Document QJz41vkronR85GKbBY0gQ6y44
RfcV 5-78)
Shell Oil Company
Interoffice Memorandum
FEBRUARY 13, 1990
PLAINTIFF'S EXHIBIT
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 diaphragmatic pleural-plaque.
- ----
joined Shell employment in September 19^7 and retired in
1987. He has worked as a general helper, pipefitter's helper, a pipe
fitter and ultimately became a zone foreman and then a maintenance
supervisor.
The radiographic findings of concern is a fairly subtle one involving the
left diaphragm surface. Dr. Conoley described it as follows on a film report from 1987, "There is a focal convexity of the superolateral aspect of the left hemidiaphragm without evidence of calcification. This structure has been present in the prior examinations dating back to 1979. The significance is indeterminate."
There is also a chest X-ray report dated February 3, 1987 by Dr. M. A. Mullican which says in part, "There is a localized convexity along the lateral aspect of the left diaphragm which could be a non-calcified plaque. The localized convexity along the left diaphragm appears much
more pronounced then on previous films."
I have had the opportunity to review the chest X-rays and agree that the changes on the left hemidiaphragm are consistent with the type of radiographic findings that may be associated with asbestos exposure. I do not see any other radiographic evidence to suggest lateral wall pleural plaques or parenchymal fibrosis.
Because of his work history, the proper chronology and the consistent radiographic findings, it is my professional opinion that this be considered a "pleural plaque" case with the OSHA 200 log recording and the informing of the patient of the findings.
CA9003802 - 0001.0.0
ABS-055382
lam 031989
Along with this consultation report, I am enclosing the pulmonary registry form with our portion of the form completed. Please return a copy to us for our records after you have had an opportunity to complete the rest of your portion of the form.
LCW:SAM
EnHosures
CA9003802 - 0002.0.0
ABS-055383
LAM 031990
S'13200 (4/90) 006061
NAME OF SXPUDW^r
*S - REASON FOR REVIEW
1. CHEST X-RAY REPORT INDICATING: a) Possible pleural abnormality-----------
PULMONARY REGISTRY
CONFIDENTIAL - MEDICAL
| EMPLOYEE NUMBER
:
LOCATION
'hf.hZ-
_
j i
7. Has the employee had a job where It is possible, or Hkely, that he has been exposed to some other agent known to cause a dust disease of the lung, (e.g.,
Silica, etc.)? If so, list
,--. YES | NO
-- 1--1
^Ty^-cblt b) Possible fibrosis.
^X/A- ficuwj-
2. PULMONARY FUNCTION TEST ABNORMAUTY: a) FVC less than 75% of predicted______________
8. PLEASE UST JOB TITLES AND NO. OF YEARS IN THAT POSITION
--JiTg.- t/sn L ff-'V'.---------------------
f j.b) Other
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41
3.
Other reason tor review
9. Is there any history of other respiratory Illness that could account for the X-ray abnormalioes-under consideration' 'f so. list
i--| i-- | ] YES | NO
Time of service
V3
Cre'l/^T)
Has the employee worked In a facility that used asbestos so that it Is possible that a pleural plaque could be related to Job exposure?
yes I
I NO
10. Is there a history of exposure to a pneumoconiosis producing agent outside of employment at Shell (prior to working at Shell or associated with a partome job, or avocation)? It so, list
6. Has the employee worked at a Job (e.g., bricklayer. Insulator etc.) tor a sufficient time (usually at least 10 years) for rt to be likely that asbestosis could have developed?
| | YES | |NO
.--. .-- YES NO
'--1 1--1
RESULT OF REVIEW: cJu'C-)-
Jv\! Recommendation: p
O/thSM? J)
OaaI
HU/4U -
lb J
tifJkrtVS f' '
/
REVIEWED k
BY
IF PLEURAL CHANGE
^^7
----- --------- ^----
DATE
MOTE: (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)
IF POSSIBLE FIBROSIS
DATE
counseled:
Rv Pt . SHCfier
A> (JrVfpti n/c/ is EU<?I /cjt
Patient counseled:
OSHA Form 200:
Worker's Compensation:
^7 ( '
OSHA
.Ux, /
. Form 200:
1 / * U ^ Worker's
Compensation:
EMPLOYEE REFERRED TO DR. (Please send copy of consultation when available)
x orsname <
COMMENTS: W
UST~ ^
T<1troj^X'
CONTEMPLATED FOLLOW-UP
y'
W"PERIOOIC EXAM
| | OTHER
INSTRUCTIONS: PART 1 - WHITE COPY - LOCATION MEDICAL DEPARTMENT
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ABS-055384 ------
LAM 031991
S-12972 in 80)
ILO PULMONARY SURVEILLANCE WORKSHEET
EMPLOYEE NAME 1 First. Middle. Lasll
COMPANY
r~i SHELL 1I OIL COMPANY
(--1 SHELL CHEM.
1--J COMPANY
r"i SHELL DEV 1--1 COMPANY
EMPLOYEE NUMBER
DATE OF X-RAY READING 2-i-g?
OTHER
TYPE OF EXAMINATION
n nj--i _
1--1 fSpecttyi-------------------------------------------------------
ASBESTOS
SILICA
OTHER
n (Speed*l
A. DATE OF X-RAY
IB FILM QUALITY
"A
2A ANY PARENCHYMAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS9
2B SMALL OPACITIES
a SHAPE/SIZE
SECONDARY
b ZONES
H Not Grade ^ Give Reason:
1C. IS FILM COMPLETELY NEGATIVE?
YES I I
to
l--J Section S
NO K I p,oceea 10
Seciion 2
YES I I COMPLETE
I----- * 28 and ?C
NO k I
PROCEED SECTION 3
c PROFUSION
% % /l Vo 'A V 2!i !A v2 3A V*
2C LARGE OPACITIES
SIZE
O A IB C
PROCEED TO SECTION 3
3A. ANY PLEURAL ABNORMALITIES CONSISTENT WITH PNEUMOCONIOSIS?
3B. PLEURAL THICKENING
a DIAPHRAGM (plaque)
3C. PLEURAL THICKENING
a CIRCUMSCRIBED (plaque)
YES
[v]
COMPLETE 38 3C and 3D
NO Q
Chest Wall
b DIFFUSE
PROCEED TO SECTION 4
S'TE KO b COSTOPHRENIC ANGLE
SITE 1.0 R L
3D. PLEURAL CALCIFICATION
SITE IN PROFILE
. WIDTH h EXTENT FACE ON ui EXTENT
a OiaPhRAGM b WALL c OTHER SITES
R EXTENT 0 1 2| 3 0 1 2| 3 0t
SITE IN PROFILE
i WIDTH m EXTENT FACE ON m EXTENT
a DIAPHRAGM b WALL c OTHER SITES
'Q L 0 0 0
EXTENT
i 23 123
23
PROCEED TO SECTION 4
4A ANY OTHER ABNORMALITIES? 4B. OTHER SYMBOLS (OBLIGATORY)
YES
COMPLETE 48 and 4C
mo l I 1|
PROCEED TO SECTIONS
i 0 ax t>u ca | cn | co [ cp | cv j d* j" et em es if hi I no I >d *h ki
Report items which may b of present clinical sigmftcance m this section
r-----i (SPECIFY od ) |V 1 _____________
V,
p< p* rp to
Date Personal Physician notified9
>' 'MONT. 0*T f
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1 CLINICAL INTERPRETATION
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ill: . .
2 B-READING COMMENTS
cv^-rVir, . z
lore ^or: anterior r i t
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net sure v;._:s r r
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Lit::' of Z i o
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interval ennone. T..ero are coicifie O plaCUCS XTt H; 1 *3 j O 3 til. . 'iV-ifc?-- 13 HC t:V
dence of oioural fluid: or oneuoct:-;. TclX.
'T 33r ^ 3T3 .'iOH Cl; L J I ~ ic3 I? 1 3 LI T 3 i
plaques on cn-e 1 ef.t oso:.,o :-,tnr.v y increase.] ^cirrcirK:
m
i - f t lov,--/
PLEASE TYPE OR PRINT
NAME OF PHYSICIAN
PHYSICIAN S SIGNATURE /. ... ^
. ,, /
!. ,
-1
ADDRESS ClTYrSTAT E/ZlP CODE
SIGNED ' DATESlGNE0
'T ' r'
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ABS-055385
INSTRUCTIONS: WHITE COPY - FOR CORPORATE MEDICAL DEPARTMENT
LAM 031992
Medical Department
Deer Park Manufacturing Complex Shell Oil Company/ Shell Chemical Company
lung field believed to be' an area of fibrosis. Followup PA and lateroJ
films are suggested to additionally evaluate the nodular density overlying the left 4th rib.
ABS-055386
LAM 031993