The Expert: Dr. Victor Roggli, a pathologist based in North Carolina, testifies for the defense concerning his opinions on asbestos exposure in brake mechanics.
During a 2015 mesothelioma trial, Dr. Victor Roggli, a Duke pathologist with a particular interest in asbestos-related lung damage, testifies for the defense. The family of a deceased mechanic who allegedly died of cancer caused by decades of exposure to asbestos went to trial claiming that the defendant companies knew their products contained the deadly material but failed to provide adequate warnings.
In this video clip, the attorney first establishes the expertise of the witness by referring to three peer-reviewed, recent papers authored by the expert on this subject, and the doctor further refers to his most recent book in its third edition in 2014 on the pathology of asbestos-related diseases.
Having established the doctor’s authority on this subject, the attorney immediately questions him on whether he believes that chrysotile asbestos in engine gaskets cause mesothelioma. Roggli says, “I think it is unlikely.” He bases this on review of the literature concerning low-dose exposures to chrysotile asbestos, which are those exposures within the workplace below the permissible exposure limit [PEL] as determined by OSHA. Such exposures do not cause or contribute to mesothelioma and “the fiber release from the use of engine gaskets is below the current PEL.”
The attorney asks that Roggli make several assumptions about this case. Assuming that the mechanic in this case performed thousands of gasket replacements on large trucks from 1974-1988, a procedure that requires grinding or scraping of gaskets containing chrysotile asbestos, and assuming that this action caused visible dust that could be inhaled, the expert again repeats that “it is unlikely” that any of this caused or contributed to the diffuse malignant mesothelioma that the deceased came down with. This is because the release of fibers from gaskets under these circumstances does not exceed the PEL. He further testifies that this conclusion is based upon studies done on fiber analysis, immunologic responses, and the different fiber types and potencies.
An idiopathic disease is one that we do not know the cause of. Although malignant mesothelioma is known to be caused by asbestos in 80 to 90 percent of cases, not all cases of mesothelioma are causally related to this substance. Some are idiopathic or due to other causes. About 11 to 16 percent of cases have no more asbestos incorporated into the tissues “than you or I have,” the doctor states. There are certainly other diseases that have idiopathic causes. We do not know the cause of most cancers, and here the expert gives the example of breast, prostate, or colon cancer in this category. Although we are aware that lung cancer is caused by smoking or being around smokers, there are definitely cases where victims of lung cancer have no exposure to tobacco smoke. This also applies to non-malignant diseases such as pulmonary fibrosis, where the lungs become scarred and the breathing is restricted. This disease can be caused by asbestos exposure as well as other types of exposure. If it is caused by asbestos, the disease is called asbestosis. If it is not known what caused it, it is known as idiopathic pulmonary fibrosis. The implication is that the cause of the malignancy in this case is also idiopathic
This very effective testimony resulted in a verdict for the defense
Gary Gansar, MD, is residency-trained in general surgery. He served as Chief of Surgery and Staff at Elmwood Medical Center and on the Medical Executive Committee at Touro Infirmary and Mercy Hospital in New Orleans, LA. Dr. Gansar was Board Certified in general surgery while in active practice. He joined AMFS in 2015 as a Physician Medical Director.
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