Decision  Eleanor Zapata v. Demoulas Supermarkets

Date:	12/15/2004
Organization:	Department of Industrial Accidents
Docket Number:	DIA Board No. 007175-01
Location:	Boston

• Employee: Eleanor Zapata
• Employer: Demoulas Supermarkets
• Self Insurer: Demoulas Supermarkets

COSTIGAN, J. The self-insurer appeals from a decision in which an administrative judge awarded the employee ongoing temporary total incapacity benefits and medical benefits for a work-related infection called toxoplasmosis.² Because all of the medical experts³ agreed that the employee at least had an acute toxoplasma infection, manifest as a right cervical lymphadenitis, causally related to her workplace exposure to raw meats, we affirm so much of the judge’s decision as finds that the employee suffered a compensable personal injury. We also affirm the award of §§ 13 and 30 benefits for the employee’s initial medical treatment for that diagnosis. However, because the medical evidence does not support the judge’s finding that the employee’s disability from and after January 19, 2001⁴ was causally related to her initial infection, we reverse that aspect of the decision and vacate the award of § 34 benefits.

¹ Judge Levine no longer serves on the reviewing board.

² Toxoplasmosis is "[a] severe generalized or [central nervous system] disease caused by Toxoplasma gondii." Toxoplasma gondii "is a small intracellular protozoan parasite that can infect any warm-blooded animal." Merck Manual, 165 (13th ed. 1977). Acquired toxoplasmosis, as opposed to neonatal congenital toxoplasmosis, manifests itself in one of two forms relevant to this case: "The more common mild lymphatic form resembles infectious mononucleosis. It is characterized by cervical and axillary lymphadenopathy, malaise, muscle pain, and irregular low fever. Mild anemia, hypotension, leukopenia, lymphocytosis, and slightly altered liver function may be present." Its other form, "[a]n acute, fulminating, disseminated infection occurs primarily in immunologically incompetent patients, often with a rash, high fever, chills, and prostration. Some patients may develop meningoencephalitis, hepatitis, pneumonitis, or myocarditis." Id.

³ There were six. Doctors Richard Fraser and Michael P. Biber served as the § 11A impartial medical examiners. Doctors Richard L. Levy and Michael A. Kane were the self-insurer’s medical experts. The reports of Drs. Donald Craven and Gregory Allam, the employee’s treating physicians, were introduced into evidence by the employee. (Dec. 3.)

⁴ The first date of disability claimed by the employee. (Dec. 2.)