Thursday, January 17, 2013

Mirena IUD News for January 2013

The Mirena Intrauterine Device (IUD) is  a form of birth control and is inserted by a healthcare provider during an office visit.  It was approved by the Food and Drug Administration (FDA) in December 2000 and is currently used by more than 2 million women in the United States.  The product is manufactured by Bayer, Inc.


The Mirena IUD consists of a T-shaped polyethylene frame with a steroid reservoir around a vertical stem.  The T-body is 32 mm by 32 mm (vertical and horizontal).  The reservoir contains 52mg of levonorgestrel (a type of hormone) and small amounts are released daily.

While the package inserts and literature do warn about complications associated with the Mirena IUD, the patient is not warned that after the IUD is inserted it can perforate or pass through the uterus into other body parts such as the abdomen.  If this occurs, it is necessary to remove the IUD through a surgical procedure such as a laparotomy.

In 2009, Bayer was reprimanded by the Department of Health and Human Services’ Division of Drug Marketing, Advertising, and Communications (DDMAC) for making false and unsubstantiated claims about Mirena® in their “Simple Style” program. 



Here is a partial list of warnings:

WARNINGS
  • Intrauterine Pregnancy
    • Long-term effects and congenital anomalies
  • Embedment
  • Perforation
  • Expulsion
  • Ovarian Cysts
  • Breast Cancer
PRECAUTIONS
  • Patient Counseling Information
  • Patient Evaluation and Clinical Considerations
    • A physical examination should include...
    • Irregular bleeding may mask symptoms and signs of endometrial polys or cancer...
    • ...If involution is substantially delayed, consider waiting 12 weeks postpartum...
    • Mirena should be used with caution in patients who have:
      • migraine, focal migraine with asymmetrical visual loss or other symptoms indicating transient cerebral ischemia
      • exceptionally severe headache
      • marked increase of blood pressure
      • severe arterial disease such as stroke or myocardial infarction
  • Insertion Precautions
    • Observe strict asepsis during insertion...
    • Fundal positioning of Mirena is important to prevent expulsion...
    • If the patient develops decreased pulse, perspiration, or pallor, have her remain supine until these signs resolve. Insertion may be associated with some pain and/or bleeding...
  • Continuation and Removal
    • Re-examine and evaluate patients 4 to 12 weeks after insertion and once a year thereafter...
    • If the threads are not visible, they may have retracted into the uterus or broken, or Mirena may have broken...
    • Promptly examine users with complaints of pain, odorous discharge...
    • Consider the possibility of ectopic pregnancy...
    • Removal may be associated with pain and/or bleeding or neurovascular episodes.
ADVERSE REACTIONS
  • ...Very common adverse reactions (>1/10 users) include uterine/vaginal bleeding (including spotting, irregular bleeding, heavy bleeding, oligomenorrhea and amenorrhea) and ovarian cysts...
PATIENT PACKAGE INSERT
  • Who should not use Mirena?
    • Do not use Mirena if you...
    • have or suspect you might have cancer of the uterus or cervix
    • have breast cancer now or in the past or suspect you have breast cancer
  • Tell your healthcare provider if you
    • have high blood pressure
  • How is Mirena placed?
  • Should I check that Mirena is in the proper position?
  • How soon after placement of Mirena should I return to my healthcare provider?
  • What are the possible side effects of using Mirena?

http://www.fda.gov/Safety/MedWatch/SafetyInformation/Safety-RelatedDrugLabelingChanges/ucm121936.htm


Granuflo Update for January 2013


The litigation involving a recalled dialysis drug continues, and here is our update for January. 

Currently there are several requests to consolidate cases involving Granuflo/Naturalyte before one Court. Parties have asked the Joint Panel on Multidistrict Litigation to centralize cases in either Massachusetts, or Mississippi, or California. The JPML hearing will be in California in March.   

 What Is GranuFlo?

Fresenius Medical Care’s dialysis product GranuFlo is a “dialysate,” i.e., a substance that physicians can use to treat acute and chronic renal (kidney) failure.
The kidneys clean the blood of waste chemicals and help maintain the body’s pH level. When they fail, the body’s pH level become more acidic than is should be. Dialysates used to treat kidney failure include chemicals that the body can convert into the alkaline substance bicarbonate, which neutralizes some of the acid buildup in the blood stream.

GranuFlo: Heart Attack Side Effects


GranuFlo contains more bicarbonate than other dialysates, and a June 2012 New York Times article describes Fresenius’s knowledge of the risks posed by its product’s high bicarbonate level. According to the article, Fresenius sent a memo to its clinics warning that the higher bicarbonate levels in GranuFlo had caused 941 heart attacks in the company’s own clinics in 2010, leading the company’s researchers to estimate that GranuFlo increases a patient’s risk of heart attack by six times. Fresenius did not send the memo to GranuFlo-using clinics that the company didn’t own, however, until March 29, 2012, when the FDA consequently began investigating Fresenius for possible violations of federal regulations, the Times reports.
The most difficult part of our investigations? Patients don't go for dialysis treatment and ask for this product.   

Wednesday, January 16, 2013

Lap Band Facility gets a Warning Letter


An FDA Warning Letter says that oBand Centers in Marina Del Rey, CA, is making misleading claims in its promotional materials for the Lap-Band, a device indicated for weight reduction in certain severely obese adults.
According to the letter, the company's website fails to reveal material facts about Lap-Band risks. The letter also says that a web video that is intended to convey indications for tse, contraindications, warnings and adverse events is not accessible to viewers, due to the brief appearance of the information and tiny, blurry print that renders the content illegible.
http://www.mmm-online.com/lap-band-gets-fda-warning-letter/article/273465/

Fake Botox Warning

According to the U.S. Food and Drug Administration, Canadian medical supplier Canada Drugs has been linked to the sale and distribution of fake Botox.

Read more: http://www.sfgate.com/business/prweb/article/Fake-Botox-Use-Rampant-Despite-FDA-Warnings-4184971.php#ixzz2I9RhAF5U


Here is the letter:



The U.S. Food and Drug Administration (FDA) has alerted more than 350 medical practices that they may have received unapproved medications, including unapproved versions of Botox, from a foreign supplier. These medications may be counterfeit, contaminated, improperly stored and transported, ineffective, and/or unsafe. Medical practices that purchase and administer illegal and unapproved medications from foreign sources are placing patients at risk and potentially depriving them of proper treatment.  
 
To minimize the chance of patients receiving an unapproved, counterfeit, unsafe, or ineffective medication, FDA requests that medical practices stop administering the unapproved versions of Botox and any other products they have received from foreign suppliers owned and operated by Canada Drugs and known under the following names: Quality Specialty Products (QSP), A+ Health Supplies, QP Medical, Bridgewater Medical, or Clinical Care.  Many, if not all, of the products sold and distributed by these suppliers have not been approved by FDA. Therefore, FDA cannot confirm that the manufacture and handling of these products follow U.S. regulations or that these medications are safe and effective for their intended uses.
 
Medications not approved by FDA may also lack the necessary and required labels that ensure their appropriate and safe use. For example, unapproved botulinum toxin products may not contain the boxed warning or Medication Guide required in FDA-approved botulinum products. As a result, health care practitioners and patients may not be fully informed of the potential serious risk of harm or death from the use of these products.
 
The text of the letter FDA sent to the physicians or medical practices on November 30, 2012 is below, along with a list of the doctors and clinics to which the letter was sent.


****************


Dear Dr.:
 
The U.S. Food and Drug Administration (FDA) has received information indicating that your medical practice has received medications from a foreign supplier owned and operated by Canada Drugs, known as Quality Specialty Products (QSP), A+ Health Supplies, QP Medical, Bridgewater Medical, or Clinical Care. Most, if not all, of the products sold and distributed by these suppliers, including versions of Botox®, have not been approved by FDA. The manufacture and handling of these products may not be of suitable quality to ensure safety or efficacy, and the products have not been proven to be safe and effective pursuant to FDA standards. FDA is very concerned that products distributed by these suppliers may cause harm to patients, because they may be unsafe or ineffective.
 
Medications obtained from Quality Specialty Products (QSP), A+ Health Supplies, QP Medical, Bridgewater Medical, Clinical Care, or other foreign or unlicensed suppliers may be from unknown sources, may have unknown ingredients, may be counterfeit, or may not have been manufactured, transported or stored under proper conditions as required by U.S. law, regulations, and standards. Such products put patients at risk of exposure to ineffective or dangerous products. In virtually all cases, importing or causing the importation of unapproved prescription medications from foreign sources violates the Federal Food, Drug, and Cosmetic Act and is illegal. FDA has previously warned about unapproved and counterfeit oncology products obtained from some of these same foreign suppliers.[1]
 
Medications that are not approved by FDA may lack necessary and required labeling to assure their appropriate and safe use. For example, FDA has determined that a prominent “boxed” warning is required in the labeling for medications that have special problems, particularly ones that may lead to death or serious injury.  A Medication Guide that contains information that can help patients avoid serious adverse events may be required instead of, or in addition to, a boxed warning. Unapproved botulinum toxin products may not contain the boxed warning or Medication Guide in its labeling as required in FDA-approved products. As a result, the healthcare provider and patient may not be fully informed of the serious risk of harm or death associated with botulinum toxin products.
 
FDA requests that you cease using, and retain and secure all remaining products purchased or received from Quality Specialty Products (QSP), A+ Health Supplies, QP Medical, Bridgewater Medical, Clinical Care, or any other foreign or unlicensed U.S. sources until further notice. Please do not return any product(s) to the place of purchase at this time. FDA is continuing to evaluate this situation. If any unapproved medications remain in your possession, please contact FDA’s Office of Criminal Investigations (OCI) to arrange for the collection of the medications.
 
On January 13, 2012, FDA issued a notice to Healthcare providers about the risks of purchasing unapproved medications from unlicensed sources, and included information on how to identify whether distributors or the products received are legitimate.[2]
 
Information regarding any criminal activity involving the importation and use of foreign unapproved medications can be reported to FDA's Office of Criminal Investigations (OCI).
 
Healthcare providers and patients are asked to report adverse events related to the use of suspect medications to FDA’s MedWatch Safety Information and Adverse Event Reporting Program either online, by regular mail, by fax, or by phone. Heathcare providers and patients can either:
·         Complete and submit the report online or
·         Download form, or
·         Call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178.
 
FDA is committed to promoting and protecting the public health by ensuring that only safe, effective, and high-quality medications are available to the American public. Please contact
Eleni Anagnostiadis at DrugSupplyChainIntegrity@fda.hhs.gov should you have any questions regarding this letter.
 
Sincerely,
 
/S /
 
Thomas J. Christl
Acting Office Director
Office of Drug Security, Integrity, and Recalls
Office of Compliance
Center for Drug Evaluation and Research


Bodega Clinicas

I'm of Cuban origin, and for me the 'bodega' was where my grandparents went for almost everything they needed. My parents too. Here's a read on how these clinics are catering to the spanish speaking population:


 The “bodega clinicas” that line the bustling commercial streets of immigrant neighborhoods around Los Angeles are wedged between money order kiosks and pawnshops. These storefront offices, staffed with Spanish-speaking medical providers, treat ailments for cash: a doctor’s visit is $20 to $40; a cardiology exam is $120; and at one bustling clinic, a colonoscopy is advertised on an erasable board for $700.

According to the article, little is known about the competency of the medical providers in the clinic, the manner and method of oversight/regulation,  and the responsiveness of the doctors at each clinic.

One thing is certain - these clinics are not going away. In my hometown of Atlanta, there are two new ones near my office. I saw a line out the door at one of them on a recent weekend. How the FDA or any state agency responds to the virtual explosion of these clinic bodegas remains to be seen. If it's business as usual, you may not see any real effort for oversight in the next two years, and by then it may be too late. Will there be instances of harm, unsanitary conditions, or issues regarding pill dispensation?    

Read more here: http://www.nytimes.com/2013/01/13/health/bodega-clinicas-draw-interest-of-health-officials.html?_r=1&

Monday, January 14, 2013

Merck Starts Overseas Recall of Cholesterol Drug


Merck & Co said it is recalling Tredaptive, its medicine to raise "good" HDL cholesterol levels, in overseas markets where it is sold, after it failed to prevent heart problems in a large study and raised safety concerns.
The medicine is not approved in the United States but the U.S. drugmaker sells it in about 40 countries.
Merck said it would recall stocks of Tredaptive now held by wholesalers, but that pharmacies can continue to dispense their remaining supplies. Even so, the company said it plans to discourage doctors from prescribing the pill based on negative findings from the trial which were announced last month. The study followed more than 25,000 patients in Europe and China for almost four years.

http://news.yahoo.com/merck-withdraws-cholesterol-drug-tredaptive-globally-135233814.html

Alabama Supreme Court: Pifzer Suit Involving a Generic Drug May Proceed

(Hat tip to Pharmalot, link below)


The Alabama Supreme Court ruled last week that a lawsuit against Pfizer by a man who claimed he was injured by a generic version of its Reglan heartburn medicine may proceed. The reason? The brand-name drugmaker purportedly failed to warn his physician about the risks.
In that case, Weeks took Reglan and developed tardive dyskinesia. Although he took only generics, Weeks accused Wyeth, which sold Reglan and is now owned by Pfizer as well as two generic drugmakers – Teva Pharmaceuticals and Actavis – of failing to warn of the risk of long-term use.
At issue was whether Weeks could press his lawsuit against Pfizer, a question that a federal court asked the Alabama Supreme Court to decide. In its ruling, the Alabama court wrote that “an omission or defect in the labeling for the brand-name drug would necessarily be repeated in the generic labeling, foreseeably causing harm to a patient who ingested the generic product.”
The issue for the Court: Under Alabama law, may a drug company be held liable for fraud or misrepresentation based on statements that it made in connection with the manufacturing of a brand name drug, by a plaintiff alleging injury from a generic drug maker, and distributed by a different company? 
We'll be digesting this opinion and commenting on it later this week. The ramifications, however, are far potentiall far reaching.  
Here's the opinion in PDF format:



Friday, January 11, 2013

January 2013 Kidney Dialysis Drug Recall: Granuflo News Update


We've been writing about a Fresinius recall of their products known as Granuflo and NatyuraLyte; there was a recall last year based on a Fresenius' internal review of patients treated at Fresenius clinics that found at least 900 instances where patients suffered some type of cardiac injury during  or just after dialysis treatment. NaturaLyte is a liquid acid concentrate and GranuFlo is a dry acid concentrate. Both products contain sodium acetate that allegedly converts to bicarbonate at higher-than-expected levels for most doctors, according to allegations raised in the complaints
At year's end in 2012, Plaintiffs filed Motion to Consolidate the cases into multidistrict litigation (MDL) for all federal lawsuit.  
Several Plaintiffs filed a request with the U.S. Judicial Panel on Multidistrict Litigation asking that all Naturalyte and GranuFlo lawsuits filed in U.S. District Courts throughout the country be consolidated for pretrial proceedings in the District of Massachusetts.
Early in 2013,  Fresenius said in court papers that it agreed that consolidation of the NaturaLyte and Granuflo litigation was appropriate and supported the transfer of the cases to the District of Massachusetts
In another response by interested parties filed on January 3, several Plaintiffs with pending lawsuits have objected to centralizing the cases in Massachusetts, indicating that the litigation should be consolidated in the southeast, because of the number of cases filed in that region. Their choices are the Southern District of Mississippi and the Northern District of Alabama. 

Here is the Fresenius Response:

Thursday, January 10, 2013

Settlement in suit on pregnancy drug


Four sisters who claimed in a lawsuit their breast cancer was caused by synthetic estrogen their mother took during pregnancy in the 1950s have reached a settlement with the drug company Eli Lilly and Co., a lawyer for the sisters said Wednesday.
Attorney Julie Oliver-Zhang said the settlement, for an undisclosed amount, was reached on the second day of a trial in U.S. District Court in Boston. They had not specified damages sought in the lawsuit.
Indianapolis-based Eli Lilly did not immediately respond to a message seeking comment.
The sisters' case was the first to go to trial out of scores of similar claims filed in Boston and around the country. A total of 51 women have lawsuits pending in U.S. District Court in Boston against more than a dozen companies that made or marketed the drug.

http://news.yahoo.com/apnewsbreak-settlement-suit-pregnancy-drug-200825567--finance.html

Update on the Rakofsky versus the Internet Case - Lessons

I'm not a party in the case known as Rakofsky versus many Defendants (including bloggers, the ABA, and others).

I had previously written about the case here: http://ageorgialawyer.blogspot.com/2011/05/rakofsky-v-internet.html. The Plaintiff claimed defamation as well as negligence for some reason against many many Defendants.  

In my prior post, I asked a question to a hypothetical potential client back in 2011: If someone like the Plaintiff came to my office to discuss a possible lawsuit like this, I'd ask him/her these questions: Are you prepared - as a recent law grad trying to build a practice - to spend the next 2-5 years emotionally involved in this litigation?

Well, now we know more about this case, and more than 18 months later, the case is still sitting. It looks like at the hearing on Motions to Dismiss, the Court asked pointed questions regarding the allegations in the Complaint. It went on to ask pointed questions regarding the theories. It went so far as to suggest ramifications if one set of allegations sounding in negligence were not dismissed - and they were not. 

After the hearing in the Summer of 2011, what has happened? Well, the Court intimated that it would take action if the negligence claims were not dismissed. A letter followed from Plaintiff, noting no cases in support of a negligence theory under New York law, and ending with a note to the Judge allowing the Court to have the counts dismissed if the Court was so inclined. 

So what happens next? Nothing. For months. Until recently, when a Defendant filed a Motion for Sanctions against the Plaintiff.      

What is the lesson here for law students, business people, and even lawyers? That in anger, the threats of litigation don't turn out the way law professors might teach. It's one thing to sit on a law library, office, or starbucks and claim that in theory there has been a wrong, but in reality? 

Reality is this case - A Complaint that expands by hundreds of paragraphs, many Defendants, and a river of Motions to Dismiss. A case that has been sitting not for months, but for years. A case that - presuming it survives the pending Motions - has discovery yet to start.   A case with no trial date ever being discussed, much less set. 

Stay tuned for what happens next- but it's going to be a while.  

  



Wednesday, January 09, 2013

Aricept Lawsuit: Public Citizen Sues FDA Over Safety Of Alzheimer's Drug


A consumer group pressing the Food and Drug Administration to remove the highest dose of an Alzheimer's disease drug from the market is suing the agency for what it calls "foot-dragging."
Public Citizen  high dose has more-dangerous, potentially deadly side effects including vomiting, which in Alzheimer's patients "can lead to pneumonia, massive gastrointestinal bleeding, esophageal rupture or death." Other side effects more common at the high dose are nausea, diarrhea, anorexia and confusion.
Read more here

Yoplait Greek Yogurt Fraud Lawsuit sent to FDA


A federal judge will let the U.S. Food & Drug Administration decide whether General Mills Inc. may label its Yoplait Greek yogurt with the words "Greek" and "yogurt."
U.S. District Judge dismissed a federal lawsuit by a consumer who accused General Mills of defrauding customers. She directed both sides to take their dispute to the FDA.
More here.

Here is the opinion:

FDA reviewers: Diabetes drug may pose heart risk


Johnson & Johnson's experimental diabetes drug could bring minor heart risks because it raised cholesterol levels in patient testing, or so claim to federal drug reviewers.
According to documents released this week, FDA staffers read  studies that showed J&J's canagliflozin raised levels of LDL, or bad cholesterol. 
Several  studies did not find other serious problems, such as weakening of bones, damage to the liver or kidneys, or various cancers.
http://www.usatoday.com/story/news/nation/2013/01/08/diabetes-drug-heart-risk/1818801/

FDA Investigates Another Compounding Pharmacy


Federal regulators have quiet­ly stepped in to inspect another Massachusetts pharmacy similar to New England Compounding Center, the Framingham company blamed for the national fungal meningitis outbreak that sickened more than 660 people and killed 40.
Food and Drug Administration workers recently joined state officials, who have been conducting surprise inspections of compounders, to inspect one pharmacy because regulators determined the company’s actions fell under federal jurisdiction. 
http://bostonglobe.com/lifestyle/health-wellness/2013/01/08/fda-quietly-steps-inspect-second-massachusetts-pharmacy/jziPqpQAtMSmwkZHo8gdMK/story.html

Tuesday, January 08, 2013

J&J Faces First Vaginal Mesh Implant Trial in New Jersey


J and J will defend its produt in the first trial over its vaginal mesh implant in a case brought by a South Dakota woman who blames the product for constant pain and 18 subsequent operations.
The lawsuit by Linda Gross, 47, is the first of 1,800 in state court in New Jersey to go to trial  over whether J&J’s Ethicon unit adequately warned of the risks of the device.
Jury selection begins this week when more than 100 potential jurors began filling out questionnaires. 
The U.S. Food and Drug Administration told J&J, C.R. Bard Inc. and 31 other manufacturers last January to study rates of organ damage and complications linked to implants. Doctors implanted more than 70,000 mesh devices in U.S. women in 2010, threading them through incisions in the vagina to fortify pelvic muscles that failed to support internal organs.
http://www.bloomberg.com/news/2013-01-07/j-j-faces-first-vaginal-mesh-implant-trial-in-new-jersey.html?cmpid=yhoo




Fisher-Price Recalls to Inspect Rock 'N Play Infant Sleepers Due to Risk of Exposure to Mold: News today from the CPSC regarding infant sleepers:  


The U.S. Consumer Product Safety Commission, in cooperation with the firm named below, today announced a voluntary recall of the following consumer product. Consumers should immediately inspect this product and stop using it if mold is found. Units currently in retail stores are not included in this recall to inspect.
Name of Product: Newborn Rock 'n Play Sleeper™

Units: About 800,000 units

Importer: Fisher-Price Inc., of East Aurora, N.Y

Hazard: Mold can develop between the removable seat cushion and the hard plastic frame of the sleeper when it remains wet/moist or is infrequently cleaned, posing a risk of exposure to mold to infants sleeping in the product. The CPSC advises that mold has been associated with respiratory illnesses and other infections. Although mold is not present at the time of purchase, mold growth can occur after use of the product.

Incidents/Injuries: Fisher-Price has received 600 reports of mold on the product. Sixteen consumers have reported that their infants have been treated for respiratory issues, coughs and hives after sleeping in the product.

Description: This recall to inspect includes all Fisher-Price Rock N' Play infant recliner seats called sleepers. The sleeper is designed for babies up to 25 pounds and is composed of a soft plastic seat held by a metal rocking frame. The product has a removable, fabric cover that is sold in 14 patterns and color palettes.

Sold at: Mass merchandise stores nationwide and online since September 2009 for between $50 and $85. Units currently in retail stores are not affected by this recall to inspect. Only products that show signs of mold after use by consumers are included in this announcement.

http://www.cpsc.gov/cpscpub/prerel/prhtml13/13087.html

FDA: Glister-Mary Lee Recalls Brownie Mix Over Allergy Concerns


 Gilster-Mary Lee of Chester, Illinois is voluntarily recalling one lot of Chocolate Chunk Brownie Mix because it contains cartons containing undeclared walnuts. (Wrong packaging/cartons were used that do not declare walnuts). People who have an allergy or severe sensitivity to walnuts run the risk of serious or life threatening allergic reaction if they consume these products.
The only brand involved is Food Club Chocolate Chunk Brownie Mix packaged in cases of 12/21.5oz. Cartons have a Best By date of NOV 28 13 D02 (UPC# 36800-13486). This Best By date code is located on the corrugated case AND on the top flap of the carton. Consumers should return the product to the store or discard it.
The product was distributed to Abingdon, VA. Warehouse on December 5, 2012.
Gilster-Mary Lee became aware of the mis-packaging during an internal review. Investigation indicated that during this production run walnut brownie cartons were inadvertently exchanged with plain Chocolate Chunk Brownie cartons. No illnesses have been reported in connection with this recall.

http://www.fda.gov/Safety/Recalls/ucm334104.htm?source=govdelivery

2012 - Apps for Lawyers

Our office is on the road for depositions across the region, and for us tablets and smartphones rule the day. Here's our go to list of apps for the prior year:

1. Dropbox:  –  this app will probably always make the list because it’s such a key tool for lawyers wanting to go mobile and deliver  documents anywhere.

2.Droidlaw: While I'm partial to Google Scholar, this is a good tablet app. Search and find materials you need. 

3.Adobe Create PDF:  Allows you to convert a word doc or other document to PDF right from your tablet. (BTW, I use a XOOM). This is just another application that the iPhone can't handle. 

4.Apps that allow you to remotely log in to your desktop:  This is the one app that seems to give our office the most trouble/choices. Logmein.com works for me. We are now trying Pocketcloud Pro.  Logmein works best, and has been not only a lifesaver, but a basic tool in our lawyer toolbox. 

5.Kindle: Not just for reading and leisure time.  Amazon has a deep library of technical treatises, including medical journals, ISO papers, etc. Worth the price (free to download the app). Read a technical book on clean room technology on the way to a meeting with an expert, and never had to run to the bookstore. 

This is my partial list - and later in the month I'll write about iAnnotate, Uber, and Mobile Transcript.  
       

Monday, January 07, 2013

Matrixx Initiatives Issues Recall of One Lot of Zicam® Extreme Congestion Relief

 Matrixx Initiatives is voluntarily recalling 1 lot of Zicam® Extreme Congestion Relief nasal gel. The company is taking this step after finding a small amount of Burkholderia cepacia in a single sample of the product taken from the affected lot. The problem was detected during a routine review at the manufacturing facility.
Tests on additional samples from the same lot have shown no evidence of the organism.
Burkholderia cepacia poses little medical risk to healthy individuals. However, Burkholderia cepacia in a nasal spray could cause upper airway colonization and secondarily lead to respiratory infections in individuals with a compromised immune system or those with chronic lung conditions, such as cystic fibrosis. The organism is resistant to many antibiotics and may be difficult to eradicate in this sensitive population if an infection occurs. Matrixx has not received any reports of illness.

The product is a non-drip liquid nasal gel used as a nasal decongestant and is packaged in a 0.5 oz. spray bottle contained in an outer carton, bearing NDC number 62750-005-10. The affected Zicam® Extreme Congestion Relief lot is 2J23, Expiration 09/15. The product was distributed to retailers nationwide throughout the United States.

 http://www.fda.gov/Safety/Recalls/ucm332787.htm

FDA Recall: ConAgra Foods Recalls Andy Capp’s Hot Fries

News on a recent recall:

ConAgra Foods, Omaha, Neb., in cooperation with the U.S. Food and Drug Administration (FDA) is voluntarily recalling a limited number of packages of its Andy Capp’s Hot Fries flavor product that may contain the Andy Capp’s Cheddar Fries flavor, and, therefore, an undeclared allergen—soy. People who have an allergy or severe sensitivity to soy run the risk of serious or life-threatening allergic reaction if they consume these products. There have been no illnesses reported to date in connection with this product.
The product was shipped to retail food distributors in New Jersey, New York and Pennsylvania for distribution to retail stores in Connecticut, New York, New Jersey, Pennsylvania, West Virginia, Maryland, Delaware, and Virginia
The affected product, Andy Capp’s Hot Fries, is packaged in .85-ounce blue poly bags with an Andy Capp’s graphic logo and picture of the hot fries product on the front panel. This voluntary recall is limited only to packages of Andy Capp’s Hot Fries bearing the following UPC and Sell By date. No other Andy Capp’s products are affected.

Case UPC: 20-0-26200-47169-7
Unit UPC: 00-0-26200-47168-6
Batch Code: 5381232500
Sell By date: August 17, 2013

In the event that consumers who have purchased this product believe they may be impacted by the undeclared soy allergen, they should return the product to the store where it was purchased for a full refund. Consumers with questions about this issue may call 866-518-4177. This product is a food safety concern only for people who are allergic to soy.

The affected packages may contain the Andy Capp’s Cheddar Fries flavor. The allergen, soy, is not declared on the product lab.

 http://www.fda.gov/Safety/Recalls/ucm334243.htm?source=govdelivery

NECC Recalled Steroids - Massachusetts Plans Stricter Control of Compounding Pharmacies

As the fallout from this national tragedy continues, the State of Massachusetts is in the news regarding its belated plan to provide for better control of compounding pharmacies:

The laws will be among the strongest in the country, said Kevin Outterson, a law professor at Boston University and a member of the expert panel that advised the state on how to curb abuses by companies like the New England Compounding Center, the Framingham pharmacy that made the tainted drug responsible for the nationwide meningitis outbreak. 

The legislation would establish strict licensing requirements for compounding sterile drugs; let the state assess fines against pharmacies that break its rules; protect whistle-blowers who work in compounding pharmacies; and reorganize the state pharmacy board to include more members who are independent of the industry and fewer who are part of it. 

http://www.nytimes.com/2013/01/05/us/massachusetts-plans-stricter-control-of-compounding-pharmacies.html?_r=0

Friday, January 04, 2013

FDA issues warning over Hepatitis C drug


The Food and Drug Administration is warning patients receiving treatment for hepatitis C with a triple drug regimen using Incevik, or telepriver, to be aware of a potentially dangerous, even fatal skin reaction.
The FDA on Wednesday announced it has altered Incevik’s label to include stronger warnings after some patients died from complications after developing a serious rash while taking Incevik along with two other medications for hepatitis C.
More than 2,700 active duty service members were diagnosed with chronic hepatitis C between 2000 and 2010, according to Pentagon data.
The Veterans Health Administration system has 170,000 patients with chronic hepatitis C, and more than 4,800 VA patients are receiving some kind of combination drug therapy for Hepatitis C.

http://www.marinecorpstimes.com/news/2012/12/military-hepatitis-C-drug-warning-122012w/

UPDATED: FDA suggests ‘widespread contamination' at Cantaloupe Facility

Four months after inspecting the farm, Food and Drug Administration officials suggested that the owner of Chamberlain Farm Produce Inc. check his operation for “a source of wide-spread contamination” in relation to a salmonella outbreak that sickened 261 and killed three in 2012.

http://www.thepacker.com/fruit-vegetable-news/FDA-suggests-widespread-contamination-at-Chamberlain-Farms-185555432.html

FDA sends out warnings of unapproved Botox


A Canadian supplier has distributed unapproved Botox which could turn out to be "counterfeit or unsafe," according to the U.S. Food and Drug Administration.
The FDA sent out warning letters in December to more than 350 medical practices alerting them of danger, the Associated Press said. The letter noted that batches of the popular wrinkle treatment drug shipped by the pharmacy Canada Drugs haven't been approved by the federal agency. It added that Canada Drugs was also accused of shipping unapproved and counterfeit versions of the cancer drug Avastin in the past, the AP said.

http://www.bizjournals.com/tampabay/blog/morning-edition/2012/12/fda-sends-out-warnings-to-unapproved.html

Wednesday, December 12, 2012

Despite FDA Warning, Sports Supplements Still Available Online: Study

DMAA sports supplements have been linked to at least two deaths and the U.S. Food and Drug Administration sent warning letters to 10 manufacturers last spring about a lack of data on their safety, but a new study finds these supplements can still be purchased online.

DMAA (dimethylamylamine) is a pre-workout supplement used by athletes to build muscle. Some research suggests that it may narrow blood vessels, which can elevate blood pressure, and may set the stage for a heart attack. Canada and the U.K have banned DMAA from all supplements.

Now, a small study published online Dec. 3 in the Archives of Internal Medicine reports that all 16 of the products mentioned in the FDA’s warning letters are still available through online retailers.
It’s good to know that the FDA is right on top of enforcement.

From the Journal:
The stimulant DMAA, also known as 1,3-dimethylamylamine, has been the subject of much controversy.1 In the United States, it is currently marketed as a dietary supplement, primarily in products promoted as a preworkout supplement for boosting strength, energy, and power. Two of the most prominent supplements containing DMAA are “Jack3d” and “OxyELITE Pro” (USP Labs) However, there are over 250 commercial dietary supplements containing DMAA on the market.2
http://health.usnews.com/health-news/news/articles/2012/12/03/despite-fda-warning-sports-supplements-still-available-online-study

Tuesday, December 11, 2012

Do Valium, Ativan, Xanax, Klonopin and Restoril Increase Pneumonia Risk?

ome studies have shown that benzodiazepine sedatives — including such drugs as Valium, Ativan, Xanax, Klonopin and Restoril — may increase susceptibility to infection. Might this risk extend to pneumonia?

THIS STUDY analyzed data on 34,661 people of all ages, including 5,895 who took benzodiazepines and 4,964 who developed pneumonia. People who took benzodiazepines were 54 percent more likely to have later contracted pneumonia than those who did not take the sedating drugs. Chances of dying were also greater among those who took benzodiazepines: 22 percent higher within 30 days of contracting pneumonia and 32 percent higher within about three years.

WHO MAY BE AFFECTED? People who take benzodiazepines. Commonly prescribed for anxiety and insomnia, the drugs are also used to relieve muscle spasticity, prevent seizures, calm agitation, sedate patients before surgery and ease alcohol withdrawal.

 http://www.washingtonpost.com/national/health-science/popular-sedatives-may-raise-risk-for-pneumonia-a-study-says/2012/12/10/57c01042-6a25-11e1-acc6-32fefc7ccd67_story.html

Does Alli Cause Liver and Kidney Damage?

Orlistat, which goes by the prescription brand name Xenical and the over-the-counter name Alli, can cause “severe toxicity” to major internal organs, says a recent study. .

The research results obtained by pharmacology professor Bingfan Yan were worrying enough that he immediately reported the results to the FDA, which approved orlistat in 1999.

Liver and kidney damage are serious enough, but the report had another finding that orlistat’s metabolic action reduces the effectiveness of many medications, including life-saving cancer treatments. In fact, the researchers reported that cancer cells multiplied faster under the influence of orlistat. Orlistat also boosts the anti-clotting effects of aspirin, raising the risk of bleeding both internal and external.


 http://www.sciencedaily.com/releases/2012/12/121210145234.htm?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+sciencedaily+%28ScienceDaily%3A+Latest+Science+News%29&utm_content=Google+Feedfetcher

http://www.forbes.com/sites/melaniehaiken/2012/12/10/popular-weight-loss-drug-may-cause-liver-failure/

Saturday, December 08, 2012

December 7, 2012: NECC Tainted Steroid Medication Update

Our firm filed a Motion to Inspect the NECC facility. The FDA issued an inspection report, and in it there are observations of the New England Compounding Facility. A number of issues will be part of the litigation, including the "Clean Room" where the recalled products were made.  

Here's a virtual clean room, put together by Purdue:





Generally found in hospitals and home health care companies, the rooms are used to prepare drugs, intravenous drips, syringes, chemotherapy treatments and the like, especially those administered directly into the bloodstream—a factor that makes vital the use of a clean room and proper clean-room procedures. Concern over the rise of antibiotic-resistant pathogens has only increased the need for such expertise.

Why this matters in the New England  Compounding Pharmacy litigation: Access, production, and preparation all will be analyzed to determine if this tragedy could have been prevented if the clean room was operated the right way. 

Talk to our law firm if you were harmed by a medication made by NECC. 

Thursday, December 06, 2012

Recall Notification of Life Pulse High-Frequency Ventilator Patient Circuits


Bunnell Incorporated will voluntarily initiate a nationwide recall notification of Life Pulse High-Frequency Ventilator Patient Circuits. A complete list of Lot numbers affected by the recall is identified in the recall notice and on Bunnell’s website,  www.bunl.com.
The product has been found to have heater wire insulation that can melt, causing sparking and smoke close to the humidifier cartridge.  There have been 12 reported failures out of 5,771 Patient Circuits distributed.  There have been no reports of patient injury or death.  However, out of an abundance of caution Bunnell wants clinicians to be aware of the potential that a Patient Circuit failure could result in patient injury or death.
Bunnell is working with the U.S. Food and Drug Administration to resolve this issue.
Bunnell will notify customers via certified mail and will post the recall notification and other important information at www.bunl.com.

http://www.fda.gov/Safety/Recalls/ucm330842.htm

FDA vegetarian meat recall: Veggie Patch – The Ultimate and Falafel

News from the FDA on this recall:


EGGIE PATCH® is voluntarily recalling two products --The Ultimate Meatless Burger and Falafel-- due to a risk of contamination with Listeria monocytogenes.  Listeria monocytogenes is an organism that can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems.  Although healthy persons may suffer only short-term symptoms such as high fever, severe headaches, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths in pregnant women.
The Ultimate Meatless Burger and Falafel, from VEGGIE PATCH, with the specific use-by dates and UPC codes listed below were distributed to a select number of retailers and distributors.
  • 9-ounce trays of refrigerated, fully cooked, VEGGIE PATCH, The Ultimate Meatless Burger with a Use-By date, Jan/12/2013; UPC code 6-10129-00211-5 (which can be found on back of package)
  • 9-ounce trays of refrigerated, fully cooked, VEGGIE PATCH, Falafel with a Use-By date, Jan/15/2013; UPC code 6-10129-06619-3 (which can be found on back of package)
The Ultimate Meatless Burger potentially affected was available for sale as of November 21, 2012, in the following states; NY, CT, PA, FL, IL, MD, IN, WI, VA, NJ and DE.  Falafel potentially affected, was available for sale as of November 21, 2012, nationwide.
No illnesses have been reported to date.  VEGGIE PATCH discovered this issue as part of its routine testing of its products.
Consumers who purchased any product with the specific use-by dates and UPC codes listed above are asked to dispose of the product. They should email contactus@veggiepatch.com to arrange for a full refund.  The recall affects only these two items. Products that do not contain the specific use-by dates and UPC codes listed are not affected by the recall.  No other VEGGIE PATCH products or other use-by dates of The Ultimate Meatless Burger or Falafel are affected by this recall.  Frozen Veggie Patch products are not affected by this recall.

Monday, December 03, 2012

Do NFL Players use Viagra to Enhance Performance?

NFL  wide receiver Brandon Marshall says he's heard of some NFL players using the drug to improve athletic performance — on the field. One benefit of Viagara and similar drugs would be the enhanced delivery of oxygen to the muscles, which also aids in hastening the body's recovery from workouts. The drug also counteracts impotence, a frequent side-effect of steroid usage.



http://msn.foxsports.com/nfl/story/nfl-players-viagra-brandon-marshall-performance-enhancing-drug-112912