Document MJ1EQwVJj4bg4ejqEqOryxkQV
FILE NAME Talc TALC
DATE 1990-1993 DOC TALC044
DOCUMENT DESCRIPTION Medical Records with Biopsy Records
HOUSE OF THE GOOD SAMARITAN
Department of Laboratories
Watertown NY 13601
315-785-4001
SURGICAL PATHOLOGY REPORT
Name
Harmer Dale
Sex
M
Doctor
Loewen
Clinical Diagnosis
Solitary pulmonary nodule RUL
Age
49
Date Received
Date Reported
Room
ASU
Feb. 14 1990 Feb. 15 1990
GROSS DESCRIPTION
A - Three right upper lobe biopsies the larger 0.3 cm B ~ Bronchial washings submitted for cell block
A Gross & Microscopic Diagnosis
- Mild chronic bronchitis and lung tissue with
asbestos bodies biopsies from right upper lobe -2
B - Negative for malignant cells cell block of bronchial washings -2
Record Room No. 203243 G00099432
//
Joven G. Kuan MD F.C.A.P. Chief Pathologist
Pathology Report No. 90-990 90-990
ade.
State University New York
Health Science Center Syracuse
CentNerw a Yol rk
Occupational Health Clinical Center
| 550 Harrison Center 300
Syracuse New York 13202
315 473-6422
March 26 1990
-
MEDICAL SUMMARY
PATIENT NAME Dale Harmer DATE SEEN January 11 1990
be
ae
a NOV 26
wy i
evaluated at the Central New York Occupational
Dale Harmer was
11 1990 Mr. Harmer is a 49-
Health Clinical Center on January
New York In the Spring of
year talc miner from Gouverneur offered physical examination
1988 the patient underwent a company
heart murmur and that his
that time that he had a
evaluated
he
and was told at looked bad
According to the patient
was function
lfuunrgtsher with an echocardiogram more extensive puflumnocntairoyn testing
testing and a treadmiwlhlichtesshtowedThaerepduulcmeodnaFrVyC and FEV 1 with a
included a spirometry
ratio
This suggests restrictive lung disease
done at that
normal FEV1
volumes or diffusion capacity were
Apparently no lung
The echo cardiogram
showed
minimal
aortic sclerosis and
outflow gradient
time
mild aortic regurgitation without a significant
were all
Flows
across
the
mitral
tricuspid and pulmonic valves
wall motion was normal as
was
the
normal
Left ventricular
of the treadmill tests are
ejection fraction
The results
unavailable to me
of shortness of breath for
The patient has had complaints
when exerting himself at
approximately the past year especially shortness of breath while
stairs He denies any
thinks he is able
work or climbing
and he
walking at his own pace on level ground
feels limited at
with others his own age However he
to keep up work and is
afraid
that
soon
he will not be
breath
He
able to is able
do his job
to ascend
because of his shortness of
before become dyspneic
The patient
approximately 8 to 10 steps
the same time period which
complaints of cough over
month
It is
has also had
has become especially pronounced during the past
denies
productive of a significant amount of whitish sputum He
any wheezing
Also
over
approximately
the past two years the patient has had
that he describes as similar to a
symptoms of chest crampingthis was occurring every two months but
mid-
charley horse Initially is occurring almost daily
The pain is located in the
lasts
now
and radiates to the left shoulder It usually
sternal area
to be brought on with certain turning
It seems
hard during
a few minutes
activities such as when he blows
motions and other
exacerbated by pushing
spirometric testing The pain is sometimes
College of Medicine
Committed to Excellence in Professional Education Patient Care and Research
College of Graduate Studies
College of Health Related Professions
College of Nursing
University Hospital ae
OF
2
Dale Harmer
is not consistently associated with exertion
on the chest wall It
of breath diaphoresis or
or emotional upset nor wiItthhasshorhtanpepsesned on a few occasions while
feelings of faintness
was resting in bed
.
the patient
or fevers
He has had about a
The patient denies any hemoptytshies past year
To the patient's
six pound weight loss over history of hypertension increased
knowledge there is no previous
His primary care physician
cholesterol or diabetes mellitus which the patient has not used
prescribed sublingual nitroglycerin on
for his chest pain
is significant only for an ulcer in 1985
The past medical history
and sinus problems which the
which
is
not
currently
a
problem
which he soon outgrew
The only
patient
experienced
as
child and tonsillectomy
when
the
patient
was
previous surgery has been a
is currently on no medications
around 8 years old The patient
in a motor vehicle accident
allergies He was
In addition in
ribs
He denies any known
and broken
and suffered a fractured spine
moving machinery at the
1974 the patient's arm got caught in some
to his right upper
Talc mill causing permanent damage
without bony
Gouverneur
a soft tissue injury
this was
arm Apparently
fracture
for coronary artery disease
The
family history
is not
significant
valvular
heart
disease
The
The
patient
has
one
sister
who
has when he was
a
child
He has 3
denies any rheumatic fever
patient all of whom are in good health
children
for the past 27 years and up until a year
has smoked
and half packs per day
The patient
half to one
was smoking between
intake to almost nothing
ago
he has cut his tobacco
For the past year
in the past have included
He drinks a
few beers per month
Hobbies
he denies
hunting
extensive
Though he enjoys all outside of the hunting
hunting and fishing
shoot at
and did not usually
an occasional
shooting
season
used a snowmobile many years ago on
other
He
wood using a chain saw He denies any
basis He rarely cut
toxic occupational exposures
significant potentially
when he worked as a
The
patient's
occupational
history
began dairy farm
From 1963
and in his early twenties on a
He worked
teenager 1969
the
patient
had
a
variety
of
short
jobs
in most
of
the
until
feed mill and was involved
and feed
for two years in an Agway
feed mill activities including
grinding the feed
Mill
at the Groveton Paper
He worked for two years
at a Kraft
delivery
machine He worked for a year
in a
running a perforating
For one year he was employed
foods plant processing cheese
bowling pins The patient was
Lowville factory puttingmolnatchqsueratonthe St. Joe's zinc mine as an
also employed for six
underground mucker
3
Dale Harmer
went to work for International Talc where he
In 1969 the patient
1974 until the present he has been
remained for five years
From
Initially the patient was employed
employed by Gouverneur Talc
mine
He held several other
as
a
driller
in
the
open pit including driving a truck
in the mill
relatively short term jobs
less than one year as a packer
crushing department for two years Since moving to Gouverneur Talc
and about five months on repairs
at the No.
in
1974
the patient has worked as
a milling operator machinery
The ore
3 mill
This
mill is an older mill with older
underground and is then crushed
milled
a
packed
variety
is brought up from
is responsible for supervising
and shipped The patient
almost all of his time in the
spends
of milling operations
running the milling machinery
He
mill and is often actually
dusty and possibly worse over
describes the work as continuously
of potentially inadequate
the last couple of yearrsoutbiencelayusleeaves work covered with dust
covers
maintenance The patient
the dust is quite thick and
describes bad nights when
dust he can
He
Prior to leaving he blows off whatever
him completely
air hose
his work clothes home and they are
He wears
that he has worn a
with an
laundered
there
The
patient estimates
is an air
75 of the time The respirator
respirator approximately
mask with dust cartridges
The
purifying half piece
shift but when the dust is
cartridges are changed every 8 hour
the cartridges two or
especially
thick he
is reqrueisrpeidrattoor chhaasngn eever been formally fit-
The
wears
three times a shift The conditions
are
also
noisy
and
the
patient
tested
50 of the time The mine safety
hearing
protection
approximately
carries
out
inspections
once
or
twice
a
and health administration
but he does not know the results of
year according to the patient
these evaluations
presure examination the patient appeared older than his stated
On physical
acute distress His pulse was 72 and regular
age but in no
and blood pressure 108/80 The HEENT exam
respirations were 20
canal which was blocked with
was
remarkable
for a right ear
tympanic membrane was normal
The patient was
was no
cerumen The left
was thickly coated
There
edentulous and his tongue
On auscultation of
cervical or supraclavicular
lymphadenopathy crackles both bases on inspiration
In the
the lungs there were
about halfway up the chest whereas on
left lung these disappeared
about thirds of the way up the
the
right they disappeared heart there was an extra heart sound
On examination of the
There was also a
wchhiecsht may have been an S4 or a systolic click
The abdominal
1/6
systolic
ejection murmur
heard
best
at the apex
without organomegaly
or
positive bowel sounds
about 2+
exam revealed
exam showed a prostate which was
tenderness Rectal
and was diffuse
smooth
and tender The testes were occult blood or masses
enlarged
without masses or tenderness
There was no
of the skin was
noted on rectal examination
Examination
without
There was clubbing of the fingernails
unremarkable
examination was within normal
cyanosis or edema
Neurological
limits
,
4
Dale Harmer
which revealed significant included audiometry the lower frequencies and
in
Additional testing
mild
loss in the left ear
the right hearing was
hmeoarreinsgevere in the 3k to 8k rewgiitohn a Ominld degree loss in the 3k
normal in the lTowheerrefw ra es quesnicgineisficant asymmetry between the ears
to 8k region
FVC was 3.38 L 78 of
function testing the patient's
FEV1 of 82
predicted On pulmonary FEV1 was 2.77 L 78 of
The chest ray
predicted predicted 25-75 of 3 L 81 of
. mid and lower lung
and an FEF
markings in the
interstitial
the right apex
An
revealed diffuse
were identified in
fields bilaterally Bullae
identified in the right upper lung
ill defined nodular density was
with ill defined borders No
It was calcified
peripherally
abnormalities were noted
definite pleural
malignancy the patient was
of the possibility of pulmonary
in Watertown New
Because
Loewen a pulmonologist
there
referred to Dr. Gregory
testing obtained by Dr. Loewen
function
York On pulmonary
with a normal total lung
diminished diffusion capacity demonstrated on PFT
was a
disease was not
of the chest
Dr. The
capacity
Obstructive
and a CT
obtained a chest ray
along each lower
Loewen also
areas of pleural thickening
on the
chest ray identified
to the findings noted
lateral
chest wall
in
addition
lobe was
nodule in the right upper
previous chest film on CT inthesize with ill defined borders No
better defined as 2.5 cm noted and malignancy was suspected
definite calcification was
and according to his report the
Dr. Loewen carried out endoscopy did not reveal malignancy The
histology of the biopsies taken
lavage however was remarkable
biopsies and the bronchial alveolarand inflammation Dr. Gerald
for numerous ferruginous bodies
alveolar lavage at the SUNY
Abraham
also
reviewed
the
bronchial
and
found
very
high
numbers
of
Health
Science
Center
in
Syracuse fluid
ferruginous bodies in the lavage
:
RECOMMENDATIONS IMPRESSION AND
chest ray and
Harmer's
symptoms
physical
examination
with pneumoconiosis
Dale
function
testing
are
all
consistent combined
talcosis
and
pulmonary
which is
most
likely
asbestosis or
as
for approximately 20 years
asbestosis
The patient has worked
according to his history
During that time
dusts which
and other
miller a talc miner and
amounts of talc
he was exposed to significant
He describes exposure to the
and Anthophyllite
during the early years
included fTorremmsoloiftethese minerals especially
has been worn a
fibrous
Respiratory protection
the cartridges
of
his
employment
amount of
time
but
it
is
unclear whether
were
appropriate
significant
of
the
appropriate
type
or whether they
has never been
fit
used were
reached The respirator
lavage
alveolar
for the exposure levels
bronchial
tested On bronchoscopy the paftoiuenndt'csontain very high numbers
fluid and biopsy material was
Dale Harmer
of ferruginous bodies which
exposure
Consequently it
are
is
:
;
5
consistent with asbestos fiber
my opinion that Mr. Harmer
definitively In addition the patient has a
malignancy
The negative
lung nodule which is suspicious for
out
the
possibility
of
a
bronchoscopy
lung tumor
reduces
but
does
not
rule
the patient must be
As recommended by Dr. Loewen
followed quite closely and if the
enlarges an open lung biopsy will be
nodule .
evaluate it If the nodule is not
necessary to
:
pneumoconiotic nodule as noted by Drm.alLiogenwaennt it is most likely a
The patient is
exertion His
experiencing significant breathlessness
out his job dduytsipensea is making it very difficult for him to
with
He has evidence of a
carry
capacity on pulmonary function testing
reduced diffusion
that his symptoms are due to decreased Consequently it is likely
his occupational lung disease The
oxygenation as a result of
patient's pneumoconiosis puts
exposure I would consider Mr. Harmer to be
lung disease
The
patient's
lung
disease
totally
is
disabled
by his
progressive
permanent and may be
Recommendations for future treatment of
include the following
the patient's lung disease
1 No further exposure to
talc Tremolite Anthophyllite or
asbestos containing dust
dust
.
oo
or any other
fibrosis causing
2 Close evaluation as recommended by Dr. Loewen for the
and pneumococcus
4 The patient should locate
a primary care physician in his
local area who can be responsible for
his medical care
coordinating all of
report If there are
any questions regarding this at 315 464-6422
please call me
Sincerely
Nabel Lud B
Michael B. Lax MD MPH Medical Director CNYOHCC
ML 1m
SUPREME COURT
STATE OF NEW YORK
LEONARD GAUMES et al
ST LAWRENCE COUNTY
.
Plaintiffs
V.
.
T. VANDERBILT COMPANY INC GOUVERNEUR TALC COMPANY INC ST JOE MINERALS CORP
and FLUOR CORP
Defendants
Index No.
.
AFFIDAVIT_
STOA F NET W YOE RK ) ONOOFNOND ONDA AGG A SA S
YORK , Dale Harmer being duly sworn deposes and says
NEW
1. am one of the plaintiffs in the lawsuits against R. T. Vanderbilt Company Inc.
SYRACUSE Gouverneur Talc Company Saint Joe Minerals Corp. and Fluor Corporation and I understand that R. T. Vanderbilt and Gouverneur Talc Company have made a motion to dismiss my action I know that
LONGSTRE this affidavit will be used as a means of opposing that motion
&
2. My lawyers tell me that R. T. Vanderbilt and Gouverneur Talc Company deny that they
CIABOTI concerning ever made any misrepresentations to me
my health and deny that they concealed from me
SETRIGHT the true condition of my health I have also been told that they deny that there is asbestos in the mines and deny that they concealed from us the fact that there is asbestos in the mines Those
denials are false and I will explain how I know that from my own personal experience
3. I am fifty years old and went to work for International Talc Company on October 6
1969 in the open pit Then when Gouverneur Talc Company took over International Talc
Gouverneur Company in 1974
Talc Company hired me Therefore since 1969 I have worked in
and about the talc mines and pits owned first by International Talc Company and then by Gouverneur
Talc Company which in turn I am told is owned and controlled by R. T. Vanderbilt Company
4. With respect to the condition of my health I want to say that every year the employees of
International Talc Company and then Gouverneur Talc Company would undergo physical examinations by the plant doctor which included chest rays So for the approximately twenty
that I worked for International Talc Company and Gouverneur Talc Company I had yearly
years
chest rays and breathing tests performed by the plant doctors Prior to 1989 I never once was
told that there was anything wrong with my lungs or anything else
5. Sometime after I filed a Workers Compensation claim in November of 1989 my lawyers gave me copies of some medical reports they had received from Gouverneur Talc Company
6. Included in the medical reports there was a report by Dr. Dodd the plant doctor back in
1979 dated October 10 1979 which stated Comparison with the previous exam of October 11
YORK 1978 now reveals an increase of pulmonary markings throughout both lung fields somewhat
NEW more accentuated in the right base I am not doctor but it reads to me like something was going
SYRACUSE on way back then I was not told by Dr. Dodd or any other doctor at that time that I had any lung or respiratory problems at all Even when I began to feel sick I wasn't told that I shouldn't work
-
there anymore
LONGSTRE&
7. During the last part of 1989 I got to a point I where got tired going up and down stairs
CIABOTI I was spitting up a lot and my lungs were feeling bad Somewhere around the spring of 1989 I had a physical examination by the plant doctor who was then Dr. Fung He talked to me after the
SETRIGH physical examination He told me that I had a heart murmur and he said that my lungs didn't look too good right then Dr. Fung told me that I had a real small spot starting in my right upper lung but
it wasn't significant enough at the time to really do anything about it He sent me down to the
hospital for some tests and again said it wasn't serious enough to do anything about He didn't tell me
to stop working and I kept on working because I didn't know anything was wrong
8. I kept getting worse and worse Finally my wife and I decided I better do something else and that is when I went to Dr. Lax somewhere around January 1990. By that time I was feeling pretty bad Shortly after that Dr. Lax diagnosed that I had lung cancer I want to know why I wasn't
told about Dr. Dodd's examination report of October 10 1979 which said I had some trouble
somewhat more accentuated in the right base especially since that is where the lung cancer
started
9. My true physical condition was concealed from me but G. E. Erdman's Office
placed Memorandum was
on the bulletin board put up there for all of us employees to see and we
all saw it A copy is attached to my statement by my lawyer and marked Exhibit A. Please note
the next to last sentence in the memorandum Even though you shouldn't need to worry about getting
cancer from our dust you must respect the possibility of getting talcosis My information is that
at that point several of the miners had developed cancer and since then several more of them have
developed cancer but on this memorandum we have the manager of Gouverneur Talc Company
telling us we don't have to worry
10. I think concerning medical condition they kept from me the true nature of it and
they even tried to tell me there was nothing wrong The manager Mr. Erdman even told us not to
_ worry about getting cancer from the dust If I had know that I was going to get sick from being in that was not so unsafe to my health I relied on
YORK the mines I would have looked for other employment
NEW
what the company was telling me and also what they were not telling me in making my
SYRACUSE determination to continue working in the mines 11. Maybe the pay is not as good being a farmer or something like that but at least you
LONGSTRE don't end up with lung cancer
&
CIABOTI 12. have a few comments as far as this asbestos thing is concerned Before OSHA came in everybody talked about asbestos being in the mines and in some areas there were more fibrous
SETRIGH materials which we all called asbestos After OSHA came in we noticed that the word asbestos disappeared from management's vocabulary and they took a position with us as well as with OSHA as far as I know which is shown in Mr. Erdman's memorandum attached as Exhibit A in the first
paragraph NIOSH knows these facts but is reluctant to recognize their earlier error in classing
tremolite as an asbestos mineral that is not a cancer causing agent and but the weight of
increasing evidence continues to indicate that our products are not causing abnormal amounts of
cancer
13. I am told by my lawyers who have retained well known mineralogist Dr. Arthur Rohl who is familiar with our talc mines and environmental pathologist Dr. Jerrold Abraham that
there is no question that there is asbestos in the mines up here and it gets into the lungs of the
miners and has been seen there by Dr. Abraham
14 Of course I have read over the last fifteen to twenty years about the dangers of asbestos All of us miners up here were interested in that because all along we have been calling some of the products coming out of the mines asbestos Now our employer and the company that owns our employer are telling us that there isn't any asbestos up here If anybody had ever told me what I have found out since we brought this lawsuit and my lawyers went out and hired experts
and if I had known then what they have said I would have gotten out of those mines years ago The
only reason why I kept working was because Gouverneur Talc Company and R. T. Vanderbilt kept
telling me that there wasn't any asbestos in the mines
15. I remember a few years ago a gentlemen by the name of Hugh Vanderbilt a big wheel
with R. T. Vanderbilt came up to the mines and talked to a lot of us at the mine head He told us that
YORK the government was claiming that there was asbestos in the mines and he said that we didn't have
NEW asbestos He said he had a senator in his back pocket and there weren't going to be any problems
SYRACUSE with our jobs because he could appeal any finding that we did have asbestos for years so we wouldn't have to worry about our jobs and there wasn't any asbestos up here anyway
-
LONGSTRE 16. We miners and miners up here are a very close knit group When we are working
& we have to depend on each other so that each one does his job and everybody is safer and better off I
CIABOTI know that none of them would have worked in those mines if they had known it was going to harm their health and especially if they had known that they were being exposed to asbestos
May SETRIGH Dated
17 17 1993
Dale Harmer
Signed and Sworn to before me this
;
17th May
, 1993
Notary Public
ANNE L. BENNETT Notary Public State of New York
Qualified in St. Lawrence County
Commission Expires June 30 19931993
f
HUG 06 71 14:51 14:51 OUT & HODVL Services
| Riverfront Services Medical
_
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|
444 EAST GENESSTEREEE SYRACUSE NEW YORK 1320
The State Insurance Fund
901 James Street
Syracuse New York 13203
ATTN Charmaine Hauff |
Emp Inj
Exam
Carrier : WCB #
R.T. Vanderbilt Company
11/01/89
Pulmonology Consultation 10/26/90 30999031-062
6891 5142
Dear Ms. Hauff
Thank you for referring Dale Harmer to Riverfront Medical with and evaluated him on October 26 1990
Services
I spoke
HISTORY
As you know he is a year white male who on 6/1/90 underwent right
thoracotomy and upper lobectomy for adenocarcinoma of the lung Pathologic
_
examination of resected lung material revealed not only the carcinoma but also numerous ferruginous materials and asbestos bodies as well
Lung tissue was examined by Dr. Abraham who concluded that the lung showed
focal interstitial fibrosis with associated asbestos and ferruginous bodies In Dr. Abraham's opinion these findings were sufficient for a diagnosis of pulmonary talcosis and asbestosis
ADMINISTERED BY EMPIRE MEDICAL MANAGEMENT LTD
08-06-91 03:50
PO4
AUG 06 '91 14:31 OOT & ASSOC SYR NY
RE HARMER DALE
.
2 rade 2
PAST MEDICAL HISTORY
He has a history of having been a significant cigarette smoker for many
years
PHYSICAL
EXAMINATION
Physical examination reveals a 5'8 tall
pressure is 130/88
152 1/2 pound male
Blood
The examinee has a healed right thoracotomy incision with a moderate
degree
rales
of hyperinflation bilaterally There are no wheezes rhonchi or
Expiratory phase is only mildly prolonged
The balance of the
physical examination is unremarkable
RAYS
An ray taken in January of 1990 showed chronic obstructive as well as interstitial change and a nodular density in the right upper lobe which
turned out to be an adenocarcinoma
A review of the examinee's chest ray supports the analysis provided by Dr. Gerle in January of this year
above
CONCLUSION
DIAGNOSIS
The question at hand is whether the patient suffers from
occupational lung disease This question must be answered in
the affirmative Not only does he have biopsy pulmonary
fibrosis associated with asbestos and talc particles
he also
.
has a carcinoma of the lung occurring in this setting
08-06-91 03:50
F03
HUG 00 21 14.01 14.01 UVI * MODUL SIK NI
3
RE HARMER DALE
CAUSAL RELATIONSHIP We may therefore conclude that the examinee's
from pneumoconiosis derives solely from his occupational dust exposures and that
given his smoking history his carcinoma derives in part his
occupational exposure
As you may know asbestos exposure and cigarette
usage act synergistically to dramatically increase the risk of carcinoma
The risk of lung cancer in nonsmoking asbestos workers is not known for
sure but is felt
asbestos worker
to be very very low may be difficult as
Indeed finding a nonsmoking
the classic studieisn this area
referred only to asbestos workers who never regularly smoked Additional
studies have failed to take into account the presence of passive smoke and
may be
flawed
by virtue
of
reliance
on
smoking histories .
which
are
notoriously misleading
What we can say is that if asbestos in and of itself operates as a
carcinogen it is very weak
asbestos exposure is however
The known
combination to be a very
of cigarette usage
strong risk factor for
and the
development of lung carcinoma In 1990 it is accepted that if a carcinoma
develops against a background of clinically or pathologically proven
asbestosis it can be assumed that asbestos exposure played a role in the
development of this cancer Certainly this is the case with Mr. Harmer who
has asbestosis as suggested by ray and proven by biopsy The absence of
crackles on his lung exam does not mitigate against the diagnosis of
asbestosis Because Mr. Harmer has asbestosis it can be concluded that his
lung cancer derives in large measure from his asbestos exposure and also
from his term usage of cigarettes
APPORTIONMENT Apportionment of this contribution is very difficult but it
that 50 of the examinee's lung cancer risk
is reasonable to conclude
,
derived from occupational exposure to asbestos
Thank you again for this referral
08-06-91 03:50
PO2
AUG 06 '91 14:30 0OT & ASSOC SYR NY
.
o,
*
4
_
RE HARMER DALE
I certify and affirm that the foregoing report is true to the best of my knowledge under the penalties of perjury
Sincerely
D
.
. .
S
David J. Davin M.D.
Pulmonologist
DJD
CC Worker Compensation Board
Atty Michael Oot 501 E. Washington St. Syracuse NY 13202 Gregory Loewen M.D. 830 Washington St. Watertown NY 13601 Joseph Meyer M.D. 826 Washingotn St. Suite 106 Watertown NY 13601 Michael Lax M.D. 550 Harrison Center Suite 300 Syracuse NY 13202
08-06-91 03:50
P01
State University of New York
D Health Science Center
Syracuse
College of Medicine
Pathology Department of
FAX 315 464-7130 June 27 1990
Jovan G. Kuan M.D.
Pathologist
The House of the Good Samaritan
830 Washington Street
P.O. Box 517 Watertown New York
13601
Re
Dale
My #
Harmer JA90-34
S90-3467
Dear Dr. Kuan
much for sending the right upper lobectomy specimen from
Thank you very for my study
as requested by Dr.
Loewen and Dr.
Lax I have all of the
Mr. Harmer
several sections from the lung tissue but apparently
prepared
in
lab If possible I would appreciate a
tumor was removed for study
your
slides of tumor for my file I am
few unstained sections of representative
of the lung tissue in the
enclosing two unstained sections representative
remaining lung
or The lung shows focal honeycombing with mucus accumulation and epithelial
There is focal interstitial fibrosis and marked accumulation of
metaplasia
dust consistent with talc and numerous asbestos bodies
strongly birefringent
bodies which may be based other
as well as larger ferruginous
minerals Mr. Harmer did relate verbally to me that he had
Wollastonite processing mill for several years
{ _f
. These findings are sufficient for a diagnosis of pulmonary talcosis and
asbestosis Studies to identify the types of fibers and other particles present in the lung tissue are underway and the results should be avai; lable
_ 5
within a few weeks I hope
Looking forward to hearing from you
Sincerely
JLA
cc
Dr.
Dr.
Loewen Lax
Jerrold L. Abraham M.D. Associate Professor and Director of Environmental
Occupational Pathology
and
College of Medicine
Committed to Excellence in Professional Education Patient Care and Research
College of Graduate Studies
College of Health Related Professions
E ast Adams Street Syriense Syriense NY
13930
College of Nursing
University Hospital