Document NeMEKQgm9R6p6pg2KnvpOdyMQ

SPRINGFIELD MEDICAL ASSOCIATES, INC. 2150 MAIN STREET SPRINGFIELD, MASSACHUSETTS 01104 TELEPHONE (413) 739-5676 Michael P. Coppola, M.D. CHEST DISEASES AND INTERNAL MEDICINE Frederick A. Flatow, M.D. HEMATOLOGY, ONCOLOGY, AND INTERNAL MEDICINE Paul C. Hetzel, M.D. ONCOLOGY, HEMATOLOGY AND INTERNAL MEDICINE Robert P. Hoffman, M.D. INFECTIOUS DISEASES AND INTERNAL MEDICINE Thomas J. Keenan, M.D. CARDIOLOGY AND INTERNAL MEDICINE David H. Miller. M.D. RHEUMATOLOGY AND INTERNAL MEDICINE David L. Pleet. M.D. GASTROENTEROLOGY AND INTERNAL MEDICINE Thomas F. Race, M.D. GASTROENTEROLOGY AND INTERNAL MEDICINE Michael H. Rosen, M.D. HEMATOLOGY. ONCOLOGY. AND INTERNAL MEDICINE Mary Ryczak. M.D. INFECTIOUS DISEASES AND INTERNAL MEDICINE Roy Stillerman, M.D. CHEST DISEASES AND INTERNAL MEDICINE May 3, 1988 Attorney James H. Tourtelotte Robinson, Donovan, Madden & Barry P.C. 1500 Main Street - Suite 1400 Springfield, MA 01115 RE: John H. Warren Dear Attorney Tourtelotte: Mr. John H. Warren was first seen in consultation June 3, 1987 at the Baystate Medical Center. The consultation was requested by Dr. Arthur McGuire following Mr. Warren's admission with neurologic symptoms. A CT scan of the brain had been done showing multiple metastatic lesions to the brain from an uncertain primary. Mr. Warren reported repeated episodes of hemoptysis, and chest x-ray also showed multiple metastatic lesions. There were episodes of gastrointestinal bleeding and hematuria suggesting abnormalities in the urinary and gastrointestinal systems. Mr. Warren also complained of pain in the right upper abdomen and lower chest, and scans showed an abnormality in the liver and first interpreted as a benign hemangioma. Mr. Warren gave a history of exposure to the chemical vinyl chloride over a period of many years at his place of employment. Given the known association of vinyl chloride exposure and angiosarcoma of the liver, this lesion was suspected in Mr. Warren's case. Therefore a needle biopsy of the lesion in the liver was undertaken, but this was not diagnostic. Therefore on June 26, 1987, an open biopsy of the left lung and pleura was done revealing a malignancy diagnosed as angio sarcoma metastatic to lung and pleural. The known lesion of the liver was then considered to be the primary site. The hematuria and blood loss from the intestinal tract were assumed to be due to metastatic lesions to these organ systems. Mr. Warren was seen in consultation at the Dana-Farber Cancer Center in Boston. After review of the biopsy material and examination of Mr. Warren, the consultants concurred in the diagnosis of metastatic angio sarcoma and recommended chemotherapy. Chemotherapy was not successful > ,n - r , I 1 "lU'f SPRINGFIELD MEDICAL ASSOCIATES, INC. 2150 MAIN STREET SPRINGFIELD, MASSACHUSETTS 01104 TELEPHONE (413) 739-5676 Michael P. Coppola, M.D. CHEST DISEASES AND INTERNAL MEDICINE Frederick A. Flatow, M.D. HEMATOLOGY, ONCOLOGY, AND INTERNAL MEDICINE Paul C. Hetzel, M.D. ONCOLOGY, HEMATOLOGY AND INTERNAL MEDICINE Robert P. Hoffman, M.D. INFECTIOUS DISEASES AND INTERNAL MEDICINE Thomas J. Keenan. M.D. CARDIOLOGY AND INTERNAL MEDICINE David H. Miller. M.D. RHEUMATOLOGY AND INTERNAL MEDICINE David L. Pleet. M.D. GASTROENTEROLOGY AND INTERNAL MEDICINE Thomas F. Race. M.D. GASTROENTEROLOGY AND INTERNAL MEDICINE Michael H. Rosen. M.D. HEMATOLOGY. ONCOLOGY. AND INTERNAL MEDICINE Mary Ryczak. M.D. INFECTIOUS DISEASES AND INTERNAL MEDICINE Roy Stillerman. M.D. CHEST DISEASES AND INTERNAL MEDICINE RE: John H. Warren 2- - April 25, 1988 in controll ing the metastatic lesions, and Mr. Warren c on tin ue d t o have hemoptysis and gastrointestinal blood 1 oss with anemia, The b ra i n metastases, which had responded previou sly to irradiati on / r ec ur r e d with return of neurologic symptoms. De spite blood tran sf usi on s, i n travenous flui ds and nutritional efforts, the disease prog re sse d an d M r . Warren expi red January 29, 1988. Angiosa rcoma of the liver is quite a r ar e tumor, and it is my opinion that in Mr. Warren's case, there is a di rect association betwe en his angiosa rcoma and his prolonged conta ct w ith viniyl ghloride. Si FAF/nbr Fr Monsanto Monsanto Chemical Company Indian Orchard Plant 730 Worcester Street Springfield. Mass 01151 Phone (413) 788-6911 July IS, 1987 Mr. John Warren 40 Midway St. Indian Orchard, MA 01151 Dear John: We have completed the Material Safety Data Sheet (MSDS) search you requested for the various departments you worked in at Monsanto. Attached are the locations, dates, and titles of the various positions you held, listings of chemicals used in those departments, and the available MSDS's of those chemicals. Please be informed that the Polyvinyl Chloride operation ended in 1975, as did Barrier Resins in 1977. MSDS's that we have provided are probably much more recent than the ones available, if any, when you worked in these departments. Since I have already sent the MSDS's 7,r the enemies}.n 1: r.dled by Tank Farm Operators and the Chemical Safety Data Sheet on vdyi chloride, I have not included them again here. If I can be of ;ny more help, please d- t't hesitate to tali. Sit.`..:re.ly, RAR/pbr Ends. Robert A. l-asczr-.d. Indx ,s tr i a 1 Hygi ane 7k oervi s o r John Warren Work History Date 5/12/47 2/14/49 2/14/49 2/17/50 2/17/50 3/6/50 3/6/50 - 4/6/50 4/6/50 - 5/5/52 5/5/52 - 1/3/53 1/3/53 - 1/9/53 1/9/53 - 5/3/53 5/3/53 - 6/1/53 6/1/53 - 11/12/53 11/12/53 - 2/1/54 2/1/54 - 6/6/54 6/6/54 - 7/12/54 7/12/54 9/7/54 9/7/54 - 9/14/59 9/14/59 4/2/62 4/2/62 - 7/19/72 7/19/72 7/16/73 7/16/73 7/1/74 7/1/74 - 3/14/77 3/14/77 - 3/21/77 3/21/77 7/19/82 Job Title Process Helper Process Helper Operator "B" "A" "B" Process Helper "" Operator "B" Operator "A" Lead Operator Process Helper Lead Operator Operator "A" Process Helper Operator "A" Control Operator Control Kettle Operator H Control Operator Process Operator Yard Tank Farm Location Resinox PVC " " PVC Barrier Res Yard Tank Farm r aa - '.v " s v