To read the FDA’s full warning, click here

Zithromax (azithromycin): FDA Statement on risk of cardiovascular death

FDA notified healthcare professionals that it is aware of the study published in the New England Journal of Medicine May 17, 2012 reporting a small increase in cardiovascular deaths, and in the risk of death from any cause, in persons treated with a 5-day course of azithromycin (Zithromax) compared to persons treated with amoxicillin, ciprofloxacin, or no drug. FDA is reviewing the results from this study and will communicate any new information on azithromycin and this study or the potential risk of QT interval prolongation after the agency has completed its review.

BACKGROUND: Azithromycin belongs to a class of antibacterial drugs called macrolides, which have been associated with cardiovascular effects; specifically, prolongation of the QT interval. In 2011, FDA reviewed macrolide drug labeling information related to QT interval prolongation and TdP. The WARNINGS AND PRECAUTIONS section of the Zmax drug label (azithromycin extended release for oral suspension) was revised in March 2012 to include new information regarding risk for QT interval prolongation, which appears to be low. The drug labels for clarithromycin and erythromycin also contain information about QT interval prolongation in the WARNINGS section. FDA is in the process of updating risk information in the drug labels for additional macrolide antibacterial drugs.

RECOMMENDATION: Patients taking azithromycin should not stop taking their medicine without talking to their healthcare professional. Healthcare professionals should be aware of the potential for QT interval prolongation and heart arrhythmias when prescribing or administering macrolides.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA’s MedWatch Safety Information and Adverse Event Reporting Program:

“I am honored and privileged to have the opportunity to continue the phenomenal work HEAL has done, and will continue to do, for the thousands of individuals and families in North Florida who deal with Autism” said Alan. “I have been involved with the autism community since 2003 and you quickly realize it is an issue that is growing at an exponential rate. The Board of Directors for HEAL is a prestigious group and I greatly appreciate the confidence they have put in me with this honor.” Current Board of Directors includes, but is not limited to, such dignitaries as University of North Florida President and Past Mayor of Jacksonville John Delaney, News Anchor Patty Crosby, NFL Jaguar’s starting tackle Eugene Monroe, well known golf developer Bobby Weed, PGA VP Bill Hughes, co founder of HEAL Leslie Weed, VP of CSX Transportation Vance Meyer, Merrill Lynch VP Dana Current, Primearica Financial’s Jim Meyer, nationally known motivational speaker and author Vic Johnson and a host of other well known people in the North Florida community.

Alan Pickert is no stranger to receiving accolades or volunteering his time for worthy projects. You may recall he is the Past President of the Jacksonville Bar Association of Lawyers, has been consistently selected as one of the top lawyers in Florida by his peers, Florida Trend Magazine (Legal Elite), Law and Politics (Super Lawyer of Florida), Martindale Hubbell and AVVO. He was also recently featured in the February edition of Newsweek Magazine as being one of the Top 20 Leaders in the Nation on Asbestos Issues.

In addition to Mr. Pickert’s work with the autism community, he is also active with Jacksonville’s I.M. Sulzbacher Homeless Shelter. For the past twelve years, he has provided free legal service on a monthly basis to the guests and residents of the homeless shelter. It was this volunteer work, coupled with his other volunteer work the Special Olympics, that resulted in Alan being awarded the Florida Bar’s Pro Bono Award for the entire Fourth Judicial Circuit by the Florida Supreme Court.

We, at the law firm of Terrell Hogan, take great pride in Alan and the many others at our firm, who strive for justice both inside and outside of the courtroom for our clients and the community in general.

Multiple Causes. Although forest and brush fires do occur through natural causes, especially in a state like Florida with the most lightning strikes, they have other causes. At times, intentional wrongdoing, arson, causes fires and, at other times, it is carelessness, for example, by negligence in burning trash or other fire-related activities by campers or homeowners. Faulty equipment or carelessness with equipment in construction, logging, railroad and other work situations can cause these fires, as can traffic accidents themselves. Then, there are prescribed or “controlled” burns that relate to the management of Florida’s forests and other acreage. Just this week Florida’s Commissioner of Agriculture noted that there has been a significant reduction in prescribed burns this year due to drought conditions. The Florida Forest Service previously announced a plan for addressing continued use of prescribed burns while balancing against Florida’s growth and urbanization. Those who use such fires must take great care to do it right.

Accountability. For victims of crashes that result from smoke that causes reduced or near zero visibility, those who suffer personal injury and the families of those who suffer death in such tragic accidents, the rules naturally vary with the facts and circumstances. The desire to determine fault and impose accountability on wrongdoers is natural, so much so that it is enshrined in the Florida Constitution as a basic right: “SECTION 21. Access to courts — the courts shall be open to every person for redress of any injury, and justice shall be administered without sale, denial or delay.”

Drivers’ Actions. Regardless of who, or whether anyone, can be faulted for the existence of smoke on a highway, the conduct of the drivers involved in these wrecks will become the subject of inquiry. This will bring into play the obligation of vehicle operators, whether passenger vehicles or tractor-trailer rigs, buses or heavy equipment, to drive with reasonable care under the circumstances. That is, of course, complicated by these questions: What is the safe thing to do in a cloud of smoke? Was there a safe way to pull off the highway? How could the drivers even know where such a safe place was? Then there is an obligation to drive at a speed commensurate with the conditions, but a driver may well be reasonably concerned about slowing and being hit from behind by vehicles that fail to slow down, or slow down sufficiently to reduce the impact in any collision. These are all considerations that investigators must evaluate, and, unfortunately, in the worst of these accidents those who were driving and those who were passengers may have died or been hurt too badly to help reconstruct the accident.

Drivers’ Pre-Accident Condition. Another factor always investigated is the pre-accident condition of the drivers themselves. This will involve whether any drivers involved were impaired as a result of alcohol or drugs, or were distracted by cell phones or other devices. Especially with professional drivers, pre-accident condition will involve the question of the operator’s previous driving record, and, if that record is poor, whether the trucking company was or should have been aware of that driving record, and whether the company took reasonable precautions to protect the public from such drivers. Training and supervision and licensing are investigated. Also, questions of the number of hours worked by truck drivers and the accuracy of driving logs will be subject to inquiry. There are strict rules that govern both trucking companies and their drivers: rules that have safety and saving lives as goals and the need for drivers to be alert and capable of exercising good judgment when operating such massive vehicles.

Smoke on the Highway. Who has responsibility for the presence of smoke on a highway? Lightning provides its own answer when it is the initial cause. However, there are times and circumstances when carelessness in working with fire, or failure to take precautions as to when and under what weather and wind conditions to set “controlled” burns, can add up to negligence and bring liability. After all, without the smoke, the accident likely would not have occurred. In a case of a controlled burn alleged to have caused a tractor-trailer to crash into a small car killing people, the appeals court for the North Florida area held the company responsible for the fire that put smoke on the highway at 9:30 at night was held potentially liable for losses even by the truck driver who himself was uninjured but lost his job after the accident. Waters v. ITT-Rayonier, Inc., 493 So.2d 67 (Fla. 1st DCA 1986). Negligence in fire fighting, especially when that work is done by government, raises questions of whether sovereign immunity has been waived by statute and whether there are any exceptions to that waiver that might defeat the ability to assess liability against the government. That issue has been addressed elsewhere. Myers v. McGrady, 628 S.E.2d 761 (N.C. 2006) (multi-vehicle collision at night in smoke and fog on I-95).

Vehicles on a Smoky Highway. Another issue arises and is addressed in part by a just released Florida Department of Law Enforcement report that analyzes the role of the Florida Highway Patrol in the closing of I-75 due to smoke from a fire on Paynes Prairie near Gainesville in January 2012 and then reopening I-75 with subsequent major collisions with many deaths and injuries. Document–FDLE-I-75-Incident-Review While much investigation is yet to be done, the report points to factual issues that open the question of potential liability by the State of Florida. The State has, by statute, waived its sovereign immunity for liability for its negligence, but that waiver is subject to rules that give leeway to state entities in taking actions in dealing with a variety of issues including public safety. There will be questions, naturally, about whether there was negligence in deciding to reopen the interstate highway to traffic on the night of the tragic accident, but there will also be questions about whether there were warnings about the potential for the smoke resettling on the highway and blinding drivers, and, if so, whether the warnings were sufficient, and whether FHP patrol cars should, for example, have been posted at, in or near the potential danger zone to better give warning to and control the vehicles traveling on the reopened interstate. The FHP, Florida Forest Service and the Florida Department of Transportation have adopted a uniform set of warning signs to be used for smoke on the roadways including signs to be used in connection with prescribed burns. The State’s waiver of sovereign immunity also contains limitations on the amount that can be recovered for wrongful death and serious injuries, although recoveries above the caps can be made through the process of legislative claims bills. Section 768.28, Florida Statutes.

Conclusion. The issue of smoke on the highways of Florida will remain with us. The dangers are all too real and the accidents are tragic. The first line of defense is taking careful steps to prevent fires from starting in the first place or, if prescribed or controlled burns are used in the management of forests and underbrush, taking all reasonable steps to protect the public from the danger of smoke on the highways. This is not a subject for shortcuts. Lives are at stake, so planning, training and dedication by those responsible is essential.

Wayne Hogan is a Florida and National board certified trial lawyer and president of the TERRELL • HOGAN personal injury and wrongful death law firm.

NHTSA Campaign ID Number: 12T009

Synopsis: Michelin North America, Inc. (Michelin) is recalling certain Michelin XZU3 LRJ, size 305/85R22.5, and Michelin XZU2 LRJ, size 12R22.5, tires produced between October 23, 2005, and September 3, 2011; and Michelin XM505 LRJ, size 305/85R22.5, tires produced between April 18, 2010, and May 8, 2010, and January 23, 2011, and February 12, 2011. These tires have a casing that may experience a loss of integrity and, in some cases, have rapid air loss. Rapid air loss of the tire while the vehicle is in use, could result in a vehicle crash. Michelin will provide information to customers on how to obtain replacement tires. The safety recall is expected to begin on or about April 30, 2012.
For more information for this particular recall, please go to 12T009.

Why, Justice Teaching? According to the website, www.justiceteaching.org, state and national surveys frequently suggest that Americans know too little about the operation of the American justice system, and too many do not understand the basic principles underlying our constitutional institutions and structures.

There has been a long drift downward when it comes to the subject of Civics. When I was in high school, Civics was its own separate part of the curriculum. In fact, it was in Civics class at St. Augustine High School where I first saw a lawyer in person; it was Frank D. Upchurch, Jr., who later went on to be an appellate judge. He was there as a part of career day appearances by local professionals and people in business. In my mind, I have always attributed my decision to become a lawyer to that classroom visit by Mr. Upchurch.

Justice Teaching is an effort by judges and lawyers to turn things around, especially the understanding of our judicial system among students, who, before we know it, will be voters and jurors. The ultimate goal is to pair a legal professional with every elementary, middle, and high school in the state of Florida.

The program benefits students by promoting an understanding of Florida’s justice system and our laws, expanding critical thinking skills and problem solving skills, and demonstrating the interaction of our courts within the constitutional structure. Justice Teaching is governed by a Select Committee with judges from each of Florida’s five appellate districts and twenty judicial circuits, and representatives of The Florida Bar, the Florida Association of District School Superintendents, and the Florida Law Related Education Association.

PARTICIPATION

Volunteers are needed to partner with local schools and to serve as resource persons in the classroom. If you are a Florida attorney and enjoy working with students and want to help teach about the courts, our governmental structure, and the Constitution, Justice Teaching would welcome your help. You will really like doing it, and you will come away with a real sense of accomplishment.

By taking the Justice Teaching training and going into the schools you will be an important part of an ongoing exercise in democracy; you will be helping Florida’s next generation become better prepared to understand, protect, and improve our State and Nation.

Volunteers may register for Justice Teaching and select from a list of available schools in their area through the Justice Teaching Website: http://www.justiceteaching.org.  This important work will take no more than two hours a month. Easy to use activity modules and lesson plans are available on the website.

Robert E. Lee High School Students Get Real Life Lesson in Bill of Rights

Wayne Hogan, president of the TERRELL · HOGAN law firm, visited Mary Chowenhill’s American Government class to lead an inter­active discussion and role playing exercise about the Bills of Rights.

Although it is true that other areas of the Florida seem to have an excessive number of drivers who fail to carry bodily injury liability insurance, the Jacksonville area has its share of uninsured and underinsured driver when it comes to liability insurance. That represents a real danger on the road. It’s bad enough to be in an accident that’s not your fault, it’s doubly bad when the at-fault driver doesn’t have insurance to cover the injuries they cause.

That’s one reason Wayne Hogan of Terrell Hogan appeared on WJCT’s First Coast Connect program, hosted by Melissa Ross, to discuss the importance of Uninsured Motorist Coverage (UM). Hogan and an insurance company executive were interviewed and took callers’ questions to discuss UM, and other aspects of car insurance policies in Florida. When Hogan noted the need for uninsured motorist coverage, the insurance company representative agreed on its importance. He also agreed with Hogan on the fact that UM is relatively inexpensive. This is particularly true when you consider the piece of mind and the protection UM provides against negligent drivers; it acts as a safety net and kicks in after you’ve been injured in a car accident caused by an uninsured or underinsured driver and pays bills, disability, lost wages and pain and suffering when an at-fault driver doesn’t have enough insurance to cover your losses. (The full interview can be heard by clicking the “play” arrow in the box below.)

With nearly one in four drivers without auto insurance and 645 crashes a day in Florida, UM is crucial to protecting your family. This previous article authored by Hogan provides more information.

Wayne Hogan is a Florida and National board certified trial lawyer and president of the TERRELL • HOGAN personal injury and wrongful death law firm.

With traffic crashes now the number one cause of death among teens, and over 5,000 lives lost each year to distracted driving, including texting, cell phone calls, gps, and social media, this negligent behavior needs to be stopped in its tracks; it has become an epidemic. This is very concerning; 46% of teenage drivers are willing to admit to texting while driving; the ACTUAL PERCENTAGE texting and driving is surely higher. Distracted driving is negligent driving, and it must be stopped.

Terrell Hogan attorney Wayne Hogan was recently interviewed by Tera Barz on FOX 30 ‘s Action News This Morning to get the word out about the dangers of distracted driving. He and attorney Leslie Goller are visiting Jacksonville area high schools in April to give teens real world examples of driving distracted and provide some strategies to prevent it. It’s part of the The End Distracted Driving Initiative, a program to save lives that was created by The Casey Feldman Foundation, The End Distracted Driving Initiative, 60 for Safety, and Injury Board. When you think about it, the choice of April as End Distracted Driving month makes sense; soon there will by proms and graduations and these young drivers need all the help they can get to stay safe.

The hope is that the students who hear the anti-distracted driving message will act as ambassadors to their parents and friends who also may not have focused on the dangers of texting and driving and the like.

The Terrell Hogan law firm has contacts with other attorneys across the country who are working to end this type of careless driving, so whether you are in the Jacksonville, Florida area or not and would like a personal injury and wrongful death attorney to bring the end distracted driving message to a school in your area, you can contact Leslie Goller at 904–632-2424.

Wayne Hogan is a Florida and National board certified trial lawyer and president of the TERRELL • HOGAN personal injury and wrongful death law firm.

Leslie Goller is an AV rated attorney — the highest rating Martindale-Hubbell gives lawyers — and has 27 years’ experience representing injured consumers.

The Carfax report stated that in Florida more than 100,000 cars had been recalled, but not repaired.

Before you buy a used car, be sure to check the vehicle identification number (VIN) for open recalls. If there is a recall on your vehicle, manufacturers’ recalls are repaired at no cost to you, provided the work is done by an authorized dealership for that make of vehicle. Also, be sure to check for open recalls on your current vehicle if you bought it used. If there is a recall that has not been corrected, contact an authorized dealer about getting it repaired.

Ignoring Auto Recalls Threatens Public Safety; Nearly Three Million Recalled Cars For Sale in 2011

Ignored vehicle safety recalls pose risk on the road

Used Car Buyers May Not Be Informed About Auto Recalls
By Wayne Hogan

June 22, 2011

A recent report by the Government Accountability Office shows that the National Highway Traffic Safety Administration does not have authority to require automakers to inform used car dealers of recalls. That issue “could pose a significant risk to the safety of millions of vehicle drivers and may have a negative impact on recall completion rates,” the study said. “Many consumers may be unknowingly putting their lives at risk by purchasing a defective vehicle.”

The fact is that used car dealers may be selling cars and trucks that have been recalled but not repaired because manufacturers don’t send them the same recall notifications that are sent to franchised dealers according to the study. To make matters worse, even if the used car dealers or franchised dealers know of a recall, there is no requirement that must tell prospective buyers or make the repairs before a sale.

In 2009, more than 35 million used cars were sold, including 11 million sold by used car dealers. According to the study, part of the problem is that there is no database that they can check using a vehicle identifi-cation number (VIN) — which all cars and trucks have — to see if there are recall-related repairs for that vehicle that haven’t been made. NHTSA estimates that average of 70 percent of repairs are made within 18 months of a recall. However, investigators said the average from 2000 to 2008 was 65 percent. The average also varied substantially from year to year.

It also varies significantly by manufacturer. Some manufacturers had a better than 90 percent average repair record for recalled vehicles, but at least one manufacturer averaged only 23 percent fixed and another 53 percent. The report didn’t name the manufacturers.

The study recommends the safety administration make its vehicle recall database searchable by VIN number and ask Congress to give it the authority to ensure car buyers are notified of recalls prior to sales.

For more information or to read the full General Accounting Office report.

The follow states have reported illnesses: Alabama (2), Arkansas (1), Connecticut (5), District of Columbia (2), Florida (1), As Georgia (5), Illinois (10), Louisiana (2), Maryland (11), Massachusetts (8), Mississippi (1), Missouri (2), New Jersey (7), New York (24), North Carolina (2), Pennsylvania (5), Rhode Island (5), South Carolina (3), Texas (3), Virginia (5), and Wisconsin (12).

Click here for the full FDA report.

In 1999, the Institute of Medicine’s report, “To Err Is Human: Building A Safer Health System” warned us that as many as 98,000 Americans die per year in hospitals from medical errors that could have been prevented.  The report was part of a larger project that examined the quality of health care in America and how to achieve a threshold change in its quality. Preventable deaths due to errors in hospitals exceeded deaths from such known threats as motor vehicle wrecks, breast cancer, and AIDS. This report set out a 50% reduction in errors over the next 5 years as the minimum goal and laid out a comprehensive strategy to achieve this. Sadly, this has not been achieved.

According to a January 2012 report released by the inspector general of the Department of Health and Human Service (HHS), hospital staff failed to report 86% of harms done to hospitalized Medicare patients. This supplemented an 2010 HHS study that had found that 1 in 7 Medicare patients suffered serious long-term injuries or died as a result of hospital care.

Here is another shocking fact: the 2012 report found that even when hospitals investigate preventable injuries and infections that do get reported, rarely do the hospitals change their policies or practices to prevent repetition of these mistakes!

The January 2012 HHS report recommends that the Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services collaborate to create a list of potentially reportable events and to provide technical assistance to hospitals in using the list. It also recommends that the list go beyond the harm events already included in the National Quality Forum’s list of 28 Serious Reportable Events and Medicare’s Hospital Acquired Conditions list and include a comprehensive range of possible patient harm. In 2008, Medicare had implemented a policy to limit payment to hospitals for treating avoidable hospital acquired conditions, such as pressure ulcers, falls and trauma, and foreign objects left in a patient after surgery. However, even this economic pressure implemented since 2008 has not reduced the likelihood of harm to patients.

The AARP article also suggests ways that you can protect against hospital mistakes including, particularly, having an advocate, a family member or close friend, with you during your hospitalization to monitor your care, support you, and assist you.

Wayne Hogan is a Florida and National board certified trial lawyer and president of the TERRELL • HOGAN personal injury and wrongful death law firm based in Jacksonville, Florida.

Leslie Goller is an AV rated attorney — the highest rating Martindale-Hubbell gives lawyers — and has 27 years’ experience representing injured consumers.