Prompted by a joint media investigation, the U.S. Department of Labor has issued a warning about one physician and his long history of denying thousand of cases of black lung—which other doctors said existed in the patients, all coal miners.

The Center for Public Integrity and ABC News teamed up to study Johns Hopkins University’s medical program, specifically its radiology department, which has a four-decade reputation for rejecting coal miners’ claims of black lung. 

One physician in particular stood out among those reading X-ray results: Dr. Paul Wheeler, described as the mining industry’s “trump card” for defeating costly black-lung cases. Wheeler, a graduate of Harvard Medical School, developed an impressive reputation for his medical knowledge and skills—and for consistently standing in the way of patients winning their cases against their employers.

In its letter dated June 2, the Labor Department noted how the media investigation found Wheeler “had never once, in more than 3,400 X-ray readings, interpreted an X-ray as positive for complicated pneumoconiosis [or black lung].”

Judges had also noticed Wheeler’s predisposition not to find black lung. Administrative Law Judge Stuart A. Levin wrote in 2009 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,” according to the Center for Public Integrity.

“Highly qualified experts can misread X-rays on occasion,” Levin wrote, “but this record belies the notion that the errors by Drs. Wheeler [and two colleagues] were mere oversight.”

The Labor Department warning also stated that in the wake of the news story, Johns Hopkins had suspended its black-lung X-ray reading program pending an internal investigation, which is ongoing.

“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 Center for Public Integrity wrote. “This was particularly true in cases involving the most serious form of the disease.”

Wheeler has said that miners should have to undergo a biopsy to prove they have black lung. When told a biopsy, which carries the risk of complications, is not required by law, Wheeler responded: “I don’t care about the law.”

-Noel Brinkerhoff, Steve Straehley

To Learn More:

Weighing Chest X-ray Evidence that Includes a Negative Reading by Dr. Paul Wheeler (U.S. Department of Labor)

Johns Hopkins Medical Unit Rarely Finds Black Lung, Helping Coal Industry Defeat Miners' Claims (by Chris Hamby, Brian Ross and Matthew Mosk, Center for Public Integrity)

Mine Safety Administration Orders First Reduction in Level of Disease-Causing Dust Since 1969 (by Noel Brinkerhoff, AllGov)

Mostly Forgotten, Black Lung Still Causes Two Deaths a Day (by Noel Brinkerhoff and Danny Biederman, AllGov)