April 26, 2012

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, 78th 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.

April 20, 2012

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.

April 4, 2012

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.”

April 2, 2012

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.
  1. 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.
  1. 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.
  1. 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 M
IC?

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. 

DWI and No-Refusal Weekends in Texas

By Megan Breckenridge, Staff Writer
SULLO & SULLO, LLP


HOUSTON—In 2008, the National Highway Traffic Safety Administration (NHTSA) reported a total of 37,261 auto accident fatalities in the United States; 11,773 (32 percent) of which involved a driver whose blood alcohol content was above the legal limit. Perhaps even more disturbing are statistics that show Texas as the national leader in alcohol-related crashes, with 1,269 drunk driving deaths documented that year.
Given this information, it’s easy to see why alcohol and drug-related traffic offenses, commonly known as Driving While Intoxicated (DWI), are frequently prosecuted criminal offenses in Texas. If the alcohol concentration in a person's blood, breath or urine is .08 percent or higher, the person is considered intoxicated by law. 

In some cases under Texas DWI law, the legal definition of intoxication is met even if a person's blood alcohol concentration is lower than .08 percent. Having alcohol, drugs or a controlled substance in one's body that causes loss of normal use of mental or physical faculties is also considered intoxication. If a person is operating a vehicle, vessel or even water skis in a public place, he or she is considered to be DWI, which is a Class B misdemeanor in Texas. Boating and operating an aircraft while intoxicated are also considered to be crimes. 

The minimum amount of jail time in Texas for DWI is 72 hours, unless there is an open container of alcohol in the person's possession, in which case the jail time is at least six days. Consuming any amount of alcohol while operating a motor vehicle is also an offense in Texas. 

In addition to jail time, a person who is convicted of DWI the first time will have his or her driver's license suspended for 90 days up to one year. Even if there is no conviction, the positive indication of alcohol from a blood, breath or urine test will result in automatic suspension of the person's driver's license. The option to complete a court-approved DWI education course within 180 days of conviction may be offered as a means of avoiding this suspension. A person who fails to complete such a program when sentenced to do so may lose his or her license. If the case presents unusual facts (i.e.—an accident, alcohol problem, bad driving record, etc.), additional conditions may be imposed. Most conditions are designed to address a problem that appears from the facts or alcohol/drug evaluation that is performed on the subject after conviction and include, but are not limited to, the installation of an ignition interlock device; alcohol treatment; an order to consume no alcohol; confinement; and restitution. 

A DWI Second Offense is considered a Class A Misdemeanor, and requires the court to order, as a condition of release from jail on bond, the installation and maintenance of an ignition interlock device. This machine requires a breath sample before it will allow an individual to start his or her car, and periodic samples while driving to monitor and ensure sobriety. New technology has made the devices “user sensitive” so that another person cannot blow into the machine for the accused.
A DWI Third Offense (or greater) is considered a Third Degree Felony in Texas, and may include a jail sentence of not less than two years nor more than ten years, along with many other stipulations and restrictions. 

Feds Crack Down On Illicit Prescription Drug Sales

By Megan Breckenridge, Staff Writer
SULLO & SULLO, LLP 



HOUSTON—Pharmacies in Illinois and Utah stand accused of illicit prescription drug sales over the Internet, according to court papers filed by federal agents in two U.S. cities. 

Search warrant affidavits allege that both pharmacies, one in Des Plaines, Illinois, and the other in American Fork, Utah, are owned by the same man, Kyle Rootsaert. The company in Des Plaines, now called Rand Pharmacy, combined with another unidentified online pharmacy shipped 30,000 packages of prescription drugs across the country during the first six months of 2010. 

"This is a pretty large ring of at least 200 websites that acted as internet pharmacies that were basically selling drugs—prescription drugs—without requiring a valid prescription," John Horton, a former official in the White House Office of National Drug Control Policy, said in an interview with CNN. "These affidavits indicate this was a multiyear, multimillion-dollar operation involving thousands and thousands of prescriptions. Going back in time, there were even deaths involved with this organization." 

Keeping Your Driver’s License after a DWI Arrest: The ALR Hearing

By Independent Staff Writer

The ALR Hearing:
If you have been charged with DWI (Driving While Intoxicated), the law allows you fifteen (15) calendar days to contact the DPS (Department of Public Safety) and request an ALR (Administrative License Revocation) Hearing. This hearing will usually be scheduled to take place sometime between two to three months from your date of arrest. Failure to request a hearing within this time is considered a waiver and will result in an automatic suspension of your driver’s license.  The objective of the ALR Hearing is to find out if the officer had reasonable suspicion to make the stop, whether there was probable cause, whether the driver was given an opportunity to provide a breath or blood sample, and if there was alcohol concentration above the legal limit.
This ALR Hearing is extremely important for several reasons:
·  This hearing will determine whether or not your driver’s license is suspended;

· 
In the event that your driver’s license is temporarily suspended, this hearing will give you the timely notice needed so that you can take the necessary steps to  request and/or receive an Occupational Driver’s License in its place. In addition, it may save you the embarrassment and the money of a future arrest if you continue driving while your license was suspended.  In other words, having notice that your Driver’s License has been suspended can prevent both another criminal case against you and the possibility of another arrest.
 Note: An Occupational Driver’s License is a driver’s license issued only to individuals who have had their driver’s license suspended. This type of license has restrictions, and only authorizes the holder to drive a passenger vehicle under limited circumstances and for specific purposes, including, but not necessarily limited to, commuting to and from work, attending to certain familial responsibilities, attending court mandated appointments, going to medical appointments, and the like.

· 
This hearing can result in the assessment of the following penalties:

First-time offenders are subject to a possible
90-day driver’s license suspension. This suspension could be doubled to 180 days if it is determined that a breathalyzer test was refused.

Offenders with one DWI conviction in the five-year time period prior to their arrest are subject to a possible
one-year driver’s license suspension;

Offenders with two DWI convictions in the ten-year time period prior to their arrest are subject to a possible
two-year driver’s license suspension;

Texas Felonies and Misdemeanors:

By Independent Staff Writer


Types of Criminal Charges and their Punishments:

First Degree Felonies        Class A Misdemeanor
Second Degree Felonies    Class B Misdemeanor
Third Degree Felonies       Class C Misdemeanor
State Jail Felonies


DISCLAIMER: The information provided below is a general overview of most of the different types of criminal charges and their punishments in the state of Texas. It is important to note that the penal code (laws regarding punishments) is very complex and that an attorney should be consulted for any advice regarding any particular case.
Furthermore: This guide does not provide any information about federal crimes, which are separate from state crimes. If you have been charged with a federal crime, you must contact an attorney who is specialized in federal offenses and their punishments.

Felonies

Capital Felonies:

Capital Felonies are the most serious and severely punished type of crime in Texas and are defined as an individual "intentionally or knowingly causes the death of [another] individual," under special circumstances.
Under Texas Law, a Capital Felony is punishable by:
v  Death by lethal injection; or
v  Life imprisonment

Examples of Capital Felonies:

Committing murder of a public safety officer or firefighter in the line of duty; murder during the commission of specified felonies (kidnapping, burglary, robbery, aggravated rape, arson); murder for remuneration; multiple murders; murder during a prison escape; murder of a correctional officer; murder of a judge; murder by a state prison inmate who is serving a life sentence for any of five offenses; [or] murder of an individual under six years of age;
First Degree Felonies

A First Degree felony is a very serious type of criminal charge in Texas, second only to a capital felony. First Degree Felonies are punishable by:



v  Lifelong imprisonment; or
v  Imprisonment from five to 99 years with a possible fine up to $10,000
v  Possibility of community supervision (adult probation)*
Examples of First Degree Felonies:

Aggravated robbery; Burglary of a habitation with intent to commit or commission of a felony; Murder;
Second Degree Felonies:

Second Degree Felonies are also very serious charges, and are punishable by:

v  Imprisonment of two to twenty years, with a possible fine of up to $10000
v  Possibility of community supervision (adult probation)*

Why Should I Hire Sullo & Sullo Attorneys to Handle My Criminal Case?

By Independent Staff Writer 
   
Have You Recently Been Arrested and Don’t Know What to Do?

If you have recently been arrested, and you are trying to make a decision as to who you should hire to handle your criminal case, you have come to the right place. The Law Firm of Sullo & Sullo has provided some helpful information below to assist you in making an informed decision about your case:
  
You Have a Lot at Stake – Don’t Trust Just Anyone!

CRIMINAL CHARGES IN TEXAS ARE A SERIOUS MATTER. A PERSON CONVICTED OF A CRIME CAN FACE MANY LIFE-CHANGING CONSEQUENCES, INCLUDING, BUT NOT LIMITED TO:
  
Incarceration (Jail):

Possible punishments for most of the criminal charges in Texas include jail time. A punishment of incarceration means giving up one’s personal freedom and is one of the greatest prices an individual can pay in society. It should not be taken lightly.
  
Fines:

Texas Courts can impose heavy and extensive fines in association with the punishment of criminal offenses. Paying these fees can easily damage one’s pocketbook and income flow, and can hinder a person’s ability to make ends meet. While not all criminal offenses result in jail time, the financial cost of being charged with any criminal offense is high and should be considered seriously.
  
A Permanent Criminal Record:

Many criminal trials or plea-bargains can result in marks on your criminal record that are not easily removed. This is particularly harmful in the case of potential employers running a background check on those individuals seeking employment. A criminal record search that reveals if you have been charged or convicted of a crime can easily result in your elimination from candidacy when being considered for a job. Ensuring that a person can be freed from having a permanent criminal record is a complicated matter and only an attorney well versed in his knowledge of criminal records and how they work in Texas should be trusted with your professional reputation and the future of your career.

Why the Law Firm of Sullo & Sullo is Right for You:

The consequences of a criminal conviction can be costly and damaging to your reputation and future, and choosing to fight the criminal charges against you is a decision you should be encouraged to make.

The competent and experienced attorneys at Sullo & Sullo can fight for you in this situation. The Law Firm of Sullo & Sullo handles a variety of criminal cases, including, but not limited to:

DWI/DUI  Assault    Theft  Drug Related Charges

When our clients face criminal charges, our primary goal is to have our clients’ cases dismissed and to prevent any criminal convictions from ever becoming part of our clients’ permanent records.

The Criminal process can be overwhelming and intimidating, and our firm can help you through this process.

The Gulf of Mexico Oil Spill-Ramifications for the Texas Coast


By Megan Breckenridge, Staff Writer
SULLO & SULLO, LLP 



HOUSTON—On April 20, 2010, an explosion on a deepwater drilling rig 40 miles off the coast of Louisiana launched what could be the largest environmental disaster in U.S. history. The Deepwater Horizon, a half-billion dollar rig owned and operated by Swiss-based Transocean, Ltd and leased by British Petroleum PLC (BP), sank, leaving a subsea well spewing hundreds of thousands of gallons of crude oil into the Gulf of Mexico each day.

For over two months residents of the Gulf Coast and around the world have watched with bated breath, waiting for the spill to be capped so that true clean-up and recovery efforts can begin. But it hasn’t happened yet, and news concerning the accident has been mostly bad. Numbers have been fudged, relief missions have failed, blame has been tossed around, and all the while oil continues to spew into once vibrant waters. 

In Texas, Gov. Rick Perry has said that the state is prepared to respond to any effects of the Deepwater Horizon spill along the coast. Though oil has yet to reach Texas shores, the State Operations Center has remained at an increased readiness level and the state continues to work with federal and local authorities to track the spill and prepare contingency plans. The Office of the Governor participates in daily conference calls with the White House, Coast Guard, Department of Homeland Security, National Oceanic and Atmospheric Administration (NOAA) and gulf state governors.

If oil does reach Texas, it is expected to be in the form of weathered tar balls, which cannot be prevented by boom deployment and would require aggressive physical removal. Texas’ General Land Office (GLO) has five coastal offices equipped with boats, trucks, trailers, ATVs, skimmers and well-trained staff to assist with response activities. 

To date, no fisheries have been closed along the Texas coast because of the spill, and the Texas Department of Agriculture is working with grocery stores across the state to promote consumer awareness that both the U.S. Food and Drug Administration and the Texas Department of State Health Services have declared Texas seafood and shrimp safe. State beaches are also expected to remain open for recreation and business for the duration of the summer.

Topamax Birth Defects: What You Should Know

By Independent Staff Writer Topamax, also known as topiramate, is a prescription drug used to treat epilepsy in adults and children.  The drug is also approved by the Food and Drug Administration to treat migraine headaches, and has been prescribed to treat bipolar disorder, obesity, and alcoholism.

Research studies have identified a risk of birth defects in children associated with mothers who took Topamax during pregnancy.  Topamax has been linked to serious birth defects including cleft palate and cleft lip.  These defects result in a notch or groove in the lip that can extend into the roof of the mouth and the nose, possibly causing ear infections and problems with eating and speaking.  Cleft lip and palate can possibly be corrected with surgical procedures.  Other birth defects potentially connected with Topamax include heart, lung, brain, and limb defects.

 
According to data from the North American Antiepileptic Drug Pregnancy Registry (NAAED), there is an increased risk of cleft palate and cleft lip in children born to women who took Topamax during the first trimester of pregnancy.  This data shows that cleft palate or cleft lip is over twice as likely to occur in a newborn baby exposed to Topamax compared to a different epilepsy drug, and over twenty times as likely to occur in a newborn not exposed to any epilepsy drug.  This research is of concern because many women may not know they are pregnant during the first trimester. 

In response to the data indicating birth defect risks for Topamax, the Food and Drug Administration (FDA) recently increased the warnings in Topamax packaging to inform patients of the risks of birth defects while taking this drug.  Topamax has been placed in Pregnancy Category D, which means that there is positive identification of a fetal risk based on human data, although the benefits of taking the drug for pregnant women may be acceptable in certain situations despite the risk.

The FDA has also recommended that women who intend to become pregnant should discuss the use of alternative therapies with their health care professionals before taking Topamax.  Physicians are recommended to consider prescribing drugs for their patients with lower risks of cleft palate and cleft lip.  Women who are concerned about the risks of taking Topamax should consult with a qualified healthcare professional. 

Depakote Birth Defects: Real Risks

By Independent Staff Writer Depakote is a prescription drug used to treat epileptic seizures, psychological disorders such as bipolar disorder, and migraine headaches.  Depakote is marketed under several brand names and generic versions of the drug, including Depakote ER, Depakote Sprinkles, Depakene, and Valproate.

Research studies strongly indicate that women who take Depakote during pregnancy are at a substantially greater risk for having children born with birth defects.  One of the most severe and disabling of these defects is spina bifida.  Spina bifida causes incomplete development of the bones of the spine, leading to protrusion of the spinal cord and fluid through a gap in the bones.  Other birth defects associated with Depakote are malformed head and facial structures including cleft palate, anencephaly, which causes a baby to be born without a brain, and fetal death.

 
Additional research has shown that children born to mothers who took Depakote during pregnancy are more likely to have cognitive defects resulting in lower IQ test scores.  In response to this research, the Food and Drug Administration (FDA) recently issued a Safety Communication to inform the public about the increased risk from Depakote of children with lower cognitive test scores compared to children born to mothers taking a different anti-seizure drug.  The FDA warns of the risk of these and other birth defects associated with Depakote, and recommends that doctors counsel their patients about these risks.

Actos Discussions Part 1: Your Actos Case

By Independent Staff Writer

Determining Whether You Have an Actos Case
Hundreds of thousands of patients who have taken the drug Actos over the past few years—believing the drug to be safe—have been very disillusioned to find that the drug can have some potentially very serious side effects. Actos is a drug which was developed for the treatment of Type 2 diabetes and works by helping the body restore its normal response to insulin, effectively lowering blood sugar. When high blood sugar is not consistently controlled, kidney damage, blindness, nerve problems and even the loss of limbs become possible medical issues. The control of Type 2 diabetes is also necessary to avoid a debilitating heart attack or stroke. Therefore, when a drug such as Actos seems to do a good job of lowering blood sugar, it becomes a very popular prescription drug. So popular that in spite of the recent rash of lawsuits against Takeda—the manufacturers of Actos—profits have only been dampened by approximately 13%. The pharmaceutical giant is still enjoys some $2.2 billion dollars in annual profits, down from an all-time high of over 4 billion dollars in annual profits. If you have taken Actos you may be wondering whether you might have an Actos case and be entitled to damages.

The FDA issued a warning which cautions patients with a history, diagnosis or heightened risk of bladder cancer to consider an alternative diabetes treatment to Actos. Although this warning sounds fairly mild, drug safety watchdogs are urging anyone who is currently taking Actos to speak to their doctor about an alternative drug with less risk factor and are strongly urging those who have taken the drug in the past to ask their doctor to set up a bladder cancer screening. The common side effects of Actos generally include upper respiratory infections, headache, sinus infection, muscle pain, tooth problems, sore throat and swelling or water weight gain. Anyone who has had symptoms which can suggest bladder cancer such as blood in the urine, pain upon urination, back or stomach pain, or an urgent need to urinate should immediately seek medical attention. Because Actos has also been tied to an increased risk of heart failure, any patient who notices swelling of the feet, a sudden increase in weight and shortness of breath should also seek immediate medical attention. In conjunction these symptoms can suggest congestive heart failure and a buildup of fluid in the lungs. In short, if you took Actos for a period of more than twelve months, or in very high dosages, you may be eligible to file an Actos lawsuit.

Could Harm from Actos Translate Into Damages?
Lawsuits resulting from bladder cancer believed to be caused by Actos started in August of 2011 with thousands expected to follow as the harmful effects of the drug continue to be investigated. Many of these lawsuits allege that Takeda either knew or should have known the long-term effects of the drug, primarily the increased risk of bladder cancer in those taking higher dosages or taking Actos for an extended period of time. The FDA did not release a safety communication regarding these risks until June 15, 2011, basing their decision on an ongoing ten-year study of the serious side effects of Actos. Among this group of 193,000 patients taking Actos, a five-year interim study revealed no overall increase in bladder cancer, however showed significantly increased risks of the disease in those taking Actos for an extended period of time or in higher dosages.

Actos Discussions Part 2: Dangers of the Drug

By Independent Staff Writer

Could Your Heart Failure Be Linked to Actos?
Links to higher heart disease rates have been associated with the use of Actos, and, in fact, Actos may cause as many heart problems as GlaxoSmithKline’s drug, Avandia. The American Heart Association reported that studies showed patients taking either diabetes drug were at least four times as likely to experience heart attacks, heart failure or even death. When a 2007 study on Avandia showed a 43 percent higher chance of heart attack, Actos quickly became the market leader. A subsequent study on both drugs showed that 602 Avandia users and 599 Actos users in the study suffered either a heart attack, heart failure or both, with 217 deaths in each group.  The latest study regarding Actos in the journal Lancet found the risk for heart failure greatest among those patients with a prior history of heart disease and heart failure, however overall the relative risk when taking Actos was as much as 72 percent higher than those not taking the drug. Both Glaxo and Takeda dispute the results of these negative studies, citing a study published in the Journal of the American Medical Association which suggests Actos might actually cut the risk of heart attack, stroke and death.

Link between Actos and Heart Failure
Actos is in a class of drugs known as thiazolidinediones, whose use has long been attributed to certain liver and cardiovascular health issues. A listed side effect of Actos includes the threat of congestive heart failure with the link between Actos and congestive heart failure being so undeniable that in 2007 the FDA escalated warnings regarding heart disease when taking the drug. Actos causes the body to retain excess fluid, leading to swelling and weight gain. This extra body fluid can worsen some heart problems, leading to heart failure or can actually cause heart problems.

When Actos causes swelling in the body, this swelling also occurs around the heart, rendering it unable to effectively pump blood throughout the body. As fluid builds up around the heart and lungs, it becomes more difficult for the heart to pump, causing it to become less and less efficient. This can lead to shortness of breath, trouble breathing when lying down, a feeling of excessive tiredness or an unusually rapid increase in weight. After an intense debate over the cardiovascular risks of Actos, the FDA agreed to surround the heart risk warnings on Actos with an emphatic black outline commonly known as a black box warning. This black box warning is the strongest FDA label change which can be added to any drug on the market.

Link Between Actos and Bladder Cancer
The FDA issued its safety announcement regarding the connection between using Actos for more than one year and the risk of bladder cancer on June 15, 2011. The bladder lies in the center of the lower part of the abdomen, and its primary purpose is to store urine prior to excreting it from the body. When cells in the bladder become cancerous, a tumor can form. Actos helps diabetics use their own insulin better by hitting at least two of the three main PPAR receptors known as the Gamma and Alpha receptors. The Gamma receptor works on glucose while the Alpha receptor affects cholesterol. Actos appears to have a higher affinity with the Alpha receptor which is why it does a good job on raising good cholesterol and lowering triglycerides.

Actos® Adverse Effects

By Independent Staff Writer

Many of us would be very surprised to find that a drug can be approved by the FDA yet still have serious—and undisclosed—side effects.  The drug Actos, used in the treatment of Type 2 diabetes, is one such drug. Actos works by decreasing the body’s resistance to insulin as a way of controlling blood sugar levels. Actos is currently being used by millions of people across the globe, with sales jumping from around $2.9 billion in 2006 to over $4.3 billion in 2010.  Actos has often been prescribed in place of the drug Avandia, which was found to carry significant risks of heart disease and possibly even death in 2007. Actos, which is manufactured by the Japanese pharmaceutical giant Takeda Pharmaceuticals, has recently fallen under scrutiny as well as studies have linked it to an increased risk of bladder cancer as well as correlating it to other serious diseases such as heart attack, stroke and liver failure.

“Minor” Side Effects of Actos
The truth is, all prescription medicines as well as most over-the-counter medications, carry some risk of adverse effects.  Fortunately the incidence of serious side effects is rare and for the most part the majority of people have either no side effects or relatively minor ones. Minor side effects associated with Actos include flu-like symptoms, headaches, toothache, sore throat or sinus pain and weight gain.  More serious side effects which should prompt the user to seek medical attention include an allergic reaction which includes difficulty breathing or chest tightness, blurry vision, symptoms of heart or liver failure including breathing difficulties, a sudden gain in weight, stomach pains, dark urine, jaundice or vomiting, low blood sugar symptoms such as tremors, anxiety or chills, severe and unusual bone pain and total exhaustion along with feeling weak and shaky.

More Serious Adverse Effects from Actos
In general, the side effects of Actos were found to be similar to the side effects of Actos used in combination with sulfonylurea, metformin or insulin other than an increase in edema when Actos was combined with insulin therapy.  Almost 200,000 patients with Type 2 Diabetes who took Actos to control their disease, were involved in a Northern California research study. Alarmingly, the study found that those taking Actos for any length of time past twelve months were at a 40% higher risk of developing bladder cancer than those not taking the drug. Prior to the release of this study, Takeda disclosed no cancer warnings on their labeling information sheet or the patient medication guide.  Other studies are now indicating that those patients who took the highest dosages of Actos or took it for at least two years with a cumulative dosage of greater than 28,000 mg faced the highest risks of developing bladder cancer.

While the FDA has compelled Takeda to adjust their labeling to include warnings about possible increased risks of bladder cancer, the United States is holding off pulling the drug until results of further studies are in.  Other countries are not so relaxed about the drug with New Zealand scheduling a recall of Actos, and France and Germany already suspending sales of the drug. The French National Health Insurance Plan studied data from a million and a half patients with Type 2 diabetes, finding a “statistically significant increase” in the risk of bladder cancer in those taking Actos as compared with those taking other anti-diabetic drugs.  Unfortunately the bladder cancer risk is not the only serious adverse effect noted in those taking Actos.

Actos® and Bladder Cancer

By Independent Staff Writer
Recent studies have shown that patients taking the drug Actos for longer than one year may suffer significantly increased risks of developing bladder cancer. The FDA warnings are being issued on the heels of France and Germany banning the use of Actos, and New Zealand also beginning the process of removing Actos from patient use. Takeda Pharmaceuticals, the Japanese corporation who began manufacturing Actos in 1999, is at the midway point in a ten-year study of the drug’s potentially serious side effects. While the five-year data shows no clear evidence of an overall increased risk of bladder cancer, patients who have taken the drug in the highest dosages or for the longest period of time appeared to be at a much greater risk of developing bladder cancer.

Actos is in a class of drugs known as thiazolidinediones, and is the second medication of its class to be associated with serious side effects.  Avandia, the sister-drug of Actos, recently had its use severely restricted due to evidence of increased heart attack risk and even death. When metformin alone no longer works well for patients suffering from type 2 diabetes, doctors typically prescribe a drug such as Actos which increases the body’s insulin sensitivity, controlling blood sugar levels in the process. Type 2 diabetes, when left untreated, can potentially lead to serious health effects such as damage to the retina which can lead to blindness, injury to the kidneys, impairment of the nerves which could lead to amputations of limbs and an acceleration of the development of fat plaques on the interior of the arteries which can potentially lead to blood clots, blockages, cardiovascular disease, stroke and a lessening of critical circulation. 

Shaped like a balloon, the bladder resides in the lower regions of the abdomen and its primary function is storage for urine.  Urine is a liquid waste made by the kidneys when they clean the body’s blood—until it is passed from the body. Bladder cancer typically begins in the cells which line the bladder and risk factors include smoking, certain infections, being male, white and elderly, eating a diet which is high in fats and fried foods, and being exposed to specific carcinogenic chemicals commonly used in hairdressing, textile production, paints and rubber manufacturing.  Symptoms of bladder cancer include frequent urination, blood in the urine or pain during urination, and lower back pain.  Procedures for determining bladder cancer include CT scans, urinalysis, an internal exam, or a cystoscopy.

The chances of recovering from bladder cancer depends largely on what stage the cancer is in when discovered as well as the patient’s age and overall health status. Treatments include chemotherapy, surgery and radiation. The five-year survival rate for patients with early stage bladder cancer is approximately 85%, however in patients with more advanced bladder cancer who have undergone chemotherapy and/or radiation, the five-year survival rate is only 60-75%. Over 14,000 deaths occur each year from bladder cancers.

Several studies have linked the use of Actos for periods of longer than a year or in higher dosages to as much as a 42% increase in the incidence of bladder cancer. The potential risk of Actos users developing bladder cancer has been known for some time; the FDA’s Adverse Event Reporting System has found that 31 cases of bladder cancer were recorded between 2004 and 2009 in patients being treated with an anti-diabetic drug containing pioglitazone, such as Actos. A study of more than 190,000 patients with Type 2 diabetes who were enrolled in the Kaiser Permanente Northern California health plan showed that while there was not a significant overall increased risk of bladder cancer, those patients who were taking higher doses or were taking Actos for longer than twelve months had as much as a 40% increased chance of developing bladder cancer as compared to patients who had never used the drug. The participants in this study were at least forty years old.