Opinion ID: 676036
Heading Depth: 2
Heading Rank: 3

Heading: Fear-of-Developing-AIDS Cases

Text: 31 1. Actual Exposure. We now pass to the fear-of-developing-AIDS cases. We recognize that in the recent wave of emotional distress cases based on a fear of developing AIDS, several courts have, as in other fear of developing disease cases, required plaintiff to prove actual exposure to the disease as a prerequisite to recovery. Again, these cases are distinguishable primarily because plaintiffs did not suffer a physical injury. See Funeral Servs. by Gregory, Inc. v. Bluefield Community Hosp., 186 W.Va. 424, 413 S.E.2d 79 (1991) (no recovery to mortician who touched HIV-infected decedent without proof of actual exposure to disease), overruled in part on other grounds by, Courtney v. Courtney, 190 W.Va. 126, 437 S.E.2d 436 (1993); Neal v. Neal, 873 P.2d 871 (Idaho 1994) (absent proof that husband or his mistress was HIV-infected, no recovery for plaintiff-wife for emotional distress based on fear of developing AIDS where plaintiff's husband had an affair); Ordway v. County of Suffolk, 154 Misc.2d 269, 583 N.Y.S.2d 1014 (Sup.Ct.1992) (no recovery for doctor who performed surgery on AIDS infected patient where no proof of channel of transmission and no allegation of physical injury); Doe v. Doe, 136 Misc.2d 1015, 519 N.Y.S.2d 595 (Sup.Ct.1987) (no recovery for wife in suit against husband who had homosexual affair where no proof of exposure to HIV virus). But cf. Johnson v. West Va. Univ. Hosps., Inc., 186 W.Va. 648, 413 S.E.2d 889 (1991) (damages for emotional distress based on fear of developing AIDS recoverable against hospital where plaintiff bitten by AIDS-infected patient because plaintiff able to prove physical injury and actual exposure). 32 2. Actual Exposure Plus Likelihood of Developing AIDS. Even where exposure was shown to exist, recovery was precluded in a number of cases because the actual likelihood of developing AIDS was remote. Again, in none of these cases did plaintiffs--unlike the instant plaintiff--suffer a precipitating physical injury. See Petri v. Bank of New York Co., 153 Misc.2d 426, 582 N.Y.S.2d 608 (Sup.Ct.1992) (mere exposure to AIDS from intercourse with infected partner insufficient to provide rational, non-speculative basis for fear of developing the disease because no proof of physical injury); Lubowitz v. Albert Einstein Medical Ctr., N. Div., 424 Pa.Super. 468, 623 A.2d 3 (1993) (no cause of action for fear of developing AIDS where in vitro fertilization took place in donated placental serum later testing HIV-positive, where when re-tested donor's blood proved negative and plaintiff had not alleged physical injury); cf. Transamerica Ins. Co. v. Doe, 173 Ariz. 112, 840 P.2d 288 (App.1992) (no recovery despite actual exposure to HIV virus, where no evidence of resulting physical injury). 33 After examining these cases, we are unable to agree with defendant that there is a common law rule in fear-of-developing-AIDS cases that proof of exposure and a medical likelihood of developing the disease is required in all circumstances. Rather, the common law rule to be gleaned is the same as it is with the other fear-of-developing-disease cases, that is to say, the exposure requirement--plus actual likelihood of developing the disease--simply is a means of ensuring the genuineness of the claim in situations where the plaintiff would not be able to satisfy the traditional tests of genuineness in negligent-infliction-of-emotional-distress cases. Because Marchica satisfies the traditional zone of danger test adopted by the Supreme Court in the FELA context, these fear-of-developing-AIDS cases are inapplicable. 34 3. Injury Plus Exposure. The railroad points in addition to a handful of fear-of-developing-AIDS cases where recovery was denied even though plaintiff suffered a precipitating injury, because there was no proof of actual exposure to the HIV virus. These cases held that emotional distress was unreasonable as a matter of law, absent proof of exposure. See Burk v. Sage Prods., Inc., 747 F.Supp. 285 (E.D.Pa.1990) (no recovery for paramedic pricked by hypodermic needle where user of needle unknown and therefore exposure to HIV not proven); Hare v. State, 173 A.D.2d 523, 570 N.Y.S.2d 125 (2d Dept.) (hospital employee bitten by patient rumored to have AIDS could not recover emotional distress damages for fear of AIDS because no proof of actual exposure), appeal denied, 78 N.Y.2d 859, 575 N.Y.S.2d 455, 580 N.E.2d 1058 (1991); Carroll v. Sisters of Saint Francis Health Servs., Inc., 868 S.W.2d 585 (Tenn.1993) (plaintiff stuck by several discarded hypodermic needles could not recover for emotional distress damages on fear of developing AIDS because unable to prove exposure to HIV virus). 35 But not all courts have applied so rigid an actual exposure test and we decline to do so. Some courts only require plaintiff to allege a specific incident of possible exposure that could lead to a reasonable fear of developing AIDS. See Faya v. Almaraz, 329 Md. 435, 620 A.2d 327 (1993) (patients operated on by surgeon with AIDS could recover for mental distress though unable to prove actual exposure); Castro v. New York Life Ins. Co., 153 Misc.2d 1, 588 N.Y.S.2d 695 (Sup.Ct.1991) (recovery for negligent infliction of emotional distress based on fear of developing AIDS after needle prick by discarded hypodermic needle allowed where claim tied to a distinct event that would cause a reasonable person to develop a fear of AIDS); Howard, 429 S.E.2d at 24-25 (plaintiff operated on with unsterile instruments and later treated intravenously, given pain shots and frequent blood tests established prima facie case of injury sufficient to support a claim of emotional distress based on a fear of developing AIDS, though no proof of exposure and no injuries as a result of the use of the instruments); cf. Poole v. Alpha Therapeutic Corp., 698 F.Supp. 1367 (N.D.Ill.1988) (plaintiff whose hemophiliac husband contracted AIDS from defendants' antihemophilic factor, alleged facts sufficient to place her in the zone of danger, but did not state cause of action under Illinois law, because she did not allege a physical injury or illness resulting from the emotional distress). 36 It is quite apparent from the recitation of the inconsistent decisional law that this area of the law is in a developing stage. In any event, the scope of FELA is a federal question, not varying in accordance with the differing conceptions of negligence applicable under state and local laws. Urie v. Thompson, 337 U.S. 163, 174, 69 S.Ct. 1018, 1027, 93 L.Ed. 1282 (1949). Although we are not bound by common law principles, they must be accorded weight in our analysis. See Gottshall, --- U.S. at ----, 114 S.Ct. at 2403-05. We adopt the approach of those cases just discussed which take a more flexible view because they are most consistent with FELA's remedial nature. Thus, a FELA plaintiff who has suffered a physical impact may recover for a fear of developing AIDS if the impact caused by the defendant's negligence occurred under circumstances that would cause a reasonable person to develop a fear of AIDS. The circumstances surrounding Marchica's puncture wound fulfill these requirements, and therefore his claim is cognizable. II Due Diligence 37 The second point defendant makes is that where a claim of emotional distress is founded on the fear of developing a disease, the plaintiff must exercise due diligence to become familiar with the realities of the disease and defendant should not be held liable for emotional distress to the extent the plaintiff's fear is based on ignorance. Had Marchica educated himself about HIV and AIDS, defendant insists, he would not have had a rational basis for his fear. 38 In support of its due diligence argument defendant cites two cases, Gideon v. Johns-Manville Sales Corp., 761 F.2d 1129 (5th Cir.1985), and In re Hawaii Federal Asbestos Cases, 734 F.Supp. 1563 (D.Haw.1990). In Gideon, the court explained that under Texas law, failure to secure medical treatment bars recovery of those damages that would have been averted had proper treatment been obtained or had medical advice been followed. 761 F.2d at 1139. While this ruling is unremarkable as a general principle of law, it does not apply to the present case. Plaintiff sought medical treatment immediately after the puncture wound, and followed the medical advice of more than one physician that he be tested for HIV. 39 In re Hawaii applied Hawaii's reasonable person standard for recovery of emotional distress and held that plaintiffs' fear of cancer following exposure to asbestos would not be reasonable absent knowledge that the exposure had caused a functional impairment. See 734 F.Supp. at 1569-70. The court went on to state: A reasonable person, exercising due diligence, should know that of those exposed to asbestos, only a small percentage suffer from asbestos-related physical impairment.... Id. at 1570. Again, we agree with the general proposition that a plaintiff may only recover for damages proximately caused by a defendant's breach of duty. But we are unable to embrace the notion that a reasonable person, punctured by a discarded hypodermic needle with blood in it, in a location known to be frequented by drug users, exercising due diligence, would not fear developing AIDS. Just the opposite is true; any reasonable person would have such fear. 40 In the vast literature on AIDS it is repeatedly stated that HIV is spread by the blood or bodily fluids of one person being transmitted to another, and that the sharing of needles is a means of transmission. See, e.g., John K. Watters et al., Syringe and Needle Exchange as HIV/AIDS Prevention for Injection Drug Users, 271 J.Am.Med. Ass'n 115 (1994) (sharing of contaminated injection paraphernalia is a major route for transmission of [HIV] in the United States); M. Levy et al., Improper Infection-Control Practices During Employee Vaccination Programs--1993, 271 J.Am.Med. Ass'n 182 (1994) (patient-to-patient transmission of HIV has occurred when needles and syringes were reused without being properly sterilized or were inadvertently reused between patients); Geoffrey Cowley, AIDS Without Needles or Sex, Newsweek, Dec. 20, 1993, at 106 (most of us can recite the truism that HIV spreads through sex and shared needles); Geralyn M. Franklin et al., AIDS in the workplace: current practices and critical issues; acquired immune deficiency syndrome, 30 J. Small Bus.Mgmt. 61 (1992) (the virus is predominantly spread through sexual contact and through the sharing of contaminated needles and syringes by intravenous drug users). 41 Evidence presented to the jury revealed that Marchica was advised to be tested for HIV, and even the LIRR medical department considered the needle that punctured Marchica's palm to be infectious. Plaintiff's medical expert on HIV and AIDS testified that the medical community was still exploring precisely how the virus is transmitted and, he added, that in his opinion the disease could be transmitted through a needle that has been used and discarded. From this evidence the jury was entitled to find there was a rational basis for plaintiff's fear of developing AIDS. 42 Moreover, in the FELA context the traditional concept of proximate cause is supplanted by the less stringent standard that there be some causal relation, no matter how slight, between the injury and the railroad's breach of duty. See Gallick v. Baltimore & O. R.R., 372 U.S. 108, 116, 83 S.Ct. 659, 664-65, 9 L.Ed.2d 618 (1963). The plaintiff only need show that the employer played a part in bringing about the injury. See Rogers v. Missouri Pac. R.R., 352 U.S. 500, 506, 77 S.Ct. 443, 448, 1 L.Ed.2d 493 (1957). Under FELA the right of the jury to decide the issue of causation must be most liberally viewed. See, e.g., Eaton v. Long Island R.R., 398 F.2d 738, 741 (2d Cir.1968). Hence, Marchica presented sufficient evidence to create a jury question under FELA as to whether LIRR's negligence played a part in bringing about his physical and emotional injuries. III Future Emotional Distress 43 As its last point, the railroad declares the jury's $55,000 award for future damages has no basis in the record. Specifically, it contends that it is unreasonable as a matter of law for a plaintiff to fear developing AIDS after a point in time when there is proof to a medical certainty that he has not been exposed to, nor will he contract the disease. In other words, recovery should be limited to the period from the time of possible exposure to that point when plaintiff knew he was not exposed to HIV. Since at the time of trial Marchica had tested negative for HIV three times over a period of three years, any continuing emotional distress stemming from a fear of developing AIDS, the LIRR maintains, would be unreasonable as a matter of law. 44 We agree that once there is proof to a medical certainty that plaintiff has not been exposed to and will not develop the disease, any continuing fear of developing AIDS is unreasonable. Accord Faya, 620 A.2d at 337. But we are unable to say on this record that there was no basis for the jury to award $55,000 for future emotional distress. A FELA plaintiff is entitled to recover for all past, present and probable future harm attributable to the defendant's tortious conduct, including pain and suffering and mental anguish. See, e.g., Hagerty v. L & L Marine Servs., Inc., 788 F.2d 315, 317, modified, 797 F.2d 256 (5th Cir.1986). The trial judge instructed the jury that only if it found any of plaintiff's injuries were permanent could it award compensation for future emotional distress and future loss of enjoyment of life. 45 Marchica presented evidence showing that he developed post traumatic stress disorder soon after he suffered the puncture wound, and that he would continue suffering from the disorder and the accompanying symptoms of weight loss, vomiting, rashes, and tachycardia for the rest of his life. Dr. J. David Gassman, plaintiff's expert in psychology testified, for example, that post traumatic stress disorder is a permanent, recurring phenomenon, and that the symptoms would occur throughout Marchica's life. This and other evidence in the record provided an ample basis for the jury's award of $55,000 for future emotional distress.