Friday, October 29, 2010

Excelsior Medical Disposable Syringe with Normal Saline (0.9% Sodium Chloride, 5mL fill in 6mL syringe)

Another Recall to report:

Product: Disposable Syringe with Normal Saline (0.9% Sodium Chloride, 5mL fill in 6mL syringe)
This recall pertains ONLY to the 5mL fill in 6mL prefilled saline flush syringe with Normal Saline (0.9% Sodium Chloride), with the following product code numbers:
  • E0100-50
  • 10056-1000
  • 10056-240
  • 14056-240
  • 910056-1000
  • S5
The product code number can be found in the barcode on each syringe as well as on the carton label.
These devices were distributed from August 8, 2008 through August 10, 2010.
Use: The Excelsior Disposable 5mL fill in 6mL prefilled saline flush syringes are intended for the flushing of venous access devices (such as, inserted central catheters) and intravenous (IV) lines.

Recalling Firm:Excelsior Medical Corporation
1933 Heck Avenue
Neptune, New Jersey 07753

Reason for Recall: There is a potential for leaking and loss of sterility. The device failure may result in an infection in the bloodstream which may result in serious injury or death.

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FDA MedWatch - Heparin Sodium (B. Braun): Recall - Trace Contaminant

FdaImage via WikipediaFrom the FDA:

AUDIENCE: Pharmacy, Risk Managers
ISSUE: B. Braun Medical Inc. and FDA notified healthcare professionals of a nationwide recall of certain lots of Heparin Sodium USP Active Pharmaceutical Ingredient (API) sold to B. Braun because testing indicated a trace amount of oversulfated chondroitin sulfate (OSCS) contaminant. These lots were manufactured in 2008 and will be expiring on October 31, 2010 and November 30, 2010.

BACKGROUND: Heparin is a blood thinner used to treat and prevent blood clots.

RECOMMENDATION: Customers who have product from the recalled product lots in their possession should discontinue use immediately. Product lot numbers, expiration dates, and recall instructions are listed in the Press Release.
Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

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Novedex XT Recall News

Gaspari Nutrition Incorproated, 575 Prospect Street - Suite 230, Lakewood, NJ, announced
that it is conducting a voluntary nationwide recall of all Lot Codes of the company's dietary supplement product sold under the name Novedex XT, which was marketed "for increasing natural testosterone production" and contains 3,17-keto-etiocholetriene, also known as ATD, an anti-aromatase. Gaspari Nutrition is conducting this consumer level recall after being informed by representatives of the Food and Drug Administration (FDA) that 3,17-keto-etiocholetriene does not meet the definition of a dietary ingredient and therefore the product is in violation of provisions of the Federal Food, Drug, and Cosmetic Act.

Potential adverse events associated with the use of anti-aromatases could include the following: decreased rate of bone maturation and growth, decreased sperm production, infertility, aggressive behavior, adrenal insufficiency, kidney failure, and liver dysfunction. Consumers with liver, kidney, adrenal, or prostate abnormalities are at higher risk for developing adverse events. Gaspari has received no serious adverse events in over five years of marketing Novadex XT.

Novedex XT had been sold internationally and domestically, to distributors, wholesalers, retail stores and direct to consumers, but was discontinued by Gaspari Nutrition for domestic sales on October 4th 2010. The product was sold in blue bottles with a black cap, containing sixty (60) capsules.

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Injectable Methotrexate Recalled

The maker of injectable methotrexate is recalling the drug after small flakes of glass were found in some of the medication. The company says this has the potential to damage patient’s blood vessels or lead to swelling and even death, although the company isn’t aware of any reported problems so far.

Methotrexate is a disease-modifying antirheumatic drug, or DMARD. It is one of the most commonly prescribed medications for rheumatoid arthritis, or RA, a disease in which an overactive immune system attacks the joints and other tissues and organs. Methotrexate is taken to slow the progression of RA. It is also used for juvenile arthritis, severe psoriasis and some forms of cancer.

Sandoz, the generic pharmaceuticals division of Novartis in Princeton, N.J., is one of several suppliers of generic methotrexate. The company is voluntarily recalling all of its 50mg/2mL and 250mg/10mL vials of injectable methotrexate that are part of the Sandoz and Parenta brands and have expiration dates ranging from December 2010 to March 2012.

Source here

FDA Questions Diet Pill Qnexa

On Thursday, the FDA sent drugmaker Vivus "complete response letter," detailing the shortcomings in the company's application to sell a prescription diet pill called Qnexa.

What were the potential issues with Qnexa? There were claimed risks ranging from birth defects for babies conceived when women were taking the drug to an increased heart rate common among people taking Qnexa.
Even though people taking the highest doses of Qnexa had lost more than 10 percent of their weight a year after starting the medicine, the risks were too high, the a panel of FDA folks concluded.

For me, the area of prescription diet pills, with their history or problems (Fen Phen and Meridia) is a real worry. Diet and exercise is a lifetime commitment. For some people, a pill may be the only or last resort. Losing weight will never be easy for most folks, and to me it is unrealistic to think that a magic pill will be devised to address real weight loss.       

Similac Recall News for Georgia

A class action lawsuit alleging deceptive business practices has been filed against Abbott Laboratories over claims that the pharmaceutical giant sold millions of tubs of infant powder formula that was contaminated with beetles and beetle larvae.

The lawsuit, which was brought in federal court in Chicago, was filed on behalf of  a mother of a newborn baby boy.  The suit alleges that Abbott knew that its baby formula was tainted for at least six days prior to announcing it to the public.  As a result, the suit claims that the named plaintiff's son, like thousands of babies throughout the country, suffered gastrointestinal health issues as a result of ingesting the tainted formula.

Stay tuned.


Thursday, October 28, 2010

FDA Asks for Tougher Warnings on GnRH Agonists

The FDA has asked manufacturers of gonadotropin-releasing hormone (GnRH) agonists -- a class of drugs used primarily to treat prostate cancer -- to add new warnings about the potential risk for heart disease and diabetes.

Earlier this year the FDA recommended that the risks of GnRH agonists be carefully considered before beginning treatment, but Wednesday's announcement solidifies the FDA's growing concerns with GnRH agonists.
Earlier this year, the American Heart Association, the American Urological Association, and the American Cancer Society issued a joint advisory warning of the increased risks of diabetes, myocardial infarction, stroke, and sudden death among men who use androgen deprivation therapy (ADT) to treat prostate cancer. GnRH is the most common form of ADT.

The groups did not offer specific guidelines for clinicians on when to employ ADT therapy or when to avoid it.

Clinical trials have shown that ADT increases body weight, decreases lean mass and increases fat mass, reduces insulin sensitivity, and triggers or worsens dyslipidemia.


FDA Warns Makers of Enfamil

Enfamil FormulaImage via WikipediaThe FDA has warned Mead Johnson Nutrition Co.  about the packaging for some of the company's Enfamil infant formulas.

In a letter dated Oct. 18 that was posted to the agency's website Tuesday, FDA said Mead Johnson didn't give the FDA product specifications about a new plastic tub and lid that is used to store certain types of Enfamil powdered formula.

Earlier this year, Mead Johnson introduced a reusable tub for Enfamil formula that allows consumers to buy refill packages of formula to store in the container.

The FDA said the plastic tub is a "food contact surface." This would require the company to "evaluate the effect of changes in processing conditions that could affect the level of nutrients in the finished product," FDA said.

The FDA said Mead Johnson did notify the agency in February about its plans to start making powdered formula in "multi-serve pouches," but didn't provide an evaluation of the plastic used for the tub and lid.
In a statement, Mead Johnson said the company had believed that it had submitted all required information and had been received a notice from the FDA that indicated the agency had no additional questions.

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Study Suggests that Gene Mutations May Limit the Effectiveness of Plavix

A box of PlavixImage via WikipediaPeople with certain gene variants who take the blood-thinning drug Plavix (clopidogrel) may be at increased risk for serious complications after coronary stent placement, a new study finds.

Having the gene variants seems to reduce the effectiveness of Plavix and put patients at higher risk of developing blood clots in the stent, suffering a heart attack or stroke, or even dying, according to the research.
"Clopidogrel is one of the most commonly prescribed medications worldwide," said lead researcher Dr. Jessica L. Mega, an instructor in medicine at Brigham and Women's Hospital and Harvard Medical School in Boston.

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Wednesday, October 27, 2010

Elections 2010: Shame on the Campaign Spammers

2010 United States Senate electionsImage via WikipediaThis election has - at least for lawyers- spawned the worst of all election campaigns - the constant barrage of unwanted, unwelcome, and automated emails that have angered many. What am I talking about you say?
 It seems that some lawyer groups I belong to have their membership emails harvested by campaigns. Perhaps it's because I voted  a certain way, or filled in a survey somewhere, or perhaps my email address was passed along by a (so-called) friend.

Here's what happens: My email gets on a list, like "Georgians for Electing JoeBob Smith" or some other group. They send one email updating me on some campaign for some person I can't vote for b/c I'm not in that district. So, I send an email telling the campaign to stop. Next  week,  more JoeBob emails. And, now there are 2 more groups that have my email - "Friends of JoeBob" and "Independents for JoeBob." Add an email a day from each one. Folks, we don't care.I even called a campaign  and asked to be removed from the email list - the same day? Another campaign email. 

It's no longer enough for me to get emails like that for candidates  in my state (Georgia). I somehow got on a list for Florida candidates, Alabama, and lastly, South Carolina. I was asked to "max out" - contribute the maximum allowed under a State's election laws - for someone I never heard of in S.C.I have even resorted to sending an irate email with a "RE" line that says "stop the damned emails" and they still keep coming.

I've moved emails to spam, only to be thwarted by a work around email

I've been asked to contribute --via email only mind you --$25,000 to one group, $5,000 to a Florida candidate, and more to others down the ballot. In the last three days, I have more than 150 emails from candidates I don't know, people I don't like, and groups for ballot initiatives in states I have not visited.

The internet has one massive failing - it allows  for senseless email solicitations that completely lose effectiveness. Worse, they are automated. I did contribute to one candidate in Georgia, a decent sum, and the next day I got an email asking me to donate.

So, my message to candidates now and in the future  - spare us. Don't become a spammer we detest. Pick
 up the phone. Raise money the old fashioned way. Mind the email accounts so when you see someone complaining, you respond. Because I have to tell you, if you can't respond to an email when you want my money and my attention, do you think I will vote for you? What happens when I need you after you are electeD?
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Tuesday, October 26, 2010

GA Lawyers: Scam Alert

This is a scam similar to the one that has ensnared lawyers in Florida. Be aware of this one, either by the named person, or something similar. Copy of a 'contact' that come to my website:

Name:Paulina Risto
Phone: Phone
Comment:Dear Counsel,

My name is Ms Paulina Risto. I was married to my ex husband Matthew Risto for 7 yrs and in Dec 2008, We mutually agreed under a Collaborative Participation Law Agreement to go our separate ways. Dino had agreed to pay me $700,000.00 under terms of the agreement so that I can settle down and to his credit; he has paid me $50,000.00 but with an outstanding balance of $650,000.00. I am hereby seeking your legal assistance in collecting the balance or helping me enforce the agreement, and have him honor the agreement in entity.

I will be providing further information upon your request. I believe that one of the reasons he has refused to pay is because I deaf. Prior to our separation due to irreconcilable differences, we were married for 12yrs of which by his instruction, I was a full time house wife to carter for our two children.

Please get back to me if this is a case you can undertake. I would love to contact you via telephone but i am deaf. I will not hear any you say on the phone. The only means of effective communication is via emails. I am hereby seeking your firm to assist in collecting the balance from him. He has agreed already to pay me the balance but have failed several times to keep to his promise of making the payment. it is my belief that a Law firm like yours is needed to help me collect payment from my ex-husband or litigate this matter if he fails to pay me this time around.

I have contacted you because my ex husband reside in your jurisdiction.

Also note that i am a poor woman who is trying to settle debts that i have owed people. I can only work with on contingency basis because i can't pay lawyer fee.

Four Loko under Scrutiny

Drinks that mix alcohol and caffeine are under scrutiny once again after dozens of Central Washington University students got sick and nine were hospitalized after claiming they had been drinking Four Loko.
alcoholic energy drinks

The maker of Four Loko says it's upset about the products being abused and consumed illegally by underage drinkers, according to a statement on the company's website.
Also on the website, a description of Four Loko's lemon-lime flavored drink:
A wild blend of tart Lemon flavor, with a sharp Lime twist, 12% alcohol and modern day ingredients such as Caffeine, Guarana and Taurine, all packed into a huge 23.5 ounce can.

 From Wiki:

Four Loko 'a $2 blackout in a can', is made from mixing a stimulant (caffeine) with a depressant (alcohol). When people combine the two, they tend to not feel the alcohol as much since the caffeine is keeping them more alert.

However, when the caffeine wears off, then the person feels the full effects of the alcohol. This often causes the consumer to drink more than they normally would because of the delayed 'drunk' feeling. [7]
A study done at the University of Florida in Gainesville, Florida found that students who mixed caffeine and alcohol tended to think they were capable of driving more often than those who drank non-caffeinated alcoholic drinks.

 More info here:
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Feds/States Launch Avandia Investigations

The maker of Avandia -- GSK --- has received from the Department of Justice more than one subpoena. Several U.S. states are also considering action against the company, and new claims from patients hit the courts regularly.

Avandia, the once-top-selling diabetes drug, has been plagued by safety concerns since 2007. After several years of weighing data and more data, regulators in Europe chose to pull the drug off the market completely, while FDA put severe restrictions on its use. The company won't market the drug anymore, either. GSK wrote off supplies of the drug--$233 million worth--because they'll never see the light of day.
Justice's subpoena involves GSK's development and marketing of Avandia, the company says; as the Wall Street Journal notes, it's unclear whether the probe is criminal or civil. No doubt the feds will be looking into allegations the company kept safety concerns about the drug under wraps. GSK maintains that it handled Avandia worries appropriately.

The company said it has also received "civil investigative demands" from states attorneys general about Avandia's development and marketing. Then there are the patient suits; GSK says it doesn't yet know whether it needs to set aside more money to cover eventual liabilities from the drug. This legal battle has only just begun.

Read more: GSK: Feds, states launch Avandia probes - FiercePharma
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Scary News: Halloween Lollipops/Raisinets Recalled

RaisinetsImage by cthoyes via FlickrMore Halloween candy has been recalled as the FDA announces the recall of Mega Pops lollipops. The lollipops may contain traces of foreign particles although the manufacturer, Colombina SA, claims there is no health risk.
The product is distributed in retail stores across the United States, including Family Dollar stores here in Rhode Island. The product comes in 14 oz and 28 oz cellophane bags in watermelon, cherry, orange and grape flavored pops.
The FDA has issued a nationwide recall for Raisinets Fun Size 10 oz bags of candy as some may contain undeclared peanuts. The Nestle Raisinets are in fun sized packages that may have been purchased by consumers for Halloween at Target, Shop Rite and Don Quixote retail stores in the US.

If a person eats the product who is allergic to peanuts, they may have a serious or life-threatening allergic reaction.Three complaints have been received to date, although there is a statement on the package that reads, "equipment that also processes peanuts," Nestle indicates that the product may actually contain peanuts.
Recalled Raisinets product code and UPC number
The only product involved is Nestlé Raisinets Fun Size Bags (10oz) with a production code of 02015748/UPC number 2800010255. No other Nestlé products are impacted.
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Fentanyl Patches Recalled

Fentanyl Transdermal System patch, 50 microgra...Image via WikipediaActavis Inc. is recalling 18 lots of its Fentanyl Transdermal System 25-mcg/hour C-II patches because the opioid-containing products may release their active ingredient faster than approved specifications permit.

From the FDA site:

ISSUE: FDA notified healthcare professionals and patients that laboratory testing identified a patch that released its active ingredient faster than the approved specification. An accelerated release of Fentanyl can lead to adverse events for at-risk patients, including excessive sedation, respiratory depression, hypoventilation (slow breathing), and apnea (temporary suspension of breathing).

BACKGROUND: Fentanyl Transdermal System is indicated for the management of persistent, moderate to severe chronic pain that requires continuous, around-the-clock opioid administration for an extended period of time and cannot be managed by other means such as non-steroidal analgesics, opioid combination products, or immediate release opioids. The product is manufactured for Actavis by Corium International in the United States.

RECOMMENDATION: Wholesalers and retailers are being asked to return the product they have on hand or in stock. See the Press Release for recalled product lots. The Control/Lot number appears on the bottom of the product box and on the black and white side of each individual patch packaging, in the lower left corner.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

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Monday, October 25, 2010

Testing for Rx Drugs in the Workplace

West face of the United States Supreme Court b...Image via Wikipedia
I found a good article on the challenges of drug testing and what employers face.

Twenty years  after the U.S. Supreme Court upheld the right to test for drugs in the workplace. In 1986, the U.S. Customs Service imposed a drug testing program for "employees seeking transfer or promotion to positions having direct involvement in drug interdiction," required to carry firearms, or have access to classified information. The National Treasury Employees Union sued and alleged that the program was violative of the Fourth Amendment, which prohibits unreasonable search and seizure. The Court of Appeals for the Fifth Circuit ruled in favor of the government.

The union then appealed to the Supreme Court. The Supreme Court upheld the Court of Appeals ruling with regard to positions involving drug interdiction and firearms. The ruling for classified information was held over, as the Supreme Court determined that the U.S. Customs Service too broadly included employee groups who would not generally have access to high levels of classified information.

Now, employees who take certain medications that may pose a safety hazard  are a concern. The growing reliance of Americans on powerful prescription drugs for pain, anxiety and other illnesses suggests that many are reporting to work with drugs in their systems, and employers are "grappling for ways to address that."

 There is a dearth of data from independent groups regarding impairment from prescription drugs in the workplace, partly because the issue has not drawn broad scrutiny. But Quest Diagnostics, a prominent provider of workplace drug tests, said that the rate of employees testing positive for prescription opiates rose by more than 40 percent between 2005 and 2009, and by 18 percent last year alone. The data, culled from the results of more than 500,000 drug tests, also indicated that workers who were tested for drugs after accidents were four times more likely to have opiates in their systems than those tested before being hired.

Read more here
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CareFusion Pump Recall

FDA (trade union)Image via Wikipedia The FDA has issued a ecall of 17,000 electronic infusion pumps made by CareFusion, saying a flaw in the devices could case serious injury or death in certain situations.

The San Diego medical device maker sent out urgent notification letters in August  to customers using model 8015 of the Alaris PC unit made between December 2008 and September 2009. The machines are mainly used by hospitals to deliver medications and other fluids to patients intravenously.

Certain wireless network conditions can cause the device to suffer intermittent communication errors that freeze the unit’s screen, the company said. The problem can cause the unit to shut down if a nurse attempts to modify drug delivery instructions.

CareFusion promised to fix all of the units. In the interim, the company provided customers with warning tags to attach to defective machines and gave them instructions on disabling the device’s wireless operation.
The company said it had put aside enough money in the fourth quarter, which ended June 30, to cover the costs of the recall.

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High Levels of Peroxide found in Crospovidone

The FDA agency announced findings in an advisory last week, warning pharmaceutical manufacturers the higher than permitted peroxide concentration, which was four times the level allowed by global compendial monographs, may reduce drug efficacy.

There are no of illness or accusations of wrongdoing as to the Crospovidone batch.

Supplier reliability review

The FDA has said  “Users and distributors implement robust supplier management programmes,” suggesting that reviewing supplier reliability is critical.

It also said drugmakers should analyse samples for peroxide levels, explaining that while no test is listed in Crospovidone monograph the a non-specific USP/EP method can be used to detect levels in excess of 400 ppm.


Teething Tablets Recalled

A California company is working with the FDA and voluntarily recalling  teething tablets for infants and toddlers. They are made by Standard Homeopathic Company and are sold as Hyland's Teething Tablets and are sold in bottles of 50 to 250 tablets.  Adverse problems have been reported but the F-D-A says a conclusive link has not been determined.  Consumers who are concerned about the safety of the product can contact the company for instructions on a refund or replacement product.
 The Hyland's Teething Tablets UPC codes included in the recall are:

1. Hyland's Teething Tablets, 125 tablets, UPC # 3 54973 75041
2. Hyland's Teething Tablets, 250 tablets, UPC # 3 54973 75042
3. Hyland's Teething Tablets, 125 tablets, UPC # 3 54973 75066
4. Hyland's Teething Tablets, 50 tablets, UPC # 3 54973 75044
5. Hyland's Teething Tablets, 145 tablets, UPC # 3 54973 75121
6. Hyland's Teething Tablets, Clip Strip 6x125 tablets, UPC # 3 54973 35109


Wednesday, October 20, 2010


An Allstate store in MonctonImage via WikipediaFrom the GTLA Blog:

Allstate has agreed to pay New York $1.2 million as part of a $10 million regulatory settlement, New York State Insurance Superintendent James J. Wrynn announced today. The agreement follows an 18-month targeted National Association of Insurance Commissioners (NAIC) multi-state market conduct examination of Allstate’s claims handling practices.
“Allstate has agreed to implement procedures to ensure transparency and fairness for consumers who have bodily injury claims,” Wrynn said. “The new processes ensure that claims will be handled consistently in different regions of the country, and consumers will have the right to get the information they need in order to understand how Allstate evaluates their claims and make sure they are fairly treated.”

The NAIC examination, for which New York was one of the lead states, focused primarily on Allstate’s use of claims handling software, particularly the software program, Colossus.

Colossus is a software program Allstate used to guide its settlement offers for bodily injury claims after automobile accidents. The examination found inconsistencies in Allstate’s management and oversight of the Colossus software program. In particular, the examination found that Allstate had failed to modify or “tune” the software in a uniform and consistent manner across its claims handling regions.

Under the settlement agreement, Allstate agreed to make a number of changes to its claims handling process, including:
  • Providing notice to claimants that the Colossus software program may be used in the adjustment of their bodily injury claims;
  • Enhancing its management oversight of Colossus to ensure that it adheres to established criteria and a uniform methodology in selecting claims to be used to “tune” or modify the software to reflect recently settled claims;
  • Strengthening its internal auditing of Colossus and bodily injury claims handling to ensure adherence to written guidelines and procedures;
  • Consolidating its bodily injury claims handling practices into a single claims handling manual; and
  • Not establishing a policy or rule requiring claims adjusters to settle bodily injury claims solely on the value recommended by Colossus and not providing incentives for claims adjusters to settle claims at or near the value recommended by Colossus.
“It is important to note that we found no systemic underpayment of bodily injury claims,” Wrynn said. “While the issues addressed were serious, Allstate cooperated fully with our examination and is working to correct these deficiencies. Here in New York, we will continue to review the use of claims handling software by property/casualty companies.

“This settlement shows how state insurance regulators work together to protect consumers,” Wrynn said. “The four lead states – Florida, Illinois, Iowa and New York – worked cooperatively to conduct this examination and will keep working with the other 41 states that have signed on to this agreement to ensure it is fully implemented and consumers are properly protected.”
Allstate’s payment will be used to establish a regulatory fund. The fund will be used by the 45 signatory states, to the extent consistent with applicable state laws, to develop and train examiners to review and monitor the property/casualty industry’s use of software technology in adjusting claims
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Another Tylenol Recall

Open bottles of Extra Strength Tylenol and Ext...Image via WikipediaA moldy odor problem has hit Johnson & Johnson's Tylenol, and the company is recalling another lot of the over-the-counter painkiller.

J&J had recalled millions of bottles of Tylenol and other consumer medicines in the past year because of complaints of a musty or moldy odor in the product, said it was voluntarily recalling another lot.

"This voluntary action is being taken as a precaution and the risk of adverse medical events is remote," the diversified healthcare company said in a release.

A company spokeswoman identified the product as adult Tylenol eight-hour caplets sold in 50-count bottles in the United States and Puerto Rico.

She said the recalled lot was made in March at a factory in Fort Washington, Pennsylvania, operated by J&J's McNeil Consumer Healthcare unit.
J&J shut down the McNeil plant the following month and is upgrading the facility to correct quality control lapses discovered by U.S. Food and Drug Administration inspectors.

The FDA cited thick dust, grime and contaminated ingredients at the Fort Washington plant. J&J plans to reopen the plant next year, and is using other McNeil plants to help offset lost production of the recalled products.

Products made at the plant had annual sales of about $650 million, about 1 percent of total annual company sales. But the spate of recalls has tarnished the reputation of J&J and its consumer brands and forced a shakeup at the McNeil unit.

Source: Here
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October Avandia Legal News for Georgia

A good report from American Counsel on Science and Health:

As drugs continue to be taken for longer periods of time, unexpected complications may arise that were absent from short-term clinical trials. New York Times science journalist Gina Kolata reported on what happens when drugs cause problems they were originally developed to prevent, focusing on the risks associated with the now highly restricted diabetes drug Avandia, and bisphosphonates, a class of medicine used to treat osteoporosis. 

After post-market analysis revealed that Avandia is alleged to be associated with an increased risk of heart failure, the drug was temporarily removed from the market in Europe and then restricted by the FDA last month. 

“Diabetic treatment is supposed to reduce the rate of diabetic complications including vascular disease, kidney disease and neuropathy — not merely control blood sugar. Studies that show Avandia may increase the risk of heart failure illustrate a case of when a drug does the opposite of what it’s supposed to.” 

Here is the link:

In the Middle East, this news:
The UAE Ministry of Health has ordered all doctors and hospitals to suspend prescribing the diabetes drug Avandia.

According to a circular issued Sunday, health officials have decided to suspend all products containing Rosiglitazone over fears in the United States and Europe over its safety. Bahraini health officials have also banned drugs containing Rosiglitazone, like Avandaryl, Avandamet and Avandia, the Gulf Daily News reports.

Dr Ameen Al Amiri, CEO for medical practice and licensing at the ministry, was reported by the official news agency WAM as saying the drug control directorate had held extensive talks with Avandia’s manufacturers and local distributors.
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Tuesday, October 19, 2010

FDA Advisers Back Anemia Drugs for Kidney Patients

Kidney-failure patients can continue taking a group of widely used anemia drugs, even though a recent study showed they can increase the risk of stroke, says the FDA.
Click here to find out more!
A panel of FDA advisers voted 15-1, with one abstention, to maintain use of the drugs for patients with chronic kidney disease who aren't yet in need of dialysis, the Associated Press reported. The FDA is not required to follow the advice of its advisory panels, but typically does so. 

The drugs -- Procrit, Aranesp and Epogen, a class of medications known as erythropoiesis-stimulating agents (ESAs) -- boost oxygen-carrying red blood cells, reducing the need for painful blood transfusions. But sales have fallen sharply since 2007, when the FDA added the first of several safety warnings to the drugs, based on evidence they can cause tumor growth and hasten death in cancer patients. The drugs are no longer used in patients with several types of cancers, the AP reported.

More here. 
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Meridia and Other Rx Diet Drugs and their Risks

Medication used for obesity. Orlistat and sibu...Image via WikipediaThe real risks of heart attacks, strokes and other possible long-term side effects still are not completely known, even after Meridia was studied and pulled from the market.

Other prescription diet pills include orlistat (Xenical by prescription, Alli over-the-counter), phentermine (Adipex-P), diethylpropion (Tenuate), and phendimetrazine (Bontril). They can help with short-term weight loss. Orlistat can potentially be taken for a longer period of time. None can be considered entirely safe, some folks say.

Orlistat is probably the safest of the five. It blocks the intestine from absorbing fat. The main side effects are frequent bowel movements, greasy stool and gas. You need to stay on a low fat diet to avoid these side effects. A long-term concern about orlistat is that some claim that a user may not get enough vitamins A, D, E, K and beta carotene. These vitamins need fat in the intestine to be absorbed.

Phentermine, diethylpropion and phendimetrazine decrease appetite for the first few weeks of use. They may be prescribed to jump-start weight loss as part of a lifestyle modification program.,0,6548317.story

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Monday, October 18, 2010

OsmoPrep News

The FDA has issued alerts regarding acute kidney injury associated with the use of OsmoPrep. This type of kidney injury is known as Acute Phosphate Nephropathy. OsmoPrep is a type of oral sodium phosphate products (OSP) and it is used for bowel cleansing prior to colonoscopy or other procedures. In some cases when used for bowel cleansing, these serious adverse events have occurred in patients without identifiable factors that would put them at risk for developing acute kidney injury. We cannot rule out, however, that some of these patients were dehydrated prior to ingestion of OSPs or they did not drink sufficient fluids after ingesting OSP.

Acute phosphate nephropathy is a form of acute kidney injury that is associated with deposits of calcium-phosphate crystals in the renal tubules that may result in permanent renal function impairment. Acute phosphate nephropathy is a rare, serious adverse event that has been associated with the use of OsmoPrep. The occurrence of these events was previously described in an Information for Healthcare Professionals sheet and an FDA Science Paper issued in May 2006. Additional cases of acute phosphate nephropathy have been reported to FDA and described in the literature since these were issued.
ndividuals who appear to have an increased risk of acute phosphate nephropathy following the use of OsmoPrep include persons: who are over age 55; who are hypovolemic or have decreased intravascular volume; who have baseline kidney disease, bowel obstruction, or active colitis; and who are using medications that affect renal perfusion or function (such as diuretics, angiotensin converting enzyme [ACE] inhibitors, angiotensin receptor blockers [ARBs], and possibly nonsteroidal anti-inflammatory drugs [NSAIDs]).

As a result of new safety information received, FDA ias required the manufacturer of OsmoPrep, Salix Pharmaceuticals, Inc. to add a Boxed Warning to the labeling for this product. FDA is also requiring that the manufacturer develop and implement a risk evaluation and mitigation strategy (REMS), which will include a Medication Guide, to ensure that the benefits of OsmoPrep outweighs the risk of acute phosphate nephropathy, and to conduct a postmarketing clinical trial to further assess the risk of acute kidney injury with use of OsmoPrep.

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Biosphosphonates get an FDA Warning (Fosamax, Actonel, Boniva)

FOSAMAXImage by flap via FlickrThe FDA last week asked that certain drug makers add a  warning to the label of all bisphosphonates, which include Boniva, Actonel, and FosamaxHealth Canada also announced last week that there is evidence that women taking bisphosphonates could have increased risk of thigh bone fractures. The drugs are currently under “safety review” in Canada.
FDA reps said the risk of  certain fractures were highest in those who took the drugs for five years or more, according to data provided by the American Society for Bone Mineral Research Task Force.
A deterioration of the jaw bone has also been associated with bisphosphonates, though osteoporosis experts emphasize that, for those with the disease, the drugs' benefits still far outweigh the risks. Experts don't know for certain if bones continue to benefit from the medications beyond the five or 10 year mark.
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FDA Warns Companies Promoting Chelation Products

The FDA is cracking down against the makers of over-the-counter chelation products which are claimed to  help remove toxic metals from the body. These are often sold over the net. Manufacturers say they are are valid treatment for conditions like autism, heart disease, macular degeneration, and Alzheimer's disease, by linking toxic metals to these conditions. 

On Thursday, the FDA issued eight warning letters to companies marketing chelation products, saying that claims about using such products to treat medical conditions violate federal law. "What we're telling consumers is that any chelation therapy marketed over the counter is suspect," Michael Levy, director of the FDA's Division of New Drugs and Labeling Compliance, said during a briefing with reporters. 

The FDA has approved some chelation products to be prescribed in cases of heavy metal poisoning, but - here is the key -  none are approved for sale over the counter or on  the Internet.

What you see most often is a chelation product marketed as a dietary supplement, with varying dosages and forms, including capsules, liquid drops, and sprays. If not used properly, or without proper warning, the products could cause dehydration, kidney failure, or death, according to the FDA. The agency says it issued the warnings in response to increased product promotion and availability to consumers. If the companies don't correct the violations detailed in the letters, their products could be seized.

More here.  
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New CPR Guideline: A Must Read

CPR trainingImage via WikipediaJust saw on ABC Good Morning America, as well as on the web, new guidelines. Learn them: 

The average, untrained person can still save a life by focusing on chest compressions first, say new guidelines from the American Heart Association.

The simplified form of cardiopulmonary resuscitation, or CPR, focuses on giving chest compressions to keep the blood -- and the oxygen in the blood -- flowing to the heart and brain.

The group's advice comes on the heels of studies in the past year trumpeting that a compression-only approach is as good or better than compression plus mouth-to-mouth. It updates guidelines from 2005.

When someone  collapses in cardiac arrest, people often don't start any type of CPR, but chest compressions alone are easy, and anyone can do it.

The American Heart Association recommends that if an adult is unresponsive and not breathing or is having occasional unusual breaths that sound like gasping, any bystander should first call 911 (or whatever the emergency number is in the area) and then begin chest compressions.

If someone else is nearby, send that person in search of an automatic external defibrillator, a device that can shock the heart back into normal rhythm.

Read more at the source:
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Tuesday, October 12, 2010

10/12/10 Georgia Meridia Recall Lawyer -Background on the product

Meridia is also known as Sibutramine. Until recently it was marketed and prescribed as an adjunct in the treatment of exogenous obesity along with diet and exercise.
My office is investigating claims of injury because of this recalled product.

Sibutramine is a centrally-acting serotonin-norepinephrine reuptake inhibitor. Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a type of antidepressant medication that increases the levels of both serotonin and norepinephrine by inhibiting their reabsorption (reuptake) into cells in the brain. Although the precise mechanism of action isn't clear, it's thought that these higher levels enhance neurotransmission — the sending of nerve impulses — and so improve and elevate mood. Medications in this group of antidepressants are sometimes called dual reuptake inhibitors.

Sibutramine was originally launched and marketed by Knoll Pharmaceuticals and was most recently manufactured and marketed by Abbott Laboratories before its withdrawal from the market.
This product should not be used by people with with:
  • Psychiatric conditions 
  • Patients with a history of or a predisposition to drug or alcohol abuse
  • Patients below 18 and above 65 years of age
  • History of peripheral arterial disease
  • Hypertension that is not sufficiently controlled (e.g., > 145/90 mmHg), caution in controlled hypertension
  • Existing pulmonary hypertension
  • Existing damage on heart valves, coronary heart disease, congestive heart failure, serious arrhythmias, previous myocardial infarction
  • A history of coronary artery disease (e.g., angina, history of myocardial infarction), congestive heart failure, tachycardia, peripheral arterial occlusive disease, arrhythmia or cerebrovascular disease (stroke or transient ischemic attack (TIA)
  • Stroke or transient ischemic attack (TIA)
  • Hyperthyroidism (overactive thyroid gland)
What are the common side effects?
Frequently encountered side effects are: dry mouth, paradoxically increased appetite, nausea, strange taste in the mouth, upset stomach, constipation, trouble sleeping, dizziness, drowsiness, menstrual cramps/pain, headache, flushing, or joint/muscle pain.
Sibutramine may  substantially increase blood pressure and pulse in some patients.
These side effects are infrequent but serious and require immediate medical attention: cardiac arrhythmias, paresthesia, mental/mood changes (e.g., excitement, restlessness, confusion, depression, rare thoughts of suicide).
Symptoms that require urgent medical attention are seizures, problems urinating, abnormal bruising or bleeding, melena, hematemesis, jaundice, fever and rigors, chest pain, hemiplegia, abnormal vision, dyspnea and edema.
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FDA : Recent Recalls

FdaImage via Wikipedia
The folks at the FDA have been busy the past several weeks. Here's a short list of recalls:

Amgen Initiates Voluntary Nationwide Recall of Certain Lots Of Epogen® And Procrit® (Epoetin Alfa):The product that is being recalled may contain extremely thin glass flakes (lamellae) that are barely visible in most cases. The lamellae result from the interaction of the formulation with glass vials over the shelf life of the product. The products are indicated for the treatment of anemia related to HIV therapy, chronic renal failure, and chemotherapy. Link.


Pfizer Consumer Healthcare Issues Voluntary Recall of One Lot of ThermaCare HeatWraps Menstrual Product  The company said it is taking this precautionary step after finding a potential for a leak of the components contained in the wrap, which could cause skin injury such as irritation or burn. Link


Recall of AROM-X Capsules, AROM-X UTT Liquid, AROM-XL Liquid, 4-AD Capsules and Decavol Capsules Marketed as a Dietary Supplements Containing ATD: FDA's states that the ingresidnets 1,4,6 etioallocholan-dione do not meet the definition of a dietary ingredient and therefore the product is in violation of provisions of the Food, Drug and Cosmetic Act.


Recall of Reversitol a Product Marketed as a Dietary Supplement Containing ATD: FDA has requested that iForce Nutrition inform consumers that adverse events associated with the use of aromatase inhibitors could include the following: decreased rate of bone maturation and growth, decreased sperm production, infertility, aggressive behavior, adrenal insufficiency, kidney failure, and liver dysfunction. Consumers with liver, kidney, adrenal, or prostate abnormalities are at higher risk for developing adverse events. iForce Nutrition has not received any adverse event reports nor are they aware of any adverse events associated with the use of these products. Link.





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Monday, October 11, 2010

Meridia Withdrawal News

From the FDA:

AUDIENCE: Primary Care, Consumers

ISSUE: Abbott Laboratories and FDA notified healthcare professionals and patients about the voluntary withdrawal of Meridia (sibutramine), an obesity drug, from the U.S. market because of clinical trial data indicating an increased risk of heart attack and stroke.

BACKGROUND: Meridia was approved November 1997 for weight loss and maintenance of weight loss in obese people, as well as in certain overweight people with other risks for heart disease. The approval was based on clinical data showing that more people receiving sibutramine lost at least 5 percent of their body weight than people on placebo who relied on diet and exercise alone. FDA has now requested market withdrawal after reviewing data from the Sibutramine Cardiovascular Outcomes Trial (SCOUT). SCOUT is part of a postmarket requirement to look at cardiovascular safety of sibutramine after the European approval of the drug. The trial demonstrated a 16 percent increase in the risk of serious heart events, including non-fatal heart attack, non-fatal stroke, the need to be resuscitated once the heart stopped, and death, in a group of patients given sibutramine compared with another given placebo. There was a small difference in weight loss between the placebo group and the group that received sibutramine.

RECOMMENDATION: Physicians are advised to stop prescribing Meridia to their patients, and patients should stop taking this medication. Patients should talk to their health care provider about alternative weight loss and weight loss maintenance programs.

Talk to us at 404-451-7781

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:Original raster version: :Image:Food and Drug...Image via WikipediaGaspari Nutrition Incorproated, 575 Prospect Street - Suite 230, Lakewood, NJ, announced that it is conducting a voluntary nationwide recall of all Lot Codes of the company's dietary supplement product sold under the name Novedex XT, which was marketed "for increasing natural testosterone production" and contains 3,17-keto-etiocholetriene, also known as ATD, an anti-aromatase.

Gaspari Nutrition is conducting this consumer level recall after being informed by representatives of the Food and Drug Administration (FDA) that 3,17-keto-etiocholetriene does not meet the definition of a dietary ingredient and therefore the product is in violation of provisions of the Federal Food, Drug, and Cosmetic Act.

Potential adverse events associated with the use of anti-aromatases could include the following: decreased rate of bone maturation and growth, decreased sperm production, infertility, aggressive behavior, adrenal insufficiency, kidney failure, and liver dysfunction. Consumers with liver, kidney, adrenal, or prostate abnormalities are at higher risk for developing adverse events. Gaspari has received no serious adverse events in over five years of marketing Novadex XT.

Novedex XT had been sold internationally and domestically, to distributors, wholesalers, retail stores and direct to consumers, but was discontinued by Gaspari Nutrition for domestic sales on October 4th 2010. The product was sold in blue bottles with a black cap, containing sixty (60) capsules.
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