Document 1OVqgKkanonwq57yY0DVLpRq

bbvt o qf m corn m ?q m Claim }io. o. B# Dec*u. August 19# 13*2v ' ' ' _ s _ ' Tb* undersigned reviewer took part in a clintcal-patbologi- * cal conference with'Staff physician at the Cincinnati General Hospital and tise staff of the laboratory of ileuropathology of that institution in early aarch.lS^* At that tim- the ealir history of the case, the-;' clinical record the necropsy findings* the analytical data* and the'-. report on the gross end microscopic study of the brain were consider*! ` orin detail. The microscopic slides v examined carefully fey the. ' review/c.ad a a m b e r of questions vere raised for discussion. The; reviewer was not convinced that the microscopic evidence presented ves sufficient to establish the diagnosis of load encephalopathy beyond cavil. However it was not possible, to set up another diagnosis that could be substantiated* and the concensus of opinion of the conference* with which the reviewer concurred, was that the diagnosis of lead encephalopathy was justified for both clinical and medico-legal purposes. A review of the record as submitted has given no reason for altering this conclusion. It cannot be said that the diagnosis of lead encephalopathy has been established without question. It is possible that the- primary clinical condition was hypertensive encephalopathy, and that death resulted from the hemorrhage. However, the hemorrhage is regarded by the neurologists and the neuropathologists as incidental in this case, and that conclusion cannot be proved erroneous. Against the diagnosis of lead encephalopathy is the opinion of Dr. viatuska who regarded the condition as primarily hypertensive, l^g 0016802 and conaiderad that thla saployee hsd aevar fc8 aysspt^s -or- Igs suggestiv f piosMsta* *2h&vmis also tli# opiaios f ibAssistent Oanaraliltepsaesr f tu# Eagle-Picher Lead Ccas^aa^- to tu afftet Uwt ttoft: had1not beea aerioXy axpoastd.fco laad is hls vorle* Tb Xafcfcor ^pinic* hcsrov? bsestly bald 1 not to t>&takm $ vte of ttse analftlcal fladifiga oft fcba tissuea ot tha Ammm* These anslyses as*cra fchafc ihm- lead exposrarhad bsen of siisifl esst pr^port^oae, and fche;.leaa ooaoifttii<a in Oho Uw?, spieen *ad susele provo tbai; tu s p o s m bad ccatisued to b oignificant mp to & tls shortiy feefore eath. Th skalatoa contalns fiffcean to mixtem tim tfee eonoaatrafcioa.of Xead fosia in fcb hone; of usexpooed persons* ln facfc* vhiX tfc lea eoaeenirations esosstrated ia thes itssues <S not prove tha esistence of iXXaoss s# to Xsad# aor to tfcay r s m i tb eaus of death, tfcey do# i^verthelase* fit ist tb rang of oosoestr* tloas fand .in usqueisticcod .ftal easea of lasd -poieonl&c and..thay ' efinitel# cst&hllsh the hasardoum charaeter of tb oceopatieX leed esposuro. ;hcXicical Snfoamtioa .in the raeord. ith raspaot to tb#.h e s a a t o lo g ica l a la a n n ft llt l* i a isa ^ eq iia t * aa exlsts&c o f o t h e r olislcal ayraptoasa of p lin M s s s n n et ho stabilst** Tb l& t t e r io o f t e s t h e c a s a wh ea fc& c e r e b r a l la s n ii'o s t a t lo n s er a a saver a t h e y were in tMs cos. The-.eXltiIs&I coure of ifcdisease was-cosspafcibl. itJt Usdiagnosis of dtffu neepfcalopathy fr any eaiie. Conaidarlng all tfce av&llsble iafons&tlQSi* th.differential iagaosle lies botveea hypertensiv eseopbalopatb# and Xead oeephalopatby Eiiber of thes . Eiay havbeen tli# p&tx&xw ausof th# fatal lllsese. The cc^isatios of tb# snalytloal rasult oa th brals# hieb is in tha rangssseeiate ith thoooarrmoa of Xea osooplmlopathy, togother ith the miero KE" 0016803 sepie patfcologyof tfe.'br&in, i#hiohtas'nowopataologist roips*.s as %gO$** a a G0* 4^ 14-i Srf I* 8, 4> + g f!I 1 m "iOS3 ih#O %;vI/-ji HS 0016804