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Ear to the Ground

Johns Hopkins Suspends Black Lung Program Over ‘National Disgrace’

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Posted on Nov 5, 2013
Big Ed's Photos (CC BY-NC-ND 2.0)

The Coal Miners’ Memorial in Richlands, Virginia.

Johns Hopkins University, one of the nation’s premier research institutions for teaching medicine, has suspended its black lung program for a review after a series of investigative reports by the Center for Public Integrity and ABC News uncovered strong evidence that a single doctor has been gaming the system for years at the expense of ailing coal miners, and to the benefit of coal companies.

The series focuses on Dr. Paul Wheeler, in charge of the Johns Hopkins unit in which coal miners’ X-rays are analyzed to determine whether the workers qualify for disability benefits covering black lung disease. Wheeler told reporters that he was the “go-to” doctor for the coal companies—and with good reason. According to the series:

In the more than 1,500 cases decided since 2000 in which Wheeler read at least one X-ray, he never once found the severe form of the disease, complicated coal workers’ pneumoconiosis. Other doctors looking at the same X-rays found this advanced stage of the disease in 390 of these cases.

Since 2000, miners have lost more than 800 cases after doctors saw black lung on an X-ray but Wheeler read the film as negative, diagnoses he continues to defend. This includes 160 cases in which doctors found the complicated form of the disease. When Wheeler weighed in, miners lost nearly 70 percent of the time before administrative law judges. The Labor Department does not have statistics on miners’ win percentage in all cases at this stage for comparison purposes.

Where other doctors saw black lung, Wheeler often saw evidence of another disease, most commonly tuberculosis or histoplasmosis — an illness caused by a fungus in bird and bat droppings. This was particularly true in cases involving the most serious form of the disease. In two-thirds of cases in which other doctors found complicated black lung, Wheeler attributed the masses in miners’ lungs to TB, the fungal infection or a similar disease.

The criteria Wheeler applies when reading X-rays are at odds with positions taken by government research agencies, textbooks, peer-reviewed scientific literature and the opinions of many doctors who specialize in detecting the disease, including the chair of the American College of Radiology’s task force on black lung.

Biopsies or autopsies repeatedly have proven Wheeler wrong. Though Wheeler suggests miners undergo biopsies — surgical procedures to remove a piece of the lung for examination — to prove their cases, such evidence is not required by law, is not considered necessary in most cases and can be medically risky. Still, in more than 100 cases decided since 2000 in which Wheeler offered negative readings, biopsies or autopsies provided undisputed evidence of black lung.

The revelations sparked a backlash from such political figures as Democratic West Virginia Sen. Jay Rockefeller, who called the conditions “a national disgrace.” His Democratic Senate colleague, Robert P. Casey of Pennsylvania, vowed to push legislation to try to revise the system and offer more safeguards to ailing coal miners.

The report also drew a scathing response from the United Mine Workers of America. “Whatever penalties or punitive actions that can be taken with respect to Dr. Wheeler should be,” union spokesman Phil Smith told ABC News and the Center for Public Integrity. “But whatever they are, they will pale in comparison to the pain and suffering he has caused thousands of afflicted miners. There is no penalty which will make up for that.”

—Posted by Scott Martelle.

 

 

 

 

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