Document 5k6qY8vE5poOmnVbyqg0jMbo5

ethyl corporation INTER-OFFICE CORRESPONDENCE to pr o m , SUBJECT Dr. Machie A. J. Baldwin Alleged Leaa Poisoning Case -- hr. addr ess addr ess dat e MewTorn Eastern Region March 20, jl9U7 Yie are attaching hereto the entire file on the above subject case, which includes the following - 1* Cover letter rrom Stu Forbes. 2. Attorney Penrose Hertaler*s letter of March 3.2, 191+7* 3c- Statement of Irwin J. Yoder, dated October 21, 191+6. 1+. The Reading Hospital Operative Record, signed by John Spannuth, dated July 26, 191+6. 5 The Bryn Mawr Hospital Clinical Laboratory Report. signed by Max H. Strumia, K.B., dated July 11, 19U6. 6. Letter to Penna. T. & F. Kut. Cas. Ins. Co., signed by C. C. Norton of Wilson Adjustment Bureau, dated February 28, 191+7 Very truly yours, AJB:G Ends . ETHYL CORPORATION INTER-OFFICE ___ CORRESPONDENCE iY m SATE.. TO'' Mr./M:. Thylor f r om ,S. Forbes su bjec t Alleged Lead Poisoning Case a ddr ess New York a ddr ess Philadelphia dat e March 17, 19-47 Attached herewith please find the file con- ' cerning an alleged lead poisoning case forwarded by Mr. Penrose Hertzler, attorney for the Pennsylvania T. & F. Mut. Cas. Ins. Co. This insurance company is handling a suit entered against the St. Johnls Cemetery n^Tn^onTr. aaiioc+.i An \irith the death of Mr. As you will recall I forwarded a preliminary letter on the above a few days ago. It was my thought that perhaps our Medical Department can be of some assistance to Mr. Hertzler. The case, in my opinion, is a little bit silly but nevertheless Attorney Hertzler will probably have to produce an expert opinion on the subject when the case is presented to the referee for hearing. Very truly yours c-y g tel S. FORBES SF:a VuduAiiiO ' PENROSE HERTZLER. E. MAC TROUTMAN LAV/ OFFICES 200 2IAHANTONGO STREET POTTSVILLE, PA. March 12, 1947 Stuart Forbes, Assistant Division Manager Ethyl Corporation : 123 South Broad Street Philadelphia 9, Pennsylvania Dear Mr. Forbes; xn re : '(Dec'd.) vs. St. J o h n 1s Cemetery Company, Inc. It was a pleasure to see you on Monday last in re the above. We are enclosing herewith copy of the statement of the co worker of the claimant's decedent, a copy of the operative find ings given by Dr. John Spannuth under date of July 26, 1946, a copy of the report of Dr. Strumia to Dr. Meharg of July 11, 1946 and a copy of the report of the investigator of February 28, 1947 for the reason that it incorporates the report of Dr. Reinhold and the further report on the condition of the claimant's decedent by Dr. Spannuth subsequent to his discharge from the hospital on June 12, 1946. We appreciate very much the courtesy you extended to us and for your statement that your company will be glad to cooperate and possibly can supply Dr. Kehoe as a witness for us in the event we are unable to rule out the use of Ethyl gasoline and, as we told you, at this date we are not prepared to do so because the operator of the local station sold both Atlantic White and Ethyl gasoline to the Cemetery Association, the latter presum ably for use in the truck operated by the claimant's decedent. PH;MAH Ends. Very truly yqurs, =/ J fi V October 21,* 1946 Irwin J. Yoder, 172 F. 3rd St., Hamburg, Fa., state I am 59 years of a^e, married ana employedby St. John's cemetery Co., Inc., Hamburg, la., since April 1-, It45, as an assistant caretaker, which consists ex' maintenance of tne four cemeteries they operate, which includes the j.reparation ox' .raves, etc. At time I started w ork tne san under whose RipectSon I wbrAidahfeb also preformed, the' same type of work, was '433'' State St., Hamburg, Fa. He then was evidently in a. gddd healthy '.coneitIpn,' ano he'made no complaints. Graves, were prepared by 'hand'. Sometime, in April 1946 we mowed the grass at the #1 c e m | j | y I CisinAg a. pcower moowweep.r!,, and We&idenhamm&r using a hand mower. ....... 'vdid!|this lit4 rtsiiing manner, it took about two or two ana'a half daysc to mow this.. Fight after this h!. started to complain about \feeling:Wfeak in :'legs., and sort of broken down. Sometime in June 1945 my'employer turned over to us for use a Power Operated Grave difetier,. which had several attachments with it for digging, cutting, t&aiikLrm ,, etc. This.is a one man operated machine, the powep being by gasoline, fuel, a low .rape of gasoline being used a s ,prescribed, it oeiha liiixeG with a portion of' oil. This _,ss<jjline used -was. a white in color, ,,bile tne fuel receptacle held about two quarts, only generally ere ...mart oj fuel was in ne receptacle at a time as not more than that .as nteasa for ti.e preparation of a grave. The spark to fire the one spark pluxgg was from a portable battery. The tool attached to this diggei vet eper xted by Compression. When a rave digging was to be prepared, tne sea and first a i r i n g s were by hand, one digger not being used until discing became more difficult. This digger is handled entirely by hand, .t first, and for a snort while operated it, wording himself, arc tnen we ootu operated it, toa etrier, we used the digger only for eduj-t size raves. This is termed a Barco Gas Hammer. An a cult O rove is op feet deep about 37 inches wide and 7 feet or better in length. Graves were prepared in the open, the only exception bein^ when one we aoner suen as rain or snow was falling when a tent cover was erected over one place where grave was being xrepared which had the sio.es and ends open. Tne high center was about six feet above surface era tee sices .about three or four off surface,. This use of cover was seldom. aid the laying out of grave digging plans. Yearly, there were an average of 50 graves all told, but how that was divided Leoween adults and smaller raves, I do not know, but adult^rsve^vvere in one majority. At any time that I used this digger with I felt no ill effects froomm, its use and at_nc time did V/eidennaffl^^maKe^ c empiaint of or show any ill effects, and I were the only employees out occasionally extra employees Ted temporarily to assist when we were extra busy. The preparation of an adult grave consumed an entire cay of eight hours > and sometimes an extra several ncui-s , especially if the grave was walled. Cur work ween is 5f days of 8 h r s . with the exception being when there are funerals on Saturday afternoons. Cn occasions several graves were prepared on successive c jS. From first time .Veicenhammer complained of physical difficulties., ne continued to complain occasionally and cut down on his activity but came cut to work regularly. He did not to me at any time indicate satenent oi rwin J. Yoder, continued difri cuit./ %as by naming any disease. The last time that " _ a s s i g n e d in urep^r-ing a grave when the asoline s-,j ses, tfO repaid the. grave of Lrs. Balthaser.,, b etween -Loth, 19e.6 t was shortly after that that1 nia net come out to. anymor:. I ;learned that he had''been STHIHimi oo a hospital in forepart of lay lt4p then returned to his home for a :h CX11 j-eriod, tha reahmitfec and died there the flatter part of July 1946. :.e.t.sonalli 1 .did hot anew inst What,,hie disease w a d . .X, :visited: once,, then at Hospital during his first stay there, but did to him s he was having a blood transfusion not discussing ive j re sc this uo L>ement of 4 panes and is it correct? /s/ Irwin J. Y o a e r KE 0016416 THE READING HOSPITAL / OPERATIVE RECORD I<ame s Code : freoperative diagnosis: Hyperhemolysis. Splenic anemia. Postoperative diagnosis: same. .. Surgeon: Dr. Rentsehler Anesthetist; Assistants; Dr. Rhodes} Dr. Matsko .-.nestnesia used: 'Cyclopropane, ether cocain, curare Dr. Woodbridge Time operation began; 5; 10 p.ii. Operation; Splenectomy Grc ss Patnological find ing s Hypertrophy of the spleen with hyperhemolysis and very marked secondary anemia. 0*.enative procedure and suture material used. _ .. left rectus incision was mace. The patient was in a very serious general condition with a hemoglobin a round 22% and the red blood count 'j around 10COG. There was marked pallar to all tne structures including | tne bowels. The gpleen was about the size of' a quart. The pedicle was ligated in four sections. It was attached posteriorly with small fibrillar acnesions but it was easily brought into the wound and above the surface of tne abdominal wall. Neither tne stomach nor the omentum nor the pancreas ; wat attached to tne spleen. Ligation of the pedicle was performed by the employment of sticn ties of chromic #1 catgut. There was no bleeding of any account. The blood that was visible was watery. There was a small accessory spleen about 1" in diameter. This was removed without a i n i c u i t y . The abdomen was closed in layers. Chromic ,,2 was used in the form of a running suture for the peritoneum. The fascia was closed with a running suture of chromic #1 catgut. Approximately 5 retention sutures | were employed. Bandage was applied. Patient had three pints of blood oh i tne table and lb000 cc. of normal saline - * Sponge.count: None Drains : None Signature of" operator; John Spannuth- H 0.016417 i *a Y ' j&x i... Strumia Director THE BEYH HtVvl HOSPITAL Clinical Laboratory Bryn hawr, Pa. July 11, 1946 B r . 0. neiiarg: leaning hospital ,,est Eeacir.& , Pa. He : H r . Bear Lector Meharg:- 0UtKKUK-,Hr. age 64, appears to have had no illnesses save typhoid, at tiie age cf six. He has been in excellent `Health until the present illness. His first admission to the hospital was on 5/7/46. At that time he had complained for three weeks of weakness and shortness of breath. Ten days before admis sion ne noticed jaundicej he had no weight loss. On admission in trie hospital he had jaundice and received eight transfusions. It was noted at one time that the urea nitrogen in the blood was *(j % and on .-aamiesion tile hemoglobin was 22>. The fragility of erythrccytre was decreased (began at .f> and w s complete at .wc) and the serum bilirubin was elevated, (2 mg. on one occasion). ;.e was Discharged on 6/15/ with a hemoglobin of 52/ and readmitted on tne 3rd with a similar complaint.- At. this time he had a serum bilirubin of 4 mg. and the red. cell fragility began at .5 and was c c n l e t e at .4. lie had a severe reaction to a transfusion and tne nemOolobin was lower after tne transfusion than before. This patient appears to nave taxen no medicine and has had no exposure to. c uemicais with tne possible exception of exposure to xScd. Tnis point is at least doubtful. Exposure to-'gasoline fumes in the open aoes not appear to be sufficient to cause lead poisoning. ..cwever, tne report of Dr. Eeinhold on the blood lead content, will clear this point. With these findings and an enlarged spleen, the aia^nosis of hemolytic anemia I feel is justified. I feel that it will be most essential to give this patient only Eh compatible blood and I would therefore immediately type this patient as well as the prospective donors. I would also recommend that in view of the fact that this patient has great tendency to hemolysis and that since you use plain citrate as preservative, I reccmnenc that you use only blood stored for not more than 48 hours. I wish also to recommend that a biological test be carried out befor *-ach transfusion. For this purpose give the patient about 100 cc. o blood, ana go a serum bilirubin immediately before and three hours after transfusion. If there is no sharp increase in the serum bilirubin level, you may give the rest of the blood slowly. CD<V Kk 001641-8 ,iy. 1%, 19A6 ` ^5.---_6 TM* The kidney function of this patient should be carefully studied since there is a s ood possibility of damage from previous nemolytis crisis. A splenectomy, I believe, is advisable since it is the only way we know to cneck hypernemclysis. The patient's serum bilirubin and urobilin should bd checked daily. Almost invariably a spontaneous remission occurs when the serum bilirubin drops to normal or near normal and the urobilin excretion greatly diminishes. At this time the patient should be transfused every day and when the hemoglobin is IS gm. or better, proceed with the -splenectomy. herewith enclosed please find report of t he differential blood count. The reticulocyte preparation was not satisfactory but the reticulocytes appear to be greatly increased. I will appreciate very much if you keep me acquainted with the ccirse of this patient. '.vith best regards and thanks for tne opportunity bo see this interesting case, I am . Very sincerely yours, . Max .... Struaiia, M.B. S/ mb enc. Kf 0016419 \ COPY Reading j henna* February 28, 1947 renna. T. pc F* mut. Css* Ins Co 325-333 South 18th Street - Harrisburg, Pennsylvania Gentlemen. EEs Claim #148030 - d/a ?/46 VS. St. John's Cemetery Co. Cur file #17145 Referring to Attorney Hertzler's letter of October 14, 1946, aodressedito your hr. Foor, be advised that we believe we have covere'a all the suggestions as concerns the investigation of this matter. In regard to Doctor Spannuth and Doctor J. G. Meharg, we feel that both of these doctors were more or less giving us the "brush off" at various times when we called on them. However, we have finally been successful in having a snort discussion with Doctor J. G. Heh&rg, Hamburg, Pennsylvania. Doctor lieharg stated that he was summoned to the home of this claimant on February 4, 1946, and his professional opinion was that "the claimant wa`s suffering with an apparently bad case of anemia. The doctor confessed that the beiden- hammer family is Known in their community as. being a "peculiar" type of family. He states that they were on-the "tight" side as far as finances are concerned. The doctor was of the opinion that this was a case beyond his, han d l i n g and since he realized the peculiarities of the family, and did not want them to condemn him at a later c a p x o n m t he termed "the lack of professional ability," he persuaded them to allow the claimant to be admitted to the Heading Hospital. ,At this time, the Doctor called Doctor Spannuth into consultation.. The file will show that the claimant was discharged from the Hospital, and then later he was readmitted. At the time of this last readmittance to the Hospital, the claimant's spleen was removed, and following this, the.claimant died. Doctor lieharg states that he did not even have the thought that this claimant suffered from lead poisoning. He states that Doctors Strumia and Spannuth, the former of the Bryn Mawr Laboratory, discovered the presence of lead. A Doctor John Q. Reinhold, of the Philadelphia General Hospital, Philadelphia, Pennsylvania; was also in on this latter procedure. Doctor Iweharg states that the only history he could obtain as concerns this claimant being in contact with lead, had to do with the claimant using the grave digger, which digger was operated by gasoline. He states that all further questioning brought k z oo 1 6 o % >. THKHSHERMEH .Liil 7rla8bbG St. John' s Cemetery Co Page 2 February 28, '47 no -evidence of lead poisoning being connected with the claimant's private life* Uiei; w informed the doctor of the fact that the fuel used in the .rave digger was a /white .gas," which contained no lean, it was quite apparent that he was^considerably flabbergasted. ,, e q u e s t i o n e d 'Doctor Hehaig concerning doctor Strumia's report of the difxerential blood count, and tne doctor stated that_he was of the opinion that this report. was part of the Hospital's riecords. ^ Doctor ...enarg tnen showed us two papers he had, which he permitted us to copy. Cne was from Doctor Heinhold, Ph.D, and was on stationery of. the Philadelphia1,Generai .Hospital,: Philadelphia,! Pennsylvania. This report was* not oated, but did contain trie following information: "I found 0.087 mg. per. liter of urine (as. lead) This is a high normal of slightly high figure depending upon the output of urine during the 24 hour period in question. Since it represents a single determination, no conclusive significance cap. be assigned to it." /s/j.G. Heinhold, Ph.D It is Doctor keharg's opinion that this report was made on the basis of urine which was furnished to Doctor Heinhold, during the claimant's secona stay at the Hospital. .s concerns Doctor Spannuth. VJe realize your need of information from, this doctor, and we can assure you that we telephoned this aocxor's office many times and a Iso maae several personal visits at nis office. V/e could never get any further than speaking to iiis nurse, wpo also acts as his secretary.. We realize the fact that, tnis dodtor is a very busy man, and all of his work is done oy appointment only. However, we feel that the doctor considers hii-.seIf so important, that an investigator, in his opinion, is notniug but a nuisance. V/e have sat in the doctor's office many times for more than an hour at a time, in hopes of gaining an interview with the doctor through his nurse. However, we have never been successful in having an interview. VJe even had, his nurse ask him when it would be a good time to see him. VJe told the nurse that we would be willing.to call on the doctor at any time that would, be convenient to him, either morning, afternoon, or ni^ht. itili we have not had his cooperation, it one time, the nurse was told by the doctor to inform us that "all the records speaiv for tnemselves." he informed the nurse that there were several other matters that we would line to discuss with the doctor regarding this case, which matters were not discussed in the records. On one or two occasions, this doctor half-heartedly made appointments, and when we attempted to Keep them, the doctor always found himself unable to keep the appointment. \ Since tne recent correspondence indicates, that the referee's hearing is drawing near, we have still continued in an effort to have a f , THRS-SHMEMEN rai :1480oQ discussion with this doctor. Tout up to the present writing) we have not been aole to interview him. le will continue with him. Frankly? if we do not accomplish our mission shortly? it would aopear to us that an interview' with this doctor is practically out of the question. It would then appear to us that some unusual strategy would have to be followed in an effort to\sea him. We know- ftyli well, that if we ever would _ be able to talk with him, that we would never be able to obtain a statement from him. . As concerns Doctor Strumia's report of the differential blood count and all tne laboratory findings on this claimant? be aavised that: we have requested the Record Librarian, to furnish us with this information?.- but in this matter, we have had no cooperation. The claimant's widow gave us written.permission uo obtain such information. For your information, we endeavored to cpntaet both the hospital record librarian ana Doctor Spannuth on February 27, 1947, but as stated before, we- were hot successful. ' _ As concerns nr. Poor's letter of February 21, to which was attached a copy of Attorney Hertzler's letter addressed to q;r. poor under date af February 17,'1947, be advised that hr. Yoder, who worked with the deceased., stated that to his oest knowledge, only white gas was used at all times, hr. Yoder states he never filled the fuel compartment, but he was sure chat colored gasoline was never used, since the insured was instructed never to use anything but white gas when operating the rave digger. In this respect,' we refer you to our report in which we stated that we called at the gasoline station where all of the gas that was used by tne insured wias purchased. We indicated in our report that this station informed us that he only gas taken away from the station in containers, was the white gas, which was supposed to contain no lead. The other type of gas sold to the insured was Atlantic White Flash, which gas was put into the insured's truck. ` Mr. Zettlemoyer of the insured, while checking through his records, found that Mrs. Balthaser died on April 11, 1846? and was buried on April 16? 1946.' While there is no record as to the exact date that her grave was prepared, it naturally would have been between those two dates. Mr. Zettle.moyer states that ne does not believe this grave would have been prepared on the date of this lady's death, and surely it would not have been prepared on the. date that she was buried. He states that most likely the grave was prepared on April 15, which day was a Monday, and which was a day and a half prior to the burial. K E 001642.2 A'* TKHSSHERI.SN 148030 St. Jo h n 1s;Cemetery Co Page 4 . February 28} ' As conceivis the third paragraph of Attorney IPefitzler's letter, we are, assuming tint someone representing your Company in PnilaGlpiiia, Pennsylvania, is obtaining tae information, as covers Doctor Strumia anl Doctor Heinhold. In answer to fixe ih&qiy aspio wxisther the', patient was. sent to Doctor Strumia, or Doctor Heinhold, be advised that we ane confident that the claimant's Specimens'only were sent to the dbctors. We are attempting to discover what type of vessel was used to send txafese'specimens ind we are attempting- to do this in such a wsy whicn will not be a lead to the other side.-- Ve assure you that we are truly putting forward our best efforts to get- the information-which you are requesting tnrcugh Attorney hertz 1er. Cne of our representatives will be in Pottsville,: Pennsylvania, during the week of iarch S, 1947, and if by that time, we- nave not developed all the information that vie are after, we will have a conference with Attorney hertzier, and possibly by this conference, we will work out some means wnereby these loose ends can be gathered together, so that everything will be in shape for the referee's hearing. ' ne report which Doctor Meharg had in his possession which was from Doctor Spannuth and which was not dated, concerned the claimant after he was discharged from the Hospital following his first visit, ine claimant was first discharged on June 12, 1946. We .quote this report: "Has improved nicely since administration of cal cium glucovate and hematimic agents. Calcium given on basis of suspected lead poisoning (used a hammer in his work powered'by gasoline). Had a transfusion on June 8, 1946. Blood count on June 1G showed 56 Kbg. d 8.25 r b c - getting- calcium glucovate gr. XXX t i d and ferrous sulphate gr. 3 t i b. Believe calcium admini stration can be stopped if milk - 1 qt. daily is used for a time." . . . /s/Spannuth he shall keep you advised of all developments as they occur. Very truly yours, . v/ILSoH ADJDdTivSHT BJPJiAU C. C. Norton CDS/hep ce; Attorney'Penrose Hertzier , K 0016423