Charles and Patricia Crawford October 20
The medical literature often repeats the statistic that 80% of all mesotheliomas
diagnosed in the U.S. are caused by asbestos. The other 20%? It's
not clear. Literally. The fancy word the researchers use to describe this
lot is "idiopathic," which translates roughly as "unknown
What if the patient doesn't know if he or she was exposed? What if
although the patient doesn't know, it turns out he or she was exposed?
Would the cause of the latter's mesothelioma still be "unknown?"
The clinical data regarding exposure usually arises from a brief interview
between the doctor and the patient. A doctor will ask a patient if he
or she was exposed and whatever answer the latter gives is usually the
end of the story. This is understandable. The doctor has a lot of ground
to cover in a short amount time, such as the patient's medical history,
diagnosis, staging, performance status and treatment options. As a reference
point, consider that in litigation defense lawyers can spend up to two
to three weeks interrogating the patient about his or her asbestos exposure history.
The simple truth is many patients don't know about their asbestos exposure
because many of the companies who put asbestos in their products didn't
tell anyone. The manufacturers did not put warnings on their boxes and
bags. Nor did they disclose on the packaging that "asbestos"
was used as an ingredient.
Asbestos fibers were incorporated in over 5,000 products in the US prior
to 1980, but only a handful of manufacturers disclosed that fact, and
not a single manufacture warned that even tiny exposures could cause mesothelioma.
It's not surprising then that a mesothelioma patient in a 40 minute
medical consultation would be hard pressed to inventory all of his or
her asbestos exposures over the past 25 to 50 years.
The consequences of a company failing to warn or disclose was illustrated
in a recent case filed in Los Angeles. Along with co-counsel, we represent
Patricia Crawford, a 72 year old widow who resides in Fontana, California.
Patricia was diagnosed with pleural mesothelioma in September, 2007. She
met with thoracic surgeon Dr. Robert Cameron on October 2, 2007. Patricia
worked for a brief time at a steel mill as a bookkeeper. When Dr. Cameron
asked her about her asbestos exposure, she answered that she had worked
at the steel mill, although she didn't work with any asbestos products.
She didn't talk about her use of joint compounds on home repair and
remodel projects back in the 1960s and 1970s. The thought did not occur
to her at the time that the joint compounds contained asbestos.
When we met with Patricia and her husband Chuck at their home in Fontana
about a month after Patricia's diagnosis, we asked whether they had
ever remodeled their home or repaired cracks or holes in the walls. When
they informed us that they had, we asked if they could recall any of the
brand names of drywall products that they used.
What's Lurking in Your Garage?
Chuck answered by offering to show us a sample of the very same joint compound
he used over thirty years ago. Chuck escorted us out to his garage, which
was cluttered with the usual stuff an active family collects over several
decades. He pulled down from a high shelf a box of Joint Filler. We knew
from legal discovery that the manufacturer of this drywall product had
admitted to using asbestos in the product until 1975, but the disclosure
was not printed on the box.
Charles and Patricia Crawford
We retrieved the box and sent it to a laboratory for asbestos content testing.
The laboratory found asbestos. Unfortunately, Chuck passed away four months
later from a long-standing respiratory illness. He died before he was
able to testify about his use of the joint filler in Patricia's presence.
The manufacturer of the joint compound defended the case by attempting
to pin the blame on Patricia's work at the Steel Mill, where, again,
she worked inside an office as a bookkeeper. The manufacturer was unable
to produce a witness who could testify that Patricia did, in fact, work
with or around asbestos dust at the mill. On the other hand, Patricia
had testified in her deposition that she assisted her husband with the
joint filler on home remodeling and repair projects and, in so doing,
inhaled dust that was generated during the mixing, sanding and clean up.
Why in the World Would They Put Toxic Asbestos in Drywall Paste?
The case eventually settled a few days into trial. Patricia is relieved
that her case has resolved, but continues to be troubled about the circumstances
of her exposure. She learned during the lawsuit that asbestos was not
even a necessary ingredient in the joint fillers she used. Asbestos wasn't
used because of its insulation properties. It was used mainly because
it was cheaper than other binding agents.
Patricia shudders to think about the millions of other housewives out there
who, like her, were exposed to dust from joint compounds used around the
home. The products were marketed as easy to use by housewives, but the
containers never warned that even casual use could decades later result
in cancer or mesothelioma. "I never saw skull and crossbones,"
Patrica reflects wearily. "I never saw the words 'cancer'
or 'mesothelioma'. I never even saw the word 'asbestos.'"
"We were conservative people. We saved everything, especially if there
was a chance we'd need it again. How many other families, just like
ours, kept old bags of joint compounds?" The spector of continued
deadly exposures worries Patricia. "How many families are continuing
to use joint compounds today that were bought decades ago that have asbestos
in them, without anybody knowing?"
"How many people have already died from this? How many other housewives
are out there with asbestos fibers in their lungs from using these joint
fillers? My children used them too. By the time the poisoning turns into
cancer, it's usually too late."
Dr. Cameron: "
Patricia is thankful that she found Dr. Cameron. "He has been a blessing."
When Patricia was initially diagnosed by doctors at Kaiser Permanente,
they tried to steer her into having her lung removed using the radical
lung-amputating extra-pleural pnuemonectomy (EPP). She was not made aware of the lung-sparing pleurectomy-decortication (P/D) surgery and probably would've consented. But, thanks to the diligence
and curiosity of her children, who logged onto the internet and discovered
Dr. Robert Cameron, she sought a second opinion.
Undaunted by the lack of a formal referral from Kaiser Permanente, Patricia
set up an appointment with Dr. Cameron. She knew that Kaiser's vast
bureaucracy would either delay or reject the referral, but time was short.
She decided to pay for the consultation herself and worry about coverage later.
Dr. Cameron talked with her extensively about her surgical options. He
explained the differences between the EPP, which removed the lung, and
the P/D, which spared the lung. He explained to her that the P/D provided
the same tumor clearance as the EPP with a lower risk of mortality. He
also explained to her the adjuvant use of radiation as well as immunotherapy
and chemotherapy. Patricia ultimately chose to undergo the pleurectomy/decortication
at UCLA on January 10, 2008. The doctors at Kaiser, who recommended the
EPP, had not even mentioned the PD as an option.
After Surgery and Radiation, Now considering Interferon
After her full recovery, Patricia began radiation therapy with Dr. Michael
Selch at UCLA in February. Her last of a total of 25 radiation treatments
was performed in April, 2008. Patricia is still under Dr. Cameron's
care and is scheduled to see him in January. She always looks forward
to seeing Dr. Cameron because not only is he brilliant but he "tickles
the wits out of me."
Patricia is currently considering interferon injections. She's even
consulted with a diabetes healthcare provider to learn how to self-inject
if she were to administer her interferon injections. Patricia is aware
that interferon injections need to be taken for the rest of her life and
is a little weary about "rocking the boat" too much at her age.
She's been through a lot this past year and has recovered beautifully.
Her pain is gradually subsiding, her appetite is strong and she enjoys
exercise. She goes out for a walk everyday and tries to push herself a
bit further every time even when she gets out of breath.
It Takes A Team
On the litigation front, Patricia couldn't be more pleased at how her
case turned out. She jokes that her two dynamic trial attorneys, Chris
Panatier and Stuart Purdy, were younger than her grandkids, but wise beyond
their years. She's at a loss of words to express how grateful she
is when it comes to the excellent representation she received. "I
didn't have the vaguest clue where to start after I was diagnosed.
I've been treated so well by everyone that's it been a pleasure."
During her trial testimony, Patricia was fortunate enough to always be
surrounded by friends and family. Two car loads of people joined her in
her daily trips to the courthouse in downtown Los Angeles. She also appreciated
the information she learned from expert witnesses, Dr. Brody and Dr. Holstein.
"I learned more about mesothelioma than I ever wanted to learn. It
was fascinating but sad, too."
These days Patricia has a lot to live for. She keeps reaching many milestones
in her family that she didn't think were possible after she was diagnosed.
Already, she's been to one grandson's wedding and witnessed the
births of two great-grandchildren. There's another grandson's
wedding in April and "I've gotta be there for that." In
a few months, Patricia is taking a cruise to Hawaii with her best friends
and her family is encouraging her to take many more trips. In the meantime,
she's immersed in many household projects and chores.
Tragically, it's been nine months since Chuck, her husband of 42 years,
passed away. She's thankful of the life they had together and has
no regrets but, of course, she wishes that they had had a lmore time together.
Recently, one of Patricia's projects included cleaning out her garage.
She admits to "a creepy feeling" every time she steps into her
garage and reflects on the fact that they had been unwittingly storing
a toxic cancer- causing poison for all those years.
In some ways, Patricia's exposure is unremarkable. Millions of Americans
were exposed in a similar way - mixing, applying, sanding and cleaning
up after the use of household joint fillers and drywall compounds. The
question lingers - how many other garages out there have boxes of asbestos
containing joint compounds in them? How many families continue to use
and inhale its toxic dust? Who would ever think to have those old boxes
tested for asbestos content? How many more consumers have been both deceived
and poisoned by this pernicious product?
*** POSTED NOVEMBER 20, 2008 ***
An Update -- 3/2/2010
Patricia is tackling one thing after another on her “to-do list”.
She recently oversaw her kitchen remodel and next plans to have new carpeting
installed in her living room. She appreciates her ability to undertake
projects that directly impact her quality of life, even when simply relaxing at home.
When she is not enjoying her updated home, she is jet-setting from one
state to another visiting her growing family across the U.S. Her whole
family is constantly vying for her company, “They’re hard
to keep up with, but even harder saying ‘no’ to!” When
not busy with family, Patricia also maintains close friendships. She regularly
attends plays and movies with her friends and is looking forward to a
“fall foliage tour” in Amish Country, Pennsylvania in October.
On the treatment front, Patricia recently had four cryoablation treatments
with Dr. Fereidoun Abtin of UCLA in January. She has three more treatments
scheduled this month. She adores Dr. Abtin and his “wonderful sense
of humor”. According to her, the hardest part about undergoing cryoablation
is lying motionless for hours, however Dr. Abtin seems to make this more
Patricia continues to defy the odds of her condition. “It takes me
longer to do the things I want to do, but I am doing very well”.
Since her neighborhood is not very walking-friendly, lately Patricia has
been building strength and balance with her new Wii Fit. Recently when
one of her grandchildren had a go-cart racing birthday, Patricia momentarily
considered partaking in the fun but in the end decided her knees would
feel too cramped in a little go-cart. As she longingly watched from the
sidelines, she promised not to deny herself next time and that her grandkids
better watch out for her notorious “lead foot”!
An Update -- 5/15/2012
On May 12, 2012, Patricia spoke at the at the 2nd International Symposium
on Lung-Sparing Therapies for Malignant Mesothelioma in Santa Monica,
California. The symposium, which featured an international panel of medical
specialists as well as a number of advocates, patients and family members,
focused on lung-sparing treatment options for patients with malignant
Patricia had undergone a lung-sparing pleurectomy/decortication (P/D) surgery
in January of 2008 performed by the symposium chair, thoracic surgeon
Dr. Robert Cameron. On the eve of the fifth anniversary of her diagnosis with pleural mesothelioma,
Patricia was invited to provide the “Patient’s Perspective”
on lung-sparing therapies.
Her initial doctors wanted to remove her lung and told her to go home and
get her affairs in order; they told her that she had a year to live. Her
children did some research and found Dr. Cameron online, and his alternative
treatment options ultimately saved her life.
Patricia has had over 36 cryoblation procedures performed since then.
Cryoablation is a minimally invasive procedure using controlled freezing to dissipate
small tumors in a relatively safe and quick manner. With the use of a
large needle, compressed argon gas is applied to the targeted tissue,
killing the cells it touches.
Patricia says, “if it wasn’t for Dr. Cameron, I would have
missed the last four or five great grandkids and at least four weddings”.
From her seven children she now has twenty grandkids and sixteen great
grandkids, and they don’t give her much slack. She had an ablation
performed right before this past New Year’s Eve and still went to
her daughter’s for a party! Her family has been very supportive;
they always give her something to look forward to and keep her laughing.
Patricia enjoys quilting with her daughter, gardening, traveling to visit
her growing family and is looking forward to an upcoming Mississippi River cruise.
She is not going to give up. “As long as Dr. Cameron and Dr. Abtin
stick by me, I will keep giving it all that I have.”
*** Patricia Crawford passed away on November 10, 2013 ***