A joint investigation by the ABC News and the Department of Labor’s Centre for Public Integrity focused on the Johns Hopkins University and, more specifically, its radiology department.
The department had a reputation of denying cases of black lung that spanned more than 40 years.
Among the study one physician came to the attention of the centre.
Dr Paul Wheeler was described as mining industry’s “trump card” for consistently blocking miner’s cases against their employers.
A letter released by the Labor Department noted that the media investigation found Wheeler “had never once, in more than 3400 X-ray readings, interpreted an X-ray as positive for complicated pneumoconiosis”
According to the CPI, in 2009 Administrative Law Judge Stuart Levin wrote that Wheeler and two colleagues “so consistently failed to appreciate the presence of black lung on so many occasions that the credibility of their opinions is adversely affected”
“Highly qualified experts can misread X-rays on occasion but this record belies the notion that the errors by Dr Wheeler were mere oversight,” Levin wrote.
The CPI explained: “The criteria Wheeler applies when reading X-rays are at odds with positions taken by government research agencies, textbooks, peer-reviewed scientific literature and the opinions of many doctors who specialise in detecting the disease, including the chair of the American College of Radiology’s task force on black lung.”
The warning issued by the Labor Department said that Johns Hopkins had suspended its black lung X-ray reading program, pending the outcome of the ongoing investigation.
“Where other doctors saw black lung, Wheeler often saw evidence of another disease, most commonly tuberculosis or histoplasmosis – an illness caused by a fungus in bird and bat droppings,” the Centre for Public Integrity wrote.
“This was particularly true in cases involving the most serious form of the disease.”
Since 2000, miners had lost more than 800 cases after doctors saw black lung on an X-ray but Wheeler said the readings were negative.
It includes 160 cases in which doctors found the most progressed form of the disease.
When Wheeler’s evidence was presented to court, miners lost nearly 70% of cases despite positive diagnoses from other doctors.
In an interview with the CPI Wheeler upheld his views.
Wheeler told the CPI he was more intellectually honest than other doctors because he recognised the limitations of X-rays and provided potential alternative diagnoses.
He claimed to be adhering to a higher standard of medical care by demanding biopsies to ensure patients received proper treatment, despite the fact that biopsies were not a legal requirement in black lung hearings.
Johns Hopkins University defended Wheeler, saying in a statement that he was “an established radiologist in good standing in his field”