By Taylor Skees, staff attorney, Memphis

Last week, the Appeals Board held oral arguments on Randall v. Food Lion, where the trial court weighed expert opinions. Wilma Randall’s unauthorized treating physician tied her condition to chemical exposure at work, while a physician who reviewed Randall’s records attributed her condition to an infectious disease such as COVID-19.

Randall worked at Food Lion for over twenty years, and also as a house cleaner. Her duties at both jobs included using chemical cleaners. In March or April of 2020, Food Lion changed the cleaning supplies she used. Afterward, she testified that she could smell and even taste the chemicals when she used them.

Three months after the change in cleaning supplies, Randall developed a cough. Three months after that she went to the emergency room, and a month later to the hospital. Records from these visits listed suspected COVID as the diagnosis, and she was given antibiotics, though she tested negative for COVID. She ultimately tested negative for COVID three times.

Randall’s attorney, Todd East, hung his hat on Randall’s negative COVID tests. He said that Food Lion denying Randall’s claim on grounds of having COVID when she tested negative three times was “like saying Peyton Manning won the Heisman Trophy; all you gotta do is forget about Charles Woodson.”

However, attorney Daniel Hall for Food Lion remarked that her first COVID test didn’t occur until three months after her symptoms developed, and both experts agreed that if someone waited three months from the onset of symptoms to take a COVID test, it was more likely to be negative. Further, Hall argued that “it is not crucial for our case if this was not COVID; it could be pneumonia or some other infectious disease” causing Randall’s condition.

As to which expert the Appeals Board should lend credence to, East relied on Dr. April Lambert-Drwiega’s status as her treating physician, though unauthorized. Dr. Lambert-Drwiega is a pulmonologist. She submitted a causation letter stating that the chemicals at work worsened Randall’s condition.

Hall relied on Dr. Christopher Holstege, who performed a records review. Dr. Holstege is chief of toxicology at the University of Virginia, and he related causation for Randall’s condition to an infectious disease such as COVID rather than chemical exposure at work. Hall explained that Dr. Holstege “treated people for decades who have undergone exposure to outside materials,” whereas Dr. Lambert-Drwiega as a pulmonologist “doesn’t have training or practice in toxicology or infectious disease.”

Hall argued that, while Dr. Lambert-Drwiega did have hands-on treatment of Randall, her treatment began about five months after her symptoms started, “so any examination wouldn’t have revealed an infection five months ago or may not have” as she had been prescribed antibiotics.

When Dr. Lambert-Drwiega released Randall to return to work, her restrictions included not being around chemicals. East argued this as another factor to show that the chemicals caused Randall’s condition.

However, Hall countered that Dr. Lambert-Drwiega didn’t have a list of the chemicals Randall used before and after Food Lion changed the cleaning supplies, nor could she identify which chemicals Randall used or which chemicals could’ve caused her symptoms. Dr. Holstege, as part of his records review, had access to this list, and he found “no major changes in the chemical compositions before and after the switch.” Dr. Holstege also had access to a more extensive history of Randall’s records than Dr. Lambert-Drwiega did when he conducted his records review.

Hall also stated that the medical evidence supports a finding that an infection caused Randall’s condition. Dr. Holstege testified that if chemical exposure causes issues in the lungs, “it doesn’t attack one portion of the lungs, it goes everywhere.” An infection, on the other hand, attacks specific parts of the lungs. Dr. Holstege testified that Randall’s imaging was consistent with an infection and not with chemical exposure.

Hall questioned Dr. Lambert-Drwiega on Randall’s imaging, and she agreed the most common differential diagnosis for that type of imaging is an infection, and the most common diagnosis for that type of imaging in mid-2020/2021 would be a COVID infection.

East, in summation, pointed out Randall’s testimony of the taste and smell of the new chemicals to show that the new chemicals caused her symptoms. Additionally, Dr. Lambert-Drwiega’s opinion, that the chemicals at work worsened Randall’s condition, should be given more weight as Randall’s treating physician.

Hall countered that Dr. Holstege should be accepted due to his relevant experience as a toxicologist, and because the records he reviewed were more extensive than the records reviewed by Dr. Lambert-Drwiega. He also argued that both experts agreed the imaging of Randall’s lungs indicated an infection and not exposure to chemicals as the cause.

Because the order is interlocutory, the Board must release its opinion within 20 business days after the arguments.

Stunningly sweet photo by the author.