February 5, 2019
[Copyrighted Material Omitted]
[Copyrighted Material Omitted]
Circuit Court for Baltimore County, Case No. 03-C-16-004811,
Ruth A. Jakubowski, Judge
by Suzanne T. Berger, Asst. County Atty. (Suja M. Varghese,
Asst. County Atty. and Michael E. Field, County Attorney,
Towson, MD), on brief, for Petitioner.
by P. Matthew Darby (Berrnan, Sobin, Gross, Feldman & Darby
LLP, Lutherville, MD; Jeffrey W. Stickle, Bennan, Sobin,
Gross, Feldman & Darby LLP, Gaithersburg, MD), on brief, for
Curiae Brief for Montgomery, Anne Arundel, Haword and Prince
GeorgeS Counties, Prince Georges County Board of Education
and City of Cumberland In Support of Petitioner: Marc P.
Hansen, County Attorney, John P. Markovs, Deputy County
Attorney, Edward B. Lattner, Chief, Division of Government
Operations, Wendy B. Karpel, Associate County Attorney, 101
Monroe Street, Third Floor, Rockville, MD 20850-2058, Gregory
J. Swain, Acting County Attorney, Anne Amndel County Office
of Law, 2660 Riva Road, 4th Floor, Annapolis, MD 21401, Ileen
M. Ticer, Esquire, Law Office of Ileen Ticer, 200
International Circle, Suite 4100, Hunt Valley, MD 21030,
Melissa Lambert, County Attorney, Harford County Law
Department, 220 South Main Street, Bel Air, MD 21014, Robert
W. Burton, Associate General Counsel, Board of Education of
Prince Georges County, 14201 School Lane, Room 201F, Upper
Marlboro, MD 20772, Rhonda L. Weaver, County Attorney, Andrew
L. Murray, Deputy County Attorney, Prince Georges County
Office of Law, 1301 McCormick Drive, Suite 4100, Largo, MD
Curiae Brief for Maryland Association for Justice in Support
of Respondent.: James K. MacAlister, Esquire, Cohen, Snyder,
Eisenberg & Katzenberg, PA, 347 N. Charles Street, Baltimore,
MD 21201-4327, Dayna Kipnis, Esquire, Kahn, Smith & Collins,
PA, 201 N. Charles Street, Baltimore, MD 21201.
Curiae Brief for Professional Fire Fighters of Maryland in
Support of Respondent: Ari N. Laric, Esquire, Berman, Sobin,
Gross, Feldman & Darby LLP, 1301 York Road, Suite 600,
Lutherville, MD 21093.
before: Barbera, C.J. [*] Greene, McDonald, Watts, Hotten,
Getty, Sally D., Adkins (Senior Judge, Specially Assigned)
Md. 8] "Definitions of occupational disease should
always be checked against the purpose for which they were
uttered." Arthur Larson, Lex K. Larson & Thomas A.
Robinson, 4 Larsons Workers Compensation Law §
52.03 (Matthew Bender, Rev. Ed. 2019). The purposes of
Marylands Workers Compensation Act are manifold and, like
others, involve a recognition of the many competing
interests— "to protect capital and labor, employer
and employee, and the State against the waste and distress
incident to modern industry ...." Liggett & Meyers
Tobacco Co. v. Goslin, 163 Md. 74, 80, 160 A. 804
(1932). Still, we bear in mind the sacrifice and special toll
certain Maryland workers withstand in the course of their
present case involves the claim of a veteran
paramedic/firefighter regarding degenerative meniscal tears
in his right knee. We review two questions, which we have
rephrased and consolidated from the questions
granted for [466 Md. 9] clarity. First, we
review whether the trial court erred in denying the Countys
motion for summary judgment, and, if not, whether the trial
court erred in finding that Quinlan met the statutory
requirements set forth in LE § 9-502(d)(1) that his alleged
occupational disease was "due to the nature of an
employment in which hazards of the occupational disease exist
...." We conclude that the trial court did not abuse its
discretion by denying the motion for summary judgment; nor
did it err in concluding that Quinlans degenerative meniscal
tears could be classified as an occupational disease.
FACTUAL OVERVIEW AND PROCEDURAL POSTURE
October 2015, Michael Quinlan ("Quinlan") filed a
claim with the Workers Compensation Commission ("the
Commission") against his employer, Baltimore County
("the County"). In it, he asserted that he
"developed meniscal tears" in his right knee due to
his job duties as a
"Paramedic/Firefighter." The Commission held a
hearing regarding Quinlans claims and evaluated, among other
things, whether he "sustain[ed] an occupational disease
arising out of and in the course of his employment[.]"
Ultimately, the Commission disallowed the claim, concluding
that Quinlan "did not sustain an occupational disease of
the [r]ight [k]nee degenerative tears arising out [of] and in
the course of" his employment.
then sought review in the Circuit Court for Baltimore County,
requesting a jury trial. In appeals from the Commission, the
trial courts role is to determine whether the [466 Md. 10]
Commission "justly considered all of the facts,"
"exceeded the powers granted to it," or
"misconstrued the law and facts applicable in the case
decided." Md. Code Ann. (1991, 2016 Repl. Vol.), §
9-745(c)(1)-(3) of the Labor and Employment Article
("LE"). The Commissions decision is presumed
"prima facie correct" and the party
challenging the decision has the burden of proof.
Id. § 9-745(b)(1)-(2).
to trial, the County filed a motion for summary judgment
arguing that Quinlan failed to present evidence that his knee
injury was an occupational disease or that it was related to
the nature of his employment as a paramedic. Quinlan opposed
this motion. Based on the parties competing submissions, the
trial judge denied the Countys motion for summary judgment
concluding that there was "absolutely a material dispute
case proceeded to trial on April 19 and 20, 2017. Quinlan, 51
years old at the time, testified first. He began by
describing his occupation and the general duties thereof.
Over the course of his career, he had served 29 years as a
paramedic, the last 24 with Baltimore County. Typically, his
schedule consisted of two 10-hour days
of work, followed by two 14-hour nights, and four days off.
During these four-day shifts, he stated, paramedics generally
"run" 26-30 calls, which last 1-2 hours each.
Quinlan also described the activities undertaken on a
"typical" emergency call that might impact his
right knee, including: climbing in and out of emergency
vehicles, carrying up to 50 pounds of gear, crouching to
address and service patients, administering compressions or
other aid, lifting patients onto stretchers and moving
stretchers, and taking patients up and down
stairs. He also stated that he is "right
dominant," meaning he uses his right leg more often
during the above tasks.
testified that he started experiencing pain and
"clicking" in his right knee in 2014, causing him
to seek out a [466 Md. 11] doctor. Although he had seen a
doctor in 2005 regarding a knee injury, he did not
necessarily see the two phenomena as related. Ultimately,
Quinlan underwent surgery to repair his meniscal tears.
parties each introduced the same experts before the trial
court as they had used before the Commission. Quinlan
presented a video deposition of Barbara A. Cochran, M.D.
("Cochran"), a physician with specialties in
internal, occupational, psychiatric, and pulmonary medicine.
Cochrans testimony was based on her research, her review of
Quinlans medical records, and her phone examination of
Quinlan, although she never physically examined him. Cochran
said that Quinlan had a tear in both his medial and lateral
menisci. These tears "extend[ed] to the articular
surface of the tibia," which Cochran identified as
important because that "is where the bones come
together" which can lead to osteoarthritis.
described Quinlans meniscal tears as "part of the
continuum of osteoarthritis." Accordingly, she focused
on repetitive use as the primary risk factor for his knee
issues. She explained that repetitively using a knee with
meniscal tears can lead to osteoarthritis because such use
leads to inflammation in the joint that is not healed before
its next use. She described this process as a cycle of
inflammation, followed by partial healing, followed by
inflammation, and so on. Alternatively, the osteoarthritis
can contribute to degeneration and tears in the meniscus in a
similar manner. She also addressed other risk factors for
degenerative knee issues, such as gender, age, weight,
genetics, and prior injury. Quinlan was five feet and nine
inches tall and weighed approximately 235 pounds. Cochran
stated that gender, age, and weight were unlikely to be the
primary factors here because Quinlans knee damage was
confined to his right knee. Moreover, she opined that
Quinlans 2005 knee injury likely had no relation to his
osteoarthritis based on the symptoms and complaints he
presented at the time of his injury. She did not have enough
information to address genetics.
Md. 12] Cochran also testified about the relationship between
Quinlans degenerative knee tears and his occupation as a
paramedic. Specifically, she pointed to a study that
concluded that paramedic/firefighters have a "relative
risk" of developing knee osteoarthritis of 2.93 compared
to the general population, meaning that there are 293 cases
of degenerative knee tears in paramedic/firefighters for
every 100 cases in the general population. Based on this
study and her examinations, she concluded that Quinlans
"essential job functions ...
which include considerable repetitive kneeling, bending,
[and] stress on the knee, [were] the cause of his knee