Cleviprex, popular blood pressure drug, recalled by Medicines Company

The Medicines Company (NASDAQ: MDCO) has issued a voluntarily recall of eleven (11) lots of Cleviprex ® (clevidipine butyrate) injectable emulsion due to the potential presence of visible particulate matter.

The affected Cleviprex lots are 61-978-DW, 61-979-DW, and 61-980-DW, Exp. 01/2010; 68-404-DJ, 68-405-DJ, and 68-406-DJ, Exp. 08/2010; 69-830-DJ, 63-385-DJ, 63-386-DJ, and 63-266-DJ, Exp 03/2011; and 64-453-DJ, Exp. 04/2011. No other lots are affected by this recall.

The Medicines company is cooperating with the U.S. Food and Drug Administration on this recall.
The particulate matter comprises sub-visible inert stainless steel particles of around 2.5 microns.
There are no known complaints or reports of adverse events related to this issue regarding Cleviprex ®

For medical inquiries, adverse event reporting or quality issues related to Cleviprex, please contact The Medicines Company Medical Information at 1-888-977-6326 Monday to Friday 8:00am-5:30pm EST or cleviprexrecall@themedco.com

Consumers with any adverse reactions associated with the use of Cleviprex may also report this to the FDA’s MedWatch Program by fax at 1-800-FDA-0178, by mail at MedWatch, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787, or on the MedWatch website.

The stock for MDCO closed at $8.04, down .08 shares from previous trading.
 

FDA Testing for Cardiovascular Implants come under Scrutiny

The Food and Drug Administration has come under fire for having insufficient scientific standards to for evaluating cardiovascular devices. This recently came to light from a report found in the Journal of the American Medical Association entitled "Strength of Study Evidence Examined by the FDA in Premarket Approval of Cardiovascular Devices".

In an Associated Press article, The New York Times reports finding from researchers at the University of California, San Francisco. This article shares alarming patterns of how the FDA frequently gave their seal of approval for heart devices based on foreign research in small groups of patients. In a further twist, common standards and protocols for device studies were lacking such as clear goals and randomization. One can't help but wonder, who is looking out for the American public, if the FDA's testing has such fundamental flaws.

Scientific American, author, Cynthia Graber states the following in her podcast transcript, in response to the JAMA article.

"We like to think that medical equipment implanted in our bodies undergoes rigorous testing before it’s put inside a person

These recent turn of events, further underscores the need to pass the Medical Device Safety Act (MDSA), according to the American Association for Justice (AAJ). Since the hotly debated Supreme Court Decision in Riegel v. Medtronic, medical device product liability has been front and center in the debate on FDA approved devices and who should be held accountable.

AAJ President Anthony Tarricone eloquently states the following in support of the Medical Device Safety Act  (HR. 1346 / S. 540)

"Passage of the Medical Device Safety Act is critical for patient safety, especially when medical devices have not gone through rigorous premarket testing and post-market monitoring.”

Time will tell if the new studies shake things up at the FDA and ignite discussions on passing  the Medical Device Safety Act. Consumers are encouraged to join in the discussions with lawmakers that if the FDA approval process is flawed from the beginning, this loop hole must be closed to provide consumers safeguards and protections. 

Medical devices such as cardiovascular devices that are implanted inside a patient's body,  after a doctor shares that the device has been approved by the FDA.  The justice system is flawed, if the medical manufacturer knows the shortfalls of their device from the beginning, but hides it,  to secure the FDA seal of approval.  

 

Preemption Victory Against Generic Drug Manufacturers!

Congratulations on the valiant efforts of the legal team of The Public Justice Foundation and the Center for Constitutional Litigation (CCL) for winning a huge victory against generic drug manufacturers in the Mensing v. Wyeth, Inc., case.  The U.S. Court of Appeals for the Eighth Circuit ruled that federal preemption can't be used by generic drug manufacturers to avoid liability for failing to warn of their drugs' dangers.

According to this ruling, an FDA approval for a generic drug does not does NOT preempt claims against the drug makers for failing to warn consumers of known risks.  Justices in this case,  included: Hon. Roger L. Wollman - Sioux Falls, SD, Hon. Diana E. Murphy, Minneapolis, MN and Hon. Kermit E. Bye - Fargo, ND

In Mensing v. Wyeth, the Eighth Circuit's decision concluded with the following:

Mensing has stated a viable claim against the generic metoclopramide manufacturers. Far from prohibiting them from taking steps to warn
their customers of new safety hazards, federal law requires such action. For the
reasons stated we reverse the judgment in favor of the generic manufacturers but
affirm the judgment as to the name brand manufacturers.

Arthur Bryant, Executive Director, Public Justice and the Public Justice Foundation made an excellent point when he recently shared the following message: 

The Eighth Circuit emphasized that generic manufacturers, like name-brand drug companies, "bear primary responsibility for their drug labeling at all times." Lawsuits like Ms. Mensing's, the court said, do not "obstruct the purposes and objectives" of federal drug regulation "in any way." Instead, they help achieve the "fundamental" purpose of federal regulation-ensuring that "all marketed drugs remain safe."

Click here to read the Court Opinion on Mensing v. Wyeth, Inc.

We are headed in the right direction of improving drug safety and holding pharma giants, both brand and generic, accountable for their actions.

Time will tell what impact this decision has on the future of generic pharmaceuticals.

Neurontin litigation goes to trial but stalls on first day

Neurontin - Pfizer drug for epilepsy - linked to suicidal tendenciesOne of the current hot legal topics is the lawsuit against Pfizer and their wonder drug, Neurontin. Neurontin had been marketed by Pfizer as a drug that treated multiple conditions prior to the Food and Drug Administration’s (FDA) approval of the drug to treat these various symptoms and ailments. While the drug was approved to treat epilepsy, it was not approved by the FDA to treat either mood swings or arthritis as its advertising indicated. Presently under investigation is whether or not a side effect of Neurontin is an increase in suicidal thoughts and tendencies of those taking the drug. This issue surfaced after the family of a 39-year old woman that committed suicide while taking Neurontin filed a lawsuit against its maker, Pfizer. The deceased was taking the drug to treat several health issues including epilepsy, mood swings, and arthritis. There are approximately 1200 additional lawsuits pending against Pfizer and their drug, Neurontin.

The first lawsuit against Pfizer, in regard to Neurontin, to be heard before the court was the case of Susan Bulger, the 39-year old woman that committed suicide. After the first day of trial, the lawsuit brought against Pfizer by Ms. Bulger’s family was dropped after an anonymous donor agreed to provide monies to the family with the stipulation that the monies be put into a trust for Ms. Bulger’s daughter. The family determined that this would be in the best interests of the child and chose not to proceed with their lawsuit. The court dismissed the case. The attorneys for Pfizer continue to assert that there is no evidence that Neurontin increases or causes suicidal thought or behaviors. However, no real answer has been provided to this question. With the first lawsuit being so quickly dismissed, the mysteries and unanswered questions regarding Neurontin may have to wait to be discovered and answered until further lawsuits come before the courts.

It appears that with so many other lawsuits pending against Pfizer regarding Neurontin that this story is long from over. If Neurontin truly is a potentially dangerous drug, the public needs to be made aware of this before more innocent people are affected.  Attorneys on both sides of the arena seem ready and willing to share their perspectives and evidence with the courts and their juries. How this legal saga is going to play out is anyone’s guess. At this point, there are still more questions than answers. It is important to note that in 2004, Warner-Lambert paid $430 million in to settle allegations involving Neurontin related to off label marketing, in a case handled by the Justice Department. 

Click here to read more on the Neurontin case from Bloomberg.

Pfizer's stock closed at $16.07 today.

Stay tuned...

Big Pharma, FDA and Preemption: Who should be held liable?

The Supreme Court Case, Wyeth v. Levine  (06-1249), the Supreme Court Justices are sharply divided over whether FDA regulations of labeling can prevent consumers from suing. Wyeth and the FDA presented the case before the Supreme Court involving Diana Levine, an amputee, whose bodily injury resulted from the use of the drug, Phenergan.

The debate among Supreme Court Justices is in the matter of whether consumers have the right to sue drug companies when the FDA has approved a drug for use. The strength of the argument presented by Levine's lawyers is that Wyeth is attempting to use FDA labeling to deny her a Consumer’s right to hold a Pharma company liable.

This is not the first case of involving a Pharma company being sued for harmful and deadly side effects of their drugs. A few notable instances include, Glaxo for their drugs Paxil and Avandia, Purdue Pharma for Oxycontin, Merck & Co. for Vioxx. In some cases, deficient research led to serious risks that was overlooked. In others, misleading advertising that omitted possible risks was the basis of these lawsuits.

The issue of FDA labeling as insurance to preempt lawsuits by consumers is an important aspect of the Wyeth v. Levine case. The issue of preemption is supported by the current Bush Administration in its attempts to reduce lawsuits by consumers against drug companies. Pharmaceutical companies argue that stiffer regulations and standards inhibit their research of newer, more effective drugs.

In the Levine case, Wyeth's argument reduces the lawsuit to a simple case of medical malpractice. Surprisingly, the FDA stands with Wyeth in the argument. The Federal Agency that is supposed to be on the side of Consumers, feels that once the FDA approved the drug for use, extraordinary risks that may appear as a result of use at some later point should not be a consideration for lawsuits against drug companies that have received FDA approval and are labeled as such. This begs the question: Who should be liable and held accountable if the FDA and the pharmaceutical maker fails to catch something in trials or overlooks a deadly side effects, because of the rush to get a drug on the market?

Another valid point of the argument by Levine’s lawyers is that Wyeth did not advise physicians or consumers of the danger of using the "push" method of injection of Phenergan. It is safe to say, that maybe more people would have had second thoughts about using this drug, if they would have known about the additional dangers. Moreover, in another case, Pfizer's anti-nausea drug, Vistrol, caused gangrene when injected into the arteries and Wyeth should therefore have requested an FDA to change the label warning of this on their Phenergan label.

The State of Vermont awarded Levine $6.8 million. In preemption arguments, federal law supersedes state law. Justices Scalia, Alito and Roberts argued in favor of Wyeth while Bader-Ginsberg argued in favor of Levine.

It would be simple to view Wyeth's position as one of preemption vs. adequacy of disclosure. Ultimately, the Supreme Court must address the potential for future lawsuits of this nature. They must also address the issue of what happens if the drug company gives the FDA false or misleading information about a drug that later proves to be harmful to consumers. Consumer advocates everywhere are following this case closely. Let’s see if the Supreme Court can do the right thing and tell Wyeth and the FDA that they do not get a free pass in this case. They are responsible for the safety of drugs that are put on the market, even if the FDA gives the drug a stamp of approval.

Jacob Goldstein, Writer and Blogger for the WSJ Health Blog, shares a few insightful comments from Diana Levine in his blog post "Wyeth v. Levine: The Mother of All Preemption Cases". He also includes a nice candid photo of the woman who Wyeth is going after for fighting for her rights to hold them accountable for taking their migraine drug that caused her to have her arm amputated. All eyes are on the Supreme Court regarding the decision of this case.  Let's see if they can get it right and hold the Pharmaceutical companies liable for unreported risks and dangers associated with their drugs.
 

Medtronic recalls Heparin CardiopulmonaryProducts

Medtronic, Inc. voluntarily recalled several Heparin products, According to the U.S. Food and Drug Administration (FDA). One can only wonder what took them so long to get this conviction. On April 8, 2008, the U.S. Food and Drug Administration's recommended that heparin supplies be checked with newly-developed tests, and that affected products be evaluated for possible field corrective action. The Medtronic recalled products include disposables used for heart surgeries and the cardiopulmonary bypass, including reservoirs, blood oxygenators, tubing packs, and pumps. It is unclear if exposure to Heparin Carmeda-coated medical devices could cause adverse events similar to those observed with injectable heparin formulations.

In a separate action, Medtronic is advising customers that selected lots of Trillium-coated products were also manufactured with heparin containing OSCS. Trillium is another biosurface used on CPB products. The ultimate goal is to remove all contaminated products from the market.

The Medtronic recall is a precautionary one. Let's all hope the company continues to take measures regarding their products that will help save lives and not threaten them.

FDA seeks comments on the new guidelines for unapproved uses of Medical Products

Concerned Citizens, Health Care Personnel, the FDA wants your opinion on the new FDA Proposed Guidance for Dissemination of Information on Unapproved Uses of Medical Products. Public Comments will be accepted for 60 days. 

"Articles that discuss unapproved uses of FDA-approved drugs and devices can contribute to the practice of medicine and may even constitute a medically recognized standard of care," said Randall Lutter, FDA deputy commissioner for policy. "This guidance also safeguards against off-label promotion."

Previously, Section 401 of the Food and Drug Administration Modernization Act set out guidelines that allowed the dissemination of information on unapproved uses of FDA-approved products. As long as the guidelines were met by the manufacturers, the dissemination of such materials was not viewed by the FDA as evidence of an intent to promote the product for an "off-label" use. However, Section 401 expired on Sept. 30, 2006.

Comments via the Internet:  go to Docket Number FDA-2008-D-0053 on the Regulations.gov Web site.

Comments via mail:
Submit comments to:
Division of Dockets Management (HFA-305)
Food and Drug Administration
5630 Fishers Lane, Room 1061
Rockville, MD 20852

All comments should be identified with the docket number, FDA-2008-D-0053. For single copies of the draft guidance, call 301-827-3360 or contact: Office of Policy, Food and Drug Administration, 5600 Fishers Lane, Room 14-101, HF-11, Rockville, MD 20857.


AM2 Pat Heparin an Saline flush recall by FDA due to Bacteria

NATIONWIDE URGENT DEVICE RECALL - Heparin and Saline Flushes by AM2 PAT

The FDA has announced an urgent nationwide recall of pre-filled Heparin and normal Saline Flushes that were manufactured by AM2 PAT, Inc. of Angier, a North Carolina based Company. The pre-filled syringes are contaminated with Serratia marcescens, which has resulted in patient infections. The products can be found under the brand names, Sierra Pre-Filled Inc. and B. Braun. They are sold in 3ml, 5ml sizes for Heparin and 3ml, 5ml and 10ml sizes for Normal Saline. Both products are sold as pre-filled syringes.

One lot under recall of this product 1003-02, Lot 070926H, Heparin IV flush syringes was found to be contaminated with Serratia marcescens, which has resulted in patient infections. The CDC  confirmed growth of Serratia marcescens from several unopened syringes of this product.

This type of bacterial infection could present a serious adverse health consequence that could lead to life-threatening injuries and/or death.

Consumers and user facilities who have any of these recalled pre-filled syringes, Heparin or Saline Lock Flush Solution USP, should stop using the product immediately. These products should be immediately quarantined in your inventory and returned to your distributor immediately.

The following information for this recall includes:

MANUFACTURER: Sierra Pre-Filled, Inc., Angier, North Carolina

PRODUCT DESCRIPTION: Heparin Lock Flush Solution USP, All Strengths and Sizes

Saline Lock Flush Solution USP, All Strengths and Sizes

LOT # NDC # CATALOG # Product Brand Name
All 64054-1003-02 1003-02 Heparin Lock Flush 100units/ml 5ml
64054-1003-01 1003-01 Heparin Lock Flush 100units/ml 3ml
64054-3005-02 3005-02 Heparin Lock Flush 10units/ml 5ml
64054-3003-02 3003-02 Heparin Lock Flush 10units/ml 3ml
64054-3003-06 3003-06 Heparin Lock Flush 10units/mL 3ml (6ml syringe)
64054-3005-06 3005-06 Heparin Lock Flush 10units/mL 5ml (6ml syringe)
64054-0910-2 0910-12 Normal Saline Flush 10ml
64054-0905-2 0905-12 Normal Saline Flush 5ml
64054-0903-2 0903-12 Normal Saline Flush 3ml

The products were recalled after bacterial contamination in some end user samples of product code 1003-02, Lot 070926H was found.

It appears from an ongoing Food and Drug Administration (FDA) inspection of AM2 PAT, Inc.’s facility that the firm is not in compliance with the Quality System regulation and failed to have adequate controls to ensure necessary sterility of its pre-filled syringes.

Consumers with questions may contact Sierra Pre-Filled at 919-552-9689, Monday through Friday, 10am-5pm Eastern Standard Time.

Any adverse reactions experienced with the use of this product, and/or quality problems should also be reported to the FDA’s MedWatch Program by phone at 1-800-FDA-1088, by Fax at 1-800-FDA-0178, by mail at MedWatch, FDA, 5600 Fishers Lane, Rockville, MD 20852-9787, or on the MedWatch website at www.fda.gov/medwatch.


House Gives U.S. FDA More Power to Police Drug Safety

This week, The House of Representatives approved legislation that gives the FDA more power to police the safety of prescription drugs, sending the measure to the Senate for final approval.

What if the the Food and Drug Administration required drugmakers to study the safety of their products after they go on the market? Would that be so terrible? Would it be a bad thing for regulators to order warnings added to prescribing information? If these measures can help save lives and prevent more illnesses, I think not.

This new legislation may be able to prevent future repeats of what happened with Vioxx, the Merck & Co. painkiller, allegedly linked to heart attacks and strokes, and Avandia, GlaxoSmithKline Plc's diabetes pill linked in some studies to a risk of heart attacks.

I hope that  Representative Henry Waxman, a California Democrat, is correct in his assessment that the legislation ``provides FDA with critical tools the agency has been desperately lacking in its efforts to protect the American public from unsafe drugs". Now let's see if the Senate agrees.

Click here to read more on this new FDA legislation from Bloomberg News.


Avandia get reprieve and receives FDA Warning not Ban

The Executives at GlaxoSmithKline  must be breathing a huge sigh of relief. They only received a mere minor setback with the new Food and Drug Administration decision. Yesterday, The FDA  advisory panels called  for new warnings for the widely used diabetes drug Avandia. New evidence has shown that it significantly raises the risk of heart attack, however, they stopped short of recommending that the drug be pulled from the market, as some FDA officials had urged. I wonder why and how they managed to get a 22 to 1 vote to allow continued sales of  Avandia?

There has been controversy among regulators, drug company officials, physicians and advocates for patients, who have offered dueling interpretations of contradictory safety studies. Maybe it is because it is a "Billion Dollar Baby" for the North Carolina Drug Maker, GlaxoSmithKline. Last year, Avandia produced $3 billion in sales for the company. Today, stock for GlaxoSmithKline closed at $51.08, an increase of $1.64 per share. I think that shareholders must be happy with the news of the new FDA warning.

                                           
The company that produces Tums and other well known brands have been given another chance to make a difference in the lives of millions of people around the world. Let's hope that this miracle they received, will keep them in check and make them proactively share critical information to unsuspecting consumers before they take a GSK drug or product, instead of after the fact. Good corporate citizenship requires as much, if not more.Click Here to read more from the Washington Post on the Avandia FDA Warning.

The LaBovick Injury Law Blog is presented as a service of the Private Law Firm, LaBovick & LaBovick, P.A., Civil Justice Prosecutors.