Document 3kn0MrzEOo1dxQBYmoKN618E

KELLEY DRYE & WARREN TADOART O. ADAM* TRACT 1. AMBLER OAVIO I. BARRY NCO H. BARREN ROMITT D. BICKFORD JR. WILLIAM C. BUND LEONARD A. BLUE R1CHAR0 W. BRADY RAUL R. BRENNER RAUL L BREMAN RICHARD D. BROORtCK JOHN M. CAUACV DAVID R. CHIRMAH BRIAN CHRIBTALDI RICHARD J- CONCANNON JCRRRCY B. COOK JOHN J. COBTELLO AMUEL S. CROBB RODENT E. CROTTT CUOBNE T. D'ABLEHONT RAUL R. DOYLE W. CHRIBTIAN ORSWEB ROBERT EHRENBARD B. HARRIBON RRANKEL JOHN A. OARRATY. JR. JOHN P. SISSONS RAUL C. OllTM ROBERT U HAtO BEN I. HARASUCHI HARVEY KENJI MABHIOATE* WILUAH C. NECK MARTIN 0. MEYERT BUO DEO. HOLMAN J. OUINCT HUHBICKER. >RO MICHAEL B. INBSL WIUIAM A. KROHLEY JOHN J. LYNASM 4EOME J. MAACHEBE CELAND J. MARKLEV JUN MORI* JOBERH B. MUTO* RREOERIC B. NATHAN CHARLES OECHLER HENRY Y. OTA* THEOOORE REARBON ALTON C. RETERS EDWARD ROBERTS. HI TERRANCB W. SCHWAB RREDERICK T. RHBA JOHN W. BIMRBON* RRAHCIB V. BODI HOWARD B. TUTHIU. Ill DAVID I- VAUOHAN ALBERT J. WALKER CHAUNCCY L. WALKER LOUIS B. WARREN SHKMRU WATAMASE* E. UBK WVCKORR. JR. CS EIMAND WALTER E BEER, JR. WILUAM C- BURT* THOMAS B. OILCHRIST. JR. NEIL T. PROTO* JOSEPH W. DRAKE JR. ALFRED W. ROBERTS OCOROC SICOEL COUNSEL *MOT ADMITTED IN NEW YORK 101 PARK AVENUE NEW YORK. N Y. 1017* 3131 SOB-7BOD CABLE "LAWYERLY" TELEX IBM* TtLECORin iris hod-tem 1213) SOB-73** WRITER-B DIRECT UNC (Bill bob-7711 November 29, BY VAN AT 11 WEST 42ND STREET IM SOUTH ORANO AVENUE LOO ANOSLES. CA- *0017 itia sbr-isoo BD CALIFORNIA STREET SAM RRAWCIBCO. CA. Mill I4IBI BSB-JB30 STANFORD. CT OBBOt ISO* 31A-I409 TELECOMER ISON itMM* 30 MAIN STREET DANBURY. CT. MM 1203* 74J-7BM 1333 NEW HAMPSHIRE AVI. N.W. WABHINOTON. D.C. 20034 13031 AB3-B333 TELECOPIER 13031 443-B33* IDO NORTH BIBCAYNE SLVD. MIAMI. PL. 3RISE I34BI 372-0030 TELECOMBR (3OBI 3SB-B1M 1984 ITS SOUTH STREET MORRISTOWN. M-l- 07*40 HASHIDATE B SOW RCaVEDl-_CTHIHOM.UOKPYCMEOHREI,AIEOCLUOHTW.rrOJOAAWOPEAHAR-NOKU fiO \l i?34 Martha Friar, Esq. Law Department Union Carbide Corporation Old Ridgebury Road Danbury, CT 06810 M.J. FRIAR Re: Sireci v. Union Carbide, et al. Our File No. 64440.132 Dear Martha: I am enclosing a status report with respect to the above entitled action in ithe form requested by your insurer Kemper. Ifasti'jnd I am also enclos ing copies of medical records, an amended third party compl.aint, and an affidavit submitted by Rohm & Haas regarding thdir lack of association with PVC products. call If you have any questions. please do not hesitate to PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" 044 7sn Martha Friar, Esq. KELLEY DRYE & WARREN 2 November 29, 1984 Best regards. JVO*G/rg Enc. cc: Ms. Patricia Steckel!, Bad G. Holman, Esq. ' John M. callagy, Esq. PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" ucc 044781 Practice Limited to Radioujsy PLUEMIM E-DSD4 A. V. HAPIRD, M. O- D. A. B. R. B. E. zcmu M. O., O. A. B. R. 4l-|10 BROWNE STREET JXljsMINO, M. Y. USES PATIENT REFERRED BY DR. PART Joseph Sirecii date April 23, 1975 Rescigno Left Leg, Proximal 2/3 including the Knee ROENiTBEN REPORT Date of Inj: 4/18/75 Employer: Elm Coa ted Fabrics, Division of W.R. Grace 220 Steiwart Ave., Bklyn., NY Carrier: C.N.A. I ns. 127 John St., NY, NY X-RAY FINDINGS There is no evidJence of any fracture or dislocation, either old or recent. The knee joint presents a normal appearance. There are no arthritic changes, joint mice or peri articular calcifications. No synovial thickening or effusion are revealed. There is some punctate calcification in blood vessels at the medial aspdct of the upper third of the left leg. IMPRESSION*: No fracture or dislocation disclosed. Thank you for the courtesy of this referral. BEZ/ll Sincerely yours. vy A.V. sjHAPIRO, M.D. BJE. ZEITEL,M.D. privileged and "CONRDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" U;u 044790 Ca ' * m</3 m%P ng% 10t-- 5QQx- S. U< iNi. mi% 100 Ac;a mgft Ab^i gm% T. Silt* mg% *-*.*.< Phos> mU./mi LQH mU./ml SSOT mU./ml 350----- 600-- 250--- Paeianc*s istm Lob. No. __<O*f*4&* Rm,^ See? S ui vs a q o u) o. z 1} *fjff 0 ___ *A r^-A^ *+ txjuJfo '+'$%+*_ , mjLju*** * - /Ja i'- 3 9vj 4rfC " j a, , * ** r /k-w C- /Kav# t M*`~4. '1 1i J <* i^f -!* /.__^ -- **Cji4 - - | n " ^ t A C^p4>ty ___^ _*_ - _ _ fjt+4L. _& <&y % /8^ut^; i . ^4-*/tr4/'_. /Co./ _f4l_ajLZ____________ i__________ _ " r <24 *----.-J^y( ___^,l?^y>u -____________________________________J. <^f0 .o~<-> t^l. <_/3^ ___^!?<crvc.6---------- _ -- /jz.t.^C^J'. =--M^M4^M^J<^hLJ:_____ ySL. / / Aof -ol c. _-ACr^L# J&^hX C^yii______________________________________ ________________/________________________ / PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" ! If : 0447*5 I '^sk\ PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" ROBERT D. KARL>N. M. O. 42>|sO MAIM ITUtr PluiMiim, N. Y. 11389 PLitMiNfl i-3l)4 Dr. Joseph Rescigno 46-27 Parsons Blvd. Flushing, N.Y. | March 27, 1981 | Dear Dr. Rescigno: The following is the report of the consultation of your patient Joseph Sired: The patient is a 56 year old right handed male who on 3/5/81 had an upper respiratory infection and the n developed pain in the chest, arms, shoulders and back and neck. He al so developed a headache on the right side of the head and thickness of h is speech. There was also some de creased sensation along the left 1awer jaw and along the right scalp, There are no focal, motor or sensoxy complaints'referable to the limbs. Memory is intact. Vision is normal The patient had been running a low grade fever, but this has impro ved in the last day or so. Most of the patient's pain has disappeared except for the pain in the neck. He still has some thickness of speech and he also has some numbness as pre* viously described. There is a past history of ulcer disease. NEUROLOGIC EXAM: Mental status is intact. Cranial r erves reveal that the tongue is somewhat deviated to the right and that alternating tongue moveaents are done poorly. Speech is slightly thick, There is decreased sensation in the submental area on the left side. T here Is also decreased sensation along the right portion of the head on th e top. The patient has some tenderness in the mid-thoracic area and along the thorax. The remainder of the cranial nerves were within, normal limits, Motor exam including gait, strength and coordination was unremarkable. Ref lexes were active and equal. There is no Babinski sign. There are no men lngeal signs. An EEG was within normal limits. IMPRESSION: This patient appears to have multip le cranial nerve involvement. This is probably on an inflanmatory basis, The symptoms seem to be gradually improving. Under these circumstances I would suggest observing him without medication. Steroids could be trie d, but in view of the ulcer history and the improvement, I think it would b e wise to defer using them at this time. Thank you for the consultation. PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" ROBERT D. KARLAN, M.D, Georgs M Soffm. M O. Roden D- Karlen. M.D. caI associates COMPUTERIZED AXIAL TOMOGRAPHY (212) 762-8300 35-14 Parsons Boulevard Flushing. New York 11354 April 13, 1981 Dr. Joseph Resctgno 46-27 Parsons-Blvd. Flushing, New York / Dear Dr. Reseigno: RE: SIRECi, JOSEPH COMPUTERIZED AXIAL TOMOGRAPHY OF THE BRAIN AND CERVICAL SPINE A CAT Scan was performed on your patient on 4-8-81 BRAIN Multiple sections were taken from the base to the vertex. In addition to a plain scan, one was performed using contrast enhancement with a lOOcc Bolus of 60% Hypaque given Intravenously. There were no osseous abnormalities!. The ventricular system was visualized and appeared somewhat enlarged. Thle midline indicators were not displaced. There were no pathological areas of] increased or decreased absorption involving the brain parenchyma. IMPRESSION: This CAT Scan of (the brain shows evidence of mild cerebral atrophy. CERVICAL SPINE Overlapping cuts were taken from approximately C-2 to C-5. The vertebral bodies-were intact and both'the osseous and cartilaginous portions were well visualized* The pedicles!, lamina, spinous processes and pars interartfcularis were well seen. The bopy of C-3 appears moth-eaten with irregular areas of decreased density. IMPRESSION: This CAT Scan of jthe cervical spine shows a lesion in the body of C-3. This looks like p neoplastic disease, although a granuloma is also possible. Thank you for the referral, ' PRIVILEGED AND RDK/ds ORDER" FLUSHING HOSPITAti and MEDICAL CENTER CONSULTATION REPORT u CONSULTATION REQUESTED OR BT CHECK ONE [~| ROUTINE EMERGENCY SIGNATURE REASON FOR CONSULTATION DATS JOSEPH SIRECI DEPARTMENT BEFARTMENT M.O. PROVISIONAL OlAONOSIS OPINION OF CONSULTANT; / DATE. 4/13/81 The patient is a fifty-six year-old male admitted to the hospital with a history of fourr days of fever and cough, responding to antibiotics, but he developed severe neck pain. X-ray examination showed?a lytic cervical lesion and bone scan was positive .foJ metastatic disease. Request was made for bone marrow aspiration. PHYSICAL EXAMINATION: Except for slight pallor vwt unremark- able. ' " BLOOD STUDIES; Hemoglobin Hematocrit White blood count 10.2 gms. % 34 vols. % 13,700 per cubic mm PERIPHERAL SMEAR: The red cells are hypochromic and micro-- cytic Basophilic stippling was noted* No abnormal white cells were nfcted. The platelets were adequate. ) BONE HARROW ASPIRATION; . The sifc^mal marrow was aspirated without difficulty. The marrow .is normal. . There is a small questionable foci of cells noted which may represent r.commwoAS51 cells. Iron stain 2+.. . . .. fI A posterior iliac crest bone .biopsy was performed and reported as showing metastatic carcinoma. FINAL DIAGNOSIS;!.Metastatic carcinoma to bone marrow. 2.Thalassemia minor. Thank you for permitting me to s.ee this patient. O MK/sf PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" Sincerely yours. M.D. SIGNATURE L'CC 044302 M.P 3X-P-313 I-AS. ACCESSION NO- FLUSHING HOSPITAL AND MEDICAL CENTER SURGICAL PATHOLOGICAL REPORT PRE-OPERATIVE DIAGNOSIS POST OPERATIVE DIAGNOSIS (CLINICAL) Sl?JECr# JOSEPH 55 420 BSSCZGSffO 2 :ed 02-42-29 05 c 4/2/81 31003966 i-352 TISSUE REMOVED PAP SMTAIMPtrrtM HISTORY: OATf 4/20/81 oocos .ESSCISNO" GROSS AMO MICROSCOPIC DESCRIPTION no TO4C2 CELLS SEEK T*sr 4/20/31 O PRW"'T?S>WAtEWAU "c0N pct^o p^tecTW s'JbjeCordER" FORM F-1091 REV t<7| Da.sssACDay DATE OlAOiQso ^ ^civdti J- fATMdOOUT 044 dry'! PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" 1, J0322E 2-29 53 n 3R( it i mj^jCISiO masssrn bass* 4-2-8X 4-25-81 PFrasaw TT.r.?Tggg# m% patient is e5^/year old nan who wea veil up to approximately one month ago whan he' developed viiAt appeased to he cold* At the time* he vu taking a lot of Aspirin. About one week later* he called me to say that hie tongue 4aa swollen and that he had difficulty eating] that -Use hack of his neok an% .those* were very painful*X told. to stop the Aspirin and started hip op Chios-Trineton heoanae -1 thought the swelling of the tongue say hove b fen due to an allergy to Aspirin. However, three or four days later, tlu patient called me to say that h9 was no hatter and X told him to oome into <the office. At that time, I noted he had a pares!$ of the right hypoglossal nerve, also some dysphoaia and masked muscular pain in hack of. the seek and thorax. 5HA and xheomatoid factor both noizsal* ^ tentative diagnosis of possible Guillain-Barre syndrome vas made, lit the time, ha also hod numbness of the left side of the chin and aleo of. [the right side of the head* Dr. Harlan believed that he had a polyneuritis end advised conservative treatment, becanae from epeeidng to him over the^hone and thou seeing-Mm a fev days later, he thought the dyephonis wee improving, which it had. However, the pain in hack of the neck end thorax were getting worse. He had been running a lev grade fever at night end then the pain started spreading to the low bock with weakness of the leg* Because of this, f advised hospital 1,cation. 7h patient is veil developed but he roves around with difficulty because of pain especially of the back of the neck, holding ihis seek quite rigidly. FOT was negative. Heck - stiff, sore because of pain on motion. Xungs vere clear to P and A. Heart -- blood presa\lre 17&/SQ. Heart action very forceful: no murmurs. Hhythaivu regular. Abdomen negative. ! '* Hi.tj.muities - varicosities with post-phlebitie changes, especially of the left leg. ITorrclcglcal examination -- protrusion of the tongue to the left, deviation to the sight while in the mouth; hyp|sthesia to pinprick, left side of chin; anesthesia to touch, ri^rt side of | vertex of head. All motor reflexes vere equal hut hyperactive. So pathologic reflexes found. Back - quite rigid as veil as his ns ok. Has difficulty moving around In bed because of pain. LS30HA70HT EATAt CSC - normal HSCi. hemoslcbia 10.69 hematocrit er. MCV 61 VDC 15,700 with 82So poly3. 10 lymphs, 2 monos, 5 eoa* All hdooglobirs rrriined around 10-1I-X2.urinalysis r.-'S&tive* Stocla for occult blood negative. God. rate 29. SMA 12 - alkaline phcjphataae 530, SOOT 39.4, H 306, all the rest '.fas negative. Alkaline phosphAtaae went up to 645 and fractionation shoved th.it 33?a of it oars from the liver |ard lp;j from the bone. CAT scan 9f the brain v?3 normal, but CAT scan goind down to Cp showed a lsyion in the body of C5. Ho also had x-n.ys of -the bones shtnh aboved scattered mat?rtasee throu^iout the bonea. the biggest one being in the body of C3- shoved non-specific ST-7 wave chrngss. Tha r3t of tba x-rays were **ithin normal limits. COJbfidilM*: 5I2SCI, J0S2S : y02-42-sr7 i i i C03TIH03D* ?a-T 2 X called Dr* Kagan la to im the patient fco confiraed the diagnosis of Meditexxeea trait, thalaoenia minor*-* Be also vaa aaan by Dr. Bate vfao confl.Tmed the diagnosis of polyneuritis* Ve did seas studies on bone biopsy taken by Dr* Xagea ifeleh shewed undifferentiated aquaraoua oell t7p# carcinoma, search for all possibilities for primary vaa uasucoessfnlv He vaa t;9en by Dr* Kata *ho did a laryngoscopy and a head and neok eranlaetloa and ha stated there vaa nothing he could find* Baoanae of the possibility `of the third ervieal vertebra collapsing, he vaa start3d on radiation therapy to his neck J<ast for that reason and he vaa placed In a Stryker collar. He Is now to receive radiation to the third cervical vertebra and Ibis *111 be `continued on an outpatient basis* 2$e patient vaa discharged*- { it BEDGWOSXS* BTgBWBCX POOR! j CTttL DIAGNOSIS* SQ3&MQP3 CBtA GASOP2JQMA, OHDCTEBB^EIASED, SI25 WI*II3 cHWB>A.?.Tgiin> vkIBB MB2AS&&SES. . ggATUCFWU m;OB' DISPOSITION! I *111 continue taking cere of this patient on the o'ltsidc. JE:cak 4-2>-31 3 t~ JOSEPH HSSCXG30, M. D ; I i 1 \ ORDER" I5 \ \ HOC f!4480^ andlytledica/^-enfe t -. -PARSONS BOULEVARD ANC 45TH AVENUE FLUSHING. N.Y. 11355 PHONE 212 670*5745 ALEXANDER FARCA, M.D. DIRECTOR RAOIATION ONCOLOGY May 8, 1981 Joseph Rescigno, M.D. 46 27 Parsons Blvd. Flushing, N.Y. 11355 RE: sireci, Joseph UNIT #02 42 29 Dear Joe: PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" This is to inform you that Mr. Sireci was evaluated on 4/16/81 for an unknown primary metastatic carcinoma which required ad* mission to Hospital that raontli. His history dated back three (3) weeks prior with the development of progressive bone pain and the development of dysliaiia. His workup showed diffuse metastatic bone disease secondary to a poorly differentiated carcinoma on bone marrow aspiration biopsy. His physical examination, at that time, revealed point tenderness in several sites of the skeleton and by Virtue of having a potential spinal cord compression due to a lesion of the cervical neck, it was elected to treat this area wi4h a radical palliative intent for which a treatment planning wa^ outlined and commenced on 4/17 completing on 5/7 delivering 1,500 RADS on a parallel opposed pair for 15/fractions. This treatment eradicated the pain and produced the anticipated radiation mucositis of the posterior pharyngeal wall. As you are aware, due to the progression of the disease and in symptom^ of other skeletal sites, the patient required re--admission I to Hospital for which half-body radiation was then implemented to the lower half of the body commencing from the diaphragm I down to the upper third of the femurs deliverng a midplane dAse of 800 RADS on a parallel opposed pair single dose. This treatment was expected to produce seme degree of nausea and vomiting which was fairly well tolerated and, as of today, which is tw^ (2) days afterthe radiation, no significant changed has yet happened but it is expected that these pains originating in the lower part of the skeleton will improve in the incoming week. Due to the significant hematological pro cess namely the presence of myelotisic anemia bone marrow support with Deca-Durabolin injectable has been prescribed for producing the ability of radiating the upper half of the body somewhere in the next four (4) to five (5) weeks if his hematological status is adequate. UUG 0448 cieacignOf M.D RE: Sireci, Joseph UNIT #02 42 29 - 2- May 8, 1981 I thank you very much for the| referral of this patient. i Very truly yours. /lp Director, Radiation Oncology .conpfridiveilnetgiaeldmaantderial SUBJECT TO PROTECTIVE ORDER" V ucc 044H i privileged and "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" \ SIRBCI, JOSEPH #02-42-29 AGEs 56-M JOSEPH P. RESCIGNO, M.D. ADMITTED: 5/06/81 EXPIRED: 5/31/31 HISTORY: The patient ia a 56 year a Id male with known bony metastatic disease, undifferentiated squama us cell carcinoma, primary site undeterminec Be wae getting Radiotherapy at t he time, to the bones of his back and neck because of intractable pain Bad to be admitted because of pain with respiratory distress. Has a hypoglossal nerve palsy on the right aide. How, has also difficulty swallowing, mainly liquids and sometimes also solids, which at times, he regurgitates through his nose. As a rule, does a little better with solid foods. PHYSICAL EXAM lift TION: Well-developed, pale male complaining of severe pain in the chest, SHT-tongue deviates to right whs n protruded. Hoarseness. Heck supple. No masses. Lungs clear to P&A Chest is very tender over the right mid axillary area around T5. He art was regular sinus tachycardia. .Ho murmurs. Sounds of good quality B/P 140/80. Abdomen-liver is 1 finger down below the costal margin. There are no other organs palpable. LAB DATA: The patient, on x-ray, had multiple bone metastases in ribs, back. He is being treated symptomatically and supportively. Some radiotherapy for the pain in the lower body With the hope of relieving some of the pain. However, despite all thi^, he continued going downhill. Became very anemic. Had to be given transfusions and had to be on narcotics around the clock. HOSPITAL COURSE: The patient was given I.V.j fluids on and off, at times, depending on his condition, but the cours^ was downhill and he expired on 5/31/81. A Post was obtained and ha was found to have CA, bronchogenic CA with generalised metastases to ^he bones, liver. FINAL DIAGNOSIS: j BRONCHOGENIC CARCINOMA WITH GENERALIZED METASTASES. JPRsplj 5/31/81 JOSEPH P. RESCXGNO, M.D 044808 prNIUEGEDW^wal "cONF'cTIto PRTECTWE subject der,, FLUSHING HOSPITAL AND MEDICAL CENTER DEPARTMENT OF PATHOLOGY ^ REPORT OF AUTOPSY SIBECI. JOSEPH . M Att*. 56 chart ><02 42 29 path, mo SI A k'ZJ FINAL CLINICAL FARGA INTIRNI DAT! AND TIMI OF ADMUIlftH 5/ 5/31 OAft AND TIMI O* BftATM. __5/51/81 . . DATE AND TIMI OF AUTOMYt_ 6/1/81 fiuu ei atATM. BRONCHCGENl : CARCINOMA. RIGHT LOWER LOTIE WITH GENERALIZE METASTASIS t "l<T0,Ti This 56 year old White male was admitted with the chief THIS SPACE IS FOR BINDING complaint of difficulty In swallowing* breathing and speech* pain / in the neck* right side of the cheat end low back* and Inability to walk due to weakness for the past six months. Patient la a known case of generalized bone metastasis from undifferentiated squamous cell carcinoma* primary sil:e unknown. Had extensive workup in March, 4 1981 and received 14 treatments of radiotherapy. History of smoking* stopped in 1967. Physical examination reveal.ed a 56 year old white male* well-developed* and well-nourished* in no acute distress. Keck* no lymphadenopathy; lungs, clear; heart, normal sinus rhythm* normal SI. LABORATORY FINDINGS: CBC: Hbg 8.1, Hct 24.9, USC 11,000* polyp 40, bands 43* lymphs 13* monos 1, eos 1. SMA-12: BCH 43.2 mg 2* uric acid 7.9, aIk phos 842 IV/t?, LCH S05/L. ucc 044809 Cheat x-ray: osseous metas tic lesions* and pathologic fractures seen in the wall in the 8t^ and the 9th ribs on the right side* 0 1-8HHD oon ISIOOlOHIVd ,,ti3oyo f9ns 3Nia!iw^N3Q'=1N00" nVW QMV 0393^'wad THIS SPACE IS FOR BINDING dotYOKoa *aa T8"IC*S * poaxdx pas <XTRnwoP 3oa XtPTdsx 30973d t& *dojq3 SA?32oddn& Jtoqao i pae jCd*4*q30ipSA po/\To:* 30I3*d sip 4no3 x*3Tdoi* qa Supxna PT 3003 ^JCBOISIK 62 21? 20 Rd3SQr *X032.IS *{/'/ V 15? *on uodeu Asdoiny jo uotitnupuoQ Continuation of Autopsy Report No. gl 4 4& SIRECI, JOSEPH 02 42 29 aCTSBIi-AL EXAMINATION: The subject is a white male, well-developed, well-nourished, who appears to be at the stated age of 56 years. He has gray hair, gray eyes, body length o 72 Inches and weighs approximately 200 pounds, IKTERSAl* EXAMINATION: The x>dy cavity is opened with a 'V* shaped incision. The subcutaneous fat In the abdominal wall measures 3*5 cm in thickness. There is app raximately 30 cc of clear, straw-colored fluid in each pleural cavity. The pericardial sac contains 40 cc of clear, straw-colored fluLd. There is no free fluid in the peri THIS SPACE IS FOR BINDING toneal cavity. The liver is enlarged, extending for two fingers below the right costal margin. HEAP: The scalp and calvar Lum are not remarkable. The brain vei^ns 1,450 grams. It has a firm consistency. The sulci and gyri are well demarcated. The blood vessels reveal mild atherosclerotic change. THYROID: weighs approximately 20 grams. It Is meaty brown and has a firs consistency. Has^cn W*i8hs 390 graais. Valvular circuafarencss are as follows: tricuspid 120, pulmonary 80, mitral 100, aortic 75. The left ven tricle measures 1.7 cm is thicknass. The right ventricle measures 0.6 cm in thickness. The c Dronary ostia are slightly narrowed at tbs origin. Oistally the v essels have marked segmental thickening with foc&l calcification of the wall and narrowing of the lumen to PATHOLOGIST RIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE U'w-'1-044811 ORDER" Continuation of Autopsy Report No. si A 4 SIRECI, JOSEPH 02 42 29 PEART* cont: three-fourths cf its original size. The myocardium on section is not remarkable* LUNGS: weigh 1,700 grams* They are voluminous* The right lower lobe has an area of pleural retraction measuring 3*5 x 3 cm in two diameters* This area has fi|ra consistency. The rest of the pleural surface is grayish--pink and has a firm consistency* On section, a large amount of frothy fluid escapes. The upper lobes have a honey combed appearance* On section, there is a grayish-white tumor mass with cavitation measuring 3 5 x 2.5 cm in two diameters. Another THIS SPACE IS FOR BINDING small lesion is seen in the left lower lobe, measuring 1 cm in dia- meter* It is grayish-white and has a firm consistency. No other definite tumor mass is seen. There are patchy areas of pneumonic consolidation. The tracheobronchial lumen contains frothy, mucoid material. The mucosa is not remarkable* The hilar lymph nodes are anthracotic and slightly enlarged, having a firm consistency* On section, small areas of grayish-white tumor mass is seen* The pul monary vessels are not remarkable* LIVER: is markedly enlarged, weighs 1,700 grams. The capsular surface is reddish-brown and Is studded with grayish-white metasta tic tumors, the largest measuring 3.5 x 3 cm. It is grayish-white and has a firm consistency* Th<t cut surface showapetastatic tumor masses, and the intervening liver parenchyma has nutmeg appearance. GALL BLADDER AND BILIARY TREE: are not remarkable. PATHOLOGIST PRIVILEGED AND "COJNFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" ijr.;C 04481 THIS SPACE IS FOR BINDING Continuation of Autopsy Report No. 331 SIRECI, JOSEPH 02 42 29 SPLEEN; weighs 450 grams. It hui a slata gray capsular surface and fins consistency* On sect: Lon a small metastatic tumor mass is seen, measuring 1*5 x 1 cm. The oesfc of the spleen parenchyma is mushy and dark reddish-purple. PANCREAS: weighs approximately 100 grams. It has a firm consistency On section, well-marked yellowish-pink lbules are seen* G* I* TRACT: The esophagus has silvery gray mucus membrane with a small submucus leiomyoma in the proximal one-third of the esophagus , measuring 1*5 cm in diameter* It has firm consistency. The cut surface is grayish-white* ihe stomach contains approximately 30 cc of greenish-yellow material* The cost of the intestinal tract is not remarkable* ADRENALS: They are normal in siaa and shape. On section, they have a well-marked cortex and medulla and metastatic tumor in the form of small nodules. | KIDNEYS: weigh 380 grams* The capsules trip off easily, leaving a smooth cortex with a few icetastatlc tumor nodules behind* On section, well-marked cortico-medullary junction is seen* The calyces, pelvis and ureters are not remarkable. BONE HA5R0W; Grossly it is not remarkable* r to p* ORDER" PATHOLOGIST 044813 Continuation of Autopsy Report No. gl ^ ^ SIRECI, JOSEPH 02 42 29 ANATOMICAL DIAGNOSES: LUNGS: BRONCHOGENIC CARCINOMA RIGHT LOWER LOBE WITH MEIASIASES TO HILAR LYMPH NODES, LIVER, SPLEEN, KIDNEYS, ADRENALS AND BONE MARROW PULMONARY EDEMA | PULMONARY EMPHYSEMA 1 PATCHY BRONCHOPNEUMONIA HEART: CORONARY ATHEROSCLEROSIS, MODERATE RIGHT VENTRICULAR HYPERTROPHY LIVER: CHROMIC PASSIVE CONGESTION (< V &in c CAUSE OF DEATH: BRONCHOGENIC CARCINOMA, RIGHT LOWER LOBS WITH GENERALIZED METASTASES | DR. PONDA:cp | V privileged and "CONFIDENTIAL MATERIAL t. SUBJECT TO PROTECTIVE ORDER" I v" TtLKPMOHt PL 2090 | JOSEPH RESCIGNO, M. D. 40.27 PARjBONS BOULEVARD rLUtHl^Q, H. Y. ttSSB --'/?--------------------.-_V t."L L\~<. ` --Cr A<- c*a !j rf \ RECEIVED PAYMENT. '~h Or-xJUy c -; - ^SSSSSS^"" TO PRC ORDER' UCC 044815 WORKMEN'S COMPENSATION Etrtor -JT to tttw Typo of Rapart. 111MAY MPORT BOARD `fjWOWW ATTWMNO PHYSICIAN'S SUmtMINTAtY WORT REPORT NNAl REPORT wcs CASE NO. (U Knownl CARRIER CAM NO. (If Known) DATE OP MJURY ANO TIME ADORESS WHERE INJURY OCCIMKD v/'/Ar HA- JZ&o MAJRED PERSON ^vTa t ^ 1r*t- M' O'r_-_*______________ aat ADORESS sir -<, % Onry - l '^Ti^yr&kL - 'e EMPIOYER uasniiiiiita CL.AJ.A '**'+** at.Cfu o- ib GUj* %. Q ANSI rER AU QUESTIONS. AVOID USE OF INDEFINITE TERMS SUCH AS "UNKNOWN." VM?." ETC. 1. Hev yaw Mad form C4I, or ** rapart, Y r?NO wHm Mi Mnwyt - ___ ___ If "No," aaawar 1 (a) and (b) (a) Slata iww injury acwrwd and gna tourca of thia information. (If cfc in it far am Malory and data d anal of aiatid aymptomt). a, iwdodo ooeupotianol n4# J *=-P- Q. <Z-*JrJQj si {1ju^the JLl * (b) Wat patient proviotidy under fa ^eoro of f"n f*~i ^ another physician far this tajayf ` L-J ^ I 2. It there any hirrory or evidence of pro- |I I ending injury, ditoaaa or physical InpaamonlT |__J Tes L-j; If MYot>*' antar hit aatno and oddrasi, and for transfer wider "Romarkt* {Ham 10], If TYot," describe tpadficollyr 3. Praaant eanditian (indodo diagnosis, (objective camplointt, , object* a fmduigs. and any change of condition dnce lad laport. If patiant wot batpHabzad data Iasi report, w dote and plot mb# and addrau af hospital)* STk*. ' Ll. /tLoj gfa 0^M> c 4. Nature Data of yowr V/V?rfirst boulaiontt ~1 Data af yaw moat recent trooimanli . If traalmant it continuing, estimate hi prabablo dwratian. If It hot terminated, indieota reason. */*'Hi W yaw continuing] i Iraoiniont? LI m NO 5. May ilia injury result in pormanant restriction. tatol.or partial. Iota of functiot of o port or tnombar, or pomonont facial, heed or nodi disfigurement? yes [3*0 If "Tot," describe! 6. On wbat data* do yow think patiant wot or'wilt bo oblo tot It patiant working? (a) Rotwino Bathed work af any kind? 'He?(b) Resume Kit regulor wo> Data. DatOr "7. r~i NO 7. H patiant b wnoblo to do hi* regular work, hot can do RmHod work, sredfy hit work Gmitationt dwo to thit inigry. UIUI IIUTIOI S. In your opinion, wat tho occurrence dotetibod above (or in yagr provisos raport which gova . thb information) tha campotant producing causa of the Injury and dba tllity (tf any) tvttoinod? Lij *** 9. b rehobiStotien treotment or torvicat evaluation thorafar advisad? J , piyes .-.rn^ Explain! NO tmiiu UIIOI If rehabifitaMon treotmont valuation it odvitod, hot abtaaanr m--ode?- I|_|I TM-5- -^| "l|nO If "Tot," to wham? tf ""No," indkote why. 10. Enter bora additional information of value, request* for autharttotioa. Dotad Typod or Printod NonlFbf Attending TSvdcian .Address >A- w4| Rating Cod7~ tVCI Authatrriixzadltikan Nr {`Telephone Writtan Signetu af Attondlng Phytidb C-4 (ym6?) ANSWER AU QUESTIONS. AVOID USE OP INDEFINITE TERMS. ** RtWM term LCJ277-C Printed In U. *. A. 0-`7 PRIVILEGED AND " CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" UC--; 044815 important TO THB ATTENDING PHYSICIAN 1. Reports on this form (or on Form C-j if filed by on ophthalmologist) must bo within 15 rfoyi offer you Hrst rondor treotment in o workmon'i compensation com or o voluntoor firemen's benefit com, and tharoaftor os prograes reports at intervals of 22 days or Isis during continuing troatmont, ` ___Pteoso ask your patient for his Workmon'i Compensation Board Com Number and the Insurance Car* rier's Case Number, if they ore known to him, and show those numbers on your reports, in the spaces ...... provided. --...................... ....... ------- -- File the signed anginal of this report directly with' (1) CHAIRMAN, WORKMEN'S COMPENSATION BOARD at the office of the district in which the jeeddent occurred and file a signed copy with (2) tho INSURANCE CARRIER, if known, or the EMPLOYER.; ' -I . Z- jJ:ti3 K * V* 2. The law provides that no daim_for. medical or iurgieol.treatment shall be valid and enforcoable unless the physiden furnishes the employer (or insurance corner) and this Chairmen with a preliminary no tice (C-48) el injury and treatment within 43 hours fallowing first treatment, and within 15 days there after a more complete report (C-4 or C-5), and subsequent thereto progress reports (C-4 or C-5) at in- ___tervals of 22 days or less, with a final report (C-4 or C-5) upon termination of treatment.^ 3. -This form mutt be signed personally by the attending physician and must contain his authorization cer tificate number and code letters. If the patient is hospitalized, it miry be signed by a licensed physician to whom the treatment of the case has been assigned as a member lof the attending staff of the hospital. 4. CHANGE OF ATTENDING PHYSICIAN; The rules of the Chairman provide that "o physidan authorized to treat workmen's compensation cases, when requested to supersede another physician, must, before -- beginning treatment of such patient, make reasonable effort to communicate with the attending physi dan to ascertain the patientVcondition.. The superseding physician must also advise the attending physicion of the home of the person_who .has 'requested him.[to assume care of the case and ctatethe rea son therefor, if the second physician cannot contact the attending physician, and the claimant's conditiorwequire* immediate.treatment, the,..seid. physioon should .advise the doctor previously in attend ance within 43 hours that he now has the patient in his care. The preceding physiden shall supply the succeeding physidan with d complete history of the cose". - >i~ r.i- -t-r.... 3. - AUTHORIZATION FOR'CONTINtiEP 'MEPFcXT^AREr Whan it Vo^***^ to" engage the Minces of a specialist, consultant, or surgeon, or . to provide for physiotherapeutic procedures or x-ray examine* ----- tion costing more than $35, or.special diagnostic laboratory tests costing more than $15, the physidan must secure authorization from'the employer, the insurance company, or the Chairman. Such author- .... izotion may be requested an this fam'uiider Ham.10. If authorization is not forthcoming oris not denied within five working days, er if a denial of authorization'is hot justifiid medically or otherwise, the spe- ---.dal .services, required, for-the.patient's welfare should be proceeded with on the 'ground that authoris- . ation has.been .unreasonably withhold.' Such authorization fi not required in an emergency"under the . .provisions, of Jachp#_13^..(5),________ _ .. . . ZZZ'..'"- ' ~*r" '' ij' ' In cases in which the datmanf's physician prescribes a surgical appliance or dental treatment or den ture, the physidan should notify the employer or.carrier.pf,thqheedlfor such, appliance .oriental, aid, and direct the^doimont to the employer or carrier forth# purpoM of socuring authorization for the pur ^ appliance or dental aid before the same It furnished to the claimant by the appliance dealer or dentist. 6. gSNAUY FOR FALSE REPRESENTATION; If for the purpose of obtaining any benefit or payment under the previsions of the Workmen's Compensation or Volunteer Firemen's Benefit Laws, or for the purpose of Influencing orvy determinations regarding any benefit or payment under the provisiohs'of these'laws, mther for himMlf or any other person, any person willfully makes a false statement or representation, he shall be guilty of o misdemeanor.'-------------- ' ~ " --[' V" ... -------- ... WORKMEN'S COMPENSATION EOARP DISTRICT OFFICES----------------= A1MNY 12201--IMS North Bioadvmy. Far ail acddaaci fat tallowing nmiw Afeur, m-m, Dulchm, Earn, FnakUa, FulM, Cmn, Hamilton, Mrewfareary, Oran**, Fuaam, haria, Ulnar, Warns, Waihiafton. Suttop, SrJwnnady, 9cho> BINGHAMTON 13901--221 WhMb|Sbq some ` For all arrirfinti ta Wlowia* < Cowiaad, Delaware, Omyo, Schuyler, 1inties. SuSnaa, Tlofa, Tocopkire. : Iraoeie, Omutf, Chenango, .BUFFALO 14203--Staia OOMBriUeg. 125 Mria Street. For afl aeddnts in ; Outnii, Erie. Niamn- rounder Cattareugua, Chou* - HEMFSTEAD 11530--175 FuIm Arena. For all teddaat* Is fallowing comae*; Naatau, s-mqs NEW YORK CITY 10007--50 Park Fbct. For all aeddeaa ia feilowisc made*: Bronx, Kiagx, New York, Queen*/ Richmond, RnrHand, WcstehaMr. , '^ ROCHESTER 14414--111 Mata Street Wat For aQ aeddentr la fieiiewiat Monrea, Ontario, Oiioia, Sraaca, Wayne, Wyoming, Yarn*. . SYRACUSE 15202--State OHca loafing. Bart WreMagUa Street- For aB Hcrkiner, Jeffinon, Lewii, Madiaon, Oneida, Onondaga, Onrego, 5c Lav dar Allegany, Creme, Livingston, ia following nuatio: Cayuga,. .C--I* Reverse .(3-6?) ... ... .. . os7rr p>^ owo 2tlU QSO2 tu -to: oc (3 < CL Ul Hi P O zJ 2 Ie>S2o- a ooc a h. ui uoc 044817 PRIVILEGED AND "CONFIDENTIAL MATERIAL SUBJECT TO PROTECTIVE ORDER" ''arch 27, 1981 Dr. Joseph Rseeigno 46-27 Parsons Blvd. flushing, N.Y, Dear Dr. Readgoo: The following la the report of Che consultation of youC patient Joseph Sired: The patient Is s 36 year old right handed male who on 3/5/81 had upper respirator? Infection and then developed pain In thercheet, ana. shoulders end back and neck, lie also developed a headache on the right side of the head and thickness of hla speech. There wee also sons decreased sensation along the left lower Jaw and along the right sealp. There are no focal, motor or sensor? eonplalnts referable te the limbs. Manor? Is intact. Vision la normal. The patient had been running a low grade fever, but this has lnproved In the last da? or so. Host of the patient*s pain has disappeared except for the pain in the neck. He still has some thickness of speech and he also has some nuabneea as pre viously described. There Is s pest histor? of ulcer dlseaee. NEUROLOGIC EXAM: Mental status la intact. Cranl al nerves reveal that tha tongue la somewhat deviated to tha right and that alternating tongue movements are done poorly. Speech la slightly tht ck. There is decreased sensation In the submits 1 area on tha left elds There le also decreased sensation along the right portion of the head on the top. The patient has some tenderncee In tha mid-thoracic area and al ong the thorax. The remainder of the erenlal nerves vers within .normal limit s. Motor exam Including gait, strength and coordination was unremarkabla. Reflexes were active and equal. There Is no Bablnakl sign. There era no meningeal signs. An EEC was within normal limits. IMPRESSION: This patient appears to have multiple cranial nerve Involvement. This Is probably on an Inflatwrstory basis. The symptoms seas to be gradually Im proving. Under these circumstances, I would suggest observing him without medication. Steroids could be tried, but in view of the ulcer history and the Improvement, I think it wo^ld be vlee to defer using thee at tMe time. Thank you for the consultation. ROBERT D. KARtAN, M.D O I >5