No HIV Anxiety Cap

BY ARTHUR S. LEONARD | The New York Court of Appeals has rejected a rule that the state's intermediate appeals courts used for more than a decade to limit emotional distress damages claimed for possible HIV infection resulting from the negligence of others.

The February 7 ruling from the state's highest court reversed a ruling by the Appellate Division in Manhattan that a plaintiff could sue for only six months of emotional distress due to fear of contracting AIDS. The Court of Appeals rejected any hard-and-fast time limitation.

High court says no time limit on emotional damages from needle-stick.

Working as a temporary nurse at Bellevue Hospital in 2000, Helen Ornstein was bathing an AIDS patient when she was stuck in the thumb by a hypodermic needle an intern had left in the patient's bed, according to Judge Victoria Graffeo's opinion. She immediately received antiviral medication as a preventive precaution, and had HIV tests over the next two years. She never tested positive.

Ornstein testified she suffered side effects from the antiviral medication, including nausea and neuropathy in her hands and feet, for several months. She claimed she continued to fear that she might develop HIV infection until her negative HIV test a year-and-a-half after the incident. She said her doctor never told her that a negative test at six months showed there was a negligible chance she had HIV infection.

Ornstein sued the intern who left the needle on the patient's bed, and also asserted that the New York City Health and Hospitals Corporation (HHC), which operates the hospital, is liable for her emotional and economic injuries. The intern was a hospital employee, and Bellevue and HHC can be held liable for injuries due to the negligence of their staff.

Ornstein sought compensation for the emotional distress she suffered after the incident, testifying that even after she was satisfied that she was not HIV-positive she continued suffering post-traumatic stress disorder, producing nightmares and flashbacks. Her fear of future needle-stick injuries, she said, made it impossible for her to work as a nurse providing direct patient care. She switched to office work and teaching, both less lucrative occupations than per diem nursing.

The hospital moved to have the trial court apply the six-month rule developed by New York courts during the 1990s, pointing to statistical evidence about how long it takes for a person to “be reasonably assured that he or she is free of infection.”

The courts have ruled that, as a matter of law, it is unreasonable to continue to fear HIV infection after that point.

The rule originated in a 1996 claim against HHC from a plaintiff who refused to be tested but claimed damages for continuing fear of infection 15 years after her needle-stick exposure. Many lower courts, including those in other states, quickly latched on to the six-month rule.

But in Ornstein's case, faced with credible allegations of continuing emotional distress, the trial court declined to apply the rule, rejecting the hospital's motion to limit the evidence on damages. The Appellate Division reversed, citing the six-month rule, and sent the case to trial placing a limit on the time period for damages.

Ornstein won a jury verdict of $333,000 for past pain and suffering and $15,000 for lost wages, but was barred from presenting any evidence of emotional distress later than six months after her needle-stick.

Writing for the Court of Appeals, Graffeo found that the six-month rule was inappropriate on several grounds. First, the restriction “makes little sense if the probabilities identified by researchers were not known to the plaintiff during the relevant time frame.” Unlike the 1996 defendant, Ornstein voluntarily got tested, demonstrating that she was not willfully avoiding the chance to dispel her fears. She was not seeking damages “for a protracted period time,” the court found.

The nature of Ornstein's damage claims also worked in her favor. She was not just claiming damages for fear of contracting HIV but also due to the post-traumatic stress disorder and its impact on her ability to work in her profession.

“Plaintiff testified that she lost income because she was never able to return to per diem hospital work after the incident due to her fear of similar future exposure incidents,” Graffeo wrote, a claim that had no logical relation to the six-month rule.

Relying on an argument often persuasive in the 1990s, the hospital asserted that a time-limit on damages was necessary to combat ignorance and irrational fears about AIDS, to take “emotions out of the equation of AIDS cases at a fixed point in time to ensure fairness and consistency.” Graffeo responded that the court was “unpersuaded that emotions can appropriately be removed from the damages equation in a negligent infliction of emotional distress claim.”

Graffeo also pointed out that such a bright-line six-month test was “unprecedented” in tort law and that the hospital had not shown it was necessary to avoid “unreasonably high verdicts.”

The court, Graffeo emphasized, was not placing any restrictions on the hospital's ability to offer evidence about the reasonableness of Ornstein's fears or lessening the plaintiff's burden of proof. Rather, it was removing an artificial constraint on the evidence she could present.

The case will go back for a new trial on damages in New York County Supreme Court. Clearly, HHC may face enhanced potential liability from needle-stick cases in the future.