Document ZB2Oo2V19mepx842rZLVbKgq8

Denver Clinic Medical Centers, RC. Celebrating 30years...1956-1986 Corporate Offices 701 East Colfax Avenue Denver, Colorado 80203 (303) 831-7171 March 4, 1987 ^ L^ Thomas W. Henderson, Esquire Henderson & Goldberg, P.C. 1030 Fifth Avenue Pittsburgh, PA 15219 \j l-*- ^:fr i-1 ^ Dear Mr. Henderson: Thank you for referring Travis Scott to me for evaluation. I interviewed and examined him on -February^,-1987_______ ____________________ Based upon this examination I find that Mr. Scott had a significant exposure to PCBs during the course of his work at the TVA. Mr. Scott has evidence of a peripheral neuropatiiy, cognitive defect, and emotional changes. He also has evidence of peptic ulcer disease, and diabetes ' mellitus, and has had a polyp of the colon resected. .| It is of interest that Mr. Scott ha^ Parkinson's disease which has not beerf-: been noted by any other physician. Although Mr. Scott's peripheral neuropathy may have a diabetic component, I believe that it was to a degree, caused by or contributed to by his PCB esposure. It is not possible at the present moment to state whether or not PCB exposure caused or contributed to his Parkinson's disease. Mr. Scott has evidence of a peripheral neuropathy, of postural tremor and of terminal intention tremor, very likely associated with his PCB exposure. He has evidence of central nervous system impairment and of neurastenic syndrome which is characteristic of the type 2 B psychoorganic syndrome. These findings are not characteristic of alcohol induced disorder. Mr. Scott demonstrates mild small airway disease which may be associated with breakdown products of PCB exposure. - Mr.-Scott also has evidence "of'past chloracne with some-residual~comedones7" and multiple dermal inclusion cysts. Based upon this examination, it is clear that Mr. Scott's PCB exposure caused or contributed to his current clinical illness. If vtfu have any questions, please do not hesitate to call me. Sito/erely, 3 oePOSiT'O*4 EXHip*T up Daniel T. Teitelbaum, M.D Central:701 E.Colfax, Denver80203*831-7171 East: 9450 E. Mississippi, Denver 80231 751 -1241 North: 84th & Zuni. Suite 225, Denver80221 429-1529 West: Denver West Office Park, Bldg. 52, Golden 80401 279-7525 Aurora: 15101 E. Iliff, Suite 140, Aurora 80014 *696-7525 Uttleton: 1900 W. Littleton Blvd., Littleton 80120* 797-6700 Tiffany Plaza: 7400 East Hampden, Denver 80231 770-3200 See reverse for professional staff listing 0 0 ,1 8 HARTOLDMONOQ21754 RE: Travis Scott BY: Dr. Daniel Teitelbaum DATE: March 3, 1987 MEDICAL DICTATION Chief complaint: ' Mr. Scott is a 67 year old retired, white male TVA employee who presents with complaints of fatigue and neurological disorder. Present illness: Mr. Scott worked for TVA from 1970-82. He began his work as a laborer.His particular responsibility at that time was to clean oil and mist from the floors and to work inside the transformers. He frequently had to work*inside tankers to clean the insides of the PCB tanks. These tankers wer^t 3000 gallon tankers. He would clean the insides with rags and with Dow and GE trichloroethylene. This would be used down in the tank and on the lathes to clean cutting oils, as well. Much of the machinery was oiled or maintained using PCB oils. For instance, the runners of the lathe were regularly oiled with PCB's. In addition, "trich" was used to clean the runners, and the runners were re-oiled as needed. During the course of this work the patient did not wear any safety clothes, but he wore his ordinary clothing. He frequently mopped up PCB material using rags and a mop. He actually then wrung out the material into buckets with his hands. He was involved in the activities of baking the transformers in the ovens and he would have to actually go into the transformer bodies wearing household rubber gloves from which the fingers would rapidly fall off. He stated that the rubber gloves would frequently rot within minutes. His shoes were always soaked with PCB oils. His feet were yellow and his socks were yellow from the PCB's every night when he returned home. He often had nausea, and general malaise while he was working with PCB oils. In July of 1981, he had calf pain, and he went to the emergency room. He had severe cramping in his leg. At that time the hospital diagnosed a peripheral neuropathy. He has noted that recently he has been dropping spoons and has a great deal of trouble with coins. He has much pain in his legs and hips. He has pins and needles in his thighs. His hip joints feel as if they are coming. His feet burn constantly, and he is very tired with only minimal exertion. Every 3 to 4 weeks he gets blisters, and the skin peels on his legs. He has been diagnosed as having mild diabetes. This is controlled entirely by diet. He had a colon polyps removed in 1976. He had stomach ulcer surgery in the past. 00183 HARTOLDMON0021755 Travis Scott Medical Dictation 3/3/87 Page - 2 - Social History: Married. Lives with wife and daughter. Smoked occasional cigars and some cigarettes. Total use less than 8 pack years. Does not drink now, but has been a heavy drinker in the past. ' Review of systems: General: He has no weigh loss lately, although he had a 30 pound weight loss 3 years ago; he has been stable since that time. He has decreased hearing and chronic tinnitus, occasional lightheadedness that is postural, but no true vertigo. He complains of decreased memory for recent events, although long-term memory is intact. HE ENT: He has chronic ankle edema, Occasionally he has heart palpitations.- He has chronic problems with his lower legs. GI: He as trouble swallowing. He has intermittent diarrhea. This occurs once or twice a week; he has 3 to 4 loosewatery stools. GU: He has some difficulty starting his stream. He urinate two to three times per night. He also has be impotent for the past 3 years. Current Medication-: Darvocet N; Xanax for muscle spasm; Bufferin'"4' to occasional Tagamet, In addition, he takes Catapres to Piroxicam. times a'ffay; and an twice a day. Allergic Family history: Mother died at age 93 of CHF. Father died at age 54 in an automobile accident. Three brothers are deceased; one from pneumonia; and two from accidents. One brother has ASCVD, and had a bypass. A sister has gall bladder disease, and one is hypertensive. Two others are alive and well. Physical Examination: The patient is a thin, elderly, frail appearing white male with Parkinsonian look, Blood pressure was 130/80; pulse 64; respirations 14; and the temperature 98.8. Examination of the head, ears, eyes, nose and throat was unremarkable. Bilateral carotid pulses were felt. The chest was clear to auscultation and percussion. Examination of the heart revealed a regular sinus rhythm. There were no thrills, rubs or .murmurs noted. The abdomen was unremarkable. The liver, spleen, and kidneys did 00184 HARTOLDMON0021756 V t Travis Scott Medical Dictation 3/3/87 Page - 3 - not appear to be enlarged. Examination of the GU system revealed a normal male. Lymph nodes were not enlarged. The abdomen showed scars in the midline, sub umbilical, and sub-costal on the right. No rectal examination was done. Neurological examination revealed the patient to be an alert, but very slow, oriented white male. The facies.were expressionless. There was a Parkinsonian appearance. There was a mild tremor bilaterally. There was marked dysmetria bilaterally, and very slow performance of alternating motions. Motor performance was slow. He was unable to button his shirt buttons. He executed rapid alternating motions with difficulty. He stated that he had trouble with the locks on his suitcases. He cannot open keys, and locks. he previously had worked in a computer factory and had excellent manual dexterity. Sensory examination revealed decreased perception of , .prick. Lowers are more dramatically affected than the uppers. Vibration sense was not tested. 2 point touch was diminished, and light touch was diminished. There was cogwheeling of the elbows, and 'at the knees. :' ij Reflexes were 2+ or 1+ throughout. The plantar responses were downgoing. The skin revealed much flaking with trophic changes in the lower extremities. Diagnoses: 1) Toxic syndrome 2 to PCB with: a) Peripheral neuropathy b) Neurasthenic syndrome c) Type B psychoorganic syndrome d) Chlorache e) Small airway disease 2) Hypertension 3) Parkinson's disease 4) Peptic ulcer disease 5) Diabetes mellitus 6) S.P. polyp of colon resection 0018b HARTOLDMONOQ21757 Name: TRAVIS SCOTT Date of Eirth: 02/02/20 I have reviewed and considered the clinical note of Dr. Daniel T. Teitelbaum. In addition, I have noted the following history from Hr. Scott. This 67 year-old man worked for the TVA from 1971. For several years he came into daily contact with oils containing PCB's. He has problems with peripheral neuropathy and with intermittent claudication. He has also had peptic ulcer disease in the past and has been treated for hypertension. He had mild acne as a teenager. During the early 701s he developed multiple blackheads and pimples over the face. These were frequently removed by his wife. They have gradually improved following cessation o'f exposure to oils. He has had five cysts removed from forehead, abdomen and thigh. He has had an occasional rash on the leg which clears with treatment with a topical agent. He also has intermittent flares of small blisters between the toes and on the insteps of his feet. He states that the last four to six years he has } en more sensitive to sunlight and sunburns very easily. . Examination reveals a few comedones behind his right ear. :| There is a se ^ rrheic keratosis on the lower aspect of the - left side of this chest. Some scattered lentigo are present over the back. There is slight dryness and scaling of the ankles laterally. The soles of both feet are scaly and slightly red and there is thickening and whitish discoloration and subungual debris involving the nails of the left first and second toe and the nail of the right first toe. Also I have prepared a potassium hydroxide preparation from scale from the sole of the right foot. I have examined and evaluated Mr. Scott with reference to his possible dermatologic problems. I have likewise reviewed various hospital, medical, and related records of Mr. Scott. A potassium hydroxide preparation from the sole of the right foot is positive for fungal hyphae. . Based upon my examination, the test indicated, and various portions of the records, it is my opinion that Mr. Scott suffers from: 1. Chloracne by history with some residual comedones and multiple epidermal inclusion cysts 2. Seborrheic keratosis, left lower chest 3. Dermatophytosis of feet and toenails I also have considered the relevant medical and scientific literature regarding exposure to PCBs, dibenzofurans, and dibenzodioxins and certain adverse health effects associated with exposure to those chemicals. It is my further opinion 0018(3 HARTOLDMON0021758 page 2 that the follorire d iagr.rses are related to, i. e- caused or contributed, Mr. Scott's previous exposure to PCBs and/or their contaminants: 1. Chloracne by history with some residual comedones and multiple epidermal inclusion cysts. 2. Dermatophytosis of feet and toenails These opinions are within a reasonable degree of medical probability. _. Edgar B. Smith, M.D. Professor and Chairman Department of Dermatology University of Texas Medical Center Galveston, Texas 77u50 0018 V HARTOLDMON0021759 RUSIM'RESBYTERIAN-ST. LUKE'S MEDICAL CENTER him west <-(>x<;hksn iwhkway, Chicago, Illinois ihhim DEPARTMENT OF NEUROLOGICAL SCIENCES 19 March 1987 Thomas W. Henderson, Esquire Henderson & Goldberg, P.C. 1030 Fifth Avenue Pi ttsburgh ,._PA 15219 \- ____ ___________________ . RE: Travis Scott Dear Mr. Henderson: , I have reviewed and considered the clinical report of Dr. Daniel T. Teitelbaum^ I have examined and evaluated Mr. Scott with reference fc his possible neuro-'J logic problems. I have likewise reviewed various hospital, medical, and related records supplied to me by your office. I also obtained a history at the time of the neurologic examination which I performed. Based upon my history and examination and supported by various portions of the records, it is my opinion that Mr. Scott suffers from: 1. Postural-tremor and terminal intention tremor (action tremor); 2. Peripheral neuropathy; 3. Neurasthenic syndrome. I also have considered the relevant medical and scientific literature regarding exposure to PCBs, dibenzofurans, and dibenzodioxins and certain adverse health effects associated with exposure to those chemicals. It is my further opinion - that Mr.--Scott's previous exposure to- PCBs--=and/or their=contaminants^caused-on--- contributed to the above diagnoses. Mr. Scott also suffers from stage-II . Parkinson*s disease. In view of our present knowledge a--toxic-contribution to . these cannot be excluded. .. ' Sincere1'1 Harold Professor, Neurology & Pharmacology /gi 1725 IV. Harrison, Suita 915, Chicago, Illinois 60612, (312) 942-5936 0018b HARTOLDMON0021760 THE UNIVERSITY OF ROCHESTER MEDICAL CENTER 300 CRITTENDEN BOULEVARD ROCHESTER. NEW YORK 14642 AREA CODE 716 SCHOOL OF MEDICINE AND DENTISTRY SCHOOL OF NURSING STRONG MEMORIAL HOSPITAL Eric D. Caine, M.D. Associate Professor of Psychiatry and Neurology Director, Ambulatory Services Director, Neuropsychiatry Program (716) 275-3571 NEUKDP5YCHIATRIC EVMIBmON NAME: Travis C. Scott DOB; 8 February 1920 Thank you for the opportunity to evaluate Travis C. Scott, who I assessed on ~26 February 1987. ..In addition to exaninfng Mr.~ScottT-T-reviewed and .:n_c considered the clinical note of Dr. Daniel T. Teitelbaum. I have also reviewed various hospital, medical, and other related records of Mr. Scott. Mr. Scott underwent a comprehensive neuropsychiatric evaluation. This - evaluation included administration of the Neuropsychological Symptcm Checklist (NSC), the 28-item version of the General Health Questionnaire (GHQ), the ' \\ . abbreviated version of the Beck Depression Inventory (BD7) the revised tj 90-item version of the Hopkins Symptcm Checklist (SCL-90 iw, and a ~ sani-structured interview using the Schedule for Affective Disorders and Schizophrenia - Lifetime Version (SADS-L), with the Global Assessnent Scale (GAS). The NSC is a general, qualitative (non-quantitative) symptcm inventory useful for preliminarily assessing patients with possible neurological, emotional, or intellectual dysfunction. The CTQ is used typically in medical, non psychiatric settings to establish the presence of clinically prominent emotional distress. The BDI is used to establish the overall severity of depressive mental symptoms, which can be grouped as mild, moderate, or severe. The SCL-90-R is used in a variety of clinical settings, most often for defining problems in patients having behavioral or emotional symptoms. From data gathered using the SADS-L interview, it is possible to develop a standardized, rigorous lifetime psychiatric diagnosis, where applicable. The _ _GAS is useful for establishing ^the. overall, level .pf current disease severity '' and functional'impairment due to psychopathology. ~........ .... "" " ~ ' Mr. Scott was also evaluated with an array of standardized neuro--- -- ---------- psychological tests to assess his intellectual functioning. These tests included assessments of orientation, attention/concentration, verbal and nonverbal memory, visuospatial abilities, language/reasoning, and motor/ "Executive" functions. ~' Based upon my examination, including the tests that I have indicated, as well as Mr. Scott's records and Dr. Teitelbaum's evaluation, it is my opinion that Mr. Scott suffers frcm a neurasthenic syndrome, as well as difficulty adjusting to his current limitations, associated with neuropsychological test results indicative of moderately severe central nervous system dysfunction. 0018S) HARTOLDMON0021761 Travis C. Scott 26 February 1987 Page 2 I have also considered the relevant medical and scientific literature regarding exposures to PCBs, dibenzofurans, and dibenzodioxins, and adverse health effects associated with the exposure to those chemicals. It is my opinion that the above conditions are related to, i.e., caused or contributed to, his previous exposure to PCB's and/or their contaminants. This opinion is within a reasonable degree of medical certainty. If you have any questions, please feel free to call me. i t 00130 HARTOLDMON0021762 HARRIS BUSCH, M.D., PH.D. PROFESSOR AND CHAIRMAN DEPARTMENT OF PHARMACOLOGY BAYLOR COLLEGE OF MEDICINE TEL. 17131 790--H67 1200 MOURSUND AVENUE HOUSTON. TEXAS 77030 EXAMINATION Dr. Harris Busch Dr. Frank Smith SCOTT, Travis March 23, 1987 Mr. Scott is 67 years of age and has multiple medical complaints including burning of the feet, general shakiness, muscle and joint pain, especially at night, inability of concentrate and impotence. He is a pale, asthenic white man who weighs 166 pounds and has a notable osteoma of the right lower chest wall. He complains of weakness and pain in the legs and problems in walking to the point where he has fallen. He had hepatitis in 1954. On physical examination, Mr. Scott is quite tall:and slender. His blood pressure is 160/100, with a respiratory rajte of 12 per minutes and regular. His pulse rate is 88 per minute and regular. There is no adenopathy. The lung fields are cl^4r to auscultation and percussion. There are no rubs, murmurs or gallops on cardiac examination. There is a hard, bony protuberance of the right costal margin just above the liver. This is non-tender and has no bruits associated with it. The liver is a normal size and there is no ascites. Neurological examination shows evidence of mild peripheral neuritis. A chest x-ray shows no active pulmonary disease and there is no evidence of malignant Change in the area of this bony protuberance. His CBC indicates a hemoglobin that is slightly low at 13.1 gm% as well as a hematocrit of 37.9%. His SMA-13 is essentially normal. He has mild muscular weakness. There are no localizing neurologic findings in the cortex, cerebellum or cranial nerves. No other abnormalities could be found on physical examination. Other than his pallor and complaints of weakness, no positive signs were identified. His ulcer is well controlled on Tagamet and ulcer diet. Preliminary Diagnosis 1. Mild peripheral neuritis, related to alcoholism? 2. Mild anemia 3. Dysthymic disorder 4. Alcohol dependency; abuse 00191 HARTOLDMON0021763 Scott, Travis C. WM 67 3-24-87 Dr. Joseph C. Schoolar HP Mr. Travis C. Scott is a 6 7 year old married white male from Russellville, Alabama, who states that he entered the lawsuit approximately 1 and 1/2 years ago, after his retirement in 1981. The comp 1 aint s that prompted him to this action include development of burning feet in 1979, so much that he would put the air hose in his shoe to cool his feet off, he noted that his socks were yellow, and further that in walking fast he couldn't control his feet precisely. That is, he would catch himself walking splay-footed. Or, another difficulty was that his heel would hit the ground seemingly uncontrollably and "too hard." In 1980 and again in 1981 he had episodes of cramping in his thighs which was diagnosed by a consulting neurologist as "peripheral neuropathy." Because of this he was retired on disability from the TVA, dating from July-|t, 1981. In 1983 he was worked up for "pinched nerves" in hjs back, diagnosed as peripheral neuropathy. He now notes fhat when sleeping on his side he is awakened with sharp pains' and cramping along that side with the ipsilateral thigh feeling like "pins and needles." Pt states that at times he is depressed because he cannot work physically in his garden. He is weak and has no stamina. He's always been accustomed to a lot of physical activity and he finds this recently developed inability to be quite disappointing. On the other hand he is a stoic and accepts this as part of his present life. The pt has had sleep difficulty. He commonly goes to bed at 10:30 or 11:00 at night and will awaken at 2 or 3 a.m. with the "pins and needles" discomfort. Oftentimes he cannot go back to sleep. He spends the rest of the night rubbing and massaging his thigh and side, or walking the halls. He maintains a strict rule that he never sleeps more than 30 minutes during the daytime because it might make it more difficult for him to go to sleep at night. Pt's appetite and weight are steady, even though he has to eat several small meals daily because of a partial gastrectomy in 1968. There are no vegetative signs of depression otherwise, no feelings of weepiness, 00192 HARTOLDMON0021764 hopelessness, despair, guilt, etc. There has never been any suicidal ideation. Past Psych._HX: Pt is current 1y not under psychotherapy. In 1 96 4, however, he was treated as an inpatient at the VA hospital, Ann Arbor, Michigan, for a period of approximately 2 weeks with an apparent diagnosis of acute anxiety or agitated depression. He states that he had been given a new responsibility of working with mail sorting machines by his employer (Burroughs) and the work was simply beyond him. He therefore began to worry, be unable to sleep, and developed a great deal of tension. He was treated with milieu therapy and "some sort of a relaxer." Psychosocial Hx: Pt was born and grew up in Franklin County, Alabama 8 or 9 miles from the small village of Hodges. His father was a very successful cotton, corn and soy bean farmer who is / described as hard working and ambitious. He accumulated : * over 1200 acres of land, had sharecroppers and was generally a very successful farmer. Father died in 1936, age 54, in an automobile accident. Mother died in 1977, age 93. There were 5 brothers and 4 sisters. Three brothers died (2 by accidents, 1 from pneumonia), 2 living and well. The 4 sisters are all alive and well. Pt describes his childhood as "good," indeed quite happy. "We worked together, we played together, we enjoyed each other a lot. Sometimes I wish we could go back to that time." Apparently they were close-knit', very productive. The pt was educated in the country schools of his area, and was apparently successful. He was a good student and liked to play basketball. Socially he reports having been well integrated. But after his father's death he quit school to stay home and run the farm and take care of other members of the family. He did not go back to school until after his service in the army. Mr. Scott reports that in 1938 he was charged with "aiding and assisting" a moonshiner and after a 2-year legal hassle was convicted and served one year in the state penitentiary. That was in 1940-1941, just before he entered the army. He has no other history of any adverse encounters with the law other than that . The pt served in the army from 1942 through the fall of 1945, serving in the Quartermaster Corps: as a truck driver in the Canal Zone. He was discharged honorably as a PFC. oolga HARTOLDMON0021765 The p t married in 1 94 4, shortly before being- d i scharged from the army. He and his wife have had a good marriage, love each other, enjoy each other's company, and have been report edly successful in their interpersona 1 relationship. There is 1 daught e r, 41 , a school teacher in Marietta, Georgia, who is stated to be doing well. The pt attended Massey Business College sporadically, interspersed with working on the farm. Work Hx: The period from 1945-53 was spent in Alabama, working on the farm and going to school. He then began what he describes as "moving back and forth from the farm to the North." From 1953-65 he worked for the Burroughs Corp., in Plymouth, Michigan, "building computers." From 1 965 -67 he was on the farm in Alabama. From 1 96 7 -7 0 he worked for the Bellville Plating Co., in Michigan. In 1971 he went to work for the TVA in Alabama, and worked there until his retirement in July, 1981. His job for the TVA consisted of shopwork, . cleaning and repairing equipment. It was during this time that he allegedly came into contact with PCB. r Past_Med. Hxj_ In addition to that listed under the HPI, pt reports that he had measles and whooping cough in childhood. He had mumps as an adult. There have been no serious accidents. He states that he has been hospitalized 5 times: in 1964 for psychiatric tx as above; 1968, hospitalized for ulcers, partial gastrectomy; 1976, benign tumor removed from colon; 1984, txd at North Alabama Hospital for alcoholic hepatitis; Dec., 1985, right carotid endarterectomy, ECM Hospital, Florence, Alabama. Habits: Tobacco: pt was vague about his past tobacco usage. stated he smoked off and on "for many years." He Alcohol: pt's hx during the interview was significantly at variance with the written medical hx supplied. He was adamant in stating that he quit drinking in 1979 and that before that he was "only a periodic drinker." He did admit to drinking "up to 3 6-packs/week," and stated that he was once counseled by the TVA counselor with respect to his drinking. Even when I pointed that he had been hospitalized in 1984 for acute alcoholic hepatitis, he denied drinking, stating that he did not know where the doctors got such an idea. He drank only 2 6-packs prior to that hospitalization. 0019'! HARTOLDMON0021766 Medica tions: Pt t ake s Darvoce t-N, 1 every 4-6 hrs while awake, for pain; Xanax, 1.0 mg bid; Pentoxifylline, amount unspecified; hydroch1 orthiazide, 5 0 mg qd; Tagomet, amount unspecified; and Bufferin. ROS : See HPI. Additionally, the pt lists blackheads, cysts and acne since the early 1970s; renal calculus, 1973; diabetes mel1itus, not treated with medication; chronic obstructive lung disease, 1983; hypertension; shakiness of the hands; impotence for the past 2 yrs: before that his sex drive was "sluggish" for 6-8 years, but the pt states that his impotence does not bother him because "that's just part of getting older;" decreased memory for recent events; decreased concentration; intermittent diarrhea; and shortness of breath. MS Exam: Pt was neat, appropriately dressed and cooperative throughout the interview. He walked in a slow, measure^5 pace, and spoke in a low, modulated voice. Speech showeB no abnormality. In mood he appeared mildly dysphoric; there was no incongruity of affect to mood. Pt's thought processes are considered to be within normal limits for his age and status. He gave his history in a clear, logical and coherent manner. He tended to be compulsively detailed in giving his history; his discursions were related to this compulsivity. He showed mild circumstantiality, was at times vague and imprecise and even contradictory, such as when discussing his drinking history and the use of tobacco. There was no concreteness, attention difficulty, or deficiency of judgment or insight. Memory for recent and past events, as evidenced by his performance in the interview, and his recall of material and ability to handle simple arithematic calculations showed no deficiency. There is some evidence of denial. For example, during summation he stated that he was not discouraged, that considering the fact that he had been told that he would be in a wheel chair before now, he believes that he is doing quite well. Impression: 1. Dysthymic disorder (neurotic depression), mild 2. Alcohol abuse or alcohol dependency, per history 0019,'j HARTOLDMON0021767 SPEC ini-.,i DATE utFkOAY/DAY Of STAY TIME 23HAR87 flON 1 UA6HRS HEHATOLQGY REFERENCE NANCE TEST ------- C'LOQD CELL PROFILE A. 0- 11.0 K/UL HPC A. AO- S. 00 H/UL RPC 1A.0- ),H 0 G/DL HGC Al.O- 31. ij / HCT 82.0- 100.0 FL ncu 27 (J- 3A.0 PG ncH 32.0- ;S i) /. ncHC 150- 100 K/UL PLATELET - PL000 SHEAR PERCENT QIFF - 35- oj /. SEGS 0- '1 / CANOS 23- ,5!> /. LYItPHS 0- io / MONO -- FLOOD SHEAR flORPHuLUGY -- PLT ESTIMATE A.AL 3. SOL 13.1L 37.9L 99. 7 3A.5H 3A. 6 170 67H 9 19L 5 ADEQUATE OtiOO.-iSSiyAA-7-7082 SEX a AGE 67 YR5 PRINTED: 2AMAR87 07:OS * = UALUE OUTSIDE REFERENCE RANGE I = RESULT CORRECTION yWethcaiist _Q000)10919AA-7 7082 Th Methodist Hospital Department ol Pathology Houston, Texas 77030 Cumulative Pathok' ' Report gz^L., SCOTT TRAUIS HEHATQLQCY SLDft FAQE 1 0019b r<WS"K'^`r>^'T * * . r .'Tvr-n-a*, S,--< . - HARTOLDMON0021768 '",1 -.a I'; riu'US i uH 77030 t, I <; H IX SPECinCH DATE WEEKDAY/DAY OF STAY TIME REFERENCE RANGE TEST -- ELECTRDLYTE/PRDFILE CHEMISTRIES - 8- 24 MG7DL CUN 0.5- 1.5 MG/DL CREATININE 65- 110 MG/DL GLUCOSE 4,0- 9.0 MG/DL URIC ACIO 8 7- 10.7 MG/DL CALCIUM 2.5- 4.5 MG/DL PHOSPHORUS 6.0- 8.4 G/DL TOTAL PROTEIN 3.5- 5.1 MG/DL ALBUMIN 0.2- 1.2 MG/DL TOTAL BILIRUBIN 30- 115 U/L ALX PHQS 5- 40 U/L ALT (SGPT) 5- 35 U/L AST (SCOT) 75- 200 U/L LD 23HAR87 HON 1 1646HRS CHEMISTRY 15 1.3 103 5. 7 10.4 3.6 7.3 5.1 0.5 47 20 20 159 <0000.- iOvi .'M-A-r-7082 SEX H ME 67 YRS PRIMTEO: 25MAR87 07:14 = VALUE OUTSIDE REFERENCE RANGE I = RESULT CORRECTION CHEMISTRY /Methodist - ------ -------------------------- -------------- ---------- ---- 10000)1091944-7 7002 Th Methodist Department ol Pathology Houston, Texas 77030 Hospital Cumulative Patholoc Report SCOTT TRAUIS SLBA PACE 1 0019 < - cmwm?mow^:----------- ^~"p---- ' "r.............. HARTOLDMON0021769 , - -./ . w.i-'O UWt t A f L3:-' r'LAEA HOUSTON 77030 " IX SPECIMEN DATE WEEKDAY/DAY DF STAY TIME 23MAR87 HON 1 1646HRS HEMATOLOGY REFERENCE RANGE TEST ----------- [:(_nOD CELL PROFILE................ 4.5- 11.0 K/UL UBC 4.40- 6.00 fl/UL RGC 14.0- 18.0 6/0L HGB 41.0- 51.0 HCT 82.0- 100.0 FL HCU 27.0- 34.0 PG MCH 32.0- 36.0 /. HCHC 150- 400 K/UL PLATELET - BLOOD SMEAR PERCENT (JIFF........ 35- 65 1 SEGS 0- 11 Z BANDS 25- 45 LYMPHS 0- 10 MONO FLOOD SMEAR MORPHOLOGY -- ------ PLT ESTIMATE 4.4L 3.80L 13.1L 37. 9L 99.7 34. 5H 34.6 170 67H 9 19L 5 ADEQUATE w jC0 [ I 'S'-rJ I j (0000)1091944-7-7082 SEX H AGE 67 YRS PRINTED: 25HAR87 07:14 - UALUE OUTSIDE REFERENCE RANGE * = RESULT CORRECTION { /Methodist - ----- - ---- -------- ------- ------------ - --------------------- (0000)1091944-7 7082 Th Department ol Pathology Methodist Houston, Texas 77030 Hospital SCOTT TRAVIS Cumulative Pathology Report . *. -1 -r-'%n1 -"."-rv tt.ess-f HEMATOLOGY SLBA PACE 2 00198 "r'TTW>T^ hi \v " `--v ' HARTOLDMON0021770 m /Methodist The Melhodltl Hospital Ot "i 01 Radiology 6565 r-.innin Houslon, roxas 77030 is /* Qy 00193 HARTOLDMON0021771 BEN COOPER, M.D., P.A. NEUROLOGICAL CONSULTATION 6560 FANNIN, SUITE 1426 HOUSTON, TEXAS 77030 (713) 797-1 180 April l, 1987 RE: TRAVIS C. SCOTT TO WHOM IT MAY CONCERN: Mr. Scott was examined on March 24, 1987. A detailed clinical history was taken and he was examined neurologica1ly. The Neurological examination revealed that he had a visual acuity of 20/50 iru the right eye and 20/200 in the left eye. His discs were normal. His pupils were five milimeters in diameter. They reacted to right and accommodation. His external eye movements demonstrated neither nystagmus nor diplopia. He had no loss of sensation on his face. His facial appearance was rather mask like and he blinked infrequently. The remainder of the cranial nerve examination was normal. In examining his motor system, I felt 1 could not be sure that he was in fact exerting his full strength. I felt that strength in his arms was normal however. In his lower extremities, he had weakness in' his iliopsoas and hamstring muscles. He demonstrated cogwheeling at both elbows, this was slight. His coordination was normal. All his reflexes were present with exception of the left ankle jerk which I was unable to elicit. The plantar responses were flexible. In examiningsensation, I found that he had an impairment to appreciation of pin prick to the junction to the lower and middle third of his forearm and leg. Joint position sense was impaired on the left foot as was vibration sense. It was my feeling that Mr. Travis Scott was suffering from a peripheral neuropathy the cause of which was not clear to me. In the sheet that his lawyers brought with him, other diagnoses had been made, including chronic obstructive lung disease and arteriiosclerosis of aorta and right carotid artery stenosis and acute alcoholic hepatitis 00200 HARTOLDMON0021772 with petic ulcer disease since 1984. His alcohol abuse could be a factor in the production of his peripheral neuropathy. This gentleman may have early Parkinsonism. To my knowledge no tests of P.C.B. have been made in this gentleman. Thank you for a 1 lowing me to participate in Mr. Scott's care. Sincerely, BC: jb Ben C, .lew. i 00201 HARTOLDMON0021773 6560 FANNIN. SUITE I 426 HOUSTON, TEXAS 77030 DOB: 2-8-20 ^, 3-24-87 IOV AC BEN COOPER, M.D., P.A. Neurological commutation 0300 FANNIN. SUITE 1420 HOUSTON. TEXAS 77030 TELEPHONE <7131 797-1 100 SCOTT, TRAVIS C. 67 ism? ' *) (7 13) 797* - <\S0- - \h2-0 ^<fcV\U&cq\ C&XX^A, ` *) \JOutW Axtoi VHlsir- ^4^ ' k&A <xXs4. cajaam^ . A>XJ* Wyj^ti l. I \UAnuui -feSRuMi - V^iAxiirt^fXA - d&te noA-'U-FuaM AmA&U^ J$ft, ^ V\* H3V> A% 0t>J2i<\ >A&& vaa ti$A $|&s!u - ^ w Vi^V itfrj Avhvo VkAiNJam dkaSoJ&tt ^ WvjMlAD # cauXjjAj^ U^t \Xa W0D2O2 HARTOLDMON0021774 KXMJtta ^ ^s i\W "" uMA\ ^ama Amu^ WuX u. hkmm^ b^A} cxaev m^sMhym Wj^Jaa Wj ' PwM y) YVtwj*uA ' ^ohj^WJ <T X^iWA % W^dxuA l\ rvM'ya/Ci A!1 A>aU f (JL&jbjX lu\ Aju&jA l\^ w SSSTfeMW fk. k Cvaa\5vMJ^ W vx^H^ll - V*w w haJ>Ar Jy&M* cJt'UaMMAW^ ^=UM . yseA .Oct VoVt 1. \VXm`A tout*. S-. .kkJi - ^AMA . ""1 /Nf\M&X JoJ^Wa Vjl ^ S>P ^> - ^ Q)cx- dJU^UMM, WtAA; ^ a^se^ ~------------ KeW^m, . . ^ ***** vteas V* !*&&** '^*- kUftitttU . 00203 HARTOLDMON0021775 6560 FANNIN, SUITE 1 426 HOUSTON. TEXAS 77030 PAGE TWO 3-23-87 AGE: ' BEN COOPER, M.D., P.A. Neurological Consultation 6S60 FANNIN, SUITE 1426 HOUSTON.TEXAS 77030 TELCRHONC (71 31 787-1 180 67 SCTT' TMAVIS C- <7 I 3) 797-! W W&o ^UJJjaA UMAjl. )^^!Ujwlaa^ Va> AaXa 4juso Ymm. - cW4&^ ANL ^ VSij.'SSjlul 'YWj^AJMA^^Uv WimmAiM | XNU&WVfc rmjA \*ifc V/Ut& Vi l|v^XkAM ^ Yt ViK^lkuV.VA wA fesV^^A' <& *&*** U ^So foW c^\ * W T* vma^jjuhA wajAa! sWk `UtA hm aW^. WV^l - Awxl*yLAAJWJ(*UJ^ Yja Vuo |A3i^ bx W cfjA&AaUifi- <xum <mwa^ NaN AvaM. ftiSAAvJlS^ W>huSA vW^t V^o. Vj5 Mm**. awjlja\ju *k)r VmlA^u Vu^jJ^a^4, i(N Pf lA<Uft ,vi AJUMjuJ^jiA '\\wUJAAAu VAJOJ^Vsi^Uu 'AAXXHMjq5i7 W-<^pA Awn ' W iMte. UteAtW. W nlNl* nl> 00201 /xvwk Ay^U Vn ^V\^cud>AUMUM ^ lU^w HARTOLDMON0021776 V YuVi-*) OU Y& ^ mhv& cV&itA XkaK v V&A W V*JA a - 'Hux^aAu j3mm. * \Vl A ]*U W1 ' ^` NU O&-iXlMlllAi V_sx^x. VI a. x. ). _^e, -IAM AJL j An&jAs. - Am. \XMD \ AmVuVs^o x>Aa x Y'NmaA uJt \^\lA 4AJ^ <v >MiS k Ct AuOf -qAaiMOW - \\e- 4JEk'*tA \vmmi umaAa, "wa IkJll Vb-UA^ %AUA VwJl'' J^vauA^i^jJvA^ ^o-mawjuuA W U 'Jhfe- ao(s'o l*J CL+4.S "" ^ ^P -H-' tfW ^ ^j _ T- ^ 'tv "v %/ i\iJ V--\ ^ 00205 HARTOLDMON0021777 6560 FANNIN, SUITE 1 426 HOUSTON, TEXAS 77030 BEN COOPER, M.D., P.A. NEUROLOGICAL CONSULTATION 6S0O FANNIN. SUITE 1420 HOUSTON. TEXAS 77030 Telephone (713) 797-1 iso (713) 797-1 180 Hoiu. H ' .AsUluX1 AAV-V w. Ajw, ^uV\VuUAsk, uwuwuaamI . W: Hii W\wL MVu VA. - Vjl. Ws VaXWjJwMM VWiUj^^ - XmjxU dl>--uA. - ^Iw. ^ \ \ X -* Wa, 5" j> '. \4NiftcJUsiiX (A V**^ v ^^ > ^ ^amj^juunA ^Jux^adi^ ' lUA/lXlu^i Huo UA*AM4 ^ Vo^vJ^, c5UaM- ^ V^Sa vj.a, 0020U HARTOLDMON0021778