Order, Supreme Court, Bronx County (Betty Owen Stinson, J.), entered December 4, 2007, which, to the extent appealed from as limited by the briefs, granted defendant's motion for summary judgment dismissing the complaint, reversed, on the law, without costs, the motion denied and the complaint reinstated.
Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.
This opinion is uncorrected and subject to revision before publication in the Official Reports.
Gonzalez, P.J., Mazzarelli, Buckley, Renwick, Abdus-Salaam, JJ.
In February 1997, the infant plaintiff and his family moved into an apartment owned by defendant. He was 21 months old at the time. In November 1997, paint on the walls and ceiling of the apartment began to bubble and peel, and dust from the paint accumulated on the windowsills and baseboards. Plaintiff would often play with the paint bubbles and place his fingers in his mouth after they became covered with dust. Shortly after plaintiff first moved into the apartment, a blood test revealed that his blood contained 4 micrograms (æg) of lead per deciliter (dl). In September 1998, a blood test revealed that plaintiff had a blood lead level of 10.4 æg/dl. Six weeks thereafter plaintiff's lead level rose to 12.6 æg/dl. Plaintiff's mother notified defendant that she believed her son had been poisoned by lead paint in the apartment. Defendant abated the lead paint condition in March 1999. Shortly before the abatement work began, the lead levels in plaintiff's blood began to decline. They never again exceeded 10 æg/dl.
In January 2000, the New York City Department of Education referred plaintiff for various evaluations to assess whether he qualified for preschool special education services. Plaintiff's mother had expressed concerns regarding his language and his fine motor and independent living skills, all of which appeared to her to be progressing normally until plaintiff began to ingest lead paint. A psychological evaluation determined that plaintiff had a "General Conceptual Ability" score in the low range. He was found to have some "mild autistic-like characteristics . . . which include . . . difficulty maintaining eye contact, difficulty relating meaningfully at times, repetitive speech, difficulty with language, unusual response to loud sounds, difficulty adapting to changes and unusual play." Physical and occupational therapy evaluations found plaintiff's gross and fine motor skills to be significantly delayed. A psychiatric evaluation resulted in a diagnosis of "PDDNOS*fn1 (perhaps secondary to lead exposure)." In early 2003, the Social Security Administration diagnosed plaintiff with autism and mental retardation.
Plaintiff commenced this action against defendant and in his bill of particulars alleged the following injuries from exposure to lead paint: "Plumbism, lead poisoning and its sequelae; Anemia; Elevated blood lead levels; Increased lead burden in blood and infant's body, causing developmental delays and brain damage; Cognitive deficits and learning difficulties; Loss of I.Q.; Behavioral irregularities; Anti-social behavior patterns; Developmental delays resulting in inability to fully interact and play with others; Difficulties in concentration, unfocused and shortened attention span, attention deficits; Necessity for extensive medical monitoring; Learning difficulties and impairment in ability to carry out responsibilities; Inability to participate in usual childhood activities; Language deficits and delay; Necessity for multiple and painful blood tests; Physical and mental pain, suffering, and anguish; Embarrassment and humiliation; Increased lead in bony formations; Elevated bone lead level; Sleep disorders; Visual disturbances; Hyperactivity; Lack of concentration; Memory Loss; Infant plaintiff has also suffered subclinical joint and connective tissue disease, disease of the immune system, kidney disease, hypertension and visual and auditory system processing deficits."
At the close of discovery, defendant moved for summary judgment. Its motion was primarily supported by the affidavit of Joseph Maytal, a pediatric neurologist who had performed a physical examination of plaintiff. In analyzing the effects of plaintiff's lead exposure, Dr. Maytal relied on a 1991 statement of the United States Centers for Disease Control (CDC) entitled Preventing Lead Poisoning in Young Children. The statement was intended to guide pediatric health care providers in how to react when confronted by blood lead levels over 10 æg/dl. It noted that "studies suggest that adverse effects of lead occur" at levels over that threshold. Dr. Maytal explained that according to the CDC statement, children with blood levels between 10 æg/dl and 14 æg/dl are in a "border zone," and " the adverse effects of blood lead levels of 10-14 æg/dl are subtle and not likely to be recognizable or measurable in the individual child.'"
Dr. Maytal further asserted that: "[I]t is my opinion, within a reasonable degree of medical certainty, that the infant plaintiff's impairments alleged in the Verified Bill of Particulars were not caused by the infant plaintiff's very slightly and very briefly elevated blood lead levels. The mere fact that [plaintiff's] lead level was documented to be minimally elevated does not mean that any of his problems are attributable to his blood lead level. Indeed, as reported by the CDC, the adverse effects of the blood lead levels measured in the infant plaintiff are subtle and not likely to be measurable." In addition, he quoted from an unattached report of an organization called the American Council on Science and Health (ASCH) entitled Lead and Human Health. According to Dr. Maytal, that publication acknowledges that lead is capable of causing neurological effects at high doses, but states that " it is difficult if not impossible to attribute toxicologically significant behavioral or neurological effects to increasingly lower [blood lead levels] because of the numerous confounding factor [sic] that influence intelligence and development in children.'" These so-called "confounding factor[s]," which Dr. Maytal related the article as identifying, "include socioeconomic status, childhood diseases, parenting skills, genetic predisposition . . . maternal and paternal intelligence . . . child abuse, nutrition and prenatal care, labor and delivery, and personality characteristics."
Finally, Dr. Maytal stated that: "It must be noted that there is absolutely no objective, empirical, scientific or medical report or study which links minimally and briefly elevated blood lead levels to the development of autism or mental retardation. Nor is such a link recognized by the relevant medical or scientific communities. It is therefore my opinion, within a reasonable degree of medical certainty, that the infant plaintiff's minimally and briefly elevated blood lead levels did not contribute to the development of either his autism or mental retardation."
The motion court held that defendant met its burden of establishing prima facie entitlement to summary judgment through Dr. Maytal's affidavit. It further held that plaintiff did not present evidence in opposition sufficient to raise an issue of fact. The court found that plaintiff's evidence, including the affirmations and affidavits of three medical experts who had examined plaintiff, collectively did not, other than through "bald conclusions," demonstrate that plaintiff's injuries were caused, at least in part, by exposure to lead. This was fatal to plaintiff's case, the court stated, because "there are several possible causes for . . . plaintiff's deficits, for many of which the defendant is not responsible."
The court erred in awarding defendant summary judgment because defendant did not establish its prima facie entitlement to such relief. Dr. Maytal's opinion that plaintiff's lead exposure did not result in his injuries was based not on an individualized assessment of plaintiff's particular condition but rather on the CDC's statement that "the adverse effects of blood lead levels of 10-14 æg/dl are subtle and not likely to be recognizable or measurable in the individual child."
To bar plaintiff's claim on that basis would be to effectively declare that a child with blood lead levels in that range can never sue for damages and we decline to make such a far-reaching determination. First, such an approach would ignore the fact that the CDC statement expressly recognizes that there is a deleterious effect on the human body attributable to blood lead levels over 10 æg/dl. Second, the CDC statement did not state that a child can never exhibit ill effects as a result of blood lead levels between 10-14 æg/dl, only that it is "unlikely" that he or she would. It is worth noting that the CDC statement predates plaintiff's allegation of lead poisoning by 13 years. During this time, the ability of the medical community to recognize "the adverse effects of blood lead levels of 10-14 æg/dl" has presumably advanced. Finally, the New York City Health Code provides that "lead poisoning [is] to be defined as a blood lead level of 10 micrograms per deciliter or higher" (24 RCNY 11.03) (emphasis added). The term "poisoning" is generally defined not merely as a person's exposure to a dangerous substance itself, but rather to an exposure that is likely to result in injury. For example, Merriam-Webster's Collegiate Dictionary [11th ed] defines "poison" as "a substance that through its chemical action usu. kills, injures, or impairs an organism." Thus, the City of New York has determined that lead paint exposure which causes a child's blood lead level to rise above 10 æg/dl usually "injures" or "impairs" the child. To not recognize the possibility that plaintiff's injuries in this case were caused by lead paint exposure would be at odds with that determination.
Because the CDC statement is insufficient to generally bar all personal injury claims by children with blood lead levels between 10 and 14 æg/dl, defendant was required to establish that in this particular case there was no causal link between the specific injuries alleged in plaintiff's bill of particulars and his lead paint exposure. Defendant failed to do this through Dr. Maytal's affidavit, because Dr. Maytal offered only the conclusory statement, without any scientific evidentiary support, that "plaintiff's impairment . . . were not caused by . . . border zone' blood lead levels" (see Winegrad v New York Univ. Med. Ctr., 64 NY2d 851, 853 ). ...