Rost, Richard, M., Exec. v. Ford Motor Co., Aplt. ( 2016 )


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  •                           [J-12-2016] [M.O. - Donohue, J.]
    IN THE SUPREME COURT OF PENNSYLVANIA
    EASTERN DISTRICT
    RICHARD M. ROST, EXECUTOR OF                  :   No. 56 EAP 2014
    THE ESTATE OF RICHARD J. ROST &               :
    ERIN SIPLEY, EXECUTRIX OF THE                 :   Appeal from the Judgment of Superior
    ESTATE OF JOYCE ROST,                         :   Court entered on May 19, 2014 at No.
    :   404 EDA 2012 affirming the Judgment
    Appellees                :   entered on December 28, 2011 in the
    :   Court of Common Pleas, Civil Division,
    :   Philadelphia County at No. 1978
    v.                              :   September Term, 2010.
    :
    :
    FORD MOTOR COMPANY,                           :
    :   ARGUED: May 6, 2015
    Appellant                :   REARGUED: April 6, 2016
    DISSENTING OPINION
    CHIEF JUSTICE SAYLOR                                    DECIDED: November 22, 2016
    I respectfully dissent, as I would center the discussion of the causation question
    on risk-based principles; I would reaffirm – and not cabin – the Court’s opinion in Betz v.
    Pneumo Abex LLC, 
    615 Pa. 504
    , 
    44 A.3d 27
    (2012); and I have a different view
    concerning the appropriate role and limits of the frequency, regularity, and proximity test
    in Pennsylvania.    On the consolidation issue, I also differ with the finding of no
    prejudice.
    The Central Significance of a Risk-Based Focus
    The science involved in attempting to examine actual, product-specific causation
    relative to long-latency carcinogens such as asbestos is fraught with indeterminacy, as
    is extensively manifested on the present record. See generally Majority Opinion, slip
    op. at 17 (discussing the present record as it relates to the inability to distinguish
    causative effects of different exposures).         For example, the plaintiff’s experts
    acknowledged the human body’s substantial efficiency in removing asbestos fibers, and
    that the lower the exposure or dose, the more effective are these defense mechanisms.
    See, e.g., N.T., Sept. 20, 2011, at 99, 103 (reflecting the testimony of plaintiff expert,
    Arnold Brody, PhD, an expert in cell biology, that the body is ninety to ninety-nine
    percent efficient in removing asbestos fibers).        Moreover, from what is known by
    scientists, rare, discrete, and idiosyncratic events occurring at the cellular level (or a
    series of them) are required to cause mesothelioma. See, e.g., N.T., Sept. 19, 2011
    (A.M.), at 141-42 (reflecting the explanation of the plaintiff’s specific causation expert,
    Arthur Frank, M.D., that scientists do not know how asbestos alters the DNA to yield
    cancer, but the process begins with a single cell).1
    In light of the great uncertainties involved in assessing actual product-specific,
    substantial-factor causation, the plaintiff’s sole expert witness testifying on the matter of
    specific causation – Dr. Frank – acknowledged that his testimony was premised on an
    assessment of the increased risk presented by discrete exposures. See, e.g., N.T.,
    Sept. 19, 2011 (P.M.), at 51 (reflecting Dr. Frank’s acknowledgement that not every
    exposure causes the DNA alteration predicate to mesothelioma, but what can be said is
    1
    One court summarized the science as follows:
    If a precise series of changes takes place, one cell becomes
    a malignant cell. A mesothelioma tumor consists of billions
    of cells but started from one single cell. Attempting to find
    that one cell to determine which fiber caused the initial
    malignancy is like “looking for a needle in a haystack.”
    Bartel v. John Crane, Inc., 
    316 F. Supp. 2d 603
    , 609-10 (N.D. Ohio 2004) (citation
    omitted).
    [J-12-2016][M.O. - Donohue, J.] - 2
    that every exposure increases the risk); accord Amici Scientists’ Brief at 2 (“Scientists
    are concerned because it is indeed an irrefutable scientific fact that each exposure does
    actually contribute to a person’s total dose and to that person’s risk or probability of
    developing mesothelioma and other cancers.” (emphasis added)).                The plaintiff’s
    general causation expert, Mr. Brody, also recognized this very clearly. See, e.g., N.T.,
    Sept. 20, 2011 (A.M.), at 78 (“You can’t say what a given exposure does. You don’t get
    to see that.”); accord Majority Opinion, slip op. at 6 (discussing Dr. Frank’s testimony
    that “it is not scientifically possible to identify the particular exposure or exposures that
    caused a patient’s mesothelioma”).         The plaintiff’s expert in Betz echoed such
    understanding also. See 
    Betz, 615 Pa. at 548
    , 44 A.3d at 55 (“[A]s is clear from various
    passages of testimony [from the plaintiff’s expert witness] . . ., his opinion was plainly
    grounded on risk assessment.” (emphasis added)).
    Thus, it should be plain enough, by now, that – because actual, product-specific
    causation generally cannot be demonstrated by those suffering from asbestos-related
    diseases – this Court, like many others, is accepting assessments of increased risk as
    surrogates for traditional substantial-factor causation. See generally Steve C. Gold,
    When Certainty Dissolves Into Probability: A Legal Vision of Toxic Causation for the
    Post-Genomic Era, 70 W ASH. & LEE L. REV. 237, 298 (2013) (explaining that many
    courts “recognize[] that in light of causal indeterminacy, it is appropriate to treat proof of
    contribution to risk as proof of contribution to cause”). Personally, I have abided by this
    particular accretion in the substantive law,2 but I do think that it is important that it be
    2
    I accept the approach, because I believe that, administered subject to appropriate
    constraints, it advances the goal of corrective justice. Along these lines, as a member
    of a previous Court majority, I have recognized “the difficulties facing plaintiffs in this
    and similar settings, where they have unquestionably suffered harm on account of a
    disease having a long latency period and must bear a burden of providing specific
    causation under prevailing Pennsylvania law which may be insurmountable.” Gregg v.
    (continued…)
    [J-12-2016][M.O. - Donohue, J.] - 3
    recognized for what it is, namely, a material adjustment to substantive-law proof
    requirements. See generally David L. Faigman, Edward K. Cheng, Jennifer L. Mnookin,
    Erin E. Murphy, Joseph Sanders & Christopher Slobogin, 3 MOD. SCI. EVIDENCE §26:5
    (2015-2016) (discussing the causal question in asbestos litigation in terms of “the
    willingness of the courts to establish special ‘asbestos rules’ that ease plaintiff’s causal
    proofs”). Viewed as such, I believe that some balance and perspective is implicated,
    particularly in terms of the degree of the relaxation of the traditional burden that is
    involved.
    Along the lines of perspective, I note that the courts were asked to take the
    leniency that has been extended to an extreme with the advancement of the any-breath
    or any-exposure theory as a means of establishing the legal requirement of substantial-
    factor causation. As is amply developed in this Court’s decision in Betz and elsewhere,
    such theory is fundamentally inconsistent with the legal requirement of substantial-factor
    causation. See, e.g., 
    Betz, 615 Pa. at 552
    , 44 A.3d at 57; Martin v. Cincinnati Gas &
    Elec. Co., 
    561 F.3d 439
    , 443 (6th Cir. 2009) (“[A]n expert’s opinion that ‘every exposure
    to asbestos, however slight, was a substantial factor’ . . . would render the substantial
    factor test ‘meaningless.’” (quoting Lindstrom v. A-C Prod. Liab. Trust, 
    424 F.3d 488
    ,
    493 (6th Cir. 2005))). See generally 
    Betz, 615 Pa. at 539
    n.25, 44 A.3d at 49 
    n.25
    (collecting cases from jurisdictions that have rejected the any-breath or any-exposure
    theory).
    (…continued)
    V-J Auto Parts, Co., 
    596 Pa. 274
    , 291-92, 
    943 A.2d 216
    , 226 (2007). Nevertheless, and
    as further developed below, I maintain that it is not “a viable solution to indulge in a
    fiction that each and every exposure to asbestos, no matter how minimal in relation to
    other exposures, implicates a fact issue concerning substantial-factor causation[.]” 
    Id. at 292,
    943 A.2d at 226-27 (emphasis added).
    [J-12-2016][M.O. - Donohue, J.] - 4
    Presently, it is the contention of Appellant and several of its amici that Dr. Frank’s
    opinion in this case represents a sort of a fallback in the aftermath of this Court’s
    rejection of the any-breath or any-exposure theory as a means of establishing legal
    causation. In their view, the approach of various experts in the medicolegal community
    is now to liberally espouse the any-breath or any-fiber theory when discussing general
    causation (e.g., any exposure can cause mesothelioma) and specific causation (e.g.,
    every exposure contributed to Mr. Rost’s mesothelioma), then, in addressing the
    substantial-factor aspect, to merely render conclusory pronouncements of substantiality
    (e.g., Mr. Rost’s exposure to Ford products was a substantial factor in Mr. Rost’s
    mesothelioma).3     For these reasons, they urge this Court to undertake a critical
    examination of Dr. Frank’s testimony to determine whether any scientific basis was
    offered to distinguish between these general and specific causation aspects and the
    essential expert opinion as it concerned substantiality.
    The majority’s response is to suggest that such arguments “confuse[] or
    conflate[] the ‘irrefutable scientific fact’ that every exposure cumulatively contributes to
    the total dose (which in turn increases the likelihood of disease), with the legal question
    under Pennsylvania law as to whether particular exposures are ‘substantial factors’ in
    causing the disease.” Majority Opinion, slip op. at 18. However, I agree with Appellant
    3
    See, e.g., Brief for Appellant at 2 (characterizing Dr. Frank’s opinion as “the same
    [any-exposure] opinion in new garb”); Reply Brief for Appellant at 20 (stating that
    “Plaintiff asks the Court to endorse a rule that condemns the any-exposure rule in name
    only”); Brief of Amicus Prod. Liab. Advisory Council, Inc. (“PLAC”) at 2 (“Dr. Frank’s
    ‘any-exposure’ opinion was glaringly transparent to anyone who cared to look beyond
    semantics.”); Brief for Amici Coal. for Litig. Justice, Inc., Nat’l Ass’n of Mfrs., Am. Tort
    Reform Ass’n, & Am. Ins. Ass’n at 23 (asserting that Dr. Frank “simply recited the
    alleged exposures and concluded they were sufficient – dose is irrelevant to his opinion
    and appears nowhere in [them]”); Brief for Amicus Honeywell Int’l Inc. at 11 (indicating
    that Dr. Frank’s opinion “discounts, indeed ignores, the substantiality of any particular
    exposure”).
    [J-12-2016][M.O. - Donohue, J.] - 5
    and its amici that – to the degree that an expert witness fails to offer a scientific basis to
    distinguish his oft-repeated opinions concerning general and specific causation from his
    opinion about the discrete matter of specific causation – the source of the confusion lies
    with the expert.
    Notably, the present case involves relatively low-dose exposure to asbestos from
    Ford products. In this regard, Mr. Rost’s attorney at trial candidly explained to the jurors
    that the dose experienced from Ford brakes during the approximately three-month
    period of exposure “was a relatively low dose compared to some other exposures.”
    N.T., Oct. 5, 2011, at 49.4 The time differential (at least ten years of largely unprotected
    industrial exposure versus three months of exposure as a garage worker) alone is
    illustrative, even without addressing the differences between exposure to friction
    products,5 versus exposure to friable insulation materials and loose powder and spray in
    the industrial setting. See, e.g., Majority Opinion, slip op. at 4 (discussing the record as
    it pertains to Mr. Rost’s industrial exposures).
    Dr. Frank, however, did not provide the jury with any standards, or benchmarks,
    or other scientifically-accepted premises for assessing the substantiality of the risk
    4
    In complex toxic tort cases, many layers of abstractions tend to obscure the material
    issues. For example, the majority repeatedly refers to material including residue
    accumulated in automobile wheel wells and around brake linings as “asbestos dust.”
    Majority Opinion, slip op. at 3. At least in terms of the premises underlying Dr. Frank’s
    opinion, however, the expert accepted that such accumulations are generally 99.6
    percent asbestos free. See N.T., Sept. 19, 2011 (P.M.), at 16.
    5
    With regard to new friction products, since most of the asbestos is encapsulated in a
    binder or resin material, Dr. Frank agreed that the material is not considered friable as
    are thermal asbestos-containing insulation products such as were used in industrial
    applications.   See, e.g., Sept. 19, 2011 (P.M.), at 14.          Moreover, Dr. Frank
    acknowledged that, upon exposure to heat and friction, much of the asbestos material in
    brake shoes is converted into a different substance, forsterite, which Dr. Frank did not
    claim was causative of mesothelioma. See 
    id. at 14-15.
    [J-12-2016][M.O. - Donohue, J.] - 6
    associated with Mr. Rost’s “relatively low dose” exposure to Appellee’s products in the
    context of Mr. Rost’s overall exposure. Rather, in response to a hypothetical question
    generally presenting the circumstances of Mr. Rost’s exposure to Ford products, Dr.
    Frank merely affirmed, in a conclusory fashion, his belief that the exposure was
    substantially causative.    See N.T., Sept. 19, 2011 (A.M.), at 116-17.6          By way of
    explanation or otherwise, the expert then reverted to various reaffirmations of his other
    opinions on general and specific causation, i.e., that “all [exposures] contributed[.]” 
    Id. at 121-22;
    see also 
    id. at 122
    (“All of the exposures that can be documented should all
    be considered as contributory to [Mr. Rost’s] developing his disease.”).
    6
    From my point of view, the majority’s assertion that Dr. Frank took into consideration
    “exposure history, individual susceptibility, biological plausibility, and relevant scientific
    evidence (including epidemiological studies),” Majority Opinion, slip op. at 20,
    represents an abstract assessment of the record in this case as it relates to the matter
    of substantial-factor causation. Dr. Frank made no attempt to even roughly quantify
    either the dose experienced by Mr. Rost at Smith Motors or his cumulative exposure or
    dose. See, e.g., N.T., Sept. 19, 2011 (P.M.), at 22 (reflecting Dr. Frank’s recognition
    that aspects of Mr. Rost’s industrial exposure “could have been high, it could have been
    low” and his statement that: “I can’t speak to what his level of exposure was.”). I have
    found nothing on the record as far as Mr. Rost’s individual susceptibility goes, or
    anything to relate such concept to Dr. Frank’s opinion concerning substantial-factor
    causation. Biological plausibility in the abstract goes more to general causation than to
    establishing substantial-factor causation, particularly where the issue is presented in
    terms of risk. In terms of the epidemiological evidence pertaining to mesothelioma in
    auto workers, Dr. Frank’s discussion was vague, with specific-study treatment focusing
    mostly on his discounting of ones that were inconsistent with his position. See N.T.,
    Sept. 19, 2011 (A.M.), at 103-05. Compare Yates v. Ford Motor Co., 
    113 F. Supp. 3d 841
    , 861 (E.D.N.C. 2015) (“Rather than engage in any specific, meaningful comparison
    of the scientific data with [the plaintiff’s] exposures, [the expert’s] opinions essentially
    attempt to overwhelm with statistics and studies, lacking guidance as to how a juror
    ought to apply them in the instant case, aside from joining [the expert’s] ultimate
    conclusion that [the plaintiff’s] mesothelioma was caused by defendants’ products. This
    is not a reliable method, and it will not assist a jury.”); Comardelle v. Pa. Gen. Ins. Co.,
    
    76 F. Supp. 3d 628
    , 635 (E.D. La. 2015) (offering similar criticisms of an expert
    witness’s substantial-factor causation grounded on a broad array of cases, studies, and
    regulatory materials to which the witness “refer[red] cursorily”).
    [J-12-2016][M.O. - Donohue, J.] - 7
    There is no dispute between the litigants concerning the essential proposition
    that cumulative dose matters relative to dose-dependent diseases such as
    mesothelioma.7 The dispute now concerns whether a plaintiff should be required to
    address this critical factor, in any sort of a meaningful fashion, as a component of the
    burden of proof to establish substantial-factor causation.8
    Where the issue is simply risk – I fail to appreciate how the substantiality of
    relatively low-dose exposures can be fairly demonstrated in the absence of some sort of
    reasonably-developed comparative risk assessment accounting for higher-dose
    7
    See, e.g., Majority Opinion, slip op. at 6 (“All exposures to asbestos contribute to the
    cumulative dose of asbestos, and the cumulative dose causes mesothelioma.”
    (emphasis added)); Brief for Appellee at 28, 43 (“[T]he total cumulative exposure
    collectively causes a disease.”); accord Brief for Amicus Asbestos Disease Awareness
    Org. at 13 (“[C]umulative dose best explains the increased risk of mesothelioma in the
    population and is the standard metric used in epidemiological studies that evaluate dose
    and risk of disease.”). See generally Joseph V. Rodricks, Reference Guide on
    Exposure Science, REFERENCE MANUAL ON SCIENTIFIC EVIDENCE 507 (Fed. Judicial
    Center 3d ed. 2011) (“Ultimately the dose incurred by populations or individuals is the
    measure needed by health experts to quantify the risk of toxicity.”).
    8
    In point of fact, Appellee accepts the burden to meaningfully address exposures to
    Ford products in the context of his cumulative dose (including his industrial exposure) to
    establish substantial-factor causation. See, e.g., Brief for Appellee at 42-43 (indicating
    that this Court’s decisions in “Gregg, Betz, and Howard maintained [a] fair balance”
    when “they required experts to consider both the frequency, proximity, and regularity of
    the plaintiff’s exposure to asbestos from the defendant’s products, and to place this
    exposure in context with other exposures to ensure, in the wider context of a plaintiff’s
    exposure history, that defendant’s contribution was a ‘substantial factor’ and not merely
    a factor.” (emphasis added)).
    From my perspective, the only remaining question should be whether, at trial, Mr. Rost
    meaningfully did so via Dr. Frank’s testimony, or whether, as Ford and its amici
    contend, the expert’s opinion concerning substantial-factor causation merely collapsed
    into his other general and specific causation opinions (i.e., that all exposures are
    contributory). The majority, however, proceeds of its own accord to overturn the
    requirement to address substantial-factor causation in the context of cumulative dose,
    see Majority Opinion, slip op. at 22-32, thus yielding the differences concerning the
    prevailing legal standards that are discussed below.
    [J-12-2016][M.O. - Donohue, J.] - 8
    industrial exposures. Surely the courts would not sanction liability on the part of an
    individual for an automobile accident if the plaintiff did not proffer some form of evidence
    that would establish a fair probability that the defendant was, in fact, one of the actual
    drivers. Although this is not a perfect analogy, it highlights that, to the degree that we
    accept amorphous possibilities or probabilities with no real effort to address the overall
    risk exposure, the substantive law of substantial-factor causation is being applied in a
    highly idiosyncratic fashion in toxic tort cases.9
    From my point of view – again, where the plaintiff is plainly proceeding to
    address causation by reference to risk – a jury that is not provided with meaningful
    information concerning cumulative dose simply lacks sufficient information to make a
    rational decision concerning substantiality. Instead, the fact finder is left to conjecture
    and speculation, colored by the liberal reaffirmations of the opinion concerning general
    and specific causation (sans the substantial-factor aspect), i.e., that all doses are
    contributory.10 Put in terms of the frequently referenced bucket-in-the-ocean analogy
    9
    In this vein, I believe that an approach that relieves the plaintiff of addressing exposure
    to a defendant’s product in the context of the plaintiff’s overall exposure is tantamount to
    a form of burden shifting, which this Court has otherwise refused to extend into the toxic
    tort arena. See, e.g., Skipworth v. Lead Indus. Ass’n, Inc., 
    547 Pa. 224
    , 231-32, 
    690 A.2d 169
    , 172 (1997). As further discussed below, I would submit that any changes to
    the law along such lines should be attended by consideration of the full host of relevant
    policy matters, which are well beyond the scope of the presentations here.
    10
    Cf. Stark v. Armstrong World Inds., Inc., 21 Fed. Appx. 371, 376 (6th Cir. 2001)
    (expressing the concern that “defendants not be subjected to open-ended liability based
    solely on a jury’s inexpert speculation on proximate cause” (citation omitted)); Burleson
    v. Texas Dep’t of Criminal Justice, 
    393 F.3d 577
    , 587 (5th Cir. 2004) (explaining that a
    causation opinion where the expert “fail[s] to conduct a dose assessment” produces “too
    great an analytical gap between the data and the opinion proffered” (citation omitted)).
    See generally Gold, When Certainty Dissolves Into Probability, 70 WASH. & LEE L. REV.
    at 320-21 (“The mechanistic model fails when proof of causation rests on evidence
    derived from population-based data on the association of disease and exposure . . .[;]
    [i]n such cases the fact-finder must test its belief in a frequentist-probability value
    supported by evidence of risk contribution.”).
    [J-12-2016][M.O. - Donohue, J.] - 9
    coined by former Judge Klein, see Summers v. Certainteed Corp., 
    886 A.2d 240
    , 244
    (Pa. Super. 2005) (rejecting the notion that “if one took a bucket of water and dumped it
    into the ocean, that was a ‘substantial contributing factor’ to the size of the ocean”), I
    submit that a jury cannot meaningfully assess the substantiality of the impact of a
    bucket of water introduced into a receptacle where the jurors have been provided with
    no means to assess whether such receptacle is a bathtub, or a pond, or a lake, or an
    ocean.
    Again, I recognize the difficulties facing plaintiffs in cases involving long-latency
    disease. See supra note 2.11 Given, however, that alteration of long-standing and
    central tort-law concepts such as the requirement of substantial-factor causation has the
    potential to have broad-scale social effects, I believe that such matters are most
    appropriately considered by the policy-making branch of government. See generally
    Seebold v. Prison Health Servs., Inc., 
    618 Pa. 632
    , 652-54 & n.19, 
    57 A.3d 1232
    , 1245-
    46 & n.19 (2012) (discussing the nature of common-law adjustments to the substantive
    law, the necessity for a fully developed policy analysis, and the superior position of the
    General Assembly to undertake such assessments).12 To the degree that the judiciary
    11
    In this regard, I acknowledge the expense and difficulty in attempting to address dose
    in concrete terms. See, e.g., N.T., Sept. 20, 2011 (A.M.), at 84 (reflecting the
    recognition, on the part of the plaintiff’s expert, Mr. Brody, that “you would need an
    industrial hygienist to explain what [the] dose might be,” albeit that Mr. Rost did not
    present such testimony). Again, however, to the degree that these sorts of practical
    considerations are at work – as opposed to a conventional application of established
    principles of tort law – I maintain that a wider-scale policy assessment is implicated.
    12
    For example, further relaxation of the governing standards of proof obviously can
    exacerbate what the Supreme Court of the United States has characterized as an
    “elephantine mass of asbestos litigation . . . [which] defies customary judicial
    administration and calls for national legislation.” Ortiz v. Fibreboard Corp., 
    527 U.S. 815
    , 821, 
    119 S. Ct. 2295
    , 2302 (1999). On a micro scale, the docket of the present
    case reflects that Mr. Rost filed his claims against 66 defendants, most of which
    attained summary dismissals. Moreover, the consequences of the adjustments
    reverberate through the product chain, since strict liability for a defective product does
    (continued…)
    [J-12-2016][M.O. - Donohue, J.] - 10
    should continue to reassess the core and fundamental requirements of tort law as
    applied in the toxic tort arena, it is my position that the policy arguments should be
    (…continued)
    not merely attach to manufacturers but extends through the product chain to distributors
    and retailers as well. See, e.g., Gregg, 
    596 Pa. 274
    , 
    943 A.3d 216
    (reflecting a suit
    against a local automobile parts supplier).
    In a footnote, the majority opinion appears to suggest an inclination to consider
    eliminating the requirement of substantial-factor causation in the asbestos-litigation
    arena altogether in favor of a de minimis threshold for liability, based on the fact that the
    Legislature has cabined joint and several liability through the enactment of the Fair
    Share Act. See Majority Opinion, slip op. at 16 n.7. For supportive policy implications,
    the majority references a law review comment for the proposition that the “‘frequency,
    regularity and proximity’ test imposes an inappropriately high burden of proof upon
    many asbestos victims,” as it “distort[s] the medically proven fact that significant injury
    can result without ‘frequent’ or ‘regular’ exposure.” Brian M. DiMasi, Comment, The
    Threshold Level of Proof of Asbestos Causation: The “Frequency, Regularity and
    Proximity Test” and a Modified Summers v. Tice Theory of Burden-Shifting, 24 CAP. U.
    L. REV. 735, 750 (1995) (for the proposition).
    It should be noted, however, that the burden-shifting premises underlying the author’s
    proposals rest, at least in part, upon his determination of culpable conduct on the part of
    asbestos product manufacturers. See, e.g., 
    id. at 759
    (charging the suppliers,
    manufacturers, and distributors of asbestos products at large with “a conspiracy to
    cover up the harmful effects of asbestos exposure”). Notably, given the once-
    widespread use of asbestos in products, there are thousands upon thousands of
    defendants in asbestos cases. See Alan Calnan & Byron G. Stier, Perspectives on
    Asbestos Litigation: Overview and Preview, 37 SW . U. L. REV. 459, 462-63 (2008)
    (tallying at least 8,400 entities spanning 75 of the 83 industries classified by the United
    States Department of Commerce), not all of whose culpability has been assessed. For
    example, asbestos defendants in Pennsylvania are often sued in strict liability, which, at
    least under the liability regime prevailing at the time the present action was litigated,
    foreclosed the defendants from from presenting conduct-based defenses, such as
    reliance on industry and government standards. See, e.g., Lewis v. Coffing Hoist Div.,
    Duff-Norton Co., Inc., 
    515 Pa. 334
    , 343, 
    528 A.2d 590
    , 594 (1987).
    I mention these points to provide one of the many layers of perspective which I believe
    would need to be considered before making further adjustments to substantive law in
    asbestos cases.
    [J-12-2016][M.O. - Donohue, J.] - 11
    made plain by the litigants, rather than proceeding as subtexts to the position that the
    traditional legal requirements are being adhered to straightforwardly.
    Returning to what I believe to be the issue in this case, see supra note 8, I find
    that the record does not present an adequate basis for any meaningful assessment of
    Mr. Rost’s long-term industrial exposure to asbestos. Accord Brief for Amicus Asbestos
    Disease Awareness Org. at 34 nn.78 & 79 (reflecting the recognition by an amicus for
    Appellee that any assessment of Mr. Rost’s industrial exposure “is wholly speculative,”
    because “[t]he record contained very little testimony regarding the duration and intensity
    of the exposures at Met-Ed”). In any event, it was quite apparent, in terms of Dr.
    Frank’s opinion, that he was not concerned with even attempting to address Mr. Rost’s
    cumulative dose on any sort of tangible or proportionate terms. See, e.g., N.T., Sept.
    19, 2011 (P.M.), at 22 (reflecting Dr. Frank’s recognition that aspects of Mr. Rost’s
    industrial exposure “could have been high, it could have been low” and his statement
    that: “I can’t speak to what his level of exposure was”). Again, another expert for Mr.
    Rost indicated that such an assessment would have been within a different realm of
    expertise. See N.T., Sept. 20, 2011 (A.M.), at 84 (reflecting the recognition, on the part
    of Mr. Brody, that “you would need an industrial hygienist to explain what [the] dose
    might be”).
    For these reasons, in the absence of any sort of a meaningful assessment of
    proportionality, I agree with Ford’s central position that the basis for Dr. Frank’s opinion
    concerning substantial-factor causation is not materially distinguishable from his other
    opinions concerning general and specific causation, i.e., that every exposure counts.13
    13
    I am not in any way suggesting that substantial-factor causation can be proved only
    by eliminating “every other potential cause of the development of disease through a
    ranking of different exposures.” Majority Opinion, slip op. at 31. I do believe, however,
    that a plaintiff must meaningfully address his long-term industrial exposure to friable
    asbestos-containing products in a case premised on short-term exposure to non-friable
    (continued…)
    [J-12-2016][M.O. - Donohue, J.] - 12
    Reaffirmation of Betz
    Consistent with the above, I would take this opportunity to reaffirm, and not
    cabin, the Court’s opinion in Betz. Initially, I do not agree with the majority’s position
    that the requirement for a plaintiff to address, in some meaningful fashion, the plaintiff’s
    cumulative dose was unnecessary to the decision in Betz. See Majority Opinion, slip
    op. at 22. Rather, the Betz Court proceeded through essentially the above analysis,
    recognizing that the liability theory was risk based, and concluded that the only rational
    way to assess substantiality in a risk calculus (particularly in lower-dose scenarios) is to
    compare the risk attributable to a particular defendant with the plaintiff’s overall risk
    exposure. See 
    Betz, 615 Pa. at 549-54
    , 44 A.3d at 55-58; accord 
    Moeller, 660 F.3d at 954
    (“The question [of] whether [defendant’s] acts probably caused [plaintiff’s]
    mesothelioma must be viewed in the context of [plaintiff’s] other substantial exposures
    to asbestos[.]” (quoting Cardinal Indus. Insulation Co., Inc. v. Norris, Nos. 2004-CA-
    000525-MR, et al., slip op., 
    2009 WL 562614
    , at *8 (Ky. Ct. App. Mar. 6, 2009))); Bailey
    (…continued)
    materials and their low-asbestos-content byproducts. Cf. Moeller v. Garlock Sealing
    Techs., LLC, 
    660 F.3d 950
    , 955 (6th Cir. 2011) (“Given that the [p]laintiff[-executrix]
    failed to quantify [her decedent’s] exposure to asbestos from [a defendant’s] gaskets
    and that the [p]laintiff concedes that [the decedent] sustained massive exposure to
    asbestos from [other] sources, there is simply insufficient evidence to infer that [the
    defendant’s] gaskets probably, as opposed to possibly, were a substantial actor of [the
    decedent’s] mesothelioma.”).
    I certainly would not hold plaintiffs to exactitude in this setting. Indeed, there is no
    question that “[l]arge swaths of tort law are, to put it charitably, highly approximate.”
    Gold, When Certainty Dissolves Into Probability, 70 WASH. & LEE L. REV. at 326. From
    my point of view, however, courts must engage in some line drawing, and, in the
    present context, Mr. Rost’s failure to offer even rough approximations of dose either as
    to the approximately three-month period of exposure to friction products at the Smith
    Ford garage or the long-term industrial exposure should be deemed dispositive relative
    to Ford’s liability.
    [J-12-2016][M.O. - Donohue, J.] - 13
    v. N. Am. Refractories Co., 
    95 S.W.3d 868
    , 873 (Ky. Ct. App. 2001); 
    Martin, 561 F.3d at 443
    (“[O]ne measure of whether an action is a substantial factor is the number of other
    factors which contribute in producing the harm and the extent of the effect which they
    have in producing it.”).
    In Betz, it was precisely because the any-exposure theory fails to account for
    cumulative dose (which drives the overall risk of disease) that the Court rejected the
    theory as a means to establish substantial-factor causation. See, e.g., 
    Betz, 615 Pa. at 550
    , 44 A.3d at 56 (“[O]ne cannot simultaneously maintain that a single fiber among
    millions is substantially causative, while also conceding that a disease is dose
    responsive.”). In this regard and otherwise, I do not view Betz as merely circling back to
    the frequency, regularity, and proximity test. See Majority Opinion, slip op. at 31.
    Frequency, Regularity, Proximity
    From my perspective, the frequency, regularity, and proximity test is best
    conceptualized as a rough exposure-related screening test, most useful for product
    identification purposes at the summary judgment stage. See generally Faigman, et al.,
    3 MOD. SCI. EVIDENCE §25:5 (explaining that, given the volume of defendants being
    hailed into court by plaintiffs in individual cases, “[c]ourts have been forced to develop a
    set of sufficiency tests for judging which cases should be taken from the jury”). After all,
    the test is undeveloped in terms of metrics or degree-based standards of any kind and,
    in cases involving mesothelioma, tends to devolve into the any-exposure theory.
    In complex toxic tort cases such as the present one, the requirement for
    competent expert testimony – to connect exposure with actual disease – obviously
    remains a central one. Accord Hamil v. Bashline, 
    481 Pa. 256
    , 267, 
    392 A.2d 1280
    ,
    1285 (1978) (“[I]t is generally acknowledged that the complexities of the human body
    place questions as to the cause of pain or injury beyond the knowledge of the average
    [J-12-2016][M.O. - Donohue, J.] - 14
    layperson[;] therefore, the law requires that expert medical testimony be employed.”
    (citation omitted)). The Betz Court recognized the influential nature of the testimony of
    expert witnesses and the potential for distortions to mislead laypersons and, therefore,
    decided that courts should maintain a gatekeeping role relative to expert testimony
    about the critical issue of substantial-factor causation in toxic tort cases. See 
    Betz, 615 Pa. at 545
    , 44 A.3d at 53.
    To the degree that the decision in Tragarz v. Keene Corp., 
    980 F.2d 411
    (7th Cir.
    1992), suggests that no comparative risk or probability assessment is required, this
    Court plainly departed from that approach based on developed reasoning in Betz. See
    
    Betz, 615 Pa. at 553-54
    , 44 A.3d at 58. Again, I respectfully differ with the majority’s
    decision to overturn this and other material portions of such decision.
    The Structural Error in Consolidation
    On the issue of consolidation, the majority recognizes that the trial court
    committed a blatant, structural error by consolidating unrelated complex, toxic tort cases
    merely on the basis that all plaintiffs suffered from the same disease. See Majority
    Opinion, slip op. at 34. In other contexts, courts have recognized the difficulty facing a
    litigant charged with establishing prejudice resulting from structural errors. See, e.g.,
    State v. Shearer, 
    334 P.3d 1078
    , 1083 (Wash. 2014). In my view, given the breadth of
    the present record – subsuming the differences among the plaintiffs and defendants and
    all of the attendant circumstances relative to the three materially unrelated cases
    involved – the high potential for prejudice is evident, even if one were to discount the
    emerging empirical evidence referenced by Ford. See Brief for Appellant at 42 (citing,
    inter alia, Kenneth S. Bordens & Irwin A. Horowitz, The Limits of Sampling and
    Consolidation in Mass Tort Trials: Justice Improved or Justice Altered?, 22 LAW &
    [J-12-2016][M.O. - Donohue, J.] - 15
    PSYCHOL. REV. 43, 66 (1998), for the proposition that consolidation “can alter the
    patterns of verdicts and awards handed down by jurors”).
    If a tipping point is needed, I would find that to have been reached, inter alia, in
    the argument presented to the jury by an attorney representing Sears in another of the
    consolidated cases:
    And, oh, the automotive companies, the brake companies
    have this grand conspiracy. Well, ladies and gentlemen, I
    represent Sears. We are a department store, a retailer. You
    didn’t hear anything about Sears funding studies about
    brakes.
    N.T., Oct. 5, 2011, at 157 (emphasis added).
    For these reasons, I believe that Ford would be entitled to a new trial, but for the
    failure of proof relative to substantial-factor causation. In light of such failure, I would
    reverse and remand for entry of judgment notwithstanding the verdict.
    [J-12-2016][M.O. - Donohue, J.] - 16