Opinion ID: 746887
Heading Depth: 2
Heading Rank: 1

Heading: Dr. Jenkins

Text: 76 Dr. Jenkins received his medical degree from the University of Texas in 1940. He received medical training at the University of Michigan Hospital as an intern, resident in medicine, resident in Tuberculosis and Chest Disease, and resident in Allergy in 1940-1945. The American Board of Internal Medicine certified him in 1947. Between 1943 and 1947 he served as Instructor and Chief Resident in Medicine and as Assistant Professor of Medicine and Physician in charge of the Tuberculosis and Chest Unit, University of Michigan Medical School. From 1947 to 1991 he served as Assistant Professor, Associate Professor, and Professor of Medicine at Baylor College of Medicine, Houston, Texas. From 1947 to 1974 he was Chief, Pulmonary Disease Section, Baylor College of Medicine. From 1975 to 1991 he was Chief, Environmental Medicine, Baylor College of Medicine. In 1991, he went into practice with The Respiratory Consultants of Houston, consisting mostly of a group of physicians that he had trained. He is either Attending Physician or Consultant in Medicine or Pulmonary Medicine at eight Hospitals in Houston, Texas. Additionally, Dr. Jenkins is a member of sixteen national, state and local medical organizations and has served as president or chairman of a section for three of them. 77 In formulating his opinion, Dr. Jenkins personally took a detailed medical history from Moore, performed a thorough physical examination, personally observed him three times, performed or supervised a series of tests on Moore including pulmonary function tests, a bronchial challenge test, a bronchodilator test, a spirometry test, a plethysmographic test, a lung volume determination, an intrapul gas distribution test, a diffusion test, an arterial bloods test, a mechanics test, X-rays, and laboratory tests, reviewed the medical records and reports of Dr. Alvarez and Dr. Simi, including a report of the bronchial dilator test by Dr. Simi two or three weeks after the accident that showed severe airways obstruction and a report of an allergy test performed by Dr. Alvarez--among some fifteen reports of examinations and tests by him--that ruled out allergic or immunologic disease and confirmed reactive airways disease as the proper diagnosis of Moore's illness, reviewed the material safety data sheet MSDS prepared by Dow Corning, and consulted a medical treatise, Carl Zenz, OCCUPATIONAL MEDICINE: PRINCIPLES AND PRACTICAL APPLICATION (2d ed.1988) and other medical literature. 78 In his proffered testimony, Dr. Jenkins explained that reactive airways disease, also known as reactive airways dysfunction syndrome (RADS), is recognized in the field of clinical medical knowledge as a disorder consisting of a reactive obstruction of air passageways in the bronchial trees and the lower respiratory tract, producing labored breathing, wheezing, shortness of breath, coughing and the raising of phlegm. Dr. Jenkins' testimony as to the nature and symptoms of reactive airways disease was accepted as accurate by the parties and other experts on both sides. In the history taken by Dr. Jenkins, Moore reported that he had been in comparatively good health until about one hour after his exposure to the chemical gases at Ashland when he began to experience these types of symptoms. In his physical examinations and tests of Moore, Dr. Jenkins observed symptoms and signs of reactive airways disease. Dr. Jenkins stated that the objective medical tests performed by him and the several doctors who had seen Moore after his exposure indicated conclusively that Moore was not malingering. 79 Dr. Jenkins offered his opinion that Moore suffered from reactive airways disease that had been caused by Moore's exposure to gases emanating from a spill of blended chemicals which Moore had cleaned up without a respirator. He testified that the manufacturer's material safety data sheet stated that the principal substances contained in the mixture of chemicals that Moore breathed were toluene, naphtha, and propylene glycol methyl ether, and that all of these have irritating properties. He further stated that any chemical with irritating properties can cause reactive airways disease in a person who is capable of responding in that way. Dr. Jenkins also stated that toluene, one of the chemicals to which Moore was exposed, is similar to the chemical nature of other properties upon which there have been written articles on reactive airways disease. Dr. Jenkins testified that, based on the history given by Moore that a substantial amount of the mixed chemical solvent had leaked onto the truck-trailer floor from two 55 gallon drums while the cargo was enclosed and en route, he roughly estimated that Moore had been exposed to 200 parts per million or higher of the chemical vapors. Dr. Jenkins also testified that Moore informed him that neither Ashland nor anyone else had taken air samples with mechanical devices at the time of Moore's exposure. 80 Although Dr. Jenkins acknowledged that he could not recall having seen a patient who had been exposed to the same chemicals under the same circumstances, he testified that he had examined and evaluated over one hundred other patients who had been exposed to chemicals under various circumstances. During Dr. Jenkins' deposition, the interrogating lawyers and the doctor sometimes referred to the mixed chemical spillage as toluene, which was in fact just one of its many ingredients. But a fair reading of the deposition as a whole clearly indicates that when the lawyers and Dr. Jenkins used the word toluene they intended to refer to the chemical mixture containing toluene and simply called the solvent mixture toluene for the sake of convenience. Dr. Jenkins' proffered testimony was that, based on his education, knowledge, training, and experience, personal examination of Moore, personal taking of Moore's history, supervision and study of his own tests on Moore, review and study of other doctors' reports, tests and opinions, study of a medical treatise and numerous medical literature articles, he concluded that Moore's exposure to the mixture of chemical gases contained in the solvent to which he was exposed caused his disease, because any chemical with irritating properties can cause reactive airways disease, and each of the chemicals in the solvent mixture had irritating properties.