Document bqrZmY71M64wwVjK5V09R1oD

March 19*1956 Dr. w. E. Ofcetz The Industrial Commission Columbus Ohio Dear Dr. Obetzi I am enclosing herewith a series of reports and extracts of reports of examinations made on James Hamblin* who has been under mgr observation for a period of several months. The illness of Mr.m has been an unusual one and it is not easy to dot mine its precise nature* By reason of my interest in the problem presented, and also because I have wished to clarify the diagnosis and to do something for this man* I have recommended hospitalizQjtion and consiiltation advice. But for his having been sent to me, the case would certainly have been diagnosed finally, as lead poisoning* and he would have been compensated on that basis. Accordingly I have considerable hesitancy in arfivlmi^Jb an opinion which may have the effect of depriving MrPIHr:!of compensation# I may also point out that the hospTtaTand medical expense would have been borne by the Commission if it had been incurred after their acceptance of'the case as one of lead intoxication. Since this would have occurred but for my intervention* so to speak* it is my feeling that this man should be given the benefit of any doubt which may exist in the minds of the Gomission* Moreover* it vjould appear that the hospital bill and the consultation fees constitute an equitable charge for services rendered to the Commission* if they can be allowed legally. In suggesting the allowance of such awards, I must disclaim any interest in compensation either for myself or for the services rendered by this laboratory, since what we have done has been in the line of our investigative Interests. The hospital expense* on the other hand* which was incurred on ay recommendation* and which was necessary in arriving at a conclusion from the point of view of lead absorption* is a matter of some diffi culty. Very truly yours* RAKjis Robert A. Kshoe, m.d . March 19*1936 Dr. if, B* Gfesfcs Tbs Industrial Commission Columbus Ohio Pear' ter# Gbefca* I am enclosing herewith a series of aborts anti extracts of reports of examinations sad on who has been 'under my observation for a period of several souths*. ' *The illness of HHv has been an unusual one and it ia not easy to oofiSIbo its precise nature* By reason of my interest in the. problem presented* and also because I have niched to clarify the diagnosis and to do something for this man* I have recommended hospitalisation and consultation advice* But for his having- been sent to me* the oas would certainly have been diagnosed finally as lead poisoning* and he would have been compensated on that basis, Accordingly 2' have' considerable "hesitancy in arriving: at. an .opinion, which say .have the effect of depriving hr. Hamblin of compensation. I may also point out that the hospital and medical expense would have been borne by the Commission if it had been incurred after their acceptance of. tb cate as one Of lead intoxication* Sine this would have occurred but for my intervention* so to speak* it is my feeling that this man should, be given th benefit of any doubt which may exist in the minds of the Gomlssion* Moreover* it could appear that the hospital bill and the consultation fees constitute an equitable charge for services rendered to the CcBtsisslon* if they can be allowed legally* In suggesting the allowance of such awards, I must disclaim any interest in compensation cither for myself or for the services rendered by this laboratory* since what have don has been in the line of our investigative interests. 2he hospital expense* on the other hand* *?hich was iticurred on fey rooossaendn ti on * and which was necessary in arriving at a conclusion from the point of view of lead absorption* is a matter of some diffi culty* Very truly yours* RAK *Is Robert"'A. k.ohoo* "'M.iD* 00166>1 Date off this Reports larch 19, 193$ 0 D* 12,907 AgOf 2? Patlout became ill on October 21at,1925* and-was-sent to hospital October 22nd, at night, restsIning there until October 25th, vis seen at Kettering .Laboratory November lth at -which time 'the examination sis described In the appended sheets as made* He ms aeon again on RovomP cr 15th* at which time the clinical picture as essentially unchanged* Son Improvement began to take place shortly after this, and ho was seen frequently in varying states of slow Improvement over a period of weeks until he, was sent to the Good Samaritan Hospital for further study on December 28th, 1925* During this ambulatory period and during the subsequent stay in the hospital, the lead excretion was watched, both under normal conditions and under various types of therapy designed to promote lead excretion. In all 21 urine samples and 16 fecal samples sore examined* At no time wore abnormal quantities of lead found in the oxcreta or blood, Varivus consultants have rendered opinions and have prescribed treatment, as noted on the appended reports. In order to "foam a judgment as to the potential magnitude of the lead caposur experienced by the patlout, the plant In which he was working at tho onset of hlo Illness was visited and subjected to detailed examination. Among the pertinent facts established by the examination, the following arc of greatest Importance, {1} The men engaged in the 3SE8 work as Hamblin, had been employed as long or longer than ho, and had experienced no symptoms, and gave no clinical evidence of significant lead absorption, (2) An air lino mask ventilating system used by this group of men was in good working order and was so designed as to prevent the possibility of significant contamination of the air supply with lead dusts, (3) The general hygienic conditions of the plant or such as to safeguard the men against the more savor types of lead exposure, (4) Routine blood examinations on the,men, checked in this laboratory, failed to Indicate the existence of significant lead essposu.ro,' Biaeageloti off - Ouse- The syzapbps&telogy at the onset, and the physical findings at the Initial examination were not convincing evidence of lead Intoxication, In the absence of blood changes, end with the acute onset- and the neuro logical findings, it as necessary to postulate the absorption of considerable quantities of.lead,.If- the latter were the causative factor, Th lack-of evidence of significant exposure, and the failure to find an abnormal load excretion, disprove the occurrence of any considerable lead absorption, (Attention is called to the fact that th blood and urinary lead were analysed on Ilovembef ipth only 2 weeks after the onset of illness and tho cos sat ? on of the exposure. In Our experience tho blood, and urine levels remain elevated for weeks or months after the cessation of severe expoaur5 0016602 N19382.01 2-- , -- 5-19-1936 On the other hand the patient maintained an elevated temperature over a period of weeks, and gave other evidences of an infectious pros so in the upper respiratory fc raofe* existence of an e&Mioi&lfcis (doe report of consultant) during the last ported in the hospital, fits Into this pattern* The present absence of organic neurolo leal involvement (see report of consultant) provides little aid In differential diagnosis, sine on acute intoxication 7 ' 30 On tho whole, however, I believe the Illness Is best r an infectious prepehsj# wlfesn bne6ri*',',<''*Ul'* ~**J 1 *Jrl|gtipff this' ,prpp6ss 5 up without significant control i Robert A* Kehoo, M*I>* HE 0016603