U.S. House still looking at mass tort screenings

By Chris Dickerson | Jun 9, 2006

WASHINGTON, D.C. – The House Energy and Commerce Subcommittee on Oversight and Investigations on Tuesday questioned a panel of state health officials about laws governing mass tort screenings and then asked medical screening company officials and their physicians about their level of compliance in generating thousands of disputed silicosis claims.

The hearing, entitled "The Silicosis Story: Mass Tort Screening and the Public Health," was the third such discussion on the topic.

In March, Bridgeport radiologist Ray Harron, a diagnosing physician for thousands of asbestsos and silicosis claims who has been called "a vital cog" in the nation's multibillion-dollar asbestos and silicosis "lawsuit machine," asserted his 5th amendment privilege when he appeared before the congressional committee.

Harron and his son, Dr. Andrew W. Harron of Kenosha, Wisc., refused to tell legislators whether they would certify the accuracy of nearly 10,000 silicosis diagnoses on grounds of self-incrimination.

On Tuesday, Wheeling pulmonologist Robert Altmeyer did testify.

His testimony, like most at Tuesday's hearing, focuses heavily on medical theory and procedure. He talked about the steps necessary to make a silicosis diagnosis.

"In my twenty five years of practicing pulmonary medicine, to my knowledge, I have not diagnosed silicosis on the basis of a chest x-ray alone," said Altmeyer, who has practiced for 25 years and has been listed in "Best Doctors" in the United States for the past several years. "The diagnosis of silicosis requires knowledge of silica dust exposure, coupled with a physical examination and medical history that excludes other more likely causes of the densities found by chest x-ray.

"Infectious diseases, cancer, sarcoidosis, drugs and other factors can mimic silicosis on a chest x-ray. A chest x-ray consistent with silicosis is not a partial diagnosis, but rather one of the components, that when combined with an appropriate history and physical, leads to an actual diagnosis of silicosis."

Rep. Edward Whitfield, R-Ky. and chairman of the oversight subcommittee, said his panel was "looking at whether there needs to be a federal standard" to control abuses in mass tort medical screenings, which critics say result in "manufactured" diagnoses of disease by doctors or X-ray technicians who never establish a doctor-patient relationship with the claimants.

The committee, which started its investigation in August 2005, likely will continue its work over the next several weeks and has not yet decided whether it will draft any legislation, a committee spokesman said.

As with asbestos, industry and tort reform groups seek legislation to halt abuses in mass tort screening for silicosis, a lung disease that can be caused by exposure to silica.

The U.S. Chamber of Commerce's Institute For Legal Reform is one of those groups. The ILR currently is preparing a database to identify "repeat players" among plaintiffs and irregularities in diagnoses.

A light began to shine on the problems in mass tort screenings in July when U.S. District Court Judge Janis Graham Jack in Corpus Christi, Texas, found that medical screening companies and physicians were diagnosing patients with silicosis for the sole purpose of referring them to law firms as plaintiffs in mass tort litigation.

Many of those diagnoses were made by Harron.

In an opinion, Jack, a former nurse, wrote, "These diagnoses were driven by neither health nor justice--they were manufactured for money."

Following Harron's admission that he did not even make the diagnoses of the patients whose x-rays he read, Jack noted that most of "these diagnoses are more the creation of lawyers than doctors.

"Both the scientific community and the federal judge must have been stunned when Dr. Harron improbably diagnosed the same people as being sick from both conditions."

In a March follow-up to Harron's appearance before the congressional committee, the Wall Street Journal described the Harrons and another doctor who refused to speak as "lawyered up and hunkered down."

"The dumbstruck docs were a lot more energetic when it came to their assembly-line diagnosis of both asbestosis and silicosis, a disease caused by exposure to silica particles found in construction materials," roared a WSJ commentary on March 13.

During Tuesday's hearing, Oversight Subcommittee ranking member Bart Stupak, D-Mich., said he was not convinced that the investigation would result in meaningful action. He said courts and state bar associations are responsible for policing the actions of plaintiff attorneys.

Darren McKinney, spokesman for the American Tort Reform Association, said federal prosecutors in New York also are looking into fraud allegations related to asbestosis and silicosis lawsuits.

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