Similar to amalgam claims .....Re: CDC recommendations for DENTISTRY, Fen-Phen patients

From: Joel M. Eichen (joeleichen_at_yahoo.com)
Date: 03/24/05 

Date: Thu, 24 Mar 2005 04:44:39 -0500

The latest study

"In contrast to some previous reports, we found no evidence of a high
rate of valvular disease among people who took fen-phen," said Dr.
Burger. The Beth Israel study followed 226 people who took the drug
combination for as long as 30 months. Patients also were in a program
of diet, exercise and behavior modification. All subjects stopped
taking the diet drug cocktail after the risk of heart valve defects
was announced to the public.

R E P L Y

I am draweing analogies between Fen-Phen where some people were
harmed, so it seems, and amalgam toxicity as it is known, where no
people are harmed.

Still, in our legal system, we are at risk. I can imagine Jan Drew and
her colleagues one day in court over issues like this.

Joel

* * * * *

On Wed, 23 Mar 2005 18:08:21 -0500, Joel M. Eichen
<joeleichen@yahoo.com> wrote:

>http://www.pronational.com/news/denrprtr/Fenphen-0698.htm
>
>Fen-Phen Litigation......Picking Up Steam
>By Theodore Passineau, J.D., ProNational Senior Health Care Advisor
>
>Not since the breast implant cases of the late 1980s and early 1990s
>has there been such a flurry of legal activity associated with a
>particular form of medical treatment. The weight reduction drugs
>commonly known as Fen-Phen, fenfluramine (or its sister drug,
>dexfenfluramine) and phentermine, have made their way into headlines
>and courtrooms. With over 18 million prescriptions having been written
>to an estimated 6 million Americans, the potential for litigation
>related to heart and lung damage is significant.
>
>The controversy began to take shape in August of 1997 when The New
>England Journal of Medicine (NEJM) reported the potential for heart
>valve problems and/or pulmonary hypertension resulting from the use of
>fenfluramine and phentermine in combination. While each drug had been
>approved by the FDA for use individually, the use of the medications
>in combination had never been approved. There were reports of
>cardiac-related problems in as high as 32 percent of the users of
>these combined medications. Subsequent reports have suggested
>cardiac-related problems with the use of fenfluramine or
>dexfenfluramine alone.
>
>The usual defendants in these cases are the pharmaceutical companies
>who manufactured the medications and the physicians who prescribed
>them. Several cases have been brought as class actions in federal
>court (and are being consolidated into one federal court case in
>Philadelphia); others have been brought as state class actions. In
>addition, many individual suits are being filed in state courts. It is
>expected that, in time, cases will have been filed in all 50 states.
>
>The Fen-Phen controversy is also important for dentists. Whenever a
>condition is associated with increased risk of subacute bacterial
>endocarditis, such as cardiac valvulopathy, the dentist must take
>appropriate prophylactic measures prior to initiating treatment.
>Prophylactic measures begin with identifying the potentially dangerous
>condition.
>
>In 1992, a ProNational study of office practices found that
>approximately 94% of general dentists use a patient-completed health
>history form. This is an excellent means of gathering essential
>clinical historical information. Health history forms should now be
>amended to include a question that asks whether the patient has ever
>taken prescription weight-reduction drugs. (Don't depend on the
>patient to recognize the names of these drugs.) If a positive response
>is elicited, you should determine the exact medications taken.
>
>Before treating a patient who has taken Fen-Phen or fenfluramine
>products alone, the CDC (Centers for Disease Control) guidelines
>should be consulted. (See guidelines below.) Additionally, you should
>be familiar with the American Dental Association's recommendations,
>which are listed below.
>
>Because dentists weren't involved in the prescribing of Fen-Phen or
>fenfluramine products, professional liability exposure for dentists
>should be very limited. However, inattention to the possibility of SBE
>(subacute bacterial endocarditis) as a result of previous use of diet
>medications is one way that members of the dental community could be
>drawn into the Fen-Phen debate. Conscientious history taking and
>recording and adherence to the CDC guidelines and ADA recommendations
>should eliminate this potential.
>
>You may call ProNational's Risk Management Department at 800/292-1036
>for further information on issues related to the prescription of
>Fen-Phen or fenfluramine products.
>
>CDC Recommendations Regarding Fen-Phen
>
>
>1. All persons exposed to fenfluramine or dexfenfluramine, for any
>period of time, either alone or in combination with other agents,
>should undergo a medical history and cardiovascular examination by
>their physician to determine the presence or absence of
>cardiopulmonary signs or symptoms.
>
>2. An echocardiographic evaluation should be performed on all
>persons who were exposed to fenfluramine or dexfenfluramine for any
>period of time, either alone or in combination with other agents, and
>who exhibit cardiopulmonary signs (including a new murmur) or symptoms
>suggestive of valvular disease (e.g., dyspnea).
>
>3. Although the clinical importance of asymptomatic valvular
>regurgitation in exposed patients and the risk for developing
>bacterial endocarditis in these patients are unknown, practitioners
>should strongly consider performing echocardiography on all persons
>regardless of whether they have cardiopulmonary signs or symptoms who
>have been exposed to fenfluramine or dexfenfluramine for any period of
>time, either alone or in combination with other agents, BEFORE the
>patient undergoes any invasive procedure for which antimicrobial
>endocarditis prophylaxis is recommended by 1997 AHA (American Heart
>Association) guidelines.
>
>Any echocardiographic findings that meet the AHA criteria for
>prophylaxis regardless of whether they are attributable to possible
>fenfluramine or dexfenfluramine use should be recognized as
>indications for antibiotic prophylaxis. The invasive procedures
>include certain medical or dental procedures where antibiotic
>prophylaxis is recommended as defined by the 1997 AHA guidelines. For
>emergency procedures for which cardiac evaluation cannot be performed,
>empiric antibiotic prophylaxis should be administered according to the
>1997 AHA guidelines.
>
>4. Because of the prevalence of minimal degrees of regurgitation in
>the general population, the current case definition of drug-associated
>valvulopathy should include exposed patients with
>echocardiographically demonstrated AR of mild or greater severity
>and/or MR of moderate or greater severity, based on published
>criteria.
>
>ADA Recommendations Regarding Fen-Phen -- 11/12/97
>
>Dentists who have patients who were on Fen-Phen (fenfluramine and
>phentermine) or dexfenfluramine or fenfluramine alone, should refer
>them to their physician for the CDC-recommended evaluation and
>treatment before conducting any dental procedures that may cause
>significant bleeding.
>
>Based on what the evaluation reveals, the dentist may then provide
>necessary dental treatment in accordance with the revised 1997
>guidelines titled: "Prevention of Bacterial Endocarditis:
>Recommendations by the American Heart Association and A Statement for
>the Dental Profession." (These guidelines were approved by the ADA's
>Council on Scientific Affairs and published in the August, 1997
>Journal of the American Dental Association.)
>
>Under these guidelines, the dentist may prescribe a single
>pre-procedure dose of antibiotics for appropriate patients who are
>undergoing procedures that put them at risk for significant bleeding.
>
>Examples of dental procedures that might warrant antibiotic treatment
>include, but are not limited to, tooth extractions, periodontal (gum)
>surgery, root canal treatment and the placement of orthodontic bands
>but not brackets.
>
>
>
>
>© Copyright 2005 ProNational, Inc. All Rights Reserved
>
>
>
>
>
>
>
>
>
>On Tue, 22 Mar 2005 22:40:25 -0500, "Andrew B. Chung, MD/PhD"
><andrew@heartmdphd.com> wrote:
>
>>"Joel M. Eichen" wrote:
>>>
>>> Hello Sharon,
>>>
>>> Here is some more information on the "reversed" case.
>>>
>>> Joel M. Eichen D.D.S.
>>>
>>> **
>>>
>>> Posted on Wed, Feb. 23, 2005
>>>
>>>
>>>
>>>
>>> Judge reverses verdict against Wyeth over diet drug
>>>
>>> Associated Press
>>>
>>> MADISON, N.J. - A judge in Philadelphia reversed a jury verdict
>>> against drug maker Wyeth Wednesday, ruling that a plaintiff who
>>> alleged heart valve injury from use of a diet drug knew the risks
>>> before she took the drug.
>>>
>>> Common Pleas Court Judge Mark I. Bernstein set aside a Nov. 3, 2004
>>> verdict that awarded Geri McMurdie $780,000 in compensatory damages.
>>> In his ruling, Bernstein said that McMurdie "knowingly and voluntarily
>>> assumed the risks" of heart damage when she signed a consent form
>>> acknowledging the potential risks of Pondimin.
>>
>>*Sigh*
>>
>>What people subject themselves to in order to avoid simply eating less
>>to lose weight.
>>
>>
>>At His service,
>>
>>Andrew

Quantcast