2021 FEN PHEN Lawsuit - Pulmonary hypertension lAWYER 

2021 UPDATE: FEN PHEN LAWSUITS ARE STILL BEING FILED AND PAID
Fen Phen Lawyer, Cynthia K. Garrett, Has Been Representing Pondimin and Redux victims since 1998.  
Accepting new Fen Phen clients nationwide.

WHAT IS FEN-PHEN: 
Fen-Phen is the common name of a weight loss protocol heavily marketed in the 1990's that combined phentermine with either fenfluramine (Pondimin) or dexfenfluramine (Redux).
Pondimin and Redux were shown to cause damage to the mitral and aortic heart valves; and a serious lung condition called primary pulmonary hypertension (PPH) now known as idiopathic pulmonary arterial hypertension (IPAH).
Pondimin and Redux were withdrawn from the U.S. market in 1997. 

WHAT IS PULMONARY HYPERTENSION:
​​Pulmonary hypertension is elevated blood pressures that affects the arteries in your lungs and the right side of your heart. 

WHAT IS PRIMARY PULMONARY HYPERTENSION  (PPH) also known as IDIOPATHIC PULMONARY ARTERIAL HYPERTENSION (IPAH):
Pulmonary hypertension is characterized as primary or idiopathic when all known causes which can be ruled out have been ruled out.  ​

Known causes which must be ruled out before pulmonary hypertension is considered to be PPH / IPAH: 
Left-sided heart disease such as aortic or mitral valve disease, failure of the lower left chamber of the heart, inherited risks for PH, congenital heart defects including Eisenmenger syndrome (large hole between the two lower chambers of the heart), portal hypertension, scleroderma, lupus, HIV, cirrhosis, use of methamphetamines or cocaine, exposure to certain toxins, and lung diseases such as: COPD, emphysema, pulmonary fibrosis, interstitial fibrosis (such as silicosis, asbestosis, and granulomatous), significant sleep apnea, long-term exposure to high altitudes, and chronic blood clots in the lungs.  Other possible causes include: certain blood disorders, sarcoidosis, glycogen storage disease, and tumors pressing against pulmonary arteries.

WHAT HARM CAN PULMONARY HYPERTENSION CAUSE:
PH can lead to complications including: right-sided heart enlargement, heart failure, blood clots in the lungs, heart arrhythmia, and bleeding in the lungs.
Pulmonary hypertension requires on-going medical treatment.  The disease is potentially fatal if it cannot be effectively treated.

TESTS USED TO DIAGNOSE PULMONARY HYPERTESION:
​Early testing often includes chest x-rays and EKGs.  If pulmonary hypertension is suspected further tests may include:

• Right-heart catheterization -  evaluate if PH is present and to measure severity.
• CT Scan - evaluate the heart's size and functional capacities, and to look for blood clots.
  
• MRI - evaluate the lower chamber of the right side of the heart, and the flow of blood from the heart to the lungs and in the lung's arteries.
  
• Pulmonary function tests - to see how much air the lungs can hold, and how well air moves in and out of the lungs. 
  
• Polysomnogram - detects brain activity, heart rate, blood pressure, oxygen levels and other factors while you sleep, as a tool to diagnose sleep disorders that can lead to PH.
  
• Perfusion scan - maps blood flow and air in the lung used to determine if blood clots are causing PH.  
  
• Blood tests - both to detect substances that may be the cause of PH, as well as diagnosing the extent of damage throughout the body.
  
• Lung biopsy - looking for changes to the tissues in the lung that could cause PH.  For example: tumors, cancerous or benign; as well as scarring or fibrosis.
  
• ​Genetic testing - performed if a family member has had PH.  Some genetic mutations are linked with PH.
  
• ​Profiles - determine if the patient has been exposed to certain drugs, toxic chemicals, or if the patient has engaged in occupational or recreational activities associated with high-altitudes.
  

​​​Treatment For Pulmonary Hypertension:
​Although there is no cure, treatments include prescription medication and in some cases, surgery:
​​Prescription Medications used to treat pulmonary hypertension:​

• Blood vessel dilators (vasodilators) - open narrowed blood vessels.  Including: Epoprostenol (Flolan & Veletri), Iloprost (Ventavis), Treprostinil (Tyvaso, Remodulin, Orenitram)​
• ​Edothelin receptor antagonists: ​Including:  Bosentan (Tracleer),  Macitentan (Opsumit), Ambrisentan (Letairis)​
  
• Vasodilators commonly used to treat erectile dysfunction, are also used to treat PH:  Including:  Sildenafil (Revatio, Viagra), Tadalafil (Cialis, Adcirca)
  
• ​Calcium channel blockers: Including:  Amlodipine (Norvasc), Diltiazem (Cardizem, Tiazac and others), Nifedipine (Procardia and others)
  
• ​Soluble guanylate cyclase (SGC) stimulator - Riociguat (Adempas)
  
• ​​Anticoagulants: such as warafin (Coumadin)​
  
• Digoxin (Lanoxin)
  
• Diurectics - also called water pills
  
• ​Oxygen
  

​Surgeries Used To Treat PH:
​Atrial septostomy - open-heart surgery to create an opening between the upper left and right chambers of the heart to relieve the pressure on the right side of the heart.
​Transplantation - lung or heart transplantation for younger people with PPH / IPAH who are otherwise a good candidate for transplantation.
​Pulmonary thromboendarterectomy - removing blood clots from the lung's arteries.

FEN PHEN LAWYER, CYNTHIA K. GARRETT, ATTORNEY AT LAW
CRITERIA FOR FREE INITIAL CASE REVIEW

1. Proof of use of Pondimin or Redux.

2. A diagnosis of:

• Mean pulmonary artery pressure by cardiac catheterization of greater than or equal to 25 mmHg at rest or greater than 30 mmHg with exercise; with a pulmonary artery wedge pressure less than or equal to 15 mmHg; or
• Peak systolic pulmonary artery pressure of greater than or equal to 60 mmHg at rest, by echocardiogram; or
  
• Extensive treatment for PH is administered, including surgery or certain prescription medications, where a heart catheterization has not been done due to severe right heart dysfunction; or
  
• Autopsy showing changes in the lung consistent with PPH where there is no evidence of alternative causes.
  

3. And, no known alternative causation factors are present.​​