Document 71wgxqE58j2qRkRkmv8XYadJg
I '
'LLjl
Nam*
9
Jfo. *
27628
latarpxatatioa of
single
t*ka oa
2/14/72
PUat* Millington, N. J.
Roadtag Data
A/22/12
roantgaaogram of ckaat
There has been an increase in the small rounded and
irregular densities and the calcified pleuro plaque is
again seen. The film is consistent with mixed asbestosis
and silicosis. See previous report.
QEOBQI W. WEIGHT, M. D. $lat Luka'* HotpiUl 11311 Skakar BealaTtxd daralaad, Ohio 44104
i
-*y
N*m
Plant: Millington, N.J.
No. 27628
Reading Data lx-13-70
;
Interpretation of
single
roentgenogram of cheat
taken on
10-26-70
The film of this date again shows the calcified pleura plaque V\ on the left. A -review of his films from 1955 to date shows
the development of barely discernible but definite increase
of the bronchovascular markings with beading or branching densities in the upper half of both lungs. The films overall strongly suggest a mild lung reaction to a mixed V exposure of asbestos and free crystalline silica; Does he have a history of such exposure? Thoracic scoliosis is again noted.
QIORGX W. WEIGHT, U. D. Saint Loko'a Moapltal 11311 Shakar Benlavtxd Claveland, Ohio 44104
V
lUc
i
Name
No. 27623
Interpretation of
Single
taken on 6-27-68
Plant: Millington, New Jersey
Reading Date
7-5-68
roentgenogram of chest
In addition to the prominent bronchovascular markings thickened pleura and scoliosis previously described there are also irregular linear densities at the level of the mid-left lung which represent calcific pleura plaque formation. If he has a history of exposure to asbestos
fiber, the plaques are likely associate*/
GEORGS W. WRIGHT. M. DSaint Luke'a Hospital11311 Shikar Boulevard Cleveland, Ohio 44104
>.
K* 0
Mat
No. 27628 IatapraUtion of
single
takaa on 12-28-66
Plat: Millington, N*J* Reading Data 2-3-67
roantgaaograiB of ohaat
The bronchovascular markings are rather prominent especially on the left and the lungs appear unu sually voluminous* The horizontal fissure is visible and there is moderate thoracic scoliosis* A comparison of this film with others going back to 1955 shows only a slight increase of the sco liosis and that the fissure became visible after 1962* The films suggest that he may have diffuse airway obstruction such as seen in anatomical emphysema and that in the last year or two he likely had pneumonia at sometime which caused pleurisy- now healed*
GXO&GX W. WEIGHT, U. t>.
Siat Loka'a HotpiUl
11311 Skakar Boolavard
CUTaUad, Ohio 44104
i
Name . No. Interpretation of taken on
Plant:
Millington t
27628 single
Reading Date 6/8/64 roentgenogram of cheat
5/13/64
.i
X The description of the film taken in 196.0 is
the same as the present one* See previous
reports. There has not been a change.
GIORGS W. WRIGHT, M, D. Salat Laka'a Hcapital 11311 Shakat Booleeasd Cleveland 4, Ohio
Name
No. 30-62
Interpretation oi single
taken on
6/21/62
Plant: Reading Date:
roentgenogram of chest
Millington, N. 3 6/27/62
No change when compared to previous reports.
GEORGE w. WRIGHT, M. D. Saint Luke'* Hotpital 11311 Scaker Boulevard Cleveland 4, Ohio
KK
NGC
Name
Plant: Millington, New Jersey
No- 52-60 Interpretation oi taken on 4/1/60
single compared with
Reading Date : roentgenogram of chest
taken on
4/20/60
A review of the films of '53, '55, and '57 togetoer with the current one indicates that the vascular markings are somewhat prominent throughout both lungs. I don't consider this a new development. I doubt if this has any significance but would like a complete occupational history to evaluate fcktt series of films.
GEORGE W. WRIGHT, M. D. Saint Loke'f Hospital 11311 Shaker Boulevard Cleveland 4, Ohio
Nam*: No. *
' 43-57-B
P---l-a--n--t-:
Millington, N. J\ (NGC)
Reading Date1-13-58
Interpretation of
Single
roentgenogram of chest
taken on
12-30-57 compared with
taken on
No change as compared to previous reports.
GXO&GS W. WRIGHT, M. D. Saint Lake'* Hospital 11311 Shaker BoaieTaxd Clerelaad 4, Ohio
George W. Wright, M. D
Ocpartmgny or
EXPERIMENTAL MEOICINC
January 16, 1956
T. CUKE'S HOSPITAL 11 3 11 SHAKER 8LVO. CCCVCLANO 4, OHIO
No. 55-32-B Name
National Gypsum Co. Interpretation of single roentgenogram
Millington, N. J.
of chest taken on 12-5-55
compared with
taken on 9-16-53
No change.
Kk
George W. Wright, M.D.
Department of Experimental Medicine
saint iuke's hospital shaker blvd.
CLEVELAND 4. OHIO
No. 8^ Name _
Natl. Gypsum Co. Millington, N.J.
-
Interpretation of single roentgenogram
of chest taken on
9-16-53
compared with
taken on
No ahnonnality seen other than a slight scoliosis of the thoracic spine.
Oote---------------------- ---------- %t M Sap'e .
Te'-ted by ."RcW-IIfcn^Cg. .
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A$e
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___ Sex _ _
. Mooted A^c
P'jkC TONE AUDIOGRAM
Frequency in Cvdes ;<*r Second
Cr>fr' No.1___ oC-___ F a.r______ Poor Awdiogrom Code
TMHtlMOlO .Vt l t-CCi(lt MIRICtH lllN U M D (.`
PRBi R 1
250
50C
SI3I
t:::
low -
_SF:CH TESTS
Fsint
Cf-SlP*
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R
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SPEECH HEARING TESTS
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NATION \L i>\ P'l'U 00 Ml* \ PHYSICAL EXAMINATION RKCORl)
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pki:-lA'fM <nmi:n i
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C\>T KMl'UnML.NT National Svpsum Company________________________________________~
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CHEST
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"(INfiCt RATION CHU'T EATA.VSIOA
BLOOD VHKSSl.Jit /S^ 0/j/Q
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|jt\L.E. 20/2 n R 20/
IIKIINIA -C"
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INGUINAL MN#> ^
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OPERATIVE SCARS
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NORMAL ENLARGED _ RELAXED
ii \Ck AND [ATKKMniOS -- EOLMA. AMPtTATIONS. FLNCTfO.VU. DEFECTS. DEFORMITIES
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1C FINDINGS - NKIKULOOICAL
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M.AWAKY OF PLHMANLNT DKFKCTS, IMP AIHMI'.N I>; EWMIM-K HAS BICKN ADVISKD OF MlAU 1(\NT FINDINGS ^TF>
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EMOTIONAL STABILITY
________________________ ________________________ _
api'lu.an ; > hi.na rrnt
^
ArcpR
Cynau. Arr-pt
Reject
IMI'iMClAN'S Sll.N^A^RE
JOB ALIGNMENT
PREVIOUS MEDICAL
/ T/ > --------
COMPANY APPKOVA1.S PERSONNEL ULEEALO
DATE
part examined
KILM NO.
DISTRICT SALES MAN r EH
T k. *CLR
kt
\\
saeety
SLPER.
M.P.
S(,
R . V'*
NATIONAL GYPSUM COMPY
Sales District
Office
Name te
Age
Color
Arthritis Operations Venerea] Diseases Liquor
Dept.
Address
___ ______ KUIlngton, H.J.
Check No.
MW
Children
PHYSICAL RECORD
^
(TO BC COMPLETED BY PERSONNEL DEPARTMENT)
_"
Epilepsy__________________________________________Hernia
Li*( aa rarer*a aid* any haapital adaiaaioea is paat $ years.
Tuberculosis
Tobacco
Drugs
Other Illnesses
Injuries -- description, location, % disability
Compensation Received
Hava you a hialory of aUieoaia or any other dual diaaaaa?
Da you have a verkaaa'a eantpanaaiiaa ci paadisg far aithar injury or illnaaa?
Hava you tear baao in Military aarriea?
Hare any ef your pertnta ar brothers or aiatera had Tuberculoaia, Cancer, Dtabalaa, Epilapay ar jnaanity*
Last previous employment
] certify that the above anewers are irua, conacdy racarded, aad that I aa in
Signature of Applicant * If divorced, give date and place
,,.w, UX`.
Eyes: Right Pupils ^
/
Laft
Witness
PHYSICAL EXAMINATION wpigh(tTO/BEyCOXMPLETED BY DOCTOR)
Corrected: Right Comes f
0*ar *ight Nanaal Veight Undar Vaighi
L*ft
Binocular V iaioa
Lungs w Heart f
Ears / Throat and Tonsils ^
Shortness of Breath Blood Pressure/^
No8C V Hearing: Right
Chest XRay Pulse ?C/
Teeth#/ Left`,Jwr
Abdomen Spine
/
Ertremities ^
Scars
^
Skin 'Reflexes
^
Blood Test
y
General Condition: Good ^
Hernia *
Hemorrhoids ^ \
.
(Nat# % af dafactn ii any anal)
(Haad and sack aaly -- giva iocadaa) Glandsfr
Muscnlaturt ^ Genitals ^
Mentality tt
Urinalysis w
Fair
Poor
Nutrition: Good *
Fair
Poor
Do yon recommend applicant for work?
fj
Type of Work?
.erosrks
.
APPROVED
FOREMAN SAFETY SUPERVISOR PLANT MAN'ACER
S). / *
___________ ^_______Yt * *. : ir:
t'/'Vi*
'
Examined bv
1 !)<< ^
M.l
# THIS EMPLOYEE'S CONDITION IS KNOWN BY HIS SUPERVISOR. YES^ NO ^
Rational gypsum co)mMpP^^
Sales District Office
Name _
._______
Address
PlaatHlxilngtai
Date___ 4/f/fc-l
Dept._______
Check No. 200
47
'Color
V
S M w D'
Children
PHYSICAL RECORD
(TO BE COMPLETED BY PERSONNEL DEPARTMENT)
_
Arthritis____________________________ Epilepsy__________________________________________Hernia -
Operations
List os rarerse aide any hospital adniaaioas is past S years.
Venereal Diaeaaes
Tuberculosis
Liquor
_
Tobacco
Drags
Other Illnesses
Injuries -- description, locatioo, % disability
Compensation Received
Kara you a history of ailicoaia or any other duat disaaoo?
Do you bare a woikoxt'i ceispaeoaiios case pending (or either injury or illness?
i
Have asy of your parent# or brother* or siater* had Tuberculeaia, Caseer, Diabelaa, Epilepay or laaanity?
Last previous employment ___________________________________________
] certify that tb above aeawara are true, correctly recorded, end that I aa ia good health, aod that 1 bare aerar auffered froa Silicoaia, aicept (history)
Signature of Applicant
Witness
* If divorced, give date and place
b L'Z" Eves: Right
PHYSICAL EXAMINATION (TO BE COMPLETED BY DOCTOR)
Weight ^o Lsft ^'"7
Corrected: Right
Pupils 1/
Comes
Lungs
Shortness of Breath
Heart i/
Blood Pressure
Ears l/ Throat and Tonsils //
Nose Hearing: Right '^/tsCS
Over Weight Norval Weight tlader Weight
Left
s B iaoeular Viaios
Chest X-Ray *__ _ ___
Pulse
///
Teeth ^ , Left %
,
'
Abdomen Spine
^
Hernia Hemorrhoids is
/
Extremities !/ Scars ^ Skin & Reflexes Blood Test L' General Condition: Good \y
(Note % of defects If asy anst)
(Head asd sack aaiy -- giva loceSss) Glands /
Mentality 4s
Urinalysis is
Fair
Poor
Nutrition: Good
Musculature Genitals 6
/ Fair
Poor
Do yon recommend applicant for work? (2-1
Type of Work?
marks
kfc " -
i:______
APPROVED
FOREX AN SAFETY SUPERVISOR PLANT MANAGER
9-6+f /) / / A Date 1/ , /
_____
Examined by
> M.C
THIS EMPLOYEE'S CONDITlON'lS KNoATbY BIS SUPERVISOR. YES gf NOC
Name |
April. 17* 19$9 ____ Jiii______ 9olor
Arthritis
Operations
Venereal Diseases
Liquor
_
___
Other Illnesses
e NATIONAL GYPol'M COMP'
Sales District Office
Dept.
Address
______ Plant Mil,
Check No.
M W D*
-- __Children
PHYSICAL RECORD
=
(TO UE COMPLETED BY PERSONNEL DEPARTMENT)
^
Epilepsy
_____
Henu*-
Lias oo reverae aide any heapnal adniaaiona in paai & rtiri.
Tuberculosis
Tobac
Drugs
Injuries -- desenption, location, % disability _
Compensation Received
Have rou a hiatorv of atlicoaia or or other dual diaeaae?
Oo rou have a workmen'* eompenaatioa eaae pending for either injury or illacae'
Have rau ever bceo io military aervice?
Have any of rour percale or broibere or aiatera had Tuberculoait. Cancer, Oiabeiea, Epilepay or Inaanity?
Last previous employment
I certify that the above enavrera are true, correctly recorded, end that I an in food _beelih, a ad that | have orver suffered from Silicoaia, except (history)___
Signature of Applicant
Witness
If divorced, give date and place
eight Eyes: Righi Pupils Lungs Heart
La ft
A
^4^.
PHYSICAL EXAMINATION
(TO UE COMPLETELY DOCTOR)
Weight
^*
A-- Corrected: Right
-'
Comea
~y
Shortness of Breath
'
Blood Pressure I1! "'I'-
Over Weight
Nonoal Weight
(Jader Weight
-
Left
'
Binocular
V latoa
Chest X-Ray Pulae j
-
Ears
y-
Nose
^ , Teeth
Throat and Tonsil 9 Abdomen
X
y
Hearing: Right
^ A.
Left
Hernia y>^fiu^/sts. A/ / 1 ^
?'
Spine Extremities Scars Skin Reflexes
y-
s
/
y
Hemorrhoids
^ /
(Note % of defect* if any axial) Gla nds (Hoad tad neck oaly -- fiv* locaooj
Musculature Genitals
Mentality
/
Blood Test
S,
Urinalysis
s'
Ceneral Condition : Good
* Fair
Poor
Nutrition: Good
Fair
Poor
Do you recommend! applicant for work?
yf'
Type of Work?
Remark
APPROVED
FOREMAN SAFETY SUPERVISOR PLANT MANACER
---------------- ' 7 "^^7 1L
7
^ Date 1 /-
Examined by
tm.
THIS EMPLOYEE'S CONDITION IS KNOWN BY HIS SUPERVISOR. YES
__________________
t
NO
o
~T.OCK NT3ER 2Qg * AA*"*
address
pir. !CAL EXAMINATION DATE
DLOOD TEST EYES
/v
EARS iS
NOSJ__ Is
THROAT : U
HEART
BLOC?. PRESSURE
'/ ''
URINE ANALYSIS___ ^ X-RAY__________ ^
REMARKS______________
'.
fc".fcfc.
. ' :
e
PHYSICAL EXAMINATION
CLOCK NU?3ER 200
DATE
1AV49
NAME. ADDRESS CITY
BLOOD TEST'i T~i
EYES EARS
I\
U
NOSE
.
THROAT:
HEART
________________________________________
BLOOt PRESSURE. /.rr/ir
!
*
A
7
f
.* -
URINE ANALYSIS__ ^ X-RAY __ REMARKS________________
^.4 ; ii r<
'Physician's Signature
oo
CLOCK NUMBER
PHYS I< AL EXAMINATION OCTOBER 1947
NAME __ ADDRESS, CITY
BLOOD TEST: NEGATIVE ^_________ POSITIVE
EYES :___^P* ' t/
EARS:
NOSE
THROAT
HEART:
'
-
,;
BLOOD PRESSURE:
V
________________________
Sc 'r /?(*', _; a / crtjy
'
r *r*
^fU'^1
"
URINE ANALYSIS: X-RAY:_ REMARKS:
?h..-::lclar.:s Signature
KK
'"'Hi
riexjiS c? ^ * v
AS* Kt: Millington, N. J.
No; -
27628
Reading Dot*
4/22/72
Interpretation of
roentgenogram of cheat
si* Single
% tokos os \ 2/14/72
There has been an increase in the small rounded and
irregular densities and the calcified pleuro plaque is
again seen. The film is consistent with mixed asbestosis
and silicosis. See previous report.
.'
GKOBQK W. WJUGHT, M. P. Saint lake* Heapital 11311 Shaker Boulevard Cleveland, Okie 44104
t v
Kk :
Nun* *
No. Interpretation of
taken on *
27528 single 10-26-70
Plant:
Millington# M.J.
Reeding Date
.
11-13-70
roentgenogram of chest
film of this date again shows the calcified pleura plague the left. A review of his films from 1955 to date shoe* ~ development of barely discernible bet definite increase
' of the bronehovascular narking* \vith **Ai*$ or branching
densities in the upper half of both lungs. * The' films overall strongly suggest a mild lung reaction to a mimed ^exposure of asbestos and free crystalline silica. Does be
have a history of such exposure? Thoracic scoliosis is ngaia noted.
GIOBGX W. WEIGHT, 1C D. Stiat Laka's Hoepltal 11311 Stake* BeolTrd Cleveland. Okie 44104
-. .
4
1C K
Name No. 27623 Interpretation of
Single
taken on $_27-68
Plant: Millington, Hew Jersey
Reading Date
7-5-68
roentgenogram of cheat
In addition to the prominent broncbcvascuUr Barkings
thickened pleura and scoliosis previously described there
ere also Irregular linear densities at the level of the Id-left lung which represent calcific pleura plague formation. If be has a history of exposure to asbestos
fiber, the plaques are likely associated/
GEORGE W. WRIGHT, M. D. Saint Luka's Hospital 11311 Shakar Boulavard Claaaland, Ohio 44104
Naao No. 27628 Interpretation of
ingle
takan on 12*28*66
Plant: KillingtOn, N-J
Raeding Data 2*3*67
The broachovascular markings era rather prominent especially on the left and the Imago appear eee* easily voluminous. The borlrootal fissure is visible aad there Is moderate thoracic scoliosis. A comparison of this file with ethers gels? back to 1955 shoes only a slight lacrosse of the sco* 4 llosis aad that the fibsmre becaee visible after Mi > 1962. The films suggest that he why have diffuse 'yfr airway obstruction such as sees in anatomical
I *Kat la the last year or too be likely
aoeetiae which caused pleurisy**
GXORGX W. WRIGHT, U. D.
Saint lake's Hospital
1X311 Shakat Boolawd
Cleveland, Okie 44104
Name No. Interpretation of taken on
27628 single
Plant:
Millington, N.J.
Reading Date 6/8/64
roentgenogram of cheat
5/13/64
If The description of the film taken in I960 is
the sane as the present one. See previous
reports. There has not been a change.
GXORGS W. WRIGHT, M. D. Saint Laka'a Hospital 113) 1 Shakai Boulevard Cleveland 4, Ohio
let-
V. Name No. 3G-62 Interpretation oi 6 jngle
Plant: Reading Date:
roentgenogram of cheat
l.lillington, N. J. 6/27/62
taken on
6/21/62
No change when compared to previous reporta.
GEORGE W. WRIGHT, M. >. Saint Luka't KoapUal 11311 Shaker Boulevard Cleveland 4, Ohio
ttc -i #
Nome
No' 5c-60 Interpretation of taken on 4 /1 / 6 0
single compared with
HGC
Plant: Millington,- New Jersey
Reading Date : roentgenogram of chest
4/JC/60
taken on
A review of the films of *53, '55, and '57 tog4ier with the current one indicates that the vascular marking* are somewhat prominent throughout both lungs. I don't consider this a new development. I doobt if this has any significance but would like a complete occupational history to evaluate fetat "series of films.
Scoliosis of thoracic spine Is again noted.
GEORGE W. WRIGHT, M. D. Saint Luka's Hospital 11311 Sbakar Boularaxd Claval&sd A, Ohio
Naxos: No.
43-57-B
Plant:
Millington, N. J. (NGC)
Reading Data:
1-13-58
Interpretation ol
Singls
roentgenogram ol chest
taken on
12-30-57 comPax#<^ with
taken on
No eking* m eoo^artd to prtiioot rsports.
> GEORGE W. WRIGHT, M. D. S*lat Lake's Hospital 11311 Shaksr Boulevard Cleveland 4, Ohio
fck.
30
George W. Wright, M. d.
DCPARTMCNT OF Experimental Medicine
January 16, 1956
T. LUKE'S HOSPITAL nan shaker blvd. CLEVELAND 4, OHIO
No. 55-32-* Name!
National Gypsum Co. Interpretation of single roentgenogram
Millington, N. J.
of chest taken on 12-5-55
compared with
taken on 9-16-53
No change.
George W. Wright, M.D.
L
Department of Experimental medicine
SAINT LUKE'S HOSPITAL 1131 > SHAKER BLVD. CLEVELAND 4, OHIO
No. 82 Name
Katl.
Co
I'illirptcn, T'.J
Interpretation of single roentgenogram
of chest taken on
" 0.1C--;?
compared with
taken on
Ko abnormality seen other than a slicht cccliosir- cf the thoracic spine.
KK'
J. WILLIAM LITTLER M. D.
14 EAST SOTH STREET NEW YORK. N. Y. 10028
August 7# 1966
Rr Tiaothy Tolin Rational Gypaua Conpsny Millington riant Millington, lew Jersey
Dsar Nr* Tolini I have recently essnincd the above 53 year old claimant whose right little finger was injured approxistately two years ago when caught under a 100 lb* bay in the flexed position* Apparently the extensor tendon was raptured frca its insertion on the tendnal phalanx* Bcosuse of his Inability to extend the texvinal phalanx an operation was carried out in October 1966 in en effort to restoro tendon oentinuity* Xlrsehoer ire fixation was used to isaoblliao the interphalangeal joints* At the tine of ay seeing hla the two interphalangeal joints could not bo fully extended, eech having a loss of apprexlaately 35 to 00 * from those polnte-the prexiSsl interphalangeal joints oould be flexed sad re-extended through en are of 45 and the distal joint through an arc of fiO Zt is ay opinion that no appreciable gain oould be sad# through any further treatsaat and that the ease should be closed*
Yours very sincerely,
Kk.
September 7, 1966.
Kational Gypsu: Company, Inc. Division Avenue Millington, New Jersey
Attn: Mr. Lawrence Grissim
Re:
Pear Mr. Grissim:
i
_ came in to see me today complaining cf inability tc straighten his right little finger. He states that about one month- ago the finger was bent under a heavy bag. He had no medical attention until about one week later.
Examination shows drooping of the terminal phalanx of the right little finger. There is mild swelling and tenderness over the distal interphalangeal joint. X-ray examination is negative.
In my opinion this patient has a so-called mallet finger with avulsion of the extensor tendon. No treatment is of any avail now except a surgical repair of the extensor tendon. The results of this operation are not one hundred percent and the patient would have to wear a splint or support to the finger for at least four weeks. The other approach would be to award him a small amount of disability (20 of the finger) and live with it.
Since it--is the little finger this would not be too bad a solution.
Thank you for sending this patient t<ji see me.
' i'
Sincerely
HKB :mbr Enel. 1 statement
Hugh K. Bebbitt, K.D.
HUGH M. BABBITT. M.D.. F.A.C.S.
BO PARK AVENUE PLAINFIELD. NEW JEJUCY
RHONE -4BB
September 7> 1966.
National Gypsum Company/ Inc. Division Avenue Millington, New Jersey Attn: Mr. Lawrence Grissfcm
Re:
Dear Mr. Grissffra: same in to see me today complaining of inability to
straighten his right little finger. He states that about one month ago the finger was bent under a heavy bag. He had no medical attention until about one week later. Examination shows drooping of the terminal phalanx of the right little finger. There is mild swelling and tenderness over the distal interphalangeal joint. X-ray examination is negative.
In my opinion this patient has a so-called mallet finger with avulsion of the extensor tendon. No treatment is of any avail now except a surgical repair of the extensor tendon. The results of this operation are not one hundred percent and the patient would have to wear a splint or support to the finger for at least four weeks. The other approach would be to award him a small amount of disability (20% of the finger) and live with it. Since it--is the little finger this would not be too bad a solution. Thank you for sending this patient to see me.
HMBrmbr Enel. 1 statement
HUGH M. BABBITT. M.O. F.A.C.S.
850 PARK .AVENUE. PLAJNFIEI-O. NEW JERSEY
PHONE 0-6469
'ovcr.ber 9, 19^7.
vC Jc 7916
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AUDICMSTHIC cYALUATiON
Dote . Nome -- Tested by j2oiLZChsitiEs..
ALdiome'er
Age Hi__ Sex
Center No. Test Nc.
5
Estimated Accuracy Good
Foir ____ Poor
PURE tone audiogram Frequency in Cycles per Second
Audiogram Code
. Am e r ic a n s t a n d a r d s c a le
th r e s h o ld l e v e l in o c c it t is
S]:sx
FRS^ 25C 50C 1000 2C00;OuOO 40a> f>OCO
R t
1 1 _____ 1_____
DISTORTED s?::ech tests
Low ^Fass _
Faint
\
Conb. I
R :. i
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SPEECH HEARING TESTS
r ~---- 1
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| S*. ft*<*<i* Tk*hl4 (5RT) i es
! 1! j I u,,.. ' < V
j Se. Oiicfim. | (PB)
1>
1 Nk j *! -------- U
V
NATIONAL GYPSUM COMPANY PHYSICAL EXAMINATION RECORD
DATE OF BIRTH 8/2U/1U(AGE51
SALARIED PLANT, OFFICE, SALES DISTRICT Millington,KJ
\THOURLY DATE / o / L
PRE- EMPLOYMENT Q REINSTATEMENT 2~ PERIODIC HEALTH
ADDRESS'
) E SINGLE MARRIED OTHER
L.AST EMPLOYNENT
PREVIOUS MEDICAL
HEIGHT
WEIGHT /s* CHEST
DISFIGUREMENT - FACE. HEAD OR NECK
CONFIGURATION
VISION-DISTANT! VISION-NEAR ff ASSERMAN
R.E. 20/
L.E. 20/ COLOR VISION:
EXPANSION HERNIA
RX. 20/ LX. 20/
'
^_
URINALYSIS SUGAR
.
Hb:
H..EART LUNGS
/Ay,..BLOOD PRESSURE / L/7> /
INGUINAL RINGS ,,
., R
_
O L
'"
j OPERATIVE SCARS
h ^
NORMAL ENLARGED RELAXED
BACK AND EXTREMITIES - edema, amputations, functional defects, deformities
. tCIFIC FINDINGS - ADDITIONAL
NEUROLOGICAL
SKIN ERUPTION CENTRAL CONDITION:JS^TCOOP fl FAIR POOR: EXAMINEE HAS BEEN ADVISED OF SIGNIFICANT FINDINGS Q YES Q NO SUMMARY OF PERMANENT DEFECTS, IMPAIRMENTS:
NATIONAL GY PS I'M COMPANY PHYSICAL EXAMINATION RECORD
*nr-
PLANT, OFFICE, SALES DISTRICT M3 HI
DATE /0 "C PRE-EMPLOYMENT Q REINSTATEMENT [X PERIODIC HEALTH
__________ ADDRESS.
~_
DATE OF BIRTH 8 /2ii/lk
(AGE <1 )
NGLE MARRIED OTHER
L.AST EMPLOYMENT National Gypsum Company
HEIGHT
DISFIGUREMENT - FACE. HEAD OR NECK
VISION - DISTANT
ISSERMAN
Hb:
WEIGHT
//
HEART
CHEST
U*vi
CONFIGURATION CHEST EXPANSION
BLOOD PRESSURE .
*T
/</ Oftfo
.............--*---------------------------------------------------------------------------------------------------------------------------------------------- *-jZ--
LUNGS
C.R.E. 20/^c
U.L.E. He
I HERNIA
-
URINALYSIS
t
SUGARt>AC* _ ALBUMIN
ABDOMEN ' |l.~M.p1
L
INGUINAL
R "XIxV
**
OPERATIVE SCARS
L .Vl
NORMAL
*JLA ENLARGED - RELAXED
BACK AND EXTREMITIES -EDEMA, AMPUTATIONS, FUNCTIONAL DEFECTS, DEFORMITIES
<L<./Ta.U.
-
.cIFIC FINDINGS - NECROLOGICAL
SKIN ERLPTION
SLNWARY OF PERMANENT DEFECTS, IMPAIRMENTS; EXAMINEE HAS BEEN ADVISED OF SIGNIFICANT FINDINGS
^ i-v. Ju. ^ -A-cr
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- Cl N
EMOTIONAL STABILITY
INTELLIGENCE
_____________________________________--__________________________._______:___________
0
APPLICANT'S SIGNATURE
*"
Accept
Condu. Accept
Reject
PHYSICIAN'S SiGNfAoTC-REr>7
JOB ASSIGNMENT
PREVIOUS MEDICAL
/Mi --------- -
COMPANY .APPROVALS
PERSONNEL MANAGER BUFFALO
DATE
PART EXAMINED
X-RAY REPORT - R ADIOGR APHIC FINDINGS
FILM NO.
DISTRICT SA* ES ' .GER
. LA NT MANAGER
k*- 10
SAFETY SUPER.
vtn
NC 909 Re'
NATIONAL GYPSUM COMPANY ` ---
Sales District Office
Name Date Age h
. Color
Arthritis Operations Venereal Diseases
Address
%
.eck No.
S M W D*
Children
PHYSICAL RECORD
CTO BE COMPLETED BY PERSONNEL DEPARTMENT)
Epilepsy
Hernia
List on reverse aide any hospital
adnioaieB* is past & year*.
Tnhercnlosis
"
Liqoor Other Illoessea
'
Tobacco
..............
Drags
Injuries -- description, location, % disability
Compensation Received Have you e history of silicosis or
uf other dust disease?
Do yon hove a mkaet'i coapeasatioa case
pending for either injury or illness ?
Hare yoo erst beea la Military eerrice?
* .
Have any of row parent* or brothera or sisters bad Tuberculosis, Cancer, Diabetes, Epilepsy or Insanity*
Last previous employment
I certify that the shore soever* are true, correctly recorded, and that I an in rood health, and that I hare nerer suffered from Silicosis. except (biatnry)
Signatnre of Applicant
Witness
' If divorced, give date aod place
Eyea: Right
iv/a
PHYSICAL EXAMINATION
(TO BECOMPLETED BY DOCTOR)
Weight
Left a-*.m
Corrected: Sight
Pnpils Longs ^ Heart f
~r Ears
Cornea Shortness of Breath Blood Preasnre/3
Nose
Throat and Tonsils
Hearing: Right
Abdomen
Hernia *
Ores Weight Mental Veight Dadar Weight
Laft
Binocular ViaiM
Chast X-Ray Poise
Teeth 4/ Left
Spine
Hemorrhoids ^
Extremities
(Not# X of defects if aay exist)
Sian -Reflexes
r
(Head and neci ealy -- gira location)
Clands I1
Mentality ft
Blood Test
Urinalysis ^
General Condition: Good ^
Fair
Do yoo recommend applicant for work?
emsrks
Poor 2
Ntfritioo: Good Type of Work?
APPROVED
*
Moscnlatore Genitals
Poor
.
1~ ter: - :
FOREMAN
SAFETY SUPERVISOR PLANT MANAGER
/I /ii
De
Examined bv
M.I
t THIS EMPLOYEE'S CONDITION IS ENOWN BY HIS SUPERVISOR. YE5/T] NO j_
NATIONAL' `GYPSUM 'COMPANY __
Sales District 0fflce
Name Date
DepL
Address - ------- -------------------
: PlantJClliingtCD ,E.J. Iheck No. 200
Age K1
Color
V
S M V D*
Children
PHYSICAL RECORD
(TO BE COMPLETED BY PERSONNEL DEPARTMENT) Arthritis____________________________ Epilepsy_________________________________________ Hernia
_,
Operations-
List a nvi aid* say hoopital - ...... ttottowiiputiTMti.
Venereal Diseases
Tuberculosis
Liquor ' Other Illnesses
Tobacco '
Drags
' ' ' ............. -- .
-
Injuries -- description, location, % disability
Compensation Received
Hit* too a history of silicosis or say other dost disease?__________________________________
So yoa bars a mdaM'i coapeasarioa case ptadiag fas eiihar injury or illaaaoT__________
Hots Too atot baas is sdlitsry semes?
Bara any of your paraat* or brothers or sioters hod Tubereoloaia, Caoear, Diahetaa, Epilepsy or Iaaaaity?
Last previons employment I certify that the ahoro answers are true, correctly recorded, asd that I aa is
rood health, asd that I hare sever suffered froa Silicosis, extent fhiatarr)
\ V.
. . . v. ________ __ '
Signature of Applicant 1 If divorced, give date and place
.. Witness \ \
Height L* 2."
Eyes: Eight 2$* , / ^
Pnpils IS
Xc
Left
PHYSICAL EXAMINATION (TO BE COMPLETED BY DOCTOR) Weight /*/S~
Corrected: Sight
Cornea \f
.
Orar Wsight
\ Nonaal Vaight ' Cadee Weight Left
Binocular
Viaioa
*
Lnngs Heart 1/ Ears l/ Throat and Tonsils 1/ Abdomen V
Shortness of Breath
Blood Pressure
-- - -
Nose
/
^**7Y' / Hearing: Right /
Hernia
Chest X-Ray .......... Poise
Teeth ^
.
Left
'%?/ /t*
' /
Spine V
- Hemorrhoids p
..
Extremities 1/ Scars ^ Skin V
CNota % of iefeca if say axtat) . (Hoad asd sock sal? --.girt location) Glands L,
Musculature -- Genitals
Reflexes u Blood Test L' General Condition: Good \/_______Fair__
Mentality L> ___ Urinalysis Is
Poor____ Nutrition: Good
+
/
__?____
Poor
Do yoo recommend applicant for work?
------------- Type of Work?
etaarka
APPROVE)
FO&DiAN
SAFETY SUPERVISOR PLANT MANAGER
E"ned by THIS EMPLOYEE'S CONDITION IS
Date (f ~ / p - P
_______ M.
BY HIS SUPERVISOR. YES & NO C
NATIONAL GJUSUM COMPANY
/ Sales District
Office
Namefr
'
Pat. Uprtl 17. 1&9
Age JUl
Color y
Arthritis Operations Venereal Diseases Liquor
Address
Plant Sil*
Dept.
Cheek No.
M W D*
Children
PHYSICAL RECORD (TO BE COMPLETED BY PERSONNEL DEPARTMENT) Epilepsy_________________________________- Hernia
Liat os ravens aid* say hospital admissions is past S yasr*.
Tohercnlosis
Tobacco
Dregs
Other Illnesses
Injaries -- description, location, % disability
Compensation Received
Have you a history of sUieoaia or say tur dost disease?
Do 70B have a wurkaea'e eoopcneetioB cut pending for either Laiary or lllaeea?
Hava you aver baaa is military eerviee?
Sara aay of your pareats or brother* or Bister* had Tuberculosis, Cancer, Diabetes, Epilepsy or Insanity?
Last previous employment
I certify that the above answers are true, correctly recorded, and that I am is tood health, aad that I have sever suffered from Silicoaia, except (history)
Signature of Applicant
Witness
* II divorced, give date and place
Height
-------- -p-o-
Eyes: Right_____
Left
PHYSICAL EXAMINATION (TO BE COMPLETEDBY DOCTOR) 1,eight____________
Corrected: Right
Pupili
.oreea
Longs
Shortness of Breath
Heart WOfU*
Blood Pressure
Ears Throat and Tonsils Abdomen Spine
z
Nose Hearing: Right Hena fr'sflasbt
Hemocrhoids________(J
Over Weight Nontl Weight Coder Weight
Left
Bioocular Vision
Chest X-Ray
Pulse xL
Teeth
Left isuS
Extremities Scars Skin
7^ 7^
(Note % of dafoca if aay exist)
(Hoad aad sack only -- giva locah
Glands
Musculature Genitals
Reflexes
Mentality
Blood Test General Condition: Good
SFair
'Do you recommend applicant for work? J.
^4*1 Remark
Poor
Urinalysis Nutrition: Good Type of Work?
Fair Poor } /l*.
APPROVvEeDd .
Io
1
I_______________________________<k^._________________ _
FOREMAN
SAFETY SUPERVISOR
PLANT MANAGER
Examined by THIS EMPLOYEE'S CONDITION IS KNOWN BY HIS SUPERVISOR. YES
NO
*
- f
'\
' PHYSICAL EXAMINATION - /1
CLOCK NUMBER avi J-------- DATg
X
,
fc~" . " -..7
- .- " .
$ l . ' BLOOD TEST '
..
v. EYES 7 ) `
V." EARS i/ y *>' *" * _wv WOS^_ V
. THROAT : A*' HBART_ e/ /
? c /?o /
>
' -v
BLOC PRESSURE
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. URINE ANALYSIS
; , .-X-RAY 4 . REMARKS
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physical examination
W-50
CLOCK NU?*BER aoo
DATE
1A4/49
NAME
_______________________
ADDRESS
CITY__________________________________________'________________ _________
.THROAT: ^
HEART
3Z
BLOOD PRESSURE
URINE ANALYSIS
X-RAY --
^
REMARKS______________
Kkr
Physician'9 Signature
>1
VTT'/ror'rj
PHYSICAL EXAMINATION OCTOBER 1947
NAME. ADORES S_ CITY
BLOOD TEST: NEGATIVE.
EYES EARS
y
NOSE: THROAT: y HEART:
BLOOD PRESSURE:
POSITIVE
* 7^0
* tgiC *<.<''r r
--
'>.tv - /-
URINE ANALYSIS: X-RAY: REMARKS:__ --
?h/i:icl3r.:s Signature
HUGH M. BABBITT. M.O.. F.A.C.S.
SO PARK AVENUE PLAINFIELD. NEW JERSEY
PHONE S-SA6S
November 9, 1967.
y7
National Gypsum Company Millington, New Jersey 07946
Attn: Mr. Timothy D. Tolin
Re:
Dear Mr. Tolin:
I examined
this morning at Muhlenberg Hospital. The
patient was being readied for the operating room in order to repair
a hernia.
As you recall he was operated on October 21, 1966 for a mallet finger of the right little finger. At the last time I saw him, or. December 30, 1966, the terminal joint extended completely. However, today there is some drooping of the terminal phalanx. There is also loss of approximately 10o of extension of the proximal interphalar.geal joint. This latter condition apparently annoys the patient. The patient has a good functional hand despite the little finger.
There is a tumor on the medial side of the right thumb about the size of a pea which is movable and not particularly tender. It is a solid turner on the order of a xanthoma. I think the tumor will er.larg
further and probably should be removed. It is not connected to his work and not compensible.
A capsulotomy could be performed or. the right little finger at the proximal interphalangeal joint with the idea of increasing extension. As in all finger surgery results are not 10055. I think the mere practical solution would be to accept permanent disability of the little finger which I should estimate as approximately 50fo of the finger. If you and the patient decide to try to improve the finger, the only approach would be surgical.
I examined an x-ray of the finger taken at Muhlenberg Hospital this morning. This x-ray is normal.
HMc :mbr Enel. 1 statement
Very truly yours,
/
M. Babbitt, K.D.
i4
cUt General Gue ipufauv.\^u*-w^.-!!.v
-ATTENDING PHYSICIAN'S STA ^ h*mUhed without expense to the ln*9aoc*.^p^'.;r^^;4^^ *>
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or injury (deamhe'coinplicatjons, ii
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...................
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_____________________________
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The patient has been continuouslydisabled (unable to work) from......../ A..- 3-4^&-3~
--....... ..........
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..... ..............
If still disabled, when should patient be able to retufn to work?../..rr...(..L*/$--....---19.--.................
Remarks.. r ,
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