Document 7OJrDvaYN37GdQ07N7pZKGnK8

SIDNEY E FRIEDMAN M D . F C C.P * DIPLOMATF AMERICAN BOARD OF INTERNAL MEOICINE CHEST DISEASES SIDNEY E. FRIEDMAN. M. D. 900 STUYVESANT AVENUE UNION. N J. 07083 TELEPHONE: 688-6034 June 30, 1992 FREEMAN & BASS ESQ. 24 COMMERCE ST. NEWARK, NJ 07102-9838 Gentlemen: Re: ______ Age 63 File No. 39678 C r edac t ed At your request Mr. was re-examined in my office on March 13, 1992. He was examined before on October 25, 1985 and a report was sent to you dated December 30, 1985. He was seen again on February 2, 1990 and a report was sent to you dated March 13, 1990. Since that time he has continued to work for Sherwin Williams Paint Company and has had continued exposure to various dusts, fumes, chemicals and carcinogens in the workplace. He has not yet received an award after his first 2 examinations. has had a 30 year exposure to asbestos in his work, as well as a considerable exposure to chemicals and pigments in the plant over the 43 years of his employment. He ingested these as well as inhaled the dusts and developed difficulty breathing as well as an ulcer. He had surgery for his ulcers twice in the past. The complaints include cough, shortness of breath, difficulty breathing and chest pain? irritation of the eyes, nose and throat; pain in the back, legs and neck; ulcers and anemia; the patient is worried about these conditions. He has a cough which is worse in the morning and produces yellow sputum. He has chest pain, tightness, congestion, pressure and wheezing. He uses 1 pillow to ease his breathing. He is short of breath walking h to 1 block, climbing stairs, lifting and carrying. He gets dizzy when he bends. He has arthritis in his shoulders and neck. He still has symptoms from his ulcers. He has an anemia and says he can't get his hemoglobin above 9.5 gm. He has had many outpatient tests in the past several years including upper and lower GI series and 3 colonoscopies to try to determine a bleeding source but none was found. He has heme-positive stools in the tecent past. He had gastric surgery twice in the past. He had surgery to his left foot in the past. He does not smoke and drinks only an occasional beer. He is on Iberet folic, Zantac, Lozol and Tagamet. PHYSICAL EXAMINATION Appearance: he is average in height and weight. He is very pale and appears chronically ill. He walks with a stooped gait Height 68 inches Pulse 60 Weight 182 pounds B.P. 120/70 Resp.16 0007-SWP-005803069 CONFIDENTIAL f- 1 2 3rd exam REDACTED Head and neck: the neck is supple; there is no adenopathy Eyes: pupils are equal and reactive ENT: upper and lower dentures in place Chest and lungs: there is a marked increase in anterior/posterior diameter of the chest; no rales or rhonchi Cardiac: there is a faint grade I soft systolic murmur at the apex; an S4 sound is heard Skin: sallow, pale, anemic in appearance; the conjunctivae and pharyngeal mucosa are pale Abdomen: there is diffuse tenderness in the lower quadrants; surgical scars are noted, 2 upper and left inguinal areas Extremities: minimal digital clubbing, no edema Chest x-ray: the heart is normal size with some straightening of the left ventricular border. The left hemidiaphragm is slightly elevated. The remaining mediastinal structures are normal. Pulmonary markings are prominent bilaterally with a diffuse fibrotic reticular pattern in both lungs. There are minimal emphysematous changes with a paucity of markings in the left upper lobe. The skeletal structures appear normal. CONCLUSIONS: Based upon the history and the findings, it is my opinion that now has a chronic industrial bronchitis with restrictive and obstructive airways disease for which I would estimate a disability of 65% of total. Based upon the history it is my opinion that this pulmonary condition is a result of the dirt, dusts, fumes and irritants as well as asbestos in his work at Sherwin Williams Paint Company. He now has severe pulmonary fibrosis, from the history a probable pulmonary asbestosis. Exposure to asbestos poses a threat to future health due to the known carcinogenic effects. The patient should have yearly chest x-rays to monitor this possibility. Based upon the history and the findings, it is my opinion that Mr. has peptic ulcer disease, post-gastric resection, under treatment, for which I would estimate a disability of 40% of total. Based upon the history it is my opinion that this gastro intestinal condition developed and progressed as a result of the physical and emotional stress and strain in his work. He appears to have a chronic anemia and it is noteworthy that he was exposed not only to asbestos but also to benzene-like chemicals as. well as other organic chemicals in his work. There is a possibility of an occult cancer to account for this anemia which has not yet been manifested. Considering the occupational history, this anemia should be counted as part of his occupational injuries. It is my opinion that has a serious medical condition and that a Deposition should be taken in order to preserve the testimony. Sincerely yours, SIDNEY E. FRIEDMAN, M.D. SEF:jb 0007-SWP-005803070 CONFIDENTIAL