Document NGeGRpYmEvBD4n38MwEYMEYjy

toy 4, 1939 Dr. 3. B, &. Blackstone Delaware Hospital 1105 Jefferson Street Wilmington, Delaware Dear Doctor Slacks tone:- I am sending you herewith reports of our analyses on samples of various mate rials obtained from your patient Mr. Theodore Jones and sent to us from the Delaware Hospital. I am in the unfortunate position of having no information whatever about this case, and for that reason an interpretation of the results is not altogether easy to make. I shall do the best X can* however* in the inter pretation of the analytical data themselves. It would appear that the samples were obtained .in our containers and I presume they werobtained in ac cordance with our instructions. It Is not clear to me, however* how the. sample of blood was collected since I am not sure that one of our needles was supplied for the collection of this sample* X mention this point because it is necessary to use a special type of needle which has no, and which is not fabricated with solder. Otherwise the results obtained will be likely to be misleading. I mention the matter for the further reason that If our needle was available* it was not returned to us, and in as much as our needier are of special fabrication and are expensive, I very much wish to get the needle back. I would appreciate it, therefore, if you would let me know whether or;3 of our needles was used and what has become of it if indeed it was used. It is my uncertainty about the matter of the needle and whether or not a syringe was used which makes me question the precise validity of the result obtained upon the blood* In any case* however* the lead content of the blood is within the range of normal values and it is* therefore* not indicative of any recent significant lead exposure. My only question arises froift the fact that the value fo'.md is slightly above the average normal value, and while not significantly high* is sll^xtly questionable. If there was any possible factor of contamination, it may well be that the actual blood in the patients veins was of average or less than average magnitude. The values obtained in the case of the urine and feces are entirely within the normal range of values, and indicate that there has been no recent -significant exposure to lead on the part of this patient. Taking the above data Into account, it is quite certain that any symptoms of intoxication which may be present in thl3 patient at this time, or which may have existed at the time the samples were drawn, were not the result of lead intoxi cation. More than that it is not possible to say without a careful examination of the clinical history, and without precise knowledge of the nature, duration/and time of cessation of the patient*a presumable lead exposure.' This brings me to the chief point of ray letter. Gur laboratory is not in position to do analytical work for compensation, and although we are willing to make observations from time to time in the interest of sound clinical practice, we can not make a business of this type of work. Generally it is our rule not to make lead determinations of this type except when the clinical information and the history of the patient are made available to us. In as much as these samples had already occasioned some expense and trouble when they came into our hands, I did not like to delay the analyses of them unduly by correspondence. Therefore we went ahead; and made the analyses. An additional factor in our doing so was the fact that our good colleague Dr. Gehrmaftn had.: . been instrumental in providing the containers and, therefore* we knew that there was good reason for the analytical pro cedures. I should appreciate it very much indeed, however, if you would make available to me the complete clinical record in this ease at your convenience. Obviously the only value of these oases to us la in the accumulation of additional useful information. Despite the above comments, I am sending to you herewith a bill for the actual cost of the services rendered in making the analyses. It is 3 not our purpose to collect professional fees on cases of tills type, but we do sake it a point, if and when the patient can afford it, to coyer the actual cost of our services^ If in this instance your patient can not afford to pay this bill, you are at liberty to ignore it. However I send it for such disposition as seems suitable to the circumstances in your mind. Very truly yours. RAKtis-' Robert A, Kehoe, M.D. KE 0020088 Dr, Robert Kehoe Kettering laboratory College of Medicine Cincinnati, Ohio Hay 1?39 So Dr, B, B, 0. Blachstone She Delaware Hospital llO^ Jefferson Street Wilmington, Delaware . for three analyses of the blood, urine and feces in the case of Theodore Jones at ?5-O0 each #, * * * * * $15,00 - H 0020089 N20116.01