The Miller Firm LLC, Garretson, and "You Have A Lawyer" Saiontz & Kirk,P.A. - AstraZeneca Seroquel Litigation - The envelope please, open the damned envelope - the losers are ??

An Anonymous source once again has provided this blog with a supposedly very ""hush hush" confidential information regarding the Seroquel Litigation that once again gives us a startling glimpse into the dark and shady legal under world of tort pharmaceutical litigation. I must honestly laugh out loud at the childish confidentiality games these firms are playing with their clients.

This latest following correspondence is in regards to an appeal letter sent HERE by this my source to The Miller Firm LLC, Garretson Resolution Group, and "You Have A Lawyer" Saiontz & Kirk, P.A. regarding their original settlement offer packet HERE.

It appears from the back & forth correspondence that I have had with this source, that these law firms completely ignored every major and pertinent issue that was addressed in the original appeals letter. But they have even gone further in their sleazy gamesmanship by recalculating and changing the rules of the settlement game merely as it suits them. In this case they have actually reduced their settlement offer significantly. Is this targeted retribution or just blatant incompetence...either way, this no doubt highlights the shameful and unprofessional conduct of these firms...

These are the highlights that make all this so disturbing & perplexing:

1. The original gross offer was reduced from $11,595.91 (-$1344.64) to $10,251.27 after the appeal
2. The Net settlement offer figure was reduced from $5,967.09 (-$748.83) to $5,218.26 after the appeal.
3. How could that possibly happen one might ask? The law firm simply changed the disbursement criteria arbitrarily adding and subtracting where ever they wanted without the input or consultation with the clients they supposedly represent.
4. They added an after 2004 seroquel use deduction of 20%
5. in seems they have Jettisoned 6 clients
6. created a larger hold back slush fund for 40 missing or dual represented cases  
7. Appear to have changed age requirement from 18 years old to 19 years old?
8. developed a new arbitrary point system for offer allocation

Of course, what still has not added or considered for obvious self gain reasoning by the law firms is that the settlement is not based upon the plaintiff injuries; it is based solely on the cost of AstraZeneca continuing to defend these claims.

If they are going to base this settlement on injuries, then AstraZeneca first needs to come forward and publicly admit that Seroquel did in fact cause the claimed injuries to be able to use this type of format or methodology in calculating settlement awards.

So aside from the glaring fact: the settlement calculation methodology leaves out so many other pertinent variables that it is virtually useless in determining equitable settlement distribution amounts. Just a small sample of the omitted criteria worth mentioning are...

1. What was the drug prescribed for...off label or unapproved use
2. actual financial loses incurred by the injured party (lost wages, employment, other)
3. past, present, and future medical expenses determination for each client
4. pain, suffering, and psychological damages incurred by the drug & aftermath
5. Was the prescribing doctor a spokesperson, paid representative, receiving actual monetary benefits for prescribing Seroquel (conflicts of interest) from AstraZeneca
6. Were the claimants properly warned about the dangers/side effects of Seroquel by their treating or prescribing doctors....
7. What were the negative effects and damage caused by the burying of important data, the off label marketing, and misinformation campaigns waged by AstraZeneca to both patients and doctors on each client injury..
8. are there litigants that have already received an award settlement for similar or the same injury claims they are now making for Seroquel, from another drug..
9. and the list goes on and on...

The bottom line is this....the source's appeal was ignored...and then it was subjected to a new calculation methodology as retribution for making an appeal. There is absolutely zero doubt who the law firms are working for...they are first working for themselves and self financial gain...they are also working as agents representing AstraZeneca attempting to force this settlement upon injured parties...and the worst of all they have completely abandoned their professional and ethical responsibility to serve each individual client's best interest...In Fact: as I read through all the many post, complaints, evidence, legal jargon, mind boggling settlement offers, threat letters, the strong arm tactics ,and see the way injured parties are being treated by these law firms....I can draw no other conclusion than The Miller Firm LLC, "You Have A Lawyer" Saiontz & Kirk, P.A., and other like firms involved in this & other drug related tort litigation never have intended to meet or full-fill their professional fiduciary duties to those who entrusted their cases and broken lives to them.

Guess what you legal sleaze balls; the damaged and forever negatively altered lives caused by AstraZeneca's drug Seroquel are not your cash cows or bargaining poker chips merely created for your own selfish gain and shameful profiteering...these are real lives, feeling real pain, are experiencing/enduring long suffering, and a diminished quality of life...You would be very wise to remember that stark reality...before it's comes back to bite you hard...

 

This is a counter appeals offer supplied & relayed to me by my anonymous source, directed to AstraZeneca, The Miller Firm LLC, Garretson Resolution Group, and "You Have A Lawyer" Saiontz & Kirk, P.A.: that AstraZeneca publicly admit that Seroquel has indeed caused thousands of deaths &/or injuries including diabetes and related conditions. That they indeed purposely mislead and lied to the public for their own profiteering gain. And that AstraZeneca supplies a written detailed public apology for all to read. Then my source will personally & happily decline any monetary award (ask for nothing 0) related to the harm and health damage caused by AstraZeneca's drug Seroquel. 

How the AstraZeneca Seroquel Plaintiff Law Firms have turned a "TORT" into a very profitable bastardized version of class action

A class action lawsuit is a complaint filed by one party on behalf of everyone in a similar situation. Such lawsuits look at the big picture and are useful, for example, to force a company to take a legal action.

A mass tort lawsuit is different. Like class action lawsuit, a mass tort combines many legal cases into a single trial, but unlike a class action each plaintiff is treated as an individual with their own individual lawsuit. The difference between a mass tort and an individual case is that in a mass tort lawsuit many similar cases are argued together saving time and money that can be better spent preparing to make the best legal case for you. Mass torts pool legal resources from many similar cases to benefit each unique case.

So how does a tort get turned into a class action...it's called a lump sum settlement...a law firm settles all cases they represent against a defendant (in this case AstraZeneca) for a one large lump sum amount of dollars & by virtue of the settlement deal guidelines guarantee full participation & compliance. At this point the law firm takes on the role of settlement marketeer for the defendants by setting up some arbitrary criteria ( that means that each individual's actual loses, injuries, or particular circumstances are not considered in coming up with an settlement offer figure ) for disbursement of funds. The plaintiff law firm then presents these offers to their clients in a "take it or leave it" threating manner sales pitch...the clients are given in reality a choice to either accept the offer (whether it's fair or equitable or individually derived) or the law firm will drop them as a client. In fact, it's set up in such a way, that even if a law firms drops/stops representing a high percentage of their clients; they will still make the same profit from this set lump sum settlement; as long as the eager defendant signs off on the agreement (which is virtually an automatic done deal from the get go).

This happens even if the plaintiff firms never take a single case to trial, or does the basic work of gathering adequate information, particulars of each individual case, or without investigating each of their clients individual claims to come up with actual loses, suffering, & injuries incurred by the defendants actions.

Today, Tort has become a nothing more than the new & more profitable class action, without having to ever prove a case, have the court or a jury determine what each individual case is worth in dollar terms based on the evidence. It also takes the court completely out of distribution and criteria used in such negotiated settlements.  In fact much the limited criteria the law firms are using in this inequitable distribution of funds schemes, and the limited arbitrary criteria methodologies being used, are the very same criteria these law firms were either unwilling or unable to prove in a court of law.

So tort today is basically when your lawyer makes a secret back room deal with the defendants for a set amount of money, and then in truth stop operating or working for those they were supposed to individually represent; but instead become a working agents for the opposition defendants.

To makes matters worse, (as in the Seroquel Litigation) the defendants (offending party) get to control the entire settlement process, and also get the final say in each individual case/settlement.

To put this in some form of simple context: it's as if the Big Bad Wolf was placed in charge of Little Red Riding-hood's complete Itinerary, was given Carte blanche to grandma's house, full reign over all conspiring events, and then is handsomely rewarded after The Wolf finishes devouring Little Miss Riding-hood. The injured parties are being virtually eaten alive; first by AstraZeneca's Seroquel; that have left them injured and suffering, and then again by greedy and self centered law firms that are only looking out for the own financial bottom line....Have they treated each individual they represent with the care, dignity, diligence, and duty they were given and hired to preform? the answer is NO!  Have they lived up to their professional and ethical obligations as legal professionals? The answer is absolutely NO...

The only question left to be answered now: is who in the legal profession is going to stand up for the "people" they are are duty bound to represent, and underlying basic guiding principles of the law & justice in America?

The people are waiting to hear from you.....America is waiting....

...and the winner is, Garretson Resolution Group and the Miller Firm ... the envelope please!

Will the dog keep its paws off of the claimant's new, Miller Firm Seroquel diabetes settlement payout-after-appeal-results in the sealed envelope? or will the story unfold like this one did?

July 8, 2010

The Dog Ate AstraZeneca's Homework! Evidence on Misleading Drug Ad Disappears From Company's Files | BNET Pharma Blog | BNET

AstraZeneca (AZN) says it has lost a crucial internal document that would explain how an ad for its antipsychotic Seroquel misleadingly claimed there was “no weight gain” with the drug and described its “favorable weight profile.” But the company admits it kept the six-year-old envelope that once allegedly contained the ad’s approval certificate, according to a ruling by the U.K.’s Prescription Medicines Code of Practice Authority.

The drug industry watchdog also alleges AZ’s Seroquel management team “pressured and manipulated” executives around them in order to make sure negative data on Seroquel was buried. The PMCPA ruled that AZ had breached its code of practice, which requires companies to operate in “a professional, ethical and transparent” manner.

If there’s a lesson here for managers, it’s this: Simply winning the legal war isn’t good enough. Consumers — and your own employees, as the Seroquel case shows — expect companies to go above and beyond. (AZ has mostly won the litigation filed against it which alleges the company failed to warn patients that Seroquel causes weight gain and diabetes. It settled with the Department of Justice for $520 million.)

via industry.bnet.com

Stay tuned!

AstraZeneca Seroquel - crime wave continues - It's just business as usual

AstraZeneca is at it again, as has been suspected and predicted for decades now....the profitable business as usual model of running a criminal enterprise without accountability or consequences has been encouraged by our government & continues unabated. Remember those DOJ "get out of jail free" slap on the wrist fines, the supposed CIA (Corporate Integrity Agreement), and the ongoing laughable & unjust Seroquel civil litigation....nothing has changed; It's still always profits before public health, profits before law, profits before anything....As AstraZeneca is bragging in their quarterly stock holder statement about how profitable they are....there is always the following types of criminal behaviors going on in the background...how does anyone negotiate a reasonable settlement with these documented serial criminals...You might start to wonder how far & deep this profitable crime wave runs?
....and now on to the latest episode of "Corporate Criminals Without Borders"

Financial Times Reports - AstraZeneca indicted in Serbian corruption case

October 27, 2011 10:46 am

AstraZeneca indicted in Serbian corruption case

By Andrew Jack, Neil MacDonald and James Crabtree

AstraZeneca has been served with a criminal indictment by the Serbian authorities as part of a widening probe into alleged bribery by several pharmaceutical companies in the Balkan country.

The Anglo-Swedish drug group said it had filed legal objections with the courts requesting them to drop the actions since receiving the indictment in August, which relates to “allegedly improper payments to physicians.”

The action follows the arrests last year in Belgrade of senior officials at the Serbian Institute for Oncology and Radiology, as well as the heads of the Belgrade offices of AstraZeneca, Roche, Actavis, Sanofi-Aventis and PharmaSwiss, concerning payments of around €550,000 during 2007-09.
It comes as US and UK authorities are stepping up scrutiny of alleged corruption beyond their own borders, which has already led to a $70m settlement reached with Johnson & Johnson earlier this year concerning misconduct in Greece, Romania and Poland.

The news came as AstraZeneca posted third-quarter results in line with expectations while unveiling a higher, narrower 2011 core earnings per share target of between $7.20 and $7.40 per share. The company cited favourable exchange-rate movements and fewer shares outstanding following recent buy-backs as part of the reason for the increase.

In fresh disclosures on litigation, it also said it received earlier this month a subpoena from the US Department of Justice “in connection with an investigation of the possible submission of false or otherwise improper pricing information to the Centers for Medicare and Medicaid Services.”

AstraZeneca gets the cash out to shareholders, chump change to Seroquel diabetes lawsuit victims: $ 759 million spent in legal defense

Business as usual at AstraZeneca

AstraZeneca PLC  Third  Q 2011

What a relief! AstraZeneca shareholders gain while the injured Seroquel plaintiffs wait for their chump change settlement checks, which are no where in sight.

What would a day at AstraZeneca be like if there wasn't a subpoena from the Department of Justice?


"On 5 October 2011, AstraZeneca LP and AstraZeneca Pharmaceuticals LP received a subpoena from the Department of Justice in connection with an investigation of the possible submission of false or otherwise improper pricing information to the Centers for Medicare and Medicaid Services. The precise parameters of this inquiry are unknown, and AstraZeneca is not in a position at this time to predict the scope, duration or outcome of this matter, including whether it will result in any liability to AstraZeneca. "


What would a day at AstraZeneca be like without a little unethical business practice?

Serbian Doctors recipients of alleged improper payments from AstraZeneca


"In August 2011, AstraZeneca UK Limited’s Representative Office in Belgrade, Serbia was served with a criminal indictment relating to allegations that local employees of AstraZeneca made allegedly improper payments to physicians at the Institute of Oncology and Radiology of Serbia.  AstraZeneca has filed a number of preliminary procedural objections, which ask the Serbian criminal court to dismiss the indictment against the Representative Office."

The Miller Firm LLC, Garretson, and "YouHaveALawyer" Saiontz & Kirk,P.A. - AstraZeneca Seroquel Litigation - Appeal, The first thing we must do...

Henry The Sixth, Part 2 Act 4, scene 2, 71–78

Dick the butcher, a character no one remembers, utters one of the few memorable lines from the entire three-part Henry the Sixth cycle. Dick's Utopian idea to kill all England's lawyers is his addition to the promises of the traitorous Jack Cade, who envisions a quasi-communistic social revolution, with himself installed as autocrat. Cade alleges that all lawyers do is shuffle parchments back and forth in a systematic attempt to ruin the common people. His demagoguery is simply a calculated appeal to simple folks' longing to be left alone. Yet one may recognize Cade's moral failings and still sympathize with Dick.

In 1987, three Supreme Court Justices convened for a mock trial, in which representatives of the poetaster Edward de Vere, the 17th Earl of Oxford (1550–1604), challenged Shakespeare's authorship of the plays. The president of American University in Washington, D.C., which sponsored the event, "drew some nervous laughter from the legal contingent in the crowd," the New York Times reported, "when he yielded to the temptation to quote the world's most-quoted English author (whoever he was) by saying, 'The first thing we do, let's kill all the lawyers. . . .'" Unsurprisingly, the justices ruled in favor of the Bard of Avon.

The Miller Firm LLC, Garretson, and "You Have A Lawyer" Saiontz & Kirk,P.A. - AstraZeneca Seroquel Litigation - Appeal, the first thing we must do...

Once again I have received correspondence from a reliable and trusted anonymous source related to the Seroquel Litigation. It appears while The Miller Firm LLC and the Garretson Resolution Group were sending out threatening intimidation letters to this Seroquel litigant over the disclosure of their  token settlement secret backroom dealings with AstraZeneca; there was a settlement appeals letter sent to them that we may assume they were none to happy about.

My source passed along to me that they had called Saiontz & Kirk P.A. seeking information related a response to the settlement appeals letter that had been sent all the client law firms involved in this settlement proceedings. Saiontz & Kirk,P.A told my source that they had absolutely nothing to do with the Seroquel Litigation @ this juncture, and referred their supposed client to call the The Miller Firm to inquire about any information regarding the Seroquel litigation or settlement appeal letter. 

That’s some invested representative co-counsel, which is taking a nice chunk of 40% of the 40% + Expenses & Fees the lawyers will take from this settlement offer if approved? I can only guess that Saiontz & Kirk are too busy drumming up new clients to sell off to other law firms right now to be concerned about a client they sold to another law firm and subsequently down the proverbial river…. I guess “You Have A Lawyer” really means “You Had A Lawyer - Who Doesn’t Give A Damn”. Let us look at this combined partial list of drug and device case pimping that is occurring from The Miller Firm & Saiontz & Kirk below…

Zimmer Knee Replacement 

Hip Replacement Injury

 Shoulder Pain Pump 

Kugel Mesh Hernia Patch

NuvaRing 

Bausch & Lomb 

Heart Stents

Actos

Accutane

Chantix  

Fosamax  

Yaz / Yasmin

Zocor / Simvastatin

Zoloft

Depakote

Diflucan

Topamax

Avandia

Darvon / Darvocet

Propecia

Reglan (Metoclopramide)

Gadolinium based MRI Contrast Agents

NuvaRing

Byetta

Fentanyl (Duragesic Patch / Actiq Lollipop)

DePuy ASR Hip Recall

DePuy Pinnacle Metal-on-Metal Hip Replacement

Wright Profemur Hip Replacement

 Zimmer Durom Cup Artificial Hip Replacement Lawsuits

Zimmer NexGen Knee Replacements

Transvaginal Surgical Mesh

Bard Avaulta Vaginal Mesh Problems

Mentor ObTape Vaginal Sling

Bard Recovery IVC Filter and Bard G2 IVC Filter

MRI with Contrast

Denture Cream: Fixodent and PoliGrip

 Yamaha Rhino ATV

Shoulder Pain Management Pumps

Kugel Hernia Repair Mesh 

Then my source called those (not so friendly) people over at the The Miller Firm.

Who was put throught to Kate Hamilton that my source shared was curt in her response to their inquirer about the appeals letter…She said it would get passed along to their nurses for review (Obviously Hamilton had either not read the appeals letter or was just sloughing it off as another meaningless client correspondence that would be not taken seriously). Hamilton did state that they “The Miller Firm” would get something out for their client to have posted on “That Blog” (I can only guess Kate is a big fan of this blog) as soon as they can…there must be nothing quite like the warm caring cordial communication feeling a client receives with a firm that is supposed to be representing their “Best Interest”.

But then again Mr. Miller stated in this Reuters News Article ,that the intimidation letter signed by him was not written or sent by him…..Now that’s what you call an exemplary client trust building moment folks…

I can only take a gander that it was one of those “if the pen doesn’t fit you must acquit” or “I never had sex with that women” historical lapse moments…

Below is listed the Miller Firm staff of ten lawyers that are supposedly handling not only 600 plus cases in the Seroquel litigation; but untold numbers of cases in other pharmaceutical & defective product litigation etc... 

 

Michael J. Miller , Julie B Isen,  Pete Miller, Nancy Guy Armstrong Miller, Bruce Burtoff, M.D., J.D., Tayjes Shah, Nathan Cromley, David J. Dickens, Jeffrey Travers, Kate E. S. Hamilton

Readers should really check out their web site miller firm llc …I would hope someone can answer for me how a firm with just ten lawyers can adequately serve and prepare thousands of cases for trial from a myriad of different pharmaceutical and defective product litigation's at the same time: while still continually advertising and taking on clients from other law firms for even more cases…. I would really like to know how the Miller Law Firm pulls off this type of seemingly Herculean task against some of the Biggest Corporations in the world and their mammoth legal teams without taking some precarious short cuts, or by sacrificing their individual clients’ best interest in the process…? 

Of course, when we look at the Seroquel litigation & the settlement documentation they are now marketing to their clients; we can see much more clearly that this appears to be a settle & profit business first and foremost…Clients appear to be little more than damaged human bargaining chips to be tossed around secret backroom gambling tables in their WIN even when we LOSE litigation poker game….high stakes poker without ever the risk of having to ante up…now, if this isn’t an organized posy scheme…I would like to know how else you would define one?

It appears Mr. Miller likes to make lots of video’s where he feeds the public & clients half baked lawyer speak squawking platitudes in broad generalizations that leaves many more questions than real answers to clients; yet when clients actually call the Miller Firm wanting vital & important information regarding their personal litigation…they get a continual run around, a lack of or misinformation; along with substandard & poor quality service, including little or no personal understanding & attention injured clients should expect & deserve from their supposed responsible & professional legal representation…

Can we assume that the next letters theses ambulance/FDA warning chaser law firms will be sending out; will it be a mass mailing dropping any client that don't go along with their huge profitable for the law firm settlement pay day, while leaving those actual injured parties that they had & still have an ethical and professional obligation to serve in the clients' best interest,
will be left without any reasonable semblance of justice or acceptable representation into the foreseeable future?


Just possibly Shakespeare was correct.....

Blindsided by Seroquel: 29 year old suffers sudden loss of vision after 3 years of use for bipolar disorder

Branch retinal vein occlusion associated with quetiapine fumarate

Abstract from Bio Med Central

Background

To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate.

Case Presentation

A 29 years old gentleman who was taking quetiapine fumarate for 3 years for bipolar mood disorder, presented with sudden vision loss. He was found to have a superior temporal branch retinal vein occlusion associated with hypercholesterolemia.

Conclusion

Atypical antipsychotic drugs have metabolic side effects which require regular monitoring and prompt treatment.

Background

Retinal vein occlusions (RVOs) frequently occur in the elderly in association with atherosclerosis. Hypertension is the commonest cause of RVOs in such population. In young adults, RVOs are associated with vasculitis and coagulopathies. Extensive work-up is required as both vasculitis and coagulopathies can lead to severe systemic morbidity and mortality. We describe a case of branch retinal vein occlusion in a young adult who has been taking quetiapine fumarate for 3 years.

Case Presentation

A 29 years old gentleman was referred from the emergency department with the complaint of sudden painless vision loss of his left eye for the past 1 week. Since onset, he experienced progressive generalized blurring of the central vision. There was neither photopsia nor floaters. Systemic review was not significant. He has no symptoms and signs of systemic vasculitis such as rashes, joint pains or mucosal surface ulcers. He was diagnosed of bipolar mood disorder in 2008, and was treated with oral quetiapine fumarate 100 mg daily. His bipolar mood disorder responded well to quetiapine fumarate without any side effects. Sexual history was not significant and he has no history of substance abuse or smoking. There was no family history of vascular events as well.

He was a medium built individual with a body mass index of 24.83 kg/m² (height 165.5 cm, body weight 68 kg). His body weight prior to quetiapine treatment was 62 kg. Blood pressure was 122/74 mmHg with a regular pulse rate of 80 beats per minute. The visual acuity of his left eye was 0.33, with near visual acuity of N24 at 33 cm. The right eye had visual acuity of 1.0 and near vision of N6 at 33 cm. Confrontation test revealed a left central scotoma. Relative afferent pupillary defect was absent. Anterior segment examination for both eyes was normal. The intraocular pressure was 16 mmHg bilaterally.

Posterior segment examination of the left eye revealed flame-shaped retinal haemorrhages along an arcuate course, corresponding to the supero-temporal retinal nerve fibre layer. Macular oedema involved the fovea and was associated with partial macular star due to hard exudates deposition. Intraretinal pigmentary spots with adjacent typical red blot hemorrhages believed to be resolving blot hemorrhages were seen. The patient has never had any laser treatment before. The supero-temporal retinal vein was dilated and tortuous along its entire course (Figure 1). The arterio-venous ratio was 2:3 infero-temporally but was 1:3 supero-temporally. There were increased arteriole reflexes with arterovenous nicking which was confined only to the supero-temporal retinal artery of the left eye. The optic disc was pink with well-defined margin and cup-disc ratio of 0.5. There was another area of flame-shaped retinal haemorrhages, two-disc diameter temporal to the fovea. The retinal haemorrhages were oriented along the distal infero-temporal retinal nerve fiber layer but did not begin at the retinal artery-vein intersection. The infero-temporal retinal vein was neither dilated nor tortuous (Figure 2). There were no cotton wool spots, the vitreous was clear, and there was no evidence of retinal periarteritis or periphlebitis. Posterior segment findings of the right eye were not significant (Figure 3).

Figure 1. Fundus photograph of the left eye; macula centered.

Figure 2. Fundus photograph of the left eye; temporal retinal field.

Figure 3. Fundus photograph of the right eye.

Optical coherence tomography (Heidelberg Spectralis ^® Tracking Laser Tomography) revealed the thickness of the superior half of the fovea was increased, with central serous neurosensory retinal detachment (Figure 4). Full blood count, renal profile, liver function test and thyroid function test were all normal. Erythrocyte sedimentation rate was 3 mm/hour, C-reactive protein was 0.05 mg/dl. Connective tissue screening test (antinuclear antibodies, anti double-stranded DNA antibodies, rheumatoid factor), Venereal Disease Research Laboratory test and enzyme-linked immunosorbent assay for human immunodeficiency virus were all negative. Fasting blood sugar was 4.7 mmol/L. However, annual lipid profile showed progressive derangement. The total cholesterol, triglyceride and LDL-cholesterol levels showed an increasing trend. While the HDL-choleterol levels were progressing in the opposite direction (Table 1). Chest radiography was normal.

The patient was diagnosed to have left major superior temporal branch retinal vein occlusion complicated by macula oedema. The cause of the RVO was attributed to dyslipidaemia secondary to quetiapine fumarate. The condition was conveyed to his psychiatrist, and he was subsequently referred to the internist for the management of his dyslipidaemia. The patient was treated with oral lovastatin 20 mg daily. His lipid profile normalized after 2 months but the final visual acuity remained 0.33 and near visual acuity N24 at 33 cm due to the presence of hard exudates at the fovea.

Discussion

Retinal vascular diseases are ocular manifestations of underlying systemic vascular disorders. The eyes are the only place in the body which allow direct visualization of the blood vessels. Therefore fundus examination offers a valuable opportunity for the early detection of occult systemic vascular disorders. Cugati et al in his analysis of 2 population-based cohorts (Beaver Dam Eye Study and Blue Mountains Eye Study) found out that participants aged less than 70 years old with retinal vein occlusion (RVO) at baseline were associated with higher cardiovascular mortality [1].

Being a part of the entity, RVO is the second most common retinal vascular disease after diabetic retinopathy. The true prevalence of retinal vein occlusive disorder is difficult to establish as many of them are asymptomatic and only diagnosed incidentally, unless it is complicated and visual disturbances manifest. Peripheral branch RVOs are asymptomatic. Symptomatic RVOs are due to macular involvement in which patients present loss of central vision. Macula oedema is the major cause of central visual loss in RVOs [2]. Nonetheless, data from longitudinal population based study has lead the Blue Mountain Eye Study to conclude the 10-year cumulative incidence of RVO to be at 1.6%, and it was greatly associated with increasing age especially those above 70 years old [3].

Although the vast majority of RVO are found in the middle aged and elderly population, it can affect young adults too. In a retrospective review of 60 cases, Lam et al found that only 1.7% of all branch retinal vein occlusions (BRVO) occurred in individual aged 49 or younger. Systemic hypertension, hyperlipidemia and increased body mass index are important risk factors for BRVO in this group of patients [4]. However, Lam et al did not test their young subjects for hypercoagulability or collagen vascular disease, and therefore they cannot comment on the need for more extensive work-up for such patients.

Quetiapine fumarate is a second generation antipsychotics that is currently in use for the treatment of many psychiatric disorders. Unlike the older phenothiazine-type drugs, these atypical antipsychotics block both the dopamine-2 receptor and the serotonin 5-HT2A receptor; hence making them a versatile group of drug to treat a wide variety of psychiatric disorders [5]. Another advantage of these second generation antipsychotics is the lower incidence of extrapyramidal side effects and tardive dyskinesia. The safety of these new atypical antipsychotics compared to the older phenothiazines is uncertain as they can cause serious adverse drug reactions.

Atypical antipsychotic agents increase the risk of glucose intolerance, dyslipidaemia and weight gain [6]. Quetiapine fumarate has been associated with high triglycerides in 23 percent and high cholesterol in 16 percent of patients taking it [7]. Olfson et al found that treatment with quetiapine was associated with increased risk of incidence of hyperlipidaemia (odds ratio:1.52, 95% CI: 1.40-1..65) [8]. Our patient had a normal baseline laboratory results, but went on to develop dyslipidaemia following 2 years of quetiapine treatment. Even though there is a link between dyslipidaemia and BRVO, the evidence in this case is not very strong since the patient's dyslipidaemia was not severe. Nevertheless, we must be vigilant and intervene at the first sign of dyslipidaemia before the patient develops central retinal vein occlusion, stroke or any cardiovascular event. In 2004, the American Diabetes Association, the American Psychiatric Association, the American Association of Clinical Endocrinologists, and the North American Association for the Study of Obesity consensus statement recommended that fasting plasma glucose, lipid levels, and blood pressure should also be assessed 3 months after initiation of antipsychotic medications. In those with a normal lipid profile, repeat testing should be performed at 5-year intervals or more frequently if clinically indicated [9].

The subtle worsening dyslipidaemia in this patient resulted in a thrombogenic environment that led to the development of BRVO. The localized increased arteriole reflexes with arteriovenous nicking found only along the right supero-temporal retinal artery were believed to be the sequelae of BRVO rather than the cause of it. This is due to hypoxia which induced localized microglial cells proliferation along the right supero-temporal retinal artery [10].

There was a smaller zone of flame shaped haemorrhages at the inferior temporal arcade. Features characteristic for a branch retinal vein occlusion were absent in this area. The presence of a peripheral branch retinal vein occlusion at this area is very difficult to prove without fluorescein angiography. We did not perform fluorescein angiography at the time of diagnosis because we felt that the risk outweighed the benefit, since the confirmation of the second smaller inferior temporal BRVO will not alter our management. To the best of the authors' knowledge, this is the first case of BRVO associated with quetiapine. This case report emphasize the importance of regular monitoring and prompt intervention of any metabolic derangement in order to avert severe morbidity and mortality.

Conclusions

RVOs in young adults require careful systemic evaluation for the presence of cardiovascular risk factors as well as to exclude hypercoagulabilities or collagen vascular diseases. The usage of antipsychotics medications require regular monitoring and prompt intervention for any metabolic side effects and adverse drug reactions.

Bailey Perrin Bailey - Weitz & Luxenberg - Pay to Play - Shall We Ask Why No One Is Minding The Hen House?

 

 Bailey Perrin Bailey - Weitz & Luxenberg - Pay to Play - Shall we ask why no one is minding the hen house?

 In a prior post about Bailey Perrin Bailey LLP on this blog, I  highlighted this law firm plaintiff heavy weight in the Seroquel litigation Bailey Perrin Bailey LLP  out of Houston Texas (also known as Houston Associates) along with Weitz & Luxenberg P.C. . These law firms were deemed the lead plaintiff counsel (here page 4) in the Seroquel litigation together compiling over 8000 of the some 28000 injured party cases. In prior post we have posed a lot of questions about some fairly obvious dubious behaviors going on in the Seroquel civil litigation and supposed tort settlement process. I would invite you the reader to browse through those post here at your leisure and convenience. 

In todays post I thought we would take a gander @ why no one appears to be looking into how a tort litigation got turned into a class action by proxy, or how plaintiff law firms with a legal & ethical obligation to serve their clients best interest are now marketing and selling a settlement that is really only serving the financial & best interest of AstraZeneca and themselves. There are many tens of thousands of injured parties lives literally hanging in the balance of how this turns out. I can only hope that bringing as much information and attention to this situation as possible can serve a higher purpose to a better outcome.

 

Let us look at what is the over riding concern of the mega law firms & pharmaceutical giants involved in this litigation? I would present to you that it's much more about the millions and even billions of dollars that are in play, than it is about justice or an equitable resolution for injured parties. Secret backroom power brokering and shady deal making appear to be the over riding factors is this perceived dubious, insulting, and unjust settlement process. All parties appear to have lost complete sight of what this should be all about, except for those actual unfortunate injured parties that have had their lives & health turned up side down by the drug Seroquel and the damage AstraZeneca has caused by their reprehensible greed driven and illegal corporate practices.   

 

So why is no one in the Government, with duty bound means & power willing to investigate or hold these law firms and corporations accountable for their despicable actions?

 

It's called PAY TO PLAY - pay in advance for favors down the road...and it's happening everyday in State Capitals, Washington DC, @ the Department of Justice, and even through those White House doors. It's called taking care of our friends (donors), demonizing our enemies for political benefit & forgetting who they are supposed to represent. Both political Parties are as guilty as the other...corruption and favoritism doesn't discriminate between political affiliations....the color of money green is the universal language.

 

I will attempt to lay out the numbers, the people, and the politics below in snippets & links....& I will give you the reader a little homework assignment to complete..you get to answer the "why" you may think the deck of cards are stacked against injured party litigants and Joe & Jane citizen when it's comes to getting justice or a fair shake in today's top down pay to play atmosphere in America.

 

Pay to Play: 

 

·  Kenneth Bailey - $8951 in Political Contributions for 2010

www.campaignmoney.com/political/contributions/kenneth-bailey.asp...

Sep 10, 2011 – Kenneth Bailey - $8951 in Political Contributions for 2010, Campaign ... Political Campaign Contributions ... Kenneth Bailey Contribution List in 2010 ... 77002, BAILEY PERRIN BAILEY, LLP/ATTORNEY, $2400, 09/30/2009, G ...

·  Michael Perrin - $18697 in Political Contributions for 2008

www.campaignmoney.com/political/contributions/michael-perrin.asp...

Sep 10, 2011 – Political Campaign Contributions ... Michael Perrin ...

·  F Bailey - $94250 in Political Contributions for 2010

www.campaignmoney.com/political/contributions/f-bailey.asp?cycle...

Sep 10, 2011 – F Bailey - $94250 in Political Contributions for 2010 ...

Pennsylvania Governor Ed Rendell Denies Accusations of Improper ...

online.wsj.com/article/SB123914567420098841.html

Apr 8, 2009 – On February 26, 2007, Bailey Perrin filed the initial complaint against Janssen on ... Asked about the timing of Mr. Bailey's political donations, Rendell .... Barnes & Noble acquired the customer list of Borders in September, in a ...

LegalNewsline | Bailey's contributions at issue in Pennsylvania case

www.legalnewsline.com/.../214306-baileys-contributions-at-issue-in-...

Jul 22, 2008 – Mike Perrin, Ken Bailey's law partner ... on the biggest companies in the world, Bailey's largest campaign contributions are often handed to the ...

http://online.wsj.com/article/SB123984994639523745.html

http://www.nytimes.com/2010/05/19/nyregion/19rice.html

·  Perry Weitz - $58000 in Political Contributions for 2010

www.campaignmoney.com/political/contributions/perry-weitz.asp?...

Sep 10, 2011 – Perry Weitz - $58000 in Political Contributions for 2010, Campaign Finance, Money, ... Perry Weitz Contribution List in 2010 ... 10003, Weitz & Luxenberg/Attorney, $2300, 12/08/2010, P, WILDES FOR CONGRESS - Democrat ...

·  Perry Weitz - $93500 in Political Contributions for 2008

www.campaignmoney.com/political/contributions/perry-weitz.asp?...

Sep 10, 2011 – Perry Weitz - $93500 in Political Contributions for 2008 ...

·  Arthur Luxenberg - $87565 in Political Contributions for 2006

www.campaignmoney.com/political/contributions/arthur-luxenberg.a...

May 2, 2011 – Arthur Luxenberg - $87565 in Political Contributions for ...

Lawyers / Law Firms: Top Contributors to Federal Candidates, Parties, and Outside Groups

Election cycle 2000

Weitz & Luxenberg  $527,550 

Williams & Bailey  $1,600,800

Election cycle 2002

Williams & Bailey $2,428,400

Election cycle 2006

Weitz & Luxenberg $580,311

Election cycle 2012

Weitz & Luxenberg $252,800

Pharmaceutical Rsrch & Mfrs of America$9,290,000Pfizer Inc$7,340,000Merck & Co$4,675,000Amgen Inc$4,490,000Eli Lilly & Co $4,480,000Biotechnology Industry Organization$3,980,000Novartis AG$3,608,136Bayer AG$3,330,000Sanofi-Aventis$3,112,000Johnson & Johnson $3,106,000AstraZeneca PLC$2,730,000Roche Holdings$2,654,893GlaxoSmithKline$2,650,000Medtronic Inc$2,473,710Teva Pharmaceutical Industries$2,110,000Abbott Laboratories$2,060,000Bristol-Myers Squibb$1,700,000Mylan Inc$1,452,123Novo Nordisk Pharmaceuticals$1,390,000CH Boehringer Sohn$1,315,936Merck KGaA$1,270,000Watson Pharmaceuticals$1,210,000Kv Pharmaceuticals$1,190,000Eisai Co Ltd$1,180,000Endo Pharmaceuticals$1,160,000McKesson Corp$1,150,000Pharmaceutical Care Management Assn$1,002,830

Lobbying

Top Industries

Years 1998 – 2011

Pharmaceuticals/Health Products $2,204,027,124