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Alaska SC denies claim of woman sprayed in eye by HIV patient's fluids

By Jessica M. Karmasek | Jul 24, 2012


ANCHORAGE, Alaska (Legal Newsline) - The Alaska Supreme Court last week upheld a state commission's decision denying a health care worker's claim for more benefits as a result of a "high-risk splash" to her eye by fluids from an HIV-positive patient.

In 2007, Esther Runstrom worked for the Alaska Native Tribal Health Consortium as a patient services assistant at the defendant Alaska Native Medical Center.

In August, she was assisting a nurse in the critical care unit when she was splashed in the eye by fluids from an HIV-positive patient.

Runstrom immediately washed her eye and went to the emergency room. The doctor there consulted with a doctor at the AIDS hotline in San Francisco and prescribed an antiretroviral medication as a preventive measure. She also received counseling.

Her employer initially paid workers' compensation benefits. It later filed a controversion based on its doctor's opinion that the employee was able to return to work.

Runstrom later asked for more benefits, but the Alaska Workers' Compensation Board denied her claim.

She appealed, but the Alaska Workers' Compensation Appeals Commission affirmed the board's decision.

In its opinion filed Friday, the state's high court sided with the commission, agreeing that "substantial evidence" supports the board's decision.

Justice Daniel E. Winfree, who authored the Court's ruling, explained that compensation cases involving exposure to disease -- when the likelihood of exposure is increased by work -- are generally classified as physical claims.

Classification, he said, is key because the presumption of compensability does not apply to mental-mental claims, making them generally more difficult to prove, and those claims must be based on "unusual" and "extraordinary" work-related stress.

"The fact that an accident produces unusual stress does not transform it into a mental-mental claim -- the key to analyzing such claims is to look at the underlying cause of the disability, which in this case was the 'high-risk splash,'" Winfree wrote, adding that the commission was correct in deciding that Runstrom's claim was not a mental-mental claim.

The Court also sided with the commission when it came to the evidence.

"Because both (nurse practitioner Ellen) Lentz and Dr. (Eric) Goranson thought Runstrom could return to her prior work after Dec. 1, 2007, and Runstrom did not offer any evidence from a health care provider to contradict these opinions, the commission correctly determined that substantial evidence in the record supported the board's decision that Runstrom was not entitled to further TTD (temporary total disability)," Winfree wrote in the 15-page opinion.

As for the employer's controversions, the Court agreed with the commission that they were in good faith, noting they were not filed until after Dec. 1, 2007 -- when Lentz said Runstrom could return to patient care.

From Legal Newsline: Reach Jessica Karmasek by email at

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