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Reading X-Rays in Asbestos Suits Enriched Doctor
By JONATHAN D. GLATER
New York Times
November 29. 2005 - BRIDGEPORT, W.Va. - About a decade ago, a radiologist in this small town gradually stopped seeing patients and instead adopted what turned out to be a much more lucrative practice: reading X-rays full time.
The doctor, Ray A. Harron, now 73 years old, reviewed as many as 150 X-rays a day, or one every few minutes, and produced medical reports for $125 each. Some of his reports supported claims by more than 75,000 people seeking compensation for lung injury caused by inhalation of asbestos. For his work, he probably earned millions of dollars over the years.
Plaintiffs' lawyers who have used Dr. Harron's services recently did not return phone calls seeking comment. But in the eyes of defense lawyers fighting some of those claims, Dr. Harron was not a professional rendering an independent opinion, but a vital cog in a multibillion-dollar lawsuit machine. They contend that Dr. Harron's X-ray evaluations are unreliable at best, fraudulent at worst.
The defense lawyers are not the only ones who have questioned Dr. Harron's work. This summer, a federal judge found that Dr. Harron "failed to write, read, or personally sign" reports supporting 6,350 claims by people saying they had inhaled silica, another potentially dangerous material.
Congressional investigators are now looking into asbestos and silica litigation. Federal prosecutors in Manhattan are also looking into asbestos claims, and while it is not clear whether they are looking at Dr. Harron's work, they have sought documents from a medical screening company that used his services and from others involved in asbestos and related litigation.
Dr. Harron has not been formally accused of wrongdoing. In depositions and court appearances he has not acknowledged any wrongdoing and has defended his work.
The spotlight on Dr. Harron's work comes at a time when critics of plaintiffs' lawyers have portrayed the sweeping product liability litigation over asbestos and silica as an effort to game a system set up to compensate injured workers. Defense lawyers have criticized expert witnesses and diagnosing doctors in the past for supporting lawsuits that the lawyers say lack merit.
While Dr. Harron rarely appeared in court, his medical reports were clearly crucial to tens of thousands of claims. Court documents in the asbestos and silica litigation show the critical role that can be played by doctors, who are less often maligned than the lawyers who hire them.
"This is the tip of the iceberg," said Walter G. Watkins Jr., a lawyer at Forman Perry Watkins Krutz & Tardy, a firm in Jackson, Miss., that has defended companies facing asbestos claims and silica claims. "There are a lot of other Ray Harrons out there."
Through a lawyer, Lawrence Goldman of New York, Dr. Harron declined to comment for this article.
Litigation involving asbestos, and more recently, silica, has grown into a huge business. Over the last 30 years, more than 700,000 claims have been filed involving inhalation of asbestos, a fire-retardant material that can cause a particularly pernicious form of lung cancer, and more than $70 billion has been spent on asbestos litigation - $49 billion as compensation, according to the Rand Corporation.
Dr. Harron, corporate defense lawyers say, had some role in providing medical documents supporting thousands of claims against other companies that made or used asbestos.
As Dr. Harron stepped up his involvement in screening potential asbestos claimants, he began to travel and was around Bridgeport less and less, said Dr. Douglas McKinney, a urologist who said he had kept a practice in Bridgeport for nearly 20 years. "He started doing this evaluation business and he was very seldom around," said Dr. McKinney, adding that he saw Dr. Harron only three or four times a year.
But Dr. McKinney said he was baffled when he learned from a newspaper article of challenges to some of Dr. Harron's work in asbestos and silica litigation. "I was surprised at that, because he had always had a straightforward business here," Dr. McKinney said. "I sent him a lot of my business for routine X-rays and ultrasounds and such."
Dr. Harron is not an active member of the county medical association, according to the organization's executive secretary. A few local residents who said they knew him and tenants in the two, two-story blue-sided office buildings he owns, on a small plaza called Harron Square off the two-lane road that runs through town, said only that he was a nice man.
A 1999 court decision gives some idea of the nature of Dr. Harron's work. He was sued by the widow of Raymond Adams, whose lung cancer Dr. Harron had spotted on an X-ray. Dr. Harron, who had never met the man, drew the possible cancer to the attention of the law firm that had sent him the X-ray as part of its search for potential plaintiffs in asbestos lawsuits. The firm never passed on the information to Mr. Adams, according to court documents, and his cancer went undiagnosed for about a year. He eventually died.
The court found that Dr. Harron was not Mr. Adams's doctor and so did not have a duty to make sure he sought medical treatment.
The distinction between a person's doctor and an independent litigation expert is critical for Dr. Harron, and it is one that he has mentioned repeatedly in depositions taken by defense lawyers over the years.
According to the transcript of a deposition in 2004 , Dr. Harron graduated from New York Medical College in 1957, completed an internship at the United States Marine Hospital in New York in 1958, was a radiology resident in New Orleans and then moved to West Virginia in 1961, where he practiced as a radiologist for more than 30 years.
Beginning in the mid-1990's, he stopped treating patients and began reading X-rays and identifying possible cases of dust-related diseases. In 1994 his medical reports supported fewer than 2,000 claims to one of the oldest trusts set up to compensate asbestos victims, the Manville trust. In the next year that number grew to more than 6,000; he averaged about 6,400 reports each year thereafter.
"The dog died and the kids left home," Dr. Harron said in the 2004 deposition. "My responsibilities were over, so I kind of gave up real medical work."
He devoted himself nearly full-time to reading X-ray films. Sometimes, Dr. Harron said, he would conduct a physical examination. Usually he also received a medical history, completed by an employee of a screening company, that would include a statement that the person was exposed to asbestos. Dr. Harron said he relied mostly on the X-ray review, not on the history.
Screening companies have portable X-ray equipment that they can set up in hotel ballrooms or in other temporary locations. Some days, Dr. Harron would review more than 100 X-rays a day, he said during his deposition. He charged $125 an evaluation, but would also charge a flat fee - perhaps $10,000 - if he had to travel to a faraway screening site, in California or Hawaii, for example. If he had charged $125 per medical report for the 76,224 claims submitted to the Manville trust, Dr. Harron would have made more than $9.5 million from those claims alone.
If Dr. Harron found the X-ray's findings were consistent with signs of asbestos-related illness, he said he would dictate a report to his staff, who would then stamp it with his signature, he said. The report, along with the other documentation, would be provided to the law firm that had hired the screening company and Dr. Harron. The law firms would file the report with a claim seeking compensation for asbestos-related injury.
Dr. Harron's son, Andrew Harron, a doctor in Kenosha, Wis., has also read X-rays. The Manville trust announced in September that it would no longer pay claims based on reports by Dr. Harron or his son, as well as several other doctors whose work has been questioned by defense lawyers.
Jed Stone, a lawyer for Andrew Harron, said that defense lawyers' attacks on doctors were "an attempt by the manufacturing industries to close down" litigation over diseases caused by exposure to asbestos and silica.
"For years they settled these asbestos cases, and now they want to open them up again," Mr. Stone said. "I don't get a do-over in my life," and neither should the companies battling asbestos claims, he added.
In a video recording of the 2004 deposition, the elder Dr. Harron strongly rejected the suggestion that he had any incentive to find signs of asbestos-related injury in the people whose X-rays he reviewed.
"I get paid the same no matter what I say," he added.
But Dr. Harron's credibility suffered a serious blow in the course of a legal proceeding in Corpus Christi, Tex., before Judge Janis Graham Jack of Federal District Court.
Dr. Harron testified about his diagnoses of silicosis, a lung disease caused by exposure to silica, a hard, glassy mineral used as a cleaning abrasive as well as in making glass, paint, ceramics and other materials. The doctor's diagnoses supported thousands of claims filed against companies that manufactured or used silica.
Judge Jack wrote that the diagnoses relied on X-rays and on medical histories taken by screening companies or law firms, not on physical examinations, as the reports under his name claimed.
Most disturbing, though, was another finding by the judge. "When Dr. Harron first examined 1,807 plaintiffs' X-rays for asbestos litigation," Judge Jack wrote, "he found them all to be consistent only with asbestosis and not with silicosis." But after re-examining X-rays of the same 1,807 people "for silica litigation, Dr. Harron found evidence of silicosis in every case."
It is possible for someone to have developed both diseases as a result of working in a place where both silica and asbestos were used. But both illnesses generally take years to manifest themselves, so it is unlikely that someone could develop signs of silicosis that were not discernible on an X-ray just a few years earlier. The diagnoses "were manufactured for money," the judge wrote last summer in an opinion that sent some claims back to state courts and imposed sanctions on one of the plaintiff firms. "The record does not reveal who originally devised this scheme, but it is clear that the lawyers, doctors and screening companies were all willing participants," Judge Jack wrote.
When defense lawyers began to ask Dr. Harron about his findings in February at a hearing that led to Judge Jack's opinion, he asked for a lawyer.
"If you're accusing me of fabricating these things, I think that's a serious charge," Dr. Harron said.