Aa
Phen fen
I graduated with an M.D. degree 30 years ago and went into immunology. Everyone in the family thinks I am the family doctor and I simply don't have time to keep up with it anymore. I have an uncle. His wife had a St. Jude's value replacement in 1994 as the result of rheumatic fever during her childhood. She recovered from that surgery and moved to another state. In 1996 she had an echocardiogram done by her new cardiologist. There is not indication of mitral value regurgitation. 1996. The class action response is due next Monday. A she stopped taking the diet drug 2001 echocardiogram indicates Mitral regurgitation: Aortic Insufficiency and her treating cardiologist indicates she has a NAY. class two heart. In June of 2001. However a right heart catheterization in May of 1998 indicated a N.Y. Heart Class IV which would make my aunt eligible for benefits. Which test would be the most reliable? Would Phen fen have caused regurgitation with a patient who already had a St Jude’s valve? I.e. did the Phen fen affect the value itself or the back pressure etc?
Ive been reading the postings. Just this week, June 20 2012 I had an echo cardiogram and a ct scan ,right side of my heart is enlarged. I took den phen in the 90's. I've been short of breath for awhile now. I hope I make thru this .I'm seeing a cardiologist this Tuesday he will most likely order a heart cath.I will be looking to get involved in the settlement. In 2002 I went for a echcocardiagram they said it was normal. So long ago .the provider was probably from the fenphen company.
Dear Maggie, don't ever say yu are just an R.N. That is a highly honrable profession and many times they have much more intiutive knowldge of a patients overall condition than do the doctors. cardiologists. I am sending a quote you may like. "Sir James Mackenzie learned, according to his biographer, that:
‘Signs and symptoms were certainly important, but they had to be interpreted against the wider back-cloth – of the patient as a person and his response to an environment of home and work, of climbing hills and stairs – the whole art and process of living. It was the whole man, and then … that had to be studied."
What drove Sir James Mackenzie on?
‘Perhaps the answer lay in a single word: compassion. Mackenzie cared about his patients and suffered with them.”
That is something modern medicine is missing. No this is not being driven by an attorney but by grief and two of her cardiologists saying it was Phen fen related.
HERE ARE THE NOTES the deceased husabnd is relying on in the medical records as summarized by me.
2. Exhibit 2: Exhibit 2 consists of 6 pages and includes a status report by Claimant treating cardiologist at the Nebraska medical Center and in the same group as Dr. __________ He took an Echocardiogram on February 29, 1996. It and the accompanying notes of her cardiologist Dr. ____________is marked exhibit 1 and consist 6 pages. That Echocardiogram indicates no indication of mitral regurgitation. Also of note is the significant overall improvement in the heart post St. Jude’s surgery including a normal right ventricular size with mildly depressed function?
3. Exhibit 3: Exhibit three consists of 9 pages and includes the hospitalization records of claimant in the University of Nebraska Medical center from My 10, 1998 until discharged on May 22, 1998. In her admission it is noted she has a New York class four heart. She was on the heart transplant list. Also included are the results of the Cardiac Catherization procedure on 5-19-98 which shows a class four heart. It is obvious that the claimant’s heart had degenerated from the condition it was in previous to the diet drug. She was diagnosed with a New York Class four heart and during that time she was placed on the heart transplant list. Dr. Douglas Blank a board certified cardiologist diagnosed claimants heart on his report as having Heart Failure: New York Class : IV Dypnea, pulmonary edema. He notes on the second page of his report tricuspid regurgitation which is an increased risk factor with the use of the diet medications called "Fen-Phen" (phentermine and fenfluramine) or dexfenfluramine.
4. Exhibit 4: Exhibit four is 2 pages and consists of the echocardiogram done by Dr. Thomas ______________ for Dr. __________on 7-2-97 and it suggests a seriously worsening heart failure, severe tricuspid regurgitation, severe globally reduced systolic function, right ventricle is dilated with severely reduced right ventricular ejection fraction, right atrial pressures are elevated and mild aortic insufficiency.
Dr. _____________Mitral Regurgitation: Aortic Insufficiency, It is noted she has moderate tricuspid regurgitation which is an increased risk factor with the use of the diet medications called "Fen-Phen" (phentermine and fenfluramine) or dexfenfluramine.
Under the Matrix test: Fen Phen has been linked to PPH or PAH, a condition which causes the pulmonary arteries to narrow which decreases the flow of blood from the heart to the lungs. As a result, the right side of heart is forced to work harder to pump blood through the lungs.This increased work causes the heart muscle to weaken and eventually the heart loses its ability to pump enough blood throughout the body, resulting in heart failure.
Heart Valve Disease- Fen Phen has been linked to Mitral Valve Regurgitation, Aortic Valve Regurgitation and other heart valve abnormalities.
The settlement established five levels of injury and two payment schedules, one for long-term fen-phen users and the other, a percentage of the first, for people who'd taken the drugs for less than two months or had alternate medical explanations for their disease. At the high end of the full payment matrix were victims whose heart valve damage was so severe that they'd had strokes, died or required heart transplants. Depending on their age, those Level V victims could receive upwards of $1.3 million. At the low end of the partial payment matrix was about $7,500 to Level I claimants, whose echocardiograms showed evidence of significant valve damage but no other indicators of serious heart disease.
Level II benefits in the trust fund, averaging almost $500,000, required not only an echocardiogram showing serious heart valve damage, but also evidence of a complicating factor that could lead to advanced heart disease. The most common complicating factors were an oversize left atrial chamber, which indicated that the heart was working harder than normal to pump blood because of the faulty valve; or a reduced volume of blood leaving the ventricle chamber.
People with serious heart valve damage received full payments if they could show that they'd taken Pondimin or Redux for more than 61 days and had no other medical conditions to explain their diseaseLevel II benefits at a wholly unanticipated rate. Level II benefits in the trust fund, required not only an echocardiogram showing serious heart valve damage, but also evidence of a complicating factor that could lead to advanced heart disease. The most common complicating factors were an oversize left atrial chamber, which indicated that the heart was working harder than normal to pump blood because of the faulty valve; or a reduced volume of blood leaving the ventricle chamber.
Wythe apparently made the assumption they could limit the damages of the lawsuit by making the guideline rather wide open as to who was eligble and by doing that they could limit the damages from private litigations which could cost hundres of millions of dollars in punitive damges. And that is what i know.
Thanks for your comments. I did file an appeal but I am not sure why as i am not sure looking at the settlement as i presetned it to you it makes sense.
‘Signs and symptoms were certainly important, but they had to be interpreted against the wider back-cloth – of the patient as a person and his response to an environment of home and work, of climbing hills and stairs – the whole art and process of living. It was the whole man, and then … that had to be studied."
What drove Sir James Mackenzie on?
‘Perhaps the answer lay in a single word: compassion. Mackenzie cared about his patients and suffered with them.”
That is something modern medicine is missing. No this is not being driven by an attorney but by grief and two of her cardiologists saying it was Phen fen related.
HERE ARE THE NOTES the deceased husabnd is relying on in the medical records as summarized by me.
2. Exhibit 2: Exhibit 2 consists of 6 pages and includes a status report by Claimant treating cardiologist at the Nebraska medical Center and in the same group as Dr. __________ He took an Echocardiogram on February 29, 1996. It and the accompanying notes of her cardiologist Dr. ____________is marked exhibit 1 and consist 6 pages. That Echocardiogram indicates no indication of mitral regurgitation. Also of note is the significant overall improvement in the heart post St. Jude’s surgery including a normal right ventricular size with mildly depressed function?
3. Exhibit 3: Exhibit three consists of 9 pages and includes the hospitalization records of claimant in the University of Nebraska Medical center from My 10, 1998 until discharged on May 22, 1998. In her admission it is noted she has a New York class four heart. She was on the heart transplant list. Also included are the results of the Cardiac Catherization procedure on 5-19-98 which shows a class four heart. It is obvious that the claimant’s heart had degenerated from the condition it was in previous to the diet drug. She was diagnosed with a New York Class four heart and during that time she was placed on the heart transplant list. Dr. Douglas Blank a board certified cardiologist diagnosed claimants heart on his report as having Heart Failure: New York Class : IV Dypnea, pulmonary edema. He notes on the second page of his report tricuspid regurgitation which is an increased risk factor with the use of the diet medications called "Fen-Phen" (phentermine and fenfluramine) or dexfenfluramine.
4. Exhibit 4: Exhibit four is 2 pages and consists of the echocardiogram done by Dr. Thomas ______________ for Dr. __________on 7-2-97 and it suggests a seriously worsening heart failure, severe tricuspid regurgitation, severe globally reduced systolic function, right ventricle is dilated with severely reduced right ventricular ejection fraction, right atrial pressures are elevated and mild aortic insufficiency.
Dr. _____________Mitral Regurgitation: Aortic Insufficiency, It is noted she has moderate tricuspid regurgitation which is an increased risk factor with the use of the diet medications called "Fen-Phen" (phentermine and fenfluramine) or dexfenfluramine.
Under the Matrix test: Fen Phen has been linked to PPH or PAH, a condition which causes the pulmonary arteries to narrow which decreases the flow of blood from the heart to the lungs. As a result, the right side of heart is forced to work harder to pump blood through the lungs.This increased work causes the heart muscle to weaken and eventually the heart loses its ability to pump enough blood throughout the body, resulting in heart failure.
Heart Valve Disease- Fen Phen has been linked to Mitral Valve Regurgitation, Aortic Valve Regurgitation and other heart valve abnormalities.
The settlement established five levels of injury and two payment schedules, one for long-term fen-phen users and the other, a percentage of the first, for people who'd taken the drugs for less than two months or had alternate medical explanations for their disease. At the high end of the full payment matrix were victims whose heart valve damage was so severe that they'd had strokes, died or required heart transplants. Depending on their age, those Level V victims could receive upwards of $1.3 million. At the low end of the partial payment matrix was about $7,500 to Level I claimants, whose echocardiograms showed evidence of significant valve damage but no other indicators of serious heart disease.
Level II benefits in the trust fund, averaging almost $500,000, required not only an echocardiogram showing serious heart valve damage, but also evidence of a complicating factor that could lead to advanced heart disease. The most common complicating factors were an oversize left atrial chamber, which indicated that the heart was working harder than normal to pump blood because of the faulty valve; or a reduced volume of blood leaving the ventricle chamber.
People with serious heart valve damage received full payments if they could show that they'd taken Pondimin or Redux for more than 61 days and had no other medical conditions to explain their diseaseLevel II benefits at a wholly unanticipated rate. Level II benefits in the trust fund, required not only an echocardiogram showing serious heart valve damage, but also evidence of a complicating factor that could lead to advanced heart disease. The most common complicating factors were an oversize left atrial chamber, which indicated that the heart was working harder than normal to pump blood because of the faulty valve; or a reduced volume of blood leaving the ventricle chamber.
Wythe apparently made the assumption they could limit the damages of the lawsuit by making the guideline rather wide open as to who was eligble and by doing that they could limit the damages from private litigations which could cost hundres of millions of dollars in punitive damges. And that is what i know.
Thanks for your comments. I did file an appeal but I am not sure why as i am not sure looking at the settlement as i presetned it to you it makes sense.
I am trying to help but still confused, sorry! It appears to me that she has left heart dysfunction primarily, which would mean that elevated pulmonary pressures are from that, and not a true pulmonary ARTERY hypertension. Phen-fen caused idiopathic PAH, meaning there was no other cause. It was NOT related to left heart disease at all. Who started the idea that her heart problems were from Phen-fen? True, she has elevated pressures, not severely, but elevated. She has triscuspid regurg but they would both be due to the left heart problems. Her right ventricle is not enlarged at all, so she didn't have right heart failure, which could've been caused by PAH from Phen-fen, but not in her case. I still don't know where this doctor got her class 2 NYHA because it is only based on functional capacity like I said.
Is some lawyer pushing this? Doesn't sound to me that her heart condition is related in any way to have taken Phen-fen, but I am only an RN, not a doctor. She had a dilated cardiomyopathy, a left heart problem.
If you have a low EF, like 20-25, you are more likely to develop clots in your heart, and thus she actually could've died from a stroke. Of course I haven't seen her autopsy report, if any, but it IS possible. I was put on Coumadin for that reason when my EF was 15%.
I hope this helps explain some of it, but I don't see how she has a case for Phen-fen.
Is some lawyer pushing this? Doesn't sound to me that her heart condition is related in any way to have taken Phen-fen, but I am only an RN, not a doctor. She had a dilated cardiomyopathy, a left heart problem.
If you have a low EF, like 20-25, you are more likely to develop clots in your heart, and thus she actually could've died from a stroke. Of course I haven't seen her autopsy report, if any, but it IS possible. I was put on Coumadin for that reason when my EF was 15%.
I hope this helps explain some of it, but I don't see how she has a case for Phen-fen.
I apologize for the poor typing as I dictated it to my secretary. Under the matrix if she had to have had her mitral value replaced after taking Phen fen and she then died she would be eligble for benefits. If it was before she is disqualified. In August of 1994 the operative procedure notes states " We opened the left atrium, found that the anterior eaf chorda had stretched out and there was no possibility of repair. A st. Judes value was used to replace the mitral value. She had somewhat mild cariomyopathy and normal coronaries.
An echocardiogram done prior to discharge revealed no significant pathology, no effusion and no tamponade. On Feb 29, 2006 and transthoracic ECHOcardiofram was performed and this demonstarted left fentricular systolic function with a global hypokinesia and ejection fraction of only 30% Her diastolic volume was 184 ml and systolic volume was 128 ml. Her LV was dialed at 5.6 cm and LV mass 122 GM/meter. St Jude normal. No evidence of thrombus and mild aortic insufficency. Moderate tricususpid regurgitation with pulmonay pressures estimated at 4o to 45 MMHg. Her prothrombin demonstarated and INR of 2.8. After being taken of the diet medication the Echocardiagram shoed kilated hypertropied left ventrticle with severe globally reduced systolic function more severe than in 96 tet, left ventricular ejection fraction of 20-25%, LV end Dias Vol. 199 ML, LV end syst volume 137 ML, stable mitral value, severe trcuspid regurgitation, doppler pulmonary systolic pressure 50-55 MM HG, increased in severity , right ventricle is lialated with severly reduced right ventricular ejection fraction, right atyrial pressuers elevated, structurally6 normal aortic valve mild aortic insufficiency. On May 1of 1998 (after diet pill) heart caterization showed 02 consumation 221 cc/min, 02 comsumation Index:133 cc/min/m2, A-V 02 difference: 6 vol%, CO Fick: 3.68 1/min, CI Fick: 2.22 1/min, CO thrmodilution:4.6 L/min, CI Thermodilution: 2.78 L/min/m2, CO Average:4.14 L/min, CI average 2.50 L/min/m2, co for caolcculations: CO Fick, hert rate 68 bpm, stroke vol. 54 cc/beat, stroke index: 33 cc/beat/m2
PVR (ARU): 217 dyne: sec. cm-5, PVR (ARU): index: 360 dyne" sec. cm-5, PVR (HRU):2.7 units, PVR (HRU)inex: 4.5 units. conclusion heart failure New York clas: IV. Dyspnea. Pulmonary edema, Periperal edema, Cardiac Rhythm: NSR. Finally in 2001 and Echocardiagram was given and it indicated severe globally depressed left ventricular systolic function, Ejection Fraction 20-25%,
Focally calcified aortic value, mild Aortic insufficiency, no aortic stenosis, Stable appearing bileaflet mitral value with trace regurgitation, normal size right ventricle with mildly depressed right ventricular systolic function, trace pulmonic insufficiency, Moderate tricuspid regurgitation estimated pulmonary artery systolic Pres is 48 MM HG., no pericardial effusion, color flow doppler aortic root 2.9 CM, LV Internal Diameter Diatole 5.9 CM, systole 5.1CM septal thickness 1.0 CM, LV posterior wall thickness 0.9 C.m,LV outfolw Tract Diameter 1.7 CM, ejection Fraction 20-25% and RV diameter 3.4CM. Like I said i went on from medical school and went straight into immunology and my Ph"D is in that field. I have not had the time to study what Phen Fen did or if it did anything. I deal with FDA regulations no as I am no longer in the science part but I am the president of the company. Can anyone tell me if this is indicative of my aunt taking the Phen fen. Her cardiologist that had the original echo in 1996 bfore diet drug, and the echo in 1997 after the drug and ordered the heart catherization in 1998 is no longer at the university and the Dr. that did the last Echocardiagram (dept. head) told her after the 2001 Echo she had a class II New York heart and she would not get benefits from Phen Fen action. He also refuses to review her chart and says she died of a stroke.
She di not have a stroke and died in her sleep of heart failure. THANKS BIG TIME.
An echocardiogram done prior to discharge revealed no significant pathology, no effusion and no tamponade. On Feb 29, 2006 and transthoracic ECHOcardiofram was performed and this demonstarted left fentricular systolic function with a global hypokinesia and ejection fraction of only 30% Her diastolic volume was 184 ml and systolic volume was 128 ml. Her LV was dialed at 5.6 cm and LV mass 122 GM/meter. St Jude normal. No evidence of thrombus and mild aortic insufficency. Moderate tricususpid regurgitation with pulmonay pressures estimated at 4o to 45 MMHg. Her prothrombin demonstarated and INR of 2.8. After being taken of the diet medication the Echocardiagram shoed kilated hypertropied left ventrticle with severe globally reduced systolic function more severe than in 96 tet, left ventricular ejection fraction of 20-25%, LV end Dias Vol. 199 ML, LV end syst volume 137 ML, stable mitral value, severe trcuspid regurgitation, doppler pulmonary systolic pressure 50-55 MM HG, increased in severity , right ventricle is lialated with severly reduced right ventricular ejection fraction, right atyrial pressuers elevated, structurally6 normal aortic valve mild aortic insufficiency. On May 1of 1998 (after diet pill) heart caterization showed 02 consumation 221 cc/min, 02 comsumation Index:133 cc/min/m2, A-V 02 difference: 6 vol%, CO Fick: 3.68 1/min, CI Fick: 2.22 1/min, CO thrmodilution:4.6 L/min, CI Thermodilution: 2.78 L/min/m2, CO Average:4.14 L/min, CI average 2.50 L/min/m2, co for caolcculations: CO Fick, hert rate 68 bpm, stroke vol. 54 cc/beat, stroke index: 33 cc/beat/m2
PVR (ARU): 217 dyne: sec. cm-5, PVR (ARU): index: 360 dyne" sec. cm-5, PVR (HRU):2.7 units, PVR (HRU)inex: 4.5 units. conclusion heart failure New York clas: IV. Dyspnea. Pulmonary edema, Periperal edema, Cardiac Rhythm: NSR. Finally in 2001 and Echocardiagram was given and it indicated severe globally depressed left ventricular systolic function, Ejection Fraction 20-25%,
Focally calcified aortic value, mild Aortic insufficiency, no aortic stenosis, Stable appearing bileaflet mitral value with trace regurgitation, normal size right ventricle with mildly depressed right ventricular systolic function, trace pulmonic insufficiency, Moderate tricuspid regurgitation estimated pulmonary artery systolic Pres is 48 MM HG., no pericardial effusion, color flow doppler aortic root 2.9 CM, LV Internal Diameter Diatole 5.9 CM, systole 5.1CM septal thickness 1.0 CM, LV posterior wall thickness 0.9 C.m,LV outfolw Tract Diameter 1.7 CM, ejection Fraction 20-25% and RV diameter 3.4CM. Like I said i went on from medical school and went straight into immunology and my Ph"D is in that field. I have not had the time to study what Phen Fen did or if it did anything. I deal with FDA regulations no as I am no longer in the science part but I am the president of the company. Can anyone tell me if this is indicative of my aunt taking the Phen fen. Her cardiologist that had the original echo in 1996 bfore diet drug, and the echo in 1997 after the drug and ordered the heart catherization in 1998 is no longer at the university and the Dr. that did the last Echocardiagram (dept. head) told her after the 2001 Echo she had a class II New York heart and she would not get benefits from Phen Fen action. He also refuses to review her chart and says she died of a stroke.
She di not have a stroke and died in her sleep of heart failure. THANKS BIG TIME.
I am very confused by your questions. First of all, I thought Phen-Fen only caused pulmonary hypertension, not mitral problems. And the NY heart classifications are based on functional capacity, not degree of valve regurgitation. So it doesn't matter which test she had because the test would not determine her heart class. A right heart cath would be the more accurate if you were measuring pulmonary pressures. An echo is only an estimate of pulmonary pressures and can be way off. Also, what do you mean by the physician indicating she has a NAY? What does that mean? :-)
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