Relevant FDA Communications on Urogynecologic Mesh

The following article will give the reader a comprehensive overview of the FDA’s communications to date concerning surgical mesh when used transvaginally in pelvic organ prolapse surgeries. The article An Appraisal of the Food and Drug Administration Warning and Urogynecologic Surgical Mesh, published in the Current Urology Reports (2012, 13:231-239) gives an overview of the FDA’s conclusions regarding the use of surgical mesh in POP surgeries. The first Public Health Notification issued by the FDA came out in 2008 after over a thousand women submitted adverse health reports following transvaginal surgery using gynecologic mesh. Three years later the FDA issued an update to that report regarding the safety and effectiveness of mesh in POP surgery. At this time the agency reviewed the currently available safety data and scientific research on gynecologic mesh.

This article states that it is estimated that over a third of pelvic organ prolapse surgeries implement surgical mesh and that 75% of all these surgeries were done transvaginally. These numbers come from the over 300,000 women who undergo pelvic organ prolapse surgery annually in the U.S. and over 260,000 who undergo a surgical procedure for stress urinary incontinence. The FDA states that as far as SUI surgeries go, “more than 80% were done transvaginally with mesh.” The FDA’s conclusion is that although POP surgery done transvaginally may restore the woman’s body anatomically, there are few if any benefits over surgeries which do not implement urogynecologic mesh. 

How Effective have the FDA’s Warnings on Urogynecologic Mesh Been?

This article will detail the relative effectiveness of warnings issued by the FDA regarding Urogynecologic mesh use. According to the article, An Appraisal of the Food and Drug Administration Warning on Urogynecologic Surgical Mesh, published in Current Urology Reports (2012, 13:231-239) manufacturers market surgical mesh kits with a goal of increasing speed and ease of placement. The FDA reports over the past few years have sought to increase the awareness of the potential risks of surgical mesh when used in a transvaginal surgical procedure despite manufacturer’s claims.

More and more often reports are coming out which emphasize the fact that surgeons who use these mesh kits must have specialized training which enables them to “recognize and manage the complications of surgical mesh implants.” Governmental regulation of these mesh devices has also come under fire; while there are many different agencies in charge of regulation and reporting, women have nevertheless been harmed by transvaginally placed mesh implants. 

FDA Warnings on Urogynecologic Mesh: An Overview

This article will detail the original warnings the FDA issued regarding urogynecologic mesh when used in pelvic organ prolapse surgical applications. According to an article titled An Appraisal of the Food and Drug Administration Warning on Urogynecologic Surgical Mesh published in Current Urology Reports (2012 13:231-239), permanent surgical mesh has been used in various applications for several decades, having been used in the repair of hernias since the 1950’s.

The FDA’s July 2011 report on Urogynecologic Surgical Mesh defines surgical mesh as “a metallic or polymeric screen intended to be implanted to reinforce soft tissue or bone where weakness exists.” Beginning in the 1970’s surgical mesh made its appearance in abdominal surgeries for pelvic organ prolapse, then in the 1980’s surgeons began using synthetic slings in the treatment of stress urinary incontinence. It was not until 1996, however, that the FDA approved a type of mesh particularly for use in stress urinary incontinence surgical procedures. Some six years later, in 2002, the Federal Drug Administration approved surgical mesh as an application for the treatment of pelvic organ prolapse. 

Consolidation of Stryker Rejuvenate Hip Lawsuits Placed in New Jersey

The state of New Jersey is expected to consolidate at least ten StrykerRejuvenate and ABGII hip implant lawsuits before one judge in order to expedite the handling of these cases. Multi-district and multi-county litigation is described by Class Action Litigation website as a procedure utilized by federal and state courts to transfer all pending cases which are very similar in nature before one judge. This procedure allows lawsuits to move in a more expeditious manner through the discovery phase while still allowing the injured party to seek an individual trial and have their settlement adjusted based on the degree of injury. This is unlike class action lawsuits which dictate that all members share equally in the settlement even though it is unlikely that all injuries would be equal. The first ten cases are coming from Florida, Minnesota, New Jersey and Arizona. Hackensack, NJ was chosen as the consolidation point because it is close to Stryker headquarters.

Problems With Rejuvenate and ABGII

The lawsuits followed the recall in July of 2012 for the Rejuvenate and ABGII. The recall was voluntary on the part of Stryker and cited the risk of fretting, corrosion and the release of metal ions as the reason for the recall. Pain, inflammation, necrosis, metallosis and total failure of the hip implant can all result from the fretting and corrosion of the hip implants. These implants were originally marketed as a way for younger clients to be able to continue their levels of activity as they were believed to last from 15-20 years. Stryker’s innovative design offered a variety of necks and stems, allowing physicians to more closely match the implant to the size and activity level of the patient. Even though the Rejuvenate and ABGII are not all-metal (they have a ceramic ball and a plastic cup liner) they have the same potential for the release of metal ions into the body as the all-metal implants. 

Sales Dip for Stryker Following Hip Implant Recalls

Stryker sales have shown a definite dip in the quart since the recall of the Stryker Rejuvenate and ABGII hip implants in July. The hip implant recall came just months after Stryker issued an Urgent Field Safety Notice to hospitals and physicians in April of 2012 citing the potential of fretting and corrosion at the neck juncture as well as the risk of metal ion release. Stryker’s hip implant sales dropped nearly 10 percent while its knee implant sales dropped 4.3 percent.

Why the Dip in Revenues?

A Stryker company official stated the recalls of the Rejuvenate and ABGII had only a “modest impact” on the company’s third quarter drop in sales. While the recalls certainly would have impacted Stryker’s revenues, the overall economy may also have played a part. Joint replacement surgical procedures are considered elective most of the time. Those with insurance may delay the surgery to avoid missing work while those without insurance likely cannot afford the procedure. Stryker’s CFO, Curt Hartman also stepped down after two decades at the helm. He reportedly received a 1.5 million dollar separation package although he will remain as an adviser to Stryker through February, 2013. 

Why Diagnosing Problems in Stryker Rejuvenate Hip Implants is So Difficult

When the Stryker Rejuvenate and ABGII were recalled in July of 2012, citing potential risk of fretting and corrosion at the neck juncture, many of the implants had already been removed during revision surgeries. Unfortunately, since most physicians were unaware of the problems with the implants, the operative reports were unlikely to list this corrosion. In other words, since the doctors hadn’t been told what issues to look for, there were few records stating that corrosion was a factor in the revision surgery. When Stryker originally told hospitals and surgeons (in an Urgent Field Safety Report in April of 2012) that there could be corrosion or fretting and release of metal ions, there was still no mention of that corrosion occurring anywhere except at the neck juncture.

Therefore, the neck juncture would likely have been the only place physicians would have examined when taking out the implant. In the same vein, when implant recipients came to their doctor complaining of pain or other symptoms, the doctor would have ordered x-rays, an MRI and a bone scan. Again, without clear information regarding what to look for, many physicians might have attributed their patient’s complaints to external issues such as the aging process.  The Rejuvenate, unlike former metal-on-metal hip implants, is a four-part device with a ceramic ball and a plastic liner in the cup. Because of these improvements, it was believed there would be no metal parts rubbing against one another causing metal ion shear. 

Stryker Rejuvenate Hip Implant: What is the Real Problem?

Just this past July Stryker Orthopedics issued a voluntary recall of their Rejuvenate and ABGII hip implant systems citing a potential for fretting and corrosion at the metal neck junction. The FDA convened a panel shortly before this recall to discuss the merits of continuing to use metal-on-metal hip implants due to the high number of complications suffered from recipients. The design of the Rejuvenate was believed to overcome most issues associated with the all-metal hip implants as it allowed surgeons to custom-fit the stems and necks of the implants to the size and relative activity level of the patient.

The Rejuvenate Design

The Stryker Rejuvenate consists of a ceramic ball which fits into a plastic-lined socket. Because there was no metal-on-metal ball and socket it was believed there were no metal surfaces which could potentially rub against one another, causing metal ion debris to enter the surrounding tissue or bloodstream. The Rejuvenate is essentially a two-piece system in that the properly sized metal stem and neck connect to one another then connect to the ceramic ball. The neck is made of chromium and cobalt, just like the all-metal implants and the stem is coated with titanium. Even so, by using a ceramic ball and a plastic-lined socket, it was believed there would be no issues regarding metal ion debris.

Motorcycle Accidents in the State of Texas

As motorcycle riding has grown in popularity over the past decade it might surprise some to realize that a large portion of these additional motorcyclists are comprised of the “over-fifty crowd.” Contrary to the stereotype of the motorcyclist who drives recklessly and too fast, this group of motorcyclists generally drive their bike in the same manner they drive their automobile—safely and respectful of the other drivers on the road.

Texas Motorcycle Facts

Although the nation has seen a decline in the overall number of motorcycle fatalities, the state of Texas has actually had an increase in motorcycle deaths, with the majority of these deaths occurring in those between the ages of 20 and 29. It can be traumatic for anyone involved in an accident of any type however those who are injured in a motorcycle accident are much more likely to suffer death or serious injury.  There is little to no protection for the motorcycle rider when he is hit by a three-thousand (or more) pound hunk of metal, steel and glass.

What Happens Following a Trucking Accident?

There are nearly half a million collisions involving large commercial trucks each year; as many as 5000 of those involve fatalities with the state of Texas having between 250 and 450 trucking fatalities annually. In fact, the fatal crash rate for large trucks is 2.4 deaths per 100 million vehicle miles traveled which is fifty percent higher than the rate for other vehicles on the road. Because of the great disparity in size between a loaded commercial truck and a passenger vehicle 98 percent of these trucking fatalities are occupants of the smaller vehicle. A normally loaded 18-wheeler can take up to 350 feet to come to a stop while an overloaded truck will take an even longer distance.

Factors in Trucking Accidents

Trucking accidents are the result of a variety of factors including truck driver error, distraction or fatigue, mistakes on the part of the driver of the passenger vehicle, and mechanical failures which are common to 18-wheelers. The scores of victims of trucking accidents may wonder how the system which is meant to keep us safe has failed time after time. Those who survive a trucking accident likely find themselves totally immersed in the health of those involved in the accident, particularly in instances where injuries are extremely serious. The focus is on medical care and the ongoing treatments required leaving little time or energy to contemplate the medical bills stacking up, the lost wages which are resulting in regular bills going unpaid and the long-term effects resulting from the trucking accident. Those involved in a trucking accident may have wondered what the “other side” was doing in the days and weeks following the collision.

When Trucking Accidents Occur in the State of Texas

The City of Houston is well-known for the number of large commercial trucks which share the roadways with other vehicles. Because the Houston area is a primary shipping route, with over three million residents in Houston and outlying areas, it is considered one of the busiest thoroughfares in America. There is also considerable truck traffic resulting from the surrounding petroleum-transport areas as well as the many 18-wheelers from out of state which continuously travel through the Houston area. When you factor in the amount of truck traffic in the area you can see that accidents are much more likely to happen simply due to the sheer volume of truck traffic.  In 2008 Houston saw 421 fatalities involving large commercial trucks and although that number was down to 284 fatalities by 2010, the numbers are still sobering.

Why 18-Wheelers are Dangerous to Smaller Vehicles

The Houston area accounted for approximately 8 percent of all fatalities associated with trucking accidents in the entire United States. Considering the sheer size of an 18-wheeler—particularly when it is fully loaded—in the event a truck crashes into a passenger vehicle, those in the smaller vehicle are obviously at a clear disadvantage. Even though trucks are now required to have under-ride bars at the rear, when a passenger car runs into the back of an 18-wheeler the impact is four times as likely to cause death than when the reverse is true (when the 18-wheeler rear-ends a passenger vehicle). A loaded truck easily weighs 20-30 times as much as a passenger vehicle meaning it takes a good forty percent longer distance to come to a complete stop. In the end, when an 18-wheeler collides with a smaller vehicle it is highly likely there will be serious injuries or death.

When Truckers Take to the Road Do They Look Out for Your Safety?

You’ve probably noticed drivers who are texting, talking on their phones, applying makeup, eating, or any number of other activities which distract them from driving and put other drivers and passengers at risk. Now, imagine that person who is not paying attention to the road is a truck driver. When you consider that a fully loaded truck needs the length of a football field to come to a complete stop—assuming it is traveling 60 mph on a totally dry road--you can see that when a truck driver is distracted, even for a moment, a tragic accident can result. The most recent federal regulations mandate shorter braking distances for commercial trucks however don’t affect existing 18-wheelers, only newly manufactured trucks.

While all drivers should avoid distractions which can lead to accidents, there is a large disparity between a crash between passenger vehicles and a crash involving a commercial truck and a passenger vehicle. A fully loaded truck is 20-30 times as heavy as a passenger vehicle and in a collision between the two the passengers in the smaller vehicle rarely fare well. Of the half a million trucking accidents in the United States each year approximately 5,000 of those will result in fatalities and a large percentage of the remainder will result in very serious injury to those in the passenger vehicle. Truck drivers are constantly under pressure to get their loads delivered; both from their employers and even from their own family members as their paycheck depends on the time they spend behind the wheel of the truck.

Miss the Filing Deadline for Your DePuy ASR Hip Case? There May Still Be Hope

Despite the fact that the August, 2010 recall of the DePuy ASR metal-on-metal hip implant caused a significant stir among the medical community, thousands of recipients of the metal implant remained unaware of recall and subsequent warnings. Due to the initial FDA notice which was issued July 17, 2010 and the recall of the implant on August 24, 2010, all those who live in a state which operates under a two-year statute of limitations may have already lost their right to file suit against DePuy and Johnson and Johnson. Over half of the states do operate under that two year SOL, while others extend that time limit to three, four, six or even ten years. A handful of states have a one-year statute of limitations.  If you are the recipient of a DePuy metal hip implant it’s important that you determine your state’s statute of limitations for defective medical products even if you are currently having no problems with your implant.

Although DePuy originally set their metal implant’s failure rate at approximately 5%, they increased that number to 12% at the time of the 2010 recall. Independent studies place the likelihood of a DePuy ASR implant failure much higher—50% at five years following implant surgery and 80% at eight years following implant surgery. Statistically speaking, even those patients who have not yet experienced failure of their hip implant or adverse health effects from metal toxicity will do so in the very near future. It is extremely important that all DePuy ASR implant recipients at least be aware of their options prior to the date the statute of limitations will run.

The DePuy ASR Metal-on-Metal Hip Implant: A Scientific Analysis of its Problems

The last ten years have seen surgical replacement of hip joints with an artificial prosthesis increase significantly. The main reason for this surge in hip replacement surgeries is our aging population. With people living longer, more active lives, degenerating hip joints can put a halt to that activity. From 1997 through 2004, the number of hip replacement surgeries increased nearly 50% and if the trend continues it is estimated that the annual number of hip replacements in the United States will reach 600,000 by 2015.

Factors in Hip Replacement Surgery

Primary reasons for patients undergoing hip replacement surgery include chronic pain, impairment of daily functions and severe arthritis in the hip joint. The most common type of arthritis leading to total hip replacement is osteoarthritis and is generally seen with aging or trauma to the hip joint. In some instances necrosis of the hip can be present, usually caused by a fracture, alcoholism, lupus, or taking steroid drugs such as prednisone. Patients may experience progressively worsening chronic pain which prohibits them from walking, climbing stairs or even getting up from a sitting position.

Types of Hip Implants

There are many different types of hip replacement implant including the metal-on metal, metal-on-polyethylene and metal-on-ceramic as well as the implants which are 100% ceramic or polyethylene. Other than the materials the implant is constructed with, the only other major difference is in how the implant is affixed—it can be cemented to the bone or attached in such a manner that it grows into the patient’s remaining bone. The idea behind the cobalt and chromium metal-on-metal hip implant was to create an implant which would not have to be re-done for fifteen to twenty years—unlike the ceramic and polyethylene hip implants which last approximately 8-12 years. 

First Three DePuy Cases settled by Johnson & Johnson for over $600,000

The DePuy metal-on-metal hip implant, approved by the FDA a mere seven years ago—has been inundated with over 8,000 lawsuits claiming the implant is inherently defective and can lead to costly and painful revision surgery as well as a myriad of other serious health issues. DePuy initially claimed the failure rate of the ASR metal hip implant to be between 4-5%. When DePuy voluntarily recalled the implant in 2010, they upgraded the failure rate to approximately 12% within the first five years. Studies independent of DePuy or Johnson & Johnson place the failure rate of the ASR metal implant at 50% within six years and 80% within eight years. These staggering numbers almost guarantee that this particular metal-on-metal hip implant will fail at some point in the majority of recipients.

Nearly a hundred thousand ASR devices were implanted worldwide prior to the recall with nearly forty thousand in the United States alone. The propensity of the implant to loosen and detach as well as the thousands of reports regarding adverse health effects from high levels of chromium and cobalt have led to over 6,000 lawsuits filed in federal court an another 2,000 filed at the state level in Maryland, California, Nevada and other states. Johnson & Johnson recently settled three Nevada cases for $600,000—an amount considered to be at the low end of the expected $200,000-$500,000 to settle each case.

“ASR” type Chromium and Cobalt Poisoning also being seen in Pinnacle Hip Implant Recipients

The DePuy ASR metal-on-metal hip implant has repeatedly made the news following a voluntary recall on August 26, 2010. While DePuy’s Pinnacle metal hip implant has not suffered under the recall stigma, many feel that it offers the same risks to implant recipients as the ASR. And, in fact, many attorneys are constantly asked by their clients about the differences between the ASR and the Pinnacle. The primary distinction between the two metal hip devices lies in the fact that the Pinnacle uses an insert liner between the acetabular cup and the femoral head while the ASR does not. It has been theorized that the ASR cup was too shallow for the head, leading to the ball hitting the edge of the cup and metal shavings to shear off into the body, also know as edge-loading.

While the Pinnacle’s cup was designed to give greater depth and allow the femoral head to move more freely within the socket, in some cases it still has been know to cause metallosis in implant recipients when the cobalt and chromium ions migrate around the body. Metal poisoning can cause a wide variety of adverse medical events. Many ASR recipients have had cardiovascular, renal, neurological and thyroid issues although studies done in the 70’s do not definitively tie these metals to cancer. Unfortunately, due to the lack of comprehensive studies on safe levels of cobalt and chromium in the body and the effects of toxic levels, nobody really knows just how dangerous these metals can be should they migrate to the bloodstream. The metal shards can also lodge into the surrounding tissues causing degeneration and destruction.

Attorneys of Sullo & Sullo Seeing DePuy Hip Implant Lawsuits Increasing

While many other firms have seen a drop in the number of metal hip implant clients, Sullo and Sullo attorneys have actually seen those numbers climb. Andrew Sullo, Class Action Lead Counsel & Managing Partner notes that “Although many firms have noticed a slowdown in the number of clients hiring them for DePuy ASR and Pinnacle lawsuits, our firm has not. I believe that is because we are constantly offering our clients new and updated information. Our job is to inform all metal-on-metal hip recipients that even though their hip may not have failed yet, it could and after August 26^th they may lose rights to recover compensation from Johnson and Johnson.”

With the statute of limitations coming up soon on the ASR metal-on-metal hip implant lawsuits, Sullo & Sullo is experiencing an increase in the ASR recipients who are coming forward and asking to be a part of the lawsuit. Many clients in the lawsuit have experienced adverse health effects as a direct result of having an ASR all metal hip implant put into their body.  On the other hand, many have experienced little or no pain with their ASR hip implant but have elected to join the lawsuit that they can be financial protected at a point in the future should their ASR device fail. Through no fault of their own, these people have become victims of a heavily flawed system which allows harmful medical devices to be sold to the public. The ASR was approved in 2005 by the FDA under the controversial 510(k) process which allows medical devices to essentially ride in on the coattails of other medical devices which have come before them. In some cases approval is granted based on a device which has actually been discontinued because of the number of problems associated with it.

Current Updates on the DePuy ASR Hip Recall

The DePuy ASR metal-on-metal hip implant was approved in 2005 by the FDA, but soon thereafter both DePuy and the FDA began receiving reports of adverse health events. Some believe that the much less rigorous 510(k) approval process which allows manufacturers to skip clinical trials could be at least partially responsible for the adverse health effects in the thousands of ASR recipients. Following a flurry of complaints, DePuy voluntarily recalled the ASR on August 26, 2010. At present there are approximately 4000 DePuy ASR lawsuits consolidated into an MDL in Ohio as well as a smaller mini-state consolidation in Chicago with approximately 600 plaintiffs and another in California containing 1500 or so plaintiffs. Since California is experiencing so many financial problems, the plaintiffs and their attorneys are expected to face problems in getting a trial setting.

The MDL, or multi-district litigation system is meant to streamline the litigation process, taking advantage of the fact that there are similar allegations from all plaintiffs made against the defendants—in this case DePuy and Johnson and Johnson. The first trial regarding the ASR was scheduled to begin in state court in Las Vegas in mid-December although it has been rumored the case settled prior to trial. Should this be true, it would be a positive precedent for all other ASR lawsuits to follow. The metal-on-metal design came about due to its ability to last significantly longer than the metal-on-ceramic or metal-on-plastic hip implants. Unfortunately, the metal-on-metal design allowed the cobalt and chromium ball and cup to shave off microscopic metal ions into the body, entering the surrounding tissues or even the bloodstream. The FDA recently held a two-day panel to discuss the safety of the metal hip implant. 

Is Joining the DePuy ASR Class Action Lawsuit still an Option for Recalled DePuy ASR Hip Implant Recipients With No Pain?

Andrew Sullo, Class Action Lead Counsel & Managing Partner at Sullo & Sullo is working hard to ensure that every single recipient of the DePuy ASRmetal-on-metal hip implant is fully aware of both the recall on August 26, 2010 and the upcoming statute of limitations expiration for those who reside in states which implement the two-year statute. There are over 40,000 people who have received an ASR implant in the United States. The ASR was approved by the FDA in 2005 and began being widely used by surgeons who believed the metal-on-metal design would last much longer than the metal-on-ceramic or metal-on-polyethylene models.

Unfortunately, adverse health reports began pouring in with over 17,000 such reports received by the FDA regarding these all metal hip implants. Of those thousands of recipients, there are only approximately 6,000 who have joined into the MDL lawsuits against DePuy. While this might cause some to wonder if the risks of the ASR have been exaggerated, there are other factors involved. First of all, many recipients may not have heard the device was recalled or may truly have no idea what type of implant was used in their surgery. Second, many recipients of the ASR and other hip implant devices are senior citizens who may believe the symptoms they are experiencing are related to advancing age rather than attributing them to the ASR implant.

Finally, many of those who have not come forward to take part in the lawsuits state they are not having any problems with the ASR at present, so why would they sue the company? This is very flawed logic in this particular instance. Although the failure rate of the ASR was originally stated by DePuy to be in the 12-13% range—still much higher than the average of .5-5% failure rates—experts in the field have estimated that by six years following the initial surgery nearly 50% of the ASR hip implants will have failed and by eight years following the surgery a staggering 80% will have failed. When you look at those numbers you can see that it is highly likely that at least half of those thousands of people who have not joined into the lawsuit will suffer a hip failure. In fact, Andrew Sullo notes that “More than 50% of our ASR hip recipient docket has already received revisions.”

Problems with the DePuy Pinnacle Hip Implant: Current Reports

As of this date the Pinnacle metal-on-metal hip implant device manufactured by DePuy has not followed in the recall footsteps of DePuy’s other hip implant, the ASR. While Johnson and Johnson and DePuy vigorously deny that the Pinnacle has any problems—and, in fact, call it the best metal-on-metal hip implant on the market today—many recipients of the device feel it has some of the same flaws as the ASR. Both the Pinnacle and the ASR are manufactured by Johnson and Johnson’s subsidiary company, DePuy. The Pinnacle made its debut in 2002 as the predecessor of the ASR which followed in 2005. The ASR is strictly a metal-on-metal hip implant device while the Pinnacle name includes metal-on-ceramic and metal on polyethylene models as well.

Nearly 150,000 Pinnacle all-metal hip replacements have been implanted compared to 93,000 ASR’s worldwide—approximately half of those in the United States alone. Both the Pinnacle and the ASR all-metal hip implants were approved under the controversial 510(k) FDA approval process. This particular process allows the majority of medical devices to get to market quickly by showing they are substantially comparable to a device which has already gained approval. The process also allows a product to get to market without expensive clinical trials however in some cases the approval process has been predicated on a device which is no longer marketed—even due to poor performance. 

Chromium and Cobalt Poisoning: What are the Long Term Side Effects of Metallosis?

It is likely that the recipients of a metal-on-metal hip implant have heard about the possible consequences from the metal shavings which can be released into the body when the metal cup and ball rub against one another during normal activities. Tiny ions of cobalt and chromium shear off when the two surfaces meet and those ions can lodge in the surrounding tissues or can end up in the bloodstream. As more and more metal hip implant patients are realizing the seriousness of metal toxicity, blood testing for elevated levels of metals is increasing. In many cases patients have been found to have levels of cobalt and chromium in their bloodstream which are as much as a hundred times normal levels. 

Although slightly elevated levels of these metals are fairly normal for patients with metal-on-metal hip implants, extreme elevations can be very dangerous—and anxiety-producing for the patient. DePuy released a report indicating that concentrations of the metals greater than 7 parts per billion are cause for concern. The Mayo Clinic has set somewhat different reference values, stating that blood serum concentrations of chromium greater than 1ng/mL suggests significant wear of the metal implant while serum concentrations greater than 5.0 ng/mL of cobalt can be considered toxic and also suggest significant wear of the prosthesis. Remember that 1 PPB (part per billion) equals 1.0 ng/mL.

Johnson & Johnson Hip Implant Settlement: Filing Deadlines are Approaching Fast

Many recipients of the ASR metal-on-metal hip implant are unaware of a crucial date which is fast approaching. The ASR was approved by the FDA in 2005 then labored under a flurry of adverse reports regarding early failure rates. Finally, on August 26, 2010, DePuy recalled the ASR, citing failure rates of around 12-13%--as opposed to their initial reports of 4-5% failure rates. What this means is that among the 26 states which operate under the two year statute of limitations, there is less than a month left to join in the multi-district lawsuits against DePuy. Of the more than 40,000 recipients of the ASR in the U.S. alone, only about 6,000 of those have joined in as plaintiffs in the DePuy suit. This means there are over 35,000 ASR recipients out there who have yet to come forward.

There may be several reasons for this including the fact that many of these people may be unaware of the recall. Others may be elderly recipients of the metal ASR and are simply chalking their negative health symptoms up to the aging process. It is believed, however that a large number of those who have not joined in the lawsuit have not done so because they are not yet experiencing problems, therefore believe they have no rights under the current lawsuit. It’s important that this group of people be aware that the actual failure rate of the ASR has been estimated at 50% at six years and 80% at eight years. Considering the ASR metal-on-metal implant has only been on the market since 2005 you can see that the likelihood of thousands more recipients having serious problems from the device is huge.

Statute of Limitations and the Likelihood of Reimbursements by Broadspire

Broadspire is one of the foremost third-party risk management administrators to large insurance companies and employers. Broadspire has been retained by DePuy to engage in damage control regarding the ASR hip implant claims.  It is likely that few people who have suffered medical harm because of a metal-on-metal hip implant truly understand the lengths such companies will go to in order to save their client as much money as possible. Broadspire is under orders by Johnson and Johnson and DePuy to downplay the public outcry regarding the ASR hip implant recall to the fullest extent possible. One of the avenues Broadspire will use for this specific purpose is to gain as much knowledge about patients as possible through the use of claimant data.

Will Benefits Be Discontinued?

If you or a loved one has suffered an adverse medical event which is directly related to a metal-on-metal hip implant then one look at Broadspire’s website should give you an idea of the true nature of this company and the depths they will go to in order to benefit their client.  Privileged medical records are being used for the benefit of Johnson and Johnson and DePuy via an entire panel of medical professionals at their beck and call. Many of those victims of the hip implant currently rely on the reimbursement benefits being offered through Broadspire which covers their co-pays and deductibles. The question on everyone’s minds now is whether those benefits will continue after the statute of limitations runs out in August, 2012.

Metal-on-Metal Hip Implants Tied to Metallosis?

Corrosion, serious tissue reactions and metallosis are all possible side effects for recipients of the metal-on-metal hip implant. The safety of these devices has come under serious question with many recipients requiring revision surgery to remove the harmful devices. The DePuy ASR was recalled in 2010 due to studies showing it corroded much more quickly than other types of implants, most notably those made of ceramic and plastic. Once corrosion occurs in the metal hip implant the tissues surrounding the implant can become inflamed or soft tissue masses, lesions and necrosis can occur. The femoral heads as well as the acetabular cup of the DePuy hip implants are constructed of cobalt and chromium. The past few years have seen serious concerns regarding the metal chromium and cobalt particles which shave off when the femoral head and acetabular cup rub against one another during any activity. Once the levels of corrosion reach the unsafe stage the implant will likely have to be removed during a revision surgery.

Journal of Anthroplasty Study

A recent study in the Anthroplasty Journal compared the levels of corrosion on the femoral heads of the metal hip implants with those constructed of metal-on-polyethylene which implements a synthetic liner between the metal cup and femoral head. This liner acts as a buffer between the two metal pieces meaning there is less chance of the small metal ions slivering off and causing metallosis or metal toxicity in the bloodstream. The metal ions in the bloodstream can lead to kidney and liver disease or certain types of cancer, while the metal shards which lodge in surrounding tissues can lead to serious inflammation, tumors and even bone loss.

U.S. Drug Watchdog Urges Pinnacle Hip Implant Recipients to Come Forward

Over 130,000 Americans received a DePuy Pinnacle metal-on-metal hip implant between the years of 2005 and 2010. Although its counterpart, the DePuy ASR XL hip replacement system was recalled in 2009, the Pinnacle, while employing the same construction methods and materials, has not been recalled. Because of the recall of the ASR, there is mounting concern that the Pinnacle may also expose recipients to the dangers of metallosis or metal toxicity. The U.S. Drug Watchdog has stated their goal of reaching each and every one of the recipients of the Pinnacle implant to ensure none who have suffered harm are left behind.

Although only about a thousand people have come forward to date, the U.S. Drug Watchdog believes those numbers will grow rapidly, reaching well over 100,000. When the victims are properly identified they will then be provided access to the most knowledgeable attorneys who possess a thorough background in the intricacies of the metal hip implant. The objective of the U.S. Drug Watchdog is to ensure every person who had their health harmed because of a metal-on-metal hip implant receives appropriate compensation for failure of the implant.

U.S. District Judge Expects DePuy MDL to Move Forward

A recent meeting between the Judge chosen to oversee the multi-district litigation in the DePuy Pinnacle hip implant case included attorneys from both sides. The goal of the meeting was to determine the most practical manner of handling the more than 1,000 current DePuy lawsuits. U.S. District Judge Ed Kinkeade—judge for the northern district of Texas—will use the MDL in the interest of expediting and coordinating these consolidated pre-trial proceedings. Unlike many MDL cases, the DePuy case appears to be moving forward with case management procedures expected in the next six weeks to two months.

The initial MDL trials in the DePuy Pinnacle cases are bellwether trials with a purpose of choosing representative cases from those filed to determine how juries will likely react to evidence which is common to all the cases. During a bellwether trial the judge and attorneys are able to gain knowledge which will be helpful in negotiating future DePuy lawsuits. The process dictates that representative attorneys will be chosen to try the DePuy bellwether trials; the knowledge gained from these trials will be extremely helpful in planning strategies and setting precedence for future Pinnacle cases. All attorneys involved in litigating the DePuy Pinnacle metal-on-metal hip implants will be watching the bellwether cases closely as well as the entire MDL.

Texas First Degree Felony Crimes and Consequences

By Independent Staff Writer

What is a First Degree Felony in Texas?

Criminal offenses in Texas are charged under the categories of misdemeanors and felonies.  Felonies are the most serious criminal offenses and carry the most severe penalties.  A felony is generally considered any criminal offense more serious than a misdemeanor, and that is punishable by imprisonment of more than one year.  A felony crime is classified as a State Jail Felony, Third-Degree Felony, Second-Degree Felony, First-Degree Felony, or a Capital Felony, the most serious being a Capital Felony that can bring a penalty of life imprisonment or death.

First Degree Felonies are among the most serious crimes in Texas, second only to capital felonies.  Examples of crimes that are considered First Degree Felonies include but are not limited to the following:

Penalties for Assault and Battery in Texas

By Independent Staff Writer

Assault charges in Texas can result from a simple threat or argument, a fistfight, or a violent attack with a weapon.  Assault charges range from misdemeanors to felony charges depending on the circumstances, and are taken especially seriously if injury occurs or if a weapon was used.  The penalties range from fines to prison terms depending on the severity of the assault and the circumstances of each case. Being faced with assault charges of any kind can have drastic negative consequences both personally and professionally.

Texas Driver’s License Fines and Suspensions

By Independent Staff Writer

A. The Texas Driver Responsibility Program and Points on Your License

Texas uses the Texas Driver Responsibility Program (DRP) adopted by the state legislature (TRC §708; Article 10, House Bill 3588, 78^th Legislative Session) to track individuals’ traffic violations, assign points to their records, and assess fines to drivers who receive or exceed a certain number of license points.  Not surprisingly, the point system has been an efficient revenue generator for the state.

Classes of Misdemeanor Offenses in Texas

By Independent Staff Writer

Criminal offenses in Texas are divided into two main categories, felonies and misdemeanors.  Misdemeanors are considered lesser crimes than felonies and are divided into three classes based on the degree of seriousness of the offense and the severity of the punishments.  It is important to take misdemeanor charges seriously, because having a misdemeanor conviction on your record can impact your life in many negative ways.  You may have difficult time getting the job you want, being admitted to an institution of higher education, or even obtaining an occupational license.

Defining Felony Crimes in Texas

By Independent Staff Writer

Texas Felony Criminal Offenses

Criminal offenses in Texas are charged under the categories of misdemeanors and felonies.  Felonies are the most serious criminal offenses and carry the most severe penalties.  A felony is generally considered any criminal offense more serious than a misdemeanor and is classified as a State Jail Felony, Third-Degree Felony, Second-Degree Felony, First-Degree Felony, or a Capital Felony, the most serious being a Capital Felony that can bring a penalty of life imprisonment or death. Criminal felony charges of any kind are a very serious matter.  The penalties for conviction are severe and can have profoundly negative and damaging consequences to one’s personal and professional life for many years.  You may face difficulty in finding employment and may face financial problems.

How Strong is Your Pradaxa Case?

By Independent Staff Writer
If your doctor has prescribed the relatively new drug, Pradaxa, as an alternative to Warfarin, you may have been alarmed to hear of the potential issues with Pradaxa. Pradaxa was approved by the FDA in late 2010 after the manufacturer, Boehringer Ingelheim, presented the drug as a much better alternative to Warfarin, which had been used exclusively since the 1950’s as a treatment for the prevention of systemic embolisms and strokes. Pradaxa is used to treat patients with atrial fibrillation and works primarily by thinning the blood of the patient. While Pradaxa did appear to work slightly better than Warfarin, it has been shown to have serious side effects, some of them fatal.

How Does Pradaxa Work?
The primary issue with Pradaxa lies in how it works in the body. While both Pradaxa and Warfarin are used to prevent strokes in patients with atrial fibrillation, Warfarin works through the inhibition of Vitamin K in the body. Vitamin K is a clotting agent, and should Warfarin cause excessive bleeding in a patient, doses of Vitamin K can be administered to slow the bleeding. Pradaxa works by inhibiting an enzyme in the blood known as a thrombin. Thrombins are also responsible for controlling blood clotting, however at this time there is no known reversal agent to Pradaxa and should it cause excessive bleeding physicians have no way of slowing or stopping the bleeding. In the case of excessive bleeding among Pradaxa users they have no choice but to wait 12 to 24 hours until the drug has cleared their system, allowing the blood to clot as it should.

DePuy Litigation: Statute of Limitations Depuy Lawsuits

By Independent Staff Writer


In August of 2010 DePuy Orthopedics, Inc. recalled two of its most popular hip replacement systems—the ASR XL Acetabular and the ASR Hip Resurfacing System. The recall came on the heels of a study which indicated the five-year failure rate of these products was as high as one in every eight patients. Severe pain and metal toxicity in the blood have required many of those who received a DePuy hip replacement to have revision surgery to replace the defective implant. Although the DePuy Pinnacle system has not yet been recalled it utilizes the same metal-on-metal design as the ASR, and many of those who received the Pinnacle implant have experienced the same symptoms including loosening of the hip implant, unsafe chromium and cobalt levels in the blood and extreme pain.  

What is a Statute of Limitations?
All lawsuits filed in the United States have an expiration period known as the Statute of Limitations. After this time period has passed an injured party is prohibited from filing a recovery case. These statutes are meant to guard companies from being exposed to lawsuits for long periods of time as well as to ensure the suits are filed while evidence is preserved and memories are clear. Depending on the state you reside in the statute of limitations for product liability can range from two to six years.

DePuy’s “Offer”
Following DePuy’s recall of their hip implants the company stated that patients who met specific criteria might be able to have some of their medical costs covered. Before any type of reimbursement is issued, however, DePuy will review patient’s medical records to determine whether the patient is eligible for reimbursement. The problem with this is that DePuy states the patient’s medical records must confirm a revision surgery is definitively related to the ASR recall rather than another cause such as a “traumatic fall.” In other words, the company is likely to attempt to blame the failure of the hip implant on a pre-existing condition, an underlying disease, physician error or misuse, therefore providing DePuy with sensitive medical records could well mean you would receive no money at all for the defective product implanted in your body.

Reviewing the Safety of Metal-on-Metal Hip Implants

By Independent Staff Writer

According to a recent BBC Newsnight investigation, literally hundreds upon thousands of patients across the globe may have been exposed to potentially toxic substances following the implantation of metal-on-metal hip implants. Even though it is now believed that the dangers of these hip devices—which appear to have been very poorly regulated at best—was well known and documented for decades, recipients of the devices were nonetheless kept in the dark. The implants which are in question are known as “metal-on-metal,” and are constructed via a head at the top and a lining the head fits into which are made of cobalt-chromium alloy.

The Failure Rate of Metal-on-Metal Hip Implants
These hip implants are used in hip replacements and hip resurfacing, and came into wide-spread use in the 1997. The target group for these metal-on-metal hip replacements was younger, still-active patients who expected the hip replacement to last the rest of their life. Unfortunately, the numbers show that the failure rates among both genders are significantly higher than normal—from 11.8% failure in resurfacing to 13.6% for the total hip replacement as compared to rates of only between 3 and 5% for implants made of other materials.

How Many People Have Hip Implants?
Since 2003, the BBC article reports that over 60,000 patients in England and Wales and over a million in the United States have received the potentially dangerous metal-on-metal hip replacement. The metal ions from the cobalt and chromium hip implants are believed to seep into local tissues causing reactions which can not only destroy muscle and bone but can eventually leave the victim with a permanent disability. The fact that cobalt and chromium can lead to such serious health issues was actually documented in scientific journals over three decades ago.

Was There a Cover-up?
DePuy, a major manufacturer of the metal-on-metal hip implant, released an internal memo in 2005 which stated that in addition to possible changes in immune functioning there was additional concern that the metal debris from the device could be carcinogenic. The memo went on to state that the possibility of distant effects of the device was “worrying,” and that one study indicated a three times higher risk of lymphoma and leukemia ten years following the hip replacement. Despite these very real concerns DePuy continued marketing the device and indicated none of the potential health concerns in their subsequent promotional materials.

A Discussion of the Long-Term Health Effects of the Hip Implant
In 2006 the Medicines and Healthcare Products Regulatory Agency convened a meeting to discuss the long-term health effects of the metal-on-metal hip implant made from cobalt and chromium. An advisory board was appointed, however out of the group’s eight members, two were consultants for DePuy and one was the director of product development for Smith and Nephew—obvious conflicts of interest. In the end the group chose to sidestep the potential dangers of the metal-on-metal hip implants, even refusing to warn women of child-bearing age of the potential dangers despite the fact that metal ions had previously been detected in umbilical cord and placental blood among women with the implant. No alert was put out to either surgeons or patients, and it was not until March of 2011 that the British Orthopedic Association sent out a warning advising that the metal-on-metal hip replacements should be “carefully considered and possibly avoided.”

Pradaxa (Dabigatran) and the FDA Safety Review

By Independent Staff Writer 

Although only on the market for a relatively short period of time, Pradaxa, the blood-thinning drug manufactured by Boehringer Ingelheim—has already suffered under the weight of threatened recalls, lawsuits and warnings by the FDA. Pradaxa is the first FDA-approved drug of its type since the drug Warfarin was approved in 1954. Both Warfarin and Pradaxa are commonly prescribed as blood thinners to reduce the risk of stroke in patients with heart rhythm irregularities.

Warfarin was used almost exclusively until November of 2005 when Boehringer Ingelheim sponsored a clinical trial to determine the long-term safety and effectiveness of their “new kid on the block,” Pradaxa. The Pradaxa blood-thinning drug trial concluded in March of 2009 to rave reviews. More than 18,000 patients were enrolled in the trial across 44 countries. Boehringer announced that Pradaxa was able to significantly reduce the risk of stroke when compared to the older established drug, Warfarin, and that it had similar or even reduced risks of causing major bleeding in the body—depending on the dosage.

Pradaxa (Dabigatran) Lawsuits

By Independent Staff Writer

March of 2012 saw the first lawsuits filed against Boehringer Ingelheim, the manufacturer of Pradaxa. This drug was the first of its type to be marketed in over half a century, and Boehringer had high hopes that Pradaxa would knock its only competitor, Warfarin, out of the running in short order. Pradaxa works differently from Warfarin; while both drugs are used to prevent stroke in patients with atrial fibrillation, Warfarin works by inhibiting the production of Vitamin K, a clotting agent in the body. Should there be excessive bleeding in a patient who has taken Warfarin, doses of Vitamin K can be administered to slow the bleeding. Pradaxa, on the other hand, works by inhibiting thrombin, an enzyme in the blood which also controls blood clotting. At this time there is no known antidote to Pradaxa in the event it leads to excessive or uncontrollable bleeding.

What is Atrial Fibrillation?

Atrial fibrillation affects more than two million Americans and is characterized by rapid, uncoordinated contractions in the upper chambers of the heart. Patients with atrial fibrillation are at a much higher risk of developing blood clots, and since the 1950’s doctors have been using Warfarin—which is also known as Coumadin—to help lessen the likelihood of stroke. The FDA approved Pradaxa for use in patients with atrial fibrillation in October of 2010, yet less than a year later reports were coming in regarding serious side effects and even death among Pradaxa users. In December of 2011, in the face of hundreds of adverse reports, the FDA issued a safety warning to patients and physicians, stating they would taking a hard look at the prior Pradaxa studies.

The Dangers of Pradaxa (Dabigatran): Part 1 of 3: Side Effects and Complications

By Independent Staff Writer

The newest drug approved for use in the treatment of heart valve problems or atrial fibrillation among patients with an increased risk of stroke is the drug Pradaxa, manufactured by Boehringer Ingelheim. The drug Boehringer is seeking to replace with its newest arrival is Warfarin—a blood-thinning drug which has been used since the early 1950’s. Boehringer claims that Pradaxa is over 30% better in decreasing the risk of a serious stroke than Warfarin. The FDA initially agreed with Boehringer, granting FDA approval of Pradaxa in October of 2010.

What is Atrial Fibrillation and How Does Pradaxa Help?

Atrial fibrillation affects over two million Americans and involves excessively rapid, uncoordinated contractions of the upper two chambers of the heart. Those with atrial fibrillation are at a much higher risk of developing blood clots which in turn can lead to a disabling stroke should the clot travel to the brain. Pradaxa works by inhibiting thrombin, an enzyme in the blood which controls blood clotting.

The Dangers of Pradaxa (Dabigatran) Part 3 of 3: Serious Vascular Risks

By Independent Staff Writer

Pradaxa, the drug which less than a couple of years ago seemed like a dream come true for the hundreds of thousands of patients who were taking Warfarin or Coumadin has had its initial glow tarnished by the ever-increasing number of reports of serious side effects from use of the drug. Although Warfarin has been used as a stroke inhibitor and for those suffering from atrial fibrillation since the 1950’s, it comes with certain restrictions and its own set of side effects. Those who are on a Warfarin regimen must have regular blood tests taken, and must also be very careful of foods and other prescription drugs they mix with Warfarin.

However, there is a significant difference in the way Warfarin and Pradaxa work in the body, most notably the fact that in the event Warfarin causes excessive bleeding, the effects can be reversed by administering a dose of Vitamin K. When Pradaxa causes excessive bleeding there is no known antidote, leaving the patient vulnerable to literally bleeding to death. Pradaxa is a direct thrombin inhibitor which, in the initial 18,000 person trial, showed great promise in reducing strokes and helping those patients with atrial fibrillation lead a healthier life. The manufacturer of the drug, Boehringer Ingelheim, has been accused of rushing through the initial trial in order to get their drug on the market before other potential rivals, ignoring some potential risks in the process.

The Dangers of Pradaxa (Dabigatran) Part 2 of 3:

By Independent Staff Writer

Some experts feel that the German pharmaceutical company, Boehringer Ingelheim, rushed their new wonder drug, Pradaxa to the market perhaps a bit too quickly in an attempt to beat the competitors to the mark. Pradaxa subsequently became the first drug to rival Warfarin in over half a century. Boehringer announced that Pradaxa was as much as 35% more efficient in decreasing the risk of serious stroke than Warfarin, and in less than a year there were over a million prescriptions issued for the drug to over 400,000 patients hoping to avoid the negative aspects of Warfarin.

How is Pradaxa Used?

Pradaxa is primarily used for patients suffering from atrial fibrillation and to reduce the risks of stroke. Pradaxa also appeared to offer additional advantages over Warfarin in that there was no need for regular blood level monitoring as well as the fact that Pradaxa users didn’t have to be as concerned with mixing Pradaxa with certain foods and other medications as those taking Warfarin. While Vitamin K antagonists, such as Warfarin, are the mainstay of long-term anti-clotting therapy, there certainly exists a need for newer and safer anticoagulants. Pradaxa and other similar drugs currently undergoing trials use thrombin inhibitors as their primary ingredient; unfortunately the side effects of Dabigatran can be serious or even fatal.

How To Find A Divorce Attorney

By Megan Breckenridge, Staff Writer
SULLO & SULLO, LLP

HOUSTON—With the national divorce rate estimated at about 50 percent, it’s likely that every American will, either directly or indirectly, experience the dissolution of a marriage at some point in their lives. Dealing with divorce is a difficult process, both emotionally and financially, and decisions made during the process can have long-term effects on many areas of your life. For this reason, selecting the right lawyer may be the most important decision that you make.

Choosing a lawyer to represent you in your divorce is an intricate process. It means establishing a close and sensitive relationship with someone that will continue for months and perhaps even years. It is important to find and hire someone whose philosophy of the proceedings aligns with yours, and as such, you must be prepared to ask questions that reflect your specific concerns.

The first step in selecting a divorce lawyer is to gather names of potential counsel in your area:

1. From other professionals: Lawyers, accountants, members of the clergy and other professionals meet and work with divorce lawyers in the course of their work and are often good sources of referrals. Ask them for the names of family law specialists with good credentials and reputations and whose qualifications are most appropriate to your case.

2. From organizations: Your state bar may be able to provide a recommendation for certified family law specialists in your area. To be certified in the field of family law usually requires a certain proven level of experience, study and interest, and specialists must pass an examination in this area of the law.

3. From your employer: The Employee Assistance (EAP) program provided by your employer may be able to provide confidential referrals to attorneys, and often affords a discount on the services performed. Your employer may also offer access to sponsored legal services, either by subsidizing all or a portion of your legal fees if you use specified legal providers, or by providing the opportunity to join a legal services program in which you pay a set premium in order to receive a certain level of legal services throughout the year.

4. From friends or relatives: You may know someone personally who has gone through a divorce. They can be a good source of information about lawyers, with two qualifications: First, every client and every case is different, so it is difficult to evaluate the performance of a lawyer in someone else’s case. And second, the lawyer-client relationship is highly personal. So while the impressions of a former client about a lawyer are useful, you should meet the lawyer and make your own judgment. 

High-Profile Divorces

By Megan Breckenridge, Staff Writer
SULLO & SULLO, LLP

HOUSTON—We’ve all heard the sobering statistics about divorce rates in the United States, where the cost of dissolving a marriage is relatively low and the process simple. But for high-profile couples with piles of cash and material assets, parting ways can be a costly and complicated affair.

Anyone with cable or Internet access knows the sordid details of Tiger Woods and Elin Nordegren’s split, which is rumored will soon be settled for a staggering $100 million. Amazingly, theirs will not be the most expensive A-list divorce to date. Here is a look some of the costliest celebrity divorces:

1. Mick Jagger and Jerry Hall.Estimated settlement: $15 to 25 million.

The Rolling Stones’ front man and sexy supermodel met in 1977 and had two children together before tying the knot in a traditional Hindi wedding ceremony in Bali, Indonesia in 1990. Hall filed for divorce in 1999 after learning that Jagger had fathered a child with another woman. Jagger, worth an estimated $325 million at the time, successfully challenged the legality of the Balinese wedding and was granted an annulment. Hall walked away with only a fraction of his estate.

2. Michael and Diandra Douglas.Estimated settlement: $45 million.

The couple met in 1977 at a Jimmy Carter inauguration party and wed six weeks later. During the course of their marriage, Michael became one of Hollywood’s top earning actors, starring in box office hits like Fatal Attraction, Wall Street and Basic Instinct. Amid rumors of the actor’s infidelities and alcohol abuse, the couple separated in 1998. Diandra was awarded an estimated $45 million in 2000, plus homes in Beverly Hills and Majorca.

In June 2010, the couple returned to court to dispute Diandra’s claim to a portion of the proceeds from Michael’s upcoming Wall Street: Money Never Sleeps. If the film is ruled to be a spin-off of the original Wall Street, which Michael filmed while they were together, Diandra will be entitled to a share of his earnings per their divorce settlement.

3. James Cameron and Linda Hamilton.Estimated settlement: $50 million.

The famed director wed the star of his first two Terminator movies in July 1997. Though their marriage lasted a mere 18 months, they conceived a daughter together during that time. Their divorce settled shortly after Titanic was released, and Cameron was forced to give Hamilton more than half of the film’s revenues.

4. Sir Paul McCartney and Heather Mills.Estimated settlement: $50 million.

The Beatles rocker married the former model and charity campaigner in 2002, with McCartney reportedly shunning Mills’ offer of a prenuptial agreement. In 2006, the pair began bitter divorce proceedings, which garnered a great deal of press and were not resolved until March of 2008. They have a daughter together who, in addition to Mills’ nearly $50 million settlement, will receive over $44,000 per year until her 18th birthday.

Paris Hilton Drug Problem Follow Her Overseas

By Megan Breckenridge, Staff Writer
SULLO & SULLO, LLP

HOUSTON—Stars in the United States have long enjoyed our nation’s brand of "celebrity justice", but overseas their status is often overlooked. Case in point: The Japanese government’s recent refusal to allow Paris Hilton into the country after pleading guilty to misdemeanor drug charges in Las Vegas.

Hilton joined the ranks of such pop icons as Paul McCartney and the Rolling Stones when she was delayed by immigration authorities at Narita International Airport and officially denied entry into Japan. Her trip came just two days after she plead guilty to drug possession and obstructing an officer; and was sentenced to one year of probation, a $2,000 fine, 200 hours of community service and completion of a substance-abuse program. Japan has strict immigration laws that bar entry to those convicted of drug offenses, although exceptions are occasionally granted. 

The 29-year-old celebrity socialite was supposed to promote her fashion and fragrance lines at a news conference on the morning of Wednesday, September 22, in Tokyo. She arrived Tuesday evening but was stopped at the airport and spent the night at a hotel there after being questioned by officials.

Tokyo was the first stop on Hilton’s planned Asia tour, during which she was to visit Kuala Lumpur, Malaysia, and open a new retail store in Jakarta, Indonesia. She was forced to cancel all of her appearances, which she has said she will make up at a later date. 

Driving Under the Influence (DUI) and

By Independent Staff Writer

What is a Charge of DUI?· If you are under the age of twenty-one (21) and you are found to have been driving in Texas with any measurable Blood Alcohol Content (BAC), then you may be charged with DUI, or Driving Under the Influence; 

·  It is important to note that Texas is a zero-tolerance state, which means that BAC measurements do not have to meet the 0.08% minimum to result in a minor being charged with DUI. Moreover, if a minor charged with DUI is determined to have a BAC of 0.08% or higher, then he or she may be subject to more severe penalties, described in more detail further below. 

· If a minor charged with DUI is under the age of 18, he or she must have a parent or guardian present with him or her at all court appearances, and at any court mandated Alcohol Awareness Program classes.

 · If, after a conviction, a minor satisfactorily fulfills all of the court’s requirements, he or she may be able to have his or her record expunged at the age of twenty-one.
What are the Penalties for a Charge of DUI? 

A First Offense DUI (any measurable BAC) is considered a “Class C” Misdemeanor, with the following penalties:

· A fine of up to $500;

· A sixty (60) day Driver’s License Suspension;

· A defined period of Community Service;

· Mandatory enrollment in a Program for Alcohol Awareness;

 A DUI with a BAC of 0.08% or higher will result in the following, more severe penalties:

 · Incarceration for up to 180 days;

· A fine of up to $2000;

· A one year Driver’s License Suspension;

Other Alcohol-Related Charges against Minors:

What is a Charge of MIP?If you are under the age of 21, and are found to be in possession of alcohol, then you may be charged with MIP, or Minor in Possession (of Alcohol);

What is a Charge of MIC?
If you are under the age of 21, and are found to have been consuming alcohol, then you may be charged with MIC, or Minor in Consumption (of Alcohol);

 

Driving While Intoxicated (DWI): Definitions and Penalties

By Independent Staff Writer
 

What is a Charge of DWI?

· If you possess a regular driver’s license, and you are found to have been driving in Texas with a Blood Alcohol Content (BAC) of 0.08% or higher, then you may be charged with DWI, or Driving While Intoxicated;

· It is important to note that the definition of DWI is simply that one’s physical and/or mental faculties were impaired while he or she was driving. As such, the charge of DWI is not limited to only being a charge involving intoxication from alcohol. It can also arise out of intoxication from drugs, including illegal narcotics or even legal prescription drugs.

· If you are found to have been driving in Texas with a BAC of 0.12% or higher, then you may be subject to higher penalties for DWI than if your BAC was only higher than 0.08% (but below 0.12%);

· If you are the holder of a Commercial Driver’s License (CDL), and you are found to have been driving any vehicle in Texas, commercial or otherwise, with a BAC of only 0.04% or higher, then you may be charged with DWI. In this case, a conviction will result in an automatic revocation of your CDL;

· If you are found to have been driving in Texas with a BAC of 0.08% or higher (0.04% or higher for Commercially Licensed Drivers), and you caused an accident resulting in specific injuries, then you may be charged with Intoxication Assault;

· If you are found to have been driving in Texas with a BAC of 0.08% or higher (0.04% or higher for Commercially Licensed Drivers), and you had a child under the age of fifteen in the vehicle with you at the time, you may be charged with a State Jail Felony DWI with a Child Passenger;

· If you are found to have been driving in Texas with a BAC of 0.08% or higher (0.04% or higher for Commercially Licensed Drivers), and you caused an accident where death occurs, you may be charged with Intoxication Manslaughter;

Drug Violence in Mexico Spills into U.S.

By Megan Breckenridge, Staff Writer
SULLO & SULLO, LLP

HOUSTON—Although Mexico has long been a source of production and transit for illegal drugs, the country now finds itself embattled with powerful and well-financed drug cartels. An upsurge in drug-related violence can be traced to the end of 2006 when President Felipe Calderón launched an aggressive assault on drug trafficking organizations by deploying tens of thousands of federal police and soldiers to reign them in. But his initiative has been largely unsuccessful to date, and there is a rising chorus of voices on both sides of the border questioning the cost and fallout of the attack on the cartels. 

Given its geographic location, Mexico has been used as a staging and transshipment point for narcotics, illegal immigrants and other contraband destined for U.S. markets from Mexico, South America and elsewhere for decades. During the 1980s and early 1990s, Colombia’s Pablo Escobar was the main exporter of cocaine and dealt with organized criminal networks all over the world. When enforcement efforts intensified in South Florida and the Caribbean, the Colombian organizations formed partnerships with Mexico-based traffickers to transport cocaine through Mexico into the United States. 

These new allegiances flourished, since Mexico had long been a major source of heroin and cannabis and possessed an infrastructure that stood ready to serve the Colombia-based traffickers. At first, the Mexican gangs were paid in cash for their transport services, but in the late 1980s, a settlement was reached wherein they would be compensated in product. Payment was usually 35 to 50 percent of each cocaine shipment, which meant that organizations from Mexico became involved in distribution as well as transportation, and quickly morphed into formidable traffickers in their own right.

 

With the demise of Colombia’s Cali and Medellín cartels in the 1990s, Mexican gangs stepped up to dominate the wholesale illicit drug market in the United States. Arrests and deaths of key leaders in recent years have led to increasing violence as rival cartels fight for control of the trafficking routes into the U.S. Amid this continuous power struggle, gang leaders often attempt to use law enforcement to their benefit, either by bribing Mexican officials to take certain action against an opponent, or by leaking intelligence about a rival’s operations to the Mexican government or the U.S. Drug Enforcement Administration (DEA). There is also mounting evidence of corruption amid border security and law enforcement officers, with suspicions being raised about agencies on both sides of the border.

To many Mexicans, the rising count of gruesome drug-related murders is evidence that the government’s strategy to combat the cartels has failed. Current estimates put the death toll at close to 23,000 since Calderón took office in December 2006, with numbers increasing exponentially each year. The government insists that the majority of those killed in Mexico’s drug violence were involved in the narcotics trade. But a growing number of bystanders are dying in the crossfire, and Americans are among them. 

Tania Lozoya, 15, of El Paso, Texas, was killed by a stray bullet at her Aunt’s house across the border in Ciudad Juárez in May 2009, after gunfire broke out when two men chased another man into the backyard of the residence. In December, a California assistant school principal, Augustin Salcedo, was killed after he was abducted from a restaurant along with five other men while he and his wife were visiting her hometown of Gomex Palacio, in the northern state of Durango. The motive for the mass abduction is still unknown.

Other Americans appear to have been specifically targeted.