Judge Janis Jack
When U.S. District Judge Janis Jack of Texas exposed 10,000 phony silicosis claims, her history as a nurse triggered a strong reaction to the shoddy practices of attorneys in her court and doctors who served them.
Jack wrote in a 2005 order that in cases before her, doctors practiced law and lawyers practiced medicine.
She meant that doctors generated lawsuits and lawyers carried out medical procedures.
In the process, all principles of proper medical care slid down the drain.
Jack counted 6,757 claims resulting from X-rays taken by screening company N&M.
She wrote that junior college dropout Heath Mason founded N&M at age 21. She wrote that he had no medical training and N&M never had a medical director.
"What Mr. Mason did possess was contacts with paralegals at law firms," Jack wrote.
She wrote that law firms would ask N&M to X-ray a group of people and send the X-rays to the firm.
She wrote that some firms would hire temporary services to take brief work histories.
"…[T]here is no evidence that anyone answering the phone, whether employed by a screening company or a law firm, had any medical training or had been instructed by any medical professional what questions would be appropriate…," Jack wrote.
"…[I]t is clear that the law firms, rather than any medical professionals, established the criteria for the screening company to use…
"With respect to the units used by the screening companies at issue here, there is no evidence of medical oversight (rigorous or otherwise), sufficiently heavy X-ray units, or a consistent power source.
"Indeed, there is no evidence any medical professional supervised the extent to which the plaintiffs were irradiated.
"…[I]t is clear that more often than not, the equipment failed to function according to American Thoracic Society requirements.
She wrote that the firm of Campbell Cherry paid N&M $750 each time a patient with a silicosis diagnosis signed up as a Campbell Cherry plaintiff.
She wrote that Campbell Cherry represented 4,256 plaintiffs in her court. She wrote that the firm likely paid N&M $3,192,000.
She wrote that Dr. Barry Levy diagnosed 1,389 plaintiffs without taking occupational or medical histories, physically examining them, reading their X-rays, or speaking to them or their physicians.
"On average, Dr. Levy devoted less than four minutes to each of his diagnostic evaluations in this litigation," she wrote.
"…[D]espite the fact that Dr. Levy has provided consulting services to NIOSH, OSHA, the CDC the Environmental Protection Agency and the World Health Organization – and therefore would know the proper people to call if he felt it was appropriate – he chose to notify no one but the lawyers who paid his bills."
She wrote that exposure histories were almost always taken by people with no medical training and were devoid of details such as duration and intensity of exposure.
She wrote that the attitude of doctors who testified before her was that the diagnoses involved more work than they were willing to devote to the task.
"…[T]he sheer volume of plaintiffs does not mean that these professionals' obligations toward each plaintiff has been lessened.
"…[T]his order should not be taken as a criticism of the right of impaired individuals to seek redress through the courts.
"What the court is criticizing is the idea that when doctors step into a courtroom, they can abandon the methodology they practice in the clinic."
She wrote that the doctors were under an impression they were practicing law.
"They referred to the plaintiffs as 'clients' rather than 'patients,' and they utilized shockingly relaxed standards of diagnosing that they would never have employed on themselves, their families or their patients in their clinical practices," she wrote.
Jack sent most of the phony silicosis claims back to Mississippi state courts where they had originated.
Thousands of the suits remain open.
No one has taken any action against any of the doctors Jack exposed.
No one has taken any action against the attorneys, beyond an $8,250 sanction that Jack imposed on one firm.