- Email: [email protected]
Robust dismissal of a claim on chemical sensitisation
297
generally converted into adipocere. This process sets in when a body is buried in a humid milieu under hermctic seal. Mummification, on the other hand, happens when a body remains on the surface for several weeks and is exposed to dry air and wind. It can also happen that an arm sticking out of the snow cover, is mummified while the snowcovered parts of the body are converted into adipocere. H tirolensis of Hauslabjoch, being completely mummified, had therefore been exposed to the glacier winds for several weeks at least. The discovery of the body last September is closely linked with the extreme ice melt in glaciers in the Tyrolean Alps during 1991, with temperatures above average, little snowfall in summer, and heavy deposition of Sahara sand, especially in spring. The corpse is stored at - 6°C at the Institute of Anatomy, University of Innsbruck. Scientific examination will take several years but we speculate that molecular biological investigations may shed light on the genetics and evolution of man in this Alpine region. At a political level no decision on the ownership of this body had been signed by Jan 28, despite reports to the contrary in some English-language newspapers.
E. Ambach W. Tributsch R. Henn W. Ambach
Medicine and the Law Robust dismissal of a claim on chemical sensitisation A female van driver exposed on two consecutive days to chemical fumes which, she alleged, had caused total allergy syndrome, had her claim for an estimated C250 000 dismissed by Mr Justice Macpherson in the High Court on Oct 14,1991. Notwithstanding his agreement to say the least possible about the plaintiffs key medical witness, the judge’s criticisms of that doctor were unusually blunt. In effect, the judge wholly rejected her evidence, opinion, and diagnosis, and he said that it was the plaintiffs"great misfortune" to have been encouraged to believe that she was sensitised and unable to endure aftershave, perfume, car fumes, and other experiences. On Nov 22, 1984, the plaintiff detected a chemical smell and saw that a 5 gallon drum of allyl caproate had leaked and soaked the back of her truck. The woman thought that she was getting influenza; her nose ran, her eyes watered, and she coughed and sneezed. On Nov 23, although she was told that the truck had been washed, she had the same symptoms eyes swelled. At hospital pads and bandages were applied to both eyes. 24 hours later she had some blurred vision and a headache, runny nose, and coughing. On Nov 26 her family doctor recorded "blurred vision, right eye, and feels dizzy" and she was provided with regular medical certificates for "chemical injury to both eyes". The judge said that "these certificates went on apparently, even after the plaintiff went to see Dr [Jean] Monro on Sept 17, 1985". Up to that date and afterwards she made several visits to her doctor but in April and May, 1985, when she stopped work, her medical records make no mention of anything specific other than eye trouble. The judge was convinced that the woman’s multiple complaints and symptoms were not present until September, 1985, at the earliest. Certainly no joint or muscle aching was proved in the’nine months after exposure to the chemical, yet a second time and her face and
Sept 17, the plaintiff was relating to Dr Monro that "almost every part of her body was in some way adversely affected..." The judge accepted evidence given by the defendant company’s medical experts-namely, Dr D. J. Pearson and Dr Lesley Bidstrup (whose "careful and impressive" evidence persuaded the judge that there was no scientific basis for the "spreading phenomenon" of chemical sensitisation). "Dr Monro may be a prophet before her time", the judge said, "but in my judgment her evidence was in many respects bizarre and unscientific". He hoped that the plaintiff would now improve perhaps "with experienced and appropriate medical or psychiatric help" and come to learn that the aftershave, perfume, car fumes, and other experiences she had been led to believe caused her harm could be endured by her as much as by other people. By September, 1985, there were several disconnected and natural ills such as headaches, some degree of arthritis, perhaps some hayfever or rhinitis, that had built up in the plaintiffs mind an anxiety not at all connected with the chemical accident. The judge was very sorry for the plaintiff though he found that she had exaggerated her symptoms. The family doctor too had to some extent encouraged the plaintiff to believe that her eyes were worse than they were "by giving out sick notes rather like confetti". London’s Moorfields Eye Hospital had cleared her by Jan 29,1985, in respect of eye difficulties (for which the plaintiff was awarded 1000). Nor did the judge spare the Personal and Medical Claims Service, which had drawn up a report "which grossly inflated the plaintiffs claim without any sensible basis at all". on
Diana Brahams
Health Watch Back to basics As the European Community tries to integrate the different economic, social, and cultural practices of a dozen nations, not the least of the obstacles to emerge will be in health and medicine. Efforts at achieving uniformity in such practical matters as cost and quality will be complicated by more elusive elements such as differing attitudes to illness and treatment.
Nonetheless, the move toward integration should provide opportunities for improving each of the national programmes-for example, by reforms to fmancing, organisation, and quality control of the sort that all the nations of the EC have long been debating independently. At the same time, some traditional, illogical characteristics of national programmes could be jettisoned. Clearly, however, the road ahead is rocky: EC health ministers have just said they intend to postpone decisions on collaborative action. In a book just published,! William Glaser, a long-time scholar of the European health insurance scene, points out some of the difficulties. For example, Belgium continues to have a multiplicity of insurance funds, although other countries do not.-, Germany has little if any government regulation of health insurance funds. Moreover, there is great variation in the benefits available from the health insurance systems. Public provision for mental health services is very uneven, and the Netherlands is the only EC country that has enacted social insurance coverage of long-term care. The public/private arrangements in
generally converted into adipocere. This process sets in when a body is buried in a humid milieu under hermctic seal. Mummification, on the other hand, happens when a body remains on the surface for several weeks and is exposed to dry air and wind. It can also happen that an arm sticking out of the snow cover, is mummified while the snowcovered parts of the body are converted into adipocere. H tirolensis of Hauslabjoch, being completely mummified, had therefore been exposed to the glacier winds for several weeks at least. The discovery of the body last September is closely linked with the extreme ice melt in glaciers in the Tyrolean Alps during 1991, with temperatures above average, little snowfall in summer, and heavy deposition of Sahara sand, especially in spring. The corpse is stored at - 6°C at the Institute of Anatomy, University of Innsbruck. Scientific examination will take several years but we speculate that molecular biological investigations may shed light on the genetics and evolution of man in this Alpine region. At a political level no decision on the ownership of this body had been signed by Jan 28, despite reports to the contrary in some English-language newspapers.
E. Ambach W. Tributsch R. Henn W. Ambach
Medicine and the Law Robust dismissal of a claim on chemical sensitisation A female van driver exposed on two consecutive days to chemical fumes which, she alleged, had caused total allergy syndrome, had her claim for an estimated C250 000 dismissed by Mr Justice Macpherson in the High Court on Oct 14,1991. Notwithstanding his agreement to say the least possible about the plaintiffs key medical witness, the judge’s criticisms of that doctor were unusually blunt. In effect, the judge wholly rejected her evidence, opinion, and diagnosis, and he said that it was the plaintiffs"great misfortune" to have been encouraged to believe that she was sensitised and unable to endure aftershave, perfume, car fumes, and other experiences. On Nov 22, 1984, the plaintiff detected a chemical smell and saw that a 5 gallon drum of allyl caproate had leaked and soaked the back of her truck. The woman thought that she was getting influenza; her nose ran, her eyes watered, and she coughed and sneezed. On Nov 23, although she was told that the truck had been washed, she had the same symptoms eyes swelled. At hospital pads and bandages were applied to both eyes. 24 hours later she had some blurred vision and a headache, runny nose, and coughing. On Nov 26 her family doctor recorded "blurred vision, right eye, and feels dizzy" and she was provided with regular medical certificates for "chemical injury to both eyes". The judge said that "these certificates went on apparently, even after the plaintiff went to see Dr [Jean] Monro on Sept 17, 1985". Up to that date and afterwards she made several visits to her doctor but in April and May, 1985, when she stopped work, her medical records make no mention of anything specific other than eye trouble. The judge was convinced that the woman’s multiple complaints and symptoms were not present until September, 1985, at the earliest. Certainly no joint or muscle aching was proved in the’nine months after exposure to the chemical, yet a second time and her face and
Sept 17, the plaintiff was relating to Dr Monro that "almost every part of her body was in some way adversely affected..." The judge accepted evidence given by the defendant company’s medical experts-namely, Dr D. J. Pearson and Dr Lesley Bidstrup (whose "careful and impressive" evidence persuaded the judge that there was no scientific basis for the "spreading phenomenon" of chemical sensitisation). "Dr Monro may be a prophet before her time", the judge said, "but in my judgment her evidence was in many respects bizarre and unscientific". He hoped that the plaintiff would now improve perhaps "with experienced and appropriate medical or psychiatric help" and come to learn that the aftershave, perfume, car fumes, and other experiences she had been led to believe caused her harm could be endured by her as much as by other people. By September, 1985, there were several disconnected and natural ills such as headaches, some degree of arthritis, perhaps some hayfever or rhinitis, that had built up in the plaintiffs mind an anxiety not at all connected with the chemical accident. The judge was very sorry for the plaintiff though he found that she had exaggerated her symptoms. The family doctor too had to some extent encouraged the plaintiff to believe that her eyes were worse than they were "by giving out sick notes rather like confetti". London’s Moorfields Eye Hospital had cleared her by Jan 29,1985, in respect of eye difficulties (for which the plaintiff was awarded 1000). Nor did the judge spare the Personal and Medical Claims Service, which had drawn up a report "which grossly inflated the plaintiffs claim without any sensible basis at all". on
Diana Brahams
Health Watch Back to basics As the European Community tries to integrate the different economic, social, and cultural practices of a dozen nations, not the least of the obstacles to emerge will be in health and medicine. Efforts at achieving uniformity in such practical matters as cost and quality will be complicated by more elusive elements such as differing attitudes to illness and treatment.
Nonetheless, the move toward integration should provide opportunities for improving each of the national programmes-for example, by reforms to fmancing, organisation, and quality control of the sort that all the nations of the EC have long been debating independently. At the same time, some traditional, illogical characteristics of national programmes could be jettisoned. Clearly, however, the road ahead is rocky: EC health ministers have just said they intend to postpone decisions on collaborative action. In a book just published,! William Glaser, a long-time scholar of the European health insurance scene, points out some of the difficulties. For example, Belgium continues to have a multiplicity of insurance funds, although other countries do not.-, Germany has little if any government regulation of health insurance funds. Moreover, there is great variation in the benefits available from the health insurance systems. Public provision for mental health services is very uneven, and the Netherlands is the only EC country that has enacted social insurance coverage of long-term care. The public/private arrangements in