1 Exhibit A Kane Legal Mesothelioma Handbook Volume No. 1 David Kane, R.Ph., J.D. Professor of Pharmacy Law, Rutgers University Table of Contents Section 1 History of Asbestos...2 Section 2 - What is Mesothelioma?...3 Section 3 - Mesothelioma Symptoms...4 Section 4 - Diagnosis...6 Section 5 - Staging...7 Section 6: Mesothelioma Treatment...9 A. Chemotherapy...9 B. Radiation Therapy C. Treatment by Stage Section 7 - Sources of Airborne Asbestos Section 8 - Your Attorney Section 9 - Mesothelioma Lawsuits Section 10 - Cases Assessment... 17
2 Section 1 History of Asbestos Asbestos has been mined and used commercially since the late 19 th century, but before the risks associated with asbestos were publically known. In the late 1800s, the Chief Inspector of Factories of the United Kingdom informed Parliament about possible health dangers to factory workers associated with asbestos dust. In 1906, a British Parliamentary Commission confirmed the first cases of asbestos deaths in factories in Britain and recommended better ventilation and safety measures. It was not until 1918 that a United States insurance company first published a study showing a significant number of premature deaths among workers in the asbestos industry. Shortly thereafter, life insurance companies began to refuse to issue policies to asbestos workers. Then, in 1926, the Massachusetts Industrial Accidents Board processed the first successful compensation claim by a sick asbestos worker, which was eventually settled without a trial. The first medical survey of asbestos workers was published in 1930 by researchers Merewether and Prince, publicizing that one in every four asbestos workers suffered from asbestosis. The researchers also revealed that asbestosis has a decades-long latency period and that asbestos dust could be controlled through proper ventilation and the use of respirators. In 1942, Dr. Heuper, the first chief of the environmental cancer section of the National Cancer Institute, suggested that asbestos caused a cancer risk for those in all lines of production and installation of asbestos based products. The following year, the first case of an asbestos-linked mesothelial tumor was reported. Nevertheless, use of asbestos increased dramatically during World War II and many people who served as shipyard workers during the war have manifested signs of mesothelioma and asbestosis. By 1949, over two hundred published references of asbestos-related disease were available to the public, including a warning by Dr. Heuper that asbestos causes a cancer risk to the general population. The 1949 edition of Encyclopedia Britannica also made note that asbestos poses a risk of occupational and environmental cancer. A major epidemiological study conducted in 1955 concluded that asbestos workers faced a risk of developing lung cancer tenfold that of the general population. A subsequent epidemiological study in 1960 confirmed that asbestos exposure causes malignant mesothelioma. The study also suggested that those who live with asbestos workers - namely their wives and children - are also at a higher risk of developing mesothelioma due to second-hand exposure to asbestos dust. In the mid-1960s, a major researcher at New York's Mt. Sinai Hospital released a report on the occupational safety hazards of asbestos. Medical and trade literature continued to describe asbestos as a dangerous occupational and environmental hazard. Notwithstanding such public knowledge, asbestos was still commonly used as a building material well into the 1980s. Asbestos attorneys help those who were unknowingly put at risk In Part I of The History of Mesothelioma, the asbestos attorneys at Kane Legal showed how even up through the 1930s there was confusion as to the exact role asbestos played in the mounting cases of lung cancer being discovered in British factory workers.
3 At that time, there were no asbestos attorneys, and no one knew much about mesothelioma, a cancer that attacks primarily the lungs but that also can harm the lining around the heart and the abdomen. Although few facts were known, many suspected that the rash of new lung cancer cases was caused primarily by exposure to asbestos. Doctors and lawyers in modern times have clear-cut data to show that asbestos is, in fact, the only known cause of what today is called mesothelioma. South African cases Asbestos mining was a booming industry in South Africa after World War II. Several decades earlier, a medical researcher in that country found that asbestos could be harmful, but he believed the main risk lay in the processing of the substance, not in mining it. Backed by stacks of medical research, asbestos attorneys today realize that not only processing asbestos but also mining it and even coming into contact with it by secondhand means can lead to the disease mesothelioma. A hospital that treated chest and infectious diseases was built in South Africa in Physicians began to see large numbers of patients with asbestos-related cancer. In the mid-1950s, a study was launched to identify the relationship between asbestos mining and the occupational hazards associated with it. By the dawn of the 1960s, based upon the work of several researchers, it became clear that asbestos exposure was the cause of mesothelioma. A qualified asbestos attorney supports mesothelioma victims by helping to identify the party or parties responsible for the disease. Knowing that in all cases mesothelioma results from exposure to asbestos, attorneys use past employment records, medical histories and other data to determine the most effective method of gaining just compensation for their clients. Section 2 - What is Mesothelioma? Mesothelioma is a form of cancer that affects the mesothelium, which is the protective sac or lining around the body's vital organs. Mesothelioma mostly affects the lining of the lungs, heart, or abdominal organs. According to the American Cancer Society, approximately 2,000-3,000 new cases of Mesothelioma are diagnosed in the United States each year. The survival time for those who suffer from Mesothelioma is generally low after the onset of symptoms. The survival time is estimated at approximately 1-2 years. Three types of mesothelioma exist: pleural, peritoneal, and pericardial mesothelioma. Pleural mesothelioma originates in the chest cavity, affecting the lining of the heart and the lungs. Peritoneal mesothelioma initiates in the abdominal cavity, where the liver, stomach, pancreas, and intestines lie. Pericardial mesothelioma is a cancer of the lining around the heart and is extremely rare.
4 Exposure to asbestos is the primary cause of mesothelioma. Mesothelioma and Asbestos According to the National Cancer Institute, the primary risk factor for mesothelioma is exposure to asbestos. Those people who work with or near asbestos, such as construction workers or factory workers, are the most susceptible to mesothelioma. When individuals inhale asbestos fibers, the fibers may damage the cell lining of the lungs, which may lead to pleural mesothelioma. Malignant tumors may form on the pleura, which is the sac or thin layer of tissue that lines the chest cavity and protects the lungs. Asbestos fibers that are swallowed may also affect the lining of the abdominal cavity, which may cause peritoneal mesothelioma. How Does Asbestos Cause Mesothelioma? Following asbestos phagocytosis, macrophages generate increased amounts of free radicals, which are prone to cause damage to virtually any type of large molecules in the body, including breakage of chromosomes which may lead to cancer. Some research has indicated that asbestos fibers may have an adverse impact on DNA. Such research has shown that phagocytosed asbestos fibers can adhere to or become entangled within chromosomes, which is likely to cause abnormalities in DNA structure. The most common abnormality is the presence of only one copy of chromosome 22 instead of the chromosome existing as a pair (monosomy), which is common in cancerous cells. More specifically, malignant mesothelial cells tend to display a deletion of tumor suppressor genes, thus increasing the probability that cancerous tumors will form. Have You Been Diagnosed with Mesothelioma? If you would like to speak to a professional regarding your rights after having been diagnosed with asbestos-related mesothelioma, please fill out the short form below and an experienced member of Kane Legal's staff will contact you. Initial consultations are free of charge and do not create an attorneyclient relationship. Kane Legal maintains offices in New York, New Jersey and Florida and its attorneys are available to practice throughout the country. Section 3 - Mesothelioma Symptoms It may take as long as years after exposure to asbestos before the onset of mesothelioma symptoms and malignant tumors develop. Mesothelioma is difficult to diagnose early on as symptoms may be similar to other health problems. Mesothelioma may cause fluid to collect around the lungs or the abdomen, which may be the cause of some side effects including breathing problems and abdominal pain. Some early symptoms of mesothelioma may include shortness of breath, persistent cough, difficulty breathing, lumps in the abdomen, abdominal swelling, and chest and abdominal pain. Symptoms may vary between pleural mesothelioma, which affects the lungs, and peritoneal mesothelioma, which affects the abdominal organs.
5 How Does Asbestos Enter the Body? Asbestos is a fibrous substance that can be separated into threads and woven to form a variety of materials that have been used in the construction trades. Although asbestos fibers are known for their durability in resistance to heat, water and many chemical reactions, when disturbed the fibers easily crumble. Eventually, the fibers may fracture into microscopic particles that may become airborne and inhaled. Asbestos fibers can also be ingested, thereby setting the stage for peritoneal mesothelioma after working themselves from the intestinal tract to the abdominal cavity. Asbestos fibers act differently in the body once they are inhaled than other inhaled substances. Generally, particles between.5 and 5 microns in diameter are capable of being deposited in the respiratory regions of the body. However, asbestos fibers up to 10 microns in diameter are able to make their way to the lower regions of the lungs, where they can cause serious damage to lung tissue. Once the fibers reach the lungs, small fibers are engulfed (phagocytosed) by special cells in the lung tissue called macrophages, which digest as much of the fibers as possible and transport remaining fibrous debris to the lymphatic system. The lymphatic system, via the lymph nodes, then acts to filter the foreign material out of the body. Even so, macrophages may be unable to engulf larger asbestos fibers, leaving them embedded in lung tissue. The embedded fibers are known to settle in a distinct configuration shaped like a drumstick, known as a "ferruginous body" or "asbestos body." It is speculated that these fibers can split and break into smaller particles that may migrate to the lining of the lungs and the peritoneal cavity. Symptoms of Pleural Mesothelioma Shortness of breath, cough, and pain in the chest due to ascites (an accumulation of fluid) in the pleural space (the area lining the lungs) are common symptoms of pleural mesothelioma. A malignant tumor of the mesothelial tissue of the pleural cavity is a marked sign of mesothelioma. In late stages of pleural mesothelioma, the patient may suffer a collapsed lung due to an abnormal accumulation of air or gas in the pleural cavity, known as a pneumothorax. Symptoms of Peritoneal Mesothelioma Peritoneal mesothelioma (cancer of the exterior abdominal lining) is a rare form of mesothelioma. Only one-fifth to one-third of all mesotheliomas affect the peritoneum. Like pleural mesothelioma, a malignant tumor of the abdominal lining is a marked sign of mesothelioma. Peritoneal mesothelioma ordinarily does not cause symptoms until the cancer has reached a late stage. Symptoms of peritoneal mesothelioma include fever, cachexia (weight loss, general muscle atrophy and malnutrition), abdominal swelling and pain due to ascites in the abdominal cavity, bowel obstructions, low blood sugar, jaundice, pleural effusion (discharge of fluid from the blood or lymph into a pleural cavity), blood clots (including pulmonary emboli), severe ascites, anemia, trouble swallowing, and swelling of the neck or face.
6 Section 4 - Diagnosis Initial Physical Examination If an individual experiences any of the marked symptoms of mesothelioma, he or she should consult a medical doctor as soon as possible for a medical examination. The physical examination should focus primarily on the patient's lungs and abdomen. The physician should especially be alerted by a buildup of fluid in the chest or abdominal areas, as this is a common symptom of mesothelioma. Additionally, doctors should pay close attention to the sound of a patient's lungs upon inhalation, as the lungs tend to exhibit a specific crackling sound when mesothelioma is present. Diagnostic Tests If a doctor suspects a patient may have mesothelioma, he will suggest that a lineage of diagnostic tests be performed. Such testing includes imaging tests, blood and fluid tests, and possibly tissue sampling. Doctors will draw blood from a patient if they suspect the patient may have mesothelioma. The doctor will have the patient's blood tested for the existence of a protein called osteopontin. An elevated level of osetopontin cannot rule out the possibility of other adverse health conditions, but it should definitely raise a doctor's suspicion that mesothelioma may be present and prompt him to run further diagnostic tests on the patient. Imaging tests may help determine the location, size, and extent of malignant mesothelioma. A chest x- ray may show irregular thickening of the lining of the lungs, calcium deposits on the lining, or fluid in the chest cavity. A computed tomography (CT) scan may also be performed, as it has proved useful in the initial diagnosis of mesothelioma and in determining the stage a patient's cancer has reached. Using a procedure much like an x-ray machine able to circle one's body, a CT scan produces an image showing a detailed crosssection of a specific region of a patient's body. In order to get the most detailed image of an affected region of a patient's body, a CT scan may be performed a second time with the additional use of a radiocontrast agent. A radiocontrast agent is a non-harmful radioactive substance that is injected intravenously into a patient or consumed in liquid form, and acts as a short-lived dye within the body, outlining and highlighting internal structures on the resulting CT image. Another imaging technique commonly performed to aid in the diagnosis of mesothelioma is a magnetic resonance imaging (MRI) scan. An MRI produces a more detailed cross-sectional image of the body than a CT scan, and can also produce parallel images of the length of the body. The image is created through the use of a computer that can translate the radio waves that are given off by the tissues of the body into detailed images of the body and its internal components. An additional imaging test is based on the fact that cancer cells utilize sugar much more quickly than normal, healthy cells. In a positron emission tomography (PET) scan, a patient is injected with a radioactive sugar solution, which any present cancerous tissue is then likely to absorb. When the PET
7 scan of the body is performed, the radioactive deposits can be seen, thus allowing doctors to determine whether once questionable tissue is cancerous or merely scar tissue. PET scans are also shown to be helpful in spotting the spread of malignant mesothelioma. A doctor may also run fluid tests on patients who suffer from ascites (a buildup of fluid in the abdominal cavity) or a pleural effusion (fluid in the chest cavity). After the doctor removes the fluid by inserting a needle into the chest or abdominal cavity, the fluid will be viewed under a microscope to determine whether cancer cells are present. If cancer cells can be seen, further testing must be implemented in order to conclude that the cancer is mesothelioma or a different form of cancer. When an imaging test or a physical examination raises the concern that a tumor has developed, a biopsy may be conducted in order to test the actual tissue in question. A tissue sample may be obtained in a number of ways, which depend upon the amount of tissue doctors need to remove. If a relatively small tissue sample must be removed, doctors can carry out the procedure by making a small incision in the patient's chest (during a thoracoscopy) or abdomen (laparoscopy). A flexible tube that is connected to a video camera is then inserted into the incision, allowing doctors to precisely locate the tissue that is to be obtained. The tissue is then removed with special forceps and will be tested by a pathologist to determine if it is cancerous. If tumors are thought to be located along the patient's airway, a bronchoscopy may be ordered. During a bronchoscopy, a doctor will insert a flexible viewing tube down the patient's airway through the mouth. Once again, the camera attached to the tube will allow the doctor to seek out irregular tissue, remove it, and send it to a pathology laboratory for testing. Additionally, if a doctor would like to determine whether a cancer has started to metastasize or needs to distinguish lung cancer from mesothelioma, he may call for a mediastinoscopy. During this procedure, a viewing tube is inserted through an incision under the sternum, allowing the doctor to view and remove lymph nodes in the chest. More invasive surgery is typically required to remove larger tissue samples or the tumor itself. In such cases, either a thoracotomy (which opens the chest cavity) or a laparotomy (which opens the abdominal cavity) will be suggested. Section 5 - Staging Mesothelioma Staging Treatment and outlook for a patient with mesothelioma depends a great deal upon the stage (extent) of the patient's cancer. Three staging systems exist for mesothelioma, but the American Cancer Society, the American Joint Committee on Cancer, and the International Mesothelioma Interest Group have endorsed the TNM
8 System, which considers variables of tumor mass and spread, as well as lymph node involvement and metastasis. The Butchart System and the Brigham System, on the other hand, narrowly focus on tumor mass and the ability to surgically remove the mesothelioma tumor. The TNM Staging System The TNM Staging System is similar to those used for most other cancers. TNM is an acronym, where T stands for the size of a tumor, N stands for spread to the lymph nodes, and M refers to metastasiswhether the cancer has spread to distant organs. Each of the three categories involves four stages, which are then grouped together to determine an overall stage for a case of mesothelioma (stage grouping). Stage 1 mesothelioma involves localized cancer in either the left or right pleura lining the chest. If the cancer has spread, at this stage it may only have reached a few small areas of the outer lining of the lung. Mesothelioma may not be found in the lymph nodes or other areas of the pleural or peritoneal cavities at this stage. If the patient's pleural mesothelioma has spread from the pleural lining of the chest into the outer lining of the lungs, the diaphragm or the lungs, the cancer will be categorized as Stage II mesothelioma. However, at this stage, the cancer still has not spread to the lymph nodes or distant sites. Once pleural mesothelioma has reached the lymph nodes of the chest on the same side as the pleural tumor, it will be considered Stage III mesothelioma. Mesothelioma will also be categorized as Stage III if the pleural mesothelioma has spread into the first layer of the chest wall or a single place within the chest wall, the fatty part of the mediastinum (the area between the pleural cavity, containing the esophagus, trachea, and thymus), or the outer layer of the heart. Pleural mesothelioma reaches Stage IV when the cancer has spread into the chest wall and muscle or ribs, through the diaphragm, into any organ of the mediastinum, into the spine, across the pleura to the opposite side of the chest from the point of origin, through the heart lining or into the heart, or into the nerves leading to the arm (brachial plexus). The cancer, at this stage, might not have reached the lymph nodes and has not spread to distant areas of the body. Pleural mesothelioma may also be diagnosed as Stage IV if it has spread to distant sites of the body, or if it has not spread to distant sites but has spread to the lymph nodes of the collar bone, or to the hilar (the depression in the surface of a lung that forms the opening through which the bronchus, blood vessels, and nerves pass) or mediastinal lymph nodes on the opposite side of lung from where the cancer originated. The Butchart Staging System The oldest staging system for mesothelioma is the Butchart System, which is based on differentiations in the mass of mesothelial tumors. As with the TNM Staging System, mesothelioma is categorized into four stages.
9 Under the Butchart System, if a mesothelial tumor is found in the right or left pleura, and possibly in the diaphragm on the same side as the affected pleura, the cancer is considered Stage I mesothelioma. Stage II mesothelioma occurs if the tumor invades the chest wall, if it implicates the esophagus, heart or both sides of the pleura, or has reached the lymph nodes of the chest. If the mesothelioma has penetrated the diaphragm and made its way into the lining of abdominal cavity, it will be labeled Stage III mesothelioma, even if the cancer has not reached the lymph nodes. Under this system, Stage IV mesothelioma is reserved for cases where the cancer has metastasized to organs other than those mentioned. The Bringham Staging System The Bringham Staging System is the most recent system devised for categorizing cases of mesothelioma. It focuses on whether the patient's mesothelial tumor can be surgically removed, and it too involves four distinct stages of the disease. If a patient's mesothelioma has not spread to the lymph nodes and the tumor can be removed with surgery, the cancer will be labeled Stage I mesothelioma. If the cancer has spread to the lymph nodes, but the tumor is operable, the mesothelioma is considered Stage II under this system. With or without having spread to the lymph nodes, a patient is considered to have Stage III mesothelioma if the cancer has penetrated the chest wall, heart, diaphragm or abdominal cavity and the tumor cannot be removed with surgery. If the cancer has metastasized, under the Brigham System, the patient is said to have Stage IV mesothelioma. Section 6: Mesothelioma Treatment Mesothelioma has proven to be one of the most difficult cancers to treat. Because there is currently no cure for mesothelioma, patients with the disease have an average survival time of eight to thirteen months post diagnosis. Although treatments are available, they are typically administered to ease the symptoms of patients and have not proved successful in defeating the cancer. Conventional therapies, such as surgery, radiation therapy and chemotherapy are available treatment options. Patients and their doctors may also consider combining therapies for more effective treatment. As when dealing with most forms of cancer, the treatment options available to an individual depend upon which stage his or her mesolthelioma has reached. A. Chemotherapy Chemotherapy is a cancer treatment that uses specific drugs or combinations of drugs that are selectively destructive to malignant cells and tissues. It can be prescribed as the patient's sole form of mesothelioma treatment, or administered with surgery or radiation therapy. The American Cancer Society has specified that chemotherapy is not a means of curing mesothelioma, but may be effective in relieving the symptoms of the disease.
10 How Does Chemotherapy Work to Ease the Symptoms of Mesothelioma? Chemotherapy drugs can be administered to the patient in pill form or intravenously, either as a systemic therapy (circulating throughout the entire body) or injected directly into the chest or abdominal cavity. Chemotherapy is normally an out-patient procedure that is administered in cycles. The number of cycles depends upon the stage a patient's mesothelioma has reached and whether the cancer seems to be responding to initial chemotherapy cycles. To begin treatment, the drugs are normally given to the patient over a few days. Then, after a few weeks in which the patient's body recovers from the effects of the drugs, another cycle of chemotherapy begins. Will Chemotherapy Cause Side Effects in Mesothelioma Patients? The main concern with chemotherapy is its tendency to damage healthy cells, especially cells of the bone marrow that are responsible for producing blood and white blood cells, which may leave the patient susceptible to potentially fatal infections. Therefore, the health of a patient undergoing chemotherapy should be thoroughly monitored by doctors, even in the hiatus between chemotherapy cycles. A shortage of blood platelets can also increase a patient's risk of bruising or bleeding. Also, a shortage of red blood cells may lead to fatigue and shortness of breath. Chemotherapy is known to cause a number of additional side effects, which normally disappear shortly after the treatment is stopped. Such side effects may include loss of hair, nausea and vomiting, loss of appetite and mouth sores. Specific side effects will depend upon the drug or combination of drugs administered to the patient, dosage, and the length of his or her treatment. B. Radiation Therapy Radiation therapy is a cancer treatment that utilizes high-energy x-rays to destroy cancer cells. It is normally administered to a patient whose health is too weak to withstand surgery. Radiation therapy may be prescribed as the sole treatment for a mesothelioma patient or may be combined with other therapies, such as chemotherapy. Overall, mesothelioma has showed resistance to radiation therapy, and may even cause damage to the lungs if a large portion of the lung undergoes radiation treatment. Some hospitals and cancer treatment centers, however, have indicated that radiation therapy may show beneficial in treating mesothelioma that is detected, diagnosed, and treated very early on in the development of the disease. Otherwise, radiation therapy is typically prescribed as a palliative therapy to ease symptoms of mesothelioma, such as shortness of breath, pain, bleeding, and difficulty swallowing.
11 Types of Radiation Therapy Available for Mesothelioma Patients There are two different procedures for administering radiation therapy and each is conducted for a specific purpose: External beam radiation therapy uses beams of radiation from a machine similar to an x-ray machine, which directs them at the area of the patient's body that is afflicted with mesothelioma. This form of radiation therapy is generally carried out on a daily basis for three to five weeks. Unlike external beam radiation therapy, brachytherapy is a type of radiation therapy performed by injecting radioactive material directly into the body at the site of the mesothelioma. It is, however, seldom used to treat mesothelioma. This procedure if often used after a buildup of fluid is removed from the abdominal or chest cavity, as it has been successful in a significant number of cases in preventing more fluid from emerging in the area. Additionally, if surgery is performed to remove malignant mesothelial tumors, post-operative radiation therapy may be conducted in order to destroy any small deposits of the cancer that could not be seen or removed during the operation. Radiation Therapy Side Effects in Mesothelioma Patients Mesothelioma patients who undergo radiation therapy are likely to experience the temporary side effects associated with the treatment, such as fatigue and a skin condition similar to sunburn. Patients suffering from peritoneal mesothelioma who undergo abdominal radiation therapy may experience more discomforting side effects, such as nausea, diarrhea and vomiting. C. Treatment by Stage Mesothelioma treatment - whether with surgery, chemotherapy, radiation therapy or a combination of the three - is determined by the stage of mesothelioma a patient's cancer has reached, along with the general condition of the patient's health and his or her age. Stage I Mesothelioma Treatment Stage I mesothelioma may still be curable, so doctors should not rule out curative surgery, such as an extrapleural pneumonectomy, for a patient diagnosed at this early stage. The most common treatment for patients with stage I pleural mesothelioma, however, is a pleurectomy / decortication. Patients suffering from peritoneal mesothelioma may benefit from similar surgeries at this stage. Post-operative radiation therapy may be prescribed for surgical patients. If the health of a stage I patient is too weak to withstand surgery, he or she may be prescribed radiation therapy alone.
12 Stage II Mesothelioma Treatment Often supplemental therapy after surgery is prescribed for patients diagnosed with stage II mesothelioma. After surgery is performed to remove as much as the cancerous tissue as possible, the patient may undergo radiation therapy, chemotherapy or a combination of the two. This therapy is prescribed in an attempt to destroy residual cancer cells that could not be removed by surgery, as well as to further ease the symptoms of mesothelioma. Stage III Mesothelioma Treatment Treatment for patients diagnosed with stage III mesothelioma tends to involve the same procedures available to stage II mesothelioma patients. Stage IV Mesothelioma Treatment A diagnosis of stage IV mesothelioma confirms that the patient's disease is terminal. Thus, treatment at this stage should focus on pain management and supportive care. Section 7 - Sources of Airborne Asbestos Inhaling asbestos fibers can lead to mesothelioma, a cancer that strikes the lungs and less frequently other internal organs. Because many victims are workers who were not told of the dangers of this substance, mesothelioma lawyers are called upon to assure that these individuals are fairly compensated in the court. Airborne asbestos causes 2,000 to 3,000 people to develop mesothelioma in the United States every year. Lawyers trained in handling asbestos lawsuits, such as the mesothelioma lawyers at New York s Kane Legal law firm, caution the public to be aware of asbestos in their home and in their workplace. A material that saw widespread use through the 1980s, asbestos can appear in many places: insulation plumbing and heating pipes ceiling spray automotive products such as brakes and clutches roofing products protective clothing for firefighters floor tiles and a host of other products people make contact with every day. While asbestos use has declined significantly over the last 30 years, mesothelioma lawyers represent scores of victims who were exposed to asbestos before its decline in usage. When counseling individuals with mesothelioma, lawyers should understand the many places where the person could have been exposed.
13 Not as many people today work directly in the production of asbestos, but the danger is still prevalent. Asbestos can be found in the air in many older homes, offices, schools and manufacturing plants. When repair, remodeling or demolition work takes place, asbestos is often broken up, releasing deadly fibers into the air for anyone to breathe them in. Medical tests can detect asbestos in urine, feces and mucus. Chest X-rays, while they will not reveal the actual fibers, can reveal initial signs of lung disease caused by asbestos. Because mesothelioma has a latency period of up to 50 years, the fibers may remain in the body for decades without causing harm. Because of this, mesothelioma lawyers warn everyone to be aware of potential asbestos exposure. Experienced mesothelioma lawyers are committed to getting you results At Kane Legal, our knowledgeable mesothelioma lawyers know that anyone exposed to airborne asbestos is at risk of developing cancer. Our attorneys are highly trained litigators who have helped many mesothelioma patients receive the financial compensation they deserve. If you have been diagnosed with mesothelioma or have symptoms common to the disease, call the respected mesothelioma lawyers at The Kane Firm. We re on your side. Section 8 - Your Attorney Mesothelioma Law Firms What skilled attorneys need to know If you have developed mesothelioma, you have the right to seek compensatory damages. A qualified mesothelioma law firm such as Kane Legal, Inc can help you receive a fair and just monetary award. Exposure to asbestos is the only known cause of the disease mesothelioma. Law firms trained to litigate these cases must be experts in the wide range of topics and disciplines that are used to attain favorable outcomes for their clients. Medical details Attorneys in mesothelioma law firms must be well-versed in how asbestos exposure leads to the disease, what the symptoms of the disease are, tests and diagnostic procedures, the course of the disease and a host of vital statistics concerning mesothelioma. Law firms must also be able to effectively communicate this knowledge in the legal arena. Statute of limitations Each state determines its own statute of limitations, which dictates the time frame within which a mesothelioma victim must initiate a lawsuit after being diagnosed with the disease. Patients are advised
14 to contact a qualified mesothelioma law firm as soon after diagnosis as possible in order to assure that they meet the statute of limitations. Mesothelioma case precedents How have previous mesothelioma lawsuits been decided? What verdicts have juries handed down? What instructions have judges given juries to help them determine financial awards? Have judges historically allowed one type of evidence but restricted another? These are just some of the things a mesothelioma law firm must be aware of in preparing a lawsuit for its clients. How to aggressively support their clients rights Attorneys in a mesothelioma law firm have heard all the excuses why defendants (companies and other entities) should not be charged with responsibility, even when they knowingly put their workers at risk for developing mesothelioma. A good attorney knows how to overcome these excuses and defenses. When to settle and when to fight Depending on many factors, an experienced mesothelioma law firm will help you make the decision to either settle out of court or engage in a jury trial. All lawsuits involve complexities, particularly those built around a diagnosis of mesothelioma. Law firms specializing in these cases will fight for your best interests. Potential awards Jury trials have produced favorable outcomes for many mesothelioma patients. Based on a jury s grasp of the pain and suffering experienced by victims and their families, awards often wind up in the tens of millions of dollars. A mesothelioma law firm must understand the potential award based on each client s specific case. Mesothelioma Law Mesothelioma law is a complex field where attorneys must litigate aggressively for their clients in court while being fully informed about the disease mesothelioma. Law firms that specialize in mesothelioma law, such as The Kane Firm, Inc, want the public to understand this disease and the rights of its victims. The reason mesothelioma law even exists is because medical evidence shows that the only known cause of this form of lung cancer is exposure to asbestos. In a great number of cases, courts and juries have decided that the parties responsible for the victim s disease are the corporations and companies that manufactured or used asbestos, thereby placing their workers at risk. In filing a lawsuit, mesothelioma law firms realize that time is of the essence. Because this is an aggressive cancer that strikes the lungs and other internal organs, many victims may survive only one to two years after diagnosis. In mesothelioma law proceedings, one of the primary objectives is to gain quick compensation to assist with medical bills.
15 Another fact recognized by mesothelioma law firms is that the asbestos-related death rate in workers who were in direct contact with asbestos insulation is up to 300 times higher that the death rate from mesothelioma in the general population. Many companies who manufactured asbestos insulation, particularly from the 1940s through the 1980s, knew how deadly this substance was but did nothing to inform their workers. Mesothelioma litigation identities asbestos-containing product(s) an individual has been exposed to, which can include: Insulation Roofing tar and shingles Vinyl floor tiles, joint compounds, caulk and gaskets Mud coats, texture coats Vehicle brake pads and brake shoes Stage curtains, fire blankets, fire doors and protective clothing for firefighters Ceiling tiles and low-density insulation board Asbestos-cement sheets and pipes used in construction, as casing for water and in electrical and telecommunications services Thermal and chemical insulation for fire-rated doors There are a number of ways in which workers have been exposed to asbestos that led to mesothelioma. Law proceedings throughout New York and New Jersey have supported victims who developed mesothelioma through the following and many other exposures. Shipbuilding Asbestos was widely used in shipbuilding between World War II and the Korean War as insulation for steam and hot water pipes, incinerators and boilers. Building construction Asbestos products used in this industry include insulation, cement pipes and ceilings and floor tiles. Demolition and remodeling When buildings containing asbestos are torn down or repaired, workers can easily be exposed to deadly levels of airborne asbestos fibers. Secondhand exposure can also be deadly Estimates indicate that some 5,000 asbestos-containing products are in use today, even after tight restrictions in the 1980s. This means people other than workers are at risk for developing mesothelioma. Law firms regularly represent mesothelioma victims who were exposed to asbestos in their homes or communities. Attorneys experienced in mesothelioma law will tell you that there is no safe exposure level to asbestos. If you have worked or lived around it, you have been put at risk for developing a disease that strikes between 2,000 and 3,000 people each year in the United States.
16 Section 9 - Mesothelioma Lawsuits Three reasons to file a mesothelioma lawsuit Experienced attorneys will help you receive the compensation you deserve. Mesothelioma is a type of cancer caused by exposure to asbestos. Inhaled asbestos fibers may stay within the body for anywhere from 20 to 50 years before the disease manifests. Most plaintiffs in mesothelioma lawsuits incur high medical bills that create hardship for both them and their families. A mesothelioma lawsuit is filed in order to accomplish three things for the victim: 1. Receive reparations for medical expenses 2. Replace lost income when the individual can no longer work 3. Compensate for pain and suffering Skilled attorneys who file mesothelioma lawsuits for their clients should be highly knowledgeable about the legal and medical aspects of asbestos-related cases. Medical expenses Medical expenses sought in a mesothelioma lawsuit include money for medications, chemotherapy, private physicians, surgery, hospitalizations, physical therapy and home care. Few patients have the level of insurance that will fully cover all these expenses. A successful mesothelioma lawsuit eases this burden for the patient and his or her family. Lost wages Although most patients are of retired age when mesothelioma develops, many are still working. A mesothelioma lawsuit addresses the hardship of lost wages by demanding compensation for all salaries, bonuses and benefits that would have been earned had the patient kept working. Pain and suffering Pain and suffering, a common phrase in mesothelioma lawsuits, describes the emotional turmoil, the psychological stress and the physical suffering experienced by the patient. These three areas of compensation have resulted in awards in the tens of millions of dollars for plaintiffs in mesothelioma lawsuits. While results will vary, if you have been diagnosed with mesothelioma, you should know experienced lawyers will fight for just compensation in every mesothelioma lawsuit. Who pays? The majority of mesothelioma lawsuits are filed against an employer that either manufactured or used asbestos-containing products. The law allows that a company can be held liable for the health of its workers, which includes paying the damages sought in a mesothelioma lawsuit.
17 Mesothelioma lawsuits have brought great success for victims of asbestos because it is often easy to prove that the employer had full knowledge of the dangers of asbestos and didn t inform its workers. Section 10 - Cases Assessment How Mesothelioma Lawsuits Work The primary reason mesothelioma litigation is possible is because it is directly caused by exposure to asbestos, and nearly all exposure to asbestos could have been prevented by taking different action in the handling of materials that contain asbestos. Unfortunately, the asbestos manufacturing and production industries have a poor historical track record for protecting the interests of their employees, with many examples of intentional concealment and minimization of the health risks of asbestos exposure. This has resulted in a great deal of suffering for many who were not given enough information about the toxicity, and were not provided with sufficient protective gear to keep them safe. Mesothelioma is a preventable disease. The fact that it exists at all points to liability with the production, distribution, and use of asbestos-containing products. What Makes Asbestos / Mesothelioma Litigation Complicated Mesothelioma frequently does not arise in a person exposed to asbestos until 15 to 30 years after their initial exposure. This simple fact makes following the trail of liability more difficult as companies cease to exist, documentation becomes lost, and memories fade. An additional complicating factor is that the laws of liability applicable to asbestos litigation and mesothelioma lawsuits are very complicated. Kane Legal experienced asbestos litigation team will search the trail of liability until it can be established to recover financial compensation for your injuries. What Determines Which Litigation Track to Follow After retaining Kane Legal, our experienced mesothelioma attorneys will work to find and analyze your medical and employment records, identify the culpable defendants, and analyze each defendant s potential liability. The individual circumstances and details of your claim will determine the specific path your case should take. Each case is different and is treated as such by our experienced team. The first step, of course is to contact Kane Legal for a free consultation. What to Expect From Your Mesothelioma Lawyer When you contact Kane Legal for a case evaluation, we will help you to understand your legal options and how lawsuits work. Our experienced asbestos lawsuit attorneys will help you at every stage of filing suit for your injuries to ensure you get the best representation possible. Here is a brief overview of how a lawsuit works. A Kane Legal mesothelioma lawyer will ask you for your medical history and work history to determine how strong your case is, and against whom you should file suit. The lawyer may recommend you take certain medical tests to gather information before deciding to file the complaint against a company or companies. The complaint or petition can be filed on behalf of you individually, or on behalf of several plaintiffs, if they all are filing against the same company or companies. When plaintiffs join together in
18 lawsuits it can help make a stronger case for all of them. Additionally, your Kane Legal mesothelioma lawyer will help determine whether there are any time limitations on your potential lawsuit. The statute of limitations is a rule that determines how long you have to file a complaint after the plaintiff s diagnosis or death. It is usually within a specified amount of years, but varies depending on where you live, and where you are filing your lawsuit. If you have been diagnosed with Mesothelioma, or someone you love has died of mesothelioma you should contact us as soon as possible to ensure the statue of limitations does not run out and you are no longer allowed to file suit. Once the complaint is filed, the defendants have a set amount of time, typically 30 days, to respond with an answer to the complaint. Once that answer is filed with the court, the case is given a date to go to trial, which could be many months in the future. If the plaintiff is still alive and has malignant mesothelioma the case will be prioritized and brought to trial sooner. Your asbestos attorneys will engage in discovery, which is when questions are asked and documentation is requested from the defendants, after the complaint is filed. The defendants will also ask questions and request documentation such as your medical records, or your work history. Additionally, you may be asked to answer questions asked directly by a lawyer in a deposition. Your attorney will help you prepare for the deposition, and help you while the deposition is going on to determine whether the questions are fair, and whether you should answer. Additionally, your Kane Legal mesothelioma attorney will work with experts in the area of asbestos exposure to further develop your case for trail. If you or someone you know has been diagnosed with mesothelioma or have symptoms of the disease, Kane Legal is the asbestos law firm that is best-prepared to fight for your rights, support you every step of the way, and earn you the just financial compensation you deserve. Contact Kane Legal at (215) for a free legal consultation. Examples of Recent court proceedings New Jersey In February 2008, a New Jersey court ordered General Motors and other defendants to pay $30.3 million to the family of a New Jersey man who died of mesothelioma at age 50. The victim was believed to have been exposed as a young boy to asbestos from the clothing worn by his father and brother, both of whom worked for GM. United Kingdom In May 2009, the widow of a mesothelioma victim in the U.K. received a record settlement (for that region) 1.4 million or $2,223,337 U.S. dollars, one of the highest compensation awards in a mesothelioma case. The lawsuit claimed that the victim was exposed to asbestos while working as an engineer in the late 1980 s. The lawsuit stated that this was how he developed an asbestos related tumor, which caused his death at the tragically young age of 47.
19 San Francisco A California man was awarded $7.5 million in a mesothelioma lawsuit some 36 years after he was last knowingly exposed to asbestos. Between 1963 and 1972, the victim, who was 64 years old when he was diagnosed in 2008, worked as a janitor for a civilian company and as a machinist in a U.S. Navy shipyard in the San Francisco area. Philadelphia Asbestos Verdict $25.2 Million 3/20/09 - The jury in the case of Baccus v. Crane Co., held and heard before Judge James Murray Lynn in the Philadelphia Court of Common Pleas, recently awarded James Baccus' Estate $25.2 million in compensatory and punitive damages. Mr. Baccus claimed to have been exposed to Asbestos while working for the Navy in Philadelphia, but also was injured in Kentucky, where he spent the remainder of his life. The defense attorneys requested the Kentucky law be applied in the hopes of more evenly distributing the liability for the injuries on defendants who had already settled, but the jury decided no liability against the defendants who settled and awarded significant punitive damages to the Plaintiff. Other plaintiffs and defendants in the suit settled for undisclosed amounts. Navy Firefighter Awarded $2.6 Million for Asbestos Related Cancer 3/12/09 - David Fortier was a firefighter aboard the USS Forrestal from 1969 to He worked on pumps and other asbestos-insulated equipment manufactured by the Allis Chalmers Corporation. He was diagnosed with mesothelioma in October of 2006, and died in June of He filed a lawsuit shortly after his diagnosis, but he did not live to see his case decided. His widow, Gail Fortier, was awarded $2.59 million when a six person Connecticut jury decided the case against Allis-Chambers on March 12, Asbestos is the primary cause of Mesothelioma, and many ships and aircraft carriers were built with asbestos-insulated equipment and contaminated with asbestos. Mesothelioma can take many years to manifest in a person who has been exposed to asbestos contamination, and symptoms do not appear until there is a significant amount of the cancer in the body.
CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Mesothelioma: Questions
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M E S O T H E L I O M A Questions & Answers A G U I D E F O R M E S O T H E L I O M A P A T I E N T S A N D T H E I R L O V E D O N E S MORGAN & MORGAN FORTHEPEOPLE.COM 877-667-4265 Mesothelioma Questions
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