Document kpj5kypGw42DYnqpnYjmjKeO

Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 1 of 11 PAGEID #: 60411 EXHIBIT F Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 2 of 11 PAGEID #: 60412 IN THE UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF OHIO EASTERN DIVISION IN RE: E.I. DU PONT DE NEMOURS AND COMPANY C-8 PERSONAL INJURY LITIGATION CASE NO. 2:13-MD-2433 JUDGE EDMUND A. SARGUS, JR. MAGISTRATE JUDGE ELIZABETH P. DEAVERS This document relates to: John M. W olf v. E. I. du Pont de Nem ours and Company. Case No. 2;14-cv-Q95. DECLAR ATIO N OF RO BERT J. H ERCEG , M B I, Robert J. Herceg, declare and state as follows: 1. I prepared the Expert Report o f Robert X Herceg, M D, dated December 8,2014 ("Expert Report") and a true and accurate copy is attached as Exhibit 1. 2. Each o f the opinions in the Expert Report is stated to a reasonable degree o f medical and scientific certainty, and was arrived at using reliable methods. 3. If called as a witness, I would testify competently to the matters stated in the Expert Report. Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 3 of 11 PAGEID #: 60413 EXHIBIT 1 EXPERT REPORT IN John M. Wolf v. E. I. du Pont de Nemours and Company C. A. No. 2:14-0545 (S.D. W.Va.) Robert J. Herceg, M.D. December 8, 2014 Prepared for: Plaintiffs' Steering Committee In Re: E. I. du Pont de Nemours and Company C-8 Personal Injury Litigation Case No. 2:13-MD-2433 (S.D. Ohio) R obert J. Herceg, M.D. Cam den-Clark M emorial Hospital D epartm ent of Pathology 800 G arfield Avenue Parkersburg, W V 26101 Ph: (304) 424-2218 Fax: (304) 424-2716 1 CONFIDENTIAL SUBJECT TO MDL PROTECTIVE ORDER Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 4 of 11 PAGEID #: 60414 Background and Experience I am a partner in the Parkersburg Pathology Services, PLLC group in Parkersburg, West Virginia. 1am a board-certified pathologist with a certification in Anatomic & Clinical Pathology with over 15 years of experience. I received my Bachelor of Science degree from the University of Chicago and a Doctor of Medicine degree from the University of Chicago Pritzker School of Medicine. I completed an internship and residency at Northwestern University Hospital. I completed a fellowship in pathology at Northwestern University. I am licensed to practice medicine in West Virginia. 1 currently provide pathology services at Camden-Clark Medical Center, Parkersburg, West Virginia. I am a member of the College of American Pathologists and participate in continuing medical education with this organization. 1 have clinically examined thousands of tissue samples, pathology slides, and biopsies, including individuals with inflammatory bowel disease and more specifically ulcerative colitis. 1 would estimate I see 2-3 cases of ulcerative colitis every month on average. Many of these are repeat patients, as patients with this condition undergo frequent monitoring to evaluate treatment effects and for surveillance of colon cancer. Please find my curriculum vitae attached to this report as Attachment A. Prior Testimony I have provided no other testimony as an expert at trial or deposition during the last four years. C om pensation My current fees include $250.00 per hour for record review, report preparation and conferences; $250.00 per hour for depositions; and court appearance fees of $1,000 for a full day or $500 for a half day. M ethodology I was asked to opine as to whether Mr. Wolf presented with ulcerative colitis during the dates of my pathology examinations. To answer this charge, 1 have reviewed the relevant medical records associated with my original reports including those made by myself and Dr. Singh. In forming my opinions, I have utilized the standard methodology of my practice as a pathologist, which includes conducting a differential diagnosis. Sum m ary of Opinions After my review of the relevant materials, including my original reports, I offer the following opinions to a reasonable degree of medical and scientific certainty: 2 Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 5 of 11 PAGEID #: 60415 9 Mr. Wolf suffers from ulcerative colitis. Jo h n W olf's M edical History Mr. Wolf initially saw gastroenterologist Dr. Anil Singh, on June 15. 2012, presenting for a screening colonoscopy.1 A colonoscopy was scheduled for August 28, 2012. Mr. Wolfs pre procedure diagnosis was "Screening" and his post-procedure diagnosis was "Normal Colonoscopy." In the description of procedure, Dr. Singh noted that "the patient has mild ulcerative colitis throughout the colon. The patient did have some area of sparing of the colon in the rectum and sigmoid colon. Ulceration was superficial and was consistent with ulcerative colitis. Biopsies taken from ascending colon and sigmoid colon. The patient had no involvement of terminal ileum." I personally examined the biopsies and prepared the Surgical Pathology Report from Mr. W olfs August 28, 2012, colonoscopy. Based on my medical examination and expertise, I noted at that time: "Ascending colon biopsy: colonic mucosa with chronic inflammation and diffuse acute inflammation including acute cryptitis" and "sigmoid colon biopsy: colonic mucosa with chronic inflammation and diffuse acute inflammation including acute cryptitis." Furthermore, I observed: "The colon biopsies show chronic colitis with diffuse somewhat superficial activity. Additionally there is a prominent eosinophilic infiltrate. The differential diagnosis includes severe acute self-limiting colitis and inflammatory bowel disease (particularly ulcerative colitis). Please correlate with clinical and colonoscopic findings. No dysplasia is seen." I made this differential diagnosis using the method which is a standard and accepted practice for pathologists and in my specialty. Mr. Wolf presented for his second colonoscopy on March 28, 2013. Pre-procedure diagnosis was "follow up ulcerative colitis" and post-procedure diagnosis was "ulcerative colitis." In his procedure report Dr. Singh noted that the colonoscope was "advanced up to the cecum. Cecum is identified by usual landmarks. The patient had ulcerative colitis. No active ulcerations were noted. Biopsy taken from the sigmoid colon for biopsy. Rest of exam is unremarkable." As with the August 28, 2012 colonoscopy, 1 personally examined the biopsies and surgical slides and prepared the surgical pathology report from Mr. Wolfs March 28, 2013 colonoscopy. 1 noted at that time: "sigmoid colon biopsy: colonic mucosa with no significant pathologic changes." Discussion of Differential Diagnosis In performing a differential diagnosis, I look for specific patterns of inflammation-- whether it is diffuse or patchy, whether it is superficial or deep, whether associated with granulomas or necrosis, and which portions of the colon are involved (this last information is usually provided by the endoscopist). Different disease entities tend to have distinct inflammatory patterns, although there is sometimes overlap. The endoscopist's impression is 1Medical Records ofJohn Wolf. [Singh (02015666) 000007 - 000022; 666538-11GTMD-00001 - 00151; 66653817GTMD-00001 - 12; 666538-6PCA-00001 - 10] 3 Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 6 of 11 PAGEID #: 60416 always valuable for the global inflammatory pattern, which might not be apparent front a few small biopsies. Based on my clinical practice and extensive experience, ulcerative colitis is usually distinguishable from Crohn's disease, Ulcerative colitis is properly diagnosed by colonoscopy, with associated visualization of the colonic mucosa, and sampling of the tissue with biopsy specimens, which are interpreted by a pathologist, Proper diagnostic studies, as were performed in Mr. W olfs case, can easily distinguish other conditions front ulcerative colitis. This method is a standard and accepted practice for pathologists and in my specialty and I contemporaneously performed it at the time of my medical examinations in the present case. Based on this differential diagnosis process. I concluded on August 28, 2012 that Mr. Wolf was presenting with ulcerative colitis. Conclusions and Summary Ulcerative colitis is a chronic inflammatory disease of the gastrointestinal tract that affects the large intestine, Through my personal medical examination of the sigmoid colon biopsy, I made a diagnosis of ulcerative colitis. This diagnosis was contemporaneously documented by my report dated August 28,2012. Based on Mr. W olfs relevant medical records, my personal examination of the pathology on August 28, 2012 and March 28, 2013, my contemporaneously performed differential diagnosis, and all documents reviewed in preparation of my report, I stand by my original diagnosis and conclude to a reasonable degree of medical certainty that Mr. Wolf suffers from ulcerative colitis.I I reserve the right to amend or modify this report as further information may become available. Dr. Robert J, Herceg, M,D, 4 Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 7 of 11 PAGEID #: 60417 ATTACHMENT A Curriculum Vitae Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 8 of 11 PAGEID #: 60418 CAMDEN-CLARK MEMORIAL HOSPITAL DEPARTMENT OP PATHOLOGY 800 G A R F I E L D A V E N U E < P A R K E R S B U R G , WV 26101 ( 3 0 4 ) 4 2 4 - 2 2 1 8 ( W) ( 3 0 4 ) 4 2 4 - 2 7 16 ( P A X) HEHCEG@PO L.NET 1998 - 2000 St Joseph's Hospital 2000 - present Camden-Ctark Memorial Hospital Associate Pathologis! Parkersburg, WV Parkersburg, WV ? STGRADUATE TRAINING..... 1992- 1997 Northwestern University McGaw Medical Center Chicago, IL Resident in Pathology (APjCP) Chief Resident, 1996 - 1997 Credentialing (fifth) year in Cytology and Surgical Pathology * Certified by American Board o f Pathology (AP/CP, May 1998) EDUCATION 1988 - 1992 University o f Chicago Doctor o fMedicine k J, Harris Ward Fellowship 1984 - 1988 University o f Chicago BachelorofScience in Biological Chemistry Graduation with General Honors Argon ne Scholarship h National Merit Scholarship Chicago, IL Chicago, IL CITIZENSHIP AND LICENSES ...................................... United States Citizen Licensed Physician and Surgeon in West Virginia PROFESSIONAL MEMBERSHIPS________________________ u________________ American Society of Clinical Pathologists (Fellow) College o f American Pathologists (Fellow) West Virginia State Medical Association Parkersburg Academy o f Medicine This fax was received by GFI FaxMakerfax server. For more information, visit: http://www.gfi.com Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 9 of 11 PAGEID #: 60419 a d d i t i o n a l p r o f e s s i o n a l a c t i v it i e s ________________________________________ _____________ . ThinPcep Interpretation Training Seminar, 1999 _______________ _____ Gftp [ ?N\ramiy4 a speirtQr 'P aining Seminar, ?QQ Q --------------------------------- PUBLICATIO NS, ABSTRACTS AND PRESENTATIO N S............ ............... ........ ......_........... ............... _ Herceg, R. J., Nayar, R. and Frias, D. V. S , Cytomorphologic Appearance of Follicular Dendritic-cell Tumor: A Case Report. Diagn Cylopathol 20: 237-240,1999- Herceg, R, J. and Peterson, L. R , Normal Flora in Health and Disease. In: Shulman, S. T., Phair, j. P., Peterson, L. R., Warren, J. R-, eds. Tbs Biobgk and CHnical Basis of Infections Diseases. 5th ed. Philadelphia: W. B. Saunders Co., 1997 Herceg, R. J-, "L o c a te d Endometrial Proliferations o f Pregnancy." Presented at: Illinois Registry o f Anatomic Pathology, Chicago, Illinois, November 1996. R EFER EN C ES...................................................................................................................................................................... Denise V. S. De Frias, M.D. Professor o f Pathology and Obstetrics & Gynecology Director, Cytology Laboratory Northwestern Memorial Hospital 251 E. Huron St. Chicago, IL 60611 Tel: (312) 908-8090 M- Sambasiva Rao, M.D. ProFessor o f Pathology* Director, Surgical Pathology Laboratory Northwestern Memorial Hospital 251 E. Huron St. Chicago, IL 60611 Tel: (312) 926-2446 This fax was received by GFI FaxMaker fax server. For more information, visit: http://www.gfi.com Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 10 of 11 PAGEID #: 60420 ATTACHMENT B List of Docum ents Relied On, Reviewed and/or Considered Case: 2:13-md-02433-EAS-EPD Doc #: 3441-6 Filed: 05/15/15 Page: 11 of 11 PAGEID #: 60421 M aterials Relied On, Reviewed and/or Considered by Expert Robert J. Herceg A ll materials referenced and/or discussed within the report are incorporated. In addition to the materials within the report, the other materials relied on, reviewed, and/or considered in the preparation of the expert report are as follows: D ocum ents John W olf medical records, Anil Singh, Bates No. Singh (02015666) 000007 - 000022