The widow of a heath care worker who died from complications related to his hepatitis C is entitled to benefits despite the fact that the man received a blood transfusion in 1970 that his employer argued could have given him the disease, the Missouri Court of Appeals has ruled.

Stephen Smith worked for Capital Region Medical Center in Jefferson City, Missouri, as a medical laboratory technician from 1969 until March 2006, court records show.

Mr. Smith and other health care workers didn't wear protective equipment while handling blood and human tissue before safety measures were implemented in the 1980s or 1990s, according to court records. They also used a narrow glass straw, known as a pipette, to prepare blood slides by placing one end in a tube of blood and sucking on the other end to draw blood into it, records show.

Mr. Smith never reported a needle stick or getting blood in his mouth while using the pipette, but Capital Region didn't require such incidents to be reported until the 1980s or 1990s, according to records.

He was first diagnosed with hepatitis in 1991, but he continued to work for Capital Region until his health worsened in March 2006, records show. He filed a workers compensation claim one month later, alleging that he developed hepatitis C as a result of occupational exposure.

According to the Missouri Department of Labor and Industrial Relations' website, an occupational disease is a condition or illness caused by exposure in the workplace. In order for an occupational disease to be covered under workers comp, the worker must prove “work was the prevailing factor in causing both the medical condition and disability resulting from the claimed occupational disease,” the website states.

When Mr. Smith died from complications related to his hepatitis C in February 2007, his wife, Dorothy Smith, substituted as a party to the claim, records show. How and when Mr. Smith contracted hepatitis C was then disputed.

Ms. Smith testified that her husband received a blood transfusion after being shot during a hunting accident in 1970, according to records. However, she said he didn’t use intravenous drugs, he had no tattoos, and he wasn’t a member of the military — all of which can increase a person’s risk of developing hepatitis C — records show.

One physician opined that Mr. Smith’s “work was the prevailing factor in causing him to develop hepatitis C,” given the risk of blood splashing into his eyes, nose and mouth, according to records. The physician said Mr. Smith only had about a 6% chance of contracting the disease through his blood transfusion, though it was also a risk factor, records show.

Another physician, who reviewed Mr. Smith’s medical records for Capital Region, opined that it was likely the blood transfusion that caused Mr. Smith to develop hepatitis C. The physician said “7% to 10% of individuals who received blood transfusions prior to 1992 contracted hepatitis C from the blood transfusion,” according to records.

An administrative law judge denied Ms. Smith benefits in November 2010, and the Missouri Labor and Industrial Relations Commission affirmed.

On appeal, the Missouri Court of Appeals remanded the matter for the commission to reconsider the evidence, stating that a “claimant must submit medical evidence establishing a probability that a working condition caused the disease even though it may not be the sole cause,” records show.

After reviewing the evidence, the commission awarded Ms. Smith burial expenses of $2,897.58, temporary total disability expenses of $9,848.83 and weekly death benefits of $675.90, leading Capital Region to appeal, according to records.

Finding that Ms. Smith “met her burden of producing substantial evidence that (Mr. Smith’s) work conditions created the probability of a risk of exposure to hepatitis C,” the Missouri Court of Appeals on Dec. 23 affirmed the judgment of the Labor and Industrial Relations Commission.