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fa*) *r*rro# INDUSTRIAL ACCIDENT COMMISSION i/Lsb pc^^^X'cJLfuX., M >. W* C *M4I MltaMM, Nonce or Heaping or Application For Adjustment or claim TwwW>> f>--n Wwile* fctwuM Nww| Iw || Ml tkM mM UkMMklaMfrt . - M, 30*, A, CkUNraU, t* . 2)r4 A; *f My, 1955* % lt *!** |,b *U wj U ri-- yUe k M A*U--> fwki*w M $ma mt CMmk *<M fnmtA t If --4 MamTk* * 8m4i ntU 1$, 1959 IKOUrriUAL AGC3DCKT OOMMttSKM * citoUta j yuuMw, J.L lmm --fhywti Un fk4timj A--Hum& Va J mr**4 cW Ufrg^dmf mit* -- A ywwL*w4liP>kj.><>lit <kw m wWf yf< tfc ^y6cwia dwwto mmnim*. fc --M --fhf k k llmJ <hy ^ "fS^igl^OO CiWw^ soAiMyppMfKfcw-- Ikfr ywyk. --4 Hiwd Qik^jnVip**cU* icsrwuss * HUM NMW T mti m na Ikiunwl SEP 7 .. . ____ \ . ft (C.K ) 3 PLAINTIFF'S ` jSSfW* JrfrT^it Dept. r nox 1*57, ouciud, caiir* 4/25/55 Occidental Ufa Inn. C*., 300 Wgqctry S.F., Calif* Jack Coskborteon. 2264 Holbmc* Dr*. Coaoord, Calif* Saltfe Jl rarrlsh. Pin. Center bids*. Oakland. Calif* riant Buboar k iaboctoa Works. 5>09 Horton 3t.f Kaeryvillo.Cal* *matron* Cork Co.. 1355 Harkat St*. 3*F*. Calif* Kuadat Cork Oorp*. 440 Brennan St.. 3.P., Calif* riant Asbaatos Co.. 5309 Horton St*. 5309 Horton St..Kaor/vlUa. Vetra Aabostoa Co.. 675 Torawsd St.. S.P.. Calif* J. r/ Thory k San. Esjoryrilla. Calif* Trurelara Ina* Co*. lnth*n Square Bid**. Oakland. Calif* Indus* Xadoa* Co*. 350 Seasons St*. S*F*. Calif* Stats Ceap. Ina* Fuad. Personal Sonrlco raaiflo Saploy* Ina* Co*. 3770 Plodaont An*. Oakland. Calif* Calif* Cesgtonaatica Z&a* Co*. 2d Co^ry St*. SF*. Calif* wc J-/0 ?/ CC.&J Iflun'il OMtfy~rtW-----194 '! fba rtw bl*T w*wW. 3hM~r*rona H-- *1 Wwy ww .)>fwVib<W*>wtr*MV WprMfWwtiiiwi Lig^n * - vWirNMwMi .jtU22-4U4l*4 *9+w- k w^fito* KWWf- VtMAfjwlaMcxt **NNk *r tu MfMrJepuabu?. 3Q* X3SX . -- Jct*J *r V?* 1954 ii-u^un i iut** Mr|wi liw Mii md*iwhtt **r . Tmv ****nitty |MfM IwmM ftt miirt *Mr*YQNQit^<tet>Y(JM*ttiTV'*t3NaitM*MMunYClt<*a --... 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CsrSt Z&aalskiea 0#* ton taaelsod, Calix# 0 Ascutoaag terfc 0a ** Iai rnaslfiOQ|CAUf . nal Asbostea 0| U8t CF BSSUaiffCS XPA*XX$ (rtrtlort Zinnaii Co Lat&oi Did*, 0afclaadt Odif . ledwrtriol ZdCttlty Co.# 350 9X*t Sum ^r6l099|8iIU Stcta OmmsmIIm Xaa* Fi&sC 450 K*llis%cr sat San Wacaloec, Calif* Pacific SkplcTQffs Ibshtamc Co#. 3770 ris&ttca &trcf Oakland,Calif* Califoral* Ctfapcsoatlea Xunefaiuo 0ct 26 0*0x7 St* 1 , Scm Frul6G3|0allf piwjVfol EMPLOYERS REPORT OF INDUSTRIAL INJURY &19 JtATI Of CAllfOBNIA DCPARTMCNT OR INOUSTftlAL ftCLATIOKt j~/ -ri &*) Dtfllt&Mt6 MVI4IOM OP UASOR STATISTICS AND ftSSSAIICH rst TSAVELSSS HfSPRAWC* COMPACT t lwyonJwMtWwwwl JfrftUj t **nU farther uc. rATLtnts to ros is a MI3DEU RATIOS SOS/XCT TO UAzttfUM rant or lies (Uc*A,Mwitmii fl 313 Montgomery <A, Sow frawchco < C*M. V Standee tm4 Pimm auk* tfcfe nt la OCPUCATS m Sl m (ulk e*'*** fck tNrktoa | labor v . ****. of the injury nr which rrqutrrt medial *d lutt, ftat mm b* Mlf by t>lf h-- r t* XMPLOYS* (CMi A Nmm Arostroog Coric_Co_ giyugtegkqt Sfc Sap Francisco, uJXT7 z9x0n*ccrircvostmjtu*r Tnf*nwfjlt Tratiiitirny mjORXO XKPtOTX* .. 4 r-- J^elr Cttthbertson A Mm ____ 2&U -Bffi?: A r ^ 1 taCM (4 A .......... .. ,fl.i-..i--.. .IMI M. WMM ^.17^ -- " 1 fUMnrttaiiMMnlMkMMalMMMM > Mll*i|l Ml roU.a m rMiMiMiilrtHiilmailw*. fe.~* c^wTr'eSgr^^' k (VI Mn*U A - e tn. i *r< * i $21 CAOss or accidirt n. oewm*m qm i*m.. i > CMttfV) ta*M<i | |P>gW X>. MM Ml ' w. J.*53C- *!**-!"***> TnrwlaMng Pln^*f Pvfcwr SQlUcnianfr It, a BumoV A*y. ** |iim nfc^r aSv Allegedly causod ftmloyoa _yolttr*txrilv rpilt. aw_7Yl^g1t JVie wtwilay Typn .flR mw4 Trttfr nrviYfrm* omplnyw. 9A WMaMckAAMti PM IM MlXa M<~ pOkVt eu. hnM H. VmVmMi IT. WmmMi A WMAini *M V Mt WUMfc **! OMl *t AT MMT. CT" rtUMlMMeUc! 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V ri-Yn-qd.ut)t. i V *f^UNn^s"( dOSMlt---- -------------------- ----------------------1( rafacrfti*r*praic/Osiir*ptim<* UmMt*WLUkCAr. ,{njoiyqwffWWb**tad|f kr * *tip*oyr cr * Imufm by tkl ck*(Mcr *h*a be tdmimibit u evident in any adremry prv-| || e*dincfc*ni tfcelnduiri*lAeddrnt Cn*"***i*n "**--*'"'* r' ** "** EXHIBIT Z-l-2b - - -- vs' ^ /O EMPLOYER'S UEPGUY Of? laDUSTMAL IHJUR* STATS Of CAUfOttWIA DEPARTMENT OF INDUSTRIAL aELATtOMS OIV16ION Or LABOR STATISTIC* AMO ItCSSAJtCM 3~/0~ Xt fC.r.y Claim DputxaaS THU TSAVEL2B8 W80BAHCS COMPANY 313 Mcntpomory St, Saw FrqwrMco 4, CpW. Beery toroteowaeiWumnt f*t>7 *< (MM MfWfWl rnx ua. tailors to a MisoRucinoa sobjsct to Tn.nu&hjvu *oni or law. Haber Cate. **er-MIJl Pleeae makethle report It DUPLICATE oa (bat we cu file c*{4ee vfcfc DliWro il labor SUOitlea and fteceert* la joor IAiS. ' Evry work injury to on employee which bum disability Lwiaf looter thaa th* day el the injury nr wnich require* roertied eerraote other that Art ai treatment owet be reported within five day* alter the injury, u (kolafury reoeJUU death, a report it be Bate by tab*hie m Mlijltfc dirocti ta th# Dlrtaloa of Labor SUUrdea rad ZLae&ejrcb aot latar thaa 24 haere ntf* dtttX RUPLOYS& (Ct*a kH nor wrrr* noscotras , kwter a-*U--m-- wa^rtL-N'n- *" . .S, r* bate, ar M. W|<W ^ - - Ntw ar 4 r- ^-*- -f a fhn wea* #r aa wn.W1 bate eetar aataaJ inna oatey aate* Mr It. W bate. Mteoala Untara hoirte to alCtte ta I aV4 m ba umt aaa rwJ blj/&fcjgL4rr.r>. -<Ce*e/J- "sitr* Vrnm*** W_ liML 19. CM Wot Mrt ta dkeUKv berate U. II p #* date tea wert -- -.................. iA Wm Ware* peM be te If ta rUae ebart t v t viUnt WHm[ fwfvip^ trieBn.'.I caos* or accident tu CmaMtete. . Kewtef uatevetbr reeeefU^ r Cbwk(V) Lawitaaei lOwxw brute, atrk'aa aaewtfbBr * naUau I cn eMutkabweiUwe^ r ] a Wklju amteree 4eb K Haute ttat-tetbeaeaat 15?4=.S-kCh^=:. mim ak^w ta* IhwU am fu. m . UuMkaaMOitwn F olv axLisE.-_--_----3g-f0l-_____BL^RQV^<V<k1iS I ULLiSUdt ^<Vm-ftvTtr>L\. hftrgPI\ftLt s MPLfl.N gLT^ f/W.TJU-f fisS.jmsx. iSfia: V *r>ntr autlM. taO. aan*laiea * * - Tm ha M. M te wwttere* teutiiroinb l*t*2a1lWu ettamlamtetoutnetfitnbhrireuf >trJt*abl yy mrtrvu tl < Deeatrer. bebaapanwaatual." laatwywbMafceraeraeeeWeetbeteaW MATURE or INJURY AMD PART OR BODY AFFSCTED (Dmcnb*:atai< lb*na<wr M tafwr a*4 <> ^rt M IM baJr a4ata4. I-.rryDo t-^vj OM. r mn t4w lur at wul |tec faararr a* tee bte |ia*n, teaateaal <> b mxi JL Wat hI aterrai Hitea. M. "--,i-f-*-- 11- i*~il (Ya ar U. HueeimiN i* wear Nri. 2*. DMUiOTMtelMtetbl ld"m--- m> M mtete. it. "r~ f-- -*-- M. la iw4 atemrki M. fc. tertWdtefer efWwt leftete. I#. Hrwwaadate te bHteteirali If aa kawr. tkfgtm--/ f~.i + C^m JUa. 141 Namai.M riUa el thU rrpart U art aa ateU*eUa <1 UabUitf. **... Nr report el injury required to be ' hy an employer u an inauter by tbie chapter ahaU be admiaaibW aa evidence in any advaraery i etedinf before the IndbaUial AutidcM Cemmiteioa." Labor Code. Section telA PUUNTIFF'S EXHIBIT Z-l-2c 1 PLAINTIFF'S i EXHIBIT ! . --........... . -Tp'-.IJW'T-s- ' 1 . . \ !;. . . -v- . ; i '% . ` t 1 " 1 v' -: ' ; - - ; * ` i ; , ' BEFORE THE INDUSTRIAL ACCIDENT COMivfISSION OF THE STATE OF CALIFORNIA ROBERT F. CUTHBERTSON, V w. A . Applicant PLANT ASBESTOS COMPANY and INDUSTRIAL INDEMNITY COMPANY, Defendant! No. 60 OAK 3913 MINUTES OF HEARING ( ORIGINAL ) PRE TRIAL STIPULATED DECISION U?l-t>E?(T tf iKDlSRlIi ffUlKS am * m\t& Moan FILED , sep um P.r 44^ Place and Timet Oakland September 23, i960 10:30 a.m. Referee: .... ' Reporter: ...... Appearance*: ANKELE SMITH Applicant Present SMITH, PARRISH, PADUCK & CLANCY By JOSEPH E. SMITH, Esq. . Defendants: PATRICK R. MALONEY, Esq. APPLICANT'S 1 Bill, Dr. Elsenberg, 4*0.00 and report, 9-7-60 DEPENDANTS' 1 Medical file .1 . . FINDINQS OP PACT: U'-. . r; - 1. Robert P. Cuthbertson, born May 4, 1920, while employed as an insulator on May 23, 1957j at Oakland, California, by Plant Asbestos Co., sustained an Injury arising out of and occurring in the course of his employment, consisting of an Injury to his left ankle. ' 2. At said time said employer's compensation Insurance carrier was Industrial Indemnity Company., 3. All medical treatment to date necessary, to cure and relieve the applicant from the effects of his injury has been furnished by defendant carrier. 4. At said time said employee's earnings were maximum. 5. Temporary disability indemnity has been paid in the sum of 4405.71 through August 4, 1957* constituting all temporary'disability indemnity due, 6. Said injury caused a pen&anent disability of 8. 7. ' Applicant incurred costs of the reasonable value of 440.00 for the examination and report of Harold J. Elsenberg,- M.D. 6. Applicant's attorney rendered services of the reasonable value of 4100.00. -. . 1p V, ' 9-23-60 .';, ! ' . ^ ;' . . ' : B l-'^ r \ Fa II . 000003 : -- , , -- ,----- (, P*- ppjT f'T :t / ' . .. * ; . ^ CUTHBERTSON - 2 . ` AWARD AWARD is hereby made in favor of Robert F. Cuthbertson against Industrial Indemnity Company in the bujb of $1120.00, payable forthwith, less an attorney fee of $100.00, payable to Smith, Parrish, Paduck Ss Clancy, together with Interest on delayed payments as provided by law. . FURTHER AWARD is hereby made in favor of Robert P. Cuthbertson against Industrial Indemnity Company for litigation costs in the sum of $40,00, payable to Harold J. Elsenberg, N.D. . J01 IKELE, Referee > kV .i * i:. ooomn OaTMeeic InduitMl-Accident Conmiition RECEIVED JQtfCPH OLICM, M. ti. HAHOLO J. CiaCNBCtta, U toil c. |4ih Tutrrjj Oakum* I, Oampbanm SKP 1 2 l<?f>0 OM.Ionr1 Office Sept 7,! 1960 ju | ! cj[ Joteph E, Smith Attorney at Law 405 14th St Oakland, California Ofj^ 8-17-60 Exam and Report 40.00 on Robert F. Cuthbertton OOOOC 'ba/HOSCsiea , ! JOICSH OietN, M. D. HAna.o a. stCNc*a, m. o. Olt (. >TH TttT QllUal 1. OiU'MKU MUII *OS I September 7, i960 Joseph E, Smith, Attorney at Law 405 14th Street Oakland, 12, Califonda Re: Robert F. Cuthbertsoo Dear Sir: Oa Auguat 17, I960, Robert Cuthbertaon vu examined in this office for injuriea received oa May 23, 1957, while patient waa employed by Plant Asbeatoe Co, He atated that he waa working on a ladder about 10 feet from the ground when thia ladder slipped out from under him and he fell from one roof to another, landing oa hit left foot and injuring hia left lower extremity. He did not euataia a head injury of any kind and had no difficulty with hie back. > He waa teeo at the office of Dr. Rudnick, where x-rays of the left ankle were made and it-waa not felt that there waa a fracture. Dr, Rudnick'a findings were that of a questionable chip off the lateral cuboid area. A diagnosis of severe sprain of the left ankle . was made, . - . . .. The patient was transferred to the care of his family physician. Dr, A.R, Thompson of Berkeley and . treatment consisted of elevation, rest and compresses. He was treated first with an elastic bandage and then later with a cast. He was also given physiotherapy at Herrick Hospital and also another place in Richmond, over a period of about two months. In August, because he was not doing well, he was sent to Dr, Melvin Hurley in Richmond, who is an Orthopedic Surgeon and he was examined by him. Dr. Hurley made a diagnosis of Sudeck's atrophy of the left foot, secondary to his sprain injury. He was treated with prlscollne, a vaao . ooooof; Joseph E, Smith Robert Cuthberteoa September Y, I960 Peg* 2 dilator, local injection of hie ankle and the use of an arch support. He returned to work about three monthe from the time of his injury, He stated that he was able to do most of the duties of his usual work. He stated that he occasionally sees Or. Hurley, but that ho active treatment had been given for sometime and he has continued to use the arch support. His complaints at the time of examination were those of continued pain in the ankle, particularly towards ** the latter part of the day's work when he had been on ladders or walking extensively. He also noted that there was . some stiffness in the morning when he would awaken and it ^ took a little while for him to limber up his foot. If he was sitting for any period of time and then started to get up. he found that his ankle was stiff and took several steps before it began to limber up. He no longer required analgesics. His past medical history was negative. His past surgical history included the resection of surgery to the right lung for asbestosis. He would still get some chest pain' associated with this disease. He had never had any serious injuries and had never had any difficulty with his ankle before. Aside from bis lobedomy, the only surgery he had had has been a tonsillectomy. Physical examination revealed a husky white male who was not in distress. The pupils were round and equal. The nose was clear. The mouth and pharynx were not in jected. The heart rate and rhythm were within normal limits. The lungs were clear to auscultation and percussion. There was an old thorocotomy scar present. There was no tender ness in the abdomen and no evidence of masses or spasm in the abdomen. , Examination of the lower extremities shoed nothing abnormal on visual inspection. Circumferential measurements were: Left calf 14-3/4 Right " 15-1/2 ' %* /t (measured 5-1/2" below the knee joln^' The thighs measured 7-1/2" above the knee Joints were equal, bilaterally. On palpation of the left ankle there -- was mild tenderness in the space between the 1st and 2nd ^ * ooooo !WPfigW^^W!TWpgWiWW^w*WW4.*|W-W!.SJUi^nMiiui,iaiii>iiiuisiBisi.j^w.ji.bii ijji. Joseph E, Smith Robert Cuthbertsou September 7, I960 Peg* 5 /. . meteteraelf et about the mid-shaft level end there wee J' ip almiler mild tendemeaw ell along the posterior tibial / tendona from behind the medial melleolua upward for an interval of about i inches* ' Joint measurements were equal, bilaterally, as _ far as any measurable motion was concerned. There was a very slight restriction of plantar flexion of the left ankle that wa apparent visually, but could not be measured. `' . There wae on forced dorsi-flexion, complaint of pain of a mild degree extending up the tibialie posticus tendons from the tip of the medial malleolus. The skis was of good color without evidence of any reeidual circulatory disturbance. There was slightly in creased pigmentation of the skin over the region behind the medial malleolus on the left as compared to the right. . , - .. ' The patient stated that while he felt that be could carry out his usual Job,' he felt insecure when be wae on scaffolds or high places, because he did not feel that he could quite trust his left ankle 100%. Also, if he had to work on ladders for several consecutive days, he had too much pain to continue, but he bad been fortunate insofar as he works with his brother who will rotate some ofthis work with him in order to help him carry out Me work. . . COMMENT: This patient sustained a severe .. sprain type of injury in the accident described. Apparently there was a question also at the time of the accident as to whether or not there may have been an emulsion from the cuboid bone. No further reference to such a fracture was made In the medical records which I have reviewed. At any rate, the patient had considerable post injury difficulty because of the onset of Sudex neurovascular distrophy in volving the injured foot and received satisfactory treatment for tMe condition. ' At the present time he has reeidual disability consisting of atrophy of the left lower extremity ('see ' circumferential measurements)1; Increased sensitivity of 000003 mm Joseph v.5ita ; Robe..*; CuthbertJao $ 5e?tjmbv< 7, 19o0 j?age 4. the aot tl*ue in the loot end ankle region* U factors are sufficient to Justify hie subjective complaints of iasecurity on scaffold or high placet; occasional stiffness ^ of the foot and ankle ia tho morning and pain toward the end of the days work, when such work involves extensive use of hia foot and -nkle. These are the factors of his present dis ability for which he can now he rated* ' Sincerely yours. HJE'RH ) 000003 ) V If > "industfui Wftjiwwl RECEIVED SEP3 l I960 MELVIN T. HURLEY, M. O. IO AOAOWAT ICMMSNO t. CAUfOANIA llM Oakland Office Industrial Indemnity Company 268 Grand Avenue Oakland, California ' f__ / September 16, I960 t Gentlemen: RE: V Claim No. 57-51-2039 Robert Cuthbertson vs. Plant Asbeetos Company Date of Loss: May 23, 1957 Attest! Following your letter of authorization of August 19, 1960, Mr. Cuthbertson reported to my office as directed on the' 8th of September, I960. At that time an interval history was obtained from the patient and a careful physical examination in relation to the complaints in reference to the left ankle was carried out. He was then referred to the X-ray Department of the Richmond Hospital where films of the left ankle were obtained. From the information obtained from these sources, my opinion herewith is offered. Mr. Cuthbertson states that he is still working for the Plant Asbestos Company as an insulator. He had been working out of the San Francisco Office on various plant installations in the Bay Area. Most recently, he has been in Antioch. He states that in reference to his left foot, "It's still there. It .. doesn't swell any more, but occasionally it pains over this area," and he indicates the medial malleolar region on the left. "It feels stiff all of the time." "Especially after working on a ladder." The patient states that a great deal of his work is daie on a ladder and he feels that by the end of a * normal work day his ankle is more stiff than usual. However, he states that it does not swell and it is only on a very rare occasion that be has any feelings " of pain or discomfort in the ankle. The patient has not had intereurrent illnesses since my last report to you in May, 1959. The examination at this time reveals a well developed and nourished white American male who did not appear to be in any discomfort. The general physical examination is essentially negative except for the findings in relation to the thorax which has been covered in prior reports. The findings in relation to the lower extremities are as follows: OOOOIO Industrial Indemnity Company -2- Soptember 16, 1960 RE: * . Claim No. 57-51-2039 Robert Cuthbertson v. Plant Asbestos Company Date of Loae: May 23, 1957 . The patient ia noted to walk without detectable limp or Hat and on inspection of the left ankle, no visible swelling or asymmetry la noted. - The patient demonstrates ability to balance on the ball of each foot, to squat to his heels and to arise without difficulty or without restricted motions in the left ankle. In the recumbent position the measurements of active motions /A'* -reveal that there is 5 degrees of dorsiflexlon present bilaterally. There is 70 degrees bilaterally of plantar flexion, 45 degrees bilaterally of inversion and 20 degrees bilaterally of eversion. No local tenderness and no _ restrictions of motion are found. The knees are symmetrical at 14 1/2 inches. The left calf reveals 1/4 Inch discrepancy at 14 1/2 inches over 14 3/4 inches ///^ in circumference. The ankles are symmetrical at 8 1/2 inches. The mld-tarsal region is symmetrical at 9 1/2 inches. The reflexes at the knee and ankle are brisk and aetive bilaterally. The dorsalis pedal and posterior tibial pulses are present and of good quality. There Is no sensory deficit to pinprick examination. The kin of the footis warm and dry. There are no abnormal weight-bearing marks on any of the digits or plantar aspect of the foot. The patient was referred to the X-ray Department of the Richmond Hospital for films of the left ankle. These have been reviewed by me and 1 am in agreement with Dr. G. R. Hencky, Radiologist, when he states: "Left Ankle: There are at least four small bone densities adjacent to the tip of the medial malleolus of the ankle and also adjacent to the medial aspect of the talus. The largest of these measures 5 mm. in diameter, and the smallest ie punctate. These shadows are apprently more numerous and somewhat better defined than the small bony bodies present on a prior study of April 1959* I feel that they represent evidence of old chip injuries secondary to an avulsion fractures. There are certainly no major fractures apparent about the ankle. The mortise Is symmetrical and is not widened. There are no arthritic changes demonstrated-" (Signed) G. R. Hencky, M.D. Discussion: It is apparent from the clinical examination that there is no restricted mtflon, local tendernoss or mal function of the left ankle. However, the patient has generalised subjective complaints in reference to the anklo after use. This is understandable 1 think particularly whon one reviews tho x-rays and notes that In the past year there, has been an Increase In the calcific densities within the ligamentous structures of the medial malleolar region. As such, 1 feel there Is evidence of increased ooooi:  Industrial Indemnity Company -3- September 16, I960 j REi ! { Claim No. 57-51-2039 Robert Cuthbertaon va, plant A ah atoa Company Date of Loa May 23, 1957 fibrosis in the medial malloolar rogion deapite the fact that I cannot, by palpation or clinical meant identify auch a condition. However, the x-raya have been reviewed by me and I am in agreement with Dr. Hencky that there ia evidence of increaaed activity of calcific nature. Accordingly, one must consider the presence of excessive fibrosis in the ligamentous areas as being evidence of residual ligamentous damage* Certainly, the ankle Is stable, "" 1 but with use such as the patient states he does on a ladder it is conceivable that the ankle may ache by the end of a work shift. Accordingly, I would ^ - feel that the-patient does have minimal residual permanent disability. I weuld classify his subjective complaints aa being minimal in that they constitute an annoyance but do not cause any particular handicap in the per formance of his work on a ladder. Objectively, there is 1/4 inch discrepancy in the circumference of the calf muscle which may be in keeping with the x-ray evidence of the lateral malleolar region. Aside from this, no other factors of ratable disability are found. 1 would not consider the patient to be in need of active medical treatment now or in the foreseeable future. Hla condition. I feel, it stationary and ratable and because of this person's particular personality 1 feel that rating this case on the basis of the factors discussed in the body of this report would be in order at this time and to the advantage of all parties concerned. . Thank you for the privilege oi seeing Mr. Cuthbertaon again in con sultation. Should you have questions regarding roy findings or opinion, I would be happy to discuss them with you. Sincerely yours. MTH:ACP Industrial Accident Comitlsjloi) RECEIVED i SCPS l I960 ! Oakland QffigA I elvin T. Hurley, OOO \ J jun ' MCUVIN T HURLEY, M. O. IAOAQW** IlCNHONO ft, CAC|/0NIA &* i C May 30* 1959 Industrial Indemnity Company 268 Grand Avenue Oakland, California Attention: J, W, Wilton Gentlemen: ?.Sk Claim No. 57-51-2039 Robert Cutbbertton On March 16, 1959, I received an authorization from you for re-examination and report on the above captioned patient. Mr. Cuthbertson came to my office on the 9th of April, 1959, and was examined and then pursued normal usage of the foot and returned for examination most recently on the 26th of May, 1959. On the basis of the findings of these two examinations, the history obtained from the patient, and a review of x-rays of the left foot and ankle taken at my direction on the 9th of April, 1959, the following ojmion Is offered. Mr. Cuthbertson stated that he continued to work at the Plant Asbestos Company as an insulator. This plant is located In Emeryville, Although the padent is employed by the company at that address, he states that be is frequently "on the road" working at various installations; and, as such, never is at one place more than a day or two. He states that he is obliged to do considerable climbing on a ladder, and as a result, "It still bothera me a bell of a lot." "Three-quarters of my work Is on a ladder, and it bothers me in the morning when I get up -- it feels stiff." "It's stiCf here," and he Indi cates the medial malleolar region. "1 can't walk without the arch support that you gave me." ' Since my reports to you, this patient has had rather extensive, drastic surgery and was off work for an additional three months. He stated 0000 o. > VUN 4 W59 Industrial Indemnity Company BB 2- May 30, 1959 Claim No. 57-51-2039 Robert Cuthbertaon that he returned to work thia time in November, 1958, and has been working teadily aince that time. There are no other intercurrent illneaaea or ir^iriee acknowledged by the patient. The examination at thia time reveal* a well developed and nouriabed ' white Aroedean male, 31 year* of age, who walk* without detectable limp or ' - Hat. The general phyaical examination la entirely negative except for finding* in relation to the left foot. On examination there la noted to be no alteration in the normal heel to toe rhythm cf ambulatiuu. There i* no viaible aweiling. There la no alteration in the dorsal venou* pattern. The range of motion found on the 9th of April revealed that the patient had doraifleadon to a right angle. He plantar flexed to 160 degrees, giving an active range of 70 degrees of plantar flexion. Inversion was restricted 5 degrees on the left, at that time, being 30 over 35 degrees; but eversion was equal bilaterally at 20 over 20 degrees. Circumferential measurements at the knee level revealed that the left knee was 1/2 inch smaller beig 14 3/4 over 15 1/4 Inches. In the calf region, 1/4 inch atrophy was found being 14 3/4 over 15. At the ankle, there was no discrepancy, circumferential measurements beig 8 1/2 inches bilaterally. In the midtarsal region, no asymmetry was found, measurements being 9 1/2 inches. The reflexes at the laxee and ankle were brisk and active, and the pulses at the dorsal level and the posterior tibial level were brisk and active. At that time, the patient was advised to continue using the foot actively, since it was felt that with his prolonged hospitalization for his thoracic surgery and just a few month* of active usage it was expected that his foot would flare up somewhat. ` Accordingly, be returned after using the foot for a period of six . weeks and waa re-examined by me on the 16th of May, 1959. At this time it is found that there has been considerable improvement in the function of his V-. foot. However, the patient still has subjective symptoms and does not adroit * to relief of his disability. On examination at this time the active range of motion in dorsifiesdon was found to be improved so that now dorsiflexion is permitted bilaterally to 5 degrees beyond the right angle. Plantar flexion still is equal OOOOI-6 I JUN \ J05J Indu*rial Indemnity Company -3RE: May 30, 1959 Claim No. 57-5U2039 Robert Cuthbertson bilaterally at 70 degreea of active motion to 160 degrees. Inversion ia improved so tbat It is now equal bilaterally at 45 degrees. Eversion is equal bilaterally to 2S degrees. The knees are symmetrical at 14 1/2 inches bilaterally, and the calves reveal only 1/4 inch atrophy on the left at 14 3/4 over 15 inches. The ankles remain equal at 8 1/2 inches, and the mid-foot is equal at 9 1/2 Inches. Again there ia no alteration in the sensory distribution or the peripheral pulses or motor strength of the foot. The x-rays taken on the 9th of April reveal that there is normal mineralization of the foot at this time. There are small separate bony fragments seen at the tip and inner aspect of the medial malleolar region presumably from "old injury representing minor chip fractures whi<h hive not united. There is no deformity through the foot or ankle to indicate other bony injury. I see no arthritic change. The soft tissues are unremarkable. ' When these films were compared with the films made in Decern* her, 1957, it Is noted that at this time the small bony fragments seen at the tip of the medial malleolus are now quite visualised; whereas in December there was only some roughening noted at the inferior margin of the medial malleolus. There was no other evidence of abnormality found at that time. Discussion: It is apparent at the present time that Mr. Cuthbertson has some residual Inconvenience in his left ankle as a result of the injury sustained on the 23rd of May, 1957, However, it la felt that this discomfort is only " slight," from an objective standpoint, since his function is excellent and there is no tenderness in the foot to palpation. The patient has subjective complaints, and although he states it bothers him while working on a ladder, it does not prevent him from doing this. Again, l feel that Mr. Cuthbertson has im proved since he has been using his foot during the period from April to May while tmderobservatloo and 1 would anticipate that further strength and im provement In the foot would continue. It is quite possible that the 1/4 Inch atrophy which ia now the only objective finding of disability may disappear with continued use In the next three months. I would anticipate, however, that subjective complaints would continue since this patient ia quite concerned 000015 Industrial Indemnity Company -4 REt May 30, 1959 Claim No. 57-51-2039 Robert Cuthbeytsoo sad* unusually apprehensive over his physical well being. I trust this report will bring your records up to date. Mean while active use of the foot is indicated and I see no need for consideration of active medical treatment at this time. .1 would advise against a disability rating at this time for the reasons outlined in the body of this report. TMHtACP ooom; MELVIN T HURLEY. M O I * IBOAOWAT lCMOHQ . CWlrMMlA (M| tOt 1% *<*<< *0 October 25* 1958 Industrial Indemnity Company 268 Grand Avenue Oakland, California Attention; K. Lucille Mackey Gentlemen: RE: Robert Cuthbertson Claim No. 57-51-02039 You will recall that on the 12th of June, I forwarded a letter in which I stated that Mr. Cuthbertson had not been seen by me. Please be advised that Mr. Cuthbertson appeared at my office on the 16th of October, 1958, stating that he was still concerned over his foot. He stated that since last seen by me he had been having considerable difficulty with his lungs and had been confined to the'Richmond Hospial where Dr. G. Crenshaw had resected a lung, (le states that he had complications from working as an asbestos worker and had developed a lesion in his lung. He states that he has not returned to work as yet, but is still concerned with the stiffness In hit foot. He states, ,fIt feels like it gets overly tired." "I get plenty of exercise because I walk a lot." , The examinetin at this time again reveals no objective evidence of residual difficulty in the foot. The patient may have some symptoms of a feeling of tightness, but the motions, certainly, by clinical examination are intact. Again, I feel that Mr. Cuthbertson Is considerably concerned over his physical well-being and that any minor deviations from the normal are misinterpreted as major catastrophes. He has been relatively inactive, due to his recent thoracic surgery, and it is understandable that his foot may not be as strong as it was originally. He may feel that ha has done con siderable activity la walking, but I am sure his activities would not approach that which are required in normal work. I feel that no active medical treat ment is indicated for the subjective complaints of the right foot at this time. Sincerely yours, MTHPAC uMmmwwumi mi in urn Melvin T. Hurley, M.D. 0000^7 a MCLVIN T. HURLeY, M. D I O BQA{*WA. ' ICHMONO a. CAUrOAMIA June 12, 1958 Industrial Indemnity Company 268 Grand Avenue Oakland, California My Dear Miss Mackey; Attention: K. Lucille Mackey Claims Adjuster BE: Robert F. Cutbbertsoa Claim No. 57-51-02039 Thank you for your letter of May 26, 1958, In which you requested Information regarding Mr. Cuthbertson. Please be advised that Mr. Cuthbertson has not been examined by me since my last report on the 6tb of February, 1958. Through the "professional grapevine," so to speak, Mr. Cuthbertson was confined to the Richmond Hospital In February, 1958, actually February 24th at which time he . alleged pneumonia. Subseqently, on the 22nd of May, 1958, the patient had a rectal fissure and talked to me about It. At that time he was In quite an emotional turmoil and was "going to jump off the Bay Bridge" because of his discomfort. His symptoms were purely neurotic; there were no symptoms or suggestions made In reference to his foot and the patient was not encouraged to elaborate upon his foot. He Is, at the present time, under the care of Dr. L. E. Brown of Richmond for his rectal fissure. date. I trust this will bring your records up to Sincerely yours, . y* MTHtACP Melvin T. Hurley, M.D. 'WWWffWII.IllHiiUJ! ji j.iijiiMJjuu.iM.i OOOCJLM Ti' ' in,ii ,iihiym I MELVIN T HURLtY, wi O. f O I NQAQWAf OlCWHOMO t. CAkiroaMIA C.<. I'Olit February 6, 195fl Industrial Indemnity Company 268 Grand Avenue Oakland, California i Gentlemen; BE; Claim No. 57-51-02039 Robert F. Cuthbertaon Mr. Cutbbertaon wai In to aee me. He baa been conalderably worried over tbe recent feeling of tlghtneaa In nla ankle with the Inclement weather. He now la afraid that tbe ankle will never be all right and that he will have difficulty In the future earning a living because of the disability In his ankle. I have again spent considerable time with the patient, reassuring him that there la not that degree of permanent disability In bis ankle that would re quire any consideration of loss of earning power or Inability to use the ankle in tbe future. I would expect symptoms of tightness at this time with the Inclement weather that we have had. As you know, this patient has had medication (Prlacotlne) In the past and has had excellent results with It. This medication was stopped In November, and It Is possible that wltb the recent Inclement weather his symptoms have become Increased. Accordingly, this evening l have again given him a 10 day supply of Prlscollne and have asked him to try this for that period of time and see me. Again, we are not overlooking any serious disability In this foot. He has had symptoms of a reflex dystrophy and the most recent x-rays on the 14th of December show that there Is no fracture and the bone densities have again returned to normal;*whereas when seen In June there was considerable osteoporosis of disuse. I will keep you advised of Mr. Cuthbertson's progress when seen in two weekj. Meanwhile, he Is physically able to continue with hla usual occupation. Sincerely yours, a MTHjACP Melvin T. Hurley, M. D wanytis oooo;j> I WMII \ V U P ........ W.IV.W INDUSTRIAL INDEMNITY COMTANY DOCTOR'S SUPPLEMENTAL REPORT Melvin T. Surley, M. D. ifO Broadway December 30, 1957 Richmond 2. Californio ................. INDUSTRIAL INDEMNITY COMlANY ' Calm Si*. 57-51-02039 Oofcioid, California .' 1. c~rtfty>Plent Asbestos Co.. 1300 f&th 8t. Smarwllia. California 2. Cuthbertaon. Robert________________________________________ ________ ________ ________ 3. f txjiiry? Left foot.. . ~:5/23/SZ--____________________________________ 4. Praiant condition [compor* with Ion mpan) Patient U ambulatory without evidence of awaiting or reflex dyatrophy. He went dancing New Year'* Eveand complain* now of asm* Ur.rr.9< Qvx llie fifth mci.lar#up'uiangei joint of too late toot. Alio, be atate* that the foot get* a little stiff on cold morning*. NBl Considerable reassurance l* needed for thla patient, and he will beaeen again In one month'* time. No'actlve'lTealmenOa'TEaTcate'd and no losT'Of'ttmo- l* anticipated. S. rroeimani; Typ^? none Funh#r __ If pbyiicol lharapy b#ing given, indicola ryp# ond limat par ##fc. _ _ Tima* p*r wiL ' ' A. if in hoipilol--How mucK long#r?__,, 7. Dole of toil aiominoiion 1/4/58 Prtvat# ft***-? W/.-U7 Anvota Norva? S. Duration of tortW diiobility__ patient doe* not have disability at the present time. 9. Dot# obto 10 rium to ort ha* been at work 10. Ool# actually r#lurn#d lo work. It. Ii lull r#cov#ry #ip#ctd?_y..*.__ X-rays taken on the 14th of December, 1957, reveal that the tarsal bone* now are of normal density a* compared with film* of August, T95Y When de-0 tTcm# of5oo<?*1 .D, PrionoI Signotur# of Qo<t, Addr#ii. 160 Broadway._Richmond, Inllrwctioni! ' (1) Submit wHy during a<ul# Hog# of o tr!oul cat#; monthly lh#r#oft#r. (2) CompUl# in >riplito>#. California, font* ii hi # oooo;:o MELVIN T. HU*LCY, M. O. I 0 ffOAOWA* * ftlCNMONO t, CAVI'dOMlA |(MH OX* September 28, 1957 Industrial Indemnity Company 268 Grand Avenue Oakland, California Attention: ' Lucille Mackey My Dear Mtaa Mackey: BE: Claim No. 57-51-02039 Robert Cuthbertaoa Following my report of August 24, 1957, Mr. Cuthbertson haa been by me on several occaalona, moat recently today. He ha a been atarted on PrlacoUne for the circulatory problem In bla foot and haa been provided with a Trlmfoot arch aupport. With thia, he haa made very good progreae, and at the preaent time atatea that hla foot la not nearly at troubleaome aa It ai previously. In the next few weeks, we will gradually decrease hla dosage of PrlacoUne so that we can have him completely off the drug In two weeks. At the end of that time we will again evaluate hla condition and will corres pond with you regarding hla progreae. . occupation. Meanwhile* he remains physically able to pursue hla usual Sincerely yours* c/.&Lua/l m? Melvin T. Hurley, m/6. / MTH:ACP PJ ii|a,iiIih; oooo::: I August 24, 195? Industrial Indemnity Company -2-L& Grind Avenue Oakland, California Gentlemen: RE: Claim No. 57-51-02039 Robert Cuthberteon ATTENTION: LUCILLE MACKEY, Claims Adjuster On the 19th of August, 1957, Mr, Cuthberteon was seen and examined by me at your request. From the patient's history, my findings on physical examination, and a review of x-rays taken at my direction at the Richmond . Hospital plus a review of the medical file furnished by your office, the following opinion Is offered. Mr. Cuthbertson states that be Is employed as an Insulator by the Plant Asbestos Company of Emeryville, California. On the 23rd of May, 1957, the patient states, be fell a distance of some 10 feet when a ladder gave way, causing him to land on hie left ankle In an oblique manner. As a result, he severely twisted the left foot. It became markedly swollen and painful and the patient was unable to bear weight on It. He was seen by Dr. Rudnlck of San Leandro and a diagnosis of a severe sprain of the left ankle was made. Subsequent thereto. Dr. A. R. Thompson of Berkeley saw the patient and has prescribed treatment. The patient states that although he has had excellent treatment to date, he Is still having pain in the left ankle. He Is quite concerned over the persistence of his pain and states that he feets that "there must be a fracture in the foot." X-rays in the past have been reportedly negative for fracture. -- ' At the time of my examination, the patient stated tha? ;e foot hurts, and he Indicates the lateral aspect of the tarsal region and Inferior to the lateral malleolar region. ' Examination; The patient Is a well developed and nourished white American mate, standing 6' 1" tall and \ Industrial Indemnity Company REt -2 August 24, 195? Claim No. 57-51-02039 Hobart Cuthbertson weighing ISO pound*. He 1* In some distress and Is noted to walk with a slight left foot limp. The examination of the left foot reveals the foot to be somewhat blanched when compared with the right and In feeling the foot there Is noted to be Considerable coolness when compared with the right foot. The skin of the left foot la moist, but not excessively so. The posterior tlblal pulse Is less strong on the left than on the right, as la the dorsatls pedal pulse. There Is 1 Inch atrophy of the left calf, measurements being IS over 14; and there la 1/2 Inch atrophy of the left ankle, being 10 1/4 over 9 3/4 Inches. There Is absorbing ecchymoal* over the entire lateral and dorsal aspects of the left foot. There la restriction of 10 degrees of plantar flexion and 5 degrees of dorslflexlon, but Inversion and eversion are unrestricted on the left. I have had x-rays of both feet taken, and It Is noted that there Is a diffuse de-oslflcatlon of all of the bones of the left foot.' The Joint space between the third cuneiform and the third metatarsal bone on the left la par ticularly Ul-deftned. There Is no localized area of bony destruction noted, but there are these changes noted above; particularly de-osslflcatlon. Discussion: I feel that at the present time Mr. Cuthbertson is exhibiting signs of an earty reflex dystrophy or Sudeck's atrophy of the left foot. The clinical findings and x-ray appearance are typically those of an early Sudeck's or reflex dystrophy. When seen on the 19th of Auguat, l started the patient on Prlscollne for peripheral vasodllltatlon of the vascular supply. He has been seen by me on two occasions, the 20th and the 24th. The foot l* Improving In color and warmth; and, since the patient has been provided with a light Trim-foot arch support to minimize the excursion of bones on weight-bearing, he states he Is much Improved. I will continue Mr. Cuthbertson on Prlscollne for an additional two to four weeks, and then will re-x-ray the foot. Meanwhile, he remains physically able to pursue his usual occupation, and I feel that even though the diagnosis of an early Sudeck's atrophy la apparent permanent disability will not be realized. Continued symptomatic treatment for an additional month Is Indicated, however. .. . Thank you for the privilege of seeing Mr. Cuthbertson In conaultatloa and for treatment. Sincerely youre, MTH:ACP Melvin T, Hurley, M. ooo< ~ ------ mu- ` ---Tinmir^----- E P a T m a n in s irrin aiamsaJas-- i t f 1. A. B. THOMPSON, M, O. *H 1UDIM May SI, 196? y Industrial Indemnity lag* Co, 269 Grand Are* CiU.sd 10,Calif. Attention Ur. niaeoervei* Re i Plant Asbestos Co* ' Robt* Cuthhertson Injured 5-23.57 Ur* Cuthbertaon was Been at this office again this morning* Re la still oonple1nin5 of lerara pain la the left ankle and lower leg* He tends to keep the knee sharply flexed and the foot extended and internal!/ rotated, Yellowish discoloration extends nearly to hla knee and to the baae of hia toea. The area about his left external malleolus la markedly bleak and blue* The ankle lastill too swollen and sore to permit any weight bearing, or to bind with adhesive tope. The xreys were reviewed, and I agree that no fraeture or dislocations are visible* la order to facilitate the reduction of swelling and aoreaess, and hastsa aetive motion, dally physical therapy at Herrlok Manorial Hospital waa ordered! fthlrl- pcol bath and light sassage* Progress will be reoheoked after a few deya* ' The present condition of his ankle would Indicate at least two nore weeks of disability* /O A*n.Thoapaon,ii. !-- II OOO'1;.:1 n ' fOA COMPANY UfK U. C.J. * O**. C1M Mu aM_--_ _- DOCTOR^* FIRST RSPORT OF WORl*iNiURY INDU'^IAL INDEMNITY C jllPANY , IM'aMAhP AVOWS . OAKLAND 10 TCH*br t-SIOt ' 7 . "9 (tdUtalo Mil a*V to ft* atviuoR or laaos mmneA a*b ariniCH, r. 0. sox at. sax nuutcaeo t. rlw< H SI* n*M IS* BttUtoa I* al<i>WM, (UW C*S*. Iirtm **et44lt.| Awmi it a**e-- mt. ron COMPANY USE BukriftalUa r.i.i .!. EMPLOYER .....?,Lait..Aabe.etoa..Company.................................................................*.*................................................ .1 Address ITu;"'..1.3.00. *A+-h fl .E*ry11 j a, C1 i ............................................................................. a . J, rO* US1 )n rWM^faMu*i arveetee. M.iiisr fefMie* m* . iMM. w I .. JA t Ul * 11 OB........................................................................................................................... 9 M ril4 A EMPLOYES Robert Cuthbartaan .. ............. ......._..... 5. Address *?,;,?...... ?.*3.a..flAr..TJ.n..AT^j..JSLU.hflnd^...................................Phone NoB.O-4"5J5.4.7... 6. Occupation...Ia.KulAti.ftn..Rflr.kar.........................................................................Ao#..I9.r^............Sex.........M............. 7. Date Injured ,6.n23-.6.7....................................Hour.lU.1.6A*..M Date last worked.fir.2J.r.5.7....--.................. 8. Injured at *c.;,?'..2ayf air Shopping...Can.tor.^................................County ..AlAJ-.ada................................ 9. Dale of your flrsl examlnallon,-2.3.T.STourlll3.01V Who engaged your services?.InJ^.............. fa Nome other doctors who treated employee for this Injury .La0n..B-..u.dfl0ok,.U.D.,,.1392L.J5... . i<* tA it* Old . 11. ACCIDENT OH EXPOSURE! Did employee notify employer of this lnlurv?...X.^.s..XmeIovee's : of cause of Injury or Illness* daer allpped sa he was ooaing down off a step roof* allowing him to fall about 10 feet bato the aeooad roof* twisting his left aokla aa he atruok a^ 2 x 12 timber* r-: -r. 1L NATURE AND EXTQfT OF INJURY 08 DISEASE qkm* *ii *i**a** nasin**, >b(*mv* U MMMWMl <I|||H i**t* *>* 0l ***t liliwy. *nS *--*) < inmrinn Tender disoolored ewelling a bout the left external mallaolus and orar the aide of the foot* Minor abrasion of the akin* Nearing an elastie bandage and on ourtohes. ' 13. X-rays: By whom taken? ___ iM..A&y.dB.*.9.k *H..9.,,.X5S-?.l...E....XAkh..8.*._Q.q ){..., Finding*: ftportedly negatiYe. ] 4. Treatment: Sleratlon, rest end Conpr 5. Kind ol ........QffA.t.c...........--If hospitalized. dot*.............. . Estimated stay.. Nam* and address of hospital..................................................................................................................... ........... 5. Further treatment ........................ ........................................................ 7. Estimated period of disability for: Regular work..jS...KO0kj>.............. Modified work.....--........ 8- Describe any permanent disability or disfigurement expected ----, ---Hone .................. ........ 9. If death onsuod. give dote Q> BD4ARXS aor P-- * !*N>m m Sw*n. ** hr ***wl **--Marne m leimur i**m, w hiiii| >iln*miJ divan a "shot" of Tstanua at Dr* Rmdneeka' Offioe* 81 Sap. Cod #3. i 36 Slg 1 pro pain, ame...4A$.!.T.9.D.?S/?............................... .Degree..tt.tl..] UINIU | ItItII*AmfVmlC ]] ato of report.....Addrosa Uh rtv*rn tid* if more space rrgefred ** T ?!r>r^rr^______ ___ ....... Phono No.Xxr.d.rXO.51. oooorr; 1 I  fJTfci-IW fO*. COMPAHT OSS DOCTORS FIRST REPORT OF WO^klNJURY INDL UAL INDEMNITY CwtfIPANY , fOl COMFAXT OSS tao sansoms antesy . 1 silk rautctsco 1 . k TUtaa moo* ,t Wifc<i>i mi fm wA m MVI *H| * to. pmstoe ee uioi sransnes un umicx. t. 0. tot n*. $am nuutcwco l rlw* to * >m m to. to tolim.n. (Utoto O^to. l.toiw mt-mu *"* ----- M*r T.M -j. CMwrtra....... . .&UAt_AA&s.4t.a_________ .. - . 2. Address *7m.7'............. ................................................................... .............. ............... ............................. ..3. Business .............. ...................... 4 EMPLOYEE Robert F, Cuthbertson A Address 'St;,? tdarvin Avenue, Richmond, Calit. pw* m,, 8E.4-5847 6- Occupation...........!i.n.5.Ul.a.fsx ........................................................ Ape -.23.......... Sex-M. 7. Date Inlured......... 5/.2S/5.7..-- -HowB.iX5...a...M Date last worked............... ................... .. 8. Injured at sa^1..-........WOxk--,----............................................. County-AlAffleda~y-- ........... 9. Date of your first amlcvatfcn.5/23/.5Jlo\uBAR5.a..M .Who encoded your services?_... ..?X--F_ 10. Name other doctors who trealed employee for this tnJurYV*??-................................................................. 11. ACCIDENT OS ECPCSUHE; Did employee r-cCfy e.plo7. U his mfuryr....Xsft.Eznplyeei* statement of couee of Injury or Illness: While working on a ladder about ten feet off of the ground, the ladder slipped out from under him and he fel 1 from one roof onto another roof landing on his left foot on a board. Left ankle is swollen and painful. He was not 1Z HATtJAE AND EXTENT OF INIUHY OB DISEASE iwmn< 4u.t nm. 4m * ............. m<wr. x ftoSIM*, aa4 <l]ni> Examination of the left ankle shows moderate swelling over the lateral malleolus and extend ing onto the foot. Severe tenderness is present to pressure. Skin has a slight axt abrasion over the dorsal portion of the foot just below the ankle. . Impression: Severe sprain of the left ankle. 11 X-rays: By whom taken? <**,_____ Leon R. Rudnlck, M. D. '' ~ ' ",______ ____ Findings: Three views of the left ankle,' no fracture seen, two views oi the left foot. There is a questionable chip on the lateral view off _ the cuboid or possibly teneiform bone. U. Treatment: Acc bandage, crutches to' the patient. 15. Kind of caae hospUollaed, date................Estimated slay._____ Name and address of hospital..................................................................................................................... 16. further treatment i!fiEr.TM....y.e.$,.................................................................................................... ................... 17. Estimated period of disability lor: Rebuke wofk..2...WCCkS...........Modified work.............................. ....... IS. Describe any permanent disability or disfigurement expected ir-ir-rn . K'on^............................... ....... 19. If death ensued, olve date VX REMARKS ix... kmm m w< w tmm4 hwinkm #* m.it * *r mukimj Tliis patient lives in Richmond and states he is unable to return to our office. He is to seek medical care in Richmond for the rest of his treatment. -\\U0ifr . iie....I^aa.Jt...Rudnici.,._M-..ruD^T*e} .^5 l LL.l-bM? of report...6/1/57..........Addreee r?,"'Li9i2J..ii..I.`1.til.S.t..5aU.iJ.'anctrO............'..Phone No................ t'*e mww axle 1/ more *f*<-s w^niref Q()(j(l" ( r^r ------ * tw -tfe K-t-. ' Before the Industrial Accident of the State of California l^'; AUG %'i W1^ '; htotrial Accident fommtelon QjMtW\il Ottlc* ;.'.' \ -V/.';- . W...'answer. :); ' ,f*. .iV. oOLtTxni v cr-mn ir_nm wnwa nfcwi F!LC-D r AUG 2 21960 Oakland GKta la Res LA.C. No. gQ OAK MU Our File.No. 57-51-02039 . ' v ROBgRT r..arnrMyrsnw r ' ?iATg iisassras cggAre arid. mnjsmiAL nra-Hrcm co-gm la answer to the application, we nuke allegation! and we nix the issues which art checked below. Should otlxr issues not now known to be proper aod necessary develop later, we reserve the right to raise such additional otoei in accordance with the provisions of Law and the rules of the Cammisaoa. .. . : .-.-4. ' . V-v; f:' ' .. Employment *:y: ' Q Earnings at the rime of injury . r> r\ . jfifcNatwre end extent of disability . rrfS Occuparion of claimant - 3cLiability for medical treatment ^ ` j[. Q Insurance coverage (Employes hat been . v V I-* -". >*U. notified to appear and defend) -'V r vV: Injury triaiag out of and occurring- '. - { *. * Q----------- . in the course of employment -i* . . -v'.i i' ' Statute of limitations jgfc Medical reports have been served u Uctcd in covering letter..' Disability indemnity has been paid u foOowst '' - i . ' V ;> " ('. ' .Vi'.'-' Temporary* * ' and 8A/57 . Total j j*Q571 .? ( \i ' 1` i * '> ; (g f hO.OQ wtek Permanent; '* _ . ' Beginning - wqwR__ -to and including. ....fll.:--i Total <--zZZ-- @ t___ Zir----------a week. y0t believe that the presentation of our evidence will require a tniaunum Eitunatad number nf if svaflahl* -- 1 _ ^ _.........r ` . - . hour ' `- ' is 'n HB'jBBtTtL THTffMHTrf CfWTWITf RaMC11CK R 7' /L5^f jf. 7K^/m . ? ' 350 SMBOg ggqgT. BAH TMX7BCO.i. CALjjHjtflA Noth A COPY of ckii Aasvst ihdl ba wrvsd aQ advans pwtiM, ar stair stw**f, sad a asesdoia ed sack sank* ai tks fwtlw mttMawtbsosadsbsrsoa. . ' ^ ... ,/jj ,y , >,. . fUM MTVsdt Balthj Parrish, PaAuck U Clancy 501 financial Center Building Oakland, California * . ' \V i . 'k i; ? v'U- ' 1'' s t V. . * v . rv.< <m i*r. . vt'c* . ..1.r-. V' " 1: X :V '. 5 f TAT< OF CAUrORMUli "f' * *' "` .O'' <-'; / 'C;;:;0;. '.'.industrial accident commission - .'- /:; "-r-yy,'v^.': ;y.V- '"-'i\` * -'TV' f,. . ' V - 0-:; '-:-XCv . . , ; ,di%. > .. .. -. /' */* !* 11 v <!.' ' '-'.i 'ii . . v j *. ; '*-v* - v -. : . . V,-' 0;.- '}; ` -* iyekpsd copt .........4'' :. : . ' ' "ilv. ' ~ --------------- > ' 1 ft ft R0B^-..f*' apUtThrftlbnBeEhRtflTwsiSoaOntriiv7r^;.,.:..-*.*.* Jr * * Tr *4 y M * *F* '' .' / _ - , *. NOTICE'OF HEARING ^ ...... vi&v .. f. v, ., v. .too'?;v 0;&; ) y> r"-:'.- - > VYvy-oy h*.v.-.'irSV-.. 7 V WVV5. PLANT. ASBESTOS CCMPAJff *nd` ;y:^' \ .*' ^.V'-- *( :^k ;: .-; INDUSTRIAL IKDEMWITI C'CMPANX '(>'y*t ^s-'-P' 1 .\J.-y V '-'Ovr' ; `0 f y. \7'y v ft -yv;;.y v*. v'-' A y Oli;.'/.O'" 'A '' ' v... ' You utFlfereby aauinl tKit la appUadoa foe uoutpum^oA ( copy of vhiefa n imcIW bema) bm been 6bd iiA ' . tb loduitrU Accident Comauanco of tb Suu of OIifomU.'.^`oa an iiteiba wstiBtd tLt' mi cpplkstM Itu boa *s - .. . \. foe bea/io^ t , i : ., ` v. ` ',. - ' ? . ' . . * . j,. ; .yAooO STATE B^JTLDtNG ' ` 7 --./V . '. "Ay : y ^ JACKSON STREET ' : v'/-; iv. ;i . V ;' Septeabr 2>rd'f'I960 OAKLAND, CALIFORNIA .!' lOOO-A.ILfl ' . ' v ` .`y ''V. /7,-FRB-TRIAL..C0If?`ERENCS .' ! - Lad due ti.uid da< tod plic* th loduttrui Accident CaBuutuoo of.tbt Sat* of Cfenit i0 procoed ts bar W ^ ' " ' diipo of tbt aid jppIlMtioB tbe ntsser peaezibod by Utr. v ../, , , . ' ; . '* ... .. ' a- ,,,..' - . ' - Nor*< TW ptrda tn n|irtil t* <ho>( fl U ram wrf kwilil pimi i in 4kMm m bk UMbci <ied>w> >S m t J a ; - / 1 ; A.;. 'i *. - ' ;`r- j> .yv..:'.'' -r 'y.-:' IJ .. . . *..7- ; .. ; .. t. t . Ybo uadnfncd cutific* tLt u ta onpVoyee of tbe ladwtrial ilccideat Comauuioa <b mntd tbo fet(onc . v the putja haninifta nentiooed, t the tine let oppodte tbe/ naptetrre nines, by defatting a copy of etid node* art^ind - * ^ l. i . to t copy ofdbe application tbmia mmtioaed, ia a acaltd carelepc in tbe United States mai on nid day, at OaUaed. - . Califofaaa, ditk the pottags tbeaeen folly prspsid, and. tddftntd > the eaid perriet at their last known place* of l~e~nr >' -. J' or refldmeo^u fallow*, to wits , i , * y ., .; '^ ;[ ' . >, . . * . . ' - . ( . . ;*, i-,> a": -v ' .'V . / a :s HAMEsopmTm jbivio -.' . y.'v f. dati of saiw - . r1 x^'"> >**<.r-.; : .. y.'v,.-. . :y -r,s. Robert^.'Cutkbertflon,` 243B Carrin. AV<inue,'v,'Richmoadr California'' r *' .. Soith.PfiiTiahaPaduck k Clancy.501 Financial-Center Bldj*.,Oakland,California Plant Aabeatoa Company, 1351 Ocean Arnue,-EeryTillet<California : .-.f '-^:v' W-^:- f< . : ; ft-'y ..'./.v?-,8" V . 'j yy .> 7 ._ P0 l|4adl.. tjm. (*! y,' \ . ' v?:'*- . v: \ 7" >-- WW?'J STAYI OF CAU70RNU ._ DtTjUTwiKT or aoumwt ulationj 'MrM " . mrttKTRlAl. ACCIDENT COMMISSION BiViPtt,';r |t;OTW Je.-r.cC* l ww if !'C'jnta ioacra rlLEO ... ' -iUL 2 S i960 \\u JuU3:-j:o APPLICATION vvJMitWw ....: Oii'ai flffica . , ^}0'"- 'CRkl&Kd Office /P - / CASS KOI ^ . ` 60 OAK3S13 / / ROBERT CUTKBERTSOH - *' * ... ' I! . V flarvl.?- _________ . inmuriJMii ' i Richmond.,, fcallfoanlft-. PLANT A3BSST03 CO. '^ IXKXKrarity Now. 7 Orran flw. ii*v*nrniiiiw ' Emeryville, Cftll-fonniA rb V INDUSTRIAL. DTDEMMITY_C.O. iinmii iirnua umii i *. nuiiw urtwr* OBlr,lftnrt.Ca.Llgoni.t& . b, . allega cine while employed w. -S/-23------ -5T 4I* m <MO , insulator MlfMl# f tUt *# 4tA1 ___ Oakland _ ______________ . otr. tv m n*t* vtoi uitT m**mn , CbSfor&ia. by Plant Asbestos i4i(rtifutu Jm ruiUtned injury amiflj oat of tod la the coone of the .aaptoywat, u feOaw*. fell itiuit ** unniu nu<n left ankle ln.lury MHtutMnw tMiwn win . nwMin nmn i. Industrial Indemnity Co .wu the employer*! nxiua carrier at date of injury. uii imuia m. w Iinttti tu ut iMin. tun mini UJ.IHM11 H liMvm J. ____________________________________________________ niiwwimi mi t* m wm 4. Tu eorapeoeaiioe YeS . iuhm - tttu 14* nil umiimim nmi ttAT nit tan uee nmi II Ml HWIT I. Exrniop it tune of lojury f--M33C .^ Yb* boaJa of pay *11. iNti aa nn nmm nmaunuuit. wnin'iMUiKi t, Tu medical treatment - - - Vb fuToiihed <r*atir.nr>_ - - --- 7. Thi* application it filed CO datermini liability (on ` a. Temporary ditaLTity - b. Permaoefit dlwbility..,,.X?. e. Medical ""> YeS d. Mtfnl a. L*(i|tMA eprate. mtl tt Mil MAM .. .0/4/K. Vasa. (am iiiHNwm mi imiiATM mil VHEMfOKjE, li U fffvttttJ iblt 4 ti*t snd fUst bt ffxri for b<*tr*t tnJ tb4t a ncr/ bt Wf ptntrjt roeb frt*f m mry br pi*p*r **Jtr the yVorkm*uU Competition Ldwt of CtUfomU* * . , Dated at., . 7/26/6Q________ Califonws_-___OSUAnd KeariAf rt^uoted at. Qalrland Number of witauaea. /y Extinctted time of **<*!-'- ^ hour ' V1 (/ Sirred oa: FOR OFFICE USB ONLY EE' EEA^` ER * ERA ' . . 'Hi "il O' (l Ms <L~-(LL~L immtrt uMimi Ip, Pflrfnrlr At filAn/<y -wwiiI'hitwmt ^QT-RInannSAl Cen^y RVg, imuin mv m tuimi mmm oomr-r M4 ***<# ArM VMS UVl U< fifMiV f M* <" * '"W* V* MfMMKM, U tvdt 0 fia* _ ....M*><W*ItaW<UU1M*i/tV< awrMltMMf Mm* I m ImM * IMIMifll M Mll|< I ft mMMt VMI MOT. 94 |Jit. *M) \___ 4 4 INDUSTRIAL INDEMNITY COMrANY Oakland OflUtt 968 GtAKo Avurtra, Oakland 10, CwndnA TVyin* TJbyltimr J.JIOI ' September 20, i960 tnflirttriji Actitlwl CtwimRiltm RECEIVED $P2 I I960 * Oakland Office Industrial Accident CrrmHalon 1111 Jackson Street Oakland,'California SUBJECT; Robert Cutbbertson rs. plant Asbestos ctnpany Our Pile No. 57-51-02039 I.A.C. No. 60 OAK 3913 _ ` \ . Gentlemen: Enclosed for filing as Defendant's Exhibit next In order, please find report of Dr. Melvin T. Burley, dated September 16, i960. Copy of this report is being served on Applicant's Attorney this date# Sincerely, Patrick R. Ms Attorney at lav PJW/df ' ` Enel. ce: Saltb, Parrish, paduck & Clancy, Attorneys at lav 405 - 14th Street, Oakland 12, California oof*'' ISHJIIJ1W IMP IM J S' r* town n cuter, jt. Ml* *. (Nil & otfioe* M. mnl MUM JWIW (MUI Mlt iui w. waiter law offices or SMITH, PARRISH, PADUCK Qc CLANCY PlMAMtflAl elNtM BUICAIN rfoi . Mt* IfUttT > 0*UH9 H. CAUP0AMIA Septeaber 8,1960, UMwf >4M Industrial Accident Commission JB<axxnAK>'Aixgtt llll Jackson Oakland, California . - Rei Robert Cuthbertson va, Plant Asbestos Co, k ind; indea. case # OAK 3913 Gentlemen* of Dr, Slaenberg Enclosed herewith find Medioal Report/whioh we request be introduced as applicant's exhibit next la order, Also enclosed is bill which we request be allowed as litigatioa expenses. Very truly yours, cet Industrial Indemnity Co; 268 Grand Awe,,Oakland SMITH, PARRISH, PADUCK k CLAHCY t po<w*'*' r* .. 4 INDUSTRIAL INDEMNITY COMPANY Sw Fmndtn Division: 350 Saniomc Sntrr, Sax Fiaxcmco 4, Cautouxu rw>fiUw riJHn >3ooo ' August 1$, i960 1 )l'* AUG 22 19i>U r-tetrlai Acdcent utnmlsslea BB industrial Accident Ccnalesioa 1111 Jackson Street . . Oakland, California : ` ; Re: Robert T. Cutbberteoa vs. Pleat Asbestos Company Claim Bo. 57-51-02039 XJLC. Ro. 60 QUC 3913 Gentlemen: ' . * Enclosed please find Aasver In the above entitled matter together vith our complete medical file as follows: Leon R. Rudnlck, M.D. A.R. Thompson, M.D. Melvin T. Hurley, M.D. 6A/57. 5/23/57, 5/31/57. , 0/24/57, 9/26/57, 12/30/57, 2/6/58, 6/12/58, 10/25/58, 5/30/59. -- Copies of the Answer end our complete medical file have been forwarded to the applicant's attorney. ^tiii Very truly yours, Patrick R. 1 Claims Attorney PRM:mae Enel* cc: Smith, Parrish, Paduck A Clancy 501 Financial Center Building Oakland, California onof'''n III**1 W-'llW JHWl 1 *>.T ATZ 9 OFFICE M'.WO |(0 > >04 ( ` r< *CAfl - QAKUJiD 0*v. 4/12/78 Beverly Eaersoo VCAB - SAM PRAMCISCO *. 557-0680 Sbj.; zxcirES PILES oenMVEO APR 13 1978 . orviiiON o ixe>t'i *CCid*t* qacuhO omiCI Heaae forward the following files to our office at my attention:_______________________ SOODaLZ, Fred jZ OAK 8566 ^ (CUTHBERTSO??"Bobe?tN5^Al!>^055^0^?^^/^ /***? EVERETT, Allan fajOkK. 11139 ,Lt2^< ~u^mks 4 STAfl Of CAUSQINIA f V $ **- -- ooo'jon iu.l_*'..:'_.- r; ' ' i rr-i .- . - - .- ' 1 BEPORE THE INDUSTRIAL ACCIDENT COMMISSION OP THE STATE OP CALIFORNIA 2 CASE KO. 59 OAK 1053 3 ROBERT P. CUTHBERTSON ) 4 Applicant ) 0 vs ) DECISION AFTER RECONSIDERATION 6 PLANT ASBESTOS COMPANY, J, T. ) THORPE, WESTERN ASBESTOS COMPANY, ARMSTRONG CORK, TRAVELERS INSURANCE 3 COMPANY, INDUSTRIAL INDEMNITY 8 COMPANY, PACIFIC EMPLOYERS ) INSURANCE COMPANY, STANDARD 9 ACCIDENT INSURANCE COMPANY, and ) STATE COMPENSATION INSURANCE FUND iO ) Defendants U) 12 Reconsideration having been granted herein and the matter having been carefully considered, including the report of 14 examination by the Independent Medical Examiner, as well as the record aa a whole, this Commission now concludes that further Id proceedings are not essential for the disposition of the claim, 17 and makes Its Decision After Reconsideration, aa follows: 18 GOOD CAUSE APPEARING THEREFOR, 19 IT IS ORDERED that the Findings and Order, filed herein 23 December 15, 1959 be, and the same hereby Is, affirmed and adopted 21 as the Decision After Reconsideration. 22 INDUSTRIAL ACCIDENT COMMISSION 23 OP THE STATE OP CALIFORNIA 24 23 26 27 28 29 30 rote >M l"-s rf, \ v ROBERT P. CUTHBERTSON December 29, i960 i# V va. PLANT ASBESTOS COMPANT, et al case mo. 59 on: 1053 REPORT OP PANEL ONE Based upon the report dated March 30, i960 by Dr. Shipman, Independent Medical Examiner, It la the conclusion of the Panel that applicant did not sustain Injury arising out of hia employments from July 1947 through December 1958. The Panel further concludes that the disability complained of by applicant was not caused by any injury arising out of and oocurrlng in the course of his employments. Decision After Reconsideration should accordingly issue. 1 ' 1`' ' ' 1 INDUSTRIAL ACCIDENT COMMISSION 1 A OP THE STATS OP CALIFORNIA 1 CoEsalssioners coo; m _ 'W'*: -------,v ..^-1^ ^ tg V .1 . : .i ' ' . u . - * . . . . .-ROBERT F. CUTHBERTSON vb, STATE COMPENSATION INSURANCE FUK3, fet al. Claud M, Dunn, Referee' - * ' ' December 13, i960 `' - Claim No. OAK 1053 * . . REPORT OF REFEREE ON DECISION AFTER RECO?fGITERATION ' Referee Anlcele, who heard praotically this entire matter, issued a" denial award, the claim being one of asbe3toois. The natter was exhaustively handled medically* .Subsequent to the eubmi-ssion rst iSie wane,'the parties agreeing upon an independent medical examiner, K. Corwin Kinshaw, M.D*, served in this capacity. The Panel, wishing furthor exploration of the problem. Itself authorized an examination by Sidney Shipman, M.D,` It was for the cross-examination of this deotor that the matter was assigned to this Roferee. The three doctors, Hlnshaw, Shipman and Brown, are in unanimity in their epinlon that the applicant does have asbestos particles in his lungs, but they are non-di3ablins, do not require treatment, and that the degree f ebservation required as a result thereof is not any core K' ' CLAUD'm.'DUNN, Referee ' V . - * \ * San-Francisco,'7-6-60 ' ';V *" ;,V . . ' **. 4-f-' | . ` . ` r` , -.1. . V 7 , . i , ' ; . ' ' . ' ' - -................ . U >'' * ' REPORT OF REFEREE' * - > ON ttEARINO AFTER HE-H5ARIMQ-GRANTED* ' ' SIDNEY SHIPMAN, M.D., qualifications stipulated, testified .. that pursuant to the appointment by the Panel, ho had seer* the* applicant and that there had been made available to hin the ` pathological report,, laboratory analysts *of lung tissue and . -* the.reports of Dra. ^Wat6on,and Hinshaw, - ' . . . ' -'Testified that there'wa3 no demonstrable evidence of asbesto-.-^^ ; sl'a.v .There was no disability at-that>tine, but the ran did ' . have" asbestos particles in. the`lungs, as well as a fibrosis, A3 the years go' by- the man'way develop symptom^ but he does not ` , have them now. He does have, ah occupational foundation there- -v fdr,` :, . * `- ; ' 1 Complaints of chest'path, $ague in location, were compatible . ..with asbestosis, and periodic x-rays, due to the presence in.,. '-.the lungs of the asbestos bodies, were indicated the sane as' l' v for everyone else working/in a-similar line of wage earning capacity, as the applicant but no greater. Testified that it ` ' was his opinion that as yet the man did not have any lung dis. ease," He probably would not have. There was, however, tefi- ' nifce evidence of the existence in the sum's lungs'of asbestos . bodies adequate in sl2e to produce the disease. Testified that' ! ' he nade this otatement even though the synptons were not on- ' * tiS'ely consistent with the diagnosis'of asbestosis. - He differ-,^. ' ' efttiated between silicosis-and asbeetosio in that silicosis set*.' -! upai fibrotio reaction which asbestosis did not. ." ; - J-Testified that the Applicant ought to* have x-rays' every six > T .months.for' several years and then the. borne every year'the cane- v'afl every other employee.similarly employed.- Testified.it was ti^ie 'that there were bodies present in the lungs and there was ' some'tissue reaction Hut that these conditions were insufficient " to cause, disability,- * 4. * `*. . ; . - `' ** >/ /' / . w' "- - . ' %- /-* /* .Testified after cross-examination of all'the various counsel ^ . 'present that he w^a'.Still, of--the same opinion as aet forth in . . . .his .report,.* * BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA ROBERT P. CUTHBERTSON, \ Applicant vs. PLANT ASBESTOS COMPANY, J. T. THORPE, WESTERN ASBESTOS COMPANY, ARMSTRONG CORK, TRAVELERS INSURANCE COMPANY, INDUSTRIAL INDEMNITY COMPANY, PACIFIC EMPLOYERS INSURANCE COMPANY, STANDARD ACCIDENT INSURANCE COMPANY, and STATE COMPENSATION INSURANCE FUND, Defendants No. 59 OAK 1052 MINUTES OF HEARING (RECONSIDERATION Place and Time: San Francisco, 7-6-60, 9:00 a.m. Referee: Reporter: DUNN PARKER ' Appearanceii Applicant present; represented bySmith, P3rrish, Paduck tc Clancy, Attorneys (Joseph E. Smithappearing) ' Defendant carriers Travelers Insurance Company and Standard . Accident Insurance Company represented by Hanna & Eroohy, Attorneys (Ivan Schwab appearing) Defendant carrier Pacific Employers Insurance Company rep resented by Mullen & Fillppi, Attorneys (John Moore appear ing) ' Defendant carrier Industrial Indemnity Company represented ' by Patrick R. Maloney, Attorney - Defendant carrier State Compensation Inaurance Fund repre: eented by James Vonk, Attorney WITNESS: Sidney J. Shipman, M.D. DISPOSITION: Twenty days to the parties for further fLlinga, this re ' latlng particularly to a Compromise and Release; the time to be extended on the request of any interested person; otherwise submitted. 7-6-60 26pp nfi.numnnmjii nupfjiiiwwppwyrawr.^i^ri.v^rs T-T \ 0 TV; Before the Industrial Accident Commission - * :\ of the State of California. : t .. *'* * t .1 x. ROBERT P*.- CUTRBERTSOF, - - .. f : ` AppfcmtJt, ' ' VS. . PLANT ASBESTOS COMPANY; J. Tv THORPS, WESTERN ASBESTOS COMPANY, ARMSTRONG ' CORK, TRAVELERS INSURANCE COMPANY, ' . PACIFIC EMPLOYERS INSURANCE COMPANY, ' ~ STANDARD ACCIDENT INSURANCE COMPANY,'.' - INDUSTRIAL IMDZKHIW COM?Ainf, and v STATE COMPENSATION INSURANCE FUND, ' . - ' ' . ' Defendant^ Notice of Time and Place or Further Hearing * - . -if rrj rlLfcO .`MAY 1 6 :3C3 . />tt/ .NOTICE TO ALL PARTIES You ire hereby notified that further hearing'will be held in tbe abore-entitled actioo at \ " ?*:. --v*:. ROOM 2302 *. :fc -*:.'h.55 GOLDEN GATE A^rcs ' ,.` SAN FRANCISCO, CALIFORNIA . - : * <1 /;/JULY 6 I960 -- 9t00 A. M. t 4 .. . .; , -) * ,, ' ; ' \ ^CROSS EXAMINE OR*. SHIPt'AN ^ ,,V-' i - . S Dtuiir. ' ; \. 'MON RECONSIDERATION GRANTED. ^V . '* San Francisco, Calif. c` . May 16, I960 . . - : V v. -- . '*i. ; W / ^NDUSTMAC-AOCIliEKr 60%QCSSOM; " i' i* . . . i NOTE* C0NT1NUAKCES. AND FURTHER HEARINGS AM NOT FAVORED, SERVnIeCEz UupPoOnN;; ; . . /' . : . . . ? Robert F, Cuthbertson,``2U3S Garvin Ave. Richmond, Calif.'- V' Smiths Parrish,-501 Flnanoial Cantor Bldg., Oakland, Calif-* Plant A3beatoa, 1300 6U.th St. Emeryville, Calif, . .* J. T. Thorpe, 1351 Ocean Ave., Sneryvilla, Calif. '* .^ Western Asbestos, 675 Townsend St., San Francisco, Calif,Y. " Armstrong Cork, 304. Shaw Road, San Franeisoo, Calif. r Traveler's Insurance Co,, 315 Montgomery St., San Franoiseo, Calif. Paciflo Employers Insurance Co., 24k Pino St., san Francisco, Calif, Stats, Compensation Insurance Fund, Personal Service Industrial indemnity Co., 350 Sansorae St*, San Francisco 6$* Calif, ' Hanna-St Erophy, 100 Bush 3t. San Francisco, Calif, ' r* $ t PM 44, inrMl, AR ew ififjuoiv / *Y $ ROBERT P. CUTHBERTSON v PLANT ASBESTOS COKPAET, J. T. THORPE, et al May 3, I960 Case Ho. OAK 1053 REPORT OF PANEL ONE Pursuant .to request dated April 21, I960, toy applicant, the case should be returned to the calendar for cross examination of Dr. Shipman, the independent medical examiner. INDUSTRIAL ACCIDENT COfCCSSION OF THE STATE OF CALIFOP.'TA Commissioners -------- ------- - <-;*;<----- ^ ..Vl'r . o Before the Industrial Accident Commission of the State of California ntr f ROBERT ?. CT7THBERTSON, OueNo__^Li^3 Applicant VJ. PLANT ASBESTOS COMPANY, J. T. THORPB, WESTERN ASBESTOS COMPANY, ARMSTRONO CORK, TRAVELERS INSURANCE COMPANY, INDUSTRIAL INDEMNITY COMPANY, PACIPICAEMPLOYERS INSURANCE COMPANY, STANDARD ACCIDENT INSURANCE COMPANY, and STATE COMPENSATION INSURANCE FUND, DefmJent NOTICE OP INTENTION TO IT APPEARING THAT the report of the Independent Medical Examiner, Sidney J, Shijxaan, M.D., dated March 30, 19^0, served herewith, has been received and filed in evidence. NOTICE IS HEREBY GIVEN that the above-entitled case will stand submitted for decision upon the record as made, including said report. 10 aid time . " *rvic hereof unlea Good Caute to the contrary i* shown in writing within . INDUSTRIAL ACCIDENT COMMISSION .OP THE STATE OP CALIFORNIA c5<^. PILED AND SERVED; ^ 23tut Carnal'ssi9herm Smith, Parrish, etal, 501 ^n&nclal Center Bldg*, Oakland State Compensation Insurance Fund, Personal Serviee Mullen and Flllppl, 315 Montgomery St., S.P. Hanna and Brophy, 1540 San"ablo Ave., Oakland Industrial Indemnity Co.^SpO Salome Street, S.P <*(*. (.*< SIONCf J SHIPMAN. *4 0 JtOUCOT W CLARKC. M 0 CIUABCTH M OAL0BAITH. M. 0. * o *<>. t '(* am rAc>tCO , Maroh 30, 1960 Industrial Accident Commission 455 Golden Oate Avenue, Room 2202 San Francisco., California Front Sidney J. Shipman, V* D* Concerning: Robert F. Cuthbertson, No* 333208 2436 Oarvin Avenue Richmond, California 0 Gentlemen* The following is my resort on Mr* Cuthbertson *jo reported for examination on March id, I960, at your request: General History: Age 31. Born May 4, 1928 in Albany, California* Married and has 3 children. Home address: 2438 Garvin Avenue, Richmond, California* The Problem: The diagnosis of asbestosis has been made In this case, baaed upon history of exposure and a pulmonary biopsy* Doea asbestosis really exist in a clinical sense and, if so, what is the degree of disability? Chief Complaint: The patient says that prior to operation he had pain in the left chest but this was so long ago that he is uncertain as to its exaet nature, whether it was sharp or dull or whether it was aggravated by breathing* Slnoe the operation, his pain la aubsternal and radiates to both sides* Family History: The father died of canoer of the larynx at age 48? Mother is living and well, as are two sisters* Patient has a twin brother ti o is said to have asbestoaia* Marital History: Wife living and well, as are three children, ages roughly 11, 6 sad 4 Past History: t See Page >'lnd. Inden. Co., s.P. wkmnudu\.\ Operations: Tonsillectomy at age 19, th good results*' Biopsy of lung tissue snd suhtotsl lobectomy in August, 1958* Accidents: Foot injured in 195? th fair recovery* Adult diseases: See Present Illness* Childhood dis eases: Usual, dth good recovery* Habits: Has never used alcohol to excess* He smoked in the p*\st up to a package a day but hat not smoked for over a year* - skkvice on: Spmmttitnh 4 Praamrrissnh,, ^lnancliu'center Bldg., Oak. Mullen 4 PUIinpsp*i, l*3u1n^4?WEWoUs*mdia*riySSetr.vioSvwjP>O,*OjL-%k-^ " Hanna 4 Brsphv, mOn-nl 37 iS|iiei|Hiiuiu in J * >s3rr i ji.sjfa iu j^ii I mm j> i. mjmju-i.wum. 'l Robert F Cuv_ i&tson Page 3* arch 30, I960 Vneulir System * Radial pulaea equal and synchronous, of fair volume but diminished tension. Vestel vails not thlokened. Blood pressure 105/65* Heart PMI not teen or felt* No palpable thrill* The sounds are of fair quality. Rhythm regular* A2 is equal to P2* There are no adventitious sounds heard* Cheat Expansion good throughout. There Is a well healed thoracotomy scar over tho lower rlrht chest extending' forward to the anterior axillary line; not tender* Right lung - note good* Breathing vocal resonance apparently normal* Ho rales* Left lung - same as right* Abdomen Ho masses* Ho tender areas made out* 5o palpable viscera* Oenltalla Normal adult male* Extremities Ho clubbing. Ho cyanosis. Ho verleosltles. Reflexes Knee jerks equal and active* Ho pathology made out* Vital Capacity 1 second, 2000 co* Total. It000 ee* Fluoroscopy Both leaves of the diaphragm move veil, although there is obliteration of the right costophrenlc angle* The heart and great vessels are within normal limits* The root shadows are somewhat accentuated* The parenchymal tones seem clear* X-ray fllme 10/10/53 - Heart and great vessels within normal limita. Root shadovs normal* Costophrenlo angles clear* Parenchymal tones are dear* 11/13/5U. - No ehango* ifisr/is3r- jH* o essential change* - 9/10/57 - Taken by Dr. H. Corwin Hinshav * now reveals linear densities in the right base with some Intervening density characteristic of pleural reaction* ....... 11/19/59 - Taken by Dr* Cabot Brown - essentially unchanged* 3/18/60 - Slight pleural thickening and. linear densities in the right lowor cheet, chiefly anterior, comparable to those seen In films of 9A0/59 and 11/19/59. Laboratory ffork - 3/18/60. Urinalysis - Clear, amber. Specific Gravity 1*026* Add reaction. Albumin & sugar negative* Few hyaline casts* Few squamous epi thelial cells* Pus cells, 0-2 per h.d*f* R.8. cells, Hone seen* 3A8/60, Complete Blood Count Hemoglobin 08%, lh*o gw Erythrocytes 5,Old,000* Color index *88* Slight achromin. Leukocytes 9,800* Neutrophils 67%, of tiieh 6ltfC were mature! 3* stab oells* Lymphocytes 28* Ho monooytes* 3 Eosinophils; 2 basophils* 3/18/60, Kolner - Negative* 3/18/60, TORL - Negative* See Page / mm v*,wwiui^mw. w w.wsu 1 J.w W / 3 Robert F. Cuthbertson Pag# 2 "3 March 30, I960 Paat Htatorr Hcblts (contd)t No nycturia. Appetite fair. blgatIonrgood. Bowels regular* Do#a not al##p wall beeause of nervousness* Occupational History: Patiant aaya ho has worked with aabeatoa and -- Insulating materials ainoa 194.7 for various con tractors, both inside and out* He ha# oovaj* xa a mask prior to November, 1959,'vwhen ho waa told ha had aabaotoala. Sinoe that time ha haa worn a aiask. Patient is somewhat Indefinite about his employment and the composition of the matariala uaad. So# "Discussion" for further information* Preaent Illness: . . Physical Examination* Kr. Cuthbertson says that ha has/some chest pain, chiefly on the left side, the exact nature of iblch he Is unable to recall, for several years* It may have begun in 1957 or even prior to that time, but it beeame severe enough in February, 1959 to cause him to consult his physician. The doctor ordered some x-rays and detected something abnormal in the films *ilch he pointed out to tho patient and for which he recommended a consultation with Dr. Gerald Crenshaw of Oakland. Dr* Crenshaw did a thoracotomy on August 13, 1959 and removed a specimen of lung tissue and some of the pleura for examination. The patient believes that thes# specimens showed the presenee of asbestos bodies* Following operation, Cuthbertson had a normal convalescence but his pain was not relieved. It was substemal and spread into both sides of the chest* Rather than being made worse by deep breathing It was somewhat improved* He has had eolds following operation and raises a small amount of sputum, but this has never been marked* At present he is working as before* a well developed and nourished man appearing ' perfectly well* He looks sanewhat younger than his stated age of 31 years* He is pleasant and eooperatlve, although he states he doesn't think much of doetors* Temperature 99.6* Pulse 74* Respirations 16* Weight 163 pounds* Height 69 inches* ' Eyes Ears Nose Mouth Glandular System Pupils equal and regular, reacting normally to light and in accommodation* The extra ocular movements are normal* The oanals are olean* Tympanic membranes ar# normal* No gross obstructions. Teeth in fair condition. Tongue olean* Pharynx injected* Thyroid palpabl# but not enlarged* No adenopathy not#4* gee Page. 1* > Rg; Robert P, Cuthbertson Peg# It, Kerch 30, 1960 i Discussion; I hare examined the rolualnoue file In thle caae# Including the report of the hearing before the Industrial Accident Commission of 11/25/59 the report of the Referee, dated 8/13/59; the hosoital- Itatlon record from the Riohmond Hoapltal Association, Cuthbertson #1053; the employment record from 1947 to 1958 eho*.ng employment by aereral concerns as listed; Dr, Hinshaw*s reoort addressed to Hanna 4 Brophy, dated 9/22/59; Dr. Garland*a reoort dated 10/12/59; Laboratory analysis of lun* tissue dated 12/31/56, signed by W. C, Thlelen; the transcript of testimony before Mr, Ankele of Z.Q/22/S94 Dr. Brown's report of 11/19/59, addressed to Mr. Schwab; xr Ankeles opinion filed 12/L5/59; Joseph B. Smith*s Petition for Reconsideration dated 1/4/60; Hanna 4 Brophy*3 answer to the Petition, filed 1/11/60; John W. Moore*a answer as well as the i answer of Patrick R. Maloney; together with a large amount of miscellaneous correspondence and material. The results of 07 personal examination today reweal no evidence of abnormality except a thoracotomy soar on tha right side of the chest and the thickened pleura at the b&ae of the right lung. My examination indicates that there is no disability at thiitime, What makes this ease difficult is that Dr, Crenshaw obtained a specimen of lung and the specimen showed the presence of asbestos bodies. Doos this mean that the patient has asbestosla? It eertalnly does not mean that he is sick or disabled and in a clinical sense it does not mean that the disease, asbestosla, exists. The diagnosis of tha disease, asbestosis, depends upon; (1) A history of exposure to asbestos dust (2) The radiological appearance consistent yi. th asbestosis and, usually, .. . . (3) A symptomology consistent with the diagnosis _ ,... . together with, ., , .. .. ..... v. . v... . (4) Evidence of impaired pulmonary function In most oases The amount of exposure neoessary to produce the diabase is hard to detsrmlne and varies somewhat from parson to person as we find in silicosis. Moreover, the size of the dangerous partloles varies more than in silicosis. In this ease 2, 3 and 4 are not consistent with the diagnosis of any type of pneumokotvioaia, Thus, essential criteria for making the diagnosis of the disease in this case ars lacking, in spite of the finding of asbestos bodies in the lung tissue ^ilch Dr. Crenshaw removed. In general, X agree with Dr, Dinahs*'* report and ii th the discussion of Dr, Brown dated November 19, INDEPENDENT SJSt*n gaols, oe't (2) medical examines Ends, statements (3) Sidney J, Shipman, V, D 1*41 lijg MU JW. eou'ji? ,irr> June 1049 1 Dion* DOugiaa J-7T77 LUCIES 0. HERTERT M. A. CtMcl Laboratory Bfcoaoalytt <90 Poal Street San FranclKO 1 * Dm March 18, 1960 a Patient Robert Cuthbertaon Doctor Shipman 4 Requeat Waeaermann Kolmer Negative VDIU* Negative yl-_<JLU LslL BK9 `h,< ,Y-y*r- L .M ^ 1 Pi , .' Sullr 104# Phon* DOujIm 3-7777 tacit* ,. trm . *. ClimcjJ laboratory fl)o*ulyif 490 Pott Street S*t FnnctKO 3 Oate March 18, i860 Pulmt Ooctor Robert CuthberUoa Shipmaa COKPLTTX BLOOD COOHT 9. 800 67 , 88_______ Achwi--,, Slight . .. yoftBrytmti.. " PotrcteeMtoptulU 3 .% ware ub !) 0 .% B<Ufflrloeyt* 0 * <r B7]aetai LfaipkacrtM 28 KwecTte* -- GOO'JIO i8n.*m>..oni hj 11 m i.g<Pi"i :~g^|rv inn IM ^ ** DSHbit *.rrn Z.UCIXN D. tfCRTKIIT. M. A. Clinical LAonATO>f 4 o*T 1THT Sun FaANciaee M *" March 18, I960 ft RATtorr Robert Culbertson Decree Shipman UftZNA&YSa Clear -Few hyaline Celar________ Amotr Spadfl* <*--1. 026 WH-AW AT,amnil. Art A { 'i ilhmh Negative rv i ii -Amc'TpboQi > = j DiiMtk______ rr If Remarksi * i ?! ?1 rswn a. turner, rt, ;o i. itv'i W MICH iowi taira 0(4* w. WtllNT LAW OFFICES OF SMITH, PARRISH, PAOUCK & CLANCY nw.wci.t, auiLD>H miuhb i*. eurM March 16, I960 JUk 455 Golden Gate Avenue San Francl3co, California Reference: Robert F. Cuthbertaon v. Western Asbestos Co. OAK 1053 Attention: Edward C. Neely Referee in Charge Gentlemen: . t - We have received notice of the appointment of Dr. Sidney Shipman as Independent medical examiner in the above case. We would request that the lung .specimens bo ^referred to Dr.Shipman, and that he have a pathologist examine these specimens for evidence of asbestos. We also respectfully request__that_the transcript of Dr. Crenshaw's testimony be forwarded as well. ' Very truly yours. JES:mr cc: Mr. Patrick Malone; Attorney at Law 350 Sansome Street San Francisco, Cal: cc: Mr. Ivan Schwab Attorney at Law 15^0 San Pablo Avenue Oakland, California cc: Mullen & Fillppi Attorneys at Law 315 Montgomery Street San Francisco, California 450 McAllister Street San Francisco, California oe: -y yqmHfmTVtyXW !ew Ft1 use*  uv MKM Hanna A 8*ophy CARWANO tf. CAUrOUNJA TlKHrMI HIM j w mc iuutm txouAi iiexiaoMR OONAkO V. WirCMiU* Karoh 11, 1960 ? s*^..V* o * Psawg>do ieu*i** * rf tl. C*vir. iti r t*fr IM, < je$t toco atrv a JOM It. C*uA. Industrial Aocident Commission P. 0. Box 603 San Francisco, California Attention* Edvard C. Neely . Referee In Charge Gentleman* Rej Robert F. Cuthberteon vs. Plant Asbestos Co., et al l.A.C. Claim oak 1053 On behalf of the defendants Travelers Insurance Company and Standard Accident Insurance Company, we join in the objections of the defendants Industrial Indemnity Company and Pacific Employer* Insurance Company to the receipt in evidence of the report of Dr. Roger B. Wilson, dated February 9, I960. Tour secretary has advised me that this case has been for warded to the Medical Bureau for the appointment of an Independent medical examiner. On January 20, 1960, I had a telephone conver sation with the attorney for the applicant in which he advised me that he had arranged for an exmnlnatlon of the applicant by Dr. ' ' Roger Wilson, and that such examination had been completed. This should be called to the attention of your Medical Bureau, aa it means that neither Dr. Wilson, nor either of his office associates. Doctors Seymour M. Farber or Mortimer A. Benloff, la eligible for appointsient as an independent medical examiner. - Very truly youra, IASJER , CL 8,0, Smith, Parrish, Paduek & Clancy, Attorneys at Law Financial Center Bldg., Oakland c.c. Mullen it Flllppi, Attorneys at Lav 315 Montgomery St., S.F. c.e. State Fund - S.F. o.o. Industrial Indemnity Co., S.F. c.o. Travelers Ins. Co., Oakland (8-6972691) c.o. Standard Aoe. Ins. Co. San Bruno (96-C 960791;) . coo': Uk. 0 V: .RECEIVED MAR l 0 !C> P_ fv. moN 4oWf i.w.,W. a.W4w ' . 1 BEFORE THE*TOMT3IAL ACCIDENT COMMISSION OF THE STATS 0? CALIPORNi 2 CLAIM NO. OAK 1053 3 ROBERT F. CUTHBERTSON, 4 'Applicant, ! 5 va. e PLANT ASBESTOS COMPANY, et al, 7 ' , Defendants. j '' MOTION TO STRIKE 3 9 COMES now, STATS COMPENSATION INSURANCE FUND, defendant 10 erein, with its Motion to Strike the letter of Roger H. Wilson, 11 .0. of February 9# I960 and In this connection shows; 12 That the letter does not constitute newly discovered 13 vldence and does not otherwise comply wj.th the provisions of the 14 bor Code and of the Rules of Practice and Procedure of the 15 ndustrial Accident Commission. 16 WHEREFORE, defendant respectfully objects to the filing 17 f the report and to its receipt Into evidence and asks that the 18 J'ej>ort be atridcn herefrom. 19 .V 20 21 ' . -: .. 7_ . ^ ... STATE COMPENSATION By' > 22 (Dated; March 9, I960 23 |c - Mr. Patrick Maloney ' Attorney at Law 24 t - 350 Sansome Street San Francisco, California 25 |c - Mr. Ivan Schwab L 'V Attorney at Law 28 | ' 15^0 San Pablo Avenue Oakland, California ' w r: :Si*; V1 27 Mullen k Flltppl v Attorneys at Law 28 | 315 Montgomery-'Street . V'/'v* . San Francisco, California . 29 P r Smith, Parrish, Faduck k Clancy. Attorneys at Law . . .. 30 | ^.^301--Financial Center Bldg. * Oakland, California ' 31 t - Claims Department `JVB: rl . . 32 ' 7 ooo'r*:3 w CASE Nn QAK" ROBERT ?t CUTHBERT30N . Applicant S . Plant Asbestos Company, et al Defendant Dr. Shipman: You ere authorised to consult with a specialist In the field of pathology if you feel It la necessary. Order Appointing Independent Medical Examiner j'n'nitc '.r inicmut * firntOT i.* s:oamia `tenon F1L0 ^ MAR3 i960 ROBERT ?. CUTHBERTSOK Oakland Office | in employee claiming compensation. is hereby directed, under the authority conferred by the Workmen's Compensation LA'5r5 to report for examination to Pr.-- Sidney Shipman _ _______________ f a regular practicing physician,at4.90 Post Street, San Francisco, California on Karch.18, I960. Friday, 2:45 p.m.^d the saidphysician is hereby appointed to make such examination and to report the result thereof to the Industrial Accident Com* mission for its consideration. . S. NEELY / Dated this___ 6th -d.y Karch R.P. Cuthbertsoa State Compensation Insurance Fund Smith and Parrish 11 60 UNLESS THIS APPOINTMENT IS KEPT, FURTHER. PROCEEDINGS IN REGARD TO THIS CLAIM MAY BE SUSPENDED ><* Piled! Served! TV. V* WA INS_____ INSA LN.a._____ 5UIF________ 000'? i Claim Vq-------- OAK .1053 --___ AcniaNT'i Namc__________RobertCuthbertaon To_________ Ran&l_________________________ Date. _Thla_case_ is.preacntly In Medical _ror_apgolnCment _of IKS_________ at COMMISSION EXPENSE since defendants declined to pay for IKE. . Dr. Roger H.L. Wilaon-2/S/60 Attached la aedical report/aubmltted by applicant aa well aa " defendant Pac. Enrp. Ins. Co Motion to Strike and letter of objection from Ind. Indem. Co. Also, I received a call fron Mr, Schwab of Harms' Brophy" stating that the'Medical'Bureau often-appolnfro-Dr; Benioff-ae--IMS and fct-aho*ld-b*- ------ the Medical Bureau^ attention that such appointment would not be in order in this eaae since Dr. Wilson, whose report has Just be submitted by applicant, la an associate of Dr, Benioff, & ___ 3 7/ /SO _____________ ate_________ -V- This information has not been conveyed to the Medical Bureau by this office, q<kmj-5 or riM town t. eucv. rt. i. irw c. uui <sut( WB. |N**0 ;6t tewaio IBITB eu w. nr t law orriccs or Q SMITH, PARRISH, PADUCK & CLANCY fuuaeni ctwria Butkoiww 40*f4tM fT*ir owklamo ta, cauaoawu 9LlMrt 1-1091 February 29, i960 0`* Industrial Acoident Commission ^55 Golden Gata Avenue Room 2202 San Francisoo, California Re: ROBERT P. CT7TKBERTS0K V. WESTERN ASBESTOS CO. IAC No. OAK 1053 Gentlemen: Enclosed herewith find medical report of l>r. Roger Wilson;-dated February 9, I960, which is filed In accordance with the rules of praotlce and procedure of the ^ponis.siOhr^/ fV t * , . ., Very truly y Enelt v JES:rb . .. . ..... JOSS cc: Industrial Indemnity Co. Kullen & Plllppl Hanna I: Srophy State Compensation Ins. pund IAC Oakland gooc:::g urn jp impwwwwww iww Ci ttvwOU" m 9 0otMC* a utntorr, m ftOOCRM L WlbldM.H 0 jgOirx 0 iMitM m 9 -e*'lSL February 9, I960 f ;**'' Joseph E. Smith Smith,Parrleh,Paduck & Clancy Financial Center 8ulldlng 405 14th Street Oakland 1*1, California Re: Robert Cuthbertaon Dear Mr. Smith, Thank you for enclosing the microscopic report on the section* of Robert Cuthberteon. 1 feel thAt such a report Is consistent with Asbeetosls of moderate extent. I sn baaing thl* uoon the oleural fibrosis, the thickened alveolar septa and the presence of asbeetos bodies. It Is difficult to tell In a .Volins' oatlent 6uch as this, whether or not he will deteriorate to develop slsns of pulmonary failure. It Is because of this difficulty in making an accurate prognosis that I think It Is ImoortAnt that he should be follow ed up. It would be ay Inclination to classify him as a patient with early asbeetosls, rather than a patient with asbestos bodies in his lungs. ** lours sincerely, \. CC: herald Crenshaw, M.D Rosrer l-i .Wilson,K.D. VQ { coo(j::7 T": . .i960- -' <* '^t?*0** >' i ' V 3EF0FE THE IIEUSTPlAI ACClDEtfl'-COililSSION OF THE 3TATS Q`r' CALIFOr":! ' .* ,,- . - , '- 2 . .claim no. oak 1053 ; ' - ' _ '<. 3 OBSnT ?. CU7HBEHT30N, 4 '..'Applicant, ) i . '5 vs. ) i: ' MOTTO?.' 70 3TrlKL '. e PCAfTE ASBESTOS COMPAQ, et al, .: . 7 . ' 8 . ._ .. ' .. :,DefndantSi ) -:. j r- ; 9 ' COMES J-GW, Pacific Employers Insurance Company* defendant . 10 herein, with it3 Motion to Strike the letter of Foger 11. Wilson, ^ u fii). of February 9-l960'and' in this connection shows: 12 ^ . 'That the letter does not' constitute newly discovered ' 13 vidence and does not otherwise comply with the provisions of the ; 14 LAbor Code and of the Pules of Practice and Procedure of t..e . ,. is Industrial Accident.Commission. .' is WiiEREFOFE, defondant respectfully objects, to the filing . `' -. > 17 of the. report, and Jo its receipt into-evidence and asks that the 18 report'be"striken ftjirefrom.'"" " v* .' '- ' ' 19 *+ ' KULLEII ii riLIPPI, .' /.X Attorneys for Defendant 20 ; / \ 'PACIFIC ZiZLy'F.X * 21*' - ;. 22 t ' . j ; ` ' *. . ; 2s Dated* March ' 24 x' . / * i '4+' >* //V- l , . 25 otfj. Industrial Indemnity.Co, lr'' * '.** * r' ; v 350 Sansoce dan ^Fran/sisco? i * .* '' 28 Vy. Hanna 4: Erop'ny, Attorneys at Law . ` (X* j.` 27 ; ' l$*Q San Pablo Ave.,/Oakland Mv . ; ;; . ' . u y -..'A/ - * 28 V. State Compensation Insurance Fund / . PV'MO McAllister.St., San Francisco"^' >'* * ' '/.j ;'* . . 29 7, ; ` >.'.* i - - *'' Silth'j Parrish, Paduck & Clancy, Attorneys at Lav ! 30 A - 501 I'inancial;.Center Building, Oakland ,, ' 31 r'.t " . t::- /)' x ^ ,v Pacific Employers Insurance Co.';-- ' - - - 3770 Piedmont..Avenue, Oakland 11 32 S v.i_ * . y$, ?. " \ ... ULICN * nu**1 **** a .. * i .i -1- . /I 000Ci*3 \/60 td' w w r 7 INDUSTRIAL INDEMNITY COMPANY Srin /hinrivn /)ivi.tinn: .15(1 Sanson* Sr*fRT, San Kxanci.k'O 4, Caurmnu REcaVED Tthpkttt J'WoN (1.2000 - MAR'*-'960 .^rss^ss1 >terch !*, i960 I Industrial Accident Cotmlsslon j P. 0. Box 603 a San Francisco, California Subject: Robert 7. Cuthbertson v Plant Asbestos Company Claim No. C 59-51-1671 IAC No. CAK 1053 . Attention: Edvard C. Neely, Referee in Charge Gentlemen: ... .. We are In receipt of a medical report of Dr. Roger Wilson, M.D. dated February 9, i960 vhleh vas filed by the applicant's attorney. Industrial Indemnity Company hereby requests that said report be stricken from the record on the ground that there is no shoving whatsoever by the applicant that this report is nevly discovered evidence as required by the rules and practice of the Commission. This matter has been submitted and properly decided by the Honor able Referee and the filing of this report in the record la this matter, without allowance of tine for the defendant to rebut the intentions of the report. Is prejudicial and improper. - Defendant Industrial Indemnity Company also maintains that the. ... report Itself is not naterial or relevant to this proceeding ' ' because Its conclusions contained therein are not based upon any examination or treatment of the applicant or based upon any review of the entire record or history in this matter. The doctor refers to a microscopic report on sections of Robert Cuthbertson without referring to any additional records or ma terial. It Is noted that the doctor does not even state what microscopic report he is referring to and for all the information that the parties la this matter have, it could easily refer to the srplieent-'e fcmther, who also filed a claim for asbestosia. r., . . ' Jfhe .inclusion mde by the doctor, therefore, is speculative and OOO'^O 1 mm A^jjj.j iiijjj 1j ujuiigr;.)1" jwipwigiuig.n J /.ECEIVED MAR 7 * I960 i conjectural inasmuch as the doctor has not examined the above-named applicant and has not revleved the entire record or history In this matter. Request is further made that this report be stricken from the record since Dr. Wilson does not set out In detail the basis for the conclusions reached therein. Although the report itself does not Indicate that the applicant's expensive surgery and medical treatment and hospitalization vas In any vay necessary or Justified. It is still submitted that said report be stricken from the record on the above grounds since this case Is complicated enough vithout adding obscure and speculative reports based upon unidentified microscopic reports and speculative findings that only the doctor Is avare of. Sincerely yours, PSJfceva ce: Smith, Parrish, Paduck & Clancy 501 Financial Center Building Oakland, California ec: Banna and Brophy " 100 Bush Street Oakland, California -v-' / r v ^ ce: rtillen and Flllppl 3I5 Msntgooery Street San Francisco, California ce: State Compensation Insurance Fund ^$0 ItAHister Street San Francisco, California t t . . . . (jot e A Q ir*aOv* M > 0 !*'$" 0 OQf* * V. W'YftQM p inni4 0 .* c*m* "ebruApy 9, Ibfio Joseph . Smith Smith, Per'-lsh, Peduck * cinncy PlnAn<*tAl Center PuUdtne AOS Hth *tre*t Oakland l-**, "llfornia Dear Mr. Smith, ^e; ^obe^t Cuthbertson Thank you fop eo<"loslofl: the microse-vole r*oort on the sections of J^obe^t luthbe**teon. I feel th*t ruch a r^oort is consistent with Asbestos!# of modernt* extent. I an baalnv this ujoo the /leursl f'.bposls, the thickened Alveolar septa and the oresence of esbestie bodies. It Is difficult to te'l In youn/* pAtlent such as this, whether or not' he will deterlorat* to develop slcna of oulmoory fAllure. It Is b*o*u*e of thl ? difficulty In making *n accurate prognosis thet I think It Is Important thAt h* shonM be follow. e<3 up. It wo 1-1 b* my Inclination to clAsslfy him e? a. patient with early Ab*#tosis, rnther than a ontlent with asbestos bodies in hie lun.s# '' f^-rs sincerely, C*tt ''.erAld hrenshnw, '.*>. coo'';.:l WAftRfM W MAMMA OONAWO 0*HV ;v>'IVAM A tCMWA AOatMt M JQHH A MAC ONAU0 IDWAMO P MC Atll* Ntaacir c. jtMtcM IDWAIO* KOAAC *S>* J M MC tLAATM TUOMAI a MCMAffOION O4HA10 V. MlTXW CAI64t M. (MLWAM '/S 1V # Hanna At Saoahy OARIAMO ft. CALiAOAMiA TtVKINWltM 0^ February 26, 1960 ,etvc la* **'< 0*ct 4ahi awo*. at. C UA. Qfci Ml j M*m tl.tiuv. few JAM Oftl 1000 W'tii4 JMt 1*. Caw. Industrial Accidont Commission P. 0. Box 603 San Francisco, California Attention: Edward C, Neely Referee in Charge Re: Robert F. Cuthbertson rs. Plant Asbestos Co., et al I.A.C. No. OAK 1053 Gentlemen: In compliance with the letter of W. T. Dur.bsr, dated February 3 I960, we requested Dr. Cabot Srovm to forward all x-raya in his possession to the Indurtrial Accident Commission. We asked that we be informed of the films forwarded, and enclosed herewith is the letter from his secretary, dated February 19, 1960, listing the films submitted to the Medical Bureau* Ky letter of November 12, 1959, to Dr. Cabot Brown, covering his appointment as an agreed medical examiner in this case, contained the following postscript addressed to the attorneys for the applicant: ' "1 will try to ret the lung tissue specimens, the x-rays token at Herrick Hospital, the Richmond Hospital x-rays, and x-rays taken for Dr. Hinshaw to Dr. Brown. If Dr* Crenshaw ever did take any x-rays, will you see that he forwards them to Dr* Brown*" It is apparent that no x-raya taken for Dr. Gerald Crenshaw were ever submitted to Dr. Cabot Brown. The testimony of Dr* Crenshaw was con fusing and amblqvous as to whether he did or did net take x-rays prior to his operation on August 13, 1958. * mm co'y:;;; 4 Pare two - 2/26/60 Re: Robert F Cuthbertaon vs. Plant ASboatoa Co., et al I.A.C. t'o. OAK 1053 RECEIVED ru . lvviS"j* U* wu'f^K Jf.ftMIs l If this case ia to br referred to nn inden^ndort r adical oxoir.ir.er, we rosoeotfuliyitja'.Q.u.eat that, prior to s':ch reference bein.y made, the attorneys^ for the applicant either: 1, File with the Medical Bureau all x-rays token for Dr. Gerald Crenshaw; or . 2. Give written assurance to the Industrial Accident Corr-.isrion that Dr. Gerald Crenshaw did net have x-rcys taken. Vo make this sufyestlon beeeuse we feel thrt films taken at or about the tine of operation would be of extrema importance for any doctor attempting to review the record. IAS:ER Ene. c,c. Smith, Parrish, Paduck & Clancy, Attorneys at Law Financial Center Bids* Oakland 12, California c.c, Mullen i: Filippi Attorneys at Law 315 ikntroraery Street San Francisco, Calif, c.c. State Fund - S.F. c.c. Industrial Ind. Co* 350 Sansome St., S.P. (C 1-1671) c.c. Travelers Lnsurar.ee Co. Oakland (B-3972691) c.c* Standard Acc. Ins. Co. San Bruno (96-C 960791+) Verv truly ^ours. Q>' / ' 1 o-*- /' C000C4 ST 1 CAOOf 00WN,.0 -HO <cr a '^NSiSCeW February 19, I960 f ~ li Mr. I. A. Schwab Hanna & Brophy 1540 San Pablo Avenue Oakland 12, California tr Dear Mr. Schwab: I am listing below all of the x-rays we have of Mr. Robert Cuthbertson, and which have been mailed to the Medical Bureau t of the Industrial Accident Commission, 455 Golden Gate Avenue, San Francisco, Herrick Hospital: 5/17/56 - PA and lateral 11/13/5* - PA and lateral 10/10/55 - PA and lateral Dr. Corwin Hinshaw: 9/10/59 - stereo and lateral Dr. Qbot Brown: 11/19/59 - stereo and lateral Yours very truly, . Secretary QWV 5; 3PXflTMENT OF INDUSTRIAL RELATIONS Intra-Dopartoental Communication To: Edward Nealy, Presiding Referee Datet Division: Industrial Accident ComsissicBocaliou: *2-16-60 San Francisco From: Frank .A. Lawrence, Presiding Commi3oioner Division: Industrial Acoldent Coomiasioijccation: Sai Francisco Subject: Robert F. cuthbertson Filo No. OAK 1053 Please arrange to have applicant examined by an Independent medical examiner, pursuant to Report of Panel dated January 28, I960. Said examination Is to be at the expense of the Commission. . ThanJc you. , - ' .. ' - . Prank A. Lawrence Presiding Conalssloner - - coo INDUSTRIAL INDEMNITY COMPANY `jT \J */'( JAninrm /Hrimiii: .150 Sanwimk Stum, Sah I'jtANCiMti 4, Cauhwixu RECi^ TtltfihM# f7Tn<* A.?>mio ILL 1 ' ': J ,ci "`'"`iMwl*'*4 February U, i960 v' ^ t o'"5"* - Industrial Accident Cosnission ^55 Golden Gate Avenue San Francisco, California j tyr \ L,' 'jA J n i Attention: V. T* Dunbar, Presiding Referee Subjects Cuthberteoa n( Plant Asbestos Company Claim No. 59-51-1671 IAC No. QUC 1053 Dear Mr. Dunbar: Reference is mode to your letter of February 3, i960 regarding tbs above matter* . Industrial Indemnity Company vill not defray the expense In connection vlth the appointment of an independent medical examiner la the above case* It vae our understanding that Dr* Cabot Brovn vas an agreed Independent medical examiner *"* ve had agreed to help defray the expenses of Ms examination. Ve can see no necessity for any additional medical examinations In this case as the present medical record indicates that the applicant has not suffered from asbestosls. .. Sincerely yours, ^ , . . - - ft Patrick R. MMoney Claims Attorney PRM:eva cc: Smith, Parrish, Paduck and Clancy 501 Financial Center Building Oakland, California cc: Banna and Brophy 100 Bush Street Oakland, California cc: Hillea & FUippi 315 Montgomery Street San Francisco, California cc: Stats Compensation Insurance Fund 450 McAllister Street San Francisco, California AT " ' \ 0000L7 f : ' --1 -- n" ` y*s fTBr'W ~4T< P^y' > THE INDUSTRIAL ACCIDENT .COMMISSION OF ' ' ;'' '; ` ` 'CLAIM NO. CAX 1053 ROBERT F. CUTHBERTSON, ]' 7iC.2jhL Firs* L stvisaK t? F I LD ' nt i960 Applicant, va. rl. `PLANT ASBESTOS COMPANY, et *8l, V / . * f i. . V` Defendants. 8 \ Oa^tand Oii\U, OBJECTION -- riT.V.1 0? D:DE?ENDNT MEDICAL LXAMCXS i 9 Conies Now defendant -Pacific, Employers Insurance Co-pany . . * . .`,. io with its objection to appointment of-T'art independent medical examine u e`rJ; V^.-m -0";Y- h- 1 ` 12 1 ' .Dr. CabotJJrown was; agreed upon ao.an "agreed medical exar.4 13 tndr" in the stead and the .place .of .an "independent medical examlr.r 14 fir" and acted in that capacity. ' .-' . r * - ' * .. r . . T.,, 15 The .medical-record of -phia case, clearly shows the Award tc . ,16 be supported without conflict. * ^ . . ` ` 17 i- . : To assign ,to an Independent radical examiner, or ar.y other *' 18 examiner, would do'ho more than to 'considerable extent retry.the ; '' 19 ease. ' ' **' *i .. ' ' 20 ^ * ^our Honorable Commission is'in the position of being a 1 dourt of Appeal and is required to consider no more thar the recorJ 22 df'the ease. To attempt to add evidence which might grant the ` 23 prayer of the applicant confers on your Commission the power and % 24 authority delegated.to the Referees.v;:lt is not Intended that your t' , . . L,, .. r .. ,. 1 ' . 25 CorBiission. act in &ny other capacity'than as a Judicial body of ^' .' -. . */ . v5 . ? V % 26 appeal.- < . . ... ' 27 "The matter?'therefore,.must be submitted fron.ar. cvidencia^ * * . . * ' - V` . 28 standpoint as therfis no stipulation or agreement upon the part o.` ' ' ' 29 Pacific'^Employers Insurance Company to add to. the record in ary;wa; 30 Whatsoever. .* ' . * 31 . . THEREFORE, fit is-respectfully prayed that 83 to'your erswerj 32 "uu.cn nunm m.a.n itfg defendant.the Award be affirmed apd the applicant ordered to i* V . .. A - * -^-.V ' ` 'v;' i -w- -1-' \' : ^v .A 000(jC:S / M IMM. 4 ~\ Aii. r ** m X. 1 taka "nothing. y , . ... ". . 2 ** '* 'To follow the procedure suggested herein would make It po3-t ..3 j slble for an Independent examiner upon independent examiner to be 4 appointed until grounds are found for the applicant's contentions. fo V V ; 6 -t- . Kespectfully Submitted: 6 ` MULLOi & FILIPPI, Attorneys for. 7 Pacific Employers Iinsure..ce Coommpp. an; % < bj . , _ y W. h. Mullen 9 Dated at San Francisco, California,./this 6th day; of February, l?6cj 10 Copies this date mailed to: v *- 11 a , Industrial-Indemnity Co.,. T ' * ** . 12 35.0 Sansome Street* Sari Francisco,. Calif . . . .. T. * V . * t' : 13 Hanna & Brophy, Attorney3-at Law, 1540 San Pablo Avei, .Oakland, Calif, - . ,. . i > : * 14 State Compensation* Insurance Fund', " 10 450 McAllister St.,.San Francisco, California ' r" * *'' ' Smith, Parrish, Padu'ck & Clancy, Attdrneys at Law, 501 Financial Center-Bldg,-, Oakland, California , 17 Pacific Employers Insurance`Co., -v- 3770 Piedmont Ave.^-Oakland, Calif.. . 13 * ' ' . *: ` 19 20 21 * * 22 ), 23 . * Y. 24 l-.-.A i- 28 yv {*> 0 >, ' JV 26 27 26 2< *i;-<. 3C - . ... U' - ' / < 3] ** - s; , / . , -2- G000,v3 Ml > 4 ` J* 7 * >VWA.,M H.MN* *OONAIS ..0N IV**. * O...T N MAC l*A* JOHN * *>*C OONAkO tOWA.O N *C ALII* UWAW w i U lie (l>AfM OONAbO V. MlfCMtkl. * Hanna A Brormy **1940 ten AtU| OAKLAND II. CAUfOKNJA riituui t ittt February 6, 1960 0 taw Mem*** <3**.*t itoeon aNvtxti*utrv rao teeuei** Dane tto*. <MI*4 II. tife(H*e 14 1 laeaM|i*e u I*w joec 0**et tIoomo M40OI't.4 Oeur, Industrial Accident Commission 455 Golden Gate Avenue San Francisco 2, California Attentions Referee V/* T Dunbar Re: Robert F. Cuthbertson vs. Plant Asbestos Co., et al . I.A.C. No, OAK 1053 Gentlemen: I have your letter of February 3* I960, inquiring as to whether the defendants will defray the expense of an independent medical examiner in this case* I am also in receipt of the objection to appointment of independent medical examiner filed by Pacific Employers Insurance Company. My clients would like additional information before we are in a position to advise you as to whether they would agree to defray the expense of an independent medical examiner# O We should like to be advised as to wherein the Commissioners * feel that the medical evidence now in the record is incomplete and why they are of the opinion that a report from an independent medical examiner is indicated. We are uncertain whether the Commissioners fully appreciate the circumstances under which the examination and report by Dr. Cabot Brown was obtained. At the conclusion of the hearing held on October 22, 1959, Referee Ankelc stated that he was dissatisfied both with the medical evidence submitted by the applicant and the medical evidence submitted by the defendants. He stated that he wonted a more complete report on the general subject of aabeatosia, and he directed the parties to agree uponamedical examiner. He then ordered that the report of the agreed medical examiner be submitted within 45 days from the date of hearing* I wish to emphasize that Referee Ankele entered this as his order, and not as a request by any of the parties* Referee Ankele proceedod to direct the parties that they were to perform the work of making the appointment, arranging for submission of prior x-rays and laboratory reports, and of all prior medical reports to Dr* Cabot Brown* My letter of November 12, 1959, contained the following paragraphs X/ \v <v ^ oooc:o Page two - 2/fl/60 Re: Robert K. Cuthbertocn vs. Plant Aebestoc Co*, et al I.A.C. No. OAK 1053 "In view of the nedleal conflict that exists, Referee Ankelo requested the attorneys In tho case to agree upon a doctor to examine the applicant and submit a comprehensive report, with the understanding that all parties should be given an opportunity to submit any specific questions they desire covered to the doctor selected. Accordingly, you will probably receive further inquiries from all, or some, of the attorneys named above. Referee Ankele requests that you incorporate in your report a general discussion as to the nature of the disease of asbest03is, with particular reference to the type and size of fibres that cause damage, the extent and degree of exposure required, the time after the inhalation of particles within which symptoms become manifest to the individual, the nature of the symptoms which, first develop and the nature of the disability resulting, and the manner in which the disease of asbestosis differs from silicosis." Dr, Brown did include such a general discussion. Further more, the attorneys for the applicant requested Dr. Brown to defer submission of hie report until he received a transcript of the testimony of Dr. Gerald Crenshaw, who had testified for the defendants. Dr. Brown did hold up the submission of his report, and after he had reviewed the transcript he added some additional comment, which is numbered points 1, 2, 3 and I4. on pages 2i and 5 of his report of November 19, 1959. It seems to me that his report adequately disposes of the medical conflict that existed prior to its receipt. You are, of course, familiar with the fact that many referees ask the parties to agree upon a medical exominer. The only difference between a report by such sr. agreed medical examiner and a report by an independent medical examiner is that the attorneys for the parties, rather than tho Kediesl Bureau of the Industrial Accident Commission, have to do the work of arranging for the appointment, When the applicant petitioned for reconsideration, the only additional medical evidence that he contended should be obtained was a report of a pathologist. As the answers filed by the defendants point out, that- is unnecessary boeause all that a pathologist could detemine would be that fibres of asbestos ore present in the specimen of lung tissue obtained at the tine of operation, and the defendants concede that the tissue contains fibres of asbestoe. WMmnmmmm si 1.1 n ua1 1 \mm 11 ll. OOO'J U Pane three - 2/8/60 hei Robert F. Cuthbertson ve. Plant Aabeatos Co., (t jl I.A.C. Vo, OAK 1053 Pleace advise whether the Corr-.issicnera have in mind the designation of a pathologist or the deeirnation of a specialist in diseases of the lung as an independent medical examiner'. Dr. Cabot Brown submitted a bill of :'?200 for his report. If there is any aspect of the case in which his report is incomplete 1 1 would feel that your Medical Bureau could obtain a supplemental report from him with less delay and expense than if the matter should be sent out to a doctor who has never 3een the case before. Very truly yours. IAS:ER c.c. Mullen & Fllippl Attorneys at Lav 315 Montgomery St. San Francisco e.c. State Fund - S.F. c.e. Industrial Znd. Co* 350 Sansone St., S.F. (C 59-51-1671) c.c. Smith, Parrish, Paduck & Clancy Attorneys at Lav Financial Center Bldg* Oakland 12, California c.c* Travelers Insurance Co* Oakland (B-Q972691) c.c* Standard Acc. Ins. Co* San Bruno (96-C 96079i*) oooc-;^ WJW-1JLi IBJSJIJULL iamHiuoatmiB^asatai - /; 1 BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA f 2 CASE NO. OAK 1053 3 .{ ' i 4 ROBERT ?. CUTHBERTSON, ) ) 5 Applicant ) e } ORDER GRANTING APPLICANT'S 7 PUNT ASBESTOS COMPANY, J. T. THORPE, WESTERN ASBESTOS COMPANY, ARMSTRONG 8 CORK, TRAVELERS INSURANCE COMPANY, INDUSTRIAL INDEMNITY COMPANY, 9 PACIFIC EMPLOYERS INSURANCE COMPANY, STANDARD ACCIDENT INSURANCE COMPANY 10 and STATE COMPENSATION INSURANCE FUND, 11 Defendants 12 13 GOOD CAUSE APPEARING THEREFOR, 14 IT IS ORDERED that applicant's Petition for Reconsideration, IS filed herein January k, I960, be, and the sane hereby is, -ranted. 16 INDUSTRIAL ACCIDEir? C0MH33ICN 17 OF THE STATE OF CALIFORNIA 18 19 20 21 --i 22 ~ Commissioners 23 24 25 28 27 28 29 30 oooo: a . ,y\:, ,^ilg.-riAf--- .: r ROBERT F. CUTHBERTSON .- January 28, I960 v. ' PLANT ASBESTOS COMPANY, et al Case No. OAK 1053 REPORT OF PANEL ON'S The Panel la of the opinion that a report of an independent medical examiner will be of assistance to it in the determination of the issue presented. The Petition for Reconsideration is therefore granted to obtain the opinion of such an examiner, if the parties so agree. ' INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OF CALIFORNIA coo'1: i Q JOHN H. ANKELE, REFEREE Oakland 1-20-60 *ECtlVKO jav JSGO *i* | COTHBERTSON--CIAIM NO. OAK 1053 Injury: Asbestosls REPORT OF REFEREE ON APPLICANT'S PETITION FOR RECONSIDERATION Due date: February 3, I960 The employee, an insulator, born May 4, 1928, claims to have sustained an aabestosis. After hearings, Findings and Order to the effect tht applicant did not sustain any injury arising out of or occupying in the course of his employment was served and filed on December 15, 1959. ` From this decision applicant petitions for reconsideration contending that the evidence does not Justify the denial. The preponderance of medical evidence in this case clearly indicates that the applicant does not have asbestosla. It is noted that the applicant quotes from the report of the pathologist as follows: "asbestos body disposition is moderately advanced." This is definitely not a finding of asbestosls. Applicant also quotes from some portions of the testimony of Dr. Crenshaw. However, the conclusion of H. Corwin Hinshaw, M. D. is to the effect that applicant does not have asbestosls. This is also the conclusion of Cabot Brown, M. D. in his report of November 19# 1959. Dr* Brown was the agreed examiner. The Answers filed by the various defendants herein are well taken and applicant's Petition for Reconsideration should be denied. It might further be observed that the opinions of Dr. Hinshaw and Dr. Brown should be good news to the applicant who is working at his old Job. JKA:rc oo<j'; INDUSTRIAL INDEMNITY COMPANY Sun Fmnnim Divi.rwn: 3,50 S*Ninr. Stmt.t, San Fjmnci.vo 4, GtumftNU Trirphn* YUkwt d.JOOO y'S January 13, I960 >' "/ Sii'c 0 Industrial Accident Cemission 577 - 14th Street Oakland, California Gentleness He: Robert F. Cuthbertson vs. Plant Asbestos Caspany Claim No. C59-51-1671 IJUC. No. CWC 1053 Enclosed please find Answer to Petition for Reconsideration In the above entitled natter. Copy of the Anever has been forvarded to the parties listed belcv. Very truly yours, IBM: sac Er.cl. cc: Smith, Parrish, Paduck & Clancy 501 Financial Center Building Oakland, California Hanna and Brophy 100 Bush Street Oakland, California Mullen k Ftllppt 315 Montgomery Street San Francisco, California State Compensation Insurance Fund 1*50 McAllister Street Gan Francisco, California 0000 ',G ft- ** mrii'tffifi'Mniri iltiitiMliirm ifitrirm PATRICK R. WMOHEY A Attorney at Law - Suite 700 **'->. 350 Sanaooe Street \, San Francisco 4 ; V yUkou 6-2000 `t 1.TT7'-- Crrtjia ft c iT'^1 i:aa *LEo Reived PU au \> ^ ^AUp.i o^iiss- . THE CTDUSTKIAL ACCIDENT CCMCSSIOT C7 THE STATE 0? CAU70R2TCA 6 fiOBQS P. CSnffiERTSdK, ., -- ; " 9' ' . ' ' Applicant, 10 TS. 11' PLMTT ASBESTOS COMPANY, INDUSTRIAL mUEMUTT COKPAWT, at al, 12 Defendants. 13 I.A.C. 50. 59 C*X 1053 ANSWER TO PBnTTOR PCS RECORSnERATTCTT 14 / Cotaea now the Defendant/ ETTXJSTRIAL DTDEWfin CCKPAHT, and b7 way of 15 Answer to tba Petition for Reeonslderatlon filed herein specifically denies 16 tbatt . 17 16 ........ . ; 19 ' a... 20 ; ' '' 1. The Coaralssion acted without and In excess of Its powers. - . 2. That the evidence does not justify the findings of fact. 3; That the findings of fact do not rapport the order/ decision or award. 21 ' . In his Petition for Reconsideration, the Applicant objected to the 22 finding of fact that he did not sustain an injury arising cut of or occurring 23 In the course of his employment. In support of his contention/ the Applicant 24 states that Dr. Cabot Brown, the agreed medical examiner, did not obtain inde 25 pendent pathological studies. The petition Is not clear ns to what purpose 261 such studies would serve and It may be helpful at this point to clarify the 27 record. - 26 - First of all, Mr. Schwab,in arranging for the examination by Dr. 29 Brown in his letter of November 12, 1959/ authorlxed Dr. Brown to a&e use of 30 the service of A Roentgenologist or a pathologist if he deemed it necessary. 31 With the reoordt sod information available to Dr. Brows, he quite properly con 32 cluded that it was not necessary to obtain an additional pathological exaalna- v ' 000',' .7 Q tioa. y 2 A review of the record sbovo that tbe applicant's own doctor made 3 use of Dr* David Slngnna a a pathologist. This doctor performed bis studies 4 at tbe time tbe applicant vas examined on December 6, 1938 at tbe request of 3 Dr. Crenshaw. Dr. Singaan testified that tbe applicant did bare asbestos in 0 the lungs but not enough to show In ordinary X-ray technique. 7 Tbe Defendant's doctor, H. Corwin Einahav, K.D., and tbe Defendant's | 8 pathologist, George Watson, M.D. also found asbestos particles in tbe lungs. 9 The important point here, however, is not tbe presence of asbestos fibers In 10 tbe lungs but rather the presence of such fibers as cause disabling pulmonary 11 disease. The Petition for Beconsideration, therefore, is not clear as to wbat ] 12 purpose an additional examination will serve inatuaueh as there already is an 13 agreement amongst tbe pathologists that tbe applicant did nave asbestos fibers 14 ia the lung. 15 Tbe erux of tbe problem In this case is vbetber tbe Applicant bad dis- 16 sbling pulmonary disease or asbesteels and not whether there were asbestos 17 fibers In tbe lung As pointed out by Dr. Cabot Brown on page 3 of bis report 18 of lknreaber 19, 1959: ' 19 20 21 22 ri V 23 24 .\ 25 "The point I wish to stress Is that tbe mere finding of a few asbestos bodies in a section of lung simply means that the Individual has at some time In the past inhaled asbestos particles and does sot indicate that this indi vidual has actual disease (esbeetoels). It is not un likely that a good many people who are required to vail . passed large construction jobs a couple of times a day would be found to have Inhaled asbestos fibers, were it feasible to subject tbelr lungs to a searching examination. Bowever, the difference between these individuals and those who have well developed clinical asbestoais lies merely la the total amount of exposure. ***" .' * 1/ ' 1 .` ' ; i t 20 The Applicant's contentions are apparently based upon the testimony 27 of Dr. Crenshaw. Keeping in mind that a clinical diagnosis of asbertosls de- 28 pends upon a history Of adequate exposure to asbestos dust, objective evidence 29 of impaired pulmonary function, and radiological appearance consistent with 30 diffuse "ground glass" pulmonary fibrosis, let us examine tbe testimony of Dr. * /. ` .. * 31 Crenshaw. ' `: ' " 32 According to Dr. Crenshav, a complete work history vas not of ' l: ; -2' ' OOOC-13 iftfmWatttf .*&*?"VJ-fea. . the Applicant. The doctor testified that be bad treated the Applicant*a brotherj approximately five years ago and be felt that a history of asbestos exposure v&a unnecessary la viev of the fact that the doctor bad already obtained a wrk history from tbe brothor. It is to be noted that INDUSTRIAL ISDS-WITY COMPANY vas the Workmen's Compensation Insurance carrier for PLAJTj ASSS3TCS CCMPASI from January 1, 1952 to January 1, 1959* The doctor neglected to even obtain a vork history of exposure to asbestos rturisg a eubetautlal portico of the eppliij cast's eaployosot vlth PUNT ASBESTOS COMPANY vhile INDUSTRIAL EtDcKJTTT CC*. PAST vas the carrier.. It is further to be noted that the doctor did aot even moke a study of the type of asbestos material used by the Applicant in his employment vlth FLAXI ASB2STC6 COMPANY. It is further to be noted that tbe doctor testified that this 14 inferred, therefore, tbit Or. Crensbav's diagnosis appears to be speculative 18 and conjectural because be did aot take so accurate vork history of the Appli 10 cant's exposure to asbestos and did aot taks any samples of the material used bj ir the Applicant* . 10 , It is also dear from the record that the Applicant does not here any 19 objective evidence of impaired pulmonary function, nor is there radiological 20 appearance consistent vlth pulmonary fibrosis. Hr. Cabot Brovti In Ms report 21 of November 19* 1959 points out that these are essential elements for a clinical 22 diagnosis of asbestosls* In his suaasry and conclusions on page 2 of his report 23 of November 19, 1959, Dr* Brovn points out: .. f, 4 ,. 24 "Vhile this sen gives a history of exposure to dust. '' * containing an undetermined amount of asbestos particles 25 over a period of some tvalve years, he has no symptoms < . ` or complaints vhich I vould attribute to asbestosls or 20 " - . any other forma of pneumonoconlosis. Limited pulmonary * 27 function studies gave normal findings, as did physical examination." - ' .J \ * ' 28 .. According to it_ Crenshav, the Applicant's doctor, the only factor of 29 disability consists of improper bronchial drainage. There is so testimony by 30 Dr* Crenshav,or any other evidence in the record -to indicate that this drainage 31 problem is in any vsy disabling or that this problem is causing an impairment 32 of pulmonary function. ` 1 ` : v' f ].. . oooarJ -3- J Q 1 " It Is also obvious from tha record that there is no radiological ert2 dence of pulmonary fibrosis. Dr* 3logman, tbe Applicant's pathologist, testi 3 fied at tbe bearing that there vas asbestos la tbe lungs according to tbe sub4 altted samples taken on December 8, 1958 but there vas not enough to shew in 6 ordinary X-ray technique. The doctor further testified that fibrosis is usually 6 found in asbestosis cases and generally tbe particles can be seen. Ee also 7 testified that most of the noxious agents that affect the lung vlll cause fi 8 brosis. It is obvious, therefore, that there vas do X-ray evidence of disabling 9 pulmonary disease in this ease according to the Applicant's ovn pathologist. 10 Dr* Hinsbav in his report of September 22, 1959 also concludes that the X-ray 11 examinations demonstrate no'progressive pulmonary disease. 12 - It Is also submitted that there is no shoving by the Applicant that 13 the lung biopsy vhlch vas performed by Dr. Crenshav as a diagnostic measure, 14 according to his testimony, vas in any vny necessary or justified. As pointed 15 out earlier, the record shovs that there is no clinical evidence of disabling 16 pulmonary disease present prior to the performing of the operation. Dr. Cxen- 17 shav did sot perform pulmonary function tests prior to the operation although 18 suoh tests were performed post operatively. - As pointed out by IK*. Einshev in j19 his report of October 12, 1959: 20 ; $ 21 * i.4`. -*t 22 } . I " *** Biopsy served- no useful purpose vhaterer in a situation such as this vhere there is no clinical, physiological or radiological evidence of disabling pulmonary disease." ' 23 . Dr* Cabot Brown, the agreed medical examiner, also points out oo the ' ' 4. i; 24 last page of his report that apparently pulmonary function tests were not per 25 formed prior to surgery end the doctor cannot understand vty the Applicant's 26 doctor belittles the.significance of such function tests vhlch are essential to 27 determine the amount of pulmonary disability present. 28 '* ' The Applicant has therefore failed to tbov that the biopsy performed 29 in this ease vas necessary to cure and relieve from the effects of his injury 30 inasmuch as standard clinical and functional tests vere sot performed prior to 31 surgery. If such tests vere performed, it is obvious that there would be no 32 necessity for the blopey because the doctor would have found that there vas no -h- ooo'jca -7--------... o J W> rr**? 0 1 disabling pulmonary disease preseat according to clinical tests. Is this par 2 ticular case, the operation has resulted in approximately tvo wetha 0' dis 3 ability to the Applicant along with aa expensive hospital bill. There is an 4 insufficient' shoving la the record that such major surgery vas necessary is order 6 to cure and relieve from the effects of injury. ' 6 It Is also submitted that if the Applicant felt that as independent .1 7 pathological exaaination would be helpful In this ease, te could have raised tide -question Immediately after the filing of Or. Brown's report at the Ccoaia- 9 sloa and he could have requested to cross-examine the doctor on that point. The! 10 report v&s filed into the record with no objection raised by anybody *M now, 11 at this late date, the applicant is attempting to obtain additional delay and 12 time in this case for -`the obtaining of examinations and reports which could 13 easily have been obtained prior to the submission of the ease. As pointed out . - 14 earlier, it is also not clear from the record what purpose such studies would 15 be inasmuch as studies were conducted by his own doctor and by Defendant's doc 16 tor and both studies indicated that there were asbestos fibers present in the 17 lung. ' - 13 . It is therefore obvious that the Applicant has failed to establish a 19 ease Inasmuch as there Is no shoving that the applicant had disabling pulmary 20 disease or asbestosls. There is also no showing that the major surgery performed 21 upon the Applicant as a diagnostic measure was necessary to cure and relieve 22 from the effects of.'hhs alleged Injury herein. 23 WHEREIN, INDUSTRIAL INDWTITY COMPANY contends that the findings and 24 Award heretofore issued in this matter is proper in all respects, and prays that 25 the Petition for Reconsideration be denied and that said findings and Award be 26 affirmed. . ./ : . 27 23 Datait January 13, I96O' 29 30 31 yf //M^, PATRICK R. MALolTf, / Attorney for Defendant * INDUSTRIAL DtDQflnxr COMPANY 32 -5- C00'- X (JOOGTJ TTJ-'l^ W '"*&&&* "r * - *' ) ' : JuL o- . THE INDUSTRIAL ACCIDENT COMMISSION OP pt-.'.T?tcr c? 5*rrrj.i m^rwts .: . ' CLAIM NO*4 59 OAIC 1053 z ROBERT P. CUTKBSRTSON, ' 4 Applicant,.. Oakland 6ffi& e vs. 6 PLANT ASBESTOS, et al, and - UNION MUTUAL LIPS INSURANCE .** 7 COMPANY, et al, _- . '-A ....... " ` . Defendants. ANSWER TO PETITION ?0R RZCONr ' SIDERATIOK * 9 . 10 v Comas now Pacific Employers Insurance Company, defendant -' ' U herein, with Its Answer to Petition for* Reconsideration in the A . 12 above entitled casS'and In this connection, denies: v.- ' ' ' . ... ' .. . - : 1* 13 v`:y ... . . V; --I, V : ' ' . . 14 15 *? The Commission acted without and in excess of its powers; ;.lv > -H; ' ' 16 ?_. That the/evidence;,does not Justify the Pindiogs of Pact; 17 in i ia ; ' That-the. Findings, of Pact do not support the Order, De- '*** * ' 1 ', , '.. 19 cialon or Award of your Honorable Cotmission. .. ' -' ' 20 . - 21 ' 22 , v > ", V< THE PETITION FOR RECONSIDERATION Applicant petitions for-reconslderatlon notwithstanding . - .as ory conflicting medical evidence`betweiri the opinions of Drs. H. ' . 24 Corwin Hlnshew end aerald Crenshaw/, there was a reference to an '* 25 agreed'medical' examifter, .' ' -f . ' .. '' 26 a^lhst the `eppXlAicCaarojtt. ,,. iabot Brown, who resolved the conflict! U"f . *i - .......W...................................... .,,, ;l' 27 * 28 n rL- - f- `os CONTENTIONS OP THE APPLICANT . ' ' 29 V' ; The applicant was'employed'ab-an installer of insulating *' 30 31 ' ' 32 .(.cm nu#( *t I. materials principally..^!) oonatructlon-Jobe. ^ Hs claims that he has * - f-i.-- ;. ' x. - . worked from 1948 through'1958 which caused a lung .condition cf - . - v */" - asbestos!s. * . . ?`\ >?. *' w.-j, .- . -.;J- . *, . - : - v r. .000;:l mrr*+ gpm Cw- ' - A A ... *;:' ' tv-* .< /.. 1 > r v ^\''Lt * u-i:, } ' : , \>\/ ` - K i J. 1 : ' / J* * -* - ';V: ; 1 'f,' 8 *' *" . * .4 ^ '' . * * # :?/ *' > facts' . ^ t ^ ,. v. /> The applicant worked from 1948 through 1958 (and contin 3 l.. '/. : 4 ue*; to work for that matter) as an installer of insulation materi als; for' various companies. Various insulating materials were used ;,5 *V. . 9 dome consisting of-non-asbestos materials such as wool felt, cork, fibre glass. 'With respect, to asbestos materials he used for the S' 7 -.8 mbet part comprised >hat,.la known in.the trade aa 85 magnesium'' pipe covering. This, material apparently contains from lo-jg to 15 ' '9 asbestos fibre. ./ ,, i v,' - '' " \ * . . ; ", ' . * ' .' ; * 10 , Mr. Cuthbertson was`apparently in good health'so Car as his chest was concerned until February of 1958 when he had a ae- i\ ` " . ; , ' , 12 vi*e attack of pneumonia which hospitalized him. . Although It la 13 not clear, it apparently was about this time or shortly thereafter^ - . 14 that' he began to experience pain in hia cheat and earns under the : ' 18 care of Dr, Crenshaw on July 89V`1958., * * *V ' ;, . ' ; Dr. Crenshaw made a ore ** .--18 operative diagnosis of asbestosls and then for some unknown reason , ' , 17 did major surgery consisting of a right lobectomy in order to bi 18 opsy the lung. The';,slides of the tissue after operation were re 19 ferred out to Dr. Singman. .According to Dr. Slngran's testimony, he could find no unusual pathology visible upon examination micro . 20 1 21 scopically. The tissue was referred to the Department of Public ` . 22 Health which reported the presence of asbestos fibre using a cer tain technique. .. ' . 23 , r- ; ' 24 5*'' . Following the chest surgery trjt*Dr. Crenshaw, the applicant A* * * t * , .* . ` V 23 syaptoma have not been changed in any manner and remain consisting 28 of some pain in \' ' , . the chest. .-This has not ... been particularly * disahlin . ' 27 and*he continues to work in the-,exact same trade, that is, install '; 28 ing Insulation materials--both asbestos and non-asbestos," -. \ '' ': . . 29 The.applicant argues that Dry Crenshaw's opinion should be s ' ' * ./ 30 accepted oven though^the conflict- that has ,, v $ , , ~ - `J \ - * i existed * \5 has been resolved l ` 31 by .the reference to art,agreed medical^xaminer. He attempts to ' .(.CM 32 avoid this by eayingtthatr it-.Wa&Mthe' contemplation of the parties : . : . , K. > f i ' : .V ' ' . .. V-*.-- , ?.' . r,.V,- // - OOOOC >*e u 9e4 a-ea* S 4 l - * .. '-sA*'\ ,fr i ,wgmr,T'"vy o QV . , ' 1 that an Independent pathological examination was to be had", No 2 thing was said about an independent pathological study* until the - 3 Petition for Reconsideration. . Mr. Schwab arranged for the examin 4 ation by Dr.. Brown..and forwarded all the material to Dr. Brown. . e While we do-not think it of great importance, we believe that the t ; - 6 slides'of the ti03iie were forwarded to Dr. Brown and were reviewed . 7 bi4y him< .v A. t the enyd*'-of * Mr-. * S' ch'4-w* a* b* 's. .letter to * * Dr. Brown, the -- 8 doctor was told *lf you desire to use the aervicos of a roentgen . , _ 9 ologist or- a pathologist* you are authorised to do sow. If . . ` 10 Dr.- Brown.had seen'fit.to Have additional pathological examina v. . , 11 tions, we are sure he would/have so "arranged. Had applicant been 12 serious about another pathological examination, we are sure that * ; .. x.j- *. - . : 13 he would then have' requested Dr. Browp to have an additional path V' - 14 ological examination- ; The Pathological opinions of Dr. Singman, .. . / s /'' ; , .. . 16 to whom the. material was referred initially by Dr. Hinshaw, and. *4. ....... 19 th. a,t of',Dr....W. atsonTidr.e...not .in- -.c-onflict. Dr. Watson con ceded the :. 17 pB4ser.ee of asbestos flbrea. Neither, of the pathologists cade a . 18 diagnosis of asbestosls. . - V - X 19 IU '_ The question here Is not whether there was some asbestos .. ' 20 fibres in the lung, .'The real question was whether there had been * V*V- .. " Vv 21 sufficient exposure, to asbestos particles of a size and in suffi 22 cient concentration;-to cause the disease of asbestosls ar.d whether ...; * . 23 the applicant.was suffering from the .disease of asbestosls. . 0* * f ' V * ''24 . It is noteworthy that Dr. Crenshaw at the hearing of . : 25 October 22,^1959,'. could not recall the size and concentration of . '26 particles of asbestos which would be.disease producing although.he ; . 27 claimed that he had-.Known this but was too' tired to recall it. The' applicant argues in-.effect that the finding of asbestos in the lungh . 28 ................ "29 nefeebaithtea the finding of asbestosls, - ; . ..." ; 30 ' 31 JIWCM 4 32 |At #IihM*4 4- . Dr. Brown points out, however, that: ' _..* H- r r';:"A clinical diagnosis of asbestosls depends on a "history of Adequate exposure to asbestos dust, ob- / Jective evidence of impaired pulmonary function, -and radiological appearance consistent with pro- - , :* ' k- if' -3- / ooomGo :/ 1 - - ,7 - .: V., ' O ' i'. i ' ' - 2 * 7- 3 . '7 _ ' 4 t i fuse `ground glass'1 pulmonary fibrosis. The find ing of asbestos bodies in the sputum or by lur.g Biopsy may clinch the diagnosis when these cor.oi- tions are met but the finding of such bodies, per ee, would not in Itself justify the clinical diag nosis of .asbestosla." - .V Dr. Brown further pointed out that the symptoms the ap-- ' . ." e .** 7 . ' 9 10 . " 11 plicant waa'complainlng of were not those usually found in aabes- tosis;, f -V .* >,M' V. ; ; ^ "The iwriiTiaxrt. symptom which causes workers exposed to any dust to seek medical advice 13, in m7 exper- , ience, shortness of breath. This la usually estoci- . ated with some degree of cough, dry or productive, as well aa weakness, weight loss, and occasionally . clubbing of the fingers. Just pain is not a fre- quent or^prominent complaint." , . , - . ..7. - 4 12 Dr. Hinshaw in hia report of October 12, 195S, points cj* 7 13 that: . " 14 /-. "It must be emphasized that the presence of'these fibres bears no relation to the degree of injury, ' 15 i'r * if any, and that other methods of examination ru3t k . V be relied upon to determine whether significant is V.. pulmonary disease is present. --r............... i ................... . ' . ' 17 . 18 i "Biopsies serve no useful purpose whatsoever in a . situation such aa this where there is no clinical, : v physiological or radiological evidence of dla- ' .7 abling pulmonary disease."- * . -. ' *' ` 19 . 30 VS . ' 22 . , 23 - v7 ' 24 ) Thia waa very aptly put by Dr. Brown: : ' . .' "The point I wish to stress i3 that the mere find ing of a few asbestos fibres in a section of lung simply means that the individual haa at some time in the past Inhaled asbestos particles and does not indicate that thia individual has actual- . disease (asbestoals)." .- . ` 25 j In the conelusion^of ,the Referee, it la well pointed out' W." 26 that the report of Dr. Brown resolved any apparent medical con- - jm : , *. v27 fUct existing In the cas^.' * i... ' 'f. . - 28 t -i `. * -' 29 30 31 32 muu.cn * ' ><.. ar*. <1 I. MutaHM !* !>( ^ WHEREFORE/'it la respectfully submitted that the Find* ' v:i " /r ; : * logs and Award and+Order^arf jjroper' inwall .respects and It -.Is.re ** * . /r. - ' 'r f; -7 >uv> ' > '-.7 . V 'r:. 7^7;7yV; ' \ OOO'JL:^ n -..I'll w TT" .V-* * ' <;f ' ^Or . .. 1 quested that, your Commission deny reconsideration without further *'..*/* , * * > . **, . 2 proceedings. ' ' V,*Jf. ';* ^ - ' . 3 Respectfully Submitted: .... .v ' 4 \~ 0 r' - MULLEN &`PJfri?PI, Attorneys for ' ' yh- Pacific ^mpla^s^Ioau^r.ee Co-paoy* 6 U By-- : /V^7^ftninoore^'---`" 7 Dated at San Francisco, California, this Uth day of January; T?60.' - T1- ?-.' Copies this date mallei to: T '' ; : 9 SP1ITH, PARRISH, PADUCK & CLANCY, Attorneys at Law,' 10 501 Financial Center Bldg., Oakland, Calif. * HANNA k BROPHY, Attorneys at Law, . ; .11 15*0 San Pablo Ave., Oakland 1, Calif INDUSTRIAL INDEMNITY CO.,.', ' .. t`J 12 350 Sansome.St., San Francisco^ Califv STATE FUND, : - . A . ... . ,' .' / " /- 13 450 McAllister St./ S;jp Francisco,. C*lif. PACIFIC EMPLOYERS DJS. CO.,> T 14 244" - *` : .' - ... 1 H 15 ' \ 16 17 18 19 C i. 20 . 21 i? l' ; *.*. VC*- 22 < i :-::> r-r 23 S., ' - - .. . V' 24 20 26 V\: io 27 28 29 30 <"r 31 v. ' V-.> 32 MUllCN * nutM ** HI '*<** ft. *M * / fl \r Vv,: ' Swr. : Ifc, : . AV.,.\' '> V V*. K '1 sr.t:-; M;;, tf-* .w, KYlt . \-5- OOOCJU < fr ^ . * 7 ; -'V ^ '^ wv ' , J * \ t.*K >** vI. {,. 1 STATE OP CALIFORNIA- 3* 2 CITY AND COUNTY OF SAN FRANCISCO . . _ 3 JOHN W. HOOKE, being first duly 3worn, deposes.and says: *; That he la'an attorney at law, admitted to practice be- V. .. ' * %. . . 5 ' fore all Courts of the State of California, and is one of the at * torneys for the defendant. Pacific Employers Insurance Company, in 7 the foregoing proceeding; that the factssthereln stated are within a the personal knowledge of affiant andhe La to naice thl^ verification on its behalf; that he haa read the Answer* to Petitloij 9 10 for Reconsideration and knows the contents thereof, and. the same 1$ 11 13 13 U 16 16 17 18 19 "20 21 22 23 24 26 '26 27 26 2$ 3C 31 32 r*t 7 re. H6 41 4 Mk tf1 \*> 0 \>' 1 frf O \ ', \Vv`;^^3EpORE THE DIIUSTRIAL ACCIDENT ":;i-r*i...r i; CO! ____________ ^"c j ' STATS OP CALIFORNIA J^N H'.CtO ** 3 ROBERT F. OTTHBERTSOH, Oakland Office 4 Applicant, 5 ' vs. no. 59 oak 1053 e PLANT ASBESTOS COMPANY, et al. 7 Defendants. a 9 10 " ANSWER TO PETITION FOR RECONSIDERATION n Come now the defendants STANDARD ACCZjENT INSURANCE 12 COMPANY and TRAVELERS INSURANCE COMPANY, answering the Petition 13 for Reconsideration herein as follows: 14 The Petition for Reconsideration proceeds upon the same 15 basic assumption advanced at the time of the hearing; namely, 16 that the presence of asbestos fibers in a sample of lung tissue 17 Is of itself sufficient to establish the presence of the industrial 18 disease of asbestosls. That basic assumption has been shewn to 19 be erroneous, in the well considered medical reports of Doctors 20 H.- Corwin Hinshaw and Cabot Brown. 21 The argument that reconsideration should be granted so 22 that Dr. Cabot Brown may have an independent pathological study 23 made is but a red herring drawn across the trail, for the purpose 24 of confusing the real issues in this ease. All that such a 25 pathological study could demonstrate would be that the tissue 26 taken from the applicant's lung contains asbestos fibers. The 27 defendants admit that fact. It has already been abundantly 28 established through the report.of Dr. George A. Vatson, which 29 .is quoted in full in the report of Dr. H. Corwin Hinshaw, dated 30 October 12, 1959. 31 At the conclusion of the hearing held on October 22, 32 19*59, the referee advised that he wonted the parties to ayree i *i *<< 0A6UN9 It. VC*V6 * OOOOoO r:-~n9' f ---- -.*" -fv*. ' :^- :. ?fc a sijcLs.ll o.itc he shs~ entsrid an hol-i^g x..: . oiss op*n t^s ric.j'i- un>s filing ii -cis^ z-opv/i't ^z*'m th- A-ridd ms.li.jal Iras J.. Schwab, the attorney :;cri Itawcard < j Asoldant inscv jii-o* Oompany and Travelers Inscrxr.ce ler-pany, '' 6 conferred wiuh the attcvRiya representing the io-difsndants, and . d than .ubmitted sc the attorns;:* for tha applicant t 11at of four ! 7 names of doctors,, x.iy one of cfhlch tould bv icceptchlo to the ! 8 defendants at. an s^-aid Medical examine To The name of Dr. Cabot S Brown was aticng the four rjius submitted. On November 3, 1959, 10 ttu attorneys-'er tfct applicant advised Mr. Schwab that the appli 11 cant wculd agree to an assassination and report b7 Ur* Cabot Brown* 12 ' The arrangements for the examination and report ye re 13 made by letter 3ent;by Hr. Schwab tc Dr. Cabot Brown, dated 14 November 12, 1959c A cony of that letter went to the attorneys 15 for the applicant, and a copy also want to the In&istrial Accident id Commission. _ Dr. Owbot Brown was .specifically advised: 17 ; "If you deolre to use the services of a roentgenologist ' - or a pctftologist, you are authorized to do so. 18 . Dr. Brown did-not consider it necessary to have any 19 further pathological studies, and the reason vhy is perfectly 20 clear when one reads his report. In his report of November 19, 21 1959, Dr. Cabot Brown states: 22 . "The point I wish to stress is that the mere finding 23 of a few asbestos bodies in a section of lung sinoly means that the individual has at cone tine in the post inhaled 24 v asbestos particles and does not Indicate that this individual l has actual disease (asbestoais) It is not unlikely that a / good many people who are required to walk passed large 25 ?. construction Jobs a couple of tinaa a day would be found to 28 have inhaled asbestos fibers, were it feasible to subject v thoir lungs to a searching examination. However, the 27 difference between these individuals and those who have " well developed clinical asbestosis lies merely in the total 28 amount of exposure. The exact size of the particles, their concentration in the inhaled air, and the duration of 29 , exposure aro all factors In the total quantity of exposure. / It is true that the larger the particles and the more concentrated they are in the inhaled air, the leas the 30 required exposure time In order to develop the disease. k There Is, however, no evidence to support the fact that it 31 Le imoossible for an individual to develop asbe3tOci3 from the inhalation of smaller particles in less concentration, 32 provided the total exposure time la adequate. utN. >. ULiroanul -- ./ uouu -2- "\ ^1  "A clinical diagnosis of asbestosls depends upon a history of adequate exposure to asbestos dU3t, objective ' evidence of impaired pulmonary function, and radlolorical . appearance consistent with diffuse 'pround class' pulr.cnary . ; flbrosi3. The finding of asbestos bodies In the sputum or /'by lung biopsy may clinch the diagnosis when these conditions are met, but the finding of- such bodies per se dees r.ot in. :V Itaelf justify the clinical dla'rriosrsof' asbestosls." ~ " 7 (Emphasis added) { " " ` ~~ ~ ~ r In his report of November 19, 1959, Or* Cabot Brown also said: " nX 2 am in complete agreement-with Dr, EinshaVs 1 statement, which 70U quote.R The reference Is to the following quotation, taken from the report 10 of Dr. H. Corwin Kinehaw, dated October 12, 1959: 11 "Doctor Watson's findings confirm the patient's statement 12 4 that he has inhaled asbestos fibers. The inhalation ar.d the depoaitton of asbestos fibers does not by Itself con 13 stitute evidence of disabling or necessarily significant i occupational pulmonary disease. It would be predictable, 14 - that any person long engaged in the handling of asbestos * materials would collect asbestos fibers in his lunss which 15 would be detected if a sufficient amount of lu^g tissue ? were examined. It must be emphasised that the presence 1 of these fibers bears no rolation to the decree'of injury, ' k If any, and that other methods of examination must be relied 17 1 *, upon to dotejoine whether slfmificant pulmonary disease is ; present* The function of lung biopsy in cases such as this id should be to determine the nature of serious injury er.d dis ability when such disability has first been demonstrated* 19 Biopsy served no useful purpose whatever in a situation such ' as this where there is no clinical, physiolorical or radio* 20 logloal evidence of disabling pulmonary disease*1 21 ` We respectfully submit that the Petition for Reconsider 22 ation presents nothing that has not been previously exhaustively 23 considered by Dr, Slash**, Dr* Brown, and the referee, and that 24 further studies of any type are not required* 25 ' WHEREFORE, it Is respectfully prayed that the Petition 26 for Reconsideration be denied* <. 27 ; DATED: January 11, I960* 28 / ' . Respectfully submitted. 29 30 31 32 MNt *0 9 * #*#* .> it. c.c. Smith, Parrish, Paduck _ Clancy Atto c.c, Kullen & Fillppl Co* and Travelers c,c. Standard Acc. Ins* Co* (96-C-96079U / ' ec* Travelers Ins*. Co* (B-8972691) c.c* IndustrialIndemnity Co,, S.F* c.c. State Fund ) -3* /  1^ ; v . *;T t 1 2 3 Under penalty of perjury I declare the truth of the 4 foilwing: (a) That the contents of the foregoing dccicient are 6 true end correct of my own knowledge, except as to r.atters stated 6 therein on information and belief; (b) that the matters so stated 7 are believed by rae to be true and corrects and (cj that Z 8 this declaration because the facta aet forth in said docuaent are 9 within my knowledge and because as attorney for the answering 10 defendants herein, I am more familiar with such facts than are U the officers of said defendants* 12 13 14 15 Dated at Oakland, California, 16 this 11th day of January, 1960. 17 18 19 20 21 22 23 24 25 26 27 j 28 29 f-/V's 30 . V * V 31 32 ** *< acuue# *t. laiifom f|e*utee i/, . . //,. i !, r> f- G00(JUA y 2 3 4 5 6 7 8 9 10 11 12 13 14 15 i ! 18 19 - '. Cornea now the applicant and petitions your Honorable j i Commission for reconsideration in the above case on the following groundst . . 1, The Commission acted without and In excess of its 1 powers. , 2, That the evidence does not justify the findings of fact. ' 3* That the findings of fact do not support the order* decision or award of your Honorable Commission. ! ( j i 20 *. Applicant herein objeots to the findings of fact that he ! i 21 did not sustain an injury arising out of or in the course of his j 22 employment* - ' I 23 That his disability was not caused by any injury arising j 24 op in the course of his employment* 25 And the order that applicant take nothing by reason of 26 his claim asserted in this proceeding. . ( j i ) 27 > A resume of the applicant*s testimony indicates he worked ; 28 as an asbestos worker doing insulation with asbestos materials { 29 from 19^7 through December 1958# the record clearly shows that ; 3C asbestos was in the materials used and applicant testified as to 31 the dusty conditions caused by the materials containing asbestos. 32 . .* ` , He was having pains in his cheat so he saw Dr. Lawrence in *' * GOO''--* --g--*--*- 'in I'Titi i-ii1ryf"Ai'f<'''?,rr'v'iV^i i t~x SMTTX. P A R R IS H . P A D U C K C L A N C Y* 1 1958, and Or. Lawrence referred him to Or. Crenshaw, a chest 2 specialist, and the doctor placed him In Richmond Hospital on 3 August 3, 1958, and surgery was performed on his lung at which 4 time Dr. Crenshaw advised him that he had asbestosis which con 5 dition was oaused by his work, i 6 . Dr. David Slngman, defendant's witness who is a pathologist, 7 testified that specimens of the lung were sent to the State j 8 Department of Health and are shown by the Referee's memorandum j 9 "a quantity of formed asbestos was even demonstrated In the 10 tissue" I i j 11 . Further the report from the Department of public Health ; 12 dated December 31# 1958, over the signature of William Thielen ; 13 definitely shows particles of and presence of asbestos in the ; lung. ,, i .. Your attention is directed to the report namely Dr. George j Watson which is set forth in the report of Dr. Otto Shaw, dated j October 12th, 1959, where the pathologist states that *a3tC3t03 i body disposition Is moderately advanced." j J . !.1he`testiraony of Dr. Gerald Crenshaw, chest specialist has i 20 been transcribed and your attention is directed to page 1, line 23 \ 21 "Q. And in your report dated Kay 25, '59, you stated that the j 22 studies were made and indicated that there was evidence of asgestoa! 23 . in the'chest? A# That is right. I 24 23 26 . X 27 28 29 30 31 32 Do you have any opinion as to whether that asbestos was causlnr: any.disability? A. Yes. I feel definitely it Is. ` Q* And what disability was it causing the man? A. Improper bronchial drainage.11 *1. . . Q, And you ultimately did some surgery on the chest? A, Ye3, we took a piece of lung as a diagnostic procedure to determine the amount of scarring and fibrosis, and de termine the presence of the asbestos particles." Further on page j 22 of the transcript line 3 "Q* And what was your diagnosis, [ Doctor, immediately after the biopsy was performed? j MMikiillMMMWUilli -\ 4k *'-*rT* Q 1 A* My pre-operative diagnosis based on what the history ar.d 2 based on his working and surrounding environment, was asbestosls. 3 My post-operative diagnosis was the same* Dr. Ia.wrence Brown 4 helped me with the surgery and collaborated. 0. And this was j 5 based upon this history and the symptoms? A* And observation, j 6 and.feeling, and palpation of the lung, which to me Is a most i 7 delicate and definite way of telling how badly injured the lung is.| 8 We are amazed constantly how little the X-ray shows us, tr.ose of j 9 us reading X-rays and entering cheats. Q As I recall your testi- j 10 mony with respect to X-rays, Doctor, you are not sure that any n X-rays were taken at your office before the biopsy? A. Hone In | my office but, of course, I wouldn't go into a chest without having! seen.the' x-rays first. I was being equivocal because I thought i i you might be hedging on certain dates and certain times and making ; much of that, and therefore, the X-rays -- * and on line 9 page I i 23, "ft. . Did you rule out asbestosis. Doctor? A. Ve ruled in asbe- stosis. 'ft.By* a process of elimination, was it? A. By a patholo-i gical examination." again on line 18 page 27, "ft. 13 thre any ! f- . ` 1 j evidence that there has been an extension or a change in the fibrous appearance of the lung? A* At surgery there was gross crange. 21 ft. Change as compared to what period, Dootor? A, Oh, I can only 22 say, speak of the actual time I saw him when the chest was opened, 23 and I had the lung in my hand, ft. Yea. When you saw It at 24 surgery, were you able to differentiate it whether or not the 25 appearanoe you saw were not -- could you differentiate between the j 26 appearance which, you.saw between residuals from a chronic pneumon- 1 27 ltia or pneumonia or whether it was due to the presence or atsenee 28 of asbestos materials, or whether it was due to quartz that cay 29 be in the lung? A, We couldn't tell what the subatance was that 30 produced it but we could tell there waa definite destruction to 31 this man's lungs, ft. So far as -- by your observation at surgery 32 you knew-- A. His lungs were injured, ft. The lung had evidence ; v oooc 1 I ?  .SJL 1 of injury? A. That Is right", then again on page 30, line Id 2 "A. ... I would deduce from these facts that this man and also 3 from my clinical and surgical experience that this man has modera 4 tely advanced asbestosls," 5 :At this point by way of clarification, I think we should i 6 refer to page 25 line 22, "Q* Dr. Crenshaw, how do you define the 7 term 'asbeatosis'l A. Aebesto3is, clinically, would te impair- 1 a ment of -- particles within the substance of the lung, asbestos 9 particles within the substance of the lung, producing sufficient 10 fibrosis that the functions, and the lung has many functions be n sides respiration, .that the functions of the lung would te impaired 12 It is agreed that the medical opinion of Dr. Kcnshaw Is 13 contrary to that of Dr. Crenshaw and it i3 to be noted that Dr. 14 *U %U 15 faic. l!l;!i jSSo* 17 Cabot Brown, the agreed Medical Examiner agrees with Dr, Kenshaw, however, in reviewing Dr, Brown-*s report it appears that the pathological report and studies would appear to be the important ' answer to the case at hand. i ; s 18 19 20 21 22 23 24 25 ` It is my understanding that Dr. Brown did not obtain inde- ; pendent pathological studied nor did he review the 3lldes as Dr. Brown makes no comment on the pathologloal findings and report of Dr. George A. Watson, who refers specifically to moderately ad- vaneed asbestos deposits. The chest men in this'matter have deferred to a certain extent. . . Dr. Crenshaw baaed his opinion upon pathologloal reports, hia treatment of the patient as well aa doing surgery on the man's 26 lung and handling and observing the lung and its functions. The 27 insurance company's doctors have based their reports and opinions 23 on the X-rays and pathological reports. 29 Dr. Brown makes no mention of the pathological reports nor 30 has he had an Independent pathologloal study made. It was within the contemplation of the parties that Dr. 'Brown would have an in 32 dependent pathological study made and it is hereby requested that -4w ooir:* r. i j1 Drt Brown have an Independent pathological study made to determine 2 the presence of asbestos and whether the asbestos fibres are 3 causing an lnflacmktion or irritation of the lung which can be | 4 classified as aabestosla and which Is causing the man disability 5 from a pathologists stand point* 6 WHEREFORE^ it la prayed that petition for reconsideration l 7 ' GTantf*i* i j 8 9 10 11 M IT H . PARRISH. PAO UCK A C LAN C Y 12 cci Hanna & Brophy . . 1$kQ San Pablo Ave, 13 i.- Oakland Mullen & Fillppl i 315 Montgomery St. San Francisco - Industrial Indemnity ' 350 Sanaome st. ~ San Francisco . . \ > State Fund 450 McAllister St. ( San Francisco - 20 !. - . 21 22 23 24 25 s' 26 27 f .1 28 * 29 V* 30 31 ` 32 .V.< i1'.*... ' 5- j i 1 j000UC7 / , .. v . - !*. . ,^-:.i........ . ;|t- -i. ^:;-vn^-...-- .l tv o '' Q TUB) AND SERVED: /< -/'^' On all parties of re cord--R. Crowley 2 BEFORE THS INDUSTRIAL ACCIDSOT COMMISSION 0? TEE STATS CP CALIFORNIA 2 CLAIM NO. OAK 1053 3 4 ROBERT 9. CUTSBHrrSOH ) 5 Applicant ) 6 . ) T TOOT ASBESTOSCTHPOT, J, T. THORPE, 1 H2STHU* ASBESTOS COMPANY, ARMSTRONG 8 CORE, TRAVELERS INSURANCE COMPANY, ) INDUSTRIAL INDEMNITY COMPANY, 9 PACIFIC EMPLOYERS INSURANCE COMPANY, ) STANDARD ACCIDENT INSURANCE COMPANY, 10 and STATE COMPENSATION INSURANCE FUND ) u Defendants ) FILED I fifC 151953., oac* ----------- FDJDIMG3 AND ORDER 12 13 The above 'entitled matter having been regularly submitted 14 before John 8, Ankele, Referee, said Referee sov makes hie decision 15 ae followst 16 FINDIW03 OF FACT IT 1. The applicant was employed by the various employers 18 above named from July, 1947 through December, 1958, and alleges 19 that he sustained an injury arising out of and occurring in the 20 course of his said employments, consisting of asbestoeis. 21 2. Applicant did not sustain any injury arising out of 22 or occurring In the course of hie employments from July, 1947 through 23 December, 1958, 24 3* The disability of whloh applicant eosplalne vae not 25 26 27 28 29 30 JBAtro OAK 1033 proxixaately caused, or caused at all, by any Injury arising out of or occurring in the coupse of hie employments, or by his e^loyaents. ORDER IT 13 HEREBY ORDERED that applicant take nothing by reason of hie claim asserted la this proceeding. >1 .( REFEREE ACCIDENT COMMISSION V mik o JOSH K. AKKHLE, Referee' Oakland, August 13, 1959 OTTHBEKTSOH Injury: 59 OAK 1053 Asbestoela RSPORT OP REFSRKB The employee, an Insulator, bora Kay 4, 1926, claims to hare contracted asbestosls as a result of his employment. Bothlng has been paid. ISSUSS: 1. xrtjury. 2. Medical. 3. Statute of limitatlona. 4. Lack of notice and prejudice. 5* Jurisdiction -- maritime. APPLICANT testified In substance as follows: He obtained the es^loyaent records from the union and the employers. In lily of 1947 he started to work for the Plant Asbestos company and worked through January of 1948. The period of employment was about seven months. He worked on ships for this employer, and cork was used for insulation. He worked for J. T. Thorpe from Way to December, 1$48, applying asbestos insulation on one Job In Tracey and one at-Hunter's point, a power house at PQfcB. He cut and fitted asbestos material and used wire and said In the application. This work went through January of 1949. The places where he worked were enclosed and there would be dust there. Others were on the Job. He then worked for the Western Asbestos Co^eny from January, 1949, to May of 1949. On that Job there was also some Insulation of asbestos material for PO&S, and also for the Union Oil Company. Then he worked again for J. T. Thorpe from Way 11th through August 10, 1949. This work included Plbreboard Products at Antioch. The work wan all in an enclosed area. Zt was hot and dusty, and there was dust from asbestos material. Prom August 11, 1949, through pebruary, 1950, he worked for Plant Asbestos and the work was at Plbreboard Products at Antioch. The work was the same and the conditions the same. Proa March 13, 1950, to August 3, 1950, he worked for the Western Asbestos Company on a POfcB power house at woes Landing. This was the same type of asbestos insulation, and it was in enclosed and dusty places. . On August 20, 1950, to September 3, 1950, he again worked for Plant Asbestos at oalland laundry. This Job was very hot and dusty. Prom September 13, 1950, to July 17, 1954, he worked for the Armstrong Cork Conpany.. . There were about nine months at the PO&E plant in Antioch in 1950 and he worked at Travis Air Force Base aat of the balance of the time. Also he worked in this period at Regal Pale for two months where they used cork insulation, and there were other smaller Jobs during this interval. The POkS power house Job was very hot, and w*r- imr i--ki i i n mbmivia e . o t Cuthbertson - 2 he worked for Plant Asbestos Cosgiany which was all asbestos work at various schools, and he worked continually for Plant Asbestos through leceaber, 1958, except when he was off on account of a leg Injury In 1957* The worktaa all asbestos work, mostly in boiler rooas and oloee quarters. He saw lr. Crenshaw on July 29, 1958, on reference from lr, Lawrence, his family dootor. He had seen lr. Lawrence two or three weeks before and he did have pneumonia In February, 1958. He had surgery at Richmond Hospital on August 3, 1958, and he was advised by Ft. Crenshaw following the surgery that his condition was due te his work, as had worked througi August 1C, 1958, and was off three months, and he returned to work at Plant Asbestos on Uoveaber 4, 1958. Before his surgery there were no masks worn on the Job. He Is doing the ease type of insulation work now but wears a mask when on the Job, continuously. Be has slowed down physloally and he hurts all the time. . He did not work on the Burgermeister Brewery for Armstrong tut he did work at Hapa State Hospital for Amstrong. That was asbestos insulation work and living quarters, all underneath the building. He did not use wool felt there. He recalls working at the State Employment Building la San prancise for about a week, insulating the storage tank. He does not remember doing the Job at Borden's hairy is Oakland but he could have been on that Job. Be worked In a radio transmission station between Pavla and winter one day. He did not work on the Camp Beale Job. He worked at a refinery In Rodeo two weeks or so In tunnels under the highway, insulating. The Travis Air Force Base Job took nearly two yo&rs. Biere was some wool felt used on that Job, but mostly asbestos. He believes that McKeesby and ftadlson were the manufacturers of the asbestos pipe covering, and It Is known as magnesia pipe covering, eighty-five per cent magnesium. They use some Fibreglass, and up to 1953 or 1954 he does not remember If they used any Johna-Kanevllle products. On heating pipes they generally use asbestos pipe covering. He has a twin brother named Jack and he worked with his brother at all times, and they were inseparable. He knew his brother had surgery at the hands of lr. Crenshaw, and he had Hr. Thocysoo check him after his second operation In 1954. At that time lr. Thompson had X-rays taken. Be did go to lr. Thompson to see if there was any danger about his having asbestosls. Be -- went two or three times. He is not sure when the second X-rays were taken. . When he had pneumonia he changed to hr. Brown, When he first saw Dr. Brown he had tightness of the ohest and pain. He bad X-rays taken at Richmond Hospital at that time for pneumonia. He Informed Pr. Brown that his brother had lung trouble but he did not lnfons lr. Brown of the previous check-ups he had at the hands of lr. Thomson. . * It was after he got out of the hospital from his own surgery that ^ lr. Crenshaw told him he had asbestosls. 000071 v ew* IB-- IT f l'>---^--- TBlt6tiiil5li.i.a-fl& Cuthbertson - 3 Hg informed th Plant Asbestos Company that he .was going to the hospital. He believes that Blue Cross paid siost of the medical bills end some of Ir. Crenshaw's bill. Be paid about 50. In hospital bills. He drew unemployment disability benefits at 50. & week all the time he was off, and he also received 12. a day for hospitalisation. Ee knew that his brother Jack had a proceeding before the Industrial Acoldent comslaslon. Be understands that dlateaacaaa# earth la the sane as asbestos. When he saw hr. Thompson for a ohest check-up he had no chest pains. At that tine he was working for Armstrong Cork. Br. Thompson told him everything looked all right. m May or June/ 1953, be began having chest complaints. He stopped smoking on the advice of Br. Crenshaw. Be was troubled with shortness of breath last year. He was off a week after he returned to work in November, 1933, and then he was off another week because of hie chest. The eighty-five per cent magnesium pipe covering that they used Is manufactured by Pabco. They always use Pabco materials. He did not lose any time before August of 1953 because of his chest. He also worked In some old buildings for Plant Asbestos. 9e did not have pneumonia before February, 195&. He Aid refuse to work on a job recently because they did sot have a blow fss. He Is still under Br. Crenshaw's care. His present complaints are In effect that: he has slowed down, he has some pain, he cannot sleep as well, and It is hard to work. . He has been a foreman since 195* on. was J. T. Thorpe was all blook work and that/worse in respect to dust. This was eighty-five per cent magnesium pipe covering. It was made by Pabco. He has covered all the employers for which he worked but he does not remember all the odd Jobs. He worked along with his brother from 19*9 through all of 1950. Re does not do home insulation. Prior to 1947 he was an able-bodied seaman In the Merchant Marine, and he did not have a history of having a lot of colds. Be perhaps would get one or two a year. In his bout with pneumonia he was In Richmond Hospital about three weeks and stayed home about sue weeks. Re felt fairly good after that. He cannot pinpoint the time when his chest pain developed. It was either In May or June of 1958. Be got so bad he saw a doctor in July. It can be very dusty when they out asbestos. They cut it on the job as they went along, and the pounding and fitting would always cause dust. "\ - . Cuthbertaon - 4 OAKLAND October 22, 1959* RICHARD B. EEAtJDRT, called by the Defendant* Traveler* Insurance Company and Standard Accident* testified in substance aa follows: He is an Independent Insurance adjuster. He reviewed the Job record on which the applicant worked between 1950 and 1954 at the Armstrong Cork office. He worked with J. 3. Taylor* the plant manager. A tabulation was made In the home office In re* sponae to a letter of August 3* 1959 (Defta. Ex. 5). The information under the column "Materials* waa made as the result of his inves tigation of the obtainable contracts. The percentage In this col* umn "Materials" stated the amount of material used on the Job and net their content. The Initials MFC stood for aaffieslu* pipe covering; ED for "fibreglass.* Where there is a dash in the materials column* the contraot could not be found. He made a special study on the Job at Travis Air Force Base. These were marked as indicated by the Z's. This tabulation supposedly covers all of applicant's em* ployment with Armstrong Cork. VICTOR SAO0ES was called by the Defendants Travelers Insurance Company and Standard Accident* and testified in substance as follows: He Is the president of the Secoao Manufacturing Company. They manufacture pips insulation* pump packings and the like. He has had 25 years of experience. He started in 193* with the Plant Rubber & Asbestos Company* and worked with them until April 1* 1948, when their factory was bought by Sacorao Manufacturing Company. They manufacture wool felt insulation. They obtain their materials from other manufacturers. They use crepe wool felt, which is laminated, and then covered by asbestos paper. This is then covered with muslin and the muslin will overlap about one and one*half Inches at one end of a 36 inch section. Wool felt is about 30% rag base* and 50 to 60% wood pulp of the kraft stock. Next to the pipe there is a water proof tarpHnSr*. The asbestos paper Is a six pound asbestos paper* and Is filled within the wool felt paper for a three inch thick wall. 13 to 14 layers of wool felt are used. This is the standard wall. They will have smaller and larger walls on the insulation. The asbestos paper is 40 to 50% asbestos fibre. The balance is wood pulp and Kraft stock. There are fillers and sizing to give the stiffness, in the manufacture of air eell insulation, they use a six pound asbestos* which Is corrugated, and then four layers are laminated to build up a one inch wall. Adhesive used la silicate of aoda* sometimes known as water glass. This is also wrapped with a muslin and put out in 36 inch lengths with an inch and a half muslin overlap. The wool felt insulation la generally used on cold lines. The air cell Insulation is used on hot water lines. The insulation material is cut with taivea, table saws or hand saws. The Joints are probably attached with asbestos cement. He did not know because he does not Install any covering. Dnibestos is made of anoslte asbestos fibre, with bundles of sodium silicate. Amosite la a long asbestoa fibre that Is mined in South Africa. These fibres are as long as five and six Inches. Yhlte asbestos or chrysotlle is mined In greater abundance in Canada, These fibre* are about 3/8ths inches la length. He is familiar with the 85% magnesium pipe covering. I0UAV J'W*" oooo7;i o Cuthbertson - 5 PAUL HIBTO, called by Defendant Industrial Indemnity Company, testified in substance as followst He is rice president of Plant Asbestos. Be has been with the* for 12 years. Be knows Cuthbertson, and has known hia for the last atx years. Be la familiar with the over-all materiala used by the company. They use 85$ magnesium pipe covering, fibreglass and wool felt. They also use foam glass, cork, and air cell covering. He does not know the breakdown or content of 8555 magnesium pipe covering but there la a certain amount of asbestos material. The asbestos materials would be adhesives and cements. The last two years they primarily would be flbreglaaa matertala. Five or eLx years ago Cuthbertson worked under his direct supervision. Em them had no lung ecmplelxrta. He had heard that Jack Cuthbertson, the applicant's brother had lung trouble, and that the applicant was troubled and worried. They do not manufacture the pipe covering but they buy most of it from Pnbeo. They use 65$ magnesium powder cement, which they mlBed with water in the work. GBIAID CRENSHAW, M.D., testified in behalf of the applicant in substance as follows: Be Is duly licensed to practice medicine in the State of California. Bis specialty is diseases of the chest. Asbestosla caused the applicant's disability aa it caused an improper bronchial drainage. A piece of lung taken out at the lobectomy Indicated the presence of asbestos fibres. The applicant was still under hia care. Hia various employments were the only places where he could have gotten aabestoa in his lungs, and he will need observation for some period of time. - Be flrat saw the applicant July 29, 1958. He never took a complete work history but he had a history of recurrent attacks of pneumonia previously last year. There were I-rays taken in October 1953 November 195^ and March 1956. He can not tell if be had all those X-rays but he attempted to get them. He does not remember if he reviewed the reports at Herrick Hospital. The X-rays taken at the Richmond Hospital on August 15, 1958.- A bronchoscopy was made on August 13, 1958. He certainly saw an X-ray report before the operation. The X-rays show an infiltmtion but they did not demonstrate what the infiltration was. He submitted the lung tissue to the pathologist at the Richmond Hospital and received a report as Indicated in the hospital record. A specimen was then sent to the laboratory of the State Department of Health. He never received a written report from the State laboratory but be reoelved an oral report from Dr. Slngsan, a pathologist. Dr. Crenshaw was recalled in the afternoon and testified further in substance as follows: The applicant returned to work roughly two months after the surgery. Be generally sees him once a month unless he is suffering from respiratory infection. Be must be properly treated. He gives him pressure breathing and antibiotics. Antibiotics were prescribed on February 16, 1959 becauae there was a respiratory infection and a sore throat. Also treated him February 20, 1959 At that time he felt he was getting over the infection. In J'une of 1959 he had a 100 degree temperature and farther anti biotics were prescribed. ` This Is the third asbestosla case that he has had In him experience. Otheroaaee were that of applicant*a brother and a Kr. Thorated. Their employment reoord was similar to that of Cuthbertson, la fact, Cuthbertson*a work history was ldentloal. y 000071 -- ve L. ------ .......................... .....V- ;. . -'- in* .' < Q 0 Cuthbertson - 6 The biopsy was major surgery, and was diagnostic. Se did not feel that fibreglass had a great effect. Recent rirgery Indicates that It should be avoided. He told the applicant that he had aabestoal# right after the surgery. Asbestos within the lung impair* the function of the lung. Elastic fibres of the lung are affected. DAVID SINGKA9, M.D., called by the Defendant Traveler* Insurance and Standard Accident, testified in substance as follows: He la duly licensed to practice medicine in the State of California. Us specialty is pathology. He does the pathology at Richmond Hospital. He received the specimen Indicated by the hospital re port. He does not know the exact number of actual specimens. He submitted specimens to the State Department of Health on December 8, 1958 at the request of Dr. Crenshaw. He brought them up to the Department of Health himself. He also received the report of t.A. Soave, a doctor of veterinary medicine. He was then called to Sacramento, there they had special X-ray diffraction apparatus, and the quantity of forved asbestos was even demonstrated in the tissue, es indicated by the report of the State Department of Health. It follow* therefore, that there was asbestos in the lungs but not enough to show in ordinary X-ray technique. He can not tell from the repo t as to the quantities of materials found. He called Dr. Crenshaw when he received the report, but he can cot recall if he seat copies of the state report to Dr. Crenshaw but he usually doe*. If Dr, Crenshaw did not get a written copy of the report the fault was that of the witness, Ha, himself, did not see n7 abnormality of the bronchii If it is not in his report. Dr. Crenshaw was unhappy with his first pathological report because Dr. Crenshaw bad expected to find asbestos, and therefore, suggested that it be sent to the State. Plbroaia la usually found In a&bestoais caaea as Is usual in silicosis cases and generally, the particles can be seen. Most of the noxious agents that affeot the lung will cause fibrosis. * ROBERT CDTHB2RTS0H, recalled, and testified in his own behalf as follows: He did not work at the Pacific Coast Portland Cement plant on Hay 11, 1952, nor on the Walnut Creek School on June 29, 1952, nor at Camp Beale on Kay 3, 1953. It was the prac tice of the company to shift the payroll records to another Job when there waa a loss on a Job from which the payroll eport was submlttod. Ha recalls all the-Jobs in the tabulation except the three he mentioned. He is not a cork man so he does not use too much cork. Se believes that he Just used cork for about a week In hie nployment with Arm strong. DISCUSSION AND DECISION: On December 3# 1959 the report of Cabot Brown, M. D., the agreed madlcal examiner, was served and filed. . It would appear that the report of Dr. Brown resolves any apparent medical conflict heretofore existing in this caaa. Dr. Brown eoncluded that the applicant docs not have asbestosis. Therefore, a denial must issue. JHA: afa/Sn/ro mu mj' n imp DS o ItOtMT IVAN A. ICM Off** M r>Ntnil Arr.^t Cordon JOHN A MAC HnT? rr C S1 V E D IDWAIO P, M* c. j OEC'i 1951* C9WA*0 w ft+AAi naMnftj Office _ J 9 mC (LffA fM DOMA10 V. M'TCMtll 0C09C *. tOWMfY Hanna A Brophy It40 lt Ntlt Allim OAKLAND II. CALIAOANIA TlM*\tA4R * December 3, 1959 f FILED i>CE.3-T3Sa.0At( Industrial Accident Commission 577 - 14th street Oakland, California A ____ l*g_Nlif*yo Q>mt 1*0 Bvm ,**rt ruM a tenor. ,<> >.. II. Cur. (t J tNin l.fl.tarirr* 14. C4l. In Jet IOOO Hmn trttiT * J4 II. Clu*. Gentlemen: Re: Robert P. Cuthbertson vs. Plant Aabeatoa Co., at al I.A.C. Ho. 59 OAK 1053 We submit herewith the report of Dr. Cabot Brown, dated November 19, 1959, who made his examination and report 4 as an agreed medical examiner. Copies of the report are being served as shown below* Very truly yours. IASJER Eno. o.o* Smith, Parrish, Paduek A Clanoy c.c. Industrial Indemnity Co* c.c. Mullen it Fillppi o.c. State Fund - S.P. ' oooot; WT *4 ^80T OWNM.. FI LED mw rftw6ro 0 3 _ 1959 Oil! November 19, 1959 /L-rCW Re: Robert F. Cuthbertson va. Plant Asbestos Company, et al t. 4 Mr. Ivan A. Schwab Hanna & Brophy 1540 San Pablo Avenue Oakland 12, California Dear Mr. Schwab: Herewith report of my findings in the case of Robert F. Cuthbertson, whom I examined today: Patient's presenting complaint is chest pain, worse on the left, and unrelated to change of position or deep breathing. It is likewise unrelated to his operation of August 1958 and in fact it antedated the operation by a long time. It would appear redundant to give you another written report concerning his occupational and clinical history. It is probably sufficient to say that the history obtained by me agreed in every detail with the report of Dr. Hinshaw. This refers to his family, past and personal history, as well as his present complaints. One point worth stressing is his complete freedom from pain and shortness of breath during the two weeks vacation he spent at Lake Almanor, despite the fact that Lake Almanor lies at an elevation of slightly in excess of 4, 000 feet, as I recall. One new complaint, which has apparently developed since Dr. Hinshaw's examination, is that of slight productive cough throughout the day. This, together with the greenish morning expectoration, is relieved by various aerosols and ultraviolet light treatments which he has received from time to time from Dr. Crenshaw. Physical Examination: He is a very well developed and well nourished young man, who gives the impression of being slightly apprehensive, although apparently in good health. Stated age 31. He seems anxious to impress the examiner with his veracity, although he evidently has a poor memory for dates and details. He is 5'8" in height and weighs 182 pounds. Temperature, pulse and respirations normal. Eyes: Pupils round, regular and equal. Reset to light and accommodation. Ocular movements normal. Fundi and disks normal. Nose: Mucosa appears slightly inflamed. There is no nasal obstruction or pus seen. Ears: Drums appear normal. Left not well seen because of the presence of oerumen in the canal. 000077 CA0OT 0OWN.M.O, A iiO tTtPT * PMMCilCO Page two - 11/19/59 Re: Robert F. Cuthbertaos i Throat: Teeth appear in fair condition. Tonsil* have been removed. Mucosa normal. ' Neck*. Thyroid normal. There is no cervical or other adenopathy. Cheat: Except for the presence of the weii-healed right thoracotomy scar, the findings are entirely normal with respect to the heart, lungs and other contents, of the thorax. Heart rate is 68, regular. Blood pressure in the right arm is lOS/bO, in the left arm 108/60. Vital capacity is 3.3 liters and the chest expansion 6 cm. Fluoroscopic examination shows normal excursion of both diaphragms. Abdomen, genitals, reflexes, extremities: Not remarkable. X-rays: Stereo and right lateral chest films on November 19, 1959 show no change from the examination of September 10, 1959. I have nothing to add to the x-ray report of Drs. Hinshaw and Garland on the earlier films. Summary and Conclusions: While this man gives a history of exposure to dust containing an undetermined amount of asbestos particles over a period of some twelve years, he has no symptoms or complaints which 1 would attribute to asbestosis or any other form of pneumonoeoniosis. Limited pulmonary function studies gave normal findings, as did physical examination. A review of his x-rays taken at intervals from October 1953 shows unchanged and normal findings throughout, except for the appearance of evidence of scarring at the bottom of the right lung since the oper ation. To answer your specific numbered questions: 1. I am in complete agreement with Dr. Hinshaw'a state ment, which you quota. 2. Even a brief review of the medical literature on asbestosis reveals a wide range of disagreement as to the length and concentration of asbestos fibers, as well as the over-all duration of exposure necessary to produce clinically significant disease. One author says that there must be at least fourteen years of exposure to air containing at least five million particles per cubic foot, varying in length from 10 to 30 microns. It is generally agreed that the degree of hasard is a function of the length of the fibers, but the boundary line between long and short fibers is ill-defined. GOO'JTo 0 CA60T MOWN, w.o. -0 tutu* %rctv AM r*C *CQ Page three - 1 i/19/59 Re: Robert F. Cuthbertson 3. I am unable to express an opinion and unwilling even to hazard a gueas as to when the fibers which were found in Mr. Cuthbertson1 s resected lung tissue were actually inhaled. It is my belief, as already expressed, that the symptoms which caused him to consult Or. Crenshaw in August 1958 were in no sense attributable to the inhalation of asbestos particles. 4. I know of no articles on asbestosis which are con cerned with percentages of asbestos in the material to which individuals were exposed. It is however generally conceded that asbestos miners and factory workers engaged in the manufacture of asbestos products have a much higher incidence of asbestosis than do workers who merely handle asbestos products. This brings us to a general discussion of the disease, as requested by Referee Ankele: Asbestos is one of a very few substances the inhalation of which produces fibrosis (scarring) in the lungs, which does not contain free silica. The fibrosis is diffuse and relatively homogeneous, although it tends to favor the lower portions of the lungs and, as in the case of any inhaled foreign material, the right lung more than the left. In contrast, silicosis characteristically produces multiple discrete nodular infiltrations. In advanced states these may coalesce so as to form what appears in the x-ray to be large tumor masses. Both con ditions tend to produce pleural as well as pulmonary fibrosis. The dominant symptom which causes workers exposed to any dust to seek medical advice is, in my experience, shortness of breath. This is usually associated with some degree of cough, dry or productive, as well as weakness, weight loss and occasionally clubbing of the fingers. Chest pain is not a frequent or prominent complaint. The interval between the time the asbestos particles are inhaled and symptoms become manifest is undoubtedly subject to wide variation. Individuals probably have to be exposed for a matter of several years before symptoms develop. The point l wish to stress is that the mere finding of a few asbestos bodies in a section of lung simply means that the individual has at some time in the past inhaled asbestos particles and does not indicate that this individual has actual disease (asbestosis). It is not unlikely that a good many people who are required to walk passed targe construction jobs a couple of times a day would be found to have inhaled asbestos fibers, were it feasible to subject their lungs i '5W !i'J'JUfJgg > "55SHP 000073 T CABOT gnOWN.M.O. a tw'tt* irt t*a ruat'ies . Page four - 11/19/59 Re: Robert F. Cuthbertson to a searching examination. However, the difference between there individuals and those who have well developed clinical asbestosis lies merely in the total amount of exposure. The exact size of the particles, their concentration in the Inhaled air, and the duration of exposure are all factors in the total quantity of exposure. It is true that the larger the particles and the more concentrated they are in the inhaled air, the less the required exposure time in order to develop the disease. There is, however, no evidence to support the fact that it is impossible for an individual to develop asbestosis from the inhalation of smaller particles in less concentration, provided the total exposure time is adequate. A clinical diagnosis of asbestosis depends upon a history of adequate exposure to asbestos dust, objective evidence of impaired pulmonary function, and radiolgical appearance consistent with diffuse "ground glass" pulmonary fibrosis. The finding of asbestos bodies in the sputum or by lung biopsy may clinch the diagnosis when these conditions are met, but the finding of such bodies per se does not in itself justify the clinical diagnosis of asbestosis. I had already dictated this report when I received notice of the impending arrival of the transcript of the testimony of Dr. Gerald Crenshaw, with the request that 1 withhold my report until 1 had read it. This document arrived on November 50. I have read it twice and will state categorically that it has in no way changed my opinion regarding this case. It does, however, raise some interesting points: 1. 1 am sure that Dr. Crenshaw did not operate on Mr. Cuthbertson in August 1958 on the basis of the latest currently available film, which is dated March 1956. The testimony refers to a report under date of February 21, 1958 of a chest x-ray, quoted in part, "wide spread bilateral infiltration, becoming confluent in the right lower lobe." The fact that this condition cleared up, as shown by the available postoperatire x-rays, proves that it could not have been a manifestation of asbestosis. Films must have been taken between February and August 13, 1958 and one wonders why these are not available. 2. A photostat of the preoperative summary dated August 13, under physical findings of the chest, states "diffuse nodulation throughout both lung fields." 1 am not aware that pulmonary nodulation can be diagnosed by physical examination. It is an x-ray finding common in silicosis and certain Inflammatory diseases and virtually unheard of in asbestosis. FS CABOT BftOWN, M. 0. 0 twiriict |N 'HHQiieO Page five - 11/19/59 Re: Robert F. Cuthbertson 4 3. Dr- Crenshaw readily admits that the pulmonary function teats which were performed postoperativeiy were within 4 normal limits. Apparently there were no such tests performed preoperatively. Just why he tends to belittle the significance of pulmonary function tests 1 do not know. 4. On page 46 he readily admits, as 1 have stated above, that the mere presence of asbestos particles is not in itself diagnostic of asbestosis. f Yours very truly, 1 CB:C Caoof Brown, M. U. mui.'*'- * rTT----- r KB***>'<*.*' if. g,- !: Tt--* ST" & i&I r*. assssssssss^ __ j--q * nmw. **/*-%'**>* 4 whs 1 1*3 2 /* A. ^aL. iBEFO: IKE INDUSTRIAL iftTTTlFNT CflMMWrnw 1 OP THE STATE OP CALIFORNIA 3 ' ' ` 4 ROBERT P. CUTKBERTSON, oOo-- ' ' 6 ' Applicant, 6 78./ '' ` No. 59 OAX 1053 r PLANT ASBESTOS COMPANY, J. T. THORPE, WESTERN ASBESTOS COMPANY, ARMSTRONG 8 CORK, TRAVELERS INSURANCE COMPANY, INDUSTRIAL INDEMNITY COMPANY, ' bivtiiS* V e I LD 9 PACIPIC EMPLOYERS INSURANCE COMPANY, NOV ji U iK&, STANDARD ACCIDENT INSURANCE COMPANY, 10 and STATE COMPENSATION INSURANCE FUND, 11 Defendants. 12 13 PARTIAL TRANSCRIPT OP TESTIMONY before JOHN H. ANKELE, 14 Referee, at Oakland, California, on October 22, 1959, at 15 9:00 a.a. Wallace H. Smith, Reporter* : * 18 . . APPEARANCES: 17 Applicant: 18 Present SMITH, PARRISH, PADUCK k CLANC1 By JOSEPH E. SMITH, Esq. 19 Deft. Travelers and HANNA & BROPHY Standard Accident: By IVAN A. SCHWAB, Esq. 20 Deft. Ind. Indemnity: PATRICK R. MALONEY, Esq. 21 Deft. State Fund: JAMES V. BURCHELL, Esq, 22 Deft. Pacific Baployers: MULLEN k FILIPPI 23 By JOHN MOORE, Esq. 24 WITNESS: PAOS 25 Gerald L. Crenshaw, M.D. 26 'X 1 46 /A-J-,5- 9 . lU/*.. . T*' ;vx GERALD CRENSHAW, M.D. called as a witness on behalf of the applicant, being first duly sworn, testified as follows: REFEREE: Have a seat. And your name, please -- Oh, somebody has that section of this hospital report. Who has that? . . MR. SMITH: Has what, sir? REFEREE: That hospital report. .. 10 uA (Document handed to Referee.) REFEREE: Q And your name, please? Dr. Gerald Crenshaw. . ' 12 Q And you're duly licensed to practice medicine in the 13 State of California? A I am. 14 Q Any specialty? 15 A Yes, medical and surgical chest. Certified American IS Board of Thoracic Surgery; eligible for the American Board,. 17 American Board in Internal Medicine, and sub-board of 18 diseases of the chest. 19 REFEREE: All right, Mr. Smith. 20 MR. SMITH: Q Doctor, excuse me -- Doctor, you had Mr. 21 Robert F, Cuthbertson under your care for a chest condition? ll 22 A I did. ' 23 Q And In your report dated May 25# *59# you stated that the 24 studies were made and indicated that there was evidence of ! 25 asbestos in the chest? A That Is right. 26 Q Do you have any opinion as to whether that asbestos was j !'! i.wij 11 uu j_ l u i (JUWS3'ill! .**.*<** , .^*tt^-. _______ i '2S2 _*---^ ..*:..*** i-* J*K * t^J***** . . ' * ;*' -**."- **a^*anM ,`i * **U*%m** -y^vr j) - -y-7 i 1J causing any disability? : .. sj^A Yes, I feel definitely it is. . Q And what disability was it causing the man? A Improper bronchial drainage. \ . *J Q And did you do anything to correct or alleviate that improper -- . . - A Yes..;.. ' ` '' t . . . Q (Continuing) -- bronchial drainage? A Since that time we have had to treat him for this per sistent upper respiratory Infections well past the time of 10 & normal individual, and recurrence of such infections u productive of cough, pains in the chest -- . 12 Q And you ultimately did some surgery on the chest? 13 A Yes, we took a piece of lung as a diagnostic procedure 14 to determine the amount of scarring and fibrosis, and deter 15 mine the presence of the asbestos particles. . ' 16 Q The man is still under your care? . IT A Still under my care, that is right, 18 Q Doctor, if the man gave a history of working in and 19 around asbestos from A7 to *5&, sometimes working in 20 materials that had ten to twelve percent asbestos in them, and 21 other times using what we call mud that had ten to twelve j 22 per oent asbestos in it, using other materials that may not 23 have had any aebeatoa but were required to use mud that con 24 tained asbestoe to Join them, and that the conditions 25 under which he workedwere duaty, do you have an opinion as 28 to whether the asbestos that you found In hia lungs could have v/ "oouust; JJetjij >**1 *v *&?*?"*V" * * *<1<^*pT^.W _ _ _ ____ 1_ t :< %, m* i-c/, irjfH'*ii'ft:"' been contacted over that period of employment? A Yea. MR. SCHWAB: X will object, Mr, Referee, aa not a prop^: hypothetical question In that It doea not Include all factor necesaary to express an opinion such aa the nature of the material, the finished material with which the man works, and what he did with It. After all a truck driver works around the asbestos If he delivers It on the job, REFEREE; It Is defective In that respect, Mr. Smith. 10 I will let It stand, however, and it will go to the weight. u ' MR, MOORE: X will make the additional objection as 12 ealllng for surmise and speculation. " \ ' '' 13 REFEREE: That goes to the weight. 14 MR. SMITH: Q 15 It, Doctor?. You say you have an opinion: what Is .. , 18 A X feel It has. It's the only source of asbestos that 17 this man could have, where he could have gotten it, and he 18 has it-present In his lungs at the present time; that's 19 to my knowledge. . 20 Q Does the man still need treatment and observation? 21 A He will need observation for some period of time, 22 that Is right- 23 MR. SMITH: I have no further questions. 24 REFEREE: Mr. Schwab. 25 MR. SCHWAB: ^ Doctor, when did you first see Mr. 28 Cuthbertson? A May I check my chart, please? ------------------------------------- ------------------------------------- 00(KJfc- II.iji I JIJJI UP IIII !! MWilWilBimri i l~ r n-------irir--r--I..................... .........--*---- 3 Q Yes. A July 29, 1958. . ' '' Q You had treated his twin brother in 1953 I believe. A Yeah, his brother Is not an Identical twin; they're just twins. Q No, but you bd not seen Robert Cuthbertson during the time that the brother was under your care in 1953 and 54? A To my knowledge or record I had heard of him but I had not seen him. , 10 Q And do you have with you the history that was taken on 11 the occasion of that first call in '58? . A I have. 18 Q May I look at it. ' '~ -. . 13 (Document handed to Mr. Schwab.) 14 A In fact, Mr. Robert Cuthbertson waa referred to me by 15 Dr. Larry Brown because of recurrent pneumoninitiea and - 16 recurrent cheat difficulties. ... , 17 REPORTER: Doctor who? ... 18 A Lawrence Brown of Richmond, California. 19 MR. SCHWAB: Q When he came to you on July 29, 1958, 80 no work history waa taken at that time? 81 A I do not believe we have a work history taken from Mr. 88 Cuthbertson at all, . 83 Q 84 A 85 Q You never took a work history? I don't think so. . And you did, though, at the time of that first call have 86 a history of there having been an attack of pneumonia in 0<.WJ' 1 the earlier part of the year? p 2 A yeah, recurrent attacks of pneumonia, 3 Q That's right. Now, when was It that you performed your 4 biopsy? A August 13, 1958. I 6 Q And prior to that time had you obtained X-rays taken 8 for Dr. A. R. Thompson at Herrick Hospital in October 1953, 7 November 195^ and March 1956? 0 A All attempts were made to get old X-rays possible. 9 REFEREE: Will you answer the question. Doctor? 10 A Veil, Z don't have -- I don't have It. u REFEREE: The question is. Did you? , .. 12 A I made attempts to get them. X can't answer.' 13 REFEREE: Read the q\stion and let's have an answer. 14 (Question read,) . 15 A Again I can only answer It 1 do not have the X-rays 16 present and I can't tell whether I have them or had them. I 17 made attempts to get then. ' 18 MR. SCHWAB: Q Vhat attempts did you make? 19 A Contacted the doctor and contacted the hospital. 20 Q Did you go out to Herrick and review the radiologist's 21 reports on any films there? 22 A I don't remember that 1 did. 23 Q Do you mean by that that as far as you can recall you 24 did not? 29 A I did not as far aa X can recall It now. 26 Q Now, before you did this biopsy, did you have X-rays _____________________ _________________________________ 5---------------------------------------------OOtJQ^T- ~:tri.-v w- a-,- - 1 taken? ' 2 A Mr. Referee, I don't have the X-rays present and I can't s be specific as to which X-rays were taken. 4 REFEREE: The question Is, Did you take X-rays. 6 MR. SCHWAB: You can refer to your file. e A There Is no record of X-raya taken in my place. 7 MR. SCHWAB: May I see the Richmond records, the - 8 earlier one? . '' ' ` - ....... 9 (Documents handed to Mr. Schwab.) ' 10 MR. SCHWAB: Q In the Richmond Hospital record there Is 11 a report of roentgen examinationty Dr. Lloyd E. Smith, of 12 fllma taken, on August 15, 1958/ at your direction. 13 A Ch huh (yes). ' 14 Q Are those the first films that were taken under your 15 direction?,. ..... ... . .. .. ... - 16 A Yes. Attempts were made by associate Dr. Eldred, who 17 was my associate at that time, to obtain the Herrick films 18 on September 2, 1958. ., 19 $ September? 20 A No, beg your pardon. This Is my error. He was awaiting r.e-i. 21 report on the one specimen. Ve had -- 22 Q You had no films taken until two days after you did the 25 biopsy? / 24 A Yes, I had the advantage of films prior to that, however, 25 X-rays taken -- * 26 Q Which ones? V' ----------------------------------------------------------------------------------------------------04)Q^.:;i J >7"*?rc?r4 r r z j & r r r r - m s s ****V44 ****V* ' v<*> ' *'. >' ****?.*->** j* dfckVttntf-ii' mk t Lzf X A They muat have been the Richmond X-rays or the -- 2 ft 3 ft 4A You mean the ones taken -- A Prior, When he was in there for pneumonia in February? Sure, j j 5 ft I found in those records first a report of films on 1 6 February 21, 1958 (handing document to witness). Do you 7 recall whether you had seen that report before your operation? 8 A I saw the X-rays and undoubtedly the reports before ray 9 operation. j ! 10 ft 11 A Are the findings reported there typical of a pneumonia? They're more than typical of pneumonia. They're also . 12 typical of a diffuse -- let me see where it stated -- : 13 "Widespread bilateral infiltration, becoming confluent ! ' 14 in the right lower lobe* 15 Does that answer your question? 16 ft Well, by infiltration, you don't know what infiltration? 17 A No. No. 18 ft Prom this? A Prom your X-ray you could not tellj. 19 ft Yea. Now, in your report you -- strike that. After 20 the operation you submitted your specimen to the pathologist?! 21 A Pathologist at Richmond Hospital, that's right. j 22 ft At Richmond Hospital, and that's Dr. -- 23 A Slngman. 24 ft -- Singman. A That is right, 25 ft And did he submit to you his written report? 26 A He did. .jUOOi2  *&$'-Vi v *M> -.4., ?M-M>Bt-M|W|--w><--WMi|m`i|'>*l.l'll>1'".fl t'*nl|lll**l|,l'l.B1l,,',lw"'>`"<,|`*' '; 1 -1 : * ,4 - *.4 ] j ) i -f i : , > .j i j i i '. 'V ft** *t ai#l j1 a And Is that one tn which, he gives the diagnosis: * chronic fibrosing pleurltls and chronic fibrous pneumonitis? 3 A That is right, _ 4 Q Now, in your report of May 25, 1959, you say the sped- 5 mens of lung tissue were sent to the Health Department for 6 study. A By Dr. Sln^nan. 7 Q Veil, do you mean by Health Department -- 8 A Dr. Slngman sent them to a laboratory for examination. 9 and he reported to me they were sent to the Health Department 10 a Did he say whther he meant a City Health Department, 11 a County Health Department or what? 12 A I have a report here from those people. 13 Q All right, fine. 14 (Vltness handed document to Mr. Schwab.) 15 REFEREE: Ve have two minutes remaining this morning. 16 MR. SCHWAB: Q As I Interpret this sheet you have shown 17 me, this Is a sheet that was prepared in submitting the 18 specimen? A That'Is right. ' 19 Q Did you ever get a reply? 20 A I have no other records than this. 21 MR. BURCHELL: May I see It, please. 22 (Document handed to Mr. Burchell.} 23 MR, SCHWAB: Q Well, Doctor, this sheet that you 3ent i 24 me contains,the only doctor's name It has Is your own. Is 25 this a sheet prepared in your office? / 26 A No, this la a sheet prepared by Dr. Slnm&j/, and sent ' `-- ------------------------------------------------------------------------------- -------------------1 -f, wr- w-* '*** a*? p"?--A'A*"^ 7~7Z\`, * \T7' V >'w V*v-l!^l i t1 iMiaiawwi trfUA^r v : $;t .3 I I J *1 3 ja with a specimen to the laboratory. Q And did he send you a copy? ! A I have no copy. Q Well, where did you get this? A This is a copy he sent to me showing that he had . forwarded the specimen. j Q I see. Well, Isn't It customary to Include In the sheet ;a i statement of the laboratory work done by Dr. Singman? A You mean he was forwarding this specimen on to, for 10 further study, and this is merely a sheet. You asked me IX where the specimen was sent, and there was some question 12 as to which health department had done it. This Is the 13 answer to that question. It was forwarded on to the 14 authority who could determine whether asbestos was present 15 In the specimen or not. ... . .. 19 Q You never got any report then from the State Department 17 of Health? 18 A I have no report, no such report. , 19 Q You have never checked with the State Department of Health 20 to see whether in fact It ever did any laboratory work? 21 A No, but I have checked with Dr. Singman. 22 NR. BURCHELL: Q Is that Dr. Singman? 23 A David Singman, S-l-n-g-m-an, the hospital pathologist 24 at Richmond Hospital and Alta Bates Hospital. . 25 MR. SCHWAB: Q Did Dr. Singman ever give you any S 26 written report following the report In the Richmond Hospital I ff w.i M' jmp i j~ww.1 *^1*555 n/uui'n J 9f*np*"* s r :>>.*<;>*> p>^.>iiFjrap /*&**' c.'1. - .i .* t n if-n.i -- ij/.iBMi.iainiiiir^i in ir 11--i-*r i>ri-- r-f ir-' `- , r -------- ir* " --in --- -------- ---y-- . i miiiimiiiiUM onim imimi oii>|Ibmiiii -nr^mrriwrnivw.i*T>rfar>f`rT urnf u^nnnmw>*-3 a * *9 1J records? 2 I a He gave me an oral report, Q And I believe that data sheet Indicates a submission on November 13th, Is It? A 11-17-58. REFEREE: Any further questions of this witness? MR. SCHWAB: Yes. REFEREE: Just a minute. : MR. SCHWAB: You said -- . i 10 REFEREE: Just a moment. It's 12:00 o'clock. Continued; 11 lj30. , . J..,. .... , | 12 MR, SMITH: Your Honor, Ibelieve Dr. Crenshaw has a ' 13 surgery scheduled at 12:30 for a cancer, and feels that he ; 14 Is unable to be here at 1:30; he can't be here. He can come! 13 later. .' .. , j 16 REFEREE: All right, wasn't this the case that Dr. j 17 Crenshaw was supposed to be here in August? 18 MR, SMITH: That's correct, sir, 19 REFEREE: He had an emergency then. He can be excused 20 onee but not twice. 21 22 Q MR. SMITH: Well, sometimes emergency cancers arise. Is this surgery one that Is Just has to be done? j j j I ! | 23 A A proven carcinoma, a proven cancer, 24 REFEREE: You see the point here, this was set before 25 and then he had an emergency, j 26 MR, SMITH: Yea, 10 ouooua- w*K* u>,. 3522822*es*!*x&&WMMMI 'wt*tote!&)f'-.+A!K jwstfag kia^e-;v`JU^. ,x VS - a 1 * :t ilj 1 fM< %\% Mil 1 j REFEREE: -- at that time, and this morning we waited 2 for him. 3 MR. SMITH: Yea. I can appreciate that, your Honor. 4 REFEREE: And wasted the time of all these attorneys 5 whocame here. Understand, other people's time 13 valuable 6 besides doctors. The ease Is continued to 1:30. 7 MR. SMITH: Will you be able or unable to be here, 8 Doctor? 9A 10 Who will pay the mal practice? REFEREE: When will you be through? 11 A It will take three hours to do this. 12 REFEREE: You knew you were going to be here for a 15 hearing today, you know. 14 A I was scheduled at 4:00 o'clock today. 16 REFEREE: You weren't scheduled as far as I was concerned 16 at 4:00 o'clock. .j 17 A That was the Information I received, 4:00 o'clock today. 18 REFEREE: When did you notify the doctor of this hearing 19 today, Mr. Smith? 'i j 20 MR. SMITH: Our records show that he was advised of a 21 hearing date. No timewasspecifically set. Thursday 22 and FridayI went out of town and advised my girl tocall j ; 23 the doctor and to ask him to be here at 10:00, 9:00 or 24 10:00 in the morning, wasn't sure on the time, or 11:00 i [ 26 o'clock at the latest. 26 REFEREE: When was that, last Friday? TV (JOWH3 ^ >| W* .' ' v'?JJ I if I 3 1 ** Vi'Vri ^'iVTnniittifettii MR. SMITH: Yea, last Friday.' REFEREE: And Doctor, I suppose you had your surgery scheduled already? A Yea, that's right. REFEREE: You note that notice of this hearing was sent out on the 27th of August, Mr. Smith. All right, recess un til 1:30. (Thereupon an adjournment was taken to 1:30 o'clock p.r. this date, Thursday, October 22, 1959.) 10 --oOo---- u 12 13 14 IB 15 17 18 19 20 21 22 23 24 29 26 T* 000`J'J * sssaa twMimtmv ctV>-w^irf.y'>'r;ii--- gtfftH1*tfiHlt'^^iii'frir - 1 GERALD CRENSHAW, M. D. . 2 recalled as a witness on behalf of the applicant, having 3 been previously sworn, testified further as follows: X 4 REFEREE: All right. Doctor. Had you finished, Mr. `U 5 Schwab? 1 . e MR. SCHWAB: No, I Just have a few more questions about ] Si 7 the nature of the treatment. 8 REFEREE: All right. 9 MR. SCHWAB: Q Doctor, after the operation had been 10 performed, when did you discharge Mr. Cuthbertson to return 11 to work? 12 A May I check my chart here? Now, let's see, he returned 13 to work -- what date Is the date of the surgery? 14 Q August 13th. 19 A August. Roughly, within a matter of two months. 18 Q And then do you have your chart showing treatment sub 17 sequent to that time? a Yes, oh, yes. 18 Q When did you next see him after the return to work? 19 A I have been seeing him routinely. I saw him October 1 20 27th, October 30, November 26, December 12, 1958. 21 22 A REFEREE: Pardon? Q At what intervale. Doctor? ' 23 Q At what intervals after surgery? 24 A Depending upon his general condition, usually once a 25 month or if he has a respiratory infection, then once a week. 28 MR. SCHWAB: Q Well, when la the first date after the 0000 <v 13 yamrntmmmmsmassss^l UaWiMHU^'WS^XgM^W*--|**,**<1*~>^,**4,*'-''*?4v<~r',~* ** ! !p s *5 i j i ,;T# 1 i -( i r* ,i 11 1; * 4 1 '" . . : ' return to work that he had any complaint# that required 1 2 treatment? ' 3 A Let's see if I can get my datea straightened out here. 4 Well, he goes from November 28th, December 12th, then to 5 January 10th, of 1959 -- 1958, then 1959* some during 6 February -- .. ..... ...... .. 7 Q Now, Just a minute. On those first three dates did' 3 you examine only or did you treat? .. . . 9 A Oh, treated. He has had treatments at that time* 10 Q All right, give me the first date and what office history 11 you took at that time. ... - 12 A It was February 9th, patient complaining of pain In 13 left chest. X-rays of the chest: rales present in the 14 left upper lobe -- beg your pardon, . 15 Q 2-9-59? f . . . ..... . , , - ... 16 A That would be 2-9-59, Is the note. Dr. Eldred saw . . 17 him September the 29th. States good rehabilitation of cheat. 18 and -- well, you got me. Then X-raya were taken p.m. right 19 lateral at that time. 20' REFEREE: Q That*a '58 now? 21 A That's September 29, '58. 22 were doing, wanted to know what we .. 23 24 A MR, SCHWAB: All right. October 30, 1958 -- ?t%>* %|16*6> 23 ft Watt Juet one minute. Doctor, Let'a take each one at 26 a time. A Dh huh (yea). ./ \y ----------------------------------------------rf-t--------------------------------------- \MJ'.ttHB-iitj------ 1 ,,>.^^(1,rrtfflfi r,sifr -,~vj, If , r*!*t.i*' * lliMW^rn 1 Q Dr. Eldredge. A Eldred. , 2 Q, Eldred. That's your office associate, la it? 3 A Yes, was. Re Is now in practice by himself, 4 Q I see. And his note. Doctor, Is that the man was 9 getting a good result? * - 6 A No, no, Oood rehabilitation of chest. ' 7 Q Yes. A And another word here which I can't read. 8 Q All right. And -- 9 A X-rays were taken at that time. 10 Q The onV thing the doctor did was to take some X-rays? 11 A Examined him. ,, , _ ' 12 Q Yes. But I mean he didn't prescribe any medication? 13 A Well, I can not tell because the medication Is not put 14 In the chart. . 15 Q All right. When Is the first date after that that you 16 saw him? . ^^ .. w i. v -s. . 17 A It's on October 30th, and the reason I didn't see him 18 at this time was I was on a lecture tour through Japan* and 19 through the Far East. 20 Q You mean you called him so you couid? A Oh, no. 21 Oh, no, this man was In association with me. 22 4 I see. You had come back at that time? 23 A I came back in October, 24 Q All right. Now, what note did you put in your file 25 at that time? 26 A I was waiting the pathological report. L(J0MU7 _ am 1 4 And then when did you next see hint 2 A January the 10th. Report states patient has asbestoaia, 3 4 That's the verbal report you got from Dr. Slnptan? 4 A Verbal report, that Is right. 6 Q Well, then -- A February 9th. ` 6 4 Pardon me. That wars January, what date? I didn't get 7 that. A January 10th.. 8 4 And up to January 10th, 1959, you hadn't given him any 9 treatment for -- A Oh, yes. 10 4 Por any respiratory Infections? 11 A We were treating him to rehabilitate him as far as 12 the motion of his chest was concerned and that went along 13 right straight up until -- that was before, actually before 14 the surgery -- wait a minute, something Is wrong. Oh, I 15 was going the wrong way. My error. That was after the 16 surgery. ^ ;.,-v `.I * .* . 17 4 What treatment were you giving him? 18 A We were giving him Intermittent positive ^pressure 19 breathing and occasional antibiotics. . 20 4 Did you prescribe an antibiotic? 21 A February 16th we gave him cerocillin and streptomycin. 22 4 On what date?? A February the 16th. 23 Q Of '59? A '59. 24 4 And that's the first time that you have a record- of 25 prescribing antibiotics? 26 A He had Intermittent positive pressure breathing right TS -Q0Ut.'J3- * **' i^CaAta"*aiaMt^^ t'fiM(,>ttauAMtfB^^ -rrriiiii'iHjiitetfiify:r`ii - i ij along. Yea, that's tha first time following the surgery, 2 j Q And what complaints did Mr. Cuthbertson make to you 3 on February 16th? 4 a He had a respiratory infection and a sore throat. 3 Q The soreness was in the throat? A At that time. j I ] 6 Q All right. Had any -- . j 7 A Sis chest -- pardon? j 8 Q At any later date was there a prescription of medication'. 9 A Well, he received a series of one, two, at that time 10 and I checked him February 20th, and felt that he was 11 getting over his respiratory infection. On March the 29th, 12 he had periodic treatments and March the 6th, patient was 13 still having pain In left side and was worried about it. 14 May the 9th he had some antibiotics. March13th -- March 13 9th, patient coughed upgreelnlsh material, and was put 18 on albumycin and other antibiotics.^ 17 ^ Are those March or May? 18 A This is May. May 9th. - 19 Q May 9th. ' 20 a Yes, he had antibiotics in March; again May 9th he 21 had antibiotics. That was May 9th. May 11th, I saw him 22 and-he was improved and stopped the antibiotics, 23 He had repeated Intermittent positive pressure breathing 24 to improve his bronchial drainage at that time, periodicallyj 25 during this time. On June the 11th, 1959* the patient 28 still having sputum but it was clear. June the 8th, 1959 '.*4> -w* r< ***** * Oc.* *^ < ^viaM5jgEagg5Sa^^^*** patient had a temperature of 100.2. Was put on antibiotics. Q Well, on those visits in June, what complaints did he make to you? A Chest pains, sore throat, fever, but no pneumonitis. -* I am very sure there would have been if it had not been controlled. ` MR. SCHWAB: I haven't any further questions. REFEREE: Mr. Maloney. MR, MALONE?: Q Doctor, have you observed any other 10 eases of asbestosis during your practice? ! 11 A Oh, many cases. This Is the third in a series asso- 1 12 elated with the same type work and the same situation. 13 Q By same type work, what are you referrsngto. Doctor? ' 14 A Installation of asbestos materials. | 18 Q I see. And you observed three cases of similar nature? | 18 a. raid... . ................... .j 17 Q Would one have been Mr. Cuthberteon's brother? j 18 A That is right. I i 19 Q And would the other one be Mr. Thorsted? 20 A That Is right. j | j I 21 As I recall your testimony; Doctor, you did not take an j i 22 occupational history when you first examined Mr. Cuthbertsoni 23 No, on Mr. -- on Mr. Cuthbertson's brother we had an 24 occupational history. We felt It was not necessary to go 25 into detail as they worked Jointly together In the same j 26 situation. -it- -xsQxyv^y ;l' *- *?x IS >.* .n ! i IS ;*l * ; iifaiwr**n>rtn-.W 1 Q So you referred to hla brother's history at the tine? 2 A That's right, 3 Q Doctor, before performing the biopsy, did you take 4 any laboratory procedures'? 5 A Routine laboratory work was done, of course, in the 9 hospital on admission and I am very sure -- 7 Q Well, that would be at the Richmond Hospital? 8 A At the Richmond Hospital, and all those reports were 9 here, blood typing, and of course, we always check for 10 tuberculosis and cancer, and diseases of this type. Those 11 reports are here. He was bronchoscoped. Ho tuberculosis; 12 no malignant cells found, 13 Q Were any sputum tests made? 14 A Yes, actually, there was more accurate washings, in 15 which we got the flow of, or the bacteria of his respira 18 tory tract, ,. . .,, .. 17 Q What was the result of the bronchlitest? 18 A Actually cultured for fungi and we cultured for 19 tubercle baeilli, which were negative, and If you would like 20 the varloua organisms that are present, their sensitivity, 21 they're rlht here on this piece of paper if you wish. 22 Q Let's see, 23 (Document handed to Mr. Maloney.) 24 You say that bronchial tests were negative, Doctor? 25 For tumor. . 29 For tumor. ,.,,,H ( > < 5331 *' *'*-'**!%WHIM ' II M ^IITINM 1 A For cancer, that's right, and also for the tuberculosis. 2 Q I see. Were any other conditions, Doctor - J A What? ' 4 Q Possibly asthma? 6 A We checked for allergy routinely. Charcot-Deyden 6 crystals and eosinophils, which designate allergy, were r checked for as well, , 8 Q. Were any blood tests also conducted? 9 A Routine blood count and urine. 10 Q And what were the results of these tests? 11 A I must get my glasses back on. I still have them 12 fogged. His -- he was running a 12,000 white count on :tfl 13 admission to surgery and, but had 97% hemoglobin, and 14 the polys, were fairly normal. Monocytes and leucocytes 13 were within normal distribution. He was a Type 0. Rh 16 negative as far as blood typing was concerned. His urine ir test was essentially negative. i 18 Q Doctor, after running these clinical tests, you mentioned, 19 was there any clinical evidence of disabling pulmonary j 20 disease present as the result of these tests? j 21 A Not of these testa. These tests are non-specific teats, j 22 Q And did you take any pulmonary function tests before the j 23 biopsy? 24 A Not before. X have some after; following It, but I 23 did not take any before because X feel they are not -- 26 as X have expressed myself in the other eases, I feel the / hutTM -....itY WI **> '. W,j/(J-jAty.i.f..tO.*iiy. wOc*w- .l*-.e-Areoiirm*> * \c 'vjShu . <4 :.; It X** . tv fca- ft.-. 1.- -V=? 1<i t i3 i \i ^ ,* i i1 'l :i y< 1$ J j| ... `j . yt* .^>vM.^n<`f n. VM3 wr^HK B^WWI'WWH I--imiu.i.i.j|i'ii*.nnifyn web la too wide. There are too many loopholea In them, and aa far aa Amotion testa are concerned, I do not feel we can rely upon them, and I think that`a the universal feel lng of practically all surgeons, and I have talked to many of them throughout the country# and throughout the world. I take them mainly because they seem to be faddish, and we are In that phase at the present time. Q Now, you performed a biopsy on August 13, 1953? A I have a surgical report here If you wish. 10 Q Doctor, what was the purpose of performing the biopsy? 11 A To find out what this man's disease actually was, 12 and I was very suspicious. It was a diagnostic procedure 13 and also rules out pneuraonitl3 of this type, to rule out . " a malignancy or a fungus infection or something of that IS sort... . | 18 Q 17 A And this Is a surgical procedure, is It not. Doctor? That Is right, an accepted surgical procedure. ' j | 18 Q Surgical procedure. ! Thisusually results In some ; 19 disability? 20 A Some disability, buttemporarydisability; notpermanent] 21 of course. J 22 Q I see. How long la the man generally disabled when you | 23 do this procedure? j 24 A That depends entirely on the individual but usually two 29 months or more. 28 Is this considered major surgery? V ------------------------------------------------- --------------------------------QOOIUJ tyrant*# nwrmwifi iWnfKrm BE? . v .,. i*. > r t y i JS '"3 / V/ 1 A Opening -- by definition opening up a cavity within a 2 body ia major surgery. 3 Q And what was your diagnosis. Doctor, immediately after 4 the biopsy was performed? 6 A My pre-operative diagnosis based on what the history and 6 based on his working and surrounding environment, was 7 asbestosis. My post-operative diagnosis was the same. 8 Dr. Lawrence Brown helped me with the surgery and col 9 laborated. 10 Q And this was based upon the history and the symptoms? 11 A And observation, and feeling, and palpation of the lung, 12 which to me is a most delicate and definite way of telling 13 how badly injured the lung is. We are amazed constantly 14 how little the X-ray shows us, those of us reading X-rays 15 and entering chests. IS Q As I recall your testimony with respect to X-rays, 17 Doctor, you are not sure that any X-rays were taken at 18 your office before the biopsy? 19 A None in ray office but, of course, I wouldn't go into 20 a chest without having seen the X-rays first, I was being 21 equivocal because I thought you might he hedging on certain 22 dates and certain tines and making much of that, and there 23 fore, the X-rays -- 24 REFEREE: Doctor, you Just answer questions. Don't 25 assume if they're hypercritical or not. 26 A All right, sir. But the X-rays not being present, I ,2T*F .V-rriWvm 2 was being equivocal. 2 ffil, ttALONEY: Q Did you ever review any of the ma 3 terials used by Mr. Cuthbertson in his employment? 4 A X do not believe I have. 0 0. Could Mr. Cuthbertson's symptoms have been produced by e other causes such as cancer, tuberculosis ~ 7 A His symptoms could have been, yes, that's right, but 8 we ruled those out. 9 <1 10 I A Did you rule out asbesto3ls. Doctor? We ruled'in asbestosls. ii 11 Q By a process of elimination, was it? 12 A By a pathological examination. ' 13 Q This was the examination you testified to earlier, was 14 it not? A Cross and microscopic. I 15 Q And the oral report was submitted to you by -- 18 A That's right. # 17 Q -- Dr. Slngnan, Doctor, would the inhalation of dust 18 or particles from foam glass, materials have any effect 19 upon the condition that you diagnosed? 20 A Foam glass? 21 Q Yes. A Foam glass. You mean fiber glass? 22 Q Foam glass. A X am not familiar with it. 23 Q I see. Are you familiar with fiber glass materials? t 24 A Yes, somewhat, 25 Q 28 A Would this material have any effect upon -- The feeling at the present time is that it doesn't have _____Ij--k J|^` ~V~ . I 1. *s-`* IN A 1 a great deal, although In the more recent literature It 2 warns you against Inhaling it in any quantity and that's 3 experimental work done on animals. an 4 ft Did you ever tell Mr. Cuthbertaon that he had asbestosis 5 condition? 6 A In my clinical opinion he has it, and I told him so. 7 ft When was this, Doctor? 8 A Immediately following his surgery. - 1 9 ft In August of ~~ j 10 A Veil, right after his surgery. As soon as I had a j 11 definite report. . : 12 ft Did you also tell him that this condition may be related; 13 to his occupation? 14 A I don't believe I had x<r do that. 15 ft Were you paid for your services In connection with the 16 operation. Doctor? . 17 A That I can not answer. My bookkeeper handles that, and 18 I do not have the records present, 19 ft When did you last treat Mr. Cuthbertson, Doctor? 20 A He was In my office on October 12, 1959, for pulmonary 21 function studies. 22 ft And what were the results of these studies, Doctor? 23 A They're within fairly normal limits as far as pulmonary 24 function studies are concerned. 25 ft / Do you have any recommendations for ruture treatment? 26 A J Yes, complete observation, especially protection from \ _/ r.U *iff *ft fywnyywM*uyu tjm jwi i VI 3 U'j 111 W *+99**^ '-^yV.^ ,^.^1^.1^.V, : , 1 further Inhalation of these agents that are causing trouble 2 In his lungs, complete protection. I do not feel he need 3 leave his chosen occupation but he certainly should be 4 protected against further damage and observation because I 5 don't believe any of us know once the fibrosis starts In a h`. 6 man's lung how far It's going to go, and that's the usual 7 story of asbestosls ond silicosis. ." 4 8 Q You say there was a fibrosis condition present? 9 A Reported by the pathologist and definitely grossly. 10 Q By the pathologist. Doctor? U A And definitely grossly at the time of surgery. 12 Q Doctor, you also mentioned this greenish material that 13 Mr. Cuthbertson coughed up, you mentioned one day of May 14 9# 1959# do you recall when he first mentioned the material? 15 A 1 have It recorded. That means an Infection in his 18 bronchial tree. That means sputum. Coughed up greenish, 17 material May 9, 1959, 18 Q I see. Is asbestosls a common disease? 19 A No, I would say it's not common. 20 MR. MALONEY: I have no further questions. 21 REFEREE: Mr. Burehell. 22 MR, BURCHELL: Q Dr, Crenshaw, how do you define the 23 term "asbestosls"? 24 A Asbestosls, clinically, would be impairment of -- 23 particles within the substance of the lung, asbestos 28 particles within the substance of the lung1, producing ----------------------------------------------------------------- 000-^ -iasa * V-.+-*. ^ .*-.****' ' ' 1+ ->.'***. ** n** aullMillWWjMniii I HI I>1 inn >!* iiil'HiirTinirii-r- sufficient fibrosis that the functions* and the lung has f?Il>. many functions besides respiration, that the functions of the lung would be impaired. Q Are you familiar with the fact that so far as the ia pathological Investigation has been determined there Is no Interference with the bronchil or bronchioles of the lungj A I don't agree with that. That's the microscopic : and I am basing mine on vh&t I saw. ' Q If this la a fact, the microscopic analysis, or Is it 10 a fact that there is no Interference with the bronchil or ; ^ n bronchiole, then do you have to conclude that there is no | 1 12 aabestosls? j IS A Oh, no, I don't accept that in the first place. i 14 REFEREE: Youdon't accept what? 15 A That there is no interference in the bronchil and 16 bronehlolea. . 17 REFEREE: They're asking you what the answer la If you 18 do accept It. 19 20 21 22 23 24 23 26 i| A ".'.nymwwfm A I didn't. MR. BURCHELL: Q Veil, assuming that they're normal. REFEREE: Assuming there is no effect. A No, that doesn't necessarily -- it's true because one of the most Important functions or factors of the lungs la exhalation in the lung as well as others. There are about twenty different functions of the lungs and the elastic fibres are probably more important in thl3 regard 0001C3 .h ft> ** J; fc %i * ' ; t fi'xft ti- ^,,>,,,1 i>mrmn<vnii----- rr" *>*`*,^^f**^''* trf f V f` w*~ * **'* n^MMppMBEtMVW MsnnessssaazsssffiSE a- than the actual conductive system In other disease In which the elastic processes are Interfered with by any scarring or sclerosing substance. You may have normal appearing bronchll and bronchioles and have a non functioning lung, and that being true in emphysema, for instance, before it gets into the cotton candy lung. Elastic fibres are extremely important in function. MR. BURCHEXX: Q You feel that asbestosls in this situation affects the elastic fibres of the lung? 10 A It affects their function.; the fibrosing elements 11 would affect their function. 13 Q How, do you have any evidence in your record that the 13 elastic fibres' function have been affected by the finding 14 that you have made or other people have made In this case? 15 A I do not think so. . . 16 Q Pardon me? 17 A I have no record of it, no, 16 9. Is there any evidence that there has been an extension 19 or*a change in the fibrous appearance of the lung? 30 A At surgery there was gross change. 31 Q Change as compared to what period, Doctor? 32 A Oh, I can only say, speak of the actual time I saw him 23 when the chest was opened, and I had thelung in my hand. 34 Q Yes, When you saw it at surgery, were you able to 33 differentiate it whether or not the appearance you oaw were 36 not -- could you differentiate between the appearance which i. / --wnr* i.wiwu'WMtJwm >* rz~*us--r--; r** you saw between residuals from a chronic pneumonitis or pneumonia or whether it was due to the presence or absence of asbestos materials, or whether it was due to quartz that nay be in the lung? A Ve couldn't tell what the substance was that produced it but we could tell there was definite destruction to this man's lungs* Q So far as -- by your observation at surgery you knew -- A His lungs were injured* . 10 Q nA The lung had evidence of 3ome injury? That is right* . ' ,. 12 Q Would your opinion be any different today if you knew 13 there had been some disposition of quartz within the pleura 14 of the lung? . . -% . 15 A What do you mean by quartz? . 16 Q Well, let's aay -- 1 mean what the Pubiic Health.. 17 Department means by quartz. . . 4 18 REFEREE: Quartz. You know what quartz is. 19 A Silica. Is that what you are getting at? i mean, 20 there are Inert substances that don't cause any trouble 21 at all and certain things that cause a great deal of 22 trouble -- silica? 23 MR. BURCHSLL: Quartz. 14 24 REFEREE: Quartz. You know what quartz is, Dootor. 25 I am still trying to get your definition of what you > 1 26 mean by quarts. L OOOltO 'll) sV*'A*rt^-A4 .J 15 REFEREE: The dictionary definition of quart*. . A Would you state your question again to me, please? MR. BURCHELt: Yea. Q Would your opinion toe any different today If you knew the record shows there was a distribution of quart* In the lunga? - * % .. A My clinical opinion has not changed In this man at all. Q Regardless of what's in the lung? ' A Regardless of'whatwas found In the lung. . 19 Q You mean it's not Important to know what was found in ' 11 the luag? sV- 13 A Oh, It*s very important to know what1a found in the 13 lung, very important to know. . 14 Q Is it Important to know the quantity of what was found 19 in the lung? A That la right. 16 Q Isn't it important to know that it la something that cold 17 not toe if there was aabestosls. It could not toe reducible 18 by ordinary pathological investigation? 19 A No, ordinarily pathological examination as done toy 20 Dr. Slngman would miss astoestosis except infer advanced 21 atagea. j 22 And that's true, the amount that was present was so slight 23 and so small it could not be found toy the even rechecked 24 pathological investigation? 23 Oh, I don't think that is true. I think theyfound far 26 advanced aabestosls in this man's lung and that's the 11 __ M^ ' )_, 1iJ_i g-r^.tv, . ^ ,v * vnufr--a *+wr* .-^w-<'*->*^rf'X>''-** ***+ - :3 11 written report. 21 REFEREE: What written report? A Dr. Watson's report, MR. BURCHEIX: Q And is this what you based your opinion on/ a far advanced asbestosis? SI i A Oh, no, I am not taking it from his report. MR. SMITH: I think the Insurance company's report shows asbestosis bodies moderately advanced. It's on page two. 10 REFEREE: "Asbestos body deposition, moderately 11 advanced lung," 12 MR. BURCHElrL: Q Well, there is a difference. Doctor,: 13 is there not, between asbestosis and the. Just the presence I 14 of asbestos in the lungs? 15 A It's the amount of reaction around it, yes. Moderate Id interference with drainage. .. 1 | , 17 Q So -- 18 A But not being an expert pathologist, I would deduce 19 from these facts that this man and also from my clinical 20 and surgical experience that this man has moderately advanced \ 21 asbestosis. j 22 Well, what evidence did you rely on to come to this \ 23 conclusion before you saw the report of Dr. Watson? | 24 The evidence was based on the history and experience wltr. 25 his brother in which I missed the diagnosis, in which the j 26 man had surgery because of an extensive pleural effusion j ---------------------------------- .. / JT .* * .TMl-*. T T *.* *' **''* f jrT^ -T* - k.wA'W/ - .i>wrv*v*>vi > * *" -----------.-- -- .-.i . ` .w- f -'l'. - *V>ro'-: <* m- Sv `I t il I 1 and I could not determine the nature of it, and then It we; on to further trouble, in which surgery was required to make a definite diagnosis again on the opposite side, and which time we took a lung biopsy and found his trouble and with real damage to this man's lung. That case has been 6 before the Commission'and has been settled, as I understand 7 And this man worked under the same circumstances. He is a 8 twin brother of the man, over the same period of time. 9 Q, Then you base, as I understand your testimony, you - 10 based your diagnosis initially on the fact that Mr. 11 Cuthbertson had a brother who had asbestosls? 12 A That was one factor. 13 4 And you did not take a history from*Mr. Cuthbertson? 14 A No, I had the history. I had the history. you're 15 talking about occupational history. I had an occupational 18 history. ' 17 4 Doctor, my initial question was to reach a conclusion 18 that the fibrosis in the lungs and you feel la present, 19 and was related to the asbestosis? 20 A That's right. 21 4 It is important to know the quantity of the asbestos tha< 22 is in the lungs, is it not? A That la right. 23 4 That la right. And if it's not found by ordinary 24 pathological medical investigation by Dr. Slngman and Dr. 25 Soave In their techniques and is only found in minute 26 quantities in the lung, keeping this in mind, and keeping ----------------------------------------------- t,---------------------------------------------(jTxrxr' In mind that the man had pneumonia In the past and other cheat difficulties. Isn't It a distinct probability that the fibroels in his lungs Is related solely to the other condition? A I can't - MR. SMITH: I will object to the question as being com pound and complex. a 8 REFEREE: Overruled. Can you answer? Answer the ques 9 tion, Doctor. 10 A Well, I wouldn't -- you put up a proposition there, 11 a hypothesis to me which isn't true in the first place, 12 REFEREE: Q What do you mean it Isn't true In the ; '1 13 first place? - 14 A He said this man didn't have, and I was basing It on ; 1 15 things that I didn't base It on, and you said that the ex- j 16 amlnatlon of Dr. Singman, who didn't look for asbestos oodles 17 was a criterion In determining whether asbestos particles j 18 are present or not Is not true; when this question comes up, ! 19 we send It to a special lab. for examination and Dr. Sln^nan* 20 won't even test for It. This is a specialty. ; *1 21 MR. BURCKELL: Well, you asked Dr. Singman to look ?2 again to see if there was any asbestos, didn't you? j 23 A I asked him what he thought of it, and he said, "Well, I 24 send It to the State lab." < 25 Q You got his report. 26 A After he got a report from the lab, 000111 sir v-- > SS2223E3 Q No, before you got his initial report, after he looked at it, didn't you? A Yes. .' j .1 i Jt : I 1 ' .`.i *' '""jl n )I r** *f ij| i>* Q, And he said he found it was fibrosed due to the pneumonitis, right? A No, chronic fibrosing pleuritis and chronic fibrosing, pneumonitis, which is entirely different from what you are trying to make it out, Q, All right. Now, then, you asked him to look again, didn't you, to see if there was any asbestos? 10 A And he said he couldn't, he would send it to the 11 state lab to paes on It. He might have said he couldn't 12 find any, but that didn't mean asbestos wasn't there. If 13 I had been served with that examination, we would have 14 stopped there, and that's no criteria to determine whether 15 a person has asbestos or not. -- 16 Q Isn't it true that after Dr, Singman says his technique 17 wasn't critical enough, he could not go down far enough to 18 get a small tracer amount, that you suggested that he19 send it up to Berkeley? 20 A No, that is not true. At surgery I suggested this be 21 sent out for an examination for asbestosis through Dr. 22 Singman, realizing that he doesn't do It, realizing the 23 ordinary hospital pathologist doesn't test for these things, 24 that it must be sent for special examination. I know Dr. 23 Singman very well, respect his ability very much, but I 26 would not respect his ability to diagnose or not diagnose. 00011.J n I mypiWMfigyji.' mtvt )Kw i fan vw ; !**>** In* --W*.y 4 -4 <* nf 1 asbestosls aa exemplified by the atepa taken. 2 Q Did you receive a report from -- have you seen 3 the report of Dr, Soave? 4 A Unless It's here, I haven't, and I don't know. 9 MR. SMITH: I think It1s that short, that one right 6 there. Doctor, 7 A I have the report here, 8 MR, BURCHELL: This is the one to William Thellen. 9 A Beg pardon? 10 Q la this the one made to William Thellen? 11 A Yea, William Thellen, 12 Q December 10, 1958. A That is right. 13 Q Which la part of the Defendants1 Exhibit No. 6 this 14 date. 15 REFHtEE: 16 Burchell, Go ahead. Let's have the question, Mr, i 17 MR. BURCHELL: Q Having read this report, If the : 18 pathological Investigation, microscopic, clinical testing ' 19 by the pathologist at the Department of Health Is negative, j 20 for any evidence of asbestosis -- 21 A Do you read that In here (indicating)? 22 Q I don't find any evidence there Is any pathology ! I /! / s\j/ ; 23 to asbestos there, 24 A Pirst of all, this man is a veterinarian, and I don't S i j 25 think he says much of anything ether than the presence of j 26 fiber glass and granulomatous lesions that couldn't be ! ! --------------------------------------oounir vaaMa 1' i'i' ftiftteV it JUP'.H determined from tuberculosis, coecidlotdomyooslo orcer& taln Irritants or toxins, REFEREE: All right, the point Is, does that report * specifically Indicate asbestosls? A The report doesn't indicate anything, Q All right, why didn't you 3ay so? A O.K. He didn't ask me. ' REFEREE: He did ask you if it Indicated asbestosls, A I didn't understand it then. 10 REFSffiE: Then you say it doesn't mean anything. Now, 11 answer the question directly. Doctor. 12 MR. BURCHET.L: 0 Now, If the amount is ao small, 13 or of such an insufficient quantity to be able to 14 be determined by microscopic analysis by two pathologists 15 on histopathological examination of the specimens that 18 were taken during your, when you did the lobotomy? . 17 A Lobectomy. 18 Q Lobectomy, I am sorry. 19 A That's right. There is a big difference, I 20 MR, BURCHELL: You're confusing me 21 A That's what you're trying to do to me, 3 22 Q I was going to suggest you would See to do it to me. 23 If this amount was such a small amount that couldn't 24 be found by microscopic analysis, would your opinion be 29 any different? 26 Not changed one iota. ---------------------------------- -------- ---------------------------------------------- UU0117 ii 4 | 'a fl >4 tUTVM'- MXiWl !gW*iWIW*WWW*W--#>W^i -m, *: 1 Q Well, Isn't the quantity of asbestos Important that you 2 find In the lung? 3 A It's the reaction of the lung to the asbestos Is the 4 Important factor, 3 Q I think you have already testified that you can not 0 determine from the reaction as to whether It's due to asbes 7 tos, pneumonia or quartz, can you? 8 A Question once more, please. 9 Q You could not tell from observing the lung or what we 10 know today what evidence we have before us today in this 11 case whether It's due to quartz, whether It's due to the 12 chronic case of pneumonia In the past or whether It's due -- 13 A Oh, that I can tell definitely. Chronic pneumonia 14 usually leaves not even scars in the pneumonic process, ; i 1 13 I can tell If it's pneumonia. Quartz -- apparently, I j 16 can't get the definition of what you mean by quartz, but | 17 quartz, saying silicosis, I couldn't tell that grossly 16 between silicosis and asbestosls. 19 Q Well, to produce a finding of chronic fibrosing < j . j 20 pneumonitis -/ any number of noxious gases or fumes could 21 produce It, could they not? ' j 22 A They can produce fibrosis in the lungs. j 23 Q And cigarette smoking could produce it? ! 24 A Cigarette smoking produces Just the opposite. It 25 produces a varfehlng lung, 26 Q Could benzine 2* cause scarring? 0001LL NMUMM -^f-l A I have no Idea of what benzine 24 causes, REFEREE: Any further questions, Hr, BurchelV? MR. BURCHELL: Yes, sir. Just a moment, REFEREE: Let's get on with It, , HR, BURCHELL: Q, Do you know whether your records [ j indicate if Mr, Cuthbertson had received any medical treat- j mentt for respiratory infections in the year before you- J first saw him? * ' ;. v -j A He was referred to me by his private doctor. Dr. Larry -w 10 Lawrence Brown, Richmond, who told me, and in fact, called u me as a chest specialist because of thl3 problem. - 12 Q When Dr, Brown first called you into the case, did he 13 discuss with you the fact that Mr, Cuthbertson had a brother 14 that had been Involved? ' 15 A He was surprised to hear that there was a family 16 relationship, that the brother had been exposed to asbestos 17 -- asbestosis, or had asbestosls aa the result of his 18 occupation and that thla man was a brother, and he was, 19 he could understand then why he had such current respira 20 tory problems, 21 Q If the bronchial, the bronchial drainage and the find -] 22 ings of the sputum and what not that you Identified aa 23 late as May 9, 1959, that were present, these could be . 24 residuals from the blood and the accumulation of material : i/ 25 following your surgery, your biopsy, could they not? 26 You're asking me, as I understand your question, that "^Viimpiijiiv i. -(RKrtlfr '- > ; ' Vy >'" a gWinfrwimtnpTimn irnurnliTrr^ in~i^*s*w*wv****a.*g* fryf-ViV*! I'i'nit'' 'll 1 changes In this lung were due to my surgery? 3 ft He. ttell, ucsru changes were. *' ' '. 3 A `There would be some changes but not -- 4 ft Ho, my question is, you said that you found a bronchial 5 draining that continued up until Hay 9th of 1959, 3 A Whether they were part of the surgery? Ho, we worked 7 with this man for sometime in an attempt to rehabilitate 8 him following surgery, and I have already testified that 9 periodically.lasts about two months in an ordinary indi 10 vidual after thoracotomy* 11 ft Had his bronchial drainage stopped following surgery? 12 A No, bronchial drainage never follows. Els abnormal IS bronchial drainage at thepresent time exists and will 14 exist because of the damage to his lung* 15 ft During surgery there is a certain amount of accumulation 18 of blood and fluid at that time, is there not? . ... 17 A Would impair the lung for a specified time in the 18 majority of cases bearing the fact that each person reacts 19 differently over a period of time. We could give them 20 around two months or roughly that length of time for them 21 to clear. Now, if you have diseased lungs and impaired 22 or injured lungs, it will take longer and much longer, 23 ft I see. 24 A You might be interested in knowing that we are very 25 actively engaged at the present time on a Navy research 26 projeot, the further details I can not tell, in which ------------------------------------------- 33--------------------- HgyBTOSffHQ U',A uni I! HH p. jy iii guywilish^ ; ----- OTjnrrrr - WhNMi *TiU .v the detailed anatomy of these lungs have been found to be entirely different than what some of the other men have been basing their knowledge upon and I Just returned from a j meeting in Arizona where parts of that program was given. Many ideas and concepts are going to have to be changed. ; Q Now, Doctor, as I understand it, your definition of -- J your diagnosis of asbestoais is based on the presence of ; fibrosis in the lungs. . .. .- I 9 A The presence of asbestos products, asbestos. | 10 MR, SMITH: The question has been asked and answered. ) 11 REFEREE: It has. Now, let's get on with it, Mr. 12 Burchell. .. . - ' 13 MR. BURCHELL: All right. 14 Q Besides asbestos in the lungs and fibrosis, is there any 15 other evidence in this record that you found? . . IS A No, I found no other evidence for this man's disease, 17 than what I have testified to. IS Q Did any other evidence for your conclusion other than 19 asbestos found in the quantity that was found and the 20 fibroala - 21 A My conclusion is being based upon the occupational 22 history, being based upon the elinlcal history, being 23 based on X-rays, being based on surgical observation and 24 gross and microscopic observation and clinical follow up 25 on this man made me come to a definite medical diagnosis of 29 asbestosis with definite injury to Mr. Cuthbertson*s lungs. e.eeyiffj. Jf *w i Jim* _____________________ _ wipwln^ wwwyyrww _______ -- i Q Now, have you had this matter referred to any patholo gist other than Dr. Singaan? A These pathologists here are the only people we have seen Q X see. And this opinion also Includes the opinion of Dr. Slngman, your opinion? A I can't give you Dr. Slnnan'a opinion. I don't even 7 have his report. 8 MR. BURCHELL: I have no further questions. Hr. Referee. 9 REFEREE: Mr. Moore. ' ' 10 MR. MOORE: Q Doctor, you say you are a hoard, 11 certified.-- . 12 A Board Certified, Founders Qroup American Thoracic 13 Surgeons, board qualified In diseases. In Internal medicine, 14 and eligible for board of sub-group of diseases of the j 18 chest, however, I can not have both because one would | 16 nullify the other. Unfortunately, that gives away my age. j 17 Q Doctor, did I also understand you to say that the three I 18 eases are the ones that you have had experience -- 19 A Two cases In this group. ,, . 20 Q Two other cases In asbestos? 21 A In this group. - 22 Q In this group. Have you had others of this -- 23 A I have been In practice of diseases of the chest and 24 surgery In this ares for twenty years. 29 REFEREE: What's your answer?? 26 A My answer Is I oan not recall any right off-hand but 0001^2 I am not sura. I have had others. ^ 'felt you can not reoall then? A I can not recall them right at this time, 0 Have you ever had any specialized training. Doctor, in occupational diseases of the chest? A Yes. 6 Q And where? .. ^. 7 A I have attended meetings throughout the world and 8 gone to groups, some group meetings throughout the world, 9 throughout the United States and part of our work in my 10 general training daysdealt extensively with Industrial U diseases. 12 Q What meetings were' these you attended? ' 13 A Internatlonl symposiums of diseases of the chest; in 14 Tokio last year; made a tour through Asia, New Zealand, IB Australia; sent out by the Navy and by -- 18 Q Doctor, the question was -- . 17 A You asked me what I had, where I had gone. You want 18 to hear -- ' 19 Q For occupational d;seases of the eheat. 20 A This all Includes occupational diseases of the chest. 21 Q I asked you If you had any specialized training In !< 22 occupational diseases. Y* 23 A I don't specialize specifically but I have as much 24 training as practically all men in this field. 25 Q Have you ever attended any lectures or studied any of 28 the material in- the symposium at Saranac Lake, New York? ?rr ouoi^a ; i. 5 fc^aigaattn^M w~r. :.. r- !* Tfc-. l ^' % <a !*i?V -i % A 1 ] J *; .1 A, ;? * j? .- j; < i. \ M Itt Mw Mil 1 A Yea, I have looked at Dr. Wright's work on pulmonary 2 physiology and silicosis. I won't say I am familiar with i It but I know them and I know Dr. Wright. 4 Q Can you tell us. Doctor, what concentration of 3 particles and what size asbestos are pathogenic for asbestos 6 A The size must be sufficiently small to pass through 7 the bronchioles on respiration to be picked up, and by the 9 lymphatics and carried through the mucus membrane at that 9 point. ' 10 Q Specifically, what is that. Doctor? U A I do not remember right at this time. I am a little 12 tired tonight. ; 13 Q Well, so far as concentration, do you know what the ' 14 concentration is? 15 A I don't, I can't. I do not, . j j IS Q Pathogenic? A X do not know at this time. ; 17 Q Well, Doctor, isn't it true you haven't made any special: 18 training in silicosis or asbestosla? j j19 A Any special training. I an trained in diseases of the 20 chest, which includes a large part of it* as exemplified \ 21 by care of these patients. Of course, I have. i j22 Q Doctor, you don't know what sizes or concentration of j23 asbestos are necessary to produce the pathological changes 24 in the lungs, do you? | 25 A I know that this man has asbestos particles in his lung 1 28 and I know they're the ones that caused the damage. / ! QfMlk'l i tv ~*J3SSQ . --ptavoc* i/4*ftisAi.-iiij2:.i-'V^rtHr k' -7,-'{ -* 4 ifl 4 ,lf i fM ||| 1 REFEREE: Doctor, will you please answer the question? , 2 A 1 have had a lobotomy but go ahead. You wanted to know j 3 the exact size. I can get them for you In two seconds. 4 I don't remember them at this time, 3 REFEREE: I can get them, too, but I want to know if you] 6 know, . ! 7 A Not at this moment I do not know. I have known them : 8 many times. ; 9 , MR. M04RE: Q Now, Doctor, there Is no reported 10 specific pathology In any of the X-rays, is that right? 11 A As far as the X-rays of the man is concerned there \ \ ; U actually isn't. If my eyes -- If I had the X-rays here, ; 13 but to rae there was In my eyes, I feel that a man, special- : 14 lzing, that there was & fine granular appearance to these 16 X-rays, however, I again can not answer that because I don'tj 16 taiow at the moment because the X-rays are not here, 17 Q You don't remember even seeing it prior to surgery? 1 t j 18 A Of course, I saw them prior to surgery. : 19 Q Well, I am sorry. I understood your testimony this 20 t morning to be that you did not remember, whether you saw then. 21 A i No, the only equivocation this morning was I was trying.i 22 I did not remember the dates the X-raya were taken or I j 23 exactly where they were, I would not operate on the man's 24 chest unless there was testing and pathology present. I 25 saw the X-rays at Herrick and I saw the X-raya at Richmond 28 before the surgery was performed. Likewise Dr. Brown ^ / oooirc^ ------------------------------------------- -*?---------------------------------------------------------------1 ft-'UJi. py.M yiy i I'ju.n v j. **** SSJST555S- --<****( S-*i * c' <'( i * vt xl> ttf t f nfi would not allow me to operate on this man before aurgecy If I hadn't seen them. Q Doctor, I understand you would not have operated on this man as you did unless there was pathology visible on X-rays, A There was pathology visible on X-ray, . 7 Q Despite the fact that the X-rays may have been reported 8 negative by roentgenologists? 9 A Who did not have a complete medical history or informa- t 10 tlon regarding the possibilities of disease in thl3 man's U chest. 12 Q Well, Doctor, don't you. In that situation don't you 13 frequently provide the roentgenologist with the history, 14 tell him what you were looking for? 15 A I do on occasion, I did not on this occasion. 18 This man read hla X-rays long before I had an opportunity 17 to talkto him and made his report. 18 Q Well, can you tell us whether prior to the time that 19 you took, whether prior to the time you did your surgery 20 you actually took current X-rays? 21 A He had current, he had recent X-raya taken. Now, I 22 can't remember at thla point Just where they were or how 23 they were, and that's why I was being equivocal this morning j 24 to your other collaborator, but he had X-rays prior to 25 surgery or we would not have done surgery, and that's a 28 matter that can easily be straightened out, merely getting `TiT ----------------------<KUU^ . 4- ">SSSS 1 the X-rays. 2 Q Doctor, I believe the ones, the X-rays which were for 3 warded to you by Dr. Thompson Included those going up to 4 1956 and included those -- strike that. Now, Doctor, so 5 far as the pathological reports again there wa^ none of 6 the pathological reports showed any specific diagnosis of 7 asbeetosia, Is that right! 3 A No, Dr. Watson reports asbestosla. 9 Q He reported asbestosla? 10 A Asbestos particles and fibrosis of the lung. 11 Q Well, Isn't Doctor -- 12 A Isn't that asbestosla? .1 13 REPHIES: I don't know. You tell us. 14 A I have tried to many times. 10 MR. MOORE: Q The question, Doctor, whether the 16 pathologist's report -- .. ... . 17 REFEREE: Before we go any further - 18 MR. MOORE: The question Is whether -- 19 REFSIEE: Just a minute. Aa you say this morning, you 20 equivocate too much. 21 A The question -- 22 REFEREE: Nobody is asking you to argue anything; 23 they're only asking you to answer questions. Answer them. 24 If you can't answer them, say so. 25 MR, MOORE: Q Neither pathologist. Doctor, made a 26 diagnosis of asbestosla? A No. W iwfF M U'F j l r JJ M J "tt5* ---------------------- WO-1V lUl'M P-M. 1 JW.l111 i-MwiJJ --- * Q The mere bare existence of asbestos particles In the lung is not diagnostic of asbestosia, Is It? A No. Q And so far as the pathological or laboratory studies arc concerned, that Is all they have shown, isn't it, the mere ii 6 existence of asbestos In the lungs? 7 A Am I to answer that Just the way he wants it? 8 Q Limit yourself solely to the laboratory examinatln. 9 A Laboratory examinations do not show the -- 10 Q Yes. . 11 A Co not show ~ wait a minute. Laboratory diagnosis - 12 the pathologist has not diagnosed asbestosls. 13 Q So you have to determine whether there is sufficient 14 asbestos and sufficient pathological changes in the tissues 15 to cause this disease, isn't that the essential question? 16 A Yes. 17 Q And in this case, this gentleman has had a history of ia recurrent episodes of pulmonary infection. 19 A Not before exposure. I am sorry, I didn't answer It 20 "Yes" or "No.* 21 Q Doctor, the fibrotle change -- 22 REFEREE: You see. Doctor, if you will answer "Yes" 23 or "No." To be frank, the way you appea.r, you impress me 24 very much as being on the defensive. 25 A Not defensive; I am merely tired. )/ 26 REFEREE: All right, answer questions directly. -oonv^-i 1 MR, MOORE: Q Doctor, the co-called fibrotic change# 2 are very, very minor in this case, aren't they*? 3 A They're not; no, they are -- now, I don't know how * 4 to answer that "Yes" or "No." 5 REFEREE: Q Are they mild or not? t 6 A They're not minute. 7 MR. MOORE; Q Well, none of the roentgenologists i i 8 have noted their existence, have they? 9 A Ho. i 10 $ Doctor, the temporal*/ phase of disability in this U ease was caused by the surgery, is that right? 13 A NO. i. i 13 Q Well, was he working up until the time of surgery? * 14 A He was not working when he came, no -- yeah, he was i 13 working. 13 Q And the reason he took off work was because you did 17 the surgery? A No. 4 18 Q Why did he leave work. Doctor? 19 A What you're asking me -- ' 30 Q Why did he leave work? 31 A He left work because of respiratory complaints, an 33 undiagnosed chest problem. 23 Q Well, Doctor, the surgery did not, was not designed to 24 alleviate his situation one way or the other? 35 REPEREE: That's been asked and answered, Mr. Moore, 38 Let's not ask useless questions. [ U^WtllW.'MiJlP! Tf ~\ .J -M Piiii Vi^ii^fetmfiar J l i> 1!I',1! 1 MR. MOORE: Q What, Doctor, la Intermittent positive 2 preMure breathing? What la this? Would you tell us? 5 A That's oxygen and air given under pressure to increase 4 Inhalation and reduce the edema and open up congested 6 air.ways. 6 Q You have been giving that since you gave it for a r period from August 27, '58, intermittently, through May 8 of '59. A And now, 9 Q Well, Mr. Cuthbertson has testified that he still has 10 the same complaints. Doctor? A That Is right. 11 4 But then this treatment has not been very effective In 12 alleviating them, has It? A Yes, it has; . 13 Q What are the normal ways. Doctor, in which you make a 14 diagnosis of asbestosls? ' - - ... 13 REFEREE: Oh, let's not go over that again, Mr. Moore. 18 . MR. MOORE: Q Speaking, Doctor, of vaccine which 17 you have given this man: what is that? 18 A Cutter mixed up a respiratory vaccine that gives them 19 temporary immunity against the organisms within his own 20 respiratory tract. It's a passive type of immunity. 21 MR. MOORE: I don't have any further questions, 22 REPEHEE: Mr. Smith, any questions? 23 MR. SMITH: q Doctor, you made reference to two or 24 three occasions where you have had to give him some anti 23 biotics and that he had respiratory infection. Was there 28 any relationship between the respiratory infection and the V njr .goal uyiiiy.T'y;<if-MffW',8) pujewf Q `-ns <* ***.** V.. * ** ---1- SB Mtmmii .V %**, ~ --T* 4. *c> ** ** m.V N-V< 3* ~ <* *4 * rA " 4 ]1 < ! .j i 4 ' i j i < * need for biotlcs and his asbestoais or not? A There la definitely, yes, Q What la the relationship? A These people, once they get a respiratory Infection, It hangs on because their lungs are not functioning normally, and goes Into periods of pneumonitis similar 7 to the one Just prior to that when I saw him, ' 8 Q Doctor, you were asked, I believe, and shown the report 9 of Dr, Soave, and you had also mentioned that you had read 1 10 the pathological-i report of Dr. Watkins? 1 11 A Watson. j 12 Q Watson. Excuse me. Which is in Dr. Hlnshaw'a report, j 13 and there is this microscope, or this report of the 14 Department of Health as to their findings. I don't know 15 whether you have had occasion to see that or not. W A NO. 17 Q I gave it to you. 1 don't know whether you read it. 13 A I haven't had a chance to see it. 19 Q Would you Just read that a minute and advise whether ; 20 or not any of those reports, whether In view of your report 21 you wish to change your opinion or diagnosis in this case? 22 A My opinion has not been changed whatsoever. 23 MR. SMITH: I have nothing further. 24 MR. SCHWAB: May I have one question on that? 25 Q When Is the first time that you saw Dr. Soave`a report? 28 A Today. . / K/Sn-i '* * yty'r** 1 REFEREE: Any further questions?' That's all, Doctor. ^ 2 A Thank you very much. 3 REFEREE: Qo ahead, ' '" ' ' j i * 4 MR. SMITH: I was Just going to ask the docter to send S me a bill for his time, which I would file, and I believe j 6 we have some litigation costs in Issue. "I 7 REFEREE: Yes, that's In issue. j a -MR. SKITS: Yes. Applicant has nothing further, your 9 Honor . 10 REFEREE: Do you want Dr. Crenshaw's report? Do you * 11 want to put that in evidence? . - .. 1 12 MR. SMITH: Yea. ' . ' v- ' V" ' ` 13 REFEREE: That wllll be Applicant's Exhibit No. 2, 14 together with hla bill. Now, anything further? IB MR, SCHWAB: No............................. .... - . IS MR. SMITH: Your Honor, we would like to submit a bill 17 from Dr. Crenshaw for his testifying before the commission. 13 REFEREE: I an not going to accept it. I am going to 19 make a suggestion. The medical evidence in this case is 20 very poor and very unconvincing one way or the other, both 21 ways. I don't toow If this man has aabeatosls. None of\ 22 the doctors will tell me what aabeatosls is and what causes ' 23 it. I would suggest you get an agreed examiner and leave 24 it to him and file his report. Agreeable with you, Mr. / 25 Schwab? jr rM m IMV -> 26 MR. SCHWAB; Yea, sir. '\S :--auttus-- J ~N '\ 3 i MR. MALONEY: It's Agreeable to at. a KJLFlHJLt: V1T1 the defendants take care of It, Mr. s Moore? 4 MR. BURCHELL: Agreeable. 8 REFEREE: Is that agreeable, Mr. Moore? 6 MR. MOORE: Yes, satisfactory. 7 REFEREE: Is It agreeable? 8 MR. SMITE: I will go along with your recommendation. 9 REFEREE: All right, you people get together and pick 10 out your agreed examiner. Set somebody who knows something 11 about occupation and who has had some background, and tell 12 me what asbestosls Is, Just like they do in silicosis cases. 13 They tell me what silicosis Is and what causes it, the 14 exposure necessary, the size particles. I want some 18 information on which I can decide a case. And see to It 16 that they get all this medical Information you have... . 17 How long do you think It will take to do that? I know 18 this Is more than the usual case. I agree that thirty days 19 Isn't too short. - 20 MR. SCHWAB: I don't know whether we can agree to a 21 man, Mr. Referee. ' 22 REFEREE: What? . .... 23 MR. SCHWAB: I don't know whether wecan agree on a 24 doctor. 25 MR. SMITH: I was going to suggest, why don't you .discuss 26 with the Medical Bureau -- 51 -\ j* i N 1 REFEREE: I am not going to do that. I want all the 3 2 parti## -- that sort of a situation, it would be much more 3 scientific for me to toaa a coin, and be much fairer to both 4 aides, 5 MR. SMITH: To whoa? * 6 REFEREE: To both aides, to toss a coin. . 7 MR. SMITH: Oh, all right, i 8 REFEREE: You take any choice of doctor -- I can hand j 9 pick a doctor, I can hand pick a doctor with the chances j 10 of having one doctor or another doctor with a better j i 11 chance going to the applicant or defendant. I am not going j . .f 13 to do that, I see no reason why you can't get together on j IS it. , 14 MR, BURCHEtX: Could we have ten days to get together? 15 REFEREE: You can have ten days to get together on it, 18 X don't think you need ten days. You get together on it, 17 Vhat is today, Thursday? You get together on It next id Wednesday. Then after that then you will have forty-five -- 19 the submission is: The parties will agreed upon an agreed 20 medical examiner by next Wednesday and thereafter they 21 shall have forty-five days to serve and file a report of 22 auch agreed medical examiner; the case then to stand sub 23 mitted without further proceedings. That's all. 24 MR. SCHWAB: Mr. Referee, we still have some physical 25 exhibits that haven't been received In evldenoe V 26 REFEREE: Vhat? i'JWJWlA1 I! '.M.J IU atcnMWiwiii)W|w,ii moii^wtMlfrjmmwiiW>iii.,imui' iT'-aytuwg^j-cx-^car^ 1 i i 4 i 4 MR. SCHWAB: There Is no longer a nan's rooting 2 section at Cal. we could give them to, so I think we j 3 should receive them In evidence. - : ! REFEREE: I don't want them In evidence. We have got j 4 ** I 5 a description of them. That won't help having them In ; 6 evidence. We have a description of what they are and j 7 how they're made. That's all we need. i 3 All right, submission as given. . . ................ , j 9 --oOo---- ' ' 10 11 .. . CERTIFICATION i 12 ' . ' 13 I hereby certify that the foregoing la a full, true and correct transcript of the proceedings taken by me 14 iI j I 15 16 17 13 19 20 21 22 23 24 25 26 0001 T f Hti HM m mm & law orriccs or - . SMITH. PARRISH, PADUCK ft CLANCY btae.v.r i t ' \ '/ a vj r*iAi eiwru um.oin* 4oti. *r.*,r oavlano i. eAki.o.wiA . v, . flovtmUr 20, 1959 piled ! Cabot Brown, M*P, 4^0 Sutter Street tea Pranolaeo, California _. . . . >* . vV .i.'- M BOHEFT P, CtmaSft?SO<'W__ . E^1LASB3TQ3__C0.. ct al---: ________ ! Dear Dr. Drown* You have been appointed 4*'an ic$jai*tlai medical examiner to examine t.*ie. above clieut. &>;<; : ` X * h*eln"`tinoaenpc of Dr. Crenhawa ' ' testimony prepared end will forward it to you when received. You ere requested to withhold your opinion and report until you nave tue ^opportunity to review aid dootor't transcript -end findings wnich we feel would be arterial to erf Opinion by you. Very twly youre. t* - JOSEPH B. SMITH - eoi ftullen A PlUppi ' 315 Mootpcoery $t. . San Franolaeo Xnduatrlal Indemnity 350 Sanaome Street San Pranolaeo Kunna 4 Bropfty 1540 San Pablo Ave, Oakland State Fund 450 MoAlliater San Franolaoo Industrial Accident Cn--Utlon 577 Ibth Street Oakland, California i P" 66MAL0 . MO^ WALfO JAOMft IVAN A. ICHWAt idiinr n mac vfan jO*H A MAC OONAVfr a 10*4*0 * Me A(.n* i.fc 1 i " i'i .. .1 ts n tcw4-ow (otftlili- '.wClV c *l-4th ^ ^ 3 \95^ raOaat I iitiuiloioinv * , . j. I4v er Hanna A Baoahy *40 *> Pava Avtv4 aaiUHD ii. CAU'OaNi, tiihimi him XmAtr 12, X159 FILED f-^ZcUST. ioo av(M ataio fHHim 4 Vaflad Oafifl 44 II. C i' >.n..i.t ota-irt ae*sa4a*iB`4feW)4 Call* ao o'Ct 1009 Hai> ft.,rf aK J0 It. Caat# \A^eL^ Dr, Cabot Hrwn . liSO Sutter Street '' San Pranclsee, Celt/*' Dear Doctor Xet Robert P, Cuthberteon Plant Aebestoa Co,, at al iQdL l hare made aii appointment for you to examine the aboro named applicant oa Horeober 19, 1959, at 3t00 P.h, >b*rt F. Accident CAynlaeion required n worx la Inctell during the year*fiL9li7 end doeItloo to Referee Cctc.letlott, 577 repreaentid b7 Smltft Bulldlsg, Oakland* lied a elaim with the Induatrlai t he auatalned dlaabllity and epbeatoele rcaultin* from hta riale which contained aabeatoe, tlfrtx vat aaaigned for hearing Apfielot Industrial Accident The applicant le 07, Financial Center Frcoi 19& to 1958i red for Plant Aabeetoa Country, which vu lntured during tb'ttv'porlt of tine by Industrial Indemnity Conpany* Patrick h* Falenoy It t) Attorney for that insurance carrier# From September 6, 1950, to July Wi 195k, the applicant worked for A matron; Cork Cow-iony* standard Apoldcnt Ineuranee Company vaa the insurance oarrler for/'matron,* Cork Carjuany until January l, 1952, and Travelers Insurance Company was the tnaureneo terrier from that date until the termination of the employment* fee appear at attorney* Tor both Insurance carriers* From 19U7 until September# 1950, the applicant worked for FIant Aabeetoa Caeoany, j* V, Tltorpe A Company, end veatem Aebeetoo Company, riant Aabeatoa Company and J 7* fhorpe A Company wore J pyemwoewaam^o jjuii uj f 1 uijjaupcmn -\ E&? two . 11/12/59 Jet j.obvrt t* cuthbertscn va# i'lant asbestos# at al Insured by heoirie Ua;jloyr* Insurance Company# Mullen i- riliypl are 6bo attorney* for that insurance carrier* western Asbestos Company ws* insured by State Compensation Insurance Pure*., ;> y, Bureball la tha attorney for that insurance carrier# Tbielosed please find tha oedloal file* You will rota that tha defendants submitted report# from Dr* H* Cotvin Hinahav wMeh inolud# raporta received by Dr# ITlnehew froa Dr# L* Haory Oerlaad and Dr# George A# Watson# Tha applicant submitted reporta of nr* Oerald L* Crenshaw# and Dr# Crenshaw also tastifisd at a hearing on October 22# 1959# radical conflict that exists# neferea torneya in tha acta to arras upon 1 dootor t and submit a comprehensive report, with all parties should be given an opportxmtty queationo they dsoirs covered to tha dootor you will probably rccaiva furttor inqulrie# Ha "attorney* named abo*a# Referee Ankala porataXln your report a general discussion dlaoaaaSof aabaetoala# with particular nd alaa of fibres that cause dsna.te# tha aztant and degree''of exposure acquired, the tint after tha inhalation of particles within vhipfisxysytoou become saanlfeat to tha Individual# nature af the/syaptoe* which first develop and tha nature of tha disability re4ultlhg#Nend tha manner In which ti* dltaaa# of aebeetottL-dlffer*/<(*ea slliootU* ' , Tha evidence astabZiabaa\haft Lrynti work this applicant used magnesia plpa covering# wool feltypipe/ covering# Aircell pipe ' * covering# Inlbestoe insulation# and fibreglass insulation# , Magnesia plpa covering eontalna froa 10/C td 12> asbestos flbra# the rest, being baste nacnealua eerbonsta# Wool felt pipe covering la ' aaoufactured vitb on inaida tar linar next^tc--THeplpe, n*xt a series of layers of wool felt paper shea*# then an outer wrap of aabeatoe paper# and finally a muslin cover, The wool felt paper is conposmt of ap-'ronlmstely 30- vood/pulp fibre# 60.'. Kraft paper pulp# and 10* stain* and waterproofing raterlals such as waxes* The asbestos np*r outer wrap is composed of 50.. to 60 asbestos fibre# and 30 to to* wood pulp end Iraft paper pulp# Alreell pipe covering is wade by comir*atinr esbeatea paper and then laminating the ce**nii:ated sheets* bnrter separate cover# we ere sending you a section of wool felt plpa covering / 00012^ ')i,W. DM M fipiJSlwiiHnepS.nj'l.ai wm '**.**.wr.rwj*-*1 ** * '.'J-.'f-i. **** Pas* thr** ll/l2/59 ; , h*l jtobert F. Cuthb*rt#on # Plant Aab**to## at al and aaetlon of Alrcall pip* covering so that you oan # for yourself what thaa* two produet* vr* like in th* condition in which th#j war* wh*n r*o*ir*d by th* applioant for inatallation. Th* only Information dlaoloaed b7 th* aianufaotur*r*a of Unlb*sto# inaultation i that 16 la approximately 70* Asoait* aebeatea* An asoert wltnea* haa taatifiad that Aaaait* aabstto* la nined in touch Afrioa, and haa a much longer fibr* than th* aabatoa uj*d in tha otbar material## which ooewa tzxm Canada . Th* fibr** in th* Canadian n*b**to* tr j/ft iMt in ' lan*tb# *' t alto ortcloa* a tabulation showing all Jobs on which tha applioant udrke\ for Amatrcn*; Cork Company# and th* material uaad on thosa/joba (3PC m**na aagnosia pip* coy*ring and FQ m*ana fibroglassls Tha appllemt d*nia that ha waa ataployod on two of th*a* Jobat follow# ij ?2Pacifie Portland Ceoaat Co* '29/52* Buaba yiata^ohool# .. . In\h* nedlodl file# yoxiwlll find a import of 25% A# R< Thonnaon# dot*d rn/Jcenber 6# I9fl# piYln- x-ray raadinra cr ftlaa taken Ootobar 10/1953 !?** 13# 1*54# and March 17# 1956# (V* will *nd*AYoi(to ect allX-rayvti^JQa# including th*a, and th* sp#elr#nt submitted to Jna paCnolo^iat to you as prcnptly aa poaalbl*#) Robert puthbw^aon ha Ova twin brother (cot an idntloal twin) who did ,<m sjm typ* of work# and Or* Garald Crenshaw performed a blopsy/on th* twin brother in 1053* For that r*aaon# th* tppllaanvimd *hbakup x*rd7 film* takan from tt to tlM. \ /7 -...I' You will alto find In tha fil* two import* fro* th* Department of Public Health# State of California* Ona import la b7 0# a* Sear*# D#V#M## dated D*onb*r liS<j>0 and tha second ie by willits tbi*l#n# dated D*ee*u*r 31# 1958* Thee* oot*r taaplta of lunr tissue suboittod/7 Dr# David Sinfnan# tha pathologist at Rletaond hospital# vhe/e Dr# Oerald Crenels* per formed a lobeetcny on Auruat 13# 1958* Th* Kleheend Hospital records haw* been received in *?ldenee# end the nodical file includes a pbotostatio copy* X r*ftr*t th* blurr*d condition of th# eery of th* hospital reeoris# but believe that th* putholortiesl report of r Cinwnan ia suffloiantly clear that you can read It without difficulty# pj'lJMWinPMii ,u i.*1 m \ oooic:j 9 Pae* four 11/12/59 ft*! Robert K* Cuthbartaon ra# .......... ~~ flant Aabaatoa, & -. Ker* *r* the apaoific quaatiu to which I vuld liko to hair* n anevart 1. In hU report of Oetobar 12, 1959, Or. w* Corwin Hinahao atatoat ' "Doctor Vataon'a findlnc# oecflra tha patient's statement that ho ha* Inhaled aaboatoa flbom- ffca lafcaXatlorv Kd .'i* tho deposition of aebeatoe fibers dor:*. not *>7 iteoir con* etltute enridence of disabling or necessarily significant occupational pulaonar7 dlaaaee* It vould be predictable, that any pexaan lonr onrared ir tha handling of asbestos ratarlala/voiuh. collect asbestos fiber* in hi a lung* which - vould bp' detected If a ruffle lent mount of lung tissue . war* oeteninod* la tract bo omphsaited that tha presence of ttxa* fiber* b^ar* no relation to the drfrea of injury, if /any, and that other nethode of exanlnetlon curt be railed ujxra to datamlao vjwthar aignlf la eat pulmonary diieaee la praajnfc* Tho funpoicn oflung biopsy la oaaoa aueh ea tMe ahourdb* to detdmtna thKnatur* of eeriou* injury and dls* ablllty-khan Eh disability hca first been demonstrated* Dlorer earvei'r.c useful pusposa whatever In c. situation *uoh at this whojf* there la no/clinlaxl, physiological or radio* logical *rinc* of dU*oliifr'/puimn4X7 diaaia**" . " . Do 700 act1** or disherao^tflth tfie#* rt&tteianta? IT 700 arree la '. part and disagree In 7*1*0, vJGvrou plocca Indicate tha arose of agreement end dlaccreoaanty^To tho oxtani that you disagree, *111 yoo plaaao ateto tho roaaaas for yqur d^aacraeaant* ;, 2* Dr. Stnpjaan has referred to antacerpt front yalrhsll. Industrial Toxieology, Soooad Edition 195?, vhloh oontatna tho following quotation! 7- *Tho flbrofenlq aetlen differ* frea^that of alliea in that the effaota are produced only by lcn*- esbactoc flbere, while tho very abort aebsetc* fiber* appear to hare little or no affect* Tha lox fiber* apparently block the finer bronohlolea and produce flbrotio ohangae a* a result of Irritation*" \ What are the maximal and nlnlwua length* of flbor* that do produo* hamful effects? In hla report of December 11, 192U# williaa Thlelen atata* that the eedle*like *r7*tala in tha tackle sub* ; 1 - a*EE I f u/12/59 K*i Hobart P. Cuthbartaon aa# Plant Aabaitoa# at 'f .-v> *lttad to hlA rmiwjtd In iIm from last than 10 alerona to vr*r 100 alerona In length and fro* or.e to rlvt alerona In width* 3* ZapLoynant bj Amatrong Cork Company# which la the only aaploytr with whoa I an oonoemad# terminated JUI7 lit* 1951^, and tha applicant 414 not experience any aymptoBf sufficient to prompt hi* to consult Dr. Crenahaw until August# 19?fl. Coneidaring tha ttno element and all arailafcl# Information as to the euantlty of flbena present and tha eondlticn or tha lung tlaata a diaaiomd at tha tlwa of opa^atlon# an* yea able -to wrpr^aa an opinion as to vbfB tha fibers that vara found wart inhaled? Za thera# la tha Literature on tba subject# any recorded Instance of aeJtfTGbela among workers handling materials containing . aebeatee In ttw percentages contained lr. tha materials handled t>7 Kr* Cnthbertson# aa distinguished from fectory workers engaged la tha manufacturing of afbaatoa products or alnera engaged In tha mining 9f asbestos? 70a desire tuavthe saraloos of a roaatgeoolotiet or a pa&ftglogist# 70: ira autSarlead to do o tf yoSTulljr forward alljcoplee of your report# and your bill# to this office# I will ayranfe for filing of tha report with tha Industrial Accidentydowilptfl^n# tha service of copies# and tha payment ox. tout bl] * zAfiCT * r . %M - -" - c.'C.e. Referee John FT. Ankelc o.o* ith# Ferrleh# Paduelc d demo? o.o* Patrick h. Kalonay - o.o* Kullan h rtllppi ' a.e. /ernes V* Burohell - State Pond s.yww.wi >1'M^ai jji m. 1; awwwyan--ywPT 0001 -U w * LAW OFFICES OF * fswu i. cuter, ;t, cjo**mi. Mtrsunee SMITH, PARRISH, PADUCK & CLANCY . >U!'Hnt JiKtIiIiJi* ou a. vciear , V >WM'CII| C2MTIK aulLOIMa 40I-UTI4 TtT . 04K14MO it. e*kiroMi4 i * \ November 11, 1959 j` fc. v'. ...... i O^fcS-J Mr. John H. Ankele* Referee j ,. NuV i > 1559 Industrial Accident Ccasnlselon ; 577 - 14th Street 1 Oakland* California 1 j Otttand Cfn-5 Industrial Indemnity Co. 268 Grand Avenue Oakland* California Hanna k Brophy Attorneys at Law 1540 San Pablo Avenue Oakland* California Mullen k Pilippi Attorneys at Law 315 Montgomery Street San Francisco* Calif. State Compensation Insurance Fund 450 McAllister Street San Francisco* California Re: ROBERT CUTHBSRTSON Bear Mr. Ankele: The parties have agreed Dr. Cabot Brown be an Impartial medical examiner in the above case. Ve have ordered a transcript of Dr. Crenshaw's testimony and would request the transcript be immediately pre pared so the doctor may have it when he renders his opinion. JES:rb / coo: 5 m(* * <rV-l. zwmr BEFORE THE INDUSTRIAL ACCIDENT COMMISSION OF THE STATE OP CALIFORNIA ---0O0--- ROBERT P. CUTHBERTSON, . Applicant, No. 59 OAK 1053 vs. MINUTES OP HEARING PLANT ASBESTOS COMPANY, J. T. THORPE, WESTERN ASBESTOS COMPANY, ARMSTRONO CORK, TRAVELERS INSURANCE COMPANY, * INDUSTRIAL INDEMNITY COMPANY, >t PACIFIC EMPLOYERS INSURANCE COMPANY,,1 STANDARD ACCIDENT INSURANCE COMPANY, and STATE COMPENSATION INSURANCE FUND, (CONTINUED) tmw rl acf R&l \ _______ _ __ Defendants. 0*' PLACE 4 TIKE: Oakland October 22, 1959 9:00 a.m. REFEREE: REPORTER: APPEARANCES: ANKELE SMITH Applicant: Present SMITH, PARRISH, PADUCK & CLANCY By JOSEPH E. SMITH, Esq, Deft, Travelers and Standard:HANNA 4 SROPHY By IVAN A. SCHWAB, Esq. Deft. Industrial Indemnity: PATRICK R. MALONEY, Esq. ' Deft. State Fund: JAMES V. BURCHELL, Esq. ' WITNESSES: Deft. Pacific Employers: MULLEN & FILIPPI By JOHNMOORE, Esq. I ^ Richard E. Beaudry (Deft. Travelers and Standard Accident) Victor Sagues (Deft. Travelers and Standard Accident) (Apoj Paul Nieto (Deft. Industrial Indemnity) r Gerald L. Crenshaw, M.D. (App) (; David Singman, M.D. (Deft. Travelers and Standard Accident) Robert P. Cuthbertson (App) | ADDITIONAL ISSUE: Litigation costs ' \ IT IS HEREBY ORDERED that the defendant Union Mutual Life Insurance Company be and they are hereby dismissed as not being a proper party defendant. APPLICANT'S 1 2 DEFENDANTS' 4 5 6 l 9 Letter, Western Asbestos, to State Fund, 9-2^*59 Report, Dr. Crenshaw, 5-25-59, and bill, $790.00 Letter, 9-10-59* KEASBEY & MATTISON CO. to Beaudry & Wilson List of jobs where applicant worked Letter, 8-14-59, Schiedt to Taylor Letter, 8-3-59, Beaudry to Schiedt Report, W.C.Thielen, 12-31-58 O.A.Soave, DVM, 12-10-58 Report, Dr. Hinshaw, 10-12-59, 9-22-59 Report, Dr. Thompson, 9-8-59 Alcor S. Browne, PhD, 9-14-59 - - Hospital records uU'Ja j*' DISPOSITION 135 pp IO-22-59 he parties will agree upon an agreed medical examiner by next Wednesday, and thereafter they shall have 45 days to serve and file a report of such agreed medical examiner; :he case then to stand submitted without further proceedings wry8! iVWBAsify.!n>, -- tf TCrESirEniBir AsisssTros co. ------------- iiTtnumt ___________ _______ _ AN M1NOIIOO O A ft h A ft 0 TOCKTON NO. SAONAMINTO P ft ft 0 A M w O f Offleat tft r*in< |frr Klo*lik l-iftt A M T A ft C. State Coapeosation Insurance Fuad k50 JfcAllister Street Saa Francisco, CaliibrnJa Attention* Nr* Cullen SUBJECT* Robert F, Cuthbertson Gentlesen* In reply to your telephone request, we have contacted the Superintendent for tfica Nr. Cuthbertson worked during the 8-1/2 nonths he was with us. As far as ve can ascertain. Nr. Cuthbertson worked In the oil refineries at Rlchaond doing pipe covering Mid boiler Jobs. This type of work requires the use of mostly 85f Magnesia Pipe Covering and Blocks* Ve trust this Is the infoantioa desired* Very t nily yours, WESTERN ASSSTCS CO. HZSjst f S* // - H. E* Siaoss 0001 -v* OERALO U. CntNSHAW. M. O, 41 0MUNO r OAblVOfMlA >!--st*f l<H4l Msy25, 1959 ;\ . ^ Joseph E.Smith, Attorney of law Smith, Parrish, Paduck and Clancy Financial Center Building 405 - 14th Street Ooklond 12 California Dear Mr. Smith: Re: Robert F. Cuthberfson Mr. Cuthberfson consulted me in July of 1953 beeduse of persistent severe pain in the right chest. He had a slight proudcfive cough and dyspnea on exertion and while et rest. The patient gave a history of having worked in an asbestos plant for many years. A partial lobectomy was performed at Richmond Hospital on August 13, 1953. On examination of the lung ot surgery there were gritty fibrous nodules palpable throughout the entire lung. The right middle lobe was resected os well as a nodule from the diaphragm. Partioi pleurectemy was performed also. The specimens of lung tissue were sent to the Health Department for study of the asbestos content and the report was positive for asbestos. Very truly yours. >jj tl u Ql^slU Gerold l. Crenshaw, M. D. GLC:fg Enclosure *1 h 0 t r y OSWALD L. CRCNflMAW. M. Q. GAUPOfttol* Humm iiMeva+ 1*89t May 25, 195? , ' . To: Robert Cufhberfson 2438 Garvin Avenue Richmond, California 7 -29-58 Consultation Complete blood count ond sed rate Urinoiyiis Coecidioidin and Mstaplasmln skin tests (55.00 eo.) 7 -31-59 Office coil 8 -11-58 8-13-59 Office call bronchoscopy Right lobectomy 8 -22-58 Post-op visit Complete blood count and sed rate 8 -25-58 8 -27-58 8 -28-58 Intermittent positive pressure breathing l.P.P.B. l.P.P.B. 9 -2-58 9 -4-58 9 -6-58 9 -8-58 9- 12-58 9 -15-29 9 -20-58 9 -22-58 9 -24-58 9 -26-58 9 -29-58 l.P.P.B. I.P.P.B. l.P.P.B. l.P.P.B, I.P. P.B. l.P.P.B. I.P. P.B. l.P.P.B. Office call l.P.P.B. l.P.P.B. l.P.P.B. PA and lateral chest x-ray 10- 1-58 10- 3-58 10-13-58 10-27-58 10-30-58 l.P.P.B. l.P.P.B. Office call Office cell Office call 25.00 8.00 2.00 10.00 5.00 5.00 75.00 400.00 8.00 1.50 1.50 1.50 1.50 1.50 1.50 1.50 1.50 1.50 1.50 1.50 5.00 1.50 1.50 1.50 14.00 1.50 1.50 5.00 5.00 5.00 0001 -ali . - ~*N OCAALD L. CneNSHAW. M. o. omuxh . c*<.io> ***** Moy 25, 195? To: Robert Cuthbertson (Continued) 11-28-58 Office coll PA and laterol chest x-ray 12-12-58 Office coll 1 -10-59 Office call 2 -11-59 I.P.P.8. Lamp end vocefa* 2 -9 -59 Office coil PA and lateral chest x-ray 2-13-59 t.P.P.B. lamp and vaccine 2-16 -59 I.P.P.S. lamp and vaccine Strep and ceroclllln 2-18 -59 lamp and veeclne Strep and ceroclllfn 2-20 -59 I.P.P.8. Lamp and vaccine Office call 2-24 -59 I.P.P.8. Lamp ond vaccine 2-26 -59 I.P.P.8. lamp and vaccine 2-28 -59 t.P.P.B. lamp <d vael ne 3- 4 -59 I.P.P.8. lamp and vaccine s.oe 14.50 5.00 5.00 1.50 3.00 5.00 u.oo 1.50 3.00 1.50 3.00 6.50 3.00 6.50 1.50 3.00 5.00 1.50 3.00 1.50 3.00 1.50 3.00 1.50 3.00 & si*-' &r- s'*. 0001- HP ? ? v> <**V ^ ** YJtr*'+ ***?iwwPa^g. pPMSW OeffALO CMEN8HAW. M.O, 44* Wf#ViCt OAKCAMn C4LI'0*Ml* *'TM WbJHK 1?59 To; Robert Cufhberfson (Confirmed) > 4-59 i.t.fA. Lamp and vaccine Office coil 3- 9-59 I.P. P.B. Lamp and vaecine 3-11 -59 Lamp and vaecine Sfrep and eerocililn 3-13 -59 Lamp and vaccine Sfrep end cerociUin 3-16 -59 I.P.P.8. Lamp end vaccine Strep end eerocililn 3-21 -59 CFffce call I.P.P.8. 5 -9 -59 Office coil I.P.P.8, PA and loterol chest X-ray 5-11 -59 Office call I.P.P.8. 5-12- 59 I.P.P.8. 5-15 -59 I.P.P.8. 5-18 -59 5-20-59 Office call L.P.P.B, I.P.P.8. Total: 5 1.30 3.00 5.00 1.50 3.00 3.00 6.50 3.00 6.50 1.50 3.CO 6.50 5.00 1.50 5.00 1.50 U.00 5.00 1.50 1.50 1.50 5.00 1.50 1.50 $ 790.00 4 .1 . KEASBEY A MATTISON COMPANY Mtnufmcturtet of <46*iro, Mwrfncuu tnd Atphait Produett iMIl I K, MNNIHVANIA Z September 10, 1<J59 Beaudry It Wilson Insurance Adjustors U2C Market Street San Francisco 11, California Attn: Hr. Richard E, Beaudry Re: Magnesia Pipe Coverings Tour File: 59-199 Gentlemen: With reference to your letter of August 25, we are unable to send you any literature on magnesia pipe coverings since we discontinued manufacturing this comedity approximately one y"tr ago. The typical &5X magnesia nipe covering contains about 125 fiber and 86* basic m-rnesiuir carbonate. Certain percentages of the fiber might be Amcsite and Chrysotile, Such blends of fiber could vary from time to time, but on an average, it represents 125. Tcu have asked us to give our consents on the feasability of asbestos dust coming off such material when installing the same. We, as manufacturers, do not apply or in.stdll pipe coverings. This work is usually* done ty the contractors or applicators. It would be cur assumption that the amount of dust vculd in . all probability be Jr.sigrificant because in a good rary in stances insulation is covered vith carv.as Jackets prior to shipment into the fi^ld. Very truly ycurs, \ L: :-d K-1^..; u i t a.T XML^ 0, C Asuist'hl to t::C Cci*TJ>l .1:1 > n .r ' / v _ 0001 V.) ) ., . eMaWg|g;.-Tt^n|'nii.r _ Fibreboard Paper Products Corporation P. 0. 00* 4111 0AKLAN0 21. CALIFORNIA October 16, 1959 I Mullen end fillip! Attorney* at Lev 315 Montgomery Street San franelseo 4, California Attention: Mr* John V. Moor* In re: Robert Cutbbertaon ?4 C 6l$fl2 Dear Mr. Moor*: va. Plant Asbestos and Pacific Employer* Insurance Company IAC #59 QAX 1053 Vou reflected through Mr. J. C, Vollea, General Manager Insulation Division, the constituent* of the material known in the insulation* trad* aa 85$ Magnesia. This material when aoalyted In accordance with Federal Specification KH-I-554 Paragraph 4,3,2 r*ult* in the following constituent*: Hygroscopic Moisture Asbestos fiber 23 Lime as CaO Magneaia calculated a*: 1.2 10 .a .71 0.12 a. 4Mg CO5 (Mg (0H)a) 5HgO b. 3Mg CO3 (Mg (03)2) 3H20 Lota on Ignition Carbon Dloride 95.5 69.5 45.6 30.0 Tour* very truly. nSUSOAf PAPER PRODUCTS CCRPCRATIOf / M . V. Torbohn Manager Insulations Manufacture taeryvllle, California T:ph cc: Mr. J. C. Voile* i>Ma< ;.>.<( . .vtaQ*aO . rQi.O`a **< " A*eee . >huu . .('9* crMv ***> . ioo* eovr>w** . wcutr.ni ^ ................ ....................................................._............................................. oooipo 1 ,*r . (Armstrong c. August 14, 1959 Mr. 3. Taylor Armstrong-Contracting and Supply Corporation 304 Shav Road South San Fraaoiaeo, Calif* Saar Mr. Taylor* In ease you did not receive & copy of the Beaudry & Yilson letter, v enclose a Thermo-Fax and worksheets containing part of the information requested In the Beaudry k Vllson letter. Records for the year 1950 have been destroyed so that the Payroll Department listed only thoae contracts sorted on by R. 7. Cuthbertaon starting in 1951. Arthur Soardasn, Controller's Departaant, than Hated vlth vjacs* and where ve had the contract. Vhere the InfOTaation is not entered, Arthur v&a unable to locate the particular files. Thought perhaps your files night disclose this information in which ease you could ocoplete the information Beaudry A Vllson is looking for. In view of the first sentence in the last paragraph, page one, of Mr. Bendry1 letter, vill you please oontaot him at your earliest oonraalenee* Tery truly yours, AIHSTfOKG COBS COKPAMT fh.&.g J1Z Ihclosures R. C. Schiedt, Insurance Depar V OGOI ) i 4 a EE* 1 !BA.xrr>K*r as wz^soar IMIUIANCI A;VIIOII dagaat J, If* ; .` fbt Araatrong Cork Canpuy Lancaster, fecnajlvaala Attn* X. C. khi*4t, *, ... . Xaturanoa Dapt*'-V7V Ml Jbbart ?, Cathbtrtiea vs* lim i ng Own Qaaptay ter mat 59-159] gnUwii Va hart baan sjalgaad to da mm lsve**igatlea''^oxfe on tbeNsbota easa by ^ Mr. Xraa Sehvab of laana A Brophy'a office, vto an the hearing .\ _' before tha lodu*trial Accident CoMlaaloa for the traveler`a sad Standard Accident Insurance Canpanlar: ttIeNfleee\haebeen sat for August 13* 1959.. ' In order far ns to oc*pieta our inveeflgatlijo, it la naeaaaary that va obtain iom lnforaatloa Tram you and also a lattar vbleh can ba eubaitted' to tha Industrial Accident Coanlsalon/la tha mat va ara uaabla to pro* .... para tha eaaf in tlaa. CM^infonatloa va require la tha oaaa and ounber . of aaeh Job Mr. Cuthbertaonwr^ployed upon daring tha pariod Septenbar 13* 1950 to July\l7, 155k. With this Job nans and nuabar, va can than Obtain tha naaasaarjnlnfonMtlM' from jrour local office, Amatrcog Contracting and ' . tepply Ccapany,''bhicb-VUl aoabla oj to datarslna that typo of aaterlsls k. w. .vers used.end handled by Mr. Cuthberteea* ^ Aa you know, Mr. uthbarteoo baa filed a daIn for aabsatoaaa. Va ara trying to datarslna tha cnoont of naterlale ha haadlad containing aabaatoa* and tha aaeunt not eootalnlag asbaatoe. . . the abort lafnnatie* as to tha anas and auabsr of tha Job should ba Met directly to ua as coon as possible* In tha aaestlse, va vould appreciate ; 7W vrlting a lattar dlraet to Mr. Iran Bchveb, Attorney, Banna 4 Brophy, 1540 San fable Avenue, Oakland, California, stating that there vlll ba scats daisy la davaloplng tha inforsatloo it this cats, flsaaa iaelnda In your ' lattar tha raaacoa for this daisy, l.e., dlstsnca involved sad laaccaaaablllty of tha records. .. \ ui " 111 J J "gwyi'iH i^spidiJ.iiiJiSjFi^lMiSUWBJ>i 000: rV -VI * , / -J , , .. ' :-i- ' '` _ Xr Smfevmb mma thn m thia lttur at tha tlm of 11 bamrlat an Aajuat ij( 1959, to r*uoat mo axtonalot of tlm mad maothmr baartnm, la tbo rmt our lavaatlgatloa la sot ao^lotod* Thmn> you for jroor eourtooua mad prospt ra^lgr Is tfeia aattor* ` _ Cordially your*, . . . mac 4'isiot - Howard Z. Zoaudry . >*# ^ *. ** * IX ' ooor^; MEMORANDUM ITAT* OP TAUPOHNU DEPARTMENT OP PUDUC i IEALT*, .,, ^ ________ RECEIVED '5J&\ [JFC :i J -f<5C `^^imCAU OF AD'JLT HEALTH T Promt Bareau of Adult Health Attention: Dr. Christina Xlaert Air and I&dnttrlal Hygiene Laboratory December 31, 19# Subject: laboratory Seaple S-736 (lung time) nil* eaaple, aa received, eonstated of four ptoess of uadlfferatlatod tlsaua preserved la dlluta foraalln. Since quantitation vu not roqueatod no eaaple velgfct vaa rtcordod. Saall placaa approxlaataly 1 on square vara renoved at randoa froa aaeh of the placet of tlaaua and forvardad to the Time laboratory for hlstopathologleal examination. A copy of the report of tbit examination la attached. The balaaea of the saaple vaa ratalaad la tbla laboratory for ldantlflcatloa of aabeatoa. Tha sample vaa aaooratad la a baring blaador and flltarad through Vhataa Vo* hi filter paper, tha filtrate being dleearded. The notarial reaAlnln* oa tha paper vaa dried la a racuua oren at 500c. She dried aatarlal vaa thaa ashed according to the eethod need by Xing aad . Jegelschaldt. To avoid eoataalaatloa ashing vae done entirely la platlaaa vara. A saall portion of tha ash vaa taken for microscopic eBaiaatloa, tha balaaea vaa retalnad for X-ray diffraction aaalyais. Xleroecopie sxsalaatloa of tho luag ash ahovad tha praaanca of considerable anabera of needle like cryetala ranging la else froa leee thaa 10 alcrona to over 100 aieroaa la length aad froa 1 to 5 microns la vldth (tea attached photomicrographs). Particles thle ihnpa are atypical of quarte but qnlte consistent vltb certain of the aabeatoa group of nlaorala. While Petrographic aeesureacate oa crystals this alto are not tec precise, certain observations vara obtained as follovaj 1. Ixtiaettoa - oblique 2. fictlnetlon angle - 12*- 16* 3. Sign - (-) U. Sarafrlagaaca - .015 (estiaatad oaly due to saall crystal alee) 0001 BAH 5-736 U Daoaabar 31, 1956 Thaoa vnluaa ara la good agraaaaat -rith tho* firaa for Trawlik* la Eenanta of Optical Mineralogy. Part II, rinchel and Vlnehol. X-7%7 diffractloa analyst* vaa and* uelay povdar r*u~tgna ma& Iroftl alpha radiation. Xxaalaatlon of tbo diffraction patters ihovad tha praaanca ofl 1. QnartB Z. Hornblaad# 3 Actlnolita k. Traaolita 5. AaphoMl# Ylth the azeoptloa of quart* tbaaa ar* all aiaarala of tba ibaatoa group. i J '1 MEMORANDUM ITATl OP CAUPOUKIA DEPARTMENT OP PUBLIC HEALTH' To. Wm. Theilen Industrial Hygiene Laboratory M Through. Sdwin H. Lennette, U.2.J Frau 0. 1. Soave, D.7.H. ' .i Virus Laboratory 3 Dt*. Daoeaber 10, 1923 Sublet: Hunan lung, hroachua (3--56, ^736) from Industrial Hygiene-Lab. i i Is reference to tissues suboitted for histopathologlca! examination, the only pathology seen was in the lung. Sara thara was a good deal of passive ooageation, small fool of carbon granules but not enough to ha significant, The major abnormality was the prasenoe of granulomatous areas with lymphocytes, epithelioid cells and fibroblasts. As granulomatous lesions may form due to many causae, it ia not possible to inoriminate any one, i.a., tuberou- loaia, eoocidicldosyooeis, and oertsin irritants or toxins. The other tissues, bronchi and bronchiole, appeared normal. OiStjs 0. A, Soave, D.V.iL last Publio Health Veterinarian \ H rt> oooi:-`> <ru t-m from TO SUBJECT M. CORWIN H INCH AW, M.O. HORTON C. HINSHAW. J.. M.O. w grtm tacrr . IM *MNeico *. CAM'MMlA 12 October 1059 H. Corwin Hlnshaw, M.D. Hanna tad Brophy 1640 San Pablo Avenue Oakland 12, California Mr. Robert F, Cuthbertaon v*. Armstrong Cork Company, et. *1. CONSULTATIONS oa FILMS AND TISSUES EXAMINES BT L, H.G6RLAND. M.D.. Radiology Consultant tad GEORGE WATSON. MD.. Pathology Consultant 1 have received the following letter from Doctor L. H. Garlaad. "Regarding Cuthbertsoo, Mr. Robert, the following are coosultntloa reports oa the submitted films of the cheat; 10.10.63 (Herrick Hospital). The heart vessel shadow la normal te size and position. Tbe brouchovascular markings are of the fairly heavy type, apparently consistent with the patient's build. The diaphragm la normal in position and outline. There la no x-ray evidence diagnostic of occupational polaooary diaeaae. 11.13.54 (Herrick Hospital). No significant change. - 3.17.56 (Herrick Hospital). No significant change, _ -.. , ... ; . 9.10.59 (Tour Office). There are some irregular acaxlike opecltlea in the right lower lung field, presumably secondary to the reported lung biopsy. In the atereoecope there are some prominent vessels In the right upper lung field. You have kindly informed us that fluoroscopically the diaphragm shows normal excursion. Conclusions No evidence of occupational pulmonary disease (silicosis or asbeatoela). Thanking you for submitting these films for consultation, I am " Tours sincerely, t/t Pip 3 Prom To Subject ; - 12 October i*S* H, Corwlo Hinahaw, M.D. Hanna tad Brophjr Mr* Robert T, Cuthbertsoo Doctor GtrUncf s opinion adds substantially to tho evidence summarized la my prerloua report dated September 22, 1959 that Mr* Cuthbortaoa does aot have x-ray evidence of asbestoslj and therefore la aot suffering from any disabling occupatloaal disorder of the luaga. Report of Doctor George A. Watson, Pathology Consultant CLINICAL SUMMARY All patient has worked for many years, be atates, la tbe asbestos industry Including time spent for Armstrong-Cork sad Western Asbestos. Be hss a twin brother similarly exposed who has been Judged disabled due to lung pathology. There was so episode of bilateral acotepoeumoeia for which the patieat waa hoepitallzed from February 21, 195S to tbe early part of March 1958. Be has some residual pathology apparently an Incompletely resolved pneumonia aad on August 12, 1958 hid s partial lobectomy. The surgeon. Doctor Crenshaw, gave the diagnosis of asbestosts but the pathologist made no mention of such condition. MICROSCOPIC EXAMINATION Two of tbe three available slides show portions of s thlct membranous tissue apparently with s serosal Untng. This is composed of dease, relatively acellular collagen with s rare cluster of lymphocytes but no other features of interest. This is taken to be pleura, although the origin Is aot oertalnly known. The third slide consists of two segments of lung parenchyma together having an ares of approximately 0.6 cm.2. It includes a portion of thickened pleura which Is composed of coarse, collagenous strands rather wavy with plump light staining, uniform, intervening fibroblasts. The parenchyma displays consistent features throughout. Tbe alveolar walla are thickened and the largely obliterated. Lining oells are prominent with plump oval nuclei but not actually hypertrophied, the change being due simply to modified tension from eoUapee. Tbe thlokened septa are occupied by the plump lining cells ' *" on each base with a few fibroblasts and collagenous strands intervening. The lumtaa are filled with mononuclear cells having oval, finely granular nuclei aad abundant, cytoplasm which commonly contains light brown, granular pigment. There la very little carbon pigment present or anlaotrophic material. Scattered throughout are a number of brown, hyalin, rod-shsped bodies generally occurring In duster*. They are characteristically tapered and commonly nodular at the wider extremity. There are approximately 243 clusters of asbestos bodies per square centimeter at aisue>section. . DIAGNOSIS; 1. ASBESTOS BOD? DEPOSITION, MODERATELY ADVANCED, LUNG 2. ATELECTASIS, LUNG NOTE Tbe asbestos bodies are quite numerous but do aot appear to have excited moeh tissue reaction. Most of the alteration seen In these sections is attributed to atelectasis, although the basis for the Utter la not evident in this Pip s from To Subject 12 Octobor^BSt H* Corwta Hinshaw, U.D* Hanna and Brophy Mr, Robert T. Cuthbertaon o Pathology Report (oontlnaad) limited sample* GAW/bo George A. Watson, M.D. Pathologist Doctor Watson's findings confirm tbe patienf i atatemeot that be has inhaled asbeetos fibers. Tbe Inhalation and tbe deposition of asbestos fibers does not by itself constitute evidence of disabling or neoeaaarily significant occupational pulmonary disease. It would be predictable, that any person long engaged in tbe handling of asbestos materials would collect asbestos fibers la his longs which would be detected if a suffi^nt amount of lung tisane were examined. It must be emphasized that the presence of these fibers bears no relation to the degree of injury, if any. and that other method! of examination must be relied upon to determine whether significant pulmonary disease la present. The function of fang biopsy in esses such as this should be to determine tbe nature of serious injury and disability when euch disability has first been demonstrated. Biopsy served no useful purpose whatever Is a situation such as this where there Is no clinical, physiological or radiological evidence of disabling pulmonary disease* . 0001 J H. COrnWtN HIN1HAW. U.O. HORTON C-MINSHAW. JB..M.D. ..o aurrt* traitr AN .NCI0 . CAUA9*N<A TW.** t-TIM FROM September H. Corwin Hinahaw, M.D. 22 1969 TO Hanna L Brofchy 1540 San Pablo Avenue Oakland 12. California' SUBJECT Mr. Robert F. Cuthbertaon rt. Armstrong Cork Co., et al SPECIAL MEDICAL EXAMINATION AND REPOST Purpose of tbe Report To determine tbe nature of Mr. Cuthbertaon1 s cheat complaints with special reference to tbe problem of asbestoais and tbe source or sources from which such condition may have arisen. Occupational and Clinical History The patient states that for more than 12 years (since about July 1947) he has worked with materials containing asbestos, fiberglass and cthor insulating materials. He states that be baa been employed by several different contractors and 3tates that a detailed record of his employment is on file, tbe details of which he cannot recall at this time. He states that be has worked under a wide variety of conditions but that he has frequently been exposed to-asbestos dust and dust from other insulating materials in closed spaces where ventilation was defective. He says that he did not wear a mask at any time and had sever been Instructed to do so until November 1958 when he returned to work after having been told that be had asbestos deposited in his lungs. He has had x-ray examinations of tbe cbest carried out occasionally and a review of the record would indicate that tbe films were made in October 1953, November 1954. March 1956 and a number of filma between February 1958 and August 1958. The patient is not Informed as to what these films may have demonstrated and the films are not currently available for review but will be acquired for study in this office, if possible. The patient's chief complaint is and has been pain in the chest. He cannct recall when this pain first became a source of concern to him but s review of medical records available indicate that he had some chest pain in February 1958 and tbe patient thinks that he may have sought medical advice for a similar complaint at some indefinite previous time. His acute illness of February 1958 required about two weeks of hospital care and Doctor L. W. Brown, his personal physiebn. ordered x-ray examinations and other studies, The x-rays apparently showed some abnormality which led to further investigation and eventually Doctor Brown recommended that be seok advice from a cbest surgeon and he was referred to Doctor Coraid Crenshaw of Oakland* Doctor Crenshaw carried out an exploratory operation on August 13. 1968 and removed a Pago %' From To Subject Hoplombor zr-Utf9 H. Corwin H. Ht#, M.D* 1 Hanna and Brophy Mr* Robert F. Cuthbortsou Report of Special Medioal Examination ' & - Occupational and Clinical Hlatory (CONTINUED) pocireeo of lung tlnuo and haa reported to the claimant1* attorney that "the report wa* poalUve taz asbestos," The patient doea not explain hta symptom* very well, not remembering whoa hia difficulties commenced or how they have progrossod but tho following is a summary of bio complaints at present* General Complaints He complains of fatigue and says that he baa difficulty sleeping at night but apparently has not lost any weight or had other systemic complaints* Respiratory Complaints Hia pain is described as follows; Location - anterior chest from the level of the clavicles on each side to the lower rfb margins* The pain is bilateral but more severe on the left side than on the right side* The pain la entirely anterior sad does not extend posteriorly. Character of pain - a tlghtnesa and a hurting sensation is described* Time of day - He says the pain may be noted at any time of day and is present much of the time* The pain is made worse by general fatigue but apparently Is not influenced by motion of the shoulder girdle muscles nor is it worsened by deep breathing* Tho pain is mads better by rest and he thinks that a deep breath may give him some degree of transient relief* The only time that he can recall when he was completely or relatively free of pain was during a two weeks vacation at Lake Alminor in the Northern Sierra . Mountains* He said that he had no explanation as to why the pain disappeared under these conditions but he was probably more relaxed and spent a good deal of time fishing and he had less trouble sleeping* He has no cough but does expectorate some greenish material In tbs morning, the origin of which is unclear to him* He probably has had no asthmatic symptoms, wheezing or other abnormal respiratory sounds* He says that be is more short of breath than formerl and doubts that he could play basketball oow as he did approximately two years ago* Cardiac Symptoms No palpitation or irregularity of heart action observed* No swelling of the ankles or other symptoms to suggest cardiac decompensation* Gastrointestinal Complaints Appetite is normal, no difficulty twAowlng, no indigestion, no abdominal pain, no cooatlpatton or diarrhea* Genitourinary Complaints ' No difficulty urinating, no obstruction to the flow of urine, no abnormal appearance to the urine or other symptoms suggestive of possible disease in these organs* Head, Eyes, Ears, Nose, Throat, Sinuses - No complaints except for tho sputum production as mentioned above* Skeletal, Muscular, Central Nervous Systems ' No complaints except he does have difficulty stooping at night and be believe* that he la much more nervous than be was a year or two ago* Personal Habits He doea not smoke, havtng quit smoking about one year ago and probably never was ,/" oook; - 4 PWJlIJjiMJ'flP Pipl From io Subject -September 27' ./it, M.l H. Corwin Jllu-rfKv, M.D. Hanna ti Brophy Mr. Robert F. Cuthbertion Report of Spocial Medical Examination Personal Habits (CONTINUED) a heavy smoker although he may have approached aa much as 20 cigarettca dally* He has never consumed alcoholic beverages regularly or to exoesa. He oats his meals at regular hours and generally leads a well-ordered life. Personal and Family History He is married and his wife la in good health, he has three children, a son ten and one-hall years of age, a son age five and one-half and a daughter three and one-half years of tge, all of whom are in excellent health. His father died of a cancer of the | throat at about 48 years of age. His mother Is living and In good health, be has two sisters who are living and well and one twin brother (not Identical) who is believed to have asbestosIs* PAST MEDICAL History Tonsils were removed at the age of 19 years and he has had no other operations except lor the lung biopsy mentioned In August 1988. He has had no other serious Illnesses except those mentioned above. He Injured one foot with fracture of some bones while working on tbe Job In 1957. He says that he still has some residual ' pain la this region. Present Medlestlons - Nods. Aysical Examination General Appearance Tbe patient is a stocky, busty-looking fellow, who would appear to be in the best of general health. He is heavily tanned and hla musculature Is well-developed and his general appearance would be consistent with his reported age of 31 years. His geoeral attitude has not been cooperative or he is a poor historian because details of his working history were Impossible to secure and hla physical complaints were very poorly described sod often inconsistently described. He seems to be restless and irritated and it la observed that his fingernails are chewed off very closely. He admits to this nervous habit. Height S feet 8 Inches. Weight 180 pounds, usual weight not known. - Blood Pressure Normal. 130/80. , Pulse Normal, 68. Temperature Normal, 98.0F. Eyes Pupils are regular and equal, reflexes to light and accommodation are normal, external ocular movements are normal. Oral Teeth are in fairly good condition, no evidence of dlsoaeed tonsils and no irritation Cavity of the pharynx is noted. The tongue appears normal, the ears appear normal. Lymph Cervical and axillary nodes are not enlarged or diseased. Nodes Thyroid Normal. Breasts Normal. Skin Normal except for tattooes and for the scar of a right lateral thoracotomy incision. / oooic:; Page 4 From to Subject September W58 11. Corwin M.D. ' llunns and Brophy Mr. Robert F. Cuthbertaon Report of Special Medical Examination Physical Examination (CONTINUE!)) Cheat Wall ` The shape is normal, respiratory excursion la good and there la no local tenderness. Lungs Percussion note la normal throughout, breath sounds are normal and equal. There are no rales detected, no wheezes or other abnormal sounds detected with the stethoscope. Heart Size la indeterminate, rhythm regular, no murmurs or other abnormal sounds were detected. The neck veins were not distended. Abdomen Ho unusual tenderness, no enlarged liver, no palpable spleen, no palpable kidneys, no other organs felt sad nO abnormal masses palpated. Genitalia Normal. Extremities All joints appear to be normal and to function normally, no abnormality of vessels, no edema, no dubbing, no unusual callus on the palms of his hands, no tobacco stains observed. Tests of Pulmooary Function Chest Expansion Normal, $ cm. Vital Capacity 3.2 liters, 3 second vital capacity 3.0 liters. Maximal Breathing Capacity 88 liters per minute. I was not convinced that his vital capacity or hla maximal breathing capacity were truly maximal efforts but In any event these are within the lower limits of normal. His breathing pattern is normal with no Indication of air trapping, no obstruction to outflow of air and there was no evident shortness of breath on the usual activity, X-rsy Examination of the Chest Stereoscopic and lateral films on September 10, 1959 Indicate that the bony structures of the thorax are normal. The heart and mediastinal structures are normal in size, shape and position. Both hemldiaphragma are normally arched and are at a normal level. Both hilar shadows are within normal limits. On the left aide the vascular markings are prominent but no more prominent than often seen in a man of this constitution. There la no evidence of any Inflammatory disease, no fibrosis or other evidence of dlsesse in the left lung. On the right side the vascular shadows are normal, the upper lung fields reveal no abnormality and In tho lower lung field there is a coarse stringy opacity at the level of the fifth rib anteriorly which appears to be the result of his thoracic surgery. There is no indication of inflammatory dlsosse and no shadow which 1 could identify at representing dust deposition. Previous films, obtained from Herrick Memorial Hospital in Berkeley, California and bearing the dates of October 10, 1953, November 13, 1954 and March 17, 1958 have been obtained and compared with current filma. Those films are all similar to current films and they also fall to reveal any convincing evidonce of pneumoconiosis, in my oploloa. Tho only difference between the previous films and the current onos is the area of scarring at the base of the right lung, produced by the surgical procedure. gnw mi 8 |i c6oor, ' SIDNEY J. SHIPMAN, M.D. ROBERT W, CLARKE, M.D. ELIZABETH H. GALBRAITH, M.D. 490 Post Street San Francisco 2 March 30, i960 Industrial Accident Comalsalon 455 Golden Gate Avenue* Room 280g San Francisco, California Proa: Sidney J. Shipman, M.D. 3 0 P y Concerning; Robert P. Cuthbertson, No. 333208 2438 Garvin Avenue Richmond, California Gentlemen; The following Is my report on Mr. Cuthbertson who reported for examination on March lo, I960, at your request; General History; Age 31. Born Kay 4, 1928 in Albany, California. Married and has 3 children. Home address: 2438 Garvin Avenue, Richmond, California. The Probleat The diagnosis of aabestosis has been made in this case, based upon history of exposure and a pulmonary biopsy. Does asbestosls really exist In a clinical sense and, if so, what is / the degree of disability? Chief Complaint; The patient says that prior to operation ha had pain in the left chest but this was so long ago that he is uncertain as to its exact nature, whether it was sharp or dull or whether It was aggravated by breathing. Sinoe the operation, his pain is substernal and radiates to both sides Family History: The father died of cancer of the larynx at age 48 Mother Is living and well, as are two sisters. Patient has a twin brother who is said to have asbestosls. Marital History: wife living and well, as are three children, ages roughly 11, 6 and 4. Past History: Operations; Tonsillectomy at age 19, with good results. Biopsy of lung tissue and subtotal lobectomy In August, 1938. Accidents: Foot injured in 1957 with fair recovery. Adult diseases; See Present Illness. folldhood oiseaseat Usual, with good recovery. Habits; has never used alcohol to excess. He smoked in the past up to a package a day but has not smoked for over a year. See Page 2. SERVICE ON; EK Snith 4 Parrish, 501 Financial Center Bldg., Oak. State Comp. Ins. Fund, Personal Service Mullen 4 Filippi, 315 Montgomery St., S.F. 000 Ind. Indem, Co., S.F. Hanna 4 Brophy, Oak. ..IJR-JUUWW* m&?r. DB aaaa * RE: Robert F. Cuthbertson Page 2, March 30, i960 Past History Habits (cont'd): No nycturia. Appetite fair, Digootion"good. Bowel8 regular. Does not sleep well because of nervousness. Occupational History: Patient says he has worked with asbestos and insulating materials since 1947 ror various con tractors, both Inside and out. He has never worn a mask prior to November, 1958/ when he was told he had asbestosls. Since that time he has worn a mask. Patient is somewhat indefinite about his employment and the composition of the materials used. See "Discussion1 for further Information, Present Illness: Mr. Cuthbertson says that he has had seme chest pain, chiefly on the left side, the exact nature of which he Is unable to recall, for several years. It may have begun in 1957 or even prior to that time, but It became severe enough in February, 1958 to cause him to consult his physician. The doctor ordered some x-rays and detected something abnormal In the films which he pointed out to the patient and for which he recommended a consultation . with Dr. Gerald Crenshaw of Oakland. Dr. Crenshaw did a thoracotomy on August 13, 1958 and removed a specimen of lung tissue and some of the pleura for examination. The patient believes that these " specimens showed the presence of asbestos bodies. Following operation, Cuthbertson had a normal convalescenee but his pain was not relieved. It was substemal and spread Into both sides of the chest. Rather than being made worse by deep breathing It was somewhat Improved, He has had colds following operation and raises a small amount of sputum, but this has never been marked. At present he Is working as before. . Physical Examination: A well developed and nourished man appearing perfectly well. He looks somewhat younger than his stated age of 31 years. He Is pleasant and cooperative, although he states he doesn't think much of doctors. Temperature 98.6. Pulse 74. Respirations 16, Weight 163 pounds. Height 69 Inches, Eyes: - Pupils equal and regular, reacting normally to light and in accommodation. The extra ocular movements are normal, Ears - The canals are clean. Tympanic membranes are normal. Hose - No gross obstructions. Mouth - Teeth m fair condition. Tongue clean. Pharynx injected. Glandular System - Thyroid palpable but not enlarged. Ho adenopathy noted, ggf-fag* 3. 0001.KS 1 o RE? Robert F, Cuthbertson Pag* 3 March 30, i960 Vascular System - Radial pulses equal and zynchronouo, of fair volume but diminished tension. Vossel walls Heart not thickened. Blood pressure 105/65. PMI not seen or felt. No palpable thrill Xhg sounds are of fair quality, ftrytm Tegular. Chest A2 Is equal to P2. There are no adventitious sounds heard, Expansion good throughout. There Is a well healed thoracotomy scar over the lower right chest extending forward to the anterior axillary line; not tender. Right lung - note good. Breathing vocal Abdomen resonance apparently normal. Ho rales. Left lung - same as right, no masses. Ho tender areas made out. Ho palpable viscera. Cenitalla Extremities Heflexea Vital Capacity Normal adult male. No clubbing. No cyanosis. No verieosltles. Knee jerks equal and active. No pathology made out, 1 second, 2000 cc Pluoroscopy Total, 4000 cc. Both leaves of the diaphran move well, although there is obliteration of the right costophrenic angle. The heart and great vessels are within normal limits. The root shadows are somewhat X-r_ay _f_il_m__s accentuated. The parenchymal zones seem clear. 10/10/53 - Heart and great vessels within normal limits. Root shadows normal. Costophrenic angles clear. Parenchymal zones are clear, 11/13/54 - No change. 3/17/50 - No essential change. 9710/59 - Taken by Dr. H. Corwin Hinshaw - now reveals linear densities in the right base with some intervening density characteristic of pleural reaction. 11/19/59 - Taken by Dr. Cabot Brown - essentially unchanged, 3/18/60 - Slight pleural thickening and' linear densities in the right lower chest, chiefly anterior, comparable to those seen in films of 9/10/59 and II/19/59. Laboratory work - 3/18/60, tTrlnalysis - Clear, amber. Specific Gravity 1.020, Acid reaction. Albumin 4 sugar negative. Pew hyaline casts. Few squamous epi thelial cells. Pus cells, 0-2 per h.d.f, R.B. cells, None seen. 3/18/60, Complete Blood Count - Hemoglobin 08#, 14.8 gm Erythrocytes 5,010,000. Color Index .88. Slight achrorain. Leukocytes 9,800. Neutrophils 67#, of which 64# were mature; 3# stab cells. Lymphocytes 28, No monocytes. 3 Eosinophils; 2 basophils. 3/18/60, Kolmer - Negative. I/IH/SO,- VdAL - Negative, See_ Page 4 0001 rr* J5T5K5 REi Hobart P Cuthbertaon Page 4 March 30, I960 Discussion: I have examined the voluminous file in this case, including the report of the hearing before the Industrial Acoident Commission of 11/25/59; the report of the Referee, dated 8/13/59j the hospital- 1ration record from the Richmond Hospital Association, Cuthbertaon #1053 the employment record from 1947 to 195#, showing employment by several concerns as listed; Dr. Hinshaw's reportaddressed to Hanna & Brophy, dated 9/22/59; Dr. Garland's report dated 10/12/59; Laboratory analysis of lung tissue dated 12/31/58, signed by v. C. Thielen; the transcript of testimony before Mr, Ankele of 10/22/59; Dr, Brown's report of 11/19/59, addressed to Mr. Schwab; Mr. . Ankele's opinion filed 12/15/59; Joseph S. Smith's Petition for Reconsideration dated 1/4/60; Hanna & Brophy's answer to the Petition, filed 1/11/60; John W. Moore's answer as well as the answer of Patrick R Maloney; together with a large amount of miscellaneous correspondence and material. The results of my personal examination today reveal no evidence of abnormality excep a thoracotomy scar on the right side of the chest and the thickened pleura at the base of the right lung. My examination Indicates that there Is no disability at this time. What makes this case difficult Is that Dr. Crenshaw obtained a specimen of lung and the specimen showed the presence of asbestos bodies. Does this mean that the patient has asbestosls? It certainly does not mean that he is sick or disabled and in a clinical sense it dees not mean that the disease, asbestosls, exists. The diagnosis of the disease, asbestosls, depends upon: (1} A history of exposure to asbestos dust (2) The radiological appearance consistent with asbestosls and, usually, (3) A symptcoology consistent with the diagnosis together with, (4) Evidence of impaired pulmonary function in most eases The amount of exposure necessary to produce the disease Is hard to determine and varies somewhat from person to person as we find in silicosis. Moreover, the site of the dangerous particles varies more than In silicosis. In this case 2, 3, and 4 are not consistent with the diagnosis of any type of pneumokoniosis. Thus, essential criteria for making the diagnosis of the disease In this.case are lacking, in spite of the finding of asbestos oodles In the lung tissue which Dr. Crenshaw removed. In general, I agree with Dr. Hinshaw's report and with the discussion of Dr. Brown dated November 19* Sincerely yours, SJS:mn Ends, ec's (2) Ends, statements (3) s/ Sidney J. Shipman, M.D. Sidney J, Shipman, M.D. JU, J.'t ,a r (I *1 2 3 * 5 6 IBhUSmAL ACCIDKHT COMMISSION Date FEB 25 ^ TO: MEDICAL BUREAU , Son Francisco Case None:nODTKT ?. <vrvffiEKT30W Can No: OAX 1033 Applicant's complaints relato to the following parts of the body: Oo ____________________ Ltft-roff ____________ ,, You are requested to: ' ~ 1 1 Hoviow the ^ileand give opinion without examination. Examine the applicant in the Medical Bureau. ' > Refer to IME specialising in IMS Pep will be paid byCglCinsaXflMj- ------------------- . --- ---------. Additional X-rays, laboratory Teats, and otner auppxementax procedures may be done if necessary. 6 Copieo of report requested. ___ Defendants will pay transportation expense. Defendants will pay living expense. \o T" ALL AVAILABLE X-rays are attached. All X-rays believed necessary are attached. . Hold days for X-rays from \ **. v \ A RZFQRT IS REQUESTED, GIVING OPINION IT?OK THE roLLOtflMO? 1. 7X Are the medical findings consistent with the original incident or injury/claimed by applicant? aSBZSTOSZS 2. X IS disability exists as result of the injury, is it: a. Temporary total. b. Temporary partial (if so, state extent of ability to work), e. Permanent and stationary for rating purposes* 3. X If permanent and stationary and ready for rating, describe; a. Permanent disability C&ctora resulting from the injury. b. Factors to which you believe the injury was an aggravating or contributing cause. c. Controversialfactors, if any, which you believe pre-existed and are unrelated to, and not aggravated by the injury. h irt* If P.D. factor or factors are so related between injury and pre-existing condition they cannot be separately stated, please state in percentage what portion is chargeable to the injury. 5. X Is any further treatment reasonably necessary to cure or rolieve the effet3 of the injury? If so, will you please give type of further treatment needed. (MOTE: Please do not include under 3 or h, physical conditions in J no way related to or aggravated by the injury sad not in controversy.) 6. FURTHER QUESTION AND ft SHARKS: V, Dunb*^ (' - C n;u* Referee o INDUSTRIAL ACCIDENT COMMISSION Data TO: MEDICAL BUREAU San Franoisco FE5 fVT Case Name: ROBERT P. CUTHBERTSON Case Not OAK 1053 Applicant*a complaint! relate to the following parts of the tody: LUNOS ' You are roquACtcd" Eo*:~~----- , -- . 1 *~hov~iew the file and give opinion without examination* _ Examino the applicant in the Medical Bureau, , XX Refer to IME specializing in , IME Foe will be paid byCOMMISSION J / 1 " * " MQ ________ ^"^Adctltlonal X-rays, laboratory teste, and other 'supplemental " _ procedures nay be done if necessary, , < (p Copies of report requested* __Defendants will pay transportation expense. Defendants will pay living expense* . . . . ..... .... ......... . X ALL AVAILABLE X-rays are attached* All X-rays believed necessary are attached* _ Hold days for X-rays from A REPORT IS REQUESTED, GIVING OPINION UPON THE FOLLOWING; 1* XX Are the medical findings consistent with the original . incident or injury/claimed by applicant? ' ASBESTOSIS ' 3, X If disability exists as result of the injury, is it: a. Temporary total,' b. Temporary partiAlVdf so, state extent of ability to work), e* Permanent and stationary for rating purposes, 3, X If permanent and stationary and ready for rating, describe: . a. Permanent disability factors resulting from the injury, . ... . . . b. Factors to which you believe the injury was an aggravating or contributing cause, c. Controversialfactors, if any, which you believe pre-existed and are unrelated to, and not aggravated by the injury. k. If P.D, factor or factors are so related between Injury and pre-existing condition they cannot be separately stated, please state in percentage what portion is chargeable to the injury* 5. X Is any further treatment reasonably necessary to cure or relieve the effects of the injury? If so, will you please give type of further treatment noeded* (NOTE: Please do not include under 3 or U physical conditions in no way related to or aggravated by the Injury and not in controversy,) 6. FURTHER QUESTION AND REMARKS: tv RT.y.u. 1,1 Refere^^f-j-* i fj j,-''-.f.s '} i-.'J .uJ."HRP-f -m Uji>i)ii*i*x` r 9 STATS Of CAUfOINIA 0 ftlV>IOH 9* *****flf**# rouNO ioww 0a>---- /OHM >. OMiM <* t*g**t*i Hvilif" # uM* v* vvroMNiav 4VI*40 99 (**<* IAIM, ## 99 MlVIV1H4 MCIMMM a. . (at*. r ***<> 99 kA999 f** Mt4c* DEPARTMENT OF INDUSTRIAL RELATIONS mwinwHi >n micw run, un mNcneo 4 ''"'Z'lTZ"'." March 8, I960 AOOtm 11PIT TOi M**lvNeHt*ia^gi eei9rT ovhhimji Dr. Sidney Shipman U.90 Post Street San Francisco, California BE: R.F. Cuthbertson 2k3Q Garvin Avenue Richmond, California APPT: March 18, 1960 Friday- 2:liS p.a* Dear Doctor: You hove been legally appointed as an Independent Medical Examiner to examine the ap-licant (or records) named above, in accordance with the Referee's Mem# of Instructions attached. If you have had professional contact with the case, do net make the examination. ' Ihe examiner should not discuss the case with any one not a member of the Commission's staff. Please express as definite an o-in.'on as possible. Such terms as -ossibly" or "may be" are of little"value in Com mission procedure. In cases requiring orthopedic measurements, the Coi.uission's approved method of measurement should be used. Please render both report and bill in triplicate and address to this office. Do not nail Commission folder as our messenger will call when you telephone us that it is ready."EXbrook 2-S302A*^ i/xt 277). In examinations made outside San Francisco and'Los Angeles the folder should be returned by registered mail. Return the report ilOT LoTE.-t THaN OKS wi;EK from date of exaa- ination as the settlement of the case will probably depend on your report. The Commission's aporoved fee for review of the medical file, examination and report is 435.00. A higher fee will usually be aoproved in the event of unusual work or difficulty caution. ' . Do not hospitalise the patient or undertake extensive diagnostic procedures such as myelography or cystoscopy un less these have been authorised. If in doubt, call this office. Ordinary x-ray and laboratory examination is permissible. Treatment wi11 never c authorised. md file films Very truly Amours, -('f&eitvr . L. lUnRITT, ;;edical Director . JLO:Jet M3-17 amend. oooir~ A j.j3 ^RnSfinTISEMKr ASESJESTTOS C 0 - - - (IT4IUIHIS I a -- ----------- --____________ _ lltN MtNeilfit tnNB iroeo mo. KctHiiiro mimc a * m , o a a * m r a f0tfieai 373 3*m KUn^lti |>lltl 3, Ctllftmlt July 28, 1959 State Coapensatlon Insurance Fund U50 HoUlister Street San Frond SCO, California Attention: Hr. Cullen SUBJECT * Robert F Cuthbertson Gentlemen: In compliance with your request, we wish to advise that Hr. Cuthbertson vss eaplcyed by us during the following periods: From 1/ 1A9 - ?AA? Hourly rate - 12,16 * 3/U/50 - 8/3/50 '12.35 His work consisted of applying insulation to pipes* boilers* etc. If we can be of any further assistance to you* please do not hesitate to call on us. Very truly yotrs, WESTBRN ASBESTOS CO. KEStar H. E. Simon* ^CclVSO 'V? 5 1959 ooo--> XHPI.CYXJWT 197 July .through December y.^, Plant Animates Co 19d January, plant Asbestos Co. 19*8 May through December, l*4d, .T T. Tnorpe 19*^1 1st or January, January 12, l$J*y, J. T. Thorpe 1949, January through May 4, 1549, Eastern Asbestos Co. 1949, May 11 through Aug. 1C, 1945, j. t. Thorpe 1949 Aug. 11 through Dec. 1J49, Plant Asbestos Co 1950, Jan. 1 tlirough Feb, 16, 1950, Plant Asbestos Co I960, March 13 through Aug 3, lr*fO, Western Asbestos Co i95c, Aug. 20 to Sept.3* I960, Plant Aabeston Co i960. So;.*. 13 through December, 1910, Armstrong Cork lyfl. January through December, 1-V1, Armstrong Jork 191i, January through December, lr<52, Armstrong Cork 1963, January through December, Armscror.; Cork 1964, January through J.ly ly, 1964, Armstrong cork 191W, July lc through December, 1914, Piant Asbestos 1961, January through December, Plant Asbestos 1916, January tnough December, Plant Asbestos 1967, January to May, Plant Asbestos 1517, May through August. 1967, leg injury 1917, Sept, through December, pi,,nt Auoestos 191-6, Jan. to Feb, lj, Plant Asbestos _ 191b, Nr\*r. p-' Ihro-.J, A .11, fiant Aftber.to.. 1-v .?, Nyv, h through D**<**n'bt *, l?lt, T.arit A .? *-.to." Ret Robert f. Cuthv-ertson vs. Plant Asbestos, et si. l.A.C. N* . OAK 1063 hnn4*"r