Background
A nurse employed by MultiCare Health System, Cora Weberg (Nurse Weberg), improperly diverted injectable narcotics for her own use. She infected some emergency department patients with hepatitis C and may have exposed many
more. MultiCare sent a letter to all 2,762 patients who received injectable narcotics in Good Samaritan’s emergency department while Nurse Weberg was on duy that they were potentially exposed. Overall, 1,863 people had their blood tested. The tests identified 11 more cases of hepatitis C. All 13 patients who tested positive for hepatitis C had been assigned to Nurse Weberg during their emergency room (ER) visit. As a result of these tests, MultiCare determined that only patients assigned to Nurse Weberg were actually at risk.
The patients brought a class action suit. They claimed MultiCare failed to meet the accepted standard of care in supervising and hiring Nurse Weberg. The trial court divided the class into two groups: those who were assigned to Nurse Weberg (“Weberg Treatment Class” – 208 patients) and those who were not (“General Treatment Class” – 2,554 patients). It then dismissed the claims of the second group. The trial court ruled that legal causation was not satisfied because Nurse Weberg did not directly treat these patients. The Washington Court of Appeals affirmed.
The Supreme Court of the State of Washington (“Washington Supreme Court”) stated in its opinion filed on January 18, 2024: “We hold that the General Treatment Class’s injuries arise as a result of health care, allowing their claim under chapter 7.70 RCW to proceed. Every member of the General Treatment Class was a patient in Good Samaritan’s ER and received injections from a health care provider as part of their treatment. These injections were part of the process of being treated or cared for by a health care provider who was using the skills they had been taught. The potential exposure to hepatitis C results from MultiCare’s alleged failure to follow the accepted standard of care in the process of providing this health care. Thus, the General Treatment Class has a chapter 7.70 RCW claim even without evidence they were treated by Weberg.”
With regard to legal causation, the Wsahington Supreme Court stated: “Most importantly, there is no objective symptomatology requirement under chapter 7.70 RCW … We agreed with the lower court that chapter 7.70 RCW
claims are already limited, as they must arise from health care and must fit within the statute’s narrow framework. Berger, 101 Wn. App. at 158. Therefore, an objective symptomatology requirement is unnecessary. The General Treatment Class may pursue a claim for purely emotional damages under chapter 7.70 RCW. Therefore, the fact that some class members suffered purely emotional damages is irrelevant in determining legal causation in this case.”
“No plaintiffs in this suit—whether in the Weberg Class or the General Treatment Class—base their claim for damages on treatment by Nurse Weberg. Patients were unaware that Nurse Weberg was responsible for spreading the virus when they learned of the outbreak. MultiCare’s letter stated only that “an employee in the Emergency Department” may have exposed patients to hepatitis C. CP at 468. The same notification letter was sent to all at-risk patients, whether they were treated by Nurse Weberg or not. Instead, the fear arose from a real risk of exposure to bloodborne pathogens, as determined by public health experts, not from being directly treated by Nurse Weberg. Thus, the fact that Nurse Weberg did not treat the General Treatment Class is not relevant to legal causation.”
“Claims for purely emotional harms often arise from a plaintiff’s knowing or learning of misconduct. However, it is irrelevant how they learn of the misconduct. The content of the notification and the underlying negligence causes the harm … In this case, there is perfect overlap between the injured group and the group that received MultiCare’s notification letter. But this does not mean that the letter caused the harm. Rather, both classes were harmed by exposure to a high risk of infection in MultiCare’s emergency department. Laudably, MultiCare chose to notify everyone in this at-risk group. But even if the class had learned of their risk of exposure from the CDC or the local health department rather than from MultiCare, they would have had an equally strong claim. … The General Treatment Class learned of the outbreak through the letter but was harmed by the allegedly negligent acts revealed in the letter. If MultiCare had properly hired, supervised, and monitored potential drug diversion by employees, notification likely would not have been necessary. The General Treatment Class’s damages are not too remote from MultiCare’s acts to impose liability.”
“This case arises under chapter 7.70 RCW and not NIED [negligent infliction of emotional dfistress]. Therefore, a physical impact requirement is unnecessary. We reject the cautious “actual exposure” test favored in NIED cases. However, a pure “reasonableness” standard lacks guardrails and could lead to excessive liability if the public lacks information about a disease. Therefore, the test we adopt must link reasonableness to a scientific understanding of how a particular disease is spread and who is at risk of infection. Additionally, plaintiffs should be able to recover emotional distress damages only for the period between discovery of the potential exposure and when it is clear that they have not been infected.”
New Test For Legal Causation
“Therefore, this court adopts a new test for legal causation for chapter 7.70 RCW claims that involve fear of disease transmission. Plaintiffs must establish (1) an objectively reasonable fear of having contracted a disease (2) through a medically recognized means of transmission (3) and damages that occur within the window of anxiety. This test weeds out frivolous litigation and accounts for public misinformation while still holding tortfeasors responsible for the consequences of their negligence.”
Washington Supreme Court Holding
“Applying the test to this case, we hold that the General Treatment Class has established legal causation in their chapter 7.70 RCW claim. The General Treatment Class has shown that class members reasonably feared contracting hepatitis C when they learned of the alleged negligence. They have also demonstrated a medically recognized means of transmission: intravenous injections of potentially contaminated drugs. Under this test, the General Treatment Class does not need to prove the injections they received were actually infected with a disease. Finally, the General Treatment Class may recover damages only for the window of anxiety, which is the period between when a person learns of the exposure and when they know or should know that they are not infected.”
Source M.N. and G.T. v. MultiCare Health System, Inc., No. 101537-2.
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