I admire clients who find the strength to tell their stories on television.  It takes guts. When Susan Galinis said she wanted to do just that, I warned her that it would be difficult and, well, embarassing.  She said she didn’t care.  If she could persuade just one woman to switch from Yaz to a traditional birth control pill, it would be worth it.  

On Monday, Susan appeared on local Fox, ABC, and NBC stations. She showed to the cameras pictures that, until now, she hadn’t shown to anyone outside her family. 

After Susan’s story aired, I received dozens of calls from Yaz survivors who asked me to thank Susan for getting the word out, or to offer her their help and support.  Some called to ask for more information or just to talk about their own experiences.  One talked about a friend she lost to Yaz.  I appreciate hearing from anyone whose life has been impacted by this drug.  

We’re working on all of our Yaz and Yasmin cases with a Yaz law firm in San Francisco.  We chuckled over the fact that Bayer had no problem speaking to reporters before the first news segment aired. But once Bayer actually saw Susan and heard what she had to say, the company apparently could think of no response and refused to speak with the reporters who produced the later segments.

Susan, you “done good.”

Beginning in July 2003, the Food and Drug Adminstration warned Bayer (or more accurately, Bayer’s predecessor, Berlex Laboratories ) that its television commercials for Yasmin were misleading and should be corrected.  The FDA warned Bayer again in 2008, and again in 2009.  Among Bayer’s more serious violations, accorYaz Commercial Screen Shotding to the FDA, was that the commercials minimized the risks associated with Yaz while at the same time overstating its benefits — especially for conditions such as premenstrual syndrome for which the drug was never approved.  According to the FDA:

These violations are concerning from a public health perspective because they encourage use of YAZ in circumstances other than those in which the drug has been approved, over-promise the benefits and minimize the risks associated with YAZ.

FDA Warning Re Yaz

Yaz and Yasmin cause blood clots that often begin in the deep veins of the legs. A clot, called a Deep Vein Thrombosis (DVT), can break off and move to the brain, where it causes a stroke. If the clot moves to the lung, it causes a pulmonary embolism. If it moves to the heart, it can cause a heart attack.

Within weeks of taking Yaz or Yasmin, women have been stricken by life-changing strokes . For some women, the stroke or heart attack occur without warning. For others, there are warning symptoms. These warning symptoms include:

  • Pain in the calf or the back of the leg (Possible DVT)
  • Sudden headaches (Possible stroke)
  • Unusual swelling in the lower legs (Possible DVT)
  • Chest pains or heaviness (Possible heart attack)
  • Drooping of the eye or mouth (Possible stroke)
  • Weakness in arm or leg or speech problems (Possible stroke)
  • Eye problems and loss of vision (Possible eye clot)

Studies show that the risk of clots is higher with Yaz and Yasmin than other birth control drugs that don’t contain drospirenone. Drospirenone is believed to cause strokes in a number of different ways.  For example, besides causing clots in the legs, it is believed that the drug changes the rhythms of the heart, slowing blood flow to the point that it clots there as well. 

Gallbladder disease includes inflammation and infection (cholecystitis), stones (chollithiasis) or other obstructions or narrowing of the ducts. It appears that Yaz increases the cholesterol level in a woman’s bile while, at the same time, decreasing gallbladder movement. That leads to gallstones which can block and damage ducts, requiring that the gallbladder be removed.

Some women function well without a gallbladder. But in about 40% percent of the cases, the women will suffer pain or discomfort for months or even years after the surgery. In one out of five cases, the common bile duct will be damaged during the surgery, leading to fever, jaundice, and chronic pain in the shoulders and abdomen. Further surgery may be needed to correct the complications. Even when a second surgery is not required, many patients who have had their gallbladder removed find that they must permanently change their diets after the surgery because without a gall bladder they are unable to digest the foods they used to eat.

The symptoms of gallbladder disease include pain under the lower breastbone, eventually progressing to under the right breast and then onto the back or between the shoulder blades. Other symptoms include fever, heartburn, nausea and vomiting. The symptoms are typically recurrent.

Yaz and Yasmin cause blood clots. When a blood clot finds its way to the lungs, the result is a pulmonary embolism. The blood clot cuts off the flow of oxygen and blood to a portion of the lung. A pulmonary embolism can be fatal. In fact, about 15% of all sudden death is attributable to pulmonary embolisms.  In some cases the pulmonary embolism can travel to the brain and cause a stroke.  In less severe cases it can lead to lung damage. The symptoms of a pulmonary embolism include:

  • Sudden shortness of breath, especially after even slight exertion;
  • Rapid breathing;
  • Coughing up blood;
  • Chest pain that mimics a heart attack. The pain gets worse with exercise but remains even after resting; and
  • Rapid heartbeat. 

A more complete list of symptoms can be found here.

Victims with full thickness burns, as discussed here, on their arms and legs experience tremendous swelling from the fluids necessary to heal. The swelling puts pressure on the nerves and tissues of the healthy sections of the burned limbs.  The pressure may cause a complete loss of blood flow and tissue damage to the distal limb.  To relieve the pressure and promote blood flow, the burn surgeon may perform the following procedures:

  • Escharotomy — slitting of the burned skin (eschar);
  • Fasciotomy — slitting of the burned  skin and splitting of the fascia (the thick white covering of the muscle) to inspect how the muscle is doing.

Although gruesome, the surgeons often take photos before and after the procedure to document the health of the tissue and progression toward recovery.  Such photos may be helpful to educate the jury about the victim’s pain and suffering.

 

Some insurance company doctors say that young brains are more resilient. These doctors testify at trial that, when it is a young child who has suffered a traumatic brain injury, the prospects for a good recovery are brighter than they would be if the child were older.

New research shows that the opposite may be true.  A traumatic brain injury may throw off a child’s normal developmental timetable. Though the child may experience encouraging improvement in the first two years after an injury, after that, it may be that the child never really catch up to his peers. Rather, he may simply fall further behind over time. Because younger children have more development ahead of them, brain injuries at younger age is a "double hazard," the researchers noted.  That means that the same injury can cause much more trouble for a 4 year old than a 12 year old.

The study was published earlier this year in Neuropsychology, 2009; 23 (3) (subscription required).
 

When a worker is injured on-the-job in California, his rights are limited by the workers’ compensation laws. Workers’ compensation is a “no-fault” system.  That means the employee is entitled to compensation from the employer’s insurance carrier without having to prove the employer was at fault.   However, the workers compensation benefits are quite limited, and they seldom fully compensate an accident victim for his injuries.     

In an appropriate case, an injured worker can seek compensation for his on-the-job injury from other sources. For example:

  • If a co-worker causes the injury, the injured worker may be permitted to seek compensation from the co-worker, but only (1) when co-worker’s actions are malicious with an intent to cause injury or (2) when co-worker is intoxicated.
  • If someone other than the employer or co-worker (also known as third party) causes the injury, the worker may seek compensation from the third party.  The victim’s lawsuit against the third party can proceed at the same time as the workers’ compensation claim against the employer.  In his third party lawsuit, the worker is not restricted to the limited benefits of worker’s comp.   However, if the worker recovers against the third party, the employer is entitled to reimbursement for any benefits paid to the injured worker.

In some cases there may be multiple causes of a worker’s injury and he should proceed against his employer, a co-worker and a third party.

 

When a head is twisted violently, such as in a car crash, microscopic brain structures, called axons, can tear.  The damage to the brain is a called a "diffuse axonal injury," or DAI.  When the axons tear, chemicals that were contained in those structures can leak into the brain tissue.  The torn axons and chemicals in the brain tissue disrupt the brain’s regular processes.  

The injury has been named "diffuse" because it was believed the damage occurred throughout the brain, and not in any one particular location.  We now know that that isn’t quite right.  For example, in severe cases, the axonal injury appears on an MRI.  When it does, it usually appears as one small foggy area.  (Seen in the center of the graphic as an opaque area.)   In fact, as it turns out, the damage caused by a "diffuse axonal injury" is usually centered in a specific part of the brain called the corpus callosum — the bundle of fibers that connect the two-halves of the brain. 

Victims suffering from DAI often have cognitive problems such as:

  • lack of concentration
  • poor long-term memory
  • difficulty dealing with more than one thing at a time,
  • lack of attentiveness
  • trouble keeping track of appointments, and
  • disorganization.

A victim can suffer a diffuse axonal injury even if there wasn’t any impact to the head. Because there is no tell-tale external bruising or bleeding, and because the DAI doesn’t always appear on an MRI, health care providers sometimes fail to diagnose the injury initially.  To represent an accident victim effectively, the personal injury attorney must be alert to symptoms which may suggest that the client should seek further medical evaluation.

Most TBI victims suffer from seizures and so need anti-seizure drugs. The drugs don’t eliminate the seizures, they attempt only to control them. Even if the TBI victim takes the drugs exactly as prescribed, the victim may still experience "breakthrough seizures." The seizures can lead to embarassment, social stigma and most troubling, a blackout while driving. The victim who experiences breakthrough seizures may lose his driving privileges until he is seizure free for three months or maybe permanently. A TBI victim is entitled to compensation for all seizure-related damages. So, for example, if the victim loses his driving privileges, one form of damages might be the costs of hiring a driver. And don’t forget damages in the form of pain and suffering associated with the loss of driving privileges (ie. embarassment, loss of independence, etc.).