FILED: NEW YORK COUNTY CLERK 01/27/ :20 PM INDEX NO /2012 NYSCEF DOC. NO. 113 RECEIVED NYSCEF: 01/27/2017. Exhibit B

Transcription

1 Exhibit B

2 Jeffrey Fegan Senior Counsel 311 East 38th Street, Apt. I SE NY, NY T F alooasto@hotmpit com Clyde & Co US LLP Direct Dial: Mobile: Date 1 /26/17 Dear Ms. King: I have reviewed the 1 CD of radiologic studies of Thomas Davis. My interpretation is as follows: 4/15/11 CT Chest, 4/18/11, 4/20/11 Chest x-rays, 4/26/11 PET CT, 7 /13/11, 7 /14/11, 7 /16/11, 7 /18/11, Chest x-rays, 8/24/11, 10/25/11 CT Chest, Abdomen and Pelvis, 12/27 /11 CT Chest, 1 /26/12 PET CT, 3/9/12 Chest x-rays, 6/12/12 CT Chest, Abdomen and Pelvis, 9/11 /12 CT Chest, 9/19/12, 11/9/12, 2/25/13, 5/7/13, 9/3/13, 12/9/13, 6/9/14 PETCT, 6/25/14 CT Biopsy, 6/25/14 Chest x-rays, 9/22/14, 3/16/15 PET CT- No pleural plaques are noted. No nodular or reticular opacities suggestive of parenchymal pneumoconiosis and/or pulmonary fibrosis are identified. Severe bullous emphysematous changes are seen in both lungs. Large right upper lobe mass-like consolidation and mildly enlarged mediastinal lymph nodes are likely neoplastic. On the 4/26/11 PET CT, abnormal hypermetabol'1sm is seen within the large right upper lobe lung mass and mildly enlarged mediastinal lymph nodes. Coronary calcification, lower lobe passive atelectasis, renal cysts and calcified mediastinal lymph nodes are incidentally noted. Presumed multifocal pneumonia versus treatment related changes particularly affecting the right upper lobe are first seen on the 7 /13/11 study. The right upper lobe mass-like consolidation has decreased in size by the 8/24/11 study. New left upper lobe nodular consolidation is seen on the 10/25/11 study, indeterminate for neoplasm. Multifocal pneumonia versus treatment related changes persist on the

3 subsequent studies with significant left upper lobe involvement noted on the 311 East 38th Street, Apt i SE NY, NY T F a!earisto@hotmai! com 12/27 /11 study. Hypermetabolism is seen in the evolving bilateral pulmonary findings on multiple subsequent PET CT's. The bilateral upper lobe findings improve but persist on the 6/12/12 study. However, a new cavitary left lower lobe mass as well as tubular left upper lobe mass are seen, indeterminate for neoplasm. They persist on the 9/11 /12 study. On the 9/19/12 PET CT, the left lower lobe cavitary mass is faintly hypermetabolic. The left upper lobe tubular mass is without abnormal FOG activity. The left lower lobe cavitary mass improves on the subsequent studies. The left upper lobe mass remains unchanged. On the 6/9/14 PET CT, a right middle lobe nodule with associated abnormal hypermetabolism is indeterminate for neoplasm. A needle has its tip in the right middle lobe nodule on the biopsy images. The right middle lobe nodule is resolved by the 3/16/15 PET CT. Bilateral hypermetabolic treatment related changes persist in the lungs. There is however a new hypermetabolic cavitary anterior right upper lobe mass, indeterminate for neoplasm. Sincerely,

4 Thomas Davis DATE OF RADIOGRAPH (m -d - [ I 6l -I 2l s I -l2 Io I 1 14 l EXAMINEE'S Social Security Number I I I I I I I I I I I I Full SSN is optional, last 4 digits are required. CHEST RADIOGRAPH CLASSIFICATION FEDERAL MINE SAFETY AND HEAL TH ACT OF 1977 DEPARTMENT OF HEAL TH AND HUMAN SERVICES CENTERS FOR DISEASE CONTROL & PREVENTION Coal Workers' Health Surveillance Program National Institute for Occupational Safety and Health 1095 Willowdale Road, MS LB208 Morgantown, WV FAX: TYPE OF READING ADB~FD OMB No.: CDCINIOSH (M) 2.8 REV. 01/2015 FACILITY Number- Unit Number I I I Ill-I I I I Note. Please record your interpretation ofa single radiograph by placing an "x" in the appropriate boxes on this form. Classify all appearances described in the ILO International Classification ofradiographs of Pneumoconiosis or Illustrated by the ILO Standard Radiographs. Use symbols and record comments as appropriate. 1. IMAGE QUALITY D Overexposed (dark) ~ Improper position D Underinflation QJ~D@'J D Underexposed (light) D Poor contrast D Mottle (If not Grade 1, mark all boxes that apply) D Artifacts D Poor processing D Other (please specify) 2A. ANY CLASSIFIABLE PARENCHYMAL ABNORMALITIES? YESD Complete Sections 2B and2c NO[;<'.! Proceed to Section 3A 2B. SMALL OPACITIES b, ZONES a SH.APE/SIZE PRIMARY SECONDARY R L [!][] [i]0 UPPER tj[-b tetb c.profusion 2C. LARGE OPACITIES ~~ ] Proceed to MIDDLE Section3A ] ] ] DD LOWER DD ~GJ~ J JIT3 DD 3A. ANY CLASSIFIABLE PLEURAL ABNORMALITIES? YESD Complete Sections 3B,3C 3B. PLEURAL PLAQUES (mark site, calcification, extent, and width) Sile Calcification Extent (chest wa!l; combined for Width (in profile only) Chest wall in profile and face on) (3mm minimum width required) Inpwfile ~0[!] ~0[!] Up to 1/4 oflateral chest wall= I 3to5mm=a 114 to l/2 oflateral chest wall= 2 StolOmm=b Face on > 112 of lateral chest wall= @][!] Other site(s) ~0[!] ~0[!] ['.] GGGJ GGGJ NO ~ Proceed to Section4A 3C. COSTOPHRENIC ANGLE OBLITERATION 0QJ Proceed to NO D Proceed to Section 30 Section4A 3D. DIFFUSE PLEURAL THICKENING (mark site, calcification, extent, and width) Chest wall Site Calcification Extenl (chest wall; combined/or Width (in profile on{1~ in profile and face on) (3mm minimum width required) Up to l/4 oflateral chest wall= 1 3to5nun=a 114 to 112 oflateral chest wall= 2 Sto lomm=b > 112 oflateral chest wall= 3 >IOmm=c Inprofile CQJ0[g @][D Face on [][]IT] [JGJGJ [][JG] [;][JG] 4A. ANY OTHER ABNORMALITIES? YES ~ Complete Sections 4B, 4C, 40, 4E NO D Comp.lete physician info and sign form. s. PHYSICIAN'S Social Security Number* READER'S INITIALS DATE OF READING (mm-dd-yyyy) I I I I- I I I -I I I I I I Ale IL I I [1 l-l2l6l-l2lol1l7i Full ~ r is optional, last 4 digits are required. I IY-AL.~~ Legasto, Alan Clint SIGNATURE v. PRINTED NAME (LAST, FIRST MIDDLE) 311 E38th Street, A~t. 18E New York INlvl I 1 lo Io I 1 I 6 I STREET ADDRESS CITY STATE ZIP CODE CDC/NIOSH 2.8 (E), Revised January 2015, CDC Adobe Acrobat 11.0, S508 Electronic Version, August 2015

5 4B. OTHER SYMBOLS (OBLIGATORY) aa at ax bu ca cg en co cp CV di ef em es fr u ~ a ~ m ~ m oo 00 ~ ili J ~ m fr hl ~ ~ ili Li = ~ ~ ~ ~ ra 00 ili DDD~~~DDDD~D~DDDDDDDDDDDDDDD atherosclerotic aorta significant apical pleural thickening coalescence of small opacities - with margins of the small opacities remaining visible, whereas a large opacity demonstrates a homogeneous opaque appearance- may be recorded either in the presence or in the absence of large opacities bulla(e) cancer, thoracic malignancies excluding mesothelioma calcified non-pneumoconiotic nodules (e.g. granuloma) or nodes calcification in small pneumoconiotic opacities abnormality of cardiac size or shape cor pulmonale cavity marked distortion of an intrathoracic structure pleural effusion emphysema eggshell calcification of hilar or mediastinal lymph nodes fractured rib(s) (acute or healed) hi ho id ih kl me pa pb pi px ra rp tb enlargement of non-calcified hilar or mediastinal lymph nodes honeycomb lung ill-defined diaphragm border - should be recorded only if more than one-thlrd of one hemidiaphragm is affected ill-defined heart border - should be recorded only if the length of the heart border affected, whether on the right or on the left side, is more than one-third of the length of the left heart border septal (Kerley} lines mesothelioma plate atelectasis parenchymal bands - significant parenchymal fibrotic stands in continuity with the pleura pleural thickening of an interlobar fissure pneumothorax rounded atelectasis rheumatoid pneumoconiosis tuberculosis 4C. MARK ALL BOXES THAT APPLY: (Use of this list is intended to reduce handwritten comments and is optional) Abnormalities of the Diaphragm D Eventration D Hiatal hernia Airway Disorders!;zl Bronchovascular markings, heavy or increased i;;zj Hyperinflation Bony Abnormalities 0Bony chest cage abnormality 0Fracture, healed (non-rib) 0Fracture, not healed (non-rib) Dscoliosis 0Vertebral column abnormality 4D. Should worker see personal physician because of findings? YES ~ 4E. OTHER COMMENTS Lung Parenchymal Abnormalities D Azygos lobe i;;z]density, lung i;zj Infiltrate IZJNodule, nodular lesion Miscellaneous Abnormalities D Foreign body D Post-surgical changes/sternal wire 0Cyst Vascular Disorders D Aorta, anomaly of D Vascular abnonnality Date Physician or Worker notified? (mm-dd-yyyy) NOD Public reporting burden ofthis collection ofinfonnation is estimated to average 3 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of infonnation unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect ofthts collection information, including suggestings for reducing this burden to CDC, Project Clearance Officer, 1600 Clifton Road, MS D-74, Atlanta, GA 30333, ATTN: PRA ( ). Do not send the completed fonn to this address. CDC/NIOSH 2.8 (E), Revised January 20'\5, CDC Adobe Acrobat 1 '\.0, S508 Electronic Version, August 2015