Document 2Rgnb97zXnENZnwN8GpLgG83b

X.,\amzu<v Mfis^z iCvIUa v % C Wo r k me n 's c o mp e n s a t io n Th e In d u s t r ia l Co mmis s io n o f Oh io .aimant Address Date &2* 3i 71st Street, ' - _ CISvelaa4, Ohio........................ SPECIALIST'S REPORT ....... Age.. NOTE: Submit report under following headings: (1) History. (2) Complaints. (3) Examinations, including X-ray and laboratory work. (4) Discussion. (5) Opinion. Sign and mail THREE copies to the MEDICAL SECTION--Retain one for your file. REPORT OF EXAMINATION TO BE RETURNED WITHIN TWO WEEKS FOLLOWING REQUEST. HISTORY V, -b." - An opinion as to the nature of this claimants illness in'August of 19^3- must rest upon the statements of Dr. Jerome Cross. In the absentee of a satisfactory record of Dr. Cross* examination, th statement that the patient -when examined had '``abdominal colic, vomiting, constlpatIon, impairment of grip, lead line, stippling of BBC in smear, must be accepted by this reviewer as ".true, unless it can be discredited by evidence to the' contrary. Mo such evidence Is available, inasmuch so there is no information obtained froa.other examinations during this period. By th time of Dr. Parysek* exa:mihhtlon.`-on Bovember 8, there had been ample time for the disap pearance of - symptoms or signs. ..of plmbism. ~ Granting the occurrence of illness as described, tlie only basis in th record for differential diagnosis is found in the viueuep for or against.the significance of this mnats lead exposure. The;shortness - of the -claimant* s exposure to lead is the only valid, reason for question* This must not be taken too seriously in view of th manifest potential hasard of th manufacture of storage batteries. Th stippling of the erythrocytes (on our count there were about erythrocytes per 51 microscopic fields), while not providing proof, suggest that there vae significant lead exposure. Moreover th analytical data obtained by Dr. H&nzol would seem to - indicate that there had been significant lead exposure. Th report Oii.th# analyse frc Dr* Gross* office is not very convincing by reason of the- statement that 0.09 (no volume or weight relationship given) is normal* If Dr. Banzol obtains such figures on normal prsjw@, his method of analysis is not sufficiently precise, or else ho is not taking proper precautions against the contamination of blood samples at see point. Th mean value of normal results on th whole blood, by the most sensitive methods of analysis available Is about 0.05 mg* per 100 gross, while the highest normal value does not c'Oo exceed 0.06* Only in the rarest instance do normal values go beyond 0.05 mg* per 100 grams. This appears to represent & certain care OS lessness in Dr. Gross* report, rather than Dr. Hanr.qi*s (the latter**3 report is not in the record) since the same report (as well as the fee bill) gives the information on th urine as followsi ;,[Jrine load 0.25 NOTE: Submit report under following headings:. (1) History. (2) Complaints. (3) Examinations, . including X-ray and laboratory work. (4) Discussion. (5) Opinion. Sign and mail THREE 'i copies to the MEDICAL SECTION--Retain one for your file. REPORT OF EXAMINATION TO BE RETURNED WITHIN TWO WEEKS FOLLOWING REQUEST. HISTORY An opinion as to the nature of this claimant * s illness in August of 19^5 must rest upon the statements of Dr* Jerome Gross* In the absence of a satisfactory record of Dr. Gross*' examination, the statement that the patient when examined had "'abdominal colic, vomiting, constipation,'impairment of grip, lead line, stippling of REGs in smear, must be accepted by this reviewer as true, unless it can be discredited by evidence to the contrary. Do such evidence is available, inasmuch as there is no information obtained from other examinations during this period. By the time of Dr. Par-yzek*s exa mination .cm Eovesfaer 8, there had been ample time for the disap pearance of symptoms or eigne of plumbism. Granting the occurrence of illness as described, the Only, baais in the record for differential diagnosis is found in the " evidence for or against the significance of this man* 3 lead exposure. The shortness of th claimant* exposure to lead is the only valid reason for question* This must not be taken too seriously in view of the manifest potential hazard of the manufacture of storage batteries. The stippling of the erythrocytes (on our count there were about 43 erythrocytes per 5- microscopic fields), while not providing proof, suggests that then v&o significant lead exposure. Moreover the analytical data obtained by Dr. Benzol would, see to indicate that there had fee&: significant lead exposure. The report on the analyses from Dr. Gross* Office is not very convincing by reason of the statement that 0.09 (no volume or weight relationship given) la normal* If Dr. Hansel obtains such figur*es on normal persons, his method of analysis is not sufficiently precise, or else ho is not taking proper precautions against the contamination of blood samples at some point* Th mein vain of normal results on th ; whole blood# by the most sensitive methods of analysis available is about G.G3 mg. per 100. grams, while the highest normal value does not exceed D.06* Only.la th# rarest instone do normal value#.go beyond 0*0$ mg* per 100 grams. This appears to represent a certain care lessness in Dr- Gross* report, rather than Dr. Hansel*# (th latter*3 . report is not in th record) since th same report (as well as the fe bill) gives the information on the urine as followsi "Urine lead 0.23 normal J.3* again without refrenceto any weigh# or voliaa relation ship* It maybe presumed that this means'0.S3 mg. of lead per liter,. "i KE (Signature of Examiner) (CONTINUE REPORT ON REVERSE OF SHEET-NOTE INSTRUCTIONS) 0016792 M. D. v IIa XS&; (CONTINUE REPORT DOWN FROM HERE) 3&--` mm - <i "Z'ly.*' ^8te*fa -* ,4;'i"V'VA - >3;- . v ' sad that the nonasl value vas in to he 0*0J mg* per liter# since the latter is the average or seen normal value. Actually# any value up to 0*0Sg. per liter Mr be regarded as vitMa th normal range la: th ^oas: of sample of on liter or more ia,volume All in all# -this report demonstrates such carelessness in dealing TiB^'tfchti'a^iljpertin^Cfaot abDto justify 'oms's;-serious skepticism 'as to tkr accuracy of1 Mfr observations and stat#nts la thd paSrtJo*f.nl- tihleje t,rtfeecsrrolW'.rd* '1oWai tr1AiS*^msJt&feet*i`M%hHV#lT*Vb** dya*Ster*&*Wv'B-,,C~ereoesssib. er S9;sa,vfUS,a^5fi!t#e,(;li ^#0 states that analyses: on the blood and urine made on Septaafcsr 89# 19^3 gave mozM'rftflNltv; to uht N^ated# that tho blood lev P st3Vli>.'ttsoincpeea1 vleeer Is not able 'J cerrespeasd^O#^ ' are not t4-; , Conoluuionl ' Tile 3si rests primarily on the opinion of Sr* r Gross. Shis O' a net teo-vellisupportad# hut it/i%4ai'-v*`" discredited.as a matter,of 'records' therefore, on the record;the reviewed admits doubt; but,aceeptr;the opinion for lack o ioehtrary1 evidence. 3b*of prwiF#ry#k justifies tho conclusion that the claSaat.3a.^o present dis^Uiy* - ^^sac.pp ''WitSf ^v* '-, . .V-. - Xv* t * i. fX. 1. -V *t * # J***, * ,, *? ' >f. 1" 1 -f -fl. ^ t .* ' "If' 'rf*.#" ^ 7 Jh t tP~'-: >*. / ** ri* *> Cf sWiti 'r .-;' r* ; . '-ir;- s*.-> * t * , <- 7 ^1"^- ^ f*- --a' -'- ' ;'f ;r-: * /*> r T ^ ^ -V * -V- _' pz**> "? -v t ^ , w -r ?-r ^ ^ ,.; ..v - : : v.|i;' ^ X^ 1 ** ^ /..3r.;.' s,,:: f l^v-i r! ; 3 xr , ... ....- : ;. tr *, k- *+ : -x-' fK f* * >' ' :? ' c .r*-'1' *= :-};; i,- '. '-Sfl;^.. ,; A* , * , - ESi 4% % -< r i *^ ?.-J,v *VT ;^^.s- #v5S"-W* " S*. "|:i S * ' J i^V -IS-sv''^ kc 0016793! . I:':;. --^J&s. =tii"r ~l z' i`4'^ * Vi vr;:-jrf 7 X'/ "V-'-'i. ,=UV.'C '* SK, - :;w`Vi3'::.K -