Document rE4qoYvLGNONwJ6xj23Y2Oe7

e t h y l c o r p o r a t io n INTER- OFFICE COREESFONDEN OE to f r om , SUBJECT Dr. W Macule A. J, Baldwin Alleged Leaa Poisoning Case ADDRESS ad d r es s dat e IfelT Toril Eastern Region March 20, j l 9U7 We are attaching hereto the entire file on the above subject case, which includes the following - 1* Cover letter rrom Stu Forbes, 2, Attorney Penrose Hertaler*s letter of March 3.2, i9U7 3c- Statement of Irwin J. Yoder, dated October 21, 191+6, U, The Reading Hospital Operative Record, signed by John Spannuth, dated July 26, 19U6. 5, The Bryn Mawr Hospital Clinical Laboratory Report, signed by Mar; II. Strumia, K,B*, dated July 11, 19U6, 6. Letter to Penna. T. &. F. Mut. Cas. Ins. Co., signed by C. C. Norton of Wilson Adjustment Bureau, dated February 28, 191+7. Very truly yours. ETHYL CORPORATION INTER-OFFICE ^ CORRESPONDENCE W SATE TO Mr./M Taylor f r om ,S. Forbes s u b j e c t Alleged Lead Poisoning Case a d d r e s s New York a d d r e s s Philadelphia DATE March 17, 1947 Attached herewith please find the file con cerning an alleged lead poisoning case forwarded by Mr. Penrose Hertzler, attorney for the Pennsylvania T. & F. Mut. Cas. Ins. Co. This insurance company is handling a suit entered against the St. John's. Cemetery ction with the death of Mr. As you will recall I forwarded a preliminary letter on the above a few days ago. It was my thought that perhaps our Medical department can be of some assistance to Mr. Hertzler. The case, in my opinion, is a little bit silly but nevertheless Attorney Hertzler will probably have to produce an expert opinion on the subject when the case is presented to the referee for hearing. Very truly yours SF:a S. FORBES KB'...00164!.'! N19291.01 PENROSE HERTZLER E. MAC TROUTMAN LAW OFFICES 200 2IAHANTONGO STREET POTTSVILLE, PA. March 12, 1947 Stuart Forbes, Assistant Division Manager Ethyl Corporation 123 South Broad Street Philadelphia 9, Pennsylvania Dear Mr. Forbes; In re '(Dec'd.) vs. St John's Cemetery Company, Inc. It was a pleasure to see you on Monday last in re the above. We are enclosing herewith copy of the statement of the co worker of the claimant's decedent, a copy of the operative find ings given by Dr. John Spannuth under date of July 26, 1946, a copy of the report of Dr. Strumia to Dr. Meharg of July 11, 1946 and a copy of the report of the investigator of February 28, 1947 for the reason that it incorporates the report of Dr. Reinhold and the further report on the condition of the claimant's decedent by Dr. Spannuth subsequent to his discharge from the hospital on June 12, 1946. We appreciate very much the courtesy you extended to us and for your statement that your company will be glad to cooperate and possibly can supply Dr. Kehoe as a witness for us in the event we are unable to rule out the use of Ethyl gasoline and, as we told you, at this date we are not prepared to do so because the operator of the local station sold both Atlantic White and Ethyl gasoline to the Cemetery Association, the latter presum ably for use in the truck operated by the claimant's decedent. PH;MAH Ends. Very truly yo^rs, '/J- / 11 i-Vif / 'Ms' KE 0016414 N19291.02 October 21,* 1846 Irwin. J. Yoder, 17.2 i\. 3rd St., Hamburg, Fa., state I am 59 years of a^e, married ana employed, by St. John's cemetery Co., Inc., Hamburg, la., since April 1', 1845, as an assistant caretaker, whicn consists ci .maintenance of tne four cemeteries they operate, which includes the I reparation of graves, etc. At time I started w ork tne san under whose oinectioh I wcrhihAfeb also prefermad, the' same type of work, was '45S; State' St., Hamburg, Pa. He then was - evidently in a good healthy c one it ispn, ana he'made no complaints. Graves, were prepared by handy Some title, in April 1846 we mowed the grass at the #1 cemetery,.: I using a, power mowth, and Weidenhampier using a hand mower. didtnis in a rustling. manner. It took about two' or'two ana'a half days:., to mow this.. Eight atter this he?: started to complain about' .feeling, ivfeak in his: legs:, and sort of broken down. Sometime in June 1845 my''employer turned over to us for use a Power Operated Grave digger, which had several attachments with it for digging, cutting, tamping,, etc. Phis is a one man. operated machine., the gowep being by gasoline;, fuel, a 'low grape of gasoline being used as, prescribed, it using mi-xea ivitn a portion of oil. This gasoline usea.was p white in color, -./bile tne fuel receptacle held about two quarts,, only generally cue guart of fuel was in the receptacle at a time as not more than that v.as needed for tne preparation of a grave. The spark, to fire the one :perK oil was from a pcorrtteabb.le battery. The tool attached to this digger c'r r- persited by compreessioin- Then a grave digging was to be prepared, tue sc-a and first airings were by hand, the ' digger not being used until discing became more dJifficult. Th__i_s___d_i_g__g_e__r_ is handled entirely by hand, nt first ana for a snort while operated it, wording himself, auc tnen- we uotu operated it, wording together, lie used the digger only for ecu. .'t size graves. This is termed a Earco Gas Hammer. An adult Orove is ; og feet deep about 37 inches wide and 7 feet or better in length. Graves were prepared in the open, tne only exception being when one we aoner suen as rain or snow was falling when a tent cover was erected over the place where grave was being prepared which had the sia.es and ends open. Tne high center was about six feet above surface ana tee siaes about three or four off surface,. This use of cover was seldom. aid the laying cut of grave digging plans. Yearly, there were an average of' 50 graves all told, but how that was divided between adults and smaller &raves, I do not know, but adult^gjsve^were in the majority. At any time that I used this digger with I felt no ill effects from, its use and at no time did \7e idennfflSrmil^ c empiaint of or show any ill effects. - ;vfere the only e mployees but occasionally extra e mployeeswer^^OTe d temporarily to assist when we were extra busy. The preparation of an adult grave consumed an entire cay of eignt nours, and sometimes an extra several iiCui-s , especially if the grave was walled. Cur work ween is 5g days of S hrs. with the exception being when there are. funerals on Saturday afternoons. Cn occasions several graves were prepared on successive c jS. From first time ,Veicfenharui;er complained of physical difficulties., i.e conti nueo to complain occasionally and cut down on his activity lut came cut to work regularly. He aid not to me at any time indicate Hf 0016415 N19291.03 oaterent oi I rw in J. Yoder, continued c. ^ v-.icr 0;. difficult./ was by namin. any disease. The last time that _ re ca --L assisted in preparing a grave when the ci scline v.- i&vd,, was, to prep-,re the grave of Lrs. BaXtkpser, between .~rii 10: t loth, 18e6. It was shortly after that that tin not come out to won. anymore:. I; learned that he had heeiT a*, to a .ics^ltai in forepart of nay lt4p then returned to his home for a snort ^eriod, then readmit!ea and died there the.-flatter 'part -of July 1846. ge;,.sonallyh I .dip not know dust What, hie disease: was* I,-: visited: 0x-ce? then at Hospital during his ,first stay there, but did to him as he was having a blood transfusion not discussing his disease. l v/e 0 O'- re-c this uo tlement of 4 i'es and is it correct? /s/ Irwin J. Yoder KE 0016416 THE READING HOSPITAL /, G-PIRATIVE RECORD h ame s Coes Breopenative. diagnosis: Hyperhemolysis. Splenic anemia. Postoperative diagnosis: same. Surgeon: Dr. aentsehler Anesthetist: Assistants: Dr. Rhodes, Dr. Matsko r-.nefctixesia used: 'Cycioproi>ane, ether cocain, curare Dr. Woodbridge Time operation began: 5:10 P.H. Operation: Splenectomy A roes P atnological findings Hypertrophy of the spleen with hyperhemolysis and very marked secondary anemia. Operative procedure and.suture material used. .. 'left rectus incision was maae. The patient was in a very serious general condition with a hemoglobin a round 22% and the red blood count around 10COG. There was marked pallar to all tne structures including tne bowels. The qpleen was about the size of a quart. The pedicle was ligated in four sections. It was attached posteriorly with small fibrillar acnesions but it was easily brought into the wound and above the surface of tae abdominal wall. Neither tne stomach nor the omentum nor the pancreas was attached to tne spleen. Ligation of the pedicle was performed by the employment of sticn ties of chromic #1 catgut. ' There was no bleeding of any account. The blood that was visible was watery. There was a small accessory spleen about 1" in diameter. This was removed without diniculty. The abdomen was closed in layers. Chromic ,,2 was used in the form of a running suture for the peritoneum. The fascia was closed with a running suture of chromic #1 catgut. Approximately 5 retention sutures were employed. Bandage was applied, patient had three pints of blood on tne table and lb000 cc. of normal saline - Sponge.count: None Drains: None Signature of operator: John Spannuth- K 0016417 N19291.04 i Y -V,- ' J&X m. Ltrumia Director Dr ] peharg Leaning, hospital ..est Reacir.&, r&. THE BRYN iYYVvR HOSPITALClinical Laboratory Bryn hawr, Pa. July 11, 1946 Bear Lector Menarg:- :-.;r. age 64, appears to have had no illnesses save typhoid, at the age of six. He has been in excellent `health until the present illness. His first admission to the hospital was on 6/7/46. At that time he had complained for three weeks of weakness and shortness of breath. Ten days before admis sion Ait noticed jaundicej he had no weight loss. On admission in tne hospital he had jaundice and received eight transfusions. It v<as noted at 'one time that the urea nitrogen in the blood was *0 % and on ,-aamiesion tne hemoglobin was 22>. The fragility of erythrccytre was decreased (began at .p and w s complete at .wc) and the serum bilirubin was elevated.' (2 mg. on one occasion)> ;.e was Discharged on 6/15/ with a hemoglobin of 51/ and readmitted on tne 2Srd with a similar complaint.- At this time he had a serum bilirubin of 4 mg. and the red. cell fragility began at .5 and was complete at .4. He had a severe reaction to a transfusion and tne hemoglobin was lower after tne transfusion than before. This patient appears to nave taxen no medicine and has had no exposure to. c uemicais with tne possible exception of exposure to xcc-Q. Ynis point is at least doubtful. Exposure to-'gasoline fumes in the open Goes not appear to be sufficient to cause lead poisoning. ..cviever, tne report of Dr. Eeinhold on the blood lead content, will clear this point. With these findings and an enlarged spleen, the aiagnosis of hemolytic anemia I feel is justified. I feel that it will be most essential to give this patient only Bn compatible blood and I would therefore immediately type this patient as well as the prospective donors. I would also recommend that in view oi the fact that this patient lias great tendency to hemolysis and that since you use plain citrate as preservative, I recommence that you use only blood stored for not more than 48 hours. I wish also to recommend that a biological test be carried out befor ach transfusion. For this purpose give the patient about 100 cc. o blood ana g o a serum bilirubin immediately before ana three hours after transfusion. If there is no sharp increase in the serum bilirubin level, you may give the rest of the blood slowly. a) >+ Kff 00164J-8 N19291.05 ? tJ 'w i 0 i~iur.p ,iy. ii, 1'9:4'6 / ate - 2 The kidney function of this patient should be carefully studied since there is a aood possibility of damage from previous nemolytis crisis. A splenectomy, I believe, is advisable since it is the only way we know to cneck hypernemolysis. The patient's serum bilirubin and urobilin should be checked daily. Almost invariably a spontaneous remission occurs' when the serum bilirubin drops to normal or near normal and the urobilin excretion greatly diminishes. At this time the patient should be transfused every day and when one uemc&lobin is IS gm. or better, proceed with the - splenectomy. herewith- enclosed please find report of t ne differential blood count. The reticulocyte preparation was not satisfactory but the reticulocytes appear to be greatly increased. I will appreciate very much if you keep me acquainted with the ccirse of this patient. '.iith best regards and thanks for tne opportunity to see this interesting case, I am Very sincerely yours, liax A. Struaiia, A.D. S/ mb enc. Kf 0016419 Pleading, Henna.' February 28, 1947 penna. T. & F. Mut. Gas. Ins. Co. 325-333 South 18th Street Harrisburg, Pennsylvania Gentlemen:- . HE: Claim #148080 - d/a ?/46 vs. St. John's Cemetery Co. Cur file #17145 referring to Attorney Hertzler's letter of October 14, 1946, aodressed;to your hr. Foor, be advised that we believe we have covered, ail the suggestions as concerns the investigation of this matter. In regard to Doctor Spannuth and Doctor J. G. leharg, we feel that both of these doctors were more or less giving us the "brush off" at various times when we called on them. However, we have finally been successful in having a snort discussion with Doctor J. G. Heharg, Hamburg, Pennsylvania. Doctor Heharg stated that he was summoned to the home of this claimant on February 4, 1946, ana his professional opinion was that `the claimant was suffering with an apparently bad case of anemia. The doctor confessed that the beidenhammer family is Known in their community as. being a "peculiar" type of family. He states that they were on-the "tight" side as far as finances are concerned. The doctor was of the opinion that this was a case t^/jond^itnte.ndling, and since he realized the peculiarities of the wMHHHMMfstiily, and did not want them to condemn him at a later aaft^for^nat he termed "the lack of professional ability," he persuaded them to allow the claimant to be admitted to the Reading Hospital. At this time, the Doctor called Doctor Spannuth into consultation.. The file will show that the claimant was discharged from the Hospital, and then later he was readmitted. At the time of this last feadirdttance to the Hospital, the claimant's spleen was removed, and following this, the.claimant died. Doctor ibeharg states that he did not even have the thought that this claimant suffered from lead poisoning. He states that Doctors Strumia and Spannuth, the former of the Bryn Mawr Laboratory, discovered the presence of lead. A Doctor John G. Reinhold, of the Philadelphia General Hospital, Philadelphia, Pennsylvaniaj was also in on this latter procedure. Doctor Leharg states that the only history he could obtain as concerns this claimant being in contact with lead, had to do with the claimant using the grave digger, which digger was operated by gasoline. He states that all further questioning brought 00164X0 N19291.06 jiia ^-letSUSO'- St. John' s Cemetery Co. page 2 February 28, '47 no evidence of lead poisoning being connected with the claimant's private life. Uifeii we' informed the doctor of the fact that the fuel used in the ^rave digger was a !%hite gas," which contained no lean, it was quite apparent that he was_considerably flabbergasted. .;e questioned'Doctor Heharg concerning Doctor Strumia's report of the differential blood count, and tne doctor stated that^he was of the opiniqn that this report' was part of the Hospital,,s ire cords. Doctor ...enarg tnen showed us two papers he had, which he permitted us to copy. Cne was from Doctor Heinhold, Ph.D, and was on stationery Of the Philadelphia1General Hospital*; Philadelphia,* Pennsylvania. This report was" not dated, but did contain tne following information: "I found 0.087 mg. per, liter of urine (as. lead) . This is a high normal of slightly high figure depending upon the output of urine during the 24 hour period in question. Since it represents a single determination, no conclusive significance can be assigned to it." /s/j.G. Heinhold, Ph.D It is Doctor Ueharg's opinion that this report was made on the basis of urine which was furnished to Doctor Heinhold, during the claimant's secona stay at the Hospital. *.8 concerns Doctor Spannuth. VJe realize your need of information from, this doexor, and we can assure you chat we telephoned this aoexor's office many times and a Iso maae several personal visits at nis officei. V<e could never get any further than speaking to nis nurse, whio also acts as his secretary. We realize the fact chat, tnis aodtor is a very busy man, and all of his work is done oy appointment only. However, we feel that the doctor considers hii-.seIf so important, that an investigator, in his opinion, is notning but a nuisance. We have sat in the doctor's office many times for more than an hour at a time, in hopes of gaining an interview with the doctor through his nurse. However, we have never been successful in having an interview. VJe even had, his nurse ask him when it would be a good time to see him. VJe told the nurse that we would be willing-to call on the doctor at any time that would be convenient to him, either morning, afternoon, or night. Chill we have not had his cooperation, it one time, the nurse was told by the doctor to inform us that "all the records speaiv for tnemselves." We informed the nurse that there were several other matters that we would line to discuss with the doctor regarding this case, which matters were not discussed in the records. On one or two occasions, this doctor half-heartedly made appointments, and when we attempted to Keep them, the doctor always found himself unable to keep the appointment. \ Since tne recent correspondence indicates, that the referee's hearing is drawing near, we have still continued in an effort to have a K 0016421 St. John's Cemetery Co rage O Feb. 28j *47 discussion with this doctor, but up to the present writing, we have not been able to interview him. We will continue with him. Frankly, if we do not accomplish our mission shortly, it would appear to us that an interview' with this doctor is practically out of the question. It would then appear to us that some unusual strategy would have to be followed in an effort to'' see him. We .know- fpli well, that if we .-ever would be able to ualK with him, that we 'would never be able to obtain a statement from him. As concerns Doctor Strumia's report of the differential blood count: and all tne laboratory findings on this claimant, be aavised that: we have requested the Record Librarian, to furnish us with this information,.- but in this matter, we have had no cooperation. The claimant's widow gave us written permission uo obtain such information. For your information, we endeavored to contact both the hospital record librarian ana Doctor Spannuxh on February 27, 1947, but as stated before, we were hot successful. .is concerns hr. Poor's letter of February 21, to which was attached a copy of Attorney Hertzler's letter addressed to Mr. Poor under date of February 17,'1947, be advised that hr. Yoder, who worked with the deceased., stated that to his oest. knowledge, only white gas was used at all times, hr. Yoder states he never filled the fuel compartment, but he was sure chat colored gasoline was never used, since the insured was instructed never to use anything but white gas when operating the crave digger. In this respect,- we refer you to our report in which we stated that we called at the gasoline station where all of the gas that was used by tne insured wias purchased. We indicated in our report that this station informed us that he only gas taken away from the station in containers, was the white gas, which was supposed to contain no lead. The other type of gas sold to the insured was Atlantic White Flash, which gas was put into the insured's truck. Mr. Mettlemoyer of the insured, while checking through his records, found that Mrs. Balthaser died on April 11, 1846, and was buried on April 16, 1946. While there is no record as to the exact date that her grave was prepared, it naturally would have been between those two dates. Mr. Zettlemoyer states that ne does not believe this grave would have been prepared on the date of this lady's death, and surely it would not have been prepared on the. date that she was buried. He states that most likely the grave was prepared on April 15, which day was a Monday, and which was a day and a half prior to the burial. KE 001642.2 * TK3BSHERI-.BN 148030 John's Pase 4 February 28, *4? As concerns the third paragraph of Attorney Hertzler's letter, we are, assuming thet someone representing your Company in Pnilaaelphia, Pennsylvania, is obtaining tae information, as covers Doctor Strumia and Doctor Heinhold. In answer to the inquiry ashto whether the', patient was. sent to Doctor Strumia. or Doctor 3einhold; be advised that we are confident that the claimant's Specimens'only were sent to the.doc tors.. e are attempting to discover what type of vessel was used to send tiaese :s>ecimens end we are attempting- to do this in such a wry wkicn will not be a lead to the other side.- Ve assure you that we are truly putting forward our best efforts to g'et the information which you are requesting tnrough Attorney Hertzler. Cne of our representatives will be in Pottsvilie, Pennsylvania, during the week of march 3, 1947, and if by that time, we- nave not developed all the information chat we are after, we will have a conference with Attorney hertzler, and possibly by this conference, we will work out some means wnereby these loose ends can be gauhered together, so that everything will be in shape for the referee's hearing. Ine report which Doctor Meharg had in his possession which was from Doctor Spanhuth and which was not dated, concerned the claimant after he was discharged from the Hospital following his first visit, fne claimant was first discharged on June 12, 1946. We .quote this report: "Has improved nicely since administration of cal cium glucovate and hematimic agents. Calcium given on basis of suspected lead poisoning (used a hammer in his work powered by gasoline). Had a transfusion on eune 8, 1946. Blood count on June 1G showed 55 Kbg. a. 3.25 r b c - getting- calcium glucovate gr. XXX t i d and ferrous sulphate gr. 3 t i b. Believe calcium admini stration can be stopped if milk - 1 qt. daily is used for a time." /s/Spannuth fe shall keep you advised of all developments as they occur. Very truly yours, WILSCH ADJUSTMENT BUHHAU C. C. Horton CiSS/hep ce; Attorney'Penrose Hertzler KS 0016423