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FILE NAME Mundet Cork MCK DATE 1966 DOC MCK123 DOCUMENT DESCRIPTION WC Claim of Peutz Pt 2 Name Contract Unit Claim File Henry Peutz 22/66 Amended Jan. 9/68 Scanned ? yes Source JMA NS Start Year 1966 Stop Year 1968 Contents claim Notes ( ANTIOCH COMMUNITY HOSPITAL Antioch Calif DEPARTMENT OF RADIOLOGY MARSHALL B. TUCKER M.D. Radiologist RADIOGRAPHIC REPORT ( RECEIVEDRECEIVED DEC 1968 FILED Division of industrial idants OAKLAND OFFICE EXAMINATION.CER.SPINEEXAMINATION.CER.SPINEEXAMINATION.CER.SPINE , CHCEHESSTT DATE2-22-72-75-544 INPATIENT OUTPATIENT DOCTOR Dowell INDUSTRIAL 35465 RAY 35465 NAME PUTEZ Henry AGE 56 outling The vertebral bodies of the cervical spine aur normal in and density and without evidence of fracture bone destruction or paravertebral ass The alignent sears normal Sone marrowing marrowing paravertebral of intervertebral spacing seeds present throughout but parti ularlyularly at 5 and 6. There is se anterior and lateral osteophyte formation anterior osteophyte The pedicles scem normal Some panterior osteophyte formation is andpanterior 5 present on the left at and 6 through the The of C1 and 2 apophy relationship The sealseal are not joints remarkable are present present about the covertebral covertebral on the right at the auto levels open mouth sechs nugal Se degeneration changes jointe Transverse pr cistespr cistes 200 . normal No cervical rib is present 181 NH Degenerative outbarthritic changes with intervertebral dise thinuing and show The chat in symptrical the diaphe m clae The heart aorta the hilus are not remarkable Both lung fields in normal the angles are the wediastima and the trichra a a fine diffuse increour in particularly n dular the particularly in the lower half with small den- bargings sities The bony structures are not remirkable diagnosis . SSION Bilateral disease suppose that this in the post Since likely thispatient patient works with arbestos Hardhall H.Tucker M.D. 13 ee ewe RECEIVED DEC 1368 FILED Divklan of innustundidiennautstundideat innustundideat OAKLAND OFFICE ' HISTORY February 27 1964 PATIENT HENRY PUETZ PHYSICIAN R. J. DOWELL M.D. CHIEF COMPLAINT Auto acciddnt PRESENT ILINESS Patient failed to make a curve in his automobile while driving and rolled his vehicle He was not wearing a seat belt was not thrown from the car but does not know exactly what or where he struck in the machine His chief complaints are o re- neos in the neck and difficulty breathing He was examined in admission arranged unconscious the emergency room rays were following these procedures He ordered had not and been PAST HISTORY Patient has significant silicosis and emphysema and is under treatment for these by a chest specialist in Oakland He has had hypertension hypertension and is under treatment He recently saw a physician in Coalinga for chest chest congestion for which he was on tri- sulfaminic PHYSICAL EXAM This is an alert well developed well nourished white male in moderate distress guerney No smell of alcohol is He holds detected his He neck firmly to the states his face is ruddy and red as ucua HEAD EYES EARS THROATE NECK CHEST LUNGS HART ABDOMEN: GENITALIA RECIAL NEURO 1NRESSION N bony abnormalities Pupils are round regular small but react to light Canals and drums are negative This is injected diffusely There is n exudate He is edentulous Tongue is negative Motion in any direction induces induces pain and is not attempted beyond perhaps No significant adenopathy Thyroid is not palpable Equal but minimal minimal expansion bilateraly bilaterally Breath sounds are somewhat distant distant the bases bilaterally display occasional medium rales The percussion note is less resonant than usually found His AP diameter appears quality be to slightly increased Sounds are fair to good quality No murmur is heard, | N enlargment is deteceted.inte deteceted.inte deteceted.inte is no localized No organs or masses palpable There tenderness Normal adult male N t done equal He is able to move all four ex- DTR present and equal paresthesias of the upper ex- tremities and reports n paresthesias elicited Babin- tremities No pathological reflexes are ski or Hoffman Probable soft tissue injury to type Will rule out fracture Chronic bronchitis emphysema a Chronicaera Chronic . aes the neck silicosis not whiplash with intercur SAN FRANCISCO OFFICE OFFI FRANCISCO C OFFE ICE OFICE 464 Market Street San Francisco 94111 SAN JOSE OFFICE 1671 THE ALAMEDA SAN JOSE CALIF 95126 11- LAW OFFICES OF HANNA & BROPHY 1540 San Pablo AveNUE OAKLAND CALIFORNIA 94612 Phone 832.8569 November 29 1968 RECEIVED FRESNO OFFICE FRESNO OFFICE 500 DEL WESS CENTER FRESNO Calif 93721 SACRAMENTO OFFICE 026 J STREET SACRAMENTO_CA 95814 od Sorrea LOS ANGELES OFFICE - ANGELES OFFICE 205 SOUTH BROADWAY . LOS ANGELES CA. BOO12- soa 21368 Dr. Joseph D. Coate 2976 Summit Street Oakland Ca. 94609 FILED FILED FILED FILED AUANS OHtiey -. : *. Dear Doctor Conte Ro Henry C. Puetz vs. Philip Casey Mfg Co. et al => Case No. 66 OAK 20668 . subpbena herauith your records which were mailed Competion Competion ppeals Board in response to dunes tech served on you at our request in this matter yours Vc.c. c.c. c.c. 1.0.A with copy Smith Parrish Deduck MCMILLAN MCMILLAN ALEXANDER 5. KEENAN ATTORNEY AT LAW SUITE 700 220 BUSH STREET SAN FRANCISCO CALIFORNIA 94104 YUKON 6-1589 December 4 1968 RECEIVED RECEIVED RECEIVED RECEIVED RECIVED RECEIVED RECEIVED RECEIVED DEC 1258 1258 FILED FILED FILED moat ., anant t M3 AN AY NY GAR CS Workmen's Compensation 1111 Jackson Street Oakland California Appeals Board Attention Referee Hickman Re Henry C. Puetz vs. Philip Carey Mfg Co. et General Accident Fire and Assurance Corp. Ltd. et WCAB No. 66 OAK 20668 al Life al Dear Referee Hickman This you that letter is filed in letter form I wish admitted pursuant to my those parts of into evidence request to note to Dr. Crantz's records The purpose of this letter is therefore to call attention to those records which show that the your suffered from cervical and lumbar problems whichapmpalyicant account for part of his disability today and to show the early discovery of Mr. Puetz's lung condition Therefore please find attached to this letter copies of certain documents contained in Dr. Crantz's records Very truly yours ASK bh Attachments SKienan SKienan . Her Her Her Her SKienan Alexander S. Keenan cc State Compensation Ins Fund Sedgwick Detert Moran & Arnold Brobeck Phleger & Harrison Norman Hays Hanna and Brophy John Wilkes Smith Parrish Paduck & Clancy Industrial Indemnity Company ( RECEIVED TO 11. trey ECHIE my my my my 1368 STANDARD Mens Love the force . my my my my my my Ensure my my my puebla my When both parts hums can compliedcomplied return ththiiss forms the INSURANCE fanINSURANCE COMPANY IProNcdSdbeUredRANCE Procddbered DEC FILED fivision of Industrial Accident OAKLAND OFFICE ue. ire) C. PUDIZ GroupClaires dialindplease 1 all I artify that 571 jus answethre following Exsplayed by Cal ed check one still Called on of + 0.0 444 I copart to retum to work on or about , Samet Naas GAS : ..... ..... ..... + ose, APrertess ne Mazi 2 If c longer disolfed disolfed pleato enover die f^...llberinfg^s...llberings Myth date of disability wes f^...llberings +O sheery . ST SNe - bee ese eee OH CONACN ee. o0e Mt. Mt. oa oe eotet oe nS 6 0 Remetee were gem Yo em ee, ; 7 . t eae . ... SSaibgaan iaraprinnsrtony peat Seach Coy dorise ty often t TCT ON ac: Ceataate = eh se eae oem Eg ame be Li yee ame 6 * ATTENDINGATTENDING PHYSICIANS PHYSICIANS LUBUHINTAY TIESIEAI PAS ey LUBUHINTAY LUBUHINTAY LUBUHINTAY GRAT 2.7723 2.7723 2.772: 3 :: : HENRY 1. M C. PUETZ 17 turn dialiren es laDay Day Meoiing ) with production of sputumn hoedselig +1.64+ pubesc Corvical Corvical Corvical esenceeseseence nceAmbeAmbrer tet samaneseg Derain Derain couch 5. Kills of filtca 12-2-67 a ....... 3 Disc cruzernent -20-63-20-63 cruzernent . 19 ........ a . of c ProqulLiieutteyna 12/2 3 4 11-67 and 1/2 3/2 29 and DP 12-2-67 & Detta Sallend Adlained Adlained woores meneame238, 12.4-67 12.4-67 12.4-67 20-1539 8. pilotstesptilotstest continuously Chatted unitievent unitievent bellstorm 13.72-23 19:42 Chul salon or reproximately when chitald patienbeltstorm C. Exter TTT 12-2-67 ritma 0-2-00 0-2-00 0-2-00 19:42 19:42 12 ; | rs esteeseeencttes vee .... sae sattee esos cesseuecnmaran onde ce a seageess e 50-22-9 be 50-22-9 50-22-9 .19 ^' vane 2 pee et att te agi na a Crente Poul E. Attic 127 B 10. se H.D. H.D. Antioch CA. 53502 oa: Som beeen ' LEON LEWIS M. SHELDON MARGEN M.D. 2435 WEBSTER STREET BERKELEY CALIFORNIA 94705 PHONE 848.2727 October 24 1968 INTERNAL MEDICINE Smith Parrish Paduck and Clancy 405 Fourteenth Street 7 Oakland California 94612 a os Attention Mr. David R. Nelson Re PUETZ Mr. Henry Employer Western Building Materials Company Gentlemen Enclosed find a copy of the Puetz at the Cardiovascular September 24 1968 second set of pulmonary Research Institute San function studies done on Mr. Francisco Medical Center on The lung volume studies 1968 and somewhat more are at slight variance with those reported on favorable since the ratio of residual volume lung capacity is only 45 rather than 56 as previously found August 9 to total The second set of studies was particularly concerned with pulmonary diffusing capacity and as noted there is moderate reduction of this function The findings are characteristic of asbestosis with moderate moderate restrictive lung disease In general the laboratory data confirm the diagnosis submitted on Page 9 of our report of July 9 1968 Sincerely yours a live Leon Lewis M. D. LL *+4the > . CARDIOVASCULAR RESEARCH INSTITUTE - PHYSIOLOGICALPHYSIOLOGICAL SERVICES | LABORATORY UNIVERSITY OF CALIFORNIA SAN FRANCISCOFRANCISCO MEDICAL CENTER ROOM 1351 MOFFITT HOSPITAL PHONE 666-1707 | Cu Cu PVT PULMONARY FUNCTION REPORT DATE 9/24/68 SERIAL 66 191 2 92 NAME PUETZ Henry STUDIED BY Dr. Read REFERRED LEWIS AGE 61 YR CODE 41-175 --- CM 4 REFERRAL DIAGNOSIS WI 73.9 S.A. KG M {| FLOOR OPO PULM FUNCT DIAGNOSIS , | | | Isoprtenal Isoprtenal Pre- LUNG VOLUMES Pre dicted Observed % Pre- After 0.5 dicted Isoproterenal % Pro- DISTRIBUTION OF dicted VENTILATION dicted | | VITAL CAPACITY inspired 40 2.5 62 we INSPIRATORY CAPACITY Li ALY GAS UNIFORMITY (S N 750-1250 ml < 1.5 EXPIRATORY RESERVE VOLUME RESIDUAL VOLUME =. TOTAL LUNG CAP TLC RESIDUAL VOL TLC FUNCT RESID CAP FRC Ny WASHOUT L 0 2.4 | 2.1 L 6.4 1 4.6 2 < 45 L 87 71 N ELIMINATION RATE Ng ofter 7 breathing O 2.5 DISTRIBUTION OF GAS TO BLOOD dand space WASTED VENTILATION 2 physiological ; Pr . | dick i 2 THORACIC GAS VOL L plethysmograph MECHANICS OF BREATHING 1 \ FORCED EXPIR No FEV VOL * EXPIR IN 1 SEC , MAX EXPIR FLOW RATRATEE | C 3 | > 79 * 400-500 min 400-500 MAX INSPINSPIIR R FLOW RATE AIRWAY RESISTANCE cm H min sec 30030-50 -500 /CNOGMPLIANCE C cm H Ol WASTED VENT. TIDALVENT. TIDALVOL %)] EFFECTIVE MIN VENT min alv vand cake from wasted vant ALV CO DIFF mmHg VENTILATION Before Test RESPIRATORY RATE breaths TIDAL VOLUME L MINUTE VOLUME EXPIRED PCO = mmHg min ALV PCO mmblg | Predicted ART PCO mmHg by gas rebreath } 38-42 DIFFUSION PULM DIFFUSING CAP Deo 4< 0 <^' Air Air = To dicted +; se COMPLIANCE FRC 004-0.07 cm H OH O TRANSPULM tom H2O1 AT FRC AT TLC 4-7 > 20 _ LUNG WHEN THIS VALUE IS REPORTED IT 15 USED TO CALCULATE V ALUES ARE LOWER IN CHILDREN AND THE ELDERLY + ON BASIS OF ACTUAL LUNG VOLUME ee COMMEN'S COMMEN'S TOTAL LUNG CAPACITY AND RESIDUAL mmHg PULM CAPILLARY BLOOD VOL L MEMBRANE DIFFUSING CAPACITY mmtig VOLUME 21.2 1 15 Oto uncorr ted for lenoglobin * Dco 71 of predicted onery diffusing diffusing capacity capacity was mooerately reduced berosit although a nor arked reduction commonly incrdir This finding is consistent with is seen in patient's with this " Jade Jade Juke Juke : Jade (ow bac Jade Juke Juke Juke Juke HOD PEV 1 Road 1.B. 3.1.C.P. Jay A. Nadel M.D. Julius H. Comroe M.D LEON LEWIS M. SHELDON MARGEN M.D. 2435 WEBSTER STREET BERKELEY CALIFORNIA 94705 PHONG BAO.3727 Smith Parrish Paduck and Financial Center Building 405 Fourteenth Street Oakland CA 94612 Clancy Attention Mr. David R. Nelson Re : PUSTZ Mr. Henry FOR PROFESSIONAL SERVICES June 21 1968 Diagnostic evaluation opinion and report Vital capacity studies 150.00 10.00 Review of outside 160.00 radiographs of the chest 30.00 wv r Note Referred for 3& radiographic other laboratory and $ i & studies see attached bill A , 2 2435 WEBSTER STREET LABORATORY SUITE B BERKELEY CALIFORNIA 94709 ; 845-1851 7 . : . Smith Parrish Paduck and Clancy TO 405 14th Street Oakland CA 94612 Attention Mr. David R. Nelson Re PUETZ Mr. Henry = For Professional Services Previous Balance ww June 21 1968 ww ww Complete blood count Complete urinalysis . Sedimentation rate 2. wg ww. . =. =, 8628 8936 8718 6.00 3.50 3.50 Hematocrit eee ee Serology . Bexic chemistry group - extended 8681 8675 ww. 8555 2.50 25.00 Sugar Cholesterol Uric Acid Urea nitrogen and Transaminase + 10 other tests Protein lodine . . . 8710 White count and differential . . 8624 & 26 Partial urinalysis =. 2... 8956 Hemoglobin a Electrocardiogram =. . Master's Exercise Electrocardiogram Rays PA and Lateral Chest films . 8622 9101 9104 7101 . . . 15.00 15.00 Chest only 7100 OKKA~ superimposed inspiratory inspiratory expiratory 10.00 Laboratory tests other RECEIVED Total PLEASE MAKE CHECKS PAYAble to 80.50 2435 WEBSTER STREET LABORATORY H. CORWIN Hinshaw M. HORTON C. HINSHAJW R M. D. 480 SUTTER STREET San Francisco CALIFORNIA 1408 YUKON 2.7188 October 8 1968 SCIF SCIF SCIF i ee From To Horton C. Hinshaw Jr. M.D. | State Compensation Insurance Fund 55 Santa Clara Oakland California Subject A15450 Henry C. Puetz RECEIV Se Be Bhs ns a ey REPORT OF MEDICAL EXAMINATION Present Illness Patient's principal complaint is shortness of breath He states he first noticed shortness of breath in 1961 and has had gradually increasingly severe shortness of breath on exertion since that time The shortness of breath became severe enough so he was unable to perform his regular work in November of 1967. He was off work from that time until five weeks ago This last five weeks he has been working off and on doing easy work He still feels he is not able to do his regular work which requires climbing which he is not able to do because of shortness of breath The patient has also had a cough which began after the shortness of breath began but he does not recall exactly when the cough began The cough has also gradually continued to get worse He states he was hospital- ized four or five times in the last year because of his shortness of breath At the present time he is short of breath on climbing six steps of stairs He is able to walk 400 to 500 feet on level ground He is not able to run at all and if he has to climb a hill he becomes out of breath very promptly His cough now bothers him mostly at night At night he chokes up and produces considerable amounts cough of thick white sputum Sometimes he has to sit up for an hour or two at night in order to clear out his lungs before he can go back to sleep He has some during the day but it is not severe He normally has about two colds per year If he does get a cold his shortness of breath is worse He feels he may have devel- oped a respiratory infection during the last day or so he has had symptoms of increased cough sore throat and upset stomach He has had pain in his chest and . in the past when he has had bad spells of shortness of breath requiring hospitaliza- a tion otherwise he does not have chest pain Lately he has developed frequent headaches He states that he feels little dizzy all the time Last week he was evaluated at the University of California Hospital here in San Francisco with complete pulmonary function studies arranged by Dr. Leon Lewis RECEIVED OCT 23 1968 OAKLAND LEGAL + Page 2 From To Subject October 8 1968 Horton C. Hinshaw Jr. M.D. State Compensation Insurance Fund Henry C. Puetz System Review of Present Symptoms General Complaints- He has no chills or fever His muscular strength is satisfactory He has gained ten pounds in the last three years respiratory Symptoms - See present illness He has not coughed up any blood He notices wheezing especially at night sometimes this will wake him up He has no anginal pains palpitations or edema intestinal Symptoms - His appetite has diminished He has no abdominal pain or indigestion Bowels are regular urinary Symptoms - No urinary frequency or nocturia No pain or burning Eyes Ears Nose Throat - He wears glasses His hearing has been diminished for a long time Neuromuscular - No back pain arthritis or rheumatism Personal History The patient used to smoke several cigars a day and an occasional cigarette until = he quit entirely about 1961. He has never been a regular cigarette smoker and has never smoked heavily He uses alcohol only occasionally for nineteen years to his second wife He has been married Family History His mother is age 86 living and well His father died at age 49 of pneumonia He has seven brothers and three sisters living and well He knows of no lung disease in the family and no other significant familial disease tendencies Past Medical History His general health has always been good He had a goiter operation about 1932 and a hernia operation in 1957. He has never had pneumonia pleurisy jaundice liver disease rheumatic fever malaria known allergies hay fever asthma or known heart disease He states he has had high blood pressure for about six to seven years He has been told it is not severe He takes medication for this Medications He takes high blood pressure medicine one tablet a day regular medication Otherwise he takes no Occupational History The patient has worked as an asbestos worker for forty years beginning in 1928 During this time he worked steadily at this trade This involved working with all types of insulating materials including asbestos During the early years of his employment asbestos was used almost exclusively He states that fiberglass and mineral wool began being used in 1941 and has been used in increasing amounts since that time but he has continued to use some asbestos all along He has done all types of insulating work and used all types of materials during the time he has worked He would usually be required to cut the material that he is using and at times would be Page 3 From To Subject October 8 1968 Horton C. Hinshaw Jr. M.D. State Compensation Insurance Fund Henry C. Puetz Occupational History con't exposed to quite dusty conditions The work he is involves applying styrofoam insulation to doing at the present time his current employment pipes He is not using asbestos in - Physical Examination General Appearance - Well developed well nourished Blood Pressure - 160/95 white male in no acute distress acute Pulse - 80 and regular Height - 69 inches Weight - 162 pounds Eyes Ears Nose Throat - No significant abnormalities Lymph Nodes - No enlarged lymph nodes are felt found Neck - The neck veins are not distended The Chest - The shape of the chest is thyroid is not palpable percussion The breath normal The lungs are clear to auscultation to sounds are normal in intensity and quality No rales wheezes are heard or Heart Not enlarged Rhythm is regular No Abdomen - No abdominal murmurs are heard masses organs or tenderness Extremities - Peripheral vessels are good There is clubbing of the fingers no edema There is moderate ElectrocardiogramElectrocardiogram Auricular Rate 75 Ventricular Rate T Waves normal R Interval 75 Rhythm sinus 0.15 R Interval 0.07 T Segment isoelectric Position semi vertical Electrical Axis normal remarks - normal record ray Examination of the Chest Stereoscopic PA expiration PA and were obtained There is a lateral views consistent with generalized fine infiltrate throughout both lung fields the heart an interstitial fibrosis The diaphragms are sharply demarkated but border is rather vague and fuzzy Expiration view shows motion Previous rays are also reviewed Film taken good diaphragm beginnings of the present disease in 1957 shows evidence of time The film taken in process largely confined to the lower lobes at this 1961 shows some advance in the interstitial fibrosis still largely confined to the lower lobes The film taken in 1966 shows further and now there is some involvement in the advance pared with 1966 shows further increase in uipntpeerrstiltoiablefsibTrhoseipsresent films when com- CONCLUSION Generalized interstitial fibrosis which has over the last ten years The gradually increased over appearance is consistent with asbestosis @ + Page 4 From To Subject October 8 1968 Horton C. Hinshaw Jr. M.D. State Compensation Insurance Fund Henry C. Puetz Pulmonary Function Studies Maximal expiratory flow rate Vital capacity in one second Three seconds Total % Vital capacity in one second Predicted 300 ~ 2.95 . 3.92 - 75 Observed ; 165 2.00 2.57 ; 2.80 71 INTERPRETATION This study shows evidence of moderate restrictive restrictive There is no significant degree of obstructive airway disease restric; tive abnormality Discussion pulmonary This patient does have a generalized interstitial fibrosis His whole picture is entirely consistent with asbestosis and considering the patient's occupational exposure it is my opinion that this patient does have asbestosis and that this is the cause of his present symptoms of rather severe shortness of breath on exertion The function studies which I did here do not accurately measure the degree of functional abnormality in a disease process of this sort The patient has had done at the University of California and I would like to complete studies of this study can be obtained review their findings if copies From the patient's symptoms however his disease is severe and limitation of physical activity causes severe He is not able to do any work which would require very much in the way of physical effort and could not do any work which climbing or sustained physical exertion required This patient's asbestosis was gradually acquired over the many years that he has been working with asbestos and exposed to asbestos dust Exposure to insulating materials not containing asbestos have not had any effect on his pulmonary problem There is no specific treatment for his condition although he may well require medical attention and treatment for some symptomatic relief of the associated cough and expectoration and would also probably require treatment of an intensive sort for infections He should avoid any further to respiratory tract exposure asbestos dust in the future . Very truly yours HCH i jiban jiban priplril , Horton C. Hinshaw Jr. , M.D. . LEON LEWIS M. SHELDON MARGEN M.D. M.D. 2435 WEBSTER STREET BERKELEY CALIFORNIA August 20 1968 . . e INTERNAL MEDICINE " RECEIVED AUG 21 1968 Smith Parrish Paduck and 405 Fourteenth Street Oakland California 94612 Clancy Attention Mr. David R. Nelson ro Re PUETZ Mr. Henry Employer Western Building Materials Company Gentlemen Enclosed please find copies of the pulmonary function report of studies = on Mr. Puetz on August 9 1968 at the Cardiovascular Research Institutepoefrfotrhmeed University of California Medical Center San Francisco The comments on Continuation Sheet 3 serve adequately to complete the submitted by our office report previously Even though the pulmonary diffusing capacity test was unsatisfactory and will probably be repeated by the Institute findings reported are sufficient to confirm the existence of restrictive lung disease characteristic of pulmonary asbestosis Sincerely yours 1 Leon Lewis M. D. LL CARDIOVASCULAR RESEARCH INSTITUTE - PHYSIOLOGICAL SERVICES LABORATORY UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER ROOM 1351 MOFFITT HOSPITAL PHONE 666-1707 Fert C ) UNIT Ss PVT PVT PULMONARY FUNCTION REPORT DATE 8/8/99/68/688/9/68 SERIAL = 6192 NAME PUETZ Henry AGE HT 170 W175 SA 1.9 YR CODECODE # CM KG M FLOOR PD HAMILTON HAMILTON XXS XXS HOLST HAMILTON HAMILTON LILKER REFERRAL DIAGNOSIS Asbestosis REFERRED BY Lewis PULM FUNCT DIagnosis Restrli ungcditsei aseve asbeswt itho ass besi toss is LUNG VOLUMES Pre- | | | | dicted Observed Predicted AHer 0.5 Isoproteronal % Prodicted ||. DISTRIBUTION OF VENTILATION =| Prodicted re) | ser VITAL CAPACITY INSPIRATORY CAPACITY L } 4.09 24 59 L | 2.72 1.46 54 ALV GAS UNIFORMITY X N 750-1250 ml = ee ee 1.1 MH 1.51.5 1.1 EXPIRATORY RESERVE VOLUME L 1.36 92 67 N ELIMINATION RATE N after 7 breathing O 8 2.5 1.2 RESIDUAL VOLUME C C C TOTAL CAP TLC RESIDUAL VOL RC UNCT RESID CAP FRC N WASHOUT L 2.36 U | 6.45 2 | 33 4 21HOPACIC 21HOPACIC GAS VOL u etnysmograph 21 MECHANICS OF BREATHING ao ( TT ADPIED ADPIED EXPIR YOL \ FEY .. ; 1 EXPIR I SEC L X | > 79 MAY EXPIR FLOW RATE min 14400-500 8" 30 54 56 3.9 nam ree? a 113366 127 84 ' IGE H | DISTRIBUTION OF GAS TO BLOOD Pre- c dicted | ser WASTED VENTILATION L _ physiological deod space * WASTED VENI./TIDAL VOL mi] EFFECTIVE MIN VENT min falv vent cak from wasted vant - ART ALY CO DIFF VENTILATION mmHg Before Test T RESPIRATORY RATE breaths 40 <4 Air 22 45 5.2 5.2 2 fa} TIDAL VOLUME MINUTE VOLUME EXPIRED PCO mmHg 14430 14430 mini | 9 MAX INSPIR FLOW RATE AIRWAY RESISTANCE min 300-500 * Yan Me cm H s O ec 1 1. ) 1% LUNG COMPLIANCE Q cm H2O H2O 121200 1.2 1.2 ALV mmHg ALV PCO mmHg | ARI PCO2 rebreath.~fimmHg Predicted PredictedPredicted 38-42 by gas rebreath.~fi DIFFUSION PULM DIFFUSING CAP Oco 5 mmtig 32m 32m ro. rs) dicted + sear COMPLIANCE FRO cm H Ol TRANSPULM cm 201 AT FRC AT ILC 004007 47 2" 0 PULM CAPILLARY BLOOD VOL ( MEMBRANE DIFFUSING CAPACITY mmFig WHEN . THIS VALUE IS REPORTED IT IS USED TO CALCULATE TOTAL LUNG CAPACITY AND RESIDUAL VOLUME ae VALLES ARE LOWER IN CHILDREN AND THE ELDERLY + ON BASIS OF ACTUAL LUNG VOLUME COMMENTS * Test of pulmonary diffusing capacity unsatisfactory for teennical teennical reasons . { day. : PVT CARDIOVASCULAR RESEARCH INSTITUTE - PHYSIOLOGICAL SERVICES LABORATORY UNIVERSITY OF CALIFORNIA SAN FRANCISCO MEDICAL CENTER ROOM 1351 MOFFIIT HOSPITAL PHONE 666-1707 PULMONARY FUNCTION REPORT DATE 8/8/99/6/8 68 SERIAL 6192 6192 GAME PPUUETEZ TZ HeHenry nry AGr Ji HI 176 W 75 Sa . R CM KG Mi CODE = FLOOR OPD yr DIED BY LILKER HOLST HAMILTON Lewis REFERRED LewisLewis REFERRAL Asbesto chrs onici brs onch- iti . PULM FUNCI RestriRestrictic ve Rest trictve ResitrictivevRestreictive pulmonary disease ~~ a fl ARTERIAL BLOOD CONTENT val TT Air alk 200 --279 --279 19.1 19.1 -- - EO OS - Acin SATURATION Sp ENSION . Ty wo yop 4 10 t S immig A.K 3 : 209 76 99 NP NO NP" > 550 .3 19.6 19.6 72 ee be ee 02 ae nt ARTERIAL BLOOD EMOGLOBIN fe , MATOCRIT Ge ) CO j CO CONTENT CONTENT CONTENT PLASMA TENSION mensuradi mensuradi \ 530 1 530 fe o: ae Jm % 150 45 mM | MIM 205-23 25 - 28 5 mmhgi a iH 38 - 42 units 742 Air 146146 46 198 24.0 24.0 36 yi 35 1.7.44 EXERCISE AND RECOVERY TREADMILL Speed Speed mph Speed mph l Inclino Incline _ Incline -- -- BICYCLE ; ARTERIAL BLOOD WD REST 150 Load Lood 229 KgM Load_2 Load_2 KgM ' 0 th ~ ta 2 b 2 ++ ee tic umety 6a te 9 1.0 ae oe 9 9 wee rr 0202 i 184 1 -- 184 ares Pog(Al tee Reena rae ' 1.0 SANURA oe 2 | NMS mikg 25 = mikg 15 0.25 5 T Sn o or 5 tin EE 2.75 s . KKUUMPULAMN PULAN . .* : 10.25 x 10.25 T AG? wef. 2.75 oy TT ne ys ve Ke + 1:85 ee we eee min ara arene tp ym Lee ates many | OE | we : raft ~ fie Hl aes 1 2.75 2.75 . . : pee : fee pee vio fe t an DF . ~ : 1:85 pee tt . es t TT 110| ~ 34 ee 0.99 0.99 0.99 arom 37.3 37.3 37 MEAD MEAD DDAATTEE Aene Te beats mo Pa _. 72 | C.19 ne Ores Ge 190 10.40 10.40 . 196_1 10.4 ( 4 Asterisk 7th -+ iod delermination tarat AN done with patient a ee ee prenthing thtrohughroue ghte hrough mouthpier ee ee mouthpier 140 = Recovery 2 6 990 0 Stopped exercis fatigue fatigue of of 7.44 - as es * al 5 PULMONARY FUNCTION CONTINUATION # 3 , ; HISTORY PUETZ Henry ns inme cops SERIAL 6192 Ti man who has been an insulation worker for 40 years was referred for assessment tunctional impairment due to pulmonary asbestosis He has noticed gradually inressing treathlessness during exertion for about 10 years For a similar period he no had a chronic cough productive of mucoid sputum At the present time he has nawhen tying his shoes when walking quickly and on climbing 8 to 10 stairs. | Onical Onical Onical examination the in the respiratory system are mild finger finding finding clubbing erine erine inspiratory crepitations in the lower parts of the lungs chest The rays show an infiltrative or fibrotic process on serial increasing since 1957 films PULMONARY FUNCTION RESULTS & Today's tests show a significant reduction of the vital capacity from the predicted values This taker with the normal airways resistance indicates a restrictive lung disesse The high proportion of wasted ventilation is due to abnormalities of ventilation and perfusion relationships in the lungs and this conclusion is supported by the fincing of a idened alveolar oxygen gradient and mild arterial hypoxemia at rest The latter is not coused by hypoventilation hypoventilation since the arterial Poz is lower than normal nor could shunting of blood be responsible since the arterial Po then the expected velur curing oxygen breathing There is chronic hyperventilation at rest and this becomes more marked during exercise Almugh Almugh oxygen transfer is improved from the resting state at light workloads the al arterial oxygen oifference incresses incresses Measurement of the diffusing capocity of for repetition restons We shall se ae intren with increasing work the lungs was unsatisfactory of this test for technical CONCLUSICOONCLUNSION The is impoirment of culary culary fun test of diffusing cararity cararity would be is consistent pareated pareated with pulmonary asbestosis The e a SCHED BY a F oa! fee nb my 4 Se, 4 oro: Dobe eat, ar SIGNED R.A.C.P. : A. 1 N .5 Julius R.Comrie M.D LEON LEWIS M.D. SHELDON MARGEN M.D. M.D. Re PUETZ Henry Page 5 Mr. Puetz is a well developed and healthy appearing male of late middle age who is of mesomorphic build with excellent musculature There is no apparent de- . formity There is a faint thyroidectomy scar and a more distinct left inguinal herniorrhaphy scar There are tattoos of both arms and forearms The anterior and central hair is thinned and nearly bald The hair is grey The cranium is smooth There is no tenderness The eyes are clear There is some wax in both ear canals but the drums are fairly well seen A watch tick normally heard at a foot distance is audible only when in contact with the right ear and at half inch distance from the left ear The nasal mucosa is normal septum is intact The paranasal sinuses transilluminate transilluminate poorly obviously because of dense bony structure The mucous membrane of the mouth is normal The gums are clear The tongue is normally coated The tonsils are small and not inflamed The mouth is edentulous compensated by two dentures There is no tenderness in the neck The thyroid gland cannot be felt no palpable lymph nodes in the neck or elsewhere There are . The thorax is well formed Breasts are negative There is generalized impairment of resonance throughout both lung fields Breath sounds are bronchovesicular There are scattered crepitant rales in many areas over the posterior lung fields Breathisimonstgly diaphragmatic abdominal excursion is normal The heart size is difficult to determine Heart rate rhythm and sounds are normal There are no murmurs Femoral and foot arterial pulses are normal The abdomen is rounded There are no palpable organs or masses The left inguinal hernia repair is satisfactory however there is now a small right inguinal hernia The external genitalia are normal Rectal examination discloses no hemorrhoids Sphincter tone is good The prostate gland is not enlarged There is no palpable mass The extremities are essentially normal aside from hypertrophic changes at the small joints of the fingers Foot and upper extremity temperatures are normal Neurological Examination Personality appraisal is rendered somewhat difficult by Mr. Puetz obvious diffi culty hearing However he seems to be an intelligent well oriented and very cooperative man who has no tendency whatsoever to exaggerate his clinical mani- festations Gait station nystagmus coordinatioannd equilibrium are normal There is no dysmetria or Cranial nerve examination discloses quite contracted light and accommodation through a small range Mr. round Puetz pupils states which react to that he uses LEON LEWIS M. SHELDON MARGEN M.D. Re PUETZ Henry Page 6 considerable amounts of containing cough medication The fundi are poorly seen but seem to be clear Ocular motion is intact Facial motor power and sensation are normal There is no impairment of bone conduction over the mastoid processes Air conduction is better than bone conduction despite the impairment of hearing The Weber sign lateralizes slightly to the left The tongue protrudes in the midline without tremor Palatal and pharyngeal func- tions are normal There is no disturbance of sensation for pain vibration or temperature The superficial and deep reflexes are normal There are no pathologic reflexes Musculoskeletal Examination Posture is good There is no localized atrophy or hypertrophy Joint motions are free and normal There is no impairment of neck or spinal motion LABORATORY DATA Complete Urinalysis Color Character Reaction Specific Gravity Albumin Sugar Yetlow Clear pH 5.0 Q.N.S. 3+ Negative Microscopic Examination White Blood Cells Rare Red Blood Cells Rare Epithelial Cells - 2 Bacteria Rare squamous Complete Blood Count Hemoglobin Leucocytes Packed Cell Volume MCHC Platelets Morphology 17.2 grams 15.150 48 36 Adequate Normal 116 Differential Neutrophiles Neutrophiles Basophiles Basophiles Lymphocytes Monocytes Count 79 0 20 % Sedimentation Rate 24 mm./hr Westergren Serologic Test for Syphilis VDRL Slide -- reactive Extended Blood Chemistry Group Glucose 1 hr Urea Nitrogen Uric Acid pc 130 mg 15.Omg 15.Omg 7.1 mg Adult formal Ranges 72 - 120 mg fasting on plasma 6 - 22 mg 3 - 6 mg LEON LEWIS M.D. SHELDON MARGEN M.D. Re PUETZ Henry July 5 1968 Page 7 Extended Blood Chemistry Group continued Adult Normal Ranges Cholesterol Total Transaminase SGPT Calcium Bilirubin Total Potassium Sodium Alkaline Phosphatase Protein Total Albumin Globulin A Ratio Protein Bound lodine 166 mg 52 U. V. units 9.7 mg .6 mg 3.8 mEq./L 137 mEq./L mEq./L 36 Intl units 9.3 gm 4.8 gm 4.5 gm 0.9 3.8 mcg 150 5 9-11 9-11 " 260 mg 50 U. V. units 9-11 mg 135 - 150 mEq./L *. 13 - 40 Inti units 6.0 - 8.0 gm 4.0 - 5.5 gm 1.5 - 3.5 gmf 3.5 8.0 mcg Vital Capacity Study FEVI 1 sec FEV2 2 sec FEV3 3 sec Vital Capacity Capacity 1.7 C. 2.1 L. 2.1 2.2 2.15 L. 2.3 2.2 2.3 2.3 2.3 Predicted Vital Capacity for height and age = 3.6 Vital Capacity is 64 of predicted FEV = 75 FEV = 92 FEV3 = 96 Electrocardiogram Electrocardiogram Rate 90 per minute Sinus rhythm PR 0.15 QRS 0.08 QT 0.36 seconds in Leads V and AVL U wave present in V through 4 Flat T waves Conclusion Scattered ventricular ectopic beats No evidence of right Rule out hypokalemia U waves specific T wave changes in AVL and LABORATORY SUMMARY heart - strain v There is unexplained proteinuria of fairly marked degree It is not associated with other urine or blood chemical abnormality It was not possible to determine urine specific gravity The red blood cell values packed cell volume and hemoglobin are high suggesting polycythemia secondary to lung disease However the leucocyte count is also high although differential count is normal Neither the leucocytosis nor albuminuria is easily explained by clinical findings LEON LEWIS M. D. SHELDON MARGEN M.D. Re PUETZ Henry Page 8 acid chemical Blood Blood is normal except for elevated serum uric survey The serologic test for syphilis is negative Electrocardiogram is essentially normal Blood chemistry studies did not , . asbestosis hypokalemia Radiographic findings are characteristic of progressive See reveal below REVIEW OF RADIOGRAPHS OF THE CHEST Outside Radiographs is identified as 759786 Kaiser Founda The first film dated December 7 1957. thorax which is asymmetrical tion Hospital Oakland It showed a medium than on the left Bone structur with relatively greater expansion so hnadotwhse rsihgohwt some prominence of central bronch of are of normal density The lunfgor haziness of the cardiac outline because vascular markings and except shadow the pulmonary findings are not remarka overlying somewhat greyish lung aortic and diaphragmatic contours are norm beyond the limits of normairlregHuelaarritty of the left leaf of the diaphragm although there is slight is dated April 15 1961 and is from the office of J. D. The second radiograph Street Oakland this time the pulmonary shadow is very By and faint greyish mottling M. D. 2976 Summit of central markings normal There is accentuation is the medial portion c The heart shadow is distinctly blurred as throughout the diaphragmatic shadow 17 1962 also from the office of Doctor Coate shov The third film on February noted There is slight thickening of a progression of the findings previously between the right middle and lower lobes This is fain marked There is more the interlobar fissure in the film of April 1961 but is now much more distinct visible and the cardiac border is no longer diffuse greyness and mottling of March 16 1963 from Doctor Coate's office made A fourth radiograph film shows relatively little progression of penetration than the prior with le the pul monary disorder 1964 another from Doctor Coate's office shows findings si film progression b There is additional By February 2 to those of 1962 but somewhat more diffuse March 5 1966 seems to st February 13 1965. A very light radiograph made on films but the most recent radiograph of February involving less density than the prCiooarte's office shows a very diffuse process and i 1957 also from Doctor the cardiac shadow is distinctly larger booutthlinleungis fbileulrdrsed By Thtehisdiatpimheragm is generally irregular However the diaph matic curve is well preserved there is no flattening LEON LEWIS M.D. SHELDON MARGEN M.D. Re PUETZ Henry Page 9 Radiograpmahdse June 21 1968 _ 7: . oe ~ As in the previously reported films there is asymmetroyf the chest Bone . ..- structures are of normal density Both lung fields show diffuse greyness wit - h . . reticulation and exaggeration of central pulmonary markings The heart and _ 70 . aortic contours are not beyond the normal rangoef size however they are distinctly blurred and a clearcut cardiac outline cannot be made out The diaphragm is slightly hazy along its margin but the costophrenic sinuses are well preserved A superimposed projection of inspiratory and expiratory views of the chest shows a diaphragmatic excursion of 32 mm on the right and 36 mm on the left Measure- ments are made at approximately the mid portion of the diaphragms) . 8 The lateral view lung fields with dorsal vertebrae shows a prominent hilar shadow and generalized greyness of exaggeration of markings The heart size appears normal are well formed and the interspaces are normal the The DISCUSSION Review of the previously made radiographs dating from 1957 interpreted in conjunction with the current film discloses a gradually progressive presumably fibrotic process in both lungs which is evidently restrictive but not associated with marked secondary emphysema Diaphragmatic excursion is quite well preserved Heart and aortic size appear normal at present The findings are consistent with occupational disease of the lungs due to asbestosis -- a diagnosis suggested by the employment history DIAGNOSES 1. Asbestosis with moderate restrictive pulmonary disease a Probable secondary polycythemia b Probable chronic bronchitis 2. Right inguinal hernia 3. Proteinuria -- cause ? 4. Leucocytosis -- cause ? 5. Hearing loss - fairly severe Sincerely yours S Jon 7 \ Omen, Leon Lewis M. 0 LL LEON LEWIS M. SHELDON MARGEN M.D. 2435 WEBSTER STREET BERKELEY CALIFORNIA 94705 PHONG 1727 July 5 1968 INTERNAL MEDICINE Smith Parrish Paduck and 405 Fourteenth Street Oakland California 94612 Clancy Attention Mr. David R. Nelson Re PUETZ Henry Employer Western Building Materials Company Social Security Number 532-112-4188 Gentlemen Gentlemen Mr. Henry Puetz a year old twice married Caucasian workman was examined in this office on June 21 1968 by the undersigned Lean Lewis M. D. EMPLOYMENT HISTORY Western Building Materials Company June 18 1968 to present asbestos worker at the University of the Pacific Stockton California Prior employment Western Building Materials Company Stockton asbestos insula- tion application two weeks November 15 - 29. 1967. Western McArthur Company San Francisco California October 1 to November 15 1967. Western Asbestos Company asbestos Los Landing worker since California April 1928 at first in to October 1967. Mr. Puetz has been an Seattle Washington until 1941 then in Portland Oregon until 1945 and since 1945 in California DATE OF ONSET OF SYMPTOMS o: 1957 PERIOD OF DISABILITY November 29 1967 to June , 1968 PHYSICIAN P. E. Crantz M. O. HOSPITALIZATIONS See Chronological Medical History 1). Punz was torn in Seattic Washington on May 25 1907 He moved to Portland egon '. 1241 and to San Francisco California win served in the United States Army from 1925 to in 1945. He completed high 1928 mostly serving in the school 6S Hipin Hippin Islands LEON LEWIS M. SHELDON MARGEN M.D. Re PUETZ Henry Page 2 His first marriage in which he fathered has two living adult sons the third son accompanied to the office by his present excellent relationship three sons terminated in divorce He was killed in the Korean War He was wife with whom he seems to have an He discontinued smoking cigarettes in 1965. Prior about half package daily He drank alcohol in cently but now does not drink at all to that time he says he moderation until fairly we smoked re- FAMILY HISTORY His mother is living and in reasonably good health at age 82 His father died of some type of pulmonary disorder leading to pneumonia at age 49 Seven brothers and four sisters are living and well His two sons are well He knows of no tuberculosis cancer or diabetes in the family PAST MEDICAL HISTORY In addition to the ordinary diseases of childhood he had diphtheria at age 12 In 1938 he developed hyperthyroidiasnmd thyroidectomy was performed at the Bremerton Naval Hospital A left herniorrhaphy was performed at Antioch Hospital by Doctor Crantz in 1957. He was hospitalized for pulmonary disorder at the same hospital in 1958 1959 1960 1962 1964 1965 1966 and 1968. His last chest radiograph was made in March 1968. A gastrointestinal radiographic series was made in De- cember 1967 SYSTEMIC REVIEW Mr. Puetz sleeps poorly and has difficulty falling asleep tives He has frequent headache and dizziness His memory He wears glasses but has not been examined by an eye doctor years He does not use sedahas begun to fail within the past two He is subject to frequent chest colds and he has a chronic annoying cough which is moderately productive He has been told that his blood pressure was elevated in the past He has some chest discomfort but no characteristic anginal pain He becomes short of breath on slight exertion All has of his teeth a new set of have been extracted dentures to which he is poor and his abdomen is distended that he had a stomach ulcer fi and he has worn dentures for some time He has not yet become accustomed after meals He has been told His appetite in the past LEON LEWIS M.D. SHELDON MARGEN M.D. M.D. Re PUETZ Henry Page 3 Nocturia occurs once There are no other genitourinary symptoms Other general complaints are fatigability nervousness and tension COMPLAINTS 1. Shortness of breath on slight exertion a Walking causes dyspnea b Even tying his shoes causes some breathing difficulty C. Climbing a flight of stairs he must stop at least once to rest 2. Productive cough especially at night a Expectorates about half cupful of greyish mucoid sputum b Has never expectorated blood 3. Frontal headache lasting several hours in attacks 4. Giddiness occurring when he bends over CHRONOLOGICAL MEDICAL HISTORY During his early years and extending Mr. Puetz was in good health While well and was never hospitalized He through on duty did not his military service until 1928 in the Philippine Islands he was contract malaria dengue fever or other infections He had no venereal infection After his return to the United States he first began to work in the asbestos trade His first employer was the United States Government at the Bremerton Navy Yard where he was discharged from military service and became an employee For 13 years he remained at the navy yard and most of his work consisted of the application of asbestos covering on pipes Most of this work was done on ships and at times he had to work in relatively confined spaces During the entire period of his employment by the naval shipyard he worked without any kind of respiratory protection No radiographs of the chest were made and no medical examinations were done during his years of work After leaving the shipyard he moved to Portland Oregon where he was employed by Plant Asbestos Company He again worked applying asbestos insulation to pipes protective equipment on ships On this job he also worked without respiratory He does not recall having any chest radiographs made at this time in 1945 he moved to the San Francisco Bay area where his first employer was Western Asbestos Company He worked in the plant and while his duty was still of asbestos coating to pipes he was also exposed to the fabri- the application since 1945 he has worked on and off for Western Asbestos cation process Company or their Ever successors He was also employed by the Fiberglas Company in LEON LEWIS M. SHELDON MARGEN M.D. Re PUETZ Henry July 5 1968 Page 4 San Francisco There he worked not only with asbestos but also with Fiberglas and rock wool all of these materials having been used for insulation He also worked for Plant Asbestos Company in Emeryville having spent about four or five years in their employ In short since 1928 except for periods of disability in recent months Mr. Puetz has been almost continuously employed in the asbestos insulation industry In 1938 while working at Bremerton he developed hyperthyroidism for which a thyroidectomy was performed at the Bremerton Naval Hospital He not had to take thyroid extract He was then quite well until 1957 when he developed a left inguinal hernia At this time he was already somewhat short of breath and coughing He remained in Antioch Hospital eight days after repair of the hernia he was not He . hospitalized for pulmonary disorder at that time but was under treatment by Doctor Crantz Although Mr. Puetz does not hospitalized about 10 or 12 Doctor Crantz care About recall the exact dates he believes that he has been times always at Antioch Hospital and always under 1962 he was in an automobile accident which required required hospitalization for a back sprain Later in 1966 he suffered a neck injury and was again hospitalized On each occasion whether specifically for respiratory difficulty or for other causes he was treated for his respiratory problem usually with intermittent positive pressure devices and various medications At present his medical regime consists of two medications but he does not know their identity He also uses a cough syrup He reports to Doctor Crantz about every four weeks He has never used intermittent positive pressure therapy at home Recently during each year his condition has fluctuated considerably He is especially short of breath during the winter and there has been gradual progression of disability over the course of years Mr. Puetz left his work with Western Building Materials Company on November 29 1967 because of shortness of breath chest discomfort and cough He returned to work for the first time since then on June 18 1967 and has put in two days with some difficulty to the date of this examination During the period off work he rested most of the time He now finds that it is difficult to work overhead and he is easily fatigued He finds that climbing and working at high levels are extremely difficult He has not had to work above the ground the past two days of his resumed employment * PHYSICAL EXAMINATION Height 63-3 Weight 161-1 pounds Maximum prior weight 168 pounds in 1966 Blood pressure initially 133/102 in the left arm sitting After approximately 15 minutes a second reading was 170/94 Pulse rate 88 per minute J. D. COATE M. D. RADIOLOGI T 2976 Summit Street DAKLAND 9 CALIFOIN TELEPHONE TEMMUR 6 US7 7121 February 13 1565 Patient Puetz Henry . . Aet 5 - Address 1531 Marshall Street Antioch . ; Physician Mr. Holres oo - . 2 Es | re a me oo, CHEST . . shows the rather extensive bilateral fibro PA film of the chest again lobes which have been observed on previo , changes throughout both lower examinations at yearly intervals since 4-15-61 There has probably been the last examination on 2-8-64 but comparison no marked increase since with previous films ment The cardiac to determine the progress of this is necessary shadow is normal and the hemidiaphragms are involve- smooth and rounded CONCLUSIONS in both lower lobes probably occupational - Bilateral chronic fibrotic changes JDC ete we D. COAT~ M. D. RADIOLOGIST 2976 SUMMIT STREET DAKLAND 9. CALIFORNIA TELEPHONE TEMPLESAR 6-4087 February 17 1962 C . 4 a Patient | Puetz Henry C. + Address Rt 2 Box 192 Oakley Physician Asbestos Workers - Survey * - - wa Aet 54 22832 eet ; Cotas Tov ae oT 7 - ra is ape a = ait + ase Both lung fields show considerable granular thickening of the root 9 aa se ~~ ars - ua toe shadows in both perihilar areas along with discrete milliary densities ee . were noted on examination 4-15-61 A direct comparison - These changes to determine the progress of 3 with the previous films would be important > this disease CONCLUSIONS Pulmonary occupational disease probably asbestosis JDC : ve ve ve ve 1148 ve Coate M. b 1. D. . ae et a) id ut Noser ger 15 15 , Joseph E. Smith Smith Parrish Paduck & Company Financial Center Building Building 405-14th Street Oakland 12 California Re Puetz Henry C. Dear Mr. Smith we. Than's My for Your Net re November 1st regarding Nr Henry C. Puetz ~ Mr. Quatz has been a tient in this office since December 9 1959. He 4713 - history of having had < cot inhalalan inhalalan years duration which multed in a chronic inchisia an asbestusis ray of the chest conficent this diagnosis Desplatnes Desplatnes included cough with production of 50 l fati Saaedea"tco revealed rales present in the lungs T asl noe at the ortccn 70 It ware sPe@E yA] ty al , Teepe . sing this case or whether or not Teotoieem pt I further ip kin ' call m3 Ceritally - ~? Man Man re oN - ate oe Crantz oe Crantz Crantz 1. 1. E. E. C J. D. COATE M. D. RADIOLOGIST 2976 SUMMIT STREET DAKLANG Y CALIFORNIA TELEPHONE TEMPLESAN 64559 64559 February 8 1964 Patient Puetz Henry Address : Physidan 1531 Marohall Street Antioch Mr. Holmes Act 56 | RECEIVED DEC 1958 FILED Division of Industrial Accidents OAKLAND OFFICE 3460 A cingle PA film of the chest shows the chronic bilateral fibrotic changes throughout the lever half of both lung flolds more markedthe right . side ansociated with moderate bilateral perfilar thickening Thes changes have apparentlyapparently in pregreasing over the past yearsyearssince 1957 A comparison comparison with all of theco former films was made in this office on extantion time cur of 3-27-62 3-27-62 From this to there comparisons ow . . , ates et \ a .. . ; . ^' , . ; be . we a ". os ar rectus.oxrectus.ox rectus.ox recrtuesc.otxus.ox . , . _ b. t. . . . ae s : i a oY ome . . . * . te ca :, t . ae noe : fet Lt. as . 7 changes erotic erotic changeschanges both lower JS." 0: pro inarked on |. ' erotic taghout . ' . apparently right side Tete dis 1 . ase to occupational apparently due due . dis 8 Le mo ary . 1 my : am ': , : . + 4 . . so . f te . YO, . : ot 4 " i an t- * uh 1 . . 5 men : * . . aan . t of Q , ty mt , ' we . ' : 4; t as : Panes a e eo. x aot . iu . . 4% a ' a re 3 l e on : . 4, . , ay e ry os . . * . : . . + . Py + : ny  3D COATE MD RADIOLOGIST RADIOLOGIST 2976 SUMMIT STREET OAKLAND CALIFORNIA 94607 we Telephone 636-4057 yre@re, Puetz Henry Aet 59 Adoressi Rt # 2- Box 101 Oakley Physicians Physicians Asbestos Workers Survey # B- 5278 - February 21 1967 w CHEST A single PA film of the chest again shows the extensive bilateral interstitial fibrosis generalized throughout both lung fields The : hilar shadows are also increased in density somewhat more marked on the right side No localized areas of parenchymal infiltration can be seen The cardiovascular shadow is still normal in outline and the diaphragms are smooth and rounded A comparison with previous films is necessary to determine the progress of the disease CONCLUSIONS Extensive bilateral interstitial fibrosis throughout both lung fields JDC Pe ..J D. Coate M.D. fo? 7 v J COATE D eAG NL OY? AKI AND re Pi 0 : CALLTOWN 01/17 elepi na 16 4957 a trays Puetz Henry Aet 58 # B- 106 Rt # 2 - Box 101- D Oakley California Asbestos Workers Survey , ' March 5 1966 CHEST . A single FA film of the chest shows extensive bilateral interstitial fibrotic changes throughout both lung fields as previously observed since examinations made annually from 4/15/61 The hilar shadows are also somewhat is normal CONCLUSIONS Extensive bilateral pulmonary fibrosis probably occupational JDC ag KF Ty wan cv? D. Coate M.D. EO ATE CAL -AD AN? aAN ND AND peered 1 ' $ COPHIA COPHIA 99 Telephone 546 4057 Puetz Henry Aet 57 1531 Marshall Street Antioch Asbestos Workers Survey A - 7121 February 13. 195 . CHEST . PA film of the chest again shows the rather extensive bilateral fibrotic changes throughout both lower lobes which have been observed on previous examinations at yearly intervals since 4/15/61 There has probably been no marked increase since the last examination on 2/8/64 but comparison with previous films is necessary to deter mine the progress of this involvement The cardiac shadow is normal and the diaphragmns are smooth and rounded CONCLUSIONS Bilateral chronic fibronc changes in both lower lobes probably occupational JDC ag Li - Li J. D. Coate M.D. . " APL RE CALIFORNIA CALIFORNIA CALIFORNIA CALIFORNIA D4069 Telephone Telephone ^ 403657 Puetz Henry Aet 56 1431 Marshall Street Antioch Asbestos Workers Survey # A 3460 February 8 1964 PA CHEST . A single PA film of the chest shows the chronic bilateral fibrotic changes throughout the lower half of both lung fields more marked on the right side associated with moderate bilateral hilar thicken- thickenning These changes have apparently been progressing over the past years since 1957. A comparison with all of these former films was made in this office on our examination of 3/27/62 From time to time these comparisons should be made CONCLUSIONS Chronic fibrotic changes throughout both lower lobes more on the right side apparently due to occupational disease marked JDC 7 J. D. Coate M.D. Tee eC ALT Cote Fates Telepi : 4057 Puetz Mr Henry C 1531 Marshall St Antioch Age 55 Asbestos Workers Survey A - 404 March 16. 1963 PA CHEST Single PA film of the chest again shows the generaliz ed fine fibrotic changes throughout the lower half of both lung fields which have been reported on previous examinations There has been no apparent increase since the examination made one year ago The only areas showing any degree of emphysema are in the dependent portions of both lower lobes The upper lobes of both lungs appear to be relatively normal in appearance The diaphragms are smooth and rounded showing no evidence of any pleural adhesions CONCLUSIONS Chronic bilateral fibrotic occupational disease changes apparently pulmonary JDC ag ON D. on vi Coate M.D. 1 COATE MD RADIO CONT SUMMIT STRIFT GAKLAND CALY OPNIA 94677 Teleplicing 36 1057 Address Puetz Mr Henry C Age 54 Rt 2 - Box 192 Cakley Phys plas Asbestos Workers Survey , - 22832 bd March 27 1967 og PA CHEST of A review the recent film made on 2/17/1962 and compared with previous films made elsewhere in 1957 show a gradual increase in the degree of fibrotic changes in the hilar areas and throughout the lower half of both lung fields The film made in 1957 shows only a very minimal however early changes There has been no great increase in the degree of fibrosis as compared with the film made on 6/10/1961 However I do feel that there is definitely a very gradual increase in the degree of interstitial fibrosis during the past five years The inferior portions of both lower lobes appear to be somewhat more emphysematous as compared with the film made in 1959 CONCLUSIONS The gradual increase in the bilateral fibrotic changes and the radiologic appearance of the process strongly suggests that this is probably pulmonary pulmonary occupational disease JDC ag PF -- V4 D. Coate M.D.  3.0 LGATE MO faye 1 thoo MVIT STPEFTSTPEFT OAKLAND CALIFORNIA Otra Telaph.no Telaph.no E36 4057 Puetz Henry C Aet 54 Rt 2 Box 192 Oakland Asbestos Workers Survey # 22832 February 17 -9 PA CHEST w. Both lung fields show considerable granular thickening of the root shadows in both perihilar areas along with discrete milliary densite These changes were moted on examination 4/15/61 A direct cor.- parison with the previous films would be important to determine the progress of this disea se CONCLUSIONS Pulmonary occupational disease probably asbestosis JDC ag ae: i) 7 sr . J. D. Coate M.D. 2G OOATE MID WAD t- TSF fete ' IMP TOEET DAKLAND DAKLAND CALL ORNIA 98 Telephone Telephone 63 1057 SaeB Puetz Mr Henry Age 54 # 21148 And was Route Box 192 Cakley Calif Physician Physician Mr Holmes ( Asbestos Workers Survey April 15 1961 PA CHEST PA film of the chest shows considerable bilateral increase in both hilar shadows with considerable generalized increase shadows throughout both lower lobes In some in the root be seen The areas small discrete parenchymal densities can heart shadow is within normal limits and the diaphragm are smooth and rounded CONCLUSIONS asbestosis The findings are very suspicious for a possible early JDC ag D. D. Coote M.D. I WORKERS COMPENSATION APPEALS BOARD 2 STATE OF CALIFORNIA 3 HENRY C. PUETZ . 4 Case No. 66 OAK 20668 5 Applicant 6 VS. 7 C.F. BRAUN et al and AMERICAN MOTORISTS INSURANCE 8 COMPANY et al 9 Defendant , CERTIFICATION . 10 11 I hereby certify that the attached documents are true 12 and correct copies of the original documents filed in the record | 13 of this office in the entitled matter 14 ATTEST my hand and the Seal of the Workers 15 Appeals Board of the State of California Compensati 16 17 18 19 Workers Compensation Judge N 20 Workers Compensation Appeals Board 21 22 24 Dated at San Francisco 25 California this 6 day 26 of April 1981 27 DIA WCAB FORM 9 NEW 1.78 DEPARTMENT DEPARTMENT OF INDUSTRIAL RELATIONE DIVISION OF INDUSTRIAL ACCIDENTS WORKMEN'S COMPENSATION APPEALS BOARD Mg * HENRY C. PUETZ STATE OF CALIFORNIA ) Applicant } CLAIM NO 66 OAK 20568 VS. 1 FINDINGS AND AWARD C. F. BRAUN et al and ) AMERICAN MOTORISTS INSURANCE 7 COMPANY et al ) Defendants 8 9 ~ FILEI FILEI SEP 8 10 The above entitled matter having been regularly submitte submit e 11 before Richard A. Hickman Referee said referee makes his decis 12 as follows 13 FINDINGS OF FACT 14 1. Henry C. PUETZ born April 25 1907 while employed : 15 asbestos worker within the State of California during the period 16 ginning 1945 through November 29 1967 sustained injury arising 17 of and occurring in the course of his employment consisting of 18 asbestosis 19 2. Applicant was employed and injury was caused by expos 20 during periods of employment and insurance coverage as follows 21 EMPLOYER 22 Cork Insulation Co. Inc. Western Asbestos Co. 23 24 Marine Engineering & YEAR INSURANCE CARRIER 1945 1946 1947 State Compensation Ins 1954-1958 1960-1962 1964-1966 9 Aho Bay Cities Asbestos Ltd. 1948 1949 Industrial Indemnity to J. T. Thorpe & Son 03 Western Fibrous Products Co. Glass ae The Industrial Insulators 10 Johns Manville Sales Corp. Armstrong Cork Co. 1948-1950 Pacific Employers Ins 1949 Industrial Indemnity 1949 1949-1953 ) 1957 1955 Travelers Insurance Travelers Insurance C Mundet Cork Corp. 1962 Aetna Casualty & Sure Thorpe Insulation Co. 10 Gay Engineering Corp. 11 Owens Corning Fiberglass Corp. 12 13 Fluor Maintenance Inc. 14 Coast Insulating Products 15 Harold G. Lorentzen Lorentzen Co. 16 Owen E. Leinio San Jose Asbestos Co. C. F. Braun 1953 1955 11996545--11996662 ) Aetna Casualty & Sure Co. 1955-1957 1956 1957 1956 Continental Casualty Argonaut Insurance Co Pacific Employers Ins Industrial Indemnity 1957 1958 American Motorists In John Newkirk Universal Insulation Co. Armstrong Contracting & Supply Co. Muldoon Co. Inc. 1960 1961 1963 1961 1962 Industrial Indemnity M. R. Carpenter Accurate Insulation Inc. Hickman Bros. Inc. 1962 1962 1963 State Compensation In State Compensation In Pac.Employers Ins Co 3. Applicant's earnings were maximum for both tempo 2 permanent disability indemnity 4. The injury resulted in temporary total disability : period November 30 1967 to and including May 31 1968 5. The injury resulted in permanent disability of 64 6 6. Applicant is in need of further medical treatment 7 or relieve from the effects of the injury 8 7. Defendants failed to furnish medical treatment ne to cure or relieve from the effects of the injury subsequent 10 26 1966 after notice of need and applicant incurred expens 11 therefor 12 8 Applicant reasonably incurred medical costs 13 295.50 14 9. The reasonable value of the services of applicant 15 attorneys is 1,500.00 16 10. The Department of Employment paid UCD benefits at 17 per week for the period December 2 1967 through May 24 196 18 currently with temporary disability found herein 19 11. The claim is barred by the Statute of Limitations 20 regard to temporary disability indemnity or medical expenses 21 period commencing prior to July 26 1965 22 12 Defendants have not been prejudiced by lack of no 23 the injury 24 13. The injury has not been caused by the serious and 25 misconduct of the employee f 1 i Board upon filing of an appropriate request therefor i! . | such proceedings being hereby expressly reserved | AWARD Jurisd AWARD IS MADE in favor of HENRY C. PUETZ against STA SATION INSURANCE FUND PACIFIC EMPLOYERS INSURANCE INSURANCE COMPANY INDEMNITY COMPANY INDUSTRIAL INDEMNITY EXCHANGE EMPLOYERS ASSURANCE CORPORATION LTD TRAVELERS INSURANCE COMPANY A | CASUALTY & SURETY COMPANY CONTINENTAL CASUALTY COMPANY ARG INSURANCE COMPANY AMERICAN MOTORISTS INSURANCE COMPANY HAR 10 ACCIDENT & INDEMNITY COMPANY GREAT AMERICAN INSURANCE COMPA 11 INSULATION CO INC MARINE ENGINEERING & SUPPLY CO GEORG 22 AND E. GUNDER FIBREBOARD CORPORATION THE INDUSTRIAL INSULA 13 THORPE INSULATION CO GAY ENGINEERING CORPORATION OWEN E.: 14 SAN JOSE ASBESTOS CO JOHN NEWKIRK UNIVERSAL INSULATION CO 15 16 ARMSTRONG CONTRACTING AND SUPPLY CO jointly and severally . follows 17 a Temporary disability indemnity at 70.00 per we 18 the period November 30 1967 to and including May 31 1968 19 1,840.00 to the Department of Employment in satisfaction of 20 for UCD benefits 21 b Permanent disability indemnity at 52.50 per we 22 ginning June 8 1968 and continuing for 256 weeks until the 23 of 13,440.00 shall have been paid less 1,500.00 to Smith 24 Paduck & Clancy as attorneys fee 25 c Further medical treatment to cure or relieve fr 1 Dr. Leon Lewis and 80.50 to 2435 Webster Street Laboratory 2 f Interest as provided by law ORDERS ... IT IS ORDERED THAT State Compensation Insurance Fund be | primarily responsible for the payment of compensation and costs for the furnishing of medical treatment as hereinabove awarded subject to said defendant's righotf contribution as provided i finding no 14 above IT IS FURTHER ORDERED THAT Van Arsdale Harris Co. and 10 The Budlong Corp. be and they are hereby dismissed as parties 11 dant herein 12 13 14 16 17 hg PUETZ 18 66 OAK 20668 RICHARD A. HICKMAN Referee 19 20 SERVICE BY MAIL ON ALL PARTIES LISTED ON OFFICIAL ADDRESS RECORD SEP 8 1969 21 22 H. yetmeyer 23 24  : = a rn, , | . ( INSTRUCTIONS Do not use use this form in death cases Use Form 16. Do not use in party cases Use 17 if the injured employee be under 21 years of age and a guardian ad litem has not been previously appointed a petition for appoint of guardian ad litem and trustee must accompany this agreement who is 3. The guardian must sign this agreement on behalf of an injured employee such minor should also sign this agreement under 21 years of age If the minor is above the agi Attach all medical reports not heretofore submitted to the Workmen's Compensation Appeals Board and advise when other reports we WORKMEN'S COMPENSATION APPEALS BOARD , DIVISION OF INDUSTRIAL ACCIDENTS RELATIONS / DEPARTMENT OF INDUSTRIAL STATE OF CALIFORNIA COMPROMISE AND RELEASE San Fr CASE OAK 20 SOCIAL SECURITY 532-12-4188 Mr. AKXXXGXX HENCY C. YS PUETZ APPLICANT Rt 2 Box 101 Oakley Calif ADDRESS C.F. BRAUN et al CORASET NAME OF EMPLOTER ADDREES AMERICAN MOTORISTS INSURANCE CO etal CONNECT NAME OF INSURANCE CARRIER ADONTOS The parties hereto for the purpose of compromise only hereby submit the following agreed statements of fact Henry C. Puetz 1967 claims that he was employed on 1945 to _day of employee herein born on 4/25/07 , MONTH 19 Various Places YEAR CITY in Ca Ca BYANE ata asbestos worker OCCUPATION workmen's compensation liability by _by Various Employers THANK OF EMPLOYER Various Insurance carriers STATE NAME OF CARRIER OR WHETHER URS^ then insured it he sustained an injury arising out of and in the course of his employment as follows evidenced by the medical reports on file with the WCAB The actual weekly wages of the employee at the time of injury were $ Maximum while the average weekly wage $. 3. The employee's present disability is in dispute STATE PRESENT DISABILITY RESULTING FROM THE INJURY and the employee_ returned to work IP 18. STATE WHEN 4. 2 Temporary disability indemnity has been paid to the employee in the sum of $ None at $ ..pe beginning ...~. to and including The amount due and unpaid to the employee is $ Covering advanced b Permanent disability indemnity has been paid to the employee in the sum of $ 1500.0 1500.0 advanced .80 .80 . 5. The marties hereby agree to settle any and all claims on account of said injury by the payment of the sum of 8280.0 8280.0 8280.0 8280.0 8280.00 8280.00 8280.0 ; . 7. Name and address of employee's attorney if any Smith 405-14th Paduck Clancy & WRIGHT Street Oakland California | Shid attorney requests a fee of $ 750.00 Amount of attorney fee previously paid if any None None 9. Reason for Compromise The parties wish to compromise their dispuatseto in A AOE OE nate uoee ree e and extent of disability neeneded ffoorr future medical tre Oe statute of limi limitat tionslimita ations t limiti ationo s lin mitas tions 10. The undersigned request that this Compromise Agreement and Release be approved 11. Upon approval of this Compromise Agreement by the Workmen's Compensation Appeals Board or a Referee and pa accordance with the provisions hereof said employee releases and forever discharges said employer and insurance carrier - claims and causes of action whether now known or ascertained or which may hereafter arise or develop as a result of sa including any and all liability of said employer and said insurance carrier and each of them to the dependents heirs ,, representatives administrators or assigns of said employee * It is agreed by all parties hereto that the filing of this document is the filing of an application on behalf of the employee the W.C.A.B. may in its discretion set the matter for hearing as a regular application reserving to the parties the right issue any of the facts admitted herein and that if hearing is held with this document used as an application the defend have available to thern all defenses that were available as of the date of filing of this document and that the W.C. thereafter either approve said Compromise Agreement and Release or disapprove the same and issue Findings and Aw hearing has been held and the matter regularly submitted for decision 13. For the purpose of determining the lien claim filed herein for the unemployment compensation disability benefits which I paid under or pursuant to the California Unemployment Insurance Code the parties propose the following division of the su upon for sertlement and release of this case SEE ADDENDUM ad for temporary disability covering the period to. 5 for accrued medical expense paid or incurred by the employee wn for future medical care for permanent disability The above segregation must be fair and reasonable and must be based on the real facts of the case There should be no made to deprive the lien claimant of a WITNESS reah sonable of 1949 fa the signature hereof this 21. recovery consistent with all the amounts involved f of ohn at Herry - Mary OL Sharen's Poss Zh O13 Poss Poss APPLICANT Herry ; SMITH PADUK CLANCY & e ) -- flaie WRIGHT WITNESSER THE INJURED DIGINTERESTED APPLICANT'S DIGINTERESTED PERSONS SIGNATURE MUST BE ATTESTED BY TWO BEFORE A NOTART PUBLIC BY : : Vi \ rN STATE OF CALIFORNIA County of for signatures 5 See attached tribtu ributiana trit butiani a tributiana a tributiana tn ributa iana L 322-2 9. and % ADDENDUM TO COMPROMISE & RELEASE AGREEMENT HENRY C. PUETZ v C. F. BRAUeNt al 66 OAK 20668 Carrier Rated Amount Signature Employers Liability Assurance Corporation Ltd. Industrial Indemnity Company State Compensation Insurance Fund acific Employers Group Fibreboard Corporation Travelers Insurance Co. Aetna Casualty & Surety Co. Continental Casualty Company Argonaut Insurance Co. v - MISCZAGNA $ 546.48 KIERNANKIERNAN & a, MISCZAGNA 1,068.12 INDUSTRIAL INDUSTRIAL 2,045.16 By STATE BY 571.32 ~~ JOHN P. By ra. al { 107.64 4 BROBECK & HARRIS PHLEGER1 794.88 "WhulWhull 2,541.96 " SEDGWICK DETERT By ByRR .. 82.80 ~~CONTINENTAL CASUALTY CO CASUALTY American Motorists Insurance Co. oy Hartford Accident & Indemnity Co. Great American Insurance Co. 124.20 AITEA BROPH Killon R. Fin 264.96 SEDGWICK SEDGWICK DETERT MORAN ByKillon yy, 66.24 HANNA & BR^ oramaBR^ orama _ CLAIM NO 66 OAK 20668 HENRY C. PUETZ REFEREE Richard A. Hickman C. F. BRAUN et al and AME MOTORISTS INSURANCE COMPAN Dictated October 2 1969 1969 INJURY from 1945 through November 29 1967 REPORT AND RECOMMENDATION OF REFEREE ON PETITIONS FOR RECONSIDERATION I INTRODUCTION Asbestos worker born April 25 1907 alleges injury to his l consisting of asbestosis as the result of harmful exposure durin~fl various employments in California during the period 1945 through | 1967 In the Findings and Award issued on September 8 1969 it wa found that applicant has sustained compensable injury consisting asbestosis the period during various employments by various employers durin~fl 1945 to and including November 29 1967. Compensation awarded for temporary total disability beginning November 30 198 through May 31 1968 and for permanent disability of 64 % It wa also found that the claim was barred by the Statute of Limitatio only with regard to temporary disability and medical treatment fr any period of disability beginning prior to July 26 1965. It wa further found that the injury was not caused by the serious and wilful misconduct of the employee Timely Petitions for Reconsideration have been filed on behalf of various defendants contending primarily that applicant is not entitled to an award for compensation benefits because the claim barred by SrseeanmA Pmaw the Statute of Limitations and that hawmnMebden aot -..%* & .. ke ee. le the amount of any contended on behalf of Aetna Casualty and Surety Company and Mundet Cork that Mundet Cork should have been dismissed because applicant's employment by said employer was outside of California II DISCUSSION Statute of Limitations Applicant testified that he first began to experience lung proble including shortness of breath in about 1961 that he was hospitaliz times for this problem thereafter that he was treated by Dr. Crantz and had periodic chest rays by Dr. Coate Applicant further testified that he first quit a job because he could not perform the climbing work involved because of shortness of breath in 1965 when he was working for Plant Asbestos The social security records however indicate that applicant did not work for Plant Asbestos in 196 and that he last worked for said employer in 1964. In his Deposition applicant testified page 9 that Dr. Crantz told him in about 1962 to get out of the business and that it was harmful to his health He further testified page 10 that he lost an average of two months of work per year and that Dr. Crantz told him four or five times that he should get out of that type of work Applicant further testi fied pages 12 and 13 that he was examined at U.C. in 1964 that a report of the examination was sent to Dr. Crantz who told applicant it indicated what Dr. Crantz already knew that applicant had emphysema or asbestosis of the lungs The application herein was fil on July 26 1966. It was concluded that applicant had suffered dis- ability as a result of asbestosis more than a year prior to July 26 aArf 3 gw ... bik inlin inlin ont an know or in the exercise of reasonat and certainly by 1964. It would seem clear however that applicar should have an enforceable cause of action for an industrial injury occurring within one year of the filed There does not appear to date on which be any reason the why application applicant's was cla should be barred to the extent that it is based upon any period of exposure during employment subsequent to July 26 1965. Applicant claim alleges an injury which is cumulative in nature The medical evidence including the report of Dr. October 8 1968 exhibit D filed Horton C. on behalf Hinshaw of State Jr. datec Compensati Insurance Fund indicates that applicant's asbestosis and present disability is attributable to applicant's continuing harmful expost subsequent to July 26 1965 as well as to exposure during various periods of ciples set employment prior to said date On the basis of the prin forth in the decisions in Miller vs. WCAB 33 CCC 68 an Burris vs. Southern California Rapid 419 applicant's aplicant's claim for permanent Transit District et al 33C disability and for the tempora disability found herein should not be barred by the Statute of Limi tations Although the cited cases did not involve an occupational disease the theories are equally applicable to an occupational dis , ease case which by its nature is a cumulative injury Under the pr visions of Labor Code Section 5412 not one but numerous dates of injury might be found on the basis of the history of applicant's various employments and recurrent periods of disability The Statut of Limitations should not be a bar to applicant's recovery for dis- ability which has resulted from the cumulative effects of his vario periods of exposure Serious and wilful misconduct of! 2. of continuing to work as an asbestos physician that such employment would worker after being be harmful to him advised b Applicant fied that he has worn a respirator whenever he worked with asbesto in California There is no indication that applicant performed his any different than any other by his various employers It employee or is apparent in a that manner not anticipat applicant knows no t other than insulation work and that to give up his trade would be face starvation or at best becoming a Welfare case Applicant's duct in this situation does not constitute serious and wilful mis conduct Form of award State Compensation Insurance Fund protests the form of the awar in that said defendant is required to pay the benefits awarded and seek reimbursement in subsequent proceedings This is the proper | cedure in cases involving cumulative injury with multiple defendant as set forth in the decision in Burris vs. Southern California Rap Transit District et al 33 CCC 419 Dismissal of Mundet Cork Defendants Aetna Casualty & Surety Company and Mundet Cork con that Mundet Cork should have been dismissed since applicant testifi that his work for Mundet Cork back East and that he was hire East for that job Applicant's testimony indicates that he first c California in 1945 but went back East in 1948 for 2 years He retu , to California in 1950 for 2 years and then went back East again unt 1954 when he again returned to California The social security re indicates that applicant was employed by Mundet Cork in the fourth of 1953. and also in the second quenten of 1060 ML lt employment by Mundet Cork was found to be only in 1962 RECOMMENDATION Deny defendants Petitions for Reconsideration hg 66 Oak 20668 PUETZ MAIL Spuyer SERVICE BY 4. ON COT COT COT Spuyer Spuyer Spuyer og 1989 ff a7, ef " RICHARD A.HICKMAN Referee Smith Parrish Paduck & Clancy 315 Financial Center Hanna & Brophy 1540 San Pablo Ave. Oakland Calif Bldg 94612 for Argonaut Insurance Company Oaklar Travelers Insurance Company American Motorists Insurance Company Great American Insurance Company Misciagna & Golman for 142 Sansome St. San Francisco 94104 Employers Liability Assurance Corporation Ltd. Sedgwfiockr D Haretftored rActci& denAtrnold 111 Pine St. San Francisco CA 94 & Indemnity Company Aetna Casualty & Surety Company John P. Herlihy 244 Pine St. San Francisco Calif for Pacific Employers Insurance Company 94104 Fermin J. Ramos 220 Bush St. Suite 700 San for Industrial Indemnity Company Francisco CA 94104 Industrial Indemnity Exchange Brobeck Phleger & Harrison for Fibreboard 111 Sutter St. San Francisco CA 9410- Corporation State Compensation Insurance Fund P. O. Box 1010 Department of Employment P. O. Box 1857 Oakland Oakland Calif CA 9460 Soc.Sec No. 532 - 12 - 4188 BEFORE THE WORKMEN'S COMPENSATION APPEARS THE STATE OF CALIFORNIA - com ILID ILID ILID ILID BOARDOF ILID ILID Varun78 HENRY C. PUETZ Applicant VS. _ C. F. BRAUN et al Defendants Claim No. 66 OAK 20668 . ~s om ~~. tee La : PETITION FOR RECONSIDERATION Defendant Fibreboard Corporation herewith petitions for reconsideration with respect to the Findings and Award served September 8 1969 upon the following grounds 1. That the Board acted without or in excess of its powers 2. That the evidence does not justify the find- ings of fact 3. That the findings of fact do not support the order decision or award and 4. That the order decision and award are not supported by substantial evidence based upon the entire record ee ee. _ ao Ss Se a rc. Si ce Ss a a . e e e ee ee mantener ee ee early as 1962 lost time from work because of it claimed that it was apparently related to his work and consulted his present counsel in that year although an application for benefits was not filed until 1966 In support of defendant's position that the case is clearly barred by the statute of limitations defendant adopts and incorporates herein as Exhibit A the Memorandum of Points and Authorities submitted by counsel for Hartford Accident & Indemnity Company and Aetna Casualty & Surety Company dated December 9 1968 Defendant further submits that in any event any finding for the applicant should have been decreasbeyd 50 because of the employee's serious and wilful misconduct in continuing in employment in conditions injurious to his respiratory system although advised by his physician that this type of work was harmful With respect to this facet of the case defendant adopts and incorporates herein as Exhibit B the Points and Authorities Regarding The Serious and Wilful Misconduct of the Employee submitted by counsel for State Compensation Insurance Fund dated December 6 1968 Defendant submits that no defense of the statute of limitations could be more valid than this case where the applicant supplied his attorney years before the filing of the application and after he had lost time from work because of the injury with a medical report with his and therefore this stale complaint is clearly barred by the statute of limitations WHEREFORE defendant prays that reconsideration be granted and without further proceedings an order issue directing that applicant take nothing Dated September 16 1969 Respectfully submitted -.._.- Brobeck Brobeck | Monin y Mle Phleger Harrison Attorneys for Defendant VERIFICATION I am one of the attorneys for the defendant named in the foregoing Petition For Reconsideration and make this verification on behalf of the defendant for the reason that the facts stated therein are within my knowledge I have read the said Petition For Recon- sideration and know the contents thereof and the same is true of my own knowledge except as to the matters which are therein stated on information and belief and as to those matters I believe it to be true I certify under penalty of perjury that the foregoing is true and correct Executed at San Francisco California this 16th day of September 1969 Binal Binal Binal Binal So Rinaldo So Sciaroni a (ir. A | SEDGWICK DETENT MORAN & ARNOLD Attorneys at Law 2 111 Pine Street Eleventh Floor San Francisco California 94111 3 | Telephone 932-0303 . Attorneys for Defendants . 10 6 BEFORE THE WORKMEN'S COMPENSATION APPEALS BOARD 7 OF THE STATE OF CALIFORNIA 8 9 HENRY C. PUETZ ) a) 10 Applicant ) ) 11 -VS- ) ) 12 PEILIP CAREY MFG ) et al ) 13 ) Defendants ) 14 ) 15 WCAB Case No. 66 QAK 20665 MEMORANDUM OF POINTS AND AUTHORITIES 16 Applicant by his application filed herein on 17 July 26 1966 alleges lung disability as a result of his e 18 | ment for the period 1945 through 1957 19 The evidence on file herein clearly shows that 20 applicant was disabled and had knowledge of the reason for h 21 disability at least one year prior to the filing of his appl 22 Therefore applicant's claim is clearly barred by the statut 22 Limitations 24 25 | POINTS AND AUTHORITIES 1 Labor Code 5412 2 The date of injury in cases of occupational disease is 3 that date upon which the employee first suffered disability there- A from and either knew or in the exercise of reasonable diligence 5 should have known that said disability was caused by his 6 present or prior employment 6 10 11 12 13 14 15 16 17 18 19 20 21 N 23 24 25 It is a well settled princial that injury in . occupational disease cases is when the accumulated effectsI deleterious substance manifest themselves and this would b when the employee becomes disabled and entitled to compensa that is when under the established meaning of the term _ disability as used in compensation law there is a combin of partial or total physical incapacity and inability to wo Assosiated Indemnity Corporation vs. Industrial Accident C 124 CA 378 The Statute of Limitations commences to run 1 the employee suffers work disability and knows or in the exercise of reasonable diligence should know that he is suffering from a disease or injury injury caused by the employment Argonaut Insurance Company vs. Industrial Accident Commissio 28 CCC 175 ARGUMENT Dr. Crantz's records indicate that applicant consultedconsulted thethe Annkor Annkor mR Banaerataw 1059 temanm ne de wes e 1 began six days ago and developed productive profuse profuse profuse cough wi w whole cup of sputum this morning which he describes as nit 3 On May 14 1962 the doctor reports There are still rails 4 the base bilaterally and coughing less some pain in the lo anerior chest wall due to coughing On May 21 1962 the doctor notes much impr 6 Jun still rails in the right base will keep off work until 8 The above entries clearly show that the appli 9 was off work because of his lung disability as early as kay 9.723 1962. On February 2 1963 Dr. Dowell in these same records 9.723 states that he is to see the consultant in Oakland soon alt 9.723 his chest for his attorney I told him it would be a good id 13 to get his films and he could use our EKG if he desires Therefore by these records it is clear that in 1963 theap 15 cant had knowledge that his disability was related to his 16 employment and he in fact was to see his attorney about his 17 chest condition 18 The fact that applicant had knowledge that hi 19 disability was related to his employment is further evidence 20 by Dr. Cote's report dated February 17 1952. Said report h 22 been made a part of applicant's deposition which is on file 22 the Commission and concludes 23 24 25 | oe Pulmonary occupational disease probably asbestosis asbestosis Applicant explains the note on the bottom of i oo oe oe _ 1 02 3 A 5 6 6 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 There is no question but that applicant had report in his possession and in fact wrote on the botton that report a note to his attorney Joe Smith The report applicant's note thereon indicates that applicant had know that his disability was related related to his employment back in 1 which was some four years prior to the filing of the applic herein Further evidence of applicant's knowledge of disability being related to his employment is on Page Six lines 1 through 15 of his deposition where he indicates the has had knowledge of his condition being related to his employment for some period of time and furthermore he sta that he has been hospitalized perhaps eight or nine times because of his lung condition On page 7 lines 5 through the applicant again indicates that he has had rays for hi lung condition since 1957 and in fact the rays were pai for through a union arrangement Applicant acknowledges receiving copies of these ray reports from Dr. Cote whic on file with the commission On Page 9 lines 9 through 11 his deposition applicant further discusses his knowledge ( his lung condition being related to his employment and stat that as as early as 1932 Dr. Crantz told him to get out of the business On Page 9 lines 22 through page 10 line 4 : lost considerahla considerahla tina 0201 2 3 3 5 6 9 10 223 223 223 15 16 17 18 19 20 21 22 23 24 work A. Some I don't know how much Not too much Q. Was there some work you couldn't do because of shortness of breath A. Well I've got so I can't hardly work now They fire me every time I got a job I can't do anything Q. Have there been any jobs that you have actually had to quit because you haven't been able to do it A. Yes going up in the air and that we do a lot of work in the air I can't climb Q. When did you first have to actually quit a job because you felt you couldn't do it A. Way back in 1965. I'd say back in 1965 Q. Who were you working for then A. Western Asbestos Q. And what was the nature of the work that you couldn't do A. at Standard Oil It was on the towers Q. And why couldn't you do the job A. Because I couldn'tE climb That was Plant Asbestos instead of WesternIt The Social Security records on file herein in that actually applicant was employed by Plant Asbestos durin the quarter ending December 3 1964 and as the application filed July 26 1965 clearly this disability predated the filing of the application by more than one year CONCLUSION It is submitted that the medical records and applicant's deposition indicate that he has had periods of disability from time to time since 1962 which is approximate four years prior to the filing of his application The reco is clear that applicant has been aware that his Jung problem were caused by his employment as an asbestos worker As 1 Labor Code sections cited above applicant's claim is barred } 2 the Statute of Limitations 3 . Respectfully submitted 4 HARTFORD ACCIDENT & INDEMNITY CO 5 AETNA CASUALAY & SURETY COMPANY By Their Attorneys 6 SEDGWICK DETERT MORAN & ARNOLD 9 DATED DECEMBER 9 1968 PARTIES SERVED -j bye Thomas Thomas William R. Thomas HARTFORD ACCIDENT & INDEMNITY COMPANY Oakland AETNA CASUALTY & SURETY COMPANY Oakland SHITE PARRISH PADUCK & CLANCY Attorneys at Law Oakland PACIFIC EMPLOYERS INSURANCE COMPANY ATTN NORMAN HAYS San Francisco CONTINENTAL CASUALTY ATIN JOHN WILKES San Francisco ; BROBECK PHLEGER & FARRISON ATTN RINALDO SCIARCHI JR Attorneys at Law San Francisco . STATE COMPENSATION INSURANCE FUND Oakland KIERNAN & MISCIAGNA Attorneys at Law San Francisco HANNA & DROPHY Attorneys at Law ATTN JAMES MCMILLAN Oakland ALEXANDER KEEMAN Attorney at Law San Francisco See ee "fi 2 10 PPEALS SECSIVE - BEFORE THE WORKMEN'S COMPENSATION SECSIVE SECSIVE SECSIVE OF THE STATE OF CALIFORNIA CLAIM 66 OAK 20668 SEP 17 1969 FILED . Division of Industrial Au CAXLANU CHRC HENRY C. PUETZ Applicant ; VS. & INSULATORS ASBESTOS INDUSTRY OF CALIFORNIA LOCAL 16 and STATE COMPENSATION INSURANCE FUND POINTS AND AUTHORITIE REGARDING THE SERIOUS AND WILFUL MISCONDUCT OF THE EMPLOYEE Defendants Section 4551 of the Labor Code of the State of ; California sets out as follows When injury is caused by the serious and wilful of the injured employee the compensation other- wise recoverable therefore shall be reduced one none half except apply of the exceptions here The evidence in this case shows through the deposi of the applicant following Henry C. | Puetz dated November 8 1958 the ok On Page 9 line 9 Q. When you were originally treated by Dr. Krantz your you ever have any discussion with him about difficulty A. You mean my lungs Q. Right . A. Yes he told me to get out of the business He said its harmful to my health Q. Did you make any attempt to try and get out of ... 1 fs, ae, ( of the serious Clemnc of Franier Co. Inowledg and injury *, Gaisba ae Mnowledge Mnowledge Ae oy is 1 ... his indcate Hort ... asbestos vs. vs. As I.A.G. 18 conditon conditon en cosemy seioas to Mnowledg Mnowlaesdbgt of aye pte asbeto expose Dr. e 8 aplicant himself vile ona> contiue + 2 Wels presnt of Ee ot 8 Y 8 But continue a a continuous 8 , thethe continue continue Aina continuous continuous contius thepresent busines himself medical medical reports and deliberate Aplicant's conditon condition the the presnt condit Ges ... Astel, wilnges Aplicant's 7 PA ...... ...... Aplicant's acept after warned cployment - - Respctfuly the ee cploymecnpltoyment cployment shows shows ap licant's ea TAC. miscon^'uet show disregad 8- a - Fl seriouThis E. Clemnc E. 88 8 E. Fh Clemnc show Clemnc disregad O- * nde cusmited, LO, Clemnc Horst Company QS serious Company and his neciu oxpcsy: covstmae thic toarls ~ Li ni*s to a: enose bosot tiaeks, oc or danger misconduct wilfu misconduct andComp Cases 3 Casedepositon depositn efect informed Iantz harmful Iantz leave such such busines asbestos proximate on asbetos was herin herin aplicant ahpilicsant the condit aplicnt of consequcs consequnces contiung for health wilful misconduct misconduct misconduct , 2.A.C. , 7 2.AC Respctfuly AtorneyRespctfuly Respctfuly Respctfuly Atorney cs TOP Henry G. Sanford Esq 714 Hobart Bldg San Francisco Calif S. Norman Hays Esq 244 Pine Street San Francisco Cal Sedgwick Detert Moran & Arnold Attorneys at Law 111 F in Street San Francisco California Kiernan & Misciagna Attorneys at Law 142 Sansome St. San Francisco Calif Hanna & Brophy Attorneys at Law 1540 San Pablo Oakland 5 Calif Robert C. Taylor Esq Sansome Street San Francisco G Calif 8 J. Patrick Calif William R. Calif Goodwin Esq 41 Thomas Esq 220 Sutter Street San Francisco Bush Street San Francisco Brobeck Phleger & Harrison Attorneys at Law 111 Sutter 9 Street San Francisco California ( . (| RECEIV DEPARTMENT OF INDUSTRIAL RELATIONS DIVISION OF INDUSTRIAL ACCIDENTS FEB 26 26 195 BOARDFILED WORKMEN'S COMPENSATION APPEALS BOARDFILED of industrial OAKLAND OFFICI ANSWER of THE EMPLOYERS LIABILITY ASSURANCE CORP HENRY PUETZ Route 2 Box 101 Oakley Calif . Case No. 66 OAK 20668 Date of alleged injury 1945 through VS. __ PLANT ASBESTOS COMPANY CORRECT NAME OF EMPLOYER THE EMPLOYERS LIABILITY ASSURANCE . CORP . LTDECT NAME OF INSURANCE CARRIER . 1300 235 ; 64th St. Emeryville Calif : EMPLOYER'S ADDRESS : INSURANCE CARRIER'S ADDRESS . Californi Californi CERTIFICATE NUMBER IF INSURED ANSWERING DEFENDANTS deny the allegations of the Application as indicated below with such explanations as ex pressly set forth and admit all other material allegations DENIALS MARK X IF ALLEGATION IS DERJED Employment EXPLAIN BELOW > Occupation _X__.I.njury IF DENIAL IS BASED ON DATE OR PART OF BOUT INJURED EXPLAIN FULLY X X_-_ Insurance coverage Liability for self procured treatment Liability for.future medical treatment M_.e_dical costs Admitted for Plant Asbestos Co. during years CHECK IF EMPLOYER HAS BEEN NOTIFIED TO APPEAR AND DEFEND 1963 196 X& Earnings X- P_e_ri.ods of disability X Permanent disability IT IS FURTHER ALLEGED GIVE LAST DAT WONXED AND CORRECT DATE OF RETURN TO WORK Apportionment IF APORTIONBENT APPORTIONBENT IS CLAIMED SO STATE 1. Defendants have paid disability indemnity in the total amount of $ None _at the rate of $ beginning _through_ -plus 2. Affirmative defenses and other matters 1. Statute of Limitations 2. Lack of Notice a week e