Document 74QybD2X556ZEZdpbGrDOezR

-12-41. - caw? atiT i^o.v- 1 C - W o r k m e n 's C o m p e n s a t i o n T h e In d u s t r ia l C o m m is s io n o f O h io an iftJ02?L86___ aimant Address & S * S ', ?l&t Street, ~ SPECIALIST'S .. ClevelsiaS/Ohio" ;.. Date dS2S5i^ft3Sn.S2.*MOS - F e b r u a r y 5 19%'4 ......... Age.... REPORT NOTE: Submit report under following headings:. (1) History. (2) Complaints, (3) Examinations, including X-ray and laboratory work. (4) Discussion. (5) Opinion. Sign and mail THREE copies to the MEDICAL SECTION--Retain one for your file. REPORT OF EXAMINATION TO BE RETURNED W ITHIN TWO WEEKS FOLLOWING REQUEST. HISTORY . .1 ' .V ^- . . An opinion as to the nature of this claimant *s illness in August of 1 9 4 3 must rest upon the. statements of Dr. Jerome Cross. In the absence of a satisfactory record of Dr. Gross* examination# th statement that the patient' when examined had "abdominal colic# vomiting*' constipation# impairment of grip# lead line, stippling of BBSs in smear#'must be accepted by-this reviewer as true, unless it can be discredits-by evidence to the contrary. Bo such evidence '.1 available# Inasmuch. as there is no information obtained from.other .examinations during'thit;period . By th time of Dr. Paryzek* exa- mlhhtion.' on Bovember 8# there had been ample time for the disap- pe&rance of symptoms or signs of plumbism. . " : Granting the occurrence of illness as described# tlie only basis in th record for differential diagnosis is found in the 'v'iaencp for or against.th significance of this man* s lead exposure. `lbs:shortness -of th .c.lsissnt*s exposure to lead is the only valid, reason for question* This must not b taken too seriously in view of the. manifest-potential hazard of the manufacture of storage batteries. Si-stippling of th erythrocytes (on our count there were'bout ft5 erythrocytes per 50 microscopic fields), -while not 'providing proof, suggests that there was significant lead exposure. Moreover th analytic! data obtained-by Dr. Hanzol would seem to -indicate that there had been significant lead exposure. The report on .the analyses fre Dr* Gross* office is not very convincing by reason of th statement that 0 .0 9 (no volume or weight relationship given) is normal* If Sr. Hanzol obtains such figures on normal par-sens, his methbd of analysis is not sufficiently precise, or else hs is not taking proper precautions against th contamination of blood samples at some point. The mean valu of normal results on th whole blood * by the most sensitive methods of analysis available is about 0.05 mg* pen 100 grsas# while the highest norms! value does not co exceed 0 .0 6 * Only in the rarest instance do normal values go beyond VO 0 .0 5 mg* per 1 0 0 grams. This appears to represent a certain care- T On lessaess in 2? Oross* report# rather then Dr. Hansel's (the latter's report is not in th record) sine the same report (as veil as the fee bill) gives th information on the urine as followsi "'Urine load 0.25 no2Z^l__0.5n.,again, without referenceto any weight or volume relation- NOTE: Submit report under following headings:. (1) History. (2) Complaints. (3) Examinations, . including X-ray and laboratory work. (4) Discussion. (5) Opinion. Sign and mail THREE " - copies to the MEDICAL SECTION--Retain one for your file. REPORT OB' EXAMINATION TO BE RETURNED WITHIN TWO WEEKS FOLLOWING REQUEST. HISTORY ` - An opinion as to the nature of this claimant *s illness in August of 19^3 must rest upon the statements of Dr. Jerome Cross. In the absence of a satisfactory record of Dr. Cross*' examination, the statement that the patient vhen examined had "abdominal colls, vomiting, constipation, impairment of grip, lead line, stippling i; of EBCs in smear, must he accepted by this reviewer as true, unless it can be discredited "by evidence to the contrary. IIo such evidence is available, inasmuch as there is no information obtained frcaa other examinations during this period. By the time of Dr. Parysek*s exa- . minaticn.cn Bovesber 8, there had been ample time for the disap pearance of -symptoms or signs of plumbiem. Granting the occurrence of Illness as described, the only basis in the record for differential diagnosis is found in the evidence for or against the significance of this men*s lead exposure. She shortness of the -claimant *s exposure to lead is the only valid reason for question. This must not be taken too seriously in view of the manifest potential hazard of the manufacture of storage batteries. The stippling of the erythrocytes (on our count there were about 43 erythrocytes per 5j microscopic fields), while not providing proof, suggests that there was significant load exposure. Moreover the analytical data obtained by Dr. Benzol would see to .indicate that there had been significant lead exposure. The report on the analyses from Dr. Gross* office is not very convincing by reason of the statement that 0.09 (ho volume or weight relationship given) is normal. If Dr* Haasol obtains such figures on normal ` persons, his method of analysis is not sufficiently precise, or else he is not taking proper precautions against the contamination of blood samples at some point. The mein value of normal results on the whole blood, by the most sensitive methods of analysis available is about 0 .0 3jag, per 100.grams, while the highest normal value does not ' exceed 0 .06* Only. In the rarest instance do normal values go beyond 0.05 ng. per 100 grams* This appears to represent a certain c&relesseess in Dr. Gross* report, rather than Dr. Hansel's (the latter*3 report is not in the, record) since the same report (as veil as the fee bill) gives the information on the urine as follows1 "Urine lead 0.23 - normal J.J8 again without' referenceto any weight or volume relation ship . It may be presumed that this means ""0.S3 xug, of lead per liter, t KE (Signature of Exam iner) (CONTINUE REPORT ON REVERSE OF SHEET--NOTE INSTRUCTIONS) 0016792 iSiifl 3 M. D. (CONTINUE REPORT D O W N FROM HERE) J'-sJ/Zi"~QSi SKJTW * ~iOJLXT*J'i-r -- -* ms.s-ss*i%* __ ' t ` ~j - --1 7 f ,i r* end that the normal value vas intended to ho 0* 03 mg. par liter# since the latter la the average or seen n o x m l value. Actually# aj value up to O.OS mg. per liter say he regarded as within the nomal range"in:the^eas:f saasplo'of one liter or more in volume* -All in all# this report teaoastr&tes such carelessness in dealing ' with anH justify oasts;-serious skepticism as to the seouracif of p i ? observations and statements is 'the Piart of >the,reotro coatributes hf Sr# Cross. - , -azu .1 ,,., WlWAVltfJ < - M kar, d:a;t. e ak tCeoemb.er ft 29, i k |} -r states that aalyses on the blood and urine mode on September. % 9 t - 12^5 gave normal results# to which Sr. Parysefc replied# that the .blood,leveliiw^t| ^ ^ l r ahove .a^isl. ^ f h i a reviewer 1' not able *x~V.to > s M @ x ^ l s i ^ ^ o S h 0 e r 1 O f -^ since the *ittar4&ti&Sa^^ ocrresimis^oe;. the date^sasgaing f *'7 1 * Ui ^ *% >~ ..J Conclusion* r The dia^iosla rests primarily on the opinion of Sr* . Gross* fhla"o'piftltii IS net too'@11 ^supported# hut it/l%J.net*'vi" - discredited. as ajBattsarjof 'record.,:; .^Therefore# on th record the reviewer admits doubt, hut ,aeeepts the opinion for lack of 'contrary:- evidence. Thf; ^aihstion of 'Pre that the claishab.has,n o !present th. c a e ^ t o a - - * X, i f ' 3!SPfe, m% %X1 , - XXi " '..;4 >:.' ' .-'ij---.- *. ts t % M fx. 7v _ *r ^ " ^ .S X1 x ^]" ] : y f M y y y . -: (y y . - : f t y; $ i? r : :y ' . V. . 4 4 1" X ' Aw# \ -& * i -*: ' r:,?' t . . ; i-.'rA 444^^4 4^:'^'. ..xv.-'-j . .4, <: :' : a. " "^ ~ >i / - 1 , X, 'r i?4 ;-4;ixfx;.444l;^fx'.y i-x-.'- X,^ i' f " _ -?i if j `X' p - -ryv-:'. ' ^ ' i 'i 1- '4 * , - v W fg S v ^ S v S^ J ^ :rf :'r-..* '' ` ' ^t,Z >' * -^v ' ffV'" x^r Se' '5 *i ^ ,,r ^ T > !T.':, ^-;v; :' v. J J ^ ^ .1'. -if'- '. r.#' ,*. , *" ' * , **-? _y* * t >*lSr>.5 ' .V jRRi' X --rr-r .^3 , ;.,xx- ` * / TJ'*'-*'^- J, t*- t^> >*- r*-' 1 X.'; X* -, ? - -tK -' * V-.::" :.r&i* . f r , & :'- y r* i ^ ,* r X . 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