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BNSF Sues Clinic, Alleging Over-Diagnosis Of Asbestos-Related Diseases

Downtown Libby, MT.
Downtown Libby, MT.

BNSF, one of the nation’s largest rail companies, is suing the Center for Asbestos Related Disease (CARD) in federal court for what it alleges is over-diagnoses of asbestos-related diseases. Courts have already ruled BNSF shares liability for spreading asbestos in the town of Libby, MT.

In response, CARD says the rail company is really accusing a third party that includes individuals and entities of committing fraud — not the center. CARD is requesting a trial over the issue.

Sara Reardon covered the ongoing lawsuit for Kaiser Health News and shared her reporting with MTPR’s Freddy Monares.

Freddy Monares Your report says that at least 400 people in Libby exposed to asbestos have died of asbestos, mesothelioma or other lung diseases — and thousands more have been diagnosed with lung damage and diseases caused by asbestos. What exactly is a rail company claiming that the center is doing?

Sara Reardon So, the Center for Asbestos Related Disease, also called CARD, they are a center that opened in the wake of this finding that so many people in the area had asbestos-related diseases, and they've been diagnosing and treating them.

And so what BNSF is saying is that this clinic — CARD — has been over-diagnosing the condition and saying a lot more people have asbestosis, have these conditions, than actually do.

Freddy Monares Have doctors outside the center weighed in on whether the diagnoses are fraudulent?

Sara Reardon So, it's kind of unclear. Like I said, doctors outside of Libby don't really see this particular condition that often — they don't see patients from Libby who have been exposed to this particular type of asbestos.

But what they did tell me is that it's more of an art than a science sometimes, figuring out what's going on in these CT scans and X-rays. So it's really difficult for people to weigh-in and say, 'This is definitely this particular type of asbestosis,' or 'This is definitely fraudulent.'

Freddy Monares If the rail company claims the Center is defrauding a federal program, why isn't the U.S. government prosecuting the case? 

Sara Reardon So, that's what BNSF originally tried to do. They filed a suit with the U.S. government saying, 'Hey, we're a whistleblower here. We found out that CARD is committing Medicare fraud — that they're billing the U.S. government for conditions that don't exist — and we want the federal government to intervene.'

The federal government earlier this year declined to intervene. They said that, 'BNSF, you're free to sue CARD if you want to, but we're not going to take part here.'

Freddy Monares Can you give us some historical context on how Libby became infested with asbestos? 

Sara Reardon Yeah, so this all occurred because of a vermiculite mine that operated during the last century just outside Libby.

A lot of the residents worked in the mine — or helped process the vermiculite — and asbestos is a byproduct of that. The asbestos also was just released through the town. A lot of people who never even worked in the mine, or worked in the processing, have these diseases.

As a result, the mine was sued and shut down. A Supreme Court ruled a few years ago that the railway contributed to this because it [the asbestos] blew off of their cars.

Freddy Monares Are asbestos-related diseases affecting, like, all residents in Libby?

Sara Reardon There’ve been studies by the CDC and others that find that people in Libby in general are up to 100 times more likely to get asbestosis than the general population. So there's clearly something going on with the general population there [in Libby].

And what some of the scientists who have studied Libby found is that this particular type of asbestos that came out of this mine is different than what might be seen elsewhere.

And so the question that they're dealing with here is that CARD sees a lot of this. They see many, many cases of people coming in, they've got shortness of breath, they've got these other symptoms, and then they've got these particular structures in their lungs that seem to correlate with those symptoms. But nobody else in the country ever sees these.

Is that because CARD is misdiagnosing it — which is what BNSF is alleging — or is it because there's something specific going on in Libby that's causing this specific disease that, just, other doctors aren't familiar with? 

Freddy Monares How are Libby residents responding to the lawsuit?

Sara Reardon I can't speak for all Libby residents but I think that there's a general sentiment there that people are angry that they were victimized by this. Yeah, they want to see these companies being held fully liable and don't feel like that has happened yet. And so this is just kind of another phase in this ongoing saga that's been happening for decades now. 

Freddy Monares Sara Reardon is a freelance science reporter who is covering the legal battle between the rail company and a Libby clinic that diagnoses patients with asbestos-related diseases for Kaiser Health News. Thanks for joining us Sara.

Sara Reardon Yeah, thanks for having me.

The Center for Asbestos Related Disease did not make any diagnoses-related medical experts available to Sara during her reporting of this story, citing the pending litigation. Deadlines to file motions and pretrial hearings have been set for this summer.

Freddy Monares was a reporter and Morning Edition host at Montana Public Radio.
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