The physicians involved in the federal case, who were called before the committee, were Drs. James Ballard of Birmingham, Ala.; Andrew Harron of Kenosha, Wis.; and Ray Harron of Bridgeport, W.V. The doctors appeared with their lawyers but said little at the hearing.

According to testimony, they were responsible for the diagnoses of approximately 120, 505 and 1,200 silicosis claimants, respectively. In addition, they supplied X-ray reports used to support many other diagnoses.

“Will you certify that each of these diagnoses and all others that you made in this litigation are accurate and made pursuant to all medical practices, standards and ethics?” they were asked by Rep. Ed Whitfield, R-Ky., chairman of the subcommittee.

One by one, Drs. Harron and Ballard refused to answer, invoking their constitutional right against self-incrimination.

Judge Jack's decision in Re: Silica Products Liability Litigation detailed how diagnoses of silicosis, a largely incurable and often fatal pulmonary disease, were produced for approximately 10,000 plaintiffs largely by the same 12 physicians for use in subsequent lawsuits.

Judge Jack concluded that “these diagnoses were about litigation rather than health care,” and “were driven by neither health nor justice, [but] were manufactured for money.”

In his comments at the hearing, Rep. Whitfield said the problems uncovered by the decision by Judge Jack “are particularly troubling because they undermine our judicial system.”

“But they also clearly show the lack of attention or concern about the actual health or treatment of patients. Dollars were the priority. Patients' health and well-being were afterthoughts.”

“That's not medicine; that's greed,” said U.S. Rep. Charlie Bass, R-N.H.

“This might be a story of medical heroes who identify and then treat and care for people with a deadly disease,” added U.S. Rep. Joe Barton, R-Texas, chairman of the full Energy and Commerce Committee.

“More likely, this is a story of medical mercenaries who allege cases of disease for the purpose of legal action and great financial gain. Particularly troubling is the prospect that thousands of people were handed bogus diagnoses of this horrible disease and, in many instances, by medically unqualified lawyers, paralegals or screening company employees.”

Another witness, Tulane University Law Professor Edward Sherman, testified that, “The system has taken on a life of its own.” He suggested that, without stronger standards, similar shaky claims could plague other industries.