Decision  Theresa Canavan v. Brigham & Women's Hospital

Date:	12/26/2000
Organization:	Department of Industrial Accidents
Docket Number:	DIA Board No. 33320-93
Location:	Boston

• Employee: Theresa Canavan
• Employer: Brigham & Women's Hospital
• Self Insurer: Brigham & Women's Hospital

WILSON, J. The self-insurer appeals from a decision in which an administrative judge concluded that the employee, Theresa Canavan, suffered permanent and total incapacity as a result of more than thirty symptoms attributable to her employment at Brigham & Women’s Hospital.¹ (Dec. 353-354, 350, 356.) After the judge’s decision awarding §34A benefits was filed, the Supreme Judicial Court reversed a different administrative judge’s earlier decision in favor of the employee. Canavan’s Case, 432 Mass. 304 (2000). In that reversed decision, the hearing judge had awarded §30 medical benefits and also denied the self-insurer’s request to discontinue temporary total incapacity benefits that it was paying for an accepted exposure-induced sinusitis, with a date of injury of August 6, 1993. Canavan at 306. The Canavan court held that the administrative judge abused his discretion when he allowed expert medical opinion evidence on the controversial diagnosis of multiple chemical sensitivity (MCS), a diagnosis without a qualifying foundation of scientific reliability under Commonwealth v. Lanigan, 419 Mass. 15 (1994). Canavan, supra at 314-315. We take note of the present judge’s determination in the instant decision that Ms. Canavan suffers not from MCS, but from “a combination of many or all of the more than thirty symptoms referenced by the employee and the doctors, and recorded by [the judge] in [the] decision.” (Dec. 350.) However, we conclude that the distinction carries no weight, in light of the Canavan court’s treatment of the issue.² After a careful review of the entire record of this difficult case, we reverse the decision awarding §34A benefits.

¹ The symptoms found by the judge include "facial swelling, neck swelling, headache, mood swings, irritability, poor memory, poor concentration, sleepiness, numbness, tingling, dizziness, extreme fatigue, mild eye tearing, sneezing spells, throat tightness, moderate nasal blockage, nasal discharge, chest tightness, moderate flatulence, fullness, bloating, mild diarrhea, nausea, severe joint aches and pain, severe swelling of the hands and fingers, moderate swollen, tender lymph nodes, and moderate chest pains with palpitations." (Dec. 323-324.)

² The Supreme Judicial Court listed the employee’s complaints, as reported by the employee’s expert, Dr. N. Thomas LaCava, as "arthritis, parathesias, organic brain syndrome, chemical induced headaches, immunodeficiency, and multiple chemical sensitivities (MCS) secondary to chemical poisoning . . . ." Canavan, supra at 306. The court then went on to discuss only MCS. The necessary implication of the court’s outright reversal of the award of benefits under §§30 and 34 is that the purported condition called MCS includes the entire panoply of the employee’s complaints. Otherwise, the court would have remanded the case for further proceedings on present medical disability, exclusive of MCS. This, of course, the court did not do.

In any event, the court’s ancillary holding, that the employee’s expert opinion evidence failed to prove causal relationship between the workplace and her claimed MCS, certainly applies equally to the employee’s symptomatology: "There is no suggestion that the judge conducted a Lanigan analysis to determine whether Dr. LaCava used a reliable methodology to conclude that the chemical exposures to which the employee was subjected caused her to suffer from MCS. This was error." Canavan, supra at 316 (emphasis in original). The same holds true as to headaches, chronic fatigue, chronic pain, swelling of the extremities or any of the other symptoms of the employee’s medical condition. (Dec. 323-324, 351-352.) See list in n. 1, supra. The issue is not the name that any doctor assigns to the symptoms; the issue is whether the work exposure caused the symptoms.