Pradaxa Lawsuit News

March 8th, 2012

Pradaxa Lawsuit News - 2/29/2012: Did you take Pradaxa? Please contact us today if you took Pradaxa and later experienced harmful side effects. We will connect you with a lawyer that is experienced in complex litigation that may be able to help you recover monetary damages.

Pradaxa Lawsuit: Intracerebral hemorrhage (ICH) accounts for 10-15% of all strokes. Primary ICH occurs when small intracranial vessels are damaged by chronic hypertension (HTN) or cerebral amyloid angiopathy (CAA), and accounts for 78-88% of all ICH. The incidence of ICH worldwide ranges from 10 to 20 cases per 100 000 population and increases with age. Certain populations, in particular, the Japanese and those of Afro-Caribbean descent, have a heightened incidence of 50-55 per 100 000 that may reflect a higher prevalence of HTN and/or decreased access to healthcare. The incidence of hemorrhage increases exponentially with age and is higher in men than in women. Neurologic deficits from ICH reflect the location of the initial bleeding and associated edema. In addition, seizures, vomiting, headache, and diminished level of consciousness are common presenting symptoms. A depressed level of alertness on initial evaluation occurs infrequently in acute ischemic stroke (AIS) but is seen in approximately 50% of patients with ICH.

Pradaxa Lawsuit: Spontaneous, or non-traumatic, ICH has a much poorer outcome than AIS.1 There is a 62% mortality rate by 1 year, and only about 20% of survivors are living independently by 6 months. About half of the deaths due to ICH over the first 30 days will occur within the first 2 days, largely from cerebral herniation. Later, mortality is more commonly due to medical complications, such as aspiration pneumonia or venous thromboembolism. By far the most important modifiable risk factor for spontaneous ICH is HTN. Primary hypertensive hemorrhage results from the rupture of small penetrating arteries originating in the anterior, middle (i.e., articulateness), and posterior cerebral (i.e., thalamostriate) arteries and the pons (i.e., paramedian perforators) (1.3). HTN causes vessel rupture at or near the bifurcation of affected vessels, where degeneration of components of the arterial wall (media and smooth muscle) are identified. The annual risk of recurrent hemorrhage is 2% without antihypertensive treatment.

Pradaxa Lawsuit: Cerebral amyloid angiopathy. This multiloculated, oparietal region (left)lobar lesion seen on non-contrast head CT scan (A), started in the right front and by the next day (right), developed extensive intraventricular involvement, subfalcine herniation with right-to-left shift, and a subarachnoid component. The hyperdense finding in the frontal horns is an intraventricular catheter (arrowhead). Macropathology: lobar hematoma, with adjacent edema (B). Note the midline mass effect on and compression of the adjacent lateral ventricle (arrows). Micropathology: amyloid angiopathy, demonstrated by deposits within the vessel wall of an acellular, eosinophilic material (hematoxylin and eosin (H&E) stain) (C, 40x; D, 100x; arrows). The amyloid material exhibits a fluorescent green birefringence under polarized light (thioflavin S stain, 100x) (E). Illicit drug use and coagulopathic disorder are associated with an increased risk of ICH. Over-the-counter stimulants, particularly if taken in excessive quantities, may predispose to ICH (case study 1). A large case-control study associated phenylpropanolamine use with ICH in young patients.Up to 70% of patients with primary ICH develop some measurable amount of lesion expansion over the initial few hours.Hematoma growth is an independent determinant of both mortality and functional outcome after ICH.

Pradaxa Lawsuit

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Pradaxa Lawsuit News

March 8th, 2012

Pradaxa Lawsuit

: By far the most important modifiable risk factor for spontaneous ICH is HTN.Primary hypertensive hemorrhage results from the rupture of small penetrating arteries originating in the anterior, middle (i.e., lenticulostriate), and posterior cerebral (i.e., thalamostriate) arteries and the pons (i.e., paramedian perforators). HTN causes vessel rupture at or near the bifurcation of affected vessels, where degeneration of components of the arterial wall (media and smooth muscle) are identified. The annual risk of recurrent hemorrhage is 2% without antihypertensive treatment. A hematoma incites local edema and neuronal damage in the adjacent brain parenchyma. This edema typically increases in size over an interval as long as 3 weeks following the initial bleeding, with the greatest growth rate over the first 2 days. Thrombin within the hematoma plays a central role in promoting perihematomal edema. Hemoglobin and its products, heme and iron, are potent mitochondrial toxins, thereby increasing cell death.

Pradaxa Lawsuit: Hemorrhage may dissect from the brain parenchyma into the adjacent ventricular space, carrying a poor prognosis, Hemorrhage may also be isolated to the intraventricular space,and lesions can expand substantially by rupturing into the ventricular system. Ventricular involvement may cause obstructive hydrocephalus and can result in long-term cognitive impairment.

Pradaxa Lawsuit: Significant clinical deterioration associated with PH is known as ‘symptomatic hemorrhage, an important outcome measure in acute stroke treatment. One common definition for symptomatic hemorrhage is a clinical deterioration of >4 points on the National Institutes of Health Stroke Scale (NIHSS) associated with hemorrhage seen on CT scan. Various predictors for symptomatic hemorrhage include hyperglycemia, concur­rent heparin use, the timing of successful recanalization, a history of diabetes and cardiac disease, leukoariosis, early signs of infarct on CT scans, and elevated pretreatment mean blood pressure. Neurosurgical evacuation typically is not a helpful treatment for symptomatic hemorrhage, because the lesion is frequently large and multifocal. Extra-ischemic hematomas are: located remotely from the initial ischemic stroke lesion; may be isolated or multifocal, with or without mass effect (1.17);23 and associated with concurrent coagulopathy and previously occult vasculopathies, such as CAA, microhemorrhages, or hypertensive vasculopathy. In the NINDS (National Institute of Neurological Disorders and Stroke) trial of IV t-PA for AIS, the incidence of extra-ischemic cerebral hematomas was 1.3%.

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Pradaxa Lawsuit News

March 8th, 2012

Pradaxa Lawsuit

: Venous occlusive intracranial disease is associated with oral contraceptive use the immediate post-partum period, and a wide range of hypercoagulable medical conditions. Significant cerebral venous thrombosis involves one or more of the major venous sinuses and typically results in parenchymal hemorrhage. By definition, the territories of the ischemic and hemorrhagic lesions are in a venous, rather than arterial, distribution. Involvement of the deep venous system (case study 3) carries a much worse prognosis than if only the superficial sinuses and/or cortical veins (1.20) are involved. Magnetic resonance venography (MRV) is commonly used to identify major venous sinus occlusions.

Pradaxa Lawsuit: The single mandated indication for neurosurgical decompression is cerebellar hemorrhage. Early craniotomy, prior to brainstem compression, is critical. The best surgical candidates are patients with an initial GCS <14 and hematoma volume >40 ml, while those with higher GCS and smaller lesions are likely to have a good outcome with conservative, non-surgical management. Neurosurgical evacuation of clot in primary hemispheric ICH has had mixed results in randomized and non­randomized clinical trials. The leading study, I-STICH (International Surgical Trial in Intracerebral Haemorrhage), identified neutral outcomes for early evacuation. Nonetheless, a role for neurosurgical decompression to reduce clot size may exist in highly selected patients, particularly younger patients (e.g., <60 years old) who have cerebellar hemorrhage, treated with neurosurgery. Head CT scan shows a large, primary ICH based in the cerebellar vermis, causing effacement of the basal cisterns around the pons and early obstructive hydrocephalus, with markedly enlarged temporal horns (arrows) (A). The patient underwent emergent craniotomy over the next few hours, and subsequent CT scan the following day (B) shows recovery of basal cisterns, reduction in ventricular size, and a pocket of air in the left cerebellar hemisphere (arrowhead), with some edema in the left middle cerebellar peduncle. Note the craniotomy defect from the left suboccipital approach.

Pradaxa Lawsuit: Less invasive surgical interventions, such as catheter-based clot aspiration or thrombolysis, are being studied. Intraventricular ICH may contribute to elevated intra­cranial pressure (ICP) by causing obstructive hydrocephalus. The amount of ventricular blood to cause hydrocephalus need not be great (1.22). In this setting, external drainage of cerebrospinal fluid via ventricular catheter may be indicated to reduce ICP.

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Pradaxa Lawsuit News

March 8th, 2012

Pradaxa Lawsuit:

Commonly considered agents: beta-blockers (labetalol, esmo­lol), calcium channel blockers (nicardipine), angiotensin con­verting enzyme (ACE) inhibitors (enalapril), and hydralazine. Other agents such as nitroprusside are effective as second-line options but carry the risk of significant vasodilation.Mass effect causing significant elevation of ICP, with the risk for cerebral herniation syndromes, may be managed emergently with osmotic agents, such as mannitol and/or hypertonic saline, and hyperventilation.However, these approaches have never been formally studied in clinical trials. Seizures occur in 10% of patients with primary ICH, usually at onset or within the initial 24 hours, and reflect cortical involvement of the lesion.

Pradaxa Lawsuit:Anticonvulsant agents are empirically recommended for patients with significant hematomas in peripheral territories in the cerebral hemispheres. The appropriate duration of anticonvulsant use has not been established. For patients who are seizure- free, guidelines suggest discontinuation of the anti-epileptic drug after the first month post-hemorrhage. Neurointensivist management of ICH in an intensive care unit (ICU) setting may improve patient outcomes.

Pradaxa Lawsuit: News and Information from related Sources

Pradaxa Lawsuit: Various clinical trials, including SHEP (Systolic Hypertension in the Elderly Program)and PROGRESS (Perindopril Protection Against Recurrent Stroke Study), have documented the critical role of antihypertensive agents in both primary and secondary stroke prevention of ICH. The JNC-7 report (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) provides an extensive overview of the role of HTN in stroke risk, specific drug classes, lifestyle modifications, and target blood pressures. In general, lower blood pressures are associated with a proportional reduction of recurrent stroke and stroke mortality.

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Pradaxa Lawsuit News

March 8th, 2012

Pradaxa Lawsuit

: By far the most important modifiable risk factor for spontaneous ICH is HTN.Primary hypertensive hemorrhage results from the rupture of small penetrating arteries originating in the anterior, middle (i.e., lenticulostriate), and posterior cerebral (i.e., thalamostriate) arteries and the pons (i.e., paramedian perforators). HTN causes vessel rupture at or near the bifurcation of affected vessels, where degeneration of components of the arterial wall (media and smooth muscle) are identified. The annual risk of recurrent hemorrhage is 2% without antihypertensive treatment. A hematoma incites local edema and neuronal damage in the adjacent brain parenchyma. This edema typically increases in size over an interval as long as 3 weeks following the initial bleeding, with the greatest growth rate over the first 2 days. Thrombin within the hematoma plays a central role in promoting perihematomal edema. Hemoglobin and its products, heme and iron, are potent mitochondrial toxins, thereby increasing cell death.

Hemorrhage may dissect from the brain parenchyma into the adjacent ventricular space, carrying a poor prognosis, Hemorrhage may also be isolated to the intraventricular space,and lesions can expand substantially by rupturing into the ventricular system. Ventricular involvement may cause obstructive hydrocephalus and can result in long-term cognitive impairment.

Significant clinical deterioration associated with PH is known as ‘symptomatic hemorrhage, an important outcome measure in acute stroke treatment. One common definition for symptomatic hemorrhage is a clinical deterioration of >4 points on the National Institutes of Health Stroke Scale (NIHSS) associated with hemorrhage seen on CT scan. Various predictors for symptomatic hemorrhage include hyperglycemia, concur­rent heparin use, the timing of successful recanalization, a history of diabetes and cardiac disease, leukoariosis, early signs of infarct on CT scans, and elevated pretreatment mean blood pressure. Neurosurgical evacuation typically is not a helpful treatment for symptomatic hemorrhage, because the lesion is frequently large and multifocal. Extra-ischemic hematomas are: located remotely from the initial ischemic stroke lesion; may be isolated or multifocal, with or without mass effect (1.17);23 and associated with concurrent coagulopathy and previously occult vasculopathies, such as CAA, microhemorrhages, or hypertensive vasculopathy. In the NINDS (National Institute of Neurological Disorders and Stroke) trial of IV t-PA for AIS, the incidence of extra-ischemic cerebral hematomas was 1.3%.

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Birth Defects Class Action Lawsuit

November 28th, 2011

Birth Defects Class Action Lawsuit

THYROID-ACTING AGENTS 465 not inducing developmental defects in guinea pigs and rabbits, the chemical did affect the thyroid in these species, causing atrophic thyroids and pituitaries in the former (Peterson, 1953) and goiter in the latter (Isono, 1960). Triatricol induced cardiac muscle malformations in rats that were elucidated by electron microscopy (Hawkey et al., 1981). Of the antithyroid compounds, only the substituted thiouracil agents, but not thiouracil itself, were teratogenic in animals (see Table 14-1). Methyl thiouracil induced eye defects in rats (Langman and vanFaassen, 1955), clubfoot in mice (Miyamoto, 1967), and brain and cardiovascular anomalies In chinchillas (Klosovskii, 1963). Only thyroid effects were obsen’ed in rabbits (Toriumi, 1959) and guinea pigs (Hagemann, 1955). Propylthiouracil caused loss of hearing in mice (Deol, 1973); three other species exhibited thyroid lesions only. Metbimazole had no teratogenic activity in the rabbit, but postnatal behavioral alterations have been described in both mice (Rice et al., 1987) and rats (Comer and Norton, 1982) from low-dose prenatal administration.

The former species is, in fact, a suitable model for behavioral test validation with this drug (Rice et al., 1987). 2′-Thiourea, given as a 0.2% aqueous solution ad lib to rats on gastation days 1-14 induced a wide variety of severe malformations (Kern et al, 1980). Notably, no congenital defects were obsen’ed with either thiouracil itself or iothiouracil. Virtually all of the antithyroid agents have shown the capacity to induce fetal goiter in animals, as would be expected. Sheep grazing on certain range plants manifested congenital goiter in an

older report (Sinclair and Andrews, 1958), presumably by ingestion of goitrogenic substances of unknown composition.

Several reports have been published that associate human use of thyroid drugs during pregnancy with congenital malformation. With thyroxinc, eye defects were observed in an infant after treatment

of the mother during gestation (Mayer and Hemmcr, 1956). Medication with this drug was also considered to be a risk factor for limb defects among ]08 cases analyzed (Polednak and Janerich,

1985). Heinonen and colleagues (1977) reported a suggestive association with cardiovascular malformations among some 537 women medicated during pregnancy with thyroxine. No further associations

with malformation have occurred with this drug in recent years, and reports of some 75 pregnancies found no increased incidence of birth defects (Harris and Podolsky, 1969; Pekonen et al.,

1984). With thyroid (extract), multiple defects were obsen’ed in a child whose mother received only one treatment with the drug, but drug therapy also included several other drugs (Degenhardt, 1968).

According to another publication, a child with unspecified defects was bom to one of five mothers who were taking thyroid extract during pregnancy (Castellanos, 1967). Two more cases of malformation

were reported from treatment with desiccated thyroid: one infant had central nervous system birth defects and the other had Down syndrome (Man et al., 1958). Some 22 normal births were reported with exposure to thyroid in one publication (Harris and Podolsky, 1969). In addition to the biological effect on the thyroid (see later discussion), a number of case reports have associated antithyroid drugs with the production of serious structural congenital malformations. MaiernaJ hyperthyroid status may be one of the factors involved in ihe etiology of malformations; thyroxin-binding globulin values were significantly lower at the I5th-16th weeks of pregnancy among women giving birth to infants with birth defects  172 cases (Sparre, 1989).

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Criminal Lawyers in San Antonio

January 6th, 2010

Criminal Lawyers in San Antonio

By: Dr Michael Eades

October 2008

Criminal Lawyers in San Antonio : I’m putting this post up today and leaving it throughout the weekend because I believe it is so important that everyone watch the videos at the bottom.

These long must-watch videos are in two parts: the first part is by a defense attorney discussing the unbelievable complexity of the law, especially federal law, and the difficulty of simply going through life without knowingly or unknowingly breaking some kind of law.  And he discusses the dangers of talking to the police without a lawyer present.  The second part is a talk by a police detective confirming everything the attorney says and, fascinatingly, discussing his own tricks, learned in over 25 years of police work, to get people to talk to him and even to confess to crimes.

I’ll probably alienate any readers who are involved in law enforcement, which isn’t my intention.  I’m sure that if any law enforcement officials were suddenly under investigation, they wouldn’t say a word without their lawyer present.  The rest of us need these same protections.

I’m not presenting these videos for any criminals who may be reading, but for the average citizen who happens to get crosswise with the police.  Every single police officer I know (and I know a half dozen or so) are hard working, dedicated, responsible, and even kind-hearted folks, but they can make mistakes.  I make mistakes, so I figure they can too.  The officer speaking on the last part of this video says that he doesn’t really interrogate people that he doesn’t think are already guilty.  So, you are basically assumed guilty if you’re under investigation for whatever.  And if the officer is mistaken, you can be in real trouble.  You can’t talk your way out of it; you can only make it worse.  When you watch these videos, you’ll see what I mean.

Martha Stewart spent six months in a federal prison not because she did anything wrong during her alleged insider trading, but because she lied to a federal official.  And it’s easy to lie unintentionally.  Let me give you an example.

When MD and I lived in Little Rock after we had gone into practice, we lived in two different houses.  In the first house, I played a practical joke on her brother out on the front porch that we’ve all laughed about for years.  The joke involved a wallet MD’s dad had left at our house that her brother was coming by to pickup to take back to her father. (The joke involved inside family information and wouldn’t make sense if I described it.  But it was hilarious – to me anyway.  I’m sure her brother may not have felt the same way about it.  Come to think of it, he never came around much after that.)  MD’s father died a couple of years later, and a year or two after that, MD and I moved into the house we lived in for the last 15 years we were in Little Rock.  Not long ago, MD was telling someone visiting from Little Rock about this joke.  As I listened, it dawned on me that MD was telling this story as if it had happened at the last house we lived in.  Later I asked her about where she thought we lived when this happened.  She said ‘on Riverview Point’ (the last house, #2 Riverview Point).  I told her that it had happened in the previous house.  She told me that I was crazy and that I should know better by now than to question her memory.  (She’s right.  She has a unbelievably phenomenal memory.  Probably the best I’ve ever been around.  Whenever I question it, I am almost invariably wrong.  So I seldom question it any longer.)  She said she remembered her brother coming to the door, the joke, and us laughing about it in the Riverview Point kitchen.  I then told her that it couldn’t have happened in the Riverview Point house because her dad had died before we ever moved there.  After a long pause, she said, I know you have to be right, but I remember so clearly that all happening on Riverview Point.

The above story is a benign example of the kind of misremembering that we all have done.  But what if MD were being questioned by the police about the incident and she swore it happened on Riverview Point?  When she would be found to be wrong, it would look like she were intentionally lying.  And if she did so to a federal investigator, she could go to prison.  Remembering incorrectly and lying are two different things, but it’s easy for law enforcement officials trying to make a case to believe that a flaw of memory is an intentional lie. Especially if spoken with authority.

The tragic Jon Benet Ramsey murder took place right after MD and I had moved to Boulder, CO, so we were keenly aware of all that went on with that. Living in Boulder, you couldn’t avoid it. I’ve driven a hundred guests by the Ramsey house, which, by the way, isn’t a mansion as was reported by virtually all the national media, as in ‘the Ramsey mansion.’  It’s smaller than our house, which certainly isn’t a mansion.  The Ramsey house is an upper middle-class house in an upper middle-class neighborhood that sits cheek by jowl with all the other such houses on the street.  There isn’t 30 feet between adjacent houses on the Ramsey’s street, which is certainly not the case for mansions, at least not as I think of mansions.

As I’m sure everyone remembers from the constant media exposure, the Ramsey family wouldn’t speak to the police without their attorney present.  Everyone (including yours truly) figured that one of the Ramsey’s (probably the son) had committed the murder, and that the Ramsey’s were protecting the guilty family member.  Why else wouldn’t they speak with the police?  They were smart.  They did just what the lawyer in this video recommends for all the reasons he recommends.  And it saved their bacon.  I believe that the Boulder police believed that one of the Ramsey’s were guilty, and the Boulder police were under huge pressure to solve the crime.  But the police could never get any traction in the case because of the Ramsey’s attorney.  Had the Ramsey’s spoken freely with the police, one of them may well have been charged with the crime simply because of a slip of the tongue.  A misremembrance that the police categorized as a lie.  As it turns out, DNA evidence has recently exculpated the Ramseys.  But at the time, they were in peril because public opinion had it that one of them was guilty.  And I’m sure the police were predisposed to charge them.

Most clever career criminals know to never speak to the police without an attorney.  The stupid criminals don’t make it long as criminals before they’re locked up.  It’s the non-criminals, the category into which I hope most readers of this blog fall, who need the protections these videos describe.  Don’t think your smart enough or clever enough to intellectually steamroll over an investigator.  They are very, very good at what they do.  It’s their world, and you are totally a fish out of water in that world.

Watch and learn.  I hope you never need the lessons from these videos, but if you do, you’ll be glad you took the time to watch.  Plus, it’s entertaining.  Both speakers are excellent in completely different ways.

In Part I of the 2 video series, Mr. James Duane, a professor at Regent Law School and a former defense attorney, tells you why you should never agree to be interviewed by the police.

http://www.proteinpower.com/drmike/tutorials/never-talk-to-the-police-without-an-attorney/#

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Criminal Defense Lawyers in San Antonio

January 6th, 2010

Criminal Defense Lawyers in San Antonio

Criminal Defense Lawyers in San Antonio and DWI: Getting a DWI in San Antonio, Texas carries severe penalties and with new Texas laws, your rights as a DWI suspect have decreased.  If you have been charged with a DWI you should immediately consult an experienced Criminal Lawyer in San Antonio.

Prior to September 2009, a police officer could not forcibly get breath or blood sample from a suspect without first obtaining a warrant. However, that changed when MADD successfully helped to get a new law passed that gives law enforcement officials much broader power in obtaining breath and blood samples.

This new law is not all encompassing and certain conditions must be met before a police officer can act without a warrant.  You are not in the position to determine if the law was correctly applied and need the advice of a criminal lawyer that is experienced with DWIs in San Antonio. Test results might be inaccurate if a sample was not correctly obtained or stored. This and other important issues need to be examined on your behalf by a Criminal Lawyer.

A DWI conviction can to the loss or restriction of your driving privileges, increased insurance rates and possibly even imprisonment. Only you can assure that your defense is adequate by contacting a San Antonio Criminal lawyer.

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San Antonio Criminal Lawyer

January 6th, 2010

San Antonio Criminal Lawyer

San Antonio Criminal Lawyer: San Antonio, like most cities, has its share of Lawyers. Not all of the lawyers in San Antonio are Criminal Lawyers. There are many reasons for consulting an attorney. Your issue may be civil and not involve the Criminal System at all. In this case you do not need a San Antonio Criminal Lawyer.

If however, you have or are, going to be charged with a Criminal offense, you must have a Lawyer in San Antonio that specialized in Criminal Law.  San Antonio Criminal Lawyers are experts in the criminal codes of both your local city and county codes as well as the laws of the State of Texas.  A  San Antonio Criminal Lawyer will also be familiar with the prosecutors and judges that work with San Antonio’s Criminal cases. This is a very important distinction in San Antonio Criminal Lawyers as opposed to a lawyer in San Antonio that practices general law.

Getting the right defense when you are facing the Criminal Justice system is paramount. The outcome of your case as well as the quality of your future depends on calling a San Antonio Criminal Lawyer immediately.

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San Antonio Criminal Defense Lawyer

January 6th, 2010

San Antonio Criminal Defense Lawyer


San Antonio Criminal Defense Lawyer: For some reason, the general public in San Antonio and all over the US, seem to think that if you have been charged with a crime that you believe you are not guilty of, you do not need a Criminal Lawyer. Nothing could be farther from the truth. In fact, The Criminal Lawyers are there to defend all of San Antonio’s citizens. Criminal complaints can arise in a number of ways. A police officer may witness what he/she believes to be a crime. A complaint may come from another person in San Antonio or the potential charge may be the result of an ongoing investigation.  Innocence or guilt must not be the determining factor when calling on the assistance of a San Antonio Criminal Lawyer.

If you have been charged with a crime or believe that you are about to be charged, you should call a San Antonio Criminal Lawyer immediately. The expertise of a San Antonio Criminal lawyer is very specific and vital to the outcome of your case. The sooner you get your Criminal Lawyer on your side and mounting your defense, the better off you will be.  Remember, laws can be very complicated. Even if there is a possibility of guilt, it may be that your charge is incorrect and can be reduced or done away with altogether. Without a San Antonio Criminal Lawyer, you will most certainly be in a very weak position with an issue that can affect the rest of your life.

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