OLDHAM & DOWLING (COUNSEL OF RECORD)issued by the Cuyahoga County Common Pleas Court's asbestos docket - a docket dedicated solely to asbestos litigation. All filings in asbestos

No. 2006-1604

In the Supreme Court of Ohio

APPEAL FROM THE COURT OF APPEALS

EIGHTH APPELLATE DISTRICT

CUYAHOGA COUNTY, OHIO

CASE No. 88062

JAMES SINNOTT, et al.,Plaintiffs Appellees,

V.AMERICAN OPTICAL CORPORATION, PNEUMO ABEX LLC, successor in interest to

ABEX CORPORATION, and CBS CORPORATION, a Delaware Corporation, f/k/a Viacom,Inc., successor by merger to CBS Corporation, a Pennsylvania Corporation, f/k/a

WESTINGHOUSE ELECTRIC CORPORATION,Defendants-Appellants,

andAQUA-CHEM, INC., et al.,

Defendants.

JOINT STIPULATION TO SUPPLEMENT RECORD(VOLUME 1 of 2)

CAROLYN KAYE RANKE (0043735) SUsAN M. AUDEY (0062818)(COUNSEL OF RECORD) (COUNSEL OF RECORD)BRENT COON & ASSOCIATES IRENE C. KEYSE-WALKER (0013143)

1220 West Sixth Street, Suite 303 JEFFREY A. HEALY (0059833)Cleveland, OH 44113 CHRISTOPHER J. CARYL (0069676)

Telephone: 216.241.1872 TUCKER ELLIS & WEST LLP

Telefax: 216.241.1873 925 Euclid Avenue, Suite 1150E-mail: kaveCoDbcoonlaw.com Cleveland, OH 44115-1414

Attorney for AppelleesJames Sinnott, et al.

Telephone:Telefax:E-mail:

216.592.5000216.592.5009saudey(@tuckerellis.comikeyse-walker(@[email protected](a)tuckerellis.com

APR 13 2007

MARCIA J iViENGEL, CLERKSUPREME C(IURT_@ppQ0W)^)

Attorneys for Appellants American OpticalCorporation and Pneumo Abex LLC,successor in interest to A bex Corporation

REGINALD S. KRAMER (0024201)(COUNSEL OF RECORD)OLDHAM & DOWLING195 South Main Street, Suite 300Akron, OH 44308-1314Telephone: 330.762.7377Telefax: 330.762.7390E-mail: rkramernoldharn-dowlin .

Attorney for Appellant CBS Corporation, aDelaware Corporation, f/k/a Viacom, Inc.,successor by merger to CBS Corporation, aPennsylvania Corporation, f/k/a WestinghouseElectric Corporation

JOINT STIPUI.ATION TO SUPPLEMENT RECORD

Introduction

The parties to the appeal agree that the trial court record as certified and filed is

incomplete. Under S.Ct.Pract.R. V(6), they jointly request that this Court direct the Clerk of the

Cuyahoga County Common Pleas Court to certify the appended documents and transmit them to

this Court.

Relevant procedural history

Appellants in this asbestos products-liability case - American Optical Corporation

("AO"), Pneumo-Abex LLC, successor in interest to Abex Corporation ("Abex"), and

Defendant-Appellant CBS Corp., f/k/a Viacom, Inc., successor by merger to CBS Corporation,

f/k/a Westinghouse Electric Corp. ("Westinghouse") - filed this appeal from an order of the

Eighth Appellate District that dismissed their appeal as premature. The appeal involves an order

issued by the Cuyahoga County Common Pleas Court's asbestos docket - a docket dedicated

solely to asbestos litigation.

All filings in asbestos' cases at the trial court level - including pleadings, motions, briefs,

and judgment entries - are filed electronically through LexisNexis® File & Serve. See Asbestos

Case Management Order (B)(2), Tab 1. Consequently, there is a limited hard-copy record in the

trial court. Instead, the trial court and the parties access motions, briefs, and judgments

electronically through LexisNexis® File & Serve.

Once a judgment rendered by the trial court is appealed to the Eighth Appellate District,

the appellate court - by local rule - requires that the parties "recreate" a hard-copy record for

review by that court. See Loc.App.R. 11. In addition to providing a signed and journalized copy

of the judgment under appeal (Loc.App.R. 11(A)(2)), the parties are to prepare "stipulated paper

copies of the electronic trial court filings that the parties deem necessary to provide a record for

appellate review." Loc.App.R. 11(A)(3). Indeed, the parties are to "confer and agree to a

reasonable stipulation of the filings necessary to comprise the record on appeal *** ."

Loc.App.R. 11(B)(2).

The parties were in the midst of preparing this "stipulation of filings" at the time the

appellate court dismissed the appeal. Because the parties could not compile the necessary

electronic filings in hard-copy format before the appellate court dismissed the appeal, the trial

court record as transmitted to this Court is incomplete.

S.Ct.Pract.R. V(6) authorizes the parties - by stipulation - to request that this Court direct

"that a supplemental record be certified and transmitted to the Clerk of the Supreme Court" when

any part of the record is not transmitted to the Court and is necessary to the Court's review.

Here, the parties stipulate that the following appended documents are necessary to this Court's

review.

'1'ab Document Description

1 Asbestos Case Management Order (filed 7/11/03)

2 Master Consolidated Complaint (filed 2/10/04)

3 Corrected Notice of Voluntary Dismissal (filed 4/8/04)

4 First Amended Complaint (filed 1/3/05)

5 Second Amended Complaint (filed 3/14/05)

6 Motion of Separate Defendants American Optical Corporation and A.W.Chesterton Co. to Administratively Dismiss (filed 4/26/05)

7 Plaintiff's Memorandum in Opposition to Defendants' Motion to Remove CaseFrom Trial Schedule for Non-Compliance with H.B. 292 (filed 6/2/05)

8 Notice of Filing of Supplemental Medical Reports and Records (filed 7/21/05)

9 Reply to Plaintiff's Opposition to Motion of Separate Defendants AmericanOptical Corporation and A.W. Chesterton Co. to Administratively Dismiss(filed 9/6/05)

2

Tab Document Description

10 Motion of Separate Defendant Pneumo Abex LLC, Successor-in-Interest toAbex Corporation, to Join in Motion of American Optical Corporation toAdministratively Dismiss (filed 12/6/05)

11 Third Amended Complaint Substituting Plaintiff and Adding Wrongful DeathClaim (filed 1/30/06)

12 Notice of Filing of Plaintiffs' Expert Report of Arthur L. Frank, M.D. andReport of Arthur L. Frank, M.D. (filed 2/22/06)

13 Trial Court's Order (journalized 3/21/06)

14 Notice of Filing Hearing Transcript of February 17, 2006 by SeparateDefendant American Optical Corporation (filed 3/23/06)

Because these documents are necessary to this Court's review, the parties to this appeal

request that this Court direct that a supplemental record be certified and transmitted to the Clerk

of the Supreme Court in accordance with S.Ct.Pract.R. V(6).

Respectfully submitted,

7'` "^"'(p'er consent)

CAROLYN IAYE RANKE (0043735)

BRENT COON & ASSOCIATES

1220 West Sixth Street, Suite 303Cleveland, OH 44113Telephone: 216.241.1872Telefax: 216.241.1873E-mail: kaye(a-)bcoonlaw.com

Attorney for AppelleesJames Sinnott, et al.

SUsAN M. AUDEY (0062818)(COUNSEL OF RECORD)IRENE C. KEYSE-WALKER (0013143)JEFFREY A. HEALY (0059833)CHRISTOPHER J. CARYL (0069676)TUCKER ELLIS & WEST LLP

925 Euclid Avenue, Suite 1150Cleveland, OH 44115-1414Telephone: 216.592.5000Telefax: 216.592.5009E-mail: saudeyCc+^tuckerellis.com

ikeyse-walker ntuckerellis.comjhealy(&tuckerellis.comccaryl(cDtuckerellis.com

Attorneys for Appellants American OpticalCorporation and Pneumo Abex LLC,successor in interest to Abex Corporation

3

(per consent)

REGINALD S. KRAMER (0024201)

OLDFIAM & DOWLING

195 South Main Street, Suite 300Akron, OH 44308-1314Telephone: 330.762,7377Telefax: 330.762.7390E-mail: rkramer at7oldham-dowling.com

Attorney for Appellant CBS Corporation, aDelaware Corporation, f/k/a Viacom, Inc.,successor by merger to CBS Corporation, aPennsylvania Corporation, f/k/a WestinghouseElectric Corporation

4

CERTIFICATE OF SERVICE

A copy of the foregoing Joint Stipulation to Supplement Record has been served this

12"' day of April, 2007, by U.S. Mail, postage prepaid, to all counsel of record to this appeal.

One of the Attorneys for Appellants AmericanOptical Corporation, Pneumo Abex LLC,successor in interest to Abex Corporation, andCBS Corporation, a Delaware Corporation, f/k/aViacom, Inc., successor by merger to CBSCorporation, a Pennsylvania Corporation, f/k/aWestinghouse Electric Corporation

538570.00686.931763.1

TAB 1

21401727I11103

IN 'I'HE COURT OF COMMON PLEASCUYAHOGA COUNTY, OHIO

IN THE COURT OF COMMON PLEAS) SS:

CUYAHOGA COUNTY ) JUDGE HARRY A. HANNAIN RE: SPECIAL DOCKET 73958 ) JUDGE LEO M. SPELLACY

)CUYAHOGA COUNTYASBESTOS CASES

CASE MANAGEMENT ORDER )TOIMPLEMENT LEXISNEXIS FILE&SERVE )INPLACE OF CLAD

))

STATE OF OHIO

TABLE OF CONTENTS

A. PREAMBLE ...........................................................................--...................................... 1

B l. GENERAI. PROVISIONS .............................................................................................. 1l.Cases to Which This Order Applies ...................................-.....---.................................. 12.The Docket ................................................................................................................... 13.The Complaint .......................-.--................................................................................... l4.Answer ......................................................................................................................... 25.Amended Complaints ...........................................................:........................................ 36.Cross-Claims and Third-Party Claims ............................................................................47.Conditions for Default Judgment ...................................................................................48.Leaves to Plead ............................................................................................................. 49.Service of Documents ................................................................................................... 510.Dismissals of Cross-Claims and Third-Party Complaints ..............................................511.Joinder in Motions ......................................................................................................512.Multiple Counsel ......................................................................................................... 613.Notice of Appearance/Pro Hac Vice ............................................................................614.Liaison Counsel ......... ................................................................................................. 615.Attendance at Hearings ............................................................................................... 716.Cooperation Among counsel Shall Not Constitute a Waiver of Privileges ....................7

B2. ELECTRONIC FILING PROCEDURES

C. CASE MANAGEMENT SCHEDULE ............................................................................717.Case Management Schedule .......................---.............................................................7

D. WRITTEN DISCOVERY ...............................................................................................718.Defendants? Master Consolidated Discovery Requests (?CDRs?) to Plaintiffs ..............8

19.Records of diagnosis .......... ......................................................................................... 820.Records Authorizations and Tax Returns ........................................ ............................821.Identification of Product Identification Witnesses and Product Identification ...............922.X-Rays, Tissue Specimens, Examination of Same ...................................................... 1023.Discovery to Defendants ...........:...............................................................................1024.Additional Written Discovery .................................................................................. 11

F. DEPOSITIONS .............................................................................................................1125.Defense Lead Counsel ...............................................................................................1126.Depositions of Plaintiffs and of Plaintiffs? Product Identification Witnesses ..............1127.Plaintift9s De Bene Esse Depositions .........................................................................15

G. MEDICAL EXAMINATION S ......................................................................................1629.Physical Exam inations ...............................................................................................16

H. WITNESS AND EXHIBIT L1STS AND EXPERT REPORTS ..................................... 1730.Identification of Expert and Lay Witnesses -- Reports and Prior Testimony ............... 1731.Fina1 Witness and Exhibits ....... .................................................................................1832.Use of Prior Testimony ............................................................................................. 18

1. PROCEDURE FOR SEEKING DISMISSAL ................................................................1833.Defendant?s Request ................................................................................................. 1834.Plaintif£!s Response ..................................................................................................1935.Action on Refiisal to Consent to Dismissal ................................................................19

J. GROIJPING OF PLAINTIFFS ......................................................................................1936.General .....................................................................................................................1937.Groups 1-13 .............................................................................................................2038.Subsequent Groups ...................................................................................................2039.Exigent Cases ........................................................................................................... 20

K. SAN CTIONS ................................................................................................................ 2040.General ....................................................................................................................: 2041.Plaintiff?s Failure to Comply .....................................................................................21

42.Defendant?s Failure to Comply ..................................................................................21

A. PREAMBLEA ....................................................................................................... PREAMBLEIt is the goal of this Court to secure the just, efficient and economical resolution of

each Asbestos personal injury, Silica, and FELA case now pending or hereafter filed in theCourt of Coinmon Pleas for Cuyahoga County, Ohio, and to facilitate discovery, eliminateduplication of effort, prevent unnecessary paperwork and promotejudicial economy in themanagement of such cases.B. GENERAL PROVISIONSB. GENERAL PROVISIONS

I. Cases to Which This Order Applies. Cases to Which This Order AppliesThis General Personal Injury Case Management Order No. 1(as amended, June

2003) shall govern pre-trial discovery activities in all asbestos personal injury casescurrently pending or to be filed in this Court from the date of this Order until further orderof this Court.

2. The Docket. The Docket'1'he Court has decided to use the LexisNexis File & Serve system in order to

increase the efficiency of the Court. (Section C of this Order).3. The Complaint. The ComplaintIn order to facilitate a manageable docketing system and to insure the proper

payment of filing fees, multiple plaintiff asbestos complaints shall only be accepted by theclerk if the complaint complies with the following guidelines:

a. The caption of the complaint must indicate that it is a?MasterConsolidated Asbestos, Silica or FELA Complaint.'

b. The complaint must have a space for the clerk to indicate a separatecase number and judge next to each primary plaintiff (not including spouse withconsortium claim).

c. All statutory filing fees shall be assessed electronically by the clerkat the time of online review of any filing with a statutory fee. Fees will betransferred upon review and acceptance by the clerk to the court?s bank accountvia Automated Clearing House. (ACH). Firms will no longer send fees to thecourt, but will receive a monthly invoice from LexisNexis File & Serve.

d. A copy of the complaint shall be provided to the clerk for eachdefendant and each primary plaintiff.

e. Only one summons will be issued to each defendant listed on the?Master Consolidated Asbestos, Silica or FELA Complaint? and will apply to allcase numbers listed on that complaint.4. Answer. AnswerDefendants and Third-Party Defendants are no longer to file answers to Plaintiff?s

Complaints or Third-Party Complaints in asbestos litigation in Cuyahoga County, Ohio.Rather, the following procedure will apply:

a. Within 28 days after service of the Complaint, the Defendant orThird-Party Defendant shall enter an appearancewhich shall constitute:

i. a denial of all averments of fact in the Complaint orThird-Party Complaint, and

ii. an allegation of all affirmative defenses.b. If any Defendant or Third-Party Defendant wishes to assert a claim

for indemnification and contribution against any other party, this may also beaccomplished by making a statement in the Notice of Appearance which

specifically identifies the party or parties against whom the claim is asserted.Failure to assert such a claim in the Notice of Appearance does not in any wayprohibit or limit a party?s right to do so at a later time pursuant to the laws of theState of Ohio and the Ohio Rules of Civil Procedure.

c. In the event that a claim for indemnification and contribution isasserted, the party against whom the claim is asserted shall nnt file a responsivepleading. All avennents of fact shall be deemed to be denied and all affirmativedefenses to the claims for indemnification and contribution shall be deemed to havebeen raised.

d. Except for the filing of motions pursuant to Rule 12 and complaintsto join a Third-Party Defendant, there shall be no further pleading after thecomplaint.

C. The entry of appearance shall include Counsel?s F-mail addreee.(Amended Standing Order No. 7)

f. A cover cheet containing the namee of each individual plaintiff and

the corresponding case nnmher in thr Master Complaint must accompany thenotice of appearance. Only one Notice of Appearance is required for each MasterComplaint, but it must have the cover sheet which lists plaintiffs? names and casenumbers.5. Amended Complaints. Amended ComplaintsAny defendant who is named as party in an original complaint need not serve or

file a responsive pleading to any amended complaint. If an amended complaint raisesadditional claims or sets forth new, substantive allegations, a defendant may serve and filea response within the time prescribed by the Ohio Rules of Civil Procedure. If a defendantchooses not to respond to an amended complaint, its previously filed appearance shall bedeemed incorporated as the answer to the amended complaint, and any new matters shallbe deemed denied. Any answers to new matters contained in an amended complaint maybe limited and may incorporate by reference the previous answers of the defendant.

6. Cross-Claiins and Third-Party Claims. Cross-Claiins and Third-PartyClaims

a. Cross-claims and third-party claims for contribution and/orindemnity must be made by service of the pleading upon the party against whomthe claim is asserted. The mere service of a letter advising counsel of the filing suchcross-claims or third-party claims shall not be sufficient.

b. When a cross-claim for contribution and/or indemnity is servedupon a defendant or third-party defendant, said defendant or third-party defendantmay, within twenty-eight (28) days from service upon it, respond thereto, or it mayrefrain from filing a responsive pleading. A failure to respond shall be deemed adenial by that defendant of any and all liability for contribution and/or indemnity.

c. Third-party defendants shall respond to all third-party complaints inthe manner described in Section 4 above.7. Conditions for Default Judgment. Conditions for Default JudgmentPlaintiffs? counsel, prior to seeking a default judgment against a defendant

represented by counsel in any asbestos case, must first notify that counsel and thedefendant, in writing, of his or her intentions and reasons for seeking default judgment.The defendant shall have twenty-one (21) days from the date of receipt of the plaintiff?s

counsel?s letter to answer or otherwise respond to the complaint.8. Leaves to Plead. Leaves to PleadIn order to eliminate the cost and administrative burden involved in docketing and

tracking leaves to plead, the Court hereby suspends the requirement for any counsel to filea request, stipulation, or motion for leave to plead, provided that the response is not morethan thirty (30) days late, and provided further that the opponent has not previouslyrequested a default judgment as outlined in paragraph 4 above.

9. Service of Documents. Service of DocumentsExcept as otherwise herein provided, counsel shall serve all discovery and other

non-filed documents electronically to counsel. Counsel are not required to servedocuments electronically to other counsel when the documents are filed with the Court.All counsel may access filed documents online through the File & Serve system. 10. Dismissals of C

Upon the dismissal by a plaintiff of a defendant who has either asserted across-claim or filed a third-party complaint for contribution and/or indeinnity, suchdefendant shall file a written Notice of Intention to Pursue Its Cross-Claims or Third-Partyclaims within thirty (30) days from the date of dismissal. Such Notice shall identify thosedefendant(s) against whom its cross-claims or third-party claims are asserted. Failure tofile such Notice shall be deemed an automatic dismissal, without prejudice, of any and allcross-claims and third-party claims asserted by that defendant against all other defendants.The dismissal shall be effective on the thirtieth (30th) day following the dismissal of the

defendant by the plaintiff.11. Joinder in Motions. Joinder in MotionsEach defendant shall be deemed to have joined in any other defendant?s motion

where the granting of the motion would benefit it or all defendants generally. Duplicativemotions or motions solely adopting the reasoning of the filing defendant?s motion shall notbe filed. A defendant may, but is not required to, file a supplemental motion setting fortharguments directly related to that defendant?s position. Should the defendant originallyfiling such motion be dismissed from the case(s) in which such motion was filed prior toruling, the motion shall remain viable as to all remaining defendants in the case.

12. Multiple Counsel. Multiple CounselWhere a plaintiff or group of plaintiffs and/or a defendant or group of defendants

have by notice of appearance or by the filing of a responsive pleading listed multiplecounsel, notice to one attorney for a party shall constitute notice to that party. Counselattending any court appearances shall have full authority to speak for all other counsel aparty may have.

13. Notice of Appearance/Pro Hac Vice. Notice of Appearance/Pro Hac ViceUpon the granting of a Motion to Appear Pro Hac Vice, counsel shall file with the

Clerk of Courts, a Notice of Appearance setting forth the attorney?s name, address, phonenumber and party represented.

14. Liaison Counsel. Liaison CounselWithin fourteen (14) days of the filing of this Order, defendants? counsel shall

designate one ?Liaison Counsel? with respect to each plaintiffs law firm, and eachplaintiffs? law firm shall designate one ?Liaison Counsel? with whom the Court maycommunicate orally for the purpose of the prompt dissemination of information to theparties regarding administrative and schcduling matters only. Liaison counsel shallestablish a system for the prompt dissemination of information to all other counsel. The

Court shall electronically serve all orders and other written communications upon allcounsel of record for all parties. Defense liaison counsel are not authorized to, nor shallthey, accept service of pleadings on behalf of parties other than their own respectiveclients, nor shall liaison counsel be required to serve any pleadings or other papers onbehalf of plaintiffs or other parties. Defense liaison counsel are not authorized to speakfor or on behalf of other parties without receiving express written authorization to do so.

15. Attendance at Hearings. Attendance at HearingsNo party shall waive any rights by failing to attend a hearing or a motion unless the

attendance of the party has been ordered by the Court. The designation of an attorney toact as spokesperson for a group of plaintiffs or defendants shall not preclude other counselfrom participating to the extent necessary to represent the individual interests of theirclients, so long as such participation does not involve duplication or unnecessary delay.

16. Cooperation Among counsel Shall Not Constitute a Waiver of Privileges. Cooperation ANo party waives the attorney-client privilege or work-product privilege by virtue

of actions taken in cooperation among parties or their counsel pursuant to this or anyother Order of this Court in these cases, nor by action taken by the party, in pursuit of thejust and efficient resolution of these cases. Because cooperation among'defendants willexpedite the handling of this litigation and aid judicial economy, the defendants? conductin working jointly for the purpose of coordinating discovery or trial efforts, in the sharingof counsel, and for other purposes designed to minimize expenses shall not constituteevidence of conspiracy, concert of action, or any other wrongful conduct, and shall not beadmissible as evidence for any purpose.

B2. ELECTRONIC FILING PROCEDURES

1. DEFINITIONS.The following terms in this Rule shall be defined as follows:

(a) LexisNexis File & Serve ? The service provided LexisNexis and approved bythe Court for filing and service of complaints, petitions, pleadings, briefs, motions,discovery and other documents via the Internet. LexisNexis File & Serve services areavailable at www.lexisnexis.com/fileandserve.

(b) Electronic Filing (•ê-file?) - Electronic transmission of documentsto the Clerk, and from the Clerk or Court, via File & Serve for thepurposes of filing.

(c) Electronic Service (?e-service?) ? Electronic transmission ofdocuments to a party, attorney or representative in a case via File & Serve.Parties who register to use the service may also consent to receive

electronic service of documents, other than service of subpoenas orsummons via File & Serve. E-service shall be deemed complete at thetime indicated as the Authorized Date and Time by File & Serve.

2. ELECTRONIC FILING AND SERVICE OF PLEADINGS ANDOTHER DOCUMENTS.

As of the commencement date of this Rule, all asbestos documents filed in the selectedcases shall be electronically filed. Additionally, counsel shall serve all documentselectronically when service is required among counsel.

3. COMMENCEMENT DATE.The commencement date for the electronic filing and service procedure shall beJuly 7, 2003.

4. ASSIGNMENT OF PERSONAL LOGIN AND PASSWORD.Upon receipt by the LexisNexis of a properly executed e-file SubscriberAgreement at their website, LexisNexis shall assign to the party's designatedrepresentative(s) a confidential login and password (used to file, serve, receive,review, and retrieve electronically filed pleadings, orders, and other documentsfiled in the assigned cases.) No attorney or other user shall knowingly authorize orpermit their useiname or password to be utilized by anyone other than authorizedattorneys or employees of the attorney's law firm, or designated co-counsel.

5. TIME FOR FILING AND EFFECT OF USE OF EFILING.Any pleading filed electronically shall be considered as filed with the Clerk whenthe transmission is completed ("authorized date and time"). Any document e-filedwith the Clerk by 11:59 p.m. ET shall be deemed filed with the Clerk on that date.However, for the purpose of computing time for any other party to respond, anydocument filed on a day or at a time when the Clerk is not open for business shallbe deemed filed on the day and at the time of the next opening of the court forbusiness. In the event of service via facsimile, File & Serve will record the dateand time the fax transmission was completed in the proof of service for thattransaction. LexisNexis is hereby appointed the agent of the Clerk as to theelectronic filing, receipt, service, and/or retrieval of any pleading or documentmaintained electronically. Upon filing and receipt of a document, LexisNexis shallissue a confirmation receipt that the document has been received. The confirmationreceipt shall serve as proof that the docuinent has been filed. A filer will receiveemail notification of documents subsequently rejected by the Clerk, and may berequired to refile the instruments to meet necessary filing requirements.

7. ELECTRONIC FILING OF PLEADINGS AND OTHER DOCUMENTS.(a) Original Petition and Original Answers ? For designated cases types,counsel representing plaintiffs shall file their complaints electronically.(b) Subsequent Pleadings. For asbestos cases, the clerk shall not accept or fileany pleadings or instrument in paper form. Parties must c-file a document either:1. By registering to use the LexisNexis File & Serve service, or;

1. In person, by electronically filing through the Public Access Terminal. Partiesfiling in this manner shall be responsible for fumishing the pleading or instrumenton an IBM formatted 3 1/2" computer disk, CD ROM, or any other diskcompatible with the clerk's office-system to be uploaded in person(c) Multi-case filing: Submit a motion or other documents to participants inmultiple cases with one simple transaction. There is no need to repeat the filing

process in every case. Create custom group lists to manage multi-case servicemore quickly and easily. Case groups can be shared with other firms in thelitigation, or kept private for your firm's eyes only.

8. SYSTEM OR USER FILING ERRORS.If the electronic filing is not filed with the Clerk because of (1) an error in thetransmission of the document to LexisNexis which was unknown to the sendingparty, or (2) a failure to process the electronic filing when received by theLexisNexis, or (3) other technical problems experienced by the filer, the Clerk orCourt may upon satisfactory proof enter an order permitting the document to befiled nunc pro tune to the date it was first attempted to be sent electronically.

9. FORM OF DOCUMENTS ELECTRONICALLY FILED.(a) Format of Electronically Filed Docmnents. All electronically filed pleadingsshall, to the extent practicable, be formatted in accordance with the applicablerules governing formatting of paper pleadings, and in such other and further fonnatas the Clerk may require from time to time.(b) Representations by Using a Typographical Signature. Every pleading,document, and instrument electronically filed shall be deemed to have been signedby the judge, clerk, attorney or declarant and shall bear a facsimile ortypographical signature of such person, along with the typed name, address,telephone number, and Bar number of a signing attoruey. Typographical signaturesshall be treated as personal signatures for all purposes under these Rules.Documents containing signatures of third-parties (i.e., unopposed motions,affidavits, stipulations, etc.) may also be filed electronically by indicating in theoriginal signatures are maintained by the filing party in paper-format.(c) Electronic Title of Pleadings and Other Documents. The document title ofeach electronically filed pleading or other document ("papers"), shall include:i. Party or parties filing the paper,ii. Nature of the paper,iii. Party or parties against whom relief, if any, is sought, andiv. Nature of the relief sought (e.g., Defendant ABC Corporation?s Motion forSummary Judgment")

10. ELECTRONIC SERVICE OF PLEADINGS AND OTHERDOCUMENTS.(a) Electronic and Facsimile Service. All parties or their representatives may

make service upon other parties electronically through File & Serve, except forservice of a subpoena or summons. Parties who register with LexisNexis mayconsent to receive electronic service of documents, other than service ofsubpoenas or summons, via the Efiling system. Paities, or their designatedcounsel, shall receive all documents eFiled and e-served upon them via access toFile & Serve over the Internet or, if a party or party?s designee has not subscribedto the Services, via facsimile transmission.(b) Effect of Electronic Service of Filings. The electronic service of a pleadingor other document shall be considered as valid and effective service on all parties

and shall have the same legal effect as an original paper document.(c) Service on Parties; Time to Respond or Act. e-service shall be deemedcomplete at the time a document has been received by LexisNexis as reflected bythe authorized date and time appearing on the confirmation receipt provided.However, for the purpose of computing time for any other party to respond, anydocument filed on a day or at a time when the Clerk is not open for business shallbe deemed filed at the time of next opening of the Clerk for business.(d) If electronic service on a party does not occur because of (1) inaccessibilityto File & Serve; (2) an error in the File & Serve transmission of notice to the partybeing served, (3) LexisNexis? failure to process the electronic filing for service, or(4) the party was erroneously excluded from the service list, the party to be servedshall, absent extraordinary circumstances, be entitled to an order extending thedate for any response or the period within which any right, duty or other act mustbe performed.(e) In the event of service via facsimile, File & Serve will record the date andtime the fax transmission was completed in the proof of service for thattransaction.

11. ELECTRONIC FILING AND SERVICE OF ORDERS AND OTHERNOTICES.The Clerk and the Court may issue, file, and serve notices, orders, and otherdocuments electronically, subject to the provision of these Rules.

12. SEALED DOCUMENTS.Documents may be filed under seal with the court via the File & Serve system.

13. PUBLIC ACCESS TERMINAL.The Clerk shall also provide a Public Access Terminal located at the Court toallow electronic filing.

14. OBLIGATION OF REGISTERED EFILE USERS TO MAINTAINPROPERDELIVERY INFORMATIONParties or attomeys who register to use File & Serve shall notify LexisNexis within10-days of any change in firm name, delivery address, fax number or email address.

C. CASE MANAGEMENT SCHEDULEC. CASE MANAGEMENTSCHEDULE

17. Case Management Schedule . Case Management ScheduleDiscovery and trial preparation for each plaintiff shall proceed pursuant to the

Case Management Schedule established for the group of plaintiffs in which such plaintiff?scase is grouped. A sample Case Management Schedule is attached hereto as Exhibit A.

D. WRITTEN DISCOVERYD. WRITTEN DISCOVERY

18. Defendants? Master Consolidated Discovery Requests (?CDRs?) toPlaintiffs. Defendants? Master Consolidated Discovery Requests (?CDRs?) toPlaintiffs

When a case is grouped, plaintiff shall within 7 days file on LexisNexis File &Serve and shall electronically serve each defendant with that plaintiff?s answers andresponses to Defendants? Master Consolidated Discovery Requests (CDRs). Attachedhereto and marked Exhibits B and C are sample Defendants? Master ConsolidatedDiscovery Requests for living injured parties and for deceased injured parties, respectively.The Court has been advised that certain counsel for plaintiffs have heretofore provided

CDR responses in formats similar to, but not identical to, Exhibits B and C. Such counselmay continue to provide CDR responses in formats previously used provided that theinformation requested in the Master CDRs is substantially provided.

19. Records of diagnosis. Records of diagnosisWhen a case is grouped, plaintiff within 7 days shall electronically serve on each

defendant objective medical substantiation that plaintiff suffers from mesothelioma,asbestos related cancer or an asbestos related functional impairment as well as all medicalrecords in plaintifl?s possession.

20. Records Authorizations and Tax Returns. Records Authorizations andTax Returns

When a case is grouped, each plaintiff shall within 7 days electronically serve onthe applicable Liaison Counsel with copies to each defendant:

a. Executed forms authorizing the release of the allegedly exposedplaintiff?s Social Security Statement of Earnings showing the names of allemployers and the quarters of years worked for each employer;

b. Executed forms authorizing the release of all medical records, alloriginal x-ray films, CT scans, MRI images, and pathology specimens, and allreports for each of the allegedly exposed plaintiff?s medical service providers;

c. Executed forms authorizing the release of military records,vcterans? affairs records, and employment records for each employer of theallegedly exposed plaintiff;

d. Executed forms authorizing the release of any workers?compensation and/or disability claim records filed by or on behalfofthe allegedlyexposed plaintiff with any federal, state or private organization; and

e. Copies of any or all of plaintiffs? tax returns for the preceding five(5) years if in the possession of Plaintiff; otherwise, authorizations for the releaseof such tax returns.

To the extent these authorizations become outdated or obsolete,defendants may request, and plaintiffs shall promptly provide, updated authorizations onlyif there has been no delay in Defendants? attempts to obtain medical records with the firstset of interrogatories..

21. Identification of Product Identification Witnesses and ProductIdentification. Identification of Product Identification Witnesses and ProductIdentification

When a case is grouped or set for trial, each plaintiff shall within 7 days file usingLexisNexis File & Serve the name and address of witnesses upon whose testimony suchplaintiff intends to rely to establish product identification. Unless good cause be shown by

motion to the Court, such witnesses shall not number more than six (6). No witnessidentified after this date shall be permitted to testify at trial or otherwise absent a showingof good cause.

Counsel for such plaintiff shall identify each other plaintiff on whose behalf suchproduct identification witness is expected to testify.

Contemporaneously with that filing, each plaintiff shall provide the identity of theproducts and manufacturers about which the plaintiff and each product identificationwitness will testify (!Product List/Work History?).

The Plaintift?s Product List/Work History shall have the same force and effect asthe plaintiffs? swortt, signed answers to interrogatories, with the provision that it may beused for impeachment purposes against plaintiff. Each Product List/Work History shallinclude:

a. The specific product natne and manufacturers of products presentat each job site. Should a defendant not be implicated in any of the ProductList/Work Histories filed in a particular case, then plaintiffs shall set forth thespecific information upon which plaintiff bases the naming of that particulardefendant, including but not limited to the identity of written documentssupporting product identification;

b. Name of employers;C. Specific location ofjob site where plaintiff or product identification

witness worked and where said products were seen or observed, including thename and address of the job site;

d. The dates the plaintiff or product identification witness worked atsaid job site; and,

C. The identity of any written documents supporting productidentification.

22. X-Rays, Tissue Specimens, Examination of Same. X-Rays, TissueSpecimens, Examination of Same

When a case is grouped, Plaintift?s counsel shall within 7 days notify each defensecounsel of any original radiology or pathology materials, including, but not limited to,slides, tissue blocks or wet tissue currently in plaintiff?s counsel?s possession, or which hasbeen requested by the plaintift?s counsel. The notice shall include the name and address ofthe provider of such x-rays or pathology.

23. Discovery to Defendants. Discovery to DefendantsWithin thirty (30) days of receipt of the information described in paragraphs 18-22,

each defendant shall admit or deny that its product was at the plaintifl?s worksite. Ifdefendant denies the presence of its product, then plaintiffs? counsel may but are notrequired to serve upon defendants? counsel master discovery requests, includinginterrogatories and/or requests for production of documents and/or requests foradmissions; upon defendants? responses thereto shall be governed by the datesestablished under the applicable Case Management Schedule.

24. Additional Written Discovery . Additional Written DiscoveryAdditional interrogatories and requests for production of documents may be

electronically served by any party only upon leave of court. Unless otherwise agreed to inwriting among or between the parties, service of and responses to request for admissionsshall be governed by the applicable Ohio Rules of Civil Procedure. The parties are

strongly cautioned against the filing of repetitive discovery.

F. DEPOSITIONSF. DEPOSITIONS25. Defense Lead Counsel. Defense Lead CounselDefendants shall select one Lead Counsel for each group of cases to coordinate

with counsel for plaintiffs the scheduling of depositions of the plaintiffs and the plaintiffs?product identification witnesses in that group.

26. Depositions of Plaintiffs and of Plaintiffs? Product Identification WitnessesDepositions of Plaintiffs and of Plaintiffs? Product Identification Witnesses

a. GeneralCounsel for the plaintiffs in each group of cases shall coordinate the

scheduling of such depositions with Lead Counsel for the defendants for suchgroup.

b. Logistics of Depositions(i) Plaintiffs? depositions shall be taken in Cuyahoga County,

Ohio, or in any other location upon which the parties may agree.(ii) Product identification witnesses? depositions shall be taken

in any location upon which the parties agree.(iii) No more than two (2) plaintiffs? depositions shall be

scheduled to take place on any one day.(iv) All depositions shall be scheduled with at least ten (10) days

notice unless such notice period is otherwise waived by all parties.Defendants shall take the lead in the discovery depositions of plaintiffs andco-workers.

(v) For each such deposition the defendants shall identify oneattorney to act as a lead counsel for the purpose of asking generalquestions. All defendants shall have the opportunity to examine eachdeponent. Every effort shall be made to avoid: (1) questions designedmerely to elicit a recitation of information already contained in the relevantdiscovery responses provided by the plaintiff; and (2) the repetition ofquestions already asked of the deponent.

(vi) If a defendant conducts a deposition of a plaintiff or ProductIdentification Witness and during said deposition additional exposures orjob sites are developed by a defendant, plaintiff may amend the ProductList/Work History to ad the additional exposures or job sites developed.

If a defendant is not present at the deposition of the plaintiff orProduct Identification Witness because the Product List/Work History didnot include notice that said plaintiff or Product Identification Witnesswould identify said defendant?s products or liability at defendant?s job site,then any information developed during the deposition regarding saiddefendant cannot be used against said defendant.

A defendant not implicated on the product identification list for thatwitness need not attend the deposition of that witness, but shall laterdepose that witness should that defendant be implicated at the initialdeposition. If such defendant declines to re-depose the witness, then theevidence adduced at the first deposition will be admissible.

(vii) Whenever a defendant attends the deposition of a plaintiffor Product Identification Witness, because said Product List/Work Historyindicated that witness would testify that plaintiff was exposed to thatdefendant?s asbestos-containing product(s) or worked at a premisesliability defendant?s job site, and said witness during the course of thedeposition is asked if he/she can identify that defendant?s product(s) orjobsite, and exposure to plaintiff, as identified in his/her Product List/WorkHistory, and said witness states under oath that he/she cannot identify saiddefendant?s product(s) orjob site as specified in his/her Product List/WorkHistory and a time when plaintiff reasonably may have been exposed to thatproduct or job site, said defendant may file a motion requesting costs forthe time incurred in the preparation, travel to, and attendance at saiddeposition. Unless plaintiff is able to demonstrate to the court that areasonable basis existed at the time of the filing of the Product List/WorkHistory upon which to believe said witness would identify said defendant?sproduct(s) or job site and exposure to plaintiff, the court may assess costsin an amount which the court deems to be reasonable and just under thecircumstances.

(viii) With each deposition schedule, counsel for plaintiffs shalllist all cases in the group in which each deponent is then expected to testifyon the issue of product identification. Defendants may conduct a thoroughdeposition of each product identification witness. Duplicate depositions ofproduct identification witnesses will not be permitted, except for goodcause shown. Defendants subsequently named in a case in which a plaintiffor product identification witness has already been deposed shall have theright to redepose those witnesses with regard to that defendant?s products.A product identification witness who has been deposed may be redeposedif that witness is subsequently identified as a witness for another plaintiffnot identified prior to the initial deposition.

(ix) It is contemplated that depositions of plaintiffs and ofproduct identification witnesses will be completed in four hours, and everyeffort shall be made by all parties to conclude each such deposition in thattime frame. Under exceptional circumstances, depositions may bescheduled for longer durations. If, upon receipt of the deposition schedule,it becomes apparent to defendants that the time allocated for a deposition isinsufficient, Lead Counsel for defendants on such deposition shall, at leastfive (5) days before the scheduled date of the deposition, arrange foradditional time to be allocated for such deposition, and shall so notify allparties.

(x) At the commencement of each deposition of a plaintiff or aplaintiff?s product identification witness, the deponent will be furnishedwith a list of all the defendants represented by counsel at the deposition.Defense counsel will not be required to identify his/her client beforecross-examining the deponent. Plaintiff?s counsel will be allowed to askdirect questions of the deponent after the defendants have completed theircross-examination. Plaintiff!s counsel will not lead the witness nor include

the name of a specific product or company in his/her direct examination ofthe deponent. Plaintiff?s counsel will be allowed to refresh the recollectionof the witness by presenting a list of products or companies so long as thelist was written or dictated by the deponent ? not counsel. The deponentwill also be allowed to view the photo album compiled by Owens-Corning(or any other collection of photographs depicting products or labels), butthere will be no conference between the witness and plaintiff?s counselduring or after the photo review. At the conclusion of the directexamination, counsel for any defendant affected by the direct will bepermitted to re-cross the deponent. Neither the direct nor the re-crossexaminations shall be longer than fifteen ( 15) minutes except with theagreement of all parties represented at the deposition or with the approvalof the court.

27. Plaintiff?s De Bene Esse Depositions. Plaintift?s De Bene Esse DepositionsIf a discovery deposition of a plaintiff has not already been taken, the

defendants shall be permitted to conduct such a deposition at lease seven (7) daysprior to the scheduled de bene esse deposition. Except as otherwise ordered bythe Court, or by stipulation of the parties, a de bene esse deposition shall not betaken unless each of the following conditions has been met at lease fourteen (14)days prior to the date of the discovery deposition:

a. Plaintift?s counsel shall have provided written notice of the takingof the deposition, together with a statement as to the reason for the taking of thedeposition;

b. Plaintift?s counsel shall have served and filed verified answers to theMaster CDRs, together with all requested documents;

c. Plaintiff?s counsel shall have provided to defendants:(1) authorizations for the release of medical, Social Security, and

workers? compensation records, and (2) copies of all discoverable medicalrecords, reports (including reports of experts), and any pathology andradiology materials in the possession of plaintiff?s counsel;d. Plaintiff!s counsel shall have provided to each defendant all

employment records of plaintiff, including, but not liinited to, handwritten notes,diaries and pay stubs.28. Cancellation of Previously Scheduled DepositionsIn the event of the cancellation of the deposition of any party, counsel representing

the party shall notify each other counsel of the cancellation by File & Serve, by telephone,or by telecopy, during normal business hours, no less than twenty-four (24) hours prior tothe scheduled deposition. In the event the deposition is canceled with less thantwenty-four (24) hours? notice without good cause, the party canceling the depositionmay, upon motion, be ordered to pay the reasonable fees and expenses incurred byopposing counsel as a result of such late or inadequate notice of cancellation, including,but not liinited to, court reporter fees, deposition location fees, reasonable attorney fees,travel costs and expenses.G. MEDICAL EXAMINATIONSG. MEDICAL EXAMINATIONS

29. Physical Examinations. Physical ExaminationsThe defendants, collectively, may require each plaintiff to undergo one medical

examination relating to plaintiff?s claim for injuries. The examination may include, but isnot limited to: x-rays, CT scans, MRIs, pulmonary function studies, and blood tests,including arterial blood gases, but only if an expert retained by the plaintiff has done bloodgas analysis. No surgical or invasive procedures, such as tissue removal, shall bepermitted under any circumstances. More than one physical examination of each plaintiffmay be permitted, but only for good cause shown, and then only by order of the Court.The provisions of Rule 35(B) of the Ohio Rules of Civil Procedure shall apply to suchexaminations. All expenses for the defense medical examination and procedures shall bepaid by the requesting defendants. If the examination is conducted outside the Clevelandmetropolitan area, defendants shall reimburse the plaintiff for reasonable costs of travel,lodging and food associated with the examination. Reasonable attempts shall be made toaccommodate the plaintiff!s work schedule. The provisions of Ohio Revised CodeSection 2317.02 shall apply with respect to the waiver of the patient-physician privilege.H. WITNESS AND EXHIBIT LISTS AND EXPERT REPORTSI-I. WITNESSAND EXHIBIT LISTS AND EXPERT REPORTS

30. Identification of Expert and Lay Witnesses -- Reports and Prior Testimony.Identification oOn or before the dates established in the applicable Case Management Schedule,

the plaintiff and the defendants must list all exhibits expected to be used at trial; identify allexpert and lay witnesses expected to be called at trial; provide reports of each medicalexpert witness who examined the plaintiff or the plaintiffs x-ray material or pathology, orwho reviewed the plaintiff?s records and is expected to testify regarding the plaintiff?sdiagnosis (?Consulting Medical Witness?); and provide reports or prior testimony of allother expert witnesses. No expert witness will be permitted to testify whose report orprior testimony was not served within the time prescribed by the applicable CaseManagement Schedule except as provided by Local Rule 21.1. No lay witness will bepermitted to testify who was not identified within the time prescribed by the applicableCase Management Schedule.

31. Final Witness and Exhibits. Final Witness and ExhibitsEach party shall file and serve a Final Witness List and a Final Exhibit List on the

day prescribed in the applicable Case Management Schedule. The final Witness List shallcontain the names of the expert and lay witnesses whom the parties actually intend to callto testify at trial, whether that testimony be live, by videotape, or by written deposition.The final Exhibit List shall include those exhibits actually intended to be used at trial. Thefinal Witness List and the Final Exhibit List may not include witnesses or exhibits notpreviously identified pursuant to the terms of the Case Management Schedule. Thepurpose of the Final Witness and Exhibit Lists is to reduce the number of witnesses andexhibits to those which will actually be needed for trial.

32. Use of Prior Testimony. Use of Prior TestimonyIf any party intends to use the prior testimony of a witness, such testimony must be

identified by case name, case number, court, date, and page(s) and line(s) of transcript. Acopy of all such testimony, whether by deposition or trial transcript, must be furnishedupon request to any party by the date indicated in the applicable Case ManagementSchedule.1. PROCEDURE FOR SEEKING DISMISSALi. PROCEDURE FORSEEKING DISMISSAL

33. Defendant?s Request. Defendant?s Request

On or before the date established in the applicable Case Management Schedule,any defendant may request any counsel for the plaintiff, in writing, by certified mail, toagree to a consent order dismissing that defendant, without prejudice, and otherwise thanupon the merits. The letter shall contain the specific reasons for seeking dismissal, andmay include one or more cases in a particular group of cases.

34. Plaintift7s Response. Plaintift?s ResponseWithin thirty (30) days of receiving such a dismissal letter, the plaintiff?s counsel

must respond, in writing, by certified mail. Such response letter shall either agree to thedefendant?s dismissal request, or must set forth the specific reasons for the refusal of thedefendant?s request for dismissal.

35. Action on Refusal to Consent to Dismissal. Action on Refusal to Consentto Dismissal

Upon the failure of a plaintiff!s counsel to respond in writing to a defendant?sletter as set forth above, defendant may petition the Court for an order of dismissalwithout prejudice and otherwise than upon the merits. Refusal by a plaintiff to dismisswithout prejudice and otherwise than upon the merits does not preclude a defendant fromfiling a motion for summary judgment.J. GROUPING OF PLAINTIFFSJ. GROUPING OF PLAINTIFFS

36. General. GeneralAll asbestos personal injury cases currently pending or hereafter filed in Cuyahoga

County shall be grouped for discovery and trial preparation purposes only, in thefollowing manner:

a. In groups of not to exceed fifty (50) plaintiffs, preferably withcommon worksite(s);

b. Grouped according to the identity of plaintiff!s counsel (e,g,:Michael Kelley, Robert E. Sweeney, etc.), preferably with commonality ofworksite;

c. Except as provided below for exigent cases, grouped in casenumber order within the group;

d. Groups will rotate among plaintiffs? counsel. Unless consolidationis ordered, each plaintift?s case will be tried individually. The status of a particulargroup of plaintiffs shall not affect the remaining groups and shall not accelerate ordelay subsequent schedules.

37. Subsequent Groups. Subsequent Groups

Subsequent groups will rotate monthly among plaintiffs? counsel. Liaison counselfor the parties shall propose to the Court the groupings and Case Management Schedulesfor twelve new groups every six months commencing on June 30, 2002 and December 31,2002 and continuing each six months thereafter until all cases are grouped and scheduled.

38. Exigent Cases. Exigent CasesIn the formulation of all subsequent groups, plaintiffs? counsel may identify no

more than three (3) plaintiffs per group who may be moved up out of case number order.

K. SANCTIONSK. SANCTIONS39. General. GeneralThe concept of grouping plaintiffs? claims for pre-trial case management will

succeed only if all counsel commit themselves to meeting the deadlines set forth in theindividual Case Management Schedules. Failures to comply with these deadlines shallresult in the sanctions set forth below.

40. Plaintiff!s Failure to Comply. Plaintiff!s Failure to ComplyIf a plaintiff fails to meet a deadline established in the applicable Case Management

Schedule; fails to provide answers to defendants? authorized supplemental discoveryrequests; fails to provide the witness lists; fails to provide the required report orrepresentative testimony of an expert; fails to provide statements of the testimony of laywitnesses; absent a showing of good cause fails to appear to for deposition or for amedical examination at the time schedules; or fails to provide exhibit lists, a Notice ofFailure to Comply shall be served upon plaintift?s counsel by any defendant affected bysuch failure. Service of such notice shall be made upon all counsel of record. A plaintiffshall have ten (10) working days after service of the Notice of Failure to Comply withinwhich to cure the identified failure. Should the plaintiff fail to cure the failure, uponmotion that plaintiffls case (including the claim of his or her spouse) may be removed fromits presently assigned group. Any case so removed shall be assigned to the next group ofcases to be created for counsel for such plaintiff.

42. Defendant?s Failure to Comply. Defendant?s Failure to ComplyShould any defendant fail to meet the deadlines set forth in any Case Management

Schedule, the plaintiffs? counsel shall serve a Notice of Failure to Comply upon suchdefendant. Such defendant shall have ten (10) working days from receipt of thenotification within which to comply. If the defendant fails to cure the failure, uponmotion, the Court may compel compliance. If the Court finds that the defendant hasthereafter failed to comply as ordered, the Court may entertain the application of the fullrange of sanctions permitted under Rule 37(B) of the Ohio Rules of Civil Procedure.IT IS SO ORDERED.

JUDGE HARRY A. HANNAJUDGE LEO M. SPELLACY

E-filed on July 11, 2003

EXHIBIT A

SAMPLE

CASE MANAGEMENT SCHEDULE

(Parenthetical references are to paragraphs of the General

Personal Injury Asbestos Case Management Order No. 1)

PLAINTIFF CASE NUMBER

PLAINTIFF

DATE BY WHICH

ACTIVITY IS TO BE

COMPLETED

Starting Date

/200 )

DEFENDANT

[Day 15] Certified mail

request for

dismissal without

prejudice. (1.32)

Response to Certified Mail [Day 30

Request for dismissal without

prejudice.

Depositions of employers may [Day 35] Depositions of

commence. employers may

commence.

Depositions of Defendants [Day 50-Day 100] Depositions of

[Day 115]

File and serve opposition to [Day 130]

motions for summary judgment

or consents for dismissal.

[Day 137]

[Day 195]

Plaintiff and

product identifi-

cation witnesses.

Motions for summary

judgment to be

filed and served.

Defendants' reply

to Plaintiff's

opposition to

motion for summary

judgment.

Pretrial: rulings on

dispositive motions;

establishment of

final pretrial pro-

cedures; settlement

negotiations.

[Day 150] Medical exam of

Plaintiff may

commence. (G.27)

Identify expert and lay [Day 180]

witnesses. Provide

reports of consulting

medical experts and

reports, or representative

prior testimony, of all

other experts. Provide

statement of testimony for

each lay witness. Provide

expected exhibit list.

Exchange final witness and

Exhibit lists (H.30)

Identify prior testimony of

witness intended to be used

at trial.

[Day 270] Identify expert and

lay witnesses. Pro-

vide reports of

Consulting Medical

Experts and

reports, or repre-

sentative prior

testimony, of all

other experts.

Provide statement

of testimony for

each lay witness.

Provide expected

exhibit list.

[Day 300] Exchange final wit-

ness and Exhibit

lists (H.30)

Identify prior any

testimony of any

witness intended

to be used at

trial.

[Day 310]

Pretrial to rule on

all outstanding mo-

tions; final settle-

ment conference.

Serve written designations

of page and line numbers of

prior testimony to be used

[Day 315] Serve written des-

signations of page

and line numbers

at trial. Serve trial brief. of prior testimony

to be used at

trial. Serve at

Trial.

Serve written Counterdesig- [Day 320] Serve written

nation of page and line Counterdesignation

numbers of prior testimony of page and line

to be used at trial. numbers of prior

testimony to be

used at trial.

[Day 330]

Trial of each Plain-

tiff's case in order

of case number.

EXHIBIT B

IN THE COURT OF COMMON PLEAS


Plaintiff(s),

V.

Defendants

CASE NO.

JUDGE HARRY A. HANNA

JUDGE LEO M. SPELLACY

DEFENDANTS' MASTER

CONSOLIDATED DISCOVERY

REQUESTS TO PLAINTIFFS

Pursuant to Rules 33, 34 and 36 of the Ohio Rules of Civil

Procedure, defendants propound the following Master Consolidated

Discovery Requests including Interrogatories, and Requests for

Production of Documents to each plaintiff. The interrogatories

are to be answered under oath by each plaintiff listed above; and

the documents requested are to be produced or objections thereto

served on all defendants' attorneys within ninety (90) days of

service hereof.

These Consolidated Discovery Requests are continuing in

nature and require each plaintiff to file supplemental answers

in accordance with Rule 26(e) of the Ohio Rules if further or

different information is obtained after the initial answers and

before trial, including in such supplemental answers the date

upon and manner in which such further or different information

came to each plaintiff's attention.

EXPLANATION AND DEFINITIONS

This document includes both interrogatories and a request

for production of documents. The documents to be produced are

in each instance identified by responses to the interrogatories

contained herein.

As used in these interrogatories and document requests, the

terms listed below are defined as follows:

(A) "You", "your", "yourself", "plaintiff" or "plaintiffs"

means each plaintiff, each individual allegedly exposed to

asbestos, and all other persons acting or purporting to act on

each plaintiff's behalf.

(B) "Defendants", unless otherwise specified, means any

defendant named as a party to this action, as well as any

predecessors in interest to any named defendants, and all other

subsidiaries or divisions of any named defendants.

(C) "Document" or "documents" means any writing of any

kind, including originals and all non-identical copies (whether

different from the originals by reason of any notation made on

such copies or otherwise), including without limitation

correspondence, memoranda, notes, desk calendars, diaries,

statistics, letters, telegrams, minutes, contracts, reports,

studies, checks, invoices, statements, receipts, returns

warranties, guarantees, summaries, pamphlets, books,

prospectuses, inter-office and intra-office communications,

offers, notations of any sort of conversations, telephone calls,

meetings or other communications, bulletins, magazines,

publications, printer matter, photographs, computer printouts,

teletypes, telefax, invoices, worksheets and all drafts,

alterations, modifications, changes and amendments of any of the

foregoing tapes, tape recordings, transcripts, graphic or aural

records or representations of any kind, and electronic,

mechanical or electric records or representations of any kind,

of which each plaintiff has knowledge or which are now or were

formerly in each plaintiff's actual or constructive possession,

custody or control.

(D) "Possession, custody or control" includes the joint or

several possession, custody or control not only by the person to

whom these interrogatories and requests are addressed, but also

the joint or several possession, custody or control by each or

any other person acting or purporting to act on behalf of the

person, whether as employee, attorney, accountant, agent,

sponsor, spokesman, or otherwise.

2

(E) "Relates to" means supports, evidences, describes,

mentions, refers to, contradicts or comprises.

(F) "Person" means any natural person, firm, corporation,

partnership, proprietorship, joint venture, organization, group

of natural persons, or other association separately identifiable,

whether or not such association has a separate juristic existence

in its own right.

(G) "Identify", "identity" and "identification", when used

to refer to an entity other than a natural person, means to

state its full name, the present or last known address of its

principal office or place of doing business, and the type of

entity (e.g., corporation, partnership, unincorporated

association).

(H) "Identify", identity" and identification", when used

to refer to a natural person, means to state the following:

(1) the person's full name and present or last known

home address, home telephone number, business address and

business telephone number;

(2) The person's present title and employer or other

business affiliation;

(3) the person's home address, home telephone number,

business address and business telephone number at the time of the

actions at which each interrogatory is directed: and

(4) his employer and title at the time of the actions

at which each interrogatory is directed.

(I) "Identify", "identity" and "identification", when used

to refer to a document, mean to state the following:

(1) the subject of the document;

(2) the title of the document;

3

(3) the type of document (e.g., letter, memorandum,

telegraph, chart);

(4) the date of the document, or if the specific date

thereof is unknown, the month and year or other best

approximation of such date;

(5) the identity of the person or persons who wrote,

contributed to, prepared or originated such document; and

(6) the present or last known location and custodian

of the document.

(J) "His" means his and/or her and "he" means he and/or

she.

INSTRUCTIONS

(A) With Respect to each interrogatory, in addition to

supplying the information asked for and identifying the specific

documents referred to, identify all documents which were referred

to in preparing your answers thereto.

(S) If any document identified in an answer to an

interrogatory was, but is no longer in your possession or subject

to your custody or control, or was known to you, but is no longer

in existence, state what disposition was made of it or what

became of it.

(C) If any document is withheld from production hereunder

on the basis of a claim of privilege or otherwise, identify each

such document and the grounds upon which its production is being

withheld.

(D) Attached to these interrogatories and request for

production of documents is a medical authorization to obtain the

plaintiff's medical records. This medical authorization should

be signed by the plaintiff and returned with the Answers to

Interrogatories.

INTERROGATORIES

1. Please state the following:

a) Your Full name:

ANSWER:

4

b) All of the names by whom you have been know, including

nicknames, maiden names or aliases:

ANSWER:

c) Your present address and the date you first resided at

that address:

ANSWER:

d) The addresses at which you have resided for five (5)

years prior to this date:

ANSWER:

e) Your Social Securitynumber:

ANSWER:

£) Your date of birth:

ANSWER:

5

1. Are you employed?

ANSWER:

a) If your answer is in the affirmative, please state your

current occupation, place of employment, and the date

you first became so employed;

ANSWER:

b) If your answer is in the negative, please state your

last occupation, your last place of employment, the

date you last worked and your reason(s) for not workingsince that time:

ANSWER:

3. State the following with respect to your parents:

a) The names of your mother and father:

ANSWER:

b) Their dates of birth:

ANSWER:

6

c) Their current health conditions:

ANSWER:

d) If deceased, their date of death:

ANSWER:

e) If deceased, their cause of death:

ANSWER:

4. Do you have any brothers and/or sisters?

ANSWER:

If your answer is in the affirmative, please state the

following for each such brother and/or sister:

a) The names and addresses of each such brother and/or

sister:

ANSWER:

7

b) The age of each such brother and/or sister:

ANSWER:

e) The current health condition of each such brother

and/or sister:

ANSWER:

d) If deceased, the age at death for each deceased brother

and/or sister:

ANSWER:

e) If deceased, the cause of death for each deceased

brother and/or sister:

ANSWER:

5. Has any member of your family ever filed a suit for an

asbestos-related disease?

ANSWER:

8

If your answer is in the affirmative, please state the following:

a) Identify the name of the family member:

ANSWER:

b) Their relationship(s) to you:

ANSWER:

c) The case name(s), court(s) and case number(s) of the

lawsuit(s):

ANSWER:

6. If you are currently married, state the following:

a) The date of marriage:

ANSWER:

b) Your spouse's name:

ANSWER:

9

c) Your spouse's date of birth:

ANSWER:

d) Your spouse's Social Security number:

ANSWER:

e) Your spouse's occupation:

ANSWER:

f) The name and address of your spouse's employer:

ANSWER:

10

h) The amount of our spouse's average gross monthly

salary:

ANSWER:

i) Whether your spouse was financially dependent upon you

at the commencement of this action.

ANSWER:

j) Whether your and your spouse were ever voluntarily or

legally separated?

ANSWER:

k) If applicable, state the circumstances, inclusive dates

and length of time of any such legal or voluntary

separation.

ANSWER:

7. Have you ever had any previous marriages?

ANSWER:

11

If the answer is in the affirmative, please state the

following:

a) The name(s) of any former spouse(s):

ANSWER:

b) The address(es) of any former spouse(s):

ANSWER:

d) If terminated by court order, the court(s), city or

cities, and the circumstances under which the marriage

or marriages were dissolved or terminated:

ANSWER:

8. Do you have any children?

ANSWER:

12


following for each child:

a) The name of each such child:

ANSWER:

b) The address of each such child:

ANSWER:

c) The age of each such child:

ANSWER:

d) The occupation of each such child:

ANSWER:

e) The current health condition, including specific

medical problems, of each such child:

ANSWER:

13

f) Whether any such child is financially dependent upon

you. If so, state the name of such dependent child.

ANSWER:

g) If any child is deceased, state his or her date of

death, cause of death, and age at death:

ANSWER:

9. Is anyone who is not listed in the preceding interrogatory

financially dependent upon you?

ANSWER:


following:

a) The name of each such dependent:

ANSWER:

b) The date of birth of each such dependent:

ANSWER:

14

c) The relationship of each such dependent to you:

ANSWER:

d) Whether you have legal custody of each such dependent:

ANSWER:

e) If custody was awarded to you by court decree, state

the date such custody was obtained for each such

dependent:

ANSWER:


following:

a) The date graduated and the name of the school:

ANSWER:

15

11. Have you ever enrolled in or attended any colleges,

vocational schools,m union sponsored training, or

correspondence courses?

ANSWER:


following:

a) The name(s) and address(es) of each such institution:

ANSWER:

b) The date(s) attended:

ANSWER:

c) Courses of study:

ANSWER:

d) Degree(s) or certification received, if any, for each

such enrollment or attendance:

ANSWER:

16

12. Have you ever been a member of the Armed Forces?

ANSWER:


following:

a) The branch of service:

ANSWER:

b) Serial number:

ANSWER:

c) Veteran's Administration Number (if applicable):

ANSWER:

d) The dates of service ending with the date of last

discharge:

ANSWER:

17

e) The highest rank or grade held:

ANSWER:

f) The type of discharge:

ANSWER:

g) The type of technical education or training received

and the length of such training:

ANSWER:

i) Whether you were ever exposed to asbestos, or asbestos-

containing products during your military service.

ANSWER:

18

J) If answer is affirmative, please describe in detail the

manner in which you were exposed, the type of duties

being performed, and the product to which you were

exposed.

ANSWER:

13. Have you ever been convicted of a crime other than a traffic

offense?

ANSWER:

If the answer is in the affirmative, please state fully in

detail the following:

a) The date(s), place(s), court(s) and nature(s)

conviction:

ANSWER:

14. Have you filed a suit for damages for any injuries?

ANSWER:


following:

a) Names and addresses of all the plaintiffs, defendants

and their attorneys for each such action:

ANSWER:

19

b) The case number, court, place and date of filing for

each such action:

ANSWER:

c) The nature and extent of injuries claimed for each such

action:

ANSWER:

d) The present status of each suit, and if concluded, the

final result, including the amount of any settlements

or judgments for each such action:

ANSWER:

15. Have you ever filed a Workers' Compensation Claim?

ANSWER:


following:

20

a) The claim number for each and every claim:

ANSWER:

b) The employer under which each and every claim was

filed:

ANSWER:

c) State the allowed conditions for each and every claim:

ANSWER:

d) State the amount of any compensation received for each

and every claim:

ANSWER:

e) The present status of each and every claim:

ANSWER:

21

16. Have you ever used cigarettes, cigars, or pipe or other

tobacco products of any kind?

ANSWER:


following:

a) The dates and time periods during which each type of

tobacco product was smoked or used:

ANSWER:

b) The types of tobacco products you smoked or used and

as to each such product whether the smoke was inhaled

or was not inhaled:

ANSWER:

c) The daily frequency with which tobacco products were

smoked or used (i.e., 2 packs of cigarettes daily, 3

cigars daily, 2 pipefuls daily, etc.):

ANSWER:

d) For any time period during which use of tobacco

products stopped, state the dates during which your use

ceased and the reasons why the use stopped:

ANSWER:

22

e) For any time period when the use of tobacco products

began after a period of having stopped, state the

reasons for restarting:

ANSWER:

f) If you ever smoked cigarettes, please state the average

number of packs per day and brand so consumed in each

of the following periods from 1930 to the present time:

ANSWER

1. 1930 to 1935 Brand(s)2. 1936 to 1939 Brand(s)

3. 1940 to 1945 Brand(s)

4. 1946 to 1949 Brand(s)

5. 1950 to 1955 Brand(s)

6. 1956 to 1959 Brand(s)

7. 1960 to 1965 Brand(s)

8. 1966 to 1969 Brand(s)

9. 1970 to 1975 Brand(s)

10. 1976 to 1979 Brand(s)

11. 1980 to 1985 Brand(s)

12. 1986 to pres. Brand(s)

g) If advice was ever given to you by any physician to

stop smoking or using tobacco products, identify each

physician who gave such advice, the dates on which the

advice was given and also state whether the advice was

followed:

ANSWER:

23

h) Are you award of the United States Surgeon General's

warning placed on all cigarette packages and

advertisements:

ANSWER:

If the answer to subpart (h) is in affirmative, please

indicate the date on which you first became aware of

such warning:

ANSWER:

j) Did you stop smoking at the time you became aware of

such warning?

ANSWER:

17. Has any diagnosis and/or prognosis of your medical condition

been made as a result of any illness or conditions allegedly

sustained as a result of any exposure to asbestos or

asbestos-containing products?

ANSWER:


following:

a) Each and every diagnosis which has been made:

ANSWER:

24

b) The date(s) of any such diagnosis:

ANSWER:

c) Identify each person making any such diagnosis:

ANSWER:

d) The prognosis made for each and every diagnosis:

ANSWER:

a) Identify each person making any such prognosis:

ANSWER:

f) The date of last prognosis regarding any diagnosis:

ANSWER:

25

f) The date the condition or conditions diagnosed first

manifested symptoms;

ANSWER:

18. For each and every symptom, indication, malaise, or

affliction which you contend to be directly or indirectly

related to any asbestos-related disease, disability or

physical condition, please state the following:

a) The nature and description of such symptom:

ANSWER:

b) The date, time, place and manner in which such symptom

first manifested itself or was made known to you,

including all pertinent information as to the source

of such knowledge:

ANSWER:

c) Whether you contend such symptom is related in any

fashion to your exposure to asbestos, and the nature

and extent of such relationship:

ANSWER:

d) All facts and opinions on which you rely in alleging

that the symptoms identified are related to exposure

to asbestos:

ANSWER:

26

19. Has any diagnosis and/or prognosis of your medical condition

been made as a result of any illness or conditions allegedly

sustained as a result of any exposure to silica or silica-

containing products?

ANSWER:


following:


ANSWER:


ANSWER:


ANSWER:

27


ANSWER:

e) Identify each person making any such prognosis:

ANSWER:


ANSWER:

g) The date the condition or conditions diagnosed first

manifested symptoms:

ANSWER:

28




of such knowledge:

ANSWER:


fashion to your exposure to silica, and the nature and

extent of such relationship:

ANSWER:



to silica.

ANSWER:

21. Have you ever been hospitalized, operated upon, or confined

to an institution, including nursing homes or extended care

facilities?

ANSWER:


following:

a) Names and addresses of all hospitals or institutions

involved:

ANSWER:

29

b) The beginning and ending dates of each period of

hospitalization or institutionalization;

ANSWER:

c) The nature of the illness, injury or complaint for

which you were admitted;

ANSWER:

d) The names and addresses and relationship to you of all

persons who treated or examined you:

ANSWER:

22. With respect to each physician, not listed in the preceding

interrogatory, who examined or treated you during your

lifetime to date, state the following:

a) Identify each physician and his address;

ANSWER:

b) List the complaint you had that caused you to see each

particular physician;

ANSWER:

30

c) The type of examination, the diagnosis and type of

treatment that each doctor gave you;

ANSWER:

d) The date or dates on which you were examined, diagnosed

and treated by each particular physician:

ANSWER:

23. Have you ever had x-rays taken of your chest other than at

any of the institutions listed previously, including x-rays

performed by the Armed Forces, employers or unions?

ANSWER:


following for each set of x-rays taken:

a) Name and address of the office or hospital where each

set of x-rays was taken:

ANSWER:

31

b) The reason(s) why such x-rays were taken;

ANSWER:

c) Whether anything was reported to you, and the nature

of any such report(s), as being the ex-ray diagnosis;

ANSWER:

d) Who paid to have the x-rays taken;

ANSWER:

e) The names and addresses of any physicians, hospitals,

clinics, or other persons to whom copies of x-ray

reports were sent:

ANSWER:

24. Have you ever had a pulmonary function test ("PFT") or

breathing test?

ANSWER:

32

If the answer is in the affirmative, please state for each

such test:

a) Name and address of the office or hospital where each

such PFT or breathing test was taken:

ANSWER:

b) The reason(s) why such PFT or breathing test was taken;

ANSWER:

c) Whether anything was reported to you, and the nature

of any such report(s), as being the PFT or breathing

test diagnosis:

ANSWER:

25. Have you ever had any of the following conditions? Please

place an "X" next to the appropriate answer and state the

date of diagnosis for each such condition:

a) bronchitis

b) emphysema

c) asthma

d) tuberculosise) Chronic Obstructive

Pulmonary Disease

Yes No Date of Diagnosis

f) pneumonia

g) high blood pressure

h) heart trouble

i) skin cancer

j) diverticulitis

k) colitis

1) ulcers

m) polyps

n) jaundice

o) arthritis

p) gout

33

26. Have you used any drugs or medicines during the past ten

(10) years in connection with any injury, complaint or

illness?

ANSWER:

If your answer is in the affirmative, please state fully in

detail:

a) A description of each item, including its name and

dosage:

ANSWER:

34

b) Identify the physician who prescribed each item, if

any:

ANSWER:

c) The injury, complaint or illness for which each item

was prescribed or used:

ANSWER:

d) The dates during which each item was used:

ANSWER:

27. Have you ever been discharged, or voluntarily left a job,

or changed residence due to health reasons?

ANSWER:

If the answer is in the affirmative, please state in detail

the dates, places and circumstances:

ANSWER:

35

28. Have you ever received financial benefits (other than

wages), either directly or indirectly, from any source at

any time in your lifetime (including but not limited to

government agencies, illness or disability wages from

employers, life or health insurance companies, service

providers or others)?

ANSWER:

If the answer is in the affirmative, please indicate the

following:

a) The date of each such payment(s):

ANSWER:

b) The source of each such payment(s):

ANSWER:

c) The time period and amount of each such payment(s):

ANSWER:

d) The reason for each such payment(s):

ANSWER:

36

e) The identity of all persons, including but not limited

to physicians, insurance carriers, government employees

or others who participated in the determination of each

such payment(s):

ANSWER:

29. Please identify each of your employers in whose employ you

claim you were exposed to asbestos. Include in your answer

the following:

a) the name, address and telephone number for each such

employer;

ANSWER:

b) For each such employer, indicate the jobsite, address

and inclusive dates of claimed exposure:

ANSWER:

c) Your job title and work description for each such

employment of claimed exposure:

ANSWER:

d) The dates of such employment of claimed exposure:

ANSWER:

37

e) The length of time you spent on each jobsite:

ANSWER:

f) The manufacturer, or if the manufacturer is unknown,

the trade name and/or the generic type of each and

every product which you believe contained asbestos,

to which you were exposed during each such employment,

and the dates from the first exposure to the last

exposure:

ANSWER:

g) Whether the jobs were inside work or outside work:

ANSWER:

30. For each exposure to asbestos and to products you believe

contained asbestos that are listed in the answer to

Interrogatory 29, please state the name and address of each

co-worker who has knowledge that these exposures occurred.

ANSWER:

38

31. Please identify each of your employers in whose employ you

claim you were exposed to silica. Include in your answer

the following:

a) The name, address and telephone number for each such

employer;

ANSWER:



ANSWER:

c) Your job title and work description for each such


ANSWER:


ANSWER:

39



every product which you believe contained silica, to

which you were exposed during each such employment, and

the dates from the first exposure to the last exposure:

ANSWER:


ANSWER:

h) For each job, whether it involved new construction,

repair, replacement or tear-out (specify which):

ANSWER:

32. For each exposure to silica and to products you believe

contained silica that are listed in the answer to

Interrogatory 31, please state the name and address of each

co-worker who has knowledge that these exposures occurred.

ANSWER:

33. Please state whether safety equipment such as respirators

or masks to reduce exposure to asbestos and/or silica

material was provided or required by any of your employers

(specify which):

ANSWER:

40

If the answer is in the affirmative, please state:

a) Whether you used the masks or respirators:

ANSWER:

b) If so, identify the jobsites at which you used such

masks or respirators:

ANSWER:

34. State whether showers were provided for each such

employment:

ANSWER:

35. State whether separate lockers for work and personal

clothing were provided for each such employment:

ANSWER:

41

36. Have you ever been a member of any trade or labor union?

ANSWER:

For each and every membership please list the following:

a) The union, including the local designation for each

such union membership:

ANSWER:

b) The beginning and ending dates of membership(s) and the

reasons why such membership(s) was terminated:

ANSWER:

c) The types of work authorized to perform by virtue of

each and every membership:

ANSWER:

d) The places, dates and offices held or the committees

on which you served in both the local and international

union(s) for each such membership:

ANSWER:

42

e) Whether union meetings are or were regularly attended

in reference to each such membership:

ANSWER:

£) The names of each and every publication(s) received

from the unions and the dates and frequency with which

they were received:

ANSWER:

g) The frequency with which such publications are or were

read (i.e., regularly, occasionally, rarely):

ANSWER:

37. State whether the you were exposed to asbestos or asbestos-

containing products which were manufacturer, sold, produced,

prepared or distributed by any entity not named as a

defendant in this lawsuit. If so, identify the

manufacturer, the product and the dates of exposure.

ANSWER:

38. Have you ever been exposed to asbestos or asbestos-

containing products outside the workplace?

ANSWER:

43


following:

a) The date of each such exposure:

ANSWER:

b) The place of each such exposure:

ANSWER:

d) The trade name(s) and/or manufacturer(s) of the

asbestos containing product(s) for each such exposure:

ANSWER:

e) The names and addresses of each individual with

knowledge to corroborate each such exposure:

ANSWER:

4439. State whether you have ever received any instruction,

recommendations or warnings of any kind regarding each

asbestos-containing product to which you were exposed (i.e.,

printed on container or package, tag, covering, or

instruction sheet accompanying the product, etc.):

ANSWER:

40. State whether you ever received any instructions or

recommendations by your employer or superior at any time

regarding the safety precautions to be taken when using each

asbestos-containing product to which you were exposed,

including, but not limited to, the creation, inhalation or

ingestion of dust.

ANSWER:

41. Did you at any time receive, have knowledge of, or possess

any advice, publication, warning, order, directive,

requirement or recommendation, written or oral, which

purported to either advise or warn you of the possible

harmful effects of exposure to or inhalation of, asbestos,

asbestos-containing materials, silica, or silica-containing

materials?

ANSWER:

42. Did you at any time receive, have knowledge of, or possess

any advice, publication, warning, order, directive,

requirement or recommendation, either written or oral, which

purported to advise or recommend techniques, methods or

equipment which would serve to reduce or guard against such

potentially harmful exposure?

ANSWER:

45


following:

a) The nature and exact working of such advice, warning,

recommendation etc.:

ANSWER:

b) The complete identity of each source of such advice,

warning or recommendation, etc.:

ANSWER:

c) The date, time, place and manner and circumstances when

each such advice, warning, recommendation, etc. was

given:

ANSWER:

e) Identify each and every co-worker or similar member of

your trade and occupation who also received the same

or similar advice, warning, recommendation, etc.:

ANSWER:

46

43. Have you ever provided testimony, or been SPRINT interviewed

in a lawsuit?

ANSWER:


following:

a) The name of the case and case number for which each

such testimony or SPRINT interview was given:

ANSWER:

b) The nature of each such proceeding and/or testimony:

ANSWER:

c) The approximate date when each such testimony and/or

SPRINT interview was given:

ANSWER:

44. Have you ever been exposed to radiation medically,

incidentally or occupationally?

ANSWER:

47

If the answer is int he affirmative, describe the

circumstances of exposure and date or dates of exposure:

ANSWER:

45. State the nature, extent and frequency of any physical

examinations which any of your employers required or made

available to you, and the frequency (with specific dates)

with which you submitted to such examinations.

ANSWER:

46. Please state whether you have obtained any judgments,

settlements, or compromises, payments from or entered into

any agreements with any person or entity arising from

exposure to asbestos, asbestos-containing products, silica

or silica containing products.

ANSWER:


a) The amount of such each and.every judgment, settlement,

compromise or payment:

ANSWER:

48

b) The date upon which each such judgment, settlement,

compromise or payment was received:

ANSWER:

c) The person or entity from whom such judgment,

settlement, compromise or payment was received:

ANSWER:

47. Please state whether you have entered into any agreement

with any party or non-party to this litigation regarding

future claims or payments resulting from your alleged


or silica-containing products.

ANSWER:


a) The amount of consideration for each such agreement:

ANSWER:

b) The date upon which each agreement was entered into:

ANSWER:

49

c) The person or entity with whom each such agreement was

reached:

ANSWER:

d) The dates upon which each such payment is to be

received:

ANSWER:

REQUEST FOR PRODUCTION OF DOCUMENTS

1. Identify and produce all literature or other documents which

relate to the product or products, allegedly containing

asbestos and/or silica, to which you claim you were exposed

which are in your possession or in the possession of your

attorney.

2. Identify and produce your complete work history including

the location of each and every jobsite at which you worked

wherein you claim you were exposed to asbestos and/or

silica. for each such jobsite, state the dates you were

present, the length of time you spent at each jobsite, the

name and manufacturers of each asbestos-containing product

to which you were exposed at each jobsite, the name of your

employer, the type of work you performed, and the names and

addresses of each co-worker with whom you worked.

3. Identify and produce all literature or other documents in

your possession or in the possession of your attorney, that

constitute or relate to advice, warnings, orders,

directives, requirements or recommendations, which purported

to advise you of the possible harmful effects of exposure

to asbestos or asbestos-containing products, or of

techniques, methods, or equipment which would serve to

reduce or guard against such exposure.

4. Identify and product all literature or other documents which

relate to your claim of conspiracy as to each defendant

named in this Iawsuit.

S. Identify and produce all medical records and reports in your

possession or in the possession of your attorney.

6. Copies of all bills and receipts for medical services,

drugs, medication, doctors' fees or other expenses incurred

as a result of the injuries you allege you received relevant

to this lawsuit.

50

7. All documents regarding any and all x-ray screening and the

results thereof.

9. Identify and produce tax returns for the last ten (10)

years, a Social Security Statement of Earnings, and any

other documents relating to income earned in the last ten

(10) years which are in your possession or in the possession

of your attorney.

9. Identify and product all non-medical expert reports which

are in your possession or in the possession of your

attorney.

10. Identify and produce all documents and prior testimonies of

which you have knowledge which relate to your allegation

that you are entitled to receive punitive or exemplary

damages.

11. Identify and produce the names and full addresses of all

persons you expect to call as expert witnesses at trial,

including a summary of the testimony that each witness is

expected to give.


non-experts you expect to call as witnesses at trial


expected to give.

13. Documents in your possession constituting or relating to

your employment history including, but not limited to,

documents which would indicate the place(s) or department(s)

of your employer(s) in which you worked, the dates worked,

and the names of co-workers with whom you worked at each job

or jobsite.

14. Any lists which have been prepared or which have been

prepared by others on your behalf which indicate the types

of products to which you claim you were exposed, and the

names of the manufacturers, installers, distributors,

sellers, suppliers and outside contractors of those

products.

15. All documents pertaining to union memberships, meetings or

events relating to the discussions or warnings given

concerning hazardous exposures in the workplace and

precautions to be taken.

16. Any and all documents or photographs you have reviewed or

will review in preparation for any testimony you may give

in this case or as a co-worker in any other case.

17. Identify and product all documents, other than those

previously identified in your responses to these requests,

that you expect to offer as evidence at trial.

18. Copies of all documents supporting the itemization of

damages you claim in this suit.

51

AUTHORIZATION FOR RELEASE OF MEDICAL INFORMATION

TO:

This is authority for you to permit any attorney of record,

or his or her agent, or any records service or its agents, to

copy, inspect, and examine any and all records, charts, reports,

pathology materials, original x-rays, x-ray reports, in your

possession pertaining to all examinations and treatments rendered

to:

NAME:

SS #:

DOB:

DATE:

This authorization shall remain valid for a period of eight

months from the date set forth herein and authorize the provider

to honor all requests for records and/or other materials made

within that period of time.

STATE OF OHIO

) SS:

COUNTY OF

SWORN AND TO SUBSCRIBED before me, a notary public in and

for said county and state on this day of , 19

NOTARY PUBLIC

PHOTCOPIES OF THIS AUTHORIZATION SHALL BE MADE AND SHALL HAVE

THE SAME AUTHORITY AS THE ORIGINAL

*Name of party seeking to provide his or her medical release.

52

AUTHORIZATION FOR RELEASE OF WORKERS' COMPENSATION INFORMATION

TO:


or any agent of any attorney of record, to copy, inspect, and

examine any and all records, correspondence, medical reports, in

your possession pertaining to any and all Workers' Compensation

claims involving:

NAME:

SS#:

DOB:

CI.AIM NO:

PHOTOCOPIES OF THIS AUTHORIZATION SHALL BE MADE AND SHALL HAVE

THE SAME AUTHORITY AS THE ORIGINAL.

DATE:

STATE OF OHIO

COUNTY OF

ss:

SWORN TO AND SUBSCRIBED before me, a notary public in and


NOTARY PUBLIC

53

EXHIBIT C

IN THE COURT OF COMMON PLEAS


IN RE:

ASBESTOS LITIGATION

DEFENDANT'S MASTER

CONSOLIDATED DISCOVERY

REQUESTS TO PLAINTIFFS

FOR DEATH CASES

Pursuant to Rules 33, 34 and 36 of the Ohio Rules of Civil

Procedure, defendants propound the following Master Consolidated

discovery Requests including Interrogatories, Requests for

Admissions and Requests for Production of Documents to each

plaintiff. The Interrogatories are to be answered under oath by

each plaintiff listed above; the Requests for Admissions are to

be answered or objected to by the each plaintiff or his attorney;

and the documents requested are to be produced or objections

thereto served on all defendants' attorneys within twenty-eight

(28) days of service hereof.

These Consolidated Discovery Requests are continuing in

nature and require each plaintiff to file supplemental answers

in accordance with Rule 26(e) of the Ohio Rules if further or

different information is obtained after the initial answers and

before trial, including in such supplemental answers the date

upon and manner in which such further or different information

came to each plaintiff's attention.

1

EXPLANATION AND DEFINITIONS

This document includes both interrogatories and a request

for production of documents. The documents to be produced are

in each instance identified by responses to the interrogatories

contained herein.

As used in these interrogatories and document requests, the

terms listed below are defined as follows:

(A) "You", "your", "yourself", "plaintiff" or "plaintiffs"

means each plaintiff, each individual allegedly exposed to

asbestos, (the decedent, if applicable), and all other persons

acting or purporting to act on each plaintiff's behalf.

(b) "Defendants", unless otherwise specified, means any

defendant named as a party to this action, as well as any

predecessors in interest to any named defendants, and all other

subsidiaries or divisions of any named defendants.

(C) "Document" or "documents" means any writing of any

kind, including originals and all nonidentical copies (whether

different from the originals by reason of any notation made on

such copies or otherwise), including without limitation

correspondence, memoranda, notes, desk calendars, diaries,

statistics, letters, telegrams, minutes, contracts, reports,

studies, checks, invoices, statements, receipts, returns

warranties, guarantees, summaries, pamphlets, books,

prospectuses, interoffice and intraoffice communications, offers,

notations of any sort of conversations, telephone calls, meetings

or other communications, bulletins, magazines, publications,

printed matter, photographs, computer printouts, teletypes,

telefax, invoices, worksheets and all drafts, alteration,

modifications, changes and amendments of any of the foregoing

tapes, tape recordings, transcripts, graphic or aural records or

representations of any kind, and electronic, mechanical or

electric records or representations of any kind, of which each

plaintiff has knowledge or which are

2now or were formerly in each plaintiff's actual or constructive

possession, custody or control.

(D) "Possession, custody or control" includes the joint or

several possession, custody or control not only by the person

to whom these interrogatories and requests are addressed, but

also the joint or several possession, custody or control by each

or any other person acting or purporting to act on behalf of the

person, whether as employee, attorney, accountant, agent,

sponsor, spokesman, or otherwise.

(E) "Relates to" means supports, evidences, describes,

mentions, refers to, contradicts or comprises.

(F) "Person" means any natural person, firm, corporation,

partnership, proprietorship, joint venture, organization, group

of natural persons, or other association separately identifiable,

whether or not such association has a separate juristic existence

in its own right.

(G) "Identify", "identity" and "identification", when used

to refer to an entity other than a natural person, means to state

its full name, the present or last known address of its principal

office or place of doing business, and the type of entity (e.g.,

corporation, partnership, unincorporated association).

(H) "Identify", "identity" and "Identification", when used

to refer to a natural person, means to state the following:

(1) the person's full name and present or last known

home address, home telephone number, business address and

business telephone number;

(2) The person's present title and employer or other

business affiliation;

(3) the person's home address, home telephone number,

business address and business telephone number at the time of the

actions at which each interrogatory is directed: and

3

(4) his employer and title at the time of the actions

at which each interrogatory is directed.

(I) "Identify", "identity" and "identification", when used

to refer to a document, mean to state the following:

(1) the subject of the document;

(2) the title of the document;

(3) the type of document (e.g., letter, memorandum,

telegraph, chart);

(4) the date of the document, or if the specific date

thereof is unknown, the month and year or other best

approximation of such date;

(5) the identity of the person or persons who wrote,

contributed to, prepared or originated such document; and

(6) the present or last known location and custodian

of the document.

(J) "His" means his and/or her and "he" means he and/or

she.

INSTRUCTIONS

(A) With respect to each interrogatory, in addition to

supplying the information asked for and identifying the specific

documents referred to, identify all documents which were referred

to in preparing your answers thereto.

(B) If any document identified in an answer to an

interrogatory was, but is no longer in your possession or subject

to your custody or control, or was known to you, but is no longer

in existence, state what disposition was made of it or what

became of it.

(C) If any document is withheld from production hereunder

on the basis of a claim of privilege or otherwise, identify each

such document and the grounds upon which its production is being

withheld.

(D) Attached to these interrogatories and request for

production of documents is

4

a medical authorization to obtain the decedent's medical records.

This medical authorization should be signed by the plaintiff and

returned with the Answers to Interrogatories.

INTERROGATORIES


A) Your full name:

ANSWER:

b) All of the names by whom you have been know, including

nicknames, maiden names or aliases:

ANSWER:

c) Your present address and the date you first resided at

that address:

ANSWER:

d) The addresses at which you have resided for five (5)

years prior to this date:

ANSWER:

e) Your Social Security number:

5

ANSWER:

f) Your date of birth:

ANSWER:

2. If this is a death claim, please state the following:

a) The decedent's full name:

ANSWER:

b) All of the names by which the decedent has been known,

including nicknames, maiden names or aliases:

ANSWER:

c) The decedent's last address:

ANSWER:

d) The decedent's Social Security number:

ANSWER:

6

e) The decedent's date and place of birth:

ANSWER:

f) The decedent's date and place of death:

ANSWER:

g) Your relationship to the decedent:

ANSWER:

h) The Probate Court and case number for the decedent's

estate:

ANSWER:

3. Are you employed?

ANSWER:

a) If your answer is in the affirmative, please state your

current occupation, place of employment, and the date

you first became so employed:

ANSWER:

7

b) If your answer is in the negative, please state your

last occupation, your last place of employment, the

date you last worked, and your reason(s) for not

working since that time:

ANSWER:


a) The decedent's last occupation:

ANSWER:

b) Decedent's last place of employment:

ANSWER:

c) The date decedent last worked:

ANSWER:

d) The reason(s) decedent stopped working:

ANSWER:

5. State the following with respect to decedent's parents:

8

a) The names of decedent's mother and father:

ANSWER:

b) Their dates of birth:

c) Their current health conditions:

ANSWER:

d) If deceased, their date of death:

ANSWER:

e) If deceased, their cause of death:

ANSWER:

6. Did decedent have any other brothers and/or sisters?

ANSWER:

9


following for each such brother and/or sister:

a) The names and addresses of each such brother and/or

sister:

ANSWER:

b) The age of each such brother and/or sister:

ANSWER:

c) The current health condition of each brother and/or

sister:

ANSWER:

d) If deceased, the age at death for each deceased brother

and/or sister:

ANSWER:

e) If deceased, the cause of death for each deceased

brother and/or sister:

ANSWER:

7. Has any member of decedent's family ever filed a suit for

an asbestos-related

10

disease?

ANSWER:


following:

a) Identify the name of the family member:

ANSWER:

b) Their relation(s) to the decedent:

ANSWER:

c) The case name(s), court(s) and case number(s) of the

lawsuit(s):

ANSWER:

8. If you are currently married, state the following:


ANSWER:

b) Your spouse's name:

ANSWER:

11

c) Your spouse's date of birth:

ANSWER:

d) Your spouse's Social Security number:

ANSWER:

e) Your spouse's occupation:

ANSWER:

£) The name and address of your spouse's employer:

ANSWER:

g) Whether your spouse is employed full-time or part-time:

ANSWER:

h) the amount of our spouse's average gross monthly

salary:

ANSWER:

i) Whether your spouse was financially dependent upon you

at the

12

commencement of this action:

ANSWER:

9. Was decedent married at the time of his death?

ANSWER:

10. If the answer to the immediately preceding interrogatory is

affirmative, please state with respect to the spouse to whom

decedent was married at the time of his death:

ANSWER:


ANSWER:

b) The spouse's name:

ANSWER:

c) The spouse's date of birth:

ANSWER:

d) The spouse's Social Security number:

ANSWER:

13

e) The spouse's present occupation:

ANSWER:

f) The name and address of spouse's current employer:

ANSWER:

g) Whether spouse is currently employed full-time or part-

time:

ANSWER:

h) The amount of the spouse's average gross monthly

salary:

ANSWER:

i) Whether the spouse was financially dependent upon the

decedent at the time of his death:

ANSWER:

7) Whether decedent and the spouse were ever voluntarily

or legally separated?

14

ANSWER:

k) If applicable, state the circumstances inclusive dates

and length of time of any such legal or voluntary

separation.

ANSWER:

11. Has the decedent ever had any previous marriages?

ANSWER:


following:

a) The name(s) of any former spouse(s):

ANSWER:

b) The address(es) of any former spouse(s):

ANSWER:

c) The date of termination of any previous marriages:

ANSWER:

15

d) If terminated by court order, the court(s), city or

cities, and the circumstances under which the marriage

or marriages were dissolved or terminated:

ANSWER:

12. Did the decedent have children?

ANSWER:


following for each child:

a) The name of each such child:

ANSWER:

b) The address of each such child:

ANSWER:

c) The age of each such child:

ANSWER:

16

d) The occupation of each such child:

ANSWER:

a) The current health condition, including specific

medical problems of each such child:

ANSWER:

f) Whether any such child was financially dependent upon

the decedent at the time of death. If so, state the

name of such dependent child.

ANSWER:

g) If any child is deceased, state his or her date of

death, cause of death, and age at death:

ANSWER:

13. Was any who is not listed in the preceding interrogatory

financially dependent upon decedent at time of his death?

ANSWER:

17


following:

a) The name of each such dependent:

ANSWER:

b) The date of birth of each such dependent:

ANSWER:

c) The relationship to the decedent of each such

dependent:

ANSWER:

d) Whether the decedent had legal custody of each such

dependent:

ANSWER:

e) If custody was awarded to the decedent by court decree,

state the date such custody was obtained for each such

dependent:

ANSWER:

14. Did decedent graduate from high school?

ANSWER:

18


following:

a) The date graduated and the name of the school:

ANSWER:

15. Has decedent ever enrolled or attended any colleges,

vocational schools, union sponsored training, or

correspondence courses?

ANSWER:


following:

a) The name(s) and address(es) of each such institution:

ANSWER:

b) The date(s) attended:

ANSWER:

c) Courses of study:

ANSWER:

19

d) Degree(s) or certification received, if any, for each

such enrollment or attendance;

ANSWER:

16. Has decedent ever been a member of the Armed Forces?

ANSWER:


following:

a) The branch of service:

ANSWER:

b) Serial number:

ANSWER:

c) Veteran's Administration Number (if applicable):

ANSWER:

d) The dates of service ending with the date of last

discharge:

ANSWER:

20

e) The highest rank or grade held:

ANSWER:

f) The type of discharge:

ANSWER:

g) The type of technical education or training received

and the length of such training:

ANSWER:

h) Whether any injury occurred while in the service

(explain):

ANSWER:

i) Whether decedent was ever exposed to asbestos, or

asbestos-containing products during his military

service.

ANSWER:

21

j) If the answer is affirmative, please describe in detail

the manner in which decedent was exposed, the type of

duties being performed, and the product to which

decedent was exposed.

ANSWER:

17. Has decedent ever been convicted of a crime other than a

traffic offense?

ANSWER:

If the answer is in the affirmative, please state fully in

detail the following:

a) The date(s), place(s), court(s) and nature(s) of each

conviction:

ANSWER:

18. Has decedent ever filed a suit for damages for any personal

injuries?

ANSWER:


following:

a) Names and addresses of all the plaintiffs, defendants

and their attorneys for each such action:

ANSWER:

22b) The case number, court, place and date of filing for

each such action:

ANSWER:

c) The nature and extent of injuries claimed for each such

action:

ANSWER:

d) The present status of each suit, and if concluded, the

final result, including the amount of any settlements

or judgments for each such action:

ANSWER:

19. Have you ever filed a Workers' Compensation Claim?

ANSWER:


following:


ANSWER:


filed:

ANSWER:

23


ANSWER:


and every claim:

ANSWER:


ANSWER:

20. Has the decedent ever filed a Worker's Compensation Claim?

ANSWER:


following:


ANSWER:

24


filed:

ANSWER:


ANSWER:


and every claim:

ANSWER:


ANSWER:

21. Did the decedent ever use cigarettes, cigars, or pipe or

other tobacco products of any kind?

ANSWER:


following:

a) The dates and time periods during which each type of

tobacco products was smoked or used:

25

ANSWER:

b) The types of tobacco products decedent smoked or used

and as to each such product whether the smoke was

inhaled or was not inhaled:

ANSWER:

c) The daily frequency with which tobacco products were

smoked or used (i.e., 2 packs of cigarettes daily, 3

cigars daily, 2 pipefuls daily, etc.):

ANSWER:

d) For any time period during which use of tobacco

products stopped, state the dates during which

decedent's use ceased and the reasons why the use

stopped:

ANSWER:

e) For any time period when the use of tobacco products

began after a period of having stopped, state the

reasons for restarting:

ANSWER:

f) If decedent ever smoked cigarettes, please state the

average number of packs per day and brand so consumed

in each of the following periods from 1930

26

to the present time:

ANSWER:

1. 1930 to 1935 Brand(s)

2. 1936 to 1939 Brand(s)

3. 1940 to 1945 Brand(s)

4. 1946 to 1949 Brand(s)

5. 1950 to 1955 Brand(s)

6. 1956 to 1959 Brand(s)

7. 1960 to 1965 Brand(s)

8. 1966 to 1969 Brand(s)

9. 1970 to 1975 Brand(s)

10. 1976 to 1979 Brand(s)

11. 1980 to 1985 Brand(s)

12. 1986 to pres. Brand(s)

g) If advice was ever given by any physician to decedent

to stop smoking or using tobacco products, identify

each physician who gave such advice, the dates on which

the advice was given, and also state whether the advice

was followed:

ANSWER:

h) Was decedent award of the United States Surgeon

General's warning placed on all cigarette packages and

advertisements:

ANSWER:

27

i) If the answer to subpart (h) is in the affirmative,

please indicate the date on which the decedent first

became award of such warning:

ANSWER:

j) Did the decedent stop smoking at the time he became

aware of such warning?

ANSWER:

22. Has any diagnosis and/or prognosis of decedent's medical

condition been made as a result of any illness or conditions

allegedly sustained as a result of any exposure to asbestos

or asbestos-containing products?

ANSWER:


following:


ANSWER:


ANSWER:


28

ANSWER:


ANSWER:


ANSWER:


ANSWER:



ANSWER:



related to any asbestos-related disease, disability or

physical condition, please state the following:


ANSWER:

29

b) The date, time, place and manner in which such

symptom first manifested itself or was made known to

you, including all pertinent information as to the

source of such knowledge:

ANSWER:


fashion to decedent's exposure to asbestos, and the

nature and extent of such relationship:

ANSWER:



to asbestos:

ANSWER:

24. Has any diagnosis and/or prognosis of decedent's medical

condition been made as a result of any illness or conditions

allegedly sustained as a result of any exposure to silica

or silica-containing products?

ANSWER:


following:


30

ANSWER:


ANSWER:


ANSWER:


AfISWER:


ANSWER:


ANSWER:

31



ANSWER:



related to any alleged silicosis or silica-related disease,

disability or physical condition, please state the

following:


ANSWER:




of such knowledge:

ANSWER:


fashion to decedent's exposure to silica, and the

nature and extent of such relationship:

ANSWER:



to silica:

ANSWER:

32

26. Has the decedent ever been hospitalized, operated upon, or

confined to an institution, including nursing homes or

extended care facilities?

ANSWER:


following:

a) Names and addresses of all hospitals or institutions

involved;

ANSWER:

b) The beginning and ending dates of each period of

hospitalization or institutionalization;

ANSWER:

c) The nature of the illness, injury or complaint for

which decedent was admitted;

ANSWER:

d) The names and addresses and relationship to decedent

of all persons who treated or examined decedent:

ANSWER:

33

27. With respect to each physician, not listed in the preceding

interrogatory, who examined or treated the decedent during

his lifetime to date, state the following:

a) Identify each physician and his address;

ANSWER:

b) List the complaint decedent had that caused him to see

each particular physician;

ANSWER:

c) The type of examination, the diagnosis and type of

treatment that each doctor gave decedent;

ANSWER:

d) The date or dates on which decedent was examined,

diagnosed and treated by each particular physician:

ANSWER:

28. Has the decedent ever had x-rays taken of his chest other

than at any of the institutions listed previously, including

x-rays performed by the Armed forces, employers or unions?

ANSWER:

34


following for each set of x-rays taken:

a) name and address of the office or hospital where each

set of x-rays was taken;

ANSWER:

b) the reason(s) why such x-rays were taken;

ANSWER:

c) whether anything was reported to decedent, and the

nature of any such report(s), as being the x-ray

diagnosis;

ANSWER:

d) who paid to have the x-rays taken;

ANSWER:

e) the names and addresses of any physicians, hospitals,

clinics, or other persons to whom copies of x-ray

reports were sent:

ANSWER:

29. Has decedent ever had a pulmonary function test ("PFT") or

breathing test?

35

ANSWER:

If the answer is in the affirmative, please state for each

such test:

a) name and address of the office or hospital where each

such PFT or breathing test was taken;

ANSWER:

b) the reason(s) why such PFT or breathing test was taken;

ANSWER:

c) whether anything was reported to decedent, and the

nature of any such report(s), as being the PFT or

breathing test diagnon for such agreement:

ANSWER:

30. Please identify each of decedents employers in whose employ

you claim decedent was exposed to asbestos. Include in your

answer the following;

a) The name, address and telephone number for each such

employeet

ANSWER:



ANSWER:

36

c) Decedent's job title and work description for each such


ANSWER:


ANSWER:


ANSWER:



every product which decedent believed contained

asbestos, to which decedent was exposed during each

such employment, and the dates from the first exposure

to the last exposure:

ANSWER:

g) whether the jobs were inside work or outside work:

ANSWER:


repair, replacement or

37

tear-out (specify which):

ANSWER:

31. For each exposure to asbestos and to products decedent

believed contained asbestos that are listed in the answer

to Interrogatory 29, please state the name and address of

each co-worker who has knowledge that these exposures

occurred.

ANSWER:

32. Please identify each of decedent's employers in whose

employee decedent claimed exposure to silica. Include in

your answer the following:

a) the name, address and telephone number for each such

employer;

ANSWER:



ANSWER:

c) Decedent's job title and work description for each such


ANSWER:

38


ANSWER:

e) The length of time decedent spent on each jobsite:

ANSWER:



every product which decedent believed contained silica,

to which decedent was exposed during each such

employment, and the dates from the first exposure to

the last exposure:

ANSWER:


ANSWER:


repair, replacement or tear-out (specify which):

ANSWER:

33. For each exposure to silica and to products decedent

believed contained silica that are listed in the answer to

Interrogatory 31, please state the name and address of

39

each co-worker who has knowledge that these exposures

occurred.

ANSWER:

34. Please state whether safety equipment such as respirators

or masks to reduce exposure to asbestos and/or silica

material was provided or required by any of decedent's

employers (specify which):

ANSWER:


a) whether decedent used the masks or respirators:

ANSWER:

b) If so, identify the jobsites at which decedent used

such masks or respirators:

ANSWER:

35. State whether showers were provided for each such

employment:

ANSWER:

40

36. State whether separate lockers for work and personal

clothing were provided for each such employment:

ANSWER:

37. Has decedent ever been a member of any trade or labor union?

ANSWER:

For each and every membership please list the following:

a) The union, including the local designation for each

such union membership:

ANSWER:

b) The beginning and ending dates of membership(s) and the

reasons why such membership(s) was terminated:

ANSWER:

c) The types of work authorized to perform by virtue of

each and every membership:

ANSWER:

41

d) The places, dates and offices held or the committees

on which decedent served in both the local and

international union(s) for each such membership:

ANSWER:

e) Whether union meetings are or were regularly attended

in reference to each such membership:

ANSWER:

f) The names of each and every publication(s) received

from the unions and the dates and frequency with which

they were received:

ANSWER:

9) The frequency with which such publications are or were

read (i.g., regularly, occasionally, rarely):

ANSWER:

38. State whether the decedent was exposed to asbestos or

asbestos-containing products which were manufactured, sold,

produced, prepared or distributed by any entity not named

as a defendant in this lawsuit. If so, identify the

manufacturer, the product and the dates of exposure.

ANSWER:

42

39. Has decedent ever been exposed to asbestos or asbestos-

containing products outside the workplace?

ANSWER:


following:

a) The date of each such exposure:

ANSWER:

b) The place of each such exposure:

ANSWER:

c) The frequency of each such exposure:

ANSWER:

d) The trade name(s) and/or manufacturer(s) of the

asbestos containing product(s) for each such exposure:

ANSWER:

43

e) The names and addresses of each individual with

knowledge to corroborate each such exposure:

ANSWER:

40. State whether decedent has ever received any instructions,

recommendations or warning of any kind regarding each

asbestos-containing product to which decedent was exposed

(i.e., printed on container or package, tag, covering, or

instruction sheet accompanying the product, etc.):

ANSWER:

41. State whether decedent ever received any instructions or

recommendations by decedent's employer or superior at any

time regarding the safety precautions to be taken when using

each asbestos-containing product to which decedent was

exposed, including, but not limited to, the creation,

inhalation or ingestion of dust.

ANSWER:

42. Did decedent at any time receive, have knowledge of, or

possess any advice, publication, warning, order, directive,

requirement or recommendation, written or oral, which

purported to either advise or warn decedent of the possible

harmful effects of exposure to, or inhalation or, asbestos,

asbestos-containing materials, silica, or silica-containing

materials?

43. Did decedent at any time receive, have knowledge of, or

possess any advice, publication, warning, order, directive,

requirement or recommendation, either written or oral, which

purported to advise or recommend techniques, methods or

equipment

44

which would serve to reduce or guard against such

potentially harmful exposure?

ANSWER:


following:

a) The nature and exact wording of such advice, warning,

recommendation etc.:

ANSWER:

b) The complete identity of each source of such advice,

warning or recommendation, etc.:

ANSWER:

c) The date, time, place and manner and circumstances when

each such advice, warning, recommendation, etc. was

given:

ANSWER:

d) Identify each and every witness to the receipt of such

advice, warning, recommendation, etc.:

ANSWER:

45

e) Identify each and every co-worker or similar member of

decedent's trade and occupation who also received the

same or similar advice, warning, recommendation, etc.:

ANSWER:

44. Has decedent ever provided testimony, or been SPRINT

interviewed in a lawsuit?

ANSWER:


following:

a) The name of the case and case number for which each

such testimony or SPRINT interview was given:

ANSWER:

b) The nature of each such proceeding and/or testimony:

ANSWER:

c) The approximate date when each such testimony and/or

SPRINT interview was given:

ANSWER:

46

45. Has decedent ever been exposed to radiation medically,

incidentally or occupationally?

ANSWER:

If the answer is in the affirmative, describe the

circumstances of exposure and date or dates of exposure:

ANSWER:

46. State the nature, extent and frequency of any physical

examinations which any of decedent's employers required or

made available to decedent and the frequency (with specific

dates) with which decedent submitted to such examinations.

ANSWER:

47. Please state whether decedent had obtained any judgments,

settlements, or compromises, payments from or entered into

any agreements with any person or entity arising from



ANSWER:


a) The amount of such each and every judgment, settlement,

compromise or payment:

ANSWER:

47

b) the date upon which each such judgment, settlement,

compromise or payment was received:

ANSWER:

c) The person or entity from whom such judgment,

settlement, compromise or payment was received:

ANSWER:

48. Please state whether decedent had entered into any agreement

with any party or non-party to this litigation regarding

future claims or payments resulting from decedent's alleged



ANSWER:


a) the amount of consideration for each such agreement;

ANSWER:

48

b) The date upon which each agreement was entered into:

ANSWER:

c) The person or entity with whom each such agreement was

reached:

ANSWER:

d) The dates upon which each such payment is to be

received:

ANSWER:

e) The date upon which each agreement was entered into:

ANSWER:

f) The person or entity with whom such agreement was

reached:

ANSWER:

g) The dates upon which payment is to be received:

ANSWER:

49REQUEST FOR PRODUCTION OF DOCUMENTS

1. Identify and product all literature or other documents which

relate to the product or products, allegedly containing

asbestos and/or silica, to which you claim decedent was

exposed which are in your possession or in the possession

of your attorney.

2. Identify and product a complete work history of the decedent

including the location of each and every jobsite at which

decedent worked wherein plaintiff claims decedent was

exposed to asbestos and/or silica. For each such jobsite,

state the dates decedent was present, the name of decedent's

employer, the type of work decedent performed and the names

and addresses of each co-worker with whom decedent worked.

3. Identify and product all literature or other documents, in

your possession or in the possession of your attorney, that

constitute or relate to advice, warnings, orders,

directives, requirements or recommendations, which purported

to advise the decedent of the possible harmful effects of

exposure to asbestos or asbestos-containing products, or of

techniques, methods, or equipment which would serve to

reduce or guard against such exposure.

4. Identify and produce all literature or other documents which

relate to your claim of conspiracy as to each defendant

named in this lawsuit.

5. Identify and product all medical records and reports,

including autopsy report and death certificate, in your

possession or in the possession of your attorney.

6. If this a death claim, identify and produce the appropriate

probate papers which designate the appointment of the

fiduciary of the decedent's estate in your possession or in

the possession of your attorney.

7. Identify and product tax returns for the last ten (10)

years, a Social Security Statement of Earnings, and any

other documents relating to income earned in the last ten

(10) years which are in your possession or in the possession

of your attorney.

S. Identify and produce all non-medical experts reports which

are in your possession or in the possession of your

attorney.

9. Identify and product all documents and prior testimonies of

which you have knowledge which relate to your allegation

that you are entitled to receive punitive or exemplary

damages.

10. Identify and product the names and full addresses of all

persons you expect to call as expert witnesses at trial,


expected to give.

50


non-experts you expect to call as witnesses at trial


expected to give.

12. Identify and produce all documents, other than those

previously identified in your responses to these requests,

that you expect to offer as evidence at trial.

51

AUTHORIZATION FOR RELEASE OF WORKERS' COMPENSATION INFORMATION

TO:


or any agent of any attorney of record, to copy, inspect, and

examine any and all records, correspondence, medical reports, in

your possession pertaining to any and all Workers' compensation

claims involving:

NAME:

SS#:

DOB:

CLAIM NO:

PHOTOCOPIES OF THIS AUTHORIZATION SHALL BE MADE AND SHALL HAVE

THE SAME AUTHORITY AS THE ORIGINAL.

DATE:

STATE OF OHIO

) ss:

COUNTY OF

SWORN TO AND SUBSCRIBED before me, a notary public in and


NOTARY PUBLIC

TAB 2

IN THE COURT OF COMMON PLEASCUYAHOGA COUNTY, OHIO

ASBESTOS DOCKET

MASTER CONSOLIDATED COMPLAINT

JURY TRIAL DEMANDED

VASILIOS PYROVOLIKOS )1654 ROOSEVELT AVENUE ) CASE NO:

STEUBENVILLE, OH, 43952JUDGE:

STELLA PYROVOLIKOS )1654 ROOSEVELT AVENUE

STEUBENVILLE, OH, 43952

CASE NO:LAWRENCE RAFAIANI336 OLD OAK DRIVE ) JUDGE:

CORTLAND, OH, 44410

FRANCIS RAFAIANI336 OLD OAK DRIVE

CORTLAND, OH, 44410

)EDWARD REITTER ) CASE NO:RT 2 BOX 282 L )

COLLIERS, WV, 26035 ) JUDGE:

)

EDWARD RILEY CASE NO:1735 MATTHEWS ROAD

YOUNGSTOWN, OH, 44514 ) JUDGE:

SUZANNE RILEY1735 MATTHEWS ROAD

YOUNGSTOWN, OH, 44514

))

RONALD ROBER'TS863 TOWNSHIP ROAD 145

CASE NO:)

IRONTON, OH, 45638

NORMA ROBERTS863 TOWNSHIP ROAD 145

IRONTON, OH, 45638

) JUDGE:

)

))

CARL ROSE2500 LYNN ROAD

NORTH LIMA, 011, 44452

CASE NO:

JUDGE:

CASE NO:NICK ROSIAN301 CHAPEL LANE

CANFIELD, OH, 44406

DIANE ROSIAN301 CHAPEL LANE

CANFIELD, OH, 44406

JUDGE:

KENNER RUSSO4535 PLUMBROOK DRIVE

CANFIELD, OH, 44406

CAROL RUSSO4535 PLUMBROOK DRIVE

CASE NO:)

2

CANFIELD, OH, 44406

EDWARD SACCOMEN ) CASE NO:163 S. BEVERLY AVENUE

YOUNGSTOWN, OH, 44515 ) JUI)GE:

ROXANN SACCOMEN )163 S. BEVERLY AVENUE


)CLIFTON SANDERS814 WINONA DRIVE ) CASE NO:

YOUNGSTOWN, OH, 44511) JUDGE:

LUVENIA SANDERS814 WINONA DRIVE


CASE NO:JOHN SAUNDERS3130 DEARBORN ) JUI)GE:

YOUNGSTOWN, OH, 44510)

EDWARD SEIVERT ) CASE NO:1544 COUNTRY CLUB

YOUNGSTOWN, OH, 44514 ) JUDGE:)

EDWARD SEMERARO ) CASE NO:17837 COURTNEY ROAD

3

BELOIT, OH, 44609 ) JUDGE:

LARENA SEMERARO17837 COURTNEY ROAD

BELOIT, OII, 44609

RAY SHAULIS ) CASE NO:5213 PRITCHARD OHLTOWN

NEWTON FALLS, OH, 44444 ) JUDGE:

CASE NO:JAMES SINNOTT1525 THOMAS STREET ) JUDGE:

IRONTON, OH, 45638)

FREDA SINNOTT )1525 THOMAS STREET

IRONTON, OH, 45638

JAMES SMITH ) CASE NO:1601 7TH STREET

PORTSMOUTH, OH, 45662 ) JUDGE:

ALEXANDER STEVENS ) CASE NO:2002 EAST MAIN STREET

GREENUP, KY, 41144 ) JUDGE:

KAREN STEVENS2002 EAST MAIN STREET

GREENUP, KY, 41144

4

JOHN STEWART104 KEITH AVENUE

SOUTH POINT, OH, 45680

MARY STEWART104 KEITH AVENUE

SOUTH POINT, OH, 45680

CASE NO:

JUDGE:

)MARION TENNEY ) CASE NO:4736 CHOCTAW AVE SOUTH WEST )

LEAVITTSBURG, OH, 44430 ) JUDGE:

)RANDALL VIRTUE ) CASE NO:49230 MURRAY ROAD

HOPEDALE, OH, 43976 ) JUDGE:

MARIANNE VIRTUE49230 MURRAY ROAD

HOPEDALE, OH, 43976

CASE NO:JOHN WARDLE1706 PLEASANT VALLEY ) JUDGE:

GIRARD, OH, 44420

PA1TY WARDLE1706 PLEASANT VALLEY

GIRARD, OH, 44420

RAYMOND WATKINS429 JONES STREET

5

CASE NO:

HUBBARD, OH, 44425 ) JUDGE:

NANCY WATKINS429 JONES STREET

HUBBARD, OH, 44425

DAVID WEAVER ) CASE NO:280 ROBINSON ROAD

CAMPBELL, OH, 44405 ) JUDGE:)

EVELYNE WEAVER280 ROBINSON ROAD

CAMPBELL, OH, 44405

)LLOYD WEBB ) CASE NO:3951 CR 51

PEDRO, OH, 45659 ) JUDGE:)

MERLE WEBB3951CR51 )

PEDRO, OH, 45659

ROY WEBER )15911MOCK ROAD ) CASE NO:

BERLIN CENTER, OH, 44401JUDGE:

JUDITH WEBER15911MOCK ROAD

BERLIN CENTER,, OH, 44401

THOMAS WEEMS2351 MT VERNON

CASE NO:

YOUNGSTOWN, OH, 44502 JUDGE:

6

JANICE WEEMS2351 MT VERNON

YOUNGSTOWN, OH, 44502)))

CARL WELLS ) CASE NO:HC 76 BOX 947

SAINT PAUL, KY, 41166 ) JUDGE:

PATRICIA WELLSHC 76 BOX 947 )

SAINT PAUL, KY, 41166

)JIM WELLS ) CASE NO:479 RIDGE ROAD

NEWTON FALLS, OH, 44444 ) JUDGE:

BARBARA WELLS479 RIDGE ROAD

NEWTON FALLS, OH, 44444

)DOUGLAS WICKHAM ) CASE NO:404 RT 646

RICHMOND, OH, 43944 ) JUDGE:

LINDA WICKHAM404 RT 646 )

RICHMOND, OH, 43944

CASE NO:HAROLD WILSON3908 N PARK STREET ) JUDGE:

WARREN, OH, 44481

7

SHARON WILSON3908 N PARK STREET

WARREN, OH, 44481

CASE NO:JAMES WILSON144 TOWNSHIP ROAD 317

IRONTON, OH, 45638

JANICE WILSON144 TOWNSHIP ROAD 317

) JUDGE:

)

IRONTON, OII, 45638

ODELL YOUNG ) CASE NO:751 EAST CAMBRIDGE

ALLIANCE, OH, 44601 ) JUDGE:)

)ALFONSE ZAPOLNIK ) CASE NO:200 LACY DRIVE

STEUBENVILLE, OH, 43952 ) JUDGE:)

PATRICIA ZAPOLNIK200 LACY DRIVE

STECJBENVILLE, OH, 43952

PLAINTIFFS

V.

AQUA-CHEM INC. )D/B/A CLEAVER-BROOKS DIVISION11950 WEST LAKE PARK DRIVE ).MILWAUKEE, WISCONSIN 53201-0421)

8

)BABCOCK-BORSIG POWER INC.F/K/A D.B. RILEYF/K/A RILEY STOCKER CORP.

P.O BOX 15040W O RCESTER,MASSACHUSETTS 01615

COOPER INDUSTRIES INC.I'RENTICE HALL CORPORATION SYS)800 BRAZOS STREET, # 750AUSTIN, TX 78701

CRANE CO.C/O CT CORPORATION, S.A. )1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114

CROWN CORK AND SEALONE CROWN WAYPHILIDELPHIA, PA 19154

DANA CORPORATIONC/O CT CORORATION SYSTEM, S.A.1300 EAST 9T" STREET, # 1010CLEVELAND, OH 44114

1)RESSER INDUSTRIES, INC.SUCCESSOR-BY-MERGER TOBROWN & ROOT HOLDINGS, INC.)C/O CT CORPORATION, S.A. )1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114

GARLOCK SEALINGTECHNOLOGIES LLCC.T. CORPORATION SYSTEM, S.A.1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114

9

KELLY-MOORE PAINT COMPANY987 COMMERCIAL STREETSAN CARLOS, CALIFORNIA 94070

UNIROYAL, INC.A NEW JERSEY CORPORATIONC/O PRENTICE HALLCORPORATION SYSTEM, S.A.50 WEST BROAD STREET # 18011COLUMBUS, OH 43215

))

INGERSOLL-RAND3080 NORTHEAST LOOP 323TYLER, TX 75201

)INSUL COMPANY, INC.C/O ALLISON AND BLASDELL139 NORTH MARKET STREETEAST PALASTINE, OHIO 44413

JNO J. DISCH CORPORATION1616 COUTANT AVENUECLEVELAND, OHIO 44107

JOHN CRANE, INCC/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9TH STREET, # 1010CLEVELAND, OH 44114

KENTILE FLOORS, INC.C/O SANDERS W. GROPPER31 EAST 28TH STREET, 8TH FLOORNEW YORK, NY 10016

MAGNETEK, INC.AND MAGNETEK CONTROLS, INC.C/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9". STREETCLEVELAND, OH 44114

10

MAHONING VALLEY SUPPLY CO.OF YOUNGSTOWN, OHIOC/O DAVID E. WILLIAMS, S.A.P.O. BOX 5498POLANI), OHIO 44514

METROPOLITAN LIFE INSURANCECOMPANYAKA METROPOLITAN INSURANCECOMPANYONE MADISON AVENUENEW YORK, NY 10010-3690

MOBIL OIL CORP.3325 GALLOWS ROADROOM 7D1740FAIRFAX, VA 22037

))

OSRAM SYLVANIA, INC.IN ITS OWN RIGHT AND ASSUC. IN INT. TO )GTE PRODUCTS CORPORATIONTHE CLARK CONTROLLERCOMPANYA.O. SMITH CORPORATIONC/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9TH STREET # 1010CLEVELAND, OHIO 44114

)

OWENS ILLINOIS, INC.C/O DAVID WARD, S.A.ONE SEAGATE PLAZATOLEDO, OHIO 43659

PFIZER, INC.C/O CT CORPORATION SYSTEM, S.A.)36 EAST 7T" STREET, # 2400CINCINNATI, OHIO 45202-4459

11

PITTSBURGH METALS PURIFYING725 SAXON BOULEVARDSAXONBURG, PA 16056

PNEUMO-ABEX, CORPORATIONSUC. IN INTEREST TOABEX, INC. ANDPNEUMO-ABEX CORPORATIONIN ITS OWN RIGHTLIBERTY LANEHAMPTON, NY 03842

PREMIER REFRACTORIES, INC.FKA ADIENCE, INC.SUC. IN INT. TO BMI, INC.2704 COMMERCE DRIVE, # BHARRISBURG, PA 17110

QUIGLEY COMPANYC/O CT CORPORATION SYSTEMSTAUTORY AGENT1300 EAST 9T" STREET, # 1010CLEVELAND, OH 44114

RAPID-AMERICAN CORP.IN ITS OWN RIGHT AND ASSUC. IN INT. TO AND LIABLE FORPHILIP CAREY CORPORATIONC/O CORPORATION SERVICE CO.2711 CENTERVILLE RD, # 400WILMINGTON, DE 19808

)

RECORD INDUSTRIAL COMPANYC/O CATHERINE M. TIERNYTECHNICAL CLAIMS ASSISTANTCLAIR ODELL GROUP3025 CHEMICAL ROAD, SUITE # 200PLYMOUTH MEETING, PA 19462-1737)

RILEY STOKER CORPORATIONC/O C.T. SYSTEMS CORP., S.A.

12

1300 EAST 9TH STREET, SUITE # 1010)CLEVELAND, OHIO 44114

ROBERTSON, FORMERLYH.H. ROBERTSON COMPANY400 HOLIDAY DRIVEPITTSBURGH, PA 15220

)))))

RPM, INC.IN ITS OWN RIGHT AND ASSUCCESSOR IN INTEREST TOREPUBLIC POWDERED METALS, INC.)BONDEX INTERNATIONAL, INC. )AND PROKO INDUSTRIES50 WEST BROAD STREET, # 1800COLUMBUS, OH 43215

)THE RUST ENGINEERING CO.C/O CT CORPORATION SYSTEM., S.A.)1300 EAST 9TH STREET, SUITE # 1010)CLEVELAND, OHIO 44114

SAFE1'Y FIRST INDUSTRIES, INC.AKA SAFETY FIRST SUPPLYOF CANADA, LTD SUC IN INT. TOSAFETY FIRST SUPPLYC/O JOSEPH R.SCHAFPER, ESQ.IiEINTZMAN, WARREN, WISE, ANDFORNELLA, P.C.35TH FLOOR, GULF TOWER707 GRANT STREETPITTSURGH, PA 15219

)THE SAGER CORPORATIONC/O RICHARD POLLEY, ESQ.DICKIE, MCCAMEY AND CHILICOTE)400 TWO PPG PLACEPITTSBURGH, PA 15222

))

P.R. SUSSMAN COMPANYFKA SUSSMAN ASBESTOS COMPANY)

13

13100 ECKER .TUNCTION ROADPERRYSBURG, OHIO 43551

))

TASCO INSULATION, INC. )THE ASBESTOS SERVICE COMPANY)C/O CALLAGHER, SHARP FULTONAND NORMANSEVENTH FLOOR, BULKLEYBUILDING1501 EUCLID AVENUEPLAYHOUSESQUARECLEVELAND, OHIO 44115-2108

THEIM CORPORATIONAND ITS DIVISIONUNIVERSAL REFRACTORIES500 WEST MARQUETTE AVENUEP.O. BOX 6 )OAK CREEK, WI 53154

UNION BOILER COMPANYC/O ROBERT PENNINGTON, SAP.O. BOX 429NITRO, WV 25143-0429

UNION CARBIDE CORPORATIONC.T. CORPORATION SYSTEM, S.A.1300 EAST 9T" STREET, # 1010CLEVELAND, OH 44114

WHEELER PROTECTIVEAPPAREL, INC.C/O ROBERT W. WILKINSON, ESQ.P.O. BOX 1618PASCAGOULA, MS 39568

ZURN INDUSTRIES, INC. )AKA ERIE CITY BOILERSC/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9TH STREET, SUITE # 1010)CLEVELAND, OHIO 44114

)

14

)ABB, LTD.C/O SUZANNE MONACO,

REGISTRED AGENT940 MAIN CAMPUS DRIVE, SUITE 500)RALEIGH, NC 27606

ALLIED GLOVE CORPORATIONP.O. BOX 2126MILWAUKEE, WI53201

AMERICAN OPTICAL CORPORATION)C/O CT CORPORATION SYSTEMSTATUTORY AGENT101 FEDERAL STREET, # 300BOSTON, MA 021110

AMERICAN STANDARD INC.C/O CT CORPORATION SYSTEM, S.A.)36 E. 7T" STREET, # 2400CINCINNATI, OHIO 45202-4459

A.O. SMITH CORPORATIONIN ITS OWN RIGHT ANDAS SUCCESSOR ININTEREST TO THECLARK CONTROLLERCOMPANY AND A.O SMITHCORPORATION

C/O PRENTICE HALLCORPRATION SYSTEM, S.A. )50 WEST BROAD STREET, # 1800COLUMBUS, OHIO 43215

))

ARGO PACKING COMPANYBOX 66 )OAKMONT, PA 15139

ATLASINDUSTRIESP.O. BOX 450

15

CARNEGIE, PA 15106

BEAZER EAST, INC.IN ITS OWN RIGHT ANDAS SUCCESSOR TOKOPPERS CO., INC. ANDOTHER RELATEDCOMPANIES INCLUDINGTHIEM CORP.,BEAZER USA INC., AND BEAZER, PLC)3400 GULF TOWERPITTSBURGH, PA 15219

THE B.F. GOODRICH COMPANY, INC.)C/O CT CORPORATION SYSTEM,STATUTORY AGENT1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114

BONDEX INTERNATIONALC/O PAULA. (>RANZIER )2628 PEARL ROADMEDINA, OHIO 44256

BORG-WARNER CORP.THE CORPORATION TRUST CO. S.A.1209 ORANGE STREETWILMINGTON, DE 19801

)CERTAINTEED CORP.C/O CT CORPOILATION SYS., S.A.1300 EAST NINTH STREET,SUITE # 1010CLEVELAND, OHIO 44114

)CLARK INDUSTRIALF/K/A THE CLARK ASBESTOS CO.BARBARA BETH CLARK SHAWBER,1893 EAST 55TH STREETCLEVELAND, OHIO 44103

16

)COILHART REFRACTORIESRT 6, BOX 82BUCKHANNON, WV 26201

CSR LIMITEDONE O'CONNELL STREETSYDNEY, NEW SOUTH WALES,AUSTRALIA 2000

DEVCON CORPORATION30 ENDICOTT STREETDANVERS, MA 01923

DIDIER TAYLOR REFRACTORIES,CORP.IN ITS OWN RIGHT AND ASSUCCESSORTO CHARLES TAYLOR SONS CO.8361 BROADWELL ROADCINCINNATI, OHIO 45244

DURABLA MFG, CO.IN ITS OWN RIGHT AND ASSUCCESSOR TO1)URABLA CANADA, LTD.2572 INDUSTRY LANENORRISTOWN, PA 19403

DURAMETALLIC CORP. )2104 FACTORY STREETKALAMAZOO, MI 49001

EXXON MOBIL CORPORATIONC/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9T" STREETCLEVELAND, OH 44114

17

F.B. WRIGHT COMPANY98 VANADIUM ROADBRIDGEVILLE, PA 15017

))

FAIRMONT SUPPLY437 JEFFERSON AVENUEWASHINGOTN, PA 15301

THE FLINTKOTE COMPANYTHREE EMBARCADERO CENTERSUITE 1190SAN FRANCISCO, CA 94111

FOSECO, INC. )20200 SHELDON ROADBROOK PARK, OHIO 44142

FOSTER WHEELER ENERGY CO.C/O CT CORPORATION SYATEM, S.A.)36 EAST SEVENTH STREET, # 2400CINCINNATI, OHIO 45202-4459

THE GAGE COMPANYF/K/A PITTSBURGH GAGE & SUPPLY)C/O CT CORPORATION SYSTEM, S.A.)1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114

GENERAL ELECTRIC CO.C/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9TH STREET, # 1010CLEVELAND, OH 44114

GENERAL MOTORS, INC.C/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9T" STREET, # 1010CLEVELAND, OH 44114

18

GENERAL REFRACTORIES CO.225 CITY LINE AVENUEBALA CYNWYD, PA 19004

))

GEORGE V. HAMILTON, INC.RIVER AVENUEMCKEES ROCKS, PA 15136

GEORGIA PACIFIC CORP.133 PEACHTREE STREET NEATLANTA, GEORGIA 30303

THE GOODYEAR TIRE AND RUBBER)COMPANYC/O JAMES BOYAZIS, AGENT1144 EAST MARKET STREETAKRON, OHIO 44316

GREENE TWEED & CO.P.O. BOX 305KULPSVILLE, PA 19443

OAKFABCO BOILER CORP210 WEST 22ND STREET, # 108OAKBROOK, IL 60523

THE EDWARD R. HART COMPANYP.O. BOX 6207CANTON, OHIO 44706

HEDMAN RESOURCES, LTD.C/O KENNETH S. ROBB, ESQUIRE1080 LONG RUN ROADMCKEESPORT, PA 15132

INDUS'1'RIAL HOLDINGS CORP.C/O CORP. TRUST CO., S.A.1209 ORANGE STREET

19

WILMINGTON, DE 19801

VIACOM, INC.SUCESSOR-IN-INTERESTTO CBS CORPF/K/A WESTINGHOUSE ELECTRICCORPORATION1515 BROADWAYNEW YORK, NY 10036

HERSH PACKING AND RUBBERSTEPHEN LEDBETTER, SA312 NORTH HIGH STREETCANAL WINCHESTER, OH 43310

)ERICSSON, INC.AKA ERICSSON RADIO SYSTEMSUC. IN INT.TOCONTINENTAL WIRE AND CABLE CO)AND ANACONDA WIRE AND CABLEATTN: LEGAL DEPARTMENT6300 LEGACY DRIVEPLANO,'1'X 75024

MVSAS SUC. IN INT. TOMAHNONING VALLEY SUPPLY CO.DAVID E. WILLIAMS, SA12060 MALLARDS CROSSINGPETERSBURG, OHIO 44454

NITRO INDUSTRIAL COVERINGS, INC.)P.O. BOX 900WASHINGTON, WV 26181

OGLEBAY NORTON COMPANYAND ITS DIVISION FERROENGINEERING1100 SUPERIOR AVENUE, # 2100CLEVELAND,OHIO44114

20

OHIO VALLEY INSULATING CO.C/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9TH STREET, SUITE # 1010)CLEVELAND, OHIO 44114

OKONITE, INC.A DELAWARE CORPORATIONCORPORATION TRUST COMPANYCORPORATION TRUST CENTER1209 ORANGE STREETWILMINGTON, DE 19801

ROCKBESTOSSUPRENANTCABLE CORP.FKA ROCKBESTOS COMPANYA DELAWARE CORPORATIONU.S. CORPORATION COMPANY, S.A.50 WEST BROAD STREET # 1800COLUMBUS, OHIO 43215

))

MAREMONT CORPORATIONC/O CORPORATION TRUST CO., S.A. )1209 ORANGE STREETWILMINGTON, DE 19801

)GOULD PUMPS, INC.INDIVIDUALLY AND ASSUCCESSOR IN INTERESTTO WORTHINGTON PUMP CO.C/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9T" STREET, # 1010CLEVELAND, OH 44114

))

MCCORD GASKET COMPANYC/O CT COROPRATION SYSTEM, S.A.)1300 EAST 9TH ST, SUITF, # 1010CLEVELAND, OHIO 44114

ESSEX WIRE COMPANY

21

IWI DIVISIONA MICHIGAN CORPORATION1601 WALL STREETFORT WAYNE, IN 46802

HONEY WELLSUC. BY MERGER TOHONEYWELL ANDALLIED SIGNAL, INC.375 NORTH LAKE STREETBOYNE CITY, MI 49712

)AKRON GASKET ANDPACKING ENTERPRISES1244 HOME AVENUEAKRON, OHIO 44310

)E.I. DUPONT DE NEMOURSAND COMPANYA DELAWARE CORPORATIONCT CORPORATION SYSTEM, S.A.1300 EAST 9TH S17tEET, # 1010CLEVELAND, OH 44114

JOHN DOES (1-200)MANUFACTURERS, SELLERS,SUPPLIERS, INSTALLERS,PROMOTERS,COMPOUNDERS, )OF ASBESTOS AND ASBESTOS-CONTAINING PRODUCTSAND MACHINERY USED, DESIGNED,)INSTALLED, IN CONJUNCTIONWITH ANDOR FOR T HE USE OF ASBESTOSAND OR )

ASBESTOS CONTAINING PRODUCTS)REAL NAMES AND ADDRESSE

)

DEFENDANTS

rACTUAL BACKGROUND

22

1. Plaintiffs worked at various job sites in Ohio with products manufactured,

distributed, processed or sold from Ohio based companies or companies doing business

in this state.

2. Defendant corporations and companies or their predecessors-in-interest

(hereinafter "Defendants") reside in this county, maintain offices in this State, have

agents in this State, and/or have done and are doing business in this State.

3. Defendants were or are miners, manufacturers, processors, distributors,

importers, converters, compounders, or merchants of asbestos, asbestos-containing

products or machinery requiring the use of asbestos and/or asbestos-containing products.

4. Defendants, acting through their servants, employees, agents and

representatives, caused asbestos and asbestos-ccmtaining niaterials to be placeci in the

stream of commerce to which Plaintiffs were exposed during their employtnent.

5. The real names and addresses of Defendants John Does 1-100 have not

been determined despite reasonable efforts of the Plaintiffs to do so.

COUNT I

6. Plaintiffs re-allege paragraphs 1 through 5 above as if fully rewritten

herein.

7. Defendants negligently produced, sold or otherwise put into the stream of

commerce asbestos and asbestos-containing products and/or machinery requiring the use

of asbestos and/or asbestos-containing products, which the Defendants knew or in the

exercise of ordinary care, ought to have known were deleterious ancl highly harmful to

Plaintiffs' health.

23

8. As the designer, developer, manufacturer, distributor and seller of the

above-described asbestos and asbestos-containing products, and/or machinery requiring

the use of asbestos and/or asbestos-containing products, Defendants owed a duty to

foreseeable users and handlers of said products, to use ordinary care in designing,

manufacturing, marketing and selling said products in such a tnanner as to render them

safe for their intended and foreseeable users.

9. Defendants negligently gave inadequate warning or instruction during and

after the time of marketing in that Defendants knew or in ttic exercise of reasonable care

should have known about the risks associated with their products and failed to provide

reasonable and/or adequate warning or instructions in light of the likelihood that the

asbestos, asbestos-containing products and/or machinery requiring the use of asbestos

and/or asbestos-containing products would cause serious physical harm to Plaintiffs.

10. Plaintiffs, as a direct and proxitnate result of Defendants' conduct, have

contracted asbestos-related diseases, asbestosis and cancers and have suffered and

continue to suffer the injuries and damages as set fortli herein.

COUNT II

11. Plaintiffs re-allege paragraphs I through 10 above as if fully rewritten

herein.

12. Although Defendants knew or in the exercise of ordinary care ought to

have known that their asbestos and asbestos-containing products and/or machinery

requiring the use of asbestos and/or asbestos-containing products were deleterious, and

highly harniful to 1'laintifl-s' health, Defendant nonetheless:

24

a) Failed to advise or warn Plaintiffs of the dangerous characteristicsof their asbestos and asbestos-containing products and/or machineryrequiring the use of asbestos and/or asbestos-containing products;

b) Failed to provide Plaintiffs with the knowtedge as to what wouldbe reasonably safe and sufficient wearing apparel and proper protectiveequipment and appliances, if any, to protect Plaintiffs froin being harmedby exposure to asbestos and asbestos-containing products and/ormachinery requiring the use of asbestos and/or asbestos-containing

products;

c) Failed to place any warnings on containers of said asbestos an(iasbestos-containing products alerting Plaintiffs of the dangers to healthcaused by contact with asbestos and asbestos-containing products and/ormachinery requiring the use of asbestos and/or asbestos-containingproducts; and

d) Failed to take reasonable precautions or to exercise reasonable careto publish, adopt and enforce a safety plan and/or a safe method ofhandling and installing asbestos and asbestos-containing products, orutilizing the macltinery requiring the use of asbestos and/or asbestos-containing products in a safe manner.

13. Defendants' products were defective due to inadequate warning or

instruction during and after the time of niarketing in that Defendants knew, or in the

exercise of reasonablc care, sltould have known about the risks associated with thcir

products and failed to provide reasonable and/or adequate warning or instructions in light

of the likelihood that the asbestos, asbestos-containing products and/or machinery

requiring the use of asbestos and/or asbestos-containing products would cause serious

physical liarm to Plaintiffs.

14. Plaintiffs, as a direct and proximate result of Defendants' conduct, have

contracted asbestos-related diseases, asbestosis and cancers and have suffered ancl

continue to suffer the injuries and damages as set forth herein and Defendants are,

25

therefore, liable, jointly and severally, to Plaintiffs in strict liability for their failure to

warn at common law and pursuant to R.C. 2307.71 et seq.

COUNT IIl


herein

16. Defendants failed to design, manufacture, market, distribute and scll

asbestos and asbestos-containing products and/or machinery requiring the use of asbestos

and/or asbestos-containing products in such a manner as to render them safe for their

intended and foreseeable uses. By way of example and not limitation, Defendants:

a) Failed to design, develop, manufacture and test the asbestos,asbestos-containing products and/or machinery requiring the use ofasbestos and/or asbestos-containing products in such a manner as to renderthem safe for their intended and foreseeable users, when Defendants knewor should have known that the foreseeable use or intended purpose of theirproducts was by persons, specifically Plaintiffs, who worked with andaround said products;

b) Marketed and sold said products while the same was in aninherently and unreasonably dangerous and defective condition, presentingan ultra-hazardous risk to the Plaintiffs' well being;

c) Failed to recall or attempt to repair the defective products whenDefendants were and had been aware ol' the propensity of said products toinjure Plaintiffs; and

d) Failed to properly test said products to ensure that they werereasonably safe for use throughout their product lifetime.

17. Defendants violated the requirements of §402(A) of the Restatement of

Torts, 2d, as adopted by the Supretne Court of the State of Ohio, all of which proximately

resulted in the Plaintiffs' asbestos-related diseases.



26

continue to suffer the injuries and damages as set forth lterein and Defendants are,

tlterefore, liable, jointly and severally, to Plaintiffs in strict liability for defective design

and manufacture and/or marketing, distributing and selling a defective product at

common law and pursuant to R.C. 2307.71 et Leq.

COUNT IV


herein.

20. Defendants impliedly warranted that their asbestos and asbestos-

containing products and/or machinery requiring the use of asbestos and/or asbestos-

containing products were of good and mercliantable quality and fit for the ordinary

purposes for which the products are used.

21. Plaintiffs worked in close proximity to the asbestos and asbestos-


containing products of the Defendants, and Plaintiffs' prescncc was known, or ought to

have reasonably been anticipated by the Defendants.

22. The implied warranty made by the Defendants that their asbestos and

asbestos-containing products and/or machinery requiring the use of asbestos and/or

asbestos-containing products were of merchantable quality and fit for their particular

intended use was breached in that certain harmful inatter was given off into the

atmosphere where Plaintiffs worked.

23. Plaintiffs, as a direct and proximate result of said breach of warranties,

have contracted asbestos-related diseases, asbestosis and cancers and liave suffered and

continue to suffer the injuries and damages as set forth herein.

27

COUNT V


herein.

25. Plaintiffs' spouses have suffered injuries in their own right, namely, the

loss of consortium as a direct and proximate result of Defendants' acts and otnissions foi-

which Defendants are liable.

COUNT VI


herein.

27. Defendants, individually and as a group, since 1929 have possessed

medical and scientific data which clearly indicates that asbestos fibers and asbestos-

containing products are hazardous to one's health. Defendants, prompted by pecuniary

motives, individually and collectively, ignoretl and intentionally failed to act upon said

medical and scientific data and conspired to deprive the public, and particularly the users

of their products, including Plaintiffs, of said medical and scientific data, and therefore

deprived Plaintiffs of the opportunity of free choice as to whether or not to expose

themselves to Defendants' asbestos and asbestos-containing products and/or machinery

requiring the use of asbestos and/or asbestos-containing protlucts; and further,

Defendants willfully, intentionally and wantonly failed to warn Plaintiffs of the serious

bodily harm which would result from the inhalation of the asbestos fibers and the dust

from their products.

28. Plaintiffs reasonably and in good faith relied upon the false and fraudulent

representations, omissions and concealments made by the Defendants regarding the

28

nature of their asbestos, asbestos-containing products and/or machinery requiring the use

of asbestos and/or asbestos-containing products.

29. The award for this Count shouhl be in such an amount as would act as a

deterrent to Defendattts and others from the future commission of like offenses and

wrongs.




COUNT VII


herein.

32. Defendants, collectively and individually, manufactured, designed,

selected, assembled, inspected, tested, maintained for sale, marketed, distributed, sold,

supplied delivered, and promoted asbestos-containing products which were generically

similar and fungible in nature and place such material into the stream of interstate

cotnmerce.

33. Plaintiffs, thorough no fault of their own, may not be able to identify all of

the manufacturers, marketers, sellers, distributors, or promoters of asbestos containing

products to which they were exposed due to the generic similarity and fungible nature of

such products as produced and promoted by Defendants.

34. Defendants are jointly and severally liable to the Plaintiffs for the injuries

and damages sustained by Plaintiffs, by virtue of industry-wide liability, enterprisc

tiability_

29

35. (a) Alternatively, Defendants constitute a substantial share of the

asbestos-containing product market where Plaintiffs worked and were exposed to

asbestos.

(b) Defendants manufactured, designed, selected, asseinbled,

inspected, tested, maintained for sale, marketed, distributed, sold, supplied, delivered, and

promoted asbestos-containing products of the kind and nature to which Plaintiffs were

exposed during the period of their employment.

36. Defendants are severally liable to Plaintiffs based upon their pro-rata

market share within the market described herein.

37. Plaintiffs, as a direct and proximate result of Defendants' conduct. have



COUNT VIII


herein.

39. Defendants' actions, as stated herein, constitute a flagrant disregard for the

rights and safety of Plaintiffs and by engaging in such actions, Defendants acted with

fraud, recklessness, willfulness, wantonness and/or malice and should be held liable in

punitive and exemplary damages to Plaintiffs.

40. Plaintiffs, as a direct and proximate result of Defendants' conduct. havc



30

r

WHEREFORE: Plaintiffs, as a direct and proximate result of the

negligence and other conduct of each Defendant, have suffered and will continue to

suffer great pain, severe mental anguish including a greatly increased risk of developing

mesothelionia, bronchogenic carcinoma, or other cancerous conditions. Further, this

increased cancer risk has caused Plaintiffs to endure great mental anguish artd will

continue to cause such anguish in the future.

Plaintiffs, as a direct and proximate result of the negligence of other

conduct of each Defendant, have incurred expenses for medicat, and/or hospital, and/or

pharmaceutical, and/or surgical care and/or other expenses in an amount not yet

determined, and will continue to incur such expenses into the future.

Plaintiffs as a direct and proximate result of the negligence and other

condition of each Defendant, have suffered lost wages and a progressive loss of earning

capacity and will continue to suffer a loss of earning capacity, wages arrd other economic

damages throughout their lifetimes.

The aforesaid acts and/or ornissions of Defendants were wanton and

willful and in reckless disregard of the safety of Plaintifrs.

Plaintiffs demand judgtnent against Defendants, jointly and severally, in

an amount in excess of Twenty-five Thousand Dollars ($25,000.00) and an amount for

punitive damages, plus interest, costs and such further relief to which Plaintiffs may be

entitled.

A trial by jury is hereby demanded as to all counts


Christopher J. Hickey (0065416)

31

Brent Coon and AssociatesBradley Builcling, Suite # 3031220 West 6°i StreetCleveland, Ohio 44113

Tclephone: 216-241-1872

Facsimile: 216-241-1873Email: chip(u)bcoonlaw.com

Mary Brigid Sweeney (0044148)The Bradley Building, Suite # 3031220 West 61h StreetCleveland, Ohio 44113

Telephone: 216-241-1872Facs i m i l e: 216-241-1873Etnail: marybrigidCa)bcoonlaw.com

Attorneys for Plaintiffs

32

LexisNexis File & Serve - Transaction Details Page I of 1

Click to Print

Transaction 3090112

Case number: CV-04-521860

Case name: Pyrovolikos, Vasilios et al vs Aqua Chem Inc et al

Court: OH Cuyahoga County Court of Common Pleas

ludge: Hanna, Judge Harry A

Alternate judge: Sweeney, Justice Francis E

Filed only at 2/10/2004 12:06 PM EST

No calendar event scheduled

O Document List (2) Total Statutory Fees: $3720.00

Main Document, 32 pages ID: 3412235

Document type: Complaint Clerk review status/ action: Accepted

Security: Public Date reviewed: 2/10/2004

Statutoryfee: $3720.00

Document title:Brent Coon & Associates (Christopher J. Hickey / Mary Brigid Sweeney) MasterConsolidated Complaint (Asbestos) (Jury Trial Demanded) for Vasilos Pyrovolikos - et al.(33 plaintiffs) vs. Aqua-Chem Inc., etc., - et al. (94 defendants)

Document type: Exhibits Clerk review status/action: Rejected

Security: Public Date reviewed: 2/10/2004

Statutoryfee: $0.00

Document title: Case Brochures. In the cases of Vasilios Pyrovolikos t hrough Alfonse Zapolnik, et al.

G OtherTransaction Data

Transaction Comment: Financial Comment:

case range: CV-04-521860 -CV-04-521892 None

0- Sending PartiesEl Sending Parties (0)

Party Party Type Attorney Attornev Tvoe

none available

1-1 Sender Information

Submitted by: Christopher J Hickey, Coon, Brent & Associates-Cleveland

Authorizer: Christopher J Hickey, Coon, Brent & Associates-Cleveland

Firm

https://fileandserve.lexisnexis.com/Review/Print V iew.aspx?Print V iew=true &filingid index... 3/15/2007

TAB 3

IN THE COURT OF COOMON PLEASCUYAHOGA COIJNTY(ASBESTOS DOCKET)

JAMES SINNOTT, et al

Plaintiffs,

vs

AQUA-CHEM, INC. et al

Defendants

CASE NO: 04 CV 521874

JUDG E ASBESTOS: DOCKET

CORRECTEI) NO7'ICE OFVOLUN'tARY DISMISSAL OFSOME DEFENDANTS NOT ALLDEFENDANTS

Now comes plaintiff, Janies Sinnott, by and through his attorney, and pursuant to Ohio R

Civ. P. 41(a) (1) voluntarily dismisses without prejudice, Defendants Aqua-Chem, Inc., Babcock-

Borsig Power Inc, Kelly-Moore Paint Cotnpany, Uniroyal, Inc., JNO J. Disch Corporation,

Magnetek Inc., Mahoning Valley Supple Co., Mobil Oil Corp., Osram Sylvania, Inc., Pittsburgh

Metal Purifying, Pncumo-Ahex Corporation, Premier Refractories, Quiglcy Company, Record

Industrial Company, Robertson, The Rust Engineering Co., Safcty First Industries, "I'he Sager

Corporation,'fheim Corporation, Wheeler Protective Apparel fnc., Zurn Industries Inc., A7SL3.

LTD., American Optical Corporation, American Standard Inc., A.O. Sinith Corporation, Atlas

Industries, Beazer Fast Inc., Clark Industrial, Corhart Refractories, CSR Limited, Devcon

Corporation, Didicr'1'aylor Refractories, Durabla MFG Co., Durametallic Corp-, Exxon Mobil

Corporation, FB Wright Company, Fairmont Supply, Foseco Inc., Foster Wheeler Energy Co.,

The Gage Company, George V. IIamilton, Gcneral Motors Inc., The Goodyear Tire and Rubber

Company, Greene Tweed & CO., Oakfabco Boiler Corp., The Edward R. Hart Company,

Hedman Resources, L1'D., Industrial Holdings, MVS, Nitrro Industrial Coverings Inc., Oglebay

Norton Company, Ohio Valley Insulating CO., Okonite Inc., and Essex Wire Company.

The claims against the remaining defendants are to remain in full force and effect.

Respectfully Suhmitted,

/s/ Christopher Hickev

Christopher Hickey (0065416)

Brent Coon & Associates

The Bradley Building, Suite SP3031220 West Sixth StreetCleveland, Ohio 44113

Telephone: 216-241-1872Pacsimile:216-241-1873F.-mail: chi ii;bcoonlaw.com


A copy of the foregoing Corrected Notice of Voluntary Dismissal of Some Defendants

Not All Defendants was served this 5th day of April, 2004 on Lexis Ncxis File and Serve anddeemed served on all parties of record.

/s/ Christopher HickeyChristopher Hickey (0065416)I3rent Coon & AssociatesThe Bradley Building, Suite #3031220 West Sixth StreetCleveland, Ohio 44113

TAB 4


JAMES SINNOTT1525 THOMAS STREETIRONTON, OHIO 45638

and

CASE NO: CV-04-521874

JUDGE: ASBESTOS DOCKETJURY TRIAL DEMANDED

FREDA SINNOTT1525 THOMAS STREETIRONTON, OHIO 45638

Plaintifl's,VS.

)

)FIRST AMENDEDCOMPLAINTADDING NEW PARTYDEFENDANTS ANDADDING BACK NEW PARTYDEFENDANTS

))

COOPER INDUSTRIES INC.PRENTICE HALL CORPORATION SYS)800 BRAZOS STREET, # 750AUSTIN, TX 78701

CRANE CO.C/O C'I' CORPORATION, S.A.1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114


DANA CORPORATIONC/O CT CORORATION SYSTEM, S.A.1300 EAST 9TH STREET, # 1010CLEVELAND, OH 44114

DRESSER INDUSTRIES, INC.SUCCESSOR-BY-MERGER TOBROWN & ROOT HOLDINGS, INC. )

C/O CT CORPORATION, S.A.1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114

GARLOCK SEALINGTECHNOLOGIES LLCC.T. CORPORATION SYSTEM, S.A.1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114


)INSUL INTERNATIONAL, INC.C/O BRAD ALLISON, S.A. )139 NORTH MARKET STREETEAST PALASTINE, OHIO 44413

))

JOHN CRANE, INCC/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9TH STREET, # 1010CLEVELAND, OH 44114


METROPOLITAN LIFE INSURANCECOMPANYAKA METROPOLITAN INSURANCECOMPANYONE MADISON AVENUENEW YORK, NY 10010-3690


PFIZER, INC.C/O CT CORPORATION SYSTEM, S.A.)36 EAST 7T° STREET, # 2400CINCINNATI, OHIO 45202-4459

RAPID-AMERICAN CORP.IN ITS OWN RIGHT AND ASSUC. IN INT. TO AND LIABLE FORPHILIP CAREY CORPORATIONC/O CORPORATION SERVICE CO.2711 CENTERVILLE RD, # 400WILMINGTON, DE 19808

))

RILEY STOKER CORPORATIONC/O C.T. SYSTEMS CORP., S.A.1300 EAST 9TH STREET, SUITE # 1010)CLEVELAND, OHIO 44114

))

RPM, INC.IN ITS OWN RIGHT AND ASSUCCESSOR IN INTEREST TOREPUBLIC POWDERED METALS, INC.)BONDEX INTERNATIONAL, INC.AND PROKO INDUSTRIES50 WEST BROAD STREET, # 1800COLUMBUS, OH 43215

P.R. SUSSMAN COMPANYFKA SUSSMAN ASBESTOS COMI'ANY)13100 ECKER JUNCTION ROADPERRYSBURG, OHIO 43551

))

TASCO INSULATION, INC.THE ASBESTOS SERVICE COMPANY)C/O GALLAGHER, SHARP FULTONAND NORMANSEVENTH FLOOR, BULKLEYBUILDING1501 EUCLID AVENUEPLAYHOUSESQUARE

CLEVELAND, OHIO 44115-2108


))

UNION CARBIDE CORPORATIONC.T. CORPORATION SYSTEM, S.A.1300 EAST 9T° STREET, # 1010CLEVELAND, OH 44114

ALLIED GLOVE CORPORATIONP.O. BOX 2126MILWAUKEE, WI 53201

ARGO PACKING COMPANYBOX 66OAKMONT, PA 15139

))

GOODRICH CORPORATIONC/O CSC LAWYERS INC.STATUTORY AGENT50 WEST BROAD STREETCOLUMBUS, OHIO 43215

))

BONDEX INTERNATIONALC/O PAUL A. GRANZIER2628 PEARL ROADMEDINA, OHIO 44256

BORG-WARNER CORP.1'HE CORPORATION TRUST CO. S.A.1209 ORANGE STREETWILMINGTON, DE 19801

CERTAINTEED CORP. )C/O CT CORPORATION SYS., S.A.1300 EAST NINTH STREET,

S U ITE # 1010CLEVELAND, OHIO 44114

)

)ILLINOIS TOOL WORKS, INC.30 ENDICOTT STREETDANVERS, MA 01923

)RHI REFRACTORIES HOLDING CO.50TH FLOOR, 600 GRANT STREETPITTSBURGH, PA 15219


)

GENERAL ELECTRIC CO.C/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9TIi STREET, # 1010CLEVELAND, OH 44114

GENERAL REFI2ACTORIES CO.225 CITY LINE AVENUEBALA CYNWYD, PA 19004

)))

GEORGIA PACIFIC CORP.133 PEACHTREE STREET NEATLANTA, GEORGIA 30303

VIACOM, INC.S U C ES SOR-IN-INTERESTTO CBS CORPF/K/A WESTINGHOUSE ELECTRICCORPORATION1515 BROADWAYNEW YORK, NY 10036


ERICSSON, INC.AKA ERICSSON RADIO SYSTEMSUC. IN INT.TOCONTINENTAL WIRE AND CABLE CO)AND ANACONDA WIRE AND CABLE )ATTN: LEGAL DEPARTMENT6300 LEGACY DRIVEPLANO, TX 75024

)ROCKBESTOS SUPRENANT )CABLE CORP.FKA ROCKBESTOS COMPANYA DELAWARE CORPORATIONU.S. CORPORATION COMPANY, S.A.50 WEST BROAD STREET # 1800COLUMBUS, OHIO 43215


GOULD PUMPS, INC.C/O JAMES E DURKIN, S.A.1761 HIGHLAND DRIVETWINSBURGH, OH 44087

MCCORD GASKET COMPANYC/O CT COROPRATION SYSTEM, S.A.)1300 EAST 9TH ST, SUITE # 1010CLEVELAND, OHIO 44114

HONEYWELLSUC. BY MERGER TOHONEYWELL ANDALLIED SIGNAL, INC.375 NORTH LAKE STREETBOYNE CITY, MI 49712


)E.I. DUPONT DE NEMOURSAND COMPANYA DELAWARE CORPORATIONCT CORPORATION SYSTEM, S.A.1300 EAST 9T" STREET, # 1010CLEVELAND, OH 44114

JOHN DOES (1-200)MANUFACTURERS,SELLERS,SUPPLIERS, INSTALLERS,PROMOTERS,COMPOUNDERS, )OF ASBESTOS AND ASBESTOS-CONTAINING PRODUCTSAND MACHINERY USED, DESIGNED,)INSTALLED, IN CONJUNCTIONWITH AND )OR FOR THE USE OF ASBESTOSAND OR )

ASBESTOS CONTAINING PRODUCTS)REAL NAMES AND ADDRESSE

DEFENDANTS

AND

PNEUMO-ABEX CORPORATIONCORPOIZATION SERVICE CO.11 SOIJTH 12r" STREETP.O. BOX 1463RICHMOND, VA 23218

AMERICAN OPTICAL CORP.C/O CT CORPORATION SYSTEM, SAI01 FEDERAL STREE"T, SUITE 300BOSTON, MA 02110

A.O. SMITH CORPORATIONIN ITS OWN RIGHT AND AS SUC. ININTS. TO THE CLARK CONTROLLER)COMPANY AND AO SMITH CORP.C/O PRENTICE HALL CORP., SA50 WEST BROAD STREET, STE. 1800COLUMBUS, OHIO 43215

GENERAL MOTORS CORPORATION )C/O CT CORPORATION SYSTEM1300 EAST 9TH STREET, SUITE 1010CLEVELAND, OHIO 44114

)OKONITE, INC. )A DELAWARE CORPORATIONC/O THE CORPORATION TRUSTCOMPANY, SA )1209 ORANGE STREETWILMINGTON, DE 19801

ESSEX WIRE COMPANYIWI DIVISIONA MICHIGAN CORPORATION1601 WALL STREETFORT WAYNE,1N46802

HONEYWELL INTERNATIONAL, INC.FKA ALLIED SIGNAL, INC.FKA BENDIX CORP.C/O CSC LAWYERS INCORPORATINGSERVICESCORPORATION SERVICE CO.50 WEST BROAD S'I'REETCOLUMBUS, OH 43215

NEW PARTYADDED BACK DEFENDANTS

AND

GENUINE PARTS COMPANYINDIVIDUALLY AND ASAS ULTIMATE PARENT TO

NAPA AUTO PARTSC/O GRANT MORRIS, S.A.2665 WEST DUBLIN GRANVLE ROAD)COLUMBUS, OHIO 43235

ALLIED SIGNAL, INC.375 NORTH LAKE STREETBOYNE CITY, MI 49712

A.W. CHESTERTON COMPANYA MASSACHUSETTS CORPORATION)MIDDLESEX INDUSTRIAL PARKROUTE 93STONEHAM, MA 02180

ANCHOR PACKING COMPANYA DELAWARE CORP.C/O CT CORPORATION SYSTEM1635 MARKET STREETPHILADELPHIA, PA 19103

)HALLIBURTON COMPANYSUCCESSOR IN INTEREST TODRESSER INDUSTRIES INC.3600 LINCOLN PLAZA 500 NAKARD STREETDALLAS, TEXAS 75201

)GEORGIA PACIFIC CORP.133 PEACHTREE STREET, NEATLANTA, GA 30303

NAPA AUTO PARTSDAVIS AND WILMAR, INC.609 EPSILON DRIVEPITTSBURGH, PA 15238

A C DELCOP.O. BOX 6020GRAND BLANC, MI 48480

FORD MOTOR COMPANYCT CORPORATION SYSTEM, S.A. )1300 EAST 9T11 STREET, SUITE 11)10 )

CLEVELAND, OHIO 44114

KELSEY HAYES COMPANYA DELAWARE CORP.28016 OAKLAND OAKS COURTSWIXOM, MI 48393

GOULD PUMPS, INC.IND. TO WORTIIINGTON PUMP CO.C/O CT CORPORATION SYSTEM, SA1635 MARKET STREET, SUITE 1120PIIILADELPHIA, PA 19103

ROBBINS & MYERS, INC1400 KETTERING TOWERDAYTON, OHIO 45423

FAIRBANKS MORSE PUMP CORP.3601 FAIRBANKS AVENUEKANSAS CITY, KS 66106

ALLIS CHALMERS CORP.C/O MARGARET BARR BRUEMMER1001 W. GLEN OAKS LNMEQUIN, WI 53092

APPLETON ELECTRIC COMPANYC/O PATRICK HENRY701 WEST WELLINGTON AVENUECHICAGO, IL 60657

EMERSON ELECTRIC COMPANYA MISSOURI CORP.C/O C1' CORPORATION SYSTEM441 VINE STREET, SUITE 3180CINCINNATI, OHIO 45202RADIX WIRE COMPANY25109 DETROIT ROAD, SUITE 300WESTLAKE, OHIO 44145

CAIZOL WIRE & CABLE COMPANYDBA CREST CO. & MILLERELECTRIC COMPANY50 WEST BROAD STREET, STE. 1800COLUMBUS, OHIO 43215

PHELPS DODGEONE NOI2TH CENTIiAL AVENUEPHOENIX, AZ 85004

JOY GLOBAL INC.AS SUC. IN INTEREST TO P & HLEXIS DOCUMENT SERVICE INC.30 OLD RUDNICK LAND, SUITE 100DOVER, DELAWARE 19901

)AJAX BOILER & HEATER COMPANY)A MACDONALD CORP.2701 SOUTH HARBOR BLVD.SANTA ANA, CA 92704

)WAGNER PUMPSADDRESS NOT FOUND

DELEVALADDRESS NOT FOUND

WEST VIRGINIA ELECTRIC CO.ADDRESS NOT FOUND

)STATE ELECTRIC COMPANYADDRESS NOT FOUND

JOHN DOES ( 1-200)MANUFACTURERS,SELLERS,SUPPLIERS, INSTALLERS,PROMOTERS,COMPOUNDERS, )OF ASBESTOS AND ASBESTOS-CONTAINING PRODUCTSAND MACHINERY USED, DESIGNED,)INSTALLED, IN CONJUNCTIONWITH AND OR FOR THE USE OFASBESTOS AND ORASBESTOS CONTAINING PRODUCTS)REAL NAMES AND ADDRESSESUNKNOWN

NEW PARTY DEFENDANTS

)

FACTUAL BACKGROUND

1. Plaintiffs worked at various job sites in Ohio with products manufactured,

distributed, processed or sold from Ohio based companics or companies doing business

in this state.

2- Defendant corporations and companies or their predecessors-in-interest,

New Party Defendants, and Added Back New Party Defendants (hereinafter

"Defendants") reside in this county, maintain offices in this State, have agents in this

State, and/or have done and are doing business in this State.

3. Defendants were or are tniners, manufacturers, processors, distributors,




representatives, caused asbestos and asbestos-containing materials to be placed in the

stream of commerce to which Plaintiffs were exposed during their employment.

5. The real names and addresses of Defendants John Does 1400 have not


COUNT I


herein.

7. Defendants negligently produced, sold or otherwise put into khe stream of

commerce asbestos and asbestos-containing products and/or machinery requiring the usc

of asbestos and/or asbestos-containing products, which the Defendants knew or in the

exercise of ordinary care, ought to have known were deleterious and Iighly harmful to

Plaintiffs' health.





manufacturing, tnarketing and selling said products in such a manner as to render them



after the time of tnarketing in that Defendants knew or in the exercise of reasonable care

should have known about the risks associated with their products and failecl to provide



and/or asbestos-containing products would cause serious physical harm to Plain[iffs.

10. Plaintiffs, as a direct and proximate result of Defendants' conduct, ltave



COUNT II

11. Plaintiffs re-allege paragraphs 1 tltrough 10 above as if fully rewritten

herein.


ltave known that their asbestos and asbestos-containing products and/or machinery

requiring the use of asbestos and/or asbestos-containing products were deleterious, an(i

Itigltly harmful to Plaintiffs' health, Defendant nonetheless_

a) Failed to advise or warn Plaintiffs of the dangerous characteristicsof their asbestos and asbestos-containing products and/or machineryrequiring the use of asbestos and/or asbestos-containing products;

b) Failed to provide Plaintiffs with the knowledge as to what wouldbe reasonably safe and sufficient wearing apparel and proper protectiveequipment and appliances, if any, to protect Plaintiffs from being harniedby exposure to asbestos and asbestos-containing products and/ormachinery requiring the use of asbestos and/or asbestos-containingproducts;

c) Failed to place any warnings on containers of said asbestos andasbestos-containing products alerting Plaintiffs of the dangers to healthcaused by contact with asbestos and asbestos-containing products and/ormachinery requiring the use of asbestos and/or asbestos-containingproducts; and

d) Failed to take reasonable precautions or to exercise reasonable careto publish, adopt and enforce a safety plan and/or a safe method ofhandling and installing asbestos and asbestos-containing products, orutilizing the machinery requiring the use of asbestos and/or asbestos-containing products in a safe manner.


instruction during and after the time of marketing in that Defendants knew, or in the

exercise of reasonable care, should have known about ttte risks associated with their

products and failed to provide reasonable and/or adequate warning or instructions in light


requiring the use of asbestos and/or asbestos-containing products would cause serious

physical harm to Plaintiffs.

14. Plaintiffs, as a direct and proximate result of Defendants' conduct, havc


continue to suffer the injuries and damages as set forth herein and Defendants arc,


warn at common law and pursuant to R.C. 2307.71 et M.

COUNT III


herein.

16. Defendants failed to design, manufacture, market, distribute and sell

asbestos and asbestos-containing products and/or machinery requiring the use of asbestos



a) Failed to design, develop, manufacture and test the asbestos,asbestos-containing products and/or machinery requiring the use ofasbestos and/or asbestos-containing products in such a manner as to renderthem safe for their intended and foreseeable users, when Defendants knewor should have known that the foreseeable use or intended purpose of theirproducts was by persons, specifically Plaintiffs, who worked with andaround said products;


c) Failed to recall or attempt to repair the defective products whenDefendants were and had been aware of the propensity of said products toinjure Plaintiffs; and



Torts, 2d, as adopted by the Supreme Court of the State of Ohio, all of whicli proximatcly


18. Plaintiffs, as a direct and proximate result of Defendants' conduct. have


continuc to suffer the injuries and damages as set forth herein and Defendants are,

therefore, liable, jointly and severally, to Plaintiffs in strict liability for defective design

and manufacture and/or marketing, distributing and selfing a defective product at

common law and pursuant to R.C. 2307.71 ct sey.

COUNT IV

19. Plaintiffs re-allege paragraplrs I through 18 above as if fully rewritten

herein



containing products were of good and merchantable quality and fit for the ordinary




containing products of the Defendants, and Plaintiffs' presence was known, or ought to

liave reasonably been anticipated by the Defendants.

22. The implied warranty made by the Defendants that their asbestos and


asbestos-containing products were of inerchantable quality and fit for their particular

intended use was breached in that certain harmful matter was given off into the



have contracted asbestos-related diseases, asbestosis and cancers and have suffereci and


COUNT V


herein.

25. Plaintiffs' spouses have suffered injuries in their own right, namely, the

loss of consortium as a direct and proximate result of Defendants' acts and omissions for


COUNT VI


herein.



containing products are hazardous to one's health. Defendants, prompled by pecuniary

motives, individually and collectively, ignored and intentionally failed to act upon said





requiring the use of asbestos and/or asbestos-containing products; and I'urther,


bodily harin which would result from the inhalation of the asbestos fibers and the dust




nature of their asbestos, asbestos-containing products and/or machinery requiring thc usc


29. The award for this Count should be in such an amount as would act as a

deterrent to Defendants and others from the future commission of like offenses and

wrongs.




COUNT VII


herein.



supplied delivered, and proinoted asbestos-containing products which were generically

similar and fungible in nature and place such material into the streain of interstate

commerce.


the manufacturers, marketers, sellers, distributors, or promoters of asbestos containing

b




and damages sustained by Plaintiffs, by virtue of industry-wide liability, enterprise

liability.



asbestos.

(b) Defendants manufactured, designed, selected, assembled,









COUNT VIII


herein.


rights and safety of Plaintiffs and by engaging in such actions, Defendants acted witlt

fraud, recklessness, willfulness, wantonness and/or malice and should be held liable in

punitive and exemplary damages to Plaintiffs.




WHEREFORE: Plaintiffs, as a direct and proximate result ol' thc



mesothelioma, bronchogenic carcinoma, or other cancerous conditions. Further, this

increased cancer risk has caused Plaintiffs to endure great mental anguish anci will



conduct of each Defendant, have incurred expenses for medical, and/or hospital, and/or


determinecl, and will continue to incur such expenses into the future.


condition of each Defendant, have suffered lost wages and a progressive loss ol' earning

capacity and will continue to suffer a loss of earning capacity, wages and other econoinic

damages throughout their lifetimes,

The aforesaid acts and/or omissions of Defendants werc wanton and

willful and in reckless disregard of the safety of Plaintiffs.

Plaintiffs demand judgment against Dcfendants, jointly and severally, in


punitive damages, plus interest, costs and such further relief to which Plaintiffs may be

entitled.

A trial by jury is hereby demanded as to all counts


/s/ Christopher J. HickeyChristopher J. Hickey (0065416)Brent Coon and AssociatesBradley Building, Suite # 3031220 West 6'h StreetCleveland, Ohio 44113

Telephone: 216-241-1872Facsimile: 216-241-1873Email: chip(a:bcoonlaw.com

/s/ Carolyn Kaye RankeCarolyn Kaye Ranke (043735)Brent Coon and AssociatesThe Bradley Building, # 3031220 West 6'h StreetCleveland, OH 44113Telephone: 216-241-1872Facsimile: 216-241-1873Email: kave(o)bcoonlaw.com



I certify that a copy of Plaintiffs Motion for Leave to File First AmendedComplaint, with attached Plaintiffs' First Amended Complaint was served on CuyahogaCounty's File and Serve System this 22"d of December, 2004 and deemed served on allpa rties. •


/s/ Christopher J. HickeyChristopher J. Hickey (0065416)Brent Coon and AssociatesThe Bradley Building, N 3031220 West 6" StreetCleveland, OH 44113"lelephone:216-241-1872Facsiniile: 216-241-1873Email: chip a bcoonlaw.com

/s/ Carolyn Kaye RankeCarolyn Kaye Ranke(043735)Brent Coon and AssociatesThe Bradley Building,# 3031220 West 61 " StreetCleveland, OH 44113Teleplione: 216-241-1872Facsimile: 216-241-1873Email: kayerdbcoonlaw.com

TAB 5

IN THE COURT OF COMMON PLEASCUYAHOCA COUNTY, OHIO

JAMES SINNOTT ) CASE NO: CV-04-5218741525 THOMAS STREETIRONTON, OHIO 45638 ) JUDGE: ASBESTOS DOCKET

JURY TRIAL DEMANDEDand )

)FREDA SINNOTT )1525 THOMAS STREETIRONTON, OHIO 45638

)Plaintiffs, ) SECOND AMENDED

vs. ) COMPLAINTSUBSTITUTING NEWPARTYDEFENDANTS

COOPER INDUSTRIES INC.PRENTICE HALL CORPORATION SYS)800 BILAZOS STREET, # 750AUSTIN, TX 78701

CRANE CO.C/O CT CORPORATION, S.A. )1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114


DANA CORPORATIONC/O CT CORORATION SYSTEM, S.A.1300 EAST 9Tn STREET, # 1010

CLEVELAND, OH 44114

))

DRESSER INDUSTRIES, INC.SUCCESSOR-BY-MERGER TOBROWN & ROOT HOLDINGS, INC. )C/O CT CORPORATION, S.A.1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114

GARLOCK SEALING1'ECHNOLOGIES LLCC.T. CORPORATION SYSTEM, S.A.1300 EAST NINTH STREET, # 1010CLEVELAND, OHIO 44114


)INSUL INTERNATIONAL, INC. )C/O BRAD ALLISON, S.A. )139 NORTH MARKET STREETEAST PALASTINE, OHIO 44413

JOHN CRANE, INCC/O CT CORPORATION SYSTEM, S.A. )1300 EAS'1' 9TH STREET, # 1010CLEVELAND, OH 44114


METROPOLITAN LIFE INSURANCECOMPANYAKA METROPOLITAN INSUIL4NCECOMPANYONE MADISON AVENUI'sNEW YORK, NY 10010-3690


PFIZER, INC.C/O CT CORPORATION SYSTEM, S.A.)36 EAST 7TH STREET, # 2400CINCINNATI, OHIO 45202-4459

))

RAPID-AMERICAN CORP.IN ITS O W N RIGHT AND ASSUC. IN INT. TO AND LIABLE FORPHILIP CAREY CORPORATIONC/O CORPORATION SERVICE CO.2711 CENTERVILLE RD, # 400WILMINGTON, DE 19808

))

RILEY STOKER CORPORATIONC/O C.T. SYSTEMS CORP., S.A.1300 EAST 9TH STREET, SUITE # 1010)CLEVELAND, OHIO 44114

))

RPM, INC.IN ITS OWN RIGHT AND ASSUCCESSOR IN INTEREST TOREPUBLIC POWDERED METALS, INC.)BONDEX INTERNATIONAL, INC. )AND PROKO INDUSTRIES50 WEST BROAD STREET, # 1800COLUMBUS, OH 43215

))

P.R. SUSSMAN COMPANYFKA SUSSMAN ASBESTOS COMPANY)13100 ECKER JUNCTION ROADPERRYSBURG, OHIO 43551

TASCO INSULATION, INC.THE ASBESTOS SERVICE COMPANY)

C/O GALLAGHER, SHARP FULTONAND NORMANSEVENTH FLOOR, BULKLEYBUILDING1501 EUCLID AVENUEPLAYHOUSESQUARECLEVELAND, OHIO 44115-2108


))

UNION CARBIDE CORPORATIONC.T. CORPORATION SYSTEM, S.A.1300 EAST 9TH STREET, # 1010CLEVELAND, OH 44114

ALLIED GLOVE CORPORATIONP.O. BOX 2126MILWAUKEE, WI53201

))

ARGO PACKING COMPANYBOX 66 )OAKMONT, PA 15139

GOODRICH CORPORATIONC/O CSC LAWYERS INC.STATUTORY AGENT50 WEST BROAD STREETCOLUMBUS, OHIO 43215

BONDEX INTERNATIONALC/O PAUL A. GRANZIER2628 PEARL ROADMEDINA, OHIO 44256

))

BORG-WARNER CORP.THE CORPORATION TRUST CO. S.A. )

1209 ORANGE STREETWILMINGTON, DE 19801

)CERTAINTEED CORP. )C/O CT CORPORATION SYS., S.A.1300 EAST NINTH STREET,SUITE # 1010CLEVELAND, OHIO 44114

ILLINOIS TOOL WORKS, INC.30 ENDICOTT STREETDANVERS, MA 01923

)RHI REFRACTORIES HOLDING CO.50TH FLOOR, 600 GRANT STREETPITTSBURGH, PA 15219


)

GENERAL ELECTRIC CO.C/O CT CORPORATION SYSTEM, S.A.)1300 EAST 9TH STREET, # 1010CLEVELAND, OH 44114

))

GENERAL REFRACTORIES CO.225 CITY LINE AVENUEBALA CYNWYD, PA 19004

)GEORGIA PACIFIC CORP.133 PEACHTREE STREET NEATLANTA, GEORGIA 30303

)

VIACOM, INC.SUCESSOR-IN-INTERESTTO CBS CORP

F/K/A WESTINGHOUSE ELECTRICCORPORATION1515 BROADWAYNEW YORK, NY 10036


ERICSSON, INC.AKA ERICSSON RADIO SYSTEMSUC. IN INT.TO )CONTINENTAL WIRE AND CABLE CO)AND ANACONDA WIRE AND CABLEATTN: LEGAL DEPARTMENT6300 LEGACY DRIVEPLANO, TX 75024

)ROCKBESTOSSUPRENANTCABLE CORP.FKA ROCKBESTOS COMPANYA DELAWARE CORPORATIONU.S. CORPORATION COMPANY, S.A.50 WEST BROAD STREET # 1800COLUMBUS, OHIO 43215


)GOULD PUMPS, INC.C/O JAMES E DURKIN, S.A.1761 HIGHLAND DRIVETWINSBURGH, OH 44087

MCCORD GASKET COMPANYC/O CT COROPRATION SYSTEM, S.A.)1300 EAST 9TH ST, SUITE # 1010CLEVELAND, OHIO 44114

)

HONEYWELLSUC. BY MERGER TOHONEYWELL ANDALLIED SIGNAL, INC.375 NORTH LAKE STREET )BOYNE CITY, MI 49712


)E.I. DUPONT DE NEMOURSAND COMPANYA DELAWARE CORPORATIONCT CORPORATION SYSTEM, S.A.1300 EAST 9TH STREET, # 1010CLEVELAND, OH 44114

)JOHN DOES (1-200)MANUFACTURERS, SELLERS,SUPPLIERS, INSTALLERS,PROMOTERS,COMPOUNDERS,OF ASBESTOS AND ASBESTOS-CONTAINING PRODUCTSAND MACHINERY USED, DESIGNED,)INSTALLED, IN CONJUNCTIONWITH ANDOR FOR THE USE OF ASBESTOSAND ORASBESTOS CONTAINING PRODUCTS)REAL NAMES AND ADDRESSE

)

)

PNEUMO-ABEX CORPORATIONCORPORATION SERVICE CO.11 SOUTH 12TH STREETP.O. BOX 1463 )RICHMOND, VA 23218

AMERICAN OPTICAL CORP.C/O CT CORPORATION SYSTEM, SA )

101 FEl)ER4L STREET, SUPCE 300BOSTON, MA 02110

A.O. SMITH CORPORATIONIN ITS OWN RIGHT AND AS SUC. ININTS. TO THE CLARK CONTROLLER)COMPANY AND AO SMITH CORP.C/O PRENTICE HALL CORP., SA50 WEST BROAD STREET, STE. 1800COLUMBUS, OHIO 43215

))

GENERAL MOTORS CORPORATION )C/O CT CORPORATION SYSTEM1300 EAST 9TH STREET, SUITE 1010CLEVELAND, OHIO 44114

)OKONITE, INC.A f)ELAWARE CORPORATIONC/O THE CORPORATION TRUSTCOMPANY, SA1209 ORANGE STREETWILMINGTON, DE 19801

))

ESSEX WIRE COMPANYIWI DIVISIONA MICHIGAN CORPORATION1601 WALL STREETFORT WAYNE, IN46802

)HONEYWELL INTERNATIONAL, INC.FKA ALLIED SIGNAL, INC.FKA BENDIX CORP.C/O CSC LAWYERS INCORPORATINGSERVICESCORPORATION SERVICE CO.50 WEST BROAD STREETCOLUMBUS, OH 43215

GENUINE PARTS COMPANYINDIVIDUALLY AND ASAS ULTIMATE PARENT TONAPA AUTO PARTS

C/O GRANT MORRIS, S.A.2665 WEST DUBLIN GRANVLE ROAD)COLUMBUS, OHIO 43235

ALLIED SIGNAL, INC.375 NORTH LAKE STREETBOYNE CITY, MI 49712 )

)A.W. CHESTERTON COMPANYA MASSACHUSETTS CORPORATION )MIDDLESEX INDUSTRIAL PARKROUTE 93STONEHAM, MA 02180

ANCHOR PACKING COMPANYA DELAWARE CORP.C/O CT CORPORATION SYSTEM1635 MARKET STREETPHILADELPHIA, PA 19103

)HALLIBURTON COMPANYSUCCESSOR IN INTEREST TODRESSER INDUSTRIES INC.3600 LINCOLN PLAZA 500 NAKARDSTREETDALLAS, TEXAS 75201

GEORGIA PACIFIC CORP.133 PEACHTREE STREET, NEATLANTA, GA 30303

NAPA AUTO PARTSDAVIS AND WILMAR, INC.609 EPSILON DRIVEPITTSBURGH, PA 15238

A C DELCO )P.O. BOX 6020GRAND BLANC, MI 48480

FORD MOTOR COMPANYCT CORPORATION SYSTEM, S.A. )1300 EAST 9T° STREET, SUITE 1010CLEVELAND, OHIO 44114

KELSEY HAYES COMPANYA DELAWARE CORP.28016 OAKLAND OAKS COURTSWIXOM, MI 48393

GOULD PUMPS, INC.IND. TO WORTHINGTON PUMP CO.C/O CT CORPORATION SYSTEM, SA1635 MARKET STREET, SUITE 1120PHILADELPHIA, PA 19103

ROBBINS & MYERS, INC1400 KETTERING TOWERDAYTON, OHIO 45423

FAIRBANKS MORSE PUMP CORP.3601 FAIRBANKS AVENUEKANSAS CITY, KS 66106

ALLIS CHALMERS CORP.C/O MARGARET BARR BRUEMMER )1001 W. GLEN OAKS LNMEQUIN, WI 53092

)APPLETON ELECTRIC COMPANYC/O PATRICK HENRY701 WEST WELLINGTON AVENUECHICAGO, IL 60657

EMERSON ELECTRIC COMPANYA MISSOURI CORP.C(O CT CORPORATION SYSTEM441 VINE STREET, SUITE 3180CINCINNATI, OHIO 45202RADIX WIRE COMPANY25109 DETROIT ROAD, SUITE 300WESTLAKE, OHIO 44145

)CAROL WIRE & CABLE COMPANYDBA CREST CO. & MILLERELECTRIC COMPANY50 WEST BROAD STREET, STE. 1800COLUMBUS, OHIO 43215

PHELPS DODGE

ONE NORTH CENTRAL AVENUEPIiOENIX, AZ 85004

JOY GLOBAL INC.AS SUC. IN INTEREST TO P & HLEXIS DOCUMENT SERVICE INC.30 OLD RUDNICK LAND, SUITE 100DOVER, DELAWARE 19901

)WAGNER PUMPSADDRESS NOT FOUND

DELEVAL )ADDRESS NOT FOUND

WEST VIRGINIA ELECTRIC CO.ADDRESS NOT FOUND

)STATE ELECTRIC COMPANYADDRESS NOT FOUND

)JOHN DOES (1-200)MANUFACTURERS, SELLERS,SUPPLIEI2S, INSTALLERS, )PROMOTERS,COMPOUNDERS,OF ASBESTOS AND ASBESTOS-CONTAINING PRODUCTSAND MACHINERY USED, DESIGNED,)INSTALLED, IN CONJUNCTIONWITH AND OR FOR THE USE OFASBESTOS AND ORASBESTOS CONTAINING PRODUCTS)REAL NAMES AND ADDRESSESUNKNOWN

DEFENDANTS

)AND )

)AJAX BOILER AND HEATER CO.C/O FRANKLIN.i. BRUMMETT, S.A.111 WEST OCEAN BOULEVARD # 1300)LONG BEACH, CA 90802

Substituted New Party Defendant))

FACTUAL BACKGIZOUND

1. Plaintiffs worked at various job sites in Ohio with products manufacturcd,

distributed, processed or sold from Ohio based companies or companies doing business

in this state.

2. Defendant corporations and companies or their predecessors-in-interest,

and substituted New Party Defendants, (hereinafter "Defendants") reside in this co mty.

maintain offices in this State, have agents in this State, and/or have done and are doing

business in this State.

3. Defendants were or are miners, manufacturers, processors, distributors,




representatives, caused asbestos and asbestos-containing materials to be placed in the

stream of commerce to which Plaintiffs were exposed during their employment.

5. The real names and addresses of Defendants lohn Does 1-100 have not


COUNTI

6. Plaintiffs re-allege paragraphs 1 through 5 above as if fully rcwritten

herein.

7. Defendants negligently produced, sold or otherwise put into the stream of

commerce asbestos and asbestos-containing products and/or inachinery requiring the use

of asbestos and/or asbestos-containing products, which thc Defendants knew or in the

exercise of ordinary care, ought to have known were deleterious and highly harmful to

Plaintiffs' health.





nianufacturing, marketing and selling said products in such a manner as to render them



after the time of marketing in that Defendants knew or in the exercise of reasonable care

should have known about the risks associated with their products and failed to provide



and/or asbestos-containing products would cause serious physical harm to Plaintiffs.


contracted asbestos-relatecl diseases, asbestosis and cancers and have suffered and

continue to suffer the injuries and darnages as set forth herein.

COUNT II


lierein.


have known that their asbestos and asbestos-containing products and/or machinery

requiring the use of asbestos and/or asbestos-containing products were deleterious, and

highly harmful to Plaintiffs' health, Defendant nonetheless:

a) Failed to advise or warn Plaintiffs of the dangerous characteristicsof their asbestos and asbestos-containing products and/or macltineryrequiring the use of asbestos and/or asbestos-containing products;

b) Failed to provide Plaintiffs with the knowledge as to what wouldbe reasonably safe and sufficient wearing apparel and proper protectiveequipinent and appliances, if any, to protect Plaintiffs from being harmedby exposure to asbestos and asbestos-containing products and/ormachinery requiring the use of asbestos and/or asbestos-containingproducts;

c) Failed to place any warnings on containers of said asbestos andasbestos-containing products alerting Plaintiffs of the dangers to healthcause(I by contact with asbestos and asbestos-containing products and/ormachinery requiring the use of asbestos and/or asbestos-containingproducts; and

d) Failed to take reasonable precautions or to exercise reasonable careto publish, adopt and enforce a safety plan and/or a safe method ofhandling and installing asbestos and asbestos-containing products, orutilizing the machinery requiring the use of asbestos and/or asbestos-containing products in a safe manner.


instruction during and after the time of marketing in that Defendants knew, or in the

exercise of reasonable care, should have known about the risks associated with their

products and failed to provide reasonable and/or adequate warning or instructions in ligln


requiring the use of asbestos and/or asbestos-containing products would cause scrious

physical harm to Plaintiffs.

14. Plaintiffs, as a direct and proximate result of Defendants' conduct, havc


continue to suffer the injuries and daniages as set forth herein and Defendants are,


warn at common law and pursuant to R.C. 2307.71 et setq.

COUNTIB


herein

16. Defendants failed to design, manufacture, market, distribute and sell

asbestos and asbestos-containing products and/ortnachinery requiring the use of asbestos



a) Failed to design, develop, manufacture and test the asbestos,asbestos-containing products and/or machinery requiring the use ofasbestos and/or asbestos-containing products in such a manner as to renderthent safe for their inte(ided and foreseeable users, when Defendants knewor should have known that the foreseeable use or intended purpose of theirproducts was by persons, specifically Plaintiffs, who worked with andaround said products;


c) Failed to recall or attempt to repair the defective products whenDefendants were and had been aware of the propensity of said products toinjure Plaintiffs; and



Torts, 2d, as adopted by the Supreme Court of the State of Ohio, all of which proximately


18. Plaintiffs, as a direct and proximate result of Defendants' conduct, liave

contracted asbestos-related diseases, asbestosis and cancers and have suffcred and

continue to suffer the injuries and damages as set forth herein and Defendants are,

therefore, liable, jointly and severally, to Plaintiffs in strict liability for defective design

and manufacture and/or marketing, distributing and selling a defective product at

common law and pursuant to R.C. 2307.71 et sec.

COUNT IV


herein.



containing products were of good and merchantable quality and fit for the ordinary




containing products of the Defendants, and Plaintiffs' presence was known, or ought to

have reasonably been anticipated by the Defendants.

22. The itnplied warranty made by the Defendants that their asbestos and


asbestos-containing products were of merchantable quality and fit for their particular

intended use was breached in that certain harmful matter was given off into the



have contracted asbestos-related diseases, asbestosis and cancers and have suffered and


COUNT V


herein.

25. Plaintiffs' spouses have suffered injuries in their own right, narncly, tt c

loss of consortium as a direct and proximate result of Defendants' acts and omissions for


COUNT VI


herein.



containing products are hazardous to one's health. Defendants, prompted by pecuniary

motives, individually and collectively, ignored and intentionally failed to act upon said





requiring the use of asbestos and/or asbestos-containing products; and further,


bodily harm which would result from the inhalation of the asbestos fibers and the dust




nature of their asbestos, asbestos-containing products and/or machinery requiring the use


29. The award for this Count should be in such an amount as would act as a

deterrent to Defendants and others from the future commission of like offenses anci

wrongs.

30. Plaintiffs, as a direct and proxitnate restilt of Defendants' condtict. havc


continue to suffer the injuries and damages as set forth lterein.

COUNT VII


herein.



supplied delivered, and promoted asbestos-containing products which were generically

similar and fungible in nature and place such material into the stream ol' interstate

commerce.


the manufacturers, tnarketers, sellers, distributors, or promoters of asbestos containing




and damages sustained by Plaintiffs, by virtue of industry-wide liability, enterprise

liability.



asbestos.

(b) Defendants manufactured, designed, selected, assembled,









COUNT VIII


herein.


rights and safety of Plaintiffs and by engaging in such actions, Defendants acted with

fraud, recklessness, willfulness, wantonness and/or malice anci should be held liable in

punitive and exemplary daniages to Plaintiffs.




WHEREFORE: Plaintiffs, as a direct and proximate result of the



mesothelioma, bronchogenic carcinoma, or other cancerous conditions. Further, this

increased cancer risk has caused Plaintiffs to endure great mental anguish and will



conduct of each Defendant, have incurred expenses for medical, and/or hospital, and/or


determined, and will continue to incur such expenses into the future.


condition of each Defendant, have suffered lost wages and a progressive loss of earning

capacity and will continue to suffer a loss of earning capacity, wages and other economic

damages throughout their lifetimes.

The aforesaid acts and/or omissions of Defendants were wanton and

willful and in reckless disregard of the safety of Plaintiffs.

Plaintiffs demand judgment against Defendants, jointly and severally, in


punitive datnages, plus interest, costs and such further relief to which Plaintiffs may be

entitled.

A trial by jury is hereby demanded as to all counts.


/s/ Christoplier J. HickeyChristopher J. Hickey (0065416)Brent Coon and AssociatesBradley Building, Suite # 3031220 West 6"' StreetCleveland, Ohio 44113

Telephone: 216-241-1872Fa cs i m i l e: 216-241-1873Email: chio(a?bcoonlaw.com

/s/ Carolyn Kaye RankeCarolyn Kaye Ranke (043735)Brent Coon and AssociatesThe Bradley Building, # 3031220 West 6'n StreetCleveland, OH 44113Telephone: 216-241-1872Fa cs i m i l c: 216 - 241-1873Email: kayc(o)bcoonlaw.com



I certify that a copy of Plaintiffs Second Amended Complaint, was served onCuyahoga County's File and Serve Systetn this 14'" day of March, 2005 and deemedserved on all parties.


/s/ Christopher J. HickeyChristopher J. Hickey (0065416)Brent Coon and AssociatesThe Bradley Building, # 3031220 West 0 StreetCleveland, OH 44113Telephone: 216-241-1872Facsimile: 216-241-1873Email: chiD(a)bcoonlaw.com

/s/ Carolyn Kaye Ranke

Carolyn Kaye Ranke (043735)Brent Coon and AssociatesThe Bradley Building, # 3031220 West 6°i StreetCleveland, OH 44113Telephone:216-241-1872Facsimile: 216-241-1873Email: kaye(abcoonlaw.com

TAB 6


JAMES SINNOTT, et a(. ) CASE NO. 521874 (HICKEY 4)

Plaintiffs,

V.

AQUA-CHEM, INC., et al.,

Defendants.

JUSTICE FRANCIS E. SWEENEYJUDCE HARRY A HANNAJUDGE LEO M. SPELLACY

ASBESTOS DOCKET

MOTION OF SEPARATE DEFENDANTSAMERICAN OPTICAL CORPORATIONAND A.W. CHESTERTON CO. TOADMINISTRATIVELY DISMISS

Separate defendants American Optical Corporation (AO) and A.W. Chesterton Co.

(AWC) respectfully request this Court administratively dismiss this case under the terms of

Ohio's asbestos litigation refonn law, RC 2307.91 et seq., because plaintiff is defined as a

smoker under the law, he alleges his lung cancer was caused by exposure to asbestos, and he has

not provided an expert opinion supporting his claim which complies with the law, commonly

referred to as H.B. 292. Further support for this motion is found in the attached brief in support,

which is incorporated herein by reference.


Debra Csikos lslJEFFREY A. HEALY [email protected] CSIKOS [email protected] PATTERSON [email protected] Ellis & West LLP1150 Huntington Bldg, 925 Euclid Ave.Cleveland, OH 44115-1475Tele p ho n e: 216.592.5000Telefax: 216.592.5009Attorneys for DefendantsAmerican Optical Corp. andA.W. Chesterton Co.

2


JAMES SINNOTT, et al. ) CASE NO. 521874 (HICKEY 4)

Plaintiffs,

V.

AQUA-CHEM, INC., et al.,

Defendants.

JUSTICE FRANCIS E. SWEENEYJUDGE HARRY A HANNAJUDGE LEO M. SPELLACY

ASBESTOS DOCKET

BRIEF IN SUPPORT OF THE MOTIONOF SEPARATE DEFENDANTSAMERICAN OPTICAL CORPORATIONAND A.W. CHESTERTON CO. TOADMINISTRATIVELY DISMISS

1. INTRODUCTION AND FACTS

Governor Taft signed Ohio's asbestos litigation reform law, RC 2307.91 et seq.

(commonly known as H.B. 292), on June 3, 2004_ It went into effect 90 days later, on September

2, 2004. Plaintiff brought his current claim against AO and AWC on January 3, 2005 when he

Ciled his amended complaint in this case, naming AO and AWC as defendants in this lawsuit.,

Because plaintiffs claimagainstAO and AWC was brought after the effective date H.B. 292, all

provisions of the asbestos reform law applies to this case.

Plaintiff in this case, James Sinnott, was diagnosed with lung cancer in approximately

1 Plaintiff initially filed this lawsuit on February 10, 2004. While AO was named as a defendant at that iime. AWCwas not. Regardless, plaintiff voluntarily rlismissed AO on April 5, 2004, without consultation wiih AO, andwithout prompting or suggestion froin AO. Thus, plaintiff had no claim pending against AO between April 5, 2004and January 3, 2005. Moreover, plaintiff never had a claim pending against AWC before January 3, 2005.

3

August 2003. See deposition of James Sinnott taken November 17, 2004 at page 118 line 20 -

pagc 120 line 1.2 He smoked 1 to 2 packs of cigarettes a day from approximately 1956 - 1995.

Id. at page 38 lincs 7- 25. Because plaintiff filed his current claims against AO and AWC on

January 3, 2005, his medical report required under H.B. 292 was due on February 2, 2005.

However, plaintiff has not filed a medical report which complies with H.B. 292. Because

plaintiff has not filed his medical report in compliance with Ohio's asbestos litigation reform

law, this Court should adtninistratively dismiss plaintiffs claims against AO and AWC.

II. LAW AND ARGUMENT

H.B. 292 sets out specific requirements a plaintiff who is or was a smoker must meet

before he can maintain a case claiming his lung cancer was asbestos-related. RC 2307.92(C)( l).

Specifically, plaintiff is a lung cancer plaintiff who is a smoker under the terms of H.B. 292.

Although plaintiff testified he stopped smoking in 1995, as defined in H.B. 292 he is a smoker

because he stnoked at least 1 pack-year of cigarettes within the 15 years prior to his cancer

diagnosis in fall 2003. RC 2307.91(DD). Titus, in order to maintain his case, he nmst show both

that he was diagnosed with primary lung cancer by a competent medical authority, and that

exposure to asbestos is a substantial contributing factor to the cancer. RC 2307.92(C)(1)(a).

Plaintiff has provided no expert reports which meet these criteria.

H.B. 292 requires that Courts administratively dismiss cases brought by plaintiffs which

do not meet the necessary medical criteria. RC 2307.93(A)(3)(c). Because plaintiff has not filed

ntedical reports in compliance witlt H.B. 292, the statute niandates that his case be

administratively dismissed until such time as he meets the medical criteria set out in H.B. 292.

2 Plaintiffls deposition of Novcmber 17, 2004 was filed with this Court on January 10, 2005.

4

III. CONCLUSION

Plaintiff has failed to meet the medical provisions set out in Ohio's asbestos litigation

reform law, RC 2307.91 et seq. Specifically, plaintiff has not produced a report by a competcnt

medical authority as defined under the law. Thus, plaintiff has not established that asbestos was

the predoininant cause of plaintift's cancer, or that, without his asbestos exposure, his cancer

would not have occurred. Thus, AO and AWC respectfully request this Court administratively

dismiss this case until such time as plaintiff produces a report complying with the requirenients

of the law.


Debra Csikos ls'lJEFFREY A. HEALY [email protected] CSIKOS [email protected] PATTERSON [email protected] Ellis & West LLP1150 Huntington Bldg, 925 Euclid Ave.Cleveland, OH 44115-1475Tel e pho ne: 216.592.5000Telefax: 216.592.5009Attorneys for DefendantsAmerican Optical Corp. andA.W. Chesterton Co.

5


A copy of the foregoing Motion of Separate Defendants American Optical Corporation

and A.W. Cliesterton Co. to Administratively Dismiss and Brief in Support were fiJed this 26"'

day of April, 2005.

lsl Debra CsikosOne of the Attorneys for DefendantsAmerican Optical Corporation andA.W. Chesterton Co.

6

TAB 7

THE COURT OF COMMON PLEASCUYAHOGA COUNTY, OHIO

ASBESTOS DOCKET

JAMES SINNOT`fPLAINTIFF

v )

A-BEST PRODUCTS COMPANY, et al., )DEFENDANTS

CASE NO: 521874

JUDGE: ASBESTOS DOCKET

PLAINTIFF'S MEMORANDUMIN OPPOSITION TODEFENDANTS' MOTION TOREMOVE CASE FROM TRIALSCHEDULE FOR NONCOMPLIANCE WITH H.B. 292

Plaintiff Jatnes Sinnott, by and through his attorneys, Brent Coon & Associates,

herein opposes Defendants' American Optical Corporation and A.W. Chesterton's

Motion to Remove Case from the trial schedule for failure to comply with the

requirements of H.B. 292 and R.C. 2307.93.

1. Introduction.

Plaintiff James Sinnott filed the instant action on January 3rd, 2004, alleging that

he had developed lung cancer as a result of his occupational exposure to asbestos-

containing products manufactured and/or supplied by numerous defendants. On or about

April 28, 2004, this case was designated for trial as a part of Brent Coon Group #3 and

incorporated into a consolidated Case Management Order which set forth deadlines for

trial discovery, motion practice and exchange of expei4 reports. Subsequently, 13IaintifPs

case was removed by counsel to Trial Group 4 and consolidated with the Case

Management Order. Trial was originally set for on September 20, 2005, This tnatter is

currently set for trial in January 2006.

Plaintiffs case has advanced through the discovery process: consolidated answers

to interrogatories have been answered, depositions of plaintiff and three (3) co-workers

have been completed. Motions for summary judgments issues have been filed and are

scheduled for oral argument on June 9, 2005. Plaintiffs have received an extension to

designate and file expert reports by June 20, 2005. To date, Plaintiff has filed ample

evidence in support of his claim and more than sufficient to support a prima facie case

under Ohio law as it existed at the time his case was filed- Exhibits "A" and "W" include

a summary of the medical evidence filed in support of PlaintifPs case as well as attached

to master interrogatory answers.

On September 2, 2004, Ohio's new asbestos tort reform legislation, Am. Sub. H.B.

292 became effective. The Act requires that asbestos plaintiffs meet a new prima facie

standard before their cases may proceed to trial which standard includes minirnum

requirements for lung cancer cases wherein the plaintiff has a history of smoking. For

sinoking lung cancer cases, the Act set forth the new requirement that the plaintiff must

show an opinion from a`competent medical authority', defined and interpreted as

treating physicians only, finding asbestos exposure as the primary cause of the lung

cancer. The Act further establishes time deadlines for producing such medical evidence

and a period in which defendants may challenge the adequacy of the evidence. The court

is then required to assess the sufficiency of each 13laintiffs prima facie evidence.

Among the other changes to the existing law, H.B. 292 purports to control

pending litigation and apply these requirements on a retroactive basis unless the court

finds that such application would violate the prohibitions against retroactive legislation

set forth in Art. 11, Sec 28 of the Ohio Constitution. The issue of the applicability ol' Am.

Sub. H.B. 292 and R.C. 2307.93 to cases arising prior to its effective date has been

previously raised before this Court. This issue was extensively briefed and argued on

similar tnotions to remove cases from the trial list filed by defendants in other cases. On

January 10, 2005, this Court issued a written Opinion and found that H.B.292 impaired

the substantive rights of plaintiffs in violation of Section 28 of Article 11 of the Ohio

Constitution. In the Opinion, this Court stated

"First, the Act's imposition of new, higher medical standards for asbestos related

claims is a substantive alteration of existing Ohio law which will have the effect of

retroactively eliminating the claims of plaintiffs whose rights to bring suit have

previously vested. Second, the Act also retroactively impairs the substantive rights of

plaintiffs by changing the common law definition of 'substantial contributing factor'.

Third, the Act retroactively impairs the substantive rights of plaintiffs by its imposition of

a requirement of'substantial occupational exposurc'which contravenes Ohio Supreme

Court authority." In Re Goldberjz 20 Cases, January 10, 2005 at page 29.

Plaintiff herein submits that itie instant action is identical in circumstance to the

specific cases addressed in this Court's recent Opinion rejecting the application of H.B.

292 to cases in which the cause of action arose prior to the effective date of the Act.

Plaintiff therefore respectfully submits that this Court should deny Defendant's pending

Motion to Remove on its own precedent alone and permit this case to proceed to trial as

scheduled. Further, Plaintiff argues that the motion should be denied based upon the

written clecision of Administrative Judge Richard McMonagle expressly stating that cases

set for trial would proceed pending a determination of the constitutionality of the Act by

the Ohio Supreme Court. Finally, without waiving its arguments against the

constitutionality of H.B. 292 or its applicability on a retroactive basis, Plaintiff further

argues that he has met the burdens set forth in the Act and provided a prima facu case

sufficient to remain on the active trial schedule.

II. Cuyahoga County Court of Common Pleas Procedural History of H.B. 292

As outlined above, the issue of the constitutionality of H.B. 292 has been raised before

this court in other outstanding litigation. On January 10, 2005, this Court issued a written

opinion in eleven cases that were consolidated in the trial group designated as Goldberg

Group 20 denying the defendants' motions to dismiss for non-compliance with the

standards of H.B 292. In the opinion, the Court held that the substantive rights of the

parties were impaired by the retroactive nature of the statute and by the imposition of

higher medical standards for asbestos related claims of plaintiffs whose rights had

previously vested. Accordingly, the application of H.B. 292 was in violation of Section

28 of Article II of the Ohio Constitution. This ruling was appealed by the defendants

and is currently pending in the Eighth District Court of Appeals. The issues raised by the

Defendants in this motion are identical and Plaintiff James Sinnott herein urges this Court

to deny the pending motion in accordance with its previous ruling.

In addition, this Court had established deadlines for filing of medical

documentation relative all pending asbestos claims that were filed prior to enactment of

H.B. 292. By administrative order, the deadline for submission of supporting medical

evidence relative all plaintiffs has been set for June 15, 2005. Accordingly, the filing of

Defendants' motion in the James Sinnott matter for alleged non-compliance is not ripe

for consideration at this time nor is the requested remedy of removal of the case froin the

trial docket. Plaintiff therefore argues that this motion should be denied for its pre-

maturity in filing.

Ill. Argument

A. The September 16, 2004 Order of Administrative Judge Richard McMonagle ref[ects

the intention of the Court to allowpending cases on the trial docket to proceed.

On September 16, 2004, Judge Richard McMonagle issued a written Order

regarding all Cuyahoga County asbestos cases which stated in applicable part, "The

Court will defer classification of pending cases under the criteria set forth in tltat Bill

(Am.Sub.H.B. 292) until after the constitutionality of the Bill has been resolved by Ohio

Courts." The plain meaning of this Order establishes that the new requirements of the

Act are not to be applied to pending, trial ready cases. 1'herefore, Plaintiff argues that

this Court should follow the express mandates of the Administrative Judge and allow the

instant case to proceed to trial as scheduled.

B. The Savings Clause of R.C. 2307.93 (A) (3) is applicable to the pending ca.re.

The instant action was filed in Cuyahoga County Common Pleas Court on

February 9, 2004 and designated for trial on April 28, 2004. Therefore, since this matter

was pending at the time the Act became effective, the Savings Clause must be applied.

R.C. 2307.93 (A)(3) provides in relevant part:

"(a) For any cause of action that arises before the effective date of this section, the

provisions set forth in divisions (B), (C), and (D) are to applied unless the court that has

jurisdiction over the cases finds both of the following:

(i) a substantive right of a party to the case has been impaired.

(ii) That itnpairment is otherwise in violation of Section 28 of Article 11 of the

Ohio Constitution.

(b) If a finding under division (A)(3)(a) of this section is made by the court that

has jurisdiction over the case, ttien the court shall determine wltether the plaintiff

has failed to provide sufficient evidence to support the plaintiff's cause of action

or the right to relief under the law that is in effect under the law prior to the

effective date of this section:'

As argued previously in the other cases, the threshold issue before the Court is whether

this 'safety valve' provision relieves a plaintiff of the retroactive obligations of the Act as

violative of substantive rights. Plaintiff submits that as argued by the Cuyahoga County

Prosecutor in the pending mandamus action before the 8°i District Court of Appeals,

State ofOhio ex rel. International Association ofHeat and Prost Insulators and

Asbestos Workers, Local No. 3 et al., P. Court of Comnion Pleas of Cuyahoxa County,

a plaintiff who does not have sufficient evidence to support a cause of action under H.B.

292, may proceed with the case under the law that was in effect prior to the effective date

of the Act. This interpretation has been essentially adopted by the January 10, 2005

Opinion of this Court and allows pending cases to proceed under the Savings Clause

without meeting the new evidentiary requirements of H.B. 292 or finding the specific

provisions unconstitutional. Plaintiff therefore joins in these earlier argutnents by

reiterating the position that the Savings Clause and its safety valve provisions require that

his case to proceed to trial under the law ancl evidentiary requirements in effect at the

time of filing of the complaint and accrual of the cause of action.

Although Plaintiff argues in this Brief, supra, that he has met the evidentiary

requirements of H.B. 292, he preserves his claim that the amendments set forth in R.C.

2307.93 (A)(3) relieve him of is obligation to present a prima facie showing under the

Act and rather require only sufficient evidence to support his claim under the prior law.

Therefore, Plaintiff seeks a ruling from this Court as to tlie applicability of the Savings

Clause in his case and all cases of similar circumstance.

C. Am.Sub. H.B. is Unconstitutional.

Plaintiff further submits that H.B. 292 is unconstitutional on its face bccause it

retroactively restricts and eliminates pending lung cancer cases by imposing new

evidentiary burdens on case already pending in violation of Section 28 of Art. 11 of

the Ohio Constitution and impermissibly deprives Plaintiff of equal protection of the

laws in violation of both the United States and Ohio Constitution.

Adopting the findings and reasoning of this Court in its January 10, 2005 Opinion

and in on reliance on the well settled principles of Bielat v. Bielat (2000) 87 Ohio

St.3d 350, citing Van Fossen v. Babcock & Wilcox Co. (1988) 36 Ohio St.3d 100, it

is clear that the General Assembly intended to apply the bill retroactively. Its express

provisions unequivocally state that its provisions are to apply to "any asbestos claim

that is pending on the effective date of this section." I lowever, prior to finding its

provisions unconstitutional, a jurisdictional court must still determine whether the

retroactivity impairs a substantive right of a litigant or is merely remedial in nature.

Again, Plaintiff and counsel assert the rationale of this Court and submit that the

provisions of the Act impermissibly impair vested rights of a litigant by both

affecting substantive rights and by imposing higher inedical standards and burdens to

a past transaction. Further, by changing the common meaning of the 'substantial

factor' requirement as defined by the Ohio Supreme Court in Horton v. Hardwick

(1995) 73 Ohio St.3d 679, the Act contravenes the express authority of the court

system itself and intrudes upon the judiciary in violation of the separation of powers

doctrine outlined in the Ohio Constitution, Art. IV. Accordingly, its requiretnents

must be deemed unconstitutional as to any retroactivity or applicability to cases

pending prior to its enactment.

D. Plaintiff has submitted suJjicient medical evidence to support his c•lain¢.

(1) Obligations under the Prior Statute, R.C. 2305.10.

Prior to the enactment of H.B. 292, R.C. 2305.10 set forth the prevailing

requirements placed upon an asbestos litigant:

" a cause of action for bodily injury caused by exposure to asbestos...

arises upon the date on which the plaintiff is informed by competent medical

authority that the plaintiff has been injured by such exposure, or upon the date on

which, by exercise of reasonable diligence, the plaintiff should have become

aware that he had been injured by the exposure, whichever date occurs first."

In the instant case, Plaintiff was diagnosed with lung cancer in August 2003 after

completing a screening test that revealed a right lung mass and evidence of underlying

asbestosis. The screening results were reviewed and interpreted by a treating physician,

Dr. Robert Altmeyer who opined that Mr. Sinnott's chest x-ray and pulmonary function

test demonstrated impairment and interstitial changes in the lungs indicative of asbestosis.

Dr. Altineyer's report is attached hereto as Exhibit "A". Further, since the x-rays

revealed a lung mass, Dr. Altmeyer referred Mr. Sinnott to his family physician for

additional testing. Subsequent tests and a lung biopsy completed at the Veteran's

Administrations Hospital in Huntington, WV confirmed the malignancy. The written

screening results and subsequent medical records relating to the diagnosis are attached

hereto as Exhibit "B". The interpretation of the CT scan on November 12, 2003

revealed evidence of change and scarring consistent with earlier diagnosis of asbestosis.

The specific findings of the treating physicians also included the express differential

cliagnosis of lung carcinoma and asbestosis given the evidence of the scarring and history

of occupational exposure. See Summary of Plaintiffs medical evidcncc attached hcreto.

This evidence in its entirety was submitted as attachments to Plaintiff's Consolidated

Answers to Interrogatories filed shortly after the designation of this case in the Trial

Group on April 28, 2004. Clearly, this evidence is sufficient to establish a causal link

between Plaintiff's lung cancer and his occupational asbestos exposure.

(2) Compliance with Ani.Sub.H.B. 292.

As outlined above, Plaintiff provided all Defendants herein with ample

evidence showing that his occupational asbcstos exposure was a substantial factor in

causing his lung cancer. Moreover, this evidence was in the express form outlined by the

Act in that it represented the findings and impressions of the `treating physician' as a

competent medical authority. While the medical evidence was not contained in a letter or

written opinion, the impressions are nonetheless sufficient to sustain a prima facie case.

This Court should not be thus persuaded by Defendant's argument and should allow

Plaintiff's case to retnain scheduled for trial.


/s/ Carolyn Kaye RankeCarolyn Kaye Ranke (0043735)Brent Coon & Associates1220 West Sixth Street 303Cleveland, Ohio 44113Telephone: (216) 241-1872Facsitnile: (216) 575-7664E-Mail: kave(&bcoonlaw.com

ATTORNEYS FOR PLAINTIFF


I ceriify that a copy of Plaintiff's Brief in Opposition was served on Cuyahoga

County's LEXIS NEXIS this 1 st day of June 2005, and deemed served on all parties of

record.

/s/ Carolyn Kaye RankeCarolyn Kaye Ranke (0043735)Brent Coon & Associates

JAMES T. SINNOTT

CUYAHOGA COURT OF COMMON PLEAS CV-04-521874

ASBESTOSSCREENING REPORT

Robert B. Altmeyer, M.D.PULMONARY MEOIC,NE

ONPEOnnrC AMCnmm+ BOARD Ov INT[nN.C MCmane

OIPIOMaTE AmE11CnN BOAROOF IrrExrqE MEOICiN[ IN PULMONARY D,sEn5C5

CenrR lEO BV AnExiCAN 64nROOF INIERN>l MEOiC,NE Irv GFrei-iCtl MEVICI YE

CERT,FiFO R REnOER 9Y Tr,E N<T,VN.C INS,ù,E OF OCCUPATIONAL $AfETY nNn HEnITN

1191 NnviONn^ FOnO

WREEUrvG. WV 26003

Isonl zn3laae

ASBESTOS MEDICAL EVALUATION

SINNOTT, JAMES T. KWV44

HISTORY:

SS#402-50-6326DATE OF EXAMINATION: 8/28/03

This patient is a 64 year old, white male whom I examined in Kenova, WestVirginia on 8/28/03 at the request of Respiratory Testing Services, Inc.

OCCUPATIONAL HISTORY:

From 1959 until he was disabled in 1997 he worked for Dayton Malleable inIronton, Ohio working in a foundry. During that time span he worked as anelectrician for 30 years and a millwright for 10 years. He was exposed to silicasand used every day in ihe operation of the foundry. He did a lot of grinding andchipping. He also did some sand blasting, at which time he wore a paper mask.He has also worked directly with asbestos insulation, pipe covering, transite,cloth, gloves, gaskets, valve packing, and fire brick.

SMOKING HISTORY:

From 1950 until 1994 he smoked 1 1/2 packs of cigarettes a day.

CARDIOPULMONARY HISTORY:

He has a chronic productive cough, chronic shortness of breath with exertion,wheezing occasionally in the mornings, but no chest pain. He has had nohemoptysis. He did have a history of an esophageal junction tear, but he hadtrue blood from his lungs. In 1999 he was told he had a myocardial infarction.He had multiple episodes of pneumonia as a child and has a history of seasonalallergies. He may have had pleurisy in the past, but he is not sure.

SINNOTT. JAMES T.Page 2

There is no history of stroke, rheumatic fever, valvular heart disease,tuberculosis, tuberculosis exposure, chest trauma, chest surgery, asthma,emphysema, COPD, rheumatoid arthritis, or connective tissue disease. Heunderwent back surgery in 1997.

MEDICATIONS:

His current medications are Vioxx, Naproxen, Rabeprocle nasal spray, andHydrocodone. He is allergic to Floxin.

PHYSICAL EXAMINATION:

Height: 72 inches

Weight: 238 pounds

Respiratory Rate: 14

Heart Rate: Approximately 78 bpm

Chest: On auscultation of the chest there were fine crackles in theaxillary areas, which persisted after repetitive deepbreathing. The forced expiratory time was normal. "!-herewere no wheezes and no rhonchi.

Neck: There was no supraclavicular adenopathy.

Extremities: There was no peripheral edema. The nails were notcyanosed or clubbed.

Heart: The heart is regular. There is an S4, but no S3 gallop.

PULMONARY FUNCTION STUDIES:

A pulmonary function study of 8/28/03 showed mild restriction, no obstruction,and a mild reduction in the specific diffusing capacity at 77% of predicted.

SINNOTT, JAMES T.Page 3

CHEST X-RAY INTERPRETATION:

I interpreted a chest x-ray, as a NIOSH certified B reader, as showing category1/1, s/t in both mid and both lower lung zones by the ILO InternationalClassification of Radiographs of Pneumoconioses. There was a right upper lobedensity adjacent to the superior mediastinum. This could be overlappingshadows or scarring, but I cannot rule out a mass in that area. For that reason, Iverbally and in writing advised this man to see his personal physician within thenext two weeks for follow up. He was given written notification of this to take tohis own physician.

IMPRESSION:

Based on the above data, it is my opinion with a reasonabfe degree of medicalcertainty, that this man has asbestosis. I make that diagnosis on the basis ofinterstitial changes radiographically consistent with asbestosis, persistentcrackles on auscultation of the chest, and a significant exposure to asbestos inthe work place with an appropriate latency period, a reduction in the specificdiffusing capacity, part of which is due to asbestosis and part is due to priortobacco smoking.

He is at increased risk for the development of lung cancer, mesothelioma, loss oflung function, gastrointestinal malignancies, and other conditions because ofashestosislasbestos exposure. For that reason, I advised him to have periodicchest x-rays and follow up examinations by his personal physician.

Sincerely,

Robert B. Altmeyer, M.D.

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Name: SINNOTT, JAMESGender: MaleAge: 64 Race: CaucasianHeight(in): 72 Weight(lb): 238Any tnfo:

(BTPS)PRED

FVC Liters 4.96FEVI Liters 3.82FEVIIFVC % 77FEF25-75°/uUsec 3.43FEF50% UsecPEF UsecMW Umin

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TLC Liters 7.42RV Liters 2.44RVITLC % 34FRC N2 Liters 3.92VC Liters 4.96

DLCO mUmmHg/min 35.8DL Adj mUmmHglmin 35.8DLCOlVA mUmHglminlL 4.90DWAAdj mUmHglinin/L

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Technician: K. CHANEY CRT

!el^K 44 402-50-6326Date: 08/28/03Temp: 21 PBar:759Physician: R.ALTMEYER,M.D.,_

POST-RXBEST %PRED %Chg

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FEV1 FkCN2 DLCo

O= OUTSIDE 95% CONFIDENCE INTERVAL Norm Set: CrapolHsu Version: IVS-0101-04-4

RESPIRATORY TESTING SERVICES4362 A MIDMOST DR.MOBILE, AL. 36609

Date: 06/28103 Pre

Flow Volume Loop -- SINNOTT,JAMES-KWV4440250-6326

VC

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3.82 2.74 72

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^FVC 4.96 3.38 68 3.31 3.31 3.38

FV1 3.82 2.74 72 2.55 2.65 2.74

ÊVI(hVC 77 81 77 79 81

EV37FVC 91 94 91 91 94

'FET700% 0.72 9.75 10.36 8.72

jEF25-75% 3.43 3.03 88 2.23 2.50 3.93

!FFF25% 7.27 5.06 7.31 7.27

p=EF50% 3.60 2.93 3.27 3.60

^FEf75% 0.96 0.71 0.74 0.96

1PEF 7.33 6.36 7.32 7.33

IFVLECode 000000 000 99o 000

pIVC 4.96 2.44 49 3.41 3.20 2.44

{F 5.46 3.15 5.07 5.46

EF7FiF50 0.70 1.01 0.73 0.70

RESPiRATORY TESTING SERVICES4362 A MIDMOST DR.MOBILE, AL. 36609

Date: 08/28l03 Pre

Lung Volumes --- SINNOTT. JAMES -KWV4440250-6326Rei 8es1 %Ref 1 2

(rlG 7.42 5.40 73 5.29 5.40

NC 4.96 3.57 72 3.46 3.57

RC N2 3.92 2.75 70 2.72 201

IC 3.27 2.58 79 2.58 2.59

flV 2.44 1.83 75 1.83 1.83

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Date: 08I28f03 Pre

Lung Volumes --- SINNOTT, JAMES - KWV44 402-50-6326Ref Best % Rel 1 2

LC 7.42 5.40 13 5.29 5.40

C 4.96 3.57 72 3.46 3.57

RC N2 3.92 2.76 70 2.72 2.81

C 3.27 2.58 79 2.58 2.59RV 1.64 0.93 57 0.09 0.96

V 2.44 1.83 75 1.83 1.83

VJTLC 34 34 35 34

I 5.41 5.19 5.63

^nsh Time 0.9 0.8 1.1

Vul ECode 000000 00 00

E 9.0 16.7 187 14.1 19.4

t 1.35 1.32 1.38

12 11 14

Vul Time 08:04 08:04 08:08

Vul Date 08128 080 06120

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Date: 08/28/03

Single Breath DLCO SINNOTT

Pre

JAMES - KWV44 402-56b326Rel Beet %Ret 1 2

I CO 35.8 10.7 52 18.7 18.7

LAJj 35.8 18.7 52 18.7 18.7

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A 4.9G 4.90 5.02

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L Adj 35.8 10.7 52 18.7 18.7

p1LCO(dA 4.90 3.77 77 3.82 3.72

^fJVAAdj 3.77 3.02 3.72

VC 3.36 3.30 3.42

Ar 4.96 4.90 5.02

8HT 10.33 10.45 10.21

rI CH4 0.300 0.300 0.300

F CH4 0.185 0.183 0.186

I FI CO 0.300 0.300 11.300

VE CO 0.106 0,103 0.108

DLCO ECude uuuu 6uu 6uu

IDLCO Dale 08120 00126 08728

^LCO lime 08:06 08:06 00:111

.JAMES SINNOTT


MEDICAL RECORDS FROM HUNTINGTON VETERANS

ADMINISTRATION CENTER

PARTIOFIV

DEPARTMENT OFVETERANS AFFAIRS

VA Medical Center1540 Spring Vatley DriveHuntington, WV 25704

OATE: 1111212003In Reply Refer To:

JAMES T SINNOTT1525 THOMAS STIRONTON, OHIO 45638-1 1 76

RE: ROI Request for JAMES SINNOTT

Dear MR SINNOTT:

The information you have requested is enclosed.

Sincerely,

Kathy HartChiet, Health Information Management Section

Page 1

Medicat ion Nov 12, 2003

AMITRIPTY-INE 2`MG TAB

TAKE ONE TABLET BY MOUTH AT BEDTIME MAY INCREASE TO 3 TAELETS IF , NEEDED

Status; ACTIVE

Start date: OCT 16, 2003

Stop date: OCT 16, 2004

Refills remaining: 3

Days supply: 30

Quantity: 90

Comments:

CYANOCOBALAMIN 250MCG TAB

TAKE ONE TABLET BY MOUTH EVERY DAY

Status: ACTIVE




Days supply: 90

Quantity: 90

Comments:

VLUNISOLIDE 25MCG 200D NASAL INHL

SPRAY 2 SPRAYS IN BOTH NOSTRILS TWICE A DAY FOR NASAL ALLERGY SYMPTOMS

Status: SUSPENDED




Days supply: 30

Quantity: 1

Comments:

RABEPRAZOLE NA 20MG EC TAB

TAKE ONE TABLET BY MOUTH EVBRY DAY FOR STOMACH

Status: ACTIVE



Refills remainin9: 3

Days supply: 90

Quantity: 90

PATIENT NAME AND ADDPESS (Mechanicai imprinting, It avsilable)

SINNOTT, JAMES

1525 THOMAS ST

rRONTON, OHIO 45638-1176

402506326

VISTA Electronic Medical Documentation

Printed at HUNTINGTON VAMC

MedicationPage 2

Nov 12, 2C03

Comments:

SALSALATE 500MG TAB

'1'AKE '1'WO TABLETS BY MOUTH TWICE A DAY W/FOOD

StatUe: ACTIVE


Stop date: OCT 1.6, 2004


D-ays supply: 30

Quantity: 120

ComtnenLs

w/food

TERAZOSIN HCL 2MG CAP

TAKE ONE CAPSULE BY MOUTH AT BEDTIME FOR ENLARGED PROSTATE SYMPTOMS

Status: HOLD



Refills remai.ning: 3

Days supply: 90

Quantity: 90

Comments:

"For enlarged prostate symptoms. Take at bedtirne.

FERROUS SULFATE 325MG TAB,UD

TAKE ONE '1'ABLET BY MOUTH EVERY DAY

Status: ACTIVE

Start date: SEP 18, 2003

Stop date: SEP 18, 2004


Days supply: 30

Quantity: 30

Comments:

AMITRIPTYLINE HCL 10MG TAB

TAKE ONE TABLET BY MOUTH AT BEDTIME FOR 1 DAY, THEN TAKE TWO 'tABLETS , AT BED1'I

PATIENT NAME AND ADORESS ( Mechanical imprinting, II available)

SINNOTT, JAMES

1525 THONfAS ST

IRONTON, 01110 45638-1176

402506326



MedicationPage 3

Nov 12, 2003

Status: DISCONTINUED


Stop date: SEP 04, 2004Refills remaining: 0

Days supply: 30

Quantity: 150

Comments:

increase dose up to 50 mg gradually; stop at dose which gives rest up to

50 mg at hs

SALSALATE 500MG TAB

TAKE TWO TABLETS BY MOUTH TWICE A DAY W/FOOD

Status: DISCONTINUE


Stop date: SEP 04, 2004


Days supply: 30

Quantity: 120

Comments:

w/food

SALSALATE 500MG TAB

TAKE ONE TABLET BY MOUTH TWICE A DAY FOR PAIN

Status: DISCONTINUE

Start date: JUN 20, 2003

Stop date: JUN 20, 2004


Days supply: 90

Quantity: 180

Comments,

k'OR PAIN

FEXOFEMADINE HCL 180MG TAB

TAKE ONE TABLET BY MOUTH EVERY DAY "FOR ALLERGIES... MAY CAUSE , SEDATION

St.at.us: DISCONTINUED

Start date: APR 07, 2003

Stop date: APR 07, 2004


Days supply: 30

PATIENT NAME AND ADDRESS (Mechanlcal hnprintlog, it available)

SINNOTT, JAMES

1525 THOMAS ST

JRONTON, OHIO 45638-1176

402s06326



MedicationPage 4

Nov 12, 2003

Quantity: 30

Comments:

"For all.ergies... May cause sedation


TAKE ONE CAPSULE BY MOUTH AT BEDTIME FOR ENLARGED PROSTA'I'E SYMPTOh1S

Status: DISCONTINUE

Start date: MAR 10, 2003

Stop date: 11AR 10, 2004

Refi.1.1s remaining: 3

Days supply: 90Quantity: 90

Comtnents :

"For enlarged prostate symptoms. Take at bedtime.

RABEPRAZOLE NA 20MG EC TAB

TAKE ONE TABLET BY MOUTH EVERY DAY E'OR STOMACH

Status: DISCONTINUE

Start date: FEB 03, 2003

Stop date: FEB 04, 2004

Refi.lls remaining: i

Days supply: 90QuanLity: 90

Comments:

ACETAMINOPHEN 325MG TAB

TAKE ONE TABLET BY MOUTH EVERY 6 HOURS AS NEEDED BOR PAIN


Start date: JAN 01, 2003

Stop date: JAN 02, 2004Refills remaining: 4

Days supply: 30

Quantity: 120

Comments:

as needed for pain

P.ABEPRAZOI.R NA 20MG EC TAB

PATfENT NAME AND ADDRESS (Mechanical imprinting, if available) VISTA Electronic Medical Documentation3INNOTT, JAMES

1525 THOMAS ST

[RONTON, OHIO 45638-1176 Printed at HUNTINGTON VAMCt02506326

MedicationPage5

Nov12,2003

TAKE ONE TABLET BY MOUTH TWICE A DAY FOR STOMACH

Status: DISCONTINUED (EDIT)

Start date: JAN 01, 2003

Stop date: JAN 02, 2004


Days supply: 30

Quantity: 60

Comments:

RANITIDINE 150MG TAB

TAKE ONE TABLET BY MOUTH EVERY DAY AS NEEDED


Start date: DEC 06, 2002

Stop date: DEC 07, 2003

Refills remaiiiing: 3

Days supply: 90

Quantity: 90

Comments:


'PAKE ONE CAPSULE BY MOUTH AT BEDTIME





Days supply: 30

Quantity: 30

Comments:

CAPSAICIN 0.025$ CR (20Z/TU)

APPLY SMALL AMOUNT EVERY 12 EIOURS AS NEEDED

Status: ACTIVE




Days supply: 30

Quantity: 60

PATIENT NAME AND ADDBFSS (Mechanical Imprlnting, if available)

S1NNO'1'T, JAMES

7S25 THOMAS ST

IRONTON, OHIO 45638-1176

402506326



Medication Page 6 NOv,2, 2003

Comments:

pt needs Lo pick up today

FLUNISOLIDE 25MCG 200D NASAL INHL

SPRAY 2 SPRAYS IN BOTH NOSTRILS TWICE A DAY FOR NASAL ALLERGY SYMPTOMS

Stattts: DISCONTINUE


Stop date; DEC 07, 2003

Refills remaining; I

Days supply: 30

Quantity: 1

Comments:

CYANOCOBAL IMJ 1000MCG/ML (1ML/VI)

INJECT 1000MCG/1ML INTRAMUSCULAR MONTHLY

Status: ACTIVE


Stop date; NOV 7.5, 2003


Days supply: 30

Quantity: 1

Comments:

CODEINE 30/ACETAMINOPHEN 300MG TAB

TAKE ONE TO TWO TABLETS BY MOIJTH EVC:RY 6 IIOURS AS NEEDC•ll] F'GR PAIN. , fMAY CAUSC

Status: EXPIRED

Start daLe: SEP 18, 2003



Days supply: 30

Quantity: 60

Coinments :

CYANOCOBAL INJ 1000MCG/P1L (1ML/VI)

INJECT 1000MCG/1ML INTRAMUSCULAR MONTHLY

Status: DISCONTINUE


PATIENT NAME ANO ADDRESS (Mechanical imprinting, if available)

SINNOTT, JAMES

1525 THOMAS ST


902506326



MedicationPage 7

Nov 12, 2003


Refillo remaining: 0

Days supply: 30

Quantity; 1.

Comments:

CAPSAICIN CREAM,TOP TOP Q12H PRN

THIN LAYER


Start date: SEP 14, 2003@22:1D

Stop date: SEP 18, 2003@16:04:04

Conunents :

to affected area

AMITRIPTYLINE TAB PO QHS (BEDTIME)

50MG

Status: DISCONTINUF,D

Start date: SEP 14, 2003@22:10

Stop date: SEP 18, 2003916:04:04

Conunents :

FEXOFENADINE TAB PO QD

180MG



Stop date: SEP 18, 2003@16:04:04

Comments:

FLUNISOLIDE INHL,NASAL NA BID

2 SPRAYS



Stop date: SEP 18, 2003@16:04:04

Comments:

RABEPRAZOLE TAB,EC PO QD

20MG

'ATIENT NAME ANf1 ADnRESS tMechanical imprinting, ir available) VISTA Electronic Medical Documentation3INNOTT, JAMES

L525 THOMAS ST

LRONTON, OHIO 4 563 8-117 6 Pririted at HUNTINGTON VAMC302.S06326

IH ed icati o n Page a Nov 12, 2003


Start dat.e: SEP 14, 2003622:10

Stop date: SEP 18, 2003@16:04:04

Comments:

TERAZOSIN CAP,ORAL PO HS (BEDTIME)2MG



Stop date: SEP 18, 2003@16:04:04

Comments:

SALSALATE TAB PO Q6H

500MG



Stop date: SEP 18, 2003@16:04:04

Comments:

CYANOCOBALAMIN INJ,SOLN IM QD

1000MCG/1ML



Stop date: SEP 18, 2003@16:04:04

CommerrLs:

X 3 DAYS, THEN MONTHLY

FERROUS SULFATE TAB PO QD

325MG

SCatus: DISCONTINUED


Stop date: SEP 18, 2003@16:04:04

Comments:

ACETA 325MG W/CODEINE 30MG TAB PO Q6H PRN

2 TABLETS


SLart date: SEP 17, 2003@14:00

PATlEN7 NAME AND ADDRESS (Mechanical imprinting, if available)

SINNOTT, JAMES

1525 THOMAS ST

IRONTON, OHIO 456381176

402506326



MedicationPage 9

Nov 12, 2003

PATIENT

SINNO

1525IRONT

40250

Stop date: SEP 18, 2003@16:04:04

Comments:

1-2 tabs po q6hours, prn for pain

DIATRIZOATE MEG & SOD. SOLN,ORA1. PO NOW

20 ML

StaCus: EXPIRED

Start date: SEP 17, 2003Q13:47

Stop date: SEP 17, 2003@14:09:02

Comments:

DIATRIZOATE MEG & SOD. SOLN,ORAL PO ONCE

20 ML

Status; F.XPIRED

Start date: SEP 15, [email protected]:22

Stop date: SEP 16, 2003@12:00

Coinments :MIX 20 ML GASTROGRAFIN IN 1000 ML OF WATER OR JUICE. GIVE 500 ML 2 HOURS

PRIOR TO EXAM. GIVE 500 ML 1 HOUR PRIOR TO EXAM.

SALSALATE TAB PO NOW

500MG

Status: EXPIRED


Stop date: SEP 15, 2003Q04:26:51

Comments:

SALSALATE TAB PO BID

1000MG



Stop date: SEP 15, 2003@03:26:04

Comments:

CYCLOBENZAPRINE HCL IOMG 'I'Ada

TAKR ONE TABLET BY MOUTH THREE TIMES A DAY FOR 7 DAYS, THEN TAKE ONE ,'1'ABLET

Status: EXPIRED

Start date: AUG 11, 2003

IAME AND ADDRESS (Mechanical imprlnWig, il available) VISTA Eleetronie Medical Documentation

'T, JAMES

'HOMAS ST

,N, OHIO 45638-1176 Printed at hiUNTINGTON VAMC326

Medication Page'o Nov 12, 2003

Stop date; SEP 10, 2003

Refills remaining; 0

Days supply; 28

Quantity; 42

Comments:

oATIENT NAME AND ADDRESS (Mechanical imprinting, if available)

SINNOTT, JAMES

1525 THOMAS ST

IRONTON, OHIO 456381176

402506326



Radiology Reportpage77

MYOCARDIAL PERFUSION

Exm Date: SEP 26, 2003@11:39

Req Phys: MUNN,NANCY J

Nov 12, 2003

Pat Loc: NUCLEAR MEUTCTNE (Req'g Loc)

Img Loc: NUC MED

Service: Unknown

(Case 962 COMPLETE) MYOCARDIAL PERFUSION (NM Detailed) CPT:78465

Clinical History:

r/o ischemia or mi

Report Status: verified Date Reported: SEP 30, 2003

Verifier E-Sig:

Date Verified: OCT 09, 2003

Report:

PERSANTINE STRESS TEST

Dictated by: Nancy Cronenberger, FNP

Date of Procedure: 09-26-03

INDICATION: Preoperative evaluation.

WRITTEN CONSENT/EXAM: The patient arrived at the nuclear stress

lab in a fasting state. The procedure, indications, potential

complications and available alternatives were explained to the

patient. Opportunity for questions was provided. After the

patient verbalized understanding of the procedure, written

consent was obLained. A bricf physical exain was done. No evidence

of significant aortic valvular disease or active wheezing was

noted.

METHODS: Intravenous access was established. The paLienL was

given a weight-based resting dose of 'Pc-99m Sestamibi.

Approximately 45 minutes later, resting images were obtained

using a SPECT camera. The patient was given a weight-based

infusion of persantine over a 4 minute interval. Three minutes

posL-infusion, the patient was given a weight-based sCress dose

of Tc99m Sestamibi. Five minutes post-infusion IV aminophylline

was given to reverse the effects of the persantinc. The patient

underwent continuous electrocardiographic monitoring and frequent

monitoring of blood pressure using an external cuff during the

infusiorr and post-infusion. The patient was observed

post-infusion until pulse, blood pressure and ECG returned to

PATIENT NAME AND ADDRESS ( Mechanical imprinting, if available)

SINNOTT, JAMES

1525 THOMAS ST

IRONTON, OI(IO 45638-1176

402506326



Radiology ReportPa9e 12

Nov12.2003

baseline, and unti7 all side effects of the persantine were

resolved. After 1 hour stress images were obtained using a SPECT

camera. Stress and rest images were processed and compared for

differences in regional niyocardial tracer uptake, and if

possible, the stress images were gated for assessment of left

ventricular myocardial contractility. The patient tolerated the

procedure well and no complications were apparent.

DOSES: Resting: 10.6 mCi Tc99m Myoview.

Stress: 33.0 mCi Tc99m Myoview.

Persantine: 60mg.

Aminophylline: 100mg.

FINDINGS: 1. Baseline ECG: Normal sinus rhythm with a right

bundle branch block.

Persantine ECG: No ischemia or irifarction.

2. Initial blood pressure: 130/66.

Infusion blood pressure: 120/66.

Post-infusion blood pressure: 122/62.

3. Nuclear Rest and Stress Images: Normal perfusion in all

segments and no evidence of ischemia or infarction.

4. Ejection fraction: 62%

Wall motion: Norinal.

Impression:

1. Normal myocardial perfusion study.

2. ECG: No ischemia or infarction.

3. Clinical: No chest discomfort with Persantine infusion.

4. Nuclear: No ischemia or infarction. Ejection fraction of

6ag and no wall niotion abnormalities.

Primary Interpreting Staff:

IMKAN ARIF, MD, ATTENDING / STAFF CARDIOLOGIST

verified by transcriptionist for IMRAN ARIF, MD

/SPT

PATIENT NAME AND ADDPESS (Mechanical imprinting, If evallab(e)

SINNOTT, JAMES

I525 THOMAS ST

IRONTON, OHIO 45638-11'76

402506326



Radiology ReportPage13

Nov 12, 2003

MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION

Proc Ord: MYOCARDIAL PERFUSION

Exm Date: SEP 26, 2003@11:39

Req Phys: MUNN,NANCY J Pat Loc: NUCLEAR MEDICINE (Req'g Loc)

Img Loc: NUC MED

Service: Unknown

(Case 963 COMPLETE) MYOCARDIAL PERFUSION STUDY WITH E(NM Deta-led) CPT:78480

Clinical History:

r/o ischemia or mi

Report Status: Verified Date Reported: SEP 30, 2003


Verifier E-Sig:

Report:

MYOCARDIAL PERFUSION STUDY: Please refer to case #962.

Impression:

Please refer to case #962.

Primary Interpreting Staff:IMRAN ARIF, MD, ATT6NDING / STAFF CARDIOLOGIST

Verified by transcriptionisC for IMRAN ARIF, MD

/SPT

MYOCARDIAL PERFUSION STUDY WITH WALL MOTION

Proc Ord: MYOCARDIAL PERFUSION

Exm Date: SEP 26, 2003011:39

Req Phys: MUNN,NANCY J Pat Loc: NUCLEAR MEDICINE (Req'g Loc)

Img LOcc NIIC MED

Service: Unknown

(Case 964 COMPLETE) MYOCARDIAL PERFUSION STUDY WITH W(NM Detailed) CPT:784v8

PATIENT NAME AND ADDRESS ( Mechanical imprinting, if availahle)

SINNOTT, JAMES

1525 THOMAS 91'


402506326



K


Clinical History:

r/o ischemia or mi



Verifier E-Sig:

Report:

MYOCARDIAL PERFUSION STUDY: Please refer to case #062.

Impression:


Primary Interpreting Staff:IMRAN ARIF, MD, ATTENDING / STAFF CARDIOLOGIST

Verified by transcriptioni.st for IMRAN ARIF, MD

/SPT

CT HEAD W&WO CONT

Exm Date: SEP 17, 2003(D15:35

Req Phys: ROSS,RHONDA S

Nov 12, 2003

Pat Loc: OP Unknown/11-12-2003e,08:36

Img Loc: CT SCAPI

Service: MEDICAL

(Case 641 COMPLETE) CT HEAD W&WO CONT (CT Detailed) CY'1':70470

Clirlical History;PT. WITH RUL LUNG MASS ON CT, PROBABLE MALIGNANCY CT HEAD FOR

FURTHER W/U


Date Verified: SEP 18, 2003

Verifier E-Sig:/ES/HENRY H HAVEN

Report:

CT OP THE HEAD WITHOUT AND w1'1'H CONTRAST:

Multiple CT scan images of the head were obtained without and

with intravenous contrast enhancement.

Axial tomographic cuts of the brain were obtained from base to

PATIENT NAME AND ADDRESS ( Mechanical imprinting, if nvaila6lc)

SINNO'C'r, JAMES

iS25 THOMAS ST

IRONTON, OHIO 4S638-1176

402506326




vertex using 5and 10 mm slice thickness

The ventricular and cisternal anatomy is felt to be within normal

limits without evidence of displacement or distortion. '1'here is

nornial appearance of the 4th, 3rd and both lateral ventricles.

Midline structures show no significant displacement.

There is no evidence of extra-axial colle:aion or enhancing

lesion. No mass effect is seeri.

The vascular anatomy demonstrated is felt to be within normal

limits.

There is no eviderice of acute hemorrhage or brain infarction.

No other significant abnormality i.s .i.dentified.

impression:

Normal examination.

Primary Diagnostic Code: CORRELATION AS INDICATED


HENRY H HAVEN, RADIOLOGIST (Verifier)

/SPT

CT ABDOMEN W/CONT

Proc Ord< CT ABDOMEN W&W/O CONT

Exm Date: SEP 17, 2003@15:35


Nov12,2003

Pat Loc: OP Unknown/11-12-20031,^08:36

Img Loc: CT SCAN

Service: MEDICAL

(Case 692 COMP7,ETE) CT ABDOMEN W/CONT ( CT Detailed) Ci?T:i4160

Clinical History:

PT. WITH RUI, LUNG MASS, EVAL. METS

Report Status: Verified Date,Reported: SEP 17, 2003

Date Verified: SEP 22, 2(]03

Verifier E-Si.g,/ES/PILAR PRABHU

PATIENT NAME AND ADDRESS ( Mechanical imprinling, il availahle)

SINNOTT, JAMES

1525 THOMAS ST

IRONTON, OIITO 4563E9-1176

402506326




Report:

CT SCAN OF THE ABDOMEN AND PELVIS: CT scan of the abdomen and

pelvis is performed with intravenous and oral contrast. Multiple

axial images were obtained from the dome of the diaphragm to the

region of the pubic symphysis.

The examination demonstrates minimal pleural effusion at the lung

bases, left greater than the right, with associated atelectasis.

The liver, spleen, adrenal glands, and the pancreas are grossly

normal. Both kidneys are opacified. No evidence of

hydronephrosis. Degenerative changes are visualized in the

thoracic spine. increased fecal debris are noted in the colon.

No significant inflammatory changes are identified in the region

of the cecum.

scanning through the pelvis demonstrates the urinary bladder and

rectum are grossly normal. The prostate gland measures

approximately 5.0 x 5.5cm and is mildly enlarged. Clinical

correlation for prostate carcinotna is suggested. The delayed

images demonstrate no obvious mass in the liver. The gallbladder

is mildly distended.

Smpression:

No discrete masses are identified in the liver. Tiny, bibasil-ar

pleural effusion with associated atelectasis, left greater than

the right. No significant adenopathy. Mildly enlarged prostate

gland. Degenerative changes in the thoracic and lumbar spine. No

other significant abnormalities are identified.



PILAR PRASHU, Staff Physician (Vcrifier)

/SPT

CT PELVIS W/CONT

Proc Ord: CT PELVIS W&W/O CONT

Exm Date: SEP 7.7, 2003915:35


PATIENT NAME AND ADDRESS (Mechanical imprinting, if available)

ST.NNOTT, J.AMES

1525 THOr1AS ST

IRONTON, OHIO 45638 1176

402506326

Nov 12, 2003

Pat Loc: OP Unknown/11-12-2003Cy08:3G

Img Loc: CT SCAN

Service: MEDICAL



Radiology ReportPaget7

Nov 12, 2003

(Case 643 COMPLETE) CT PELVIS W/CONT (CT Detailed) CPT:72193

Clinical History:PT. WITH RUL LUNG MASS, EVAL. METS

Report. Status: Verified Date Reported; SEP 17, 2003

Date Verified: SEP 22, 2003Veri.fier E-Sig:/ES/PILAR PRABHU

Report:

CT SCAN OP THE PELVIS: Please refer to case 7t642.

Impression:



Primary Interpreting Staff;PILAR PRABHU, Staff Physician (Veritie

/SPT

CHEST FLURO OR FLURO UP TO 1 HR

Extn Date: SEP 17, 2003(009c46

Req Phys: MUNN,NANCY J Pat Loc: OP Unknown/1112-2003(6108:36

Img Loc: RADIOLOGY

Service: MEDICAL

(Case 544 COMPLETE) CHEST FLURO OR FLURO UP TO 1 HR (RAD Detailed) CPT:76000

Proc Modifiers : PORTABLE EXAM, OPERATING ROOM EXAM

Clinical History:

fluoro for bronch

Report Status: Verified

Verifier E-Sig;/ES/PILAR PRASHU

Date Reported: SEP 17, 2003


Report:

FLUORO EXAM: Fluoroscopy was provided for the service during the

performance of a procedure.

PATIENT NAME AND ADDRESS (Me<hanical imprinting, if available)

SINNOTT, JAMES

1525 THOMA9 S'P

T.RONTON, OHIO 45638-1176

402506326



Radiology ReportPageT8

Nov 12, 2003

Impression:Utilizing of fluoroscopy only.

Primary Diagnostic: Code: CORRELATION AS INDICATED


PILAR PRABHU, Staff Physician {Verificr)

/MJT

CHEST SINGLE VIEW

Exm Date: SEP 17, 2003@09:35

Req Phys: MUNN,NANCY J Pat Loc: OP Unknown/11-12-2003@08:36

Img Loc: RADIOLOGY

Servicer MEDICAL

(Case 533 COMPLETE) CHEST SINGLE VIEW (RAD Detailed) CPT:71010

Proc Modifiers : PORTABLE EXAM

Clinical History:

bronch with bx's. r/o pneumo.



Verificr E-Sig:/ES/PILAR PRABHU

Report:

CHEST, SINGLE PORTABLE VIEW: Comparison is made with the prionr

study dated 09-04-03. Examination demonstrates mildly enlarged

cardiac silhouette. The patient is status-post bronchoscopy. No

obvious pneumothorax identified. Mild COPD persists.

impressiori:

No gross evidence of pneumothorax. The patieiit is status-post

bronchoscopy. Mild COPD.


Primary Interpreting Staff:PILAR PRABHU, Staff Physician (Verifier)

/MJT

PATIENT NAME AND ADDRESS ( Mechanical imprinling, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506326



Radiology ReportPage 19

BONE IMAGING, WHOLE BODY

Exm Date: SEP 16, 20036P0B:37


Nov 12, 2003

Pat Loc: OP Unknown/11-12-2003908:36

Iing Loc : NUC MED

Service: MEDICAL

(Case 272 COMPLETE) BONE IMAGING, WHOLE BODY (NM Detailed) CPT

Clinical History:PT. WITH RUL LUNG MASS, PROBABLE CA, EVAL. METS




Reporc:

BONE SCAN: This examination consists of delayed AP and PA

images following the intravenous administration of 22.5

millicuries of Technetium 99m HDP. Degenerative activity is seen

in the shoulders, sternoclavicular joints, and probably

anteriorly in the cervical region which may represent activity in

the thyroid. Bilateral knee prostheses are in place.

lmpression:

1. No evidence of fnetastatic disease.



/MJT

CT THORAX W/CONT

61xm Date: SEP 11, 2003@08:09

Req Phys: JOSEPH,SANDRA

78306

Pat Loc: AMB CARE WALK-IN lReq'g Loc)

Iinq Loc: CT SCAN

Service: Unknown

*** THIS IS AN AMENDED REPORT ***

PATIENT NAME AND ADDRESS ( Mechanical imprinfing, if available)

STNNOTT,JAMES

1525 THOMAS ST


402506326



Radiology Report Page20 Nov12,2003

(Case 818 COMPLETE) CT THORAX W/CONT (CT Detailed) CPT:7126G

Clinical History:

rul mass on screening for asbestosis xray here suggestive please

inform patient of time and date

Report Status: Verified Date Reported: SEP il, 2003



Report:

CT CHEST WITH CONTRAST: There is confirmaLion of a pleural-based

mass lesion lying anteriorly and medially in the right upper

lobe, which demonstrates minimal linear extension to the anterior

right upper lobe pleural surface.

This mass measures some 3.3 x 3.8cm in its maximum diameters. A

small, pleural-based lesion is imaged posteriorly in the right

upper lobe.

Impression:

1. Evidence of a large, probably neoplastic mass lying

anteriorly and medially in the right upper lobe, which is

pleural.-based and which has minimal linear extension to ttie

anterolateral portions of Che right upper lobe. A biopsy is

recommended for further evaluation.

2. Small pulmonary nodule, which is also probably pleural-based,

lying posteriorly in the right upper lobe,

PRIMARY DIAGNOSTIC CODE 4 ABNORMALITY, ATTN. NEEDF.D

*.***********.**ADDENDUM BY DR. HAVEN ON09-17-03*************:.*.***.*+,,,**

'1'here is reimaging of a large probable neoplastic mass,

pleural-based, in the right lower lobe.

Primary Diagnostic Code: ABNORMALITY, ATTN. NEEDED



/SPT

CHEST 2 VIEWS PA&LAT


SINNO'1"1', JAMES

1525 THOMAS ST


402506326




Nov 12, 2003

Exm Date: SEP 04, 2003009:56

Req Phys: JOSEPH,SANDRA Pat Loc: AMB CARE WALK-IN (Req'g Loc)

Img Loc: RADIOLOGY

Service: Unknown

Clinical. History:

has evidence of RUL mass on screeniing CXR for asbestosis also

R/O asbestosis



Verifier E-Siga

Report:

PA AND LATERAL CHEST: Comparison is made with the prior study

dated 03-10-03. Examination demonstrates ttie heart is top-normal

in size. The pulmonary vascularity is unremarkablc. Chronic

emphysematous changes with scarring are noted at the lung bases

and at the lurig apices. There is vague opacity in the right apex

abutting the mediastinum which was not well appreciated on the

previous study and may represent scarring. In the absence of

prior CT, a C'1' scan with intravenous contrast is suggested for

further evaluation. Degenerative changes are visualized in the

thoracic spine.

Impression:

Somewhat increased opacity in the right apex as described which

may be related to scarririg. A CT scan with inCravenous contrast

is suggested for further evaluation. No gross evidence of acute

infiltrate or pleural effusion. Mild COPD persists.



PILAR PRABHU, Staff Physician

Verified by transcriptionist for PILAR PRASHU

/MJT

PATIENT NAME AND ADDRESS ( Meehanlcal Imprinting, ii available)

SINNOTT, JAMES

1525 THOMAS ST

TRONTON, OH1O 45638-1176

402506326



Lab ResultPage22

Nov 12, 2003

- ROUTINE CHEMISTRY ----

SERUM NA K CL HC03 BUN CREAT

Ref range 135-145 3.5-5 98-110 23-32 8-27.

MMOL/L MEQ/L MMOL/L MMOL/L MG/DL MG/DL

------------- --_-.------------------------------------------------------------

09/15/2003 05:00 137 3.9 104 27.9 12 0.8

09/14/2003 16:23 136 4.1 102 25.6 11 08

09/04/2003 09:47 134 1, 4.6 100 27.7 7 L 0.8

08/11/2003 10:23 136 4.8 101 28.8 7 L 0.9

SERUM B/CR AGAP C/OSM OSMO AST ALT

Ref range 3-16

mEq/L

275-300

mOSM/L

285-310

mOSM/L

5-40

IU/L

5-40

IU/L

------------- -- - -----------------------------------------------------------

09/04/2003 09:47----------

17----------

14--------

SERUM ALKP GGT LDH TBIL TP ALB

Ref range 40-120

IU/L

8-60

IU/I,

90-230

IU/L

.11MG/DL

6.5-9

G/DL

3.6-5

G/DL

09/04/2003 09:47 69 0.9 6.9 3.7

SERUM CA PHOS

Ref range 8.4-10.7 .7-1.5

MG/DL MMOL/L

-------------------------------------------------------------------------------

09/15/2003 05:00 8.9

09/14/2003 16:23 8.909/04/2003 09:47 9.308/1.1/2003 10:23 9.1

---- METABOLIC ----

SERUM PSS 10:00 16:00 22:00 RAN GLU CHOL

Ref range 70-110 -120 70-110 140-240

MG/DL, MG/DL MG/DL MG/DL MG/DL MGiDI,

09/15/2003 05:00 9209/14/2003 16:23 9109/04/2003 09:47 10508/11/2003 10:23 105

PATIENT NAME AND ADORESB (Mechanlcal Imprinting, if availabte)

SINNOTT, JAMES

1525 THOMAS ST


402506326



Lab ResultPage 23

Nov 12, 2003

SERUM URIC AC MG ICETONES

Ref range 4-8

MG/DL

1.5-2

ME(1/i.

0MG/DI,

SPECIAL/ENZYMES

SERUM

Ref range

AMY

15-105

U/L

LIP

4-24

U/L

DHIL

0-.4

MG/DL

NH3 LAC

11-35 6-2.2

UMOL/L MMOL/L

CPK

35-232

IU/L,

------------------------ -09/04/2003 09:47 0.1

08/11/2003 10:23 36

SERUM

Ref range

CK/MB

0-10

Lll1

0-49

ACP

0-.8

CKMB

0-9

NG/MC, U/L U/L U/L

------------------------------ --------- ----------- ------------------- ---

- C

SERUM IRON

Ref range 70-120

HEMISTRX SPECIALS -

TRANS $SAT

212-360 20-50

FER

50-350

PRE-ALB

182-332

UG/DL mg/dL % ng/mL MG/L

a 09/16/2003 05:00 185 L

b 09/16/2003 05:00 42 L 189

09/04/2003 09:47 56 L

SERUM HAPT IONZ C

Ref range 30-210 1.19-1.27

MG/DL MMOL/L

-------------------------------------------------------------------------------

a. Evaluation for TRANS:

Please note, new methodology and reference ranges beginning

3/23/2000.b. Evaluation for IRON:

$SAT=FE/(TRANSFERRIN*1.37) x 100

- CHC PROPILG I -

BLOOD WBC AB NEUT AB LYM RBC HGB HC'1'

Ref range 5-10 1.9-8 1.5-4 4.7-6.1 14-18 42-52

PATIENT NAME ANO ADDRESS (Mechanical imprinfing, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506326Printed at fiUNTINGTON VAMC

Lab ResultPage 24

Nov 12. 2003

K/cmm K/cmm K/cmm M/cmm g/di.

------------------------------------- -------------------- -----------_.---...----

09/1.6/2003 05:00 6.30 4.00 1.50 4.68 L 13.7 L 41.1 L

09/15/2003 05:00 5.80 3.00 1.80 4.47 L 13.2 L 39.2 1

09/14/2003 16:23 6.30 3.40 1.90 5.03 14.5 44.109/04/2003 09:47 6.30 4.00 1.50 4.90 14.2 43.108/11/2003 10:23 7.60 5.10 1.70 4.84 14.3 4.3.0

BLOOD PLT RETIC CD4 CD8

Ref range 140-440 15-50 395-1601 161-807

K/cmm K/cmm CELLS/UL CELLS/UL

09/16/2003 05:00 247 .3909/15/2003 05:00 24909/14/2003 16:23 29709/04/2003 09:47 27508/11/2003 10:23 272

- CBC PROFILE II -

BLOOD NEUT % LYMPH % MONO % EOSIN % BASO % LUC %

Ref range 40-74 19.6-52.7 3.4-10 0-7 0-1.5 0-4

$ % % s $ °s-------------------------------------------------------------------------------

09/16/2003 05 : 00 62.8 23.6 9.5 3.8 0.3

09/15/2003 05:00 51.9 31.3 11.7 H 4.S 0.6

09/14/2003 16:23 54.4 30.5 10.9 H 3.8 0.409/04/2003 09:47 63.9 23.1 9..3 3.4 0.308/11/2003 10:23 67.1 21.9 7.7 2.8 0.5

BLOOD MCV MCH MCHC RDW HDW

Ref range 80-94 27-35 31.5-36.5 11.5-14.5 2.2-3.2

fl uug G/DL %g/dL

09/16/2003 05:00 87.7 29.3 33.4 13.7.09/15/2003 05:00 87.4 29.4 33.6 13.109/i4/2003 16:23 87.5 28.0 32,9 13.1

09/04/2003 09:47 87.9 29.0 33.0 13.308/11/2003 10:23 88.9 29.6 33.3 12.9

BLOOD MPV ANISO MICRO MACRO HYPO

Ref range 7.2-11.1 0-1+ 0-1+ 0-1+ 0-1.+

fL U-4i 0-4+ 0-4+ 0-4+

-------------------------------------------------------------------------------

PATIENT NAIA8 AND ADDRFSS (Mcchanical imprinting, ll available)

STNNOTT, JAMES

152S THOMAS ST

TRONTON, OHIO 45638-1176

402S06.326



Lab ResultPage 25

Nov 12, 2003

09/16/2003 05:00 8.809/15/2003 05:00 9.209/14/2003 16:23 8.309/04/2003 09:47 7.9OB/11/2003 10:23 7.8

- COAG

PLASMA PT TNR PTT PIRRINO TIiROMBT

Ref range 10-13.4 .81-1.09 25-35 188-383 8-14

Seconds Seconds mg/dL Sec

a 09/16/2003 05:00 14.3 H 1.21 H 28

PLASMA AT III FSP D-DIMER BLEED T

Ref range 84-123 0-5 0.5 2-9

% NtiP ug/mi ug/ml Mins-- ----------------------------------------------------------------------------

a. Eva2uation for PT:

NOTE: NEW NORMAL RANGES TAKING EFFECT 11-18-1999. DIFFERENCES

WILL BE NOTED WHEN COMPARING RESULTS BEFORE THE DATE ABOVE TO

ONES AFTER.

Evaluation for PTT:

NOTE: NEW RANGED AS OF 11-18-1999.

PLEASE NOTE TkIAT VALUES BEFORE 1118-99 MAY NOT CORRELATE

WITH EARLIER RESULTS DUE TO NEW REAGENTS AND INSTRUMENTATION.

PANIC VALUES FOR PATIENTS NOT ON HEPARIN THERAPY ARE (>45)

PANIC VALUES FOR PATIENTS ON HEPARIN THERAPY ARE (>100)

HEPARIN THERAPY RANGE = 48-81 sec-

'1'HE APTT IS THE RECOMMENDED LABORATORY TEST FOR MONITORING HEPARIN

THERAPY.

Evaluation foc INR:

THE INTERNATIONAL NORMALIZED RATIO (INR) IS THE RECO14I4ENDED LABORATORY

TEST FOR MONITORING ORAL ANTICOACULANT(COUMADIN THERAPY) AT THIS FACILITY.

Therapeutic range for coumadin therapy: 2.0 - 3.5

IMMUNOLOGY/SEROLOGY ----

SERUM RPR MHA-'I'P RF MONO TE STREPTO

Ref range Nonreactive NON-HEAC't'1VE Negative Negative NI3l:A'I'fVE:

09/04/2003 09:47 NEG

PATIENi NAME AND ADDRESS (Mechanical Imprinting, if available)

SINNOTT, JAMES

1525 'I'IIOMAS ST


402506326



Lab ResultPage 26

Nov 12, 2003

SERUM ANA

Ref range NegaLive

---- THYROID FUNCTTON TESTS

SSRUM TT4-RIA FT4-RIA TSH-RIA T3-RIA T4-LAB

Ref range 6.1-11.8 .65-2.2 .4-3.1 80-200 4.5-12

UG/DL NG/DL uIU/ML NG/DL ug/dl

------------------------- --------------------------------------------------------

SERUM FT4-LAB TSH-LAB T3-LAB

Ref range .71-1.85 .32-5 80-200

ng/d1 uIU/ML ng/dl

------------------------------------------------------------------------

09/04/2003 09:47 1.0 0.6--- VITAMIN B12 / FOLATE ----

SERUM B12-RIA POL-RIA RC-POL. B12-LAB

Ref range 225-1000 2.9-18.7 160-650 1.79-7.132

PG/ML NG/ML NG/ML pg/tnJ.- -- -- -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - -

09/16/2003 05:00 283.00

SERUM FOL-LAB

Ref range 2.9-18.7

ng/ml

-------------------------------------------------------------------

09/16/2003 05:00 7.20

---- ARTERIAL BLOOD GAS **ASSAYED IN RESPIRATORY THERAPY LABORATORY** --

ARTERIAL BLOO PH PC02 P02 AHCO3 BE

Ref range 7.35-7.45 32-46 74-108 21-29 -2-+2.0

MMHG MMHG MMOL/L MMOL/L

-------------------------- - - --------------------------------------

a 09/25/2003 14:43 7.35 41 82 23 -2.2 L

b 09/14/2003 16:25 7.41 43 76 27 3.0 H

ARTERIAL BLOO 02CT. 02SAT 11' HB

Ref range 15-23 92-96 13-18

ML/DL % G/DL

PATIENT NAME AND ADDRESS (Mechanfcal imprinting, it available)

SINNOTT, JAMES

1525 THOMAS ST


402506326



Lab ResultPage 27

Nov 12, 2003

a-09/25/2003 14:43 95

b 09/14/2003 16:25 95

a. RA/RBA/TEMP 37.0

b. DRAWN FROM RRA, A+, ON ROOM AIR, TEMP 36.8C. BH.

- DIFF -

BLOOD 09/16 09/04

2003 2003

Reference

05:00 09:47 Unit's Ranges--------------------------------------------------------------------------

SEGS 45-70

BANDS 0-8

LYMPH % 15-40

MONOS 3-12

EOSINO 0-5

BASO 0-2

ATY LYM 0-0

META : 0-0

MYELO 0-0

PROS 0-0

BLASTS 0-0

PLASMA 00

NRBC %/WBC 0-0

PLT.E ADEQUATE

ANISO 0-4+ 0-1+

MICROCY 0-4,0-1+

MACRO 0-4+ 0-1+

POIKILO 0-4+ 0-1+

HYPO 0-4+ 0-1+

POLYCHR 0-4+ 0-1+

OTHER

LAP 25-130

SICKLE NEG

ESR 25 H 29 H MM/HR 0-10

MISCELLANEOUS TESTS ----

DATE TIME SPECIMEN TEST VALUE Ref ranges

10/23/2003 FECES

10/23/2003 FECES

10/23/2003 FECES

09/04/2003 09:47 SERUM

Evaluation for ANA-LC:

PATIENT NAME AND ADOt1ESS (Mechanical Imprinting, il available)

SINNOTT, JAMES

1525 TIiOMAS ST


402506325

OCCULT : NEGATIVE NEGATIVE-

OCCULT2: NEGATIVE NEGATIVE-

OCCULT3: NEGATIVE NEGATIVE

ANA-LC: 1:40 Speckled <1:40 (NEGATIVE)-



Lab Resu ltPage 28

Nov 12, 2003

TESTING PERFROMED AT LEXINGTON VAMC BEGINNING 6-1-99.

---- MICROBIOLOGY ---

Accession: AFB 03 180 Receiveci: Sep 17, 2003 10:55

Collection sample: BRONCH WASH Collection date: Sep 17, 2003 09:30

Site/Specimen: BRONCHUS

Provider: MI7NN,NANCY J

Test(s) ordered: AFB CULTURE & SMEAR completed; Nov 07, 2003

* MYCOBACTERIOLOGY FINAL REPORT =n Nov 07, 2003 TECH CODE: 1B3

Concentrate Acid Fast Stain: Negative

Myco6acteriology Remark(s):9/17 TESTING PERFORMED BY WV. OFFICE OF LAB. SERVICES

167 11TH AVE SOUTH CHARLESTON, WV 25303

9/18 CONCENTRATE SMEAR RPT BY RKC

11/07 NO ACID FAST ORGANISMS ISOLATED ON CULTURE. /MRP

---- MICROBIOLOGY ----

Accession: MYC 03 230 Received: Sep 17, 2003 10:55

Collection sample: BRONCH WASH Collection date: Sep 17, 2003 09:30


Provider: MUNN,NANCY J

Test(s) ordered: MYCOLOGY CULTURE completed: Oct 16, 2003

* MYCOLOGY FINAL REPORT => Oct 16, 2003 TECH CODE: 183

Fungus/Yeast:

CANDIDA ALBICANS

Comment: 9/24 RPT BY RKC

Mycology Remark(s):

9/22 YEAST GROWTH PRESENT. /RKC

---- MICROBIOLOGY ----

Accession: MICRO 03 3593 Received: Sep 17, 2003 10:54

Collection sample: BRONCH WASH Collection (laCe: Sep 17, 2003 09:30


Provider: MUNN,NANCY J

Testjs) ordered: GRAM STAIN completed: Sep 17, 2003 14:29

CULTURE & SUSCEPTIBILITY completed: Sep 19, 2003

* BACTERIOLOGY FINAL REPORT => Sep 19, 2003 TECH CODE: 7078

GRAM STAIN:

9/17 2+ RED BLOOD CELLS


STNNOTT, JAMES

1525 THOMAS ST


402506326



Lab ResultPage 29

Nov12,2003

TRACE SQUAMOUS EPITHELIAL CELLS

2+ GRAM POSITIVE COCCI

2+ GRAM POSITIVE RODS

Bacteriology Remark(s):

9/18 3+ NORMAL FLORA /RhtA

9/19 3+ NORMAL FLORA /RMA

ABO Rh: 0 POS

No UNITS assigned/xmatched

No component requests

---- BLOOD BANK -

I --- AHG(direct) --- I I -AHG(indirect) - IDate/time ABO Rh POLY IgG C3 Interpretation (Antibody screen)

____ ___ ___ ______________ _________________

---- CYTOPATHOLOGY ----

Dat.e Spec taken: Sep 17, 2003 Pathologist:NGUYEN HUU DICH M.D.

Date Spec rec'd: Sep 17, 2003 14:13 Tech:

Date completed: Sep 18, 2003 Accession #: CY 03 701

Submitted by: NANCY J MUNN Practitioner:NANCY J MUNN

Specinten:

1-BRONCH BRUSHINGS POSTERIOR SEGMENT RUL

2-BRONCH BRUSHINGS APICA_L SEGMENT RUL

3-BRONCH BRUSHINGS ANTERIOR SEGMENT RUL

4-BRONCH BRUSH TIP

5-BRONCH WASF[INGS

Brief Clinical History:

NONE GIVEN

Px-eoperative Diagnosis:

RIGHT UPPER LUNG MASS

Operative Findings:

NONE G1VEN

Postoperative Diagnosis:


Gross Description:

1.- Two prepared slides.

2.- Six prepared slides.



5.- 25 cc of bloody fluid. Four cytospin slides are prepared.

Microscopic exant/Diagnosis (Date Spec taken: Sep 17, 2003)

1,2,3, and 4: Multiple bronchial brushings and one brush tip:

- Positive for malignant cells (See comment).

Bronchial washings:

PATIENT NAME ANf) ADpqESS ( Mechanical Imprinting, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506326



Lab ResultPage 30

Nov12,2003

- Negative for carcinoma cells- Part 5 consists mostly of epithelial cells

ancl some leukocytes.

Conlment: Please see surgical specimen SP-03-2191 for details.

---- SURGICAL PATHOLOGY -

Date Spec taken: Sep 17, 2003 PaChologist:WILLIAM E TRIEST

Date Spec rec'd: Sep 17, 2003 13:33 Resident:

Date completed: Sep 18, 2003 Accession 4: SP 03 2191

Submitted by: NANCY J MUNN Practitioner:NANCY J MUNN__--------------------------------------------------------------------------

Specimen:

BX RUL APICAL SEGMENT

Brief Clinical History:

NONE GTVEN

Preoperative Diagnosis:


Opcrative Findings:

NONE GIVEN

Postoperative Diagnosis:


Gross description:

The specimen is labeled with the name of the patient, Sinnott and

^biopsy right upper lobe apical segment". The specimen consists of

multiple small pieces of soft tissue altogether measuring 0.8 cm X 0.7 cm

X 0.1 cm. The specimen is entirely einbedded in one cassette between

spongcs. ND/jkb

Microscopic exam fDate Spec taken: Sep 17, 2003)

Microscopic examination performed.

Diagnosis8iopsy right upper lobe apical segment:

Non small cell carcinoma.

Note: Dr. Dich concurs with the diagnosis. Dr. Munn was

notified in person at 12:05 p.m. on 9-18-03. A staging sheet will be

sent.

PATIENT NAME AND ADDHESS ( Mechanical impfinting, if available)

SCNNOTT, JAMES

1.525 THOMAS ST

IRONTON, OIIrO 4S638-1176

402506326



Discharge SummaryPage31

TITLE: Discharge Summary

ADMIN DA'1'E: SEP 14, 2003 DISCH. DATE:

DICT DATE: SEP 17, 2003@13:39 ENTRY DATE: SEP 17, 2003@13:39:40

DICTATED BY: ROSS,RHONDA S ATTENDING: ROSS,RHONDA S

URGENCY: routine STATUS: COMPLETED

*** Discharge Summary Has ADDENDA ***

DISCHARGE DIAGNOSIS:

RRIGHT UPPER LOBE LUNG MASS

MUSCULOSKELETAL PAIN 2NDARY TO ABOVE

ANEMIA/IRON DEF.

VITAMIN B12 DEFICIENCY

WEIGHT LOSS

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

GASTROESOPHAGEAL REPLUX DISEASE

CHRONTC LOW BACK PAIN *

}3P}I

OPERATIONS & PROCEDURES PERFORMED AND DATES:

WHOLE BODY BONE SCAN 9/16/03

BRONCHOSCOPY 9/17/03

CT ABD./PELVIS 9/17/03

CT HEAD 9/17/03

COMPLICATTONS:NONE

Nov 12, 2003

HOSPITAL COURSE:64yo admitted after found abnormal CXR, CT done which

showed RUL luug mass.Pt. states pain started back 5/03 in shoulder areas

"muscles" and occ. feels like in joints. Has decreased grip strength and

pain with abduction of arms bilat., no hempotysis, no change appetite, 10

lb. wt. loss x 1 month. Pt. worlced as industrial millwrite where he was

exposed to asbestos and other chemicals he does not know names of, then

worked as electrician last 28 years, retired 1997. Pulmonary consulted and

bronchoscopy done 9/17/03 with results pending. Whole body bone scan

negative for evid. of malignancy. CT abdomen and pelvis pending. Pt.

hospital course unremarkable, no complications. On admit found to be

deficient in vitamin B12 and also iron def. anemia. Pt. statrted of Vit.

812 inj. and to continue monthly along witki ferrous sulfate 325mg daily.

Pt. discharged home in stable condition.

PMH: GERD, CHRONIC LOW BACK PAIN, BPH, SUNUSITIS, ANGINA, CATARACT RIGHT

EYE, DRY EYE SYNDOME, COPD, MALLOWRY WEISS TEAR 1/03, UGI BLEED 1/03, HX

EtERPES ZOSTER, QUIT SMOKING APPROX. 8 YEARS AGO(45 YEAR HISTORY)

PHYSICAL EXAP1:

GENERAL:AO X 3, NAD

I{EENI':wnl


SINNOTT, JAMES

152S THOMAS ST


402506326




NECK;supple, no JVD, no Lymphadenopathy

CARDJ:OVASCULAR:RRR w/o murmur, no ectopy

RESPIRATORY:CTA bilat., no wheezes, no rales, no ronchi

GASTROINTESTINAL; abd. soft., NT, +d3S, no masses, no organomegaly

MUSCUI.OSKF,LETAL:4/5 MS in UE & LE, mildly decreased grip strengt.h bilat.,

pain with abduction to 90 degrees bilat.

SKIN:wnl

NEUROLOGICAL:CN II-XII grossly intact

EXTREMITIES:no clubbing, no cyanosis, no edeina

DISCHARGE MEDICATIONS:

AMITRIPTYLINE TAB 50MG PO QHS (BEDTIME)

CAPSAICIN CREAM,TOP THIN LAYER TOP Q12H PRN to

affected area

CYANOCOBALAMIN INJ,SOLN 1000MCG/1ML IM QD X 3 DAYS,

THEN MONTHLY

PERROUS SIJLFATE TAB 325MG PO QD

FEXOFENADINE TAB 180MG PO QD

FLUNISOLIDE INHL,NASAL 2 SPRAYS NA BID

RABEPRAZOLE TAB,EC 20MG PO QD

SALSALATE TAB SOOMG PO Q6H

TERAZOSIN CAP,ORAL 2MG PO US (BEDTIME)

ACETA W/CODEINE 1.-2 TABLETS EVERY 6 HOURS AS NEEDED FOR PAIN

ADDENDUM:(instructions on medications)

po means to take by mouth

QD means to take once a day

BID means to take twice a day

TID means to take three times a day

QID means to take four times a day

QHS means to take at bedtime

QOD means to take every other day

PRN means to take only as needed

CHANGES IN MEDICATIONS:

ACETA W/CODIENE ADDED FOR PAIN

FERROUS SULFATE 325MG PO QD ADDED

ACTIVITY: AS TOLERATED

DIET:REGULAR

CONDITION AT DISCHARGE: STABLE

FOLIAW-UP:

-PULMONARY CLINIC 1 WEEK

-PRIMARY CARE PROVIDER, DR_ BOWMAN 4 WEEKS

/es/ RHONDA S ROSS,MD

PATIENT NAME AND ADDRESS (Mechanical imprinfing, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506.326



Nov 12, 2003


STAFF PHYSICIAN

Signed: 09/18/2003 11:01

Nov 12, 2003

09/18/2003 ADDENDUM:

Pt. bronchoscopy results positive for non-small cell lung cancer.

Dr. Munn has scheduled pt. for PET Scan, PFT's, and Persantine Stress Test

in preparation for possible future surgical resection if pt. would be a

candidate.

/es/ RHONDA S KOSS,MD

STAFF PHYSICIAN

Signed: 09/18/2003 15:51

PATIENT NAME AND ADDPESS ( Mechanical imprinling, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506326

VISTA Elecfronic Medical Documentation


Consult RequestPage 34

Current PC Provider: BOWMAN,SARA C

Current PC Team: BLUE TEAM D

Current Pat. Status: Outpatient

Primary Eligibility: NSC

Order Information

To Service; THORACIC

From Service: PULMONARY/CHEST

Requesting Provider: MUNN,NANCY J

Service is to be rendered ort an OUTPATIENT basis

Place: Consultant's choice

Urgency: Routine

Orderable Item: THORACIC

Consult: Consult Request

Reason For Request:

Patient with non small cell ca of RUL. Got w/u for possible thoracotomy

but PET scan suspicious for metastatic disease to right paratracheal and

tracheobronchial space. Please review films to see if you feel that

biopsy of riodes is warranted. Metastatic w/u is otherwise negative.

Please let me know and will refer to Oncology and Radiation if not a

surgical candidate.

Inter-facility Information

This is not an inter-facilitv consult request.

Status: PENDING

Last Action: PRINTED TO

Nov 12, 2003

Eacility

Activity Date/Time/Zone Responsible Person Entered By_______ __________________________ _________.

CPRS RL'LEASED ORDER 11/10/03 15:36 MUNN,NANCY J MUNN,NANCY J

PRINTED TO OR4 11/10/03 15:36

Note: TIME ZONE is local if not indicated

No local TIU results or Medicine results available for this consult

------ END

Current PC Provider:

Current PC Team:

Current Pat. Status:

Primary Eligibility:

Order inforination

To Service:

From Service:

BOWMAN,SARA C

BLUE TEAM D

Outpatient

NSC

FEE BASIS-PET SCAN

5 S-M

PATIENT NAME AND ADDRESS (Mechanlcal Imprinting, it available)

SINNOTT, JAMES

1525 THOMAS ST


402506326



JAMES SINNOTT


MEDICAL RECORDS FROM HUNTINGTON VETERANS


PART II OF IV


Nov72,2003


Service is to be rendered on an INPATIENT basis

Place: Bedside

iJrgency: Routine

Orderable Item: FEE BASIS-PET SCAN


Reason For Request:

Patient with new diagnosis of lung cancer RUL. Has hilar and enediast:inal

adenopathy. Needs PET scan to assess for metsiri mediastirium. Please

schedule ASAP.


'Phis is not an inter-facility consult request.

Status: SCHEDULRD

Last Action: SCHEDULED

Facility

Activity Date/Time/Zone Responsible Person Entered By_____________________________________________________________________________..

CPRS RELEASED ORDER 09/18/03 14:25 MUNN,NANCY J MUNN,NANCY J

PRINTED TO HUNMASI8 09/18/03 14:25

SCHEDULED 09/30/03 11:21 ZBAN,BILINDA H ZBAN,BILINDA H

PT. SCHEDULED FOR A PET SCAN ON 10/27/03 AT ST MARY'S HOSPITAL AT

10:30A.M.


No local '1'IU results or Medicine results available for this consultEND ------------------ _-

Current PC Provider; BOWMAN,SARA C

Current. PC Team: BLUE TEAM D



Order Information

To Service: STRESS TES'1'

From Service: 5 S-M



Place: Consultant's elioice

Urgency: Routine

Orderable Item: STRESS TEST


Reason For Request:

PATIENT NAME AND ADDRESS (Mechanical ImprlnNng, II available)

S_NNOTT, JAMES

1525 THOMAS S'P


402506326




Nov 12, 2003

Select a procedure and give a brief history:

Patient with new diagnosis of lung cancer, needs preop evaluation.

History of stable angina.

Please specify date it not routine *

Exercise Stress Test (Non-Nuclear)

Exercise Cardiolyte Stress Test

x Persantitie Cardiolyte Stress Test

_ Dobutamine Cardiolyte Stress Test

24 Hr Delayed Thallium Imaging (for viability)

Tnter-facility Information

This is not an inter-facility consult request.

Status: SCHEDULE

Last Action: SCHEDULE

Facility

Activity Date/'1'

CPRS RELEASED ORDER 09/18/

D

D

im

03

/Zone

14:25

esponsi.ble Person

MUNN,NAAICY J

ntered By

MUNN,NANCY .J

PRINTED TO CAR2-S 09/18/ 03 14:25SCHEDULED 09/23/ 03 15:57 BARRBTT,WILLIAM R '1'RAU'tNER,E St)SFN

PERSANTINE STRESS TEST SCHEDULED FOR 9-26-03 AT 7:30 AM


_-____ _________--------- END

Current PC Yrovider: BOWMAN,SARA C

Current. PC Team: BLUE TEAM D


Primary Eliqibility: NSC

Order Information

To Service! PULMONARY PROCEP.URES

From Service: 5 S-M



Place: Bedside

Urgency: Routirle

Orderable Item: PULMONARY FUNCTION TEST

Procedure: PULMONARY NUNC'1'ION TEST

Reason For Request:

PATIENT NAME AND ADDRESS (Mechanical impriminy, if available)

SINNOTT, JAMES

1y2S THOMAS ST


402506326



Consult Request Page 37 Nov12,2003

•Pest needed:Spirometry only.

_x_Spirometry with and without bronchodilators.

__x_Lung volumes._xDiffusing capac:ity.

_x Flow volume loops (for upper airway obstruction)

x Resting arterial blood gases (room air) perforn)ed with PFT.

Reason for request: Pre-op eval

schedule asap.


This is not an inter-facility c

uat

ons

ion for pos

ult requeSt

sible thoracotomy.

.

Please

Status: COMPLETE

Laat. Action: COMPLETE

Facility

Activity Date/T

/UP

ime

DATE

/Zone esponsible Person ntered By

---------------------------------------- . .. ......._.__----------- ---------------

CPRS RELEASED ORDER 09/18/ 03 14:25 MUNN,NANCY J MUNN,NANCY .7

PRINTED TO PULl 09/18/0 3 14:25

RECEIVED 09/18/ 03 1457 FANNIN, PA1l[, D FANNIN, PP..iL 1)

PFT'S SCHUDUDULE

COMPLETE/UPDATE 09/25/0 3 '16:S7 FANNIN,PAUL D FANNIN,PAUL D

Medicine Procedure performed: SEP 25, 2003914:40:58


Medicine Package Report

Medicine Report

PULMONARY FUNCTION TEST - RELEASED ON-LINE VERIFIED

PROCEDURE DATE/TIME: 09/25/03 14:40

SE%: M AGE:64 74 in/227 lb AMBIENT: 21C/794T

RACE: WHITE, NOT OF HISPANIC ORIGIN TECH: FANNIN,PAUL D

NON-SMOKER EFFORTo GOOD

CONSULT DX:

UNITS PRED ACTUAL %PRED I'REV1 PREV2 C'I

VOLUMES .........................................................................

PATIENT NAME AND ADDFESS ( MechanlCal Imprinting, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506326



Consult Requestpage38

Nov 12, 2003

13ODY BOX

VC L 5.11 3.61 70.6 7.92FRC L 3.39

RV L 2.74 2.14 78.0 U 3.53

NITROGEN WASH OUT

TLC I, 7.56 5.75 76.1 6.56

VC L 5.11 3.61 70.6 1.92

FRC L 3.39RV L 2.74 2.14 78.0 U 3.53

RV/TLC % 37

UNITS PRED ACTUAL °aPRED PREVl PREV2 C T

FLOWS ...........................................................................

MACHINE: DRY WATER SEAL

STANDARD STUDY

PVC L 5.11 3.61 70.6 3.75

FEVl L 3.50 2.92 83.4 2.50PF L/SEC 9.382 6.390 68.1 5.51FEF25-75 L/SEC 3.108 3.250 104.6 1.26

MW L/MIN 148.82 101.00 67.9 93.06

FEV1/FVC "s B1

AFTER BRONCHODILATOR

FVC L 5.11 3.63 71.0 3.75FEVI L 3.50 3.07 87.7 2.50PF L/SEC 9.382 7.640 81.4 5.51PEF2S-75 L/SEC 3.108 3.770 121.3 1.26hIVV L/MIN 148.82 11'].00 78.6 93.06FEV1/FVC % 85

DIFFUSION .......................................................................

METI[OD:

DLCO-SB L 37.84 26.40 69_8 29.64

eLOOD GASES .....................................................................

STUDY TYPE pH pC02 p02 02HB COHB MHB HB Fi02 A-a02 QS/QT

(NORMAL) 7.36-7.44 36-44 80-100 >88% <3% <2$ <22

ROOM AIR 7.350 41.0 82.0 95.0$ 23.0°s 0.0% 0.0 0.210 13

PATIENT TEMPERATURE (C):

INTERPRETATION ..................................................................

PATIENT NAME AND ADDRESS ( Mechanical impriming, iF zvailable)

STPINOTT, JAMES

1525 THOMAS ST

1:ROniTON, OHIO 45638-1176

402506326




Nov 12, 2003

PULMONARY FUNCTION TEST RELEASED ON-LINE VERIFIED


INTERPRETATION: VERY MILD RESTRICTION,NO OBSTRUCTION,NO POST BRONCHODILATOR

RESPONSE,NORMAL DIPFUSING CAPACITY.

COMMENTS AND RECOMMENDATIONS:

DID ROOM AIR BLOOD GASES PATIENT COUGHING DURING TESTPatient effort

and cooperation good.Composite Flow-Volume Loop was generated to rule

out upper airway obstruction.Med-Neb 9iven with 2.5 mys albuterol

with 2.5cc n/S

INTERPRETED BY; GHANEM,AMMAR

REVIEWED BY: MUNN,NANCY J

PULMONARY FUNCTION TEST - RELEASED ON-LINE VERIFIED


PREDICTED VALUE FORMULAS USED

TLC

VC

FRC

RV

FVC

FEV1

PF

FEF25-75

MVV

DLCO-SB

COFIR CORR.

(.239*HT/2.54)-(.015*AGE)-9.17MORRIS/POLGAR '84


000 MORRIS/POLGAR

(.069*HT/2.54)+(.017*AGE)3.45MORRIS/POLGAR '84

(.148*HT/2.54)-(.025*AGE)4.24MORRIS/POLGAR '84



(.047*HT/2.54)-(.045*AGE)+2.51MORRIS/POLGAR '84

(3.39*HT/2.54)-(1.26"AGE)-21.4MDRRIS/POLGAR '84

(.416*HT)-{.219*AGE)-26.34 CRAPO '81

ACT MORRIS/POLGAR '84

HB CORR. ACT MORRIS/POLGAR '84

NOTE: HT=helght,WT=weight,ACT=actual measurement value

R e p o r t R e 1 e a s e S t a t u s

PATIENT NAME AND ADDRESS ( Mechanical impdnting, if availaWe)

SINNOTT, JAMES

1.525 THOMAS ST

IRON'1'ON, OHIO 4 56 3 8-1176

402506326




Nov12,2003

Current Date Person Who

Report Status Last Cha:iged Date of Report

Status Changed The Status Entry Version

RELEASED ON-LINE VERICIED

9/25/03 PAUL D FANNIN . 9/25/03 1 of 1

-------- END ________-____-


Current PC Team: DLUE TEAM D



Order Information

'1'o Service : PULMOt7ARY

From Service: S S-M

Requesting Provider: ROSS,RHONDA S

Service is to be rendered on an OUTPATIENT basis


Urgency: Routine

Orderable Item: PULMONARY


Provi.siona7. Diagnosis: RUL LUNG MASS

Reason For Request:

PLEASE SCHSDTJLE F/U APPT. AS OP IN PULMONARY CLINIC 1 WEEK

For assessment and recommendations

(No orders, please)

For assessment, recommendations and management

(Orders as necessary)

Inter-faCility InformationThi.s is not an inter-facility consult request.

Status: CANCELLED

Last Action: CANCELLED

Facility

Activity Date/Time/Zone Responsible Person Entered By

CPRS RELEASED ORDER 09/18/03 11:15 ROSS,RHONDA S ROSS,RHONDA S

PATIENT NAME AND ADDRESS (Mechanical Imprinting, it available)

SINNOTT, JAMES

1525 THOMAS ST


402506326




Nov 12, 2003

PRINTED TO PUL2_S 09/18/03 11:15

RECEIVED 09/24/03 12:32 WILLIAMS,PETG WILLIAMS,PE'1'E

CANCELLED 11/07/03 14:22 WILLIAMS,PETE WILLIAMS,PETE

Known to Pulmonary Service. Scheduled for Pulmonary Clinic on 11/10/03 aC

2pm and patient personally notified. Consult is being administratively

cancelled.



- END _________---------------- ________-





order InformationTo Service: EKG PROCEDURES

From Service: 5 S-M

Requesting Provider: CHANEM,AMMAR


Place: Bedside

Urgency: Routine

Orderable Item: EKG 12 LEAD (Today)

Procedure: EKG 12 LEAD (TODAY)

Reason For Request:

Do today.

Icrter-facil.ity Information

'Chi.s is not an inter-facility consult request.

St.atus: COMPLETE

Last Action: COMPLETE/UPDATE

Significartt Findings: Unknown

Facility

Activity Dat.e/Time/Zone Responsible Person Entered By------------------------------------------------ -------------- -- --------------

CPRS RELEASED ORDGR 09/16/03 09:38 GHANEM,AMMAR GHANEM,AMMAR

PRINTED TO CAR2-S 09/16/03 09:38

COMPLETE/UPDATE 09/16/03 MOLINA,PATRICIA A MOLINA, PATRICIA A

(entered) 09/17/03 08:34

done

PATIENT NAME AND ADDRESS (Mechanical imprinting, i1 available)

SINNOTT, JAMES

1525 THOPiAS ST

IRONTON, OHIO 4S638-1176

402506326


v

Consult Request Page 42 Nov,2, 2009

Note: TIMF ZONE is local if noL indicated

Significant Findings: Unknown- - - - -- -- -- - - - - - - - - - - - - - - - - -- - - - - - - -- - - - - - - - - - - - - - - - - - - -- - - -- -- - - - - - - - - - - - - - - -

No local TIU-resultsor Medicine results available for this consult-------------- -------- ____.______

_-____________________-___________= END

Current PC Provider; BOt3MAN,SARA C




Order Information

To Service: PULMONARY

From Service: 5 S-M

Requesting Provider: AKERS,MARK JASON


Place: Bedside

Urgency: Routine

Orderable Item: PULMONARY


Provisional DiagnoSiS: RUL mass

Reason For Request:

_ For assessment and recommendations

(No orders, please)

_ For assessment, recommendations and management

(Orders as necessary)

64 y/o w in pt with pmh of gerd, s/p mallory weiss tear, chronic low

back pain and BPH presents to VAMC er today after being told to return

by er physician. pt states that he had a chest ct performed earlier

this week and after Dr. Joseph in the er learned of the results she

called him and told him to come to the er. this all begaii a couple of

weeks ago when pt was being screened for asbestosis with a cxr and

pfts. cxr at that time showed a RUL mass and follow-up CT scan was

suggested. pt presented to er with this information to Dr. Joseph and

CT was ordered and performed. It showed a large rt upper lobe mass w/

extension to left upper lobe. Biopsy was suggested. Bec of these

findings and the fact that pt has been complaining of upper chest pain,

Dr. Joseph called him and told him to come to er and be admitted so he

wouldn't get "lost,"

inter-facility Snformation

This is not an inter-facility corisult requesL.

PATIENT NAME AND ADDRESS ( Mechanical imp,inling, il available)

SINNOTT, JAMES

152S THOMAS ST

IRONTON, OHTO 45638-1176

402506326




Nov 12, 2003

Status: COMPLGTE

Last Action: ADDENDUM ADDED TO

Facility

Activity Date/Time/Zone Responsible Person Entered By________________________--_____________________________________________________

CPRS RELEASED ORDER 09/14/03 2203 AKF.RS,MARK JASON AKERS,MARK JASON

PRINTED TO PUL2_S 09/14/03 22:03RECEIVED 09/15/03 10:19 WILLIAMS,PETE WILI.,IAMS,PETE

INCOMPLETE RPT 09/15/03 10:56 GHANEM,AMMAR GHANEM,AMMAR

NoteB 4094838

COMPLETE/UPDATE 09/15/03 15:50 GHANEM,AMMAR MUNN,NADiCY J

NoCeit 4094838

ADDENDUM ADDED TO 09/15/03 16:47 GHANEM,AMMAR MUNN,NANCY J

Note>< 4094838


TITLE: PULMONARY CONSULT

DATE OB NOTE: SEP 15, 2003®10:31 ENTRY DATP•.: SEP 15, 2003@10:32:08

AUTHOR: GHANEM,AMMAR EXP COSIGNER: MUNN,NANCY J

URGENCY: STATUS: COMPLETED

referring physician:Dr. Ross

reason for Lhe consult:RUL mass

HPI:

The patient is 64 white man with a past inedical h/o smoking/?copd in the past

and significant asbestos exposure who got admitted to the hospital with eU1,

mass. the story of recent complains started on the spring of this year with sonte

abdoininal symptoms of distention and gas that resolved with medication but later

on the patient started to have aching and pain started on the shoulder area and

spread to involve the whole body bilaterally. This pain prevented sleep and has

been difficult to control and the pt. now is using salisylaCe and amitriptyllin

for pain control.there is acomplain of fatigue because of lack of sleep. He also

complained of dry eyes but no bluury or change in vision. ttte achirtg is also

associated with some occipital h/a in the last 2 weeks.No joint swelling or

inflammation and no skin rash. no inouth or genital ulcers. No respiratorv

symptoms of sob or c/p. some little dry cough and apatiLe is good but the

patient has recently loosing some weight.

pt states that he had a chest xray and ct performed earlier this week as part of

screeening for asbestos and after Dr. Joseph in the er learned of the resul.t.s

she called him and told him to conte to the er.wiLh this information

PATIENT NAME AND ADDRESS ( Mechanical ImOfinting, If availabfe)

SINNOTT, JAMES

1525 THOMAS ST

IRONTON,OHIO 45638-1176

402506326

VISTA Electronic Medicat Documentation



Nov12,2003

and CT was ordered and performed. It showed a large rt upper lobe mass w/

extension to left upper lobe. Biopsy was suggested and we were consulted for

that reason.

PMHX:PAST MEDICAL HISTORY:

1.COPD: No PFT and the patient currently is exsmoker quit 8 years ago, the

pateitnhas significant asbestos exposure in the past when works in a fctory for

35-36 years and has been screened multiple Linres in the past which was negative.

2. Hx of Mallory Weiss Tear S/P Upper GI Bleed secondary to #1

3. Stable angina

4. BPH

5. PostherpeLic neuralgia

6. GERD

7. Chronic low back painSocial History:exsmoker 60 pack year of smokinq/ h/o asbestos exposure.

FAMILY HISTORY:

Coronary artery disease history - His dad had

heart attack at 65 to 68. No history of diabetes. His mother also has

some heart probleni.

ALLERGIES:

FLOXIN

MEDICATIONS:

Active Dutpatient Medications (including Supplies)

Issue Date

Status Last Fill

Active Outpatient Medications Refill.s Expiration

___

1) AMITRIPTYLINE HCL 10MG 'I'AB Qty; 150 for ACTTVE Issu:09-04-03

30 days Sig: TAKE ONE TABLET BY MOUTH Refills: 1 Last:09-04-03

AT BEDTIME FOR 1 DAY, THEN TAKE TWO Expr:09-04-04

TABLETS AT' BEDTIME FOR 1 DAY, THEN

TAKE THREE TABLETS AT BEDTIME FOR 1

DAY, THEN TAKE FOUR TABLETS AT BEDTIME

FOR 1 DAY, THEN TAKE FIVE TABLETS AT

BEDTIME FOR 1 DAY INCREASE DOSE UP TO

50 MG GRADUALLY; STOP AT DOSE WHICH

GIVES REST UP TO 50 MG AT HS

2) CAPSAICIN 0.025^ CR (20Z/TU) Qty: 60 ACTIVE Issu:12-O6-02

for 30 days Sig: APPLY SMALL, AMOUNT Refills: 2 Last:08-25-03

EVERY 17 HOURS AS NEEDED Expr:12-07 03

3) FEXOFENADINE HCL 180MG TAB Qty: 30 for ACTIVE Issu:04-07-03



SINNOTT, JAMES

1525 THOMAS ST


4025063.^.6



Consult Request Page 45 NOv12,2009

EVERY DAY "FOR ALLERGIES... MAY CAUSE Expr:04-07 04

SEDATION

4) FLUNISOLIUE 25MCG 200D NASAL INHi. Qty: ACTIVE Issu:12-06-02

1 for 30 days Sig: SPRAY 2 SPRAYS IN Refills: 2 Last:08-25-03

BOTH NOSTRILS TWICE A DAY FOR NASAL Expr:12-07-03

ALLERGY SYMPTOMS

5) RABEPRAZOLE NA 20MG EC TAB Qty: 90 for ACTIVE Issu:02-03-03

90 days Sig: TAKE ONE TABLET BY MOUTH Refilis: 1 Last:07-23-03

EVERY DAY FOR STOMACH Expr:02-04-04

6) SALSALATE 500MG TAB Qty: 120 for 30 ACTIVE Issu:09-04-03

days Sig: TAKE TWO TABLETS BY MOUTH Refills: I Last:09-04-03

TWICE A DAY W/FOOD Expr:09-04-04

7) TERAZOSIN HCL 2MG CAP Qtyc 90 for 90 ACTIVE Issu:03-10-03

days Sig: TAKE ONE CAPSULE BY MOUTH Refills: 3 Last:0310-03

AT BEU'1'1ME FOR ENLARGED PROS'1'A'1'L Expr:03-1O-0,1

SYMPTOMS

REVIEW OF SYSTEMS:as HPI

PHYSICAL EXAMINATION

Gen: Patient is awake, alert, and oriented to person, place, time, and

situation. NAD

Vital Signs:

BP :135/88 (09/14/2003 14:34)

TEMP:98.2 F' (36.8 C] (09/14/2003 14:34)

P :72 (09/14/2003 14:34)

RR :16 (09/14/2003 14:34)

HEENT: NormoCephalic, atraumaliC. Pupils equally round and reactive to

light and accomodation. Extra-ocular movements intact. No sinus

tenderness. Oral mucosa moist and pink wittr no erythema or exudate.

Neck: No carotid bruits, no jvd, no cervical lymphadenopathy.

Heart: Normal sl, s2. No murmurs/rubs/gallops.

Lungs: Clear to auscultation bilatrally, no wheezing, rales, or rhonchi.

Good air entry bilaterally.

Abdomen: Soft, nontender, nondistended, bowel sounds posit.ive. No

appreciable hepatospenomegaly.

Extiremitiese No cyanosis, clubbing, or edema. Peripheral plQses 2+.

Neurological: Cranial rterves II to XII intact, normal sensation to

pinprick and light touch. Deep tendon reflexes +2.

Musculoskeletal: motor strength 5/5 in upper and lower proximal and

distal extremities. tender in the shoulder and bones. no sighns of inflammation

or skirt rash

Labs:

N.A: 1.36 MMOL/L (09/14/2003 16:23)

K: 4.1 MEQ/L (09/14/2003 16:23)

PATIENT NAME AND ADDRESS (Mechanlcal imprinting, if available) VISTA Electronic Medical DocumentationSINNOTT, JAMES

1525 THOMA$ ;T

IRONTON, OHIO 45638-1176 Printed at HUNTINGTON VAMC402506326


Nov32,20U3

CL: 102 MMOL/L (09/14/2003 16:23)

C02: 25.6 MMOL/L (09/14/2003 16:23)

BUN: 11 MG/DL (09/14/2003 16:23)

CREAT: 0.8 MG/DL (09/14/2003 16:23)

GLU: 91 MG/DL (09/14/2003 16:23)

WEC: 6.3 K/cmm (09/14/2003 16:23)

HGB: 14.5 g/dL (09/14/2003 16:23)

HCT: 44.1 % (09/14/2003 16:23)

PLTLT: 297 K/cmm (09/14/2003 16:23)

+pecimen: ARTERIAL BLOOD. RT 0914 3

09/14/2003 16:25Test name Result units Ref. range

HC03a 27 MMOL/L 21 - 29

PH 7.41 7.35 - 7.45

PCO2 43 MMHC 32 - 46

P02 76 MMHG 74 - 108

BASE EXCESS 3 H MMOL/L -2 -+2.0

02HB% (SAT) 95 % 92 - 96

CT of the chest: right upper lobe 3x4 mass medial and attached to the

mediastinal pleura. located in the apical or anterior segment of the right upper

lobe and asociated with lymphadenopathy.no liver or arenal lesions.

A:Right upper lobe mass with h/o smoking and asbestos exposure make the patient

liigh rislc of lunq ca. wewill do diagnostic bronchoscopy to ger a tissue if

possible even the locatation of the lesion might be hard to reach. we will chech

pt/ptt and esr before the procedure and get tibial xray to check for HPO as

possible paraneoplastic syndrome.

/es/ AMMAR GHANEM /es/ NANCY J MUNN, M.D.

PGY4 CHIEF, PULMONARY SECTION

Signed: 09/15/2003 10:57 Cosigned: 09/15/2003 15:50


Personally interviewed and exaniined patient, discussed with Dr. Ghancm. 64

yo nfale with history of asbestos exposure for 37 years and prior smoking

history of 1 1/2 ppd x 45 years. Admitted after CT chest showeda right

upper lobe lung mass. History of some shoulder pain in that area as well

as diffuse pain. Says has noted unintentional weight loss recently. Denies

any dyspnea, sputum, wheezing but does have a dry cough. History of rigid

PATIENT NAMF ANP ADDRESS (Mcchanical imprinting, if available)

SINNOTT, JAMES

1;25 THOMAS ST

LROMTON, OHIO 45638-1176

402506326



Consult RequestPage47

Nov 12, 2003

bronchoscopy in the 1950's while in the service and was told had scarring

ot lower lungs. History of COPD (no pfts) , stable angina, gerd, low back

oain.

On exam, pleasant male in no distress. Breathing comfortably at rest. No

conversational dyspnea. vs normal. No cervical adenopathy or jvd. Lungs

clear to a and p. RRR. Abdomen soft and nontender. No clubbing, cyanosis,

edema. Alert and oriented.

Labs relatively unremarkable. CXR with evidence of RUL mass.

CT chest reviewed with Radiology art<i RUL mass noted with question of some

satellite lesions. NO LESION NOTED ON LEFT. Some mediastinal and hilar

adenopathy.

Clinical presentation suggestive of bronchogenic carcinoma with RUL mass.

Signiticant smoking and occupational exposure history.

Location of lesion may make biopsy difficult. Will try bronchoscopy as

first diagnostic procedure. Scheduled for bronchoscopy on 9/17/03 at 8am.

If non-diagnostic, then may need needle biopsy and/or open biopsy. Agree

with plans for metastatic w/u.

/es/ NANCY J MUNN, M.D.

CHIEF, PULMONARY SECTION

Signed: 00/15/2003 16:47

--------------

------------------ _- END ------------- _--___________



CurrenL Pat. Status: Outpatient

Primary Eligibilit-y: NSC

Order Information

To Service: PULMONARY PROCEDURES

From Service: AMB CARE WALK-IN

Requesting Provider: JOSEPH,SANDRP.



Urgertcy:

Orderable Itenl: ARTERIAL BLOOD GAS

Proce.dure: ARTERIAL BLOOD GAS

Reason For Request:

On Oxygen @On Room Air

After Oxygen Change NEEDS LUNG BIOPSY

After Ventilator Change

Ventilator patient AM

PATIENT NAME AND ADDRESS (Meehanical imprinting, if available)

SINNOTT, JAMES

1525 THOMAS ST

IRONTON, OHIO 4S638 1176

902506326



Consult RequestHoine Oxygen

Other:

Page 48


This is not an inter-facility consult request.

Status: COMPLETE

Last Action: COMPLETE/UPDATE

Nov12,2003

Facility

Activity Date/Time/Zone Responsible Person Entered By_________________________________________________.____---__..____-___-_---_-__ .

CPRS RELEASED ORDER 09/14/03 16:14 JOSEPH,SANDRA JOSEPH,SANDRA

PRINTED TO PULl 09/14/03 16:14

COMPLETE/UPDATE 09/14/03 16:33 HUMPHREY,JOHN BRI HUMPHREY,JOHN BRI

Mote# 4093638

Note: TIME ZONE is local it not indicated

TITLE: RESPIRATORY PROCEDURE

DATE OF NOTE: SEP 14, 2003@16:33:23 ENTRY DATE; SEP 14, 2003Q16:33:23

AUTHOR: HUMPHREY,JOHN BR7AN EXP COSIGNER:


SUBJECT: ABG

ABG DRAWN, RESULTS IN LAB MENU.

/es/ JOHN BRIAN HUMPHREY

CRTT

Signed: 09/14/2003 16:33

----------------- -------------------------------

---------- --------------END -___-- ---___________________________

PATIENT NANE AND ADDRESS ( Machanical imprinting, ii available)

STNNOTT, JAMES

1525 THOMAS S'1'

iRONTON, OHIO 45638-1176

402506326



04

Progress NotePage 49

Nov 12, 2003

TITLE: PULMONARY OUTPATIENT-PHYSICIAN

DATE OF NOTE: NOV 10, 2003Cd14:59 ENTRY DA'PE: NOV 10, 2003@14:59:48



*** PULMONARY OUTPATIENT-PHYSICIAN Has ADDENDA ***

VITAL SIGNS:

Blood Pressure: 150/81 (10/16/2003 13:31)

Pulse : 61 (10/16/2003 13:31)

Respiration : 20 (10/16/2003 13:31)

'I'emperature . 98.2 P [36.8 C] (10/16/2003 13:31)

Wei.ght : 239 lb (108.6 kg] (10/16/2003 13:31)

PAIN: 6 (10/16/2003 13:31)

*** If Pain Score is 4 or greater or it the patients perception of pain

at any level is not tolerable, complete the Pain Assessment found

uncler Shared 'I'emplates.

RTC:

CUTURE LABS:

FUTURE X-RAYS:

CONSULTS REQUESTED:

Subjective: The patient is 64 yo MALE who

Is coming today for follow up orr recently diagnosed right upper lobe mass as non

small cancer on mid septernber. the patient ct scan showed right upper lobe mass

4x4 associated with small second peripheral lesion and right paratracheal

lymphadenopathy. thebx was positive for nscc o£ the lung. The patient is kriown

past medical history of smoking 75pack/ycar arid significant exposure to

asbestos. He presented with incidental mass during screening for asbestos

exposure. The patient has been

Recently doing around the same, st.i7l complaing of fibromyalgia symptoms but no

respiratory symptoms.

Objective:

Temperature98.2 F[36.8 C] (10/16/2003 13:31) pulse6l (10/16/2003 13:31)

respiration20 (10/16/2003 13:31)

alood pressure150/81 (10/16/2003 13:31)

General: alert, oriented and no acute distress

Heent: perrl, ENT is normal

Neck: supple, no jvd, thyromegaly or bruits

Chest:cta, no adventious breattr sounds

Heart: rrr, no murmurs or gallops

Abdomen: soft, NT, nd active bowel sounds

Extremities: no oedema, pulse is palbable bilaterally

Neurologic: nonfocal

PATIENT NAME AND ADDRESS (Mechanical imprinUng, it available)

SINNOTT, JAMES

1525 THOMAS ST

1RONTON, OHIO 45638-1176

402506326



P rog ress NotePage 50

Nov 12, 2003

Musculoskeleeal: normal, no skin rash

pftg. 1 11/10/03

15:04CONFIDENTIAL PULMONARY FUNCTION TEST - RELEASED ON-LINE VERIFIED

SINNOTT,JAMES T 402-50-6326 NOT INPATIENT DOB: APR 10,1939


SEX: M AGE;64 74 in/22i lb AMBIENT: 21C:/744T

NACE: WHI'PE, NOT OF HISPANIC ORIGIN TECH: FANNIN,PAUL D

NON-SMOKER EFFORT: GOOD

CONSULT DX:

UNITS PRED ACTUAL °aPRED PREV1 PREV2 Cf

VOLUMES .........................................................................

BODY BOX

VC L 5.11 3.61 70.6 1.92FRC L 3.39RV L 2.74 2.14 78.0 U 3.53

NITROGEN WASH OUT

TLC L 7.56 5.75 76.1 6.56VC L 5.11 3.61 70.6 1.92FRC L 3.39RV L 2.74 2.14 78.0 U 3.53RV/TLC o 37

UNITS PRED ACTUAL %PRED PREV1 PREV2 C I

FLOWS ...........................................................................

MACHINE: DRY WATER SEAL

STANDARD STUDY

FVC L 5.11 3.61 70.6 3.75FEV1 L 3.50 2.92 83.4 2.50PF L/SEC 9.382 6.390 68.1 5.51FEF25-75 L/SEC 3.108 3.250 104.6 1.26MVV 1,/MTN 148.82 101.00 67.9 93.06FEV1/FVC % 81

AFTF,R BRONCHODILATOR

FVC L 5.11 3.63 71.0 3.75FEV1 L 3.50 3.07 87.7 2.50PF L/SEC 9.382 7.G40 81.4 5.5-

PATIENT NAME AND ADDRESS ( Mechanlcal Imprlntinq, if availabla)

SINNOTT, JAMES

1525 THOMAS ST

IRONTON, OI110 45638-1176

402506326




Nov 12, 2003

FEF25-75 L/SEC 3.108 3.770 121.3 1.26M`N L/MIN 148.82 117.00 78.6 93.06

FEV1/FVC $ 85

DIFFUSION .......................................................................

METHOD:

DLCO-SB L 37.84 26.40 69.8 29.64

BLOOD GASES .....................................................................

STUDY TYPE pH pCO2 p02 O2HB COHB MHB HB Fi02 A-a02 QS/QT

(NORMA6) 7.36-7.44 36-44 80-100 >88% c3% <2% c22

ROOM AIR 7.350 41.0 82.0 95.0°s 23.0% 0.0% 0.0 0.210 13

PATIENT TEMPERATURE (C):

Pg. 2 11/10/C3 15:04

CONFIDENTIAL PULMONARY FUNCTION TEST - RELEASED ON-LINE VERIFIED

SINNOTT,JAMES T 402-50-6326 NOT iNPATIENT DOB: APR 10,1939


- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -INTERPRETATTON ..................................................................

INTERPRETATION: VERY MILD RESTRICTION,NO OBSTRUCTTON,NO POST BRONCHODILATOR

RESPONSE,NORMAL DIFFUSING CAPACITY.

COMMENTS AND RECOMMENDATIONS:

DID ROOM AIR BLOOD GASES PATIENT COUGHING DURING TESTPatienL effort

and cooperation good.Composite Flow-Volume Loop was generated to rule

out upper airway obstruction.Med-Neb given with 2.5 mgs albuterol

with 2.5cc n/s

Imaging studies:ct of the head and abdomen/pelvis reported as normal. bone scan

also reportedas normal. and the pet scan done in outside facility reported as

abnormal with the mass intake and another small intake in the right upper lobe

peripheraly and paratracheal and bronchotracheai lymphadenopathy.

Impression:right upper lobe mass diagnosed as nscc with positive ct. and pet ccan

for another lesion on the same upper lobe area and positive pet for parat-acheal

lymphadenopathy on the right side. the pt. would be mostly not a candidate for

resection. we will speak to ct surgery to confirm our impression and if so willrefer the pt. for chemo/radiation.

PATIENT NAME AND ADDFESS (Mechanlcal imprinting, il available)

SINNOTT, JAMES

1525 THOMAS ST


402506326




Nov 12, 2003



Signed: 11/10/2003 15:10 Cosigned: 11/10/2003 15:37


Personally interviewed and examined patient. Breathing okay and doing okay in

general except for his fibromyalgia. Breathing comfortably at rest. Lungs clear.

RRR. Alert and orienLed. Discussed results of PET scan with him and that this is

suspicious for metastatic disease in his lymph nodes which would probably make

him non-resectable. Will review with Thoracic Surgery but if not felt to be a

surgical candidate, then will refer to Oncology arrd Radiation Oncology. He

agrees to this. Will notify him after discuss with Thoracic Surgery. His cell

phone is (740) 317-5263.

PET scan was done at St. Mary's Medical Ceriter on 10/27/03 and was reported as

follows:

"Report: Total body scintigraphic survey was performed using 27 mCi Tc FDG.

There is hypermet.aholic uptake within the media7. right upper lobe soft tissue

mass that was demonstrated on CT of the the chest 9/11/03 VA Medical Center,

Huntington, WV_

There is adjacent hypermetabolic uptake seen within right paratracheal and

tracheo bronchial lymph nodes, suggestive of inetastatic neoplasm. Above and

lateral to the primary tumor there is a nodule abutting the pleural surface on

the CT examination. Scirttigraphically this demonstrates hypernietabolic uptake as

well, suspicious for a second focus of neopl.asm. Remainder of study is

unremarkable.

Conclusion: Malignant uptake within a right upper lobe soft tissue mass and a

smaller peripheral nodule which abuts the pleural sur.gace near the right lung

apex. Metastatic adenopathy within the righL paratracheal and tracheobrortchi.al

space is also suspected.

Read by: W. S. JR SHELLS, M.D."



Signed: 11/10/2003 15:44

TITLE: PCC-PHYSICIAN


SINNOTT, JAMES

1525 THOMAS ST


402506326




Nov '2, 2003

DATE OF NOTE: OCT 16, 2003014:00 ENTRY DATE: OCT 16, 2003Cs44:00:44

AUTHOR: BOWP4P.N,SARA C EXP COSIGNER:


VITAL SIGNS:

Blood Pressure: 150/81 (10/16/2003 13:31)

Pulse . 61 (10/16/2003 13:31)

Respiration . 20 (10/16/2003 13:31)

Temperature . 98.2 F[36.8 C] (10/16/2003 13:31)

Weight 239 lb [108.6 kg] (10/16/2003 13:31)

Pain : 6 (10/16/2003 13:31)

*** If Pain Score is 4 or greater or if the patients perception of pain

at any level is not tolerable, complete the Pain Assessment found

under Shared Templates.

PROBLEM LIST:

1) nonsmall cell lung ca

2) fibromyalgia

3) FiTN

4) HO mallory weiss tear with UGIB

5) CAD stress 9/03 (-)

6) COPD

7) post herpetic neuralgia

8) s/p lamenectomy 1997

9) s/p B TKR 1994

10 ) asbestosis

11) nephrolithiasis

OUTSIDE PHYSICIANS:Dr Herr ( ortho)

ALLERGIES: FLOXIN

pt presents for initial visit with me. he was tound with lung mass on

asbestos.is screening. cytology is (+) for NSCLca. he is P PET scan 10/27 to

evaluate for mediastinal disease and to determine if surgical candidat.e. he

denies SOB/DOE. He sLates he ah sadditional fibroniyalgia but thaC sx are

improved on TCA and he is sleeping 4-5 hrs a night now. No cp with activity. no

melena, hematochezia

FHX - father with CAD/Mi 65yo

tobacco - quit 7-8 yrs ago

OBJECTIVE:

HEENT:sclera ciear, no lad, no bruits

PULM:clear

CARDS:rrr

ABD:soft, nt, nd

EXT:no edema

RECTAL:nl tone smooth nontender prostate, no nodu)es no masses heme (-)

All available labs and vital signs were reviewed with the patient withemphasis on any abnormal results.

PATIENT NAME AND ADDRESS (Mcchanical imprinting, if available)

SINNO'I'T, .7AMES

7.525 THOI+:AS ST

IRON'1'ON, OHIO 45638-11'76

402506326



P rog ress Note Page 54 Nov 12, 2003

Followinq Medications were discussed with the patient with an opportunity

for questions to be asked:

Active Outpatient Medications (including Supplies):

Active Outpatient Medications Status

_..____________________________________--_

1) CAPSAICIN 0.025% CR (2OZ/TU) APPLY SMALL AMOUNT EVERY ACTIVE

12 HOURS AS NEEDED

2) CODEINE 30/ACETAMINOPHEN 300MG TAB TAKE ONE TO TWO ACTIVE

TABLETS BY MOUTH EVERY 6 HOURS AS NEEDED FOR PAIN.

(MAY CAUSE DROWSINESS)

3) CYANOCOBAL INJ 1000MCG/ML (1ML/VI) INJECT 1000MCG/1ML ACTIVE

INTRAMUSCULAR MONTHLY

4) FERROUS SULFATE 325MG TAB,UD TAKE ONE TABLET BY MOUTH ACTIVE

EVEftY DAY

5) FLUNISOLIDE 25MCG 200D NASAL INHL SPRAY 2 SPRAYS IN ACTIVE

BOTH NOSTRILS TWICE A DAY FOR NASAL ALLERGY

SYMPTOMS

6) RABEPRAZOLE NA 20MG EC TAB TAKE ONE TABLET BY MOUTH ACTIVE

EVERY DAY FOR STOMACH

7) SALSALATE 500MG TAB TAKE TWO TABLETS BY MOUTH TWICE A ACTIVE

DAY W/FOOD

II) TERAZOSIN HCL 2MG CAP TAKE ONE CAPSULE BY MOUTH AT ACTIVE

BEDTIME FOR ENLARGED PROSTATE SYMPTOMS

Pending OutpatienL Medications Status

-________

1) AMITRIPTYLINE 25MG TAB TAKE ONE TABLET BY MOUTH 2 QHS PENDING

2) CYANOCOBALAMIN 250MCG TAB TAKE ONE TABLET BY MOUTH PENDING

EVERY DAY

10 Total MediCations

ASSESSMENT/PLAN:

1. NSCL ca - await PET and further tx rccs from puim

2. fibromyalgia - increase amitriptyline to 50-75 mg qhs as tolerated

3. CAD - stress (-), no cp , cont asa qd

4> vit B12 def - pt with low normal levels, no abd surgery will use oralrepalcement

RTC:RR 1 month no labs

CONSULTS REQUESTED:

FUTURE LABS:

Pat.ient should return: _ Fasting Non-Fasting

FUTURE IhII1GING:

PATIENT NAME AND ADDRESS ( Mechanical imprinling, if available)

SINNOTT, JAMES

1525 THOMAS ST

IRONTON, OHIO 4563£3-1176

402506326


Printed at HUNTINGTON VAMG


Nov 12, 2003

NURSING INSTRUCTIONS:

/es/ SARA C BOWMAN

MD

Signed: 10/16/2003 14:12

TITLE: PCC-NURSING INTAICE

DATE OF NOTE: OCT 16, 2003@13:32 ENTRY DATE: OCT 16, 2003@13:32:49

ACITHOR: LENARZ,SHEILA G EXP COSIGNER:

URGF,NCY: STATUS: COMPLETED

Allexgiesa FLOXIN

Denies any new allergies

Level of consciousness:

Alert

oriented to: Person, Place, Time

Past medical history per patient:

COPD

Spirometry: 9-03

Other:

lbp,gerd,bph

Medications:

Per profile

Do you take ASA on a regular basis? no

Psychosocial:

If needed, do you have someone at home who could assist

with health care? YES

Is your home environment conducive to health care? YES

If needed will you be able to provide for your care at home: YESDo you know of any barriers thaL could affect your healLla or

the provision of your health care? NO

Functional Assessment:

Do you have sufficient energy to perforni your activities of daily

living? YES

Do you have a new functional impairmer.t/limitation with a limbor ambulation? NO

Ilave you hacl a recent amputation of an ext:remity and are not

currently receiving physical therapy? NO

Nutritional Assessment:

Has the patient recently developed difficulty swallowing? NO

Is the patient receiving tube feeding or parenteral

PATIENT NAME AND ADDRESS IMechanical impdming, if available)

STNNOTT, JAMES

1525 THOMAS ST


402506326




Nov 12, 2003

nutrition? NO

Unintentional weight loss greater than 10 pounds in the past

one mnth? NO

Is patienL pregnant or lactating? NO

Undesired weight gain of 20 pounds or more in the past one

month? NOSurgical geriatric (75 years or older) patient experiencing

eating problems? NO

Educational:

Assessment documented within the past year:

Counseling provided on weight control

Counseling provided on exercise

Advance Directive:

Discussed Advance Directive advised patient that Social Work could assist

w/living will

CLINICAL REMINDER ACTIVITY

Alcohol Screening/Audit C:

Patient has had at least 1 drink in the last year.

Comment: on occ

AUDIT C (Mental Health Instrument)

An alcohol screening test fAUDIT-C ) was positive (score=4),

ProState Educatioil Sc1"eening:

Patient had prostate screening education, which included the pros and

cons of screening for his age group and the potential risks

associated with an evaluation of a positive test (c.g. biopsy), at.

this visit.

Level of Understanding: Good

Fecal Occult Blood Test:

A fecal occult blood test bas been ordered. Please distibute 3 fecal

occult blood test cards to patient.

RTC: Three Hemoccult cards have been issued. Schedule the Telephone

Triage Nurse for 2 weeks for hemaccult cards issued.

flu vac not available at this tinte

/e9/ SHEILA G LENARZ,LPN

STAFF NURSE

Signed: 10/16/2003 13:35

TITLE: CARDIOLOGY PROCEDURE-TECHNICIAN

DA'I'E OF NOTE; SEP 26, 2003912:46:01 ENTRY DATEe SEP 26, 2003012:46:01

APPt10R: BARRETT,WILLIAM R EXP COSIGNER:


stress test was done

PATIENT NAME AND ADDRESS (Mechanical imprinting, if available(

SINNOT'P, JAMES

1525 THOMAS ST


402506326


Printed ai HUNTINGTON VAMC


Nov f2, 2003

/es/ WILLIAM R BARRETT

ntedical instrument tech

Signed: 09/26/2003 12:46

TITLE: DISCHARGE-PATIENT/FAMILY EDUCATION

DATE OF NOTE; SEP 18, 2003@15:08 ENTRY DATE: SEP 18, 2003©15:08:54

AUTHOR: CREMEANS,LISA DAWN EXP COSIGNER:


DISCHARGE - PATIENT / FAMILY EDUCATION

A copy of the "Patient Discharge Instruction Note" has been provided and

reviewed.

All personal belongings have been returned artd receipt acknowledged.

A print-out of follow-up appointments has been provided.

At time of discharge the patient is oriented to time, place, and person.

The patient is being discharged ambulatory wieh family.

A vertous access device is not in place.

EDUCATIONALASSESSMENT:

An educational assessment was completed at the time of admission. I

reviewed this assessment and no changes were identiEied. The patient

demonstrates readiness and ability to learn.


Issue Date

Status L1SC Fil].

Active Outpatient Medications Refills Expiration------------------------------ - ___-____

1) AMITRLPTYLINE HCL 10MG TAR Qty: 150 for ACTIVE Issu:09-04-03

30 days Sig; TAKE ONE TABLET BY MOUTH Refills: 1 Last:09-04-03


TABLETS AT BEDTIME FOR 1 DAY, THEN



FOR '1 DAY, THEN TAKE FIVE TABLETS AY'




2) CAPSAICIN 0.025% CR (2OZ/TU) Qty: 60 ACTIVE Issu:12-06-02

for 30 days Sig: APPLY SMALL AMOi1N'r Refiils: 2 Last:08-25-03

EVERY 12 HOURS AS NEEDED Expr:12-07-03

3) CODEINE 30/ACETAMINOPHEN 300MG TAB Qty: ACTIVE Issu:09-18-03

60 for 30 days Sig: TAKE ONE TO TWO Refills: 0 Last:09-18-03

TABLETS BY MOUTH EVERY 6 HOURS AS Expr:10-18-03

NEEDED FOR PAIN. (MAY CAUSE

DROWSINESS)

PAT(ENT NAME AND ADDAESS ( Mechanicel imprinting, i1 available)

SINNOTT, JAMIiS

1525 THOMAS ST


402506326




Nov 12, 2003

4) CYANOCOBAL INJ 1000MCG/ML (1ML/VI) Qty: ACTIVE Issu:09-18 03

1 for 30 days Sig: iNJECT 1000MC0/1ML Refills; 0 Last:09-18-03

INTRAMUSCULAR MONTHLY Expr:10-18-03

5) FERROUS SULFATE 325MG TAB,UD Qty: 30 ACTIVE Issue09-18-03

for 30 days Sig; TAKE ONE TABLET BY Refills: 3 f.ast:09-18-03

MOUTH EVERY DAY Expr:09-18-04

6) FEXOFENADINE HCL 180MG TAB Qty: 30 for ACTIVE Issu:04-07-03


EVERY DAY "FOR ALLERGIES... MAY CAUSE Expr:04-07-04

SEDATION

7) FLUNISOLIDE 25MCG 200D NASAL INHL Qty: ACTIVE Issu:12-06-02

1 for 30 days Sig: SPRAY 2 SPRAYS IN Refills: 2 Last:08-25-03


ALLERGY SYMPTOMS



EVERY DAY FOR STOMACH Expr;02-04-04


days Sig: TAKE TWO TABLETS BY MOUTH Refills: I Last:09-04-03

TWICE A DAY W/FOOD Expr:06-04-04

10) TERAZOSIN HCL 2MG CAP Qtyo 90 for 90 ACTIVE Issu:03-10-03

days Sig: TAKE ONE CAPSULE BY MOUTH Refills; 3 Last:03-10-03

AT BEDTIME FOR ENLARGED PROSTATE Expr:03-10-04

SYMPTOMS

Diet / Drug - Food Interactions

InsCruction regarding either diet or food/drug interaction was not

indicated,

Hygiene / Grooming

Educational issues related to hygiene are not identified.

Medical Equipment

Instructions regarding medical equipment are not indicated.

Community Resources

Inforntation regarding community resources is not indicated.

Rehabilitation Techniques

Special instructions regarding rehabilitation techniques are not indicated.

This patierLL does not have a history of CHF. Therefore, CHF education is

not indicated.

Other Instructions

Questions or issues that develop after discharge should be addressed with

the telephone care unit. A telephone care nurse is available to answer

your clinical concerns, Monday tlirough Friday, by calling the phone unit

at 304-429-6755 or 800-827-8244 extension 3580. After 4:30 pm duri.nq the

PATIENT NAME AND ADDFESS ( Mochanleal imprlming, il adailable)

SINNO7"I', JAMES

1525 THOMAS ST


402506326


Printed at 1-IUNTINGTON VAMC


Nov 12, 2003

week, and anytime during the weekend or on holidays, the New Health Care

Nurse Network line will answer your clinical concerns by dialing

1877291-5311.

/es/ LISA DAWN CREMEANS, RN

STAFF NURSE

Signed: 09/18/2003 15:10

TITLE: PULMONARY INPATIENT-PHYSICIAN

DATE OF NOTE: SEP 18, 2003@13:48 ENTRY DATE: SEP 18, 2003@13:48:52

AUTHOR: MUNN,NANCY J EXP COSIGNER:


Bronchoscopic biopsy and cytology positive for non-small ceil carcinoma.

Di.scnssed results of biopsy and diagnosis of cancer with Mr. Sinnott. Reviewed

CT results showing enlarged hilar and mediastinal acienopathy and told him that

the enlarged lymph nodes may contain cancer cells and if so, surgery would

probably not be curative. However, at this point cannot definitively determine

if adenopathy is positive. Offered w/u to see if a candidate for resection and

tic agrees at this time. Will order PE'r scan to assess mediastinum, pfts and

cardiac stress test. If PET shows tumor in mediastinum, then will refer to

Radiation and Oncology.

/cs/ NANCY J MUNN, M.D.


Signed: 09/18/2003 1.4:28

TITLE: PATIENT DISCHARGE INSTRUCTION NOTE

DATE OF NOTE: SEP 18, 2003ca10:50 ENTRY DATE: SEP 18, 2003@10:50:57

AUTHOR: ROSS,RHONDA S EXP COSIGNER;


*** PATIENT DISCHARGE INSTRUCTION NOTE Has ADDENDA **•

DISCNARGE DIAGNOSIS:

RRIGHT UPPER LOBE LUNC MASS

MUSCULOSKELE'1'AL PAIN 2NDARY TO ABOVE

ANEPtIA/IRON DEF.

VITAMIN B12 DEFICIENCY

WELGH'1' LOSS

CHRONIC OBSTRUCTIVE PULMONARY DISEASE

GASTROESOPHAGEAL REFLUX DISEASE

CHRONIC LOW BACK PAIN * -

BPH

OPERATIODiS & PROCEDURES PERFORMED AND DATES:

PATIENT NAMF. AND ADDRESS ( Mechanical imprinting, it available)

SINNOTT, JAMES

1525 THOMAS ST

IRON'CON, OHTC) 45638-1176

402506326



Progress Note Page 60 Nov12,2t1D3

WHOLE BODY BONE SCAN 9/16/03

BRONCHOSCOPY 9/17/03

CT ABD./PELVIS 9/17/03

C'T IiEAD 9/1'7/03

DISCHARGE MEDICATIONS:

AMITRIPTYLINE TAB. 50MG PO QHS (BEDTIME)

CAPSAICIN CREAM,TOP THIN LAYER TOP Q12H P12N to

affected area

CYANOCOBALAMIN INJ,SOLN 1000MCG/1ML Iht QD X 3 DAYS,

THEN MONTHLY

FERROUS SULFATE TAB 325MG PO QD

FEXOFENADINE TAB 180MG PO QD

FLUNISOLIDE INHL,NASAL 2 SPRAYS NA BID

RABEPRAZOLE TAB,EC 20MG PO QD

SALSALATE TAB 500MG PO Q6H

TERAZOSIN CAP,ORAL 2MG PO HS (BEDTIME)

ACETA W/CODEINE 1-2 TABLETS EVERY 6 HOURS AS NEEDED FOR PAIN

ADDENDUM:(instructions on medications)

po means to take by mouth

QD means to take once a day

BID means to take twice a day

TID mcans to take three times a day

QID Ineans to take f.our times a day

QHS means to take at bedtime

QOD means to take every other dayPRN means tc> take only as needed

CHANGES IN MEDICATIONS:

ACETA W/CODIENE ADDED FOR PAIN

ACTIVITY: AS TOLERATED

DIET:REGULAR

CONDITION AT DISCHARGE: STABLE

FOLLOW-UP:

-PULMONARY CLINIC 1 WEEK, (DISCUSS RESULTS OF BRONCHOSCOPY)

-PRIMARY CARE PROVIDER, DR. BOWMAN 4 WEEKS


STAFF PHYSICIAN

Signed: 09/18/2003 10:58


FERROUS SULFATE 32SMG PO QD ADDED FOR IRON DEFIECIENCY ANEMIA

PATIENT NAME AND ADDRESS ( Mechanical lmprinting, it available)

SINNOTT, JAMES

1525 THOMAS ST


402506326




Nov 12, 2003


STAFF PHYSICIAN

Signed: 09/18/2003 11:01

TITLE: NURSING-PLAN OF CARE/GENERAL


AUTHOR: CREMEANS,LISA DAWN EXP COSIGNER:


*-" NURSING-PLAN OF CARE/GENERAL Has ADDENDA ***

MOBILITY ASSISTANCE

Transfers independently _x_ yes no

Mechanical lifting device needed for transfer _ yes _x no

Weight Bearing: _x full _ partial none

Restrictions to activity: x no ycs

AssisCive devices:

uses: x none wheelchair cane walker other:

needs: x rrone wheelchair cane walker other:

ACTIVITY STATUS

x Ambulatory: x unassisted with assistance

room x hall off unit

ambulated (distance & tolerance):

Hyge.ine

Bath: _x_ self _ assist complete

Mouth care: _x_ self assist complete

Dressing: _x self ^ assist complete

Grooming: _x_ self _ assist complete

Toileting: _x_ self assist. complete

Bowel Movement yes x no

Incontinent stool yes x no

Number of BMS:O

Voiding

Incontinent urine

Foley catheter

External device

EUD changed

Patient Safety

YES NO

x_ yes no

yes x no

yes no

yes x rio

yes x no

x Bed exit alarm turned on

Top side rails in up position

PATIENT NAME AND ADDRESS (Mechanieal imprinting, If avallable)

SINNOTT, JAMES

1525 THOMAS ST


402506326

VISTA Eiectronic Medical Documentation


Progress NotePage62

Nov 12, 2003

x Bottom side rails in up position

Bed in low position

x Trapeze

x Smoking precautions


STAFF NURSE

Signed: 09/18/2003 10:39


Pt has been up and about this day, to shower. Couqhing up only slight pink

tinged sputum from bronch yesteiday-


STAFF NURSE

Signed: 09/18/2003 10:43

TITLE: NURSING-PLAN OF CARE/GENERAI.


AUTHOR: DAVIS,CONNIE EXP COSIGNER:


UNEVENTFUL NIGHT SHIFT. PT AWAITING RESULTS OF HIS TESTING. DENIES ANY WANTS

OR NEEDS AT THIS TIME.

/es/ Connie Davis, RN

Staff Nurse

Signed: 09/18/2003 06:52

TITLE: NURSING-ACTIVITIES OF DAILY LIVING

DATE OF NOTE; SEP 18, 2003@01:42 ENTRY DATE: SEP 18, 2003@01:42:56

AUTHORt FRAZIER-NEWTON,VIVIANEXP COSIGNER:


MOBILITY ASSISTANCE

Transfers independently _x_ yes _ no

Mechanical lifting device needed for transfer _ yes _x_ no


Restrictioris to activity: _x_ no yes

Other:

Assistive devices:

uses: none x wheelchair cane walker other:

needs: none x wheelchair cane walker other:

PATIENT NAME AND ADDRESS (Idechanical imprinting, if availabfe)

SINNOT'I', JAMES

1525 THOMAS ST


402506326




Nov 12, 2003

ACTIVITY STA'PUS


room _ hall off unit


Bathroom privileges

Bathroom privileges with assistance

tolerance:

_ Bedrest: z turns self turn q2h: even

Red or broken areas noted: _ no _yes

Team leader notified/aware of skin condition

Comments/action taken;Bath: _ self assist complete

Mouth care: self assist contplete

Dressirtg: self assist complet.e

Grooming: self assist complete

Toileting: _x_ self assist complete

Adapt.ive devices needed/used:

Bowel Movement yes no

Iricontinent stool yes no

Number of BMs:

Voiding _ yes no

Incontinent urine yes no

Foley catheter yes x no

ExCernal dcvicc yes x no

EUD changed yes no

Education provided - no _ yes:

Comment/action taken;

MEAL

x_ breakfast lunch supper

_ tube feeding

snack

TYPE

_x_ solid _ cl liquid ful.l. li.quid other:

NPO

Percent entree consumed:

Percent tray consumeda

METHOD OF EATING


SINNOTT, JAMES

1525 THOMAS ST


402506326



odd hours

Progress Note Page 64 Nov,2,2008

x self assist feed

COMMENTS:

YES NO


_x_ _ Top side rails in up position


Bed in low position_x_ Trapeze

Smoking precautions:

private room

staff present when patient smokes

Other:

Education provided: no yes:

Comments/Action taken:

/es/ VIVIAN FRAZIER-NEWTON, NA

nursing assistant

signed: 09/18/2003 06:39

TITLE: NURSING-ACTIVITIES OF DAILY LIVTNG

DATE OF NOTE: SEP I7, 2003i20:06 EN7'RY DATE: SEP 17, 2003C^20:06:50

AUTHOR: BOOTH,BROOKE E EXP COSIGNER:


MOBILITY ASSISTANCE

Transfers independently x yes no

Mechanical lifting device needed for transfer - yes _x_ no


Restrictions to activity: x no yes

Other:

Assistive devices;

x uses: x none wheelchair cane walker other:

x needs: x none wheelchair cane walker other:

ACTIVITY STATUS

_x_ Ambulatory: _ unassisted _ x_ with assistance

room hall off unit


Bathroom privileges


SINNOTT, JAMES

1525 THOMAS ST


402506326




Nov 12, 2003

_x_ Bathroom privileges with assistancetolerance:

_x_ Bedrest: _x turris self - tnrn q2h: _ even odd hours

Red or broken areas noted:

Team leader notified/aware of

no - yes

skin condition

EDUCATION PROVIDED X no yes:

Comments/action taken:

Bath: self _x_

Mouth care: self _x_Dressing: self _x_

assist

assist _

assist _

complete

complete

completeGrooming: self _x_ assist

Toileting: self _x_ assist

complete

complete

Adaptive devices needed/used

Bowel Moveinent yes no

Incont.i.nent stool yes no

Nuniber of EMs:

Voiding x_ yes noIncontinent urine yes x_ noFoley catheter yes no

External device yes x_ no

Education provided _x_ rio - yes:

Comment/action taken:

MEAL

breakfast lunch _x_ supper

tube feeding

TYPE

x sol.id

NPO

cl liquid


Percent tray consumed:75%

METHOD OP EATING

_x_ self

COMMENTS:

assist

snack

full liquid otherc

feed

YES NO


Top side rails in up position

PATIENT NAME AND ADDRE55 ( M¢chanical Imprinting, il available)

SINNOTT, JAMES

1525 THOMAS ST


402506326




Nov 12, 2003

x__ Bottom side rails in up position

Bed in low positior.

Trapeze

_x_ Snioking precautions:

private room


Other:

Education provided; no _x yes:pt told to call out when he

needs help


/es/ Brooke Booth, NA5

NURSING ASSISTANT

Signed: 09/17/2003 20:08

TITLE; IMAGING INVASIVE-TECHNICIAN

DATE OF NOTE: SEP 17, 2003@16:29:23 ENTRY DATE: SEP 17, 2003@16:29:23

AUTHOR: WILLIAMS,ANGELA MARIAEXP COSIGNER:


EXAM PERFORMED:ct head abd pelvis

ALLERGIES: FLOXIN

Lab Values: 12 BUN 8 CREAT

Diabetes: _ YES x NO

Diabeti.c Medi.cation:

Metformin: YES NO Last dose date:

NO YES

History of Renal Disease

Dialysis

Multiple Myeloma

Sickle Cell Anemia

x Patient instructed and educated about exam

x Past Reaction to IV Contrast? If YES, describe:

IV CONTRAST UTILIZED

Type:ultravist

Amount: 100cc

Lot #: 039692t

Expiration: 3/06

cc/sec injection rate:2cc per sec

PATIENT NAME AND ADDRESS (Mechanical imprinting, il avallable)

SINNOTT, JAMES

1525 THOMAS ST

IRONTON, 01110 45638-1176

402506326


Printed'at HUNTINGTON VAMC

P rog ress NotePage67

Nov 12, 2003

Contrast reaction: x NO YES: Describe:

PATIENT EDUCATION

Yes - No Patient was educated prior to the examination.

Yes - No All patient concerns were addressed prior to exam.

IF NO:

Yes _ No Surrogate educated prior to examination in accordance with

the instruction pamphlet detailing the procedure.

Yes _ No Exam was completed without education due to the patients

condition at the time of the exam-

/es/ ANGELA MARIA WILLIAMS

NT

Signed: 09/17/2003 16:30

TITLE: MEDICAL ATTENDING-INPATIENT

DATE OF NOTE: SEP 17, 2003013:33 ENTRY DATE: SEP 17, 2003@13:33:54

AUTHOR: ROSS,RHONDA S EXP COSIGNER:


VITAL SIGNS:

Blood Pressure: 135/77 (09/17/2003 00:50)

Pulse . 73 (09/17/2003 00:50)Respiration . 16 (09/17/2003 00150)Temperature . 99 F[37.2 C] (09/17/2003 00:50)Weight . 227 lb [103.2 kgl (09/15/2003 06:35)

Pain . 6 (09/17/2003 00:50)S: Pt. doing well. S/p bronchoscopy this am.

GENERAL:AO X 3, NAD, lying comfortably in bed

CARDIOVASCULAR:RRR w/o murmur, no ectopy


EaTREMITIES:no clubbing, no cyanosis, no edema

WHOLE BODY BONE SCAN

Impression:

1. No evidence of inetastatic disease.

ASSESSMENT:

-RUL LUNG MASS (discussed case with Dr. Munn and there is not any extension into

LUL)

-ANEDILA/IRON DEF.

-B12 DEFICIENCY

-WT. LOSS

PATIENT NAME AND ADDRESS (Methanical imprinting, if avallable)

SINNOTT, JANIES

1525 THOMAS ST

IRONTON, OHIO 45638-1.1.76

402506326



Progress NotePage69

Nov 12, 2003

-COPD

-GERD

PLAN:

BRONCHOSCOPY RESULTS PENDING

CT HEAD,A6D./P8LVIS PENDINC

WILL DISCUSS WITH PULMONARY PLANS FOR DISCHARGE AND CONTINUE W/U AS OP


STAFF PHYSICIAN

Signed: 09/17/2003 13:39


DATE OP NOTE: SEP 17, 2003@10:45 ENTRY DATE: SEP 17, 2003@10:4525

AUTHOR: DEMARIA,JANET L EXP COSIGNER:


Patient returned to room following bronchoscopy--Patient having no difficulty breathing-no complaints of pain or discomfort aL

this time.

Head of bed elevated

Instructed not to eat or drink until orders are obtained.

Instructed to call for assistance if needed.

/es/ Janet L DeMaria, RN

SLaff Nurse

Signed: 09/17/2003 10:56

TITLE: PACU DISCHARGE NOTE-NURSING

DATE OF NOTE: SEP 17, 2003Q10:24 ENTRY DATE: SEP 17, 2003%1D:24:44

AUTHOR: MILLER,RANDALL D EXP COSIGNER:


D/C From The PACU t.o: 5s

Aldrete score:10

Pain Level:0

Vital Signs: Stable

See PACU flowsheet for more information.

PATIENT NAME AND ADDNE$5 (Mechanical impriming, if available)

STNNOTT, JAMES

"_525 THONtAS S1'

I'kONTON, OHIO 45638-1.176

402506326




Nov 12, 2003

/es/ RANDALL D. MILLER, R.N.,CPAN

STAFF NURSE

:iigned: 09/17/2003 10:25


DATE OF NOTE: SEP 17, 2003[N10:20 ENTRY DATE: SEP 17, 2003010:20:33

AUTHOR: GHANEM,AMMAR EXP COSIGNER:

URGENCY: STATU+c COMPLETED

subjective:The patient is 64 yo MALE who

has been in the hospital for days for the reason of right upper lobe mass .

The patient has been doing stable since yesterday and he had his bronchoscopy

done this morning and he is stable after the bronch.

objective: temperature99 F(37.2 Ci (09/17/2003 00:50)

00:50) respirationl6 (09/17/2003 00:50)

blood pressure135/77 (09/17/2003 00:50)

heent:perrl, ent is normal

neck:supple, no jvd, thyromegaly or bruits

chest:cta/no wheezing or decreased breath sounds

heart:rrr, no murmurs or gallops

abdomen:soft,nt,nd a<:tive bowel sounds

extremities:no oedema, pulse is palbabl.e bilaterally

neurologic:nonfocal

musculoskeletal;normal, no skin rash

pulse73 (09/17/2003

impression:right upper lobe inass with risk factors of smoking and asbestos

exposure, malignancies is of a niajor concern. s/p bronchoscopy on the

patient today morning which showed suspeCious endobronchial lesion on the apical

segment of the right upper lobe that have been biopsied.we will wait fot

pathology studies.

/es/ AMMAR GHANEM

PGY4

Signed: 09/17/2003 10:24

TITLE: INTRAOPERATIVE REPORT-NURSING

DATE OF NOTE: SEP 17, 2003@10:05 ENTRY DATE: SEP 17, 2003010:05:32

AUTHOR: MACHADO,MIRIAM EXP COSIGNER:


PATIENT NAME ANDADDNESS(Mechanical imprinting, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506326




Nov 12, 2003

MEDICAL RECORD I NURSE INTRAOPERATIVE REPORT

Operating Room: OR2 (MINOR/ENDO) Surgical Priority: ELECTIVE

Patient in Iiold: SEP 17, 2003 07:45

Patient in OR: SEP 17, 2003 08:15

operation Begin: SEP 17, 2003 08:30

Operation End: SEP 17, 2003 09:25

Patient Out OR: SEP 17, 2003 09:30

PAGE 1

Surgeon: MUNN,NANCY J First Assistant: GHANEM,AMMAR

Attending Surg: MUNN,NANCY J Second Assistant: N/A

Anesthetist: NOT ENTERED Assistant Anesth: DAURIA,JOHN J

other Scrubbed Assistants: N/A

OR Support Personnel:

Scrubbed Circulating

JOURNELL,JAMES W () MACHADO,MIRIAM ()

ADKINS,PENNY S O

Other Persons in OR: N/A

Preop Mood: RELAXED Preop Conso: ALERT-ORIENTED

Preop Skin Integ: INTACT Preop Converse: N/A

Valid Consent/ID Band Confirmed By: MACHADO,MLRIAM

Time Out Verification Completed: YES

Preoperative Imaging Confirmed: NOT APPLICABLE

Skin Prep By: N/A Skin Prep Agent: N/A

Skin Prep By (2): N/A 2nd Skin Prep Agent: N/A

Preop Shave By: N/A

Surgery Position(s): SUPINE Placed: N/A

Restraints and Position Aids:

SAFETY STRAP

BLANKET(LIMITED EXPOSURE)

PILLOW, UNDER H[:An

Electrocautery Unit: N/A

ESU Coagulation Range: N/A

ESU Cutting Ranget N/A

PATIENT NAME AND ADDRESS (Mechanical imprinlin9, il available)

SINNOTT, JAMES

1525 THOMAS ST

iRONTON, OHIO 45638-1176

402E;06326


I'rinted at HUNTINGTON VAMC

JAMES SINNOTI'


MEDICAL RECORDS FROM HUNTINGI'ON VE'1'ERANS


PART III OF IV

Progress Note Page 71 Nov 12, 2003

Electroground Positi.on(s): N/A

Minor Operations Performed:

Primary: BRONCHOSCOPY WITH BIOPSY

CPT Code: NOT ENTERED

Material Sent to Laboratory for Analysis:

Specimens:

1.BIOPSY RIGHT UPPER LOBE APYCAL SEGMENT

2.BRI7SHING POSTERIOR SEGMENT RIGHT UPPER LOBE X 2 SLIDES

3.BRUSHING APYCAL SEGMENT RIGHT UPPER LOBE X 6 SLIDE

4.BRUSHING ANTERIOR SEGMENT RIGHT UPPER LOBE X 2 SLIDES

5.BRUSH TIP FOR CYTOLOGY

6.BRONCH WASH FOR CYTOLOGY

Cultures;

1.BRONCH WASHING FOR CULTURE

Anesthesia Technique(s) :BLOCK

Tubes and Drains:

n

'Pourniquet: N/A

Thermal Unit: N/A

Prosthesis Installed: N/A

Medications:

LIDOCAINE SOLN TOP 4% (SOML/BT)

Time Administered; SEP 17, 2003 08:30

Route: TOPICAL Dosage: 15CC

Ordered By: MUNN,NANCY J

Administered By: MUNN,NANCY J

Comments: MIX WITH SALINE 'PO MAKE 2%

Irrigation Solution(s): N/A

Blood Replacement Fluids: N/A

Sponge Count: NOT APPLICABLE

Sharps Count: NOT APPLICABLL•'

Instrument Count: NOT APPLICABLE

Counter: N/A

Counts Verified By: N/A

Dressing: n/a

Packing: NONE


SINNOTT, JAMES

7525 THOMAS ST


402506326



Progress Note Page 72 NDv,2, 200$

Blood Loss: 0 cc's Urine Output: 0 cc's

Postoperative Mood: RELAXED

Postoper.rative ConsCi0u5neSS: SEDATED

Postoperative Skin Integrity: INTACT

Postoperative Skin Color: PINK

Type of Laser: NONE

Sequential Compression Device: NO

Wound Classification: CLEAN/CONTAMINATED

Operation Disposition: PACU (RECOVERY ROOM)

Discharged Via: S'IRETCHER

Nursing Care Comments:

ARRIVE PT IN HOLDING AREA FROM 5 SOUTH VIA STRETCHER.PROCEDURE

EXPLAINED AT THAT TIME. PT SEEN BY ANESTHESIA; IV STARTED.

PT INTERVIEWED AND CHART REVIEWED. PT ASSESSMENT DONE.

PROCEDURE EXPLAINED AND PRE & POST OP TEACHING DONE. PT DENI]:S ANY

QUESTIONS AT THIS TIME. PT CONFIRMED NPO;STATES HAS ALLERGY TO FLOXIN,

PERMIT VERIFIED. PT MOVED TO OR TABLE RM #4 WITH LITTLE ASSISTANCE.PT

MEDICATED BY ANESTHESIA. AREA OF EXPOSURE LIMITED WITH WARM BLANKETS.

SKIN WARM TO TOUCH. MONITOR APPLIED AND PT MONITORED THRU-OUT PROCEDURE

BY ANESTHESIA. PT POSITIONED AND ALL PRESSURE AREAS PADDED. PT TOLERATED

PROCEDURE WELL AND HAD NO NOTED INJURY AFTER CASE. REPORT CALLED TO

PACI7. PT TRANSPORTED TO PACU ON STRETCHER.

/es/ MIRIAM htACHADO, RN,BSN

S'1'AF[' NURSE

Signed: 09/17/2003 10:07

TITLE: PACU ADMISSION NOTE-NURSING

DA'1'6 OF NOTE: SEP 17, 2003909:53 ENTRY DATE: SEP 17, 2003009:53:58

AUTHOR: MILLER,RANDALL D EXP COSIGNER:


Arrives PACU @ 936a

Procedure:bronch with bx's.

Anesthesia Type:mac

Pain Leve1:0

Aldrete Score:8

PATIENT NAME AND ADDRESS (Mechanical imprinling, il available)

SINNOTT, JAMES

1525 THOMAS ST

IRONTOPI, OHIO 45638-1176

402506326



Progress Note Page73 Nov12,2009

Vital Signs: Stable

cxr done in the pacu

See PACU flowsheet for more information.

/es/ RANDALL D. MILLER, R.N.,CPAN

STAFF NURSE

Signed: 09/17/2003 09:54

TITLE: PULMONARY PROCEDURE- PHYSICIAN




*•* PULMONARY PROCEDURE-PHYSICIAN Has ADDENDA •**

Indication for the procedure:R UPPER LOBE htASS

Supervisor: Dr. Munn

Anesthesia: Patient has local nerve blocks and sedation done by

anesthesia

Procedttre: After local anesthesia and sedation preparation, I went with the

bronchoscope through the side nose to the supraglottis area and then

anteriorly

to visualize the vocal cords which look normal in appearance and motility. Then

1 went down the trachea

all the way to the carina level that look nornnal without any lesions or mucosal

abnormalities.

Then I looked at the normal L side and all the major bronchus and segmentalbronchus looked normal in

appearance wi.thout endobronchial mucosal lesion or masses. there is no stenosis

or other abnormalities.

the bronchoscope than was drawrr back to the level of the carina and then pushed

down the R side: the right lower lobe and middle lobe segments look normal

except for mild mucosal changes consitent with chronic bronchitis.the right

upper lobe segment and ttie three subsegments looked the same with some ntttcoasal

changes except for one suspecious lesion in the apical segement. there is sonte

rrarrowing with this lesion and washing, brushing and biopsies were taken from

that area.

Intervention:washing, brushing and 5-6 biopsies were taken from that area in

the apical segment of the right upper lobe.Brushing also was done on the oChertow segments of the right upper lobes.

PATIENT NAIAE AND ADDRESS ( Mechanical imprinting, ii available)

SINNOTT, JAMES

1525 THOM.AS ST

IRON'L'ON, OfiIO 4 563 8-1176

402506326




Nov 12, 2003

At the end of the procedure,cleaning of the airways with saline and suctioning

were done, there is no signs of significant bleeding. the bronchoscope was

drawn back and the patient was taken to the recovery room for observation.

chest xray was ordered and will he checked to role out pneumothorax.



Signed: 09/17/2003 09:48 Cosigned: 09/17/2003 16:03


Present for and participated in the entire procedure. VC moved normally. Trac.hr:a

and main carina appeared normal. Left bronchial anatomy appeared normal with

some chronic bronchitic mucosal changes. Right middle lobe and right lower lobe

anatomy normal. Right upper lobe showed patent anterior and posterior segments

with some mild mucosal irregularity. Apical segment with question of some

narrowing of one of the subsegments and some mucosal irregularity. Washings,

brushings done from all segments of RUL, transbronchial biopsies done from

apical segment under fluoroscopic guidance. Patient tolerated the procedure well

and was taken to the PACU in stable condition. Post-procedurc CXR showed no

pneumot.horax.



Signed; 09/17/2003 16:07

'I'ITLE: ANESTHESIA-IMMEDIATE POST ANESTHESIA RECOVERY

DATE OF NOTE: SEP 17, 2003009:35 ENTRY DATE: SEP 17, 2003e09:35:42

AUTHOR: DAURIA,JOHN J EXP COSIGNER:


HLOOD PRESSURE:148/81

PULSE:71

RESPIRATION:15

SaO2:99% on NRB FM

TEMPERATURE:

PAIN:O

COMMENTS: Pt awake, sedated in MAD

/es/ JOHN J D'AURIA, M.D.

Anesthesiologist-in-Chief

Signed: 09/17/2003 09:36

TITLE: ANESTHESIA OCCURRENCE INDICATOR 911ECiT

PATIENT NAME AND ADDRESS (Mechanical Imprinting, it available)

SINNOTT, JAMES

1525 9'HOMP.S ST


402506326




Nov 12, 2003

DATE OF NOTE: SEP 17, 2003@09;34 ENTRY DATE: SEP 17, 2003@09:34:43

AUTHOR: DAURIA,JOHN J EXP COSIGNER:


Procedure:Bronchoscopy/Bx RUL Mass

Provider: Munn

ASA CLASS:

Class III:A patient wiCh severe systemic disturbance; e.g.,angina

pectoris, severe COPD.

MALLAMPATI AIRWAY CLASSIFICATION (assessed by tongue extension & phonation)

Class 2: uvula, but not tonsilar fauces visualized

There was no adverse occurrence.

/es/ JOHN J D'AURIA, M.D.

Anesthesiologist-in-Chief

Signed: 09/17/2003 09:35

TITLE: NURSING-PLAN OF CARIi/GliNERAL

DA7'E OP NOTE: SEP 17, 2003@09:04 ENTRY DATE: SEP 7.7, 2003@09:0S:01

AUTHOR: DEMARIA,JANET L EXP COSIGNER:


Pat.ient ott floor having bronchoscopy-

/es/ Janet L DeMaria, RN

Staff Nurse

Signed: 09/17/2003 09:05

TITLE: PRE OPERATIVE VISIT-NURSING


AUTHOR: MACHADO,MIRIAM EXP COSIGNER:


Proposed operating room (OR) procedure: BRONCH BIOPSY

Patient identified by armband correct, chart reviewed, ID card correct,

verbal identification

Specialty: General Surgery

History/Physical: Yes

Patient on 02 : No

OR consent : Yes


STNNOTT, JAMES

1525 THOMAS ST


402506326



Progress NotePage76

Nov 12, 2003

Family present : No

Allergy: denies additional allergies

FLOXIN

Level of consciousness: alert, oriented

Lim.itations: none

Past medical history:

Prosthetics: none

Imolants: none

Ostomy: none

TubCs: noile

Transport to OR: stretcl-ier

Education

remove dentures/jewelry-completed

shave/scrub prep-completed

NPO-completed

transport-completed

sights/sounds of OR explained-completed

pt/signficant other encouraged to verbalize concerns-completedOR patient education sheet given-compleCed

Surgery site verification; Intra Op

Verball.y announces tilne out prior to surgery start

Start time: 8:7.5A

Stop time : 8:17A

Anesthesia, Circulating Nurse, Physician identify:

Correct patient: Yes

Correct surgery site marked: Yes

Correct implants available per MO: N/A

Imaging:

OR team confirnis images are correct and properly laLeled:N/A

Names of two team members:

/es/ MIRIAM MACHADO, RN,BSN

STAFF NURSE

Signed: 09/17/2003 08:26

TTTT.E- ANRCTHESSA.


PATIENT NAME. AND ADDRESS (Mechanical imprinting, if available)

SINNOTT, JAMES

1525 THOMAS S'1'


402506326

VISTA Electronic Medica! Documentation


+ p Page 77

P ^p î5►7 Note Nov 12, 2003

AUTHOR: MOUFARREGE,GHASSAN T EXP COSIGNER:

URGENCY: STATIJS: COMPLETED

DATE OF CWNSENT:09/17/2003

TIME OF CONSENT;0820

PATIENT'S COND11'TON AT THE TIME OF SIGNING:

_X_ AWAKE/ALERT

SLEEPY/SEDATED

CONBIISED

LETHARGIC

PROPOSED TYPE OF ANESTHETIC:

_X_ METHODS:

_X_ BENEFITS:

_X_ RISKS:

X OPTIONS:

DISCUSSED WITHc

X PATIENT

FAMILY

COMMENTS:

PATIENT/LEGAL REPRESENTATIVE SEEM TO UNDi•1RS1'AND THE PROPOSED TYPE OF

ANES7'HESIA:

X YES NO COMMENTS:

PATIENT/LEGAL REPRESENTATIVE IFAD TFiE OPPORTUNITY TO ASK QUESTIONS:

X YES NO COMMENTS:

PATIENT/LEGAL REPRESENTATIVE SEEM TO GIVE CONSENT WITHOUT DURESS OR

COERCION:

X YES NO COMMENTS:

/es/ GHASSAN T. MOUFARREGE, M.D.

Anesthesiologist

Signed: 09/17/2003 08:28

TITLE: ANESTHESIA-IMMEDIATE PRE OP REASSESSMENT


AUTHOR: MOUFARREGE,GHASSAN T EXP COSIGNER:


VITAL SIGNS:

Blood Pressure: 135/77 (09/17/2003 00:50)

Pulse . 73 (09/17/2003 00:50)

Respira[ion . 16 (09/17/2003 00:50)

PATIENT NAME AND ADDRESS (Mechanioal imprinling 1 available) VISTA Electronic Medical DocumentationSINNOTT, JAMES

1525 THOMAS ST

IRON'I'ON, 01110 45638-1176

402506326Printed at HUNTINGTON VAMC

Progress Note Page 78 Novt2,2009

Temperature . 99 F[37.2 C] (09/17/2003 00:50)

Weight . 227 lb [103.2 kgl 109/15/2003 06:35)

Pain 6 (09/17/2003 00:50)

Proposed Surgical Procedure:

Pre-anesthetic Checklist:

_X Patient ID'd

_X NPO after B hrs

X c:hart review

_X Anesthesia consent.

X Anesthesia consent progress note

_X_ Equipment, drugs, gas supply check

Blood product availability:

Iavnediate Pre-op Re-evaluation:

ASA Class: III (I-V)

Planned Anesthetic Technigue:

X Choice

GETA:

_ Mask or LMA GA:

riVA:

Spinal:

Epidural:

IV Bier block:

_ Nerve/Plexus block:

MAC:

Other:

Invasive Lines/Monitoring:

IV in situ;

X IV in OR:

A-line in situ:

A-line in OR:

CVP/PA line in situ:

CVP/PA line in OR:

/ee/ GHASSAN T. MOUFARREGE, M.D.

Anesthesiologist

Signed: 09/17/2003 08:28

TITLE: ANESTHESIA-HISTORY & PHYSICAL

DATE OF NOTE: SEP 17, 2003008:15 ENTRY DATE: SEP 17, 2003@08c15:19

AUTHOR: MOUFARREGE,GHASSAN '1' liXP COSIGNER:

URGENCY: STATUS; COMPLETEll

Vital Signs

PATIENT NAME AND ADDRESS ( Mechanical impfinting, il available)

SINNOTT, JAMES

1525 'i'6ONIDS ST


402506326


Ptinted at HUNTINGTON VAMC


Nov 72, 2003

Sex: MALE

Heiqht: 73 in [185.4 cm) (08/11/2003 09:20)

Weight: 227 lb f103.2 kg] (09/15/2003 06:35)

Temp: 99 F[37.2 C] (09/17/2003 00:50)

BP: 135/77 (09/17/2003 00:50)

IIR: 73 (09/17/2003 00a50)

RR: 16 (09/17/2003 00:50)

Pain: 6 (09/17/2003 00:50)

DIAGNOSIS; RT. LUNG MASS

OPERATION:BRONCHOSCOPY WITH BIOPSIES

SURGEON: MUNN

DATE OF SURGERY:09/17/2003

PMH:

Medi.cations:Active Inpatient Medications (including Supplies):

Active Inpatient Medications Status----------------------- _______.____________...____________________

1) AMITRIPTYLINE TAB 50MG PO OHS (BEDTIME) ACTIVE

2) CAPSAICIN CREAM,TOP THIN LAYER TOP Q12H PRN to ACTIVE

affected area

3) CYANOCOBALAMIN INJ,SOLN 1000MCG/1ML IM QD X 3 DAYS, ACTIVE

THEN MONTHLY

4) FERROUS SULFATE 'PAB 325MG PO QD ACTIVE

5) FEXOF'ENADINE TAB 180MG PO QD AC'I'IVB

6) FLUNISOLIDE INHL,NASAL 2 SPRAYS NA BID ACTIVE

7) RABEPRAZOLE TAB,EC 20MG PO QD ACT'iVR

8) SALSALATE TAB 500MG PO Q6H ACTIVE

9) TERAZOSIN CAP,ORAL 2MG PO HS (BEDTIME) ACTIVE

Allergies: FLOXIN

1.

Date

1994

Operation Anesth

B/L TKR

etic Techn

GA

ique Complications

NONE

2. 1995 SEPTOPLASTY GA NONE

3. 1996 L5-Sl LAMINECTOMY GA NONE

4. 1996 RT. FOOT SURGERY GA NONE

PATIENT NAME AND ADDRESS (Mechanical Imprinting, II avallable)

SINNOTT, JAbIES

1925 THOMAS S'1'


402506326




Nov 12, 2003

Social Habits

Tobacco: QUIT 8 YRS AGO. PRIOR, 1 1/2 PPD X 50 YRS.

ETOH:2-3 DRINKS ON WEEKENDS.

ROS:

Neurological

Other: H/O HERPES ZOSTER AND POST HERPETIC NEURALGIA

Pulmonary

Other: CT SCAN: RUL ANTERIOR MASS 3.3 X 3.8 CM IN SIZE.

Cardiovascular

CAD:DENIBS CP. LIMITED EXERCISE TOLERANCE DUE TO LBP.CAN WALK 1 BLOCK W/O

CP.

MI; O1.D INFERIOR MI. DIAGNOSED ON EKG. PT. DIDN'T KNOW ABOIJT IT.

GI/GU

GERD: ON RABEPRAZOLE. CURRENTLY ASYMPTOMATIC.

Other: H/O MALLORY WEISS TEAR AND SECONDARY UPPER GI BLEED IN JAN. 2003.

H/O KIDNEY STONES, REMOVED IN THE PAST.

Endocrine

Negative

Hematology

Negative

Musculoskeletal

Back Pain:LOW BACK PAIN RADIATING TO BOTH LOWER EAT7tEMITIES.

Other:H/O FIBROMYALGIA. PAINS IN THE SHOULDERS, ARMS AND LOW BACK.

PE:

Airway

MALLIIMPATI AIRWAY CLASSIFICATION

(assessed by tongue extension & phonation)

Cl.ass 2: uvula, but rtoL tonsilar fauces visualized

Dentition: OWN

Neck ROM:GOOD

Thyromentum distance: 4 FB

Pul ntonaryBreath sounds:CTA

CVS

PATIENT NAME AND ADDRESS ( Mcehanit2l impdnting, if available)

SINNOTT, JAMES

1525 111OMAS ST


402506326




Nov 12, 2003

Rhythm: RRR

Neurologic

Mental status: A,A,O X 3

LABORATORY:

PT 14.3 Seconds H (0 9/16/2003 05:00)INR 1.21 H (09/16/20 03 05;00)PTT 28 Seconds (09/1 6/2003 05:00)

Sodium 137 MMOL/L (09/7 5/2003 0S:00)

Potassium 3.9 MEQ/L (09/15 /2003 0S:00)

Chloride 7.04 MMOL/L (09/1 5/2003 05:00)Co2 27.9 MMOL/L (09/ 15/2003 05:00)Bun 12 MG/DL (09/15/2003 05:00)Creatinine 0.8 MG/DL (09/15 /2003 05:00)Glucose 92 MG/DL (09/15/ 2003 05:00)

WBC 6.3 K/cmm (09/16 /2003 05:00)HGB 13.7 g/dL L (09/1 6/2003 05:00)HCT 41.1 % L (09/16/2003 05:00)Platelets 247 K/Cmm (09/16/2003 05:00)

Total Protein 6.9 G/DL (09/04/2003 09:47)Albumin 3.7 G/DL (09/04/2003 09:47)Total Bil.irubin 0.9 MG/DL (09/04/2003 09:47)Alkaline Phosphatase 69 IU/L (09/04/2003 09:47)AST 17 IL'/L (09/04/2003 09:47)ALT 14 113/L (09/04/2003 09:47)

GKG: NSR. RBBB. OLD INFERIOR MI.

IMPRESSION:

ASA CLASS:

Class III:A patient with severe systemic disturbance; e.g.,angina

pectoris, severe COPD.

MALLAMPATI AIRWAY CLASSIFICATION (asseseed by tongue extension & phonation)

Class 2: uvula, but not tonsilar fauces visualized

PLAN:

Choice

Hemodynamic Monitoring

NIBP, EKG, Sp02,+/-ECCO2

PATIENT NAME AND ADDRESS (Mechanicai imprinling, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506326




Nov 12, 2003

/es/ GHASSAN T. MOUFARREGE, M.D.

Anesthesiologist

Signed: 09117/2003 08:27

TITLE: CHAPLAIN

UA'i'E OF NOTE: SEP 17, 2003@07:45 ENTRY DATE: SEP 17, 2003®14:44:29

AUTHOR: ROSE,OSCAR H EXP COSIGNER:


REASON FOR VISIT

Pre-Surgery Inpatient, Post-Surgery Inpatient

ASSESSMENT

Patient's religious preference is Unknown/No Preference.

Alert/responsive

Comments: talk to patient's nurse; patient is scheudled for surgery- lung

biopsy- patient requested prayer; falnily present- visited with family

PLAN OF CARE

Regular Visit1. Provide prayer, spiritual support and emotional encouragement

J. Accessible for family counseling

3. Accessible for Holy Communion

4. Provide religious literature upon request

5. See patient as needed or on regular patient rounds

IN'1'L•'R V h:NTI ON

Pray, Counsel, Religious literature, Family counseling

/es/ OSCAR H ROSE

CHAPLAIN

Signed: 09/1'7/2003 14:46

TITLE: PRE OP NOTE-SURGERY

DATE OF NOTE: SEP 17, 2003@07:35 ENTRY DATE: SEP 17, 2003907:35:15


URCENCY: STATUS: COMPLETED

Diagnosis: Right upper lobe mass

Planned Procedure:Hronchoscopy with biopsy

Actending Surgeon:Munn

Risks and benefits of the planned procedure as well as alternative

treatments were discussed with the

patient as recorded on the Inforlned Consent? Yes

PATIENT NAME AND ADOf7ESS (Machanlcal imprinling, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506326




Nov 12, 2003

The patient had an opportunity to ask questions? Yes

Coniments :

Patient's condition at the time of signing Informed Consent?awake and alert

Pertinent clinical information (significant abnormalities) :Patient with

RUL mass, right shoulder pai.n.

Blood:


CHIEP, POLMONARY SECTION

Signed: 09/17/2003 07:35

TITLE: PRE OP HISTORY & PHYSICAL-SURGERY

DATE OF NOTE: SEP 17, 2003@0"1:34 ENTRY DATE: SEP 17, 2003M?07:34:22



See H and P, initial Pulmonary Consult.

1. Chief Complaint:

2. History of Present I1lness (location, severity, timirrg, modifying

factors, qualitv, duration, context, associated signs and symptoms):

3. Past Medical HisLory (illness, operat'..ons, injuries and t.reatment):

4. Social History (including smoking history, etoh history):

5. Family History (family disease, hereditary, risk factors):

6. Psychosocial (past current activities, religion)

7. Outpatient Medications:

Active Outpatient Medications (including Suppiies)

Issue Date

Status Last Fill

ACt.ive OutpaLient Medications Refills Expiration

------------- ------

1) AMITRTPTYLINE HCL 10MG TAB Qty: 150 for ACTIVE IssU:09-04-03

30 days Sig: TAKE ONE TABLET BY MOOTH Refills: 1 Last:09-04-03


i'ABLETS A'1' BEDTIME FOR 1 DAY, THEN

PATIENT NAME AND ADDHESS tMechanical imprin[ing, il availabie)

S7:NNOTT, JAMES

1525 THOMAS ST


402506326




Nov12,2003

TAKE 7'HREL•' TABLETS AT BEDTIME FOR 1


FOR 1 DAY, THEN TAKR FIVE TA17LL•P15 AT




2) CAPSAICIN 0.0251 CR (20Z/TU) Qty: 60 ACTIVE Issu:12-06-02

for 30 days Sig: APPLY SMALL AMOUNT Refills: 2 Last:08-25-03

EVERY 12 HOURS AS NEEDED Expr:12-07-03

3) FEXOFENADINE HCL 1BDMG TAB Qty: 30 for ACTIVE Issu:04-07-03


EVFRY DAY "FOR ALLERGIES... MAY CAUSE Expr:04-07-04

SEDATION

4) FLUNISOLIDE 25MCG 200D NASAL INHL Qty: ACTIVE Issua12-06-02

i for 30 days Sig: SPRAY 2 SPRAYS IN Refills: 2 Last:08-25-03


ALLERGY SYMPTOMS





days Sig: TAKE TWO '1'a.BLETS BY MOUTH Refills: 1 Last:09-04-03

TWICE A DAY W/FOOD Expr:09-04 04

7) TERAZOSIN HCL 2MG CAP Qty: 90 for 90 ACTIVE Issu:03-10-03

days Sig: TAKE ONE CAPSULE BY MOUTH Refills: 3 Last:03-10-03

AT BEDTIME FOR ENLARGED PROSTATE Expr:03-10-04

SYMPTOMS

8. Review of Systems (what the patient reports - complete

each system; document if unremarkable):

Constitutional (weight loss, etc.)

Mental Status:

Head:

Neck:

Eyes:

Ears, Nose, Mout.h, Throat:

Respiratory:

Cardiovascular:

Hematology/Lymph:

Genitourinary/Renal:

Gastrointestinal:

Neurological:

Musculoskeletal:

Skin:

Allergies/immunizations:

9. Physical Examination ( comment on each):

pA71ENi NAME AND ADDRESS ( Mechanical imprinting, if available)

SINNOTT, JAMES

1525 THOMAS ST


402506326



Noteogress N{.Page 85 NOv12,2003

Mental Status (orientation, recent/remote memory, mood, affect)

Constitutional (vital signs, general appearance):

Head:

Neck (including airway):

Eyes:

Ears, Nose, Mouth, Throat:

Chest:

Heart:

Abdomen:

Genitalia/Rectal:

Lymphatic:

Musculoskeletal:

Skin:

Neurological:

Impression/Diagnoses (r/o, signs, symptotns)

Plan (management, complexity, and risk):



Signed: 09/17/2003 07:35


DATE OF NOTE: SEP 17, 2003@05:09 EN'1'RY DATC: SEP 17, 20D3@OS:09:40

AUTHOR: FRAZIER-NEWTON,VIVIANEXP COSIGNER:

URGENCY: STATL'S: COMPLETED

MOBILITY ASSISTANCE

Transfers independently X_ yes _ no

Mechanical lifting device needed for transfer _ yes X no

Weight Rearing: X_ full _ partial none

Restrictions to activity: _X no yes

PATIENT NAME AND ADDRESS (Mechanical imprinting, if availabb)

SINNOTT, JAMES

1525 THOMAS ST


402'.:0632E


Printed at HUNTING1'ON VAMC


Nov 12. 2.003

Other:

Assistive devices:uses: none X wheelchair cane x walker

needs: none X wheelchair cane x walker

ACTIVITY STATUS

X Ambulatory: _X_ unassisted _ with assistance

room ha11 off unit


X Bathroom privilegesBathroom privileges with assistance

tolerance:

Bedresta X turns self turn q2h: _ even

Red or broken areas noted: no _ yes

Team leader notified/aware of skin conditiori

EDUCATION PROVIDED no yes:


Bath: self

Mouth care: _ self

Dressing; self

Grooming: self

Toileting: self

Adaptive devices needed/used:

assist completeassist complete

_x_ assist complete

_ assist complete

_x_ assist complete

Bowel Movement yes _x no

Incontinent stool yes X no

Number of BMs:

voiding yes _ no

Incontinent urine yes X no

Foley catheter yes X_ no

External device yes X_ no

EUD changed yes _ no

Education provided _ no _ yes:


MEAL

TYPE

PATIENT NAME AND ADDRESS (Mechanical imprintlng, It availabfo)

SLNNOTT, JAMES

1525 TIiOMAS ST


402506326



other:

other:

odd hours


Nov 12, 2003

solid c1 liquid full liquid other:

X NPO


Percent tray corrsumed:

COMMENTS:

YES NO

X Bed exit alarm turned on

X _ Top side rails in up position

X Bottom side rails in up position

Bed in low position

_X_ Trapeze

Sniokin9 precautions:

private room


other:

Education provided: no yes:

CommP.nCs/Action taken:

/es/ VIVIAN FRAZIER-NEWTON, NA

nursing assistant

Signed: 09/18/2003 01:39


DATE OF NOTE: SEP 17, 20031@02:04 ENTRY DA'PE: SEP 17, 2003ca02:04:28

AUTHOR: DETROW,RHONDA L EXP COSIGNER:


MENTAL STATUS

no acute change acute change

_X_ alert confused forgetful

oriented: _X time _X_ place _ X_ person

comments/action takeneWNL

NP.UOLOGICAL

_X_ no acute change acute change

coinments/action taken:NO DEFICITS NOTED. PT IS AMBULATORY.

BEHAVIOR

no acute change acutc change

cooperative uncooperative anxious


SINNOTT, JAMES

1525 'I'HOMAS ST


402506326



Progress Note Page 88 Novt2,2003

_ agitated _ combative

cornments/action Laken:PT IS PLEASANT WITH STAFF.

depressed

SPEECH


x clear - slurred aphasic inappropriate

comments/action taken:WNL

CARDIOVASCULAR

_ no acute change acute change

Cardiac rythms:

X not applicable_ NSR sinus tach sinus brady

A-fib A-fluLter PACs

PvCs PJCs heartblock

V-Cach V-fib

paced junctional

Peripheral pulses:+ BILATERALLY

Comments/action taken:N/A

MIJSCULOSKELETAL


moving all extremites WITHOUT llIFFICULTY.

chronic deficit

comments/action taken:PT IS AMBULATORY.

Si:IN

X no acute change

X warm

acute changehot cool

moist diaphoretic

^flushed ashen

jaundiced mottled

X_ dry

pale

cyanotic

edema

turgor X good fair poor

comments/action takenaOVERALL GOOD SKIN INTEGRITY.

RES P I RATORY

__X_ no acute change:

_ acute change;

comments/action taken

DISTRESS.

RESPIRATIONS ARE EVEN AND NONLABORED. NO SIGN OF ACUTE

GASTROINTESTINAL

_X_ no acute change acute change

Bowel sounds: _X_ present absent-

Abdomen: X soft firm

X nontender tender

Abdominal girth (if indicated):

comments/action taken:NO VOICED DISCOMFORTS.

PATIENT NAME AND ADDRESS (Mechanical Imprinting, 11 availablel

SINNOTT, JAMES

1525 'PIiOMAS ST

IRONTON, 01110 45638-1176

402506326




Nov 12, 2003

_X_ yes _ nc

yes _x_ no

yes X no

X yes

PT

_ no-PER PT

pain/discomfort with urination: yes X no

comments/action taken:NO VOICED DISCOMPORTS.

-continent urine

foley catheter

external drainage

perineal skin intact

urine color:YELLOW=PER

GENITCURINARY


EDUCATION PROVIDED no X yes:PT INSTRUCTED ON NPO AFTER MIDNIGHT FOR

AM PROCEDURE. PT DENIES PAIN. BED IS IN LOW POSITION, SIDERAILS UP X2, CALL

LIGHT WITHIN REACH. NO SAFETY ISSUES AT PRESENT. PT REMAINS INJURY FREE. WILL

CONTINUE TO MONITOR.

/es/ Rhonda L. Detrow, RN

STAFF NURSE

Signed: 09/17/2003 02:24

DATE OF NOTE: SEP 16, 2003@14:10

AUTHOR: HENDRICKSON,LORI

URGENCY:

'r7.'1'LE: NURSING-ACTIVITIES OF DAILY LIVING

ENTRY DATE: SEP 16, 2003@14:10:49

EXP COSIGNER:

STATUS: COMPLETED

*** NURSING-ACTIVITIES OF DAILY LIVING Has ADDENDA *'*

MOBILITY ASSISTANCE

Transfers independently

Mechanical lifting device

Weight Bearing: _x_ fullRestrictions to activity:

Other:

x_ yes no

needed for transfer yes _x_ no

_ partial none

_x_ no yes

Assistive devices:uses: x none wheelchair cane walker other:

needs: x none wheelchair cane walker other:

ACTIVITY STATUS

_x_ Ambulatory: _x_ unassisted with assistance

room hall off unit

ambulated (distance & tolerance) :

_x Bathroom privileges

_ Bathroom privileges with assistance

PATIENT NAME AND ADDRESS ( Mechanical imprinting, If available)

SINNOTT, JAMES

1525 THOMAS ST


402506326



Q w' Q Page 90

Progre

ssN

ote Nov 12; 2003

tolerance:

Sedrest; x turns self turn q2h: even

Red or brokeri areas notede x no


yes

odd hours

I;OUCA'CION PROVIDED x no yes:

Comments/action taken:compiete bed

Bath: x self

changed

assist complete

Mouth care: x self

Dressing: _x_ self

Grooming: x_ self

Toileting: _x__ self

assist complete

assist complete

assist complete

assist completc

Adaptive devices needed/used:

Bowel Movement yes _ no

Incontinent stool yes

Number of BMs:

Voiding yes

x_ no

no

Incontinent urine yes

Foley catheter _ yes

External device _ yes

EUD changed yes

x

_x_

_x

_x

no

no

no

no

F:ducation provided _x_ no _ yes:


MEAL

breakfast x lunch supper snack

tube feeding

TYPE

x solid cl liquid full liquid other:

NPO

Percent entree consumed:100

Percent tray consumed:100

METHOD OF EATING

x self assist feed

COMMENTS:

YES NO


x Top side rails in up position

PATI[NT NAME AND ADDF1E88 ( Mechanical iinprinling, If avaliable)

SINNOTT, JAMES

1525 'ffiOMAS ST


402506326




Nov 12, 2003


x Bed in low position

x Trapeze

_x_ Smoking precautions:

_ private roomstaff present when patient sniokes

Other:

Education provided: _x_ no yes:

Comments/Action taken:Instruct.ed to call for any needed assistance.

/es/ Lori Hendrickson,LPN

Staff nurse

Sigried: 09/16/2003 14:13


MOBILITY ASSISTANCE

Transfers independently x yes no

Mechanical lifting device needed for transfer _ yes _x_ no

Weight Bearing: _x full _ partiai none

Restrictions to activity: _ x no yes

Other:

Assistive devices:uses: x none wheelchair cane walker other:

needs: x none wheelchair cane walker other:

ACTIVITY STATUS


_x room hal.l. off unft

ambulated {distance & tolerance) :

`x_ Bathroom privileges

__ 8athrooin privileges with assistance

tolerance:TOL WELL

Bedrest: _x_ turns self turn q2h: even _ odd hours

Red or broken areas noted: _r._ no ycs


EDUCATION PROVIDED no yes:


Bath: _ self assist _ complete

Motith care: self _ assist complete

PATIENT NAME AND ADDRESS (Mechanlcal Imprinling, if available)

SINNOTT, JAMES

7525 THOMAS ST


402506326




Nov 12, 2003

Dressing: _x_ self assi.st coinplete

Grooming: x self assist complete

4bileting: _x_ self assist complete

Adapti.ve devices needed/used:

Bowel Movement _ yes x___ no

Incontinent stool yes - no

Number of BMO:

voiding x yes _ no

Incontinent urine _ yes _x_ no

Foley catheter yes x no

External device yes x no

EUD changed _ yes _x no

Education provided _ no yes:


MEAL

breakfast lunch x supper_ tube feeding

snack

TYPE

_x_ solid cl liquid f+.ill liquid other:

NPO


Percent tray consumed:90%

METHOD OF EATING

x self assist feed

COMMENTS;

YES NO

Bed exit alarm turned on

_ Top side rails in up position_x_ Bottom side rails in up position

Bed in low positionTrapeze

_x_ Stnolcing precautions:

_ private room

_ staff present when patient smokesOther:

Educ•ation provided: no yes:



SIMJO'I'T', JAMES

1525 THOMAS ST


402506326


Prinled at HUNTINGTON VAMC


Nov12.2003

/es/ PENELOPE P TAYLOR,LPN

Staff Nurse

igned: 09/16/2003 22:46S

1

TITLE: MEDICAL ATTENDING-INPATIENT

DATE OF NOTE: SEP 16, 20031n'12:47 ENTRY DATE: SEP 16, 2003@12:47c29

AUTHOR: ROSS,RHONDA S EXP COSIGNER:

URGENCY: STATUS: COMPLL'1'ED

VITAL S1GNS:

Blood Pressure: 142/78 (09/16/2003 02:41)Pulse 67 (09/16/2003 02:41)

Respiration . 20 (09/16/2003 02:4])

Temperature . 97.5 F[36.4 C] (09/16/2003 02:41)

Weight . 227 lb (103.2 kgl (09/15/2003 06:35)

Pain . 7 (09/16/2003 02:41)

5: Pt. doing well. No complaints.

GENERAL:AQ X 1, NAD

CARDIOVASCULAR:RRR w/o murmur, no ectopy


EXTREMITIES:no clubbing, no Cyanosis, no edema

09/16/2003 05:00Test name Result units

B12 (LAB) 283 pg/ml

FOLATE (LAB) 7,2 ng/ml

IRON 42 L UG/DL

Eval: %SAT-FE/(TRANSFERRIN*1.37) x 100

FERRITIN 189.4 ng/niL

09/16/2003 05:00Test name Result units

ESR (SF.D RATE) 25 H MM/HR

WBC 6.3 IC/cmm

AB NEUT 4.0 K/cmm

ABSOLUTE LYMPH COUNT 1.5 K/cmm

RBC 4.68 i, M/cmm

HGB 13.7 L g/dL

HCT 41.1 L

PLT 247 K/cmin

MCV 87.7 fl

MCH 29.3 uug

MCHC 33.4 G/DL

RDW 13.1MPV 8.8 fL

NEUTROPHIL ^ 62.8 $

LYMPH % 23.6

PATIENT NAME AND ADDflESS ( Mechanical imprinting, il avallable)

SINNOTT, JAMES

1525 THOMAS ST


402506326

Ref. range

179 - 1132

2.9 - 18-7

70 - 1'e0

50 350

Ref. range

0 - 10

5 - 10

1.9 - 8

1.5 - 4

4.7 - 6.1

14 - 18

42 - 52

140 - 440

80 - 94

27 - 35

31.5 - 36.5

11.5 - 14.5

7.2 - 11.1

40 - 74

19.6 - 52.7




MONO % 9.5 % 3.4 - 10EOSINOPHIL % 3.8 % 0 - 7

BASOPHIi, t' 0.3 0- 1.5

RETICULOCYTE, #

ASSESSMENT:

39 K/cmm 15 - 50

RUL LUNG MASS WITH EXTENSION LUL

ANE3MIA/IRON DEF.

B12 DEFICIENCY

WT. LOSS

COPD

GERD

HX UGI BLEED 2NDARY MALLORY WRISS TEAR

BPH

PLAN:

PULMONARY PLANNING BRONCHOSCOPY TOMORR04l

CT HEAD,ABD./PELVIS PENDING

WHOLE BODY BONE SCAN PENDING

START FESO4

B12 LEVELS BORDERLINE LOW, WILL START B12 INJ. QD X 3 DAYS, THEN REC. MONTHLY


STAFF PHYSICIAN

Signed: 09/16/2003 12:52


DATE OF NOTE: SEP 16, 2003@09:31 EN'1'RY DATE: SRP 16, 20030(19:31:]7

AUTIlORO

URGENCY:

GHANEM,AMMAR EXP COSIGNER:

STATUS: COMPLETED

slbjective:The patient is 64 yo

has been in the hospital for 2

lesion/mass . The patient has

complains.

IDu[.E who

days for the reason of right upper lobe

been doing the salne sinse yesterday without new

objective: temperature97.5 B[36.4 C] (09/16/2003 02:41) pulse67 (09/16/2003

02:41) respiration20 (09/16/2003 02:41)blood pressure142/'i8 (09/16/2003 02:41)heent:perrl, ent is norinal

neck:supple, no jvd, thyromegaly or bruits

chest:good airentry, no advetious breath sourids

heart:rrr, no murmurs or gallops

abdomen:soft.,nt,nd active bowel sounds

extremities:no oedema, pulse is palbable bilaterally

neurologic:nonfocal

muscul.oskeletal:normal, no skin rash

PATIENT NAME AND ADDRESS ( Mechanlcal Imptlnting, if available)

SINNOTT, JAMES

1525 'IIIOMAS ST


402506326




Nov 12, 2003

impression:Right upper lobe mass witll risk factors of smoking and asbestos

exposure, malignancies is of a major concern. we plan to do brorstroscopy on the

patient tomorrow morrring. the procedure was explained to the patient with

benfits/ri.sks and alternatives. A consent was obtained.

/es/ AMMAR GHANEMPGY4

Signed: 09/16/2003 09:35



AUTHOR: BLATT,ANIANDA D EXP COSIGNER: LOCHER,CATHERINS J


MENTAL STATUSno acute change acute change

_x alert _ confused forgetful

orierited: x time x place x person

comments/action taken:

NEUOLOGICAL

_x_ no acute change _ acute change

commerrts/action taken:

BEHAVIOR

_x_ no acute change _ acute change

cooperative _ uncooperative anxious

agitated _ combative depressed


SPEECH

x_ no acute change acute change

x clear slurred aphasic inappropriate

coinments/action taken:

CARDIOVASCULAR

_x_ no acute change acute change

Cardiac rythms:

not applicableNSR sinus tach sinus brady

A-fib A-flutter PACs

PVCs PJCs heartblock

V-tacl'r V-fib


SINNOTT, JAMES

1525 THOMAS ST

IRONTON, ON10 45638-1176

402506326


Printed at HUNTINGTON VAU1C


paced junctional

Peripheral pulses:


MUSCULOSKELETAL

no acute change

moving all extremites

chronic deficit


SKIN

x no acute change

x_ warm

x_ dry

_ pale

cyanotic

edema

acute change

acute change

hot

moist

flushed_ jaundiced _

turgor: __ good fair

comment.s/act:ion takena

RESPIRA?ORY

__x_ no acute change:

acute change:


(iASTROINTES'I'INAL


Bowel sounds: _x_ present _ absent

Abdomen: soft firm

x nontender terrder

Abdominal girth (if indicated):

commentsiaction taken:

GENlT'OURINARY

_x_ no acute change acute change

continent urine x yes _ no

foley catheter yes x no

external drainage ^ yes ^x_ no

perineal skin intact

urine color:

_x_ yes _ no

cool

diaphoretic

ashen

mottled

pain/discomfort with urination: yes x no

comments/actiorr taken:

EDUCATION PROVIDED _x_ no - yes:

/es/ Amanda B1aCt, MUSN4

Marshall University Nursinq Stttdent

PATIENT NAME AND ADORESS ( Mechanical imprinting, if available)

SINNOT'r, JAMES

1525 THOMAS ST

IRONTON, ORTO 45638-1176

402506326

/es/ CATHERINE J. LOCHER, RN, MSN

Patient Care Coordinator




Nov 12, 2003

Signed: 09/16/2003 09:10 Cosigned: 09/17/2003 09:02


DATE OF NOTE; SEP 16, 2003@04:15 ENTRY DATE: SEP 16, 2003@04:16;02

AUTHOR; MCCORMICK,THOMAS H EXP COSIGNER:


*** NURSING-ACTIVITIES OF DAILY LIVING Has ADDENDA ***

MOBILITY ASSISTANCE

Trarisfers indeperidently _x_ yes _ no

Mechanical lifting device needed for transfer - yes _x_ no

Weight Bearing: _x_ full _ partiztl none

Restrictions to activity: _x_ no yes

Other:

Assi.stive devices:

x uses: x none wheelchair cane walker other:

needs: none wheelchair cane walker other:

ACTIVITY STATUS

_x_ Ambulatory: x^ unassisted _ with assistance

room hall off unit


_x Bathroom privileges

__ Bathroom privileges with assistance

tolerance:

Bedrest: x turns self - turn q2h: even odd hours

Red or broken areas noted: x no yes

x Team leader notified/aware of skin condition

EDUCATION PROVIDP•.D no _ yes:

Comments/action taken:Bath: - self assist complete

Mouth care: x self assist complete

Dressing: _x self _ assist complete

Grooming: self assist complete

Toileting: _x_ self assist complete

Adaptive devices needed/irsed:

Bowel Movement ye5 no

Incontinent stool yes x no


SINNOTT, JAMES

1525 THOMAS ST

iRON'i'ON, OHIO 45638-1176

402s06326



P rog ress NotePage98

Nov 12, 2003

Number of BMS:

Voiding

Incontinent urine

Foley catheter

External device

EUD changed

Education provided

Cominent/action taken:

YES NO

Bed exit alarm turned on

x Top side rails in up positionx Bottom side rails in up position

Bed in low position

_x_ Trapezex Smoking precautions:

private roomflame retardant pajamas

flame retardant bed linenstaff present when patient smokes

Other:

Education provided: _x_ no yes:


/es/ THOMAS H. MCCORMICK, NA3

NURSING ASSISTANT

Signed: 09/16/2003 04:17

x__ yes no

yes x 110

yes x no

yes _x__ no

yes _ no

yes:x no


MEAL

_x_ breakfast lunch supper

tube feeding

TYPE

sol:d

x NPO

cl liquid - full liquid


Percent tray consumed:

METHOD OP EATING

self assist feed

arailable)PATIENT NAME AND ADDRESS (Mechanical imprinting, if

SiNNOTT, JAMES

L525 THOMAS ST


4025D6326

snack

other:




Nov 12, 2003

COMMliN'A'S :

/es/ THOMAS H. MCCORMICK, NA3

NURSING ASSISTANT

Signed: 09/16/2003 04:18

TITLE: MEDICAL AT'PENDING-INPATIENT


A[iTHOR: ROSS,RHONDA S EXP COSIGNER:

(IRGENCY: STATUS: COMPLETED

VITAL SIGNS:

Blood Pressure: 133/74 (09/15/2003 09:00)

Pulse . 77 (09/15/2003 09:00)

Respiration . 20 (09/15/2003 09:00)

TemperatUre . 97.7 F(36.5 Cl (09/15/2003 09:00)

Weight . 227 lb (103.2 kg] (09/15/2003 06:35)

Pain . 6 (09/15/2003 09:00)

S:64yo admitted after found abnormal CXR, CT done which showed RUL lung mass.

Resident's notes reviewed and concur. Pulmonary note reviewed.

Pt. states pain started back 5/03 in shoulder areas "muscles" and occ. feels

like in joints. Has decreased grip strength and pain with abduction of arms

bilat., no hempotysis, no change appetite, 10 lb. wt. loss x I month. Pt.

worked as industrial millwrite where he was exposed to asbestos and other

chemicals he does not know names of, then worked as electrician last 28

years, retired 1997.

PMH: GERD, CHRONIC LOW BACK PAIN, BPH, SUNUSITIS, ANGINA, CATARACT RIGHT EYE,

DRY EYE SYNDOME, COPD, MALLOWRY WEISS TEAR 1/03, UGI BLEED 1/03, HX HERPES

ZOSTER, QUIT SMOKING APPROX. 8 YEARS AGO(45 YEAR HISTORY)

EXAMINATION

GENERAL:AO X 3, NAD

HEENT:wnl

NECK:supple, no JVD, no Lyntphadenopathy

CARDIOVASCULAR:RRR w/o murmur, no ec:topy

RESPIRATORY:CTA bilaL., no wheezes, no rales, no ronchi

GASTROINTESTINAL: abd. soft, NT, +BS, no masses, no organomegaly

MUSCULOSKELETAL:4/5 MS in UE & LE, ntildly decreased grip strength bilat.,

pain with abduction to 90 degrees bilat.

SKIN:wnl

NEUROLOGICAL:CN II-XII grossly intact

EXTREMITIES:no clubbing, no cyanosis, no edema


UREA NITROGEN 12 MG/DL 8- 22

PATIENT NAME AND ADnFESS (Mechanical imprinting, i1 available) VISTA Electronic Medical DocumentatioriSINNOTT, JAMES

1525 THOMAS ST

IRONTON, OHIO 45638-1176 Printed at HUNTINGTON VAMC402506326


Nov 12, 2003

SODIUM 137 MMOL/L 135 - 145

POTASSIUM 3.9 MEQ/L 3.5 - 5CHLORIDE 104 MMOL/L 98 - 110

CO2 27.9 MMOL./i, 23 - 32

CREATININE 0.8 MG/DL .5 - 1.3

GLUCOSE 92 MG/DL 70 - 110

CALCIUM 8.9 MG/DL 8.4 - 10.7

09/15/2003 05:00Test nanic Result units Ref. range

WBC 5.8 K/cmm 5 - 10

AB NEUT 3.0 K/cmm 1.9 - 8ABSOLUTE LYMPH COUNT 1.8 K/cmm 1.5 - 4RBC 4.47 L M/cmm 4.7 - 6.1

HGB 13.2 L g/dL 14 - 18

BCT 39.2 L % 42 - 52

PLT 249 K/cnim 140 - 440

MCV 87.4 fl 80 - 94

MCH 29.4 uuq 27 - 3S

MCHC 33.6 G/DL 31.5 - 36.5

RDW 13.1 11.5 - 14.5

MPV 9.2 fL 7.2 - 11.1

NEUTROPHIL °a 51.9 % 40 - 74

LYMPH °s 31.3 19.6 - 52.7

MONO % 11.7 H °a 3.4 - 10

EOSTNOPHIL % 4.5 % 0 - 7BASOPHIL % 0.6 % 0 - 1 . 5

07/21/2003 10:33Test name Result units Ref. rangePSA 2.59 NG/ML 0 - 4

ASSESSMENT:

RUL LUNG MASS WITH EXTENSION LUL

ANEMIA

WT. L08S

COPD

GERD

HX IJGI BLEED 2NDARY MALLORY WEISS TEAR

BPH

PLAN:

PULMONARY PLANNING BRONCHOSCOPY

SCHED. CT HEAD,ABD./PELVIS

SCHED. WHOLE BODY BONE SCAN

IRON STUDIES, B12, FOLATE

CONT. CURRENT


PATIENT NAME AND ADDRESS (Mechanlcal imprinling, il available)

SINNOTT, JAMES

1525 THOMAS ST


402;06326



P rog ress Note Page 101 Nov 12, 2003

STAFF PHYSICIAN

Signed: 09/15/2003 13:37

TITLE: INTEGRATED TEAM ROUNDS-MEDICINE

DATE OF NOTE: SEP 15, 2003811:30 ENTRY DATE: SEP 15, 2003N11:30:39

AUTHOR: MCKEE,PAULA S EXP COSIGNER:


An interdisciplinary meeting mas held this morning in the 4 South

conference room. Services represented include: Rehabilitation, Social Services,

Chaplain, Case Management, Quality Management. The patient is a 64 year old

PiALE admitted Sep 14,2003 with diagnosis of. RUL mass.

PAST MEDICAL HISTORY:

Hx of Mallory Weiss Tear, s/p upper GI Bleed secondary to #1,

stable angina, BPI1, postherpetic neuralgia, GERD, and

chronic low back pain

PRIORITIES OF CARE/MEDICAL ISSUES:

1. RUL Mass:

Consult pulmonary in am for evaluation and possible biopsy of

lung mass. Will follow their suggcstions and recommendations.

2. GERD:

Continue rabeprazole.

3. BPH:

Cont terazosin.

NURSING ISSUES:

Impaired Gas Exchange

Alteration in Tissue Perfusion

Knowledge Deficit

Morse score of 35

PAIN ISSUES:

Pain control is currently not an issue.

EDUCATION:

Prefers written handouts for educational method. Has a high school

education. Unreceptive to education on admission.

N[JTRITIONAL ISSUES:

Height: 73" Weight: 227# BMI: 30

REHAB ISSUF.S:

No issues identified.

SOCIAL SERVICG ISSUES:

PATIEMr NAME AND AOONESS ( Mechanical imprinting, il availaLle)

SINNOTT, JAMES

1525 THOMAS ST


402Snfi.326




The patient does not have, or want, an advance directive.

PHARMACY ISSUES:

Allergi_es/Adverse Reactions: FLOXIN

WOUND AND SKIN CARE ISSUES:

Braden Score is 22

SPIRITUAL ISSUES:

No Firr_ference specified.

DISCHARGE PLAN/NEEDS:

Plan to return to home at discharge.

/es/ Paula S. McKee RN, BSN, CNA, B

QM Coordinator

Signed: 09/15/2003 11:35

Receipt Acknowledged Byc

09/17/2003 08:50

09/16/2003 15:53

09/15/2003 12:48

09/17/2003 08:01

09/16/2003 15:32

* AWAITING SIGNATURE *

/es/ SHARON K LEWIS

ACSW,SOCIAL WORKER

/es/ MICHELE J. MICHAEL, MSW

SOCIAL WORKER

/es/ OSCAR H ROSE

CHAPLAIN

/eS/ TERRY J GEE

PHYSICAL THERAPIST

/es/ Sarah McWhorter, RN, BSN, CMC

CARE MANAGER

MCCOY,STEPHANIE H

TITLE: CHAPLAIN

DATE OF NO'1'E: SEP 15, 2003Q910:50 ENTRY DATE: SEP 15, 2003@11:16:27

AUTIIOR: CREASY,GREGORY K EXP COSIGNER:


REASON FOR VISIT

New Admission/Initital Assessment

ASSESSMENT

Patient's religious preference is Protestant, No denomination.

Alert/responsive

Comments: Good visit with pt. Addressed some spiritnal issues related to pts.

illness. Offered spiritual and emotional support. Prayer per pt. request.

Pt. has experienced multiply difficulties in his life over the

PATIENT NAME AND ADDFESS ( Mechanical imprinting, if available)

SINNOTT, JAMES

1525 THONtAS S'1'


402506326

VISTA Electronic Medica! Documentation



Nov 12, 2003

past few year. Offered encouragment to him personaJ.ly.

PLAN OF CARE

New Admission

1. Provide prayer, spiritual supporC and emotional encouragement

2. Accessible for family counseling

3. Accessible for Holy Communion

4. Provide religious literature upon request

5. See patient as needed or on regular patient rounds

INTERVENTION

Pray, Counsel, Religious literature

Coinments: I offered the pt. the ministry of presence and providedcompassion, love and care. Pray offered on behalf of pt.

/es/ GREGORY K CREASY

Staff Chaplain

Signed: 09/15/2003 11:18

TITLE: PULMONARY CONSULT

DATE OF NOTE: SEP 15, 2003'a'10:31 ENTRY DATE: SEP 15, 2003@10:32:08


URGENCY: STATUS; COMPLETED

•*x PULMONARY CONSULT Has ADDENDA ***

referring physician:nr. Ross

reason for the consult:RUL mass

HPI:

The patient is 64 white man with a past medical h/o smoking/?copd in r.he past

and significant asbestos exposure who got admitted to the hospital with RUL

mass. the story of recent complains starCed ori the spring of this year witti some

abdominal symptoms of distention and gas that resolved with medication but later

on the patient started to have aching and pairt started on the shoulder area and

spread to involve the whole body bilaterally. This pain prevented sleep anci has

been difficult to control and the pt. now is trsing salisylate and amitriptyllin

Eor pain control.there is acomplain of fatigue because of lack of sleep. Tte also

complained of dry eyes but no bluury or change in vision. the aching is also

associated with some occipital h/a in the last 2 weeks.No joint swelling or

inflammation and no skin rash. no mouth or genital ulcers. No respira_ory

symptoms of sob or c/p. some little dry cough and apatite is good but the

patiertt has recently loosing some weight.

pL states that he had a chest xray and ct performed earlier this week as part of

screeening for asbestos and after Dr. Joseph in the er learned of the results

she called him and told him to conie to Lhe er.with this information

PA}'tENT NAME AND ADDRESS (Mechanical imprinting, il available)

SINNOTT, JAMES

1525 TnON.nS ST

IRONTON, O:IIO 4 5 63 8-1176

402506326


Prfnted at HUNTINGTON VAMC

Progress Note Page104

Nov 12, 2003

anc3 CT was ordered and performed. It showed a large rt upper lobe mass w/

extension to left upper lobe. Biopsy was suggested and we were consulted for

that reason.

PMHX:PAST MEDICAL HISTORY:

1.COPD: No PFT and the patiertt currently is exsmoker quit 8 years ago. ttte

pateitnhas significant asbestos exposure in the past when works in a fctory for

35-36 years and has been screened multiple times in the past which was neqative.

2. Hx of Mallory Weiss Tear S/P Upper C,I Blee<i secondary to q1

3. Stable angina

4. BPH

5. Postherpetic neuralgia

6. GERD

7. Chronic low back pain

Social History:exsmoker 60 pack year of smoking/ h/o asbestos exposure.

FAMILY HISTORY:


heart attack at 65 to 68. No history of diabetes. His inother also has

some heart problem.

ALLERGIES:

FLOXIN

MEDICATIONS:


ssue ate

Status 6ast Fill

Active Outpatient Medications Refills Expiration-------------------------------

AMITRIPTYLINE HCL 10MG 'I'AB Qty: 150 for ACTIVE Issu:09-04-03


AT BEDTIME FOR 1 DAY, THEN 'l'AKE 'CVJO Expr:09-04-04


TAKE THREE TABLETS AT BEDTIME FOR 1.



BEDTIME FOR 1 DAY INCREASE DOSE UP 'f'O



CAPSAICIN 0.025^ CR (2OZ/TU) Qty: 60 ACTIVE Issu:12-06-02


EVERY 12 lIOURS AS NEEDED Expr:12-07-03

hEXOFENADINE HCL 180MG TAB Qty: 30 for ACTIVE Issu:04-07-03


PATIENT NAME AND ADDRESS (Mechanical Imprlnting, il available)

SINNOTT, JAMES

152S THOMAS ST


402506326



I D

TAB 8

!^J

N THE COURT OF COMMON PLEASCUYAHOGA COUNTY, OHIO

JAMES SINNOTT, et al. ) CASE NO: 04 CV 521874

Plaintiffs ) JUI)GE: ASBESTOS DOCKET

VS. )

NOTICE OF FILINGA-BEST PRODUCTS INC., et al. ) OF SUPPLEMENTAL MEDICAL

) REPORTS AND RECORDSDefendants

Now come Plaintiffs, by and through counsel, and herein notice the filing of the

Supplemental Report of Dr. Robert Altnteyer M.D., Pulmonary Medicine and additional

medical records from Dr. Nancy Munn, Pulmonary Medicine at the Veteran's

Administration Hospital in Huntington, West Virginia for use in the within matter and

identify said physicians as witnesses for Plaintiffs. Further, Plaintiffs notice their intent

to use said reports and records in the trial of the within matter.


_/s/ Carolyn Kaye RankeCAROLYN KAYE ILANKE (0043735)Brent Coon & Associates1220 West Sixth Street 303Cleveland, Ohio 44113Telephone: (216) 241-1872Facsiinile: (216) 575-7664E-Mail: [email protected]

ATTORNEY FOR PLAIN'1'IFl'S


I certify that a true copy of the forgoing Notice of Plaintiffs' Filing of

Supplemental Reports was served on Cuyahoga County's F.lectronic File and Serve

System, this 21" day of July, 2005 and deemed served on all parties of record.

/s/Carolyn Kaye RankeCAROLYN KAYE RANKE

Robert B. Altmeyer, M.D.PIILMONI.PY MEBICINE

olvLVrnnm. wrnERlcnn ao4ao ov In,[wNnt MFOIU^+[

p!t".Omci? 4mER,.^.<n BYnNn Or INT[RNnL Mco,CiuE In Pu,.M(,nnwv I:ÊEASEfi

f,lw^^rirnp ncn,i,u uv il.[ NFr,Jnwt INei^^VTE 11 0^:^^^^NnTInNw^ S.rEi-r nN] MEnL,

1131 N/.r^[^Nn1. HO.p

Wn[[unq WV 2GI103

t30Il1 2n:lwnn

July 5, 2005

Carolyn Kaye RankeBrent Coon and Associates1220 West 6"' Street, Suite 303Cleveland, OH 44113

RE: SINNOTT, JAMESDOB: 04/10/39SS#: 402-50-6326

Dear Ms. Ranke:

As requested by your letter to me of June 22, 2005, which I reviewed in itsentirety, I reviewed various medical documents and other documents regardingJames Sinnott. I will review these documents in the order that I received themand then answer the questions specifically posed by your letter to me. All of myopinions in this report are given within a reasonabfe degree of medical certainty.If you have any questions regarding this report, please call me in my office at(304) 243-1446.

Document 1: Your letter of June 22, 2005 indicates that Mr. Sinnott worked as amillwright in the maintenar ce department at Dayton Malleable Foundry from1959 until the mid 1970's. After that period, your letter ir dicated that he wastransferred irdo ti, e electrlcal deparlilent at DaytVll IVlaileable wliele i-le worked

until his retirement in 1997. He further indicated that, "During the entire period ofhis employment, Mr. Sinnott was exposed to numerous asbestos containingproducts in and around the iron foundry which is the basis of his law suit." Yourletter also indicated, "I had examined this man on August 23, 2003, made adiagnosis of asbestosis, found a mass in his right lung, and advised that he havefollow up by his personal physician, which he apparently did, which lead to adiagnosis of lung cancer shortly thereafter by his physicians at the HuntingtonVeteran's Administration Hospital.

Carolyn Kaye RankeBrent Coon and AssociatesRE: SINNOTT, JAMESPage 2

Document 2: A report, which I authored entitled, "Asbestos Medical Evaluation,"from my examination of this individual on 8/23/03. I examined this man inKenova, West Virginia on 8/23/03 at the request of Respiratory Testing Services,Inc. I recount that his occupational exposure, as outlined on Page 1 of my report.He worked directly with asbestos insulation, pipe covering, transite, cloth, gloves,gaskets, valve packing, and fire brick. The report indicates that from 1950 until1994 he smoked 1 1/2 packs of cigarettes a day. He complained of a chronicproductive cough, chronic shortness of breath with exertion, and wheezingoccasionally in the mornings, but no chest pain or hemoptysis. He had a historyof myocardial infarction, esophageal junction tear, multiple episodes ofpneumonia as a child, and a history of nasal allergies. He had no history of anyconnective tissue diseases. On ptiysical examination of the chest, I noted thatthere were fine crackles in the axillary areas which persisted after repetitive deepbreathing. The forced expiratory time was normal. There were no wheezes andno rhonchi. There was no peripheral edema, cyanosis, or clubbing. A pulmonaryfunction study from that examination revealed mild restriction, no obstruction, anda mild reduction in the specific diffusing capacity at 77% of predicted. Iinterpreted a chest x-ray, at that time, as a NIOSH certified B reader, as showingcategory s/t, 1/1 in both mid and lower lung zones by the ILO InternationalClassification of Radiographs of Pneumoconioses. There was a right upper lobedensity adjacent to the superior mediastinum. I had noted that this could be anoverlapping shadow or scarring, but I could not rule out a mass in that area. Forthat reason, I verbally and in writing, advised this man to see his personalphysician within the next two weeks for follow up. He was also given writtennotification to take to his own physician. I made a diagnosis, with a reasonabledegree of medical certainty, according to my report, of asbestosis. I made thatdiagnosis on the basis of interstitial changes radiographically consistent withasbestosis, persistent crackles on auscultation of the chest, a significantexposure to asbestos in the vvork place with an appropriate latency period, areduction in the specific diffusing capacity, part of which was due to asbestosisand part of which was due to prior tobacco smoking. I reviewed my B readingreport form as well as the pulmonary function studies from that examination.

Document 3: Records from the Huntington VAMC. A chest x-ray from thatfacility of September 17, 2003 indicated no evidence of pneumothorax. Thepatient was post bronchoscopy. A CT scan of the head was normal. A CT scanof the abdomen showed no discrete masses in the liver, tiny bi-basilar pleuraleffusions with associated atelectasis left greater than the right were noted by the


interpreting staff radiologist. A bone scan showed no evidence of metastaticdisease. The CT scan of the thorax showed, "Evidence of a large probablyneoplastic mass lying anteriorly and medially in the right upper lobe, which ispleural based, which has minimal linear extension into the anterolateral portionsof the right upper lobe." It also showed, "Small pulmonary nodule, which isprobably also pleural based, lying anteriorly in the right upper lobe." Abronchoscopic biopsy of the right upper lobe showed, " Non-small cellcarcinoma." A discharge summary from that institution signed 9/18/03 indicated,"Bronchoscopy results positive for non-small cell carcinoma, non-small cell lungcancer." A consultation report indicated that, "PET scan suspicious formetastatic disease to right peritracheal and tracheal space." A November 12,2003 Huntington VAMC Spirometry Report showed that there was a normalFEV1 /FVC ratio. Interpretation from that institution was, "Very mild restriction, noobstruction, no postbronchodilator response, normal diffusing capacity." I wouldnote, however, that the single breath carbon monoxide diffusing capacity isrecorded as being 26.40 with a predicted value of 37.89. The recorded percentpredicted is 69.8, which would be in the mild reduction category. So, in thatregard, I disagree with the "normal" diffusing capacity interpretation. Almost all

authorities agree that a diffusing capacity less than 80% of predicted is abnormal.

The total lung capacity was 76% of predicted, which was mildly reduced,indicating a mild restrictive ventilatory impairment. A past medical history fromthat institution from a pulmonary consultation stated, "Ex-smoker quit eight yearsago." That means that he would have quit smoking cigarettes in 1995, which isroughly consistent with this man's testimony.

Document 4: A report by Nancy Munn, M.D., Chief Pulmonary Section,Huntington VAMC, signed on 9/15/03 indicated, "Right upper lobe lung mass withhistory of smoking and asbestos exposure make the patient high risk for lungCanCer." There was r,o doubt that she made a correct assessment in that regard.

Based on my review of the above records, it is my opinion that this man'stobacco smoking and asbestos exposure were major contributing causes for thedevelopment of his lung cancer, Which is documented in these records. Thebronchoscopic biopsy revealed the presence of a non-small cell carcinoma.Non-small cell carcinomas of the lung are known to be caused by both tobaccosmoking and asbestos exposure. Asbestos exposure, with or without asbestosis,is a known primary pulmonary carcinogen and there is ample scientific medicalliterature to support this generally agreed upon opinion.


Individuals who have had a significant exposure to asbestos with an appropriatelatency period have up to five times the risk of devetoping lung cancer comparedto the never-having been exposed to asbestos population of individuals.Individuals who are long-term tobacco smokers, and particularly those who havesmoked within the past 13 - 15 years, have an increased risk for developing lungcancer up to approximately 20 times the risk of individuals who have neversmoked. Unfortunately, iridividuals who have had a significant exposure toasbestos with an appropriate latency period and have had a significant smokinghistory, have approximately 80 - 100 times the risk of developing lung cancercompared to the population of individuals who have never smoked tobacco andwho have never been exposed to asbestos. This is the well known anduniversally accepted synergistic or multiplier effect that exists between asbestosexposure and tobacco smoking. Therefore, it is my opinion that both this man'stobacco smoking history and his asbestos exposure/asbestosis were bothsignificant contributing causes for the development of his lung cancer.

If you have any questions regarding this report, please contact me. Thank you.

Sincerely,

Robert B.-Altmeyer, M.D'

RBA/jrd

DEPARTMENT OFVETERANS AFFAIRS

VA Medical Center1540Spring Valley DriveHuntington, WV 25704

DATE: 11/1212003In Reply Refer To:

JAMES T SINNOTT1525 THOMAS STIRONTON, OHIO 45638-1 1 76

RE: ROI Request for JAMES SINNOTT

Dear MR SINNOTT:

The information you have requested is enclosed.

Sincerely,

Kathy HartChici, Health Information Management Section


Nov'2,2003

Note: TIME ZONE is local if riot iudicated

Significant Find.ings: Unknnwn------------ .,_------------------------------------- _

No local TTU results or Medicine results available for t.hi.s consult

--------------

END = . . - ..-._-


Currerrt PC Team: BLUE TEAM D


Primary Eligi.b.ility: NSC

Order Information

To SerVice: PULMONARY

From Service: 5 S-M

Requesting Provider: AKSRS,MARK JASON

Service is to bc rendered on an INPATIENT basis

Place: Bedside

Urgency: Routine

Orderable item: PULMONARY

CorisulL: Consult Request.

Provisional Diagnosis: RUL mass

Reason For Request:

For assessment and recommendations

(No orders, please)

For asscssment, reconimendations and management(orders as necessary)

64 y/o w m pt with pmh of gerd, s/p mallory weiss tear, chronic low

back pain and BPH presents to VAMC er today after being told to return

by er physician. pt states that he had a chest r.t performed earlier

this week and after Dr. Joseph in the er learned cif Lhe results she

called him and told him to come to the er. this all began a couple of

weeks ago when pt was being screened for asbestosis with a cxr and

pfts. cxr at that time showed a RUL mass and follow-up CT scan was

suggested. pt presented to er with this information to Dr. Joseph and

CT was ordered and performed. It showed a large rt upper lobe mass w/

ext--sion to left upper iobe. uiopsy was suggesced. uec of t.hese

findings and the fact that pt has been complaining ot upper chest pain,

Dr. Joseph called him and told him to come to er and be admitted so he

wouldn't get "lost."

Tnter-facilit.y Informatiorr

This is not an inter-facility consult regiiest.

PATIENT NAME AND ADDRESS (Mechanical imprinting, iF avaifabin)

SINNO'1P, JAMES

1525 THOMAS STIRON'1'UN, OHIO 45638-].!76

402506}26


Printed at IiUNTINGTON VAMC


Nov12,2003

Status:

La3C Action:

COMPLETE

ADDENDUM ADDED '1'O

Facility

Activity Dat.e/'1'ime/Zone sdesponsible Person F.otered by

--------------- ----------- ----------- ------------------

CPRS RELEASED ORDER 09/14/03 22:03 AKERS,MARK JASON AKERS,MARK ÂSON

PRINTED TO PUL2_S 09/14/03 2203RF.CRIVED 09%15/03 10:19 WILLIAMS,PETE WILLIAMS, PETE

INCOMPLETE RPT 09/15/03 10:56 CHANEM,AMhLAR GHANEM,AMMAR

Note# 4094838

COMPLETE/UPDATE 09/15/03 15:50 GHANEM,AMMAR MUNN,NANCY J

Note# 4094838

ADDENDUM ADDED TO 00/15/0:3 1h:4-1 GHANEM,/'.MMAR MUNN,NANCY J

Note)i 4094838


TITLE: PULMONARY CONSUL'f

DATP OP NOTE: SEP 15, 2003oa10:31 ENTRY DATE: SEP 15, 20031,P10:32:08


URGENCY: STATUS: COMPI.ETED

**•' PULMONARY CONSULT Has ADDENDA **4

referring physician:Dr. Ross

reason for the consult:RUL mass

HPI:

The patient is 64 white man with a past medica7 h/o smoking/?copd in t.he past

and significant asbestos exposure who got admitted to t.he hospital. with RU6

mass. the story of recent complains started on the spring oc this year wit,h some

abdominal symptoms of distention and gas t.hat resolved with medication but later

on the patient started to have aciiing and pain started on the shoulder area and

spread to involve the whole body bilar.erally. '2his pain prevented sleep and has

been difficult to control and the pt. now is using salisylate and amitriptyllin

for pain control.there is acc»nplain of fatigue because of lack of sleep. He also

complained of dry eyes but no bluury or change in vision. the aching is also

associated wi.th some occipital h/a in the last 2 weeks.No joint swelling or

in'_;am:^.atio:: a.... ..,, skin raaL. no muutif or genital ulcers. No respiratory

symptoms of sob or c/p. some little dry couah and apatite is good but the

patient has recently loosing some weight.

pt states that he had a chest xray and r.t performed earlier this week as part of

screeening for asbestos and after Dr. Joseph in the er. 7.earned of the results

she called him and cold him to come cc the er.with this information

PATIENT NAME AND ADDRESS ( Mechanical imprinting, if availabla)

SINNOTT, JAMES

]S2S THOMAS ST


402706326

VISTA Electronic Medical Docwnentation


Consult Request Page 44 Nov12,2003

and CT was ordered and performed. It showed a large rt upper lobe mass 4

extension to left upper lobe. Biopsy was suggested and we were consulted òr

Chat reason.

PMHX:f'AST MEDICAL HISTORY:

1.COPD: No PFT and the patient currently is exsmoker quit 8 years ago. [he

pate.itnhas siqnificant asbestos exposure in the past when works in a fctoiy tor

35-16 years and has been screened multiple tinies in the Dast which was negative.

2. Hx of Mallory Weiss 'Pear S/P Upper Gl Bleed secondary to q1

3. Stable angina

4. BPH

5. Postherpetic neuralgia

6. GERD

7. Chronic low back pain

Social History:exsmoker 60 pack year of smoking/ h/o asbestos exposure.

FAMILY HISTORY:


heart attack at 65 to 68. No hi.story of diabetes. His mother also has

some heart pr.oblem.

ALLERGIES:

FLOXIN

MEDICATIONS:


ssue ate

Status Last Fill

Active Outpatient Medications Refills Expiration-----------------------------------

]j AMITI2IPTYLINE HCL lOMG TAB Qty: 150 for ACTIVE Issu:09-04-03

30 days Sig: TAKE ONE TABLET BY MOUTH Refills: 1 LaSt:09-04-03

AT BEDTIME FOR 1 DAY, THEN TAKR TWO Expr:09-04-04



DAY, THEN 'fAKE FOUR TABLETS A'1' BEDTIME


BEDTIME FOR I DAY INCREASE DOSE UP TO

50 MG GRADUALLY; STOP AT Dw.. WHICH


2) CAPSAICIN 0.0255 CR (2OZ/TU) Qty: 60 ACTIVR lssu:l2-06-02


EVERY 12 HOURS AS NEEDED Gxpr:12-07-03

3) FEXOFENADINE NCL 180MG TAB Qty: 30 for ACTI9E Issu:04-07-03

30 days Sig: TAKE ONE TABLET BY MOUTH Refills: 11 Last:04-O7-03

PATIENT NAME AND ADDRESS (Mechanicql imprinling.Il available)

SINNOTTJAMES

1525 'IHOMAS ST


402506326



I D


Nov12,2003

CL: 102 MMOL/L ( 09/14/2003 16:23)C02: 25.6 MMOL/L ( 09/14/2003 16:23)BUN: 11 MG/DL ( 09/14/2003 16:23)OREAT: 0.8 MG/DL ( 09/14/2003 16;2))GLU: 91 MG/DL ( 09/14/2003 16:23)

WRC: 6.3 K/cmm ( 09/14/2003 16:23)HGB: 14.5 9/dl, ( 09/14/2003 16:23)HCT: 44.1 3 ( 09/14;2003 16:23)PLTLT: 297 K/cmm (09/14/2003 1G:23)

Speciinen: ARTERIAL BLOOD. RT 0914 3


HCO3a 27 MMOL/L 21 - 29

PH 7.41 7.35 - 7.45

PC02 43 MMHG 32 - 46

P02 76 MMHG 74 - 108

eASF EXCESS 3 11 MMOL/L 2 -+2.0

O2HB$ (SAT) 95 $ 92 - 96

CT of the chest: right upper lobe 3x4 mass medial and attached to the

mediastinal pleura. located in the apical or anterior segment of the right upper

lobe and asociaLed with lymphadenopat.hy.no liver or arenal lesions.

A:Right upper lobe mass with h/o sir.okincF and asbesLOS exposure make. t.he pat.i.erit.

high risk of lung ca. we will do diagnostic bronchoscopy to get a tisa ue ...

possible even the locatation of the lesion might be hard to reacFr. we will chech

pt/ptt and esr before the procedure and get tibial xray to check for HPO as

possible paraneoplastic syndrome.

/es/ AMMAR GHANEM /es/ PIANCY J MUNN, M.D.


Signed: 09/15/2003 10:57 Cosigned: 09/15/200.-1 3s:sa

09/15/2003 IwDEND'JM:

Personally interviewed and examined patient, discussed w:Ch Dr. Gnancm. G4

yo male with history of asbestos exposure for 37 years and prior smoking

history of 1 1/2 ppd x 45 years. Admitted after CT chest showed a right

upper lobe lung mass. History of soina shoulder pain in that area as well

as diffuse pairt. Says has noted unirrterrtional weight loss recently. Denies

any dyspnea, spututn, wheezing but does have a dry cough. History of rigid

PATIENT NAME AND ADDRESS (MOchanical imprinting, if available)

.SINNOTP, JAMES

1525 THOh1AS ST


402506326


PriNed at HUNTINGTON VAMC


Nov12,2003

EVERY DAY "FOR ALLERGIES... 'dAY CAUSE F.xp:':04-0i-04

SEDATION

=k) FLUNISOLIDE 25MCG 200D NASAL INHL Qty: ACTIVE Issu:12-06-02

1 for 30 days Si.g: SPRAY 2 SPRAYS IN Refills! 2 T.asi-.:OR-2.5-03

BOTH NOSTRTLS TWICE A DAY FOR NASAL Ezpr:12-09-03

ALLERGY SYMPTOMS

5) RASEPFAZOLE NA 20MG EC TAB Qty: 90 for ACTIVE Issu:02-03-03

90 days Sig: TAKE ONE TABLET BY MOUTH Refill5: I Last.:07-23-03


E) SP.LSALATE SOOMG 'cAB Qty: 120 for 30 ACTIVE Issu:09-04-03

days Sig: TAKE TWO TABi.ETS ITY MOUTH Refillsc 1 LasL:09-04-03

TWICE A DAY W/FOOD Expr:09-0404

7) TERAZOSIN HCL 2MG CAP Qty: 90 for 90 ACTIVE Issu:03-10-03

days Sig: TAKE ONE CAPSULE BY MOU'1'H Refil1s: 3 Last:03-10-03

AT BEDTIME FOR ENLARGED PROS1'A'rE Expr:03-10-04

SYMPTOMS

RE01EW OF SYSTEMS:as HPI

PHYSICAL EXAMINATION

Gen: Patient is awake, alert, and oriented to person, place, time, and

sit.uation. NAD

Vita1 Signs:

BP :135/88 (09/14/2003 14:34)

'fEMP:98.2 F [36.8 C] (09/14/2003 14:34)

P :72 (09/14/2003 14:34)

RR :16 (09/14/2003 14:34)

HEENT: Normocephalic, atraumatic. Pupils equally round and reactive co

]ight and accomodation. Extra-ocular movements intact. No sinus

tenderness. Oral mucosa moist and pink with no erythema or exudate.

Neck: No carotid bruits, no jvd, no cervical lymphadenopathy.

Heart: Normal sl, 52. No murmurs/rubs/gallops.

Lungs: Clear to ausctiltation bilatrally, no wheezing, ralea, or rhonchi.

Good air errtry bilaterally.

Abdomen: Soft, nontender, nonciistended, bowel sounds po>;itive. No

appreciable hepatospenomegaly.

Extremities: No cyanosis, clubbing, or edema. Peripheral pulses 2+.

Neur.ological: Cranial nerves II to %II intact:, normal sensation to

pinprick and light touch. Deep tendon reflexes +2.

^^„sr.:leskcleLal: .^.,otor strength Si5 i q upper and lower proximal and

distal extremities. tender in the shoulder and bones. no sighns of inf).arnmat:on

or skin rash

Labs:

NA: 136 MMOL/L ( 09/14/2003 16:23)K: 4.1 MEQ/L ( 09/14/2003 16:23)

PATIENT NAME AND ADDDESS ( Mechanical imprinting, if available)

SINNOTT, JAMES

7525 THOMAS ST


402506326




Nov12,2003

bronchoscopy in tile 1950's while in the service and was told hed scarring

of lower lungs. History of COPD (no pfts), stable angina, gerd, low back

pain.

On exam, pieasant male in no disLress. BreaCiiing comfortably at rest. No

conversational dyspnea. V9 normal. No cervical aderiopathy or jvd. Lungs

clear to a and p. RRR. Abdomen soft and nontender. No clubbir.g, cyanosis,

edema. Alert and oriented.

Labs relatively unremarkable. CXR with evidence nf RUL mas3.

CT chest reviewed with Radiology and RUi, mass noted with quescion o- uo:nc

satellite lesions. NO LESION NOTED ON LEFT. Some mediastinal and hilar

aderiopathy.

Clinical presentation suggestive o£ broalchogenic car.cinoma with RUL mass

Sigrrificant smoking and occupational exposure history.

Location of lesion may make biopsy diffi.culr. Will try bronchoscopy as

first diaynostic procedure. Scheduled for bronchroscony on 9/17/03 at 8am.

If non-diagnostic, then may need needle biopsy and/or open biopsy. Agree

with plans for metastatic w/u.

/es/ NANCY J MU61N, M.D.


9iqned: 09/15/2003 16:47

--------------

ENâ ---------------





Order Information

TO Service: PULMONARY PROCEDURES

From Service: AMB CARE WALK-IN

Requesting Provider: JOSEPH,SANDRA



Urgency:

Orderable Item: ARTERIAL BLOOD GAS

Procedure: ARTERIAL BLOOD GAS

Reasou Foc Request:

On Oxygen @

On Room Air

After Oxygen Change NEEDS LUNG BIOPSY

After Ventilator Chanqe

VenLilator patient AM

PATIENT NAME AND ADORESS (Mechanical imprinting, il available)

SINNOTT, JAMES

1S2S THOThAS ST


40250(3:6

VISTA Electronic Medical âocumentation

I'rinied at HUNTINGTON VANIC