Court hears amputee's case on limits of drug suits

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Posted on 3rd November 2008 by Gordon Johnson in Uncategorized

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Date: 11/3/2008

By MARK SHERMAN
Associated Press Writer

WASHINGTON (AP) — The Bush administration and a drug maker urged the Supreme Court on Monday to throw out a multimillion dollar verdict to a Vermont musician who lost her arm because of a botched injection to relieve nausea.

The case is being watched closely by the pharmaceutical industry and consumer groups because of its potential for broad limits on lawsuits by people, such as Diana Levine, who were harmed by prescription drugs.

But the justices seemed more likely on Monday to be headed toward a narrow ruling that might be confined to the facts of Levine’s case.

A Vermont jury awarded Levine $6.7 million after the improper injection of Phenergan, an anti-nausea drug made by Wyeth Pharmaceuticals, caused gangrene that led to the amputation of her right arm.

The jury agreed with Levine that Wyeth should have included a stronger warning about the risks of a method of intravenous injection known as IV push.

But lawyers for Wyeth and the government said Levine’s case should have been thrown out of court because Phenergan has been approved by the federal Food and Drug Administration and its label adequately warned about its risks. FDA approval serves as a shield against liability lawsuits under state law in such cases, they said.

“The labeling plainly comprehended and warned about the specific risks of IV administration,” Seth Waxman, representing Wyeth, told the justices.

In recent years, the administration and business groups have aggressively pushed limits on lawsuits through the doctrine of pre-emption — asserting the primacy of federal regulation over rules that might differ from state to state.

But Justice Samuel Alito, among others, had a more basic question for Waxman.

“How could the FDA have concluded that IV push was safe and effective,” Alito asked, given that Phenergan is not a lifesaving drug and gangrene can result from improper administration?

Justice Ruth Bader Ginsburg chimed in, “How could the benefit outweigh the substantial risk?”

Waxman responded that testimony in this case was clear that there are circumstances in which IV push is “medically warranted.”

David Frederick, representing Levine, argued that Wyeth never made clear to the FDA how dangerous IV push could be. He noted that Pfizer, Inc., stopped making IV push an acceptable method of injecting its anti-nausea drug after two amputations were reported.

A ruling probably will not come before early next year.

Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

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Amputee awaits high court, wants musical glow back

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Posted on 30th October 2008 by Gordon Johnson in Uncategorized

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Date: 10/30/2008

By DAVE GRAM
Associated Press Writer

MARSHFIELD, Vt. (AP) _ When Diana Levine turned 63 recently, her daughter made her a birthday card, drawing on Greek mythology with an illustration of Diana the Huntress, her bow string drawn taut, an arrow ready to fly.

But the arm pulling at the bowstring was amputated below the elbow — just like Diana Levine’s — and the target was labeled the “Wyeth monster.”

That’s Wyeth as in Wyeth Pharmaceuticals, the company Levine blames for a botched injection of the Wyeth-made drug Phenergan that led doctors to amputate her right arm in 2000.

Levine, once a professional guitar player and pianist, now plays with one hand and sings. “It’s about getting my glow back,” she said recently as she was awaiting a hearing Monday before the U.S. Supreme Court, where Wyeth is appealing a $6.7 million verdict in her favor.

The outcome of Levine’s case could have major ramifications for drug makers and consumers. The court is expected to decide whether people can sue under state law — or are pre-empted from doing so — for harm caused by a drug approved by the federal Food and Drug Administration.

Levine said the drug makers “are using my case … to get through this doctrine that will say that if it is FDA-approved, then we are not accountable, because FDA said it’s OK. … Mr. Pharmaceutical Company is not responsible and is not liable and doesn’t have to help the person who just lost her arm, or her life.”

Levine, who suffered from migraine headaches, had a particularly bad episode in the spring of 2000. A friend drove her from her dirt road farmhouse-turned-music studio in Marshfield, Vt. to a clinic in neighboring Plainfield.

She was given drugs for the pain and, to combat nausea, an intramuscular injection of Phenergan, a drug that has been around for 50 years.

When Levine complained that she still felt nauseous, the clinic suggested an “IV-push” of Phenergan. This delivered a high volume of the drug very quickly to her right arm, not the slow flow that could have been delivered by an IV drip.

The second injection accidentally punctured an artery, prompting gangrene to set in. After several weeks of deterioration, her arm was amputated.

Levine recalls first seeing what remained of her arm after surgery. “I was horrified and shocked and about as sad as I ever have been in my life,” she said.

She reached an out-of-court settlement with the clinic and sued Wyeth, contending that the label on the Phenergan she was given should have more clearly warned about the danger of giving the drug IV-push.

Combatting an upset stomach with a method that can end up causing limb loss is “an unfathomable benefit-risk ratio,” Levine said. With two other methods for injecting Phenergan, “there’s no earthly reason for this third option (IV-push) to even be made available,” she said.

Wyeth and the FDA say that when a drug like Phenergan has a federally approved label, its manufacturer is immune from lawsuits in state court. Wyeth maintains its label clearly describes the risks of Phenergan, and that it was not only approved but mandated by the FDA. “Wyeth could not change Phenergan’s labeling to comply with Vermont law without violating federal law,” it said in court papers.

Consumer groups are mounting a vigorous campaign against that position, saying federal regulation should represent the floor, not the ceiling, of a drug company’s responsibility.

“What a trial lawyer reasonably could fear in this case is that in one fell swoop, the U.S. Supreme Court would eliminate the right of an injured person to recover from a drug company in the case of a dangerous drug that caused their injury,” said Fordham University law professor Benjamin Zipursky, a product liability expert.

The court could effectively “eliminate all pharmaceutical company liability in this one case,” Zipursky said.

Bert Rein, a lawyer for Wyeth, said that concern was overblown. “Some of the hysteria being whipped up is really unjustified,” he said. “We believe the court will rule on the specific facts of the case,” rather than so broadly as to affect most liability claims.

That was not what Wyeth argued when urging the Supreme Court to take the case.

In its appeal to the court, Wyeth said the justices should act to prevent erroneous rulings in “tens of thousands of individual claims and potentially millions of class action claims” that are pending in state and federal courts.

While the legal war continues, Levine wages a more personal struggle. Sometimes it’s just to roll her left sleeve up or down, file papers, wash dishes or mow the lawn.

“If you were to put your hand in your pocket for a day and not use it, you would pretty much come to the conclusion that there’s nothing that’s a one-handed activity,” she said.

Mostly, the struggle is to continue a life in which songwriting was her gift and the guitar and piano were the tools of her trade.

“My identity was seriously damaged. Not just the musical one, but the physical. I mean, I had lost my glow, the glow was gone,” Levine said, recalling her recent performance with a group of women singers. “That’s what it’s about, it’s about getting my glow back.”

Levine has had more than a little help from her friends.

“She’s determined not to let this setback destroy her music,” said singer-songwriter Jon Gailmor, who had collaborated with Levine and her late husband in performances and on recordings. “It’s probably given her some new material, made her stronger even. She’s an amazing person.”

Quoting a musician friend, Levine calls the right hand the “joyous hand” — the one that gets to strum or pick the guitar, finding the rhythm, while the left searches the neck for the right note or chord. On keyboards, the right hand most often finds the improvisational riffs while the left lays down the underlying rhythm and chord changes.

Levine has no joyous hand now.

A piano and guitar player since childhood, she studied chemistry and psychology at the University of Vermont. Levine, who performed under the name Diana Winn, married a blues guitarist David “Crow” Levine, playing bass alongside of him in the Re-Bops, a band that gained a regional following in the 1980s.

Her husband died in 1993, leaving Levine and the couple’s daughter, Jessamine, now 25.

Now, she’s less concerned with the legal arguments than with making music and sharing it, especially with children.

She pays the bills using her monthly disability check from Social Security, Re-Bob Records sales — though she says she’s unable to keep up the business as well as she used to — and assistance from her family. “I have help from home. Nobody’s going to let me be out in the cold.”

Levine sat one recent afternoon at her
piano, accompanied by Jessamine on guitar, working out a new tune she hoped to send to actor Dennis Quaid, who is waging a drug labeling fight of his own after his infant twins were given a dose of the blood-thinnerHeparin — 1,000 times what was called for.

The twins’ birthday is in November, and Levine was writing a song for them.

Plunking out chords with her left hand, Levine asked Jessamine, “What do we go to there? Do you like G? Or should it be D-minor?”

And then she sang a song fragment:

“It’s the twinses’ birthday, celebrate times two. It’s the twinses’ birthday, if you only knew. There’s been some hard times they’ve both been through …”

Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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Report: FDA officials opposed drug suit policy

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Posted on 30th October 2008 by Gordon Johnson in Uncategorized

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Date: 10/29/2008

By KEVIN FREKING
Associated Press Writer

WASHINGTON (AP) _ Top scientists and career employees at the Food and Drug Administration opposed agency regulations that weaken consumers’ ability to sue drug makers, congressional investigators said Wednesday.

At issue is language in a drug-labeling rule from 2006 that effectively limits when people can sue in state court over injury claims involving medications. The FDA contends federal regulations prevail when there is a conflict with state law. This concept is called pre-emption.

Internal agency documents showed that career officials opposed this approach, according to a report released by Rep. Henry Waxman, chairman of the House Oversight and Government Reform Committee. In the past, the agency had viewed private suits as an additional layer of protection against unsafe drugs, the report said.

“Much of the argument for why we are proposing to invoke pre-emption seems to be based on a false assumption that the FDA-approved labeling is fully accurate and up-to-date in a real time basis,” the report quoted Dr. John Jenkins, who oversees FDA’s new drug reviews, as saying. “We know that such an assumption is false.”

Patients injured by drugs have won suits against drug manufacturers for failing to warn against certain dangers.

In a case to be argued before the Supreme Court on Monday, a Vermont woman sued Wyeth after she lost her right arm below the elbow following a high-volume injection of the drug Phenergan. The injection accidentally punctured an artery, prompting gangrene to set in. Levine argued that the company had a duty to warn consumers that such injections could have devastating consequences. The state courts agreed, awarding her nearly $7 million.

Wyeth appealed, saying it was protected from such suits. It argued a state court cannot overrule the FDA’s judgment on label warnings.

FDA scientists had weighed the risks and benefits of Phenergan, used to treat nausea and allergies, when it approved the prescribing literature, or label, as a guide for doctors. The FDA was aware of risks associated with injecting some forms of Phenergan, but the label did not specifically warn about the technique used with Levine.

The FDA said in its 2006 rule and in a 2008 rule that state suits could encourage drug makers to propose unnecessary labeling. Such labeling could result in scientifically unsubstantiated warnings and less use of beneficial treatments.

Waxman’s staff obtained documents rejecting that warning. Jane Axelrad, an associate director for policy at the agency, wrote: “We rarely find ourselves in situations where sponsors want to disclose more risk information than we think is necessary,” she said. “To the contrary, we usually find ourselves dealing with situations where sponsors want to minimize the risk information.”

FDA officials said the agency encourages robust debate on public policy, so some dissension can be expected.

“As in any organization, there is rarely unanimity of opinion,” said spokeswoman Rita Chappelle.

In the end, the agency determined that finalizing the rules were the appropriate action.

“It was appropriate because FDA is the public health agency charged by Congress with the responsibility to ensure that drugs and certain medical devices are safe and effective and that the labeling adequately informs users of the risks and benefits of the product,” Chappelle said. “In addition, the agency is uniquely qualified to make such important and complex judgments.”

Public Citizen, the consumer advocacy group, said the Bush administration had pushed pre-emption clauses in a wide array of regulations.

“This effort to prevent injured citizens from using the courts and holding negligent companies’ accountable must be stopped,” said Brian Wolfman, director of Public Citizen’s litigation group.

The report said the FDA has yet to provide a complete set of documents that would show communications between the White House and the agency, but some documents suggested the agency and the White House would not go forward with a rule on labeling until the pre-emption changes were included.

___

On the Net:

House Oversight and Government Reform Committee: http://oversight.house.gov


Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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Pfizer completes part of painkiller settlement

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Posted on 23rd October 2008 by Gordon Johnson in Uncategorized

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Date: 10/22/2008

NEW YORK (AP) _ Pfizer Inc. said Wednesday it finalized part of a larger, $894 million deal to settle lawsuits over its promotion of the painkillers Celebrex and discontinued Bextra.

The company made official a deal that would pay $60 million to settle investigations by 33 states and Washington, D.C., over Bextra, while also agreeing to adopt compliance measures. Various states alleged Pfizer promoted the painkiller for “off-label” uses, or uses it was not approved for. While a physician is allowed to prescribe drugs for off-label uses, a company cannot market them for unapproved uses.

States also alleged the company misrepresented the safety of the drug.

As part of the settlement, Pfizer denied that its promotional practices violated any laws.

Among other strictures, the settlement requires Pfizer to submit all consumer television advertisements to the FDA for approval, the New Jersey attorney general’s office said. Pfizer said such practice was already company policy.

Last week, the company said it would pay $745 million to settle personal injury cases, $60 million to cover settlements with attorneys general in the 33 states and Washington, D.C., and $89 million to cover consumer fraud class action cases over reimbursement for money spent on the two drugs.

In all, the company said the settlements would cover more than 90 percent of the pending legal actions.

“As we announced last week, these settlements avoid the disruption and expense of litigation and put these matters behind us,” Amy W. Schulman, senior vice president and general counsel of Pfizer, said in a statement.

Celebrex and Bextra came under scrutiny following lawsuits over a similar drug made by Merck & Co., called Vioxx. Merck has begun paying a $4.85 billion settlement to end about 50,000 lawsuits brought by people claiming the drug caused heart attacks, ischemic strokes or death.

Bextra, like Vioxx, was a Cox-2 inhibitor.

“This medicine (Bextra) was rigorously studied and tested by the company and independent medical experts, and information about its benefits and risks was fully disclosed to the FDA,” Schulman said.

Celebrex is currently the only Cox-2 inhibitor on the market.

Pfizer has also agreed to other compliance measures regarding its promotional programs. The New Jersey Attorney General’s office, in a statement, said the settlement places strictures on such practices as companies “ghost writing” drug-related articles and studies, deceptively using scientific data when marketing to doctors, and awarding incentives to sales staff to increase off-label prescribing by doctors.

“This case should send a strong message to the industry at large that New Jersey does not tolerate deception and misleading claims in the promotion of prescription drugs,” Attorney General Anne Milgram said in a statement.

Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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Lilly takes $1.4B charge related to investigation

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Posted on 21st October 2008 by Gordon Johnson in Uncategorized

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Date: 10/21/2008 10:31 AM

By TOM MURPHY
AP Business Writer

INDIANAPOLIS (AP) _ Eli Lilly and Co. will take a big bite out of its third-quarter earnings with a $1.4 billion charge related to a government investigation over marketing practices for the anti-psychotic Zyprexa.

The drug maker said Tuesday it would take a charge that equates to $1.29 per share because it was in advanced discussions with the U.S. Attorney’s Office for the Eastern District of Pennsylvania over U.S. marketing and promotional practices for the drug.

But a Lilly representative also cautioned that the company isn’t admitting it did anything wrong in selling the anti-psychotic, its top revenue producer.

“All we’re doing today is taking a charge to earnings, so there is no admission or settlement or anything beyond that,” spokeswoman Marni Lemons said. “We are in advanced discussions with the government, but we have not concluded those discussions, and they could take more time.”

Patty Hartman, a spokeswoman for the U.S. attorney’s office, declined to comment on Lilly’s announcement.

“We’re aware that Lilly has released the information to the public, and it’s premature for us to comment about any disclosure,” she said.

The U.S. attorney’s office launched its investigation in 2004, and Lilly received a grand jury subpoena for a range of documents late last year. Lemons said the investigation has been a distraction.

“Our primary motivation is to put this issue behind us and get back to focusing on providing medications for patients, caregivers and health care professionals,” she said.

The charge surpasses Lilly’s entire profit for last year’s third quarter, when the drug maker reported net income of $926.3 million, or 85 cents a share. Lilly shares rose 5 percent Monday to close at $34.10, but the stock price fell 50 cents to $33.60 in Tuesday morning trading.

Analysts generally will exclude this charge from their earnings calculations for Lilly, analyst Les Funtleyder of Miller Tabak and Co. said.

“I think Wall Street will understand it’s a one-time event, and maybe a positive at that, because we’ll get past it,” he said.

Zyprexa has been Lilly’s top-selling drug for years and brought in $4.7 billion in revenue last year. But it also has been the subject of reams of litigation.

Lilly has settled more than 31,000 product-liability claims against the drug since 2005, shelling out more than $1.1 billion in the process.

Earlier this month, Lilly announced a separate $62 million settlement with 32 states and Washington, D.C., over marketing practices.

Lilly paid $15 million to settle a lawsuit with the state of Alaska in March. The drug maker still faces litigation with 11 states, generally involving consumer protection issues or Medicaid reimbursement.

But Lemons said some of those cases may be affected by settlement talks with the U.S. attorney’s office.

A group of insurance companies, unions and others are suing Lilly for billions of dollars, saying the drug maker charged too much for Zyprexa and marketed the drug for off-label uses. A federal judge has recommended that Lilly settle that case and last month granted the plaintiffs class-action status.

Aside from that case, Lilly still faces lawsuits from about 1,600 plaintiffs, Lemons said.

Lilly is scheduled to report its third-quarter earnings Thursdsay.

Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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$894 million deal ends pain of Pfizer's lawsuits

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Posted on 17th October 2008 by Gordon Johnson in Uncategorized

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Date: 10/17/2008 9:47 AM

By LINDA A. JOHNSON
AP Business Writer

TRENTON, N.J. (AP) _ Drug giant Pfizer Inc. has reached an $894 million deal to end most of the lawsuits over its two prescription pain relievers, the popular Celebrex and a similar drug, Bextra, no longer on the market.

The world’s biggest drugmaker said Friday it has agreements in principle to end more than 90 percent of personal injury lawsuits brought by people claiming the pills caused heart attacks, strokes or other harm.

The settlement includes roughly 7,000 personal injury cases, mainly plaintiffs who took since-withdrawn Bextra, said plaintiff attorney Perry Weitz. He represents nearly 2,000 claimants, about 10 percent of them relatives of people who died.

“It gives Pfizer closure and the claimants their money sooner, rather than later or never at all,” Weitz said.

Pfizer hopes to finalize claims covered by the settlement, which now includes up to 92 percent of plaintiffs, by year’s end. It also hopes to include many of the remaining claimants in the settlement and will fight any remaining personal injury suits with court motions or at trial, General Counsel Amy Schulman told The Associated Press.

“I don’t think either side has an interest in protracting this,” Schulman said in an interview.

Weitz said plaintiff lawyers will “have issues” with Pfizer “if their claimants aren’t paid before the end of the year.”

In early trading, Pfizer shares were down 47 cents, or 2.8 percent, at $16.50.

Schulman said the deal comes after two important court rulings — one by a New York state judge overseeing many of the state-level personal injury cases and the other by a federal judge in San Francisco coordinating pretrial steps in federal lawsuits over the drugs.

“We teed up some pretrial motions for a court ruling on whether there was significantly reliable evidence that would allow an expert to testify as to whether there was an increased risk of heart attack and stroke at the most common dose,” 200 milligrams, Schulman said. Both judges ruled that was not the case, she said.

The proposed deal also would end suits by insurers and patients seeking to recover what they spent on Bextra and Celebrex, as well as claims by 33 states and the District of Columbia that Pfizer improperly promoted Bextra.

Out of the total settlement, $745 million will go to settle personal injury cases, $60 million will cover settlements with attorneys general in the 33 states and the District of Columbia, and $89 million will cover consumer fraud class action cases over reimbursement for money spent on the two drugs. Two additional states, Louisiana and Mississippi, still have pending cases regarding Pfizer’s promotion of the drugs.

New York-based Pfizer withdrew Bextra from the market in 2005, a year after Merck & Co. withdrew its Vioxx, a similar drug.

The Vioxx withdrawal, which triggered an avalanche of lawsuits against Merck, also raised concerns about the safety of other medicines in the same class, called Cox-2 inhibitors. They were heavily touted by their makers as superior to traditional nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, because they block an enzyme involved in promoting inflammation but — unlike NSAIDs — don’t block an enzyme that protects the stomach from bleeding and other side effects.

Other NSAIDs, such as ibuprofen and naproxen, have also been linked to increased heart risks.

Celebrex is the only Cox-2 inhibitor that the Food and Drug Administration has allowed to remain on the U.S. market.

Attorney Christopher Seeger, a member of the plaintiffs steering committee, said he’ll “have no problem recommending” the settlement to the roughly 400 clients he represents.

“We’re very satisfied with the deal,” Seeger said.

Schulman said the company’s negotiations with opposing lawyers had been under way for some time but picked up in the late summer.

“Litigation can be distracting, and putting these matters behind us helps our shareholders and, most importantly, patients and doctors,” Schulman said.

Weitz noted that it took four or five years to get through trials for less than 20 cases in the massive Vioxx litigation, because the court system can only handle a limited number of cases at a time.

Pfizer will take a pretax charge of $894 million to its third-quarter earnings, which it is scheduled to report on Tuesday.

Merck, based in Whitehouse Station, N.J., has begun paying a $4.85 billion settlement to end about 50,000 lawsuits brought by people claiming Vioxx cause heart attacks, ischemic strokes or death. It still faces other litigation over the former blockbuster arthritis treatment.

Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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Study: Vioxx risk lingered after use of painkiller

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Posted on 13th October 2008 by Gordon Johnson in Uncategorized

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Date: 10/13/2008 8:04 PM

By LINDA A. JOHNSON
AP Business Writer

TRENTON, N.J. (AP) _ A doubled risk of heart attack, stroke and death persisted at least a year after people stopped taking withdrawn painkiller Vioxx, according to an analysis of long-term data from the study that led drugmaker Merck & Co. to stop selling the drug.

The analysis, published online Tuesday by the British medical journal The Lancet, also appears to show the higher risk started soon after patients began taking Vioxx, though the study notes a small sample size precludes a definitive finding on this issue.

Doctors critical of Merck and its reporting of Vioxx studies have long argued increased cardiovascular risks from the former blockbuster arthritis drug started after just a few months’ use and persisted after use ended.

Merck continues to insist cardiac risks didn’t increase until people took Vioxx for about 18 months — a cornerstone of its strategy to fight tens of thousands of lawsuits by people claiming harm from Vioxx.

The new findings should be interpreted cautiously because of the small number of patients who suffered heart attacks, strokes and related problems after participating in the three-year study, said Doug Watson, a cardiovascular epidemiologist and senior director at Merck Research Labs.

He said the study had some other limitations and noted the authors stated that “small numbers prohibit detailed conclusions about when the increased risk begins and ends.”

“But our data are compatible with an early increase in risk that seems to persist for about 1 year after 3 years of treatment,” the authors added.

Known by the acronym APPROVe, the study was intended to prove that Vioxx, heavily promoted as relieving pain with lower gastrointestinal risks than older anti-inflammatory drugs, could prevent recurrence of colon cancer. Merck stopped the study two months early and pulled the drug from the market on Sept. 30, 2004, when data showed roughly double the risk of cardiovascular complications and death in the group getting Vioxx, over those getting placebo.

Merck funded the new analysis, provided the data and commented on an early draft of the report but said it had no other involvement. The analysis was conducted by six scientists who worked on APPROVe, plus two statistics experts at the University of Wisconsin who were not involved then, the company said.

The eight researchers reported in The Lancet that in the year after the 2,587-patient study was halted, 34 people who had taken Vioxx and 18 who had taken placebo suffered a heart attack, for a 94 percent higher risk with Vioxx; strokes occurred in 19 Vioxx users and nine people on placebo, for a risk slightly more than double. Altogether, 76 Vioxx users and 46 placebo takers had a heart attack, stroke, blood clot or died during that follow-up year.

The increase in those complications was roughly the same as what was found during the three-year trial and the first two weeks after the study ended — the period included when Merck first reported results of APPROVe in the New England Journal of Medicine in February 2005.

Merck critics have said it was inappropriate to end patient follow-up 14 days after the study.

“This study is raising an important red flag about that” cutoff, showing the risk persisted for at least a year, although too few patients were followed longer than that to see if the risk subsided, said Dr. Harlan Krumholz, a Yale University cardiologist who has assisted Vioxx plaintiffs suing Merck.

“It adds another important chapter to the Vioxx story, but also is an important warning to us about how we assess the safety of medication” long-term, including after use stops, Krumholz said.

After Merck published its first analysis of APPROVe, numerous experts criticized it. Editors of the New England Journal in 2006 published a correction stating the risk of heart problems was elevated throughout the time people took Vioxx.

Merck posted all the data from APPROVe — the data used in the new study — on its Web site that same month.

In an editorial, doctors from the University of Oxford in England and Catholic University of Rome wrote that differences in the approach of the new analysis make it clear there’s no “latent period” before Vioxx increases heart risks, and shows the danger appears to have been worse in people who already had risk factors — something they said is shown in a combined analysis of six studies of Celebrex.

Made by Pfizer Inc., Celebrex is the only drug from the same class as Vioxx still on the market in the United States.

The editorial writers also note that older nonsteroidal anti-inflammatory drugs — such as naproxen and ibuprofen — also can bring cardiovascular risk, plus risks of stomach bleeding and other complications.

Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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Limit on cold remedies for kids was FDA's idea

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Posted on 11th October 2008 by Gordon Johnson in Uncategorized

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Date: 10/10/2008 5:59 PM

By RICARDO ALONSO-ZALDIVAR
Associated Press Writer

WASHINGTON (AP) _ When drug makers made a surprise announcement this week that they no longer recommend cough and cold remedies for youngsters under 4, they didn’t let on that it was the government’s idea.

And why age 4 rather than the age 6 that pediatricians’ wanted?

Because the Food and Drug Administration suggested that, too.

FDA officials proposed the cutoff earlier this year in private discussions with the industry, government and industry officials confirmed Friday. The companies agreed, and this week announced they were “voluntarily” changing their advice to parents.

The maneuvering is an example of how government health officials and the industries they regulate seek to come to an accommodation behind the scenes on tricky issues. In this case, there is scant evidence that the widely used over-the-counter medicines really do work in children. Emergency-room data shows that they sicken some 7,000 kids a year, mostly because of overdoses.

“There is a delicate dance between how much legal authority the FDA has and their use of the bully pulpit for getting some sort of compromise,” said Dr. Joshua Sharfstein, Baltimore’s health commissioner.

Sharfstein and other pediatricians have asked the FDA to ban the cold products for children under 6. A panel of independent advisers to the FDA strongly seconded that recommendation. But the agency took a different approach.

“The analysis that led to the under-4 cutoff was performed by FDA,” said Rita Chappelle, a spokeswoman for the agency. “We suggested it, and then it was voluntarily adopted by industry. (They) did not come up with the proposal themselves.”

Even now, however, the reasons for setting a cutoff specifically for kids under 4 remain unclear.

The FDA says it settled on age 4 after a careful data review and a vigorous internal debate. Officials said emergency room data shows that most of the problems with the drugs involve kids under 4. But the FDA refused to release the hospital data, which comes from a study by the Centers for Disease Control and Prevention. And CDC said Friday it could not immediately supply a detailed breakdown.

Still, some of the FDA’s independent advisers question the under-4 recommendation.

“There was no data suggesting that the drugs were effective in kids under 12,” said Sean Hennessy, a professor of epidemiology and biostatistics at the University of Pennsylvania. “I don’t see how that’s a fully rational approach to the problem.”

The Consumer Healthcare Products Association, which represents the industry, acknowledged the new safety recommendation was the FDA’s idea.

“CHPA moved forward with voluntary label changes at the suggestion of FDA because all the available data shows a clear distinction in the rates of adverse events in children under age four,” said Elizabeth Funderburk, a spokeswoman for the trade group. “Industry has always and will continue to make decisions based on the science as well as what is in the best interest of parents and their families.”

The industry has taken other precautions as well. Drug makers are advising parents not to give their children antihistamines to make them sleepy. The companies are also adopting better child-resistant packaging, and they are expanding an educational campaign aimed at parents.

Meanwhile, the FDA says it intends to revise government regulations for OTC cough and cold medicines and may eventually require much more sweeping changes that reach kids all the way up to the teenage years.

___

On the Net:

FDA statement on cold remedies:

http://tinyurl.com/52u69h

Copyright 2008 The Associated Press.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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Eli Lilly settles Zyprexa inquiries in 32 states

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Posted on 7th October 2008 by Gordon Johnson in Uncategorized

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Date: 10/7/2008 2:25 PM

By TOM MURPHY and MARLEY SEAMAN
AP Business Writers

INDIANAPOLIS (AP) _ Drugmaker Eli Lilly & Co. cleared another legal cloud hanging over its top-selling drug Zyprexa when it announced a $62 million settlement Tuesday, but several other storms are still brewing for the antipsychotic medication.

Lilly agreed to pay 32 states and Washington, D.C., to resolve an investigation into the company’s marketing practices.

Attorneys general from several states had accused Lilly of marketing Zyprexa for off-label uses and inadequately disclosing the drug’s side effects to health care providers, the same claims made in reams of other litigation against the drugmaker.

Lilly was accused of marketing the drug for pediatric care, for use at a high dose and for the treatment of dementia, according to a statement from the Indiana attorney general’s office. Doctors are free to prescribe drugs for uses not approved by the FDA, but drug companies cannot market them for those situations.

The company did not admit wrongdoing in the settlement.

Tuesday’s settlement will be divided among the states and the district based on population, said Greg Zoeller, Indiana’s chief deputy attorney general. Indiana, for instance, will receive $1.6 million.

Lilly also agreed to several mandates that will last until 2014, well beyond Zyprexa’s patent expiration in 2011. The company agreed to avoid making false, misleading or deceptive claims about the drug and not to promote it outside FDA-approved uses.

The drugmaker also agreed to give its medical staff, not the marketing staff, ultimate responsibility for approving the content in “all medical letters and medical references regarding Zyprexa,” according to the Indiana attorney general’s statement.

“The one thing that’s really key here is they’ve agreed to have a much more transparent system,” Zoeller said.

However, Lilly spokesman Phil Belt said many of the items his company agreed to were things it either already did or was in the process of doing.

“There’s no admission of wrongdoing, there’s no dramatic changes in the way we’re doing business,” he said.

He said Lilly agreed to the settlement to avoid being wrapped up in litigation and other things it deems counterproductive to drug development.

“We think its better for Lilly, better for patients, better for prescribers to have this kind of activity behind us,” he said.

Lilly said it will take a related charge of 4 cents per share in the third quarter for the settlement.

The states involved in Tuesday’s settlement are Alabama, Arizona, California, Delaware, Florida, Hawaii, Illinois, Indiana, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Missouri, Nebraska, Nevada, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Vermont, Washington and Wisconsin, as well as the District of Columbia.

Zyprexa rang up $4.8 billion in sales last year. But Lilly also has settled more than 31,000 product liability claims against the drug since 2005, shelling out more than $1.1 billion in the process.

Last year, Lilly paid $15 million to settle a lawsuit with the state of Alaska in March. The drugmaker still faces litigation with 11 states, generally involving consumer protection issues or Medicaid reimbursement. These cases are separate from the settlement announced Tuesday.

Those states include Arkansas, Connecticut, Idaho, Louisiana, Mississippi, Montana, New Mexico, Pennsylvania, South Carolina, Utah and West Virginia.

The U.S. Attorney’s office for the Eastern District of Pennsylvania also is investigating Zyprexa marketing.

A group of insurance companies, unions and others are suing Lilly for billions of dollars, saying the drugmaker charged too much for Zyprexa and marketed the drug for off-label uses. A federal judge has recommended that Lilly settle that case and last month granted the plaintiffs class-action status.

All told, Lilly still faces about 185 product liability lawsuits involving 1,185 plaintiffs, according to its latest quarterly statement.

Lilly shares rose more than 3 percent to $39.73 in trading Tuesday.

Copyright 2008 The Associated Press.
Summary


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
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Supreme Court will be looking at drug maker liability

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Posted on 4th October 2008 by Gordon Johnson in Uncategorized

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Date: 10/4/2008 10:20 AM
By The Associated Press

The Supreme Court is back in session on Monday. One high-profile case they will be taking up involves drugmaker Wyeth.

—Drug maker liability: Vermont musician Diana Levine won a $6.8 million judgment against drugmaker Wyeth after having part of her right arm amputated in 2000 when an anti-nausea drug was injected improperly. Now Wyeth, backed by the Bush administration, wants the high court to rule that Food and Drug Administration regulation of prescription drugs — in this case, approval of warning labels for drugs — overrides state laws and makes it easier for companies to defend against consumers’ claims.


Attorney Gordon Johnson
Chair Traumatic Brain Injury Litigation Group, American Association of Justice
g@gordonjohnson.com :: 800-992-9447 :: Attorney Gordon S. Johnson, Jr.

http://subtlebraininjury.com :: http://brainanatomyguide.com :: http://car-accident-rain.com :: http://tbilaw.com
http://waiting.com :: http://vestibulardisorder.com :: http://youtube.com/profile?user=braininjuryattorney