Medico-legal issues in occupational lung disease litigation

Our plain-English summary of Medico-legal issues in occupational lung disease litigation, by N.A. Schachtman, C.J. Rhodes (Seminars in Roentgenology, 1992).

The study

• Authors: N.A. Schachtman, C.J. Rhodes
• Journal: Seminars in Roentgenology
• Published: 1992;27(2):140-3
• Type of article: Review
• Cited by: 1 article, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004963).

In plain English

This was a lawyers' commentary, not a research study, on legal issues for physicians, especially radiologists, serving as expert witnesses in lawsuits over asbestos-related lung disease. The authors described Raymark Industries, Inc. v Stemple, in which an asbestos products manufacturer sued lawyers and three physicians for fraudulently "manufacturing" claims through x-ray screenings of tire workers. A National Institute of Occupational Safety and Health report found a prevalence of parenchymal abnormalities of less than one half of 1%, while the defendants claimed over 90% in similar tire worker groups. The case settled confidentially in July 1991. The authors explained that a physician retained by an attorney to examine radiographs or a claimant owes a duty of care to the attorney, not the patient, though ethical obligations to a patient may still be felt. Courts, they noted, had ruled both ways on whether gallium scans and high-resolution computed tomography are generally accepted in asbestosis cases. The authors concluded that radiologists have a special civic obligation to participate in the legal process and to speak out about the quality of the medical profession's role in it.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Legal commentary written by lawyers on medico-legal issues for physician expert witnesses; not a research study
• Who was studied: No study population. The article discusses court cases, mainly Raymark Industries, Inc. v Stemple, which concerned x-ray screenings of tire workers
• Exposure: No exposure was studied. The article concerns lawsuits in which plaintiffs claim asbestos-related lung disease. No fiber types or doses are given
• Main results:
  • In the Stemple case, an organization set up by lawyers and physicians used vans equipped with x-ray machines to screen tire workers around the country. The asbestos product manufacturer alleged that false claims were presented for settlement
  • The trial court found sufficient inferences of fraud from the defendants' failure to follow standard diagnostic criteria and from their assigning impairment ratings to claimants with totally normal pulmonary function
  • The article cites a National Institute of Occupational Safety and Health report that found a prevalence of parenchymal abnormalities of less than one half of 1%. The defendants claimed a prevalence of over 90% in similar tire worker groups
  • The lawyer and physician defendants settled the case in July 1991, and the terms were confidential
  • The authors stated that once a physician contracts with an attorney to examine a claimant or radiographs, the physician owes a duty of care to the attorney, not to the patient
  • The authors acknowledged that a consulting physician may still feel bound by ethical obligations to a patient. They said the physician should nonetheless view the consulting relationship as creating obligations primarily to the party who requested the evaluation
  • In asbestosis cases, objections under the Frye general-acceptance test have been raised against gallium scans and high-resolution computed tomography. According to the authors, courts decided the issue both ways
  • The authors suggested that plaintiffs may be reluctant to undergo thoracic high-resolution computed tomography for fear that it would show emphysema not apparent on plain films
• The authors' conclusion: The authors concluded that, because radiology is often the deciding evidence in asbestos personal injury litigation, radiologists have a special civic obligation to participate in the legal process and to speak out about the quality of the medical profession's role in it

Topics

Medical terms in this study, explained in our Lexicon: Occupational Lung Disease.

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