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Smoker's Deadly Cancer Began in Lungs, Not Elsewhere, Dr. Concludes in Trial Against R.J. Reynolds

Posted by Arlin Crisco on Nov 15, 2017 9:41:10 PM

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West Palm Beach, FL—A 42-year-old Florida smoker likely died of lung cancer that spread to her brain, a cancer specialist testified Wednesday, despite scant remaining medical records surrounding her treatment, as trial over the woman’s death continued against R.J. Reynolds. Adamson v. R.J. Reynolds, 2016CA008532.

Jacklyn Adamson’s “overall picture with smoking—heavy smoking—gives her at least an 80 percent chance… a 90 percent chance that this is [primary] lung cancer,” Dr. Howard Ozer, an oncologist and professor at the University of Illinois, told jurors Wednesday.

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Adamson began smoking as a teenager and continued until her 1993 cancer death. Her daughter, Julie Adamson, contends R.J. Reynolds, makers of cigarettes her mother smoked, is responsible for her death by concealing the dangers of smoking throughout much of the 20th century.

Julie Adamson contends her mother suffered from smoking-related lung cancer that spread to her brain. However, only a fraction of likely hundreds of medical records from Adamson's treatment remain. The absence of key documents, including records of the disease’s initial diagnosis, has raised questions surrounding the origin, and cause, of Adamson’s cancer.

On Wednesday, Ozer detailed  “multiple pieces of circumstantial evidence” to support his conclusion that Adamson’s cancer started in her lungs, including the Florida woman’s heavy smoking history. Ozer also noted the disease's rapid progression in Adamsom and the fact that it seemed to spread to the brain quickly after diagnosi, both often assocated with lung cancer. 

Ozer said it was possible that Adamson’s cancer could have begun in her breast or colon. However, he noted there was nothing in any of the available medical records describing cancer in those areas. “Almost all the time [with breast or colon cancer], there’s first evidence of the tumor in the breast or the colon,” Ozer said. “It would be vanishingly rare, although remotely possible, that she would present with a lesion of the lung and nothing else at all.”

Ozer testified medical records surrounding treatment for Adamson’s brain tumor referred to the cancer as spreading from her lung. However, on cross-exam Ozer acknowledged there was nothing to show where doctors got that information. Ozer also acknowledged that, Adamson, at 40 when she was first diagnosed, would have been unusually young to develop lung cancer. But, he said, “Forty-years old is very young for almost all cancers. You’re basically protected at 40.”

The Adamson case stems from a massive class action lawsuit, Engle v. Liggett Group Inc., originally filed in 1994. After a trial victory for the class members, the state’s supreme court ultimately decertified the class, but ruled that so-called Engle progeny cases may be tried individually. Engle progeny plaintiffs are entitled to the benefit of the jury's findings in the original verdict, including the determination that tobacco companies had placed a dangerous, addictive product on the market and hid the dangers of smoking, if they prove the smoker at the heart of the case suffered from nicotine addiction that was the legal cause of a smoking-related disease such as lung cancer.

During Wednesday’s cross-exam, Ozer noted the cancer found in Adamson’s lung was an adenocarcinoma, the same type of tumor in most breast cancers, leaving open the possibility the cancer began in her breast. That risk for breast cancer, Ozer said, was doubled by Adamson’s family history, including a sister who developed the disease in her 40s.

Still, Ozer told jurors medical evidence and Adamson’s smoking history rendered him confident in his ultimate conclusion. “The overwhelming, more likely than not possibility,” he said on direct exam, “is that this is lung cancer.”

Trial in the case is expected to last through the week.

Email Arlin Crisco at acrisco@cvn.com.

Related Information

Julie Adamson is represented by Morgan & Morgan’s Kathryn Barnett.

R.J. Reynolds is represented by King & Spalding’s Randall Bassett and Bethany Schneider.

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Topics: Adamson v. R.J. Reynolds, Florida, Engle Progeny