Phony medical testimony, or phony news article?

Re Reading X-Rays in Asbestos Suits Enriched Doctor, by Jonathan D. Glater, New York Times, November 29, 2005:

Most readers of this front-page story would conclude that its subject, Dr. Ray A. Harron, 73, a graduate of New York Medical College who practiced as a radiologist for more than 30 years, is a crook. The indications are damning:

About a decade ago, Dr. Harron gradually stopped seeing patients and instead adopted what turned out to be a much more lucrative practice: reading X-rays full time. He 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.

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.

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.

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.

[Edited excerpt.]

OK, I'm ready to toss Harron into the slammer.

Besides selling phony medical advice for big bucks, Harron seems to be more or less a murderer:

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.

So it's fair to say jail is too good for Harron. He should be fried.

Oh, there's just one thing:

Dr. Harron has not been formally accused of wrongdoing.

"Formally." That's just an annoying legal quibble, isn't it? The system of safeguarding criminals' "rights" run amok. There isn't really any reason to delay sending him to the chair, is there?

It's just that.... Well, the victims here are generally corporations. They are the defendants who've apparently been swindled out of $49 billion, thanks to phony reports by Harron and his ilk.

One has to wonder — why did they just roll over and take their lumps for so many years?

Anyone can understand how you go about buying false testimony: You go on a drunken thrill-ride and knock down a lamppost. A cop appears, and you're given a breathalyzer test. The test shows you're zonked. So you pay the cop to testify that the test showed you hadn't touched a drop.

But how do you do that if the prosecution has an exact, authentic record of the result of that same breathalyzer test??

That is the analogy here. Harron's purportedly false testimony concerned X-rays which opposing legal counsel presumably had full access to. Those opponents had to have their own medical experts scrutinizing the same X-rays Harron was testifying about. How could Harron's diagnoses be "manufactured for money," as stated by a judge's finding that the article quotes?

How do you lie, with great frequency, for years and years, about things that are on record?

This question has not occurred to the New York Times.

There is only one way to make sense of this. It's weird, but the Times reader has to posit that analyzing X-rays is so much an inexact science that a radiologist can tell bald lies, over and over, with impunity — and if anyone calls him a liar, the following response is guaranteed to work: "Hey. Inexact science. Back off."

Where is radiology school? This is really too easy. A radiology certificate seems to be a license to print money. Small wonder one of the lawyers quoted in the article remarks, "There are a lot of other Ray Harrons out there."

What about the judge's finding that Harron " 'failed to write, read, or personally sign' reports supporting 6,350 claims by people saying they had inhaled silica"?

This is amplified later in the article. The judge "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."

What's going on here? Does a radiology certificate give you total freedom to perpetrate fraud on the courts? Is a radiologist's signature inexact science too?

How is it explicable that "Dr. Harron has not been formally accused of wrongdoing"?!

Silence from the Times.

The article mentioned that doctors like Harron in the court process "are less often maligned than the lawyers who hire them." Translation: While a lawyer won't shock anyone by saying opposing counsel are a bunch of lying bastards (which is already the default operating assumption about lawyers), one is constrained to treat the opposition's medical experts more tenderly.

Still, though. If you were a corporate lawyer, wouldn't you take a hard look at the enemy's medical experts? Track them in a database? Analyze their testimony? Challenge suspicious patterns or inconsistencies?

Before accumulating $49 billion in losses?

Might you not have discovered, and discreetly mentioned to the court, that your worthy opponent's expert witness analyzes 150 X-rays daily at $125 each? Wouldn't you let the judge know that his X-ray reports have supported 75,000 other claims? And wouldn't you share with the judge your fear that — although you have enormous respect for the medical profession and the extremely important work they do blah blah blah — it's conceivable that this particular expert's judgment is not rigorously neutral?

And if you didn't — wouldn't you be ripe for a malpractice suit yourself?

But none of these questions ever struck the Times.

And why isn't even one of these victimized corporations named?

Who paid for this article?

Litigation lawyers support the Democrats. Are the Republicans behind this?

Whether or not Harron himself is a crook, are there really a lot of crooked doctors supporting phony court claims? Is this article conveying a balanced view of asbestos litigation?

As long as we're reconsidering our position, let's re-think that murder of Harron's. He spotted cancer on an X-ray; never told the patient; the cancer went undiagnosed for a year; it then killed the patient, who no doubt would otherwise have lived many more years. The old lady naturally sued Harron. Yeah, this "gives some idea of the nature of Dr. Harron's work," like the article says.

But as the article also reports, the suit against Harron failed because "[t]he 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."

Harron was paid by a law firm to analyze the man's X-rays, among others. He detected and reported the cancer to the firm.

Harron had never met the man. Should he have independently sought to contact him? Would it have been unreasonable of him to assume the law firm would do so? Did he violate medical ethics in any way?

The Times is silent on these questions. But if Harron is totally free of guilt in this matter, then his reputation has been unjustly harmed through the Times's powerful influence.

Towards the end of the article, a further blow is delivered against Harron, as the Times tells of a judge's "disturbing" finding:

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. The doctor's diagnoses supported thousands of claims filed against companies that manufactured or used silica.

Judge Jack wrote: "When Dr. Harron first examined 1,807 plaintiffs' X-rays for asbestos litigation, 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.

[Edited excerpt.]

Surely that clinches it. Doesn't it?

Actually, no. Thank goodness we don't have mob rule, that guilt isn't decided by the New York Times, that people like Harron do have those "rights," and that they can get a full hearing, if charged, and respond to allegations. (So long, of course, as they're not "enemy combatants.")

Harron may well be guilty here, but the above passage is thoroughly ambiguous. As far as the Times reader knows, it is consistent with, for example, this scenario:

A law firm had Harron analyze 75,000 X-rays for asbestosis. Obviously, for efficiency, one tends to standardize the procedure when faced with such a massive task. Harron's task was, for each X-ray, to produce either a positive or negative finding of asbestosis and nothing else. That was his job. He was working for a law firm conducting a class action lawsuit for asbestosis. In focussing for efficiency on only asbestosis, he was not in breach of any legal or ethical codes.

He came to a positive finding for, let us say, 15,000 of the 75,000 X-rays.

A few years later, a case for silicosis emerged, and the same firm had Harron examine another batch of 75,000 X-rays, but for silicosis this time. He found 10,000 positives for silicosis.

Among the 10,000 people found to have silicosis, there were 1,807 who'd also been among the 15,000 previously found to have asbestosis.

In this scenario, Harron is guilty of nothing.