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PPH-Primary Pulmonary Hypertension News
September 2004

7-year-old overcomes rare condition
Local child fights primary pulmonary hypertension
By SUE SOWARDS
Advocate Correspondent

MADISON TOWNSHIP 9/7/04-- He has his father's lanky frame, his mother's large hazel eyes and the sweet cheerfulness of a happy 7-year-old. No one knows where Jared Fracker, of Madison Township, got his rare, usually disabling or fatal disease. It has a dauntingly cumbersome name, primary pulmonary hypertension, a progressive disease of unknown cause that results in the narrowing of the blood vessels in the lungs, causing high blood pressure and eventually leading to heart failure, according to the American Lung Association.

Jared, a second-grader at Madison Elementary School, has so far beat the odds. In 2000, there were 3,065 deaths attributed to PPH, according to the ALA. Dramatically improved, he is now just as active as other children, and no one would guess he is sick, his parents, Brian and Brenda Fracker said. Brian, 38, and Brenda, 35, said the diagnosis of PPH was made when other illnesses, including secondary pulmonary hypertension, were excluded. Jared is unlike most PPH patients, who are young adult females.

Normal at birth, a month later Jared became critically ill. He labored for each breath. Taken to Children's Hospital in Columbus, he was put on a ventilator. He had a virus, the doctors said. With medical treatment, he improved. But at three months, the symptoms returned. Struggling for each breath, "He would suck (briefly) on his bottle, then stop and breathe," his mother said recently. Reflecting upon their painful journey, they credit Dr. David Chan, pediatric cardiologist at Children's Hospital in Columbus, along with Dr. Robyn Barst of New York Presbyterian Pulmonary Hypertension Center, with Jared's recovery.

When Dr. Chan diagnosed Jared, the Frackers were devastated and scared. "Dr. Chan said Jared was in bad shape" and he'd only diagnosed PPH two other times, and neither patients had good outcomes, Brenda said. The American Heart Association estimates 500 to 1,000 new cases of PPH are diagnosed each year of those. Brian and Brenda wasted no time in bundling their son off to New York, where he was immediately equipped with a portable pump and surgically inserted tube in his chest. Blood pressure in his lungs was more than eight times the normal pressure.

A then-new Glaxo-Wellcome drug, approved in 1995, Flolan, was pumped into Jared 24 hours a day beginning March 5, 1997, and during the next two weeks, he improved. His parents learned how to mix the medicine so they could provide around-the-clock treatments at home. For the next six years, Jared and his parents flew to New York every six months for checkups, and Jared continued his Flolan treatments.

In time, the five-pound pump and five-foot tube made crawling and walking difficult for Jared. Brenda made alterations with a leather strap to prevent the tube from pulling loose when he crawled beyond the five-foot span. When he began walking, she fashioned a backpack so he could wear the pump on his body. "My wife was a real trooper. She did the brunt of the work, cared for him medically. I take no credit for that," Brian said. Brian is a vice president at Heartland Bank in Newark and a 1985 Newark High School graduate. Today, Flolan is not a part of his treatment, but Jared continues to take eight other prescription drugs. His lung blood pressure is down to less than twice the norm.

"That is awesome," Brenda said. "He is doing extremely well. Throughout this whole process, he has been a happy kid, never complaining. He always did his treatments with a big old smile on his face. Nobody even knew he was sick." Jared's treatments and the expenses involved in multiple trips to New York, lodging and meals while there have set the Frackers back several thousand dollars every year. Jared's health problems have changed the Frackers. "I've learned to appreciate life and deal with what God gives you," Brenda said. "We had to adapt. It's made me a much better person because of it. People take life so for granted. When it's almost taken away, you realize how every moment is important."

"We became a family of faith through many trials," Brian said. "No question, Jared is a gift from God. It's a humbling experience. You learn to treasure the finer details and the little things in life more than you may have noticed before." Meghan, Jared's nine-year-old sister, has become a protector to her brother. He calls her Sis, but she functions as a second mother, Brian said. As for Jared, he's very active. He loves Meghan. He loves pizza, and playing basketball and football. His favorite pet is Buster, his dog. He says school bores him. He'd rather be at home with his mother, but he liked learning about a.m. and p.m. He already knew how to tell time. He isn't allowed to ride roller coasters because going quickly up and down alters the activity of the heart, but his relationship with Buster helps make up for that loss. "I love him, and I kiss him on the lips. He's slobbery," Jared said.

Fighting back
For more information or to make a donation, contact the Pulmonary Hypertension Association at 850 Sligo Ave., Suite 800, Silver Spring, MD 20910.

September 5, 2004
Fen-Phen arrests revive rap on county
Fraud allegedly used to join suit

By Jerry Mitchell
A few years ago, the roof collapsed at the Family Dollar store in Fayette. A handful of people were shopping there at the time, but dozens who weren't showed up in the emergency room for treatment. It's one reason Jefferson County has gained a reputation as a place so friendly to plaintiffs that the American Tort Reform Association dubbed it a "judicial hellhole." At one point, the number of plaintiffs suing (many from out of state) outnumbered the 9,740 people in Fayette. (In 2001, the state Supreme Court upheld a case that permitted out-of-state plaintiffs to join in a Mississippi lawsuit.)

Last week's arrests of a dozen people from this town certainly won't help that reputation. FBI affidavits accuse each of faking prescriptions of Fen-Phen to get paid $250,000 each (about $150,000 after attorney fees and expenses) from a 1999 lawsuit against the diet-drug maker, American Home Products, that ended in a $400 million settlement. One of those arrested, Eva Johnson, says she's innocent and really took the diet-drug combination Fen-Phen, half of which was permanently removed from the market in 1997 after some users developed heart damage. "I doubt seriously I'd know how to falsify a prescription," she said. "I'm tired of my name being scandalized."

The arrests in Mississippi follow criticism by officials from Wyeth, formerly known as American Home Products, that while they estimated there should be 8,300 claims of severe heart damage nationally, they've received 71,000 claims — a figure they attributed to "tens of thousands of baseless claims." Those damaged by Fen-Phen were upset to hear the allegations that some may have faked prescriptions.

"I feel like a victim," said Vernessa Sanders, 34, of Jackson, who said she suffered from heart problems, chest pains, high blood pressure and shortness of breath after taking Fen-Phen. "It almost killed my daughter. She was laying down in bed," said her mother, Mylinda Thompson, a Jackson nurse. "I almost had a nervous breakdown." Sanders said she received $70,000 for her injuries (about $40,000 after attorney fees and expenses). "She had that much in bills," Thompson interjected. Sanders said she believes she would have received more without such alleged fraud. Pat Bennett, a professor at Mississippi College School of Law, said if fraud proves substantial in the case "you might go back and try to disburse to individuals who had a legitimate claim."

But lawyers connected with the case say payments to those affected by the diet drugs were awarded based on categories, which ranked the severity of those injuries. American Home Products and a special master appointed to the case reviewed all documentation plaintiffs provided. "They had to show there was some injury, and the way to determine injury was the echocardiogram," said Doug Petkus, a spokesman for Wyeth. An echocardiogram uses sound waves to give doctors a moving picture of the heart. Petkus said those who had fake prescriptions likely turned in such echocardiograms. "Were they legitimate?" he asked. "I can't tell you that."

Lawyers familiar with the case say the people now charged were each paid $250,000 because they had supposedly taken the diet drugs and were from Jefferson County. Those from other counties were paid less. Questions also have been raised about the legitimacy of some claims in a separate national Fen-Phen settlement for $3.75 billion. A court-appointed expert criticized some test results from a physician who read 2,500 echocardiograms of those who had taken the diet drugs and received nearly $3 million from law firms for her services.

In the end, U.S. District Judge Harvey Bartle III of the Middle District of Pennsylvania tossed out 53 echocardiogram readings for being "beyond the bounds of medical reason," ordering an audit of all medical records. The judge concluded cardiologist Dr. Linda J. Crouse allowed a law firm employee to instruct her staff with regard to the machine and spent little time reviewing the results. "She never met with the claimants, never reviewed their medical records and largely relied on the law firms to provide the medical history," the judge wrote. "When considering the thousands of echocardiograms that Dr. Crouse interpreted during the period that she worked for the (law) firms, her practice resembled a mass production operation that would have been the envy of Henry Ford."

Some plaintiffs fear the $3.75 billion set aside nationally could end up providing paltry amounts to patients damaged by the diet drugs. That's certainly what Myrna Goldsmith of Chicago thinks. She took Fen-Phen for about six months in 1996, only to find out later she had damage to two heart valves. So far, she's received $6,090. She's still waiting for her portion of the national settlement. "I probably won't live long enough to see it," she said. She could possibly get help from a new $1.275 billion fund for Fen-Phen users expected to cover payments for more than 40,000 people who have suffered valve damage that isn't life threatening. In this case, independent specialists would examine the echocardiograms in what the company described as a streamlined process that could pay an average of $68,000.

In Mississippi, FBI agents have been investigating diet-drug litigation for the past 18 months, saying they anticipate more arrests. A federal grand jury that meets next week could consider indictments in the case. Since May of last year, federal authorities have subpoenaed records from lawyers involved in the case. Asked whether these lawyers are being investigated, Assistant U.S. Attorney John Dowdy replied, "No comment." Those representing plaintiffs' lawyers say their clients knew nothing about the purported wrongdoing revealed last week.

John Colette of Jackson, the attorney for Jackson lawyer Dennis Sweet, said the continuing investigation "really does not affect Dennis because his role was limited to the trial of the Fen-Phen lawsuit." Because attorney fees had already been determined at the time of the $400 million settlement, there was no incentive for any of the lawyers to sign up additional clients after the trial, Colette said. "It was not like your normal personal injury case. The fee was predetermined." Traditionally, training manuals for federal prosecutors urge them to catch the "smaller fish" and work their way up to the "bigger fish." "That's how they broke organized crime," said Ron Rychlak, a professor at the University of Mississippi School of Law. "You get someone on the low level who will talk."

But this may be a case that involves no higher-ups, he said. He compared the allegations to those who stage accidents. "The analogy is there's a bus wreck and someone lays down beside it and says he was hurt," he said. "It's people trying to jump on what they perceive as a gravy wagon. If these charges are in fact true, it's a very serious abuse of the legal system."

Former Fayette Mayor Charles Evers said the justice system needs to take its course. "Let right correct wrong," he said. "It doesn't matter who it is. If you're wrong, you're wrong." He reiterated criticism for litigation filed in Jefferson County when only a few plaintiffs are from the county. "My concern is these lawyers think people down here don't have the mentality to say no to certain cases. They're trying to take advantage of folks because they believe people here are somewhat illiterate, and it's an emotional case."

Twelve charged with fraud in $400 million fen-phen settlement in rural Mississippi county known for eye-popping jury verdicts

DENISE GRONES

JACKSON, Miss. Wed, Sep. 01, 2004 - Two more Fayette residents who received portions of a $400 million settlement with the manufacturer of the diet drug fen-phen in 1999 have been arrested and charged with fraud for allegedly lying about taking the drug. Lizzie Hammett, 52, and Regina Green, 56, were the latest two among ten other Fayette residents who had appeared before U.S. Magistrate Judge James C. Sumner Tuesday on the same charges. "These people were seeking money for a drug they never took. They conspired with others who were more knowledgeable about the system. They were never entitled to any type of compensation," FBI agent Bob Garrity said Tuesday.

The defendants are accused of submitting fake pharmacy documents showing they used the diet drug. They face up to five years in prison and a $250,000 fine if convicted of conspiracy to commit an offense against the United States. Dennis Joiner, with the U.S. Public Defender's Office, said a federal grand jury investigation has been done, which means other witnesses have probably been interviewed in secrecy. The group will appear before a grand jury next week and Joiner said he's not sure if any of the 12 will testify. "I always advise my clients not to testify," he said.

Joiner asked Hammett and Green to make no comments to the media. He said he's not sure yet, if the group will be represented as a whole, have separate representation from the public defender's office or seek their own counsel. The arrests Tuesday and Wednesday came after a yearlong federal investigation into a rural corner of southwestern Mississippi where juries have been known to return multimillion-dollar verdicts, attracting lawyers who were eager to capitalize. The FBI said it wanted to learn how individuals became part of these lawsuits and how juries were picked from an area where many people are kin or acquaintances.

The $400 million settlement with nearly 800 people nationwide came after one of those so-called "jackpot" verdicts. A Jefferson County jury had awarded $150 million to five people who claimed fen-phen gave them heart and lung problems. Drug maker American Home Products, which has since changed its name to Wyeth, quickly settled the case, offering to cap damages at $400 million for the five plaintiffs and claimants in about 800 other cases. All those arrested for alleged fraud are from Jefferson County. They were released Tuesday and Wednesday on their own recognizance. More arrests were expected, the FBI said.

American Home Products made Pondimin, the fenfluramine half of fen-phen, and Redux, a chemical cousin. About 6 million people took the drugs before they were pulled from the market in 1997 amid evidence they caused heart-valve damage in some patients. Wyeth Pharmaceuticals spokesman Douglas Petkus said Wednesday that the company cooperated with authorities, but he would not discuss any details.