Interview with PPH attorney David Friend

Austin, TXAlthough prescription Fen-phen is no longer on the market due to its association with pulmonary hypertension and heart valve problems, personal injury attorney David Friend at Hissey Kientz LLP says that herbal Fen-phen continues to be a popular alternative to consumers. However, this appetite suppressant has also been linked to numerous health problems, including primary pulmonary hypertension (PPH).

Friend says the real concern with herbal Fen-phen is how the products are marketed.
Herbal Fen-phen, sold over-the-counter (OTC) in drug stores and health food stores, is often branded as "all natural", "herbal" or "natural product". Consequently, most people would think of these products as safe, organic and natural, especially nowadays where there is an increased emphasis on "green" and organic. But Friend points out that numerous health problems have been associated with the use of ephedra and that herbal Fen-phen normally consists of two main ingredients: St. John's Wort and ephedra.

One very serious injury related to the use of both prescription and herbal Fen-phen is primary pulmonary hypertension, or PPH. "By its very definition, PPH is an unexplained disease, it has no known cause," explains Friend. "People can have pulmonary hypertension secondary to another cause such as heart valve disease, but PPH is a title given to pulmonary hypertension when there is no known cause other than the use of appetite suppressants." So how can you determine whether you have PPH that was caused by an appetite suppressant such as Fen-phen?

Friend says PPH testing can rule out other causes: If no primary cause of the pulmonary hypertension is identified and you took an appetite suppressant, it is quite possible that PPH was caused by drug use. PPH isn't easy to detect simply because early signs of PPH can be attributed to a number of things, such as getting older or just being out of shape. "We recommend seeing your doctor and discussing your symptoms and any history of diet drug use," says Friend. "Only medical professionals can make the differential diagnosis. Normally the first thing to be done is an echocardiogram. If the echocardiogram indicates an increased pulmonary artery pressure, your doctor may want to conduct a heart catheterization."

Although the FDA banned the sale of dietary supplements containing ephedra in 2004, Friend likens the drug to another insidious—and lethal—product. "People don't use asbestos anymore but due to the latency of the disease, we are still seeing mesothelioma diagnoses. The same can be said of Fen-phen and PPH: it can take years for symptoms to develop.

"Several years ago there was a nationwide class action against Wyeth [the company that bought American Home Products, the maker of Fen-phen] but it only encompassed claims of valvular heart disease. PPH claims were excluded from the class action. PPH claims are, and always have been, litigated independent of the class." In other words, if you have a claim based on valvular heart disease, it is unlikely that you will have a viable claim due to it being time-barred. But Friend adds that in only very limited cases, an individual will be able to pursue a claim for valvular heart diseae attributable to diet drug use.

"With a PPH claim, generally your statute of limitations will start when you are first diagnosed," says Friend. "And because it often takes several years for PPH to appear, these claims are not necessarily time-barred, even though prescription Fen-phen was taken off the market years ago. Many people who first experience PPH symptoms may not relate them to drug use."

Currently, the Hissey Kientz law firm is evaluating PPH cases involving both prescription and herbal Fen-phen, specifically targeting Wyeth products for prescription Fen-phen and a variety of manufacturers related to herbal Fen-phen.