Doe v. Pharmacia & Upjohn, Inc.

UNPUBLISHED
UNITED STATES COURT OF APPEALS
FOR THE FOURTH CIRCUIT
No. 03-2166
JANE DOE,
Plaintiff - Appellant,
versus
PHARMACIA & UPJOHN, INCORPORATED,
Defendant - Appellee.
Appeal from the United States District Court for the District of
Maryland, at Greenbelt. Peter J. Messitte, District Judge. (CA-
03-702-PJM)
Argued: October 28, 2004 Decided: February 4, 2005
Before NIEMEYER, KING, and SHEDD, Circuit Judges.
Order of certification of questions of law to the Court of Appeals
of Maryland.
ARGUED: Stephen Bennett Mercer, SANDLER & MERCER, P.C., Rockville,
Maryland, for Appellant. Stephen Edward Marshall, VENABLE, L.L.P.,
Baltimore, Maryland, for Appellee. ON BRIEF: Paul F. Strain,
Mitchell Y. Mirviss, Mark D. Maneche, VENABLE, L.L.P., Baltimore,
Maryland, for Appellee.
PER CURIAM:
Jane Doe appeals from the dismissal of her amended complaint
for failure to state a claim upon which relief can be granted.1
See Fed. R. Civ. P. 12(b)(6). In her amended complaint, Jane Doe
alleges generally that John Doe contracted the human
immunodeficiency virus (“HIV”) while he was employed by Pharmacia
& Upjohn, Incorporated (“Pharmacia”) as a laboratory technician at
Pharmacia’s Montgomery County, Maryland, viral production facility;
that Pharmacia negligently tested and informed John Doe that he did
not have HIV; and that she subsequently contracted HIV from John
Doe through unprotected marital relations. The district court
dismissed the amended complaint, which (for our purposes) is
grounded in Maryland negligence law, based on its conclusion that
Pharmacia did not owe a legal duty of care to Jane Doe.
Pursuant to Maryland Code Ann., Cts. & Jud. Proc. §§ 12-605
and 12-606, we now certify the following questions of Maryland law
to the Court of Appeals of Maryland:
(1) For purposes of a negligence cause of action, does a
commercial manufacturer of two strains of HIV (“HIV-1"
and “HIV-2"), which conducts blood tests on its employees
who have been exposed to HIV while on the job, and which
manufactures test kits for HIV-1, owe a legal duty to its
employees’ spouses to exercise reasonable care in
conducting testing, including testing for both strains of
the virus?
1
The district court authorized Jane Doe to proceed under a
fictitious name. We refer to Jane Doe’s husband, who is not a
party to this litigation, as “John Doe.”
2
(2) For purposes of a negligence or negligent
misrepresentation cause of action, does a commercial
manufacturer of two strains of HIV (“HIV-1" and “HIV-2"),
which conducts blood tests of its employees who have been
exposed to HIV while on the job, owe a legal duty to its
employees’ spouses to exercise reasonable care in
informing the employees of the nature of the test
results, including the fact that a “false positive” test
result for HIV-1 may indicate an HIV-2 infection?
The answers to these questions, which are potentially determinative
of this appeal, do not appear to be directly controlled by any
Maryland appellate decision, constitutional provision, or statute.
We acknowledge that the Court of Appeals of Maryland may
reformulate these questions. We also emphasize that these
questions are premised on the factual allegations of Jane Doe’s
amended complaint which, as explained below, indicate (1) that
Pharmacia was specifically aware of many pertinent facts, including
the identity of Jane Doe as John Doe’s wife and sexual partner and
that the test results could indicate the presence of HIV-2; and (2)
that Pharmacia had the capability to test its employees for both
HIV-1 and HIV-2.
Counsel of record for Jane Doe is Stephen B. Mercer, Sandler
& Mercer, P.C., 27 West Jefferson Street, Suit 201, Rockville,
Maryland, 20850. Counsel of record for Pharmacia is Stephen E.
Marshall, Venable Baetjer and Howard LLP, Two Hopkins Plaza, Suite
1800, Baltimore, Maryland, 21201.
3
I
Jane Doe alleges the following facts in her amended complaint
which, for purposes of this appeal, are not disputed. See GE Inv.
Private Placement Partners II v. Parker, 247 F.3d 543, 546 (4th
Cir. 2001) (“Because the complaint was dismissed pursuant to Rule
12(b)(6), we assume the facts alleged in the complaint are true”).
Jane Doe has been married to, and living as husband and wife
with, John Doe since 1971. (Amended Complaint (“A.C.”) ¶ 1).
Between 1974 and 1991, John Doe was employed by Pharmacia as a
laboratory technician at its Montgomery County, Maryland, viral
production facility. (A.C., ¶ 4). Pharmacia cultivated pathogens
at this facility for use in diagnostic test strips manufactured and
sold by Pharmacia and others. (A.C. ¶ 3). John Doe’s primary job
responsibilities included the daily feeding, growing, and
harvesting of pathogens for large scale propagation. (A.C. ¶ 4).
Pharmacia closed this facility in 1991. (A.C. ¶ 4).
In 1984, researchers discovered that the primary causative
viral agent of acquired immune deficiency syndrome (“AIDS”) is HIV.
(A.C. ¶ 7). By 1986, two types of HIV, designated as “HIV-1” and
“HIV-2,” had been discovered. (A.C. ¶ 7). The first reported case
of HIV-2 in the United States was in 1987, and there have been few
reported HIV-2 cases in the United States. (A.C. ¶ 7). Both HIV-1
and HIV-2 have the same modes of transmission and are associated
with AIDS. (A.C. ¶ 7). Compared with persons infected with HIV-1,
4
those with HIV-2 are less infectious early in the course of
infection. (A.C. ¶ 7).2
Beginning in 1984, approximately 80% of the viral production
at the Pharmacia facility where John Doe worked was HIV-1 and HIV-
2. (A.C. ¶ 3). Pharmacia cultivated and harvested HIV cultures on
a daily basis and shipped them to another facility for
incorporation into a test for HIV antibodies. (A.C. ¶ 3). Between
1985 and 1991, John Doe was exposed to high concentrations of HIV-1
and HIV-2 while on the job. (A.C. ¶ 9).
At some point around 1985, Pharmacia (through its agent) began
testing its employees, including John Doe, who were exposed to HIV
in the workplace every six months. (A.C. ¶¶ 11, 12). Pharmacia
manufactured the test strips that were used in this testing. (A.C.
¶ 11). Although Pharmacia was aware of the existence of HIV-2,
commercial test kits were not available in the United States to
test for an injurious exposure to HIV-2 before 1991 because of the
statistically insignificant incidence of the virus. (A.C. ¶ 7).
Therefore, Pharmacia’s testing was limited to detection of HIV-1.
(A.C. ¶ 10). However, Pharmacia possessed the materials,
knowledge, and capability to manufacture its own test strips to
detect HIV-2. (A.C. ¶ 10).
2
In Faya v. Almaraz, 620 A.2d 327 (Md. 1993), the Court of
Appeals of Maryland, finding that a surgeon who had AIDS owed a
duty to his patients to warn them of his condition, took judicial
notice of several facts about HIV and AIDS.
5
The testing conducted by Pharmacia consisted of a two-part
protocol whereby an initial screen (the Elisa test) would, if
positive, be followed by a confirmatory test (the Western Blot) for
HIV-1. (A.C. ¶ 11). By 1989, Pharmacia was aware that the HIV
tests being used would detect core proteins present in both HIV-1
and HIV-2, and that while the HIV-2 proteins (among other factors)
could cause a positive result on the Elisa test, the Western blot
test would confirm only the presence of HIV-1. (A.C. ¶ 13). Thus,
as of 1989, a person infected with HIV-2 could test positive on the
Elisa test but negative on the Western blot test. (A.C. ¶ 14).
This type of result was considered to be a “false positive” for
HIV-1. (A.C. ¶ 14).
John Doe consistently tested negative until 1989, when he
received a positive result on the Elisa test. (A.C. ¶¶ 11, 22).
John Doe was retested, and the result was negative. (A.C. ¶ 22).
John Doe’s subsequent tests were negative. (A.C. ¶ 22).
Pharmacia did not counsel or warn either John Doe, Jane Doe,
or its testing agent about the potential negative ramifications of
a “false positive” test. (A.C. ¶¶ 15, 16, 18, 19). However,
Pharmacia (and/or its agent) did tell John Doe after the “false
positive” test that the Western Blot test failed to confirm the
presence of HIV-1; that the test result could have been caused by
factors unrelated to exposure to HIV; that the test result did not
indicate that he was infected with the virus that causes AIDS; and
6
that the test result did not indicate a significant risk to his
health. (A.C. ¶ 27). Neither Jane Doe nor John Doe was aware that
a “false positive” test could indicate an HIV-2 infection. (A.C.
¶¶ 20, 21).
In October 2000, John Doe was admitted to the hospital where
he was found to be suffering from multiple AIDS-like conditions.
(A.C. ¶ 5). Although John Doe tested negative for HIV-1, he tested
positive for HIV-2 and was diagnosed as having AIDS. (A.C. ¶ 5).
John Doe became infected with HIV-2 while handling the virus as a
Pharmacia employee. (A.C. ¶ 6).3
Upon learning that he was infected with HIV-2, John Doe
immediately informed Jane Doe. (A.C. ¶ 29). Subsequent testing of
Jane Doe revealed that she also is infected with HIV-2. (A.C. ¶
29). Jane Doe was John Doe’s only sexual partner and was known as
such by Pharmacia. (A.C. ¶ 30). Jane Doe became infected with
HIV-2 because of unprotected marital relations with John Doe.
(A.C. ¶ 30). The Does would not have engaged in unprotected
marital relations had they been aware that John Doe was infected
with HIV-2. (A.C. ¶ 29).
Pharmacia was aware at times pertinent to this case that HIV-2
was a pathogen that could have significant consequences, including
3
Jane Doe attached to the amended complaint a report from her
medical expert who opines within a reasonable degree of scientific
certainty that John Doe became infected during the course of his
employment by Pharmacia.
7
death for humans, and that it could be transmitted by sexual
contact and exchange of body fluids. (A.C. ¶ 32). Pharmacia also
knew that the spread of HIV-2 between sexual partners could be
effectively prevented through behavior modification and the use of
barrier devices. (A.C. ¶ 33). Pharmacia also learned, subsequent
to the conclusion of John Doe’s employment, that at least one co-
worker of John Doe’s at the Montgomery County facility had
unexpectedly become infected with one or more lethal pathogens that
had been propagated in that facility; however, despite having this
knowledge, Pharmacia did not warn the Does of any danger. (A.C. ¶
41).
II
Jane Doe filed this action in Maryland state court. After
Pharmacia removed this case from state court and moved to dismiss
pursuant to Rule 12(b)(6), Jane Doe filed an amended complaint with
nine causes of action. Pharmacia then moved to dismiss the amended
complaint. Following briefing on the motion to dismiss, the
district court conducted oral argument. At the conclusion of the
hearing, the district court orally granted the motion and dismissed
the case. The district court subsequently denied Jane Doe’s motion
for reconsideration.
8
This appeal involves only five of Jane Doe’s causes of action,
all of which sound in negligence.4 Specifically, Jane Doe asserts
in these five causes of action claims for negligent operation of an
HIV production facility (Count I); negligent failure to rule out an
HIV-2 infection (Count II); negligent failure to test for HIV-2
(Count III); negligent failure to warn of cross reactivity (Count
V); and negligent misrepresentation (Count IX). Jane Doe asserts
that Pharmacia breached a duty of care to her -- as a person known
to Pharmacia to be at risk of contracting HIV-2 from John Doe -- by
“failing to rule out that John Doe had been injuriously exposed to
HIV-2 at [Pharmacia’s] production facility” (Count II); by “failing
to test . . . John Doe for HIV-2 where John Doe was exposed to HIV-
2 at [Pharmacia’s] production facility” (Count III); by “failing to
warn John Doe . . . that HIV-2 would produce a ‘false positive’
HIV-1 test result” (Count V); and by “negligently misrepresenting
to John Doe that his ‘false positive’ test result for HIV-1 did not
indicate the presence of the virus that causes AIDS and did not
indicate a significant health risk.”5 Jane Doe alleges that she
became infected with HIV-2 (through unprotected marital relations
4
Jane Doe withdrew three causes of action (Counts IV, VI, and
VII) in the district court, and she has not appealed the dismissal
of another cause of action (Count VIII).
5
In Count I, Jane Doe does not assert a specific duty owed by
Pharmacia to her. Rather, Jane Doe’s allegations relate more
generally to Pharmacia’s alleged duties to its employees.
9
with John Doe) as a direct and proximate result of Pharmacia’s
breach of these asserted duties.
The district court held that each of these claims fails as a
matter of law based on the lack of a legal duty of care owed by
Pharmacia to Jane Doe. The district court specifically relied upon
Adams v. Owens-Illinois, Inc., 705 A.2d 58 (Md. App. 1998), in
which the plaintiff contended her husband was exposed to asbestos
in his workplace and that she developed asbestosis as a result of
handling his work clothes. The Maryland Court of Special Appeals
held that the plaintiff’s negligence claim against her husband’s
employer failed as a matter of law because the employer “owed no
duty to strangers based upon providing a safe workplace for
employees.” Id. at 66. The district court concluded that Adams
“suggest[s] that the Maryland courts would, if asked to decide this
case, hold that there is no duty that an employer has with regard
to alleged deficient workplace standards to the spouse of an
employee.” J.A. 74.
In her motion for reconsideration, Jane Doe argued that the
district court failed to consider another Maryland intermediate
appellate decision, Lemon v. Stewart, 682 A.2d 1177 (Md. App.
1996), which she contends is in conflict with Adams. In Lemon, the
Court of Special Appeals rejected a medical malpractice claim
brought by extended family members against a physician because he
failed to inform them that his patient -- their relative -- was
10
HIV-positive. Although the Court of Special Appeals recognized
that the physician had a duty to inform the patient of his
condition, the extended family members could not base their claim
on the breach of that duty. The Court of Special Appeals did note,
however, that “[h]ad any of the appellants been a sexual or
needle-sharing partner of [the patient], an arguable claim could be
made that they were foreseeably potential victims of any breach of
the duty to [the patient] and ought to have a cause of action for
that breach, to the extent they could prove injury.” Id. at 1184.
Because of this purported conflict, Jane Doe asked the
district court to certify the case to the Court of Appeals of
Maryland. The district court found that Lemon -- which involved
duties to third parties arising from the physician-patient
relationship -- is inapplicable and that the part of the Lemon
opinion relied upon by Jane Doe is dicta. The district court
reiterated its holding that this case is controlled by Adams, and
it therefore found certification to the Maryland Court of Appeals
to be inappropriate.
III
On appeal, Jane Doe contends that the district court erred in
holding under Maryland law that Pharmacia did not owe a duty of
care to her. Under Maryland law, a necessary element of a cause of
action for both negligence and negligent misrepresentation is that
the defendant owed a legal duty of care to the plaintiff. Patton
11
v. United States of America Rugby Football, 851 A.2d 566, 570 (Md.
2004) (negligence); Law v. International Union of Operating
Engineers Local No. 37, 818 A.2d 1136, 1145 (Md. 2003) (negligent
misrepresentation).
A legal duty is “an obligation, to which the law will give
recognition and effect, to conform to a particular standard of
conduct toward another.” Patton, 851 A.2d at 571 (internal
quotation marks omitted). The existence of a legal duty is a
question of law to be decided by the court, and in deciding whether
a legal duty exists courts must consider a variety of factors
including the foreseeability of harm to the plaintiff; the degree
of certainty that the plaintiff suffered the injury; the closeness
of the connection between the defendant’s conduct and the injury
suffered; the moral blame attached to the defendant’s conduct; the
policy of preventing future harm; the extent of the burden to the
defendant and consequences to the community of imposing a duty to
exercise care with resulting liability for breach; and the
availability, cost and prevalence of insurance for the risk
involved. Id. at 570-71. “The determination of whether a duty
exists under Maryland law is the ultimate function of various
policy considerations as adopted by either the Legislature, or, if
it has not spoken, . . . by Maryland courts.” Grimes v. Kennedy
Krieger Institute, Inc., 782 A.2d 807, 850 (Md. 2001).
12
No Maryland appellate decision, constitutional provision, or
statute appears to address the precise questions presented in this
case.6 The answers to the certified questions are potentially
determinative of this appeal because Jane Doe’s claims, sounding in
negligence, may go forward only if Pharmacia owed her a legal duty.
Therefore, the questions are properly subject to review by the
Court of Appeals of Maryland on certification.
IV
Accordingly, pursuant to the privilege made available by the
Maryland Uniform Certification of Questions of Law Act, we hereby
ORDER: (1) that the questions stated above be certified to the
Court of Appeals of Maryland for answer; (2) that the Clerk of this
Court forward to the Court of Appeals of Maryland, under the
official seal of this Court, a copy of this Order, together with
the original or copies of the record before this Court to the
extent requested by the Court of Appeals of Maryland; and (3) that
the Clerk of this Court fulfill any request for all or part of the
record simply upon notification from the Clerk of the Court of
Appeals of Maryland.
QUESTIONS CERTIFIED
6
Pharmacia contends that the recent decision in Dehn v.
Edgecombe, No. 117, 2005 Westlaw 77094 (Md. Jan. 14, 2005),
dictates that it did not owe a legal duty to Jane Doe. However,
because the facts and circumstances of Dehn are distinguishable
from the facts of this case, we are not convinced that Dehn is
controlling.
13