Pathologist's Testimony Helps Clear J&J in Talc Trial

Dr. Richard Attanoos, a pathologist at University Hospital, Cardiff, Whales, specializes in pulmonary pathology with special emphasis on occupational lung disease. He has been chair of the European Working Group in Pulmonary Pathology and chair of the European Mesothelioma Panel. The doctor is seen here testifying with remarkable effectiveness and authority for the defense in a 2019 California product liability trial, Fong v. Johnson & Johnson, in which a plaintiff claims asbestos in talc-based products caused her mesothelioma. This video begins with the doctor’s discussion of naturally occurring mesotheliomas, those unrelated to environmental conditions and exposures, which are “absolutely recognized in the scientific literature”. These naturally occurring tumors are more prevalent in women because men are more exposed to commercial sources of environmental asbestos in the fields of construction and ship building. Female rates of mesothelioma have persisted at a low steady level therefore, while male rates have mirrored the usage of asbestos in the construction industries. Women exposed to asbestos to the same degree as men, develop mesothelioma at the exact same rate has men do, but since so few are so exposed, their rates of disease development overall reflect a more natural development of this problem. Mesothelioma has a latency period of 30 to 40 years from the time of exposure. Utilizing visual displays, the expert demonstrates how the rates of mesothelioma in men have increased substantially from 1975 to the mid 1990’s at which point the rates begin to fall. This curve is mirrored by a graft of asbestos consumption which began increasing after World War II and peaked in 1971 when it began decreasing markedly. This is entirely consistent with the development of tumor related to asbestos exposure. During this same time frame, the rates of mesothelioma development in woman were far lower and remained steady, showing no peak or decline with overall asbestos use. This represents natural development of the disease unrelated to asbestos exposure. Mesotheliomas arising in children or those younger than the 30 to 40 year latency period, are considered to have been naturally occurring, or unrelated to asbestos exposure, since they have not lived as long as the latency period demands. Animals develop more cancers with age, as do humans. They are caused by cell mutations that become more difficult to correct or eliminate as the subject becomes older. The pathologist found “no evidence in Ms. Fong’s tissue that she had been exposed to above background levels of asbestos.” The plaintiff was in Hong Kong from 1971 to 1984. Epidemics from previous exposure to commercial forms of asbestos have occurred in Hong Kong, so Dr. Attanoos took this into consideration in formulating his opinion. This is further explored later in the trial though not in this clip. The testimony then addressed the finding of anthracosis in a mediastinal lymph node of the plaintiff and what that might imply. Anthracosis is also known as “black lung” and is found in coal miners due to their breathing in of black coal dust. This finding in a non-coal worker is indicative of exposure to substantial urban pollution and is commonly seen in older individuals after an accumulation of pollution products within the lungs over a long lifetime. Seeing this in a 45 year old woman is unusual and indicates exposure to a significant amount of urban pollution which was taken into her lungs. The implication is that the plaintiff, in addition to not fitting into the timeframe for latency from exposure, had been chronically exposed to other substantial lung toxins. The testimony was authoritative, simply explained, and convincing. The jury ruled for the defense. -- Gary Gansar, MD, is residency trained and Board Certified in General Surgery. He previously served as Chief of Surgery and Staff at Elmwood Medical Center and on the Medical Executive Committee at Mercy Hospital and Touro Infirmary in New Orleans, LA. Dr. Gansar also served as Clinical Instructor and Professor of Surgery at Tulane University. He received his MD and served as Chief Resident at Tulane University Medical School. Dr. Gansar joined AMFS as a consulting medical expert in 2011 and has served as Medical Director since Nov. 2015. In this capacity, Dr. Gansar provides consultation, review and guidance to attorney clients.