Johns Hopkins Medical Institutions received millions of dollars from coal companies for reading chest X-rays yet rarely confirming that miners are suffering from black lung disease. This famed teaching hospital has been the subject of an investigation for the past year by ABC News and the Center for Public Integrity after miners were told they didn’t have black lung and therefore could not collect benefits.
At the center of the controversy is Dr. Paul Wheeler, age 78, who is the leader of the medical unit that reads the miners’ chest X-rays and CT scans on behalf of the coal companies. Dr. Wheeler and his team of radiologists issue reports based on what they determine the X-rays show. Those reports are then used to confirm or deny whether the miner has black lung disease.
Coal companies have relied on the expertise and stellar reputation of Johns Hopkins for the past 40 years. Even though the doctors read the chest films as part of their regular duties, the university charges the coal companies up to 10 times more than what the miners pay their personal physicians. According to past judicial opinions on file with the U.S. Department of Labor, Dr. Wheeler often testifies that the findings of other doctors who had previously determined the X-rays showed black lung disease were, in fact, indications of something else such as cancer, tuberculosis and other lung diseases. As a result, the miner’s claim is denied.
Over the years, judges have accepted Wheeler’s testimony and have referred to him as the “best qualified radiologist” with “superior credentials.” His impressive resume includes Harvard University undergraduate and medical degrees, leadership history at Johns Hopkins, numerous presentations and published works. With credentials like these, and the support of Johns Hopkins, miners repeatedly lose case after case.
The investigation, Breathless and Burdened, uncovered alarming statistics:
- Out of over 1,500 cases since the year 2000 that involved Wheeler reading at least one of the X-rays, he never confirmed the severe form of black lung disease known as complicated coal workers’ pneumoconiosis. In contrast, other doctors found evidence confirming severe black lung in 390 cases.
- Wheeler’s “negative” readings of X-rays have resulted in miners losing over 800 cases since the year 2000 even though other doctors said those same X-rays were positive for black lung. That included 160 cases of the severe form.
- Wheeler read the abnormalities on miners’ chest X-rays as tuberculosis or a fungal infection from bird and bat droppings known as histoplasmosis. Other doctors reported the same films as indicating black lung.
- Wheeler applies different criteria when reading X-rays than what is recommended by related government research agencies and doctors who are specialists in determining a positive diagnosis. Among those doctors is the chair of the black lung task force of the American College of Radiology.
Investigative reporter Chris Hamby for the Center for Public Integrity and ABC News’ Chief Investigative Correspondent Brian Ross conducted a joint interview that was broadcast Oct. 30 on ABC World News With Diane Sawyer and Nightline. Dr. Wheeler denied any wrongdoing and stated, “I think if they have [black lung], it should be up to them to prove it.”
Miners have proven it with their lives. Autopsies have repeatedly provided overwhelming evidence of black lung disease even though Wheeler’s report was negative. Acceptable proof, to him, is a lung biopsy in order to make sure miners receive “proper treatment.”
Several leading organizations have stated that a biopsy is not required by law to diagnosis black lung. The American Lung Association and the National Institute for Occupational Safety and Health are two of the groups that say lung biopsies put patients at risk. Judges who have ruled in favor of miners have found that some of their rulings have been overturned on appeal.
Senator Jay Rockefeller (D-WV) is championing the cause of the miners and their families. He said the findings of this investigation are a “national disgrace” and that the deck is stacked against men and women who work in the coal mines.
Officials at Johns Hopkins have disputed this report and issued a statement defending their radiologists by claiming that the diagnoses and decisions made regarding black lung have never been called into question by any “medical or regulatory authority.” This investigation, however, was prompted by Hamby’s earlier project in 2012 on the rise and the misconceptions of black lung disease.
Whether working in mine shafts or mountain tops, in Kentucky or West Virginia or any mining location, miners inhale coal dust. It builds up over time, gradually robbing the lungs of the ability to function. In its most advanced stages, breathing is aided by oxygen tanks and the patient must often choose between breathing and eating. The lungs are so scarred that patients can only sleep by sitting up. The victim coughs a lot and becomes incapacitated.
To read more about the investigation of the Johns Hopkins’ unit and miners’ claims of black lung disease, please click on the link to Breathless and Burdened listed below.
By Cynthia Collins
US Dept. of Labor – Federal Black Lung Benefits Program