Document KGKDaLzap8B7ek7YV7JLEewEo
SM-32 (REV 5-78)
Shell Oil Company
Interoffice Memorandum
PLAINTIFF'S EXHIBIT
JANUARY 24, 1990
TO: DR. ROBERT HUGHES, DEER PARK MANUFACTURING COMPLEX
FROM:
LOUIS C. WADDELL, JR., M.D.
SUBJECT: PULMONARY REGISTRY REVIEW,
, EMPLOYEE
This case is reviewed because of a possible pleural abnormality noted in the left chest.
Several film readers have commented on radiopacities in the left mid-lung field in its lateral aspect that are consistent with en face pleural plaques. For example the chest X-ray report dated 02/15/89 by Dr. M. A. Mullican said, "there are believed to be non-calcified pleural plaques on the left." The chest X-ray report of Dr. Patrick M. Conoley dated 02/04/88 said, "examination demonstrates densities projected over the left chest suggesting en face pleural plaque formation."
joined Shell employment in the maintenance department in 1942. He retired in 1985.
His spirometry done in February 1989 showed a vital capacity of 112% of predicted and a FEV1 of 102% of predicted.
It is,my opinion, after having reviewed the chest X-rays, that there are changes in the left chest consistent with en face pleural plaques. His job history at the refinery would suggest a possible exposure to asbestos in the appropriate time frame for chest X-rays done in the late 1970s and 1980 to demonstrate findings.
I recommend that this case be recorded on the 0SHA 200 log as "pleural plaques" and judging from the record that I was sent he has probably already been counseled about his chest X-ray and the implications of a pleural plaque. If he has not, that should be done and appropriate documentation made in the clinical record.
We are returning along with this consultation report a copy of the pulmonary registry form with our portion completed. After the 0SHA 200 log entry is made please indicate that that had occurred- in the appro priate portion of the form and return a copy to us for our files.
anQ-nFifiSSS.
LAM 031995
Thank you for your help. Enclosures
rflQnn??nc . non? o.o
LAM 031996
ABS-055389
$>13290(4/80) 009061
PULMONARY REGISTRY
CONFIDENTIAL - MEDICAL
NAME OF EMPLOYEE
REASON FOR REVIEW
1. CHEST X-RAY REPORT INDICATING: a) Possible pleural abnormality _i/L
EMPLOYEE NUMBER
LOCATION x
i> p/sq*.
- -.....
/
7- Has the employee had a Job where it is possible, or |--, p--, likely, that he has been exposed to some other agent | YES NO
known to cause a dust disease ol the lung, (e.g..
Silica, etc.)? If so, list
Urn J\n.vA-un^
h) Pns<ahlp fihrn<a<!
2. PULMONARY FUNCTION TEST ABNORMALITY: FVO Ipc<; man nf prpriirtfvl
8. PLEASE LIST JOB TITLES AND NO. OF YEARS IN THAT POSITION ih r\ JUuCT 1}
h) Other
^)p /S fa0 J) /
. Other reason lor review
l/ ^
7T-/r
9. Is there any history of other respiratory Illness that could accc . ' for me X-ray abnormalities under consideratiori? If so, list
r~] v_ _ i 1 1 rtb LkT"0
4 Time of ' service
5 Has the employee worked In a facility that used asbestos so that it Is possible that a pleural plaque could be related to jo6 exposure?
6. Has the employee worked at a Job (e.g., bricklayer, msuiaior. etc ] lor a sufficient time (usually at least 10 years) lor it to be likely that asbestosis could have developed?
m/ 1--1 ]_{</] YES |___| NO
10. Is mere a history ol exposure to a pneumoconiosis producing agent outside of employment at Shell (prior to working at Shell or associated with a pantime job, or avocation)? If so, list
/ rT/Tvrc 1--1 IzJ Yti 1___1 N<J
. RESULT OF REVIEW: Recommendation: '
0(M As <
^
f/tuM.
pof(J/c Mr; j> f
,--, ,-- YES k'-fN0
REVIEWED BY
counseled.
iFPLEURAL CHANGE />> /7^ !U^/- <*-
OSHA Form 200:
l ' -f / '/
Worker's Compensation:
~i
EMPLOYEE REFERRED TO DR. (Please send copy ot consultation when available)
COMMENTS: IT /y>---^L>/Vy
NOTE: (check list of actions to be completed by the Company doctor and returned to registry in Houston, with one copy to be retained in employee's / chart)
DATE
\JL 1^1
\j ^ ^y-J * -f--
Lj11
Patient counseled:
OSHA Form 200:
Worker's Compensation:
IF POSSIBLE FIBROSIS
. / fr
Lp / O' / r 7 ' 7
y C
DATE
CONTEMPLATED FOLLOW-UP
f^fpERIODIC EXAM
INSTRUCTIONS: PART 1 - WHITE COPY - LOCATION MEDICAL DEPARTMENT
| | OTHER
ABS-055390
LAM 031997
'V: >:,v^-,'*-'`smape/size^.t-j^'V1 ;: '' -TS
PRIMARY
SECONDARY
X
rr
b ZONES
Y
% %%
'/o 'A '/a
2/> */i V:
v2 V, V+
SIZE fa ABC
PROCEED TO SECTION 3
SA. ANY PLEURAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS? ; /
PYES
COMPLETE 38. 3C and 30
NO
JB. PLE URAL TH*'.IC,KENIN.VG.vJ
a. OlAPKRAGM (plaque)
3C. PLEURAL THICKENING . . . Chest Wall
a CIRCUMSCRIBED (plaque)
b OlFFUSE
PROCEED TO SECTION 4
SITE | O 1 R PCl
b costophrenic ANGLE
SITE 1 O j R IXl
; - i,., *iJ* t.v.
30. PLEURAL CALCIFICATION
SITE IN PROfILE
I. WIOTH
it EXTENT FACE ON ; ' m EXTENT ,
|o X/ . 'r 'SITE
* a DIAPHRAGM
0.
b WALL .... ................
0
C OTHER SITES.....
oV'
EXTENT t23
tV 3 1 23
4A. ANY OTHER ABNORMALITIES? 4B. OTHER SYMBOLS (OBLIGATORY)
: y.U
* S ax l bu i ca
/
Report items which may be
of present clinical signifi cance in this section
(SPECIFY o<3.)
" SITE IN PROFILE
V L WIOTH
m. EXTENT
:q R OA BC 0t 23
FACE ON
- r . Mi. EXc-TE Nt:Tt-
& '*-r^ i .i'T:
/ ; ^b. wall--:..... ` ' c. OTHER :
.yK
i
.
Vv
0
i
-
< v.
EXTENT
1X 3
1 23 1 2 3 PROCEED TO
* SECTION 4
YES
m cCOoMPLETE
* pLJ 48 and 4C
NO
PROCEED TO SECTION 5
: " 'Z'J IS
p rp ItJ
Date Personal Physician notified?
MONTH OAY
,1-- -J_
YR
I
1. CLINICAL INTERPRETATION
2 B-READING COMMENTS
PLEASE TYPE OR PRINT
NAME OF FWYSiCjAh*
!; SAPPER, M O./R. a HUGHES Mn
addressoHtLL OIL COMPANY, p o BOX nn
DEER PARK, TEXAS
CITY/STATE/ZiP CODE
* ^ //OJ(j
PHYSICIAN'S SIGNATURE
-'"SIGNED
/
2^/Zsf
date signed
INSTRUCTIONS: WHITE COPY - FOR CORPORATE MEDICAL DEPARTMENT YELLOW COPY - FOR LOCATION MEDICAL DEPARTMENT PINK COPY EXAMINING PHYSICIAN S FILE
/
ABS-055391
LAM 031998