In a purely diagnostic sense, consideration as to causal factors of an individual’s injury is typically an unnecessary, and perhaps irrelevant, component of patient assessment, in light of the medical provider’s ultimate goal of providing intervention and treatment for benzene exposure. Although diagnostic criteria may unavoidably result in the identification of benzene exposure as being the actual substance suspected to have caused an injury, such discovery is unlikely to have been purposeful, because this determination is rarely an automatic extension to medical diagnosis, and may not be necessary for treatment purposes. Further, and more importantly, diagnostic processes typically fail to identify the source of the benzene exposure due to its apparent irrelevancy in a purely medical setting.
In the legal arena, by contrast, isolation of both the presence of benzene, as well as the exposure source, is fundamentally essential to claims in which a plaintiff seeks compensation for injuries allegedly sustained through exposure to a particular substance from a specific source. Proper evaluation, for legal purposes, therefore, necessitates identification of benzene exposure as an alleged cause of an injury, and only then, can suggestions concerning the source responsible for causing its exposure, be properly formulated. Without application of these guiding principles, limitation concerning which individual(s) fault should be directed at, and therefore, who should be properly named as defendant(s) to the benzene exposure action, would be a nearly impossible feat.
Overcoming causation issues in benzene exposure cases requires an initial two part analysis. First, evidence must be presented tending to prove that benzene is capable of causing the injury alleged by the plaintiff; this is commonly referred to as general causation. Second, the plaintiff must offer evidence sufficient to conclude that benzene exposure was causally connected to the injury alleged in that specific plaintiff; this is commonly referred to as specific causation. Epidemiological studies are often used in overcoming evidentiary issues concerning general causation, however, general causation necessitates a simultaneous consideration of specific causation. In his article, Getting to Causation in Toxic Tort Cases, author David. E. Bernstein suggests, “[b]ecause proof of general causation cannot satisfy a plaintiff’s burden without proof of specific causation, and proof of specific causation implicitly requires proof of general causation, the focus of inquiry in toxic tort cases typically is on the existence of specific causation.” http://www.law.gmu.edu/assets/files/publications/working_papers/0966GettingtoCausation.pdf.
As stated by Bernstein in the aforementioned article, “[b]eyond general and specific causation, an additional causation issue arises when multiple defendants are responsible for exposing the plaintiff to a harmful substance.” Id. In such cases, the defendant alleged to have caused the benzene exposure must have been a substantial factor to the injuries sustained.
Medical assessment for liability determination purposes, therefore, requires a more comprehensive diagnostic approach, then would typically be conducted in scenarios in which diagnosis is for purely medical purposes. As a result of the divergent goals of the medical and legal field, the former being for intervention, and the latter being for compensation, the extent and type of available documented medical records is often lacking, in terms of legal value, in cases where the medical examiner is not intended to testify. This can be problematic to practitioners, who then must seek, on the claimant’s behalf, re-examination by a medical provider who is prepared to testify, or, in the alternative, obtain a separate expert for interpretive and testimonial purposes.
By: Alicia McKnight, J.D.