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Medical Forum / General / Dentistry / April 2005Informed Consent Discussion
Informed Consent is extremely important! Here's an example of how a jury verdict was reversed because of the informed consent issue. Joel ** Wyeth says judge overrules jury in diet drug case Wed Feb 23, 2005 08:55 PM ET NEW YORK, Feb 23 (Reuters) - Drugmaker Wyeth (WYE.N: Quote, Profile, Research) on Wednesday said a judge had set aside a jury's verdict from last November that found in favor of a woman who claimed one of the company's diet drugs had damaged her heart value and instead entered a judgment in favor of Wyeth. The company said in a statement the jury had originally found in favor of plaintiff Geri McMurdie, awarding her $780,000 in damages, after she alleged heart valve injury from the use of diet drug Pondimin, which was once marketed by Wyeth. FACT BOX WYE.N (WYETH) Last: 38.91 Change: 0.00 Up/Down: 0.00 Quote Full Chart Company Profile Research Reports News for WYE.N HEADLINE STOCKS - U.S. stocks to watch on March 22 U.S. stocks seen lower; Fed comments awaited Wall Street seen flat ahead of Fed meeting But Wyeth said evidence showed McMurdie had signed a consent form acknowledging the potential risks of diet drugs at the time she was prescribed Pondimin and Judge Mark Bernstein of the Court of Common Pleas of Philadelphia found McMurdie "knowingly and voluntarily assumed the risks". McMurdie was one of four Utah plaintiffs whose trials were combined last year. The judge has not yet ruled on Wyeth's challenges to the other three verdicts, Wyeth said. The Madison, New Jersey-based drugmaker in 1997 recalled Pondimin and a second drug, Redux, used in the fen-phen slimming cocktail after the appetite suppressants were linked to heart valve damage and a fatal lung condition. Total charges to cover liabilities to former users of the drugs have since crossed the $21 billion mark, © Reuters 2005. All Rights Reserved. NYSE and AMEX quotes delayed by at least 20 minutes. Nasdaq and all other quotes delayed by at least 15 minutes. Reuters does not endorse the views or opinions given by any third party content provider. It would be nice to know which risks the plaintiff "knowingly and voluntarily assumed". In my own medical-dental malpractice case, as a plaintiff, the judge agreed that the plaintiff had not been provided with a proper informed consent. For that reason, among various others, he agreed to send the request for punitive damages to the jury. As some readers are aware, the jury never knew punitive instructions were in their hands because they voted 100% "no negligence"... and that was the end of what they knew or needed to know. Discussion of informed consent issues is complicated. from http://www.lawyerscollective.org/lc-hiv-aids/Abstracts/Consent.htm > The question that arises is how much should be disclosed to the patient to > ensure that consent is informed. In England, the standard of care which a [quoted text clipped - 17 lines] > the principles laid down in the Indian Contract Act and the Indian Penal > Code. Webby > Informed Consent is extremely important! > [quoted text clipped - 59 lines] > other quotes delayed by at least 15 minutes. Reuters does not endorse > the views or opinions given by any third party content provider. Here is a recent update explaining how important INFORMED CONSENT can be! Joel M. Eichen D.D.S. >Informed Consent is extremely important! > [quoted text clipped - 58 lines] >other quotes delayed by at least 15 minutes. Reuters does not endorse >the views or opinions given by any third party content provider. Jury Finds Wyeth Liable for $2.5 Million in Fen-Phen Trial Melissa Nann Burke The Legal Intelligencer 01-07-2005 In Philadelphia's largest fen-phen verdict to date, a jury found pharmaceutical manufacturer Wyeth liable for $2.5 million in damages Tuesday, saying the company should compensate three women who alleged their heart-valve injuries were caused by taking the diet drug Pondimin. The verdict came at the conclusion of the liability phase of a reverse-bifurcated trial that began last week before Common Pleas Senior Judge Alfred J. DiBona Jr. and lasted five days. The six jurors deliberated for 10 minutes, a lawyer for the plaintiffs said. The trial's first phase concluded Dec. 22 when the jury -- then seven strong -- awarded $1.25 million to plaintiff Susan B. Rives of Keswick, Va.; $750,000 to Lorraine Gordon of Harrisonburg, Va.; and $500,000 to Sonia Jones of Oxon Hill, Md. The three cases, Rives v. Wyeth, Gordon v. Wyeth and Jones v. Wyeth, were coordinated for trial. The jury began with eight members but dwindled to six by the end of phase two. The judge excused one juror for medical reasons and the other because she admitted to talking about the case outside the jury room, said Michael J. Miller, who represented the three plaintiffs with Christopher A. Gomez. Both attorneys practice at Miller & Associates in Alexandria, Va. Wyeth was represented during phase one by Richard "Rip" Sullivan and phase two by George E. McDavid. Both attorneys practice at Reed Smith. Wyeth said in a statement it would pursue post-trial motions and, "if necessary, will appeal the verdicts." Most of the Philadelphia judges presiding over the fen-phen trials have severed the trials into two phases and reversed their traditional order. Thus, juries have decided the damages owed to a plaintiff before deciding whether the defendant was liable. To date, only one other fen-phen jury in Philadelphia has gone through the second phase of a reverse-bifurcated trial. A jury last fall found Wyeth liable for a $2.135 million judgment awarded to four plaintiffs. Ten fen-phen trials have gone to verdict since the trials began in July, according to the Complex Litigation Center. Many others were settled before or during trial -- often after the jury awarded damages in the first phase. The diet-drug compound fen-phen was pulled from the market in 1997 after doctors found that the drugs likely caused heart-valve problems in some patients. Rives, 42, Gordon, 46, and Jones, 50, all took Pondimin (fenfluramine) for a period of months in 1996, said Miller, whose firm has 1,600 fen-phen cases pending in Philadelphia. During the liability phase, Miller presented an expert who said Wyeth should have heeded 35 reports of valvular heart disease in Belgium. Had they done so, the diet drugs would have come off the market sooner, he said. Another medical expert testified that had sufficient warnings accompanied the diet drugs, reasonable doctors wouldn't have continued to use them to treat obesity, Miller said. Michael Scott of Reed Smith, lead counsel for Wyeth locally, could not immediately be reached for comment. >Here is a recent update explaining how >important INFORMED CONSENT can be! [quoted text clipped - 63 lines] >>other quotes delayed by at least 15 minutes. Reuters does not endorse >>the views or opinions given by any third party content provider. > Jury Finds Wyeth Liable for $2.5 Million in Fen-Phen Trial > [quoted text clipped - 140 lines] > >>other quotes delayed by at least 15 minutes. Reuters does not endorse > >>the views or opinions given by any third party content provider. > Jury Finds Wyeth Liable for $2.5 Million in Fen-Phen Trial > [quoted text clipped - 140 lines] > >>other quotes delayed by at least 15 minutes. Reuters does not endorse > >>the views or opinions given by any third party content provider. 168 lines to reply and requote yourself? But thanks for all the dental info in this post It would be an interesting twist of the media if it began to report the cases that did not prevail, but should have... and at what $$loss. Webby > Jury Finds Wyeth Liable for $2.5 Million in Fen-Phen Trial > [quoted text clipped - 22 lines] > The three cases, Rives v. Wyeth, Gordon v. Wyeth and Jones v. Wyeth, > were coordinated for trial. So, did the form she signed specify "heart valve damage and a fatal lung condition"? Or was it a general 'risks of dieting' wording? If the latter, does accepting risk at a particular point in time grant carte blanche to all risks identified in the future? Also, even if the FDA had not yet recognized the risks, does this imply she knew or should have known these risks? > Here is a recent update explaining how > important INFORMED CONSENT can be! [quoted text clipped - 63 lines] >>other quotes delayed by at least 15 minutes. Reuters does not endorse >>the views or opinions given by any third party content provider. Welcome sci.med.cardiology and sci.med .... is sci.med.dentistry finally moving up in the world????? Wow! Does anyone know the answer to Sharon Hope's question? Webby > So, did the form she signed specify "heart valve damage and a fatal lung > condition"? [quoted text clipped - 73 lines] > >>other quotes delayed by at least 15 minutes. Reuters does not endorse > >>the views or opinions given by any third party content provider. >So, did the form she signed specify "heart valve damage and a fatal lung >condition"? [quoted text clipped - 5 lines] >Also, even if the FDA had not yet recognized the risks, does this imply she >knew or should have known these risks? Interesting question ... I will try to research it ........ Joel Hello Sharon, Here is some more information on the "reversed" case. Joel M. Eichen D.D.S. ** Posted on Wed, Feb. 23, 2005 Judge reverses verdict against Wyeth over diet drug Associated Press MADISON, N.J. - A judge in Philadelphia reversed a jury verdict against drug maker Wyeth Wednesday, ruling that a plaintiff who alleged heart valve injury from use of a diet drug knew the risks before she took the drug. Common Pleas Court Judge Mark I. Bernstein set aside a Nov. 3, 2004 verdict that awarded Geri McMurdie $780,000 in compensatory damages. In his ruling, Bernstein said that McMurdie "knowingly and voluntarily assumed the risks" of heart damage when she signed a consent form acknowledging the potential risks of Pondimin. McMurdie's case was one of four involving Utah residents that were heard beginning last September. Bernstein has not yet ruled on the other three jury verdicts. Wyeth, formerly known as American Home Products, made Pondimin, the fenfluramine half of the diet combination fen-phen, and a chemical cousin, Redux. It pulled Pondimin and Redux from the market in September 1997 amid reports some users had heart valve damage and a few had a deadly lung condition. Fen-phen was never an FDA-approved combination, and the phentermine half is still sold. ** >So, did the form she signed specify "heart valve damage and a fatal lung >condition"? [quoted text clipped - 73 lines] >>>other quotes delayed by at least 15 minutes. Reuters does not endorse >>>the views or opinions given by any third party content provider. > Hello Sharon, > [quoted text clipped - 20 lines] > assumed the risks" of heart damage when she signed a consent form > acknowledging the potential risks of Pondimin. *Sigh* What people subject themselves to in order to avoid simply eating less to lose weight. At His service, Andrew -- Andrew B. Chung, MD/PhD Board-Certified Cardiologist ** Suggested Reading: (1) http://makeashorterlink.com/?L26062048 (2) http://makeashorterlink.com/?O2F325D1A (3) http://makeashorterlink.com/?X1C62661A (4) http://makeashorterlink.com/?U1E13130A (5) http://makeashorterlink.com/?K6F72510A (6) http://makeashorterlink.com/?I24E5151A (7) http://makeashorterlink.com/?I22222129 I have been thinking that exact same thought ........ Exercise ...... walk to the market ......... better food choices ....... and oh yes. More of a purpose with life! Joel >*Sigh* > [quoted text clipped - 4 lines] > >Andrew > I have been thinking that exact same thought ........ > > Exercise ...... ... in extreme amounts to injury. "No pain no gain (loss)" > walk to the market ......... better food choices > ....... and oh yes. > > More of a purpose with life! In truth, eating food is not God's purpose for your life (Deuteronomy 8:3-5). > >*Sigh* > > > >What people subject themselves to in order to avoid simply eating less > >to lose weight. Would suggest you befriend hunger for it is one of the Lord's blessings (Luke 6:21). At His service, Andrew -- Andrew B. Chung, MD/PhD Board-Certified Cardiologist ** Suggested Reading: (1) http://makeashorterlink.com/?L26062048 (2) http://makeashorterlink.com/?O2F325D1A (3) http://makeashorterlink.com/?X1C62661A (4) http://makeashorterlink.com/?U1E13130A (5) http://makeashorterlink.com/?K6F72510A (6) http://makeashorterlink.com/?I24E5151A (7) http://makeashorterlink.com/?I22222129 > I have been thinking that exact same thought ........ And everyone should read this carefully: http://www.humaneventsonline.com/article.php?id=6942 KM You hit the nail on the head there! (and heaven forbid they would begin an exercise program) Fawks > *Sigh* > [quoted text clipped - 8 lines] > Andrew B. Chung, MD/PhD > Board-Certified Cardiologist http://www.pronational.com/news/denrprtr/Fenphen-0698.htm Fen-Phen Litigation......Picking Up Steam By Theodore Passineau, J.D., ProNational Senior Health Care Advisor Not since the breast implant cases of the late 1980s and early 1990s has there been such a flurry of legal activity associated with a particular form of medical treatment. The weight reduction drugs commonly known as Fen-Phen, fenfluramine (or its sister drug, dexfenfluramine) and phentermine, have made their way into headlines and courtrooms. With over 18 million prescriptions having been written to an estimated 6 million Americans, the potential for litigation related to heart and lung damage is significant. The controversy began to take shape in August of 1997 when The New England Journal of Medicine (NEJM) reported the potential for heart valve problems and/or pulmonary hypertension resulting from the use of fenfluramine and phentermine in combination. While each drug had been approved by the FDA for use individually, the use of the medications in combination had never been approved. There were reports of cardiac-related problems in as high as 32 percent of the users of these combined medications. Subsequent reports have suggested cardiac-related problems with the use of fenfluramine or dexfenfluramine alone. The usual defendants in these cases are the pharmaceutical companies who manufactured the medications and the physicians who prescribed them. Several cases have been brought as class actions in federal court (and are being consolidated into one federal court case in Philadelphia); others have been brought as state class actions. In addition, many individual suits are being filed in state courts. It is expected that, in time, cases will have been filed in all 50 states. The Fen-Phen controversy is also important for dentists. Whenever a condition is associated with increased risk of subacute bacterial endocarditis, such as cardiac valvulopathy, the dentist must take appropriate prophylactic measures prior to initiating treatment. Prophylactic measures begin with identifying the potentially dangerous condition. In 1992, a ProNational study of office practices found that approximately 94% of general dentists use a patient-completed health history form. This is an excellent means of gathering essential clinical historical information. Health history forms should now be amended to include a question that asks whether the patient has ever taken prescription weight-reduction drugs. (Don't depend on the patient to recognize the names of these drugs.) If a positive response is elicited, you should determine the exact medications taken. Before treating a patient who has taken Fen-Phen or fenfluramine products alone, the CDC (Centers for Disease Control) guidelines should be consulted. (See guidelines below.) Additionally, you should be familiar with the American Dental Association's recommendations, which are listed below. Because dentists weren't involved in the prescribing of Fen-Phen or fenfluramine products, professional liability exposure for dentists should be very limited. However, inattention to the possibility of SBE (subacute bacterial endocarditis) as a result of previous use of diet medications is one way that members of the dental community could be drawn into the Fen-Phen debate. Conscientious history taking and recording and adherence to the CDC guidelines and ADA recommendations should eliminate this potential. You may call ProNational's Risk Management Department at 800/292-1036 for further information on issues related to the prescription of Fen-Phen or fenfluramine products. CDC Recommendations Regarding Fen-Phen 1. All persons exposed to fenfluramine or dexfenfluramine, for any period of time, either alone or in combination with other agents, should undergo a medical history and cardiovascular examination by their physician to determine the presence or absence of cardiopulmonary signs or symptoms. 2. An echocardiographic evaluation should be performed on all persons who were exposed to fenfluramine or dexfenfluramine for any period of time, either alone or in combination with other agents, and who exhibit cardiopulmonary signs (including a new murmur) or symptoms suggestive of valvular disease (e.g., dyspnea). 3. Although the clinical importance of asymptomatic valvular regurgitation in exposed patients and the risk for developing bacterial endocarditis in these patients are unknown, practitioners should strongly consider performing echocardiography on all persons regardless of whether they have cardiopulmonary signs or symptoms who have been exposed to fenfluramine or dexfenfluramine for any period of time, either alone or in combination with other agents, BEFORE the patient undergoes any invasive procedure for which antimicrobial endocarditis prophylaxis is recommended by 1997 AHA (American Heart Association) guidelines. Any echocardiographic findings that meet the AHA criteria for prophylaxis regardless of whether they are attributable to possible fenfluramine or dexfenfluramine use should be recognized as indications for antibiotic prophylaxis. The invasive procedures include certain medical or dental procedures where antibiotic prophylaxis is recommended as defined by the 1997 AHA guidelines. For emergency procedures for which cardiac evaluation cannot be performed, empiric antibiotic prophylaxis should be administered according to the 1997 AHA guidelines. 4. Because of the prevalence of minimal degrees of regurgitation in the general population, the current case definition of drug-associated valvulopathy should include exposed patients with echocardiographically demonstrated AR of mild or greater severity and/or MR of moderate or greater severity, based on published criteria. ADA Recommendations Regarding Fen-Phen -- 11/12/97 Dentists who have patients who were on Fen-Phen (fenfluramine and phentermine) or dexfenfluramine or fenfluramine alone, should refer them to their physician for the CDC-recommended evaluation and treatment before conducting any dental procedures that may cause significant bleeding. Based on what the evaluation reveals, the dentist may then provide necessary dental treatment in accordance with the revised 1997 guidelines titled: "Prevention of Bacterial Endocarditis: Recommendations by the American Heart Association and A Statement for the Dental Profession." (These guidelines were approved by the ADA's Council on Scientific Affairs and published in the August, 1997 Journal of the American Dental Association.) Under these guidelines, the dentist may prescribe a single pre-procedure dose of antibiotics for appropriate patients who are undergoing procedures that put them at risk for significant bleeding. Examples of dental procedures that might warrant antibiotic treatment include, but are not limited to, tooth extractions, periodontal (gum) surgery, root canal treatment and the placement of orthodontic bands but not brackets. © Copyright 2005 ProNational, Inc. All Rights Reserved >> Hello Sharon, >> [quoted text clipped - 29 lines] > >Andrew OK, let's say that your patient claims history of fenfloramine ingestion. What precautions should you, as the dentist take, to avoid possible complications and possible malpractice suit? Joel ANSWER _ _ _ _ _ _ AND ....... Here is the original list of 58,000 that is now whittled down to around 16,000 cases remaining. Joel *** Phonetic Search: off Last Name: wyeth Begin Date: 01-jan-1997 ID Name/Company Address Party Type Filing Date I13436 WYETH 5 GIRALD FARMS MADISON NJ 07940 Case ID: 040402076 LESTER VS WYETH ET AL DFT 12-APR-2004 @4418916 WYETH 150 RADNOR CHESTER RD RADNOR PA 19087 Case ID: 011204443 LANDI ETAL VS WYETH AYERST LABORATORIES ETAL DFT 03-JAN-2002 @4538648 WYETH 555 E LANCASTER AVE WAYNE PA 19087 Case ID: 020701542 BLOCH VS WYETH ETAL DFT 11-JUL-2002 @4540526 WYETH FIVE GIRALDA FARMS MADISON NJ 07940 Case ID: 020900771 BORELLI ETAL VS WYETH ETAL DFT 06-SEP-2002 @4540526 WYETH FIVE GIRALDA FARMS MADISON NJ 07940 Case ID: 020701964 MILLNER ETAL VS WYETH ETAL DFT 15-JUL-2002 @4540526 WYETH FIVE GIRALDA FARMS MADISON NJ 07940 Case ID: 040100625 BOTTOMS ETAL VS AMERICAN HOME PRODUCTS CORP ETAL DFT 08-JAN-2004 @4540526 WYETH FIVE GIRALDA FARMS MADISON NJ 07940 Case ID: 050302036 MINEAR ETAL VS WYETH ETAL DFT 18-MAR-2005 @4545742 WYETH 555 E LANCASTER AVE RADNOR PA 19087 Case ID: 031002949 SEBOR JR VS AMERICAN HOME PRODUCTS CORP ETAL DFT 24-OCT-2003 @4563503 WYETH CO CORP SERVICE CO 2704 COMMMERCE DR HARRISBURG PA 17110 Case ID: 020803393 PENNEWELL VS WYETH ETAL DFT 23-AUG-2002 @4563503 WYETH CO CORP SERVICE CO 2704 COMMMERCE DR HARRISBURG PA 17110 Case ID: 030301281 GUARNERE ETAL VS WYETH ETAL DFT 10-MAR-2003 @4657931 WYETH FIVE GIRALDA FARMS MADISON NJ 07940 Case ID: 030202262 DELANEY VS WYETH ETAL DFT 18-FEB-2003 @4576481 WYETH FIVE GIRALDA FARMS MADISON NJ 07940 Case ID: 020901962 MUNRO ETAL VS WYETH ETAL DFT 16-SEP-2002 @4576481 WYETH FIVE GIRALDA FARMS MADISON NJ 07940 Case ID: 020901959 SUTPHIN VS WYETH ETAL DFT 13-SEP-2002 @4576481 WYETH FIVE GIRALDA FARMS MADISON NJ 07940 Case ID: 020901900 OETTAWAY VS AMERICAN HOME PRODUCTS ETAL DFT 13-SEP-2002 @4576481 WYETH FIVE GIRALDA FARMS MADISON NJ 07940 Case ID: 020901893 SHEEHY ETAL VS WYETH ETAL DFT 13-SEP-2002 Page: Next Last Records Found: 58,480, Displayed: 1 to 15 ************** >http://www.pronational.com/news/denrprtr/Fenphen-0698.htm > [quoted text clipped - 168 lines] >> >>Andrew > OK, let's say that your patient claims history of fenfloramine > ingestion. What precautions should you, as the dentist take, to avoid [quoted text clipped - 229 lines] > >> > >>Andrew Send them to another dentist > http://www.pronational.com/news/denrprtr/Fenphen-0698.htm > [quoted text clipped - 171 lines] > > > >Andrew You can still get Fen-Phen? >You can still get Fen-Phen? History of ...... meaning prior to 1997 they were on fenfloramine ...... > >You can still get Fen-Phen? > > History of ...... meaning prior to 1997 they were on fenfloramine > ...... http://www.pronational.com/news/denrprtr/Fenphen-0698.htm Fen-Phen Litigation......Picking Up Steam By Theodore Passineau, J.D., ProNational Senior Health Care Advisor Not since the breast implant cases of the late 1980s and early 1990s has there been such a flurry of legal activity associated with a particular form of medical treatment. The weight reduction drugs commonly known as Fen-Phen, fenfluramine (or its sister drug, dexfenfluramine) and phentermine, have made their way into headlines and courtrooms. With over 18 million prescriptions having been written to an estimated 6 million Americans, the potential for litigation related to heart and lung damage is significant. The controversy began to take shape in August of 1997 when The New England Journal of Medicine (NEJM) reported the potential for heart valve problems and/or pulmonary hypertension resulting from the use of fenfluramine and phentermine in combination. While each drug had been approved by the FDA for use individually, the use of the medications in combination had never been approved. There were reports of cardiac-related problems in as high as 32 percent of the users of these combined medications. Subsequent reports have suggested cardiac-related problems with the use of fenfluramine or dexfenfluramine alone. The usual defendants in these cases are the pharmaceutical companies who manufactured the medications and the physicians who prescribed them. Several cases have been brought as class actions in federal court (and are being consolidated into one federal court case in Philadelphia); others have been brought as state class actions. In addition, many individual suits are being filed in state courts. It is expected that, in time, cases will have been filed in all 50 states. The Fen-Phen controversy is also important for dentists. Whenever a condition is associated with increased risk of subacute bacterial endocarditis, such as cardiac valvulopathy, the dentist must take appropriate prophylactic measures prior to initiating treatment. Prophylactic measures begin with identifying the potentially dangerous condition. In 1992, a ProNational study of office practices found that approximately 94% of general dentists use a patient-completed health history form. This is an excellent means of gathering essential clinical historical information. Health history forms should now be amended to include a question that asks whether the patient has ever taken prescription weight-reduction drugs. (Don't depend on the patient to recognize the names of these drugs.) If a positive response is elicited, you should determine the exact medications taken. Before treating a patient who has taken Fen-Phen or fenfluramine products alone, the CDC (Centers for Disease Control) guidelines should be consulted. (See guidelines below.) Additionally, you should be familiar with the American Dental Association's recommendations, which are listed below. Because dentists weren't involved in the prescribing of Fen-Phen or fenfluramine products, professional liability exposure for dentists should be very limited. However, inattention to the possibility of SBE (subacute bacterial endocarditis) as a result of previous use of diet medications is one way that members of the dental community could be drawn into the Fen-Phen debate. Conscientious history taking and recording and adherence to the CDC guidelines and ADA recommendations should eliminate this potential. You may call ProNational's Risk Management Department at 800/292-1036 for further information on issues related to the prescription of Fen-Phen or fenfluramine products. CDC Recommendations Regarding Fen-Phen 1. All persons exposed to fenfluramine or dexfenfluramine, for any period of time, either alone or in combination with other agents, should undergo a medical history and cardiovascular examination by their physician to determine the presence or absence of cardiopulmonary signs or symptoms. 2. An echocardiographic evaluation should be performed on all persons who were exposed to fenfluramine or dexfenfluramine for any period of time, either alone or in combination with other agents, and who exhibit cardiopulmonary signs (including a new murmur) or symptoms suggestive of valvular disease (e.g., dyspnea). 3. Although the clinical importance of asymptomatic valvular regurgitation in exposed patients and the risk for developing bacterial endocarditis in these patients are unknown, practitioners should strongly consider performing echocardiography on all persons regardless of whether they have cardiopulmonary signs or symptoms who have been exposed to fenfluramine or dexfenfluramine for any period of time, either alone or in combination with other agents, BEFORE the patient undergoes any invasive procedure for which antimicrobial endocarditis prophylaxis is recommended by 1997 AHA (American Heart Association) guidelines. Any echocardiographic findings that meet the AHA criteria for prophylaxis regardless of whether they are attributable to possible fenfluramine or dexfenfluramine use should be recognized as indications for antibiotic prophylaxis. The invasive procedures include certain medical or dental procedures where antibiotic prophylaxis is recommended as defined by the 1997 AHA guidelines. For emergency procedures for which cardiac evaluation cannot be performed, empiric antibiotic prophylaxis should be administered according to the 1997 AHA guidelines. 4. Because of the prevalence of minimal degrees of regurgitation in the general population, the current case definition of drug-associated valvulopathy should include exposed patients with echocardiographically demonstrated AR of mild or greater severity and/or MR of moderate or greater severity, based on published criteria. ADA Recommendations Regarding Fen-Phen -- 11/12/97 Dentists who have patients who were on Fen-Phen (fenfluramine and phentermine) or dexfenfluramine or fenfluramine alone, should refer them to their physician for the CDC-recommended evaluation and treatment before conducting any dental procedures that may cause significant bleeding. Based on what the evaluation reveals, the dentist may then provide necessary dental treatment in accordance with the revised 1997 guidelines titled: "Prevention of Bacterial Endocarditis: Recommendations by the American Heart Association and A Statement for the Dental Profession." (These guidelines were approved by the ADA's Council on Scientific Affairs and published in the August, 1997 Journal of the American Dental Association.) Under these guidelines, the dentist may prescribe a single pre-procedure dose of antibiotics for appropriate patients who are undergoing procedures that put them at risk for significant bleeding. Examples of dental procedures that might warrant antibiotic treatment include, but are not limited to, tooth extractions, periodontal (gum) surgery, root canal treatment and the placement of orthodontic bands but not brackets. Copyright 2005 ProNational, Inc. All Rights Reserved On Tue, 22 Mar 2005 22:40:25 -0500, "Andrew B. Chung, MD/PhD" <andrew@heartmdphd.com> wrote: >"Joel M. Eichen" wrote: >> [quoted text clipped - 31 lines] > >Andrew oh http://www.ynhh.org/healthlink/cardiac/cardiac_11_99.html November 30, 1999 News this month New study shows low incidence of valve disease among fen-phen users Researchers led by Dr. Andrew Burger of Beth Israel Medical Center in Boston published a study in Octobers edition of the Journal of the American College of Cardiology showing a low incidence of valve damage among people who had taken fen-phen. What is fen-phen? Fen-phen is fenfluramine and phentermine, which were often prescribed together for patients trying to lose weight. In 1997, fenfluramine was voluntarily removed from the market when reports suggested it might cause heart valve damage. Phentermine was not suspect, and it remains on the market. " we found no evidence of a high rate of valvular disease among people who took fen-phen. " The latest study "In contrast to some previous reports, we found no evidence of a high rate of valvular disease among people who took fen-phen," said Dr. Burger. The Beth Israel study followed 226 people who took the drug combination for as long as 30 months. Patients also were in a program of diet, exercise and behavior modification. All subjects stopped taking the diet drug cocktail after the risk of heart valve defects was announced to the public. The study population included 183 women and 43 men with a mean age of 46.9 years. The investigation sought to determine the prevalence of valvular heart disease in these patients. Early reports suggesting fenfluramines association with an increase in heart valve disease were based on small numbers of patients and limited data on both dose and duration of fen-phen usage. All subjects in the Beth Israel study underwent echocardiography to detect valve damage within three months of discontinuing the medications. The diagnostic tests were reviewed by two independent readers. About 8 percent of those in the study had detectable heart valve problems. Fifteen subjects (6.6 percent) showed aortic regurgitation, a condition in which blood leaks from the aorta, and three subjects (1.3 percent) showed evidence of mitral valve leakage, but none of the subjects showed evidence of severe disease. Those with valve disease were experiencing no symptoms and required no medical treatment. Study participants compared to a control group Dr. Burger and his research team compared this group to the general population and found the rate of heart valve defects to be similar. The control group was represented by subjects in the Framingham Heart Study who are comparable in age, gender and geographic location. In this group, 1.6 percent had moderate or greater mitral leakage whereas 4.8 percent had mild or greater aortic insufficiency, compared to 1.3 and 6.6 percent in the Beth Israel study. The study also showed people who took higher doses of fen-phen were no more likely to develop heart valve defects than people who took lower doses. "I dont think it gives the drug a green light to come back," Dr. Burger said, "but fenfluramine may not be as great a health hazard as thought initially." Previous concern may be the result of sloppy science In a commentary in the same journal, Dr. Nelson Schiller of the University of California at San Francisco suggested the early studies that led to the drugs withdrawal may have been sloppily done. "As studies have become more scientifically rigorous, the role of fen-phen in valve disease appears to be approaching the vanishing point," Schiller wrote in his commentary. He complained of an "almost universal misapplication of echocardiography" to evaluating whether peoples valves were damaged. Physician Referral Online A free and confidential service of Yale-New Haven Hospital. Physician Referral Online Using your own criteria, you can request information from a database of 900 area physicians who have registered to participate. Request an appointment We would be happy to assist you in scheduling an appointment with a member of the hospital's medical staff. Use the link above or call: 203-688-2000 or toll free 1-888-700-6543 to talk with a referral coordinator. How dangerous is fen-phen: the jurys still out This most recent study by Dr. Burger and his colleagues about the relationship between fen-phen and heart valve disease may be reassuring to the millions of people who took the diet drug cocktail before it was taken off the market in 1997. "It is probably premature to draw any firm conclusions about a causal relationship [between fen-phen and heart value disease]." In 1996 alone, the total number of prescriptions for the two drugs exceeded 18 million in the U.S., so many people have naturally been concerned about the long-term implications for their health. At this point, it is probably premature to draw any firm conclusions about a causal relationship. This study was well controlled, whereas many of the earlier reports were not, but we still have no long-term data, and many of the reports to date have been anecdotal and conflicting. Other reports In August 1997, a report in the New England Journal of Medicine first linked valvular heart disease with the use of fen-phen. The concern stemmed from a report by Mayo Clinic physicians, who found unusual heart problems in 24 women who had used fen-phen for an average of 12 months. Each had a thickening of one or more heart valves, which causes blood to leak back into the heart, making it work harder. Five of the women needed surgery to repair or replace the damaged valves. In 1997, the FDA received independent echocardiographic surveys of patients from five geographic areas who had received fenfluramine alone or in combination with phentermine. The prevalence of valve disease meeting the FDA definition was similar in all five surveys and ranged from 30 to 38 percent. The prevalence increased with the duration of drug use. But there is no proof of a causal link, and it is not clear that the 113 cases reported to the FDA were representative of the estimated 4.2 million people who were taking the drugs. "Valve problems may regress after the drug is discontinued." A new study published in the November 23 issue of Circulation showed 7.6 percent of patients treated with the drug dexfenfluramine, which is very similar to fenfluramine, had either mild aortic valve disease or moderate mitral valve problems, compared to 2.1 percent who did not take the drug. Valve problems were detected at twice the rate among patients who had stopped treatment less than eight months before their echocardiogram compared with those who had been off the medicine for longer than eight months suggesting valve problems may regress after the drug is discontinued. Despite several additional studies, there is still no consensus among cardiologists on the causal relationship between fen-phen and valve disease, which doesnt offer those who took the drugs much reassurance. What should you do if youve taken fen-phen? I would recommend anyone who has taken fenfluramine or dexfenfluramine for any period of time should have a thorough medical history and cardiovascular physical examination, if they have not already done so. It is possible to have valve disease and experience no unusual symptoms. In fact, the 15 subjects in the Burger study who were found to have valve disease had no obvious symptoms. Many healthy adults have mild valve leakage that poses no threat to their health. Your physician can listen for heart murmurs or detect valve abnormalities with an echocardiogram, which is particularly important if you do have unexplained symptoms such as easy fatigability, shortness of breath, palpitations or chest pain. The fen-phen experience has confirmed the need to be cautious about medical treatments for obesity. There is no magic bullet to weight loss. Consistent lifestyle changes in diet and exercise are the only long-term solution, but research into the causes and possible treatments for obesity continues. Its obvious that significant obesity is a very serious health concern in the U.S, and were hopeful that some of the genetic research into the bodys regulation of fat storage may result in some effective and safe treatments. -------------------------------------------------------------------------------- Dr. Blum is a cardiologist on staff at Yale-New Haven Hospital and an assistant professor in the section of cardiovascular medicine at Yale University School of Medicine. For more information on this story: Summary of the study published in the Journal of the American College of Cardiology, October, 1999 Summary of the study published in Circulation, Nov. 23, 1999 Previous issues of HealthLINK-Cardiac Heart failure drug, October 1999. Mitral valve prolapse, September 1999. High volume heart hospitals, August 1999. Mediterranean diet, July 1999. Aspirin and heart disease, May 1999. Viagra risk and heart disease, April 1999. Other cardiac resources Cardiac Services, Yale-New Haven Hospital American Heart Association American College of Cardiology Healthfinder: Heart Disease >http://www.pronational.com/news/denrprtr/Fenphen-0698.htm > [quoted text clipped - 168 lines] >> >>Andrew The latest study "In contrast to some previous reports, we found no evidence of a high rate of valvular disease among people who took fen-phen," said Dr. Burger. The Beth Israel study followed 226 people who took the drug combination for as long as 30 months. Patients also were in a program of diet, exercise and behavior modification. All subjects stopped taking the diet drug cocktail after the risk of heart valve defects was announced to the public. R E P L Y I am draweing analogies between Fen-Phen where some people were harmed, so it seems, and amalgam toxicity as it is known, where no people are harmed. Still, in our legal system, we are at risk. I can imagine Jan Drew and her colleagues one day in court over issues like this. Joel * * * * * >http://www.pronational.com/news/denrprtr/Fenphen-0698.htm > [quoted text clipped - 168 lines] >> >>Andrew > The latest study . > R E P L Y > > I am draweing analogies between Fen-Phen where some people were > harmed, so it seems, and amalgam toxicity as it is known, where no > people are harmed. So your saying the FDA has not recieved 1000's of adverse reactions reports for amalgam? studies have not been published in journals linking high Hg blood levels and micromercurialism to amalgam? By the way how many dentists would report that they poisoned thier patients with amalgam, when the ADA even threatend those who replaced amalgam for health reasons with liscence removal. And how many doctors would be able to definitively link high Hg levels to amalgam and not, say fish. My personal experience is that dentists are more concerned with removing patient records than filing adverse reaction reports. The day a dentist calls up the FDA and say's "you know what" i think my patient is suffering toxicity from an amalgam i placed 10 years ago or, "someone came in yesterday with signs of Hg toxicity from amalgam placed by another dentist I'd like to file an adverse reaction report", is the DAY THAT PIGS FLY! >So your saying the FDA has not recieved 1000's of adverse >reactions reports for amalgam? Actually they have not received legitimate reports. They have received reports of witches and goblins too but like amalgamitis, these must be largely discounted. Joel >studies have not been published in journals linking high >Hg blood levels and micromercurialism to amalgam? ......and what disease does any of this cause? Joel > >So your saying the FDA has not recieved 1000's of adverse > >reactions reports for amalgam? > > Actually they have not received legitimate reports. Right, you don't even know how many reports they have received or who receives them. You making it up as you go along. In fact the FDA is supposed to follow up or investigate all reports regardless of who makes them. FDA dental doesn't bother. By the way, what would you call a "legitimate report". 1 in 8 has elevated levels of Hg in blood and as you know it takes months, years to recover from Hg posioning. What dentist/doctor is going to wait a year or two to monitor gradually recovery after amalgam removal and file an adverse reaction report. It's not like a drug where adverse reactions occur over days or months. They have received > reports of witches and goblins too but like amalgamitis, these must be > largely discounted. Getting defensive Huh? Because now you realize that no dentist ever reports poisoning their patient, and no formal adverse reaction reporting system is in place for amalgam. Most doctors are not going to wait two years for the patient to partially recover from what "may be" chronic Hg toxicityand no test can accurately determine longterm Hg buildup from amalgam anyway (even in the 1 in 8 with elevated Hg). There is no way anyone could ever know how many adverse reactions there have actually been because its almost impossible for these reports to be made the way the system is set up. at any rate the assertion that no adverse reaction reports have been made to FDA dental by patients and professionals is absolutely false. Like Jan says, a real whopper. > Joel > >studies have not been published in journals linking high > >Hg blood levels and micromercurialism to amalgam? > > ......and what disease does any of this cause? Acute cases of poisoning and micromercurialism micromercurialism A form of mercury poisoning resulting from long term exposure to low doses of mercury. The syndrome of micromercurialism involves complex symptoms of stress, fatigue, memory loss, fine tremors, muscular and reflex insufficiency and low blood pressure, caused by accumulation of mercury in the system. A condition >Right, you don't even know how many reports they have received >or who receives them. You making it up as you go along. Actually I do. They only have six reports and three are from Jan Drew ...... Previous concern may be the result of sloppy science In a commentary in the same journal, Dr. Nelson Schiller of the University of California at San Francisco suggested the early studies that led to the drugs withdrawal may have been sloppily done. "As studies have become more scientifically rigorous, the role of fen-phen in valve disease appears to be approaching the vanishing point," Schiller wrote in his commentary. He complained of an "almost universal misapplication of echocardiography" to evaluating whether peoples valves were damaged. >http://www.pronational.com/news/denrprtr/Fenphen-0698.htm > [quoted text clipped - 168 lines] >> >>Andrew > Hello Sharon, > [quoted text clipped - 24 lines] > heard beginning last September. Bernstein has not yet ruled on the > other three jury verdicts. Okay, how much was he paid off by the drug companies? How much you want to bet he takes a vacation to the Bahama's next month? >Okay, how much was he paid off by the drug companies? How much >you want to bet he takes a vacation to the Bahama's next month? Your knee muscles must be so strong from all that knee-jerking. -- Here in California, US immigrants do the really dirty jobs nobody else wants to do. Cleaning toilets. Being governor. SBH > >Okay, how much was he paid off by the drug companies? How much > >you want to bet he takes a vacation to the Bahama's next month? [quoted text clipped - 4 lines] > Here in California, US immigrants do the really dirty jobs nobody else > wants to do. Cleaning toilets. Being governor. Weeeally? I wouldn't know about California, or San Jose, Milpitas, Mountain View, Los Altos, redwood city, Scotts Valley, Fremont,Glenn Ellen , Sacramento, Sonoma SF etc. N California has a huge immigrant community that votes. You ever been to orange county near LA? If there is injustice for say Mexican or Vietnamese,Indian, Chinese immigrants than look no further than the voters in their own community. Immigrants make up nearly 50% of the population! YOu think I'm so dumb I don't know that? And your giving me some sob story about immigrant explotation. That's a bunch of BS. By the way, there is no buildable land in California. Of course people get caught when the rents go through the roof. Just move to Nebraska instead of paying a small fortune in rent and bottled water at the edge of a desert where there are no jobs. Did you know that San Jose had the largest > SBH Nope, he is an excellent judge! Joel >Okay, how much was he paid off by the drug companies? How much >you want to bet he takes a vacation to the Bahama's next month? >So, did the form she signed specify "heart valve damage and a fatal lung >condition"? [quoted text clipped - 5 lines] >Also, even if the FDA had not yet recognized the risks, does this imply she >knew or should have known these risks? ************************************************ R E P L Y This is Pennsylvania Law ..... each state varies ..... Joel *********************************************** Based on the precedent established by the Pennsylvania Supreme Court in Howell v. Clyde, 533 Pa. 151, 620 A.2d 1107 (1993), which this Court followed in Duquesne Light Company v. Woodland Hills School District, 700 A.2d 1038 (Pa. Cmwlth. 1997), we conclude that the doctrine of assumption of the risk is not applicable to the instant matter. In Duquesne Light Company, we summarized the Supreme Courts limitation of the doctrine of assumption of the risk as follows: In Howell v. Clyde, 533 Pa. 151, 620 A.2d 1107 (1993), the Supreme Court abolished assumption of risk as an affirmative defense decided by the jury. The court concluded "to the extent that an assumption of risk analysis is appropriate in any given case, it shall be applied by the court as a part of the duty analysis, and not as part of the case to be determined by the jury." Id. at 162, 620 A.2d at 1112-13. The court preserved the doctrine as an affirmative defense "in cases involving express assumption of risk, or cases brought pursuant to 402A (strict liability theory), or cases in which assumption of risk is specifically preserved by statute." Id. at 162 n. 10, 620 A.2d at 1113 n. 10. An express assumption of the risk is where the plaintiff has given his express consent to relieve the defendant of an obligation to exercise care for the plaintiff's protection. Rutter v. Northeastern Beaver County School District, 496 Pa. 590, 437 A.2d 1198 (1981); Hannon v. City of Philadelphia, 548 A.2d 693 (Pa. Cmwlth. 1988), petition for allowance of appeal denied, 522 Pa. 598, 562 A.2d 322 (1989). "Ordinarily such an agreement takes the form of a contract, which provides that the defendant is under no obligation to protect the plaintiff, and shall not be liable to him for the consequences of conduct which would otherwise be tortious." Restatement (Second) of Torts § 496B, Comment (a) (1965). >> Here is a recent update explaining how >> important INFORMED CONSENT can be! [quoted text clipped - 63 lines] >>>other quotes delayed by at least 15 minutes. Reuters does not endorse >>>the views or opinions given by any third party content provider. I believe the judge in this case got confused between a consent form and a release form >I believe the judge in this case got confused between a consent form and a >release form Nope, its called "Assumption of Risk" and its permissible. The concept is that if I told ya, and you did it anyway, you can't blame me. Joel Thank you for the origninal post. Products liability cases, like this one, are "strict liability"cases that take on that classification if the product is "unreasonably dangerous". It is an action in tort law not contract law.Assumption of risk, through "informed consent" is a defense to "strict liability" cases. However, if "informed consent" is obtained through fraud (as in handing a patient a consent and telling them to sign the form without explaining the contents), there is no effective informed consent. I was the nurse-paralegal who exposed the fact that many major law firms were submitting claims based upon knowingly false and fabricated echocardiograms. The law firms in question deposed me in Phildelphia with regard to the same and informed me that they had spent approximately $100,000 "investigating me". These law firms were later adjugedby the Federal District Court in Philadelphia as criminal organizations that were adjuged to be subject to "Rico" (organized criminal) classification and punishment. It was my experience that being a "whistle blower" in this case was extremely deleterious to me financially and professionaly. I received no protection nor reward from the Settlement Trust for the retaliation and retribution that I experienced from these "RICO" law firms,although I saved the trust tens, if not hundreds of millions of dollars. >Thank you for the origninal post. >Products liability cases, like this one, are "strict liability"cases that [quoted text clipped - 4 lines] >patient a consent and telling them to sign the form without explaining the >contents), there is no effective informed consent. We had a judge reverse the Verdict By Jury a few weeks ago over "assumption of risk." Its an interesting theory and holds water under Pennsylvania law. Joel >I was the nurse-paralegal who exposed the fact that many major law firms >were submitting claims based upon knowingly false and fabricated >echocardiograms. YUP, but its not a HARD science ...... it s a fuzzy interpetation at best. >The law firms in question deposed me in Phildelphia with regard to the same >and informed me that they had spent approximately $100,000 "investigating >me". REALLY? The M.D.s have pulled down around $800K to $1 million EACH. >These law firms were later adjugedby the Federal District Court in >Philadelphia as criminal organizations that were adjuged to be subject to >"Rico" (organized criminal) classification and punishment. Can you send me the caption by e-mail or here if you like? joeleichen@yahoo.com EDPA, 3rd Circuit. >It was my experience that being a "whistle blower" in this case was >extremely deleterious to me financially and professionaly. >I received no protection nor reward from the Settlement Trust for the >retaliation and retribution that I experienced from these "RICO" law >firms,although I saved the trust tens, if not hundreds of millions of >dollars. The settlement has already reached $21 billion ....... Joel > REALLY? > > The M.D.s have pulled down around $800K to $1 million EACH. Huh? Who got $ 1 million? For doing what? Isn't there a law against that? >> REALLY? >> >> The M.D.s have pulled down around $800K to $1 million EACH. > >Huh? Who got $ 1 million? For doing what? Isn't there a law >against that? Nope. Each of three doctors, two from Utah and the third from Johns Hopkins, a pathologist have each earned $1 million for reading echocariograms and tendering expert opinion in Fen-Phen lawsuits for law firms. Joel M. Eichen DDS > Each of three doctors, two from Utah and the third from Johns Hopkins, > a pathologist have each earned $1 million for reading echocariograms And you as a dentist have never been paid that much for reading a echocariogram? BTW - is this a rather new method to detect cavities by echo effects? Peter  Signature-History of fluorine, fluoride and fluoridation-: --- http://www.fluoride-history.de/index.htm --- ---------------------------------------------------- >> Each of three doctors, two from Utah and the third from Johns Hopkins, >> a pathologist have each earned $1 million for reading echocariograms [quoted text clipped - 4 lines] > >Peter I roll up a sheet of paper into a cone, put the small end to my ear, and then I listen closely to the tooth as the hygienist shouts at the top of her lungs. An echo (or a yodel) is indicative of a huge cavity. Joel > >> Each of three doctors, two from Utah and the third from Johns Hopkins, > >> a pathologist have each earned $1 million for reading echocariograms [quoted text clipped - 10 lines] > > An echo (or a yodel) is indicative of a huge cavity. I bet if you converted all the brain cells in your head devoted to funny to science you would be the leading anti-amalgamist in the nation. Actually as you are probably aware some dentists do read "cavities" or "cavitations" by echo, its called a cavitat and is based on sound wave technology. Of course the technology is questionable so in essence these dentists get paid for reading what may not be there. > Joel >I bet if you converted all the brain cells in your head devoted >to funny to science you would be the leading anti-amalgamist in the >nation. True, but the question is why would I want to be ....? >Actually as you are probably aware some dentists do read "cavities" >or "cavitations" by echo, its called a cavitat and is based on >sound wave technology. Of course the technology is questionable so in >essence these dentists get paid for reading what may not be there. So far, science has entirely discounted this ... sorry DUDE! This goes along with EAV../... electroaccupuncture according to Voll. That's nonsense too. Joel > >Actually as you are probably aware some dentists do read "cavities" > >or "cavitations" by echo, its called a cavitat and is based on > >sound wave technology. Of course the technology is questionable so in > >essence these dentists get paid for reading what may not be there. > > So far, science has entirely discounted this ... sorry DUDE! I see your reading skills are as good as your science skills. See three lines above where I wrote: "Of course the technology is questionable." Did I say I thought it was valid? > This goes along with EAV../... electroaccupuncture according to Voll. > > That's nonsense too. Did I ever say I thought that was valid. No. Now you've wasted more of my time having to correct even more of your misstatements/missattributions. One head of the Hydra said: > Actually as you are probably aware some dentists do read "cavities" > or "cavitations" by echo, its called a cavitat and is based on > sound wave technology. Of course the technology is questionable so in > essence these dentists get paid for reading what may not be there. That remark is a perfect display of why I find it so funny that his Hydra cranial appendage claims to be a member of Mensa. If he only a tiny clue about what he is trying to talk about. Pagliacci comes to mind. > One head of the Hydra said: > [quoted text clipped - 6 lines] > cranial appendage claims to be a member of Mensa. If he only a tiny clue > about what he is trying to talk about. Pagliacci comes to mind. Oh sure, everyone has heard of Pagliacci. Hey your a regular "Recardoniadavicci"! Actually you do remind of one person. Pinochio! Because you tell so many lies about amalgam. How long is your nose now? But you know what the victims of amalgam posioning are like. They are like the kids that went into the "dental carnival" with Pinochio to have a filling placed and came out as donkeys. I don't like that you and professional dentistry poison people with sh.t material and literally try to make assess out of them. YOUR REMARK is a perfect example of your professional and personal ignorance. It is well know that the "Cavitat" is designed to look for changes in bone density using sound wave technology. In fact using sound waves to test material density is nothing new and has been utilized in materials science for years. The sound waves travel at different speeds and refelct differently in different mediums allowing a soundwave emitter and separate sensor to map the inside of different material. This technique also has applications in sonar and for mapping underground geologic formations that cannot otherwise be seen. Since your are too dumb and lazy to read and comprehned the posts preceding and following that I will repeat again that I am not saying the Cavitat (invented by Bob Jones) is a reliable technology. In fact I hear it is not reliable. http://cavitatmedtech.homestead.com/ I would really like to know what you think is so funny about my post. Now I am really straining to comprehend you inbred idioicy. You realize the Cavitat is an actual machine sold by Bob Jones? You know that it uses sound waves? You know what soundwaves are? You know it's stated purpose is to detect changes in bone density in the jaw? You know 1+1=2? <I will repeat again that I am not saying > the Cavitat (invented by Bob Jones) is a reliable technology. In fact I > hear it is not reliable. > > http://cavitatmedtech.homestead.com/ In that case I apologize for thinking you liked the device and supported a device only supported by what sounds to be table click presentations passed off as research papers. I just never expected to see you support Joel in anything written here. > <I will repeat again that I am not saying > > the Cavitat (invented by Bob Jones) is a reliable technology. In fact I [quoted text clipped - 7 lines] > > I just never expected to see you support Joel in anything written here. Actually if you look through the archives I first pointed out that the Cavitat was unreliable. In principal it is a good idea and ultrasound is already used in other areas of medicine. I suppose in the future a technology may be developed that can use sound wave technology to map bone density but I hear from some dentists and patients that the results do not correspond to clinical findings or CT scans. One patient had four different Cavitat scans done on four different days and each one was different. Some of the problems with the CAvitat include: Changes in blood flow change results from day to day Cannot tell changes in jawbone density from hollow sinus cavity near top of jawbone. Probably lack of signal strength away from sound emitter. Any probably just doesn't work. " I just never expected to see you support Joel in anything written here." I think we actually agree on many issues. We both agree that it is not known what epidemological effects Hg has. We both agree that Amalgam loses a substantial amount of Hg. We both agree that placement technique can affect the corrosion of the amalgam. If I took time to print out the adverse reaction reports he would agree to that too ( that they had been filed). >" I just never expected to see you support Joel in anything written >here." > >I think we actually agree on many issues. >We both agree that it is not known what epidemological effects >Hg has. agree >We both agree that Amalgam loses a substantial amount of Hg. We might argue about the term "substantial." >We both agree that placement technique can affect the corrosion >of the amalgam. But, we disagree on the significance of it. >If I took time to print out the adverse reaction reports he would >agree to that too ( that they had been filed). Eliminate one narrow topic and we could agree on many things. .. Stephen Mancuso, D.D.S. Troy, Michigan, USA I am writing on a Tablet-PC,so forgive me if the PC misreads my handwriting. > >" I just never expected to see you support Joel in anything written > >here." [quoted text clipped - 8 lines] > > We might argue about the term "substantial." I meant that Joel would probably agree with those statements but I'm glad to see you agree with many of them too! > >We both agree that placement technique can affect the corrosion > >of the amalgam. > > But, we disagree on the significance of it. > One head of the Hydra said: Ridicule, ridicule, ridicule. It is far and away the single most chillingly effective weapon in the war against discovery and innovation. Ridicule has the unique power to make people of virtually any persuasion go completely unconscious in a twinkling. It fails to sway only those few who are of sufficiently independent mind not to buy into the kind of emotional consensus that ridicule provides Absolutely not! (First paragraph is about DentalTown) It was a gang to ten or twenty who use their DOCTOR power to put down people ...... sorry but my opinion is my opinion ... about dental hygienists, about false diagnosis, about what makes this world not such a good place. Why am I wasting many hours at the Fen-Phen trials? I am trying to figure out where the whole business could have stopped. Many of these people are just common people ,, good people who are into scrapbooking, having barbecues, and family stuff. They are not troublemakers. Yet here they are in Philadelphia and the damage so far is $18,000 million ... ($18B). Do you know how many have blood pressures of 160/100 in that range and they are on no medication? So many have echocardiograms and NO DOCTOR says a word to them. No kind words, no suggestions to reduce blood pressure and no one dispensing the FACTS about PONDIMIN. Doctors .. .ugh. The echocardiograms were paid for by the lawyers, I heard three doctors testify to $2.8 million take between the three of them for echocardiograms for trial! Joel Quote: Originally Posted by Sue Hey Joel--- Maybe that thread who is the most annoying poster was meant in fun only. What do you honestly think. HOW did you guys take that thread at THAT time (as fun or as a warning.. we do not want you here) Joel344 View Public Profile Send a private message to Joel344 Send email to Joel344 Find all posts by Joel344 Add Joel344 to Your Buddy List #39 Today, 08:22 PM >Informed Consent is extremely important! > [quoted text clipped - 58 lines] >other quotes delayed by at least 15 minutes. Reuters does not endorse >the views or opinions given by any third party content provider. > Absolutely not! > [quoted text clipped - 6 lines] > > Why am I wasting many hours at the Fen-Phen trials? It is hauntingly similar to many of the people I met in the last century... and I have not wondered for a single moment *why* you are sharing information with us about these trials. I'm quiet just now for reasons that should not be a mystery to anyone who knows me. ... just wanted to respond to this post. Webby > I am trying to figure out where the whole business could have stopped. > Many of these people are just common people ,, good people who are [quoted text clipped - 10 lines] > > Doctors .. .ugh. >> Why am I wasting many hours at the Fen-Phen trials? > >It is hauntingly similar to many of the people I met in the last >century... and I have not wondered for a single moment *why* you are >sharing information with us about these trials. It is boringly familiar to most things encountered in the previous five millenia. Have long since given up wondering why. History repeats itself, you know ? -- W_B wubbabubbazG@RBAGEyahoo.com Take out the G'RBAGE > >> Why am I wasting many hours at the Fen-Phen trials? > > > >It is hauntingly similar to many of the people I met in the last > >century... and I have not wondered for a single moment *why* you are > >sharing information with us about these trials. > > It is boringly familiar to most things encountered > in the previous five millenia. Yep, WB has seen it all....in his past life. |
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