Benicar Lawsuits Continue to Grow

November 4, 2014

On June 17, 2014, California resident Susanne Ambler and her husband filed a lawsuit against Daichi Sankyo for injuries Ms. Ambler suffered while taking Benicar, a product manufactured by Daiichi Sankyo. Benicar was approved by the FDA in 2002 for use in the treatment of hypertension. According to court filings, Ambler claims that she suffered sprue-like enteropathy symptoms which resulted in numerous hospitalizations. Her case was transferred to federal court with a final pretrial conference scheduled for December of this year.

In Texas, another Benicar lawsuit was filed by George Williams against Daiichi Sankyo and Forest Laboratories, Inc. in the Superior Court of New Jersey for Atlantic County. The case was then removed to the U.S. District Court for the District of New Jersey. Like Ms. Ambler, Mr, Wiliams suffered sprue-like enteropathy symptoms and was hospitalized over 100 days over a four-year span. In addition to suffering from enteropathy, Mr. Williams is alleged to have developed villous atrophy that ultimately required the placement of a feeding tube. Mr. Williams claims that the use of Benicar and/or the use of steroids in the treatment caused him to get cataracts. Williams also suffered a compression fracture to his spine related to being prescribed Benicar.

New Jersey resident Christy Brooks also filed a claim against Daiichi Sankyo and Forest Laboratory, Inc. in the New Jersey courts for injuries she suffered from her use of Benicar. Similar to other victims of Benicar, because the side effects of Benicar may not appear in a user for months to years after initiating use, her doctors could not connect her mystery illness with her use of Benicar. They only made the connection when the FDA forced Daiichi Sankyo to include warnings in 2012 for the side effect of sprue-like enteropathy and in 2013 for the side effect of villous atrophy.

Ohio resident Brenda Baugh filed suit seeking damages for her injuries resulting from the use of Benicar on October 15th of this year. Baugh was hospitalized multiple times for the symptoms that are now known to be linked to the use of Benicar. Baugh’s suit was filed in Federal District Court in the Northern District of Ohio. Baugh was repeatedly misdiagnosed due to her physician’s lack of knowledge regarding the connection between Benicar and the symptoms she displayed.

Each plaintiff in these suits suffered similar injuries that are consistent with those found in research published by the Mayo Clinic in 2012. Those symptoms include sprue-like enteropathy including chronic diarrhea, weight loss, nausea and vomiting, as well as several forms of colitis. These symptoms have occurred long-term in the plaintiffs in these lawsuits, resulting in malnutrition and dehydration. The Mayo Clinic released additional research in 2013 that found the long-term occurrences of these symptoms also lead to villous atrophy, a permanent condition, which is characterized by damage to the villi in the intestinal tract which absorbs nutrients and causes malnutrition.

Unfortunately, the symptoms that people experience from injuries caused by Benicar use are often misdiagnosed as celiac disease. In these cases, the patient can suffer long-term damage. In some cases, the symptoms may subside after discontinuuing the use of Benicar.

Approximately 45 million people in the United States are being treated for hypertension. Currently, there are numerous cases pending across the country in state and federal district courts. With 1.9 million prescriptions for Benicar documented to date, that number is expected to grow.

Toni Kohlbeck, Intern Jacoby & Meyers, LLC.

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U.S. Judicial Panel on Multidistrict Litigation to hear Oral Arguments regarding Xarelto

On July 25, 2014, the McGowen family filed a claim in the U.S. District Court for the District of Vermont against Xarelto drug manufacturer, Bayer Healthcare and Johnson & Johnson’s Janssen Pharmaceuticals subsidiary for the wrongful death of Thomas C. Dunkley. Mr. Dunkley was diagnosed as suffering from atrial fibrillation, a heart-related disease that is characterized by an irregular and often rapid heart rate that usually causes reduced blood flow to the body. For his condition, Dunkley was prescribed Xarelto (rivaroxaban) to treat atrial fibrillation to reduce his risk of sustaining an embolic stroke. Dunkley passed away less than two weeks after he began using Xarelto.

According to the court filings, Dunkley began taking Xarelto on July 17, 2012. Seven days later, he experienced a brain hemorrhage and suffered a life-threatening, irreversible bleed.

Dunkely’s condition arose after taking Xarelto for only nine days. The family alleges that Mr. McGowen experienced pain and suffering due to the adverse effects from taking Xarelto. It is further alleged that the drug manufacturers of Xarelto failed to adequately warn the consumer of that one of Xarelto’s deadly side effects is uncontrolled bleeding. It is further alleged that the manufacturer concealed the safety risks from not only Mr. Dunkley, but also the FDA, the general public and the medical community. Finally, it is alleged that the manufacturer negligently and improperly failed to test Xarelto on humans in clinical trials before presenting it in the market for public use.

This is not the only claim regarding the adverse effects of Xarelto. In fact, there are now 21 product liability lawsuits in 10 federal district courts involving either injuries or deaths related associate with uncontrolled bleeding from the use of Xarelto. As a result, a group of plaintiffs have filed claims to present before one judge for pre-trial proceedings in a Multi-District Litigation (MDL).

An MDL is different than a class action in that each case in an MDL is separately prosecuted as an individual lawsuit. Cases in an MDL are coordinated together, usually for discovery purposes, but the trials are usually conducted on an individual basis. The U.S. Judicial Panel on Multidistrict Litigation (JPML) is expected to hear oral arguments by January 2015. The Dunkley case and the other claims that presently exist against Xarelto are in the early stages of litigation, and experts suggest that there will continue to be more claims that arise in the coming months.

Alexandra Bhatti, Intern Jacoby & Meyers.

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Maryland Appeals Court Revives Medtronic Infuse Injury Suit

The Maryland Court of Special Appeals recently revived a medical device products liability case, ruling that the claim was not preempted by federal law.

The personal injury claims, brought by Steven McCormick together with his wife, arose from the so-called “off-label” promotion of a medical device, called the Infuse Bone Graft. Manufactured by defendant Medtronic, the device left McCormick disabled and unemployed allegedly due to this improper “off-label” use.

The Infuse Bone Graft was developed by Medtronic and was approved by the FDA in 2002. The three components of the device consist of:

  • A genetically-engineered protein that stimulates bone growth.
  • A collagen sponge.
  • A cage that holds the vertebrae in place to direct the development of bone growth.

The protein serves to spur the bone growth necessary to achieve fusion. The Infuse Bone Graft was created by Medtronic to replace the conventional method of performing spinal-fusion surgery.

Only one safe approach

The Infuse Bone Graft’s label requires surgeons to utilize an anterior approach, during which the surgeon approaches the spine through the front of the body. The device cannot be used without a cage component, making the anterior approach the only safe and viable option for device implementation.

McCormick underwent spinal-fusion surgery conducted by defendant Dr. Rosner to relieve his persistent back pain. Dr. Michael K. Rosner, M.D., allowed a Medtronic sales representative, defendant Vincent Profitt, to be present in the operating room during McCormick’s surgery.

Dr. Rosner used an inappropriate amount of the genetically-engineered protein component of the device and used a Medtronic cage that had not been approved by the FDA for use with the Infuse device. Dr. Rosner also took a posterior approach during his surgery.

Steven McCormick became permanently disabled in 2008, and in the spring of 2010, his physicians discovered a narrowing of the cervical disc space where the Infuse device had been implanted. McCormick underwent revision surgery to remove the “bony overgrowth” in the fall of 2010, during which his surgeon had to “chisel away the excess bone-growth” caused by the Infuse device.

McCormick learned approximately one year later that he had two nodules in his lungs that he must monitor to ensure they do not become cancerous.

Extensive and illegal effort

According to the McCormicks, Medtronic engaged in an extensive and illegal effort to promote the off-label use of the device by means of a posterior approach without the required cage. Medtronic promoted this practice by providing physicians with information from consultants. Sales of the device exceeded $900 million dollars in 2010, of which more than 85 percent resulted from improper off-label procedures.

Additionally, the genetically-engineered protein component of the Infuse Bone Graft is a cancer-promoting substance, a fact the McCormicks claim Medtronic knew about and failed to inform the public or medical community. The Spine Journal, which is a medical periodical, devoted an entire issue in July 2011 to the concerns surrounding the use of the Infuse device. Journal discussed Medtronic’s failure to report accurately adverse side-effects that occurred during clinical trials, as well as Medtronic’s downplaying of the risks associated with the device.

Sales rep in the operating room

The McCormicks brought their claims collectively against Medtronic, a Medtronic subsidiary, the Medtronic sales representative who was in the operating room during surgery, and Dr. Michael K. Rosner. The claims as against Medtronic were asserted for negligence, strict products liability, breach of warranty, fraud, and violations of the Consumer Protection Act.

The claim as against Dr. Rosner alleged his failure to obtain informed consent. The McCormicks, as husband and wife, then asserted a joint claim for loss of consortium. The circuit court dismissed the claims against Medtronic during the case’s original proceedings but did not render a final judgment.

Congress passed the Medical Device Amendments (MDA) of 1976, which “swept back some state obligations and imposed a regime of detailed federal oversight.” The MDA expressly preempts certain state-law requirements with respect to federally regulated medical devices.

The MDA specifically preempts requirements that relate to the safety or effectiveness of the device and are different from, or in addition to, any requirement applicable under the MDA itself. This preemption of state-law claims only occurs when a manufacturer has complied with federal law, and not when the manufacturer has in some way violated federal law.

Scylla and Charybdis

The Court, citing Greek mythology, determined that a plaintiff, such as Steven McCormick, can survive a state-law tort claim concerning an allegedly defective medical device only by steering between the Scylla of express preemption and the Charybdis of the implied preemption of claims that exist solely by virtue of the FDCA. This is a challenge the plaintiff must overcome by avoiding one obstacle without colliding with another, having the choice between two evils.

The court articulated this loophole by saying, “The conduct on which the plaintiff’s claim is premised must violate the FDCA if the claim is to escape express preemption, but the conduct must also be the type of conduct that would traditionally give rise to liability under state law even if the FDCA had never been enacted.”

The Special Appeals Court reversed the trial court, specifically the trial court’s conclusion that federal law preempts the claims for breach of any express warranties that Medtronic may have made in voluntary communications with the public or members of the medical professions outside of the context of the FDA-mandated and FDA approved labeling for the device.

The full case opinion, which was reported on October 6, 2014, in the Court of Special Appeals of Maryland during the September Term, is titled Steven L. McCormick, et ux. v. Medtronic, Inc., et al.

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Texas Jury awards $73 Million in Pelvic Mesh Case

A 12-person jury on Sept. 8 ordered Boston Scientific Corp. to pay a Texas woman $73 million after finding the company negligent in both the design and marketing of its Obtryx transvaginal mesh sling.

The case, Salazar vs. Lopez, was the first to go to trial against Boston Scientific in Texas state court, and the first to render a verdict against the company — a hopeful sign for thousands of woman bringing similar product liability lawsuits in state and federal courts across the country. The jury’s award included $50 million in punitive damages, far exceeding amounts awarded in previous pelvic mesh cases.

“Over a seven-year period, Boston Scientific failed to warn doctors and their patients of the serious complications associated with the Obtryx sling, even though the company was aware of the product’s problems,” said Ms. Salazar’s attorney David Matthews, who tried the case alongside Dallas attorneys Tim Goss, Rich Capshaw and Kevin Edwards.

Ms. Salazar’s attorneys also presented evidence that showed the medical device maker had deliberately withheld from doctors a clinical study that proved serious complications resulted from the company’s mesh implant.

After nine days of testimony and one afternoon of deliberation, jurors found Boston Scientific’s Obtryx transvaginal sling caused (then) 38-year-old Martha Salazar permanent pain, a pronounced limp and the burden of 42 additional procedures, including four major surgeries, to treat complications associated with the mesh implant.

A former 20-year employee of a property management firm, Ms. Salazar can no longer sit comfortably, walk, or exercise without constant pain as a result of injuries caused by the plastic mesh, said Matthews.

“We asked the jurors to deliver a verdict that would change the way Boston Scientific does business,” he said. “The $50 million in punitive damages should get the company’s attention.”

Also working on the case were Sheila M. Bossier of Bossier & Associates in Jackson, MS, and Tim Goss, David Matthews and Richard Capshaw of Freese & Goss, PLLC, of Dallas.

Boston Scientific Corp. faces an additional 12,000 lawsuits in which other women claim the company’s transvaginal slings caused pain and tissue and organ damage, resulting in further surgeries to remove the plastic from their bodies.

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Special report: The dangers of painkillers

https://www.consumerreports.org/cro/video-hub/3705124027001/

Every year, Percocet, Vicodin, and other opioids kill 17,000 Americans and acetaminophen sends 80,000 people to the ER

America is in pain—and being killed by its painkillers.

It starts with drugs such as OxyContin, Percocet, and Vicodin—prescription narcotics that can make days bearable if you are recovering from surgery or suffering from cancer. But they can be as addictive as heroin and are rife with deadly side effects.

Use of those and other opioids has skyrocketed in recent years. Prescriptions have climbed 300 percent in the past decade, and Vicodin and other drugs containing the narcotic hydrocodone are now the most commonly prescribed medications in the U.S. With that increased use have come increased deaths: 46 people per day, or almost 17,000 people per year, die from overdoses of the drugs. That’s up more than 400 percent from 1999. And for every death, more than 30 people are admitted to the emergency room because of opioid complications.
Find out the 5 things to know about prescription painkillers.

With numbers like that, you would think that the Food and Drug Administration would do all it could to reverse the trend. But against the recommendation of its own panel of expert advisers, last December the agency approved Zohydro ER, a long-acting version of hydrocodone. “We think the benefits of the drug outweigh its risks,” says Douglas Throckmorton, M.D., who oversees regulation of drugs for the FDA. He says that Zohydro ER offers an option to some people in pain, and that the FDA has taken steps to make all opioids safer by, for example, requiring stronger warnings on drug labels. The FDA says it will also keep a close eye on how Zohydro ER is used in the marketplace.

But attorneys general from 28 states have asked the FDA to reconsider its decision because the drug offers no clear advantages over others already on the market and its potency makes it a target for misuse and abuse. And more than a dozen Republican and Democratic members of Congress have signed a bill that would ban Zohydro ER.

Opioids aren’t the only painkillers that pose serious risks. Almost as dangerous is a medication renowned for its safety: acetaminophen (Tylenol and generic). Almost 80,000 people per year are treated in emergency rooms because they have taken too much of it, and the drug is now the most common cause of liver failure in this country.

Though some of those tragedies stem from abuse, many are accidental. It’s not just that people are careless. Advice to “take only as directed” doesn’t cut it when the advice is confusing and conflicting. And with acetaminophen, the advice is exactly that. For example, the FDA has lowered the maximum per-pill dose of prescription acetaminophen, but it hasn’t taken the same step for over-the-counter products. And OTC drugmakers have wildly different notions of what people can take: Some labels advise taking no more than 1,000 milligrams of acetaminophen daily; others set the limit almost four times as high.

And with acetaminophen, accidentally taking too much is all too easy. That’s because it’s the most common drug in the U.S., found as an ingredient in more than 600 OTC and prescription medications, including allergy aids, cough and cold remedies, fever reducers, pain relievers, and sleep aids.

“All of this doesn’t mean that everyone should avoid opioids and acetaminophen altogether,” says Marvin M. Lipman, M.D., chief medical adviser for Consumer Reports. “But it does mean that the FDA should fulfill its role to protect consumers by taking strong steps to reduce the dangers, starting by reconsidering its approval of Zohydro ER and finally establishing consistent standards for acetaminophen.”

It also means you need to know the risks, not only of opioids and acetaminophen but also of drugs such as ibuprofen (Advil and generic), naproxen (Aleve and generic), and Celebrex. That last drug, now prescribed only under its brand name, should be available in the next year or so as a lower-cost generic called celecoxib. But like its nonprescription cousins, it poses serious risks to your heart and stomach when taken regularly, as millions of Americans do.

“Pain drugs can be as bad as the pain itself,” Lipman says. “So you need to know when they are really needed and how to use them safely.”

Opioids: Deadly misconceptions

One of the biggest misconceptions people have about opioids is that the risks apply to other people, not themselves. But the “typical” victim of overdose might not be whom you think. About 60 percent of overdoses occur in people prescribed the drugs by a single physician, not in those who “doctor shopped” or got them on the black market. And a third of those were taking a low dose.

Used properly, opioids can ease severe short-term pain from, say, surgery or a broken bone, and manage chronic pain from an illness such as cancer. But people run into trouble when they inadvertently misuse the drugs—combining them with alcohol or other drugs (such as sleeping pills), taking them in too high a dose or for too long, or using them while driving or in other situations when they need to be alert.

Ideally, health care professionals should act as gatekeepers, prescribing painkillers only when they’re appropriate and monitoring patients for side effects. But that’s not always done, says Richard Blondell, M.D., director of the National Center for Addiction Training at the State University of New York in Buffalo, N.Y. “No doubt, the public needs to be better educated about the risks,” Blondell says. “But ultimately this epidemic starts with the doctor’s prescription pad.”

The general public and health care providers harbor outdated and dangerous notions about opioids. Below are three of the biggest misconceptions and the facts you need to know to stay safe.

Misconception #1: Opioids work well for chronic pain.

An estimated 90 percent of people suffering long-term pain wind up being prescribed an opioid despite little evidence that the drugs help much or are safe when used long-term. “But we do know that the higher the dose and the longer you take it, the greater your risk,” says Gary Franklin, M.D., research professor of environmental and occupational health sciences at the University of Washington in Seattle. People who take opioids for more than a few weeks often develop tolerance, so they require higher doses, which in turn breeds dependence. And although higher doses can ease pain, they commonly cause nausea and constipation, disrupt your immune system and sex life, and leave you feeling too fuzzy-headed to participate in things such as physical activity that can speed your recovery. And in a cruel twist, the drugs can make some people more sensitive to pain.

The safer approach. For certain types of pain—including nerve pain, migraines, and fibromyalgia—other prescription medications usually work better than opioids. For other types of chronic pain, ask your doctor about trying OTC drugs such as acetaminophen, ibuprofen, and naproxen before prescription drugs. Nondrug measures such as exercise, massage, behavioral therapy, spinal manipulation, and acupuncture might also help. If you have chronic pain that hasn’t responded to other treatment, opioids may be an option. But your doctor should prescribe the lowest effective dose for the shortest possible time and monitor you for side effects.

Misconception #2: Opioids are not addictive when used to treat pain.

“That’s what I and a lot of other doctors learned in medical school,” Blondell says. “But we now know that’s just not true.” Somewhere between 5 percent and 25 percent of people who use prescription pain pills long term get addicted. Fewer women are dependent on prescription painkillers than men, but they may become dependent more quickly and are more likely to doctor shop.

The safer approach. Chronic pain often waxes and wanes. If you and your doctor feel you need an opioid, reserve it for flare-ups. If you take it for more than a few weeks, your doctor should advise you about early signs of addiction, including unusual moodiness, cravings, temper flare-ups, and taking unnecessary risks.

Misconception #3: Extended-release versions are safer.

Opioids such as hydromorphone (Exalgo), oxycodone (OxyContin and generic), morphine (Avinza, MS Contin, and generic), and the newly approved Zohydro ER stay in the body longer and are usually stronger than short-acting forms. They should be reserved for patients who need round-the-clock relief. But doctors sometimes prescribe them for convenience—patients need to take fewer pills—and because they believe that long-acting drugs are less likely to cause a drug “high” and lead to addiction. But there’s no evidence those drugs work better or are safer than short-acting ones. And people dependent on opioids seek out the higher potency of long-acting versions. That’s why public health groups and law-enforcement agencies fear that the new Zohydro ER is prone to abuse.

The safer approach. It’s usually best to start with a short-acting opioid. Because long-acting drugs are more likely to be stolen, misused, and abused, if your doctor prescribes one, expect careful monitoring.

Acetaminophen: Dangerous doses

When taken at recommended doses, acetaminophen is safe for most people, even when used long term. But there’s little margin for error. Exceeding the maximum recommended dose—by even a little bit—can prove toxic, especially to the liver. And that’s relatively easy to do. For example, take the maximum recommended doses for Tylenol Extra Strength for your joint pain, Nyquil Cold & Flu, and an nighttime sleep aid like Walgreens PM, and you will get 6,600 milligrams—well above the 4,000 milligrams a day that’s linked to liver damage (see chart, below).

It has long been known that large doses of acetaminophen taken at once can be fatal. But cumulative smaller doses totaling more than 4,000 milligrams (eight 500-milligram, or “extra strength,” pills) can be just as dangerous, if not more so. People who took repeat doses of the medication—for complaints such as headaches, muscle pain, and toothaches—that put them over the maximum daily amount were more likely to have brain, kidney, and liver problems, and faced a greater risk of dying or needing a liver transplant than people who had taken a single, large overdose. That’s according to a 16-year Scottish study of people treated in the emergency room published in 2011.

Read more about how to manage pain.

That same year, the FDA tried to reduce acetaminophen poisonings by limiting the prescription products to 325 milligrams per pill. The agency noted that higher doses don’t relieve pain better and that people are more likely to overdose on them.

But the agency has not yet imposed the same limits for nonprescription products, even though they account for 80 percent of the acetaminophen taken in the U.S. No doubt, that pleased OTC drugmakers: “Extra strength” products with 500 milligrams of acetaminophen per pill are big sellers.

And because acetaminophen shows up in so many products, you need to check all drug labels for acetaminophen. Then make sure you stay below the safe upper limit when you combine the pills. And you should avoid acetaminophen altogether if you are at risk for liver disease or drink alcohol heavily, because that multiplies the dangers. If you regularly take the drug, watch for signs of liver damage, including dark urine, pale stools, upper-right abdominal pain, and a yellowish tinge to the whites of the eyes.

By Consumer Reports

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Johnson & Johnson recalls hysterectomy power morcellator that may spread cancer

Healthcare company Johnson & Johnson announced that it will stop the sale and distribution of its power morcellators after the Food and Drug Administration (FDA) discouraged its use for hysterectomy, or the removal of the uterus, and myomectomy, the removal of uterine fibroids, as the
use of the device could spread undetected cancer.

Johnson & Johnson, however, said it is merely suspending the commercialization of the surgical device while awaiting update from the medical community. Findings of the study “Uterine Pathology in Women Undergoing Minimally Invasive Hysterectomy Using Morcellation” which was published in the Journal of the American Medical Association on July 22, however, appear to have helped prompt the company to finally recall its hysterectomy power morcellators.

On Wednesday, the company said that will ask doctors to return the power morcellators it has manufactured. It also plans to reach out to customers to ask them to return the morcellators they have purchased following a company decision for a worldwide withdrawal of all its morcellation devices that still remain in the market.

Johnson & Johnson’s Ethicon unit, which makes the controversial device, said that it is pulling out the power morcellators from the market because the risks and benefits of using the device in hysterectomies and myomectomies remain uncertain.

“Due to this continued uncertainty, Ethicon believes that a market withdrawal of Ethicon morcellation devices is the appropriate course of action at this time until further medical guidelines are established and/or new technologies are developed to mitigate the risk,” company spokesman Matthew Johnson said.

The FDA said that of the 350 women undergoing surgery using morcellators, one may have a type of cancer that can spread beyond the uterus and this spread of malignant cells to other parts of the body could have a significant impact on a woman’s chances for survival.

“There is no reliable way to determine if a uterine fibroid is cancerous prior to removal,” William Maisel, from the FDA’s Center for Devices and Radiological Health said. “Patients should know that the FDA is discouraging the use of laparoscopic power morcellation for hysterectomy or myomectomy, and they should discuss the risks and benefits of the available treatment options with their health care professionals.”

Results of the JAMA study strengthened this contention as the findings showed that 27 in every 10,000 women undergoing hysterectomy had cancerous tumors that can spread to other parts of the body by morcellation.

By Rhodi Lee, Tech Times.

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FDA bans generic versions of original OxyContin pills

(CNN) – In an effort to curb prescription painkiller abuse, the Food and Drug Administration is banning generic versions of the original OxyContin formula.

“The FDA has determined that the benefits of original OxyContin no longer outweigh its risks,” the agency said in a statement.

Read More at the article source on CNN.

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FDA probes new pancreas risks with diabetes drugs

WASHINGTON (AP) — The Food and Drug Administration is looking into new evidence that a group of recently approved diabetes drugs can increase the risk of pancreatitis and other problems.

The agency said Thursday samples of pancreas tissue taken from a small number of patients showed inflammation and cellular changes that often precede cancer. Academic researchers took the samples from diabetes patients who were taking the new medications, after they died from various causes.

Read More at the article source: Yahoo News.

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FDA: Popular antibiotic can cause fatal heart rhythms

(CNN) – A popular antibiotic used to treat bacterial infections can cause abnormal — and possibly fatal — heart rhythms in some patients, according to a new warning from the Food and Drug Administration.

The drug, azithromycin, sells under the name Zithromax or Zmax and is commonly sold in what’s called a Z-Pak.

Full Article

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Tylenol cases – short form complaint – questionnaire

Please download here: Tylenol Short Form Complaint and Tylenol Questionnaire.

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