Document npR4MzrGZw39NKML5ov6L1y0G

October 3, 1968 Mr. W. M. Pallies Health and Safety Manager ESB Incorporated P.O. Box #8109 Philadelphia, Pa. 19101 V 'O Dear Mr. Pallies: I have gine over the information contained in the record of Reuben D. Shoemaker which yoi| forwarded to me, and have concluded that this would be a very difficult case to defend unless you have other and better information than that contained in the record. The point that would be hardest to deal with, in evidence of the incorrectness of the diagnosis of lead poisoning, is the finding of 0.079 mg. of lead per 100 grams of blood (or as itsis expressed in the record, .079 mg.%). In evidence of the likely significance of the finding is the record of the analytical findings previously. The record gives values as high as 0.10 mg./lOO g., fxtom time to time, and other high results more recently. As you know, the analytical error of the best methods is of the order of 0.01 mg./lOO g. for samples of 10 to 15 grams of blood, and since this figure is not challenged, and appears to be the only one given in the record, it may well be satisfactory evidence of significant exposure, .especially if the claimant had been out of exposure for a time. The clinical work-up appears to have been reasonably good, and here again, unless you have evidence that will challenge the findings severely, you are up against it. To answer your direct questions, I am still available for medico-legal testimony if I can arrange to obtain information that enables me to arrive at an opinion. In industrial cases, whether those of compensation claims or those concerned with civil suits, and in trials based on alleged negligence, I am prepared to review the facts and to advise concerning the validity of the claims. My appearance in such cases is dependent upon my being able to meet the date or dates set for the hearing, after I have determined whether or not I can testify effectively and in good conscience. The efficacy of the testimony intended to counteract false or mistaken claims, in the specific case, is based, to a considerable extent, upon the reputation of the specific plant for freedom from dangerous types of exposure to lead. The more specifically applicable feature of the defense is the evidence available in the hands of the plaintiff, to demonstrate (a) that the illness complained of is not lead poisoning, and (b) that it is due to some definitive, alternative type of disease. Without these'features, a plausible medical record from a physician or medical group with good professional standing, in association with a reputable hospital, is very likely to stand against any outside opinion. I feel sure that you know these things, but I mention them for emphasis. Ho honest and competent expert witness can prevail against such testimony unless he is in possession of incontrovertible evidence to the contrary. Mr. W. M. Failles Page 2 October 3. 1968 I9 ' If you wish me to give further consideration to this case, you should obtain for me such evidence as may be available to discredit the diagnosis of lead poisoning. If it should turn out that no such evidence exists, I would consider that my service to your people might well be that of reviewing the situation of your plant, or plants, from the aspect of industrial hygiene and medical information, and determining, if possible, what should be done about them. . Sincerely yours, RAKtwp ' Robert A. Kehoe, M.D. Professor Emeritus of Occupational Medicine . f