims brought by a plaintiff who was not, nor could not have known that he was, the victim of tortious conduct because the consequent harm was unknowable within two years of the negligent act. Wilkinson, 243 A.2d at 752. In Lee, the court set forth its rationale for a manifestation of injury rule of accrual saying that a person [should] have a reasonable opportunity to become cognizant of an injury. Lee, 469 F.2d at 361. In Anthony, the court referred to its conscious balancing of policies to prevent the unexpected enforcement of stale claims with the opportunity of a person to have her day in court to vindicate those rights that have been violated but have remained undiscovered or undiscoverable. Anthony, 490 A.2d at 46. 27 We also take note of the willingness of the Supreme Court of Rhode Island to take a realistic approach to the long-established rule against splitting causes of action, not hesitating to carve out situations to which this approach should not apply, where its invocation would work an injustice. For example, in Lemieux v. American Universal Insurance Co., 360 A.2d 540 (R.I. 1976), the court, recognizing the disparity of interests of a subrogated insurer and its insured, permitted each to seek recovery from a third party in separate suits for property damage and personal injury. See id. at 545. 28 We, therefore, are confident that a Rhode Island court would not deem cancer to be so foreseeably related to the very beginning of plaintiff's respiratory difficulties as to identify that as the time of accrual of her cause of action for cancer. Plaintiff argues for setting the time of medical diagnosis of cancer as the time of accrual. While there may be cases where such a time would be appropriate, it is also possible in the case of a long-time addictive smoker that the progression of illnesses, the presence of symptoms indicative of cancer, the nature of materials read, or discussions with doctors, etc., so point to the likelihood of cancer that it is fair to expect a plaintiff to bring suit and where further delays would impose an untoward burden on a defendant. 29 It seems to us, as it did to the district court, that a fair balancing of the legitimate interests of the parties lies in a middle position that would not allow a plaintiff to sleep on her rights but would not, in the interests of repose and evidence preservation, severely jeopardize a plaintiff's opportunity to obtain compensation for contracting cancer. The district court's framing of its decision in terms of the ready foreseeability of cancer from the nature and extent of current disabilities appears to us consistent with the Rhode Island Supreme Court's emphasis in Wilkinson and Lee on the unfairness of barring a plaintiff before he could have become aware of the consequent harm. 30 This approach also reflects a sensitive and sensible balancing of interests. We first note a number of characteristics of cancer that militate against requiring a possible victim, even though an addicted smoker, to make an early decision to commence litigation. The causes of cancer are various, by no means confined to prolonged smoking. Nor is cancer an inevitable result of such smoking. Often its incidence defies foreseeability. It is quite different from afflictions of shortness of breath, emphysema, or other respiratory difficulties. It is of a different magnitude, often involving the possibility of death. Unlike impairments to breathing, cancer does not lend itself to lay identification. It is most dependent upon medical diagnosis. We can understand the apparent absence of case authority for this approach. 31 We pursue our search for an appropriate balance by examining the impact on defendants of a middle approach based on foreseeability. We do not anticipate that this would be an open sesame for stale claims. A plaintiff with some awareness of her susceptibility is not likely to sleep on her rights. Moreover, cancer claims remotely connected in time to earlier illnesses run greater risks of failure of proof, because of the very multiplicity of causes of cancer. A defendant is not without weapons to dismantle a specious claim of ignorance. Particularly, looking to the future, we strongly suspect that it will not be an onerous burden on a defendant to prove that a plaintiff was exposed to enough contemporary information about cancer to have reasonably foreseen its likelihood. We should add that this case went to judgment on a sparse record, containing the plaintiff's deposition and medical records. There was no testimony from other witnesses, including medical experts. No evidence is in the record as to any conversations between plaintiff and doctors or others about suspicion of cancer. 32 In accepting this approach as that which would comport with Rhode Island law, we realize that it points in the direction of fact-intensive analysis. By the same token this introduces unavoidable uncertainty into prediction, litigation, and the attainment of repose. We have, therefore, probed on our own the possibility of linking the time of accrual of a cause of action for cancer to some objectively identifiable stage in the progression of the illness. For example, one might say that once the condition of an addictive smoker has regressed to the stage when she is substantially and permanently disabled, she should be held to know enough to bring suit for present and any subsequent illnesses attributable to her smoking. 33 On close examination, this approach reveals numerous flaws of its own. We first observe that even this approach does not avoid a case by case inquiry into whether the threshold stage of seriousness has been reached. We then realize that the same problem of anticipatory litigation presents itself: a plaintiff, however reluctant to engage in a premature lawsuit, is faced with a sue or lose dilemma before having reliable knowledge of her likelihood of contracting cancer. Paradoxically, instead of serving the truth-enhancing, evidence-preserving function of statutes of limitation, this approach forces resolution before the development of relevant reliable medical or scientific evidence. 34 Even were such a plaintiff able to prove by a sufficient quantum of evidence the likelihood of incurring cancer, her damages would be subject to substantial discounting based upon a range of contingencies regarding the probability of her contracting the disease. The plaintiff would also be subjected to several other burdens. She would be under pressure -- with the consequent expense -- to search for experts to maximize the seriousness of her prognosis, as well as pressure to delay the progress of her suit to take advantage of subsequent deterioration. Such a series of disadvantages jeopardizes the societal interest in affording fair compensation to victims. To the extent that a sue or lose rule based on an arbitrarily defined stage results in a shielding of a tortfeasor, the community interest in deterrence is also compromised.