Document 71eM3d1aRE1XrRQ3myjQ9kEyj
MR . VA SSALOTT I
10
1 ONCOLOGY.
2 Q.
WHEN AND FROM WHAT SCHOOL DID YOU*
3 RECEIVE YOUR MEDICAL DOCTOR DEGREE?
4 A.
JEFFERSON -- THOMAS JEFFERSON
5 UNIVERSITY MEDICAL COLLEGE 1967.
6 Q.
IS THAT IN PHILADELPHIA,
K)0
7 PENNSYLVANIA?
8 A.
YES .
!
9 Q.
UPON COMPLETION OF YOUR MEDICAL
10 SCHOOL TRAINING, DID YOU SERVE AN INTERNSHIP?
11 A.
YES, I D I D .
12 Q.
WHERE DID YOU SERVE YOUR INTERNSHIP?
13 A. 14 Q.
PHILADELPHIA GENERAL HOSPITAL. AND HOW LONG DID YOU SERVE THAT?
15 A.
ONE YEAR.
16 Q.
AND COULD YOU DESCRIBE BRIEFLY THE
17 DUTIES THAT YOU HAD DURING YOUR INTERNSHIP?. .
18 A.
I'D BE RESPONSIBLE FOR THE CARE OF
19 MEDICAL IN PATIENTS AND OUT PATIENTS.
20 Q.
IN GENERAL MEDICINE?
21 A. 22 Q.
YES. UPON COMPLETION OF YOURINTERNSHIP,
23 DID YOU SERVE A RESIDENCY?
24 A.
YES, I DID.
25 Q.
WHAT IS A RESIDENCY? WHAT DOES THAT
5
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MR. VASSALOTTI
11
1 MEAN?
2 A.
WHEN ONE GRADUATES FROM MEDICAL
3 SCHOOL, ONE BECOMES -- IS REQUIRED TO SERVE 4 ONE YEAR AS A PHYSICIAN IN A HOSPITAL SETTING
5 AND THEN ONE GETS A LICENSE TO PRACTICE
6 MEDICINE. DURING INTERNSHIP, UNDER IMMEDIATE
7 SUPERVISION. A RESIDENT IS A FURTHER TRAINING
8 IN WHATEVER F. I ELD IS DESIRED.
9 Q.
SO IT'S FURTHER TRAINING IN A
10 SPEC I AL I ZED FIELD?
11 A.
YES .
12 Q.
WHERE DID YOU SERVE YOUR RESIDENCY?
13 A. 14 Q.
THOMAS JEFFERSON UNIVERSITY HOSPITAL. AND HOW LONG WAS THAT RESIDENCY?
15 A. 16 Q.
IT WAS TWO YEARS. AND WHAT FIELD OR AREA OF MEDICINE
17 DID YOU SPECIALIZE IN IN YOUR RESIDENCY AT
18 JEFFERSON ?
19 A.
INTERNAL MEDICINE, WHICH IS THE NONE
20 SURGICAL TREATMENT OF ADULTS.
21 Q.
IT IS INTERNAL ORGANS OF THE BODY?
22 A.
YES.
23 Q.
AFTER THE COMPLETION OF YOUR
24 RESIDENCY, DID YOU SERVE ANY ADDITIONAL
25 RESIDENCY OR FELLOWSHIPS TO FURTHER
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MR. VASSALOTTI
12
1 SPEC I ALI ZED
2 A.
I WAS A MEDICAL ONCOLOGIC FELLOW,
3 WHICH IS A SUBSPECIALTY OF MEDICINE.
4 Q.
WHERE DID YOU SERVE THIS FELLOWSHIP?
5 A.
I SERVED O.NE YEAR AT JEFFERSON
6 UNIVERSITY HOSPITAL AND ONE YEAR AT AMERICAN
7 ONCOLOGIC HOSPITAL, BOTH IN PHILADELPHIA.
8 Q.
NOW, UPON COMPLETION OF YOUR
9 FELLOWSHIP, DID YOU BEGIN TO WORK IN THE 10 PRIVATE PRACTICE OF MEDICINE?
11 A.
YES, I DID .
12 Q .
IS THERE ANY PART ICULAR AREA OF
13 MEDICINE THAT
IN WHICH YOU RESTRICT YOUR
14 PRACTICE OR SPECIALIZE IN?
15 A. 16 Q.-.
MEDICAL ONCOLOGY. CAN YOU DESCRIBE FOR USWHAT
17 ONCOLOGY IS AND WHAT AN ONCOLOGI ST DOES ? .
18 A.
IT COMES IN A GREEK WORD MEANING
19 CANCER, GROWTHS, AND IT HAS TO DO WITH THE 20 DIAGNOSIS, TREATMENT, PREVENTION OF CANCER.
21 Q.
DOES ONCOLOGY --DO YOU
AS AN
22 ONCOLOGIST ALSO CONCERN YOURSELVES WITH THE
23 CAUSES OF CANCER AND THE GROWTHS OF CANCEROUS
24 TUMORS?
25 A.
YES .
21110003
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13
1 Q.
IS ONCOLOGY AN AREA OF MEDICINE THAT
2 IS RECOGNIZED AS AN AREA SPECIALIZATION 8 Y
3 ANY BOARD OR ORGANIZATION?
4 A.
YES.
5 Q. 6 A.
HAVE YOU BEEN CERTIFIED BY YES.
7 Q.
BY SUCH BOARD OR ORGANIZATION?
8 WHAT IS THAT BOARD THAT
9 CERTIFIES SPECIALIST IN ONCOLOGY?
10 A.
IT'S A SUBSPECIALTY OF INTERNAL
11 MEDICINES, SO THE CERTIFIER IS THE AMERICAN
12 BOARDS OF INTERNAL MEDICINE.
13 Q. 14 A.
AND WHAT HAVE YOU BEEN CERTIFIED AS? FIRST I WAS CERTIFIED IN INTERNAL
15 MEDICINE IN 1972 AND I WAS THEN CERTIFIED IN
16 MEDICAL ONCOLOGY IN 1977.
17 Q.
WERE THERE ANY REQUIREMENTS TO
18 OBTAIN THIS CERTIFICATIONS THAT YOU RECEIVED
19 FROM THAT BOARD?
20 A.
ONE HAS TO BE RECOMMENDED BY THE
21 HEAD OF THE TRAINING PROGRAM AND ONE HAS TO
22 PASS AN EXAMINATION.
23 Q.
DOCTOR, WITH WHAT HOSPITALS ARE YOU
24 PRESENTLY ASSOCIATED?
25 A.
CURRENTLY I'M WITH FOUR HOSPITALS:
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MR. VASSALOTTI
14
1 THOMAS JEFFERSON UNIVERSITY HOSPITAL, 2 METHODIST HOSPITAL, NAZARETH HOSPITAL, ALL IN
3 PHILADELPHIA AND OUR LADY OF LOURDES HOSPITAL 4 IN CAMDEN, NEW JERSEY.
5 Q.
WHAT IS YOUR POSITION AT THE
6 JEFFERSON HOSPITAL?
7 A.
I'M AN ATTENDING PHYSICIAN IN THE
8 HOSPITAL AND I'M ASSISTANTS PROFESSOR OF
9 MEDICINE IN THE MEDICAL SCHOOL.
10 Q.
SO, YOU TEACH, IN ADDITION TO YOUR
11 MEDICAL PRACTICE, YOU TEACH AT THE MEDICAL
12 SCHOOL?
13 A. 14 Q.
YES . AT JEFFERSON?
15 A .
YES .
16 Q.
WHAT IS YOUR -- WHAT DO YOU TEACH
17 OVER AT THE MEDICAL SCHOOL, WHAT AREAS OF
18 MEDICINE?
19 A.
INTERNAL MEDICINE AND MEDICAL
20 ONCOLOGY.
21 Q. 22 A.
WHO DO YOU TEACH? MEDICAL STUDENTS, RESIDENTS.
23 Q.
MEDICAL STUDENTS AND RESIDENTS?
24 A.
RIGHT.
25 Q-
DOCTOR, HAVE YOU WRITTEN ANY
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MR. VASSALOTTt
15
1 ARTICLES THAT HAVE BEEN PU3L 1 SHED IN ANY
2 MEDICAL OR SCIENTIFIC JOURNALS?
3 A.
YES, I HAVE.
4 Q.
APPROXIMATELY HOW MANY ARTICLES HAVE
5 YOU WRITTEN OR PUBLISHED?
6 A.
SEVENTEEN ARTICLES AND TWO CHAPTERS
7 I N BOOKS.
8 Q.
AND GENERALLY, WHAT OF THESE
9 ARTICLES AND CHAPTERS IN THE BOOKS DEALT WITH?
10 A.
MAJOR EMPHASIS HAS BEEN ON
11 IMMUNOTHERAPY OF MALIGNANCY.
12 Q.
THAT'S THE TREATMENTS OF CANCER?
13 A.
TREATMENT OF CANCER.
14 Q.
IN ADDITION TO THE DUTIES THAT
IS YOU'VE JUST DESCRIBED TO US, DO YOU ALSO 16 ENGAGE IN AT ANY TIME AS A CONSULTANT FOR ANY
.17 OUTSIDE AGENCIES?
' v -
'-
18 A.
WELL, NOT -- NOT USUAL USUALLY.
19 I'M A PARTICIPANT IN A CANCER RESEARCH GROUP, 20 BUT IT'S NOT A CONSULTANT, I DON'T THINK.
21 Q.
NOW, DOCTOR, IS IT TRUE THAT
I'VE
22 ADVISED THAT OUR OFFICE WILL BE PAYING YOU
23 FOR THE TIME YOU'RE USING TO TESTIFY IN THIS
24 MATTER ?
25 A.
YES .
21110006
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IB
1 Q.
DOCTOR, WHEN DID YOU FIRST COME TO
2 TREAT MR. JOHN GRASSO? I'M SORRY, DOCTOR.
3 BEFORE WE GET INTO THAT, YOUR HONOR, I'D LIKE 4 TO MOVE INTO EVIDENCE AS PLAINTIFF'S EXHIBIT
5 TEN THE RECORDS OF FOUR HOSPITALIZATIONS OF
6 MR. GRASSO AT THE JEFFERSON HOSPITAL, THE
7 FIRST HOSPITALIZATION PERIOD BEING JUNE 15, 8 1975 THROUGH JUNE 30, 1975; THE SECOND
9 HOSPITALIZATION BEING JULY 28, 1976 THROUGH
10 AUGUST 21, 1976; THE THIRD HOSPITALIZATION
11 BEING DECEMBER 23, 1976 TO DECEMBER 24, 1976;
12 AND THE FINAL HOSPITALIZATION BEING DECEMBER
13 29 -- DECEMBER 29, 1976 TO JANUARY 8, 1977. 14 THE COURT: THEY'RE ALL
15 MARKED AS ONE EXHIBIT.
16 MR. VASSALOTTI: THEY'RE
17 ALTOGETHER AND TABULATED AND I' BELIEVE MR.
18 RENNEISEN HAS NO OBJECTION TO THIS.
19 THE COURT: ARE THEY
20 PREMARKED.
21 MR. VASSALOTTI: THEY'RE
22 PREMARKED . 23 MR. RENNEISEN: YOUR HONOR, I 24 HAVE AGREED ALL ALONG THAT I WOULD NOT
25 REQUIRE THE CUSTODIAN TO BE CALLED TO
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MR. VASSALOTTl
17
1 AUTHENTICATE THEM. I THINK THAT THE DOCTOR
2 CAN REFER TO THEM AND, THEY WOULD BE
3 ADMISSIBLE OTHERWISE^ I'M NOT AGREEING ON THE 4 ADMISSIBILITY TO THE. ENTIRE RECORD.
5 THE COURT: LET'S HAVE THEM 6 MARKED FOR IDENTIFICATION AND THE DOCTOR MAY
7 REFER TO THEM. 8 MR. VASSALOTTl: IT'S BEEN 9 PREMARKED YOUR HONOR AS PLAINTIFF'S EXHIBIT 10 TEN .
11 CAT WHICH TIME THE AFOREMENTIONED EXHIBITS
12 WERE MARKED FOR IDENTIFICATION. )
13 BY MR . VASSALOTT I :
14 Q.
NOW, DOCTOR, DID THERE COME A TIME
15 HAD YOU TREATED A MR. JOHN GRASSO?
16 A.
YES.
17 Q. 18 HIM?
DO YOU RECALL WHEN YOU FIRST TREATED
19 A.
REFERRING TO THE RECORD, IT WAS
20 AUGUST 6, 1976.
21 Q. 22 A.
AND WHERE WAS THAT? THOMAS JEFFERSON UNIVERSITY HOSPITAL.
23 Q.
AND DID YOU EXAMINE HIM AT THAT TIME?
24 A.
YES.
25 Q.
AND WHAT WERE HIS PHYSICAL
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MR. VASSALOTTI
13
1 COMPLAINTS WHEN YOU FIRST SAW HIM AT THAT
2 TIME?
3 A.
H E HAD COUGHED UP BLOOD, PAIN I N H I S
4 ABDOMEN, FEVER.
5 Q.
D I D YOU INQUIRE AS TO WHETHER HE HAD
6 BEEN AT THE JEFFERSON HOSPITAL BEFORE THE
7 TIME THAT YOU
THE HOSPITALIZATION WHEN
8 YOU FIRST TREATED HIM?
9 A.
I WAS AWARE, YES.
10 Q.
DID YOU REVIEW THE RECORDS OF THAT
11 PREVIOUS HOSPITALIZATION WHEN YOU WERE CALLED
12 IN TO SEE MR. GRASSO?
13 A .
I DID.
14 Q.
NOW, DOCTOR, YOU'VE JUST BEEN HANDED
15 THE MEDICAL RECORDS FOR THE HOSPITALIZATIONS.
16 THOSE RECORDS INDICATE THAT MR. GRASSO WAS
17 FIRST HOSPITALIZED AT JEFFERSON IN JUNE OF
18 1 9 7 6 .
19 FROM YOUR REVIEW OF THOSE 20 RECORDS, CAN YOU TELL US WHAT MR. GRASSO'S
21 PHYSICAL COMPLAINTS WERE WHEN HE WAS TREATED
22 DURING THAT FIRST HOSPITALIZATI ON?
23 A.
HE COUGHED UP BLOOD.
24 Q.
AND WHAT TESTS OR TREATMENT WAS
25 UNDERTAKEN DURING THAT FIRST HOSPITALIZATION
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- LAUCIUS - MR. VASSALOTT1
19
1 OF MR. GRA5SO TO DETERMINE WHAT MIGHT RE
2 CAUSING HIS PROBLEM?
3 A.
WELL, HE HAD A CHEST -- CHEST
4 X-RAY; HE HAD BRONCHOSCOPY, WHERE ONE LOOKS
5 INTO THE LUNG, THE BRONCHI TO SEE WHETHER 6 THEY WOULD FIND A TUMOR. THEY DIDN'T. AND HE
7 WAS DISCHARGED WITH A DIAGNOSIS OF
8 HEMOPHTHISIS, WHICH IS A COMPLAINT,
9 BRONCHIECTASIS AND POSSIBLE
10 Q.
EXCUSE ME, WHAT IS HAD I MONTHS /TEU
11 CYST?
12 A.
CAUGHING UP BLOOD.
13 Q. 14 A.
AND WHAT WERE THE OTHER AND POSSIBLE AS8ESTOSIS.
15 Q.
WAS THERE ANY DIAGNOSE MADE OF WHAT
16 MR. GRASSO'S CONDITION WAS AT THAT TIME?
17 A. ' . . ' NO. THERE WERE LABORATORY TESTS THAT
18 WERE ABNORMAL. BUT A CLEAR CONCLUSIVE
19 DIAGNOSIS WAS NOT REACHED.
20 Q.
WERE ANY TESTS OF THE LIVER DONE
21 DURING THAT FIRST HOSPITALIZATION?
22 A.
HE HAD ON PHYSICAL EXAMINATION, HIS
23 LIVER WAS OF NORMAL SIZE. LIVER ENZYMES WERE
24 PERFORMED AND ONE OF THEM WAS ABNORMAL.
25 Q.
WHILE YOU THERE THERE WAS NO
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MR. VASSALOTTI
20
1 DIAGNOSIS AT ANY -- OF ANY SPECIFIC
2 CONDITION AFTER THAT FIRST HOSPITALIZATION?
3 A.
NO.
4 Q.
WHEN WAS HE DISCHARGED FROM
5 JEFFERSON THAT FIRST TIME?
6 A.
JUNE 30, 1 9 7 6 .
7 Q.
AND THEREAFTER, WAS HE
8 REHOSPITALIZED AT THE JEFFERSON HOSPITAL?
9 A.
YES.
10 Q.
WHEN WAS THAT?
11 A.
JULY 28, 1976.
12 Q.
THAT WAS THE HOSPITALIZATION WHEN
13 YOU FIRST CAME TO TREAT MR. GRASSO; IS THAT
14 CORRECT?
15 A. 16 Q .___
YES. WHAT WAS HIS CONDITION UPON
17 ADMISSION TO JEFFERSON HOSPITAL. THE SECOND ' 18 TIME?
19 A.
THIS TIME, HE HAD RIGHT UPPER
20 QUADRANT PAIN, THAT'S IN THE ABDOMEN, COUGHED
21 UP BLOOD, FEVER.
22 Q.
WERE ANY TESTS CONDUCTED ON MR.
23 GRASSO DURING THE SECOND HOSPITALIZATION IN
24 AN ATTEMPTS TO DETERMINE
25 A.
YES.
21110011
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MR. VASSALOTTI
21
1 Q. 2 A.
-- WHAT CAUSED HIS PROBLEMS? YES.
3 Q.
CAN YOU GIVE ME A DESCRIPTION OF
4 SOME OF THE TESTS THAT WERE ADMINISTERED TO
5 HIM?
6 A.
WELL, A PHYSICAL EXAMINATION
`
7 REMEMBER SEALED HE HAD A.LARGE LIVER,.A MASS.
8 Q.
YOU MENTIONED IN THE FIRST
9 HOSPITALIZATION THE PHYSICAL EXAMINATION DID
10 NOT REVEAL A ENLARGED LIVER?
11 A
YES.
12 Q.
AND THE SECOND HOSPITALIZATION DID
13 REVEAL AN ENLARGED LIVER?
14 A .
YES .
15 Q. 16 DONE?
WHAT OTHER FINDINGS OR TESTS WERE
17 A.
A LIVER SCAN WAS ABNORMAL. IT WAS
18 CONSISTENT WITH METASTATIC DISEASE, OR CANCER.
19 BRONCHOSCOPY WAS REPEATED WHICH SHOWED HE HAD 20 DIFFUSE PULMONARY BLEEDING. CHEST X-RAY NOW
21 SHOWED TUMOR NODULES.
22 Q.
IN THE LUNG?
23 A.
IN THE LUNGS .
24 Q.
THEY WEREN'T PRESENT BEFORE IN THE
M
25 X-RAY ?
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MR. VASSALOTTI
22
1 A. 2 Q.-
NO, THEY WERE NOT. THOSE TUMOR MODULES DID NOT SHOW IN
3 THE X-RAYS IN THE FIRST HOSPITALIZATION?
4 A.
THAT'S CORRECT. THELIVER BIOPSY
5 WAS PERFORMED.
6 Q.
WHAT IS A BIOPSY?
. 7 A.
WELL, BIOPSY IS TAKING ASAMPLE OF
8 SOMETHING. IT'S USUALLY SURGICAL.
9 Q.
WAS A SURGICAL BIOPSY DONE WITH MR.
10 GRASSO OR WAS IT DONE 8Y ANOTHER MEANS?
11 A.
IT WAS DONE BY A NEEDLE.
12 Q.
HOW IS THAT ACCOMPLISHED?
13 A.
ONE PUTS IN A LOCAL ANESTHETIC AND
14 PUTS A NEEDLE , WHICH HAS A HOLLOW CORE, AND
15 ONE STICKS IT IN AND TAKES -- SUCKS OUT A 16 PIECE OF LIVER FOR MICROSCOPIC EXAMINATION.
17 Q.
AND AS A RESULT OF THE NEEDLE BIOPSY
18 THAT WAS DONE ON MR. GRASSO, WAS A DIAGNOSIS
19 OF HIS ILLNESS MADE?
20 A.
YES.
21 Q.
WHAT WAS THATDIAGNOSIS?
22 A.
ANGIOSARCOMA.
23 Q.
WAS THE ANGIOSARCOMA LOCATED IN ANY
24 PARTICULAR PLACE?
25 A
IT WAS IN HIS LIVER
**
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- LAUCIUS - MR. VASSALOTTI
23
1 Q.
WHAT IS ANGIOSARCOMA OF THE LIVER,
2 CAN YOU TELL US?
3 A.
IT'S A SMALL -- AN GI 0 MEANS BLOOD
4 vessel. Sarcoma means malignancy deriveo from
5 MESOTHELIUM; CARCINOMA AND SARCOMA ARE THE
6 TWO MALIGNANTS TUMORS IN HUMANS. COMA COMES
7 FROM SURFACE OF ORGANS, LIKE THE SKIN. 8 SARCOMAS ARE SOLID ORGANISMS LIKE BONE, ' 9 MUSCLE, BLOOD VESSELS. ANGIOSARCOMA IS 10 DERIVED FROM BLOOD VESSELS.
11 Q.
AND HIS CANCER APPARENTLY DEVELOPED
12 IN THE LIVER?
13 A . 14 Q.
YES. WHEN YOU WERE CALLED IN TO SEE MR.
15 GRASSO, DID YOU PROVIDE ANY COURSE OF 16 TREATMENT FOR HIS CANCER?
17 A.
YES, I DID.
18 Q.
BEFORE WE GET TO THAT, IS
19 ANGIOSARCOMA OF THE LIVER A TYPE OF CANCER
20 WHICH CAN BE CURED UNDER KNOWN MEDICAL
21 METHODS?
22 A.
ALMOST ALWAYS WHEN THEY OCCUR IN THE
23 LIVER, THERE INOPERABLE. ONE CAN'T REMOVE THE
24 ENTIRE LIVER. IN OTHER SITES, WHICH ARE RARE,
25 THEY CAN BE SURGICALLY REMOVED AND ARE
frT O G T T T g
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MR. VASSALOTTI
24
1 CURABLE. HIS SITUATION WAS NOT A CURABLE
2 S I TUAT I ON.
3 Q.
DID YOU TELL MR. GRASSO ABOUT THE
4 SEVERITY OF HIS DISEASE?
5 A.
YES .
6 Q.
DID YOU TELL HIM THAT HIS CONDITION
7 WAS TERMINAL?
8 A.
I TOLD HIM IT WAS POTENTIALLY FATAL.
9 Q. 10 THAT?
AND DO YOU RECALL WHEN YOU TOLD HIM
11 A .
I BELIEVE I TOLD HIM DURING THIS
12 HOSPITALIZATION WHERE I FIRST SAW HIM.
13 Q.
WHAT WAS -- WHAT WAS MR. GRASSO'S
14 CONDITION, PHYSICAL CONDITION, AS HE
15 PROGRESSED THROUGH THAT SECOND 16 HOSPITALIZATION AT THE END OF AUGUST OF 1975?
17 A.
WELL, HE HAD -- HIS MAJOR SYMPTOMS
18 WERE PAIN IN HIS LIVER, COUGHING UP BLOOD,
19 FEAR .
20 Q.
YOU SAY FEAR?
21 A.
OF DYING; AND ANGER THAT HE WAS
22 DYING.
23 Q. 24 A.
DID HE EXPRESS THOSE FEELINGS TO YOU? YYpES- .
N^
25 Q.
NOW, YOU MENTIONED THAT YOU STARTED
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25
1 A COURSE OF TREATMENT FOR MR. GRASSO'S
2 ANGIOSARCOMA OF THE LIVER.
3 CAN YOU DESCRIBE WHAT TYPE OF
4 TREATMENT YOU ADMINISTERED TO HIM?
5 A. .
YES. BASIC --
6 Q.
WHAT -- I'M SORRY, GO AHEAD.
7 A.
BASICALLY, WHEN HE WAS DIAGNOSIED,
8 WE HAD LIMITED ABILITY TO USE OF ACTIVE
9 CHEMOTHERAPEUTIC AGENTS. AND HE WAS INVOLVED 10 IN A STUDY THAT COMPARED GIVING ADRIAMYCIN OR
11 WHICH IS A CHEMOTHERAPEUTIC AGENT VERSUS
12 CYTOXAN, VINCRISTIN AND ACTINOMYCIN D.
13 Q.
ARE THESE DRUGS ALL KNOWN AS
14 CHEMOTHERAPEUTIC DRUGS?
15 A. 16 Q.
YES. WHAT IS CHEMOTHERAPY, HOW DOES IT
17 WORK AGAINST CANCER? '
18 A.
WELL, SOME CASES, WE DON'T KNOW WHY.
19 SOME SPECIFIC DRUGS DO. BUT IN GENERAL, IT'S
20 DESIGNED TO KILL GROWING CELLS AND HOPEFULLY
21 GET A PREFERENTIAL EFFECT OVER THE CELLS THAT
22 ARE MALIGNANT THAT ARE GROWING VERSUS THE
23 .NORMAL CELLS THAT ARE GROWING IN THE BODY
24 THAT ARE NORMALLY REQUIRED FOR SURVIVAL.
25 Q.
SO, THE CHEMOTHERAPEUTIC AGENTS HAVE
21110016
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25
1 ANY EFFECTS ON OTHER PARTS OF THE PATIENTS
2 BODY IN ADDITION TO THE CANCEROUS TUMORS?
3 A.
YES.
4 Q-
WHAT TYPE OF EFFECTS DOES THE
Y\5 CHEMOTHERAPY^HAVE ON THE REST OF THE PATIENTS
6 BODY? WHAT ARE THE SIDE EFFECTS? '
7 A.
WELL,\THE MOST SERIOUS MEDICAL SIDE
8 EFFECTS ARE SIDE EFFECTS UPON GROWING CELLS
\9 THAT ARE NORMALLY REQUIRED. AND THE GROWING
10 CELLS THAT ARE NORMALLY REQUIRED ARE THE BONE
11 MARROW, WHICH MAKES RED CELLS AND WHITE CELLS
12 AND PLATELETS.
13 Q. 14 A.
THAT'S BLOOD CELLS? YES. AND THEN SORE THROAT, SORE
15 MOUTH, G.I. TRACT, NAUSEA AND VOMITING, WHICH
16 MR. -- JOHN HAD A FAIR AMOUNT OF THAT;
17 HAIR LOSS.
......
18 Q .
PATIENTS WILL LOSE ALL THEIR HAIR AS
19 A RESULT OF THE CHEMOTHERAPY?
20 A.
THE ADRIAMYCIN, YES, AND TO A LESSER
21 EXTENT, THE CYTOXAN.
22 Q.
DID MR. GRASSO LOSE ALL OF HIS HAIR?
23 A.
YES, HE DID.
24 Q.
HOW MANY TIMES AND HOW OFTEN WAS
CHEMOTHERAPY GIVEN TO MR. GRASSO WHILE HE WAS
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27
1 HOSPITALIZED DURING THAT SECOND TIME IN 1975?
2 A.
I BELIEVE HE RECEIVED IT ONCE,DURING
3 THE HOSPITALIZATION. THE ADRIAMYCIN WAS GIVEN
4 EVERY THREE WEEKS.
5 Q.
AFTER HE WAS DISCHARGED FROM THE
6 HOSPITAL THAT TIME, DID YOU CONTINUE TO SEE
7 MR . GRASSO?
8 A.
YES.
9 Q.
AND TREAT HIM?
10 A.
YES.
11 Q.
HOW OFTEN WAS THECHEMOTHERAPY
12 ADMINISTERED AFTER HE GOT OUT OF THE HOSPITAL
13 IN AUGUST OF 1976?
14 A.
WELL, THE REMAINDER OF HIS LIFE HE
15 CONTINUED ON CHEMOTHERAPY. THE AGENTS CHANGED.
16 Q.
HOW OFTEN DID HE RECEIVE THE DOSAGE?
17 A.
THE ADRIAMYCIN WAS EVERY THREE WEEKS :
18 AND LATER WHEN HE WORSEND, HE RECEIVED
19 CYCLOPHOSLOMID, ADRIAMYCIN, VINCRISTIN. AND
20 DURING HIS LAST HOSPITALIZATION, HE RECEIVED
21 TWO OTHER AGENTS. THAT'S JUMPING AHEAD.
22 Q.
DID YOU CONTINUE TO TREAT MR. GRASSO
23 UP UNTIL THE TIME OF HIS DEATH?
24 A .
I DIO.
25 Q.
DURING THE COURSE OF YOUR TREATMENT
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23
1 OF MR. GRASSO, DID HE EVER COMPLAIN OF PAIN
2 TO YOU RELATIVE TO HIS CONDITION?
3 A. 4 Q.
YES. WHAT TYPE OF COMPLAINTS DID HEMAKE
5 TO YOU ?
6 A.
HE HAD FAIRLY CONSISTENT LIVER PAIN.
7 HE HAD --
.....
3 Q.
WHEN YOU SAY LIVER PAIN, WHAT DO YOU
9 MEAN BY LIVER PAIN?
10 A.
IT'S A -- THE LIVER IN THE
11 BETWEEN THE CHEST AND THE ABDOMEN AND IT'S
12 ON THE RIGHT SIDE. SO, IT CONSISTENT
13 Q. 14 A.
PAIN ON THE RIGHT SIDE OF THE BELLY? YES. SOMETIMES IT'S REFERRED AS
15 THAT THE SHOULDER, TOO.
16 Q.
HE COMPLAINED OF THAT PAIN. DID HE
17 HAVE ANY OTHER COMPLAINTS OF PAIN?
18 A.
THAT WAS HIS MAJOR PAIN COMPLAINT.
19 Q.
DID YOU ADMINISTER OR PRESCRIBE ANY
20 MEDICATIONS FOR MR. GRASSO FOR THE PURPOSE OF
21 RELEAVING HIS PAIN?
22 A.
YES .
23 Q.
WHAT TYPES OF PAIN RELIEF
24 MEDICATIONS DID YOU PROVIDE TO HIM?
25 A.
WELL, HE WAS -- HEWASONA
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29
1 NARCOTIC CODEINE UNTIL -- I BELIEVE, UNTIL 2 DECEMBER. AND THEN HIS PAIN WORSENED AND HE 3 WAS ON PERIDIN, WHICH IS DEMEROL. AND LATER 4
5 Q.
IS THAT A STRONGER PAIN RELIEF
6 MEDICATION THAN CODEINE?
7 A.
YES. AND HE ALSO RECEIVED MORPHINE,
8 WHICH IS STRONGER YET.
9 Q.
WERE THESE PAIN RELIEF MEDICATIONS
10 COMPLETELY EFFECTIVE IN RELEAVING HIS PAIN?
11 A.
IN GENERAL, THEY HAD REASONABLE
12 CONTROL, I SUPPOSE. ALTHOUGH ONE ALWAYS HAS
13 PAIN. IT'S NEVER TOTAL RELIEF.
14 Q.
YOU MENTIONED THAT MR. GRASSO
15 EXPRESSED FEAR AND ANGER TO YOU, AT LEAST AT 16 ONE POINT. DID HE EVER EXPRESS THOSE EMOTIONS
17 TO YOU AGAIN AS YOU WERE TREATING HIM UNTIL
18 THE TIME OF HIS DEATH.
19 A.
NO, -- FEAR, CERTAINLY. -- YOU
20 KNOW, HUMAN REACTION, HE DIDN'T WISH TO DIE.
21 HE WAS AN ACTIVE, ENTHUSIASTIC PERSON THAT 22 WAS NOT LIKELY TO GIVE UP, BECOME PASSIVE.
23 Q.
CAN YOU DESCRIBE HOW MR. GRASSO'S
24 ILLNESS PROGRESSED DURING THE MONTHS OF
25 SEPTEMBER, OCTOBER AND DECEMBER OF 1975?
21110020
-- LAUCIUS - MR. VASSALOTTI
30
1 A.
WELL, HE HAD A CONTINUED
2 DETERIORATION OVER ALL HIS -- HE HAD SOME
3 RELIEF OF HIS PAIN WITH THE CHEMOTHERAPY 4 WHILE HE'WAS GETTING THE ADRIAMYCIN. UNTIL
5 DECEMBER. THE PULMONARY NODULES, THE SPREAD
6 OF THE CANCER HAD NOT CHANGED APPRECIABLY. SO,
7 HIS IMPROVEMENT WAS MARGINAL. 8 IN DECEMBER, HE FAILED
9 TOTALLY ON THE ADRIAMYCIN AND WAS SWITCHED TO 10 DIFFERENT CHEMOTHERAPY, WHICH WAS INEFFECTIVE.
11 AND FROM DECEMBER UNTIL HIS DEATH IN JANUARY,
12 HE DID PROGRESSIVELY WORSE, NO APPETITE, NO
13 STRENGTH, NO VIGOR, PAIN, SHORTNESS OF BREATH.
14 Q.
DOCTOR, YOU HAD MENTIONED BEFORE
15 THAT CHEMOTHERAPY DRUGS THAT YOU ADMINISTERED
16 HAD EFFECTS UPON PARTS OF THE BODY THAT MAKE
17 OUR BLOOD CELLS. WAS MR. GRASSO'S BLOOD
18 CONSTANTLY MONITOREO DURING THE TIME HE WAS
19 GIVEN CHEMOTHERAPY?
20 A.
YES. THE MAJOR PROBLEM WE HAD WAS
21 WITH HIS RED CELL COUNT. HE LOST BLOOD 22 WHETHER HE COUGHED UP BLOOD. CHEMOTHERAPY 23 PREVENTED HIM FROM MAKING IT WELL AND HIS 24 DISEASE ALSO HAS AN EFFECT. AND HE WAS 25 CONSISTENTLY ANEMIC, WHICH WOULD MAKE HIS
TfXJOTTTZ
EC - LAUCIUS - MR. VASSALOTTI
31
1 SHORTNESS OF BREATH WORSE AND HE REQUIRED
2 MULTIPLE BLOOD TRANSFUSIONS.
3 Q.
AND DID HE RECEIVE A CONSIDERABLE
4 NUMBER OF BLOOD TRANSFUSIONS DURING HIS
5 TREATMENT?
6 A.
YES, HE DID.
7 Q.
NOW, WAS MR. GRASSO REH0SP I TAL I ZED
8 IN DECEMBER OF 1975?
9 A.
YES, HE WAS.
10 Q.
WHAT WAS THE DATE OF HIS FIRST '
11 HOSPITALIZATION IN DECEMBER?
12 A.
12-23 TO 12-24.
13 Q.
AND WHAT WAS HIS CONDITION UPON
14 ADMISSION AT THAT TIME?
15 A.
HE WAS WORSE. HE WAS SEVERLY ANEMIC.
16 DURING THE HOSPITALIZATION, HE RECEIVED BLOOD
17 TRANSFUSIONS. HIS LIFE WAS LIMITED. HE WAS 18 DETERMINED TO GO HOME FOR CHRISTMAS.
19 Q.
AFTER CHRISTMAS, WAS HE
20 REHOSPITALIZED AGAIN?
21 A. 22 Q.
YES, HE WAS. AND WHEN WAS THAT?
23 A. 24 Q.
IT WAS 12-29, 1975. AND THAT WAS HIS LAST
25 HOSPITALIZATION, WASN'T IT?
zzo OTTTZ
LAUCI US
MR. VASSALOTT I
32
1 A.
YES, IT WAS.
2 Q.
DID HIS CONDITION CONTINUED TO
3 DETERIORATE AT THAT POINT?
4 A.
i YES, IT DID.
5 Q.
D ID\ HE EVER THE SAME TYPES OF
6 COMPLAINTS?
7 A.
YES .
8 Q.
WAS IT\ AT THIS POINT THAT HE BEGAN
9 TO RECEIVE MORPHINE FOR CONTROL OF PAIN? \
10 A .
YES .
11 Q.
DURING THE COURSE OF THAT LAST
12 HOSPITALIZATION, WAS MR. GRASSO -- YOU SAW
13 MR. GRASSO, I PRESUME, ON A DAILY BASIS THEN?
14 A.
YES.
15 Q.
16 A.
WAS HE CONSCIOUS FOR THE MOST PART? YES. DROWSY AT TIMES, WEAK.
17 Q.
HE WAS VERY WEAK?
18 WHEN DID HE DIE, DOCTOR?
19 A.
JANUARY 8, 1977.
20 Q.
WAS AN AUTOPSY PERFORMED, DOCTOR?
21 A.
YES, IT WAS.
22 Q.
AT JEFFERSON?
23 A.
YES.
J
24 Q.
WHAT DID THE AUTOPSY REPORT INDICATE
25 WAS THE CAUSE OF MR. GRASSO'S DEATH?
EC - LAUCIUS - MR. VASSALOTTI
35
1 A.
HE HAD MASSIVE INTRA-ABDOMINAL
2 HEMORRHAGE WITH ANGIOSARCOMA OF THE LIVER.
3 Q.
WAS THE INTRA-ABDOMINAL HEMORRHAGE,
4 WAS THAT INTERNAL BLEEDING IN THE AREA OF THE
5 ABDOMEN?
6 A.
YES, FROM THE LIVER.
7 Q.
IT WASFROM THE LIVER?
8 A.
YEAH.
9 Q.
WAS THAT AS A RESULT OF THE
10 ANGIOSARCOMA OF THE LIVER?
H A. 12 Q.
YES . DOCTOR, I'D LIKE YOU TO REFER TO THE
13 NARRATIVE SUMMARY RECORD IN THE SECOND
14 HOSPITALIZATION, THE ONE OF JULY, 1975.
15 DID YOU PREPARE THAT
16 NARRATIVE SUMMARY?
17 A.'
I did.
;v,..
18 Q.
AND THEREIS A REFERENCE IN THAT
19 SUMMARY TO THE FACT, AMONG OTHERS, THAT MR.
20 GRASSO HAS HAD EXPOSURE TO A VARIETY ORGANIC
21 CHEMICALS AT PEDRICKTOWN, MARYLAND. 22 APPARENTLY, THERE WAS A VINYL CHLORIDE PLANT.
23 OF WHAT SIGNIFICANCE WAS IT
24 TO YOU THAT MR. GRASSO LIVED IN THE VICINITY
25 OF A VINYL CHLORIDE PLANT?
tZ O 0 T T T 2
- LAUCIUS - MR. VASSALOTTI
34
1 A.
BECAUSE ANGIOSARCOMA IS A RARE TUMOR
2 AND THERE'S BEEN A LINK WITH VINYL CHLORIDE
3 EXPOSURE.
4 Q.
DOCTOR, BASED UPON YOUR REVIEW OF
5 MR. GRASSO'S HOSPITAL RECORDS AND ALL OF THE
6 TESTS STUDIES THAT WERE DONE ON HIM AND YOUR
7 TREATMENTS OF HIS ILLNESS FOR APPROXIMATELY 8 FIVE MONTHS AND BASED UPON YOUR EXPERIENCE AS 9 A PHYSICIAN SPECIALIZING IN THE TREATMENT OF 10 CANCER, DO YOU HAVE AN OPINION, BASED UPON A
11 REASONABLE DEGREE OF MEDICAL PROBABILITY AS
12 TO WHETHER -- AS TO WHEN MR. GRASSO'S
13 ANGIOSARCOMA OF THE LIVER FIRST DEVELOPED?
14 A.
I WOULD SUSPECT WITHIN THE LAST SIX
15 MONTHS -- AT THE EARLIEST SIX MONTHS PRIOR 16 TO HIS BRONCHOSCOPY. SO, I WOULD SUSPECT IT
17 DEVELOPED IN THE SAME YEAR, 1976, ALMOST
18 CERTAINLY. I BASE THAT
19 Q.
FOR MY OWN CLARIFICATION, DOCTOR,
20 ARE YOU SAYING THAT HIS TUMOR PROBLEM
21 DEVELOPED WITHIN A PERIOD SIX MONTHS FROM
22 WHEN HE FIRST STARTED COUGHING UP BLOOD IN
23 MAY OF 1976?
24 A.
YES .
25 Q.
WHAT IS THE 8ASIS FOR YOUR OPINION
SZOOtTTZ
- LAUCIUS - MR. VASSALOTTI
35
1 THAT THE TUMOR DEVELOPED WITHIN THAT PERIOD 2 OF TIME?
3 A.
BASICALLY, IT HAS TO DO WITH ITS
4 GROWTH RATE.
5 Q.
CAN YOU EXPLAIN TO ME WHAT YOU MEAN
6 BY THAT?
7 A.
WELL, IN JUNE OF 1976 WHEN HE HAD
8 HIS FIRST SYMPTOMS, HIS X-RAY WAS NEGATIVE, I
9 HAD SHOWED NO NODULES ANO HIS X-RAY WAS NONE
10 REMARKABLE. HIS LIVER WAS NOT ENLARGED. BY
11 JULY, HE HAD CLEAR PULONARY TUMOR NODULES ON
12 HIS CHEST X-RAY AND HIS LIVER WAS
13 DRAMATICALLY ENLARGED.
14 Q.
AND WHAT CUT FROM THE GROWTH RATE OF
15 A TUMOR. IS THIS KIND OF TIME MORE A RAPID 16 GROWING TUMOR AT ALL STAGES OF ITS LIFE OR
17 DOES IT GROW MORE RAPID AT THE BEGINNING OR 18 THE END?
19 A.
THE EVIDENCE SUGGESTIONS THAT FROM
20 ANIMAL AND HUMAN EXPERIENCE THAT THEIR
21 GROWTHS RATE IS GREATEST AT THE BEGINNING AND 22 SLOWEST AT THE END.
23 Q.
AND BASED -- YOU TREATED MR.
24 GRASSO AT THE END OF HIS DISEASE; IS THAT
25 CORRECT?
szoom z
EC
LAUC I US
MR. VASSALOTTI
36
1 A.
TO THE END, YES.
2 Q.
TCT THE END. AND DID YOU OBSERVE THE
3 GROWTH RATE OF HIS TUMOR DURING THE END 4 PER I ODS OF HIS LIFE?
5 A.
YES, IT SLOWED.
6 Q.
IT SLOWED. BUT WOULD YOU
7 CHARACTERIZE IT AS A RAPID --
8 A.
YES, VERY RAPID.
9 Q.
VERY RAPID. AND DID THAT INDICATE TO
10 YOU THAT PRIOR TO THE TIME THAT HIS DISEASE
11 WAS FOUND THAT THE TUMOR WAS GROWING EVEN
12 MORE RAPIDLY?'
13 A. 14 Q.
YES . BASED UPON WHAT YOU JUST TOLD US?
15 A. 16 Q.
YES. AND BASED UPON THAT, IT'S YOUR
17 OPINION THAT HI S TUMOR PROBABLY DEVELOPED
.
18 SOME TIME APPROX IMATELY SIX MONTHS BEFORE HE
19 FIRST COUGHED UP BLOOD IN MAY OF 1976?
20 A.
YES.
21 Q.
DOCTOR, IN YOUR PRACTICE OF ONCOLOGY
22 AND YOUR TEACHING OF ONCOLOGY TO -- AT THE
23 JEFFERSON MEDICAL SCHOOL, ARE YOU CONCERNED 24 AT ALL WITH THE CAUSES OF CANCER?
25 A .
YES .
t"4
LA UCI US
MR. VASSALOTTr
37
1 Q.
WHY ARE YOU CONCERNED WITH THE
2 CAUSES OF CANCER AS AN ONCOLOGIST?
3 A.
WELL, PART OF THE JOB IS NOT JUST
4 INDIVIDUAL PATIENTS. IT'S AN ATTEMPT TO
5 PREVENT CANCER AS MUCH AS POSSIBLE. OFF TIMES
6 WE HAVE PATIENTS WE CURE WITH DRUGS WHOM
7 WE'VE -- WE GIVE CANCER TO BY GIVING THEM 8 THE CHEMO THERAPY, BECAUSE OFF TIMES, THE
9 AGENTS ARE CARCINOGEN. SO, NATURALLY, WE HAVE
10 AN INTEREST.
11 Q.
WOULD YOU CONSIDER YOURSELF AS ONE
12 WHO KEEPS A BREAST OF SCIENTIFIC DEVELOPMENTS
13 IN THE AREA OF CANCER CAUSATION?
14 A.
YES .
15 Q.
DOCTOR, THERE'S BEEN A CONSIDERABLE
16 AMOUNT OF TESTIMONY SO FAR IN THIS CASE
17 REGARDING WHERE MR. GRASSO LIVED, ITS ; 18 PROXIMITY OR ITS RELATIONSHIP TO THE GOODRICH 19 PVC PLANT. I'M GOING A -- YOU WEREN'T HERE 20 TO HEAR THAT TESTIMONY, SO I'M GOING TO ASK 21 YOU TO ASSUME CERTAIN FACTS AND THEN I'M 22 GOING TO ASK YOU FOR AN OPINION. 23
24
m m xw
EC
LAUCI US
MR. VASSALOTTI
3S
1
2 AND THAT HIS PARENTS AND BROTHERS AND SISTERS 3 ALSO HAD NO PRIOR MEDICAL HISTORY OF CANCER 4 OR LIVER'DISEASE. 5 I FURTHER ASK YOU TO ASSUME 6 THAT MR. GRASSO BEGAN WORKING AT THE DUPONT 7 CHAMBERS WORKS IN DEEPWATER, NEW JERSEY IN 8 APPROXIMATELY 1946 OR 1947; AND THAT EXCEPT 9 FOR PERIODS DURING W-HICH HE WAS LAID OFF, HE 10 WORKED AT THAT FACILITY UNTIL MAY OF 1976. 11 I ASK YOU TO FURTHER ASSUME 12 THAT IN HIS EMPLOYMENT AT DUPONT, HE WAS NOT 13 EXPOSED TO ARSENIC OR ARSENIC COMPOUND OR TO 14 VINYL CHLORIDE; AND THAT DURING THE PERIODS 15 WHEN HE WAS LAID OFF FROM DUPONT FACILITY, HE 16 HELD VARIOUS JOBS RANGING FROM A GROCERY 17 CLERK, AN AUTO PARTS SALESMAN, A GAS STATION 18 ATTENDANT, AS A CONSTRUCTION LABORER ON A 19 HIGHWAY JOS, AS AN AUTO MECHANIC, A BUS 20 DRIVER AND A SHEET METAL WORKER; AND IN 21 CONNECTION WITH HIS POTENTIAL EXPOSURE TO 22 VINYL CHLORIDE IN THE AREA OF HIS HOME, 1 ASK 23 YOU TO ASSUME THAT DURING THE YEARS OF 1970 24 THROUGH 1975, MR. GRASSO WAS AWAY FROM HIS 25 HOME APPROXIMATELY 50 TO 55 HOURS PER WEEK,
DIRECT
LAUCI US
MR. VASSALOTTI
39
i r' V \\ \ \
e
1 AND THAT -- AND THAT, THEREFORE, HE WAS 2 HOME OR IN THE AREA OF HIS HOUSE 3 APPROXIMATELY 50 PERCENT OF THE TIME FOR 4 THOSE YEARS. IN ADDITION TO BEING HOME 50 5 PERCENT OF THE TIME GENERALLY, DURING THE 6 PERIOD OF FEBRUARY, 1973 TO DECEMBER OF 1973, 7 MR. GRASSO WAS AT HOME OR IN THE AREA OF HIS 8 HOME CONTINUOUSLY AS HE WAS RECUPERATING FROM 9 A CORONARY ARTERY BYPASS SURGERY. 10 NOW, I FURTHER ASK YOU TO 11 ASSUME THAT DURING THE PERIOD FROM MARCH OF 12 1970 TO DECEMBER OF 1975, THAT MR. GRASSO'S 13 HOME WAS LOCATED APPROXIMATELY 1.7 MILES FROM 14 A POLYVINYL CHLORIDE PLANT OPERATED BY THE 15 8.F. GOODRICH COMPANY AND THAT DURING THE 16 YEARS IN QUESTION, IT HAS BEEN ESTIMATED THAT 17 THE GOODRICH PLANT EMITTED 8ETWEEN 1.4.AND 18 OVER 4.3 MILLION POUNDS OF VINYL CHLORIDE 19 INTO THE ATMOSPHERE ON AN ANNUAL BASIS; AND 20 IT HAS ALSO BEEN ESTIMATED THAT DURING THE 21 YEARS, THE PVC PLANT ALSO EMITTED INTO THE 22 ATMOSPHERE DUST PARTICLES THAT RANGED IN SIZE 23 FROM ONE TO TEN MICRONS AND THAT SUCH PVC 24 DUST PARTICLES CONTAINED IN THEM ENTRAPPED 25 LEVELS OF VINYL CHLORIDE THAT WOULD SLOWLY
OfiOOTTTZ
i Ii I
LAUCI US
MR. VASSALOTTI
40
1 DISSIPATE AND THOSE LEVELS OF ENLARGED VINYL 2 CHLORIDE RANGED FROM ANYWHERE FROM 40 PARTS 3 PER MILLION UP TO AN ESTIMATED 2,000 PARTS 4 PER MILLION. 5 IT HAS BEEN FURTHER ESTIMATED 6 THAT DURING THE YEARS 1970 THROUGH 1975, THAT 7 THE LEVELS OF VINYL CHLORIDE IN THE AIR 8 AROUND THE GRASSO HOME RANGED FROM A LOW OF 9 1.1 PARTS PER MILLION UP TO 28 PARTS PER 10 MILLION FOR A TOTAL OF 1,508 HOURS DURING 11 THAT FIVE AND A HALF, SIX YEAR PERIOD; AND 12 THAT DURING THOSE YEARS, IN ADDITION TO THE 13 RANGE OF EXPOSURES AT THAT TIME, DURING A 14 NUMBER OF HAZY POLLUTION DAYS, THAT THE 15 LEVELS OF EXPOSURE IN THE AREA OF GRASSO HOME 16 RANGED AS HIGH AS FROM TEN TO 90 PARTS PER 17 MILLION; AND FINALLY IN ADDITION TO ALL OF 18 THAT, I ASK YOU TO ASSUME THAT DURING THE 19 PERIOD FROM MARCH OF 1970 TO DECEMBER OF 1975, 20 THERE WERE PERIODS DURING WHICH SHORT PERIODS 21 OF EXPOSURE OF VINYL CHLORIDE IN THE AREA OF 22 THE GRASSO HOME, RANGING FROM FIVE TO FIFTEEN 23 MINUTES WOULD HAVE OCCURRED IN LEVELS UP TO 24 SEVERAL HUNDRED PARTS PER MILLION. 25
211X0031
- LAUCIU5 - MR. VASSALOTT1
i+l
1
2
3
4
5 aumcews---r--m----ok - - ----
4^'iijii ..in I.I.HIIII !
mum.. . . W-v.iX^v-UlL.^L.1 '. > m. .....
6
7
8
9
10
11 MR. RENNEISEN: YOUR HONOR, I 12 OBJECT TO THE QUESTION. THERE IS NO EVIDENCE 13 WHATSOEVER THAT IT IS DUST PARTICLES THAT MAY 14 HAVE BEEN* EMITTED FROM THE PLANT REACHED THE
IS GRASSO HOME. THERE'S BEEN TESTIMONY AS TO 16 DUST AND IT WAS WHITE, BUT THERE IS NO 17 TESTIMONY THAT DUST WAS POLYVINYL CHLORIDE. 18 FURTHERMORE, ANY ESTIMATES 19 MADE BY THE WITNESSES CONCERNING THE VINYL 20 CHLORIDE CONTAINED IN THE DUST IS SO 21 SPECULATIVE BECAUSE IT DEPENDS ON THE AGE AND 22 THE DUST AND SO FORTH, THAT I THINK THAT PART 23 OF THE QUESTION CLEARLY IS ADMISSIBLE. 24 MR. VA5SALOTTI: YOUR HONOR, 25 FIRST WITH RESPECT TO THE ADMISSION OF DUST
ZZOOTITZ
EC
LAUC I US
MR. VASSALOTT1
42
1 AND THE TRANSPORT TO THE AREA OF THE GRASSO
2 HOME, PROFESSOR DAVIDSON TESTIFIED THAT THE
3 PLANT WOULD CAUSE EMISSION OF PVC DUST 4 PARTICLES AND SPECIFICALLY DUST PARTICLES 5 WITHIN THE RANGE OF ONE TO TEN MICRONS, AS HE 6 DESCRIBED IT. PROFESSOR DAVIDSON -- I'M
7 SORRY, PROFESSOR PESKIN ALSO TESTIFIED THAT . 8 PARTICLE SIZES OF PVC DUST IN THE RANGE OF 9 ONE TO TEN MICRONS WOULD BE CARRIED IN THE
10 ATMOSPHERE IN A SIMILAR MANNER TO THE VINYL
11 CHLORIDE GAS TO WHICH HE MODEL HAD -- AND I
12 RECALL HIS TESTIMONY SPECIFICALLY THAT THOSE
13 MATERIALS WOULD REACH THE AREA OF THE GRASSO
14 HOME UNDER THE WIND CONDITIONS THAT HE
15 DESCRIBED. 16
IN ADDITION, WE HAVE THE
17 OBSERVATIONS OF MRS. GRASSO AND HER SON 1 18 CONCERNING THE WHITE DUST AND I 19 THE COURT: I'LL OVERRULE THE 20 OBJECTION. I'LL ALLOW IT. LADIES AND
21 GENTLEMEN, IT'S YOUR RECOLLECTION OF THE
22 TESTIMONY, NOT WHAT COUNSEL MAY SAY AS THEIR
23
RECOLLECTION. IT'S YOUR RECOLLECTION OF THE
H
!*
24 TESTIMONY. YOU MAY PROCEED.
25 BY MR. VAS SALOTT I :
s
03
LAUCI US
MR. VASSALOTTI
1+3
1
2 3 4 A. 5
fjitirtW
6
7 8 HY POTill 9
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-I.,, ........ in ill m "--;---------------- ypWTTffT^Tfr*1?^
-
'10
11 ARE
12 THERE OTHER KNOWN CAUSES OF ANGIOSARCOMA OF
13 THE LIVER?
14 A.
YES.
15 Q.
WHAT ARE IT IS OTHER KNOWN CAUSES,
16 ' TO. .YOUR KNOWLEDGE?
17 A.
ARSENIC, ARSENIC COMPOUNDS AND'
18 THQROTRAST.
I 19 Q.
IS THAT THOROTRAST?
20 A.
YES.
21 Q.
IN MY HYPOTHETICAL FACT SITUATION,
22 DOCTOR, I DIDN'T MENTION TO YOU THOROTRAST.
23 BUT LET ME ADD FURTHER THAT .THERE IS NO
24 KNOWLEDGE THAT MR. GRASSO -- NO ONE
STRIKE THAT. THERE'S NO EVIDENCE THAT MR.
21110034
I E C - LA UC I US - MR. VASSALOTTI
44
1 GRASSO HAD ANY DIAGNOSTIC X-RAYS IN WHICH A
2 DIE OR RADIOACTIVE DIE WAS USED.
3 WHAT IS THOROTRAST USED FOR
4 OR WHAT WAS IT USED FOR?
5 A.
IT WAS A RADIOACTIVE DYE THAT WAS
6 USED FOR BLOOD FLOW STUDIES TO -- FOR
7 X-RAYS, ARTERIALGRAMS.
8 Q.
AND HOW LONG HAS IT BEEN SINCE THAT
9 MATERIALS BEEN USED FOR THAT PURPOSE?
10 A.
I SUSPECT IT'S BEEN -- IT WAS
n KNOWN TO CAUSE DIFFICULTY IN THE THIRTIES AND
12 ITS BEEN DISCONTINUED.
13 Q.
DOCTOR LAUCIUS,YOU'VE TESTIFIED
14 THAT VINYL CHLORIDE IS A KNOWN CAUSE OF
15 ANGIOSARCOMA OF THE LIVER?
16 IF A HUNDRED PEOPLE WERE
17 EXPOSED TO VINYL CHLORIDE IN A GIVEN .
18 CONCENTRATION AT ONE TIME, WOULD YOU EXPECT
19 EVERYONE TO DEVELOP CANCER?
20 A .
NO .
21 Q.
WHY IS IT THAT SOMEPEOPLE ARE
22 SUSCEPTIBLE OR DEVELOP CANCER AS A RESULT TO
23 EXPOSURE TO CANCER CAUSING MATERIALS AND
24 OTHER PEOPLE DON'T?
25 A.
THEORY OR EVIDENCE?
fig O O T T T Z
LL - LAUCIUS - MR. VASSALOTTI
45
1 Q.
WELL, DOES ANYONE NO INFORMATION FOR
2 SURE?
3 A. 4 Q.
IT'S UNKNOWN. IS IT KNOWN FOR SURE THOUGH THAT NOT
5 EVERYONE REACTS THE SAME WAY TO A CANCER
6 CAUSING MATER IAL?
.7 A .
YES .
8 - Q.
WHY IS IT THAT MR. GRASSO WOULD HAVE
9 DEVELOPED ANGIOSARCOMA OF THE LIVER AND MRS. 10 GRASSO HAS NOT?
11 A.
ONE SUSPECTS CHANCE, CHANCE EVENT IS
12 A POSS IBILITY.
13 Q.
DOES IT HAVE ANYTHING TO DO WITH THE
14 SUSCEPTIBILITY OF INDIVIDUALS TO -- FOR THE
15 SENSITIZATION OF INDIVIDUALS TO THESE 16 PARTICULAR TYPE OF CANCER MATERIALS?
17 A.
THAT'S YOUR UN IFYING .HYPOTHESIS FROM
18 ANIMALS.
19 Q.
DOCTOR, TO YOUR KNOWLEDGE, HAS ANY
20 LEVEL OF EXPOSURE TO VINYL CHLORIDE BEEN
21 ESTABLISHED AS BEING SAFE?
22 A.
NO.
23 MR. VASSALOTTI: ALL RIGHT.
F24 THANK YOU DOCTOR, I HAVE NO FURTHER QUESTIONS. B25 The COURT: CROSS-EXAMINE
0)
: r c EXAMINATION - LAUCIUS MR. RENNE I SEN
46
l CROSS EXAMINATION BY MR. RENNE ISEN.
2 Q.
DOCTOR, HAVE YOU WRITTEN ANY PAPERS
3 CONCERNING VINYL CHLORIDE ITS RELATIONSHIP TO 4 ANGIOSARCOMA?
5 A.
NO, I HAVE NOT .
; 6 Q.
HAVE YOU MADE ANY STUDIES OF VINYL
7 CHLORIDE IN ITS EFFECT AND ITS RELATIONSHIP
8 TO ANGIOSARCOMA?
9 A.
WELL, THIS MAN, JOHN I DID -- I
10 DON'T KNOW WHETHER IT'S A STUDY. I HOPE TO
11 INITIATE ONE. I DID CALL, WHEN I FOUND OUT HE
12 HAD AN ANGIOSARCOMA, I DID CALL THE
13 CARCINOGENESIS BRANCH OF THIS COMMUNICABLE 14 DISEASE CENTER.
15 Q.
IS THAT IN ATLANTA, GEORGIA?
16 A.
YES.
17 Q.
YOU HAD SOME CORRESPONDENCE WITH
18 DOCTOR FAULK, DID YOU NOT?
19 A.
HE NEVER RETURNED ANY OF MY CALLS. I
20 FOUND OUT ABOUT THE SUBSEQUENTLY, I GUESS
21 THROUGH PLAINTIFFS ATTORNEY.
22 Q.
YOU ARE -- YOU ARE FAMILIAR WITH
23 HENRY FAULK, ARE YOU NOT?
24 A.
YES, I AM. HE'S THE PERSON I CALLED.
25 Q.
AND HE IS ASSOCIATED WITH THE CENTER
4O O TTTZ
EXAM I NAT I ON
LAUCI US
MR. RENNE I SEN
47
1 FOR DISEASE CONTROL IN ATLANTA, GEORGIA, IS
2 HE NOT?
3 A. 4 Q.
YES, HE I S . HAVE YOU READ ARTICLES THAT HE'S
5 WRITTEN ABOUT VINYL CHLORIDE IN CANCER?
6 A.
YES, I HAVE.
7 Q.
ARE YOU FAMILIAR WITH AN ARTICLE IN
8 THE LANCET, L-A-N-C-E-T, DATED NOVEMBER 24,
9 1 9 7 9 8 Y DOCTOR FAULK DISCUSSING ANOTHER CAUSE
10 OF VINYL CHLORIDE?
11 THE COURT: ANOTHER CAUSE OF
12 VINYL CHLORIDE.
13 BY MR. RENNEISEN:
14 Q.
I'M SORRY, CAUSE OF ANGIOSARCOMA.
15 A. 16 Q.
UM-HUM, YES, I AM. ARE YOU FAMILIAR WITH THAT ARTICLE?
17 A. 18 Q.
UM-HUM.
:
AND THAT ARTICLE DISCUSSES A FOURTH
19 KNOWN CAUSE OF ANGIOSARCOMA, DOES IT NOT?
20 A.
YES, IT DOES.
21 Q.
AND WHAT IS THAT FORTH KNOWN CAUSE?
22 A.
ANDROGENIC ANABOLIC STEROIDS.
23 Q.
AND DOES THAT ARTICLE SAY FROM A
24 GROUP OF CASES STUDIED BY DOCTOR FAULK AND
25 HIS ASSOCIATE WHAT'S THAT APPROXIMATELY 25
EXAMINATION
LAUCI US
MR. RENNEIS EN
48
1 PERCENT OF THE CAUSES OF ANGIOSARCOMA WERE
2 KNOWN AND, THEREFORE, APPROXIMATELY 75
3 PERCENT WOULD BE UNKNOWN?
4 A.
YES.
5 Q.
DO YOU AGREE THAT MANY CAUSES OF
6 ANGIOSARCOMA OR -- MANY CASES OF
7 ANGIOSARCOMA ARE OF UNKNOWN ORIGIN?
8 A.
WELL, THERE AREN'T THAT MANY CASES.
9 Q
10 A
HOW MANY CASES ARE THERE A YEAR? I'M NOT AWARE, BUT I THINK IN 1976
11 WHEN HE WAS DESCRIBED, I THINK THERE WERE^6^/
12 IN A YEAR IN THE UNITED STATES.
13 Q.
IN THIS ARTICLE, DOCTOR FAULK IS
14 STUDYING ANGIOSARCOMA DATA REPORTED FROM 1964
15 TO 1974 AND HE REPORTED 168 SUCH DEATHS AND
16 HE'S CONCLUDED 22 WERE ASSOCIATED WITH
17 PREVIOUSLY KNOWN CAUSES, VINYL CHLORIDE,
18 THOROTRAST AND ARSENIC AND 3.1 WITH THE
19 STEROID THAT YOU MENTIONED, WHICH WOULD MEAN
20 75 PERCENT B.F. UNKNOWN CAUSES, IS THAT TRUE?
21 A.
THAT'S WHAT HIS -- THAT'S WHAT HE
22 STATES.
23 Q.
AND HE IS CONSIDERED TO BE AN
24 AUTHORITY IN THE FIELD, IS HE NOT, OF CANCER
+"*
AND THE CAUSES OF CANCER?
00'
RO EXAM 1 NAT I ON LAUC I US MR. RENNE 1 SEN
40
1 A.
YES, HE I S .
' 2 Q.
HAVE YOU DONE -- FROM YOUR
3 LITERATURE THAT YOU'VE READ -- AND I THINK
4 YOU SAID YOU KEEP UP TO DATE, DO YOU HAVE AN
5 OPINION AS TO WHAT THE LATENCY PERIOD IS FOR
6 ANGIOSARCOMA? WELL LET ' S FIRST DEFINE LATENCY
7 PERlOD. HOW DO YOU DEFINE LATENCY PERIOD?
8 A.
LATENCY IN CARCINOGENESIS?
9 Q.
YES.
10 A.
HAS TO DO WITH TIME TO EXPOSURE TO A
11 CARCINOGEN TO THE DEVELOPMENT OF CANCER.
12 Q.
FROM THE FIRST EXPOSURE TO
13 DEVELOPMENT?
14 A .
RIGHT.
15 Q.
FROM YOUR LITERATURE, STUDIES, DO
16 YOU KNOW WHAT THE LATENCY PERIOD IS FOR
17 ANGI OSARCOMA? .
18 A.
GENERALLY, THE CASES T H A J HAVE BEEN
19 DESCRIBED HAVE BEEN LATENCY PERIODS OF TEN TO
20 20 TO 30 YEARS.
21 O.
AND WITH RESPECT TO MR. GRASSO, IT
22 WOULD BE LESS THAN SIX YEARS,WOULD IT NOT?
23 A.
YES, IT WOULD.
24 Q.
YOU MENTIONED THAT ARSENIC WAS A
CAUSE OF ANGIOSARCOMA; IS THAT CORRECT?
OKtOTTin
EXAM I NAT 1 ON
L A U C I U S_ - MR. RENNEISEN
50
1 A. 2 Q.
YES. DO YOU KNOW
THAT ARSENIC IS USED IN
3 INSECTICIDES?
4 A.
YES.
5 Q.
DO YOU KNOW THAT ARSENIC
lM 6 INSECTICIDES CONTAIN ARSENIC WERE USED OVER A
7 LONG PERIOD OF TIME IN SALEM COUNTY ON THE
8 FARMS DOWN THERE?
9 A.
I DON'T KNOW, OF COURSE.
10 MR. VASSALOTTI: YOUR HONOR,
11 MAY WE APPROACH THE BENCH?
12 A.
YES, SIR.
13 (SIDE BAR DISCUSSION ON RECORD)
14 MR. VASSALOTTI: YOUR HONOR, I
15 ASK FOR AN OFFER OF PROOF FROM THE DEFENDANT 16 AT THIS POINT WITH REGARD TO THE REPEATED
17 STATEMENTS THAT ARSENIC IS USED IN
18 INSECTICIDES AND WAS USED HEAVILY IN THE
19 SALEM COUNTY AREA.
20 THE COURT: LET THE RECORD
21 REFLECT THAT MR. RENNEISEN HAS GIVEN TO 22 COUNSEL FOR THE PLAINTIFF SOME DOCUMENT TO 23 READ . 24 MR. RENNEISEN: IT'S A STUDY 25 PERFORMED OF THE NEW JERSEY AGRICULTURE
TItOOTTTS
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MR. RENNEISEN
51
1 DEPARTMENT, I BELIEVE. 2 MR. VASSALOTTI: THERE'S NO 3 THIS IS AN EXTRACTION OF SOMETHING 4 WITHOUT ANY TITLE, AUTHOR, DATE. 5 MR. RENNEISEN: YOUR HONOR, I 6 WOULD LIKE TO ASK JOHN BULEY, MY ASSOCIATE TO 7 COME UP AND IDENTIFY ON THE RECORD WHERE THIS 8 DOCUMENT CAME FROM. SINCE MR. VASSALOTTI DOES 9 NOT ACCEPT IT AS AN OFFIC'lAL DOCUMENT. I CAN 10 IDENTIFY WHAT IT IS, BUT I'D RATHER IT BE 11 CORRECT IN STATING WHERE IT CAME FROM. 12 THE COURT: WELL, I'M SORT OF 13 HESITATE SOMEBODY SITTING IN THE AUDIENCE. 14 MR. RENNEISEN: HE'S FROM MY 15 OFFICE. I .CAN PUT IT ON THE RECORD. WE GOT 16 THIS DOCUMENT FROM THE STATE OF NEW JERSEY. I 17 CAN FIND IT IN MY NOTES, BUT I DON'T WANT TO 18 BE INACCURATE. THERE IS NO DOUBT THAT ARSENIC 19 WAS USED IN SALEM COUNTY IN OLDSMANS TOWNSHIP. 20 MR. VASSALOTTI: YOUR HONOR, 21 THIS APPEARS TO BE 22 THE COURT: LET ME SEE IT. 23 MR. VASSALOTTI: 35 PAGE 24 DOCUMENT OR 25 PAGE DOCUMENT. 25 THE COURT: WHY DON'T YOU
2111004
T
EXAM I NAT I ON
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MR. RENNE I SEN
52
1 CONFER WITH HIM AND GET THE -- YOU MAY 2 CONFER WITH HIM AND GET THE CORRECT TITLE TO
3 THIS. 4
MR. RENNEISENt YOUR HONOR,
5 THIS DOCUMENT WAS PREPARED BY THE PESTICIDE
6 PROJECT -- D F P4U^Ftn=-N T -- NEW JERSEY
7 DEPARTMENT OF HEALTH, TRENTON, NEW JERSEY. IT
8 WAS SUPPLIED TO JOHN BULEY FROM MY OFFICE L
9 FROM DOCTOR TERRY SCHULTZ, S-C-H-U-L-T-Z, WHO
10 IS EMPLOYED BY THE NEW JERSEY DEPARTMENT OF
11 HEALTH.
12 MR. VASSALOTTI: JUDGE, I'M
13 AT A COMPLETE LOSS. ARE YOU GOING TO OFFER 14 THAT?
IS MR. RENNE ISEN: IF YOUR 16 WITNESS CONTINUES TO DENY THAT THEY
17 CONSIDERED ARSENIC AS A CAUSE, THEN AS 18 REBUTTAL, I'LL OFFER THAT INTO EVIDENCE. IF
19 YOUR WITNESS ADMITS THAT ARSENIC IS A
20 POSSIBLE CAUSE AND HE WAS EXPOSED TO ARSENIC,
21 THEN I WON' T OFFER IT.
22 THE COURT: WELL, WHAT'S YOUR
23 POSITION RIGHT NOW? HE HAS IDENTIFIED THE 24 DOCUMENT WHICH HE'S USING FOR PURPOSE OF 25 CROSS-EXAMINATION, WHICH HE -- NOW
21110043
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CROSS EXAMINATION
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MR . RENNE I SEN
53
1 MR. VASSALOTTI: I WOULD 2 OBJECT TO HIM USING THAT DOCUMENT AT THIS 3 PO I NT TO CROSS EXAM INE THE WITNESSES 4 I WOULD LIKE A COPY OF THE 5 DOCUMENT. THE REASON I WOULD OBJECT TO H I M 6 USING THE DOCUMENT IS BECAUSE WE DO N ' T EVEN 7 KNOW WHAT IT IS. BUT MORE SO THAN THAT, IF HE.. 8 WANTS TO QUESTION THE WITNESS REGARDING 9 POSSI8LE ARSENIC EXPOSURES, FINE. BUT I WOULD 10 I WOULD NOT WANT THAT DOCUMENT USED TO
11 CROSS EXAMINE THIS WITNESSES. 12 MR. RENNEISENt RIGHT NOW HE 13 SAID HE DOESN'T KNOW. 14 THE COURT: THE POINT IS THIS:
15 HE HAS A RIGHT TO UTILIZE' A DOCUMENT ASKING
16 QUESTIONS, BUT, OF COURSE, YOU'VE GOT TO
17
IDENTIFY THE DOCUMENT AND ASK SOMEBODY IF
..
18 HE'S FAMILIAR WITH THE DOCUMENT.
19 MR. RENNEISEN: I SAID DO YOU 20 KNOW WHETHER OR NOT ARSENIC WAS USED. AND HE
21 SAID, NO, HE DIDN'T NO, AND THAT'S THE END 22 OF IT. THE NEXT QUESTION, WAS THAT USED, DID 23 YOU MAKE ANY EFFORT TO DETERMINE WHETHER 24 ARSENIC WAS USED.
25 THE COURT: THAT'S THE END
21110044
ii ( I
:rc
EXAM I NAT I ON
LAUCI US
MR. RENNE I SEN
5'4
i OF THAT. IF HE WANTS TO -- IF HE'S CROSS 2 EXAMINED, GET AN EXPERT BASED ON THAT
3 DOCUMENT, HE'S GOING TO DOCUMENT ASSESS A 4 WITNESS,WHETHER HE CONSIDERS THAT AN
5 AUTHORITATIVE SOURCE, THAT WHOLE BIT HAS GOT
6 TO BE GOTTEN INTO.
7 MR. RENNEISEN: THAT'S TRUE, 8 BUT I HAVEN'T GOTTEN TO THAT POINT.
9 (THE FOLLOWING TAKES PLACE IN OPEN COURT.)
10 BY MR. VASSALOTTI:
11 Q.
DOCTOR, I WAS ASKING YOU WHETHER OR
12 NOT YOU KNEW IF ARSENIC INSECTICIDES HAVE
13 BEEN USED IN SALEM COUNTY IN THE AREA WHERE 14 MR. GRAS SO LIVED.
15 A. 16 Q.
I OBVIOUSLY DON'T KNOW. DID YOU MAKE ANY EFFORTS TO FIND OUT?
17 A. 18 0.
NO, I DIDN'T.
' *' ' -r-
FOR HOW LONG MEDICALLY HAS THE
:'
19 DISEASE OF ANGIOSARCOMA OF THE LIVER BEEN 20 KNOWN AND IDENTIFIED?
21 A.
I CAN'T ANSWER THAT.
22 Q.
WELL, IS IT -- IS IT A SHORT
23 PERIOD OF TIME, TEN YEARS, ARE WE TALKING 24 ABOUT 50 YEARS OR A HUNDRED YEARS?
25 A.
I SUSPECT IT'S BEEN SINCE PATHOLOGY
21110045
EXAMINATION - LAUCIUS - MR. RENNE1SEN
55
1 STARTED, PERHAPS 80, 90 YEARS WOULD BE MORE
2 LIICELY .
3 Q.
SO THAT ANGIOSARCOMA OF THE LIVER
4 EXISTED BEFORE THERE WAS VINYL CHLORIDE OR
5 THOROTRAST, ISN'T THAT TRUE?
6 A.
THAT'S CORRECT, PROBABLY CORRECT.
7 Q.
HAVE YOU DONE ANY STUDIES CONCERNING
8 STRIKE THAT QUESTION.
9 ARE YOU FAMILIAR WITH THE
10 LITERATURE WHICH DISCUSSES THE CASES OF
n ANGIOSARCOMA WHICH THE MEDICAL PROFESSION HAS
12 ATTRIBUTED TO VINYL CHLORIDE?
13 A. 14 Q.
I'VE READ SOME OF THE ARTICLES, YES. AND GENERALLY SPEAKING, DO YOU KNOW
15 WHAT JOB -- WHAT TYPE OF WORK THE MEN HAD 16 WHO GOT ANGIOSARCOMA WHO WERE REVIEWED AND
17 DISCUSSED IN THOSE ARTICLES?
18 A.
YES.
19 Q.
WHAT KIND OF JOBS DID THEY HAVE?
20 A.
GENERALLY THE ONES THAT WERE FIRST
21 LINKED HAD HIGH EXPOSURE JOBS WORKING ON THE
22 PLANT, CLEANING OUT THE PLANT.
23 Q.
THEY WORKED ON PVC PLANT, DID THEY
24 NOT?
25 A.
YES .
21110046
T
, RC S EXAMINATION - LAUCIUS - MR. RENNEISEN
55
1 Q.
And they were people who within that
2 CATEGORY HWD HIGH EXPOSURE, DID THEY NOT?
3 A.
YES, THEY DID.
4 Q.
IS IT TRUE THAT THEY HAD EXPOSURES
5 FOR - -- WELL, DO YOU KNOW THE LENGTH OF
'y
6 THEIR EXPOSURES?
7 A.
WELL, SOME OF THEM HAD EXPOSURES FOR
8 VERY LONG LENGTHS OF TIME.
9 Q.
\
DO YOU-^HAVE ANY -- DO YOU HAVE ANY
10 KNOWLEDGE AS TO THE DEGREES OR THE
11 CONCENTRATION TO WHICH THOSE GENTLEMEN WERE
12 EXPOSED?
13 a.
they were exceedingly high, hundreds
14 OF PARTS PER MILLION.
15 Q.
MUCH HIGHER THAN MR. GRASSO'S; IS
16 THAT CORRECT?
17
a. ...
. - yes . . .
", .
.
18 Q.
WHAT --- WHAT IS YOUR REASON FOR
19 DECIDING THAT VINYL. CHLORIDE IS THE CAUSE
20 WHAT IS YOUR REASON OR REASONS FOR
21 DECIDING THAT VINYL CHLORIDE IS THE CAUSE OF
22 THE ANGIOSARCOMA THAT MR. GRASSO HAD?
23 A.
WELiL, I SUSPECT I WAS LOOKING FOR A
24 CAUSE OF CARCINOGENS. I TOLD DOCTOR NEELD. HE
25 TOLD ME THERE WAS A B. F. GOODRICH. I LOOKED
a w o t it j:
EXAM I NAT I ON
LAUCIUS - MR. RENNE1SEN
57
1 IT UP IN CHEMICAL ENGINEERING NEWS; THERE 2 WAS. I CALLED THE COMMUNICABLE DISEASE CENTER.
3 THAT THEY HAD A POTENTIAL E I PDEM I 0L0G I CAL 4 PROBLEM THERE. I SUSPECT IT WAS HYPOTHESIS,
5 WHERE IS HIS EXPOSURE, FINDING AN EXPOSURE 6 AND ATTRIBUTION; IS IT MERE COINCIDENCE THAT
7 THE ONLY CASE OF VINYL CHLORIDE. -- . .WELL, I 8 TAKE IT BACK. THE ONLY CASE OF ANGIOSARCOMA I 9 SEE AND MY PARTNERS SEEN IN TEN YEARS HAPPENS 10 TO BE THE PERSON WHO LIVES NEXT TO A VINYL
11 CHLORIDE PLANT. THAT'S ONE WAY OF LOOKING AT
12 I T .
13 Q.
OF COURSE, THERE WERE MANY PEOPLE
14 WHO LIVE NEAR THE VINYL CHLORIDE PLANT WHO
15 DON'T HAVE .AN ANGIOSARCOMA; ISN'T THAT TRUE?
16 A.
THAT ' S TRUE.
17 Q.
AND FROM THE LITERATURE, DO ,,YOU KNOW
18 THAT THERE ARE PEOPLE WHO LIVE NOWHERE NEAR
19 VINYL CHLORIDE PLANT WHO GET ANGIOSARCOMA,
20 TOO, ISN'T THAT TRUE?
21 A.
THAT'S TRUE, ALSO. HOWEVER, THEY
22 POTENTIALLY DO HAVE SOME EXPOSURES THAT HAVE
23 NOW BEEN LIMITED ELSEWHERE, LIKE THE AIR
24 FLOWS -- I MEAN THE PRODUCTS.
25 Q.
IN OTHER WORDS, A PERSON LIVING IN
81110048
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S EXAMINATION - LAUCIUS - MR. RENNEISEN
53
1 WYOMING NOWHERE NEAR A VINYL CHLORIDE PLANT \
2 COULD HAVE EXPOSURE TO VINYL CHLORIDE BECAUSE
3 IT WAS $S E D AS A PROPELLANT IN SPRAY CANS, IS
A
4
\ THAT CORRECT?
5 A.
\
THAT'S CORRECT.
6 Q.
SOy WHEN YOU SAID THE CAUSE OF MR.
7 GRASSO'S DISEASE WAS VINYL CHLORIDE, YOU 8 DIDN'T NECESSARILY MEAN IT WAS IN THE B.F. 9 GOODRICH PLANTu IT COULD HAVE BEEN FROM 10 AEROSOL CANS, \s THAT TRUE?
11 A.
IT COUUD HAVE BEEN, BUT YOU'RE
12 ASKING WHY I BELHEVE WAS MOST PROBABLE. WE
13 HAVE NO WAY OF DOING THE KIND OF STUDY YOU
14 PROPOSE AND THAT IS EXPOSING EVERYBODY TO
15 DIFFERENT PARTS PER MILLION OF VINYL CHLORIDE 16 TO HUMANS AND WAITING FIVE YEARS AND SEEING 17 HOW MANY END UP WITH ANGIOSARCOMA. I MEAN, 18 ONE CAN'T SAY WITH CERTAINTY, BUT YOU CAN SAY
19 WITH A DEGREE OF PROBABILITY.
20 Q.
YOU FOUND A CASE AND A CAUSE AND YOU
21 LINKED THEM TOGETHER; IS THAT RIGHT.
22 A.
THE LITERATURE HAS LINKED THEM
23 TOGETHER, THE MEDICAL INFORMATION.
24 Q.
BUT THE MEDICAL LITERATURE AND THE
25 FIRST ARTICLE I TALKED TO US, THAT 75 PERCENT
1110049
\ S EXAMINATION - LAUCIUS - MR. RENNEISEN
\
59
1 OF THE CASES ARE OF UNKNOWN ORIGIN? WHY 00
\
2 YOU PICK QNE OF FOUR KNOWN* ORIGINS INSTEAD
3 SAYING, IT'WAS OF UNKNOWN ORIGIN? V
4 A.
' BECAUSE
BECAUSE I THOUGHT
5 THOUGHT IT w'a S MOST LIKELY DO TO VINYL
\
6 CHLORIDE. I S^ILL BELIEVE THAT. I MEAN,- HOW
7 WOULD YOU PROPOSE TO -- HOW WOULD YOU
3 REASONABLY ASK E TO CHANGE MY OPINION?
9 Q.
\
WELL, LET ME ASK YOU THIS, DOCTOR.
10 THE COURT: WELL, LET ME SAY
11 THIS. YOU CAN'T ASK QUESTIONS OF COUNSEL.
12 THAT'S GETTING INTO AN ARGUMENT IT I VE 13 SITUATION. YOU ASK THE QUESTIONS, YOU ANSWER 14 THEM .
15 THE WITNESS: OKAY. 16 BY MR. RENNEISEN:
17 Q.
LET ME ASK YOU THIS, DOCTOR:. IN
18 MAKING YOUR DETERMINATION, DID YOU CONSIDER
19 THAT THE MEDICAL LITERATURE INDICATES LATENCY 20 PERIODS MUCH LONGER THAN MR. GRASSO'S?
21 A. 22 IT.
IS THERE A QUESTION THERE? I MISSED
23 Q.
I THOUGHT IT WAS A QUESTION. LET ME
24 ASK AGAIN.
25 IN MAKING YOUR DECISION THAT
21110050
T
E XAMI NAT I ON
LAUCI US
MR. RENNE1SEN
SO
1 IT'S VINYL CHLORIDE THAT CAUSED -- DID YOU
2 CONSIDER THE FACT THAT THE MEDICAL LITERATURE
3 INDICATES LATENCY PERIODS GREATER THAN MR.
4 GRASSO ' S' LATENCY PERIOD?
5 A.
I DID .
6 Q.
IN MAKING YOUR DECISION, DID YOU
7 CONSIDER THE FACT THAT OF THE KNOWN CASES
8 WHICH THE MEDICAL PROFESSION HAS ATTRIBUTED
9 TO VINYL CHLORIDE EXPOSURE TO ANGIOSARCOMA,
10 THE PEOPLE WHO CONTRACTED ANGIOSARCOMA HAD
11 INTENSE EXPOSURE IN THE WORK PLACE?
12 A.
YES.
13 Q.
AND, DID YOU CONSIDER THE FACT THAT
14 MR. GRASSO DID NOT HAVE INTENSE EXPOSURE IN
15 THE WORK PLACE; IS THAT CORRECT?
16 A.
I CAN'T TESTIFY TO WHAT EXPOSURE HE
17 REALLY HAD, WHERE HE WORKED. BUT I -- IF
18 YOU TAKE THAT AS A GIVEN AND HE DIDN'T HAVE
19 ANY EXPOSURE WHERE HE WORKED
20 Q.
THE EXPOSURE
21 A.
THEN I DID CONSIDER IT, YES.
22 Q.
THE EXPOSURE YOU KNEW ABOUT WAS
23 LIVING APPROXIMATELY TWO MILES FROM THE PLANT?
24 A.
AND BEING TOLD BY DOCTOR NEELD AT
25 DUPONT THAT THEY DIDN'T MAKE QUANTITIES OF
TSOOTTT:
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1 2 3 4 5 6 7 3
V 10 11
I 13 14 15 16 17 18 19 20 21 22 23 24 25
EXAM I NAT I ON
L A UCI US
MR. RENNEI SEN
61
VINYL CHLORIDE. Q. HE ACTUALLY TOLD YOU THEY HAD SOME,
DIDN'T HE? A. HE TOLD ME THEY HAD NONE, BUT I
SUBSEQUENTLY LEARNED THAT THEY HAD SOME IN A
DIFFERENT AREA WHERE HE DIDN'T WORKI.. I THHIIJNJK. ft
IT WAS TO FILL
FILL OUT THg^AIR SOLE^), I
BELIEVE.
Q. DID YOU -- AND I THINK YOU'VE ALREADY TOLD ME THAT YOU DIDN'T MAKE ANY
VESSELS TO ELIMINATE ARSENIC AS A CAUSE? A. WHERE BLOOD ARSENIC LEVELS DONE ON
HIS AUTOPSY, NO, BUT THE POSTMORTUM DIDN'T SHOW ANY EVIDENCE OF CHRONIC ARSENIC COMPOST
AS FAR AS WE CAN TELL.
Q.__
INCIDENTALLY, DOCTOR, JUST SOMETHING
THAT YOU SAID EARLIER, WHEN MR. GRASSO WAS
.
WAS (CAUGH I~NG\ UP BLOOD, WAS THAT BECAUSE
IT IS LIVER CANCER HAD SPREAD TO HIS LUNGS? A . YES, I BEL I EVE . Q. SO THAT EVEN THOUGH THERE WERE NO TUMORS ON THE X-RAYS IN MAY OF 1976, IT WOULD HAVE MEANT THAT THERE WERE SOME BLOOD INVOLVEMENT BY THAT TIME; IS THAT CORRECT? A. I HAVEN'T GOT A X-RAY. JUNE IS THE
EXAM I NAT 1 ON
IAUC1 US
MR. RENNE1SEN
S2
1 EARLIEST X-RAY I'VE SEEN.
2 Q.
WELL, HE WAS'" CAUSHINjp>U P BLOOD IN
3 MAY, I 8ELIEVE.
4 A.
YES .
5 Q.
ACCORDING TO THE TESTIMONY WE HAD
6 HERE.
7 A.
ONE WOULD SUSPECT THAT THE TUMOR IS
8 PRESENT.
9 Q.
I N THE L I TERATURE THAT YOU WERE
10 FAMILIAR WITH
I GUESS TH IS I S A
11 VIOLATION OF THE COPYRIGHT LAWS
BUT ARE
12 YOU FAMILIAR WITH THIS DOCUMENT WHICH
13 WHICH WAS A PUBLICATION OF THE NEW YORK 14 ACADEMY OF SCIENCE, TOXICITY OF VINYL
15 CHLORIDE, POLYVINYL CHLORIDE?
16 A.
NO, I'M NOT.
17 18 BE LONG
THE COURT: ARE YOU GOING TO
19 MR. RENNEISEN: NO, I'M VERY
20 CLOSE TO BEING FINISHED.
21 THE COURT: BECAUSE I'M
22 HOLDING UP THE RECESS. WILL THERE BE REDIRECT,
23 MR. VASSALOTTI?
24 MR. VA SSALOTTI : JUST A
25 COUPLE OF QUESTIONS, YOUR HONOR.
21110053
EXAMINATION
LAUC I US
MR. RENNEI SEN
63
1 BY MR. RENNEISEN1
2 Q.
WHEN YOU SAID THAT YOU WERE FAMILIAR
3 WITH SOME LITERATURE IN THE FIELD THAT 4 DISCUSSED THE RELATIONSHIP BETWEEN VINYL
5 CHLORIDE AND ANGIOSARCOMA, DO YOU RECALL NOW
6 WHO THE AUTHORS OF THAT LITERATURE WERE?
7 A.
WELL, I HAD SOME OF THE LITERATURE
8 OVER THERE THAT I BROUGHT ALONG THAT
9 Q.
I WON'T TEST YOUR MEMORY.
10 A.
BUT I MEAN THE BASIC REVIEW ARTICLE
11 IN THE MEDICAL COMMUNITY IS THE ANDERSON
12 INTERNAL MEDICINE. AND I READ THAT.
13 Q.
AND THESE ARE PUBLISHED 8Y ACCEPTED
14 PUBLISHING HOUSES THAT KEEP THEM APPRISED OF
15 LATEST DEVELOPMENTS; IS THAT RIGHT?
16 A.
YES .
17 Q.
AND THAT LITERATURE INDICATED TO YOU
18 THE LONG LATENCY PERIODS THAT YOU AND I HAVE
19 BEEN TALKING ABOUT; IS THAT CORRECT?
20 A.
IT INDICATED THERE WAS A LATENCY
21 PERIOD, YES.
22 Q.
AND THAT SAME LITERATUREDISCUSSED
23 THE CONCENTRATION LEVELS TO WHICH
h
24 ANGIOSARCOMA -- ANGIOSARCOMA PATIENTS HAD
3$225 BEEN EXPOSED WHEN THEY WERE EXPOSED TO VINYL
T
: ro EXAMINATION LAUC I US MR . RENNE I SEN
S4
1 CHLORIDE; IS THAT TRUE?
2 A.
YES, IT HAD SOME NUMERICAL PHYSICIAN,
3 YES. 4 Q.
AND THOSE FIGURES, AGAIN, WOULD YOU
5 TELL ME WERE AGAIN IN HUNDREDS OF PARTS PER 6 MILLION?
7 A.
YEAH.
8 Q.
ON A REGULAR BASIS IN THE WORK PLACE;
9 IS THAT CORRECT?
10 A.
YES .
11 MR. RENNEISEN: THANK YOU,
12 DOCTOR
13 THE COURT: REDIRECT. 14 MR. VASSALOTTI: NO, YOUR
15 HONOR .
16 THE COURT: l HAVE NO FURTHER
17 QUESTIONS.
18 THE COURT: LADIES AND
19 GENTLEMEN, LET'S TAKE OUR MORNING RECESS, TEN 20 MINUTES.
21 CJURY LEAVES THE COURTROOM. ) 22 THE COURT*. TEN MINUTES RECESS. 23 YOU MAY STEP DOWN.
24 (RECESS . )
25 (THE FOLLOWING TAKES PLACE IN OPEN COURT WITH
S500TTT2Z
RC
EXAM I NATION
LAUC I US
MR. RENNEIS EN
55
1 THE JURY PRESENT.) 2 THE COURT: CALL YOUR NEXT
3 WITNESS. 4 MR. VASSALOTTI: THANK YOU, 5 YOUR HONOR. DOCTOR SAMUEL EPSTEIN. 6 SAMUEL EPSTEIN SWORN.
7 DIRECT EXAMINATION BY MR. VASSALOTTI.
8 Q.
DOCTOR, BY WHOM ARE YOU PRESENTLY
9 EMPLOYED?
10 A.
THE UNIVERSITY OF ILLINOIS MEDICAL
n CENTER IN CHICAGO.
12 Q.
AND WHAT IS YOUR POSITION WITH THE
13 UNIVERSITY OF ILLINOIS MEDICAL CENTER?
14 A.
I'M PROFESSOR OF OCCUPATIONAL AND
15 ENVIROMENTAL MEDICINE.
16 Q.
CAN YOU DESCRIBE THE AREA OF
17 MEDICINE AND/OR TOXICOLOGY THAT YOU ARE 18 INVOLVED WITH IN THAT POSITION?
19 A.
MY MAJOR PROFESSIONAL INTERESTS
20 RELATING TO THE TOXICS AND CANCER CAUSING OR
21 CARCINOGENIC EFFECTS OF CHEMICALS IN THE
22 ENVIRONMENT WITH PARTICULAR REFERENCE TO
23 POLLUTANTS IN AIR, FOOD> WATER AND THE WORK 24 PLACE.
25 Q
YOU ARE A MEDICAL DOCTOR?
S900TTT:
t
"vR. V- 5 S ' L
'I
1 THE ELiOEE THAT YOU HA")
' J\ ERE C- R A ^ - 3
2 09 CHARTS .0 R CASES 0 F 0 I ) G N " S i E ) i A i 0 3 ' 7 0 0 M
3 . \ j t a r j ; U ; 1:
7 :4 0 D 0 ^ !J L a 7 i 0 ' i
, 2 .1 c r ^
4
7 0;
1 3 THAI CORRECT?
5
, ~ a - h 5 that i
wee:
6 , N G I 0 3 A 9 C 0 :! A RELATED TO VINYL
7 :URS .
8 0
WELL, WHEN YOU SAY RELATED TO VINYL
9 CHLORIDE EXPOSURE, WAS IT REALLY RELATED TO
10 V I N YL CHLORIDE E X P 0 S U RE 0 ? V[N Y L CHLORIDE
11 EXPOSURE OF P VC V 0 R ,< E R S ? .
12 A .
NO. THE ___ T MS T c o A p V c ----- A M H I
13 T-' {'.< I:.; vinyl chloride, I USE, I think, 'a
14 LITTLE VOTE SEPARATELY . T'Mf OCC JRR E N C E D "
15 A.sG i CS ARC 0 RA has OCCURRED NOT I': THE
16 PRODUCTION, THE A < [ N G OF vINYL CHLORIDE. IT 17 HAS 6EcN ASSOCIATED WITH VINYL CHLORIDE BEING
18 USED TO FOR, -1 THE POLYHER , PVC. AND IT HAS NOT
19 SEEN ASSOCIATED WITH THE POLY V INYl CHLORIDE
20 3 E i MG USED F 0 R FARR IC A T I 0 NS. AND ALL The
21 ANGIOSARCOMA CASES THAT aoc shown IN THERE
22
ARE THOSE WHOSE D E V E L 0 P l c N T OF
~ HF
T J '1 D R A \; :D
23
THE IP
o R K h [ S t D p i F S ' w '"W E 0 ^ EHR '/ A : Y I v G
24
DEGREES 0 p
; o p < _ s - |_r w rj C - R S I n v
r ? v [ n y L
25
C H _ S' R IDE T- " L Y V I Y L C -* L 0 I
DE .
1110057
fi
. V A S 5 " L .1 T 7 1
1 0.
N HA i 3 3 0 U P iv AS T H A T Y 0 U 5 ! U') I :D
2 EP 1 DEM 1 OLOG I CAL STUD t ES . 'IT'S CALLED A
3 C0HC7T, [ 3 ' T IT? IS THAT ; H A 7 YOU CALLED
4
5 A.
THIS WAS A 0 T A CCHD-T STUDY. THIS
6 SIMPLY l D E T I F I F S ALL T HP CASES THAT W E HAVE
7 THAT WE .< M 0 W OP IN THE LITERATURE, FROM OUR
3 OWN E X PE E I l W C E, FROM OTHER PLANTS, -NO W"'RE 9 L 0 0 < INC A T THESE -A N G l 0 3 A R C 0 M AS A N O
10 C H A R. ACTED IE 1 w G GOING ON THEIR CLInICAL,
11 ri I S TuLGG I C AL , PHYSICAL CHARACTER IS T ICS, THE I:
12 EXPOSURE HISTORIES.
13 V.
u <A Y. IN YOUR 0 IR e C T TEST In 0NY, Y C J
14 HEnT l O'.NEo THAT l OCT OR HA TALON I h - D DONE 3 ONE
15 STUDIES ON THE CANCER-CAUSING EFFECTS OF
16 Y L C H L 0 R I D E. I THINK YOU TEST I
17 NO A N G I 0 S A R C 0 MA S IN RATS E X P 0 S
18
T S PE R
I L LION.
19 I A E L I E V F THAT W AS THE L 20 OH HE PQiJ'i n ! ! T
21 0 I D HE FI NO CHANGES YES,
22 s. A 1 , 1 0 S I N DOSES LOWER THAR; T
23 YES, HE REPORTED T H AT.
24 0 .. FAR COHN DID HE GO?
25 i F i R E C A i i C 01 " C T L , I
W
H*
O or Q3
S - DR . T A PURR
- '17 . V A 3 S M~T~ \
1 HAD A T-j.-io? 1 'l 0 N 5 a N' I i A 1_ -- I'VE - ^ R G'
2
W H f c H 0 9f,i v s r 3 T = -! __ -v-iff .:a^7
? >
4
5
r; e e
Tie i_ i T" 4 *
6 One OR AT r 1 VE .
AG 2 ! The5- at
8 YOU .Oi ARTICLE THAT'S ENTITLED " V I 0 Y L
9 CHLOT i 0 E CARCINOGENICITY AND EXPERIMENTAL
10
NO DEL FOR CARCINOGENIC STUDIES." IT'S
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15 A L L Y r I I S A 0 T PR ED 1 C T A 3 L E. WHAT
16 1 TH EP IDEM I 0 L J b I C A L 5 T 0 0 l E S IS
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19 AT A L EVFL V: ! LL MOT P P a n IJ C E A 20 TUTOR WITHOJT ACTUALLY LOOK I MG A T T^E
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23 ' E TR 0 S PEC T I -!! STUDIES 5H~W THAT T r -
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NO, THAT'S SCIENTIFICALLY 4
11
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15 CF E X P E R ! E N C E AND P Y C H a S 4 C T E 3. [7X7 ! A N OF T H r 16 DISEASE. A M0 YOU 1P F SAYING ON THE A 4 S I 5 0 c 17 THIS PAST EXPERIENCE, THIS VAST PAST
18 EXPERIENCE, THAT BIOLOGICALLY, E SHONE J NOT 19 EXPECT SC E T H 1 \ G T 0 0 h A P P E N . A N 0 T H A T 1 S
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D 0 YOU AGREE T19 DISAGREE '! I TH T h a j
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11 A.
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12 0.
DOCTOR, ARE YOU - A `; [L 1 A7 A ! h- 7'J!f
13 1 R 0 J P A NO AO A S THE PRESIDENT'S C C ' 1 T r E E ON 14 TO,, i C EUR STANCES STRATEGY?
15 A .
I ' V c HE A R D 0 F THE G R 0 U ? .
16 Q .
A N D v. AS THAT G R 0 U r PUT T C G T H E R T C
17 STUDY TOXICOLOGICAL EFFECTS OF C H E .Ml C A L
18 S U S S T A ;nC E S , A .S 0 N G 0 THERE ?
19 A .
YOU'RE ASKING THE O U E 5 T I 0 N IN A
20 F 0 R M AT THAT I A ? L I E 5 That THEY L ERE SET UP TO-
21 DO STUDIES.
22 0.
NO, I DON'T i E A N STUDIES.
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15 PAGE 0ME 33 Or THIS R?30RT W H E IT SPATES: 16 " 'A E T H 0 0 S -- " STRI:< THAT. 17 " `` E T H 0 0 S M D W A V A I L A 3 L E F C 7 18 j 0 A T I F Y I :G THE E S t I V- A T E A HHVM 'ISAS PRC'1 19 GIVEN EXPOSURE TO A p 0 T E * T l A L C A R C I 0 G E V 0 20 IE -- " i' . soary, "; v\ P7-'vi:i: only ~ '.: : 21 A P P R 0 A i7 1 0 A S )- 7r- C TO \ l -1 l S < S . " 22 Y 0 J ANT ME T C READ T H AT T 23 I J U A o A i N ( 24 M') , l H t A R 0 n A T Y 0 0 5 A l 0 . 25 Do YOU AGREE OR DISAGREE /IT
21110074
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9 PROBABILITY, '"35.
10 0 .
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15 I . I V 3 L v . 3 A T
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17 CONTROLS Of, T - E L Ev E L .
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8 FEDERAL AGE-.CY, PTOHULGATE D A S T A >: DA" 9 IN E F r ; C T , INTENDED TO "EDUCE <=*. I 5 S I 0 ; 10 VINYL C H L 0 9 IDE FFOr' PVC ''UXTi LINE T'
n I.'! QUESTION 7 0 THE EX TENT ' = "5 PE ' CE'
12 A . 13
YES. I \; y n i rs
n .< c r--? t u e
C. O '' 7 ' T r _
14
COMPANY, D r ~ I ~
\ v D T 'J - 7 ~ . r r -- a 7 t - v -v;
15 YOU 0 0 THE G 9 * N T 3 , DID THE G D -D D 7 I C ^ CO.'-ANY
16 POO v IDE YOU WITH *4 NY STUDIES REGARDING r -1 E
17 TOXICITY OP. C A P. C I \ 0 G ENICTY 0 F VINYL C H L 0 T IDE
18 T ,H AT THEY H
0 U C T-D 0 r0 9 E THEY DETAIN!
19 YOU V
20 A.
NO, THEY u 10 NOT..
21 U.
DID YOU I n<;U I :? AS TO whether A
22 SUCH STUDIES 7 A 0 HEEN U 'J 0 E 0 T A < E N ?
23 a.
YES, WE'VE DISCUSS"' u T 0 I' E> S
24
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25 r 0 *.*. P v. f --r r u \ ^
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4. 1 ah T " 0 ... "AO THEY 0 J W E A Y T IH IMG W H E N THEY
3 - i P 3 T CONT ACTED YOU I\ THIS AREA?
4 A.
THEY HAL DO HE STUDIES 'ELATED TO
5 HU MAN 3, 3 U T NOT TO AM [MALE .
6 0.
THOSE STUDIES FN V 0 L Vc 0 THE T H' E E
7 C A S E 3 0 F A \' G 1 0 S A 0 C 0 M A THAT W ERE DISCOVERED?
8 A.
D , TUF Y H A o ALREADY a = c h v x
9 3 C 0 5 5 Li I *! G "TOGO A K-, ^ A 0 DESIGNED The SCREENING 10 PROGRAM, HAD I MPL EMcNTED A SCREENING a R n G < A .-1 ,
11 H A J LOGGED AT A N 0 M 0 E R OF IN D i V ! D L` L S ' /0 h ;
12 NO CHE H. ICAL A 3 N 0 R 1 A L f T I S , HADMEDICALLY
13
0:UlJ Tric.-i UP;
THEIR INITIAL SCREENING
14 PEC GRAM CAS RE A SOM A ELY S TAP TEC MY Thh TI ;E I
15 ARRIVED AT THE UNIVERSITY OF LOUISVILLE. 16 C . T H A T W A S IN 19 7 4?
17 A .
10 7 4. THAT WAS BETWEEN JANUARY AN 0
18 SEPTEMBER.
19
m p # VA S S A L 0 T T I :
I HA VE
20 -N C T I \' G F U ? T -* H , DOCTOR, T H A N K Y O m .
21
T li c r V|'j t
A Y ' ^D [ R FC T7
22
1 R . R E NN E r3 E N :
I HAY H A V E
23 u J j T C r. w y U E 5 T [ 0 N .
24 REDIRECT EXAM I NAT IO-Y -3 Y MR. RE ONE I SEN.
25 3 Y . i X . A E '< N I I 5 S ;. :
21110073
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4
= ? 3 3 o i_ v v ! Y 1 r '-i [_ ^ ~ [ ~ p i
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6 n o, f o o ' T .
7
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3 TO c. A R L i S R I A THIS CASE THAT T H G G \ E A A T A E 9 .-1 ILL ION WORK PLACE R ECU I RE M E N T WAS, I THINK, 10 iN LATE 7-f; //AS THE OTHER REGULATION 3 E F 0 ?. E 11 AFTER THAT?
12 h i s IT WAS A c T E R .
13
.HR. R E N N E ! S E :
I HAVE
14 U?.T*ER 'MI EST 10**5 .
15
the COURT:
anything ''-TTUER .
16
MR. V A S S A L 0 T T 1 :
NOTHING,
17 YOUR HONOR.
18
the court:
all right. t h a n k
19 YOU VERY ;ioCh, DOCTOR. YOU HAY 3 T c ? 00//-..
20 A N Y FURTHER WITNESSES?
21
.! S. R c V N 5 I SE :
I HAVE NO
22 FURTHER WITNESSES. I HAVE EXH I 0 ITS TO OFFER
23 INTO EVIDENCE, 3 U T I BELIEVE AFTER THE JU RY
24 IS DISMISSED.
25
r j - T
I TM T:
4110079
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4
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the count:
JO Y 0 U - J V E A -: y
7 3 YOUR HON 05. 9 10 HAVE TESTED * 11
M . VASSALOT t I :
N A- T1 'J ] V r /
the cou.v :
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T H C 0 U0 T :
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13 j A ; i L t M L U , I T H I NX WHAT WE'L 1 p 0 1 5 THIS:
14 7 H 1 E C A j L , r 0 S A L L I nTE.NTS A N 0 RUN POSES A P
15 FAN AS TEST I n 0 . ji vl AMO EVIOSNC E 1 s c 0 -M L L-R N t o ,
16
IS r i i\ I S H iS D
0 H , T H E R E ARE C ER TA I N LEGAL
17 A R G 'J M ENTS I ;*. u S T HEAR AND CE R T A I M ? R 0 C E D U RES
18 I MUST F 0 L L w ; AT THIS TIME. A '! D TH A T MAY T A < E
19 SO/-1? TIME. SO 74THE7 THAN FIN-) YOURSELVES IN
20 THE p 0 S IT I ON OF H A V [m o s ij M M A T I 0 m c A v 0 C H A 9. 0 E
21
LATE IN THE 0 A Y , I 'GO I NO T 0
c X 0 !! S E Y'J c 0 0
22
the tala n CE op THS D A v A ni o
p ' i_ i_ o o-'ir <? .a g '<
23 TO.-1C1 ? 0-,/ HONUiNG AT " : 3 ! , AT WHICJ FI'S THERE
24 Ali-L J. E S JM.-.AT I OflS F Y COUNSEL, FOLLOWED -Of MY
25
CHANGE AS TO T -> E LA'
\-j THE . Y VJ .'ILL. "H',
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1 have the case - ; w i ll take the case w i ?h you
2
TO THE
J u 7 Y 0 E L I ? E A T [ O M 9 0 0 m A \| 0 0 E L I ~ E 7 A T E
3 UNTIL YOU HAVE - E A 0 r '* A ^ r
. Rn;
4 T 0 0 h> ^ ' ,.r f i_ |_ 3 ft :i r r A L W n R .< T '! A 0 A Y HP',/ 0 n A
5 ;-i -
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6 A-ALLY 3 ; I M S . SO, I T H [ M < THAT THIS f 3 THE
7 3 E S T COURSE OF ACTION TO FULCv.
8
i 0 W , L A 0 I 3 3 A. , , 0 b 3 'I T L
^ ; H3
9
I HAVE
C A o T I 0 N EU YOU 3 F 0 R E A >1D w l L L C 0 M T I '! Li E
10 TO -- a ELL, NO LOO CEO, 3uT AS I'VE 11 C A u T I J N E u YOU BEFORE, UNTIL THIS CASE IS
12 SUBMITTED TO YOU = OR YOUR DELIBERATIONS,' 'YOU
13 OUST NOT DISCUSS THIS CASE U I T H ANYONE CR
14
R E M A I !
I TH I N
A3 I
n F A v Y o M F D I "CUSS I v 0 IT
15 NE I THE?. SHOULD YOU READ A. 'J Y M E u 5 p \ O = O *, Q T I C L " 16 LISTEN TO RADJO OF OAD rA <- ^ i'j 0 3 V f tr v a v y
17 THLEVIS t.0H PROGRAM THAT 0 I 5 C U S 5 =: 5 T H ! : C A S E . 13 I=, HOW - V - R, YOU S H 0 U L D
19 3 EC G. iE A A R E 0 c A :W Y j U C H 5 TORY, A R T I C L E CR
20 N E W 5 RE PORT, YOy ARE TO ? t P 0 R T THAT --ATT E R TO
21 HE IN PIY CHAMBERS AT YOUR EARLIEST
22 OPPORTUNITY SO THAT ,V E -1 AY DISCUSS IT.
23 iNccOLESS TO SAY, SHOULD YOU 24 HAVE. SUCH E LEO SURE, YOU SHOULD NOT M ENT 10 N 25 T'Hm T -ACT to A Y OF Y 0 !j'J FELL CW JURORS. YOU
1110081
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-i
1 i ' f TO ; E 5 - A . ) PE'- A V ' YTJ HI 2 DEC IDE aY 1 > 3 U ! ' . THIS C S E UNTIL 3 i 3 `j -J . i 1 T T j TO YaJ "O' Y 0 J 1 DEUl'E 4 j-iO: i Th; i i . j T AC T 1 0 .3 OP T He C 0 U O T 5 .X 0: V;, .v E 'EE AT 6 5 T A S E IN THIS CASE, 50, 9 LEASE, I Vi A M T TO 7 .1 ? H A 5 I Z AGAIN, DON'T DISCUSS TH IS WITH 8 ANYONE, NOT EVEN A MONO ST YOURSELVES. 1 EC A 'J $ 9 THE TINE TO DISCUSS TUE CASE A-`'0`:SST 10 YOU" SELVES IS IN J'J "> Y 900 M W f T u ILL 0* Y-D'j
11 TOGETHER .A m D A c T c r Y 0 'J H A V - '-* E a 9 o T H E
12 SUMMATIONS AND ' Y C >J 4 9 SE . 5 0 , WITH T H A * , I ' '
13
NL ^-
DU J '-.TIL TO NO 2 9''W TMn! NO AT ' : 3 :i .
14 : E THE J V R Y
15 LEAVES THE COU NT TOG'1. 5
16 THE COURT: ALL A l G H T .
17
HR. RENNE ISSN:
I'LL TA <E THE
18 EXHIBITS IN 0 COER, YOUR H0N0 R, I THINK.
19
THE COURT:
YES.
20
>19. renneisen:
your honor,
21 0-1 f s 4 SCOTCH I A 0 E S H 0 I M G V.' I M 0
22 DIRECTIONS '/ u T C H W AS PREPARED 0 i.l7 I N 0 T H E
23 C R 0.3 5 -E XA ; I N A T I ON Oc ?RC = FSSO'> E ? ' I ' .
24
T !-- - C C UR T :
ANY 0 " vj E C T i A M TO
25 0 - 1 ?
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1 7 ASS AL A T 7 I :
2 13 0 t C T ION.
3
E COURT;
Ev l
4 C? - 1 [ 3
5 a7 . r sf : : o - c ; s
6
A ': C T n " " SKETCH I '* 4 D 5 S :_l 0 H ! M G W 1 N 0 'PS
i ' ':
7 CURING T-iE EHl'Pv at!!'. OF PROFESSOR PE 3
8 T'-1 E C : U 7. T : AMY P JEC T I
9
A LETT [ :
0 3 JE C 7 l C
10
I r" M JJ:
I i V ! r;
11 NARKED i N E VIDE CE . )
12 AR, E HiE 1 3 E N : 0 -3 IS
13 RCFESSOR P E 3 < I N * S REPORT v; HIGH I WIT H 0 ' A v .
14
h J r .\
o T I 0 L E T H A T ': c y E
15 GOT A STICKER ON IT 3 ECAUSE THE ONLY COPY I
16
H A 0 'W A 5 U '! 0 E R L l M E 0
A NO f H A V E v 0 T TEEN A?LE
17 TO LOCATE A CLEAN' COPY OF IT. IT IS A R E => OR
18 THAT I WAS USING WHEN [ C R - S 3 -- E X " I '; E 0 SCC'1
19 EPSTEIN 3 Y PETE7 3 A X TEN - RII ' T E 0 IN the
20 3 < I T 1 S ri RED I CAL JOURNAL, O C. 7 0 ' H 0 , 1 " 7 7 . 1
21 COULD P J T A. STICKER ON IT.
22
v A, j j L u T I I :
JJ 1 : w
23 TO 0 r F d < T h A 7 I w T 0 i V I 0 L v C E '
24
A M'M E 1 3 E N :
YES, I DO .
25
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I
21110083
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7 3 c T .v E A N C A N l)
8 F.EPORT S AYS.
9
THE COUFT;
WELL,
HAT
10 1-1 A F P E N S ALL T ^E
11
VA S5 1LOTT I :
r"
12 ON THE P tCFF :: .
13 D T ~ \ \! C I T
14 T H F 0 E ' E C E 7 T
15 REFOFT IN I C H I
0 1 F F E < >: T F 9 0,
16 lHYjuA JL c o t a i 17 the jury S rlOULCl 18 L A -sj U A u i_ i n the 19 TH C 0UI? T : Y0 <J S H 0SE THE 20 FEDERAL FULE OF E V 1.0 E N C THAT SAYS I CA':
21
A L), 1 ( T [T. [
thc HE ANT I HE, f DENY YOU 2
22 APPLICATION UNTIL YOU CAN SHOW E Uv') THE
23
F S O'E 3 A i_ 9 U L E S T-tan; a h W S 5 I n L E .
r u = 0 I ' i "
24 The 1 Jirr [ " [ c "51j l c , yon r .j\< ;ic" f r - n
M
25
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1110084
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5 CR055-EX A I AT 1 0 N , I CAN -AIVT 0 U ~ A `-J 6 j \j C 0 m c j s T E N i" Y P 17 TW F p D h r T o 9 rJ^f" ! M ' S
7 TEST I :vi 0 N Y A N ") THE9 E ~ 0 R T , th- J U Y S !J 0 U L D 3 E 8 ALLOWED TO 0 E T c o m, j *, = ;hc*aE1 NT M 0T T h E 1 E 15 9 AN INCONSISTENCY. I'M GOING TO GIVE YOU Th= 10 OPPORTUNITY. YOU C H E C X THE RULE - N 0 Y 0 J 3 H C ';
11 '1C*
Ll H 'j L 3 i n A i I * s A > E (A 1 . u ..
12 << c '! N C 1 J Al ; ALL TIGHT
13 0-5 15 A CHART E N T I T L c
i. i i U L
14 EXPOSURE LEVELS OUE TO EV!SSiOvS = R 0.1 THE
15 3 . F. GOODRICH PLANT, NOVEL AMD DATA RASE 16 COMPARISON" PREPARED 3 Y 17 THE COURT : AMY 03UECTION? 18 MR. V A S S AL 0 T T I : MO 03 JECT I
19
THE COURT
- 5 f ' TV I
20 CO-5 IS 1A A X E R IN :E V I D !
21 D-S IV
22
A i < C T ! i El :4
CM A R Tf R E P A R E i' 3 Y R . G U T F R EU D ,
23 A , i N Um-L A V l k A h L VI N Y LC H L 0 P. IDE E X P 0 5 UR tl 0 i
24 o A A A o vj JLl TO E ;/i I 5 S I J N S F R0 v. T i i . X .
25 j 0 0 J R I C H, ;jLh N T.
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7 FEkM EPISODIC CONCENTRATIONS AT GRAS50
8 RES I DENCc C /\ L C U L A T E D 3 Y i A ' \ R . " SHALL I T U R -i 9 IT A x 0 J N 0 r 0 R Y 0 U M R . V A S S A LOTT I . rt HR. VA SSALOTT I : NO, I HAVE
11 NO 0 3 J E C T I 0 N .
12
THE COURT:
i 'j EVIDENCE
13
r) * 7 J 5 f : A ? < z 0 \ N Z V !
,VC : . ^
14
7 7 c v \j p i - rr m
.o y i_i " | .\ c
15 TWO DRAW I nGS WHICH WERE .'`.AOS HAVE NEVER BEEN
16 w ASKED. ONE WAS MADE 3 Y
I GUESS THEY
17 WERE 6 0 T H M ACE
i R. G U T F R E J M D. I'LL CALL
18 T H E r [ R S T 0 N c E I 'o H T , ;1 HIGH HE N A 5 0 'i l N G T G 19 1 LLuS TRATE THE F L Ui'lt OF ,, - - OF A >; M I S 'i I 0
20 ROM A
FROM A STAC A, A.\D MUMEfR NINE
21
22
THE COURT: FIRS
ALL, A Y
23 C3JECTION TO 0-
24
:-\ 5 . VA SSALOTT I ;
NO 0 3 .j E C 7 I .' !
25
up ':-H|0 T
0 - IN EVIDENCE..
9800TTTZ
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1 { J - ' IS ' A ;< if D IN EVioE :C E . )
2 1*1 R . ;l f IN ! S E N 1 , i J M i .< N I .1
3 i ^ CH M Kj 4 j n -
i i
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C T i 1) NS A N 0 ALSO 5 H 0 W 1 N S
5 CHARACTER 1ST ICS OF A PLUME WHEN YOU L 0 0 .< D C W M
6 O'J IT = R C J A 3 C V E .
7
HR . VAS S 4 L j T TI :
\0 REJECTION
8 THE C 0 U R T : D-? IN EVIDENCE
9 ( )- IS '1 A R \ E O iv EV[RG\CE.>I
10
THE COURT:
COES T hA T T A < E
11 lw _ w I' i r.
12 13 ."I \J -H \J X 14
Mi. R VIE I 5E.\ : YES, YOU':
THE COURT:
IS T - A i A A Y T - ! : G
15 further .at this time, g e n t l e a. e \ . 16 MR. VASSALOTTI: YOUR HUMOR, 17 ONLY THAT IF :-1 P . RSNNSISEN FINDS THE 3 A S I S TO 18 A D M I T THE -- IS IT THE 3 A XT SR ARTICLE, I.,K*
19 SORRY, M p . R E 'I'! E l S E N , Y O ij i v T THE 3 A X T r ^ 20 A R T [ C L E A 0 HI T T E 0 ?
21 :! p P 2 \ N c I A " ! ; y r S .
22
'*: R . v a j l L .) T T [ :
I WOULD
I A:
23 AN 0 P Pj < T U i'*! I T Y TO O F " S R
R E ;UTT AL Thp " 0
24 A c P `J i T 5 T n A T I OFFER I: S U rv, rI nc oS Ir u* :M* y wi1 ~* P. <w' < II T' -
25 .i >i I - ~ ."i - j I j o R LED.
21110087
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11
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12 ALL 7 I 0- ' .
13 I'LL .MIT 14 : ir T - - N- T
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15 m r . 9 e ;4 E I 5 E i: r h a *! < rrj, 16 ('LL JUGGLE :i [ TH IT.
17 THE C 0 J T T ; r:0 : , I 3 T ;! E " E
18
19 .'ia. gemi; I S E u : .>, Sin.
20
T H c C 0 'J H T
ALL fig h t .
21 A S u J T IF i ri GO THIS, G E v T L c 'A c ' i ? LET'S H
22
L. U i\ l~*,
0 i f YOU ''LL COME
23
LIKE TO St
YOU l'l 'Y
24 I A TO THE RULE SI H 1 1
ITH > E
25 C ,-i A AGE .
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T
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THE C 0 U < T : A 7 - E 7 E A y
6 -10 T 1 0 F 0 R DIRECTED V E 7 D I C T U N DEE R U L E 5 3
7 SUBMITTED TO THE COURT. I'LL C- I V E v 0 'J T w 0
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15
DIRECTED VERDICT [j --
a 5 5 'J ,N A A I Z E 0 unEN
16 I .HADE A HOT I ON FOR DIRECTED VERDICT AT THE
17 END OF THE PLAINTIFF'S CASE. DURING THE
18 COURSE OF DEFENDANT S CASE, IT HAS PECOAE, I
19 THINK, OUIT E CLEAR THAT WITH R E S ?E C T TO
20 NEC LICENCE, Twfoc SI HPLY IS HONE.
21
THE COURT:
IN 0 T,J E *. ~ 0 S ,
22 Y 0 U 'RE REHEATING THE SA''G A A G UNE N 7 3 V"U '. 0
23 ^ T I r C C 0 N C L U 3 i 0 N --
24 N R . R E N N E I S E ;*: A ; ) [ DON'T
25 R c h L _ Y .. A I 7 C D u R u E >.
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1 THE COU^T: -- OF THE
2 J LA I MTIFF'S CASE.
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4 7 h 5 - A 0 r 7-77 T'-E^E IS NOT h f 'IQ['! OF = = H ' N T 1 S
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THhT I M ,\ D E? R E V I 0 U 5 L Y , A \* 0
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7 THOSE A .R G LM E N T S WITH RESPECT TO NEGLIGENCE 8 A ;-i j Til ACTIVITY C J ' i 0 !J C T E 0 AT T H E ? . F . 9 a 0 0 D R I C H PlANT.
10 THE COURT: ALL RIGHT. EXCEPT,
11 OF COURSE, THE COURT riA 5 HEARD T E S T I MON Y
12 W HIGH IT DID 'IDT HAVE AT THE TIME IT
13 CONSIDERED THE PLAINTIFF 'S -- Tm= mot I 0 N S 14 H A OE AT The C 0 '! C L !J S 10 M OF THE P L 1'iTI-- ' S
15
16
M 1? . o - \; ! E I 5 p M j
T M A T 1 C T UE
17 There ' S SEE N A D D l T I 0 M A L TE 5 T I -ION Y . ? UT T HAT
IS ADDITION AL TES T I MON Y, I T H T N < , STRENGTHS N S 19 THE oefe *.*1 iu~\ >A-*. NT'S P0 S I T I 0 ' ; IF WE'RE GOING TO
20 T A L .< ABOUT NEGLIGENCE. IT'S CLEAR NOW THAT
21 T n E -- THE PLANT /,' AS 0 E 5 I G E 0 A N D
22 CONSTRUCTED 3Y COMPETENT, ^ U A LIp lE D REDDLE
23 -vho roo.\ into cons i oerat ion . industry 24 STANDARDS AT THE TINE, GHAT HAS RNOV/N 4 R 0 U
25 TOXICITY A 'I D, 1 FACT, JH => l A NT `-'AS = E E N
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7 DON'T CONTEND THAT THE PLANT WAS NEGLIGENT
8 W HEN NJ1LT. WE DID N ' T P 'J T I V A N Y 3 0 00 F T M.\ T 9 THE PL A N T VI AS NOT 3 U ! L T OP VI AS 0 0 I L T IN A
10
NEGLIGENT c a 3 h I o \j . ? .
5 E `E ! S E S ' v S ! ~ ' S
11
T D 'J E , IT
A 3 GUILT --
12 THE C 0 U "I T : YOU 'PE T A L < t NO
13 AiJJT NEGLIGENT OPE PAT I 0 N, AREN'T Y o `j .
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17 3 A 5 IC NEGLIGENCE CLAli-i? WHAT DO YOU SAY- WAS 18 THE NEGLIGENCE OF THE GOOD?. I CH C 0 M ? N Y ? 19 MP . VASSALOTT I : THAT THE 20 GOOD? ICH CCMP4NY FAILED TO CONDUCT ANY '"ESI
21 OP STUDIES TEC- A 0 D I N 5 THE C A P C I 0 G E I C I T Y 0 0
22 TOXICITY OF VINYL CHLOP IDE , EVEN THOUGH T'JI
23
ANEW UNTIL the CON3 T- ijcr I
OF 7-< r S 13 L 'N
1110091
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THAT W .
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25
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9 3 J I L T The H _ A A T .
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11 I H/v T ' S IT, I.'iaT T riE Y FAILED TO CO N DUCT T h C 5 E
12 STUDIES. THEY FAILED TO COW DUCT ANY TESTS 13 h L F O R i; C R /AFTER. T H c Y JUST W c N T A H, -AD A N 0 DIO 14 IT.
15
THE COURT:
IM OTHER WORDS,
16 YOU'RE SAY I MG THAT R . F . GOODRICH W 4 S
17 NEGLIGENT IN NOT CONDUCTING PROPER TESTS OR
18 STUDIES EITHER 8 5 F 0 E IT RP E N E 0 the
19 ROLY V I NYLCHLOR I DE PLANT I ? E 0 R T C :< T 0 s N O R
20
AFTER THE OPE N I J y . i
PLANT; IS T A T
21 .. < t L i .
22 V h S 5 A L 0 T 23 CANCER Causing Oh T j x I C 24
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T,-E COURT:
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6 R nAO I N G r X 0 M T rl E ALLEGATIONS OF THE PLEADINGS
7 A N D T ri 0 5 E SET F 0 R T h INYOUR TRIALMEMORANDUM.
3
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9 YOUR ri 0 N 0 ,7 . 10
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11 THE S A M E W A V E L E GTH OR HAVE WE 3
12 SOMEWHAT.
13
MR. VA s 3 MOTT I :
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14 A 0 0 I T ! "' N A L C 0 N 7 ENT I R'-G THAT ARE 3 OH: - HAT
15 RELATED. THE 0 M I S THAT THEY DIDN'T MON I TOR 16 L \ THE R E b I ulN T I AL AREAS. THE OTHER I 5 T H A T
17 THEY N EVER W A X ,N E OR A D V I 3 ED THE .PE OP L 0 F
18 PEORICKTOWn AS TO N HAT uA 5 J E I N G E M I T 7 EO 0 3
19 ITS CANCER CAUS IN G
20
THE COURT:
THE F ACT RE M A I N S
21 YOU'RE NOT ", A i< 1 NG ANY CLA IM THAT THE
22 0 E = E i\! 0 A N T WAS N EGL I GENT IN AMY U A Y IN THE
23
c o struct ion
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24 C 0 M S 7 R U C T I 0 -N OF THAT 3 L a N 7 .
25
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3 C : N S T < U C T I 0 N Or THE PLANT.
4 THE COUP T : ALL 3. ! C- J T .
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15 0 I ON ' T WARN THE PEOPLE IN THE PEOP I C.<TO '! M 16 A REA.
17
I NC E THIS IS
TH IS IS
18 NEGLIGE'! C E C 0 U N T ; W F ' R E T A L !< I N G -''OUT ./ wit I s
19 REASONA3LE A N 0 o o 'JOE NT !J :N O E P Thc
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23 HARMFUL EFFECTS OF j [ n Y L COLOR I 0 E HERE, ONE,
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17 CHLORIDE -- VINYL CHLORIDE IS A HYDROCARBON 18 AND AS SUCH, IT'S P R 03 A3LY LIKE GASOLINE AMD
19 ABNORMALLY DANG F. ROUS IF I T EXPLODES. 20 Tu G COll'T: -"V/l 4 p OUT r r.
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1 .'1 R . R E N N E I S E N : DOCTOR 2 TAM3 JRR0 . 3 PREVIOUSLY S W 0 R M. 4 DIRECTION! EXAMINATION. 5 MR. REMME [SEN: M AY l PROCEED, 6 YOUR HONOR.
7 8 Q.
THE COURT: YES, SIR. DOCTOR T A M 3 U R R 0 , WOULD YOU TELL US
9 WHAT ANGIOSARCOMA OF THE LIVER IS?
10 A.
THIS IS A CANCER OF THE SUPPORTING
11 CELLS OF THE' LIVER, MAINLY THOSE CELLS WHICH
12 LINE THE VASCULAR SEGMENTS OF THE LIVER.
13 3 . 14 A .
AND HOW IS IT OIAGNOSIEO? 'WELL, I T H I N :< I COULD 3 E S T
15 ILLUSTRATE WITH SLIDES. 16 THIS IS SIMPLY AN 17 ILLUSTRATION TO POINT OUT WHERE THE LIVER IS. 18 though most people i think have a concept, it
19 IS A VERY LARGE ORGAN WHOSE MAJOR PURPOSE IS 20 SOME SYNTHESIZE OR MAKE TODY P R 0 T = [ N , BODY
21 CATS, 3 0 D Y HYDROCARBONS, IT'S THE E N E R G Y 22 SYSTEM FOR IT IS BODY . IT ALS 0 HAPPE NS TO 23 HAVE AS A M A U 0 R F U N C T 1 0 N T H E R E M 0 V A L 0 = WASTE
24 P R 0 D U C T S AND TOXIC MATERIALS. IT IS the MAJOR
DETOXIFYING OR TOXIC REMOVING 0 ^ Cj A i >< OF THE
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1 BODY. AND IT ALSO HAS' A DUAL S Y3 T EM 07 2 GETTING RID O.F THESE TOXIC MATERIALS, mot 3 ONLY 3 Y 3 URN I \' G THE: 1 0 R 3 Y M E TABCL l Z ING THE M 4 OR ALSO BY E X T R U 0 I N C- THE M TO THE GALL 3 L A 0 D E R 5 INTO THE INTEST I M E S . IN ADD I T I 0 N TO THIS, IT 6 HAS A BLOOD'SUPPLY SYSTEM, ONE COMING PROM 7 ARTERIES OF TiiE 3 JOY AND A 30DY SUPPLY SYSTEM 8 THAT COMES FROM THE GASTROINTESTINAL TRACT 9 THAT CARRIES OXYGENATED BLOOD TO THE LIVER. 10 N 0 W, IF 0 N E WILL TAKE A L 00 < 11 AT THE VASCULAR SYSTEM SPREAD OUT THROUGHOUT 12 THF L I V ER, IT LOOKS DIFFERENTLY AND THE LIVE R 13 I S CUT I N SLICES. A ND UP HERE IN this corner 14 A S A N A RT I S T S VIE W of the liver WHEN IT'S CUT 15 IN SLICES AMD THESE RED CU301DAL OR 16 RECTANGULAR CELLS ARE THE LIVERS MAIN CELLS, 17 THE CELLS THAT DO ALL THE BUILDING AND ALL 18 THE DETOXIFYING. BUT THE SPACE IN BETWEEN 19 HERE, THIS AREA IN HERE (INDICATING) IS THE 20 BLOOD PASSAGEWAYS, AND T H E R E CALLED 21 SINUSOIDAL. AND . IT IS THESE CELLS INSIDE HERE, 22 IF YOU CAN' SEE THI5 BETTER HERE (INDICATING) 23 these blood vessels that line these cords of 24 LIVER CELLS THAT HAVE -- THAT ARE MADE UP 25 OR CONSTRUCTED OF WHAT WE CALL ENDOTHELIAL
I
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.'i 3 U R * 0 - . i R . y. c i% WE 1 5 E N
11
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1 CEL L S . m N D IT IS T H E S E CEL L 5 THAT iaRE HE?IE ' 2 I THINK TH I S IS 3 E S T, I'LL -- THESE ARE 3 THE L IV E R C E L L S . A N D THESE ARE THE CELLS OF 4 THE BLOOD VESSEL WALL THAT LINE THE BLOOD 5 AGE CENTER. AND THESE ARE THE CELLS THAT 6 M E MALI G N A N T I N ANGIOSARCOMA. THAT'S W H Y 7 TER M, ANG I 0 WHICH MEANS PLOOD VESSEL A NO 8 S A R C 0 M A WHICH MEANS A TUMOR FRO M the 9 SUPPORTING STRUCT URE OF THE OR G A N A M D THERE ' S 10 W HERE THE T ER M CO M E S F R OM . T H E R E HAVE 11 OTHER TER M S USED W H I C H ARE ALSO 3L00D RELATED 12 IN Trie PAST, 3 U T THEY ALL MEAN THE SAME THING. 13 THEY'RE IN ADDITION, OTHER CELLS INSIDE THE 14 3 LOGO SYSTEM THAT CONSUME, EATS UP 15 PARTICULATE 3 0 D Y THAT THE BOD Y MAY HAVE 16 CIRCULATING IN ITS 3L00D AND THESE ARE CALLED 17 MACROPHAGES OR CUPFFER CELLS. NOW, THESE 18 LIVER CELLS ALSO CAM B E C 0 M E M A L I G N A N T , BUT 19 WHEN THEY DO, THEY FORMA DIFFERENT TYPE OF 20 LIVER TUMOR CALLED A PRIMARY LIVER CELL TUMOR. 21 AND THAT'S THE DIFFERENCE BETWEEN THE 22 ANGIOSARCOMA AND LIVER TUMOR. 23 NOW, WHEN ONE GOES TO
DIAGNOSE THIS, YOU NEED TO TEST THE SYSTEM
THAT TESTS FOR THE 3L00D VESSELS AND MOST.
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T BURRO ~ H R . R E N N E I S E N
1 MEDICAL T E ST SYSTEMS ONLY T S S T FOR the live 2 CELL. AND SO, THE DIAGNOSIS 0 F A M G I 0 S A R C 0 M A 3 IN ITS EA R L Y DEVELOP M ENT IS VERY 0 IF - [CULT. 4 I '1 -ACT, IN THE EARLIEST STAGES, A PEESOM M A Y 5 HAVE NO ABNORMALITIES 0 F ANY TEST THAT WE
6 NORMALLY U'SE. AND SO, ONE HAS TO USE VERY
7 SPECIALIZED TESTS WHERE YOU ACTUALLY INJECT
8 MATERIAL INTO THE 3 L 0 0 0 VESSELS AND OUTLINE 9 T H cM AND SHOW THAT THERE'S SEEN A DISTORTION; 10 BLOOD VESSELS AT A TIME WHEN ALL THE TESTS 11 THAT WE USE FOR THE LIVER AND HOW IT 12 FUNCTIONS APPEAR NORMAL.
13 0.
ALL RIGHT. AT ITS LATER STAGES, CAN
14 ANGIOSARCOMA - OF THE LIVER B E DIAGNOS IED FRO;-'
15 OTHER TYPES OF LIVER CANCER BY A TRAINED
16 PHYSICIAN?
17 A.
IT CAN. THIS REOUIRES A PATHOLOGIST
18 AND A LIVER BIOPSY TO BE OBTAINED.
19 0.
AND WHAT DOES THE PATHOLOGIST DO
20 THEN?
21 A .
.WELL, HE ACTUALLY L00<S AT THE LIVER
22 TISSUE AND DISTINGUISHES WHICH CELL IS 23 abnormal. AND I HAVE SOME I L L U 5 T R a T I V E SLIDES 24 that show THE PROGRESS ION OF THIS F R GM I TS
25 NORMAL STAGE T0 T H E ACTUAL STAGE 0 f THE
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3 ;N G V<i , THIS IS THE R E A L -- - THIS IS
4 N 0 T AM ARTISTS DRAWING, 3 U T THIS IS T H E REAL
5 LIVER FROM A NORMAL INDIVIDUAL SHOWING THE
6 LIVER CELLS HERE. EACH ONE OF THESE (INDICATING)
7 IS THE NUCLEUS OR THE CENTRAL CONTROL CENTER
8 FOR EACH Op THE CELLS. AND THEY ARE IN CORDS,
9 ONE ATTACHED TO THE OTHER. AND ON ROTH SIDES
10 OF THE CELL, THERE ARE THESE p L 0 0 D VESSELS
11 WHICH ARE LINED WITH CELLS THAT ARE THE
12 E.NDOTHEIAL LINING CELLS OR THE CELLS THAT
13 3 c C AME MALIGNANT IN ANGIOSARCOM A. 14 NOW, THESE SLIDES COME FROM A
15 COMPOS IT GF INDIVIDUALS 'WHO HAD TO HAVE 16 3IOP3YS FOR MEDICAL REASONS OR BECAUSE IN OUR 17 SCREENING PROGRAM, THEY HAD SOME ABNORMALITY 18 WHICH MEDICALLY INDICATED OUR GETTING A LOOK 19 AT THEIR LIVER TISSUE. 20 NOW, THIS IS THE EARLIEST
21 CHANGE THAt ONE SEES WITH CHEMICAL EXPOSURES 22 TO VINYL CHLORIDE AND ONE BEGINS TO SEE THESE
23 LINING CELLS HFRE 3EGINNING TO CHANGE IN ,
24 THEIR SHARE AND IN THEIR SIZE WHILE THE LIVER
25 CELL ITSELF DOES NOT.
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14
i AT A LATER STAGE, THE CELLS 2 3ECOME EVEN MORE CHAT: GEO AND DISTORTED IN 3 THEIR CONFIGURATION, IN THE JR SHAPE. NOW, AT 4 THIS TIME, THERE ARE ONLY THE MOST REFINED 5 AND SENSITIVE TESTS OF ABNORMAL l T I E 5, THE 6 THINGS THAT. . `a* E WOULD USE FOR ONLY RESEARCH
7 PURPOSES. THESE ARE VARIOUS TESTS. IT MEANS
8 WE HAVE TO INJECT THINGS AMD LOOK AT PEOPLE
9 AND IN THE STANDARD PRACTICE OF MEDICINE,
10 these would not be detected, at this stage.
11
The PEOPLE WERE "SYMPTOMATIC ".
IT MEANS
12 THEY HAD NO COMPLAINTS. THE REASON WE
13 DISCOVERED THIS, BECAUSE AT THAT TIME, WE 14 WERE DELIBERATELY LOOKING CQ* POSSIBLE
15 PROBLEMS.
16 THIS IS A MUCH LATER STAGE IN
17 WHICH THE CELL.S THAT LIME THE SINUSOIDAL OR 18 THE VESSEL SURFACE HAVE NOW BEGUN TO
19 REPLICATE, GROW, SO, THIS IS THE EARLIEST
20 STAGES OF. MALIGNANCY. AND AT THIS P A R T I C U L
21 STAGE, THE X-RAYS, THE LABORATORY TESTS THAT 22 ARE COMMONLY USED WERE NORMAL. AND AT THIS
23 POINT, THE PATHOLOGIST WAS REASONABLY SURE 24 THAT THIS WAS A MALIGNANCY, BUT STILL HAD 25 SOME CONCERNS BECAUSE THESE ARE VERY T Y I C A L
21110115
T M8U3 R0 - M9 . R EMNE I 5 EN
1?
1 CELLS. HERE, TH I S NUCLEUS HAS 3 E EN BROKEN UP 2 AND THE CELL 1 5 ABOUT TO DIVIDE.- AMD FOP. THIS 3 PARTICULAR REASON, ONE SEES THE D E V E L 0 M ENT 4 OF A ,\ G I 0 3 A .RCOi-lA PRESENTING ITSELF I N 5 COMPLAINTS 3 Y THE PATIENT VERY, VERY LATE In 6 THE STAGE OF THE DISEASE PROCESS. 7 AND FINALLY, THIS IS THE 8 MALIGNANCY ITSELF. AT THIS STAGE, The PERSON 9 IS SYMPTOMATIC, LABORATORY TESTS ARE ABNORMAL 10 AND THIS IS ONE OF THE LATER PHASES Oc THE 11 DISEASE PROCESS. 12 N 0 W , I F E W E R E A l S 0 13 FORTUNATE IN HAVING THE OPPORTUNITY TO FIND 14 X-RAYS, VASCULAR X-RAYS, IN SOMEONE HAD BEEN 15 M E D I C A L L Y E X A ri I N E D FOR ANOTHER REASON AND 16 THOSE X - R A Y S , .W H E ,N WE LOOKED AT THEM 17 RETROSPECTIVELY, HAD THE SAME VASCULAR 18 CHARACTERISTICS AS WE FOUND I N THE SAME 19 INDIVIDUAL FOUR YEARS LATER WH EN HE HAD 20 TUMOR IN THE EXACT SAME SPOT. SO, FROM THESE 21 TWO GROUPS OF STUDIES, WE HAVE EVIDENCE THAT 22 THE TUMOR MAY BE PRESENT AS EARLY AS -OUR 23 YEARS BEFORE THE INDIVIDUAL BECOMES 24 SYMPTOMATIC OR ILL OR AS LATE AS D\e YEAR. 25 AND THIS IS REASONABLE WIT H W HAT WE
2 1 1 1 0 1 1G
T M3URRO - MR. RENNEISEN
'
1"
1 U N DERSTAND the GROWTH' OF T U M 0 R S TO B E ; THAT 2 THEY ARE PRESENT FOR A CONSIDERABLE AMOUNT OF 3 TIME BEFORE THE PERSON IS AFFECTED BY IT- AND 4 ESPECIALLY W.HEN it INVOLVES the liver, since 5 IT is such a enormous organ, HAS SUCH great
6 RESERVE, THAT IT TAXES A CONSIDERABLE AMOUNT
7 OF TIME BEFORE ONE REDUCES THE RESERVE IN
8 ORDER FOR SOMEONE TO BECOME -- HAVE
9 S YM PT 0H S .
10 q.
DOCTOR, .WHAT ARE -- OTHER THAN
11 VINYL CHLORIDE, WHAT ARE OTHER KNOWN CAUSES
12 A N G I 0 3 A R C 0M A OF THE LIVER? 13 I 3 EL I EVE YOU'VE HEARD THEM ALL, 3 U T 14 repeating them. OTHER THAN VINYL chloride.
15 WE HAVE GOOD BIOLOGICAL EVIDENCE THAT ARSENIC, 16 A MINERAL, CAUSES ANGIOSARCOMA; THAT A
17 RADIOACTIVE ISOTOPE CALLED THOROTRAST
18 PRODUCES THIS, and I THINK WE HAVE VERY GOOD
19 EVIDENCE THAT A MALE HORMONE CALLED
20 ANDROGENIC ANABOLIC STEROIDS ALSO CAUSES
21 A N G I 0 S A .R C 0 M AS.
22 q.
FOR THESE FOUR KNOWN CAUSES, ARE
23 THEKt ANY PHYSICAL OR CHEMICAL SIMILARITIES
24 IN THE CAUSATIVE AGENT OR ARE THEY ALL
W
25 DIFFERENT OR ALL THE SAME?
1110117
I v '3 J 1 5 0 _ M o ^ q = v \i c j c; p \]
'
-[7
1 A.
o, .THESE are ALL D I F c E ? E N T A 5 ? \ T S
2 AMD WE HA VE ' SO M EVIDENCE T H A T THE M E C H A ' I S V,
3 3 y WHICH THEY CAUSE the tumor 05 THE
4 lECHAN ISM -v E BELIEVE CAUSE THE TUMOR IS 4
5 'DIFFERENT. FOR I. N 5 T A iN C E , l N THE CASE OF
6 THQROTRAST, THIS IS a RADIOACTIVE MATERIAL
7 THAT IS ATTACHED. TO A PROTEIN THAT IS 8 INJECTED INTO THE INOIVl'DUAL AND IS TAKEN UP 9 8 Y THOSE BLOOD VESSEL LINING CELLS AND HELD 10 THERE. AND THEN ONE IS A 5 L E TO TAKE A FILM OR
11 A X-RAY OF ONES LIVER WITH THESE RADIOACTIVE
12 MATERIALS OUTLINING ON IT. 13 IN THE EARLY DAYS 0 f RADIO
14 ISOTOPES,- WE DID NCT REALIZE THE LIFE OR THE
15 DURATION OF THESE RADIATION EMITTING
16 MATERIALS AND THE THOROTRAST HAPPENS TO BE
17 500 YEARS. SO, IN THIS PARTICULAR CASE, ONE
18 RETAINS THE RAD l OACTIVE MATERIAL AND THE
19 RADIATIONS THAT WE BELIEVE CAUSES THE
20 ANGIOSARCOMA IN THAT CASE; WHEREAS, THE
21 VINYL CHLORIDE I 5 5 E CAUSE OF THE WAY THE BODY
22
METABOLISES IT. I N T HE C A
OF A R S E N I C*, W E R E
23 NOT AS CLEAR ON WHAT THE M E c H A M I SM IS. IN THE
24 CASE OF THE STEROID, T <-< E S E APE STIMULATORS
25 FOR. GROWTH AND WE = EEL THAT HAS -- FLAYS A
21110118
11.1
T .;8uR:<G - . 1 R . V E \i N I 3 E- 'l
'
12
1 JOu IN WHY THE CELL DEVELOPS INTO A T U M 0 R .
2 0.
APPROXIMATELY HOW MANY CASES OF
3 ANGIOSARCOMA ARE 0 I AG VOS I ED IN THE YEAR IN 4 THE UNITED STATES?
5 A.
WELL, THE ESTIMATES HAVE VARIED
6 ANvWHERE FROM ONE CASE IN EVERY FOUR MILLION
7 PEOPLE TO A S P P U AS . 0 N E CASE IN E V FRY 90
8 M l L L I 0 N . 3 U T xOU ghly 2 5` TO 3d CA SES A YEAR
9 HAVE 3 E E N D 0 C U M E NT E D I N V A R I 0 U S SURVEYS.
10 Q.
ARE ALL CASES OF ANGIOSARCOMA
11 ATTRIBUTED TO ONE OF THE FOUR CAUSES YOU JUST
12 DISCUSSED?
13 A.
NO. ONLY ABOUT A QUARTER, 25 PERCENT
14 OF THEM ARE.
15 g.
DO YOU HAVE AN OPINION AS TO WHETHER
16 OR NOT ADDITIONAL CAUSES WILL BE DISCOVERED
17 AS MORE RESEARCH IS DONE?
18 A.
FROM WHAT WE UNDERSTAND ABOUT
19 3I0L0GY AND OUR- EXPERIENCE WITH OTHER TUMORS,
20 I WOULD SUSPECT THAT WE WILL FIND AT LEAST
21 ONE ; MOST LIKELY MANY MORE CAUSES FOR A TtJMCR . 22 I KNOW OF NO TUMOR THAT DEVELOPS BECAUSE OF A
23 SINGLE CAUSE. THE MECHANISM BY WHICH IT MAY 24 EVOLVES MAY 3 E THE SAME, 3 U T THERE ARE MANY,
25 NUMEROUS, l SHOULD SAY, AGENTS WHICH WILL
21110119
T URRO M R . R E N N E I S E `!
1 CAUSE -r U - SAME KINDS OF TUMORS.
2 Q
c ROM YOUR
FROM YOUR STUDIES
i>
1/1
m
3 -- I TH I N < Y 0 U S 'J G G E S T " D THAT I N AN EARL 4 5 DO YOU H A VE I N F 0 R M A T I 0 N 5 C 0 N C E R N I N G HOW VINYL CHLQR I DE IS' actually 6 H A N D L ED 3 Y THE LIVER 2
7 A.
WELL, WE'VE CONDUCTED 30 T H A N I M A L
8 AND HUM AN STUDIES RE LA TED TO THIS . AND I ' M
9 -- I T I S , I THINK, NECESSARY TO E X P L A I N
10 LI T T L 3 t T ABOUT HOW THE BODY HANDLES
11 CHEMICALS TO UNDERSTAND WHY WE SEE VARIATION
12 AND WHY WE THINK WE 'RE CORRECT IN WH A T WE SEE.
13 AND AGAIN, I'D LIKE TO USE, I c I MIGHT, SOME 14 ILLUSTRATION TO DEMONSTRATE THIS AND M A :< E IT,
15 I HOPE, CLEARER.
16 THE LIVER IS A VERY, VERY
17 INTERESTING ORGAN I IN THE SENSE THAT IT IS
18 3 1 0 L 0 G I C I A L L Y DES I GNED TO GET RID OF A 3 N 0 R M A L
19 PRODUCTS. 3 U T THE CREATOR MAY OR MAY NOT HAVE
20 ANTICIPATED THAT WE'D USE SYNTHETIC AGENTS.
21 3 U T IT IS DESIGNED E VO L U T I 0 N A R Y - W I S E TO
22 HANDLE NATURAL AGENTS. NOW, WHEN IT GETS A
23 SYNTHETIC PARTICULATE, IT HAS A LIMITED
24 NUMBER OF MECHANISMS BY WHICH TO HANDLE THESE
25 AGENTS.
1110120
t:
i
1 N0 W, THIS SIMPLY ILLUSTRATES 2 the chemical- formula for vinyl chloride down 3 HERE. IT'S A VERY SIMPLE MOLECULE. IT HAS TWO 4 C A R 3 CN AT 0 M S AND THEN A CHLORIDE. AND THESE 5 ARE JUST SIMILAR STRUCTURAL AND SYNTHETICS. 6 NOW, IT'S THESE TWO CARSONS 7 THAT ARE ATTACHED 3Y BONDS, AND THESE BONDS 8 CAN BE BROKEN, IN FACT, THAT'S HOW YOU 9 METABOLIZE SOMETH IMG, YOU BREAK THE. BONDS OF 10 A MOLECULE IN THE SUB STANCE DEGRADA TED. 11 NOW, THE CHEMISTS AT DC!W AND 12 AT SOME OF THE U N I V E R S I T I E S IN ME W YORK HAD 13 6 c c N u 0 I NG SOME CHEMICAL STUDIES ON HOW VINYL 14 CHLORIDE M U L T I P L Y 5 . AND T H E S E ARE THREE S TE PS 15 BY WHICH IT IS METABOLIZED. THE FIRST STEP 16 AND THIS IS VINYL CHLORIDE. 17 'THE COURT: DOCTOR, WHAT DO 18 YOU MEAN BY METABOLIZE, SO THE JURY WILL KNOW. 19 THE WITNESS: METABOLISM IS A 20 WAY OF BREAKING DOWN A SUBSTANCE, BURNING IT 21 UP. THE SAME THING ONE WOULD DO IN BURNING 22 COAL. YOUR CONSUMING IT OR CHANGING IT IN ITS 23 STRUCTURE. AND IT'S A GENERAL TERM FOR THAT. 24 THE ALCOHOL -- THE FIRST 25 STEP IS THE SAME ROUTE THAT IS TAKEN FOR
21110121
21110122
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2:
i i S A S T m 3 L c. ij u 3 i T h C E ' A M 0 M A X I NG IT I N T Q A . 2 CANCER PROOUCING SU3STANCE. 3 Ni 0 . / , THE LIVER, ALSO W H I L E 4 IT'S DOING THIS, GETS RID OF IT 3Y A 5
NEC HAN I S M OF CONVERGING ON THIS W I T H W A TER 6 AND THEN BEING ABLE TO RELEASE IT OR EXCRETE
7 IT INTO THE BODY. AND THIS BALANCE BETWEEN 8 HOW MUCH IS MADE AM D HOW MUCH IS GOTTEN RIO
9 OF WE BELIEVE IS A CRITICAL FACTOR I N W H E th pr 10 the TUMOR IS )F V5L0ED .
11 NOW, THIS IS JUST A DRAWING
12 ILLUSTRATING ON -A LIVER CELL, THAT SQUARED
13 CELL AND THEN THE ' L I MI MS CELL, THAT'S AT THE 14 surface, it is our p r e s e n t belief that vinyl
15 CHLORIDE AND POSSIBLY OTHER CHEMICALS SIMILAR 16 TO IT ARE TAKEN UP BY THE MAJOR LIVER CELLS 17 AND THERE THE INTERMEDIATE ACTIVE SUBSTANCE, 18 THE APPOXY, IS FORMED. AND DE PEND I NG UPON HOW
19 WELL THE LIVER CAN' GET RID OF THAT IS A
20 CRITICAL FACTOR IN W H E T H E R OR NOT THE LIVER
21 CELLS BECOMES M ALIGN ANT OR 'WHETHER r T BECOMES 22 INJURED AND DIE S .
23 NOW, THIS ALSO HAPPEN S TO
*0
24
HOLD TRUE FOR T HE LINING C ELLS. IN FA CT, FOR
K
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25 ANY CELL IN THE BODY. IT DEPENDS ON THEIR
T
1 ABILITY TO GET R I J 'JiC *1** -J. ri 5 S U 3 S T a N C E T U j. T ' S
2 MADE. AND 0 E PE N D I N G U P 0 M THAT C A P A P ILI T v , one
3 F IND S THE r S < 0 F r \! ^ I N C R E A s [ N 0 W I T M T-E
4
,o F f
^ c - n i 3 [ L 1 t r DR. REVE 7 S E .
5 N OH, WE 3 ELI5VE THIS C \ v ,
6
ACCOUNT OR
u y s 0 y E P E 0 P L E DEVELOP M-L 1 G '! A N C Y
7 and others DON ' T AT VERY, V E R Y L 0 W L E V E L s. 8 the liver c ELL C A N HANDLE T H E M E T A 3 0 L I 5 M OF 9 This CO ih p 0 J >i 0 AND ALSO IT S REMOVAL OF TH
10 I N T ,R M E D [ A T E M ATE RIAL. AT A MORE M 0 D E R A T = 11 LEVEL, IT MAYS E 0 V E R W H E L M ED AND ALLOW TH C
12 A P 0 XS I D E TO S E A'R 0 U N D AMD DO DAMAGE TO T H
13 NUCLEUS OR TO THE GENETIC MATERIAL AND T H E M 14 THAT INJURE D C ELL C A N G 0 IN THE FU T UR E A V '
15 DEVELOP CANCER. AT VERY HIGH LEVELS, I T 16 ACTUALLY <IL L S the C E L L AN D THE M THE P 00 Y
17 REPLACES IT WITH ANOTHER ONE AND THERE 15
18 THEN NO DEVELOPMENT OF CANCER 3ECAUSE THE
19 CELL THAT W A S INJURED HAS D I E l). a m :) SO, THERE
20 MAY 5 E PE OPL E W H G C A N GET THE 3 A M E LEVEL OF 21 EXPOSURES I N ;VH C M THE :R E ' S CELLS THAT HAVE 22 3 E E N VJ E N L T I C A L L Y TRAN S F OR M E D , D I ED A N D 23 therei-grc, though thcY've 3ccn exposed in the 24 SAME LEVELS, THEY DO'MOT DEVELOP TUMORS.
25 0.
DOCTOR, HAVE YOU ACTUALLY TREATED
2 1 1 1 0 1 2 -*
T
R30 -
1 ANGIOSARCOMA PAT I EOT S'?
2 A.
YES,
HAVE.
3
4 i'i 0
A ND
4 A.
w z. HAVE T ?. t 4 T E 3 SIX A N G I 0 5 A R C 0 M A ,
5 FIVE AGE VINYL CHLORIOE EXPOSED INDIVIDUALS
6 AND A SI X T H -;i A S 0 N E W E DON'T REALLY HAVE THE
7 SOURCE OF THE ANGI OSARC CMA.
8 Q.
WITH RESPECT TO THE VIMYL CHLORIDE
9 EXPOSED PATIENTS, DO YOU <NCW WHAT THE
10 ESTIMATED LEVEL 0 F V I V Y L CHLORIDE WAS?
11 A.
IN ALL FIVE CASES FROM OUR DETAILED
12 0 C CU P A T 1 0 A L RECORDS, THEIR E X P 0 3 U R E S LEVELS
13 WERE ABOVE 50 PARTS PER MILLION AND W E' 14 ESTIMATE SOMEWHERE' IN THE RANGE OF 20J TO 53U
15 OURING A GREATER .PROPORTION OF THEIR WG R K 16 HISTORY.
17 Q. 18 A.
DOCTOR; WHAT IS EPIDEMIOLOGY? THIS IS THE STUDY OF THE DEVELOPMENT
19 OF DISEASE IN POPULATION. W E CAN STUDY IT IN 20 AN INDIVIDUAL, 3 UT THERE ARE ALSO TIMES WHEN
21 WE WANT TO STUDY - THE OCCURRENCE
DISEASE IN
22 GROUPS OF INDIVID U A L S, WHERE WE 1 R E NOT
23 ACTUALLY S T U D YIN G THE INDIVIDUAL D I S E AS E 24 PROCESS ITSELF. AND IT IS THIS AREA OF 25 MEDICINE THAT A L L 0 W S US TO D E T E R M I NE THE
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1 C 0 ,'4 PAYABLE ? 0 P U L A T I n t u 4 T 3 r, = z .\j q t . a s;n 7 h = \| 2 Y DU F I : J D 0 U T UFTHER THE OCCUR 9E N C E 0 - THE 3 D I b : A 5 E 0 C C u 7 3 N Y GR E A TER I :'l ONE ? 0 P U L A 7 I 0 '
4 VERSUS A OTHER . A 0 ,V , IF IT DOES, T H E '4 YOU 5 ri A V E m VERY HIGH PROBABILITY, 95 C ri A U C E 3 OUT 6 OF A HUNDRED, THAT THAT 15 RELATED TO THE 7 S'l V I RON,RENT OR TO THE AGENT YOU'VE IDENTIFIED 8 IN ANOTHER. AND 3Y REPEATING THAT SAME STUDY 9 IN ;; H I C H POPULATION AND FINDINGS THE S A M E 10 RESULTS, YOU IN C E E A S E THE RELIABILITY THAT
11 THAT'S A TRUE EVENT, THAT -DID NOT HAPPEN' by
12 CHANCE.
13 Q .
VARE 0 !J F .4 M [LIAR W I T H
14 EPIDEMIOLOGICAL STUDIES DONE WITH RESPECT TO
15 VINYL CHLORIDE a m q ANGIDS ARC 0 H A ?
16 A.
.MOST I ATT .
17 Q.
AND HAVE YOU DONE STUDIES YOURSELF?
18 A-.
'.lE HAVE.
19 Q.
WITH .RESPECT TO THE STUDIES THAT
20 YOU'VE DONE YOURSELF, WHAT GROUP OF PEOPLE
21 DID YOU -- WHICH G R 0 U0 3 OF o=nLS DID YOU
22 C CM PAR E ?
23 A .
WELL, IT IS NOT ALWAYS E A S V . H \< = OF
24 THE MAJOR LIMITATIONS TO E P l D EM I 0 L 0 0 I C A L
25 STUDIES IS T H A T WE HAVE 0 I FCERENT 0 0 P 'J L A 7 ION.
iz n n rf?
t 0 - r i R. A N iN i S >1 N
2.
1 .; HAVE DIFFERENT RACES, OF DIFFERENT SEX, WE L HAVE DIFFERENT EATING PATTERNS, DIFFERENT
_ I V I `I G PATTERNS, D I FF ERE NT E N V IRO'iENTAL 4 patterns, so, you try to get a .match in the 5 ? 0 p U L A T I 0 N AS 5 E 5 T YOU 0 A N . 6 NOW, THE VARIATION TO THIS, 7 YOU CAN TAKE ONE POPULATION AND DIVIDE IT 8 INTO TWO G R 0 U 3 5 A NO A X E A CO .*- A R I S 0 N I N THAT 9 WAY, OR YOU CAN GET TwO GROUPS FROM DIFFERENT 10 AREAS AMD MAKE A COMPARISON . ./HAT W E WERE 11 A d L A MO ,s ERE F.OR T UNA TE N 0 U GH TO DO IS T D 12 HAVE A POPULATION OF INDIVIDUALS WHO WERE
EXPOSED FOR A VERY LONG T I ME AT WHAT IS 14 3 E L l E V E D TO 3E THE HIGHEST LEVELS AND ALSO 15 THE LOWEST LEVELS OF VIH Y-L CHLORIDE. AMD 16 A 3 0 U T 1 , 2 0 0 OF THESE INDIVIDUALS AND A 30 U T 17 500 RETIREES WHO HAD WORKED IN A PROLONGED 18 PERIOD OF T I M E AND W E W A T chfd THE I R T9 DEVELOP M ENT. A \ D W E W ERE A3 LE TO S E PERATE IN 20 THAT GR OUP 3 E TWEE N THE G R 0 u ? THAT W O R K E D WITH 21 V I N Y L C H L O :R I D E AMD THE GR OUP THAT O R KE D WITH 22 SYNTHETIC RUG 3ER OR NAS A 3 L E T 0 S h O W THERE 23 WAS A O 1FFE RE is CE IN THE TYPES OF DISEASES I 24 these two groups and that it was rslated to 25 W OR <. WE w ERE ALSO DOING STUDIES IN
8ZTQTTTZ
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9"
1
p j 3 ; [ <* a T A 9 ~
H 0 Q? K = D A ~ ^ t -* = ? ' L ' v T -3 A. 'i ~
2 LOOKING c 00THE -0 C C U 0 0 r '! C F 0 c L I V E R DISEASE
3 A -!0 'i G THE -! 43 V I 0 E : 1C >E
E ^ P 0 S U 0 E TO THE
4
CHEM I CAL ' I N
C 0 0 EAT I 50 0 TO 0 T H E 0 G 0 0 U 5 S A H 0
5 WORKED wITH 0 1 F F 5 R E N T KIND OF AGENTS. AMD
6 T.l I 5 W AY, WE'VE SEEN A S L TO FI N D 0 U T W H E T H E 0
7 OR NOT T h E R wAS A GREATER OCCURRENCE OF
8 LIVER DISEASE OR OTHER KINDS OF DISEASE AMONG
9
THESE WORKERS.
LET'S TAKE THE HIGHLY EXPOSED
10 GROUP. DID YOU F[MO A HIGHER INCIDENCE THAN
11 EXPECTED IN ANGIOSARCOMA AMONG THAT GROUP ?
12 A .
YES, A N 0 '/ E W ERE A 3 L E TO IDE M T I e Y
13 THE AGENT 3 Y THESE EPIDEMIOLOGICAL S T UD I E ? .
14 0 .
.1 H ,ru ^ t 1 a ^ t -) ~ ~ ' P 0 9 'J R ~ ! F Y F L O c
15 THAT G R G U 3 ?
16 0.
EXPOSURE-LEGAL OF VINYL CHLORIDE?
17 A.
VIE HAVE TO DO TH I S ON THE BASIS OF
18 HISTORY, BE CAUSE WE DO NOT HAVE ASSOLUTE DATA 19 SO, I W GOLD LIKE, I F I CAN , TO ILLUSTRATE H 0 W
20 At WENT ABOUT DOCUMENTING THAT THE EXPOSURE 21 wAS HIGH AND THEN TO- SHOW WHAT EVIDENCE WE 22 HAD AND WHAT THAT EXPOSURE - - THAT, QUOTE,
23 H I GH EXPOSURE WAS, IF I MIGHT. ''HEN DOCTOR
24 CREECH AND DOCTOR JOHNSON h a 0 D I SCOVSREO "HE
25 a N G I 0 S A R c 0 M A I N M A N , W E H A D A U N I O U
21110129
1
r J 1 < 0 - R . .7 N N I 3 E N
i S IT u * T ION' o c C A U Cw w- i>.r uZ ri .-A '_j AM I ii A L j i u 3 1 5 5 5 V E N
2 6EF0RE THAT OR AT THE SAM c T I M E , WHIG h nAD 2
3 n 0 v, .4 T n A i I F Y 0 U USE 0 '-J L V V I N Y L CHLO RIDE,
4 Y 0 U PRODUCE THE T U M 0 R . 3 U T I M T HE EAR L Y
5 STAG ES, IT W A S U M CLEAR WH E T HER 0 R N 0 T [ T W A S
6 THE V I N Y L C H L OR IDE IT SELF >' THE M 0 U 0 '1 E R TH A ""
7 YOU HEARD A ROUT , 0 R W >-) r 7 H ER I T ,i 2, c T H p
8
POLY i P R OR
THE
P0LYV
T
'! Y L C
HL O R
I
D
c
-
>
t u' e
O 3 O 0 'J r 7
9
THAT CAUSED TH I S . ' A N D S 0,
S PA R T 0" OUR
10
M A T I 0 N A L C A \| r c H
INSTI T ij T E
/"
7
3
:VMT
,
-i E W E NT
11 A 3 J U 7 SE T T 1 or U P A 5 Y S T EH; 7 A T WOULD ALLOW US
12 TO 0 E T E R M I M E EXPOSURE 3 AS ED 0 N ' ! H E R E PEOPLE 13 n A l) Vi URGED, H 0 W L 0 N G THE Y HAD Vj 0 R n E D AM D 14 WHE TH ER OR NOT THOSE JO 3 S w c. R E ASSOC ! A TED
15 W L T H VINYL CHLORIDE IN A
WHAT W E C A L L A
16 RANK 0 R D E R I N G; THAT is. THAT WE WOULD TAKE A
17 SETS OF INDIVIDUALS, S I X THAT WE TOOK, MAKING
18 ZERO PEOPLE WHO WERE OUt4^DE THE PLANT
19 ALTOGETHER, ONE WOULD RE THE MINIM UM AMOUNT 20 OP POSSIBLE EXPOSURE ONE COULD HA Vc, A v0 3 [ X
21 using those -people who were intimately 22 I NV 0 L V 0 W I T H THAT. AMD 3 Y THE USE 0 F THIS
23 RANK ORDER ING ANp THE X I M D S ' CF JOSS THAT T?
24 I jN L) I V I DUALS HAD, w E WERE A3 L E TO DESIGN AN
25 ciT I MATS THAT DID MOT HAVE AM ABSOLUTE FIGUR E
21110130
7
T M 3 LI R 9 0 - M ,9 . ,< 5 N N E I S E N
TO
1 0 N HO HAD THE HOST EXPOSURE RELATIVE TO 2 THEIR C 0 h P -A \! Y 0 OXERS . AMD P Y DOING THIS, W E 3 i ERE A => l E TO SEE W - ~ T H E 0 OR NOT THOSE 4 INOIV I DUALS :i ! T H THE HIGHEST lOd ,T_ ' *y HV ~ r n 5 EXPOSURE ON THESE ESTIMATES VI ERE M 0 R E
6
ASSOCIATED
I T H ANGIOSARCOMA t h a THOSE / H0
7 HAD LESS. AMD ;! HAT TH I S 0 EM0 N S T R A T E J w AS THE
8
FOLLOW I N'G :
EACH Of THESE COLUMNS HAS MADE UP
9 uF l I i T L c STAC IN/ cJ EACH STACK I S AN INDIVIDUAL
10 W r, 0 HAS A w 0 R A H I S TORY ES TI MAT E OF THEIR
11 EXPOS URE TO A C H EM I CAL CALLED ACRYLONITRILE.
12 WE EXAMINED 22 CHEMICALS. THIS IS JUST SIMPLY
13 ONE TO ILLUSTRATE THIS. THIS IS THE EASE 14 CHEMICAL FOR T H~ FORMAT I 0 m OF SY'-ITMiTIC
15 R'JBSER. 16 N 0 v: , W E HAD F 0 U M D F 0 U 17 ANGIOSARCOMAS DURING THIS TIME OF 1074 TO
18 1 0 7 7 . AMD EACH A N G10 SARCOMA CASE IS
19 ILLUSTRATED IN RED. NOW, THE POSITION THE
20 ANGIOSARCOMA HAS IN THESE GROUPS OF
21 l N D I v [DUALS IS RELATIVE TO THEIR EXPOSURE TO 22 This particular chemical, and what this 23 SIMPLY ILLUSTRATES I S THAT FOR men of TuE
24
SAME SEX, ROUGHLY the SAME A 0 c
PLUS OR
INI
25 A YEAR W H 0 W 0 R .< E D FOR THE q A M 5 NU MS E 3 OF
2/110131
I 1 :3 J R ? 0 - MR. 7 i: V \i ; [SEN
'll
1 YEARS, T.iii * TOTAL 3 T I MATEO EXPOSURE TO TO IE 2 particular chemical put them somewhere in the
3 M l DOl OR Trie LOWER END CF THIS CHEMICAL, 4 INDICATING TnAT THE ANGIOSARCOMA CASES 0 I D 5 NOT HAVE A r> I G,i ASSOCIATION WITH, THIS 6 CHEMICAL. 7 N0 W, W HEN WE LOOK at VINYL 8 CHLORIDE, WE SEE THAT THE ANGIOSARCOMA CASES 9 ARE' THE HIGHEST OR AMONG THE HIGHEST I N THEIR 10 EXPOSURE to VINYL CHLORIDE, ILLUSTRATING ON 11 -- 'THEN -"ROM AN EPIDEMIOLOGICAL POINT OF 12 v I E , THAT IT IS VERY HIGHLY PR 03 A RLE THE 13 CHANCES OF u 5 -i A ,< I N G THE ERROR IN T H E S E 14 ? >\ < T I C J L A R CASES STATISTICALLY IS ONLY CnE IN IS A THOUSAND, SO, IT'S A 99 -- 900-99 CHANCES 16 WE 'RE RIGHT WITH THIS HYPOTHESIS AND ONE 17 CHANCE WE'RE WRONG, THAT THIS PARTICULAR 18 T U MOR IS ASSOCIATED WITH VINYL CHLORIDE 19 EXPOSURE. 20 NOV/, OF THE 22 CHEMICALS THAT 21 W E HAVE A CHANCE TO LOOK AT, ONLY POUR 3 H OWE O
22 THIS ASSOCIATION. N0 W, ANY T IME YOU TRY TO
23 TAKE A LARGE N U m 0 E R OF POSSIBILITY S "> N 0 3 U T 24 THEM TOGETHER, Y CHANCE, YOU'LL COME UP WITH 25 AN ASSOCIATION. IT'S ESTIMATED THAT IF YOU
2JU0132
BURRO - M R . REN N E I S E N
1 HAD 2 0 P'O S S I 3 I L I T I E S, ' YOU 1 0 HAVE A N AT LEAST 2 ONE BY CHANCE, M E A N I N G I T W A S N ' T REAL, J 'J 5 T 3 l-i ^ p p c'\j n p y C H A N C c that v 0 U S A w thiI 4 ASSOCIATION:. WELL, WE C A M E U W I T H <= 0 U R . WE 5 WE 3 E FATHER SURPRISED RECAUSE TPAT W AS higher 6 THAN W E WOULD HAVE EXPECTED. A N 0 HAVE SOURCE, 7 ivE DID EXPECT THE VINYL CHLORIDE, 3 U T WE HAD 8 T..0 OTHER -- THREE, other AGENTS; ONE OF 9 WHIGH WERE CATALYSTS THAT WE U S E 0 W ITH VINYL 10 CHLORIDE TO CONVERT IT INTO THE POLYMER. THE 11 section was a solvent, so m e t h i n g to q i s o l v e 12 THE CATALYST. AND THE THIRD, WHICH IS 13 SPECIALIZED CATALYST USED IN VINYL CHLORIDE. 14 SO, all OF THE SYNTHETIC RUBBER CHE '1IC A L S , 15 THE ONES USED FOR RUBBER MANUFACTURING DID 16 NOT SHOW ANY ASSOCIATION. RUT THE AGENTS 17 THAT WERE USED WITH VINYL CHLORIDE SHOWED 18 THAT IT DID. AND THIS FURTHER DOCUMENTED THAT 19 OUR ESTIMATES, OUR -WORK ESTIMATES A 3 OUT THEIR 20 EXPOSURE WERE CORRECT EPIDEMIOLOGY AND THIS 21 a A S A S S 0 C I A T E U I T n THE DEVELOP M ENT C F C A N C E FI . 22 N 0 W, WH E N WE W ENT TO LOCK AT 23 LUNG CANCER, WHICH IS ALSO HIGHLY SUSPECTED 24 OF BEING ASSOCIATED WITH VINYL CHLORIDE, w E 25 WERE UNABLE AMONG OUR SEVEN' CASES OF LUNG
eeTom z
r ;3j
[ 3 5M
1 C A N C E R T 3 3 H C : r U T there was A N Y AS 3 0 C 1 A 7* I "> V
2 /; J T H .w N Y- OF T H E R U 3 3E R CHE M IC AL5 A S
3
1 L-
T R A T ED i Y
C R Y L 0 N I T R I L E A 0 A L 5 C T H -4 j
4 there :i A S N ' T A :N Y T H [ i \3 02 w' C I A TED W I T H V l y j
5 C H L 0 R I D . \ o w, THIS HAS LED U S TO S I M PLY
6 CONCL UD E THAT THERE IS AN IN C REAS E I N C A ;v r s ?
7 OF TH E LU N G, BUT THAT IT IS MOT A S 3 0 C I A T E D
3
SPICE M I 0 L 0 G Y W I T H THE CHEMICALS WE LOOKS
AT
9 AND THAT >1 E A M S W E S TILL HAVE TO F I ND THE
10 AGE N T
11
/\ V
DOCTOR, IN YO'JR SIX CATS GOR T * S C1 ~
12 E X PCS JR E 5 r P C `*1 P-S 0 P L E OUTSIDE THE P L A M T u -
13 THRO ij GH T H z V A R I 0 J 3 LEVELS, ! N ''! H I C H CAT Z .j 0 R Y
14 DID Y OUR
THE A i G I G 3 A R C 0 M A c s - : T r! A - Y 0 J
15 FOUR D r A L w1 V
16 A ,
they WERE .-1 0 S T L Y IN CATE GOR I E 5 OF
17 FOUR, FIVE AND SIX. WE FOUND N 0 N E W H 0 F E L L
18 INTO THE C A T E G OR I ES OF ZERO, ONE, T.W 0 OR
19 THREE.
20 0 .
AND WHAT T Y D E S OF JOq S OIO FOUR,
21 FIVE'AMD SIX HAVE?
22 A .
WELL, THE INDUSTRY A 0 A
23 F 0 R GIVE M E FOR USING THE ? 0 "! G TE R " , I ASS J M
24 THEY HAD SOME SORT qp SENIORITY 0R0E R .
25 EVERYONE .-.HO CAME TO WORK DID ONE JOB r PST
21110134
i t
t
8 9 10 11' 12 1314 15 16 II. 18 19 20 2T' 22 23 24 25...
! J ?. R 0 - ;-it. .. N \' ISSN
A ;N D THAT ,i AS v; 0 R .< IN G I \ The C LE AM I MG ON OF THE 3 l G VATS # A N D SO, /T KA 8 A S THE WORKER
then ' W OULD 3 E PR C .'4 n T " H
f-4 O W > 0 U L 0 LEAVE that
JOS . SOME ST A Y E 0 0 N T H A T JOT L 0 MGER T rp E 5 T H A N n* r h p- ps c- / =? 'J T all c f T H E H M A 0 ': 0 R K E 0 = 0 7 C 0 N 5 IO=RA3L= PER T 0 0 S OF TP-'E I >: these vats
A ?. 0 U N D THESE VATS.
yr^f^r tfrsrrt'n
I A L h R 0 '-j m H I L i t~T
0135
* A H >J q o fj _ y 9
o .= M M rr f c p y
Uj.MJJMIH.I iu.,1.1! U.Jiumi .UUJ... 1 -tAT -H-ASrg.tiASfTS' g*f-VM gfrWM'E i
2 Then 0N WOULD H WE EXPECTED that :3> r ^ M ' T . WOv.',
3 1I
I T BECOMES SUSPICIOUS .-i H :
4 '< D T ri A 7 IS :i H Y 0 \ : D 3 c 5
5 EPIDEMIOLOGICAL STUDIES, TO FIND OUT WHETHER
6 YOUR SUSPICIONS ARE CHANCE HAPPENINGS OR
7 WHETHER OR -NOT SINCE YOU'RE REALLY SEEING
8 SOMETHING THAT'S REALLY HAPPENING.
9 0.
DOCTOR EPSTEIN TESTIFIED CONCERNING
10 A NGI 0 3 A RCOMA AT L 0 W LEVELS OF EXPOSURE. I
11 3ELIEVE HE DISCUSSED P V C F A 3 R I C A T B c 0 R C E 12 EXPOSED TO LEVELS 0" NONE DETECT A RLE TO T >/ 0 13 PARTS PER MILLION. AS A RESULT Oc STUDIES 14 DONE 3 Y YOU OR Y 0 U R R 5 E A R C H , n o YOU <N 0 W IF
15 T H E R E IS ANY H 1.5 HER I NC I DE NC5 OF - A N G i 0 5 A R C C M A
16 AMONG PVC FAS 3 I C A T E FORCE?
17 A .
BOTH BY OUR STUDIES AND THOSE THAT
18 HAVE BEEN PUBLISHED, VIE HAVE NOT FOUND ANY
19 EVIDENCE THAT THE PVC PRODUCTION WORKERS OR
20 FABRICATORS HAVE ANY INCREASED INCIDENCE OF
21 EITHER INJURY ASSOCIATED WITH CHEMICALS OR
22 WITH A MG I OSAR CO r. A .
23 0 .
I F A N AGENT IS `('13 V * to CAUSE A
24 PARTICULAR -- I M SORRY. IF. A V AGENT IS
25 KNOWN TQ CAUSE CANCER IN A PARTICULAR PART OF
M
90TOTTT
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1
O \ v vJ _ O
D i- . 'i :\ e is-:
J
1 T1 i _. ---- BODY, AIL L I T N EC E S S AR 1 L Y C A USE rH. H/-*. I'N. C E < T 0 2 0 T hi if R PARTS 0 P THE BODY ?
3 ONE H A 3 T\j U N 0 E R S T A N D T h .* T E V E D '* C LL
4
ri A S A DIFFERS M T J OR
\j r) Hi Q D I F F E D " m T
5
CAPA B I L I T l E S . A no the r e a s o N W E R EL I EVE
,\i c
6 CELL DEVELOPS r AN'C E 5 A M 0 A N q T |-| c n 0 0 ESN ' T I 5
/ DE PE NDENT UP 0 >! T n $ E capabilities A N D AS Y OU 8 5 A W ILLUSTRAT " n [ N the live R I T S E L F w i m H T \fi 0
9
0 IFF E R E nT
CEL i
p
>
n f-- PEND l \G
ON
THE I R. A B I L I T Y f
10 THEY EITHER D E V E L 0 P C A 0 C t. k 0 \ THE V ) 0 N ' T . I M
11 GENE R a L, YOU CAN BE HIGHLY 3 US P I C I 0 US T i A T
12 0 N E C HEM I CAL, i F I T D E V E L 0 P S A c A IN u ER I N 0 N -
13 T I S S UE MAY DO I T I N OTHERS. 3 UT Y ou CAN N 0 T
14 SAY BECAUSE I T
LOPED IT [ N 0 N rr T I S 3 j -- p I T
15 W i L L DEVELOP IT I N OTHERS. A N D 0 N E HAS TO 16 TAKE INTO CONSIDERATION HOW THAT "ARTICULAR
17 AGENT IS. HANDLED BY THE CELLS AND WHETHER THE 18 CELL HAS THE CAPABILITIES OF DEFEND T N G ITSELF.
19 AND THOSE CELLS THAT DON'T, THEN TME
20 PROBABILITY IS CREATE0 THAT T H E v 'LL HA 3 3 = ' i .
21 AND IF IT DOESN'T, IT WON'T. AND SO, YOU 22 C A N'T JUST M A K A SIMPLE STATE Pi ENT T H A T
23 cancer developments in one tissue will
24 DEFINITELY DEVELOP I N ANOTHER.. YOU C A N 3 E
25 5 u 5 r iC l0 U S , iU T YOU HAVE TO 0 EH0 '; S TR A TE IT.
21110137
T
E v! \' E I 3 ~ N
X
1 C.
DO T r* qj c O 5 T - TNI H A S DISC US S 5
EIGHT-
2 CASES OP AN - [ 0 S A ?. C 0 >1 A IN I NO I V I D J A L S L ! V I N G
3
i I T ih I .'i T ,v C
ILES 0 ?
VC P L A T S A ND M "
4 RE=ERRED T_C A R T I C L E S ^ Y C u R I ST IAN, 3 A X TER A N0
5 3 R A J Y . F l .< 5 u r A L L; AR: Y 0 U FA .4 I L I AR W I T H
6 T ri 0 S 5 ARTICLES?
7 A.
YES.
8 Q.
DOESTHE EXISTENCE
OF THESEEIGHT
9 CASES MEAN THERE IS A 'SU3STANT I A L MEDICAL
10 P R 0 3 A 3 I L I T Y THAT THEIR ANGIOSARCOMAS WERE
11 CAUSED BY VINYL CHLORIDE?
12
MR. VASE A LOTT I:
EXCUSE MC.
13 ARE YOU ASKING THE DOCTOR Pi HIS OPINION.
14
1 3 #9 E NM c I S E N J
yc AH ,
IN M I
IS OPINION, I'M SORRY. SHALL IR E P H R A S E THE
16 QUESTION?
17
MR. VASSALOTTI:
NO, I JUST
18 N h N T iz D IT C L ci H R
19 BY M iR . RE N N I S E N 1
20 Q.
IN YOUR OPINION, DOCTOR, DOES THE
21 EXISTENCE OF THESE EIGHT CASES MEAN THAT
22 THERE IS A SUBSTANTIAL MEDICAL PR 03 ABILITY
23 THAT THOSE INDIVIDUALS HAD ANGIOSARCOMA
24 CAUSED BY VINYL CHLORIDE?
25 A.
WELL, THE PRESENCE Oc THESE CASES
80TOTTTZ
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1 HA VC HADE J 5 ALL SUSPICIOUS THAT T --i [ S
o POSSIBILITY M I G H T EXIST A X D T n A T 1 S W H Y THE
3 E P I 0E,-i I OLOG I CAL STUDIES WERE CARRIED OUT. N G w ,
4
those epidemiological studies have mot
5 VALIDATED THAT THERE IS A CAUSAL R E L A T I 0 N S H I p .
6 M 0 W , - IN! EPIDEMIOLOGY, HE C A N MOT PROVE A
7 NEGATIVE. YOU PROVE ONLY A ?OSITIVE. AMD SO, 8 W H A T / E H A V E IS I N C R E A S I N G ATTEMPTS TO = r n y = 9
THE POSITIVE COMING UP WITH THE NEGATIVE. AND 10 SO LONG AS THAT CONTINUES ON, WE DO NOT HAVE
11 SCIENTIFIC DATA THAT SAYS. ThAT THESE CASES
12
vv E R t ----
DID NOT HA P P E
3 Y CHANCE.
13 0
I'D L 1 X E 1 '-J A S is YOU A H Y P 0 T H E T I C A L
14
Q 'J c s T i o ,\ :
;J 0 C T 1J R , A S S J M E T'i A T J 0 H M C G R A 5 5 0
15 i< A S BORN ON- DEC EM 6 ER 2 7/ 1927 AND WAS 16 E M P L 0 Y E D AT THE DUPONT C H AM B E R S W 0. K S FROM 1 0 17 44 UNTIL 1973 WITH A PERIOD AROUND 1950 WHEN
18 HE HAD OTHER 'TYPES OF EMPLOYMENT ; ASSUME T HA T
19 MR. GRAS SO LIVED 1.7 MILES FROM THE B . F . 20 GOODRICH PE OR I C <7 OWv PLANT FROM THR oats- j t
21 OPENED IN- 1 9 7 0 UNTIL HIS DATE OF DEATH IN 22 1977. ASSUME FURTHER THAT THE ?EOR fCKTCW v
23 F L a H T IS rl N S A L E i-l 0 U N T Y , W H I Crt GENERALLY IS
24 a RURAL AREA AMD A 5 S U H THAT W H z i\ -1R . GRAS 5 0
25 w a S AT DUPD;, T, DUPONT USED A GREAT NJM 3ER OF
6BT0TTT:
7
T -1 3 U P. R 0 - MR. R Z '1
1 CHEMICALS; 4 S S 'JME THAT MR. 5 9 A S S 0 -/AS 2 HOSPITALIZED I '-I j'j S> = Qi= 1 n 7 s H E N UE ME G A ':
3
COUGH [MG U RL00D A HO
A D 0 T H - R c y v. p t n c \ -; >
4 CONDITIONS AS DE 3 C R I E 0 IN 'lie u 0 3 P I "r ;i l
5 R h C U' R D S W H I C H I ' V E SUR M [TTED TO YOU -35 voUR
6 REV I E W . A 5 3 U M E THAT M '< . GRA530 :i A S
7 H05P I TAL IZci) AT THOMAS J t F F t R 3 0 N El ED I C A L 8 COLLEGE I i i AUGUST OF 19 7 5 AND THAT ON iAUGUST 9 5, 19 7 5, THE D I A G NOS I 5 OF AN G I QSARCCMA OF THE 10 LIVER .v A S MADE. ASSUME THAT THE PL AMT j ,m 11 PE DR ICKTO W N DID OPEN 0 N MARCH 25, I ? 7 0 A N D I T 12 A A M UP AC TUR ED POLYVINYLCHLORIDE. DURING THE 13 COURSE 0" THE MANUFACTURING P R 0 C E S S , V l N y L 14 CHLORIDE GAS -'/AS EMITTED INTO the ATMOS PHER *
15 A S 5 U M E THAT CONCENT' A T I 0 N S OF V l NYL CHLORIDE 16 ERE' FOUND IN THE AR EA OF THE GR A S c o HO e I N
17 THE RAN G OF SIX T 0 N I NE PART S p ER 3 ILLIOY 18 m N D i H A T MR. GRASSO C N A N ANN ij t?, I_ A VE RAGE T H A T
19 ri R G R A S 50 HIMSELF HA D A N A NNUAL A VE R A G E 20 c X ? 0 S U R E OF FIVE TO E IGHT PAR T 5 PER 3 I L L I A 1
21 A S S u .-I E TH AT THE HIGH 24 HOUR A V E RAGE F OR M R . 22 G R A S S 0 WO U L D HA V E 3 EE N 2 6 0 PA RTS P E R BILL ION
23 A N D 0 N AN I HOURLY 3 AS I 5 ON T ,*/ \j TO FOU R T I E S A 24 YEAR, A N HOURLY A V E R A GE W OULD HA VE 3 E E N 4 S 25 HIGH AS p I V E TO' S I X P ARTS PER MILLION. AS S U u E
i
0HOTTT2
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1 THAT .-1 R . G R 4 5 S C A 3 EX POSED AS A R~ 5 JL T OF
2 EPISODIC EMISSIONS GCC GORING A D ? 0 C X I MATE'. Y 2 Li
3 T [ M c is [X 'S [ a T E n ^ S F 0 x PERIODS OF Tv.O TO 1 5 4 . -i i a U T E 5 A N 0 D :J X 1 0 G 7 H 0 3 E EXPOSURE PERI 0 0 S, 5 7 H. E VINYL CHLORIDE L E V EL - - THE V I N Y L
6 C H L OR I D E CONCEMTRATION WAS SEVERAL HUNDRED
7 PARTS PER MILLION.
8 = I ? S T RASED ON THOSE A S'3 U v E D
9 FACTS AMD YOUR < ;! 0 W LED g? nr THF m E 0 I C A L
10
RECORDS, DO YOU HA V E A M 0 3 I \ I 0 M
rTH -
11 SUBSTANTIAL MED I CAL => R OR*? ILITY AS TO WHS';
12 the liver t u mor d i a g n o S IED ON AU G U 5 T S, 1 A 7 3
13 first NAS PRESENT IN . i R . G R A S S 0 ?
14
Y l 5 , IDO.
15 Q .
A NO .(HAT [ S THAT CPI N I 0 N ?
16 A.
FROM OUR OWN EXPERIENCE WITH' THE
17 DISEASE AND FROM THAT THAT'S IN THE
18 L I T E R A T U R E , I WOULD S U S P E C T THAT THE T U M 0 R
19 HAD BEE N PR E SENT AT A M I N I MUM Or A YEAR AND
20 PCS S I B L Y U ? TO FOUR.
21 q.
A N D THAT'S
Y 0 U ' V F " = S T T - IE X .a c
22 T 0 Y 0 IJ R E ypL A NAT I 0?-! OF T H AT PREVIOUSLY, H i V E
23 Y 0 'J N 0 T ?
24 A .
WELL, THE R E A S 0 M v; E CHARACTER I ZEO a
25 -> i S c A 5 E IS BECAUSE -i I T H .A C H CASE 0 F A
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1 w i -- c i h - - = c J ^ = l* w --1 3 - - 7 ri i L ' v - * 3 S v 3 S I G Sri -- I S 'b r o S U c d iv t f i 1 G !'' zl H 1 01 S V ivGl IVWtOdN 1* i j r ~ ~i C J 01 G2 fi1 1 ;. o j 3- /.. / r r. 3 3 !' 1 V H 1 ~ S t 3 S I C
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1 Q.
WO CAN YO'J 5 X? L - I * =0= THE JURY <-> 0 W
2 ecu analyzed that s itj't*ion * [; order tc dive
3 H E 7 H T A > 5 ,'i E R .
4 A.
I'D L l .A w T:j , I'D L I A V AG A IN T *; J v -
5 S CME SLIDES TO ILLUSTRATE WHAT WE AVOW A3 OUT
6 THE ANGIOSARCOMA FROM ALL THE CASES THAT -HAVE'
7 6EEN 0 3 TA INA3LE IN THE WORLD RELATED TO VINYL 8 CHLORIDE.
9 this is a chart illustrating
10 ALL T^E REpORTED CASES THAT WAVE SEEN
11 VERIFIED R Y PATHOLOGISTS AND MEDICAL EXPERTS
12 THAT T H E 5 E ARE TRULY A N GI 0 S A R C0MAS, NOT S OME 13 OTHER KINDS OF TUMOR, AND W E ALSO KNOW THE 14 u X P 0 3 UR 5 5 Or T H ESE I ND I V I D UALS A M D A L L 0 F
15 the, 4 HAD SEER W 0 R X I N G W I T H VI ?; YL C HLO RIDE FOR 16 V m R Y I nG PERIODS OF TIME. THE R E I S R 0 U Only 3 u 17 SOME CAS E S WITH AN ADDITIONAL TWO I N 1979 AND
18 ONE IN 1930. THAT IS NOT ON THIS CHART.
19 TH E ONES THAT ARE I N RED ARE 20 THOSE FROM THE UN I TED STATES A NO THE 0 N E S I N 21 W HITE ARE FRO M TH = N 0 R T h A M E R I C A , C A !\[ADA A N D 22 FROM ALL OF EUROPE AND ASIA.
23 N 0 , t P 0 :N E L'DO !< S AT '< HEM
24 WHEN THESE CANCER OCCURRED, THAT IS,
25 V HEM They w e r e D I A G N 0 3 l E D IN THE VAR! O ij =
21110143
T
U i R 0 - M R . * E ;-j N E I 5 E N
TJ
1 C 0 0 W T R I E S , I ' V E I L L U S T ? A T T p> FOUR CO U N T R I r - 9 2 BECAUSE T H E S rz ARE THE COUNTS I E S THAT H A V e r\ :*5
3 ACCOUNT FOR ? 0 PERCENT C F AL L T H F
4 A N G I 0 S A R C 0 M A s AM0 NG VI N Y L C H L 0 R I D E W ORKE 3 C
5
WHAT YOU SEE
ERE IS THE N A M P p C J _! c C 0 u V T =? Y
6 AND THE 0 A 7 E
MEAN t NG 1 9 * 1 IS R 0 U G H L Y T UC
7 EARLIEST EXP OS U R E C F ANY OF THE I N D I V I 0 u A L s
8 IN THIS G R 0 U p 0 F I N D I V I D 'J A L S
9 H.
DCC i v> R., AS YOU G 0 THROUGH, TELL o 5
10 the n a .h e o f TH E COUNTRY, EEC A U S E
11 A .
S U R / CANADA IS AT TnE TOP. THE I *
12 PLANT STARTE W"N IN 1939, 19 '+ 0 ' 5. THE A , ERICAS
13 PLANTS
THIS IS AN E R RCR , THAT S HOU L D
14 HAVE BEE N 19 '4 1
IS
-
I'M S ORR V
T 'r1 A T
15 IS NOT AN ERRC R . THERE IS A PLANT IN THE 16 UNITED STATE 5 that BEGAN ITS E X P 0 S U R ES ! V 17 1959, FCRGIV c ME. THEN F ? A M C E, THEY STAR J C D
18 IN 1941, BUT THE MAJORITY OF THEM V.' E 9 E IN THE 19 FIFTIES. ANO IN GERMANY, THEY STARTED IM T HE
20 MID 1950'S AND LATE 1950'S. SO THAT THE
21 C J JN T R I E S ARE LIST O.D I N THE OLDEST PLANTS TO
22 the more recent ones, and you'll notice that
23 T He OLDER OR T HE PLANTS T rt A T W ERE STARTED I N
24 THE EARLIER TIMES HAVE THE EARLIEST
25 DEVELOPMENT OF ANGIOSARCOMAS, STARTED IN THE
21110144
; 3 J R R 0 - y -? . ? Z N N F I S E N
1 FORTIES, RE GUM TC
T 0 E M T I F I E 0 IN the
2 FIFTIES, A >j 0 T H 0 S E *r HAT STARTED IN THE i_lTF
3 - i F T I 11 5 3 E I M G I 0 E 0 T I F I ZD ( : THE S I X T I E s. so
4 THAT THIS TREND, A s WELL AS THE P-A X N :J ! '1 -> ~ < 5 ___ y .A T IS, THE H 0 ST FIEQ U ENT 0 C C L R R E xi C E
6 A ,'i ij I 0 3 A < u L/ '! A ^ " *" ALSO shows
5 H 0 y; N I N
7 YELLOW, T HE SAME OCCUR RE MCE. MOW , THIS TELL
8 US THAT T HE ON SET F EXPOSURE A ND WHE N 0 iN E 9 BEGINS TO DEVELOP T H E TUMOR, AS W ELL A 5 ONE 10 REACHES T H F M A X I M 'J M N UMR E R OF CASES A D PEA R S
11 TO 3 E THE SAME, W H ETHER THEY ARE I M C A NA DA,
12
THE UNITE 0 STATES, C R A N C E OR G E R M .A \J Y
SO,
13 THIS GIVE S US .AM I ^s c_ A A ROUT THE D I S EAS h
14 PROCESS A S HAVING C E R T A I M C H A R A C T E R I S T I C S
15 WRICH AR E C 0 N 5 l 5 T Z N T ' 16 THIS TAXES NINE S A ME CASES
17 3 uT DISTR I3UTES THEM U N 0 c R D I F F E RENT 18 C I R C U M S T A N C E 5 . T H I r HAS THE TOTA L M U M 3 ER OF
19 Y c AX S OF EXPOSURE OF EACH OF THE CASE WHO 20 0 E V E L 0 P E 0 HEPATIC A M G I 0 S A R C 0 M A , LIVER
21 A N G I 0 5 A R C CM.A, IN THESE VINYL CHLORIDE W C R < E 22 AMO THIS INDICATES T HEIR NUMBER ___ T 0 T 'N L 23 N U M o E A 0 F years of r X P 0 S U R t . A M D AS YD W SEE
24 this r am g E S A N Y W H E R E r R 0 ,M A R 0 lJ T three YEARS
25 TO AS 'i'JCu AS 33 YEARS OF EXPOSURE.
21110145
O S. 'sj -- , t . I; N c. I 5 ~ '
'l ^
1
H0.
i P U T A N U Hi 3 E R OF T-ESE
2 IN RED. A N 0 THAT ' 5 SEC AUSt THERE A P P EAR S TO
3 EE T .v 0 PE A .< S . THE RE ARE a uROuP, A 3 0 U i - i a ~ ! , 4 N H 0 j E V E L OPED A \ c- I 0 S A R C 0 H A u I T h ONLY T H R - E T 0
5 SIX YEARS OF EXPO SURE AND the n t HE MA JOT I T Y 6 OF CASES THAT h t\ rj TEN' TO X o V p i 7 S HI T <-> THE
7 MEAN; 3 E I N G A R 0 U N D 15 tq ?0 . f N = ACT, THERE 8 MAY 3 E THRE: ?E'A<S. ?UT, THIS GROUP HAS 9 THOUGHT TO BE POSSIBLY A UN I OUE GROUP. AND I 10 Illustrate them i n a \ o t h e < c on t e x t . .a s . e 11 D t 5 C R 1 3 ED -- AS W HERE J r 0N T riE\ L00< AT The
12 S A M E THING/ vi E L 0 0 < \ 0 W AT LATE N C Y . A 5 YOU
13 0 4, ThaT 1S Tht TIME FROM THE FIRST EXPOSURE
14 To The TIME THE PATIENTS ' : C C M E 5 0 I AG'nOS I ED
15 NG THE TUMOR. AND THIS IS c o N S 1 D E " - 0 16
P 0 R T A N T FACTOR IN CANCER, SINCE THERE 17
TO BE A TIME R E 0 U I R E M E N T FOR THE 18 M ENT OF CANCER A N n THIS IS U S U A L L v
19 9 E RELATE? TC THE DOSE OF E X P 0 S U 3 E .
20 The LOWER THE LOSE of EXPOSURE/ I T ' s PEL IEVE 0
21 THE LONGER IT TARES to OSVEL 0 P CAM C S 3. so.
22
they
thought
that
these
low
exposeo
- "i ,*n > i 3 r
3 N UL . 3
23 SHOULD THEM HAVE THE LONGEST LATENCY. AND AS
24 YOU SEE, THAT'S NOT QUITE TRUE. THESE EIGHT,
25 .I n 1 C H ARE S ri 0WN ( .\j RED, HA VS LATENCIES H I C H
21110146
n j .'.-1 '?
e is
] v n i 2 A S _j "4- Y c A ^
n y ~ :i o1 ir
J
4 E JC V
' 1 ' '* ' '
-,
j3
j j j 1
r 7 'I
5 :a'^J:1E ;<* A Y HE, IT STILL R E o U ! 7 E 2 47 L . - o :
6 'i I s: 7 0 TEN YEARS FOR THE DISEASE T 0 E V0LVE
i 7 A :-i D j L y E i_ 0 P ; A N0 T nAT S
PEOPLE R - 1 U I R - m
I
3-
,-l - .. P j b y < c 0 J S E I `4 G R 0 s R TO SET THIS
!
I
9 p R Ov. so I H ' ! 0 T 10 In T H A N OTHERS, 3 UT THAT 7!-;
10 LATENCY OOES H 0 T STRICTLY FOLLOW THOSE 3 U L S F
11 0.
DOCTOR, WHAT IS T -*E AVERAGE LATENCY
12 PER I 0 D ?
13 A.
THE V E R A G E LATENCY 3 E R 1 0 D HERE IS
14
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15 16 n
AMD LATENCY I S D E F I N ~ "N A S H 0
17 AS THE T I '-1E 1 N TERVAL F R ori TH
18 /< ? 0 5 U R S TO THE TINE TH 'ij I A NOS I s I S
19 w 20 A .
I FINE, T HA N
YO 0
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21 OcPICTIKG DM ALL OF THESE CASES OF
22 A N G I 05 A SCO M A EASED O'; T H E YEAR THEY 3 E G
23 their exposure and as one sees, all the rase'
24 R E G Am THEIR EXPOSURE A PTE? THE . 1 0 '4 ) 'INTERVAL
25
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pURR0 - M . RENNE I S EN
1 1 N THE FINGERS WAS DISCOVERED. 2 n: 0 , 'HIS GIVES 'US S^E 3 E 3 ( 0 E ' 1 I 0 L 0 G I 0 A L I 'v R I C A T l N Oc H O'W H U C H 4 E X P 0 S U R E 1 S REQUIRED I '! 0 ?. Q E R TP START T - I 5 5 PARTICULAR DISEASE PROCESS IV A N Y AREA IN THE 6 PROCESS AND IT APPEARS THAT THERE ARE NO 7 CASES UJOc.R 50 PARTS PER ,H I L L I 0i'i A ND THAT 8 THEY CAN GOING ON UP TO 2,0 00 PARTS PER 9 MILLION. AND THIS, WOULD, AGAIN, GOING ON 10 A L 0 N G W I T H W H A T W E :< N 0 W I N A N I MAL STUDIES. I N 11 ANIMAL STUDIES, WE'VE NOT SEEN A 3 L E TO INDUCE 12 THE TIME MORE UNDER 25 PARTS PER MILLION" AMO 13 HAVE NOT SEEN A3LE TO INCREASE THE NUMBER 03 14 TUMORS WHEN WE GO BEYOND e I'/= OR c n fl P A R" S 15 PER M I L LI 0N. A N D ' I THINK THIS C AN R E 16 EXPLAINED AGAIN 3 Y T H E BIOLOGICAL FACT THAT 17 AN AGENT IN SMALL QUANTITIES CAN BE HANDLED 18 3 Y THE NORMAL BODY TISSUE; THAT AS IT 19 REACHES AN INTERNED IATE STAGE, THAT THE BODY 20 (MAY NOT HANDLE ADEQUATELY, BUT THAT THE CELLS 21 may survive with the injury and then later go 22 ON TO DEVELOP CANCER. AND THEN AT THE HIGHER 23 LEVELS, THE C H E M [CAL OR AGENT MAY THEREFORE 24 < I L L THE CELL AND, THEREFORE, NOT EVOLVES 25 I N T0 A T U: 1 OR. AND THAT WOULD EXPLAIN ':! HY 0 ') E
T
8frTOITTZ
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2 FRO .i 5 J PARTS TO A j 0 U T 2 , 0 0 0 OP. 3,0 JO AMO
3 THEN SEES T H E 0 C C R R E N C 0TRAIL 0 F F . 4 NOW , THIS ii CJLD ALSO E >; 3 L A I 5 WHY TnE PEAK OF THE ANSI OS ARC CMAS CASES 32 I 6 REPORTED WAS REACHED I N 1975. V/ H E N V E REG A N
7
OUR STUDY, OUR PROTOTYPE STUDY IK 1 n 7 5 ,
E
8 ANTICIPATED THAT THE 3 0 IJ L A T I 0 N WE HE3 E
9 STUDYING SHO'J L D C 0 N T I M U E 0 TO D E V E L 0 p
10 ANGIOSARCH A A S EASED 0 N THE I 3PAST E X D 5 V R E
11 FOR AT LEAST A N0 T H E R
YEARS, BECAUSE T. rH "
12 EXPOSURE WAS HOT REDUCED TO 0 N PART PER
13 A 1 LL I ON U NT I L i 3 7 A, 19 7 5; A '-J D THEN W E nA 0
14 STILL ALL THOSE PEOPLE .V H 0 H A D BEE N E X HOSED
15 BEFORE THAT TIME.
16 NOW THIS HAS SURPRISED US, 17 BECAUSE THE RE ' s 3EEN A MA RKE 0, A RAPID DR 0 P 18 IN THE IN U M 8 ER . 0 F CAS ES R E POR TED I H THE UN I tfd 19 STATES, IN GE R M A NY, 1 N e p ANC E A N D 0 T H E p
20 C 0 U N T R I ES . AND T HAT ! T I S NO W FUR THE R
21
SUPPORT I VE DA TA T H A T w E u AY HAVE [; HAT VI -
p LL
22 A S I 0 L 0 G I C A L THR E S H 0 L D - - THAT IS, A LEV E L
23 AT WHIG H . i G S T P c OPLE C 0 UL D H HOLE THE A GE N TS
24
N I TH0UT
I
;
o
:i
vy
r \,
I
\ G
the
CA N C ER
I tH I N rh5 I R
25 lIFETI h L- y W i.i f v* E Kill. < 0 '' 'ORE A 8 0 U T TH I 0
6^TOTTT2
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' 4
1 AS YEA 9- S GO ON, BECAUSE AS EACH YEA' GOES 0 N ,
2 IT I S DOCUMENTATION THAT TH I S IS A T1 i I L 1 N G
3 QfF EFFECT '/ILL ? E P U 9 T H E 9 0 r C, IJ E M T E D .
4 ~
O o r T q q , IF IN 3 T E A 0 0 P - N U A i
5 E X P 0 S U R = 5 r. p 5 I X TO NINE P \ T T f, O P - q I LLI 0 N,
6
IF YOU
P ? c TO A S S U i-i E THE A 7 E R a' /VJ* c_ A NUAL
7 E X P 0 S u 3 C w R E 2 U TO 2 5 P A RTS
3 I LL I 0N ,
8 ` 0 U L D Y 0 U 1 * E A i' i S W E R I !: G C H A i> 'a E U
9 A.
NO, I T W 0 U L 0 NOT.
10
N 0 ./ ,
- - NOW , YOU E 9 E PRESENT
11 TESTER Dm Y ,7 H " N DOCTOR U 0 h N SON .TEST I F I ED AND I 12 THIN .< YOU WERE PRESENT WHE N D 0 C T 0 R E P S T E I N 13 HAS T E S T l F I ED ___ T^S T I F I ED, AND EACH 0 N E OF
14 THE M W E F E READ A LONG HYPOTHETICAL n 'J S S T I 0 V .
15 I ' M N0 T GOING TO 9BAT THAT OUEST ION. I. 16 LIKE YOU T 0 A S S UM E THE P AC TS THAT wERE
17 LONG OUEST I 0 N THAT I R E A D TO DOCTOR 18 JOHNSON YESTERDAY A N D THAT M R . V A 5 S A L 0 T T I 19 READ T.O DOCTOR EPSTEIN LAST `.VEEK AND
20 PARTICULARLY ASSUME THAT THE CONCENTRATIONS
21 r>. T TnE GRAS SO HOME ./ERE F R CM 1.1 70 2 C PARTS 22 PER MILLION FOR 1, 5 0 3 HOURS, FOR FIVE A N Q A
23 HALF YEARS AND THAT THE EXPOSURE -- THE
24 C 0 NC E N T R A TI 0 N LEVEL W AS TEN TO CO PARTS PER
25 MILLION AND 11 ON 11 TO 1 p HAZY DAYS A YEAR
21110150
u.RGD - .12. RENNEISEN
5l
1 FOR A PERIOD OF APPROXIMATELY POUR MOORS A 2 DAY.
3 A S S U M l N G THOSE = A C T ' , W A IJ L 0 4 tt C H A 'ir,= YOUR 0 I'M O': C 0 v C E ? :: I '! 0 W H E T h = "
5 N 0 T M 0 . G R 4 3 S 0 * S 0 I S E A S E 'AS C A ') S E 0 - - YOU R
6
03fNI0N WITH _____
LET ME GET THE WORDS THE
7 5 A ,M e SO THE 0 U E S T 1 0 N S A A A L L E L .
8 WOULD T .H A t C H A ! G E YOUR
9 OPINION AS TO WHETHER OR NOT NR. OR AS SO S
10 DISEASE w A 5 C .A U S E 0 3 Y V I .i Y L CHLOR I OE W i T M
11 SU3STA-\T I AL MED I CAL PROBABILITY?
12 A.
nQ, IT WOULD NOT CHANGE MY OPINION.
13 0 14 A .
AND YOUR 0 PINION A G A I N I 5 7 H A T ? 3ASE0 Of.' W HAT W E N 0':! FR OM ALL T H =
15 C A S E S AND THE CHARA C T E R I Z A T I 0 N o F THE OISE
16 I T D OE 5 NOT. HAVE Th OSE CHAR ACT ~ P I 3 T I C 3 A N'D
17 T H E R E F 0 RE, I 0 0 NOT T H r MK THAT T H I S I S THE 18 E 0 U R CE OF THE ANG l 0 S A R C 0 M A I N T - I 5 0 4 s p .
19 Q .
0 0 YOU KN 0 W WHAT 010 CA U S E m R
20 G R A 3 3 0'S A N G I 0 S A R C 0 M A ?
21 A.
I HAVE SOME THEORIES, HUT I HAVE NO
22 GOOD MEDICAL DATA TO SUPPORT THAT .
23
IS THIS UNUSUAL WI
E C T. TO
W 24 VINYL CHLORIDE AND ANGIOSARCOMA, NOT TO WAV:
25 A N 3 P I N I 0 N ?
TSTOTTT
1 A.
I ' 0 T S 'Jn E I UNDER = T.i : .
2 0.
LET * * A S < THE DUE S T ION THIS WAY:
3
15 IT UNUSUAL -
r HE
E
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A'
r-'
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TD
4 3E u N A 5 L E TO D E - ,r < N i :-i E T >--;l 'T_ /" AA. USE 0 F
5 \ >i j I 0 5 A AGO, 'i 0 F 7 HE LIVE R ?
6 A.
N 0 . A S I ' V E ST A TED 3 = F 0 * E, AND AS
7 OTHER PEOPLE H A V E I N D I C A T E D , THE MAJORITY OF
8 A N G I 0 3 A R C 0 M A5 W E 00 NOT <>40 W THE ETIOLOGY TO.
9 Q.
WHAT A 3 O'JT 0 T H E 9 CANCER, DO WE <MQW
10
THE etiology OF o t h e
CANCER?
11 A .
NO, THE MAJOR I T Y OF C A N c F R W
12
SURE 0 c THE ETIOL 0 G Y . T h =
ARE A F E W
13 C A U S 5 IS CLEARL Y D 0 C U M E N T EO, RUT N D T 14 D H N ' T < n o w OF ; n Y C - N-C - R r <_ a T LJ r " \ s
15 SOURCE.
16 Q . : i
AND WOULD you tell .ye again the
17 PE ri CENT AGE OF ANGIOSARCOMAS WHICH ARE
18 ATt.R I 3UTED 3 Y THE i E 0 I C A L PROFESSION TODAY TO
19 U N 0 W is CA J 5 E S ?
20 A .
l T IS ESTIMATED GETW E E' 1 7 0 T 0 7 5
21 P = R C E T OF the - i .
22
, M R. REN NF I S E ,N :
THAN < V Q >J
23 HAVE N0 FUR THER ODES t I 0 \i p 24 the court \A 0 V A ? 5 A L n T T
ZSTQ TTTZ
25 3Y MR. VASSALCTTI:
6 5 - J .< . F a '1.3 >j R R 0 - , ii . VA G S AL U T T I
1 0 0 C T 0 T A M 3 U R R 0 , A 3 0 U T 13 A T 7 3 T 0 7 5 2 P E R C N T C F U IN < N 0 W IN r A U S E S , HQ Vi WERE T H rJ* --3 1--
3 STUDIES L 0 N 0 U C T E D TO DE T E R.i I N - FIRST T u c 4 NU ARE R 0 F CASES OF A N G I 0 S A R C 0 v| A A N 0 T H - n
5 T R Y I NG TO attrmut rr A C A U S E ? A R E YOU ^ A N I L I
6
W I TH H0
j u c v r: 7 c C 0 N 0 IJ c TED?
7 A 8 Q.
Vi H I C H E V E R T\ wo of THE 'M, YES.
A N 0 W H 0 C ON D U C T E V TH
S T 'J D I E S 7
9 A.
ONE WAS C 0 \ D 'JCTE D I N \ E v,1 Y 0 R :< AND
10 T H E G T n 2 5 .V AS
11
A U
v< ELL, W H 0 ru 0 N D U C TED T H AT ONE?
12 A
WELL, YOU ' L L F 0 R G I VE M E . 0 N E OF T H
13 TH I N G 5 I HAVE NOT A i c \ D NC Y TO DO IS
14 < i-i t M 3 E R NAMES. 3 U T ! CAN GET YOU THE
15 LITERATURE FOR THAT IF YOU DON'T HAVE IT. 16 THEY CONDUCTED A SURVEY IN -- BY USING THE
17 REGISTRY IN NEW YORK.
18
../ U T REG I S T 9 Y IS THAT?
19
T H E R E ' S A CANCER REGISTRY I N TH -
20 TATE OF N E W YORK i HIGH RE CORDS THE C A u; E 5 0 r
21
E A T H DUE TO C A N C F . THERE ' s A REG! S T l R I
IN
22 Ur.NEC T I C UT . T H 5 R A R E A N U M 5 E R 0 - S T A T L L
23 TriA T ri m V E CANCER --
24 Q
now DOES A CANCER GET REGISTERED I
25 THIS cancer registry?
1110153
21110154
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2 A.
HlsTOLOGICALL PROVEN E 1 T-iEx 7 0 HAVE
3 0 x -i o T I 'w' n m V i. M 7 u OR#
4 ; .
N 0 ;i , WE'VE HAD SOME TESTIMONY IN
5 THIS CASE THAT IT WASN'T REALLY UNTIL 1 ~ 7 5 O'
6 1 0 7 u ; h E RE T H E MEDICAL COMMUNITY B E C Amp
7 C 0 N C E 7 \i E D A30UT THE RELATIONSHIP RETwEEN 8 V I N Y L CHLORIDE AN0 A NG I OS AR C 0 M A OP THE LI VE R 9 AND AS A matter 0 c F A r / I T MINK DOCTOR 10 JOHNSON TES T I F I ED THA T A C 0 u RLE 0 p THE CASES 11 THAT 3 . F . GOOD R. I CH .1 E RE r `i I S 5 DIAGNOSIED AS
12 P R I .-I ARY LIVER CANCER. ARE YO !J A W ARE OF T H A T ?
13 m. 14
YES. I H -j i -
CASES W H ERE AUTOPSIES
15 WERE PE ,R F 0 R M E D , W E R E N ' T THEY ?
16 A.
THAT'S CORRECT.
17 Q.
AND THEY WERE STILL MISSDIAGNOSIED.
18 A.
THAT'S CORRECT.
19 C.
IS THERE A CHANCE -- I'LL
JUST a?'(
20 YOU THIS: IS THERE A CHANCE THAT JN THESE
21 CANCER REGISTRIES THAT NOT ALL ANGIOSARCOMAS 22 OF THE LIVER THAT ACTUALLY HAPPEN ARE LISTED?
23 .
wE L L > IT'S NOT A CHANCE. T H A T IS A
24 fact .
25 Q
THAT'S A =A C T .
*0 hh* h* .
M Ol tin
JD
1 A.
THAT'S T9 UE OF T V E - Y C-VlC" " .
2 0.
AS A MATTER Dc FACT, T'liT'S r R U Z R =
3 -- \ r ; v r _ m r ~ 7
p ? p c ' t o
4 A.
' ':! W 0U!_ O NOT <>in ! ~ F T E i!E 1 C I : " -: C C
5 OF C A 'i: 9 ; I S i A S 3 J N LESS V E MAC A A ;J " 0 P ' Y 0 v
6 EACH a,-VO EVERY 1A3 I VISUAL WHO DECIDE. ASA IV,
7
THAT'S
h Y EPIDEMIOLOGICAL 5 T J 0 I E 5 ARE USED
8 TO j E T E .< .M I.mc, EASED 0 THE NU M 3 R 0 F
9 AUTOPSIES, .%' HAT THE POSSIBILITY IS THAT THE
10 data Y 3 J HAVE CAM DRAW A C OR R ECT CCNCLU S I 0 M .
11 Q.
WELL, YOU JUST T A L K E 0 ABOUT C A \ C E R
12 REGIS 7 R I E S TH.AT INCLUDE D A T A T H A T IS OP T a I m E D
13 FROM OTH E R T H A U A !j T 0 P S I C7 C
14 a
0 1 r 1-1 r
! -7 . ,
15 q.
THAT WAS INC L U D E D I U Y 0 U R
16 EPIDEMIOLOGICAL STUDIES, CORRECT?
17 A .
WOULD YOU < I M OS RE Mi E MR E R REPEAT THE
18 A 0 -- T I D N . I ' -1 is 0 T --
19 H .
the data from the cancer banks or
20 REGISTRIES
21 A .
YES.
22 Q
-- THAT'S v.'ii AT THESE
23 EPIDEMIOLOGICAL STUDIES THAT YOU REFER TO 24 W ERE RASED U ? 0 N , W E *R E N ' T THEY?
25 A.
YES. \' 0 T TOTALLY,
that 743 hm?
21110156
T
' -v 3 3 \ i - r * r
1 y.
0 5 SOURCE OF THE I NFOR.MAT 1 ON?
2 A.
R I G 1 T , B l/T THERE ARE 0 7 H E R 5 .
3 -mo v,, .4 c e r - e r - - these - - this
4 STUDY i V NEW Y 0 R .< THAT YOU PARTICULARLY REFER
5 TO .vE.AT 3 A C X AND LOOKED THROUGH THE CANCER 6 REGISTRY AMD I ASSUME THEY LOOKED FOR A L L
7 A N G l 0 S A R C C M A CASES?
8 A.
YES.
9 0.
I ALSO ASSUME - -I D 0 \! ' T M E A N T 0
10 8E FAC E TI 0 U S THAT THESE PEOPLE ARE ALREADY n DEAD IN THERE IN T H CANCER REGISTRY. H0 W D0
12 THEY GO A3 OUT ATTRIBUTING A CAUSE TO THESE
13 PEOPLE CANCER?
14 A.
UNFORTUNATELY, AS YOU PR03AULY HEARD
15 FR 0i-i OThER SOURCE S , THE OCCUPAT I 0N I 5 A 16 REQUESTED PIECE OF INFORMATION, 3 U T NOT A 17 REQUIRED ONE ON DEATH CERTIFICATES. SO IT IS 18 REQUIRED THAT THE INDIVIDUAL WHO S INTERESTED
19 IN DETERMINING WHAT POSSIBLE C 0R 3 LA T I 0 N S ARE,
20 W ILL GO BACK TO EACH AND EVERY CASE, EITHER
21 3 Y DIRECT, VISITING THE RELATIVES OR The 22 HOSPITAL OR the doctor w ho cared for the m,
23 AnD DETERMINE WHAT THE INDIVIDUAL DID AS AN
24 OCCUPATION. AMO THEN F'lOrf THAT OAT A, ONE THEM
25 T T z,. 1 F r 5 I >j 0 1 A b 0 c C G * C L J 3 I j '-J S A 5 TO
TOTTT2
J < TAMi'JM.O
M R . VA S S A L 0 T T I
1 7J H T H Z R T H E R E'S A RELATIONSHIP 3 E TWEE N T H E I-R 2 '! 0 R K IS H I S T 0 R IE S AND THE OISE A S E THEY H A VE .
3 0
- f IN tmc MID m I NETS r: v- CTyc; t ; f - f
4 p ? 0 P L r v/ F ^ !7 ~ 0 M r ~ 0 v P 0 5 5 11! f T `J - n r r 'j 3 i T I M
5 ___ p 5 0 P L 5 S TJ DY I N G the e pId e M I 0 L 3 G I C A L
6 5 I G N I F I CANCE OF AN GI0 3 A R C 0M A W ERE C 0 M C E R N 5 j 7 w 1 T h T H i.Z "L\V rw r UPATIOMAL H IS T 0RY OR THE 8 0 C L U P A T ION, I T HiN < YOU SAID, 0 F THE P E 3 P LE
9 /. HO Die D Or A 'j G I w 5 A R C u M A j Ip I HAT C OR R EC T 9
10 YES.
11 Q.
MOW, WHEN DATA 15 GIVEN ON A DEATH
12 CERTIFICATE A 5 TO OCCUPATION, THAT'S ONLY THE
13 LAST OCCUPATION OF THE PERSON, ISN'T IT?
14 THAT IS ABSOLUTELY CORRECT. Y0 U
15 THAT'S USUALLY THE THING.
16 0.
IN THE
NINETEEN SEVENTIES, WAS
17 T H e R E ANYONE CONCERNED ABOUT PROXIMITY OF 18 LOCATION OF THE P E 0 P L E WHO D IED OF
19 A l-i S I 3 3 A S CO A A TO A P V C 0 R V C ?LA M T In THE
20 STUDIES THAT YOU RELIE-J UPON?
21 A .
YES, T.H.-Y :V ENT A N J LOOKED AT W HERE
22 ThE PEOPLE ACTUALLY LIVED TO DETERMINE
23 WHETHER 0 R N0T
24 0 .
AT WHAT POINT I N THEIR LIVES DID
25 THEY -- AGAIN, w E ' w E RELYING 0 N LAST
8S70TTTZ
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1 ADDRESS; ISThM CO"A-'EC T?
2 A.
0N j 0 ULD H AVE T0 0 E PE M0 0 LA T
3
..-ELl, IT
3 U L D AGAI1 D A E N 3
4
JE?E\0 THIS
i 3 \ 0 T I is THESTUDIES.
I IE
ONE
5 DOES ,4 1 T KN Ow I A PUBLICATION T HE A C T U A _ j
6 E X T NT OF the INVESTIGATORS' EF F 0R T S TO '
7 DE TE R M 1 >4 ~ ALL LOCATIONS. IN SOM E CASES, THE Y 3 M A Y H A V E K \ 0 ! N ALL THE LOCATION s the 9 I ;N D I V I 3 U A L L I V ED AT AND IN SOME CASES NIT. so. 10 0 N = O v> C S 'J K F S T HAT W F 1 IE 0 E A L T NG 3 q 5 3 n m l -j A \ T L y 11 W I T H TH E L A S T L 0 C A T I 0 N .
12 Q.
DOCTOR, ISN'T IT FA IT TO SAY THAT
13 PERCENT OF TOE ANGIOSARCOMAS THAT HAVE 1EEN
14 F 0 -j N J SO. FAR -- THIS I S ~ A S E C> CP 0 / H A T ,, E
15 J a 5 T T AL .< E D A 30 U T -- HAVE 3 E EASSIGNED AN
16 J N < i\l 0 v. In CAUSES BECAUSE u E DO N 1 T H A VE E NC 'JGH
17 I 14 FORMAT I 0 N TO DETERMINE WHAT THE CAUSE WAS?
18 A.
YES, THAT IS A POSSIBILITY. BUT I
19 THINK ONE HAS TO LOOK AGAIN AT THE FACT THAT 20 SINCE 197'+, PEOPLE HAVE ACTIVELY BEEN LOOK I -v G
21 TO LIN .< 'J P ALL T H E I :R A N G I 0 S A R C 3 M AS W I T H '"HE 22 KNOWN CAUSES, SO THAT IT IS UNLIKELY THAT AN
23 A N G I 0 S A RC0 MA 0 I A G N 0 S I E 0 AFTER 1*74, HA V I NG
24 ANY POSSIBILITY OF H = I N G ASSOC I A T E 0 WITH ANY
25 OF THE FOUR CAUSES, -OUL0 NOT BE ATTEMPTED TO
6ST0TTTZ
T
-) R i A . 1 J J ~ 'J
:'' V
)TT !
3
1 d E L I N A 7 D . T H A T ' S J J S T .1 NAT U = A L r E N D E N C Y . .
2 YO J < N 0 W W HAT IT IS AND YOU TRY 7 0 L I N < I T U P
3 W 1 Trl W H A T Y 0 U A N o W . T E F -i C ' T U! A " 7 M P ? F A ^ =
4
5 7 ILL, DE S ? I T p T u i j
\ i :j . s p c 7 0 F
5
A 11 G I 0 S A R C 0 A 3 T W A J
P C - N: N H T L I M < UP w r th A ,v Y
6 r a S 0 MA'LE 9 ? D 3 A 3 1 L I T Y 0 F 0 5 I 5 C 9 9 R E C T ,
7 INDICATES THAT WE HA VE M 1 T YET EXCLUDED ALL
S THE 'SOURCES OF ANGIOSA'CD A .
9 DOCTOR, I ,'i A S 5 U ? P L I E D SOME
10 I W FOR . -I A T I On HIGH I D I C A T = J, T '--Ji "\* T1
I'LL
11
0 U 0 T L I T TO you:
Y 0 U ti 1 LL TE S T I F Y THAT EVE N
12 AT THE - - E V E N IF THE EXPOS U R E L E V E L A T THE
13 GRASS 0 HO iN E W A S A Y EARL Y A V E R A G E OF THREE 1i *A4 PARTS = ER MILLION, THAT THAT DOSE WOULD PE
15 INSUFFICIENT TO C A USE A .= . G R A S 3 0 ' 3
16 ANGIOSARCOMA. DID YOU TELL ANYBODY THAT?
17 A .
I'VE SAID THAT A NUMBER OF TIMES.
18 0 .
THAT'S TH'EE PARTS 0ER MILLION, 24
19 HOURS A DAY?
20 A.
IF that ASSUMPTION v A S MADE CASED
21 TnZ CHARACTER I S 7 ICS OF HIS D I S E A 3 E, HIS ONSET,
22 ThE P R 0 G R E S S I0N Or ThE DISEASE, I * D STILL
23 J\a .v THAT C U : M C L U 3 I 0 M
24 0 .
;vj 0 ti j oETTINvj 3 A C .< T 0 H 0 W VINYL
25 C HL 0 RIDE IS HAM3 LED I N THE TODY, YOU ' V E
21110160
T
- 0 R . T \ M "j ij 1 q 0 - :l 3 . V A G S A L 0 T 7 I
1 SHOWED US S ONE ACTUAL ' !SS')' SLICES, I
2
EEL [EVE .
E 9 E T H'O SE SLICES TAKE `"I F 9 0 M
3
o j or i c h v c s < e s s
ho h a ; ang i o s a = c o - a ?
4 a.
A - j D THOSE - l I T H 0 U T A N G l C 3 A R C 0 M. A
5 '
3 U T T h E Y W E RE F R 0M G00 0R I C H W C R ' E R 5 ?
6 A.
T HOSE PARTI C U L A R SLIDES , Y E 5 .
7 Q.
A N D W H E YOU WERE TALK I NG A 3 0 U T H 0 W
8 THE LIVER M ETAS 0LISE S OR C HA N GE S V I N Y L
9 CHLORIDE, YOU -- AND YOU HAD A 5 i_ IDE 0 s;
10 there s h ow IMG THREE different l e VE L S 0 F 11 M E T A R 0 L I2 A TI0N. YOU KEPT RE^ETR I N G T 0 w E HAVE *
12 D E V E L O' RED THIS a p p 3 o A C H . ! HO I ? T H ~ W E T A T
13 Y 0 U A E t E R TO ?
14 A .
ELL, IT'S S 0 R T 0 " U N F I R r j 3 - Y (
15 DID IT, 31 N C E '.! E ARE M U L T I P L E -v 0 R ;< E R S IN THE
16 AREA AND A LSO THE FACT THAT THER E ARE 0 T HER
17 collegjes AT OTHER I AST I T U T I 0 N S W H 0 HAVE D 0 N E 18 IT. SO, I USE E I N AN EDITORIAL SE 3 U IT'S
19 S IMPLY I HD I C A T I N G T H AT WE'VE DON E S 0 M E V/ 0 R .<
20 OURSELVES.
21 0 .
W HO IS THE E E ' V E DOM c --
22 A.
M Y S E L F , .-1 Y BIOCHEMISTS, MY
23 IMHUAOLOGI STS, MY L A oratory tec H : 0 I A v 3 , MY
24 C 0 L L E 3 U E S WHO DO THE H [ 5 T 1 H 'Z Y . VQT
W H
25 EVERYTHING THAT W E P RESENT [S PE R R " N A L L v D 0 M r c
cn
T
-/ \ T l M 3 U R R 0 - M R ' V " S S A L U T T I
1 3Y E.
rn
>
OT C A P A 3 LE
2 x
I `J N D= R S T A N 0 THAT. l U J 5 T ./ A N T T O 3 E
3 C L EAR. 3 E C A U S i YOU :M fT V T I ON S OM e woa:< v;as dome
4 z Y THE DOW CHEMICAL /v-- Vo m p4:y j
5 A. 6 0.
YCv.
DID v 0 U W O R
W I T H THE M Z
7 A
THERE ARE T ;/ 0 V F R Y P" OM I `'I E ,\| T
8 CHEMISTS W H o HA v E DONE A G R E A T DEAL 0 - THE
9 TAJ IN\ACTIVE KE T A 3 0 L l SM OF VInYL CHLORIDE, ALL \
10 < I G H T .\ A N 0 THEY H A V E P J .3 L I 5 H E 0 THAT / A T E R I A L .
11 A N D r R LAp A 3 L Y THEY ' V E GO N T ri E C 0 R c 0 R < \
12 RELATED TO THAT.
13 Q
THEY'VE DOME THE PRINCIPAL WORK I A
14 TRYING TO SHOW THAT AT LOWER LEVELS, VINYL
V 15 CHLOiR IDE IS \N 0 T A CANCER CAUSING AGENT; IS
16 that correct \
17 A .
FRO M 'A\\ METABOLIC POINT OF VIE W . FROM
18 A HISTOLOGY POINT OF VIEW, OTHERS HAVE DONE
19 M ORE.
20 Q.
THAT WAS IT THE 00W CHEMICAL 'COMPANY
21 WHO DIO THAT?
22 A.
DOCTOR WAT ANOR Y, THAT'S CORRECT.
23 V*
AMD THE -STUDIES -THAT YOU DID
24 AMD WHEN I MEAN YOU, I DON'T MEAN YOU
25 PERSONALLY, I ME 4- YOUR WHOLE GROUP -- .. I T H
2111016
T
5 S - D R . T A M '3 J R R C - '* R . V i S S A L 1 T T f . .
'3
1 REGARD TO T hp m E T A 1 ri L 1 c '' r>P /!'!/' Cu' ^ 'M 0 E 1 N
2 THE LIVER, W HO = LJ N 0 F r) THOSE S T ' 1 0 ! E 3 ?
3 A.
T- A T CAME ER CM THREE 5 0 URGES:
4 P R I V A T \ D 0 W M c N T , . A 0 U P A C T U R IG G C H E I 5 T S '
5 A 5 3 0 C 1 A T 1 C N, A "! THE N A T 1 0 A A L INSTITUTE 0 F
6 ncAlTH
7 g.
DID THE GOODRICH COMPANY PROVIDE ANY
8 FUNDING FOR T H 0 5 E STUDIES?
9 A.
NOT THE ONES RELATED TO HETA 30L ISM .
10 THEY PROVIDED SOMS OF THE ORIGINAL M A T F R [i!_
11 T H A T WE USED FOR DEVELOPING SCREEN I NG TESTS
12 FOR DETECTING The A VGI 0S AR CCMA .
13 0.
THAT WAS TO DETERMINE WHETHER "HR I 7
14 EMPLOYEES ACTUALLY HAD A N G I 0 S A RC C M A, TRYI"G
15 TO GET IT IN AN EARLY STAGE. IS T H AT WHAT Y 0 U 16 M E A ,\ 3 Y SCREENING TESTS?
17 A.
NO, WHAT WE WERE WORKING ON IS
18 ,j rt T H E R OR in 0 T W E COULD IDENTIFY GENETIC
19 MARKERS WHICH WOULD TELL US WHICH PEOPLE DO
20 M0 T HANDLE CHE M I C A L S WELL, SPECIFICALLY VINYL 21 CHLOR IDE. SO, w E WERE SETTING UP A SYSTEM F 0 R 22 LOOKING AT ;v H A T IS CALLED H L A TISSUE TYPING.
23 THAT IS, THERE ARE CERTAIN MOLECULES ON CELLS
24 THAT IDENTIFY IT AS HAVING CERTAIN KINDS OF
25 GENETIC CHARACTERISTICS and T h p r < ARE C E T A I m
21110163
T
s--
\ r - -j J R < 0 - . < . V A S 7) A L J T T t
1 J I 3 E-.S E S T n m T OCCUR U 1 T H MU n H Nj REA T 2 F R E 0 J N C Y IN PEOPLE THAT H V T H A T N I MO 0
3 GENET 1 C SETUP . A N j W E Vi E R - T M Y I 'i sJ T 0 5 E = 1 F 4 .;e con L 0 0 E 5 i G M A S Y S T E M TO I DE N'T I c V W H 0 5 w o u l o 3 E A T H I GH RISK
6 The s E C 0 n n 5 E T OF S r 'i 0 { -- C ,/ ?
7
WERE GOING WE RE ALSO TO LOO /
--
8 q.
LET' S T A L < A 3 0 U T *r H 1 T F I ' c* r .'*> M E .
9 IT'S FAIR TO s AY T ^ AT 10 0 I F F E R ENT PEG P L E HA VE OIF s c R E M T S E v 5 I T [ V I T I E S
11 TO CAN C E R C A `j S I N G C H E in I C A LS 7 I s N ' T I T ?
12 r\
THAT ' S C 0 R R E C T .
13 V
5 G T-i E P E 0 P L E A! A Y S E A 3 L r_ ti r- ti 0 R K W I T H
14 IT HO TEARS A NO NEVER H A V 2 AN Y E - F EC T A NO
15 SO.-1E P EOPlE HAY 3E A 3 L E T kj W 0 R .< v7 I T H I T p 0 R 16 T H R E E Y E A R S A N D DEVELOP A N G I 13 5 A R C 0 M A OF T HE
17
OF T He LIVER;
ISN'T THAT CORRECT?
18 A.
THAT'S A POSSIBILITY.
19 0.
AS A M A T T c o 0 F PACT, PEOPLE WHO GOT
20 THE ANGIOSARCOMA OF THe LIVER AT r h = GOODRICH
21 P L A m T - - A N 0 I RELIEVE AT THE 0 T H E R P VC
22 PLANTS - - W ERE, AS I T H I N i< Y 0 U SAID,
23 REACTION CLEANERS, REACTOR C L E ANE R S ?
24 A
M GST OF THE .-1 a1 E " E .
25 ;-i
H 0 .V M ANY OTHER PEOPLE I N THOSE
K h-
C M CD
T
J 2 J R. 7A.MSURRO - MR. ViSS-'L-iTn
1
p i_ a NTS '; E R c IF
" 7 0 L E A -.j = ^ c r, 9
;/ 0 7 7 = 7 ' 3
2 REACTOR C L E a M S a 9 = a AT O \i F 3 7 1 vl T 3 I M ? H $ 17
3 LIVES?
4 a.
'WELL, IN THE SLITS W 2 S H 0 : E 7 ' I ?
5 T H E IN LEX CASES IN TED, EVE-Y ONE T LJ 0 5 E
6 ORRERj, EEC A. 335 THOSE INDIVIDUALS 5 3 E
7 /I A T L 4 4 J r C R T HEIR vi G R .< EXP U9E AREAS. AND
8
SINCE ALL 0 F THEM -- S I N
IT .-.'AS THE
9 POL I C Y _ OF THE C 0"! P A N Y THAT VET TONE h A D TO
10 C OM E wHEN THE Y FIRST W 0 R < E
11 WORK AS A PC L v1 rO Li u-- n .\1; C^ |N0 , A L
12 EXPERIENCE .V OR K I N G I ! THE REACTOR 3 .
13 C.
SO, ALL OF THE PEOPLE IN T'-E PL* v T
14 4 7 q * j e a ^ | m y 0 7 4 q t y F i
y ( .4
15 EXPERIENCE -- E x p f p [ f N| c = D CLEANING REACTORS?
16 A .
YES, RUT THE RE A r T 0 R c W c 9 = T 0 T Y -3 E S
17 YOU < i'i 0 Vi, THEY DID HAVE REACTORS THAT HAD TO 18 DO WITH SYXTHE TIC PURSER AND THOSE D 01 NO WITH
19 S Y N T H E T iI C P L A S TICS. SO, T H 0 UGH 50 !'; E 0 F THE M
20 A ERE IN THE PLANTS WITH VINYL CHLORIDE IN Trl;
21 A T .VTJ S P H E .< E , THEY W ERE WORKING AT D I F F E R N T
22 WORKING wore INTIMATELY WIT- DIFFERENT
23 3T5 Cr CHEMICALS. 24 25 GOODRICH o LA N'T 3 .1 - -3 C C
r -t Y^
to K* K-*
C * CJ) cn
T
j > 7 4 ? :J a R 0
IL'JTT [
1 C-\lL-:; - i > ; LEVELS ' F / I . Y L C H L 0 R 1 E . 1 T -! L '
2 rou SAID 5 y TO 2 0 0 parts per M I L L I 3 \ . 3
SC.N&.vHERE I N THE TONE 0= A TOUT * 0 C ,
4 SOU Jr Tni; 1 , 2 0 0 .
5 Q.
A N D : i 0 :! M A N Y C A S i S 0 F A N G [ OS A R. C 0.4 A
6 WERE THERE WITHIN THAT GROUP?
7 A.
IN THE TIME WE LOOSE 0 AT IT, pOUR
8 A Nl 0 THERE ' - ERE NO FURTHER ----
9 A. 10
C AC cc I 0E NT I " I E 0 ?
11 U ' R E A S :< I NG ME A R0U T T HE I
12 E ST UD I E D . THOSE ' ERE d e 0 P
13
DM 1 3 7'+ UNTIL. N 0 V. . !: J
in o r
14 i r! E z 1 4 4 N A B OUT 5 S H j \ 0 R E D E M P L 0 Y E
15 B . F . GOOD: C H S I N C E THE START OF THE 16 AND HAVE THEM, THERE'S BEEN II CASES OF
17 ANGIOSARCOMA.
18 Q.
SO, 5 S HUNDRED PEOPLE HAD RELATIVELY
19 HIGH EXPOSURES AND 11 DEVELOPED ANGIOSARCOMA
20 OF THE LIVER?
21 A .
I THINK IT WOULD ? E FAIR TO SAY THAT
22 P R 0 3 A 3 L Y R 0 'J G H L Y H A L F .
23 Q
0KAY . 20
24 m .
S AY 2 ' .
25 N
2 3 -i UN ORE ) , 11 DEVELOPED
M K =
H1 or m
T
b 5 -- \ T Ai'ib U^O -- .*'1 VAb:^LjTTi
1 A 'j G f 0 5 A * C 0 M A . 2 \.j w y pi [ p) xj i t THr 0 T H c 7 2 S ; 0 T 0
3 u r: ") r .p z t r to
4
vi r>
p z \i \t " r q r vi .
j c x r et o r
__ _
5 . .-'i 9 . V A S 3 A L n r T I : . I 1 SORRY. 6 3 Y m * . VASSALOTT ! :
7 Q. .
The OTHER 0.2,500. 12,533
8 W ELL, AS 1 ? O I IN T i* 0 OUT,THERE 15, AS
9 YO`J ' </1 INDICATE O AS A P O 5 S I 3 I L l T Y , THAT THERE
10 IS A 51 O LOGICAL VARIATION IN PEOPLE [M HOW
11 THEY HANDLE THE CHEMICAL. THERE IS, ALSO, A
12 DIFFERENCE 3Y WHICH THE CHE M ICAL HAS THE
13 CHANCE TO PRODUCE THE GENET I C INJURY. NO/, 14 S IMPLY BECAUSE YOU PRODUCE TH- A G R `! T O O r5 0 T
15 NECESSARILY M E AN Y O U 'RE OOI U C TO PRODUCE 16 THOSE GENET IC INJUR I ES WHICH ARE GOING T 0 17 LEAD THE CELL TO EVENTUALLY DEVELOP A 18 M AL IG N A NC Y. N0W, EVEN IN THE AN I M A L STUDIES,
19 the largest percentage that was able to -e
20 I u iD U C E D w I T H VIiYl c H L OR I DE E X P 0 S JRE wAS 1 2
21 PE R C E N T . T H A T M E A N T THAT THE M A J 0 < IT Y OF T n E 22 A N I M A L S W ERE ABLE TO H A ''i OLE THAT W HOLE R 23 U F EXPO SURE .,W I T H 0 U T THAT UUL T I PLE COMPLE -V\ 24 c V E;nT Q C C U R R I N G THAT ALL OWED THE DMA TO BE 25 I N J U .1 E Q .
e s ro rrn
r'
1
\ C w , IT'S
T H a,T a o r A T n A A '! -i
2 LY LAC < ACE OU A T E .< N 0 W L E 0 G E TO SAY
3 S 1- 5. C IF I C A L l 7 H y T H ERE I 5 A L I N I T 4 5 TC H 0;.*
4 T5 S z \J A ( w a j c \TS - h. . `I . ' 1 r-V N A G E THE IT T R i F F RC H 5 T ri E cell to the `\j z. \ E TIC :M A T E R I A L . NOW, Tn G S E
6
THAT GET THROUG H !l A V E THOSE P 0 S S I 3 I L I T I E 3
cr
7 DE VE LOP I N G THE TUN OR . AND I T H I N ;< THAT
8 EXPL A I N S , AT L E AST v.7 IVES a \; I 3 z A r-S\ c` ;t u v
9 /V** *
THAT ' S MY O 0 ! '! T . THE FAT T THA T N OT A
10 H U ' i 0 x E Q PERCE '! T Oc T1 HE o E 0 Q L r E X - 0 3 EO
AS
11
A NA T T E R OF FAC T > T E M A U 0 R I T Y 0 F -rup 3 r *> => L E
-
12 p V' ,H p. 3 E0 TO THIS C H p '' I C AL 0 l 0 NOT 0 E V E L 0 3
-
13 A i G - 0 3 A R C 0 H A C F T H E L I V E R I 3 \! 0 7 A N
14 1 N O 1 C A T I 0 N T H A T T -i I 3 CHE ! I CAL - ' - S NOT C A USE 15 THAT C A N C c '< .
16 A .
OH, T H ERE ' S A 3 S O L U T E L Y N 0 DOUBT I N
17 A iN Y 0 N E ' S M I N D S , AT L EAST NOT F R CM A 18 5 C 1 E N T i F I C POINT 0 c V I E W , THA T V I \ Y L CHL D RIDE
19 DOES CAUSE ANGIOSA RC OH A . THE CUES T I 0 N THAT
20 0 N E I s A s :< E 0 IS I N - V E P Y CASE OF A N G I 0 S A R C 0 A ,
21 IS IT VINYL CHL o ? r D F . AND THA T, I THINK, ^ A S
22
T 0 0 P \ p ^ Q \/ P fj D v E P I 0 EHTOLOG!C AL 0 p
v
23
24 U.
NOW, YOU'VE I `-10 I C A TED, l TH I V< , THAT
25 r H i _GW -- L 0 v.` E R LEV^L OF S a ? d S u 0 Z THAT THF
89TOTTT
T
" J . i n,1 3 J R H D " i'l 3 V
^ i. ] T T I
1 Live.? :-I7a3GL 13 5 THE' AMOUNT OF V I 4 Y L 2 CHLORIDE f'rl AT GETS INTO THE 3 LD 0 D S T R E A M ; [S
3 y H 4 y r Q do a r y o
4 A.
YES.
5 0.
YOU ha.V5
TO GIVE US VE < E A l i'!;";5,
6 0 00 TO 9: .
7 A.
YES, YES, I'M SOOTY.
3 0.
HO,-. DIO YOU DETERMINE T M I S ? DID YOU
9 OETcT/.lNE THAT OR .7 A S THAT THE 0 0 0 C H E M I C A L
10 C G H. P A N Y ?
n A.
THE S E PETE STUDIES DONE AT 00W AND
12 3 Y OUR GUN CHEMISTS AT THE UNIVERSITY OF
13 LOUISVILLE, DOCTOR .7 0 N G .
14 C .
A N 0 W ERE THESE I M HUMAN STUDIES 0 R
15 IN ANIMAL STUDIES?
16 A .
THESE W ERE ALL I N A N { M A L S T U 0 I E S .
17 0. 18 A .
HOW DID YOU DO THE S E AN I :M AL STUDIES take A N A N I A L 0 - A C ER TA I N S E C IE
19 A N 0 G E N E T I C BREED I N G 0 N A N D LET 7 H E M BREATHE
20 IN 0 [ M Y L CHLORIDE AT DIFFER?v y L y cLS 0F
21
p a 7 s p 1 X ri I L L i '}
A NO T H EM G E T E R 'i I N E 3 r
22 * A j I 0 A C T I V 1 L Y T A G G 1 N G T H E V I N Y L r ^4 L 0 <
23
i*i U C n ur I T I S CO N V c R T E 0 INTO IT 5
Y PR0DUC T S
24 A N D .7 H I C H ROUT C A N D T H I S IS DO `N ^ 0 N ThE
25
T ISSUE CF the
\; I M A L AFT E R THE A U I V. A L I S
o
T
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N
H h* o
m
C R 3 7 . T 4:1 - 3 " - ; -> . y \ 3 3 i !_ 0 T T I
7"
1
5 ' - r 3 -3 D T 3 IT. T z ~ ~
0f
E p~ ^ I r ~ ^
2 W HERE O'jl ACTUALLY T A A 5 3 THE 4 I 4L T ISSUE
3 F G Mi 4 N .) :>i - X P USED ,a,'i I.-4L - ND ACTUALLY 7. 4=5
4
m Col rU\; .
z 5 7 L 4 7 D j :/
7 .i E C L L 5 4 n j,
5 i:.Nc.lATc THE3 JUT AN.) YOU ACTUALLY GROw THE
6 CELLS iUOEPESOE M T L Y AMD YOU EXPOSE THEM. TO
7 T n tz AGENT AMD THEM WATCH In THE r L U I 0 THAT
8 THE CELLS ARE LIVING AND HO v/ MUCH OF THE
9 PRODUCT IS PRODUCED.
10 0 .
SO, YOU EXPOSED ANIMALS, RATS,
11 HAMSTERS, MICE, WHATEVER, T! A f? AMD VIMYL
12 CHLORIDE, MEASURED W "AT UA JaENr) TO THE VINYL
13 CHLORIDE. AND THESE STUDIES SHOWED THAT A T 14 LOvER LEVELS U M D E R T H ~ S T SITUATIONS AT L 0 V: E R
15 LEVELS OF EXPOSURE -- AND WHAT DC WE M E A N
16 3Y LOWER LEVELS OF EXPOSURE?
17 A.
3 Y LOWER LEVELS, I'M USUALLY
18 SPEAK I NG A30UT U N D E R 2 5 PARTS PE R -M ILL1GM.
19 y
A NO AT L C W ER LEVELS OF EXPOSURE, THE
20 LIVER OF THESE' AMM A L S META? OL I
21 V I N Y L CHLORIDE A N0 R E 5 U L T E D I M N 0 N C A N C E R
22 C A U S I M G M E T A 3 0 L I T E S ; IS THAT C 0 o r> r r j >
23 r~-
THAT'S THE c-dnclus I
j M 4 T Q, C
*3 4 v/ \j
24 ON THE R A S I S 0 r T h = fact THAT NONE r c -r-4 =
25 .A N I M A L S EXPO S E D A '! D W E 71 F A L L .0 W ED 70 U f V F
H
T
j -- j R . 7 A J >0 --
. 7 . v >. j j A L -1 T T !
/L
1
j 4 / ^ L -3 F D T n AT K I M D OF T 0 ;i u R , T r\ A T i i i T ;
, a ^
2 N0 V [ 0 E N C T rlA T :! H N THESE AMI M A L S V. E3 F
3 EXPOSED, TmAT TheLIVER COLLS SHOOED 4 HISTOLOGICAL E V I D E N C E OR R I 0C HE '' ! C A L EV I ~ E N C E
5 OF INJURY, AMD THAT THE MATERIALS, THE
6 SIM STANCES that DETOXIFY TUESE AGE MTS HAS IN
7 SUFFICIENT QUANTITIES S 0 THAT LIVES CELL
8 DIDN'T H A V E TO M A .< x Q R F .
9
T w E CO U R T :
`1 R . V A S S A L O T T I ,
10 w HE/-. YOU REACH & POINT WHERE YOU WANT TOSTOP,
11 WE'LL TAKE OUR RECESS.
12 HR. V AS S A L0 T T I : YOUR HONOR,
13 i ' JUST LIKE TO G0 0N W 1 TH A C 0 U P L E M ORE 14 QUESTIONS AT THIS POINT.
15
THE COURT:
I'LL LEAVE IT AT
16 YOUR DISCRETION.
17 BY MR. VASSALOTTI:
18 0 .
DOCTOR, YO'J STARTED AT THE 3 E G I N N r
19 OF Y 0 IJ R T E S T I v 0 N Y TH I S HORNIN' G AND Y 0 U 5 A 1 0 20 THA T THE M A J 0 R F U M C T I ON OP T H E LIVER ( S TO
21 'J U. 1 0 X I r Y CHEMICAL A. G E N T S
N 0 T S 0 MUCH
22 CHE MIC A L AGENTS, ANY FOREIGN AGE N T S 1 N 0 u R
23 bojy; is that correct?
24 A-
<i ELL, IT IS THE major D E T 0 X I = Y I \ G .
25 IT IS MOT THE 0L Y 0 .N E .
H
T
7a 7 !!7
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16 A L S WERE 0 N L
17 TO VINYL CHLORIDE?
18
19
5 C A 5 E, YOU
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20 CHE ri-ICAL PLA 21 YOU o
22 A.
YES.
23 0 .
W ERE YOU A W ARE THAT HE ;7 A 5 A L 3 0
24 EXPOSED TO VARIOUS TYPES OF 0e '3 A V IC AND
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9 YES.
10 HAVE YOU EVER M A 0 E A N Y ANIMAL 11 3 T J 0 1 E 5 W H E R E , IN* A 0 D I T i 0 h TO X ? 0 5 U ' E TO
12 VINYL CHLORIDE, THE AM I HALS HERE EXPOSED TO
13 H U L T l P L OTHER CHEMICAL AGENTS?
14 A.
OUR GROUP HAS PARTICIPATED I :V 5 J C H
15 STUDIES, iv L HAVE "i OT CONDUCTED THEN.
16 G .
AND ISM' T I T A FAC T THA T M R G R A S 5 0
17 OR TH E ANIMALS I N THE STUDY ARE EXPOSE D TO
18 OTH E R CHE M I C A L AG ENTS, I N T H I S C A S E TO V ! N Y L
19 CHL 0 R IDE, A F f f CT THE w AY T H E L I V C R -- THE 20 L I V F R 13 A R L E T 0 r l E l N 0 U T 0 U R S YS TE A N D
21 ME T A 0 0 L I Z E THIS HATER lA L ?
22 A .
YES.
23 0
IN OTHEP Vi CROC, THE V I mYL CHLORIDE
24 THAT HE ,;ao E X POSED T 0 .< 0 U L D H A V E TO S T .A N D I N
25 LINE a j ,i AIT FOR ', H A T E V E I 0 T H E 1 TO X I \ S w ERc
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8 stands in line, i r. a layman, doctor. i don't
9 UNDERSTAND EXACTLY HOW THE LIVER WORKS.
10 A.
WELL, WHAT YOU'RE SAYING 15 THAT
11 THERE WAS A COMPETITION FOR THE ABILITY OF
12 THE LIVER CELL TO GET RID 0 " T E S E S U R S 7 A \! C E S .
13 AND THA7 1 5 TRUE OF ALL SUBSTANCES. 'OW, 14 '>/H5 ThE ? THE LIVER S = l E C 7 I \/ = l " T a < 3 5 r a n ? - c
15 ONE AGENT OR ANOTHER, THAT you C A N ' T RE AS
16 SIMPLISTIC A R 0 U T IT. THE LIVER WILL DO that
17 A T T I M E S .
18 Q.
DOES IT DO THAT WITH VINYL CHLORIDE?
19 A.
PARDON?
20 0.
. DOES IT 00 THAT WI T H VINYL CHLORIDE?
21 a.
IT WOULD HAVE TO DEPEND ON A GREAT
22 DEAL WHAT AGENTS IT WAS COMPETING WITH.
23 C E :R T A 1:* AGE N T S W C U L D IMPEDE IT, CERTAIN 24 AGENT 5 W 0 U L D DO NOTH I[ N G A N D CERTAIN AGE '
25 WOULD SPEED IT U=.
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6 Q.
WHAT W 0 U L 0 YOUR SPEC IJ L A T I 0
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THE court;
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10 T I vi E TO STOP, X R . V A S S A L n T T r , FOR 0 11 A* 0 VA S SA L OT T I : ox
12 H 0 M 0 R .
13
the COURT:
LET ' S T
14 4 I >. u T s: < E C 3 5 , LADIES A N A G c N T L -z E N .
15 AT Tn I S TIME THE JURY LEAVES C OUR TROGM . ) 16 THE COURT: WE'LL STAND IN 17 RECESS FOR T E N MINUTES.
13 (SHORT RECESS.)
19 THE COURT: MR. V a $ 5 A L 0 T T I ,
20 YOU MAY CONTINUE WITH YO'JR C R 0 S 3 - E X A M I M A T I 0 N .
21 3 Y MR. VASSALOTTt:
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9 H Y D R 0 C A R S 0 N 5 F OR Y E T A S 0 L I S Y ?
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11 R A D I C < E . WHAT THE STUDY 3 h 0 W EDW A S T H A " THE
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18 Q.
LET'S TALK ABOUT THAT. THAT'S THE
19 RADICKE WORK THAT DOCTOR EPSTEIN TALKED ABOUT.
20 YOU WERE HERE WHEN HE TEST l F I = D .
21 A. 22 0 .
THAT'S C C R R E C T. I THINK HE H ENT 10 N E D THAT I \| a
23 DISCUSSION OF SYNERGISTIC EFFECTS Oc
24 CHEMICALS. AGAIN, SYNERGISTIC EFFECTS OF
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