There’s a saying that “everyone is entitled to their day in court.” Fair enough. But, to have your day in court, you have to have standing. While the requirements for standing vary from jurisdiction to jurisdiction, all courts require a plaintiff to have suffered an injury in fact. Afterall, the entire idea of standing is to ensure courts handle real disputes—not speculative ones based on things that could, might, or possibly, if the stars align, go wrong. If plaintiffs without injuries can sue, then courts become astrologers, predicting future diseases like they are reading tea leaves. Standing exists because courts deal with facts, not probabilities that sound like they were calculated on a napkin.
In toxic-exposure cases, however, there is a category of plaintiffs who want to treat the courthouse like a medical clinic with a very generous insurance plan. These are individuals who seek medical monitoring because they were exposed to a chemical but experienced no actual physical injury. Not a rash, not a cough, not even an impressively dramatic fainting episode. Fortunately, in line with the growing trend, Colorado recently became the fifth state in a row where an appellate court expressly rejected no-injury medical monitoring claims.
Smith v. Terumo BCT, Inc., — P.3d –, 2025 WL 3029699 (Co. Ct. App. Oct. 30, 2025), is not a drug or device case, but it is adjacent. Defendants sterilize medical equipment using ethylene oxide (EtO), a known carcinogen. Plaintiff filed a purported class action on behalf of individuals who resided near defendants’ facilities alleging they had been injured by exposure to EtO emissions. The purported class explicitly excluded anyone who had been diagnosed with cancer due to EtO exposure, creating a class of individuals who were only alleging an increased risk of cancer or other illness in the future and seeking to be awarded the costs of diagnostic testing for early detection. Id. at *1.
The trial court dismissed the case for lack of standing. After which time, the procedural history gets a little complicated. But in short, plaintiff did not appeal the original order but instead filed a motion for leave to file an amended complaint. That motion went unruled on for three years. In which time we should note that, fortunately, plaintiff remained injury free. Finally, the court denied the request for several reasons, including that amendment would be futile because plaintiff did not cure the legal deficiencies that caused the court to dismiss the complaint in the first place—still no injury in fact, still no standing. Id. at *2.
The appellate court’s reasoning and conclusion were simply stated:
One of the basic principles of law is that a party may not recover damages if he has not suffered an injury. Consistent with this principle, a person cannot pursue a tort claim for future death, future physical injury, or future property damage. [An] allegation that EtO exposure increases [the] risk of cancer or other disease amounts to nothing more than a hypothetical claim of future physical injury. . . .
In recent years . . . courts throughout the country have repeatedly held that a toxic tort claim cannot proceed in the absence of a present physical injury. Because these cases are consistent with Colorado‘s longstanding rejection of tort claims based on the potential of future physical harm, the district court did not err by following them.
Id. at *6-7 (citations to other state appellate decisions rejecting medical monitoring claims) (emphasis original).
In other words: you can’t recover for harm you haven’t suffered. It’s the legal version of “no dessert until after dinner.” Plaintiffs asking for medical monitoring without an injury are basically saying, “I haven’t gotten sick, but I’d like to get paid just in case I might someday.” Future illness is speculative by definition and damages based on pure speculation don’t belong in the legal system.
The court addressed two additional arguments. First, plaintiff tried to get the court to adopt the Restatement (Second) of Torts definition of bodily harm which makes mention of a change to the structure of any part of the body even if that change causes no other harm. Restatement 2d, §15. So, plaintiff claimed that the EtO had been “absorbed” and “distributed” in his body constituting a “change in the structure of his body.” Id. at *7. No Colorado court has ever adopted that definition of bodily harm, and the Smith court decided it need not tackle the question because plaintiff’s claims were conclusory. “[A]bsorption and metabolization do not necessarily lead to changes in the body’s structure or function.” Id. Because plaintiff had no specific allegations that he or any other named plaintiff was experiencing a “currently existing adverse event”, the court rejected the claims as conclusory.
Second, plaintiff argued that medical monitoring was an economic injury. But that argument “blurred the line between establishing injury and damages.” Id. A plaintiff has to demonstrate both a present physical injury and economic losses that result from that injury. You can’t just jump to damages and bypass injury.
At the end of the day, allowing no-injury medical monitoring claims would convert speculative fear into a legally compensable condition—and that’s a recipe for chaos. Let’s leave hypothetical harms where they belong–late-night WebMD spirals—not the courtroom.