Can the Heart Medication MULTAQ Cause Severe Liver Injury

Posted on February 27, 2011 by Jeff Blackwell

Atrial fibrillation is a huge health issue affecting many individuals.  It is estimated that this condition affects 2.3 million Americans.  At present, the FDA has approved a variety of treatments.

In 2009, the drug company Sanofi-Aventis began to market dronedarone under the brand name Multaq as an additional medication for atrial fibrillation.  Although the FDA approved the marketing of Multaq in July 2009, a petition several years earlier had been denied due to patient safety concerns.  According to medical data, in just over a year on the market, around 147,000 patients filled prescriptions for the medication.  At the time of approval in 2009, the company estimated that sales would eventually reach $1 Billion a year.

However, medical research now indicates that Multaq may not be the blockbuster medication for atrial fibrillation as marketed by its manufacturer.  Researchers at Cedars-Sinai Medical Center are now reporting that the medication is only half as effective as a different generic medication.  However, it is not just the effectiveness of the medication that is now being called into question.  Patient safety is also an issue.

On January 14, 2001, the Food & Drug Administration (FDA) issued a safety announcement warning health care professionals about the possibility of severe liver damage associated with the medication.  Then, on January 28, 2011, the FDA issued a warning letter directly to Sanofi-Aventis.  This warning letter follows an FDA inspection in which it was revealed that the drug maker had failed to timely report possible adverse consequences of its medication Multaq.  At present, it has been reported that several patients on the medication have suffered liver injury, including two who even suffered acute liver failure requiring them to undergo liver transplants.

This is a potential health issue that has already received some coverage from news outlets in Alabama.  In light of the significant number of people suffering from atrial fibrillation and the numerous other treatments available, it is important to continue monitoring developments with Multaq and whether this drug poses a danger of acute liver failure to patients.

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Alabama's Mandatory Automobile Insurance Requirement Needs Instant Verification

Posted on February 16, 2011 by Jeff Blackwell

Imagine that you are injured by a negligent driver on an Alabama roadway.  Alabama law requires the other driver to carry liability insurance coverage.  The accident report even lists the other driver's insurance carrier.  At least there is insurance coverage for your injuries.  Or, so you think. Unfortunately, things are not always what they seem.

Despite a law requiring drivers to carry liability insurance coverage, it is estimated that 25% of the drivers on Alabama roads do not currently have insurance.  How is this possible?  It is possible because many people purchase the required coverage, receive their insurance card, and then promptly cancel for a refund.  Although the driver does not possess current coverage, they do possess an insurance card which indicates that they possess coverage.  That card is all the person needs when insurance information is requested by law enforcement.

What can you do to protect yourself from a driver who fails to carry valid or sufficient liability coverage?  The most important thing you can do is to make sure you have adequate uninsured motorist coverage on your policy.  This coverage is fairly inexpensive and it provides coverage for injuries caused to you by a negligent driver who does not possess sufficient liability coverage.

What can the State of Alabama do to help with the problem of uninsured drivers?  The State can create a system of instant verification.  It would be simple to create this system.  Law enforcement can already immediately verify the status of your license with its database.  Simply require insurance carriers to report the issuance or cancellation of coverage so that this information can also be part of the database. That way, insurance coverage could be immediately verified by law enforcement as well.  One member of Alabama's legislature, Senator Arthur Orr of Decatur, is proposing the creation of such a system.  

Uninsured drivers cost the rest of us greatly.  Instant verification is a great proposal to help law enforcement protect us from uninsured drivers on our roadways.

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Recovering the Money Lost to Health Care Fraud is an Important Issue

Posted on February 13, 2011 by Jeff Blackwell

Last November, I wrote about the U.S. Justice Department's recovery of $3 Billion in fiscal year 2010 that had been originally lost to our government due to fraud.  When you look at the government's recoveries, you soon see that much of the fraudulent activity against our government involves the health care system.

This morning, The Birmingham News had an interesting article concerning the penalties assessed for health care fraud over the last four years, just in North Alabama.  It appears that over the last four years, the U.S. Attorney's office in North Alabama has recovered $48 Million dollars in penalties.  This recovery is estimated to be only a small portion of the illegal fraud in our health care system locally.

Fraud and abuse in our health care system threaten the delivery of basic health services.  Last week, Alabama's Medicaid Agency Director painted a grim picture of the agency due to budget issues.  On a Federal level, we've all heard the near constant debate on Medicare's projected budgets. 

During these difficult economic times when so many people are dealing with personal budget problems, it is good to see that our U.S. Attorney in North Alabama has taken an active role in pursuing some of the fraud in our system.  These cases can be initiated by our U.S. Attorney or by private citizens under the False Claims Act.  If we want to curb the cost of health care, the best place to start is with those who abuse the system by defrauding the government.

 

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The Importance of Having Enough Potential Jurors for Trial

Posted on February 8, 2011 by Jeff Blackwell

It's a basic lesson from grade school social studies that the right to a jury trial is fundamental.  In this day and age, that basic right is under attack from many sides.  It is under attack from special interest groups who seek to limit their accountability for misconduct.  It is also under attack from the effects of general budget issues that chronically underfund our Courts.  With that said, let me come down from my soapbox and talk about something a little more practical - the importance of having enough potential jurors present for trial.

This morning, The Huntsville Times ran an article about a local case that had to be continued simply because of a lack of potential jurors.  The local case involves a proposed rock quarry and a significant claim for damages against a local municipality and its mayor.  Naturally, it's a high profile case.  Finding impartial jurors would have been difficult under the best circumstances.  That's understandable.  The residents living in and around the proposed quarry may very well have deep feelings on the issue preventing their service on the jury.

Yet, it appears the problem is not simply one of finding unbiased jurors.  Instead, it's a problem of starting numbers - too few people from which to strike a jury.  Several civil jury trials were set in Madison County this week, including this high-profile case.  However, according to the article in the paper, only 90 potential jurors were available for all these cases.  That's too few to provide panels for all the cases set.  It's far too few when one of those cases also brings some publicity with it.

I don't know why only 90 jurors were available.  However, I do know that the printed lists of people contacted for jury duty on trial weeks is much, much larger than 90 people.  I frequently see those printed lists because of my law practice in Madison County.  Is this a problem of the court system being ineffective in actually notifying all those potential jurors?  Does the court system need to better calendar and coordinate its jury trials?  I don't know.  I'll leave that issue to the people who run our local court.

In my experience, the people serving on our juries are deeply committed to bringing justice to the case they are hearing.  Our jurors listen and often take notes.  They pay close attention to the evidence and take the job very seriously.  After I finish a trial, I often talk with the jurors about their experience.  Every time I leave one of those conversations, I walk away with a deeper respect for our system and the seriousness in which the jurors listened and tried to make the best decision possible (often under difficult circumstances).

Whatever caused the lack of potential jurors, it is important that people are available to hear the cases in our local courts.  It does often take a very large starting number of potential jurors to get the 12 needed to hear each individual case.  It takes a large number when there are multiple trials happening at one time.  It also sometimes takes a large number when the issues, like the case this week, are public issues involving a local community.

It also takes a large number of potential jurors in the typical case involving damages from an automobile collision.  Why?  Alabama law requires every driver to have liability insurance.  Yet, in a trial involving damages from an automobile collision, the attorneys are prohibited from ever mentioning the truth that the defendant actually has insurance.  While this fact cannot be mentioned at the trial, the courthouse officials will typically ask the entire panel of potential jurors about their individual coverage before the trial ever begins.  What happens next - in our State several large automobile insurance companies dominate the market.  When those potential jurors have the same insurance as the defendant, they are typically stricken from serving on that particular jury.  In these cases, there could to be too few jurors remaining to have a trial.  That's why it is so important for our courthouse officials to plan and do everything possible to make sure that enough potential jurors are available.  It's also important that those called to jury duty appear, if at all possible.  Justice delayed often results in justice denied for all of us.

 

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