Autism is not murderous

12 Aug

Lives lost to autism is a new website with what seems at first glance to have an excellent reason for existence – to record all the non-natural deaths of autistic people.

But the name ‘Lives lost to autism’, the strapline ‘For many, autism can be deadly.’ and most particularly the statement ‘This site tells the story of the precious lives cut short by autism.’ are very misleading. Blaming autism for murder is utterly misleading. Autism didn’t murder any of the children listed as murder victims – or the ones that haven’t been listed either.

The site seems to be set up and run by Ginger Taylor (left) who’s position on autism has grown more and more extreme over the years. It seems now she is happy to denigrate autism itself as a murderous entity.

Should there be a site where victims of murder AND natural deaths are remembered? Of course there should, its a great idea. But to politicise it so graphically and so ham-fistedly is wrong. Its a testament to the ideas of Ginger Taylor and not a lot more right now.

New study – “90% diagnostic accuracy”

11 Aug

According to study author Christine Ecker in today’s Guardian:

We know already that people with autism have differences in brain anatomy and some regions are just bigger and smaller or just different in shape…[o]ur technique can use this information to identify someone with autism.

The study used 20 non autistic controls and 20 autistic people – all adults – and found ‘significant differences’ in the grey matter areas of the brain which control behaviour and language. This is nothing new in itself, differences in brain structure have long been known about in regards to autism. Whats new in this study is the method – and resultant accuracy – of the detection of autism.

In the experiment, Ecker showed that her imaging technique was able to detect which people in her group had autism, with 90% accuracy. “If we get a new case, we will also hopefully be 90% accurate,” she said. The research, supported by the Medical Research Council, Wellcome Trust and National Institute for Health Research, is published today in the Journal of Neuroscience.

If this is established as a viable method (Carol Povey of NAS states that further testing is still required) then it’ll be the first true objective test for autism ever developed. So far, as everyone knows, autism is diagnosed based on the opinion of a clinician (or team of specialists). Whilst they will probably still play a role, this test offers an objectivity that would be unparalleled. It would also have the interesting effect of making the DSM diagnosis largely obsolete.

Evidence of Harm

9 Aug

A new Cochrane Review looks at the issue of SSRI’s in use for autistic populations.

OBJECTIVES: To determine if treatment with an SSRI: 1. improves the core features of autism (social interaction, communication and behavioural problems); 2. improves other non-core aspects of behaviour or function such as self-injurious behaviour; 3. improves the quality of life of children and their carers; 4. has short and long term effects on outcome; 5. causes harms.

SSRIs (Selective serotonin reuptake inhibitors) do exactly what they say – they combat depression by ‘boosting’ serotonin. They are usually fairly effective in that role, although not all people with depressive tendencies use SSRIs, the majority tolerate them well. The most famous SSRI is Prozac.

The outcome of the study was:

There is no evidence of effect of SSRIs in children and emerging evidence of harm. There is limited evidence of the effectiveness of SSRIs in adults from small studies in which risk of bias is unclear

This is worrying. It indicates to me that autistic people are being treated for autism with SSRIs. Bearing in mind I haven’t read the full paper, it does read to me as though we are verging into the territory of chemical cosh.

A chemical cosh is shorthand for the administration of drugs to people who don;t actually require its benefit but who are kept quiet by its effects or side effects. This isn’t the fault of the drug or even the manufacturer but the prescriber. This is also not a situation unique to autism but is frequently found throughout all areas of mental health.

Upcoming IACC Services Subcommittee Conference Call – August 10, 2010

6 Aug

I just got this announcement:

The Interagency Autism Coordinating Committee (IACC) Services Subcommittee will be holding a conference call on Tuesday, August 10, 2010 from 2:00 PM – 3:30 PM ET. For more information see: http://iacc.hhs.gov/events.

The purpose of this meeting will be to discuss plans for the IACC Services Workshop that will be held on November 8, 2010 in Rockville, Maryland. (More information about the workshop is posted on the IACC website and will continue to be updated.)

To access the conference call:

USA/Canada Phone Number: 800-369-3340
Public access code: 8415008

Members of the public who participate using the conference call phone number will be able to listen to the meeting, but will not be heard.

I’ve been offered a job as a paid blogger to promote a medical website!

5 Aug

“Pharma shill!” I get called that fairly often. People claim (incorrectly) that I am paid for what I do here at LeftBrainRightBrain. That I only write what I write because I am a shill.

When this comes up I point out that, no, I am not paid. I find the idea that there are many paid bloggers like that to be a bit of a stretch anyway.

I just found this email in our spam comment queue:

“Hi! We are browsing for potential future writers, would likely you be intrigued? This process is not going to get you rich yet unfortunately there is an alluring pay and if you literally appreciate publishing then now this gig is for you.”

Yes, I could get “alluring pay”.

All I have to do is write for a blog that touts HBOT. Yes, a hyperbaric oxygen therapy blog.

I could be an alt-med-pharma-shill!

I think I’ll pass.

Communicating Effectively About Vaccines

4 Aug

A new study is looking at how messages regarding vaccines are assimilated by the US public.

Immunization rates continue to be high but concerns about vaccine safety are increasing. Current communication methods do not appear to lead to more comfort with vaccines, making it more important than ever that state and territorial public health agencies, charged with promoting, monitoring and tracking vaccine use, understand the growing reluctance among parents and guardians to fully vaccinate their children and identify effective messages about the benefits of vaccines.

According to this report 5% of all respondents mentioned autism-related concerns and above average amount of people designated the statement:

Vaccines can cause serious health problems like…autism

‘convincing’.

and the conclusion states:

…Current communication methods based on scientific research do not appear to lead to more comfort with vaccines…

Reading this blog post one would tend to think it was a bad report for vaccines. Far from it, its wholly positive, which one will gather if one reads the whole thing. However, the aspect of the report I’m particularly concerned with (autism) shows that there is a growing trend of belief and a shrinking trend of science in what leads a parent to make up their mind. And apparently autism plays a relatively large percentage in that decision making process.

So what do we do about that? The science is clear that vaccines don’t cause autism but the US public seem to be ignoring such science. What else is there available that we can use? Because take note, we in the autism community have an obligation to society as much as they do to us. Their obligation is to do right by autistic people. Our obligation is continue to fight the idea that vaccines cause autism. If we do not then the public will believe that *all* parents of autistic people and autistic people themselves believe that vaccines cause autism – thats a very dangerous place to be.

Microglial Activation and Increased Microglial Density Observed in the Dorsolateral Prefrontal Cortex in Autism.

4 Aug

Here is a study that will likely be discussed for a long time to come. There has been a lot of interest in the study by John’s Hopkins researchers (Pardo, et al.) on microglial activity in the brains of autopsied autistics. A paper just released by Prof. Pardo together with Prof. Courchesne at UCSD shows markedly increased microglial cell activiation in 5 of 13 autistics, including children under 6.

The exact implications of this are not yet determined. The authors conclude the abstract with

“Given its early presence, microglial activation may play a central role in the pathogenesis of autism in a substantial proportion of patients. Alternatively, activation may represent a response of the innate neuroimmune system to synaptic, neuronal, or neuronal network disturbances, or reflect genetic and/or environmental abnormalities impacting multiple cellular populations.”

Here is the full abstract:

Biol Psychiatry. 2010 Aug 15;68(4):368-376.
Microglial Activation and Increased Microglial Density Observed in the Dorsolateral Prefrontal Cortex in Autism.

Morgan JT, Chana G, Pardo CA, Achim C, Semendeferi K, Buckwalter J, Courchesne E, Everall IP.

Department of Neuroscience, School of Medicine, University of California, San Diego, La Jolla, California.
Abstract

BACKGROUND: In the neurodevelopmental disorder autism, several neuroimmune abnormalities have been reported. However, it is unknown whether microglial somal volume or density are altered in the cortex and whether any alteration is associated with age or other potential covariates. METHODS: Microglia in sections from the dorsolateral prefrontal cortex of nonmacrencephalic male cases with autism (n = 13) and control cases (n = 9) were visualized via ionized calcium binding adapter molecule 1 immunohistochemistry. In addition to a neuropathological assessment, microglial cell density was stereologically estimated via optical fractionator and average somal volume was quantified via isotropic nucleator. RESULTS: Microglia appeared markedly activated in 5 of 13 cases with autism, including 2 of 3 under age 6, and marginally activated in an additional 4 of 13 cases. Morphological alterations included somal enlargement, process retraction and thickening, and extension of filopodia from processes. Average microglial somal volume was significantly increased in white matter (p = .013), with a trend in gray matter (p = .098). Microglial cell density was increased in gray matter (p = .002). Seizure history did not influence any activation measure. CONCLUSIONS: The activation profile described represents a neuropathological alteration in a sizeable fraction of cases with autism. Given its early presence, microglial activation may play a central role in the pathogenesis of autism in a substantial proportion of patients. Alternatively, activation may represent a response of the innate neuroimmune system to synaptic, neuronal, or neuronal network disturbances, or reflect genetic and/or environmental abnormalities impacting multiple cellular populations. Copyright © 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

PMID: 20674603 [PubMed – as supplied by publisher]

Diagnosis of autism occurs much later than it should among Medicaid-enrolled children

4 Aug

This from a recent study by Prof. David Mandell’s group. The abstract is below:

Psychiatr Serv. 2010 Aug;61(8):822-9.
Age of diagnosis among medicaid-enrolled children with autism, 2001-2004.

Mandell DS, Morales KH, Xie M, Lawer LJ, Stahmer AC, Marcus SC.
Abstract

OBJECTIVE: This study examined child- and county-level factors associated with age of diagnosis of autism among Medicaid-enrolled children and the change in age of diagnosis over time. METHODS: National Medicaid claims from 2002 to 2004 were used to identify age of diagnosis and characteristics of children younger than ten years old with a diagnosis of autism (ICD-9 codes 299, 299.0x, or 299.8x). These data were linked to county-level education and health care variables. Linear regression with random effects for state and county was used to examine associations between these variables and age of diagnosis. RESULTS: A total of 28,722 Medicaid-enrolled children newly diagnosed with an autism spectrum disorder were identified. Their average age of diagnosis was 64.9 months. Adjusted average age of diagnosis dropped 5.0 months for autistic disorder and 1.8 months for other spectrum disorders during the study period. Asian children were diagnosed earlier than children in other racial or ethnic groups, although these differences were much more pronounced for other spectrum disorders than for autistic disorder. Children eligible for Medicaid through the poverty category were diagnosed earlier, on average, than children who were eligible through disability, foster care, or other reasons, although this difference decreased over time. Children in large urban or rural counties were diagnosed later than children in small urban or suburban counties. CONCLUSIONS: Findings showed that diagnosis of autism occurs much later than it should among Medicaid-enrolled children, although timeliness is improving over time. Analyses suggest that most of the observed variation is accounted for by child-level variables, rather than county-level resources or state policies.

PMID: 20675842 [PubMed – in process]

The age of diagnosis in California for the general population was 3 years by 2000 (falling from 6 in 1992) according to a recent paper by Bearman’s group at Columbia. Why are medicaid children diagnosed later?

I find it odd that children on medicaid due to poverty are diagnosed earlier than children “eligible through disability, foster care, or other reasons”. Naively, I would expect the opposite: that children already identified with a disability would be under greater scrutiny and more likely to receive evaluations to determine an ASD diagnosis.

Much more can be said about this, but I will stop with “Diagnosis of autism occurs much later than it should among Medicaid-enrolled children”. This is just wrong. We as a society should take better care of our most vulnerable.

The California pertussis outbreak of 2010

4 Aug

If you haven’t already heard, California is in the midst of a major outbreak of pertussis (whooping cough). The California Department of Public Health is predicting that this could be the biggest outbreak in 50 years.

Here is a graph from the CDC (via the LA Times) which shows the number of pertussis cases in the entire US as a function of time up to and including the 2004/5 outbreak:

That was not just the sort of cyclic bump seen every 4-5 years even with vaccines. That was a big outbreak. And, now, California is set to see an even bigger outbreak.

So far 7 infants have died. They were too young to be vaccinated. What is especially troublesome is that usually the worst part of the year starts in August. Here is a figure from the CDPH comparing this year to last year:

By this time last year, no children had died.

Why bring this up on an autism blog? Because unfortunately much discussion focuses on vaccines and pertussis is a vaccine-preventable disease. Many autism organizations promote under vaccination or skipping vaccination. Also, groups such as the self-named “National Vaccine Information Center” (NVIC) use autism as a major part of their message touting the dangers of vaccination. Because of this, these groups react strongly to accusations that these outbreaks are due to their activism. Such an accusation came from Nancy Snyderman of MSNBC

http://www.msnbc.msn.com/id/32545640

Visit msnbc.com for breaking news, world news, and news about the economy

Dr. Snyderman is an “unabashed advocate” for vaccines and points out that people who selectively undervaccinate put people like the immune compromised and the very young at risk.

As you might imagine, these strong comments brought a strong response. Becky Estepp of Talk About Curing Autism gave her response at the at the Age of Autism blog.

Barbara Loe Fisher of NVIC defended her group’s positions even before the MSNBC spot aired:

After watching the NVIC video I had a lot of questions. I posed a few of them to the California Department of Public Health. I appreciate them taking the time to reply:

NVIC states that there are outbreaks every 4-5 years and that “this is nothing new”. I asked CDPH:

There is an outbreak every 4 to 5 years (implying this is no big deal). I think this is correct as far as it goes, but the magnitude of this outbreak appears to be large. Is there public data on the size of previous outbreaks to compare this one to? I realize that will likely involve an estimate of the size of this year’s outbreak.

Yes, historically, there are “peak years” for pertussis every 3-5 years. This was true for other vaccine preventable diseases as well before they were controlled by vaccination. This is because once a disease sweeps through a population it takes at least a few years for adequate numbers of susceptible people to accumulate again in the population to allow sustained, widespread transmission of the disease. What is different about pertussis than other vaccine-preventable diseases such as measles, is that, unlike measles, neither pertussis vaccine or disease confers lifelong immunity. Pertussis susceptible people accumulate in the population via birth cohorts who are too young to be vaccinated, people whose immunity from vaccine or disease has waned, and people who are eligible to be vaccinated, but are unvaccinated.

The last peak year for pertussis in the U.S., including California was in 2005. This was a nationwide peak year with over 25,000 cases in the U.S, the most cases in 45 years, and over 3,000 cases in California, including 8 deaths. Although Tdap was first licensed in June 2005, not many people received it that year and it did not have an effect on the outbreak. We now have Tdap to use as a control measure that was not available in other peak years. Therefore, we are trying to increase the level of pertussis immunity in the population by encouraging the use of Tdap, particularly in people who have contact with infants.

California is having a peak year/epidemic in 2010. If current trends persist, there will be more cases in California this year than in 2005 and more cases than in 52 years (see attached document, which has been released to the public). Although some other states are reporting increases this year, no state has reported an increase similar to that seen in California, which has now had a six-fold increase from the numbers reported during the same time period in 2009, a non-peak year.

NVIC seems to be implying that parapertussis is the cause of the outbreak and that is not covered by the vaccine. Aren’t many cases, especially those hospitalized or the deaths, confirmed by PCR?

Parapertussis is also circulating and pertussis vaccine does not provide protection against parapertussis. However, we do not think parapertussis is the cause of our epidemic because most of the reported pertussis cases in California are laboratory confirmed to be pertussis. In addition, parapertussis does not kill healthy young infants. Tragically, there have been seven infant deaths in Calfornia this year, all of whom had laboratory confirmed pertussis.

NVIC is also claiming that B. Pertussis may be mutating away from the vaccine strain, so the vaccine would be failing. Besides being at odds with her own assertion that the outbreak is due to parapertussis, is there evidence for this? Are the outbreaks in unvaccinated individuals? The comparison is, of course, most valid in the very young, where immunity will not have had the chance to wane.

We are not aware of any evidence that the currently circuclating strains of pertussis are not covered by the vaccine. Of the reported cases for whom we have vaccination information, most were unvaccinated or undervaccinated. None of the seven infants ❤ months of age who died had received any pertussis-containing vaccines.

I have a lot more questions and there is much to deconstruct in the NVIC and TACA statements, but this is not the time for that.

Is the current outbreak due to the activities of groups like NVIC, TACA and the Age of Autism? Let me put it another way since accusations bring on such strong reactions from these groups: does it matter right now if they are at fault? People are dying. The goal right now is to minimize suffering and death. Vaccines do offer protection and could limit this outbreak.

Another example of the workings of the vaccine court

4 Aug

This doesn’t involve the autism cases. Instead it is about the Hepatitis B omnibus proceeding which is also ongoing. It does involve some familiar names: Clifford Shoemaker (attorney), Dr. Mark Geier and his son David Geier. It does give us some insight into the billing practices of these gentlemen.

As background I’ll note that Clifford Shoemaker subpoenaed blogger Kathleen Seidel of Neurodiversity.com. He ended up being sanctioned for that action.

Dr. Mark Geier has been a frequent consultant to Mr. Shoemaker’s cases in the vaccine court. Ms. Seidel has covered some of the cases before where Dr. Geier has participated.

David Geier has so far not been compensated as a consultant to the Court.

In a recent case, Quinton O. Riggins, Jr. v. Secretary of HHS, we can see some of the decision processes involved in awarding fees to attorneys and consultants in the Court.

The application was for a total of $221,211.34:

On April 1, 2008, petitioner’s counsel, Clifford Shoemaker, filed an Application for Attorneys’ Fees and Costs (hereinafter referenced to as Petitioner’s Application), requesting a total of $221,211.34 in attorneys’ fees and costs. Counsel requests $16,592.16 in fees and costs related to the above-captioned matter, and $204,619.18 in fees and costs related to the “general hepatitis B proceedings.”

Of this, about $96k was paid:

Accordingly, petitioner is entitled to the following award for fees and costs for efforts in the Riggins case and for efforts on the hepatitis B cases in general: $95,801.72 for attorney’s fees and costs to be paid by check payable to petitioner and petitioner’s counsel; and $528.25 in petitioner’s costs to be paid by check payable to petitioner. The Clerk shall enter judgment accordingly.

The analysis of the application is lengthy. I will quote some sections below.

In regards to Mark and David Geier:

“Petitioner’s counsel requests $110,386.73 in costs related to S&A’s general hepatitis B work, of which counsel has earmarked $97,443.43 as costs (for fees and expenses) owed to Dr. Mark Geier and his son, David Geier.”

In the end, Dr. Mark Geier was paid $10,000 and David Geier was not compensated.

In denying payment to David Geier, who holds a bachelors degree, the Special Master noted:

“In summary, the undersigned finds the costs for David Geier’s efforts to be obviously unreasonable as Mr. Geier is not qualified to address the medical issues involved in the Program and his work was duplicative of the efforts by Dr. Geier. Thus, the undersigned denies the request for costs for David Geier in its entirety.”

In regards to Dr. Mark Geier:

However, Dr. Geier’s qualifications as an expert, testimony in the Program, and credentials, have been subject of considerable criticism over the years by the court. The undersigned questioned his expertise as far back as 1991. Daly v.Sec’y of HHS, No. 90-590V, 1991 WL 154573, at *7 (Cl. Ct. Spec. Mstr. July 26, 1991) (“[T]his court is inclined to not allow Dr. Geier to testify before it on issues of Table injuries. Dr. Geier clearly lacks the expertise to evaluate the symptomatology of the Table injuries and render an opinion thereon.”). More recently, in a published Order, my colleague, Special Master Vowell, addressed this criticism, as well as her concerns regarding petitioners utilizing medical articles authored by Dr. Geier, as follows:

I found that the articles authored by Dr. Geier unpersuasive and not scientifically sound, based on my prior reading of the articles and critiques of them. I am also aware that Dr. Geier is trained as a geneticist and obstetrician, not an immunologist, epidemiologist, or rheumatologist, and that my fellow special masters and several other judges have opined unfavorably on his qualifications and testimony as an expert.

It appears that since the Court has found that Dr. Geier is not qualified as an “expert”, he was retained as a “consultant”. However, he appears to have acted in ways overstepping the bounds of “counsultant”.

In the instant matter, the undersigned finds it was reasonable (and appropriate) for counsel to consult with Dr. Geier in a limited manner regarding the hepatitis B claims. Those efforts would entail Dr. Geier performing an initial review of the counsel’s hepatitis B claims and some initial research regarding vaccine injuries resulting from hepatitis B vaccine. Dr. Geier would then educate counsel as to the nature of the issues and the types of experts required. However, once Dr. Geier performed an initial review of these claims for counsel, and once counsel began reaching out to doctors who would ultimately serve as experts in S&A’s hepatitis B claims, it was no longer reasonable for Dr. Geier to be billing hours and incurring costs in S&A’s general hepatitis B efforts. Dr. Geier at this point was moving well beyond the role of a consultant.14 Thus by the beginning of 2002, when Mr. Shoemaker began to meet with experts15 to assist in the prosecution of the hepatitis B claims, Dr. Geier’s work on behalf of S&A’s general hepatitis B efforts was no longer needed and should have concluded.

Because of this, Dr. Geier was compensated at a reasonable amount for his consulting activities.

The undersigned notes an award of $10,000.00 represents an almost 90% reduction of the invoice submitted by the Geiers in this matter. The award of $10,000.00 is reasonable for Dr. Geier’s consultant efforts, and thus should not be viewed as a “reduction,” but viewed as reasonable compensation for Dr. Geier’s role as a consultant. The time not compensated is time largely spent by Dr. Geier duplicating the efforts of the experts, duplicating his own work, or performing work as an expert (work he is not qualified to perform). Stated another way, once experts were identified and became involved, Dr. Geier’s role as a consultant ended.

Mr. Shoemaker requested $221,211.34 in fees and costs:

On April 1, 2008, petitioner’s counsel, Clifford Shoemaker, filed an Application for Attorneys’ Fees and Costs (hereinafter referenced to as Petitioner’s Application), requesting a total of $221,211.34 in attorneys’ fees and costs. Counsel requests $16,592.16 in fees and costs related to the above-captioned matter, and $204,619.18 in fees and costs related to the “general hepatitis B proceedings.”

The court found that $64,254.45 was reasonable.

Here is an example of a charge that was denied:

The 5/30/2006 entry bills 0.5 hours to “[r]eview excel chart and update information; transfer information needed for SC to laptop,” P. App at 18. The “transfer information needed for SC to laptop” entry was explained by counsel asconstituting mere seconds and thus not administrative overhead. P Resp at 2, fn 1. However, counsel failed to address the remainder of the entry and identify what excel chart he was updating and how that activity was relevant to Mr. Riggins’ case. However, far more egregiously, counsel has billed for this exact same activity on precisely the same date twice before in two separate hepatitis B cases.

Trips to France and Italy were also excluded:

Another extreme example of counsel’s error in billing judgment is the request by counsel for fees and costs billed by Dr. Mark Geier and David Geier for trips to France and Italy in the summer of 2005 and winter of 2006 respectively, and for Mr. Shoemaker to travel to France with the Geiers in the summer of 2005. These requests represent a complete abdication of billing judgment.

Dr. Geier and Mr. Geier together billed a total of over $20,000.00, P App at 62-63, to travel along with Mr. Shoemaker to France and meet with various doctors and lawyers to discuss adverse events following the hepatitis B vaccination. Dr. Geier, in his affidavit, and counsel in Petitioner’s Sur-Reply, allege it was necessary to travel to France to discuss the doctors’ and lawyers’ experiences and research relating to adverse reactions stemming from the hepatitis B vaccination, and that this information could only be obtained in “face-to-face” discussions. In addition, Dr. Geier and Mr. Geier together billed $23,690.00 to travel to Italy to attend the 5th International Conference of Autoimmunity. Petitioner argues in Petitioner’s Response that the Geiers were invited to present their research at the conference by Dr. Shoenfeld, a leading expert in autoimmunity, and that at the conference they were able to secure Dr. Shoenfeld’s services as an expert in counsel’s cases. Petitioner further alleges the Geiers were able to discuss autoimmune disorders with experts at the conference and further “expedite the prosecution of various hepatitis b cases.” P Resp at 12.

and

Additionally, the Geiers provided absolutely no supporting documentation, such as receipts, to evidence the $9,399.68, see P App at 60, they allege they incurred in costs for airline tickets, other transportation costs, parking, hotel, “daily expenses,” food, and conference fees during these trips. P App at 61-62. By itself, this failure justifies not awarding these costs.

Many expenses for Mr. Shoemaker were questioned by the Special Master. Some based on the lack of adequate justification for the costs:

Petitioner’s counsel has failed to provide adequate information for the undersigned to determined exactly what the costs represent and whether or not the costs were reasonably incurred. No receipts are provided for any of these expenses. For example, for what did counsel pay costs to Federal Express? Who traveled to Boston and stayed at the Ritz Carlton? What expert was met with in Boston? Who traveled to Florida? And what attorney was met with in Florida?

Other expenses were considered to be “overhead”

Respondent objects to five hours of time billed by counsel for “‘meeting with consultants about scanning issues’” on April 19, 2000; one hour of time billed by counsel for “‘review[ing] computer breakdowns and update computer field’” on October 8, 2002; and three hours of time billed by counsel for a “consultation with Legal Nurses Association to discuss reviewing cases and preparing chronologies” on September 19 and 21, 2001. R Opp at 17; see also R Reply at 7. Respondent objects to these billings on the basis that the billings are administrative in nature, “more properly categorized as overhead” and would benefit “all petitioners represented by [counsel’s] firm.” Id. The undersigned agrees.

The entire decision is 37 pages long, detailing the requests for reimbursments, fees and costs.