Document jNQJpYxZZKdjvoYdGZRYa7LJ5

0 !>:??!a5 ,:<lb4' E, ?lst, Street# , Cleveland, Ohio ':0^1tti;cas February 3$ 1344 V : n opinion as to the nature of this claimant* illness in August of must rest upon th -statements of Dr. Jer-oa Gross. In the absence of a satisfactory record of Dr. Grose1 examination!, the statement chat the patient when examined had ''abdominal colic vomiting, constipation, impairment of grip, load line# stippling of BSCs in smear,, must be accepted by this reviewer a true, unless it an be discredited 'by .evidence to the contrary, ao' such evidence ` i3 available., inasmuch as there is.no information obtained fycm other- examinations during this period. By the time- of Dr. baryks epa . mlnation on November 3, there had been ample tits for the disap- 'ic-ar-Enca of symptaes or signs of plumb iem. Granting the occurrenoe of illness as describe,' the only basis In the record for differential diagnosis is found in tho ovMeneb'for or against the significance of this jaan,3 lead' exposure. %tm shortness of the claimant *s exposure to lead is the only valid reason for question.' This must not c taken tco seriously in view of the manifest potential hazard of th manufacture of storage battx*ieo* Ih stippling of th erythrocytes {on our count- there were, about 43 erythrocytes per 5-s mteroBcoplc fields) *. while not .-reviding proof, ftugf.est# that- there was ` significant lead exposure. Moreover the analytical'data obtained by Dr. uaarol would s&m to Indicate that'there had been significant load exposure. Th report on the analyses from Dr. Gross# office is not very convincing- by reason of the statement that O'.03 (no volume or weight relationship given) la normal. If Dr. H&nzol obtains such figures on normal persons,.his' method of analysis is not sufficiently precise, or else ho ia not taking proper precautions against th eoatealnatlon of blood samples at some, point * The mean value of normal results on th whole blood, by th most sensitive methods of analysis available ia about u.u3 mg. per ld.> grams, while- th highest normal value doe not exceed 0*o6* Only in the rarest instance do normal values g beyond >.0p rag, per.10 d grams* This appears to represent & certain care lessness in Dr. Gross1 report, rather than Dr. r;snsol*s (th. 1stter*a report is not in'the: record) since th seme report (as well as the fee'bill), gives the inforiaati^aa on, the urine as follows# ^Jrine load J.S3 normal '3.3* again ,without referenceto any weight, or volume relation sad that the norm.il value vaa .intended ce-fce -*.b3 mg. per liter, since the latter in the average or vs&en nonaal value. Actually, any valhe up to .;.J jag* per liter njay lo regarded a within the norstal range in vhc ease of camples of one liter or acre its volume* All Is 4X1, this* rcTiort desonatrates s-uoh s&poXessncsa in dealing with ttijbse important ua pertinent fee ms As to Jocufy cne*3 serious al5^pt1ii<?lsi?i as to the < : curacy of other oeservncipne said atatea'.e iia'ihl t44t Of the record cdafcrihUtotl1 by Dy* Gross. A letter of Dr. Andrews, da loti Deeessfcor 33, 1143, states that analyses on the blood and arise made on September 23, gave inoswi results, to which By* Fuxysek replied, that the bleed [level mfe Slightly shove normal** ihi reviewer'Is sot able to consider t^ife significance of tnis xebsng of ccru spendease, since the , analytical results, their source, and the date of sampling are not given* Gcnelusfmt Hie diagnosis rests primarily on ifc opinion of Dr* Gross* litis opinion is not too veil support a, but it is not discredited &s a natter of record I'harefor, on the record, the reviewer admits doubt, out accepts the opinion for lack of contrary eul&eape. $h examination of rru i'arysek .justifies the conclusion Usat the claimant has no present dieability. HE 0016788