Appeals : Arbitrator
Decisions : #24 - November 27th, 2001
D E C I S I O N
1. On September 26, 2001, the Administrator denied the claim
for compensation as a Primarily-Infected Person under the
Transfused HCV Plan. The claim was denied on the basis that
the Claimant did not receive transfused blood within the Class
Period from a donor who is determined to be HCV antibody positive.
2. The Claimant requested that the Administrator's denial
of his claim be reviewed by an arbitrator.
3. Neither of the parties sought a hearing to review the
Administrator's denial of the claim.
4. The Claimant provided written submissions and documentation
in support of her claim. These submissions have been carefully
considered but, unfortunately for the Claimant, they are of
no assistance to her for the reasons set out below.
5. The relevant facts are not in dispute and can be summarized
as follows:
(a) The Claimant is infected with Hepatitis C.
(b) The Claimant received three blood transfusions on September
7, 1988. She also received Albumin 5%, a substance excluded
from the definition of Blood in Article 1.01 of the Plan.
(c) The Claimant initiated a Traceback.
(d) When the claim was made, the Administrator also directed
the required Traceback Procedure to be carried out by Canadian
Blood Services.
(e) By letter dated May 30, 2001, the Administrator was
advised that all class period donors were cleared as not
testing positive for HCV antibodies.
(f) The Administrator denied the claim on the basis that
the Claimant did not receive a blood transfusion from a
primarily infected person during the Class Period.
(g) Following the filing of the claim, Fund Counsel requested
further information from Canadian Blood Services concerning
the Traceback process carried out with respect to the Claimant,
which confirmed and supported the facts noted above.
6. Based on these facts, it is clear that the Administrator's
decision must be sustained.
7. The 1986-1990 Hepatitis C Settlement Agreement defines
"Class Period", as the title implies, as the period
"from and including 1 January 1986 to and including 1
July 1990." The Transfused HCV Plan provides the identical
definition. The Plan defines a "Primarily-Infected Person",
a status a successful Claimant must achieve, as a "person
who received a Blood transfusion in Canada during the Class
Period
".
8. Pursuant to Article 3.01 of the Plan, a person claiming
to be a Primarily-Infected Person is required to produce to
the Administrator medical records "demonstrating that
the Claimant received a Blood transfusion in Canada during
the Class Period."
9. In this case, it is not disputed that the Claimant did
receive a blood transfusion in the Class Period, namely in
September 7, 1988.
10. Article 3.04(1) of the Plan provides as follows:
Notwithstanding any other provision of this Agreement,
if the results of a Traceback Procedure demonstrate that
one of the donors or units of Blood received by a HCV-Infected
Person or Opted-Out HCV Infected Person before 1 January
1986 is or was HCV antibody positive or that none of the
donors or units of Blood received by a Primarily-Infected
Person or Opted-Out Primarily Infected Person during the
Class Period or was HCV antibody positive, subject to the
provisions of Section 3.04(2), the Administrator must reject
the Claim of such HCV Infected Person and all Claims pertaining
to such HCV Infected Person or Opted-Out HCV Infected Person
including Claims of Secondarily-Infected Persons, HCV Personal
Representatives, Dependants and Family Members.
11. A Traceback Procedure is defined in Article 1.01 of
the Plan as follows:
"Traceback Procedure" means a targeted
search for and investigation of the donor and/or the units
of Blood received by a HCV Infected Person.
12. As has been noted, the evidence is that a Traceback
Procedure was conducted. As a consequence, it was established
there was three units of blood transfused, all on September
7, 1988. Each of the donors was identified by using the computerized
information system that tracks blood donor information. In
each case, the donors were tested to detect HCV antibodies
and, in each case, the result of the test was negative. Unfortunately,
the Claimant did not receive a blood transfusion during the
Class Period from a donor who is determined to be HCV antibody
positive.
13. The Claimant does not dispute these facts. However,
she submits that what has been done in refusing her claim
is unfair and unjust to her.
14. On the basis of the facts of this case, the Administrator
had no alternative but to deny the Claim. The words of Article
3.04(1) of the Plan are clear and unambiguous that the Administrator
"
must reject the Claim
" in circumstances
such as these. The Administrator must administer the Plan
in accordance with its terms. The Administrator does not have
the authority to alter or ignore any of the provisions of
the Plan and neither does an arbitrator when called upon to
review a decision of the Administrator.
15. Accordingly, I am obliged to find that the Administrator's
denial of the claim must be upheld.
Dated at Vancouver, British Columbia, the 27th day of November,
2001.
___________________________
John A. Sanderson, Q.C.,
Arbitrator
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