Document gbVrRb3eknNKxR1z1nx2mbX99

J. W. BEALL, CHAIRMAN 1 WILL T. BLAKE CLARENCE H. KNISI.EY -- A. d . c a o d e l l . s e c r e t a r y Wo r k me n 's c o mp e n s a t io n fHE INDUSTRIAL COMMISSION OF OHIO MEDICAL. SECTION COLUMBUS DR. SIDNEY MCCURDY, Su p e r v is o r o p Me d ic a l s e c t io h Dr. R. A. Kehoe University of Cincinnati College of Medicine Cincinnati, Ohio 2-15-40 Claim No. .0U.,14.4.5i. NAME, ADDRES S__12Q2..Lakas.i.da.Ay.a*.._ - .AJbr.03a,...Qh.iQ. Dear Doctor:-- We are referring the above claimant to you for...ejeBmina.tiao...tn..de.'terinine the alaimat!^...presmL-h.nondi.tAon..&..3shether,.OE..not..same,,is..attEihuted..to..lead..pQisoning which, clt. allegedly .contracted on 1^18-37.......................................................................... You may notify the claimant at the address given above when to appear at your office for this purpose. We are enclosing, herewith.... S8py..9f..wedic.al._Eeport........................................... which will give you a history of the case, as shown by our files. Kindly send your report in TRIPLICATE, together with your fee bill, direct to the Medical Section, as soon as possible. The extra form enclosed is for your files. In preparing your report, please use the following subheadings in the order given:-- (1.) HISTORY--of injury and treatment, past medical history, pre vious injuries, family history (if applicable). (2.) PATIENTS COMPLAINTS--describe in detail even if they have no apparent connection with the injury. (3.) EXAMINATION--include all objective findings, clinical, lab oratory and X-ray. (4.) DISCUSSION--summary and treatment indicated. (5.) OPINION--extent of disability (total or partial). If total how soon will he be able to work. If partial, estimate degree on percentage basis if possible. Use the Form (C-lll)enclosed and continue your report on the re verse if necessary. Very truly yours, DR. SIDNEY McCURDY, Supervisor of Medical Section. IN REPLYING, ALWAYS GIVE CLAIM NUMBER. NOTIFY THE CHIEF IF YOUR INQUIRIES ARE NOT ANSWERED WITHIN TEN DAYS. 'r8KX., C'*P 14451 .MJfc irfcesloe Ave., f'iCTzn, Chi. J^ ( - .' V: ' C^^crcis 1 printing: & I4.tho.Co, 5 `- ' -.4 ' January 5, 1940 REPO R T / - -: Claimant alleges lead poisoning* However, - after reviewing file, it is questionable if claimant had lead poisoning in view of nature of her employment, namely a press feed operator; in any event, exposure must have been uildv . Dr, Jenkins (apparently.Company physician) diagnosed "anemia, secondary type; neurasthenia accompanying menopause," Dr. ?. A, Davis examined claimant on Kerch 12 > ana 17,' 1937, shortly after inception of disease* He found a slight mitral murmur (compensation good),' B.P. 150/70, no ai*e/.ia, some leucocytosis and 2$ stippling; .urine showed a trace of albumen and many bacteria,: but iio lead. He was of opinion that claimant had'amildcase of; chronic lead absorp tion. V'''' /' She was examihed:recently(September 9/-i - 1939) by Dr. A, P. Ormond who found some cardiac pathology, definite arteriosclerosis, hypertension, B.P. 220/110, no anemia, some leucocytosis (10,530); and a trace of albumen in urine; also a neurosis. He attributes condition to lead poisoning and was of opinion claimant was totallyvand. permanently disabled due to secondary effects of lead poisoning. COMMENT: - vh . ' iK - It would seem that there should,be vey little residuals present from any possible mild exposure-to lead that claimant had at this late date, i some? two and one- half years after inception of disease, . * KX i mV ' < OPINION: ' ' ' / ` . 'v Recommend that claimant be sent to Dr* R, A. Kehoe, associate professor of Physiology, University of Cincinnati, Medical School, pin outstanding authority on lead poisoning, for hospitalization, observation, consultation, review of entire file, etc., for opinion as to present con dition, relation to lead poisoning and degree of disability - IduXto samef;-''',' ', y :' Respect'a"J.ly. submitted. v. V--' M 0016667 N19412.01  January 5, 1940 . *' - REPORT - . J ;* * \ Olaiasaat alleges'lead poisoning. However, "after reviewing file, -it is questionable if claimant had lead poisoning in view of nature of tier e.spicy:ient, namely a press feed operatorj.in any event, exposure must have been mild* ' * " , Dr/''3'cnisiiis (apparently^Company physician) diagnosed "anemia,' secondary type? neurasthenia accompanying menopause.* Dr. IV A;\ Davis examined claimant. on Kerch 12 and-17;' 1937,. Shortly after`inception of disease. He found a - slight mitral murmur (compensation good), E.P. 150/70, no anemia/ sons leucocytosis and %tf> stAppling; urine showed a ` `` ,rtrac` of' albumen arid cany bacteria, but no lead, Ee was of J.'.sr opinion, that claimant had' a mild case of chronic lead absorp- tion.y '! w' She was examined recently (September 29, 1939) by Dr. A. P. Ormond who found some cardiac pathology, definite arteriosclerosis, hypertension, B.P. 220/110, no , anemia, . eoBie leucocytosis (10, 550); and a trace of albumen in i V= urine; also a neurosis. Ee attributes condition to lead poisoning and was of opinion claimant was totally ana permanently disabled due to secondary effects of lead poisoning. CGJ&fcSKT.: '.vV-y'' It; would sees that there ishhuid be very little residuals present from any possible;mildiexposure to lead that claimant had at this late date, 1 some, tvfo and one- half years after inception of disease. y.-s.-V . OPIHIQNs - J, ,'f- \.i if- /.> 1 -`'ii':'-.,-- Recommend that claimant be sent to Dr* R. A.' ;.-Kehoa, associate professor of Physiology, University of T' Cincinnati, Medical School, an outstanding authority on lead /poisoning, for hospitalization, observation, consultation, preview of entire file, etc., for opinion as to present con dition, relation to lead poisoning' and degree of disability -.due to same. Respectfully submitted. Sidney AicCardy, k.D. v 'v . '-.""t .* mmiii t.; . r-; >- 'K:Ky:-;vK-' kf ff.:' vf'.-v ` ,.K. 0016668 * k. -- x KQS&z'iiiW-^' 4'V m^ .......... SPECIALIST'S REPORT Address, Bate of Examination MfU*.Ch..10*..2.9.40..------------------- ------------Age ....... r v .47------- --------------------------- NOTE: Submit report under following headings: (1) History. (2) Complaints. (3) Examination. r including X-ray and laboratory work. (4) Discussion. (5) Opinion. Mail THREE copies to the MEDICAL SECTION--Retain one for your file. HISTORY CC* "Bhrting Id . eld and neuritis** P, I, M October 1936 noticed swelling In knees ana logs and pain la said* afeteen aggravated by pressure of wfedboardn In printing machine. There wop sorted shortness of breath* "blueness* of lips* frequent headache and nausea without vertigo, saves* constipation* and epigastric pain with waiting after meals* At this time* also* there was- pain in the back and eh b and trawling down left log* Stiffness in hands was noted* particularly in A*i! ^as seen by physician who expressed ih opinion that her condition was lead poisoning* All symptoms have persisted to varying"' degree sine 1937 with the exception .of yomlting which now occurs- only' at. r*r intervals * norm in past 5-4 months* For the past' few months hands, have been stiff and weak With numbness of 'tips of fingers so' that it' has - been difficult to pick up and bold small objects* Peripheral circulation noticeably poor in winter with coldness of xtrealties* Sternal -pain has bees sever# past 7-8 months*' occasionally radiating to right cte- t - never to shouldte or arms* - v %M.K* No other illness - la 1936 suffered severe injury to hoed and back in fall down Stepp - hospital 1 week - .home 3 weeks - returned to work in 1 nonth* - ?*H* ItWllW^b nr ' ` ,. 4, -.. v--. )ccup School tlU 14* she sorter in factory'tilf;;IS'.' uiudry till 17* housewife 3 years* hoX boscing*work in Shoe factory till. 18, Printing prose "' operator off -ted on since, j . .-y - Lead 10-12 years in print hop - lead was melted at" end of room where presses"''' exp* war located and deposits of dust wore noticeable on machines* ventilation was poor* ,. Hoj other workers in *10 years period ever had plushlsm though `their work was -ouch nearer to source of exposure* -* . i.R* negative for ?*x* >2* Appetite li* only since P,I* - metallic taste' In'mouth for about 1 year after ns yet* 'dion# frequent - *5c * Headache read* *9* Bycturl *H Onset 13 misearr sensation*:1 let Mainly ve, or eloofap! .**.. **-* * Locs not think sencation .of taste-has returned to normal ICh severe past few years - hemorrhoid in that time wither' _ ! `' - " 1' > f . .';V Softer wakons at night with wpliting* pain. Glasses to 3 in head at times when patient become nervous* Lar 28 days since except for 3 pregnancies (all term}, Ho January and Feb* 1940 flow ws unusually groat* Bearing dofra |it|ir|!,^f#w otontha*.... - i21 d, - 1*-gla^ss. m^ i**l k***d***-l~iy*-**---* *** mips aefffl ds W-* ------ K 0016669 OTE* including X-ray and laboratory work. (4) Discursion. (5) Opinion. Mail THREE copies to the MEDICAL SECTION--Retain one for your file. HISTORY ;-v .v . p~mell, "sorting , ,# , In October 1936 noticed swelling in knees ana lags arripainin^Idw " aMossett gg#ited W of *feed!Jara,,'. s printing Ibm 1 d!^rtb*Is of breel^h, of V'.-3fc $Sf5g$i!$ ip'q; v|5S(i!a he^t **S traveling deft Vftt .U&i-:. tiffns| in:fsgS$ was iifii in iuf#, .Van seen by.physician. *ho s^resw toe ^ Lr lead P?lontn?ji<AUf^taSgbS5P^l.^uto.*|i TFltiLJSX.'tfStftgirate ifatsrwut* >' (h* i pft 3H..n..o..n.&..t.yo.t.*f..".t.i.p# ,jdf' ' fingers e TM ' lift winter to _ or arms* ,v: i- * \ jjjjv--1* ?,v,B. i:$fpr .pness * w 1956 'suffered isevere ->B dTOwTriO.nliDttr.nnf- oec*p* 1 wok * jbon 8 w*mm r.cnt.h. ^^ &,,,*.*J *v in factory`'tilt:15'. Laundry-till 3?|;jtai!*ife *<* " factory MIX 18. ^lifting -r - -^`v 0px#sor fMind on alnoe, * ........ . Load -. 10l year' in print shop - lead, was melted at end of rooe* whcr prater, xp# vre located and deposits of duet were noticeable on machines, ventilation wa*rir* ,`K other workers inJftD years period over had plumbic though ^thWS work i adch nearer to source of ensure# iJ * >**' '-< CR* ^gaiisre- soddfe for - R* I* . V - ;f ; ' " ; G*X*., Appepite. fi|r' np|r. nine R* 2;: - metallic. taste inisouth for about 1 year siftef onwfe: %mi Doe not think sensation.of taste has reamed to normal , yet,' Constipation severe past tm years - hoaorrhoide in that timewith -* - v frequent bleeding, '. ' . ' N.S, Bea^che after wakens ' at night: with deputing ""pain,'; Glasses to,,- read. Pull feeing in head at tine when patient become nerewis, o,tr, Hyeturia 2-3 *4.^. - - M*H, Onset 13, reJtlsr :^3 days since except for 3 pregnancies Call term), Bo miWcerriage^rfirKiary and'fob* 1940 floe w|s unusually great* Bearing dopn sensations.,sact fearmonths* -*-* *, ^ >:j- Piet Maihly vegetables ?;1 glass milk daily - 3 cups cofi^e dally. Bo tobacco or pKebolJ^:^ 1 ;f " V4""'`5^ - - - dbits-Bleep is restless - frequent bad dreams - Insomnia frequent, nt&l-Cop#ratlw - well balanced History apparently reliable. V'W'-;-/, t=-- ? : Physical SUa^lnatlon / IStiai-teSi& * >&&< _____ . ...... _, ' ______ _ eiisnjiy beajsoailtea ^IQ/IOS -abibouarXseorfcy.ecaouoi pooffuatglveo-. not - - X'eisbtiVim'.lM acutely ill, nervous. ISS mIMv S * otherwloo oW,-.heelthy. polo. . Bars negative Tynpani clear, -- : IS KWteB "*2^ * *. now-i. ' r- ernets on both sides, 'mth &g'%$Z8 l8ft 0h"'` at 0001"1 -tetaM. guma ^ ridge. 2SF,*`S8Jf are" 1'>"'' SOft palot9 "^Mrleal and dlBtortBd by .ear. Chest Clear ' '* (Signature of Examiner) k'f (CONTINUE REPORT ON REVERSE OF SHEET--NOTE INSTRUCTIONS) 0016670 (CONTINUE REPORT r>OWN FROM HERE) Heart Tones clear no R#c*D# indetera. bdLcssen Obese * numerous lvls xtress* CflCx* -i 't-S extra , limits* right hypochondrias x#s--hypereti.v* so^o glove parasthoela and distur* '...a- and distal half of hands, ' - pale amborT* lire 'Itmte* Albumin. -t+- giorosooplo - numerous pus sand epithelial colla - sos: columnar pfihslius ., no easts * no erythrocytes# ---v,.. Xtoad' anaiyait* 0*03 ngt per./liter*1 Blood-. E*> 14 ga ~ 8& ; 7!0 4,780,000 ' IBS 11,000-' Poly :1*3 - - stabs , 3* 8 Stippled erythrocytes * none per 80 fields lymph 26*S Koao* 6*8 bead analysis | 0*03 mgs psr 100 gres.; :; Eoain* 1*0 Base* 1*3 Discussion '- J/ *r`"n"in "ilior**is no.evidence of residual damage due to lead absorption* and frost the history thoro is considerable, doubt as to the correctness of . the original diagnosis of lead poisoning* There is a- well' defined athero* -sclerosis* with hypertens!on and circulatory impairment*' There Is no adqua to raceon for attributing the-disability frost; this, condition to -ooov patlonal- illness in the fora of lead intoxication* That'is to say* the - circulatory condition in our opinion is not a residual effect of lead poisoning* Recoattagat&ffl . '''' ; heeds medical attention - history of $ years ago Suggests : period of cardiac doeaspensation* Present slight, enlargement of liver, .-7V hemorrhoids, albuminuria and edema of extremities Indicate low reserve .' at present* The pain in dorsal and lumbar roln* with vague deep pains'1:' wad stiffness of back are consistent with presence of spinal rtbritis77 or 60X30 residual of the injury, sustained 'in 1986* - There is no clinical ,7; evldsno of menopause* The-condition of skin and breasts susd ,the typo; :"v,,r of cells in urine indicate that adequate estrogenic substance is present*- Pcfcicnt is lightsncurotis .ar^,. overemphasises 'her symptoms,! but :the - -f existence of symptoms. is. -not <$^atien@d* Patient should receive treatment* X-ray examination of spine and : proctologic examination are indicated# - ;r-'- The sbascry disturbances of the hands appear to be of circulatory origin and are .associated with low skin temperature and slight cyanosis* k'E 0016671 ,, O.D. 14451 Mrs : 3-10-1940 Complete qllnical examination (consisting of physical examination, \ \ microscopic blood examination (^ed count, white count, differential count, haemoglobin deter mination, count of stippled erythrocytes), urinalysis, lead analysis of urine and lead analysis of blood^ ,* $35 00 n. v \V \ \ K 0016672 $ 35 00 N19412.03