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Alder v. Bayer Corp.11/26/2002
, a professor of medicine at Yale University, testified at deposition that the temporal relationship between exposure and symptoms provides an objective way to verify patients' subjective reports. Dr. Cullen is the author of seventy-seven original peer reviewed manuscripts, the majority of which address occupational health and exposure to toxins. Dr. Cullen was prepared to testify that the symptoms complained of by Ms. Alder and Ms. Jones were "toxicologically probable consequences of [chemical] exposure." Regarding Jones, Dr. Cullen observed:
The headache, difficulty concentrating, and upper respiratory symptoms, particularly the hoarseness which she experienced during this time period, I believe can be directly attributable to those exposures as was suggested by almost all of the contemporaneous evaluations and supported by physical examination done at the time.
Dr. Cullen strongly recommended that both Technicians leave their work as radiographers and avoid all further exposure to x-ray processing and related chemicals. He expressed the opinion that for Jones any return to her prior occupation would be impeded by "her neuropsychological impairments as well as her reactivity to the chemical environment."
In the spring of 1997, Technicians were examined by an independent medical panel of the Occupational and Environmental Medicine Clinic at the University of Utah Medical Center. The panel prepared a report for Administrative Law Judge Kathleen Switzer. The report indicated that " ased on reasonable medical probability" Jones' chemical exposure caused her irritant-induced laryngeal disorder and substance-induced persisting dementia, and that she had no functional ability to continue work at the hospital. The panel made similar findings regarding Alder. Judge Switzer inquired what portion of Technician Jones' sixteen percent permanent impairment as determined under the guidelines of the AMA's Guides to the Evaluation of Permanent Impairment, 4th Edition, was "a result of the glutaraldehyde and hydroquinone exposure at LDS Hospital and what portion is due to other causes?" The panel representative responded, " e have no reason to apportion causation to factors or agents other than the x-ray processing fluid."
Regarding Jones, the panel also noted that
bjective measures of the patient's neurocognitive functioning by way of neuropsychological testing revealed impairment more serious than a cognitive or amnestic disorder, meeting criteria for dementia. Since the dementia is persistent following exposure to substances known to cause neurocognitive problems, the specific diagnosis of Substance-Induced Persisting Dementia appears specific and appropriate.
The panel further stated that Technicians' "future medical treatment that could be reasonable and medically necessary for [their] occupational exposure while employed at LDS Hospital is four months of cognitive rehabilitation to help [them] adjust to [their] cognitive loss."
AGFA's experts dispute the reports of Technicians' symptoms, as well as the connection between the symptoms and chemical exposure. AGFA's physician, Dr. Emile Bardana, examined Technicians and concluded that they had "suffered no permanent respiratory impairment or immunological injury of any kind," and could return to work as radiology technologists. He discounted the diagnoses of MCS or "immune toxicity" as lacking a consistent disease definition and never having been demonstrated through testing.
Technicians left their positions at the hospital in June 1995 upon the recommendation of their own physicians, and allegedly have since been unable to pursue their specialty as radiology techn
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