Document M4VZK3ODxN3Qda0QRqbbGOabj

CHAIRMAN l_ E. NYSEWANDES J. W. BEALL. A. O. CA DO^i0TA Wo r k me n 's Co mp e n s a t io n Th e In d u s t r ia l Co mmis s io n o f Oh io MEDICAL SECTION Co l u mb u s CHIEF MEDICAL EXAMINER . . . ' ' Qct. 22, 1935, Dr, R. A, Kehoe, University of Cinn.Collegeof Medicine, Cincinnati, 0, \ Claim No...?.?...?rTM ....... .--.... NAMB..VHHRHHiillR.L.. ADDRESS.... .................................... Cincinnati, 0. Dear Doctor:-- We are referring the above claimant to you f or.... sis, .?.gpo?-^-^.,.Q-Q.-QgiQiQj:l...a-g...to- whether or not claimant..is..no)?, suffering from the effect of lead poisoning. You may notify the claimant at the address given above when to appear at your office for this purpose. We are enclosing, herewith.__59.P?...?.?...?..4..r...^.?5*...7r.?.5.T.?5.............. ......... which will give you a history of the case, as shown by our files. Kindly send your report in TRIPLICATE, together with your fee bill, direct to the Medical Section, as soon as possible. The extra form enclosed is for your files. In preparing your report, please use the following subheadings in the order given:-- (1.) HISTORY---of injury and treatment, past medical history, pre vious injuries, family history (if applicable). (2.) PATIENTS COMPLAINTS--describe in detail even if they have no apparent connection with the injury. (3.) EXAMINATION--include all objective findings, clinical, lab oratory and X-ray. (4.) DISCUSSION---'Summary and treatment indicated, (5.) OPINION--extent of disability (total or partial). If total how soon will he be able to worfc. If partial, estimate degree on percentage basis if possible. ..... Use the form (C-fll)enclosed and continue your report on the re verse if necessary. Very truly years/', H. H. D.CRR'J^M?D., Chief Medical Examiner. WEE/ eh MED. 11--5 >1--2-35. * IN REPLYING, ALWAYS GIVE CLAIM NUMBER, NOTIFY THE CHIEF IF YOUR INQUIRIES ARE NOT ANSWERED WITHIN TEN DAYS. \ / obfc. worsoy ` ro * ^Inciaai f* 'j v JL ^ VjiAV 7/20/35 7/25/25 ,,l .-- 44 SJUTT: Onset- 0/3.0/34: -< f.T-'T'T Tn . - v*.s.i.1. - i:v . .w i. o5 -ft *r * t i -*. w,-.f . f; 'E.esd /oltanil"?/ with r.eeon&ery anemia na 2, I. p-toias of basophilic granules in the blood cells! "Boor appotlt - oonatItalian - tes end weakness*-M Claimant la a fairly sell developed, end rather poor ly noutished Alts sale, his skin is of a sallow caste and his lips are moderately pale. The mucous .y-ybryns of the mouth a ad throat, are rale and the teeth are art ifielsl- apart souu&s are of rather ":oor .quality and radial arteries are thickened, blood pressure is 134/76. Tenderness is complained of ir. the right upper quadrant, as well as the left lower u.:d -ant of fcha abdomen. There is no muscu lar r:. laity. ..bdominnl reflexes are present. All tendon reflexes are present and normally active* fupils react to light and there is a. alight icterus r- in.ee ' of the sclerse. ' OiSTEBT; K claimant x*ela; es symptoms of the onset nearly on year ago, which consisted of stiffness of the knees ond a "ir.ht feeling about th chest. 1 diagnosis has been made of load poisoning* Claimant at first attributed whose symptoms to extreme.heat, until this ciagrtosi s was pads. In the past three or four weeks 'he has noted some discomfort and fee-liar of heaviness after acting. /Ms Is particularly true following ingestion of fats or greasy foods. H denies dyspe'sia trier to the onset of lead poison ing. in June of this year, a nasal operation 'was done because of furunculosis of the acres. This has relieved tha local,ryuptoms out he does not admit any Improvement in general health. The time olesest in the onset of his digestive symptoms is . not in favor, of a causal rolatioa.,tptht,./lsivd. pol- .::Pv,S0ning*,.Xt *y. be well to raf0r -_. . N19508.01 -T. ' ' "W 4>- - ': m HBH pm 5S3$Mi! ^flights |k@f ia.rn; fclerae#? *, .. asiM|%|,#X6tes sysj ,.|rf tie ;oaaet^ 1 fih .C0Mr it.m thest.f ^ #-*&i ' .tata'afca* of X ' ;issi'g< wa iifcatliiotM ... " * ., * i T* < .," .',: j V. . * ** i * " f# ^ tit-\ itissaiitX Sw^ .;. -- *- ,... 31 ii * '.. .. *. ^ 'jn, > -. 'i 5? v-r -:- ;- ysr*m ilifeM asst cypt< geaei ?M* 4! t$rla$ Wsrf{ rat or. Xfei! pesra|| -'tk A. *_ ifs; * - , 1?fc . y-* liyKSsSaiiisSyaiSai: 1 _ , i.A ,#1 rf *f a ' ? sr>>`;r. -Jti ; ': < *t. '-> mHHBH iKmmm a sm M" Xm?'-Sm.'x- Kr?) 1)16831 Sj^'S .# : # WORKMEN'S COMPENSATION Th e in d u s t r ia l Co mmis s io n o f Oh io Claim No.,,._.UU.-XLa&y Claimarr Address .2-7-JLusa.t....S.fcreeb......................... SPECIALIST'S REPORT Date of Examination...... ............................................................... ............. 2..Age..... --............................................... : NOTE; :--- -- - - --------------------------------*-- :- ------------------------------ ------------------------------------------- Submit report under following headings: (1) History. (2) Complaints. (3) Examination, including X-ray and laboratory work. (4) Discussion. (5) Opinion. Mail THREE copies to the MEDICAL SECTION--Retain one for your file. ^ HISTORY ' 0*0# ''Weakness and logy feeling"* ' ;-|f| P*I Has beats painter. for Z$ yeara* Was In good health bill June l?$k' 1 when there gradually began weakness and stiffness In legs and arms*,, | X6 became difficult to rise from stooping position.or to negotiate .' -j stairs* Was:'wbxfclng usual 8 hour day but condition bedame wore with pronounced malaise, sense of constriction In chest and gastric ^ diucoafort particularly after eating* Appetite was peer for breakfast as haa been true for years* About August 20, 1934 stopped work because of symptoms particularly the stiffness In the arras end legs* Con suited physician and has been under treatment for lead poisoning since then* Mad little progress till M*rut 193 when k@ began -to.-Improve somewhat* At present tlmeeh&a some weakness, aching and 1 feehing In legs with general isalais. Gastric symptoms-:hare disappeared* Appetite good except for breakfast* He history of cello, wrist drop etc*.. Headaches have been frequent and annoying particularly at fctsm of onset Insomnia was annoying no terrifying dream* Constipation has been sever In recent'years take saline cathartics regularly* Ho numb-' n#S# oh tingling, no chills, fewer or metallic taste* X#H, School till 13* 'Woodworker 2 mouths*Xidathsr and hair worker on ~ carriage scats 2 months* Faint shop worker, paint and putty mixing, cleaning, glazing to, 2 months* Carriage painter 2 months* Wpholsterei 1 year* painter since, M Ph*H* Has been working with lead, paints almost continuously since age of 18, all types of work, sanding, mixing, glazing. Interior and exterior -. painting* Averaged usually,, 8 hrs.dally* in 1920 and 1929 worked long as 12*li* hours dally* - Since 1930 fens worked 8 hour days for about f months of the year* ---Prior to onset F.I* had six months - steady employment* Ho unusual exposure * no dry lead compounds, etc* F*H* Father died 2 C.C*R* 1 brother living and well. Sother died 82 - senility* 3 sisters living and well* 1 slater died 22 tuberculosis* - H.Z* Basal ppertifcfon yuii 1935* Frequent colds lasting 2-3 day* C*R* Beget titre 1 , G*l* Appe bit ...usually gOod._except.for -breakfast-*- Constipated -catharsis ~ ~ 1 x 2 weeks* * ..'' G.U* llycfewrla 1 > 2 k before and during early part of P.x -4iMAsa*.. - -- ff*K* ' * Ho venereal N19508.02 C 0 016 BBS NOTE: Submit report under following headings: (1) History. (2) Complaints. (3) Examination. including X-ray and laboratory work. (4) Discussion. (5) Opinion. Mail THREE copies to the MEDICAL SECTION--Retain one for your file. HISTORY ; v,';" P*X Has bbeeaeun. pjainter for .years# '$as In g_ood health till JttB l$,_3k. when there gradually began weakness and stiffness In legs and anas. . constrict os beeaas-iworsOfjtw^y,;/.-i.^1' ' '^TinifTf a #i rt ',i #n'i:'i~Tl -fcii'iri irn ' : V' X.B. School till 15# Woodworker 2 monthsheather and hair worker on carriage seats 2 months# Paint shop worker, paint and putty mixing, cleaning;.- gMsing etc# 2 month* G&rriftgs ^Ulnterj 2;months# Upholster 1 year, painter sine. Ph.K# Has been working with lead paints almost continuously since'age of 18. all types of work, sanding, mixing, glebing, interior and exterior ., painting# Averaged usually.8 hrs.daily. In 1928 tmd 1929 worked as long as 12-lh hours daily# Sine 1930 has worked 8 hour clays -for;-' about-'7:::^ont|ies of the ..year -Prior to onset P.X* .had six months steady employment. Ho unusual exposure - no dry lead'compounds, etc. P.H* Father died J2 - C.U.R. 1 brother living and well* Mother died 82 - senility* 3 slaters living and'well* 1 sister died 22 tUboreuIoais.- Il.I. Hcsal operation une 1933* Ffequent colds lasting 2-3 days# C#H# Negative'' * v-;-- , G.X*_ APltlt0isually.good,,xeept.for breakfast. Constipated - catharsis : 1 x 2 weeks# - Q*0*,,. Nycturia. 1 2 k before and during early part of p.z. lio von; real -* * - - '*~^dieeee-. _.. ^ * i . . > ; m.ll# "'Fre.qjMmfc headaches prlor` and during rik^SI*r*ha'*tired -feelti%~lnii~ * 'feet*for 3 months prior to onset' P.X* * gradually*spreading up legs# Batlts Average 8 hours sleep nightly - not restful during P.X. Ho tea or ....... coffe - no spirits# Weight U#W* 180 r B.W. 200 (1910) L.W# 159 (I93I4,) P.tf. 169 3 .Examination ** General Fairly wall developed and*nourished whit man about IpQ years of age prematurely gray# Hot acutely 111 but with pasty pallor and unhealthy ............................ ................ - ..............................M. D. (Signature o Examiner) t (CONTINUE REPORT ON REVERSE OF SHEET--NOTE INSTRUCTIONS) Kr....00.16836 .... r*:. v:i:r ::"1,;;: : . :. , (CONTINUE REPORT DOWN FROM HERE) appearance*. Alert arid cooperative* Temps 96.2 ' " Pulses "69 Hi 26 Weights l6l " B.P.l30/86 Hoed Hot remarkable - Wei Ear Drums whitened other! Ok Bys: R equal L med, reg* ' react well. E.O.M. Ok* Kose hep to deflected to right * m*m* dusky red both sides - left turbinates led evidence of ohrvaie n|Mal dfaeaa* Mouth 1 - ss*m* good color - tonsils very small - submerged glossae injected V .. - .#* 'dry W" B*O.E. '2.5 x 12*0 K.2* Ht* 8 B.E, K*I. &t* 8` - 5 - 0*E. 5 -y * Lungs are normal - Heart tones soft, aleer* Reaction good In 2 minutes :"aciolrates 15/ min* after 25 hop '0 - Abdomen lax - slight tenderness over cecum oh deep pressure * sticaold full and palpable - .belly is negative t'" 7!hh^-;v: h -h.:-,- - Pelvis normal. Eat* kin pale and dry* Scattered superficial abrasions from scratching pulse poor in dorsalis padla - 2nd degree pronation both foot* Syndactylism 5 and 4 fingers left* Reflexes feddbh reflexes hyperactive * #+ Superficial normal# Sensorium - normal* Tactile . disc* exceptionally good* .Muscular system' normal well developed coordination .good - gait and speech good - Cranial nerves Ok* Bb 82$ BBC 5,050,000 Poly*. 66$ Lymph 30$ Bos* 2* Bas* 2$ WBC 8*920 Stippling 3 P** 5 fields Mm : 0*02 g/hifeer alb* negative Sugar negative Microscopic negative kMissEsiaa : fh pdtient Is no defintely convalescent and in a fairly good state f health, There la no evidence f any permanent injury or residual effects f the.episode.of-lead intoxication* The urinary lead which is within normal limits* indicatesthat be has eliminated such abnormal quantities f lead a may have been mbsorbed* While the present state of health is t below the normal* It is believed that the symptoms no in evidence are associated with other onuses* She nasal disease is the probable cause of the few general symptoms remaining* while most of the difficulty referred by the patient to the legs Is associated with pronatlon of the feet and . j> ^should be improved by corrective measures* disability my-be considered to be of the order or 30$ of total for the next 3d days at the end of nh*ch time it appears that it will be proper for him to return to his occupation* We have reeosamended ear f the nos and correction for the feet* Robert A. Eehoe* M.D* HE 0010337 June 1934 10-24-1935 Complete clinical examination (consisting of physical examination, microscopic blood examination (Red count, white count, differential count, haemoglobin determination, count of stippled erythrocytes), urinalysis, lead analysis on urine. j^g gg KE 00168-38 N19508.03 Dr. Machje Urine: Received IO-2I4.-I935 Mgs Pb/liter - 0.02 0016839 Reported: 10-26-35 Specfcrogrsaphlc N19508.04