Bryant v. Gen. Motors Corp.

[Cite as Bryant v. Gen. Motors Corp., 2015-Ohio-4911.]
IN THE COURT OF APPEALS OF OHIO
THIRD APPELLATE DISTRICT
DEFIANCE COUNTY
LORETTA S. BRYANT, SURVIVING
SPOUSE OF IVAN BRYANT, DECEASED,
PLAINTIFF-APPELLEE, CASE NO. 4-15-03
v.
GENERAL MOTORS CORP.,
DEFENDANT-APPELLANT,
-and-
MARSHA P. RYAN, ADMR., OPINION
OHIO BUREAU OF WORKERS
COMP, ET AL.
DEFENDANTS-APPELLEES.
Appeal from Defiance County Common Pleas Court
Trial Court No. 09-CV-40370
Judgment Affirmed
Date of Decision: November 30, 2015
APPEARANCES:
Marc S. Barnes for Appellant
Shawn M. Acton for Appellee, Loretta S. Bryant
Case No. 4-15-03
SHAW, J.
{¶1} Defendant-appellant, Powertrain Division, General Motors
Corporation (“GM”), appeals a jury verdict finding that plaintiff-appellee, Loretta
Bryant (“Loretta”), is entitled to participate in the Ohio Workers’ Compensation
Fund as a result of the occupational exposure to asbestos sustained by her
deceased husband, Ivan Bryant (“Ivan”), which contributed to his death from lung
cancer.
Procedural History and Facts
{¶2} Loretta commenced the underlying case as an appeal, pursuant to R.C.
4123.512, after the Ohio Bureau of Workers’ Compensation denied her request for
widow’s benefits of her late husband, Ivan. Loretta alleged that Ivan sustained an
injurious exposure to asbestos as a result of his job duties at GM and that his
asbestos-related lung cancer was the direct and proximate cause of his death. The
complaint claimed that Ivan’s employment with GM created a risk of contracting
asbestos-related diseases and conditions in a greater degree and in a different
manner than the public generally. GM denied that Ivan’s lung cancer was
asbestos-related and denied that he contracted his lung cancer as a result of his
employment at GM’s Defiance facility. Further, GM contended that Ivan’s long-
time habit of smoking one to two packs of cigarettes a day was the sole cause of
his lung cancer.
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{¶3} The case proceeded to a jury trial. Loretta presented Robert Bell, a
former GM employee, who testified to the existence several products containing
asbestos at GM and common practices at the plant relating to the use of those
products. Bell also relayed his interactions with Ivan at GM and his recollection
of their occupational exposure to airborne asbestos. In addition, Loretta presented
the expert testimony of Dr. L.C. Rao who reviewed several medical records
belonging to Ivan and gave his expert medical opinion establishing a causal link
between Ivan’s asbestos exposure at GM, the development of his lung cancer and
his death. Loretta also took the stand and recalled her experience with Ivan’s
employment at GM and his subsequent illness and death.
{¶4} In addition to this testimony, Loretta also submitted Plaintiff’s
Exhibits 5 and 6. These exhibits were documents produced by GM during
discovery which summarized the removal of asbestos from the Defiance facility
between 1981 and 2011 and detailed GM’s 2006 policy regarding the prevention
of airborne asbestos exposure at the Defiance facility.
{¶5} GM presented two medical experts in its defense: Dr. David
Rosenberg and Dr. John Lockey. Both experts reviewed pertinent portions of
Ivan’s medical records and disputed Loretta’s claims that there was any medical
evidence establishing Ivan had suffered an injurious exposure to asbestos.
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Accordingly, the defense experts opined that the lone cause of Ivan’s lung cancer
was his long history of smoking cigarettes for over forty years.
{¶6} GM orally moved for a directed verdict at the end of Loretta’s case-in-
chief. The trial court denied the motion for directed verdict. After the testimony
of their two medical experts, GM renewed its motion. The trial court again
overruled the motion for directed verdict.
{¶7} After the close of all the evidence, the jury entered its verdict in favor
of Loretta’s claim. In specific interrogatories, the jury found that: (1) Ivan was
exposed to airborne asbestos fibers during the course of his employment at GM;
(2) the conditions of Ivan’s employment at GM resulted in a hazard of exposure to
airborne fibers, which distinguished his employment in character from
employment generally; (3) Ivan’s employment at GM created a risk of contracting
lung cancer in a greater degree and in a different manner than the public generally;
and (4) Ivan’s exposure to airborne asbestos fibers was a proximate cause of his
lung cancer. The jury further found that Loretta is entitled to participate in the
Workers’ Compensation Fund.
{¶8} GM filed this appeal, asserting three assignments of error.
ASSIGNMENT OF ERROR NO. I
THE TRIAL COURT ERRED BY DENYING GENERAL
MOTORS’ MOTION FOR DIRECTED VERDICT, WHERE
THERE WAS NO EVIDENCE DECEDENT WAS
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INJURIOUSLY EXPOSED TO AIRBORNE ASBESTOS AT
GENERAL MOTORS.
ASSIGNMENT OF ERROR NO. II
THE TRIAL COURT ERRED BY ADMITTING GENERAL
MOTORS’ DOCUMENTS OVER GENERAL MOTORS’
OBJECTIONS.
ASSIGNMENT OF ERROR NO. III
THE TRIAL COURT ERRED BY ADMITTING THE
EXPERT OPINION OF DR. L.C. RAO, WHERE THE
OPINION WAS BASED ON FACTS, WHICH WERE NOT
ADMITTED INTO EVIDENCE.
First Assignment of Error
{¶9} In its first assignment of error, GM argues that the trial court erred in
denying its motion for directed verdict. “A motion for directed verdict tests
whether the evidence is sufficient to warrant a jury’s consideration, so in deciding
whether to grant a directed verdict, a trial court considers neither the weight of the
evidence nor the credibility of the witnesses.” Ahmed v. Wise, M.D., 10th Dist.
No. 12AP-613, 2013-Ohio-2211, ¶ 9. Civil Rule 50(A) sets forth the standard of
granting a motion for directed verdict:
When a motion for directed verdict has been properly made,
and the trial court, after construing the evidence most strongly
in favor of the party against whom the motion is directed, finds
that upon any determinative issue reasonable minds could come
to but one conclusion upon the evidence submitted and that
conclusion is adverse to such party, the court shall sustain the
motion and direct a verdict for the moving party as to that issue.
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{¶10} “In deciding a motion for a directed verdict, the trial court must
assume that the evidence presented by the nonmovant is true, must give the
nonmovant the benefit of all reasonable inferences to be drawn from that evidence,
and ascertain whether any substantial probative evidence supports the
nonmovant’s claim.” Snyder v. Manuel, 3d Dist. Hancock No. 5-11-39; 2012-
Ohio-5951, ¶ 16, citing Ruta v. Breckenridge–Remy Co., 69 Ohio St. 2d 66, 68
(1982). We employ a de novo standard of review in evaluating the grant or denial
of a motion for a directed verdict. Grau v. Kleinschmidt, 31 Ohio St. 3d 84, 90
(1987).
Establishing a Right to Participate in the Ohio Workers’ Compensation
System—Elements of Plaintiff’s Claim
{¶11} Under R.C. 4123.68, Loretta is entitled to widow’s benefits if she can
demonstrate that Ivan’s death was caused by an occupational disease. Lung
cancer is not a specified occupational disease included under the statute. Loretta
therefore bears the burden of demonstrating that Ivan’s lung cancer meets the
criteria for an occupational disease.
R.C. 4123.01(F) defines an “occupational disease” as
a disease contracted in the course of employment, which by its
causes and the characteristics of its manifestation or the
condition of the employment results in a hazard which
distinguishes the employment in character from employment
generally, and the employment creates a risk of contracting the
disease in greater degree and in a different manner from the
public in general.
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{¶12} In this case, Loretta had to prove that her husband contracted and
died from an occupational disease as a result of an injurious exposure to asbestos
in the course of and arising out of his employment. See Snyder v. Ford Motor Co.,
3d Dist. No. 1-05-41, 2005-Ohio-6415. This includes establishing a direct and
proximate causal relationship between the employment and the condition alleged.
See Fox v. Indus. Comm. of Ohio, et al., 162 Ohio St. 569 (1955), syllabus.
{¶13} Loretta’s burden of proof is a preponderance of the evidence, which
is defined as “the greater weight of the evidence, that is, evidence that you believe
because it outweighs or overbalances in your mind the evidence opposed to it. A
preponderance means evidence that is more probable, more persuasive, or of
greater probative value. It is the quality of the evidence that must be weighed.”
Cawrse v. Allstate Ins. Co., 5th Dist. No. 09COA002, 2009-Ohio-2843.
{¶14} With these foregoing principles in mind, we turn to discuss whether
the trial court erred in denying GM’s motion for directed verdict which requires us
to examine the evidence presented to support the elements of Loretta’s claim.
Evidence Relating to Asbestos Exposure at GM
{¶15} Ivan’s career with GM spanned nearly thirty years. He began
working for GM in 1973 at its Defiance facility and continued working there until
he retired in 2001. Ivan died of lung cancer on February 28, 2007. Robert Bell, a
former co-worker of Ivan’s who also worked at the Defiance facility for nearly
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thirty years, testified that he first met Ivan in the mid-1970’s in Plant 1 at GM’s
facility. He recalled they worked together in the “core room” on line 3 for a “few
weeks.” (Doc. No. 117 at 50-51). After that, Bell remembered Ivan working “up
front” and in the foundry, where he observed Ivan performing “clean-up” and
other jobs. (Id. at 51). Throughout the proceeding years, Bell also passed through
Ivan’s area “to get to the locker room, to the break room, to wherever [he] went.”
(Id. at 77). Bell described the GM facility where he and Ivan worked as one large
open space. He recalled that when he first began working there in the early
seventies “you couldn’t see fifty-six—sixty foot down the plant” because of “the
dust and dirt in the air.” (Doc. No. 117 at 44).
{¶16} Bell testified that he was not initially aware of the dangers of
asbestos when he first began his employment at GM, but later learned about
asbestos from safety meetings conducted at the plant. Bell recalled that these
safety meetings occurred monthly and sometimes weekly. During these safety
meetings the plant foreman warned the employees about asbestos products in the
plant. According to Bell, both he and Ivan were exposed to harmful asbestos at
GM. He testified to working with several products containing asbestos during his
tenure at GM.
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1. “Asbestos Cloth”
{¶17} One such product was referred to by Bell as “asbestos cloth,” which
was material used as heat shields throughout the plant. Bell described the product
as a white cloth fabric that came in ten-foot rolls. Bell testified that the “[a]sbestos
cloth was hung all over. Any place where there was heat they used it as shields.”
(Doc. No. 117 at 37). Specifically, Bell recalled that the heat shields were “placed
[] in areas where the hot irons would be splashed and the cloth would protect
people from getting splash [sic] by that iron.” (Id.). Bell further described the
method customarily used to clean the heat shields. “When those build up so thick
with iron, the heat shields, you take an iron bar and you beat the iron off of these.
And then when you’re beating on them that white powder just flies.” (Id. at 71).
He explained that when the condition of heat shields “did get bad burn up, you
know, where it’s falling apart you would change it.” (Id. at 38). Bell stated that
changing the cloths entailed cutting a new piece of fabric from the ten-foot roll,
which caused dust to emit from the fabric. Bell provided the following testimony
relative to Ivan’s work experience with the heat shields:
Plaintiff’s Counsel: Now when the two of you, you and Mr.
Bryant, were working in the cores—
Bell: Um-hm. Yes.
Plaintiff’s Counsel:—now where [sic] you subjected to any
asbestos, airborne asbestos at that time?
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Defense Counsel: Objection. Relevancy.
Bell: Yes.
Trial Court: Overruled.
Plaintiff’s Counsel: And how so?
Bell: The cloth was hanging right next to me.
Plaintiff’s Counsel: And during that time, did you see Mr.
Bryant being exposed to any airborne asbestos?
Bell: Yes.
Plaintiff’s Counsel: How so?
Bell: He was standing right beside me.
Plaintiff’s Counsel: Right next to the cloths?
Bell: Yes.
(Doc. No. 117 at 52-53). Bell recalled that the management later eliminated the
use of the heat shields in the late 1970s.
2. Pipe Insulation
{¶18} Bell also testified that the pipes located above the employees’ heads
were wrapped in asbestos and were in poor condition. Bell described the
condition of the pipes:
Bell: Well, a lot of time in material, like on your steams [sic]
pipes are falling off, breaking, you know, and their water pipes
are constantly leaking.
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Plaintiff’s Counsel: Okay. Would you see the insulation from
these pipes on the ground anytime?
Bell: Oh, yes you would. Yeah.
Plaintiff’s Counsel: Would that create any dust?
Bell: Yes, it would.
(Doc. No. 117 at 42).
3. Furnaces
{¶19} Bell also observed Ivan performing a specific “clean-up job”
sometime in the 1970’s “[w]hen he worked up front in the core room they tore out
what they called vertical furnaces and he was the one that cleaned them out, and
those was wrapped with asbestos.” (Doc. No. 117 at 53). Bell’s testimony
continued:
Plaintiff’s Counsel: You saw him cleaning these vertical—
Bell: I saw him cleaning it up.
Plaintiff’s Counsel: Okay. And there was asbestos?
Bell: Yes.
Plaintiff’s Counsel: Did you see dust?
Bell: Yes.
Plaintiff’s Counsel: Did you ever see Mr. Bryant wear
anything—anything, any type of mask when he was working.
Bell: I can’t say so.
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(Id. at 53-54). Regarding the asbestos wrapped ovens, Bell explained that “[o]ver
a period of years they did away with them. Over probably, all the way up until the
‘90’s * * * they tore them out.” (Id. at 78).
4. “Firebricks”
{¶20} In addition, Bell described “firebricks” made with asbestos that lined
the furnaces. (Doc. No. 117 at 39). He explained that employees replaced the
“firebricks” when needed and described the method customarily used by the
employees to replace the “firebricks,” which created a “dusty situation.” (Id. at
40). “Well I tore ‘em out when they got burned up. When a furnace gets so
warm, burn out, you go inside of it and you tear ‘em out. That’s done with a jack
hammer. You know, and then after you get all the fire brick tore out then you
have to replace it with all new—you know, we handled it the whole time.” (Id.).
Bell testified that eventually the employees were told by plant foremen to wear
protective masks because the firebricks contained asbestos. (Id. at 74). Bell
recalled that the employees “were still passing fire bricks in the ‘80s.” (Id. at 73).
5. Ladles
{¶21} Bell also described the process for making ladles which required the
mixing of water and a powdery material into a mold.
Bell: They bring them in and—the material’s brought in, in
bags and it’s set upon the deck and you bust the bags open, put
in the—it’s more like a big concrete mixer.
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Plaintiff’s Counsel: okay
Bell: You add water and the materials to it.
Plaintiff’s Counsel: And what are that—what are [sic] the
contents of that bag look like?
Bell: It’s a greyish white material.
Plaintiff’s Counsel: Okay. Was there a label on that bag?
Bell: Yes there is.
Plaintiff’s Counsel: What was it labeled?
Bell: Label, uh—
Plaintiff’s Counsel: What did it say on the bag?
Bell: It’s says asbesto [sic]—.
Plaintiff’s Counsel: Okay.
Bell: —on the bags.
Plaintiff’s Counsel: Now would you be pouring that in and
mixing it together yourself?
Bell: Yes.
Plaintiff’s Counsel: Again would dust—
Bell: Oh yes.
Plaintiff’s Counsel:—emanate?
Bell: Oh yes.
(Doc. No. 117 at 40-41).
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{¶22} Bell testified that he was responsible for cleaning up the dust and
described the practice of using air hoses to clear the settled dust off surfaces and
materials. He was also involved in the removal of the “asbestos cloth” from the
facility. He recalled the removal being “kind of like an OSHA thing, we had to
get rid of it all. So what we did just cut it down put it in tubs and haul it out back.”
(Id. at 43). Bell further stated that to the best of his knowledge there were still
asbestos products in the plant at the time he retired from GM in 2000. (Id. at 55).
He explained that he personally removed asbestos products and placed them in
back rooms. (Id.).
{¶23} Loretta also provided testimony at trial. She and Ivan married in
1956 and she recalled when he began his employment at GM. She remembered
Ivan working many overtime hours at GM and often working seven days a week.
She described Ivan’s routine of using the downstairs shower in their home after
coming home from GM. She recalled that Ivan typically looked like a “coal
miner” and that he was “[v]ery dirty. Dusty. His face would be so dirty that when
he take his glasses off you could see where his glasses were.” (Doc. No. 117 at
100, 104). Loretta stated that Ivan was a long-time smoker of approximately forty
years. She recalled his diagnosis of lung cancer in April of 2005 and his death in
February of 2007.
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Discussion
{¶24} On appeal, GM claims that Loretta failed to establish Ivan suffered
an injurious exposure to asbestos while employed at GM. Specifically, GM argues
that the testimony of Robert Bell was insufficient to establish Ivan’s asbestos
exposure at the Defiance facility. GM takes issue with the fact that Bell testified
he only worked with Ivan for a “few weeks” in the mid-1970’s and could not
recall whether Ivan was present during the time when the heat shields made from
“asbestos cloth” were struck with iron bars and produced dust. GM further
contends that Bell’s limited knowledge regarding which asbestos products Ivan
was exposed to and the fact that Bell admitted to never testing or knowing of any
tests performed on the dust to confirm whether it contained asbestos fibers
rendered his testimony deficient to establish that airborne asbestos was even
present at the GM facility, let alone that Ivan suffered an injurious exposure.
{¶25} With respect to the existence of airborne asbestos at GM, Bell
identified several products he worked with on a regular basis that contained
asbestos. He also testified from first-hand knowledge as to how these products
were used which caused a significant amount of dust to emit from the product and
become airborne. Notwithstanding the fact that Bell’s testimony indicated that
some of these products were either labeled with word “asbestos” on the package—
i.e., the ladle mix, or were commonly referred to as being made from asbestos—
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i.e., the heat shields or “asbestos cloth,” Bell also testified to participating in
monthly, sometimes weekly, safety meetings where the hazards of asbestos were
discussed, and to assisting in the removal of specific asbestos products from GM’s
facility.
{¶26} Notably, GM failed to present any testimony countering Bell’s
assertions that these asbestos products were present in the plant and that these
products were used in the manner described by Bell. To the contrary, the
documents submitted by GM during discovery which were admitted as Plaintiff’s
Exhibits 5 and 6 (the summary of asbestos removal and asbestos prevention
policy) corroborate Bell’s testimony to the extent that he discussed the existence
and use of several asbestos products throughout the plant.
{¶27} Also, we are not persuaded by GM’s argument that Bell’s lack of
empirical knowledge confirming whether the dust at GM contained friable
asbestos fibers somehow rendered his testimony inadequate to establish the
presence of airborne asbestos at GM’s facility. Bell was qualified to provide
testimony from his first-hand knowledge of the things he had actually perceived as
an employee at the plant for nearly thirty years, which included his perception as
to the existence of and his exposure to airborne asbestos. See Evid.R. 602; see
also Welsh v. Ford Motor Co., 8th Dist. No. 94068, 2011-Ohio-448, ¶ 28 (finding
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the decedent’s co-worker qualified to testify to the existence of asbestos in the
facility as well as to the decedent’s specific asbestos exposure).
{¶28} Turning to Bell’s testimony regarding Ivan’s injurious exposure to
asbestos, Bell recalled that he and Ivan worked in close proximity to the “asbestos
cloth” heat shields that were hung throughout the facility and that were
periodically beaten to remove excess build-up, which according to Bell generated
a considerable amount of dust. Bell also witnessed Ivan performing a “clean-up”
job of a vertical furnace which was known by Bell to be wrapped in an asbestos
product. Bell noted that this particular “clean-up” job involved the disturbance of
a significant amount of dust and debris.
{¶29} Moreover, Bell described the GM facility where he and Ivan worked
as a large open-air building that was filled with so much airborne dust and debris
that it limited visibly across the plant. Bell further testified to a common practice
in the plant of employees using air hoses to clear the dust and debris off surfaces,
which in turn redistributed the settled dust back into the air. Loretta also provided
testimony that Ivan typically came home from his shifts at GM covered in dust and
debris. Notably, there was also testimony from the medical experts on both sides
indicating that the visible dust emitting from an asbestos product contains millions
of friable asbestos fibers, which is a greater amount of asbestos fiber than that
generally found in the ambient air. (Doc. No. 79 at 21; Doc. No. 76 at 53.)
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Loretta’s expert, Dr. Rao, further testified that there is no safe level of exposure to
airborne asbestos.
{¶30} We also find it noteworthy, that several documents contained in
Ivan’s medical records submitted at trial demonstrate that Ivan’s treating
physicians listed “asbestosis” either as a secondary diagnosis or as part of his past
medical history. Some of these pages even notate that Ivan had been
“compensated for asbestosis” in the past or “had a disability for environmental
lung disease.” (see, e.g, Plaintiff’s Ex. 3, page 69 “History & Physical” Apr. 23,
2005; Plaintiff’s Ex. 3, page 85 “Consolation Report” Apr. 23, 2005). Also of
note, is an “Information Sheet” from the Northwest Oncology Center completed
and signed by Ivan on May 4, 2005. In this document, Ivan specifically indicated
that he had been exposed to asbestos during his work experience. (Plaintiff’s Ex.
3).
{¶31} In sum, as it pertains to establishing Ivan’s injurious exposure to
asbestos at GM, we find that there are numerous factors supporting the trial court’s
decision to overrule GM’s motion for directed verdict. For example: (1) Ivan’s
co-worker, Robert Bell, identified several asbestos products used at the GM
facility during the time of Ivan’s employment; (2) Documents produced by GM
corroborated Bell’s testimony that asbestos products were used at GM during
Ivan’s employment; (3) According to Bell, these products were inherently dusty
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and generated significant amounts of dust during use; (4) After that use, the
products deteriorated or were removed in a process that generated substantial
amounts of dust and residue; (5) In addition to the use, the cleaning of the products
and other surfaces generated additional dust; (6) Expert testimony established that
dust seen emanating from asbestos products contains millions of harmful asbestos
fibers; (7) Bell witnessed Ivan working in close proximity to some of these
asbestos products and engaging in clean-up activities in the locations of asbestos
products that generated a significant amount of dust; (8) Loretta stated that Ivan
often worked seven days a week during his nearly thirty-year tenure at GM and
regularly came home covered in dust and debris; (9) GM’s Defiance facility was a
large open-air building permitting dust and debris to drift from one department to
the next; (10) Bell described the limited visibility in the facility at times due to the
amount of floating dust and residue in the air; (11) Several documents in Ivan’s
medical records referenced conditions associated with a harmful exposure to
asbestos; and (12) Expert medical testimony from Loretta’s expert indicated that
there is no safe level of exposure to airborne asbestos.
{¶32} After construing this evidence most strongly in favor of Loretta, our
standard of review requires us to also give her the benefit of all reasonable
inferences that may be drawn from the evidence. In applying this standard of
review, we find there is sufficient evidence, if believed, relating to the issue of
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Ivan’s occupational exposure to asbestos at GM to permit reasonable minds to
reach different conclusions on this issue. Accordingly, we conclude that the trial
court did not err in determining there was sufficient evidence as to this element of
Loretta’s claim in order for it to be submitted to the jury. See O’Day v. Webb, 29
Ohio St. 2d 215, 220 (1972) (“[i]t is uncontestably the duty of a trial court to
submit an essential issue to the jury when there is sufficient evidence, if believed,
relating to that issue to permit reasonable minds to reach different conclusions on
that issue”).
Medical Evidence Regarding the Causal Relationship
{¶33} In addition to demonstrating that Ivan sustained an injurious
exposure to airborne asbestos while employed at GM, Loretta must also establish a
direct and proximate causal relationship between the employment and Ivan’s lung
cancer. Cook v. Mayfield, 45 Ohio St. 3d 200, 204 (1989) (A Workers’
Compensation claimant seeking the right to participate for an injury arising from
an industrial accident must show by a preponderance of the evidence, medical or
otherwise, the existence of a direct and proximate causal relationship between the
accident and the injury).
{¶34} “Proximate cause” is “ ‘a happening or event which as a natural and
continuous sequence produces an injury without which the result would not have
occurred.’ ” Williams v. Parker Hannifin Corp., 188 Ohio App. 3d 715, 2010–
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Ohio–1719, ¶ 31 (12th Dist.), quoting Randall v. Mihm, 84 Ohio App. 3d 402, 406
(2d Dist.1992). An injury may have more than one proximate cause. Murphy v.
Carrollton Mfg. Co., 61 Ohio St. 3d 585, 587 (1991); McRoberts v. Gen. Elec. Co.,
12th Dist. Butler No. CA2012-10-216, 2013-Ohio-3083, ¶ 21. “In Ohio, when
two factors combine to produce damage or illness, each is a proximate cause.”
Norris v. Babcock & Wilcox Co., 48 Ohio App. 3d 66, 67 (9th Dist.1988). Expert
medical testimony is generally necessary to establish both general and specific
causation. Walker v. Ford Motor Co., 8th Dist. Cuyahoga No. 100759, 2014-
Ohio-4208, ¶ 21.
1. Plaintiff’s Expert
{¶35} At trial, Loretta presented an expert in support of her claim that Ivan
contracted an asbestos-related disease during the course of his employment with
GM. Dr. L.C. Rao testified that he is board certified in internal, forensic, and
pulmonary medicine, and that he is also a “B-reader,” which means that he has
specialized training to read chest x-rays for the detection of occupational-related
lung disease. He is one of approximately 240 B-readers in the world.1
{¶36} Dr. Rao explained that asbestos is fibrous mineral that was
extensively used in many industries in the past for its heat resistant properties and
that a person can be both directly and indirectly exposed to asbestos. Direct
1
Dr. Rao’s testimony was presented to the jury by way of a video-taped deposition taken on September 10,
2014.
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exposure consists of handling asbestos fibers—i.e., asbestos bundles of fibers
wrapped around pipes or preparing the asbestos cement or asbestos “mud.” (Doc.
No. 79 at 20). Indirect exposure occurs when the asbestos becomes fragmented, is
disseminated into the ambient air, and the asbestos fibers are inhaled into the
lungs. He explained that the dust seen coming from an asbestos product contains
hundreds and hundreds of millions of microscopic asbestos fibers. (Id. at 21).
{¶37} According to Dr. Rao, there are cancerous and non-cancerous
conditions associated with asbestos exposure and inhalation-related lung injury.
The two cancerous conditions are (1) lung cancer, due to the fact that asbestos is a
well-known carcinogen; and (2) mesothelioma, which is specifically the cancer of
the pleura or the membrane covering the lung.
{¶38} The first non-cancerous condition is called asbestosis, which occurs
when the asbestos fiber is inhaled and penetrates the lung tissue resulting in
irritation and tissue damage. The body reacts by forming a specific pattern of scar
tissue called interstitial fibrosis when it heals. Dr. Rao explained that asbestosis
typically produces an interstitial thickening in both lung bases and is considered a
chronic interstitial lung disease.
{¶39} The second non-cancerous condition is called pleural plaque or
diaphragmatic plaque. According to Dr. Rao, this kind of plaque is the scarring of
the pleura, which can be damaged by the penetration of asbestos fibers and can
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lead to an inflammation called pleurisy. When the pleurisy heals, it causes
scarring or pleural fibrosis, and over the years it can become a pleural plaque or a
diaphragmatic plaque depending on the location. If the scarring is located around
the chest wall, it is pleural plaque. If it is located at the bottom of the lung, it is
diaphragmatic plaque.
{¶40} Dr. Rao also discussed a latency period associated with asbestos-
related diseases and cancers; specifically, that it may take anywhere from five, ten,
fifteen, or twenty plus years from the time of the asbestos exposure to the
development of the asbestos-related disease. He further indicated that the
presence of asbestosis or diaphragmatic plaque indicates that someone has been
exposed to a significant amount of asbestos. However, he also stated that even a
minimal exposure in the remote past could later give rise to an asbestos-related
disease. Accordingly, he opined that there is no safe level of exposure to airborne
asbestos fibers.
{¶41} Dr. Rao reviewed a chest x-ray of Ivan, taken on December 11, 2000,
five years before Ivan was diagnosed with lung cancer. Dr. Rao found bilateral
interstitial fibrosis in the lower portion of Ivan’s lungs, which he indicated is
consistent with mild asbestosis. In his report dated April 16, 2006, Dr. Rao
concluded “[i]n the presence of a significant occupational exposure history to
asbestos dust, and latency period, the radiological findings are consistent with the
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diagnosis of bilateral interstitial fibrosis due to asbestosis and asbestos associated
diaphragmatic plaque on the left side. In addition, there is evidence of chronic
obstructive pulmonary disease.” (Doc. No. 79, Ex. 4). At trial, Dr. Rao identified
the scarring in Ivan’s lungs as being consistent with asbestosis and distinguished it
from the kind of scarring related to smoking. (Doc. No. 79 at 37-38). Similarly,
Dr. Rao stated that the presence of the diaphragmatic plague is consistent with
asbestos-related plural disease and is not caused by smoking. (Id.).
{¶42} Next, Dr. Rao reviewed a chest x-ray of Ivan, taken on October, 3
2005, five months after Ivan was diagnosed with lung cancer. He identified
shadowing consistent with bilateral interstitial fibrosis due to asbestos. In
addition, Dr. Rao noted evidence showing that the asbestos-related diaphragmatic
plaque was now present in both lungs, whereas it was only present on the left side
in the 2000 x-ray. He stated that this finding was consistent with the progression
of an asbestos-related disease. Dr. Rao also observed evidence of Ivan’s lung
cancer and the radiation changes from the cancer treatment, which did not appear
in the 2000 x-ray. Dr. Rao distinguished the asbestos-related diaphragmatic
plaque from the pleural thickening attributable to the cancer and cancer radiation
treatment. Specifically, he indicated that the diaphragmatic plaque found on the
bottom portion of Ivan’s lungs was related to solely to his asbestos exposure and
was not caused by smoking or cancer radiation treatment. (Doc. No. 79 at 41-42).
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Dr. Rao’s conclusions regarding this x-ray were included in a report dated
September 6, 2014. (Doc. No. 79, Ex. 5).
{¶43} In addition to the two x-rays, Dr. Rao also reviewed several
documents from Ivan’s medical records relating to the diagnosis and treatment of
his lung cancer. One document was a CT scan report dated January 12, 2007,
which was created approximately six weeks prior to Ivan’s death. (Doc. No. 79,
Ex. 6). Dr. Rao highlighted a specific finding by the reporting physician
identifying the presence of “interstitial thickening in both lung bases which may
represent chronic interstitial lung disease.” (Id.). Dr. Rao testified that this
finding is consistent with a diagnosis of asbestosis and that this specific type of
scarring is not caused by smoking. (Doc. No. 79 at 51-52). Dr. Rao again noted
that the changes related to the progression of the asbestos-related diaphragmatic
plaques were located at the bottom of the lungs, whereas the changes related to the
lung cancer and the radiation treatment were isolated to the top of the lung. (Id. at
52-53).
{¶44} Dr. Rao reviewed two additional documents, marked Exhibits 7 and
8. Exhibit 7 is a Toledo Hospital “Facesheet” from April 23, 2005 to May 2,
2005, which was compiled during Ivan’s hospital visit when he first was
diagnosed with lung cancer. Dr. Rao noted in the document that the treating
physician listed asbestosis as a “secondary diagnosis” to the primary diagnosis of
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lung cancer. Exhibit 8 is the April 23, 2005 Emergency Room Report from the
treating physician at Defiance Regional Hospital where Ivan was first seen prior to
being transported to the Toledo Hospital and where Ivan initially received his lung
cancer diagnosis. Dr. Rao noted asbestosis listed by the treating physician in the
“past medical history” section of the report.
{¶45} Dr. Rao explained that occupational exposure to asbestos creates an
increased risk of developing lung cancer and can cause lung cancer in all areas of
the lungs. He further elucidated that smoking and occupational exposure to
asbestos dust multiplies the risk of developing lung cancer:
The occupational exposure to asbestos dust, especially in a
person who is a smoker, increases the risk of lung cancer
synergistically. In other words, it is not one and one is equal to
two. It’s one and one is equal to probably five or ten just to give
you an example. If you’re just exposed to asbestos and you are a
non-smoker, chances is [sic] 5 in 100 of developing lung cancer.
If you are just a smoker but not exposed to asbestos, chances are
10 in 100 of developing lung cancer. But if you’re a smoker at
the same time you are exposed to asbestos, chances are 50 in 100.
The—it is not a cumulative effect. It’s called as a synergistic
effect of the smoking and asbestos giving rise to this exponential
increase in the incidence of lung cancer.
(Doc. No. 79 at 57-58). Dr. Rao continued to state that asbestosis is not a
prerequisite to the development of asbestos-related lung cancer. Instead, asbestos
exposure alone is sufficient to cause lung cancer. He discussed several peer-
reviewed articles supporting this conclusion.
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{¶46} Relying on the assumption that Ivan was exposed to and breathed in
a significant amount of airborne asbestos dust during his long tenure with GM and
that Ivan smoked one to two packs of cigarettes a day for 47 years, Dr. Rao opined
that the “inhalation of respirable asbestos dust while employed by General
Motors” was the cause of Ivan’s asbestosis and diaphragmatic plaques. (Doc. No.
79 at 72). Dr. Rao also opined that Ivan was at “an increased risk of development
of lung cancer because of his exposure to respirable asbestos dust while working
at General Motors.” (Doc. No. 79 at 73). Finally, Dr. Rao offered his expert
opinion that the “inhalation of respirable asbestos dust in association with the
smoking combination caused [Ivan] to develop lung cancer and eventual death.”
(Id. at 72).
2. Defendant’s Experts
{¶47} GM presented two experts in defense of its case: Dr. David
Rosenberg and Dr. James Lockey, both board certified pulmonologists,
occupational medicine specialists, and “B readers.”2 Both experts agreed that the
interaction between smoking and asbestos-related diseases, such as asbestosis and
pleural plaques, elevates an individual’s risk of developing lung cancer. Dr.
Rosenberg characterized the effect of asbestos and smoking overall as “more than
additive, less than multiplicative.” (Doc. No. 76 at 56). Dr. Lockey noted that
2
The testimony of both defense experts was presented to the jury by way of a video-taped deposition
played at trial. Dr. Rosenberg’s deposition was taken on September 5, 2014 and Dr. Lockey’s on
September 22, 2014.
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historically there was a “synergistic effect” identified between smoking and
asbestos exposure and recent studies have “refined” the risk to show that people
with asbestosis are at a higher risk than those with pleural plaques. (Doc. No. 77
at 26-29). Both experts stated their opinion that radiological evidence of
asbestosis was necessary in order to causally relate lung cancer to asbestos.
However, they both acknowledged that there was conflicting medical research
regarding this issue.
1. Dr. Rosenberg
{¶48} Dr. Rosenberg explained that asbestos only poses a danger when it is
no longer encapsulated and becomes friable, meaning that the asbestos fibers
become loose, are dispersed into the air, and can be inhaled into the lungs. He
stated that only a small minority of people will develop an asbestos-related disease
because the development of these disorders requires a significant exposure to
friable asbestos over time.
{¶49} Dr. Rosenberg testified to the findings contained in his July 6, 2009
report which was based upon his examination of several documents, medical
records and radiologic studies. During his testimony, he specifically discussed his
review of a chest x-ray taken of Ivan on April 23, 2005, when Ivan was initially
diagnosed with lung cancer. He also spoke of his review of a chest x-ray taken of
Ivan on October 3, 2005, five months after Ivan was diagnosed with lung cancer.
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Dr. Rosenberg noted evidence of scarring on Ivan’s lungs which he attributed to
the cancer and radiation from the cancer treatment. However, he concluded there
was no evidence of asbestosis or asbestos-related pleural plaque formation. He
further opined that Ivan did not have an asbestos-related disease or disorder and
that Ivan’s “lung cancer and ultimate demise were related to his long smoking
history.” (Doc. No. 76 at 39).
2. Dr. Lockey
{¶50} Dr. Lockey initially recalled his 2009 evaluation of a selected
amount of Ivan’s medical records, which he performed at the request of the Ohio
Bureau of Worker’s Compensation. He stated that the records were “relatively
scanty.” (Doc. No. 77 at 30). He was later provided with additional medical
records pertaining to this litigation several days before his deposition. Dr. Lockey
discussed his review of these records which contained the reports of radiologists
and oncologists treating Ivan’s lung cancer. He searched the documents for
notations by the radiologists of changes in the x-rays or CT scans consistent with
asbestos exposure, such as evidence of pleural plaques or interstitial fibrosis due to
asbestos exposure.
{¶51} Dr. Lockey specifically discussed a CT scan report from April 23,
2005 wherein the treating radiologist identified “pleural plaques but no calcified
pleural plaques” and “chronic interstitial lung patterns.” (Doc. No. 77 at 32, Depo.
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Ex. D, p. 356). Dr. Lockey determined these findings to be “nonspecific” and
stated that calcification suggests the plaques have “been around for a long time.”
(Id. at 32). He also reviewed the April 23, 2005 CT scan and testified that he did
not find any pleural plaques or interstitial changes consistent with the diagnosis of
asbestosis. In addition, Dr. Lockey discussed his review of a chest x-ray taken of
Ivan on October 3, 2005. Again, he noted markings in the x-ray film that he
attributed to the lung cancer, but stated that he saw no indication of pleural
plaques or other interstitial changes in Ivan’s lungs consistent with asbestos
exposure. Based on his review of Ivan’s medical records along with various x-
rays and CT scans pertaining to the diagnosis and treatment of Ivan’s lung cancer,
Dr. Lockey opined that Ivan’s lung cancer was related to his “forty to eighty pack
year history of cigarette smoking” and “the potential exposure to asbestos was not
a significant contributing factor for his development of lung cancer.” (Id. at 41).
Discussion
{¶52} In examining the medical evidence pertaining to a causal relationship
between Ivan’s lung cancer and his employment at GM, we note all three experts
testified that occupational exposure to airborne asbestos can lead to the
development of lung cancer. It was also well-documented in the record that Ivan
had a long history of smoking a pack to two packs of cigarettes a day, a habit
which can also lead to the development of lung cancer. Thus, the critical issue as
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it relates to causation is establishing a connection between Ivan’s occupational
exposure to asbestos at GM and his lung cancer.
{¶53} All three experts testified that the combination of an occupational
exposure to asbestos and smoking significantly increases a person’s risk of
developing lung cancer as compared to the general population—i.e., smokers who
are not exposed to asbestos and non-smokers who are occupationally exposed to
asbestos. The majority of Ivan’s medical records, including the radiologic studies,
submitted at trial pertained to his diagnosis of lung cancer in 2005 and the
subsequent cancer treatment until his death in 2007. Ivan’s death certificate stated
the cause of death as “Carcinoma of lung—metastatic to brain.”3 GM maintains
that Ivan’s long history of smoking was the only cause of Ivan’s lung cancer.
Both of their experts rendered opinions supporting this conclusion on the basis that
they did not find any evidence of an asbestos-related disease in the radiologic
studies.
{¶54} However, Dr. Rao identified specific characteristics on the x-rays he
reviewed which he opined to be consistent with asbestosis and diaphragmatic
plaques—both of which are markers of an asbestos-related disease. Specifically,
Dr. Rao identified the presence of bilateral interstitial fibrosis due to asbestosis
and pleural plaques in the lower portion of Ivan’s left lung on the December 11,
3
GM argues that the fact asbestosis was not included on Ivan’s death certificate is somehow dispositive to
prove that his lung cancer was not asbestos-related. However, Dr. Rao testified that it is not unusual for a
secondary diagnosis of asbestosis to be omitted from the death certificate. (Doc. 79 at 130).
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2000 x-ray—which was taken almost five years prior to Ivan’s lung cancer
diagnosis. (Doc. No. 79 at 88, Ex. 4). Dr. Rao distinguished the findings
indicative of asbestos-related diseases from other evidence on the x-ray which he
attributed to chronic obstructive pulmonary disease related to Ivan’s smoking.
According to Dr. Rao’s testimony, there was radiologic evidence of Ivan having
an asbestos-related disease years before he was diagnosed with lung cancer.
{¶55} All three experts also provided similar testimony regarding the
latency period between the injurious exposure to asbestos and the development of
an asbestos-related disease. Dr. Rao also reviewed much of the same medical
evidence as GM’s experts and reached a different conclusion regarding the
characteristics of the radiologic changes; specifically, where GM’s experts
attributed those changes solely to Ivan’s lung cancer, Dr. Rao distinguished the
progression of the asbestos-related diseases from the changes associated with the
lung cancer and its treatment.
{¶56} Given this evidence, a reasonable juror could conclude that Ivan
developed lung cancer as a result of his employment with GM. The question of
whether the medical evidence supports the conclusion that Ivan had an asbestos-
related disease which contributed to the development of his lung cancer could
reasonably be resolved either way. The parties put on a “battle of the doctors.”
Which doctors to believe was up to the jury to decide. Construing the evidence
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most strongly in favor of Loretta, we find that she presented sufficient evidence to
support the jury’s verdict that she was entitled to participate in the Ohio Workers’
Compensation System for Ivan’s condition of asbestos-related lung cancer.
Therefore, because reasonable minds could have reached more than one
conclusion based on the evidence submitted, GM was not entitled to judgment as a
matter of law, and the trial court properly denied GM’s motion for directed
verdict. Accordingly, GM’s first assignment of error is overruled.
Second and Third Assignments of Error
{¶57} On appeal, GM argues that the trial court erred in admitting certain
evidence at trial. We review the trial court’s rulings on admissibility of evidence
under an abuse of discretion standard. Estate of Johnson v. Randall Smith, Inc.,
135 Ohio St. 3d 440, 2013-Ohio-1507, ¶ 22. Presuming that the trial court is in a
better position to evaluate the evidence and assess its credibility, we will not
reverse the trial court’s evidentiary ruling unless it was “contrary to law,
unreasonable, not supported by the evidence, or grossly unsound.” Schwarck v.
Schwarck, 3d Dist. Auglaize No. 2-11-24, 2012-Ohio-3902, ¶ 16.
Plaintiff’s Exhibits 5 and 6
{¶58} GM claims the trial court erred in admitting Plaintiff’s Exhibits 5 and
6 at trial. Both of these exhibits were documents produced by GM during the
course of discovery and tend to establish the presence of asbestos at GM’s
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Defiance facility. It should be noted the record suggests that over a matter of
several months GM impeded the discovery process by refusing to comply with
numerous requests for discovery. It is only after the trial court finally ruled in
favor of Loretta on these issues that GM produced the documents at issue.
{¶59} Exhibit 5 is a six-page document detailing GM’s safety policy for the
prevention of exposure to asbestos fibers which was implemented in March of
2006. Exhibit 6 is entitled “Asbestos Removal Summary” and lists the removal of
specific amounts of asbestos by department and date. The list spans as far back as
1981 and extends into 2011. GM argues that the documents are not relevant and
are unduly prejudicial because they cover a timeframe which is outside of Ivan’s
employment with GM and do not indicate whether the asbestos removed was
friable or otherwise hazardous.
{¶60} Evidence is relevant if it has “any tendency to make the existence of
any fact that is of consequence to the determination of the action more probable or
less probable than it would be without the evidence.” Evid.R. 401. “Although
relevant, evidence is not admissible if its probative value is substantially
outweighed by the danger of unfair prejudice, of confusion of the issues, or of
misleading the jury.” Evid.R. 403(A). We are not persuaded by GM’s complaints
regarding the admissibility of these documents. The existence of asbestos at the
GM facility is a fact of consequence to the determination of this action. These
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documents produced by GM were therefore relevant in tending to establish this
fact which was essential to Loretta proving her claim.
{¶61} Moreover, GM has failed to persuade us that the admission of these
exhibits somehow had a prejudicial effect on its case based on its own assertions
that asbestos is not dangerous unless is its friable and airborne. These documents
only establish the mere presence of asbestos in the facility and do not specify the
condition of any of the products. Moreover, the jury heard extensive expert
testimony distinguishing the safety of encapsulated asbestos from the hazards of
friable asbestos and explaining the presence of a nominal amount of asbestos to
which the public is generally exposed that poses no danger or health risks. Thus,
we find no support for GM’s position that the admission of these documents
permitted the jury to make an improper inference regarding Ivan’s injurious
exposure to asbestos. Therefore, we are not convinced by GM that the trial court’s
admission of this evidence was so unreasonable, arbitrary, or unconscionable that
it was an abuse of discretion. See Cunningham v. Goodyear Tire & Rubber Co.,
104 Ohio App. 3d 385, 391 (9th Dist.1995) (finding no abuse of discretion in a
trial court’s decision to admit evidence of an employer’s asbestos removal after
decedent’s employment). Accordingly, GM’s second assignment of error is
overruled.
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Dr. Rao’s Expert Opinion
{¶62} GM also argues that the trial court erred in admitting Dr. Rao’s
expert opinion over its objection on the basis that his testimony assumed facts not
in evidence. GM claims that Dr. Rao’s expert opinion finding a causal
relationship between Ivan’s work responsibilities at GM and his lung cancer
should have been stricken because it was based on the assumption of three facts:
(1) that Ivan “worked for General Motors from approximately 1973 to 2001;” (2)
that Ivan “was occupationally exposed to and breathed in asbestos dust and fibers
while working for GM between 1973 and 2001;” and (3) that Ivan “smoked one to
two packs of cigarettes a day for approximately 47 years.” (Doc. No. 79 at 70-71).
{¶63} “Experts have the knowledge, training and experience to enlighten
the jury concerning the facts and their opinion regarding the facts.” Ramage v.
Cent. Ohio Emergency Servs., Inc., 64 Ohio St. 3d 97, 102 (1992), citing McKay
Machine Co. v. Rodman, 11 Ohio St. 2d 77 (1967). Ohio Evidence Rule 703
provides that the “facts or data in the particular case upon which an expert bases
an opinion or inference may be those perceived by the expert or admitted in
evidence at the hearing.” See also Evid.R. 705 (providing “[t]he expert may
testify in terms of opinion or inference and give the expert’s reasons therefor after
disclosure of the underlying facts or data. The disclosure may be in response to a
hypothetical question or otherwise”).
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{¶64} The contents of a hypothetical question posed to an expert witness
must fairly reflect the facts established by the evidence and upon which the
witness is prepared to give an opinion. Price v. Daugherty, 5 Ohio App. 3d 157,
158–59 (2d Dist.1982), citing Surman v. Ohio & Pennsylvania Oil & Gasoline
Co., 116 Ohio App. 453 (8th Dist.1962), paragraph four of the syllabus. Thus, the
facts underlying an expert’s opinion must be either part of the expert’s personal
knowledge or admitted into evidence at the hearing or trial. Frazier v. Ohio State
Univ. Hosp., 10th Dist. No. 95API06-774 (Dec. 19, 1995). “If there is no
evidence to support an assumed fact * * *, the trial judge should intervene and
sustain an objection to the use of a hypothetical question containing such fact.”
Price at 160.
{¶65} “Where there is conflict in the evidence concerning the existence of a
fact which is material to the expert’s forming an opinion, counsel propounding the
hypothetical question is entitled to include as an assumed fact his version of the
evidence on the disputed fact. It is then for the trier of the facts to resolve the
factual dispute and, depending upon its findings, to determine what weight it will
give to the opinion-answer.” Mayhorn v. Pavey, 8 Ohio App. 3d 189, 191-192
(1982).
{¶66} At trial, Loretta provided evidence in support of each hypothetical
question asked of Dr. Rao in rendering his expert medical opinion. On appeal,
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GM specifically takes issue with Dr. Rao assuming the fact that Ivan “was
occupationally exposed to and breathed in asbestos dust and fibers while working
for GM between 1973 and 2001.” However, as discussed in the resolution of the
first assignment of error, we found there was substantial evidence presented at trial
to sufficiently establish Ivan’s occupational asbestos exposure at GM to permit the
issue to be determined by the jury. Thus, there was independent evidence in the
record to support Dr. Rao’s assumption on this disputed fact. Accordingly, we
find no abuse of discretion in the trial court’s decision to allow the trier of the fact
to resolve the factual dispute as to the issue of Ivan’s occupational asbestos
exposure and to determine the weight to accord Dr. Rao’s expert opinion. GM’s
third assignment of error is also overruled.
{¶67} For all these reasons the judgment is affirmed.
Judgment Affirmed
ROGERS, P.J. and PRESTON, J., concur.
/jlr
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