Memorandum Opinion: Award of Attorneys' Fees
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February 25, 1998

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Case Files, Thompson v. Raiford Hardbacks. Corrected Declaration of J. Routt Reigart, M.D., 1992. 105454e4-5c40-f011-b4cb-000d3a1ccbbc. LDF Archives, Thurgood Marshall Institute. https://ldfrecollection.org/archives/archives-search/archives-item/5d53ca2a-79bd-49ca-a2dd-3419a2269eea/corrected-declaration-of-j-routt-reigart-md. Accessed June 18, 2025.
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. od UNITED STATES DISTRICT COURT [DEC § 1992 i NORTHERN DISTRICT OF [rEsag WA on ML ANC ~Y DOF HER { A K DALLAS DIVISION | 8 ———— LOIS THOMPSON on behalf of and as next friend to TAYLOR KEONDRA DIXON, ZACHERY X. WILLIAMS, CALVIN A. THOMPSON and PRENTISS LAVELL MULLINS, Plaintiffs, PEOPLE UNITED FOR A BETTER OAKLAND, on behalf of its members; DENVER ACTION FOR A BETTER COMMUNITY, on behalf of its members; NEW YORK CITY COALITION TO END LEAD POISONING, on behalf of its members; ROBIN GOURLEY on behalf of and as next friend to BRYAN ALAN GOURLEY, WESLEY KYLE GOURLEY, BRIDGET MICHELLE GOURLEY, LINDA DANIELLE GOURLEY and BETSEY IRENE GOURLEY; TEARRAH ROBERSON on behalf of and as guardian ad litem to JUAN WILKINS; and MARY MARIE ROBERSON on behalf of and as guardian ad litem to ASHARD MOORE, JASON ROLLINS, ASHEA ROBERSON, and NASHEIKA ROBERSON, Proposed Plaintiff-Intervenors, V. BURTON F. RAIFORD, in his capacity as Commissioner of the Texas Department of Human Services, The UNITED STATES OF AMERICA, Defendants, uLOUIS W. SULLIVAN, in his capacity as Secretary of the United States Department of Health and Human Services, Proposed Additional Defendant. CADOC\THOMPSON\BRIERAMICIMEM a a a EE A A CASE NO. 3-92 CV 1539-R Civil Action Class Action CORRECTED DECLARATION OF J. ROUTT REIGART, M.D. CORRECTED DECLARATION OF J. ROUTT REIGART, M.D. I, J. Routt Reigart, M.D., declare as follows: 1. The matters stated herein are true of my own personal knowledge. If called as a witness, I would competently and truthfully testify consistent with the following. 2. I am an Associate Professor of Pediatrics at the Medical University of South Carolina in Charleston, South Carolina. Attached hereto as Exhibit 1 is a copy of my abbreviated curriculum vitae. 3 Since July 1991, I have served as the Chairman of the American Academy of Pediatrics’ Committee on Environmental Health ("Committee"). This Committee is reviewing the Academy’s policy on lead testing and treatment, which is currently contained in a five-year-old document entitled Statement of Childhood Lead Poisoning. We are currently reviewing this document because recent information about lead toxicity in children requires revised recommendations to pediatricians. I also serve as Chairman of the Childhood Lead Poisoning Prevention Advisory Committee of the Centers for Disease Control ("CDC"). PROFESSIONAL BACKGROUND +. As a pediatrician I have devoted much of my professional career to the study, screening and treatment of pediatric lead poisoning. For over 20 years I have been researching, writing, teaching and lecturing on lead poisoning issues. In my medical practice I have also screened and treated several thousand children who have been lead poisoned. I I 5 I have authored and co-authored numerous articles and papers dealing specifically with pediatric lead poisoning issues, including: Chisolm, Currant, Finbert Hopkins, Lin-Fu, Piomelli, Reigart, Houk, "Increased Lead Absorption and Lead Poisoning in Young Children. A Statement by the Centers for Disease Control," J. Pediatrics, 87:824 (1975); Penny, Reigart, Loadhold, Taylor, "Variability in Response to Lead Exposure: Demonstration of a Genetic Influence," (Abstract), Pediatric Research, 11:438 (1977); Whitlock, Reigart, Priester, "Lead Poisoning in South Carolina," SCMA Journal, 73:378 (1977); Reigart, "Lead Poisoning," Hospital Medicine, 17:161 16J, 16N, 16P: August, 1981; Reigart, "Future Directions," Childhood Lead Poisoning — Current Perspectives (1988) and Reigart, "Recommendations of the American Academy of Pediatrics on Lead Screening in Children," Proceedings of the First National Conference on Laboratory Issues in Childhood Lead Poisoning Prevention, October 31 - November 2, 1991. 6. Last month I addressed members of the Annual Academy of Pediatrics at its annual conference in San Francisco on the issue of "Childhood Lead Poisoning." This month I lectured at the University of Medicine & Dentistry of New Jersey, School of Osteopathic Medicine, in Atlantic City, New Jersey, on the topic of "Pediatric Lead Poison Prevention Continuing Education for Physicians," and in December I will facilitate a panel at the National Childhood Lead Poisoning Prevention Conference discussing "Medical Management Issues." I I I 7 I serve on numerous committees dedicated to pediatric environmental health issues, including: Chairman, Committee on Environmental Health, American Academy of Pediatrics; Member, Lead Poisoning Education Task Force, Presidents Council on Environmental Quality; Chairman, Centers for Disease Control Childhood Lead-Based Paint Poisoning Advisory Committee; and as a Member of the Pew Charitable Trust’s Advisory Committee on Lead Poisoning. In the past I have served on the Centers for Disease Control Childhood Lead-Based Paint Poisoning ad hoc Advisory Committee and worked with the Environmental Protection Agency as a Medical Consultant for Acute Pesticide Poisoning. LEAD POISONING AND MEDICAID ELIGIBLE CHILDREN 8. Speaking as a pediatrician, I am someone who has actually worked for many years in lead poisoning prevention out in the field. The situation in my city, Charleston, South Carolina, illustrates the enormity of the lead poisoning problem in young children. In 1972, when we began screening in Charleston, we were detecting that somewhere in the neighborhood of 39% of our children had blood lead levels greater than 40 pg/dL. By 1975, I was following over 1,250 children with lead levels greater than 30 pg/dL. Today the Centers for Disease Control has decreased the level of concern to 10 pg/dL, so that there are many more children out there who are potentially injured by dangerous blood lead levels. I I I 9, Although the American Academy of Pediatrics’ revised report is not yet completed, one recommendation that will certainly come from the Committee is that there is a need for more testing. Lead poisoning cannot be detected absent a blood test; a series of questions cannot verify blood lead levels. Nor will a series of questions guarantee that a child will be appropriately classified as low risk. In other words, a child can answer all risk-identifying questions in the negative and still be poisoned. 10. Pediatricians obviously want to test for lead using a test that will accurately measure blood lead at the levels of concern announced by the CDC (= 10 pg/dL.) The erythrocyte protoporphyrin or "EP" test (which really does not measure blood lead levels at all) is simply incapable of accurately predicting lead levels below 40 pg/dL. 11. In my opinion, as a pediatrician with extensive experience in lead poisoning prevention, Medicaid eligible children represent a high risk group since the environment of low-income children often contains numerous sources of lead exposure. 12. As noted in the CDC’s October 1991 statement, "[a]lthough all children are at risk for lead toxicity, poor and minority children are disproportionately affected. Lead exposure is at once a by-product of poverty and a contributor to the cycle that perpetuates and deepens the state of being poor." U.S. Dep’t of Health & Human Services ("HHS"), Public Health Service, Centers for Disease Control, Preventing Lead Poisoning in Young Children, 12 (Oct. 1991) ("CDC Statement"). I I I 13. The CDC Statement concludes, and I concur, that accurate measurement of blood lead levels can only be determined through the use of blood lead tests. Id. at 41. Accordingly, if the lead testing program is to be effective and if children are to be saved from lead poisoning’s devastating effects, it is essential that HHS immediately mandate that States replace the EP test with the blood lead test as the primary lead screening method. I declare under the penalty of perjury that the foregoing is true and correct, this id { th day of December, 1992 in Charleston, South Carolina. Nd fo tro Ap Reigart, MD. MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE ABBREVIATED CURRICULUM VITAE NAME Reigart gp Routt DATE OF BIRTH 01/28/43 Last First Middle Initial SOCIAL SECURITY NO.: 212-44-1620 CITIZENSHIP AND/OR VISA STATUS: US CITIZEN OFFICE ADDRESS: MUSC Childrens Hospital TELEPHONE: 792-5345 171 Ashley Avenue Charleston, SC 29425 HOME ADDRESS: 1036 Ft. Sumter Dr : TELEPHONE: 795-3831 Charleston, SC 29412 EDUCATION: Dartmouth College 1961-1964 A.B.Biology Dartmouth Medical School 1964-1965 Bachelor Med Science Harvard Medical School 1965-1967 eM. Marine Biology Lab 1964 Embryology Course GRADUATE MEDICAL TRAINING: INTERNSHIP: Childrens Hospital Medical Center 1967-1968 Boston, Massachusetts RESIDENCIES OR POST DOCTORAL TRAINING: Childrens Hospital Medical Center Boston, Massachusetts 1968-1969;1971-1972 BOARD CERTIFICATION: DATE: Diplomate, American Board of Pediatrics July 1973 LICENSURE: Diplomate, National Board of Medical Examiners 1968 South Carolina State Board of Medical Examiners 1970 FACULTY APPOINTMENTS: : PLACE DATES RANK Harvard Medical School 1971-1972 Teaching Fellow Medical University of SC 1972-1976 Assist Professor Medical University of SC 1976-1992 Assoc Professor Medical University of sc 1973-1978 Assist Prof Med MUSC Family Medicine 1978-1992 Assoc Professor Connecticut & Ohio Academies of Family Practice/Core Content Review 1973-1976 Faculty MUSC Clinical & Institutional Pharmacy 1983 Assist Professor FIRST APPOINTMENT TO MUSC: RANK: Assistant Professor DATE: 1972 MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE CURRICULUM VITAE NAME: Reigart John Routt November 18, 1992 HOME ADDRESS: 1036 Ft. Sumter Drive PHONE #: 795-3831 Charleston, SC 29412 OFFICE ADDRESS: MUSC Childrens Hospital PHONE #: 792-5345 171 Ashley Avenue Charleston, SC 29425 SOCIAL SECURITY #: 212-44-1620 EDUCATION: YEARS TRAINING IOCATION 1961-1964 A.B.Biology Dartmouth College 1964-1965 Bachelor Med Sc Dartmouth College 1965-1967 M.D. Harvard Medical School 1964 Embrology Course Marine Biology Lab 1967-1968 Intern, Medicine, Childrens Hospital Medical Center, Boston, Mass 1968-1969 Junior Assistant Resident, Medicine, Childrens Hospital Medical Center, Boston, Mass 1971-1972 Assistant Resident, Medicine, Senior Program, Childrens Hospital Medical Center, Boston, Mass SPECIALTY CERTIFICATION: 1973 Diplomate, American Board of Pediatrics LICENSURE: 1968 National Board of Medical Examiners 1970 South Carolina State Board of Medical Examiners MILITARY SERVICE: 1969-1971 USNR, Naval Weapons Station Dispensary 1970 Senior Medical Officer, NWS Dispensary FACULTY APPOINTMENTS: | 1971-1972 Teaching Fellow/Pediatrics Harvard Medical School 1972-1976 Asst Professor/Pediatrics MUSC 1976-1992 Assoc Professor/Pediatrics MUSC 1973-1978 Asst Prof/Medicine MUSC 1978-1992 Assoc Professor MUSC - Family Medicine 1973-1976 Faculty Core Content Conn/Ohio Acadenies 1983-1992 Asst Prof of Clinical/Inst Pharmacy, MUSC HOSPITAL APPOINTMENTS: 1972-1975 Utilization Review Committee 1983 Bed Space Utilization ad hoc Committee 1987-1992 Director, Division of General Pediatrics 1983-1992 1981-1992 1987-1992 i972-1992 1989-1992 1972-1992 1977-1992 1977-1983 1972-1975 1975-1992 1973-1983 1976-1977 1979-1982 1987 1987 ¥986 Pharmacy & Therapeutic Committee Medical Records Committee Children's Hospital Executive Committee Charleston Memorial Hospital Active Pediatric Staff Charleston Memorial Hospital Chief of Pediatrics Medical University Hospital Pediatric Staff Medical University Hospital Medical Director Infant Acute Care Ward Medical University Hospital Control Center Medical Director Poison RESEARCH APPOINTMENTS: Project Pediatrician, Charleston Childhood Lead Poisoning Detection Project, Project Pediatrician, South Carolina Childhood Lead Poisoning Project Consultant in Pediatrics, South Carolina Pesticides Project Principal Investigator: Medical Decision Theory, A Synopticon of the Literature Principal Investigator: Amino-Levulinate Dehydratase Variation and Susceptibility to Lead Induced Protoporhyrinemia. NIEHS Co-Investigator: A Comparative Study of Parenteral Sulbactam Ampicillin versus Ampicillin and Chloramphenicol in the Treatment of Meningitis in Infants and Children - Pfizer, Inc. Co-Investigator: Hemophilus Influenzae Protocol. noncomparative study of Parenteral CP-45, 899 in Combination with Ampicillin - Pfizer, Inc. Principal Investigator: Contract - HRSD 86-316(P) ~ To Develop an Administrative Guide for Prevention of Lead Poisoning in Children. (A AWARDS, HONORS, MEMBERSHIP IN HONORARY SOCIETIES: Outstanding Young Men of America Selection, 1976 Pediatric Attending of the Year Award 1989 MEMBERSHIP IN PROFESSIONAL/SCIENTIFIC SOCIETIES: (INCLUDING OFFICES NATIONAL SOCIETIES AND COMMITTEES American Academy of Pediatrics Chairman, Committee on Environmental Hazards, 1991-1992 Environmental Protection Agency Medical Consultant for Acute Pesticide Poisoning, 1974-1982 Presidents Council on Environmental Quality Member, Lead Poisoning Education Task Force, 1992 Dept of Health and Human Services/BHCDA/MCH/SPRANS Member, Technical Advisory Committee, 1986-1992 Southern Society for Pediatric Research Executive Council, 1976-1980 American Academy of Clinical Toxicology Moderator: Annual Meeting, Boston MS, 1983 American Medical Association Consultant for Drug Evaluations, Division of Drugs & Toxicology, 1992 enters for Disease Control Childhood Lead-Based Paint Poisoning ad hoc Advisory C ittee, 1977-78 airman, Childhood Lead-Based Paint Poisoning Advisory Committee 1984-1992 National Academy of Sciences Member, Committee on Enhancing the Role of the Primary Care Physician in Occupational and Environmental Medicine, 1989- 1990 Pew Charitable Trusts Member Advisory Committee on Lead Poisoning, 1992 Kids And The Environment Member, National Advisory Committee, 1992 NIH/NIEHS/OSAAD Medical Consultant, 1988-1992 LOCAL SOCIETIES - Charleston County Medical Society South Carolina Medical Association South Carolina Pediatric Association South Carolina Pesticide Advisory Committee EDITORIAL POSITIONS: Assistant Editor - Poisondex Reviewer - Journal of American Medical Assoc Reviewer - Hospital Formulary Reviewer - Pediatrics Reviewer - Journal of Pediatrics Reviewer - JAMA Reviewer - New England Journal of Medicine EXTRAMURAL GRANTS/AWARD AMOUNTS A Safety and Efficacy Trial of 2,3-Dimercaptosuccinic Acid (DMSA in Children with Lead Toxicity) ~ 5% Effort McNeil Consumer Products company 04-18-91 to Open Direct Costs $19,500 Indirect Costs $4,524 Pediatric Emergency Room Coverage Charleston Memorial Hospital : 07/01/90 - 06/30/91 : Direct Costs $132,000 07/01/91 - 06/30/92 Direct Costs $193,645 General Pediatric Service Contract Naval Regional Medical Center Charleston Navy Hospital 04/01/92 - 3/30/94 Low Country Childrens Center Contract Low Country Childrens Center 12/01/91 - 11/30/92 INTRAMURAL GRANTS/AWARD AMOUNTS Pediatric Continuity Clinic Children's Hospital 09/01/90 - 06/30/91 Direct Costs $82,210 07/01/91 - 06/30/92 Compensation $102,710 Continuity Care Clinic MUSC Hospital 09/01/90 - 06/30/91 Direct Costs $225,000 07/01/91 - 06/30/92 Subsidy =~ $236,250 ACADEMIC COMMITTEE ACTIVITIES: UNIVERSITY Physical Therapy Program Medical Advisory Committee (1978- present) Graduate Student Advisory Committee COLLEGE Curriculum Review Committee (1983) Children's Hospital Executive Committee (1985-present) Continuing Medical Education Committee Behavioral Science Course Committee (1973-1978) Faculty Advisory Council (1972-1976) Interviewer for Admission Committee (1973-1979) Curriculum Review Sub-committee (1983-1986) Intro to Clinical Medicine Steering Committee (1985-1988) Chairman, Curriculum Review Committee (1984-1986) Basic Clinical Genetic Course ad hoc Committee (1983) Task Force on National Boards (1983-1984) Task Force on Premedical Education (1983-1984) DEPARTMENT “Pediatric Executive Committee -/937-/442 Student Curriculum Committee (1983) DIVISION Director (1987-1992) FOR TEACHING RESPONSIBILITIES: (CURRENT) UNDERGRADUATE MEDICAL EDUCATION Division Director Pediatric Core Course Core Course Ward Teaching GRADUATE MEDICAL EDUCATION Resident Lectures and Clinical Teacher GRADUATE STUDIES EDUCATION Fellow Lectures/Training Graduate Student Advisory Committee Sherry Stine, M.D., Ph.D., Biochemistry William McLean, M.S. Biochemistry Richard Porter, M.S. Biometry Julie McElrath, Ph.D. Pathology Sandra Russ, M.S. —- CAH, MUSC CONTINUING MEDICAL EDUCATION Ground Rounds Lectures : Instructor for Louisville/Jefferson Co Dept of Health, Childhood Lead Poisoning Training Workshop MAJOR CLINICAL INTERESTS AND RESPONSIBILITIES: General Pediatrics, Toxicology INVITED LECTURES: "Experience with Newborn Transport Systems". New England Pediatric Society, December, 1971. "Diagnosis and Treatment of Lead Poisoning". Memorial Hospital, Savannah, Georgia, August 27, 1973. "Longitudinal Studies of Blood Lead and Free Erythrocyte Protoporphyrin". Also Workshop Moderator. "Screening and Treatment". Tri-Regional Lead Poisoning Staff Conference, New Orleans, Louisiana, December 11, 1974. "Diagnosis and Implications of Low Level Lead Toxicity". South Carolina Pediatric Society, April 5, 1974. Moderator - South Carolina Forum on Child Protection, Columbia, SC, March 14, 1974. "Longitudinal Observations of FEP and Blood Lead", Charleston, SC., May 29, 1974. National Conference of Childhood Lead Poisoning Control Projects, Center for Disease Control, "Clinical Aspects of Childhood Lead Poisoning".Pediatric Grand Rounds, South Alabama Medical Center, July 22, 1975. Pediatric Grand Rounds, University of Louisville School of Medicine, August 22, 1975. -"Clinical Aspects of Childhood Lead Poisoning". National Conference of Childhood Lead Poisoning Prevention, Norfolk, VA, October 22, 1975. "Program Operations with Erythrocyte Protoporphyrins". Pediatric Grand Rounds, University of Tennessee Medical School, Memphis, November, 1975. "Clinical Aspects of Childhood Lead Poisonings". Chairman - Sessions Medical Management. HEW ~ Tri-Regional Conference of Childhood Lead Poisoning Projects - February 25, 1976. Mobile, Alabama. Visiting Professorship and Grand Rounds - University of North Carolina Medical School, Chapel Hill. Topics: Lead Poisoning and Toxicology. March 4-5, 1976. "Variability in Response to Lead Exposure - Demonstration of a Genetic Influence" - APS-SPS Annual Meeting. April 29, 1977. San Francisco, CA. "Clinical Aspects of Childhood Lead Intoxication! - Workshop on Planning Pediatric Lead Screening Program in North Carolina, NIEHS-RTP, NC, May 5, 1977. "New Aspects of Prevention of Lead Poisoning". National Association for Retarded Citizens. Northeast/Southeast Regional Conference. Myrtle Beach, SC, April 15, 1978, "Lead Poisoning in Childhood" ~ Grand Rounds. M.C.G. - Augusta, Georgia, March 15, 1979. "Symposium on Childhood Lead Poisoning". South Carolina Department of Health and Environmental Control. Columbia, SC, October 23, 1980. "Interaction of Nutrition and Lead Poisoning in Childhood". Nutrition Council and Area Health Education Center. Columbia, SC, June 20, 1980 "6th Annual Conference on Vital Records and Statistics". Department of Health and Environmental Control, Columbia, SC, October 5-6, 1980. "An Alternative Method of Intravenous Drug Administration in Pediatric Patients - The Use of Low Volume Tubing", Vander-veen TW, Reigart, JR, and Smith S. Presented ASHP MidyearClinical Meeting, Los Angeles, CA, December 5-9, 1982. "Management of Common Ingested Poisons in Children", Care of the Critically Ill or Injured Patient. Charleston, SC, December 3, 1982. "Medical Evaluation and Management of Pesticide Exposure", Southeast Louisiana Emergency Medical Services Council, Recognition and Management of Environmental Disease in the 1980's, New Orleans, 1A, December 9, 1983. "Childhood Lead Poisoning" - Pediatric Grand Rounds, University of Louisville College of Medicine, March 25, 1984. "Pesticide Exposure in Children", 1984 Migrant Health Conference, The Migrant Child. Charleston, SC, April 14, 1984. "Acute Pesticide Exposure" - Care of the Critically Ill or Injured Patient =~ Charleston, SC, November 17, 1984. "Childhood Lead Poisoning" - New Jersey Anti-Lead Poisoning Coalition, Trenton, New Jersey, October 10, 1984. "Medical Aspects of Childhood Lead Poisoning" - Migrant Health Workshop - salt Lake City, Utah, January 18, 1985. "Relationship Between E.P., Iron Deficiency and Lead Poisoning", Workshop, Commonwealth of Virginia - Richmond, VA, August 29, 1985. "Diagnosis, Supportive Management and Chelation Therapy" - Current Issues in Pediatric Lead Poisoning - Chicago Department of Health - March of Dimes, Chicago, Illinois, May 3, 1985. "Children at Risk: The Impact of Lead" - Eastern Area Health Education Center, Greenville, NC, April 4, 1986. "Childhood Lead Poisoning", Grand Rounds - Rhode Island Hospital, June 6, 1986. "Current Perspectives - Future Directions", National childhood Lead Poisoning Conference, Indianapolis, Indiana, Decenber, 1987. "Lead Poisoning Prevention", Injury Control/Lead Poisoning Prevention Program, Chatham County Department of Public Health, Savannah, Ga, May 10, 1989. "Health Effects and Medical Management of Lead Poisoning", First Lead Poisoning Workshop, North Carolina Department of Human Resources, Raleigh, North Carolina, May 3, 1989. "Laboratory Issues in Childhood Lead Poisoning Prevention", Association of State and Territorial Public Health Laboratory Directors, Columbia, Md, November 1991. "Childhood Lead Poisoning", Committee on Children with Disabilities, Chicago, Ill, December 1991 "Pesticides, Children, and Food Safety", Public Voice's 1992 Children and Nutrition Conference (Guiding Kids to a Healthy Life), Washington, D.C., January 1992. "Childhood Lead Poisoning", Division of Children's Health Grand Rounds, Richland Memorial Hospital, Columbia, SC January 1992. "Childhood Lead Poisoning Prevention" Trident Regional Hospital, Charleston, SC, May 1992. "Childhood Lead Poisoning", Grand Rounds, Orangeburg Regional Hospital, Orangeburg, SC June 1992. "Clinical Answers: The Modern Approach", Metal Binding in Medicine~--Lead/Cadmium Conference, Great Lakes Association of Clinical Medicine Meeting, Grand Rapids, MI, September 1992. "Childhood Lead Poisoning", Annual AAP Meeting, San Francisco, CA, October 1992 Moderator for NIEHS Meeting, Triangle Research Park, NC, November 1992. "Pediatric Lead Poison Prevention Continuing Education for Physicians", University of Medicine & Dentistry of NJ, School of Osteopathic Medicine, Atlantic City, NJ, November 1992. "Medical Management Issues", Facilitator; National Childhood Lead Poisoning Prevention Conference, December 1992. EXTRAMURAL PROFESSIONAL ACTIVITIES: Get the Lead Out Committee Childhood Lead Poisoning Talk Forum, Channel 5 Charleston Lead Poisoning Prevention Coalition Charleston Memorial Hospital Executive Committee COMMUNITY SERVICE: District Enrollment Director, SC District, Dartmouth College President, Kiwanis Club of Charleston Board of Directors, MUSC Childrens Hospital Fund BIBLIOGRAPHY: JOURNALS: Lash J, Reigart JR, Studies in Ascidian Metamorphosis: Birefringence in Tail Epidermis", Biological Bulletin 129:395:1965. Habercam JW, Keil JE, Reigart JR, Croft HW. "Lead Content of Human Blood, Hair, and Deciduous Teeth:Correlation with Environmental Factors and Growth". The Journal of Dental Research, 53:1160, 1974. Reigart JR, Brueggeman JL, Keil JE, "Sodium Fluoracetate ("1080") Poisoning". American Journal of Diseases of Children, 129: 1124, 2197S. Harmon GE’, Reigart JR, "Long-Term Follow-up of Survivors of Severe Acute Pesticide Poisoning". South Carolina Medical Association Journal. 71:253, 1975. Reigart JR, Whitlock NH, "Longitudinal Studies of Blood Lead and Free Erythrocyte Protoporphyrin". Pediatrics, 57:54, 1976. Cupp CM, Kleiwer G, Reigart JR, Sandifer SH, "Hypothermia in Organophosphate Poisoning and Response to PAM". South Carolina Medical Association Journal, 71: April, 1975. Allen RC, Harley RA, Reigart JR, "Quantitative and Qualitative Studies of Protease Inhibitor Phenotyping by Isoelectric Focusing on Polyacrylamide Gel Slabs". (Abstract) American Journal of Clinical Pathology, 63:767, 1975. Reigart JR, Graber CD, "Evaluation of the Humoral Immune Response of Children with Low Level Lead Exposure". Bulletin of Environmental Contamination and Toxicology, 16:112, 1976. Chisclm JJ, Currant AS, Finbert AS, Hopkins DR, Lin-Fu Js, Piomelli Ss, Reigart JR, Houk VH, "Increased Lead Absorption and Lead Poisoning in Young Children. A statement by the Center for Disease Control", J. Pediatrics, 87:824 1975. Penny LD’, Reigart JR, Loadhold CB, Taylor HL, "Variability in Response to Lead Exposuro: Domonctration of a Cenetic Influence". (Abstract), Pediatric Research, 11:438, 1977. Whitlock N, Reigart JR, Priester L, “Lead Poisoning in South Carolina". SCMA Journal, 73:378, 1977. Reigart JR, "Lead Poisoning". Hospital Medicine, 17:161 16J, 16N, 16P: August, 1981. Trammel HL, Sandifer SH, Reigart JR, and Hurwitz GA (Abstract) "National Pesticide Telecommunications Network: A Specialized Poison Information Center", Veterinary and Human Toxicology, 23:52, 1981. Reigart JR and Trammel HL. (Abstract), "Treatment of Acute Dapsone Intoxication in a Child by Pulse Dosing with Activated Charcoal". Veterinary and Human Toxicology. 23:58, 1981. Thompson DF’, Trammel HL, Robertson NJ, and Reigart JR."Telephone Evaluation of Regional and Non-Regional Poison Centers", New England Journal of Medicine. 308: January 27, 1982, Number 4. Reigart JR, Trammel HL, and Lindsey JM, "Treatment of Symptomatic Dapsone Poisoning by Repetitive Activated Charcoal Treatment in a Child". Journal of Toxicology-Clinical se Toxicology. 19:1061, 1983. = Reigart JR, and Trammel HL: "Plasma and Red Blood Cell Cholinesterase Levels are Poor Predictors of Cholinergic - Symptomatology". Veterinary and Human Toxicology. 24:276, 1982. (Abstract). Olanoff LS, Bristow W, Colcolough J, and Reigart JR. "Acute Chlordane Intoxication". Toxicologyv-Clinical Toxicology 20:291-306, 1983. Medical Students’ Graduate Students® Residents’ 10 Trammel HL, and Reigart JR. "Acute Herbicide Intoxication". Clinical Toxicology Consultant. 5:56-69, 1983. Rogan WJ, Reigart JR, and Gladen BC, "Association of Amino Levulinate Dehydratase Levels and Ferrochelatase Inhibition in Childhood Lead Exposure". The Journal of Pedjatrics. 109:60- 64, 1986. Weist DB, ONeal W, Reigart JR, Brundage RC, Gillette PC, and Yost RL, "Pharmacokinetics of Ranitidine in Critically I11 Infants". Developmental Pharmacology and Therapeutics. Dev Pharmacol Ther 1989; 12(1): 7-12 Durand RP, Fincher RE, Reigart JR, Lichtenstein LS, Lancaster, CJ, and Levine JH "An Analysis of Third Year Medical Students’ Abilities to Order Appropriate Diagnostic Tests and Procedures". Learning. Academic Medicine. 66(11):702-04, July, 1991. Hammill WW', Reigart JR, Laver J, "Ehrlichia Canis Infection in a Child in South Carolina", Clinical Pediatrics, Clin Pediatr (Phila) 1992 Jul; 31(7):432-4. Reigart JR, Chairman, Committee on Drugs, American Academy of Pediatrics; and Committee on Environmental Health, American Academy of Pediatrics, "Use of Chloral Hydrate for Sedation in Children" Pediatrics (In Press). Reigart JR, Chairman, Committee on Environmental Health, American Academy of Pediatrics, "Lead Poisoning - From Screening to Prevention" Pediatrics, (In Press). Reigart JR. Chairman, Committee on Environmental Health, American Academy of Pediatrics, "Ambient Air Pollution: Respiratory Hazards to Children", Pediatrics, (In Press). BOOKS AND OTHER MONOGRAPHS: Krall AR, McLean Jr ws¥, Gamble HF, Rogers Jr EW, Reigart JR, Collawn Ss”, "Effects of Magnesium Infusions on the Metabolism of Calcium and Lead: Evidence for Release of Calcitonin and Parathyroid Hormone in Response to Changes in Plasma Magnesium Content." In Magnesium in Health in Disease Proceedings of 2nd Int. Symposium on Magnesium, Montreal. May, 1976. Miller MC, Westphal MC, Reigart JR, Barner C,Medical Diagnostic Models: A Bibliography. University Micro-films International, 1977. Medical Students’ Graduate Students’ Residents’ 11 Miller MC, Westphal MC, Reigart JR, Mathematical Models of Medical Diagnosis. Praeger, Inc, NY, NY, 198). Reigart JR, "Future Directions", Childhood lead Poisoning - current Perspectives, 1988. Mahaffey KR, McKinney J, and Reigart JR, "Lead and Compound". (1991) In: Critical Reviews of Environmental Toxicants. EQ. M. Tiinnmann Van Nnetrand Rainhnld, Nam Vark Reigart JR, "Recommendations of the American Academy of Poediatrice on Lead Sorooning in Children", Drocecdings ef the First National Conference on Laboratory Issues in Childhood Lead Doiconing Droevention, Ooctobor 21 - November 2, 19291 Medical Students’ Graduate Students” Residents’ 4 a \ i 7 4 J ue i UNITED STATES DISTRICT COURT NORTHERN DISTRICT OF TEXAS DALLAS DIVISION LOIS THOMPSON on behalf of and as next friend to TAYLOR KEONDRA DIXON, ZACHERY X. WILLIAMS, CALVIN A. THOMPSON and PRENTISS LAVELL MULLINS, : Plaintiffs, PEOPLE UNITED FOR A BETTER OAKLAND, on behalf of its members; DENVER ACTION FOR A BETTER COMMUNITY, on behalf of its members; NEW YORK CITY COALITION TO END LEAD POISONING, on behalf of its members; ROBIN GOURLEY on behalf of and as next friend to BRYAN ALAN GOURLEY, WESLEY KYLE GOURLEY, BRIDGET MICHELLE GOURLEY, LINDA DANIELLE GOURLEY and BETSEY IRENE GOURLEY; TEARRAH ROBERSON on behalf of and as guardian ad litem to JUAN WILKINS; and MARY MARIE ROBERSON on behalf of and as guardian ad litem to ASHARD MOORE, JASON ROLLINS, ASHEA ROBERSON, and NASHEIKA ROBERSON, Proposed Plaintiff-Intervenors, V. BURTON F. RAIFORD, in his capacity as Commissioner of the Texas Department of Human Services, The UNITED STATES OF AMERICA, Defendants, uLOUIS W. SULLIVAN, in his capacity as Secretary of the United States Department of Health and Human Services, Proposed Additional Defendant. CADOCQTHOMPSON\BRIERAMICIMEM CASE NO. 3-92 CV 1539-R Civil Action Class Action CORRECTED DECLARATION OF J. ROUTT REIGART, M.D. CORRECTED DECLARATION OF J. ROUTT REIGART, M.D. I, J. Routt Reigart, M.D., declare as follows: 1. The matters stated herein are true of my own personal knowledge. If called as a witness, I would competently and truthfully testify consistent with the following. 2. I am an Associate Professor of Pediatrics at the Medical University of South Carolina in Charleston, South Carolina. Attached hereto as Exhibit 1 is a copy of my abbreviated curriculum vitae. 3. Since yuly 1991, I have served as the Chairman of the American Academy of Pediatrics’ Committee on Environmental Health ("Committee"). This Committee is reviewing the Academy’s policy on lead testing and treatment, which is currently contained in a five-year-old document entitled Statement of Childhood Lead Poisoning. We are currently reviewing this document because recent information about lead toxicity in children requires revised recommendations to pediatricians. I also serve as Chairman of the Childhood Lead Poisoning Prevention Advisory Committee of the Centers for Disease Control ("CDC"). PROFESSIONAL BACKGROUND 4. As a pediatrician I have devoted much of my professional career to the study, screening and treatment of pediatric lead poisoning. For over 20 years I have been researching, writing, teaching and lecturing on lead poisoning issues. In my medical practice I have also screened and treated several thousand children who have been lead poisoned. I I 3. I have authored and co-authored numerous articles and papers dealing specifically with pediatric lead poisoning issues, including: Chisolm, Currant, Finbert Hopkins, Lin-Fu, Piomelli, Reigart, Houk, "Increased Lead Absorption and Lead Poisoning in Young Children. A Statement by the Centers for Disease Control," J. Pediatrics, 87:824 (1975); Penny, Reigart, Loadhold, Taylor, "Variability in Response to Lead Exposure: Demonstration of a Genetic Influence," (Abstract), Pediatric Research, 11:438 (1977); Whitlock, Reigart, Priester, "Lead Poisoning in South Carolina," SCMA Journal, 73:378 (1977); Reigart, "Lead Poisoning," Hospital Medicine, 17:161 16J, 16N, 16P: August, 1981, Reigart, "Future Directions," Childhood Lead Poisoning — Current Perspectives (1988) and Reigart, "Recommendations of the American Academy of Pediatrics on Lead Screening in Children," Proceedings of the First National Conference on Laboratory Issues in Childhood Lead Poisoning Prevention, October 31 - November 2, 1991. 6. Last month I addressed members of the Annual Academy of Pediatrics at its annual conference in San Francisco on the issue of "Childhood Lead Poisoning." This month I lectured at the University of Medicine & Dentistry of New Jersey, School of Osteopathic Medicine, in Atlantic City, New Jersey, on the topic of "Pediatric Lead Poison Prevention Continuing Education for Physicians," and in December I will facilitate a panel at the National Childhood Lead Poisoning Prevention Conference discussing "Medical Management Issues." 1 I! I 7. I serve on numerous committees dedicated to pediatric environmental health issues, including: Chairman, Committee on Environmental Health, American Academy of Pediatrics; Member, Lead Poisoning Education Task Force, Presidents Council on Environmental Quality; Chairman, Centers for Disease Control Childhood Lead-Based Paint Poisoning Advisory Committee; and as a Member of the Pew Charitable Trust's Advisory Committee on Lead Poisoning. In the past I have served on the Centers for Disease Control Childhood Lead-Based Paint Poisoning ad hoc Advisory Committee and worked with the Environmental Protection Agency as a Medical Consultant for Acute Pesticide Poisoning. LEAD POISONING AND MEDICAID ELIGIBLE CHILDREN 8. Speaking as a pediatrician, I am someone who has actually worked for many years in lead poisoning prevention out in the field. The situation in my city, Charleston, South Carolina, illustrates the enormity of the lead poisoning problem in young children. In 1972, when we began screening in Charleston, we were detecting that somewhere in the neighborhood of 39% of our children had blood lead levels greater than 40 pg/dL. By 1975, 1 was following over 1,250 children with lead levels greater than 30 pg/dL. Today the Centers for Disease Control has decreased the level of concern to 10 pg/dL, so that there are many more children out there who are potentially injured by dangerous blood lead levels. I I I 9, Although the American Academy of Pediatrics’ revised report is not yet completed, one recommendation that will certainly come from the Committee is that there is a need for more testing. Lead poisoning cannot be detected absent a blood test; a series of questions cannot verify blood lead levels. Nor will a series of questions guarantee that a child will be appropriately classified as low risk. In other words, a child can answer all risk-identifying questions in the negative and still be poisoned. 10. Pediatricians obviously want to test for lead using a test that will accurately measure blood lead at the levels of concern announced by the CDC (= 10 pg/dL.) The erythrocyte protoporphyrin or "EP" test (which really does not measure blood lead levels at all) is simply incapable of accurately predicting lead levels below 40 pg/dL. 11. In my opinion, as a pediatrician with extensive experience in lead poisoning prevention, Medicaid eligible ilies represent a high risk group since the environment of low-income children often contains numerous sources of lead exposure. 12. As noted in the CDC’s October 1991 statement, "[a]lthough all children are at risk for lead toxicity, poor and minority children are disproportionately affected. Lead exposure is at once a by-product of poverty and a contributor to the cycle that perpetuates and deepens the state of being poor." U.S. Dep’t of Health & Human Services ("HHS"), Public Health Service, Centers for Disease Control, Preventing I.ead Poisoning in Young Children, 12 (Oct. 1991) ("CDC Statement"). I 11] I 13. The CDC Statement concludes, and I concur, that accurate measurement of blood lead levels can only be determined through the use of blood lead tests. Id. at 41. Accordingly, if the lead testing program is to be effective and if children are to be saved from lead poisoning’s devastating effects, it is essential that HHS immediately mandate that States replace the EP test with the blood lead test as the primary lead screening method. I declare under the penalty of perjury that the foregoing is true and correct, this _ th day of December, 1992 in Charleston, South Carolina. J. Routt Reigart, M.D. MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE ABBREVIATED CURRICULUM VITAE NAME Reigart J. Routt DATE OF BIRTH 01/28/43 Last First Middle Initial SOCIAL SECURITY NO.: 212-44-1620 CITIZENSHIP AND/OR VISA STATUS: US CITIZEN OFFICE ADDRESS: MUSC Childrens Hospital TELEPHONE: 792-5345 171 Ashley Avenue Charleston, SC 29425 HOME ADDRESS: 1036 Ft. Sumter Dr TELEPHONE: 795-3831 Charleston, SC 29412 EDUCATION: Dartmouth College 1961-1964 A.B.Biology Dartmouth Medical School 1964-1965 Bachelor Med Science Harvard Medical School 1965-1967 M.D. Marine Biology Lab 1964 Embryology Course GRADUATE MEDICAL TRAINING: INTERNSHIP: Childrens Hospital Medical Center 1967-1968 Boston, Massachusetts RESIDENCIES OR POST DOCTORAL TRAINING: Childrens Hospital Medical Center Boston, Massachusetts 1968-1969;1971-1972 BOARD CERTIFICATION: DATE: Diplomate, American Board of Pediatrics July 1973 LICENSURE: Diplomate, National Board of Medical Examiners 1968 South Carolina State Board of Medical Examiners 1970 FACULTY APPOINTMENTS: PLACE DATES RANK Harvard Medical School 1971-1972 Teaching Fellow Medical University of SC 1972-1976 Assist Professor Medical University of SC 1976-1992 Assoc Professor Medical University of SC 1973-1978 Assist Prof Med MUSC Family Medicine 1978-1992 Assoc Professor Connecticut & Ohio Academies of Family Practice/Core Content Review 1973-1976 Faculty MUSC Clinical & Institutional Pharmacy 1983 Assist Professor FIRST APPOINTMENT TO MUSC: RANK: Assistant Professor DATE: 1972 MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE CURRICULUM VITAE NAME: Reigart John Routt November 18, 1992 1036 Ft. Sumter Drive Charleston, SC 29412 HOME ADDRESS: PHONE #: 795-3831 OFFICE ADDRESS: MUSC Childrens Hospital 171 Ashley Avenue Charleston, SC 29425 PHONE #: 792-5345 SOCIAL SECURITY #: 212-44-1620 EDUCATION: YEARS 1961-1964 1964-1965 1965-1967 1964 1967-1968 TRAINING A.B.Biology Bachelor Med Sc IOCATION Dartmouth College Dartmouth College M.D. Harvard Medical School Embrology Course Marine Biology Lab Intern, Medicine, Childrens Hospital Medical Center, Boston, Mass Junior Assistant Resident, Medicine, Childrens Hospital Medical Center, Boston, Mass : Assistant Resident, Medicine, Senior Program, Childrens Hospital Medical Center, Boston, Mass 1968-1969 1971-1972 SPECIALTY CERTIFICATION: 1973 LICENSURE: 1968 1970 1969-1971 1970 Diplomate, American Board of Pediatrics National Board of Medical Examiners South Carolina State Board of Medical Examiners MILITARY SERVICE: USNR, Naval Weapons Station Dispensary Senior Medical Officer, NWS Dispensary ~ FACULTY APPOINTMENTS: 1971-1972 1972-1976 1976-1992 1973-1978 1978-1992 1973-1976 1983-1992 Teaching Fellow/Pediatrics Asst Professor/Pediatrics Assoc Professor/Pediatrics Asst Prof/Medicine Assoc Professor MUSC - Family Medicine Faculty Core Content Conn/Ohio Academies Asst Prof of Clinical/Inst Pharmacy, MUSC Harvard Medical School MUSC MUSC MUSC HOSPITAL APPOINTMENTS: 1972-1975 Utilization Review Committee 1983 Bed Space Utilization ad hoc Committee 1987-1992 Director, Division of General Pediatrics 1983-19892 1991-1962 1987-1992 1972-1992 1989-1992 1972-1992 1877-1992 1877-1983 Pharmacy & Therapeutic Committee Medical Records Committee Children's Hospital Executive Committee Charleston Memorial Hospital Active Pediatric Staff Charleston Memorial Hospital Chief of Pediatrics Medical University Hospital Pediatric Staff Medical University Hospital Medical Director Infant Acute Care Ward Medical University Hospital Medical Director Poison Control Center RESEARCH APPOINTMENTS: 1972-1975 1975-1992 1973-1983 1976-1977 1979-1982 1987 1987 X986 Project Pediatrician, Charleston Childhood Lead Poisoning Detection Project, Project Pediatrician, South Carolina Childhood Lead Poisoning Project Consultant in Pediatrics, South Carolina Pesticides Project Principal Investigator: Medical Decision Theory, a Synopticon of the Literature Principal Investigator: Amino-Levulinate Dehydratase Variation and Susceptibility to Lead Induced Protoporhyrinenia. NIEHS Co-Investigator: A Comparative Study of Parenteral Sulbactam Ampicillin versus Ampicillin and Chloramphenicol in the Treatment of Meningitis in Infants and Children - Pfizer, Inc. Co-Investigator: Hemophilus Influenzae Protocol. (A noncomparative study of Parenteral CP-45, 899 in Combination with Ampicillin - Pfizer, Inc. Principal Investigator: Contract - HRSD 86-316(P) - To Develop an Administrative Guide for Prevention of Lead Poisoning in Children. AWARDS, HONORS, MEMBERSHIP IN HONORARY SOCIETIES: Outstanding Young Men of America Selection, 1976 Pediatric Attending of the Year Award 1989 MEMBERSHIP IN PROFESSIONAL/SCIENTIFIC SOCIETIES: (INCLUDING OFFICES HELD) NATIONAL SOCIETIES AND COMMITTEES American Academy of Pediatrics Chairman, Committee on Environmental Hazards, 1991-1992 Environmental Protection Agency Medical Consultant for Acute Pesticide Poisoning, 1974-1982 Presidents Council on Environmental Quality Menber, Lead Poisoning Education Task Force, 1992 Dept of Health and Human Services/BHCDA/MCH/SPRANS Member, Technical Advisory Committee, 1986-1992 Southern Society for Pediatric Research Executive Council, 1976-1980 American Academy of Clinical Toxicology Moderator: Annual Meeting, Boston MS, 1983 American Medical Association Consultant for Drug Evaluations, Division of Drugs & Toxicology, 1992 Centers for Disease Control Childhood Lead-Based Paint Poisoning ad hoc Advisory Committee, 1977-78 airman, Childhood Lead-Based Paint Poisoning Advisory Committee 1984-1992 National Academy of Sciences Member, Committee on Enhancing the Role of the Primary Care Physician in Occupational and Environmental Medicine, 1989- 1990 Pew Charitable Trusts Member Advisory Committee on Lead Poisoning, 1992 Kids And The Environment Member, National Advisory Committee, 1992 NIH/NIEHS/OSAAD Medical Consultant, 1988-1992 LOCAL SOCIETIES - Charleston County Medical Society South Carolina Medical Association South Carolina Pediatric Association South Carolina Pesticide Advisory Committee EDITORIAL POSITIONS: Assistant Editor - Poisondex Reviewer - Journal of American Medical Assoc Reviewer - Hospital Formulary Reviewer - Pediatrics Reviewer - Journal of Pediatrics Reviewer - JAMA Reviewer - New England Journal of Medicine EXTRAMURAL GRANTS/AWARD AMOUNTS A Safety and Efficacy Trial of 2,3-Dimercaptosuccinic Acid (DMSA in Children with Lead Toxicity) ~ 5% Effort McNeil Consumer Products company 04-18-91 to Open Direct Costs $19,500 Indirect Costs $4,524 Pediatric Emergency Room Coverage Charleston Memorial Hospital 07/01/90 - 06/30/91 Direct Costs $132,000 07/01/91 - 06/30/92 Direct Costs $193,645 General Pediatric Service Contract Naval Regional Medical Center Charleston Navy Hospital 04/01/92 - 3/30/94 Low Country Childrens Center Contract Low Country Childrens Center 12/01/91 - 11/30/92 INTRAMURAL GRANTS/AWARD AMOUNTS Pediatric Continuity Clinic Children's Hospital 09/01/90 - 06/30/91 Direct Costs $82,210 07/01/91 - 06/30/92 Compensation $102,710 Continuity Care Clinic MUSC Hospital 09/01/90 - 06/30/91 Direct Costs $225,000 07/01/91 ~ 06/30/92 Subsidy ~ $236,250 ACADEMIC COMMITTEE ACTIVITIES: UNIVERSITY Physical Therapy Program Medical Advisory Committee (1978- present) Graduate Student Advisory Committee COLLEGE Curriculum Review Committee (1983) Children's Hospital Executive Committee (1985-present) Continuing Medical Education Committee Behavioral Science Course Committee (1973-1978) Faculty Advisory Council (1972-1976) Interviewer for Admission Committee (1973-1979) Curriculum Review Sub-committee (1983-1986) Intro to Clinical Medicine Steering Committee (1985-1988) Chairman, Curriculum Review Committee (1984-1986) Basic Clinical Genetic Course ad hoc Committee (1983) Task Force on National Boards (1983-1984) Task Force on Premedical Education (1983-1984) DEPARTMENT Pediatric Executive Committee - /787-/692 Student Curriculum Committee (1983) DIVISION Director (1987-1992) FOR TEACHING RESPONSIBILITIES: (CURRENT) UNDERGRADUATE MEDICAL EDUCATION Division Director Pediatric Core Course Core Course Ward Teaching GRADUATE MEDICAL EDUCATION Resident Lectures and Clinical Teacher GRADUATE STUDIES EDUCATION Fellow Lectures/Training Graduate Student Advisory Committee Sherry Stine, M.D., Ph.D., Biochemistry William McLean, M.S. Biochemistry Richard Porter, M.S. Biometry Julie McElrath, Ph.D. Pathology Sandra Russ, M.S. - CAH, MUSC CONTINUING MEDICAL EDUCATION Ground Rounds Lectures : Instructor for Louisville/Jefferson Co Dept of Health, childhood Lead Poisoning Training Workshop MAJOR CLINICAL INTERESTS AND RESPONSIBILITIES: General Pediatrics, Toxicology INVITED LECTURES: "Experience with Newborn Transport Systems". New England Pediatric Society, December, 1971. "Diagnosis and Treatment of Lead Poisoning". Memorial Hospital, Savannah, Georgia, August 27, 31973. "Longitudinal Studies of Blood I.ead and Free Erythrocyte Protoporphyrin®". Also Workshop Moderator. "Screening and Treatment". Tri-Regional Lead Poisoning Staff Conference, New Orleans, Louisiana, December 11, 1974. "Diagnosis and Implications of Low Level Lead Toxicity". South Carolina Pediatric Society, April 5, 1974. Moderator - South Carolina Forum on Child Protection, Columbia, SC, March 14, 1974. "Longitudinal Observations of FEP and Blood Lead", Charleston, SC., May 29, 1974. National Conference of Childhood Lead Poisoning Control Projects, Center for Disease Control, "Clinical Aspects of Childhood Lead Poisoning".Pediatric Grand Rounds, South Alabama Medical Center, July 22, 1975. Pediatric Grand Rounds, University of Louisville School of Medicine, August 22, 1975. -“"Clinical Aspects of Childhood lead Poisoning", National Conference of Childhood Lead Poisoning Prevention, Norfolk, VA, October 22, 1975. "Program Operations with Erythrocyte Protoporphyrins®. Pediatric Grand Rounds, University of Tennessee Medical School, Memphis, November, 1975. "Clinical Aspects of Childhood Lead Poisonings®", Chairman - Sessions Medical Management. HEW - Tri-Regional Conference of Childhood lead Poisoning Projects - February 25, 1976. Mobile, Alabama. Visiting Professorship and Grand Rounds - University of North Carolina Medical School, Chapel Hill. Topics: lead Poisoning and Toxicology. March 4-5, 1976. "Variability in Response to Lead Exposure - Demonstration of a Genetic Influence" - APS-SPS Annual Meeting. April 29, 1977. San Francisco, CA. "Clinical Aspects of Childhood Lead Intoxication" - Workshop on Planning Pediatric Lead Screening Program in North Carolina, NIEHS-RTP, NC, May 5, 1977. "New Aspects of Prevention of Lead Poisoning". National : Association for Retarded Citizens. Northeast/Southeast Regional Conference. Myrtle Beach, SC, April 15, 1978. "Lead Poisoning in Childhood" - Grand Rounds. M.C.G. - Augusta, Georgia, March 15, 1979. "Symposium on Childhood Lead Poisoning. South Carolina Department of Health and Environmental Control. Columbia, SC, October 23, 1980. “Interaction of Nutrition and Lead Poisoning in Childhood". Nutrition Council and Area Health Education Center. Columbia, SC, June 20, 1980 "6th Annual Conference on Vital Records and Statistics". Department of Health and Environmental Control, Columbia, SC, October 5-6, 1980. "An Alternative Method of Intravenous Drug Administration in Pediatric Patients - The Use of Low Volume Tubing", Vander-veen TW, Reigart, JR, and Smith S. Presented ASHP MidyearClinical Meeting, Los Angeles, CA, December 5-9, 1982. "Management of Common Ingested Poisons in Children", Care of the Critically Ill or Injured Patient. Charleston, SC, December 3, 1982. "Medical Evaluation and Management of Pesticide Exposure", Southeast Louisiana Emergency Medical Services Council, Recognition and Management of Environmental Disease in the 1980's, New Orleans, LA, December 09,1983. "Childhood Lead Poisoning" - Pediatric Grand Rounds, University of Louisville College of Medicine, March 25, 1984. “Pesticide Exposure in Children", 1984 Migrant Health Conference, The Migrant Child. Charleston, SC, April 14, 1984. "Acute Pesticide Exposure™ - Care of the Critically 111 or Injured Patient - Charleston, SC, November 17, 1984. "Childhood Lead Poisoning" - New Jersey Anti-Lead Poisoning Coalition, Trenton, New Jersey, October 10, 1924, "Medical Aspects of Childhood Lead Poisoning" - Migrant Health Workshop - Salt Lake City, Utah, January 18, 1985. "Relationship Between E.P., Iron Deficiency and Lead Poisoning", Workshop, Commonwealth of Virginia - Richmond, Va, August 29, 1985. "Diagnosis, Supportive Management and Chelation Therapy" - Current Issues in Pediatric Lead Poisoning - Chicago Department of Health - March of Dimes, Chicago, Illinois, May 3, 1985. “Children at Risk: The Impact of Lead" - Eastern Area Health Education Center, Greenville, NC, April 4, 1986. "Childhood Lead Poisoning", Grand Rounds - Rhode Island Hospital, June 6, 1986. "Current Perspectives - Future Directions", National childhood Lead Poisoning Conference, Indianapolis, Indiana, December, 1987. "Lead Poisoning Prevention", Injury Control/Lead Poisoning Prevention Program, Chatham County Department of Public Health, Savannah, Ga, May 10, 1989. "Health Effects and Medical Management of Lead Poisoning", First Lead Poisoning Workshop, North Carolina Department of Human Resources, Raleigh, North Carolina, May 3, 1989. "Laboratory Issues in Childhood Lead Poisoning Prevention", Association of State and Territorial Public Health Laboratory Directors, Columbia, Md, November 1991. "Childhood Lead Poisoning, Committee on Children with Disabilities, Chicago, I11, December 1991 "Pesticides, Children, and Food Safety", Public Voice's 1992 Children and Nutrition Conference (Guiding Kids to a Healthy Life), Washington, D.C., January 1992. "Childhood Lead Poisoning", Division of Children's Health Grand Rounds, Richland Memorial Hospital, Columbia, SC January 1992. "Childhood Lead Poisoning Prevention" Trident Regional Hospital, Charleston, SC, May 1992. "Childhood Lead Poisoning", Grand Rounds, Orangeburg Regional Hospital, Orangeburg, SC June 1992. “Clinical Answers: The Modern Approach", Metal Binding in Medicine--Lead/Cadmium Conference, Great Lakes Association of Clinical Medicine Meeting, Grand Rapids, MI, September 1992. "Childhood Lead Poisoning", Annual AAP Meeting, San Francisco, CA, October 1992 Moderator for NIEHS Meeting, Triangle Research Park, NC, November 1992. "Pediatric Lead Poison Prevention Continuing Education for Physicians", University of Medicine & Dentistry of NJ, School of Osteopathic Medicine, Atlantic City, NJ, November 1992. "Medical Management Issues", Facilitator; National Childhood Lead Poisoning Prevention Conference, December 1992. EXTRAMURAL PROFESSIONAL ACTIVITIES: Get the Lead Out Committee Childhood Lead Poisoning Talk Forum, Channel 5 Charleston Lead Poisoning Prevention Coalition Charleston Memorial Hospital Executive Committee COMMUNITY SERVICE: District Enrollment Director, SC District, Dartmouth College President, Kiwanis Club of Charleston Board of Directors, MUSC Childrens Hospital Fund BIBLIOGRAPHY: JOURNALS : Lash J, Reigart JR, Studies in Ascidian Metamorphosis: Birefringence in Tail Epidermis", Biological Bulletin 129:395:1965. Habercam JW, Keil JE, Reigart JR, Croft HW. "Lead Content of Human Blood, Hair, and Deciduous Teeth:Correlation with Environmental Factors and Growth". The Journal of Dental Research, 53:1160, 1974. Reigart JR, Brueggeman JL, Keil JE, "Sodium Fluoracetate ("1080") Poisoning". American Journal of Diseases of Children, 129: 1124, 1975. Harmon GE’, Reigart JR, "Long-Term Follow-up of Survivors of Severe Acute Pesticide Poisoning". South Carolina Medical Association Journal. 71:253, 1975. Reigart JR, Whitlock NH, "Longitudinal Studies of Blood Lead and Free Erythrocyte Protoporphyrin". Pediatyice, 57:84, 1976, Cupp CM, Kleiwer G, Reigart JR, Sandifer SH, "Hypothermia in Organophosphate Poisoning and Response to PAM", South Carolina Medical Association Journal, 71: April, 197s, Allen RC, Harley RA, Reigart JR, "Quantitative and Qualitative Studies of Protease Inhibitor Phenotyping by Isoelectric Focusing on Polyacrylamide Gel Slabs". (Abstract) American Journal of Clinical Pathology, 633767, 1975. Reigart JR, Graber CD, "Evaluation of the Humoral Immune Response of Children with Low Level Lead Exposure". Bulletin of Environmental Contamination and Toxicology, 16:112, 1976. Chisolm JJ, Currant AS, Finbert AS, Hopkins DR, Lin~Fu JS, Piomelli §, Reigart JR, Houk VH, "Increased Lead Absorption and Lead Poisoning in Young Children. A statement by the Center for Disease Control". J. Pediatrics, 87:824 1975. Penny LD’, Reigart JR, Loadhold CB, Taylor HL, "Variability in Response to Lead Exposuro: Domonctration of a Cenctic Influence". (Abstract), Pediatric Research, 11:438, 19577. Whitlock N, Reigart JR, Priester L, "Lead Poisoning in South Carolina". SCMA Journal, 73:378, 1977. Reigart JR, "Lead Poisoning". Hospital Medicine, 17:161 1l6J, 16N, 16P: August, 1981. ‘Trammel HL, Sandifer SH, Reigart JR, and Hurwitz GA (Abstract) "National Pesticide Telecommunications Network: A Specialized Poison Information Center", Veterinary and Human Toxicology, 23:52, 1981. Reigart JR and Trammel HL. (Abstract) , "Treatment of Acute Dapsone Intoxication in a Child by Pulse Dosing with Activated Charcoal". Veterinary and Human Toxicology. 23:58, 1981. Thompson DF’, Trammel HL, Robertson NJ, and Reigart JR."Telephone Evaluation of Regional and Non-Regional Poison Centers", New England Journal of Medicine. 308: January 27, 1982, Number 4. Reigart JR, Trammel HL, and Lindsey JM, “Treatment of Symptomatic Dapsone Poisoning by Repetitive Activated Charcoal Treatment in a Child". Journal of Toxicology-Clinical Toxicology. 19:1061, 1983. Reigart JR, and Trammel HL: "Plasma and Red Blood Cell Cholinesterase Levels are Poor Predictors of Cholinergic - Symptomatology". Veterinary and Human Toxicology. 24:276, 1982. (Abstract). Olanoff LS, Bristow W, Colcolough J, and Reigart JR. "Acute Chlordane Intoxication". Toxicology~-Clinical Toxicology 20:291-3086, 1983. Medical Students” Graduate Students® Residents’ 10 Trammel HL, and Reigart JR. "Acute Herbicide Intoxication. Clinical Toxicology Consultant. 5156-69, 1983. Rogan WJ, Reigart JR, and Gladen BC, "Association of Amino Levulinate Dehydratase Levels and Ferrochelatase Inhibition in Childhood Lead Exposure". The Journal of Pediatrics. 109:60- 64, 1986. Weist DB, ONeal W, Reigart JR, Brundage RC, Gillette PC, and Yost RL, "Pharmacokinetics of Ranitidine in Crirically J11 Infants". Developmental Pharmacology and Therapeutics. Dev Pharmacol Ther 1989; 12(1): 7-12 Durand RP, Fincher RE, Reigart JR, Lichtenstein LS, Lancaster, CJ, and Levine JH “An Analysis of Third Year Medical Students Abilities to Order Appropriate Diagnostic Tests and Procedures". Learning. Academic Medicine. 66(11):702-04, July, 1991. Hammill WwW’, Reigart JR, Laver J, "Ehrlichia Canis Infection in a Child in South Carolina", Clinical Pediatrics, Clin Pediatr (Phila) 1992 Jul; 31(7):432-4. Reigart JR, Chairman, Committee on Drugs, American Academy of Pediatrics; and Committee on Environmental Health, American Academy of Pediatrics, "Use of Chloral Hydrate for Sedation in Children" Pediatrics (In Press). Reigart JR, Chairman, Committee on Environmental Health, American Academy of Pediatrics, "Lead Poisoning - From Screening to Prevention" pediatrics, (In Press). Reigart JR. Chairman, Committee on Environmental Health, American Academy of Pediatrics, "Ambient Air Pollution: Respiratory Hazards to Children", Pediatrics, (In Press). BOOKS AND OTHER MONOGRAPHS: Krall AR, McLean Jr Ws®, Gamble HF, Rogers Jr EW, Reigart JR, Collawn SS", "Effects of Magnesium Infusions on the Metabolism of Calcium and Lead: Evidence for Release of Calcitonin and Parathyroid Hormone in Response to Changes in Plasma Magnesium Content." In Magnesium in Health in Disease Proceedings of 2nd Int. Symposium on Magnesium, Montreal. May, 1976. Miller MC, Westphal MC, Reigart JR, Barner C,Medical Diagnostic Models: A Bibliography. University Micro-filns Internaticnal, 3977. Medical Students Graduate Students” Residents’ 11 Miller MC, Westphal MC, Reigart JR, Mathematical Models of Medical Diagnosis. Praeger, Inc. NY, NY, 198]. Reigart JR, "Future Directions", Childhood Lead Poisoning - Current Perspectives, 1988. Mahaffey KR, McKinney J, and Reigart JR, "Lead and Compound". (1991) In: Critical Reviews of Environmental Toxicants. Ed. M. Tinnmann Van Nnetrand RainhnldA, Nau Varlk Reigart JR, "Recommendations of the American Academy of Pediatrice on Lead Sorooning in Children", Drececcdinegs of the First National Conference on Laboratory Issues in Childhood Lead Doiconing Drovontion, Octobor 21 - November 2, 19921 Medical Students Graduate Students” Residents’