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Friday, August 22nd 2008

Civil Jury Trials: Restoring Our Faith in Humanity

A young woman in Iowa has had a jury of her peers find in favor of her for $1.5 million in a case against her ex-boyfriend. As you might expect, if it is to be posted on this blog, the nature of the verdict and award are…stunning.

The plaintiff claimed the defendant gave her human papillomavirus. HPV comes in many flavors (serologies). Two of those serologies (6 and 11) cause more than 90% of all “common” genital warts, which despite cosmetic and comfort concerns are not a serious threat to your health. There are many forms of the virus which are associated with cervical cancer but serologies 16 and 18 account as the etiology for approximately 70% of cervical cancers.

In this case in Iowa this woman claims she contracted at least on HPV virus associated with the warts and at least one associated with cervical cancer. Here is the story over at On Point,

Karly Rossiter, 25, has been diagnosed with both strains of the human papillomavirus (HPV), one of which causes genital warts and the other cell abnormalities that can lead to cervical cancer. In a petition filed in March 2007, she alleged that Dr. Alan Evans, a Muscatine, Iowa, dentist, infected her during their 18-month relationship and failed to warn her to take appropriate steps to protect herself from infection.

So there are several weird things about this case.

First, the defendant was not tested for HPV and his status is unknown. The claim that the plaintiff contracted the infection from Dr. Evans was based solely on her announcement that she had only been with two men in her life and Dr. Evans was the most recent.

Second, and in line with the first point, the plaintiff claims a strange time table for the development of symptoms.

In April 2005, she learned that she could have the virus and about a year after the New Year’s Day encounter with Evans she developed genital warts.

The average time to the development of warts from infection is 2-3 months. 1 year is not too far astray. Also not too far astray is that at least 30% of low-risk HPV infections don’t clear and the women get reoccurences of genital warts from the same infection. Maybe she was infected before. And a lay jury was burdened with making that determination? Give me a break.

Third, the notion that this infection is worth $1.5 million is beyond belief. And that is if there was some proof this infection was due to the defendants actions (or lack thereof).

This woman is likely to clear her low-risk HPV infection (which caused her genital warts) and if she doesn’t, this remains a largely cosmetic issue. And this woman is very, very, very unlikely to get cervical cancer from her HPV infection.

For all of the media surrounding the HPV vaccine attention cervical cancer is not an epidemiological emergency. In fact one of the questions surrounding the vaccine is if it is really needed, if it is really cost effective considering the low incidence of cervical cancer in the U.S.

Here are the numbers: 30% of the women in the plaintiff’s age range (20 – 25) are infected [PPT] with at least one high risk form of HPV. 30%! Yet there will be only 11,000 (and that really is a small number when you think about the number of women in this country) new cases of cervical cancer in this country.

Yes there is an increased risk she has been burdened with but life is full environmental factors which increase our risk for cancer – such as when she was sitting out on her porch and a diesel pick up came through billowing exhaust. I would feel comfortable betting that, with regular health maintenance, the plaintiff will not suffer from invasive cervical cancer as a result of this infection.

Jury decisions like this make me cringe. But this case is nothing new.

An Ohio Woman Sues for an HPV Infection

A woman in New York is also seeking damages from a lover for HPV infection.

I’ve said it before and I’ll say it again: I would not trust myself to judge fault in a plane crash with the technical aspects; imaging that some meter maid or some house wife or some unemployed writer are capable of judging a case like this is absolutely ridiculous.