Second Circuit Grapples with Medical Monitoring

On May 1, 2013, the Second Circuit issued an important decision in Caronia v. Philip Morris USA Inc., 2d Cir., No. 11-0316 (5/1/13). The Court provides an excellent summary of the law concerning medical monitoring claims in New York state and federal courts, and in other jurisdictions around the country. However, the Second Circuit concluded that the New York Court of Appeals was best suited to determine whether New York recognizes an independent claim for medical monitoring.

Therefore, the Court certified the following questions of New York law to the Court of Appeals: (1) Under New York law, may a current or former longterm smoker who has not been diagnosed with a smoking-related disease, and who is not under investigation by a physician for such a suspected disease, pursue an independent equitable cause of action for medical monitoring for such a disease? (2) If New York recognizes such an independent cause of action for medical monitoring, (a) what are the elements of that cause of action? and (b) what is the applicable statute of limitations, and when does that cause of action accrue?

Caronia, a putative class action, was commenced on January 19, 2006. The class plaintiffs are persons aged 50 years or older who currently smoke Marlboro cigarettes or ceased smoking them within one year prior to the commencement of the lawsuit, and smoked Marlboro cigarettes for at least 20-packed years. The complaint alleges that none of the plaintiffs are presently diagnosed with lung cancer nor under investigation under a physician for suspected lung cancer. Plaintiffs’ most recent amended complaint alleges that a newly established medical surveillance technique known as Low Dose CT scanning of the chest is a safe, efficacious and inexpensive technique which, for the first time, provides the means to identify and diagnose lung cancer at an early stage, when it is still curable.

In the trial court, the plaintiffs sought medical monitoring as a remedy for their tort claims of strict liability, negligence and breach of warranty but had not pled a free-standing claim for medical monitoring. It was not until plaintiffs filed their Fourth Amended Complaint that a stand-alone claim for medical monitoring was pled.

The Second Circuit affirmed the SDNY’s dismissal of plaintiffs’ traditional strict liability, negligence, and breach of warranty claims for redress of the smokers’ increased risk of developing lung cancer on the ground that these claims were time-barred. Thus, whether plaintiffs’ sole remaining claim for medical monitoring is a stand-alone claim or merely an element of consequential damages becomes critical to plaintiffs’ right of recovery. Because the statute of limitations bars plaintiffs’ pursuit of their traditional claims for negligence and strict products liability, any medical monitoring issue becomes moot if it is merely an element of consequential damages. If the underlying negligence and strict products liability claims are time-barred, then no consequential damages are recoverable.

 However, if New York recognizes an independent cause of action for medical monitoring, and, if, as recognized, that claim is viewed as accruing when an effective monitoring test becomes available, then, according to the Second Circuit, the statute of limitations likely will not have run on such an independent cause of action. Thus, the question certified to the New York Court of Appeals takes on critical importance.

 In Donovan v. Philip Morris USA, Inc., an almost identical case brought by the same plaintiff lawyers in the District of Massachusetts, the federal district court certified similar questions of law to the Supreme Judicial Court of Massachusetts. Notably, Sheila Birnbaum, now with Quinn Emanuel, and Gary Long of Shook Hardy & Bacon, argued on behalf of Philip Morris in both Massachusetts and New York.

In Donovan, the court held that plaintiffs who sued for medical monitoring, based on sub-clinical effects of exposure to cigarette smoke and increased risk of lung cancer, stated a cognizable claim under Massachusetts state law.

 The issue is whether the New York Court of Appeals will adopt the reasoning of Donovan, which sets a dangerous precedent, or take a more conservative approach. The obvious concern is that the “damages floodgates” may potentially open if the burden of medical monitoring plaintiffs is reduced to demonstrating a sub-cellular or physiological change rather than an injury or disease. Under such a loosened standard, particularly if an independent cause of action for medical monitoring is permitted to proceed, a sun tan, a skin blemish, a sneeze or elevated cholesterol could justify permitting a medical monitoring claim to proceed.

Perhaps we exaggerate, but why would not McDonald’s restaurants potentially be exposed to claims for diabetes medical monitoring claims brought by customers alleging they suffer  from  fast food-induced obesity?  Why would not Coppertone be subject to damages claims by customers with sunburns who allege they may be at risk for developing skin cancer due to the sun tan lotion’s  lack of efficacy in preventing sunburns?  In both situations, sub-cellular or physiological change could be demonstrated, particularly in the absence of a requirement to demonstrate phsical injury or disease.  A cynic might argue that a Donovan-style medical monitoring rule is designed only  to punish the tobacco industry rather than establish sound jurisprudence..

Although New York courts have held that medical monitoring may be an element of consequential damages, if certain requisites are met, Donovan can be distinguished from several Appellate Division medical monitoring cases in New York. For example, in Abusio v. Consolidated Edison Co., the Second Department upheld the trial court’s dismissal of cancerphobia claims on the grounds that plaintiffs had not presented sufficient evidence to prevail. However, in its decision, the Second Department cited cases which found that future medical monitoring costs could be sought for cancerphobia if a plaintiff could “establish both that he or she was in fact exposed to the disease-causing agent that there is a ‘rational basis’ for his or her fear of contracting the disease… this ‘rational basis’ has been construed to mean the clinically demonstrable presence of PCBs in the plaintiff’s body, or some indication of PCB-induced disease, i.e., some physical manifestation of PCB contamination… .”

A much-cited Fourth Department Appellate Division case, Askey v. Occidental Chemical Corp, examined claims of exposure to toxic discharges from a landfill and considered whether plaintiffs could recover for an anticipated need for medical monitoring. In particular, the court examined the then “novel issue” whether persons with an increased risk of disease could recover the costs of future medical monitoring in the absence of any apparent physical injury. In that case, the court concluded that recovery for medical monitoring was available as an element of consequential damage, but not as a stand-alone cause of action. But this article is not intended to be a survey of New York law on the subject.  The Second Circuit decision provides a cogent analysis of the important New York case law on medical monitoring and .I direct the reader to that discussion.

It is my view that any medical monitoring plaintiff should be required, at a minimum, to demonstrate injury or disease to recover medical monitoring damages and that no stand-alone claim for medical monitoring should be permitted.