Attachment 3 September 7, 1994 Martha Stephens An annotated record of certain short survivors of the U.C. radiation experiments. (Of the 77 victims of the tests, 25 died within a month or two of being irradiated, 19 within 38 days. Of those receiving the high doses of 150, 200, and 250 rads, 42% died within 60 days, mostly within about half that time.) 045 Maud Jacobs. 150r. 25 days. Well documented destruction of bone marrow, full blood counts given in her Patient History, squares exactly with what her family remembers. She was at home caring on her own for three children when called in for her "treatment," went back home the same day but the next day was violently ill and taken back to hospital, where she died 25 days later extremely ill and mostly out of her mind. Her daughter Lillian Pagano is an excellent witness to Jacobs' last travail and death, was 32 when her mother died and with her every day in hospital. A nice woman. She did not even know her mother was getting TBR, was told nothing. Jacobs had "a normal hemogram" before her radiation; seven days later her counts began to fall; the day before her death her WBC was 850 (down from 5100) and her platelets 38,000 (from 370,000). It should be recalled that before Maud Jacobs was irradiated, nine patients had already died within 54 days of this "treatment." She was the 13th person to receive 150 or 2004 (and five of this group had died within one or two months). Regardless of what the doctors say they knew or did not know before they started this project in 1960, they knew by the time they selected this mother of young children for radiation in 1964 that the chances of anyone surviving the higher doses were not good, and that they could not even try to protect her bone marrow. Yet her family was told nothing about the risk entailed. No consent form exists in her records, and certainly it is clear that she never knew the risk she was taking (and that if she had known, would not have taken it). Her children all tell the same story as that recounted above, and we have written testimony (submitted to the Cincinnati hearing) from her son Bob Phillips. 077 Grey ("Mike") Spanagel. 200r. 31 days. Blood counts extremely well documented in History; a clear radiation death. His wife Madge was only 47 when Spanagel died, took care of him daily at home until his death, has his full medical records, understands now what happened quite well. "They killed him," she says -- and this is what the evidence shows. Dr. Hortwitz visited the house just once right before Spanagel's death, just came in and pulled back the sheet to look at him and left, says his wife, offered no information or reassurance. Spanagel had throat cancer that was not responding to treatments, apparently, but was still sometimes going to work as a salesman to WCKY before his radiation, and also regularly in touch with clients by phone; he was taking a long walk ever day; he drove himself to the hospital the day he was irradiated. His wife was asked nothing and never knew what kind of radiation he had. Se says he thought it posed a chance for him to get well. His -- she feels rather sudden -- death meant that he did not have his affairs in good order and she was left with little from his will; most of what he had went to two older daughters by another marriage. There was fourteen-year-old daughter who suffered greatly from this sudden bad turn in his illness, Madge Spanagel says. She feels they never recovered economically; she went to work but has had to move recently into subsidized housing. She fees strongly that she ought to be compensated (and possibly she has a particularly good case for compensation, is one of the few remaining spouses, now in her sixties). We read in this History that Spanagel's hemogram remained stable until November 27. But on December 1 his WBC went down to 400 and his platelets to 18,000; on December 9 he died. He had had a bone marrow transplant, but obviously it did not work. 090 Margaret Bacon. 150r. 6 days. Complete documented death from a stroke related to her anesthesia for a bone marrow operation. Excellent additional documentation from medical records as to her relatively good condition near time of radiation (and her desire not to have radical intervention for cancer). It would be nice to have someone familiar with her last weeks to discuss them, but we do not have such a person. Three of her family, however, have gone on record about their anger at discovering the way she died, which they had never known, they say. Their written testimonies for the April hearing should be available. Doctors would like, I expect, to erase the sentence on page 37 of Ninth Report to DOD that refers to Bacon's death as an "anesthesia-related death." This fact was not recorded in her Patient History, and her death was described in other ways in subsequent writings of Saenger and the team. Her full medical records, however, make everything more than clear. 021 John Edgar Webster. 200r. 36 days. (It is somewhat interesting that his "study status" terminated on May 14, 16 days after TBR.) In his History: "His WBC dropped from an average of 10,000 prior to therapy to a low of 600 29 days post tbr. Platelets dropped to 50,000 on the same day and did not recover before his death. His course was progressively downhill, and he expired June 3, 1962 (36 days post TBR)." Chest x-rays had shown "infiltrate in the lungs which was diagnosed as either tumor or pneumonia." From staff notes on medical records as far as we can make them out: "Death Note -- Death Dx: #3 bone marrow depression [secondary] to...total body irradiation...." And: "final notes: Diagnoses: #6 Severe hypoplasia of the bone marrow, underlying. Dr. Perry." Laboratory Findings speak of "no change until the time of total body radiation" and them "a rather marked but progressive leukopenia...." His descendants are scattered. But Terry Webster and her husband (a great-grandson I believe) live in Cincinnati and are articulate about this grandfather's life an dhow they feel about his death. (The are apparently not in line for financial reward.) Webster is recalled as a country musician and a long-time caretaker for a Catholic elementary school on the west side of town. 007 James Tidwell 100r. (32 days) Tidewell did not seem to be extremely ill when he entered the hospital October 6 (1960). Was having seizures from what seemed to be brain cancer, but they were "well controlled with dilantin and phenobarbital." Ye on October 28 he received 100r TBR. Then -- his Patient History in the DOD reports described a "progressively deteriorating course of lethargy and paralysis." X-ray therapy to his head (for his brain cancer) began on November 7 (only 10 days after tbr) and continued up to his death on November 29. Progression of "neurologic disease with quadriplegia" leading to death. But his autopsy shows "lobular pneumonia." And if we look at the full medical records, we find crucial information on his blood scores: Before radiation his WBC was 8100, his platelets 435,000. Four days before his death these scores read: WBC 1120 Platelets 45,000 No doubt continuing to drop in the remaining days before his death. The 100r TBR plus the seemingly numerous tumor radiations to his head may be seen to have destroyed his marrow. Talking to his son Clifford is a little difficult; he is having trouble understanding radiation doses and so on, and the difference between tumor radiation and TBR. But I think he can be of some help about his father's condition before radiation. The cases above are among the most critical cases at this time simply because we have in them not only completely documented bone marrow failure, but also cases where we have surviving families. They do not all have the same lawyers. ##Here are four other cases very much like those above (Maud Jacobs and Mike Spanagel and so on), that is, well documented bone marrow destruction, but where either we don't know who the victims are or know little about their families. 037 Unidentified. 150r. 53 days. WBC drops are extremely clear: WBC 7800 prior to radiation 1500 23 days post tbr 1100 27 days post tbr At 27 days we read he "elected to withdraw" and died on 53. This fellow goes to CGH for help; they find what seems to be advanced cancer, but the only "treatment" they give him is a large dose of TBR that destroys his bone marrow. He decides three weeks later that he wants no more of them and dies about a month later, seemingly without any further treatment or even help for symptoms. 053 Louis Romine. 200r. 28 days. A clear radiation death. WBC 12,500 pre-radiation 7,250 6 days post tbr 5,500 3,250 day 18 350 day 26 (platelets 8,730) died on day 28 Problem: he has only grandchildren surviving, and family more or less scattered; Raymond Romine was in his 20's but seems to remember little; Deborah Kramer I haven't talked to yet. Two daughters-in-law survive: Deborah's mother Helen, who also remembers little, and Raymond's mother, who is in poor health and may not wish to be involved. (Kramer has an attorney.) But certainly the records are clear. Romine had t.b. as of 1960; first entered CGH April 6, 1965 with, apparently, lymph and bronchial cancer; but no treatment recorded in his History expect for 200r TBR a month later. Died June 5. 059 Unidentified. 150r. 32 days. Very clear radiation death. Had normal hemogram before radiation. Radiated on October 16 (1965). On November 3 WBC dropped to 4500 On November 9 to 1800 On November 15 to 200 On November 17 he died. Too bad we don't know him. But his case is one that should be outlined to all concerned parties. 060 Carolyn Brown. 150r. 30 days. Again -- a clear radiation death. Prior to treatment a normal hemogram. Then on day 16 her WBC dropped to 3200 (from 5100), an don the day of her death to 800. Platelets at death only 48,000. I am not sure we know her relatives or whether or nor she has an attorney. ##We also have a number of cases where early death directly from, or very closely related to, radiation must be strongly suspected, but where the records are either difficult to interpret or are somewhat incomplete. This is partly because doctors were getting a little more canny in later years, with review committees beginning to look them over, and also because they were becoming more interested in finding a marker for radiation injury and for tracking mental effects than studying blood effects, and no longer really needed to document to the marrow failures and radiation depths they were still bringing about. They were trying to perform b. m. transplants, by no means always succeeding. These too were clearly "experimental." We have a number of other short survivors who would probably look just like Jacobs and Sprangel and Romine and so on if we had their blood counts -- Louise Richmon, for instance, Philip Daniels (099), Mary Hampton Singleton, probably John Henry Wells. Lula Tarlton, in my opinion. some of these medical records have, in fact, already been released, but I have not yet examined them all; I hope others will help in this. ##Consider these two cases: 078 L.H. 200r. 61 days. We have some record of falling WBC, down to 900 on January 2, 1968, then "steady deterioration and increase pain" and death in VA Hospital February 4 on day 61. 086 M.J. 100r. 20 days. Her History should be closely examined. Blood counts dropped and she was given infusions but continued downhill and died on day 20. The 100r plus tumor radiation almost surely finished this woman. We definitely need to see the full records of Phillip Daniels (099), mentioned above, (the one individual who got 250r. (Some records list 230r, but that is a typo.) Also Willie Williams (case 102); even though he got partial body (200r), his blood counts dropped and he died on day 22. There is good evidence that partial body radiation could definitely deliver a severe blow to the immune system. This is a case should that I think is definitely of interest: 068 Willie Thomas. She had a severe reaction to her 150r PBR in all the immediate post-radiation effects, and seems never to have recovered her mental powers. No record of any confusion before treatment. In other words, she suffered precisely that severe mental derangement that was being tracked for the DOD. (She lived only 59 days, but it is difficult to say just how damaging to her the radiation was with respect to her demise.) I have not met her son Leon Thomas, assume he would be a strong witness to the way his mother died. 044 Beatrice Plair. 100r. 197 days. Her case is of some interest for its well-documented cruelties to a frightened patient, and because her family are active in this cause. And it is interesting to me that with only 100r, but with concomitant tumor radiation, her blood scores suffered and took 75 days to recover. It would, in my view, however, definitely be a problem if it were contended that Plair died directly of radiation--we do not have proof of that, it is highly unlikely, and it would probably be easy for the doctors to refute such a claim. Not sure Gwendon Plair understands this. ## A note on Donna White Cristy and on David Jungnickel, two of the three children set to CGH from Children's Hospital. As the only survivor, the Advisory Committee or others many wish to speak to Cristy about consent and so on. But as to both these children, I have the impression that the treatment of Ewing's Sarcoma patients will be much more easily defended than the others, and that doctors at Children's may have had somewhat better grounds for thinking that whole body radiation might serve a purpose for them. (Even so, the risk was probably far too severe, and one wonders if the Children's doctors knew what had been happening to the other high-dose patients.) The third Ewing's family got in touch with me this past spring but asked me not to identify them to anyone; they aren't ready to be part of the suit or talk to press, they said since the child's mother is in poor mental health. ##The following additional cases should be certainly be among those kept in mind for further study: 010 Lula Tarlton. 100r. 49 days. 022 Evelyn Jackson. 150r. 10 days. A tragic case it seems to me. 025 John Henry Wells. 150r. 34 days. 081 Irene Shuff. Hard to say what part radiation played in her death even after studying medical records. Instinct tells you it did play a large part...and yet the proof is hard to find. One would like very much to have a forthright opinion from doctors on the panel about such cases as this. 086 M.J., 088 K.K., 089 E.A., and 091 G.S. all need further study. They are all serious cases but so far somewhat ambiguous, mainly from lack of complete records. ##Understanding the short-term deaths from radiation is, to me, the key to understanding the tragedy that occurred at the University of Cincinnati. It not only shows us the enormous risk that high-dose subjects were taken (again, 42% of them died within a month or two, over the whole course of project) and the cruel deaths they so often suffered, but it illuminates all the other cases -- for it makes plain the risk that almost all victims faced to one degree or another. The doctors know this full well. They seem to dread more than anything else having to respond to the individual histories of these high-dose cases of bone marrow failure -- and have ever done so. Saenger in all his voluminous writings and statements in defense of himself in the past, has never selected out for analysis the high-dose subjects as a group. Always groupings by cancer type and so on, never by dose. ##I will try to help, if needed, the families more or less coordinate their testimonies for any public meeting, and help assure that any such meeting we have includes some of the short survivors. (We had no short survivors testifying in the congressional hearing in April.) I am not planning to become a paid consultant for any law firm or organization. My interest began as a member of a junior faculty group in Arts and Sciences at U.C. studying this project, and my interest in the plight of the victims and their families has continued over the years. I'm a teacher and educator (and writer) interested in public education around this issue and related social issues. ##All the subjects of these tests and their families suffered, it seems to me, and are deserving of having their ordeals acknowledged and some remedy afforded. All were made ill -- more ill, that is, than they would have been from their cancers alone, and to a degree we cannot in every case with any precision determine. Many spent weeks in hospital they would not otherwise have had to spend. Whether short survivors or not, these individuals were usually deprived of weeks or months of what would have been more normal life, even of work in some cases. Some were afflicted with the serious mental confusion that such radiation can bring on. Almost all subjects suffered, to some degree, the risk of dying of their radiation. ##v NOTE: The full medical records for most of the above individuals are available from the office of Robert Newman; others would need to be acquired from the families involved (Madge Spanagel has copies of her own records, for instance) or their attorneys. The full records of the unidentified victims are expected to be made available by the courts quite soon, and the presiding judge could be contacted, if necessary. The technical evidence from Patient Histories alone (all included in the original DOD reports made by the doctors) is often conclusive, as noted above; in other cases, full records are essential if we wish to understand certain individual histories.