Randall Dahler v. Auto-Owners Insurance Company ( 2014 )


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  •                           This opinion will be unpublished and
    may not be cited except as provided by
    Minn. Stat. § 480A.08, subd. 3 (2012).
    STATE OF MINNESOTA
    IN COURT OF APPEALS
    A14-0343
    Randall Dahler,
    Appellant,
    vs.
    Auto-Owners Insurance Company,
    Respondent.
    Filed December 8, 2014
    Reversed and Remanded
    Chutich, Judge
    Benton County District Court
    File No. 05-CV-13-557
    Michael A. Bryant, Bradshaw & Bryant, PLLC, Waite Park, Minnesota (for appellant)
    James S. McAlpine, Garin L. Strobl, Quinlivan & Hughes, P.A., St. Cloud, Minnesota
    (for respondent)
    Considered and decided by Chutich, Presiding Judge; Halbrooks, Judge; and Ross,
    Judge.
    UNPUBLISHED OPINION
    CHUTICH, Judge
    Appellant Randall Dahler appeals summary judgment in favor of respondent Auto-
    Owners Insurance Company. He contends that the district court erroneously found that
    the injury he received in the course of medical treatment for his automobile-related injury
    did not arise out of his use of an automobile and therefore was not covered by his no-fault
    insurance. Because an injury directly caused by an adverse reaction to the medical
    treatment of a no-fault-covered injury arises out of the use of a motor vehicle, we reverse
    and remand.
    FACTS
    On February 24, 2009, appellant Randall Dahler went to his truck to leave for
    work. Upon opening the door, Dahler placed one foot on the truck’s running board; his
    other foot slipped and Dahler fell backwards on his back and buttocks. Although he went
    to work, Dahler soon began to feel pain in his back and had difficulty walking. After two
    months of chiropractic therapy and continued pain, Dahler was referred to his primary
    physician.
    Medical imaging revealed that Dahler had a pinched nerve and inflammation in his
    back. Dahler was then referred to another doctor, who recommended steroid injections to
    treat his back problems. In July and August 2009, Dahler received steroid injections in
    his lower back. After the injections, Dahler began experiencing symptoms of Guillain-
    Barré syndrome,1 and Dahler’s primary physician diagnosed him with the disease.
    An independent medical examiner opined, to a reasonable degree of medical
    certainty, that the “steroid injections that were given for [Dahler’s] back pain following
    1
    “Guillain-Barré syndrome (GBS) is a rare disorder in which a person’s own immune
    system damages their nerve cells, causing muscle weakness and sometimes paralysis.
    [The syndrome] can cause symptoms that usually last for a few weeks. Most people
    recover fully from [the syndrome], but some people have long-term nerve damage. In
    very rare cases, people have died of [the syndrome], usually from difficulty breathing.”
    Guillain-Barré Syndrome (GBS), Centers for Disease Control and Prevention,
    http://www.cdc.gov/flu/protect/vaccine/guillainbarre.htm (last updated Nov. 24, 2014).
    2
    the injury of February 24, 2009 were related to the back injury at that time . . . .” 2
    Respondent Auto-Owners Insurance Company, with which Dahler had an auto insurance
    liability policy, reimbursed him for his out-of-pocket expenses for the treatment of his
    back injury, including the injections. But Auto-Owners also informed Dahler that it
    would not pay any expenses for either the syndrome or missed work related to the
    syndrome under Dahler’s no-fault policy.
    In June 2012, Dahler sued Auto-Owners.           Dahler alleged that the medical
    expenses arising out of the treatment of the syndrome should be covered by his no-fault
    insurance.
    Auto-Owners moved for summary judgment, arguing that the syndrome did not
    arise from the use or maintenance of an automobile and therefore was not covered under
    Minnesota Statutes section 65B.44 (2012) of the Minnesota No-Fault Automobile
    Insurance Act (no-fault act). For purposes of the summary-judgment motion only, the
    parties agreed that the steroid injections directly caused the syndrome.
    The district court granted summary judgment to Auto-Owners. Relying on the
    factors in Continental Western Insurance Company v. Klug, 
    415 N.W.2d 876
    (Minn.
    1987), the district court determined that the syndrome did not arise out of the
    maintenance or use of an automobile. The district court reasoned that the truck was not
    actively connected to the injury and that the fall from the truck was not a substantial
    factor in causing the syndrome. The district court further reasoned that Guillain-Barré
    2
    The doctor further opined that the injections did not cause the syndrome, but this
    factual issue was not raised by Auto-Owners in its summary-judgment motion.
    3
    syndrome “caused by non-negligent medical treatment for a motor vehicle related injury
    is not a foreseeable, natural, and reasonable consequence of motoring.” This appeal
    followed.
    DECISION
    On appeal from a grant of summary judgment, this court asks two questions:
    (1) whether any genuine issues of material fact exist and (2) whether the district court
    erred in its application of the law. State by Cooper v. French, 
    460 N.W.2d 2
    , 4 (Minn.
    1990). Here, the parties agree that no genuine issues of material fact are present.
    Dahler asserts that the district court erred because his automobile-related injury
    necessitated the steroid injections, which in turn caused the syndrome. He argues that
    this connection shows that treatment for the syndrome relates to his use of an automobile.
    Auto-Owners counters that no causal relationship exists between the syndrome and the
    motor vehicle. It further argues that, even if there is a causal relationship, the steroid
    injections were an act of independent significance that broke the causal link. Finally,
    Auto-Owners argues that because the vehicle was not the situs of the injury, no relief is
    available. Because a causal link exists between the use of the motor vehicle and the
    syndrome, which was not broken by the non-negligent medical treatment,3 we reverse
    and remand.
    3
    Neither party argues that the injections Dahler received were improper, negligent, or
    medical malpractice.
    4
    Arising Out of Maintenance or Use of an Automobile
    The no-fault act provides medical expense benefits for injuries “arising out of
    maintenance or use of a motor vehicle.”         Minn. Stat. § 65B.46, subd. 1 (2012).
    “Maintenance or use of a motor vehicle” includes “occupying, entering into, and
    alighting from it.” Minn. Stat. § 65B.43, subd. 3 (2012). Whether an injury arises out of
    the maintenance or use of a motor vehicle is a question of law that this court reviews de
    novo. Dougherty v. State Farm Mut. Ins. Co., 
    699 N.W.2d 741
    , 743 (Minn. 2005).
    Determining whether an injury arises out of the use of a vehicle is a recurring legal
    question that defies a simple test. 
    Klug, 415 N.W.2d at 877
    . Each case turns on the
    specific facts presented. 
    Id. at 877–78.
    The Klug court set forth three general factors to
    consider when addressing this issue: first, the court examines the extent of causation
    between the automobile and the injury. 
    Id. at 878.
    Second, the court considers whether
    an act of independent significance occurred that broke the causal link between use of the
    vehicle and the injuries inflicted. 
    Id. If these
    two factors are met, the court then must
    consider what type of use of the automobile was involved. 
    Id. A. Extent
    of Causation
    A causal connection between the injury and the use of a vehicle “is established if
    the injury is a natural and reasonable incident or consequence of the vehicle’s use.”
    
    Dougherty, 699 N.W.2d at 743
    (quotation omitted). The causal connection must be
    reasonably apparent. Associated Indep. Dealers, Inc. v. Mut. Serv. Ins. Cos., 
    304 Minn. 179
    , 182, 
    229 N.W.2d 516
    , 518 (1975).
    5
    In examining this factor, courts consider whether the vehicle was an “active
    accessory” in causing the injury. 
    Dougherty, 699 N.W.2d at 743
    (quotation omitted).
    This analysis does not require that the vehicle “actively cause the damages; rather, the
    requirement is satisfied if the injury occurred because the vehicle’s use is actively
    connected with the injury.” Illinois Farmers Ins. Co. v. Marvin, 
    707 N.W.2d 747
    , 752–
    53 (Minn. App. 2006).
    “This causation standard requires something less than proximate cause in the tort
    sense and something more than the vehicle being the mere situs of the injury.”
    
    Dougherty, 699 N.W.2d at 743
    (quotation omitted). The phrase “arising out of” is
    broadly construed, 
    id. at 744,
    and has been interpreted to mean “originating from,”
    “having its origin in,” “growing out of,” or “flowing from,” Associated Indep. 
    Dealers, 304 Minn. at 182
    , 229 N.W.2d at 518 (quotation omitted).
    The district court here noted, and the parties agree, that Dahler’s back injury arose
    out of his use of a motor vehicle because he sustained it while entering his truck.
    Medical expenses for treating that injury were properly covered under his no-fault policy.
    The issue here is whether the requisite causal connection exists between Dahler
    developing Guillain-Barré syndrome and his use of the motor vehicle. We conclude that
    it does.
    But for the accident and resulting back injury, Dahler would not have sought
    medical treatment that resulted in the syndrome. To be sure, “but for” causation has been
    rejected in Minnesota in tort cases. See Harpster v. Hetherington, 
    512 N.W.2d 585
    , 586
    (Minn. 1994). But the no-fault act “causation standard requires something less than
    6
    proximate cause in the tort sense.” 
    Dougherty, 699 N.W.2d at 743
    (quotation omitted).
    Moreover, the connection between the vehicle and the syndrome is also “reasonably
    apparent.”   See Associated Indep. 
    Dealers, 304 Minn. at 182
    , 229 N.W.2d at 518.
    Dahler’s truck may not have actively caused the syndrome itself, but that is not required;
    instead, the truck must be “actively connected with the injury.” 
    Marvin, 707 N.W.2d at 752
    –53.
    Furthermore, courts construe the phrase “arising out of” broadly. 
    Dougherty, 699 N.W.2d at 744
    .     This phrase can mean “originating from,” “having its origin in,”
    “growing out of,” or “flowing from.” Associated Indep. 
    Dealers, 304 Minn. at 182
    , 229
    N.W.2d at 518 (quotation omitted). Because Dahler’s use of the vehicle caused his back
    injury, and medical treatment for that injury caused him to develop the syndrome, the
    syndrome grew out of and flowed from his use of an automobile. The required casual
    connection between the use of an automobile and the injury in question is therefore met.
    B.     Act of Independent Significance
    The second Klug factor determines whether an act of independent significance
    broke the causal link between use of the vehicle and the injury. 
    Klug, 415 N.W.2d at 878
    . This factor is tied to the first factor: although a causal connection exists if “the
    injury is a natural and reasonable incident or consequence of the vehicle’s use,”
    
    Dougherty, 699 N.W.2d at 743
    (quotation omitted), an independent intervening act
    breaks the causal chain when it “is not a foreseeable risk[] associated with the use of the
    covered automobile.” Lindsey v. Sturm, 
    436 N.W.2d 788
    , 790 (Minn. App. 1989).
    7
    Auto-Owners asserts that the steroid injections are acts of independent
    significance that break the causal connection between Dahler’s back injury and the use of
    his truck. After carefully reviewing the record, we disagree.
    We conclude that administration and receipt of the steroids shots that allegedly
    caused Dahler’s syndrome cannot be viewed as “acts of independent significance” when
    they were deemed appropriate medical steps in the treatment of Dahler’s back injury.
    The Independent Medical Examiner specifically opined that the “steroid injections that
    were given for [Dahler’s] back pain . . . were related to the back injury at that time . . . .”
    The cost of these injections were paid for by the insurance company and they were
    undertaken to remedy an injury that arose out of the use of an automobile.
    Since the possibility of receiving medical treatment is a well-known risk
    associated with motoring, see Minn. Stat. § 65B.48, subd. 1 (2012) (requiring that all
    motor vehicle owners maintain a no-fault insurance policy), the requisite connection
    exists between Dahler’s use of the truck and the injuries that he sustained when receiving
    treatment for his back injury. Cf. Edwards v. State Farm Mut. Auto. Ins. Co., 
    399 N.W.2d 95
    (Minn. App. 1986) (recognizing connection between use of a vehicle and
    injuries “when the injuries arise from a risk associated with motoring”), review denied
    (Minn. Mar. 13, 1987).
    At trial, the parties will vigorously dispute whether Dahler’s Guillain-Barré
    syndrome was in fact caused by the steroid injections and we express no opinion as to the
    merits of Dahler’s claims. On the record before us, however, receiving these steroid
    8
    shots is not an act of independent significance breaking the causal chain between
    Dahler’s injury and the use of his truck.
    C.     Type of Use of the Automobile
    If the first two factors are met, a court must consider what type of use of the
    automobile was involved. 
    Klug, 415 N.W.2d at 878
    . Although not discussed by the
    district court, we conclude in our de novo review of the undisputed facts that this factor is
    met as well. The parties do not dispute that Dahler’s back injury occurred while entering
    his truck, a use covered by the statute. See Minn. Stat. § 65B.43, subd. 3. Based on our
    analysis above, we conclude that a nexus exists between the syndrome and the use of an
    automobile for transportation purposes.
    Finally, we note that other states with similar no-fault laws have considered
    analogous cases and have reached the same conclusions.           See Haff v. Hettich, 
    593 N.W.2d 383
    , 391–92 (N.D. 1999) (holding that no-fault benefits extend to those who
    receive negligent medical treatment for injuries sustained in an automobile accident);
    Varner v. Nationwide Mut. Ins. Co., 
    489 A.2d 918
    , 919–20 (Pa. Super. Ct. 1985) (finding
    that an injury sustained as a result of negligent medical treatment of an automobile-
    related injury is covered by no-fault insurance). Although these cases are not binding
    upon us, their reasoning is persuasive.
    9
    In sum, because a causal connection exists between the Guillain-Barré syndrome
    and Dahler’s use of a motor vehicle that was not severed by the medical treatment he
    received, we reverse the grant of summary judgment in favor of Auto-Owners and
    remand the case for further proceedings.
    Reversed and remanded.
    10