Posted on 05/18/2005 7:40:46 PM PDT by neverdem
A federal grand jury has been convened in Manhattan to consider possible criminal charges arising out of civil litigation over exposure to silica and asbestos, according to lawyers involved in the civil cases.
The grand jury has subpoenaed documents from at least one of the companies that screened people who later claimed they had suffered injuries as a result of exposure to silica, a material that can cause respiratory disease and that is used in making glass, paints, ceramics and other materials.
The federal investigation comes amid questions about some silica-related claims that emerged in federal court proceedings in Corpus Christi, Tex. Several doctors testified there that they had diagnosed silicosis in patients they had never met or interviewed.
Some of the doctors had made diagnoses of asbestos-related disease in claimants at one time, then silicosis in the same claimants at a later time - with no mention of what happened to the earlier illness. That testimony may have cast doubt on claims, many of them already paid, that were filed in the past over asbestos-related disease.
Lawyers involved, who spoke on the condition of anonymity because of the criminal investigation, said they did not know whether individual doctors who had made the questionable diagnoses had yet received subpoenas from federal prosecutors. They cautioned that the investigation appeared to be in its early stages.
A spokeswoman for the office of the United States attorney in Manhattan declined to comment.
The silicosis litigation has been centered in Texas, far from Manhattan, so it might appear odd that the grand jury has been convened by prosecutors in the Southern District of New York. Criminal lawyers who are not involved in either the civil cases or the criminal investigation, however, said that it was not unusual for prosecutors in the Southern District, who...
(Excerpt) Read more at nytimes.com ...
IIRC, you're a radiologist. Can you differentiate asbestosis from silicosis with normal chest X-ray projections? How about CT scans?
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I can't imagine there are many people still alive who suffer from asbestosis. Silicosis is the most terrible and lethal of the dust diseases. Past a certain point the quartz crystals just keep destroying alveoli until you're dead. It can hit anyone from hard-rock miners to stonemasons to potters who work with certain clays to guys who handle diatomaceous earth. The blade-grinders of old Sheffield were legendary for their short lifespans.
It is helpful to not only know what a disease looks like on imaging but why.
Silica dust is composed of crystalline particles. When you inhale them, the smaller ones can be cleared out by the normal lung clearing mechanisms (mucous, ciliary action, etc.) but the larger ones are harder to cough up. The macrophages in the lungs then "swallow" them as they would any other invader except that, since they are rock, the macrophages can't digest them and they get a fatal case of "indigestion". When the macrophages die, they release all their enzymes leading to a local inflammatory reaction.
The X-Ray appearance in silicosis is therefore one of fibrosis of the lung interstitium in a nodular pattern with each tiny nodule representing a silica crystal that has done its damage. This can progress to more fibrosis and coalescing nodule.
In asbestos, we are dealing with a crystalline fiber. The fibers work their way out to the periphery of the lung and actually puncture through the outer lung pleural. Microscopically, imaging the lining of the pleura looking like velvet with the tiny velvet hairs being the asbestos fibers. When you breath in and out, these fibers are scratching the pleura of the inner chest wall.....with every breath.......for every hour, day, week and year for many years. Eventually, you get "plaques" on the pleura of your inner chest wall and disphragm that can calcify. Sometimes the irritation leads to cancer of that irritated pleura (mesothelioma) that is a nasty form of cancer. Such changes can take many years after exposure to develop.
So, asbestosis can be diagnosed easily by the calcified pleural plaques. Industrial medicine also has "B Readers" that are technicians who quantify the degree of fibrosis, plaques, etc. for the purpose of workman's comp cases.
Calcified pleural plaques and diaphragm calcifications are a "giveaway" for asbestosis but it must be remembered that lung fibrosis can occur with all sorts of insults to that lung, even after a bout of pneumonia. You show me a 60 year old chest X-Ray and I will show you something that does not look 100% right. So, it is easy for "Doctor Whores" to get together with shyster lawyers and claim all sorts of things and fool insurance companies. If you make thousands of small fake claims, it is cheaper for ther companies to pay out thousands of small settlements that to investigate every single one.
There will be a test on this tomorrow.....Open book. ;-)
If any of you were interested in this story, please check comment# 5 from Polybius.
For those of you who are interested, here's a link to the definition of macrophage and other words you may not understand. Just cut and paste.
FReepmail me if you want on or off my health and science ping list.
Here is the kicker related to this thread. They answered a advertisement for a booklet on Mesothelioma and three days later two lawyers were on her doorstep singing here up. These ghouls HAD FLOWN IN FROM TEXAS to pick her bones like the vultures they are...
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