Opinion ID: 201309
Heading Depth: 3
Heading Rank: 1

Heading: Whether MS Can Be Improved Through Treatment

Text: 12 Whitman first argues that the district court erred in finding that MS is incapable of being improved through treatment. Whitman bases this argument on the fact that she is being treated with Betaseron, a disease-modifying drug that acts at the cellular level to alter the immune system's response to MS. Whitman states that the goals of her treatment include slowing, stabilizing, arresting, or reversing her MS symptoms. Relying on our decision in In re RJF, Whitman argues that this treatment is not palliative and will improve her medical condition. 13 Whitman's reliance on In re RJF is misplaced. In that case, a seaman suffered severe, permanent brain damage with symptoms including muscle spasticity and contractions. Id. at 106. The seaman's physicians provided evidence that further treatment, including rehabilitation directed in part at the muscle spasms, would lessen the muscle ailments and result in further, although incomplete, cognitive improvement. Id. at 107. Because the evidence showed that further treatment would improve the seaman's underlying condition, we found that the seaman had not reached the point of maximum medical recovery and that the shipowner's duty of maintenance and cure continued. Id. 14 In the instant case, Whitman concedes that her MS is permanent. The question is whether Whitman's treatment would improve her medical condition such that she had not, as of August 15, 2000, reached the point of maximum medical recovery. The testimony of the doctors for both parties leaves no genuine issue of material fact that Whitman's treatment would, at best, slow or arrest the progression of her MS, but would not reverse her symptoms or improve her condition beyond the point of maximum medical recovery. 15 Dr. Richard Tenser, Whitman's treating physician, testified in his deposition that Whitman's condition had not improved and had probably worsened. 4 Dr. Tenser's testimony also indicated that, at best, he hoped treatment with Betaseron would slow or arrest the progression of Whitman's MS to prevent her from becoming disabled: 16 Q. Would you agree with me that it is more likely than not that Ms. Whitman will at some point in the future become disabled from her MS? A. Again, a tough question. I mean the whole goal of her treatment is to try to prevent that...[S]he has pretty severe MS. Whether she will become disabled or not, I don't know. Obviously using the Betaseron to try to prevent that, so do I want to acknowledge that the medication will fail, I'm reluctant to do that. I would just say that she certainly has a significant chance of becoming disabled. 17 Moreover, Whitman mentions several times that one of the goals of her treatment is to reverse her symptoms. However, Dr. Tenser never testified that this was the goal of her treatment. Miles's medical expert, Dr. Edward Collins, mentioned reversing some of Whitman's symptoms in his deposition testimony, but not reversing the MS itself. Further, Dr. Collins noted that, while he hoped that treatment might reverse certain symptoms of MS, he was not predicting that result. He also later testified that the goal of her treatment was to slow the downward progression of Whitman's MS, and that an upward improvement would not occur. 18 The testimony of both doctors is very different from In re RJF, where the seaman's doctors opined that further treatment would not merely arrest symptoms of the underlying condition, but would improve the condition itself. Id. Further, in In re RJF, the testimony of the shipowner's doctors left room for the conclusion that further treatment could lead to long-term improvement of the seaman's condition. Id. In the instant case, Dr. Collins explicitly stated that no reversal or upward improvement in Whitman's condition would occur. 19 In sum, while Whitman's treatment may be necessary and beneficial to her, its benefits relate to slowing or arresting the progression of her disease. We agree with the district court that [s]lowing or arresting a decline, while medically important, simply is not the same as effecting an improvement.... Whitman, 294 F.Supp.2d at 123.