(I will add here a link to a pdf of this document as it has pasted into blogger very inaccurately.)
CLINICAL NEGLIGENCE (in part)
IN THE HIGH COURT OF JUSTICE CLAIM NO.
QUEENS BENCH DIVISION
ROBIN PHILIP CLARKE
THE DEPARTMENT OF HEALTH
/ THE CHIEF DENTAL OFFICER
1. The Claimant’s earliest extant Dental Records indicate that he already had at least nineteen dental amalgams before age 24, and “says didn’t visit dentist for a few years before coming here”. Ever since age 17 he has experienced chronic invalidity and has had to depend on benefits payments. In the UK, advice and views as to whether systemic harm may result from use of dental amalgam are given by officials within the Department of Health (DH) such as the MHRA and the Chief Dental Officer (“CDO”).
2. In accordance with the Pre-Action Protocol for Clinical Negligence Claims, the Claimant sent a Letter of Claim on 10th November 2009 . On 30th November 2009 the Defendant sent a reply, resting its defence entirely on five documents namely, SCENIHR 2008, COT 1997, WHO 1997, FDA 2002, and EC 1998.
3. In the latter two instances it was unclear as to which documents the DH had in mind. A further reply of 7th April 2010 still failed to fully clarify, other than giving three titles that were claimed to be “available online”. In respect of EC 1998 the nearest the Claimant has been able to identify is a 1997 draft. In respect of FDA 2002, the reply stated that it was the [draft] Special Controls Guidance Document of that year. The FDA thereupon told the Claimant that that document was no longer available, being superceded by the 2009 final version.
4. The Defendants’ replies would have us assume that that FDA in 2002 constituted expert testimony that there is no reason to believe that amalgam causes any toxicity. Yet this is a misrepresentation, because, on the contrary, the FDA 2002 Proposed Rule contains the following statements:
“Conversely, the evidence is not persuasive that the potential for toxicity at the levels attributable to dental amalgams should be totally disregarded. The potential for effects at levels of exposure produced by dental amalgam has not been fully explored.”;
“it is not possible to determine whether those changes observed in persons with low-level occupational exposure to mercury might also occur as a result of exposure to mercury from dental amalgams. Adverse health consequences, however, cannot be totally dismissed.”;
“The Risk Assessment Subcommittee could not draw unambiguous conclusions or develop a risk assessment based on these [neurological and psychological] endpoints…”;
“The Risk Assessment Subcommittee [is] comprised of 34 senior level experts…”.
Expert reports on Amalgam Illness cases
5. It is usual in a Clinical Negligence case to include expert opinion in respect of diagnosis. But the Defendants here deny all existence of Amalgam Illness, so must also deny existence of expert experience in diagnosing it.
6. In a context of vicious persecution of medical heretics, diagnosis of Amalgam Illness does not have some recognised school of experience-developed skill like violin-playing, but rather entails an ad hoc judgement of how well the facts of the case accord with the facts of the science. And it really is not (in this case) very complicated, notwithstanding those whose career interests might encourage them to claim otherwise.
7. Any purported such diagnostic expert opinion in this case would be not an enlightening predicate but rather a timewasting added issue in question.
8. This claim involves two causes of action:
(a) Negligent breach of duty of care.
(b) The release of a dangerous thing, namely poisonous mercury vapour, causing foreseeable injurious consequences.
Negligent breach of duty of care
Duty of care
9. The Claimant made a FOI request on 28thFebruary 2010, namely: “Who has responsibility for approving dental amalgam?”. To which the DH replied:
“…. dental amalgam is classified as a medical device under the European Community Medical Devices Directive 93/42/ EEC (MDD). The enforcement of the Directive in the UK is the responsibility of the Medicines and Healthcare products Regulatory Agency ( MHRA). In conjunction with European counterparts, MHRA monitors the use and effects of dental amalgam.
In the light of the MHRA’s advice, it is the Chief Dental Officer’s view that that the use of dental amalgam is free from risk of systemic toxicity and that only a very few cases of adverse reactions occur, despite its widespread use over the past 150 years. ….“
10. The MHRA in giving that advice, and the Chief Dental Officer in expressing that view, function as regulators of clinical practice, with a duty of clinical care towards all those patients in respect of whom their advice and view are to be applied.
11. The abovementioned EC Directive 93/42/EEC states:
“Member States shall take all necessary steps to ensure that devices may be placed on the market and put into service only if they do not compromise the safety and health of patients ….” [Article 2]
“Where a Member State ascertains that the devices referred to in Article 4 (1) and (2) second indent, when correctly installed, maintained and used for their intended purpose, may compromise the health and/or safety of patients, users or, where applicable, other persons, it shall take all appropriate interim measures to withdraw such devices from the market or prohibit or restrict their being placed on the market or put into service. The Member State shall immediately inform the Commission of any such measures, indicating the reasons for its decision and, in particular, whether non-compliance with this Directive is due to: [….] (c) shortcomings in the standards themselves.” [Article 8(1)]
12. The above Articles of the Directive thus make additionally clear that this duty of care to prevent the unsafe usage of amalgam in the UK lies within the Member State (of which the DH is the relevant agency).
13. And in years prior to that EC Directive, the DH likewise had that duty of care.
14. The preceding paragraphs indicate that the Defendants have had at all material times a duty of care to carefully seek and recognise any evidence of harm of usage of dental amalgam and to advise accordingly to prevent its unsafe usage.
15. Within that duty of care there lies a duty to ascertain in respect of reviews of evidence, as to whether (a) those reviews give proper consideration of any evidence which suggests possible harmfulness, or (b) they instead unsoundly dismiss such evidence or even fail to mention it.
16. The Claimant has been at all material times a resident and citizen of the UK and therefore the defendants have had this duty of care towards him during all this time.
Breach of duty of care
17. The Defendants, and their predecessors, breached their duty of care in that throughout all material times:
(a) they failed to carefully seek or give recognition to the evidence of harm of the use of dental amalgam;
(b) they persistently advised that amalgam was without systemic risk, when at all material times there existed substantial known evidence for suspecting such harm and absence of sound evidence of safety; and they did so in defiance of repeated warnings from well-informed and well-qualified critics whom they merely ignored without acknowledgement;
(c) they ignored reports indicating harmfulness, and cited in their advice only reports which failed to mention evidence of harmfulness and gave an unduly reassuring distorted account of the evidence.
Particulars of breaches of duty of care
18. Some Particulars of breaches of the duty of care are detailed in the following paragraphs 19-30 under the heading “Pervasive untruthfulness, misleading statements, and hence lack of credibility of the most expert defenders of amalgam”, and the toxicity section paragraphs 31-38.
Pervasive untruthfulness, misleading statements, and hence lack of credibility of the most expert defenders of amalgam
19. The Defendants, who purport to speak with expertise when they defend dental amalgam as being supposedly safe, habitually fail to mention the evidence which runs counter to their assertions.
(a) Pro-amalgam official reports, authored by committees of supposed experts, fail to mention the studies and facts that run counter to their assertions of safety. (Particulars in Paragraph 23)
(b) Criticisms pointing this out are ignored, as if they did not exist. (Particulars in Para 24)
(c) The defenders then habitually cite those grossly-biased reports as supposedly showing that amalgam is safe, but never cite the other official reports which conclude it is harmful (or uncertain) instead. (Particulars in Para 25)
(d) The CDO recently publicly denied knowledge of the even most basic easily demonstrable facts of dental mercury. (Particulars Para 26)
(e) Whenever patients appear to possibly have dental amalgam poisoning, or themselves suggest that they might have, the Defendants take extensive evasive measures to avoid any proper investigation of the possibility. (Particulars in Para 27)
These habitual omissions and misrepresentations, of which instances are particularised below, call into question whether there exist any genuine experts supporting the Defendants’ position and whether any testimony of the defenders of amalgam is worthy of belief.
Particulars of failing to mention evidence of harm.
20. Historical reasons to suspect harm from mercury vapour
Numerous studies and reports exist, for example:
(a) Alfred Stock 1926:
”Mental weariness and exhaustion, lack of inclination and ability to perform any, particularly mental, work, and increased need for sleep.…. nearly complete memory loss…..Obstacles, which formerly I would have overlooked smilingly, seemed insurmountable….merely writing a simple letter caused unending effort….”
(b) BMJ 287:1961 (1983) Did the Mad Hatter have mercury poisoning? HA Waldron:
“The principal features of erethism were excessive timidity, diffidence, increasing shyness, loss of self confidence, anxiety, and a desire to remain unobserved and unobtrusive. The victim also had a pathological fear of ridicule and often reacted with an explosive loss of temper when criticised.”
21. Historical critiques of dental amalgam specifically
Numerous examples include:
1899 Tuthill: “makes a mental wreck of its victim”.
1974 J Am Dent Soc 98(4),904: “symptoms include …. self-consciousness, embarrassment without justification, disproportionate anxiety, indecision, poor concentration, depression, irrational resentment of criticism, and irritability.”
22. 28 studies showing benefits of amalgam removal
(a) Numerous published scientific studies have supported the notion that dental amalgams have serious adverse effects on those having them. Not least are 28 studies of amalgam removal, featuring 6622 patients. There are 25 of these studies cited and discussed in a publicly online meta-review by Mats Hanson (“Effects of amalgam removal on health; 25 studies of 5821 patients”), and three later studies are Prochazkova Sterzl Kucerova 2004; Sterzl Prochazkova Hrda 2006; Wojcik Godfrey Haley 2006.
(b) And these are the studies of the most powerful kind, namely direct evidence, and positive evidence. Such simple direct evidence trumps any amount of opposing speculative inferences via intermediary concepts such as urine or plasma levels (which are demonstrably misleading anyway) . And given 28 positive studies, a lot more than 28 negative studies would be required to cancel them out (because an instance of failing to find evidence is a lot less significant than an instance of succeeding in finding it). And yet there is no more than a handful of (methodogically dubious) negative studies, which come nowhere near countering them.
(c) And these findings cannot be dismissed as merely placebo effects. As Mats Hanson’s review indicates, “Often the removal of amalgam is a final, unpleasant and expensive measure after many years of ill health where conventional medical therapies have not improved the situation”, and patients regularly experienced long-term resolutions of problems which had affected them for many years previously.
(d) Nor can the findings be dismissed due to some of them lacking controls. For such objections to have any merit we would have to accept the fantastic thesis that miraculous prompt and sustained resolutions of longstanding intractable serious problems have “just happened to” coincide with amalgam removals in thousands of documented cases.
23. Reports citing only studies opining in favour of amalgam while not mentioning those that contraindicate.
(The first five of these following are the five “expert” reports on which the Defendants based their defence in their reply to the Letter of Claim.)
(a) The 2008 SCENIHR report, even though 72 pages long, failed to mention any of the above-cited 28 among its references. Commentaries by various authors have pointed out extensive additional serious omissions. And yet the SCENIHR did cite the misleading Kingman et al 2005 paper, and other numerous papers relating to blood and urine levels without mentioning that they have long been well-known to be seriously misleading because what matters is the level of mercury in brain etc. cells rather than in blood or urine which have negligible relationship with it (as explained in Para 27).
(b) The 1997 COT statement merely refers to an EC report which in turn reviews five other reviews from pre-1994. Whatever the merits of that opaque audit trail, it anyway likewise failed to relate to any of those removal studies (about half of which were before its date) or to the autopsy evidence (which is the most informative), and then ended with a citation of:
Larsson KS (1995). The dissemination of false data through inadequate citation. J Internal Med, 238:445-450.
And in that same year the COT issued a statement against vitamin B6 which was described in the Lancet by Prof. Arnold Beckett as “one of the worst applications of pseudoscience that I have ever encountered” and “this travesty of science” (doi:10.1016/S0140-6736(98)26027-2). The COT’s B6 recommendation was abandoned in the face of an unprecedented level of public protest.
(c) The EC 1998 report not only contains these same faults of omission and commission, but also complacently mentions in-passing the condition of “when water spray cooling and vacuum suction are used”, while not giving any consideration of the situation when such cooling or suction briefly (or not so briefly) fail to be applied, and the patient consequently breathes in a lungful of the dust. In the Claimant’s own 27 years of personal experience at the Dental Hospital, such breaches of suction were not rare, and there was never any warning to avoid inhaling. Such dust in the lungs causes hugely-increased mercury vaporisation from the large surface area of the dust, hence hugely-increased vapour intake until such later date at which the dust has all vaporised away. This intake can be expected to soon overwhelm the detoxification capability and thereby lead to frank amalgam illness. And yet this very serious likelihood (or rather certainty) is sidestepped.
(d) The “WHO Consensus Statement on Dental Amalgam 1997” does not cite any studies but merely asserts that amalgams are “considered safe”, “not been shown to cause any other [i.e. systemic] adverse health effects”, and “there is no scientific evidence that general symptoms are relieved by the removal of amalgam”. It also falsely claims that “It has been used successfully for more than a century and its quality has improved over the years.” On the contrary, the modern standard non-gamma-2 amalgams were only invented in 1963 and are well-established as emitting 30-50 times more of the toxic mercury vapour, a very strange sort of “improvement”.
(e) The FDA 2002 Proposed Rule likewise misleadingly declared “the significant human experience with amalgam for over 100 years”. It failed to mention the removal studies. It dismissed uncited as “methodologically flawed” all of the many studies that contradicted its premises.
(f) The 53-page Clarkson TW, Magos L. Crit. Rev. Toxicol. 36:609-662, 2006 omitted mention of the large number of contrary studies, while endorsing numerous patently unsound or misleading ones (such as relating to blood and urine levels), as documented by Mutter J, Naumann J, Guethlin C. Crit. Rev. Toxicol. 37:537-549, 2007.
(g) The FDA in their 2009 Final Rule cited that seriously flawed Clarkson/Magos 2006 review but failed to mention the Mutter et al damning commentary on it that was published in that very same journal.
24. Criticisms likewise being ignored and pretended not to exist.
None of the above-cited documents (or their issuing agencies or endorsers) give any hint of the existence of the numerous severe, damning criticisms that have been made of them in commentaries.
25. Documents citing only reports that support amalgam while omitting any mention of the various ones that contraindicate it.
(a) the letter (30 Nov 2009) in reply to the Letter of Claim, mentioning only SCENIHR 2008, FDA 2002, WHO 1998, EC 1998, and COT 1997;
(b) a reply to a Freedom of Information request from Tim Hayward filed on 26 August 2009, essentially identical to (a) above:
26. The CDO denying knowledge of the most basic facts of dental mercury.
"England's Chief Dental Officer has dismissed a TV documentary highlighting the dangers involving mercury amalgam as ‘scare mongering' and ‘sensationalist'.” But you can see for yourself his supposed expertise (on ITV in 2009) (http://tinyurl.com/chiefdental or
www.youtube.com/watch?v=mMI_em8UPo4 from 5m30s):
“I’m not sure that’s true” (that mercury vapour is continually released);
“not measureably”; and “I’m not sure that’s actually true” (that amalgam is the main source of mercury in the body**).
· Svare, C.W., Peterson, L.C., Reinihardt, J.W., et al. (1981): The effect of dental amalgams on mercury levels in expired air. J Dent Res 60:1668-1671.
· Patterson, J.E., Weissberg, B.G., Dennison, PJ. (1985): Mercury in human breath from dental amalgams. Bull Environ Contam Topical 34:459-468.
· Vimy, M.J., Lorscheider, F.L. (1985): Serial measurements of intra oral air mercury: estimation of daily dose from dental amalgam. J Dent Res 64:1072-1075.
· Berglund, A., Pohl, L., Olsson, S., Bergman M. (1988): Determination of the rate of release of intra-oral mercury vapor from amalgam. J Dent Res 67: 1235-1242.
· Vimy, MJ., Lorscheider, FL. (1985): Intraoral air mercury released from dental amalgam. J Dent Res 64:1069-1071.
· Clarkson, TW., Friberg, L., Hursh, JB., Nylander, M. (1988): The prediction of intake of mercury vapor from amalgams. In: Clarkson, TW., Friberg, L., Nordberg, GF., Sager, P.R. editors. Biological Monitoring of Toxic Metals, New York. Plenum Press: 247-260.
· Vimy, M.J., Lorscheider, F.L. (1990): Dental amalgam mercury daily dose estimated from intra oral vapor measurements: a predictor of mercury accumulation in human tissues. J Trace Elem Exp Med 3:111-123.
· Mackert, J.R., Jr. (1987): Factors affecting estimation of dental amalgam mercury exposure from measurements of mercury vapor levels in intra oral and expired air. J Dent Res 66:1775-1780.
· Olsson,, S., Berglund, A., Pohl, L., Bergman, M. (1989): Model of mercury vapor transport from amalgam restorations in the oral cavity. J Dent Res 68:50~508.
· Olsson, S., Bergman, M. (1987): Intraoral air and calculated inspired dose of mercury [Letter]. J Dent Res 66:1288-1289.
**Criteria 118 WHO 1991 states that amalgam is up to 6x the other sources combined; **Aposhian HV, Environ Health Perspect 1998: – 2/3 comes from amalgam.
**Richardson GM. Assessment of mercury exposure and risks from dental amalgam. Health Canada 1995. Tolerable Daily Intake is exceeded in adults with 4 or more amalgams.
Poison in the Mouth (BBC TV Panorama 1994) stated:
“MANGOLD (BBC): …. It's easy to demonstrate how the mercury vapor escapes from their small fillings. We invited an expert to bring a mercury vapor tester to check. The air around the fillings is measured. [….] This is the actual reading as the needle goes off the scale.”
27. Evasive mis-management of patients with possible mercury poisoning.
(a) Other patients: Mats Hanson’s commentary on the SCENIHR report states: “Patients in both Norway and Sweden have repeatedly complained to the health authorities about the way they have been (badly) treated and their reports on health changes after amalgam removal have been ignored.”
(b) This claimant’s own experience of seven years’ ongoing evasions by NHS staff:
2004 Requested Dental Hospital to show evidence of safety; defective response; then they failed to answer the Claimant’s rebuttal; then they abruptly shooed him away from their other victims of uninformed consent.
Dental Hospital said the Claimant should see a doctor instead.
2006 GP Dr Daniell made referral to the QE Hospital for amalgam removal “as a precaution”. She said there were no useful tests of amalgam toxicity.
QE Hospital said they could not do the removals.
Referral switched to Dental Hospital.
Dental Hospital Consultant Stephen Chambers said a student would do the removals.
Six months later, on attending the student appointment, the Claimant was told that the Dental Hospital could not do the removals after all.
Stephen Chambers sent to the Claimant’s GP a secret letter containing three defamatory falsehoods (that he had concealed his previous registration; had concealed that there had been a “lengthy” correspondence; had been discharged several times with insinuation of unworthy reasons).
20th March: GP Dr PRW Turner of Karis asserted there was no basis for amalgam referral, reciting upon that secret letter from the Dental Hospital. In reality the letter from Chambers contained no evidence about the mercury question except for accidentally confirming the Claimant’s persistent difficulty remembering to do things which is a characteristic symptom of amalgam poisoning.
3rd September: Harley Street dentist el-Essawy found the Claimant had exceptionally high 460mcg/m3 oral mercury vapour (unprovoked, open mouth) and recommended melisa test.
2009 Harley Street melisa test positive 3/3 mercury, 3/3 nickel, 3/3 silver.
New GP Dr Peter Gini of Broadway Centre said the Claimant should see a dentist instead.
NHS Dentist Deborah Morse said the Claimant should see a doctor instead.
Dr Gini said the Claimant should instead get the dentist to send a request.
After a lot of chasing, eventually the request was received by GP’s fax.
Dr Gini wrote back saying he did not have anything to say about it.
The Claimant pointed out in a letter to Dentist D Morse that there were three pre-existing breaches of manufacturer’s directions for use of amalgam.
After further correspondence the Dentist again dismissed the matter, citing defunct Healthcare Commission.
Dentist’s phone never answered.
19th October: The Claimant travelled there himself and the practice manager told him they were not contracted to do or refer for Advanced Mandatory, so approval from contracts manager Steve Connelly was required.
Steve Connelly said the dentist must do the referral instead.
Dentist practice manager again said Steve Connelly must do it (as not normally NHS funded).
Steve Connelly said the Claimant should see a doctor
10th December: The Claimant asked Dr Verma for a referral to a toxicologist; she said she would have to confer with Dr Gini.
29th January: The Claimant was told that Dr Gini was referring to a toxicologist.
22nd April: Dr Verma said an (unrequested) referral to Dental Hospital had been declined. And that referring to a toxicologist would not be useful, and it would be better to refer to a psychiatrist.
11th June: First appt with psychiatrist Dr Pradhan.
1st October: Dr Pradhan declared that there was no capability for diagnosing mercury poisoning anywhere within the Birmingham/Solihull MHFT.
So the Claimant immediately went back to the the GP clinic. GP Dr Zaman phoned toxicologist Mrs Khan who proposed a urine mercury level test, which even GP Dr Daniell had ruled out as useless 4 years before. So the Claimant himself phoned Mrs Kahn. She explained that a urine test was the standard test for occupational recent mercury intake, and that it would (supposedly) indicate whether there was currently significant mercury input from the amalgams. She declined to discuss it further, proposing instead that the Claimant could discuss it with his GP.
Arch Environ Health 9, 735-741 (1964) stated:
“Those investigators who have studied the subject are in almost unanimous agreement that there is a poor correlation between the urinary excretion of mercury and the occurrence of demonstrable evidence of poisoning.”
and a joint statement of the National Institute of Dental Health and the American Dental Association stated in 1984 that:
“The distribution of mercury into the body tissues is highly variable and there appears to be little correlation between levels in urine, blood or hair and toxic effects.”
And later studies have further confirmed that conclusion. Even with normal or low mercury levels in blood, hair and urine, high mercury levels are found in critical organs such as brain and kidney (Danscher et al., 1990; Drasch, 1997; Hahn et al. 1989, 1990, Hargeaves et al., 1988; Lorscheider et al., 1995; Opitz et al., 1996; Vimy et al., 1990; Weiner & Nylander, 1993). Drasch et al. (2001, 2002, 2004) found that 64% of individuals occupationally exposed to mercury vapor and having typical clinical signs of mercury intoxication had low mercury levels in blood. A more recent autopsy study again confirmed the lack of correlation between inorganic (e.g. dental) mercury levels in urine or blood and mercury levels in brain (Björkman et al. 2007).
9th November: The Claimant took a letter to Dr Gini questioning the pseudoscience of Mrs Khan’s proposed test.
10th November: Dr Gini wrote back that “….this is a dental problem.…please arrange to see any dentist of your choice. Unfortunately we cannot take this any further.”
11th November: The Claimant delivered a reply to Dr Gini, indicating the absurdly conflicting words and deeds of the various people abovementioned, all in conflict with Dr Gini’s own last letter. Later the same day the Claimant attended an appointment at which Dr Gini then said that there was a directive from the PCT that prohibited him from dealing with “dental matters”. He said the Claimant would have to enquire of the PALS of the HOBtPCT about this.
15th November: An email from the PALS stated:
“I can trace no directive from this PCT regarding the issue that you raise.”
The same day the Claimant enquired by letter of Dr Gini to clarify quite what was the directive to which he had referred.
22nd December: A letter (16 Dec; PM’d 21 Dec) from Dr Gini’s receptionist which requested the Claimant to make an appointment for a blood test.
23rd December: The Claimant sent a reply questioning the need or value of a blood test which would also be pseudoscience (as per the quotations above). And also pointing out that he still had not been told what was the directive from the PCT that Dr Gini reckoned was constraining him.
29th December: A reply dated 29th Dec from Dr Gini, at last included the supposed directive which turned out to be from BENPCT, a letter of 30th Sept 2009 headed “Re: Patients with dental problems that access GP services.”, and which turned out to be manifestly irrelevant to the Claimant’s case, being concerned only with typical dental problems properly investigated primarily by dentists such as painful teeth.
And yet Dr Gini’s letter again repeated the fallacy that the Claimant should instead see a dentist about his “dental and allied problems”. His letter concluded with “We .… do not intend to respond to any other communications from you about your dental amalgams.”
12th February 2011: The Claimant sent a carefully documented report to the PALS of the HOBtPCT requesting proper diagnosis and treatment action.
23rd March: The Claimant received a reply from the PALS indicating that the Claimant’s (non-dental) problems had been referred exclusively to their dental advisory panel; which is logically equivalent to them referring the autopsy of a suspected murder only to the local union of murder suspects (whose official view is that no murders have ever been committed and the whole concept of “murder” is just a big scare story).
At no time in all this seven year farce did any of these NHS personnel attempt to make any diagnosis or conduct any tests (except finally the pseudoscience urine and blood tests).
28. The compilation of facts in paragraphs 19-27 points to an outstanding record of misrepresentation among those purporting to speak as experts in support of the supposed safety of amalgam.
29. These “experts” NEVER ANSWER the criticisms, or even acknowledge their existence. BECAUSE THEY HAVE NO ANSWERS.
30. Even the most key advisors and decision makers on public health policy have participated in this misrepresentation. So it calls into question whether any testimony or documentation of purported experts in defence of amalgam is worthy to be believed, and whether they have any case to present that has merit.
Evidence of systemic toxicity of dental amalgam restorations: history and outline
31. There have been regular expert condemnations of amalgam up to the present day. In the above-cited 1994 BBC TV Panorama broadcast “Poison in the Mouth”, the following notable experts expressed their opposition to the use of amalgam:
Prof. Boyd Haley (University of Kentucky)
Dr. Murray Vimy (University of Calgary), WHO consultant
Prof. Lars Friberg, the world's leading authority on mercury poisoning and was chief advisor to the WHO on mercury safety
Prof. Fritz Lorscheider (University of Calgary)
Prof. Vasken Aposhian (University of Arizona)
Dr. David Eggleston (University of Southern California)
Dr. Diana Echeverria (University of Washington)
Prof. Gustav Drasch (University of Munich)
Prof. Stephen Challacombe (Guy's Hospital, London)
The BBC invited the Department of Health to respond to the criticisms but they declined to do so.
32. In the 1990s Prof. Max Daunderer of the University of Munich published a “handbook of amalgam illness” extending to three large volumes – about this illness which the Defendants claim does not even exist.
33. A 1995 report for Health Canada, “Assessment of Mercury Exposure and Risks from Dental Amalgam”, stated that the permissible Total Daily intake (TDI) was exceeded in adults with 4 amalgams.
34. Three main lines of evidence and reasoning attest to systemic toxicity from amalgam restorations:
(a) the direct studies of the health effects of removal of amalgams;
(b) autopsy measurements (and inferences therefrom) of levels of tissue/intracellular mercury accumulation resulting from amalgams, compared with determinations of the threshold levels of tissue/intracellular mercury at which toxic effects become observable;
(c) studies of the health effects of dental occupational exposure, viewed in the context of determinations of ratio between the levels resulting from occupation and the levels due to amalgam-bearing.
35. These lines of evidence have been presented in publicly-available expert report documents such as:
(a) Mutter J, Naumann J, Guethlin C. Comments on the Article “The Toxicology of Mercury and its Chemical Compounds” by Clarkson and Magos (2006). Crit. Rev. Toxicol. 37:537-549, 2007.
(b) Mutter J. Criticism to the Europaen Commission’s SCENIHR Paper on the Safety of Dental Amalgam.
(c) Mutter J. Is dental amalgam safe for humans? The opinion of the scientific committee of the European Commission. Journal of Occupational Medicine and Toxicology 6:2, 2011.
(d) Mats Hanson. Effects of Amalgam Removal on Health; 25 studies comprising 5821 patients.
36. The following additional publicly-available expert reports provide yet further testimony to the toxicity of amalgam :
(a) Swedish Dental Materials Commission / Maths Berlin 2002.
(b) Maths Berlin, Mercury in dental-filling materials – an updated risk analysis in environmental and medical terms, 2003.
(c) Health Canada 1995, “Assessment of Mercury Exposure and Risks from Dental Amalgam.” G Mark Richardson.
(d) Critique on SCENIHR preliminary report. Graeme Munro-Hall (European president of International Academy of Oral Medicine and Toxicology).
37. The (non-) responses of the Defendants’ purported experts to the lines of evidence listed in Paragraph 35 have consisted of the following:
(a) pretending the direct studies of amalgam removal do not exist (or dismissing them with unsound objections such as placebo effects or lack of controls or lack of “peer-reviewed” publication);
(b) ignoring the autopsy measurements and instead focusing exclusively on blood and urine levels despite it being long well-known that such levels are largely unindicative of the in-cell levels which are what actually matter; thereby non-significant results are obtained which supposedly justify their claims that the mercury levels do not reach harmful levels;
(c) pretending the more unfavourable occupational evidence does not exist, and pretending that levels from normal amalgam bearing must be far below those from occupational exposure, when in reality they are found quite comparable;
(d) pretending that new studies, such as those of DeRouen et al 2006 and Bellinger et al 2006, competently demonstrate a lack of harmfulness;
(e) other patently untrue statements and omissions of key facts.
38. In respect of the DeRouen and the Bellinger studies in JAMA, the criticisms by Joachim Mutter, Boyd Haley and others are damning enough. And further, even if this Claimant who has suffered decades of devastating subsequent invalidity had been included in one or both of those studies, even his case would have been recorded in these studies as “evidence of safety” rather than of harm.
Release of a dangerous thing
39. These Defendants were responsible (as shown in Paragraphs 9-27) for advice which allowed the release of a dangerous thing, namely substantial levels of toxic mercury vapour, in the Claimant’s mouth, thereby causing foreseeable injuries (as per Paragraphs 42-107 below).
40. In a case of release of poison, the burden of proof was placed on the Defendants to show that the release of the poison was an unavoidable consequence of carrying out their obligations.
41. In the present case, the prolonged (over four decades) release of further mercury vapour into the Claimant’s body could have been prevented by advising changing to non-amalgam restorations in respect of patients starting to show signs of systemic mercury toxicity. So it was not an unavoidable consequence of their obligations.
First installation of the claimant’s amalgams
42. The earliest extant Dental Records show that at least 19 of the 20 amalgams were already in place by age 24. They also state: “Says didn’t visit dentist for a few years before coming here” (which is hardly surprising given the catastrophic mental state indicated below here) and “Doesn’t eat sweets”.
43. It is therefore highly improbable that none were already in place when his disabilities started at age 17. Indeed the Claimant recalls some fillings being installed in his early teens.
Particulars of Injuries
44. List of ill-effects experienced
(Note: NO psychotic/schizophrenic symptoms at any time throughout 40 years of severe mental disability.)
(a) Extreme deficits of memory and concentration
By age 20 this was so severe that he could not get to the end of a sentence without forgetting its beginning, and so reading, writing and listening became nearly-impossible (and he rarely did much speaking anyway).
(b) Much fatigue, lack of energy (mental/physical) for no evident reason.
(c) Extreme indecision (“procrastination”). What most people can decide in moments may take weeks for him to decide.
(d) Severe reaction to hair-washing and bath-ing for 30+ years from ~1973 onward. Consequent phobia of washing and obvious consequent severe social problems. The fact that he smelt unwashed convinced everyone that he must certainly be an insensitive fool. In 2003 he established that this was sensitivity specifically to hot water storage systems and adopted use of shower and kettles in substitute (as per correspondence with the housing co-operative about his problems with the hot water system).
(e) Extreme instability of circadian cycle, such that he was no longer able to get to school on time, and ultimately at best only able to arrive in the afternoon, and in later 1970s regularly unable to get up before 4pm (in the days when banks and offices closed by 4pm). In 1980 he read a science report in The Times which enabled him to invent and construct an effective light-entrainment system which eased this problem substantially thereafter, but still a significant problem.
(f) Extreme shyness, extreme tendency to blushing, various phobias, including severe agoraphobia/social phobia and phobia of writing (and consequently failed English Language O‑level twice) and of communicating in general (Obviously much reduced from earlier). The Claimant would stay in his bedroom till no-one was around before hurrying out; would crouch down to avoid being seen through the window.
(g) Blank mind, like writers’ block applied to life in general.
(h) Prolonged crash after exertion.
(i) Inability to adapt to abrupt changes of temperature, such that on entering any public building in winter he becomes extremely overheated and sweaty however many clothes he took off. (This symptom has not reduced or been adequately worked-around.)
(j) Several years of IBS, now managed by regular consumption of glutamine and avoidance of gluten products (wheat etc).
(k) Constant adrenal deficiency such that he has had to take bottles of salty water with him everywhere for many years.
(l) Muscular weakness to the extent that he could never do press-ups, pull-ups or squats (until improved in recent years following heavily enhanced nutrition).
(m) Exciteable, restless, irritable (zinc/copper ratio keeps this down).
(n) For many years used to get delirious (non-psychotic), used to get hyperactive; both ceased after he started colloidals containing lithium.
(o) Dry skin (recently reduced by coconut oil and humidifying).
(p) Slight jerkiness of fine movements (which he noticed was increased by wind-less days; reduced by installing large nose-level ventilation slots).
(q) Eyebrows red with eczema, constant for last 20 years.
(r) Disappearance of outer ends of eyebrows.
(s) Female-pattern hair-loss.
(t) Low temperatures down to 35.2C (r,s,t = three hypothyroid features).
(u) Easily getting confused, silly mistakes.
(v) Persistently unpleasant effect from drinking alcohol
(so lifelong non‑drinker).
(w) Periodontal disease.
(x) Food allergies.
(y) Depression (till 1978).
(z) Excessive salivation, waking up choking several nights a year.
(aa) Migraines (till 1978).
(bb) Hot flushes, extreme sweating. Etc.
(cc) Neuritic pain (like gnat bites).
(dd) Joint pains.
(ee) Clumsiness (hopeless at sports).
(ff) Biting teeth together produces ringing in ear. [now ceased]
(gg) Temporary muffling of hearing for no apparent reason.
All the above despite substantial spending on healthcare efforts and entirely avoiding abuses such as drinking, drugs, junk foods or even passive smoking.
45. A report from a medical practitioner detailing the readily observable aspects of the Claimant’s current condition is attached (and is a little inaccurate, e.g.: upper scalp not anterior).
The severity of the injuries
46. The nature and severity of the Claimant’s injuries are reflected in
(a) a stark transformation from superlative academic expectations to total career failure, and
(b) an exceptionally bizarre paradox of his biography.
From easy excellence to total failure in formal education and career
47. Beginning around age 17 there began a drastic transformation from easy academic excellence to multiple severe disablements. With no subsequent recovery even 40 years later, despite repeated desperate attempts at making progress in formal education.
48. The graph and data below here show he was still getting high exam rankings at term 14 (age 16), following a previous record of regularly high rankings.
49. Grammar School Exams of Term 9 (age 14):
first in Maths, first in Physics, first in Chemistry, first in Geography, third in French, fifth in Latin (in a class of 32).
“He achieves this standard with little effort.” (first in physics);
”Not enough effort”(Latin).
O-level results of Term 15: Maths 2, Physics 2, Chemistry 2, French 2, Biology 3, Religion 3, History fail, English Language fail, Literature fail.
A-level results of Term 21: Maths C, Physics D, Chemistry O (fail).
Next year, Bromsgrove COFE: A-level Music D.
Next year, Bromsgrove COFE: retakes, unable to continue courses.
Year after next, Redditch COFE: O-level English B, A-level Economics unable to continue. And two psychology extramural evening classes.
Next year, Human Psychology at Aston Univ: failed all first year exams.
Next year, sought readmission.
Five+six years thereafter, Bournville COFE: A-levels Physics B, Maths C, Psychology unable to complete, Computer science unable to complete.
Ten years thereafter, Matthew Boulton COFE: A-levels Biology and Sociology, unable to continue beyond three weeks.
50. Persistent correspondence with universities trying to get admission to undergraduate courses (and re-admission to Aston). He made his final admission attempts in 1996, 24 years after his first.
51. The Claimant has been unable to attain other than excessively mediocre qualifications and never been able to usefully complete courses of formal education or develop any sort of career. And instead has been a benefits dependant for all but a few months of his adult life.
52. Severe mental disabilities led to all his attempts being consistently failures, no matter how much he tried to succeed.
53. In the decades after leaving school the Claimant tried again and again to make some progress in formal education, or in earning money by one means or another. But all these efforts encountered the same difficulties, and ended in exhaustion and failure.
Exceptionally paradoxical biography
54. The Claimant has had a number of major scientific papers published (and written numerous others of equal quality, just never fully prepared for publication due to the above disabilities) including:.
1993: A theory of general impairment of gene-expression manifesting as autism. Person Indiv Diff 465-482.
1994: Draft of a theory of manic-depressive illness. New Ideas Psychol.
1998: Outline of a theory of manic-depressive illness. Med Hyp.
2000: Does longer-term memory storage never become overloaded, and would such overload manifest as Alzheimer’s and other dementia? Med Hyp.
2011 (currently with a journal): The causes of autism: A theory further confirmed by four predictions; why dental amalgams caused increased autism; and why mercury pollution caused the Flynn effect IQ increase.
55. Not a single fault of reasoning or evidence has ever been found in any of his theories — which is very exceptional.
“Robin P Clarke is one of those rare souls”;”excellent”; “fine work” ‑‑ Bernard Rimland, most famous autism researcher, founder of Autism Research Institute etc.
“Well worth publishing” – HJ Eysenck, most cited-ever scientist.
56. But due to his total lack of institutional status and qualifications his publications have been steadfastly unmentioned by the vast majority of professional researchers, who have a narrow “closed shop” contempt against anyone lacking the exam qualifications they consider to be the obligatory exclusive criterion of intellectual competence.
57. The mental capabilities that are obligatory for the narrow concept of intellectual excellence which totally monopolises the academic and other career selection systems—facility in reading, writing, remembering, recalling, and doing these things with speed and reliability and endurance and on demand — are exactly those mental qualities that are most impaired by mercury poisoning.
58. Certain rare valuable capabilities, of generating significant original ideas, of readily distinguishing true from false and reality from mere myth, and seeing beyond the false assumptions of oneself and conventional wisdoms, tend to be little or not at all affected by mercury poisoning. But almost no‑one ever credits these important talents anyway in an individual who is deficient in those other capabilities which are impaired by mercury.
59. The Claimant was able to get published the great theory papers despite the disabilities because his massive patience and conscientiousness was not there casually cast aside merely for want of speed or facility or fulfilling of deadlines. Editors don’t demand to know whether you wrote it within some maximum permitted number of hours and during daylight.
The Claimant’s persistent, consistent lack of distinction in community groups.
60. Over the decades the Claimant has been regularly involved in a number of voluntary community or campaigning groups and attended many meetings thereof (listed below). But his extensive archives of minutes show in every case his involvement has been characterised by marginalness, and paucity of actual contribution, rather than any significant role as would have been expected of an academically excelling, initiative-taking, person.
Woodstock Residents Association. Woodstock Area Caretaker. Push Bikes (Birmingham cycling campaign). Friends of the Earth. Birmingham for People. Stop-the-War Coalition. Ladywood Housing Liaison Board. Summerfield and Ladywood Neighbourhood Management Board. Ladywood Constituency Tenants Group.
The beginning and continuation of the disabilities
61. Before age 17 the Claimant had not had any significant health or social problems. And he had consistently ranked at or near the top in exams, as per Paragraphs 48 and 49 above.
62. From age 17 there began a drastic transformation from easy academic excellence to multiple severe disablements. With no subsequent recovery even 40 years later.
63. School reports of the sixth form state:
Term 17: “Frequently absent.” “Frequent late arrival.” “A rather enigmatic personality who does not seem to be putting his heart into the work in which he could do so well…”.
Term 18: “Misses too many lessons.” “Misses too many lessons.” “So often absent.” “Frequently late and absent without any satisfactory reason to offer.” "Chemistry practical absent.”“His knowledge of organic chemistry was far from complete.”
Term 19: “he has surrendered none for marking. A tragic waste of outstanding ability.” “No written work of any description has been submitted this term.” “We all know he has some good qualities. Why does he fail to show them here?”. “He no longer cooperates with the school in any way …. he attends so seldom anyway.”
Term 20: “Attended for only one of the three papers. in this he scored 37/150. A shocking waste of ability.” “If regular absence continues…”. “Rarely present….”. “Contributes absolutely nothing to the lesson.” “He takes no part in school life and very little in lessons.” “His attitude and behaviour perplexes me.”
Term 21: “His attendance has continued to be erratic.” “attendance has been so irregular…”. “has taken no part”. “His enigmatic personality….”.
64. Around the same age, the Claimant developed a sort of phobia of writing and talking. He recalls his perplexity at this, on one occasion in desperation telling his mother he could not write, but they were both at a loss what to do, so he never talked about it again. This longstanding writing phobia was reflected in failing O-levels English language, English Literature, and History, and then failing English Language a second time (despite excellent spelling and grammar). He eventually passed it at age 22, after a concentrated effort on that minimal single objective.
65. In the sixth form, on trying to study the chemistry textbook, for all that the subject fascinated him (and his father was a FRIC and a head of chemistry research who invented a method of analysis) he could never get beyond the first page, he just could not remember it. Contrast Term 12 (Age 16): “Certainly redeems himself when it comes to a test of memory…”.
66. And a problem of disordered waking/sleeping overwhelmed the Claimant, to the extent that he became unable to wake up till the afternoon and unable to get to sleep until breakfast-time.
67. He was intensely embarrassed to be arriving at school in the late afternoon, and increasingly tended not to go at all. No-one offered him any help with what to do about any of these problems. As the preceding excerpts from school reports make clear, they were as utterly baffled as himself, and he was too embarrassed and social-phobic and confused to say anything himself. People with mental disorder/disability tend to be in denial as do their parents due to the stigma.
68. The year after Alcester Grammar School the Claimant studied A-level Music (one year) at Bromsgrove College of FE. The result was a D grade.
69. The next year he re-enrolled at Bromgrove College of FE to retake Music and Physics A-levels. But his symptoms increased again and his attendance became as infrequent as it had been in the last year at the school. He took no exams that year.
70. In the period of some years before or after leaving school, the problems became worse and at some point therein he developed some severe allergic reaction to hair-washing and bath-ing. In consequence he also became very phobic of hair-washing and bath-ing.
71. In an attempt to correct his sleep-wake cycle, the Claimant devised the idea of a week of six “days” each about 27 hours long. In due course this did lead to him waking at 7am and going to college. But the next day he woke at 10am, and the six “days” had been such a horrendous experience that there was no question of trying any such again.
72. His memory and attention deteriorated to the extent that he could not get to the end of a sentence before forgetting its beginning. This made reading, writing, listening and speaking almost impossible. His secret “thinking-books” (detailed below) indicate his attempts at “practicing” of concentrating on listening to the radio, something no normal 20-year old would even think of doing let alone writing down the idea.
73. In an attempt to cope with the severe memory and attention deficits, and try to make progress in understanding and resolving his manifold problems, the Claimant started to write his thinking down in secret thinking-books, to use a process of paper-assisted thinking. The content of these thinking-books was (mainly) not like the organised record-keeping or note-taking of healthy people but rather comparable to the scrap paper a student might use for doing a maths calculation.
74. These secret thinking-books have provided, fortuitously, a comprehensive, direct, and uncontrived record of the symptoms of his illnesses and personal experiences thereof. They contain repeated references to depression, indecision, sleeping disorder, tiredness, allergy, phobias, shyness, social anxieties, difficulties with concentration/ attention, sense of failure and striving to solve the mystery of what had happened and how to regain normal functioning again.
75. He started writing in the first of his secret thinking-books at about the demise of his college attendances at age 20, and he continued through approximately ten of such notebooks till about age 28. The earliest thinking-books contained very primitive, disorganised, unsound ideas as befitted the very naive, very inexperienced and ignorant young person with prematurely truncated educational development.
76. By the time he was writing his lattermost thinking-books, at approximately age 28, the content had greatly advanced in quality such that in parts it was beginning to form the basis of the documents for publication which he started writing at that time. But that improvement was not due to mere maturation or passage of time as will be explained further below.
77. After the collapse of his second year of studying at Bromsgrove COFE, in the summer break he obtained a casual job as an office assistant to the engineers at Redditch District Council. But by the third week he was becoming increasingly overstressed and he gave notice of resignation.
78. Throughout the following academic year he was neither employed nor enrolled in any course. His thinking-books indicate much preoccupation with trying to get accepted by universities.
79. In the academic year after that, he enrolled at Redditch COFE to study English Language O-level and Economics A-level. He also attended two extramural (non-examined) evening classes in psychology at the University of Birmingham. He made an obsessive focus on preparing for the English Language exam, as can be seen in his secret thinking-books. Only in that way did he manage to pass it at last. But his studying of the A‑level Economics collapsed yet again and he did not attend the exam.
80. Meanwhile he had been given a conditional offer by Birmingham University, and an unconditional offer by Aston University, and lacking in confidence that he would pass the Economics he accepted the unconditional offer.
81. Thus, five years behind time, he managed to start on a course of Human Psychology at Aston University, but not due to any improved examination results (apart from at last passing English Language). Within weeks the same problems overwhelmed him and his studying ground to a halt as he became engrossed in trying to understand what was happening to him.
82. The most noticeably troubling problems at this time were the sleep/wake problem, the washing allergy/phobia, paralysing indecision, and crippling social phobias. He also recalls an incident in an experimental class: the students all had to do some tedious arithmetic (this being before the age of calculators) and it took him much longer to do than the other students, long after all the others had finished, to his great embarrassment as if he was making an exhibition of himself as some sort of idiot.
83. In due course he failed all the first year exams (due to uncategorised psychological illness), as is indicated by the letters of correspondence with the university about his appeal against termination and thereafter the possibility of rejoining the course on basis that he was supposedly not ill anyway.
84. At this time, he developed all sorts of peculiar symptoms, including migraines, outbreaks of extreme sweating, hyperactivity, and delirium.
85. A crucial event occurred in the year after the university when the Claimant was a tenant sharing in a house in Moseley, Birmingham. His waking/sleeping problem was still very much present, so he was sitting awake in the kitchen late at night. He noticed a book on a shelf, with its title concealed by a paper wrapping. He opened it and found that it was a very detailed compilation of information about nutrition (Let’s Eat Right to Keep Fit, by Adelle Davis). He could barely read coherently, and barely remember any of what he did read, but he was impressed by the thoroughness and rationality of that book, and so he struggled to carefully study it, re-reading sentences many times over due to the memory difficulty, and started to follow its recommendations.
86. The great importance of that development is that almost all other victims of mercury poisoning have not had that crucial information available to them. The power of that book can be seen in that in the few years before reading it he acquired 19 of the 20 amalgams, whereas in the more than three decades since he has needed only one more (and no lost teeth).
87. That book dated from many years before the present, and did not say anything about mercury poisoning. It was only many years later that nutritionists became commonly familiar with the importance of selenium, zinc, glutathione, in any role let alone in counteracting mercury. But nevertheless, the information that was fortuitously invaluable in counteracting the mercury. That is because one can discern the different nutritional deficiencies from the characteristic symptoms, regardless of what is causing those deficiencies. And mercury produces a whole load of nutritional deficiencies, not least as an anti-antioxidant.
88. Due to following this advice some of the commonplace mercury symptoms became eliminated or reduced to greater or lesser extent. These included depression, obsessions, anxiety, some of the phobias, migraine, periodontal, and the IBS he was burdened by for several years at a later stage.
89. The next month the Claimant moved to an unfit flat (rising damp, dry rot, rats, mice, seriously improper electrics, and rain flooding in six places inter alia) and in the subsequent years he continued working on trying to improve his health and overcome his problems among other things.
90. He spent a lot of time trying to find ways of earning money. Among other things working on trying to develop inventions. He spent much time researching them in the patents libraries. But it is almost impossible to succeed even with a brilliant invention unless one already has substantial personal energy or resources to do the production oneself.
91. Meanwhile, like most mentally disabled people he was very reluctant to think of himself as disabled. He instead registered as able and available for work, though this was partly because he could find no indication that he could get social security benefits otherwise (not having any NI contributions record).
92. But then a new policy was introduced, whereby unemployed claimants had to attend monthly interviews to report their job-seeking attempts. He attended a number of these interviews, and meanwhile attended job application interviews even though they bore no resemblance to any job he wanted to do or would even be capable of actually doing.
93. He was somehow transferred to invalidity benefits instead. He has no recall of how it happened, but guesses that at some point the employers started complaining about a clearly pathological candidate coming to their interviews.
94. In 1980 he read the here-attached science report in the Times about light and sleeping, and this enabled him to invent and make the world’s first effective light-therapy device. This substantially reduced the sleep/wake problem.
95. However, the improvement of sleeping pattern did not resolve the entire collection of problems. He then identified that some key problems were varieties of neuroses, more specifically phobias and to a lesser extent obsessions. There was especially the problem that he regularly tended to blush for no reason (in public), and that he had a phobia of getting in such blushing situations (i.e. just about any public situation). And he found just about any social encounter to be traumatic.
96. He struggled to overcome this social phobia, via a notion that the more one exposed oneself to social situations the less salience any particular situation would have, a sort of habituation. He entered into correspondence with the Society for Behavioural Psychotherapy about this. He thinks eventually the combination of his own habituation therapy, combined with his understanding of the anti-neurotic effect of vitamin B6 substantially resolved these problems.
97. The next year his curiosity was aroused by a report that high IQ of parents was associated with autism, and claims of a seeming relationship of genius with autism. Therefrom he accidentally discovered the first of his still-unchallenged theories, the gene-expression theory of autism (and IQ). Only by huge investment of years of time and effort was he able to write up the theory to publishable form. After nine years the autism theory was accepted for publication by the world’s most-cited-ever scientist HJ Eysenck (“well worth publishing”), and the world’s most famous autism researcher Bernard Rimland wrote of it as “excellent” “fine work” and “Robin P Clarke is one of those rare souls”. But the vast majority of professional scientists are intensely hostile to ideas coming from a person devoid of institutional status or qualifications. Everyone else then assumes that because the “leading” Professor S B-C avoids ever mentioning it (like those non-mentioning amalgam “experts”), it must “therefore” be obviously worthless rubbish anyway.
98. He then moved on to publishing some of the other theories.
99. In 1992 the Claimant enrolled yet again to take A-levels, this time Biology and Sociology at Matthew Boulton COFE. But by the third week he was too exhausted to continue. So he turned back to concentrating on the theories and hopelessly trying to make a success of the many business opportunities that are advertised as relatively easy means to earn an income.
100. In 2003, he at last discovered the (seemingly sole) cause of his several decades of severe reaction to washing/bath-ing. Namely defective hot water systems without a lid on the tank, such that the tank thus became contaminated by dust and thereafter organisms. As part of dealing with this, following fruitless correspondence with his landlords, the Claimant installed a shower and bought some kettles.
101. His expectation was that he had thereby resolved the central cause of his health problems and could now at last start to make progress in his life. But instead he still continued to experience most of the same symptoms as before. He was regularly exhausted or otherwise feeling unwell. Just a modest amount of exercise was enough to bring on familiar threatening sensations (of acute oxidative stress?).
102. After 35 years of illness, he was still struggling unsuccessfully for the ordinary health that others find so casually.
103. When the dental hospital proposed to add yet another amalgam he challenged them to provide evidence of safety. Their reply was unconvincing and they failed to respond to his rejoinder.
104. The NHS would not remove the amalgams, and as a chronic benefits dependant he could not afford the high cost of paying for it himself. So he continued to become more ill from the continuing enforced poisoning.
105. Much experience shows that the Claimant’s present symptoms would be much worse or fatal were he not following a very tedious regime of constant precautions. For instance: carefully ensuring a nose-level draught at all times (even when freezing outside); correct levels of selenium and zinc and the full range of essential antioxidants at regular spacing throughout every day; conscientiously avoiding both over-exercising and under-exercising; no junk food (i.e. what most people consider normal food); preventing the IBS by daily intake of glutamine and avoidance of all gluten (wheat etc); avoiding the washing/bath-ing reaction by avoiding all hot-water tank systems; keeping his life very simple with limited activity to avoid mental overload; trying to keep a bit of floss-tape separating the gold from the adjacent amalgam (which makes a big difference to vapour output). All these precautions are born of bitter experience rather than any mere theory or superstition.
106. While he is far less mentally dysfunctional than in the 1970s, he continues to have a serious problem of slow memory, attention, indecision, slowness, sleep/wake, and especially lack of energy and endurance, among other things such as inability to adapt normally to changes of temperature (such that he becomes drenched in sweat while others are nochalantly wearing warm coats). He barely copes now whereas in the 1970s he would not have been coping at all (and wasn’t then running his own household, to any standard).
107. A report from a medical practitioner detailing the readily observable aspects of his current condition is attached.
108. It is the Claimant’s case on causation that:
(a) had the Defendants not given defective advice concerning usage of dental amalgam, which failed to properly reflect the evidence of harm and lack of evidence of safety, the Injuries as particularised in this Claim would not have occurred;
(b) the defective advice from the Defendants caused NHS personnel to install amalgams, in increasing numbers, and with insufficient caution, and to fail to remove them at any stage;
(c) those amalgams then released mercury, during installation and or thereafter, and as vapour and otherwise, such as to enter the Claimant’s body and thereby cause chronic injuries characteristic of chronic dental mercury poisoning.
109. Numerous facts point towards dental mercury as the cause.
(a) Firstly the predominant and most disabling symptoms are a whole list of some most characteristic features of dental mercury poisoning as reported by many studies and individuals we can cite in evidence.
(b) The symptoms include some quite peculiar ones notably associated with chronic mercury poisoning, such as an unpleasant reaction to alcohol, lengthy crashes starting after stopping exercising, lack of normal temperature adjustment.
(c) This collection of symptoms developed after amalgam had been placed in teenage years, and have not gone away in 40 years since.
(d) The symptoms extend well beyond any standard psychological or metabolic syndrome recognised by the DH etc.
(e) In the 1990s he had taken a tablet of alpha-lipoic acid (ALA), which is considered an exceptionally health-enhancing antioxidant. It made him so ill that he never took a second tablet. Only many years later he learnt that it is a key chelating agent which gets mercury out of the brain but also allows it to flood into the brain. It should not be used until several months after amalgam removal when out-of-brain levels have fallen sufficiently.
(f) He had improvements in the last few years due to his growing understanding of mercury vapour and devising countermeasures thereof. For instance arranging elaborate nose-level ventilation systems, and antidoting with selenomethionine, zinc, mackerel, etc, avoiding everyday chelators, being cautious about excessive exercising.
(g) He had a notable improvement in 1975-6, on getting much outdoor air in those two years of famous drought, to the extent that he was at last accepted into a university.
(h) But then in 1976-7 in his small under-ventilated university room (Stafford Tower), the symptoms rapidly became worse again (effectively ceasing attendance by the second term).
(i) The checklist in Andrew Hall Cutler’s book at page 56-9 gave a score of at least 99.9% certainty of mercury poisoning.
(j) In breach of published Directions For Usage of amalgam, a gold inlay has for many years been placed such that it contacts with amalgam occlusally and proximally. This causes a galvanic battery effect and massively increases mercury output. As AHC’s book says on page 82, “The work has to be re-done immediately, removing all amalgam from contact with a dissimilar metal. This is very dangerous…”. The Claimant’s attempts to get NHS personnel to do anything about this were persistently unsuccessful, so to ameliorate he has tried to keep a piece of floss-tape wedging the gold and amalgam apart. But it falls out and he forgets to reinstate it.
(k) After 40 years of illness in 2009 he at last got two test results confirming a mercury problem. Firstly, the MELISA measurement of abnormal level of immune reactivity which produced 3/3 mercury positive results. This test is not some fanciful pseudoscience but rather is well-attested by numerous studies published by reputable scientists.
(l) The second test result was a finding that he has extraordinarily high levels of mercury vapour in his mouth, from which it follows that he must have an equally extraordinarily high level of intake of mercury, and much of it ending up in his brain. With the Jerome mercury vapour analyser he has been found to have some of the highest oral measurements ever recorded, even with open mouth and no preceding stimulation of the amalgams. On visiting Dr El-Essawy of Harley Street in September 2009 he obtained readings of 460 overall open mouth, and 610 near the improper gold-amalgam contact in the upper-left quadrant (despite much less amalgam there). On re-visiting in November 2010 readings about 40% of the previous were obtained, which is explainable in terms of his having left the floss-tape wedged by the gold since the previous day (which he had forgotten about and only remembered when it fell out after he got back to Birmingham).
Please note the readings of others in this 2009 ITV video:
From 5m25s, you can see readings of 9.93, 2.58, and 1.66 mcg/m3 just before the CDO is seen stating his expertise about it all being unmeasureable anyway, and immediately thereafter a further measurement of 2.44. Compare the Claimant’s 2009 results of 460 overall open mouth, and 610 near the improper gold-amalgam contact in the upper-left quadrant.
Even Lichtenberg’s severely symptomatic patients only had an average of 55 mcg (Lichtenberg H, J Orthomolecular Med 11, 87-94, 1997). The following chart makes this point clear:
[see pdf version for chart, which I will upload later.]
110. In 2010-2011 the Claimant had some weeks of serious regression eventually identified as due to thiols in camembert cheese; then a second regression after switching to reblochon which also contains thiols.
111. That mercury affected the Claimant when it did not affect others can be understood as follows:
(a) He had a huge number, nineteen, fitted within a handful of years, and producing the huge vapour intake indicated above.
(b) It only takes a moment of impaired suction to enable the patient to inhale the amalgam dust which then lodges in the lungs where its very large surface area causes a greatly increased intake of mercury vapour.
(c) A reiterated principle in the literature is that a person has a certain amount of initial tolerance of mercury but after continuing intake the capacity for detox/removal becomes impaired and finally exhausted. Thereafter, a level of intake that has no noticeable effect on others, in the words of Tuthill (in concurrence with many others) “makes a mental wreck of its victim”.
(d) Mercury during infancy tends to act as an antiinnatia factor, in lower levels causing increased IQ. It follows that genes reducing mercury removal will tend to cause raised IQ. The Claimant had a particularly high IQ (~180, even higher than his four brothers), which could very likely have been partly due to one or more mercury-retaining genes. And those genes would also cause a genetic vulnerability to mercury poisoning.
(e) There were breaches of Directions For Usage, namely gold in occlusal and proximal contact with amalgam, excessive use, use in a case with immune sensitivity (melisa test).
Any reasonable alternative explanations?
112. No other causal event happened around age 16-17 that could account for this drastic deterioration followed by permanent invalidity. The Claimant had continued living at the same address as for the previous 13 years, and there was no change of household or of school. He continued to share meals with his parents and four brothers, there were no environmental incidents in the locality, and no onset of symptoms among the six other family members or his school colleagues.
113. School reports of the last two years indicate a mystery, not present before: “A rather enigmatic personality”; “Why does he fail to show them here?”; “His attitude and behaviour perplexes me”; “His enigmatic personality….”.
114. The collection of symptoms does not correspond at all well with any recognised syndrome (other than chronic mercury vapour), such as neurosis, schizophrenia, bipolar, dementia, delirium, autism, stroke, etc. The symptoms extend well beyond any purely psychological syndrome.
115. Schizophrenia can begin in late teens but this has clearly never been schizophrenia. The most schizophrenia-diagnostic symptoms have never been present, at any time in approximately 4 decades of mental disability, and most of the symptoms are not at all characteristic of schizophrenia.
Limitation / knowledge
116. This case falls within the scope of Limitation Act 1980 s.11, by which there is normally a time-limitation of 3 years from the “date of knowledge”.
117. The Claimant could not reasonably be expected to file a claim at a time when he lacked knowledge of clear facts and instead had only vague, confidently-dismissed suspicions available to him, such as could not enable a successful claim and would rightly be dismissed as inadequate.
118. In the present case the nearest equivalent of “knowing” these key “facts” would be when the Claimant has received information sufficient to justify confident dissenting views that (a) amalgam toxicity does indeed exist, (b) he himself has been injured by such amalgam toxicity, and (c) the Defendants’ advice was biased to a non-trivial extent.
119. It was only by 2009 that the Claimant could with adequate reasonableness form opinions (i) that the Defendants were unacceptably negligent and (ii) that his own injuries were very much likely caused by the amalgam and hence by that negligence….and reasonably hope that those same facts could persuade a court to the same opinions.
120. Thus the Claim has been filed within the designated limitation period.
121. Furthermore, even if there had been an earlier “date of knowledge” in this case, various criteria for discretionary exclusion indicated in s.33 (1) and s.33(3) would apply.
Particulars of Damages
122. The losses incurred by the Claimant are set out in the Schedule of Losses served with these Particulars of Claim.
123. The Claimant also claims interest pursuant to Section 35A of the Senior Courts Act 1981 on the amount found to be due to the Claimant at such rate and for such period as the Court thinks fit.
AND the Claimant claims:
(2) Interest pursuant to Section 35A of the Senior Courts Act 1981, to be assessed.
STATEMENT OF TRUTH
I believe that the facts stated in these particulars of claim are true.
Robin Philip Clarke
CLINICAL NEGLIGENCE (in part)
IN THE HIGH COURT OF JUSTICE CLAIM NO.
QUEENS BENCH DIVISION
ROBIN PHILIP CLARKE
THE DEPARTMENT OF HEALTH
/ THE CHIEF DENTAL OFFICER