In this intro episode, Dennis tells you what Legal Squeaks is all about, and why these short snippets of law-related discussions are helpful.
Episode Audio
Episode Video
Summary
Barbara Capasso and John Ray of Mass Tort Nexus provide us with insights and the science behind the Zantac recall, the drugs possible relation to a cancer diagnosis, and the litigation that is happening now.
In This Episode
- The science behind Zantac and NDMA
- When Zantac may be most cancerous
- Should you stop taking Zantac?
- The Zantac and ranitidine recall
- What to do if you have a cancer diagnosis after taking Zantac
Full Episode Transcript
Hi, I’m Dennis VanDerGinst.
Being an attorney, I know that the law can get confusing.
In Legal Squeaks, we provide you with useful and easy to understand
squeaks of information on legal and consumer issues
that you can apply in your daily life.
Let’s get started.
Hi everyone. I’m Dennis VanDerGinst,
and welcome to Legal Squeaks.
Before we get started, I’d like to remind you all
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Also, if you’d like to watch the video version of this
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Today’s topic is the Zantac litigation which affects
so many Americans who have taken that
popular heartburn medication.
The interview that we will be airing today
was actually previously recorded
With two of our favorite experts on the topic
Barbara Capasso and John Ray of Mass Tort Nexus.
They’re experts on pharmaceutical and medical device litigation.
And the information that they shared within this presentation
was too helpful not to share with you on this podcast.
So without further ado,
let’s get into the interview.
Today, I’m happy and proud to announce
that our guests are
Barbara Capasso and John Ray.
They’re the founders of Mass Tort Nexis,
an incredible educational resource
on the practice of mass torts,
specifically pharmaceutical
and medical device litigation.
Essentially, what they do is teach,
consult, and provide in-depth knowledge
and research to plaintiff law
firms across the country.
And I’m happy to say
that VanDerGinst Law is one of those
those plaintiff law firms.
We consult with them on a weekly basis.
We’re happy to have them here to provide
their expert insights
into the Zantac litigation.
We’re also going to hear
from Kitka Galvin,
who is the lead paralegal and mass
tort coordinator for VanDerGinst Law.
So, John and Barb,
thank you for being here.
I’d like to begin by having you explain
what Zantac and ranitidine are,
and what they’re designed to address.
OK. First I’ll start
with explaining acidity
in general.
Everyone probably realizes
a fruit like a lime is acidic.
If you put it on your skin, i
f you put it on a cut, it’ll burn.
It’s acidic.
And then the battery in your
car is also full of acid.
If you put that same
acid in your battery on your hand,
it’ll eat a hole through it.
So not all acids are created equal.
The battery acid in your car is far
more acidic than the acid in a lime.
Now your stomach is basically
a vat of acid that digests food.
Your body produces this acid.
Drugs like Tums and Alka Seltzer and so
forth are just used to enter that acid
and react to the acid that’s
there and make it less acidic.
Make it closer to lime,
further from battery.
Where drugs like Zantac
operate differently,
they don’t affect the acid that’s already
in your stomach, they affect
the pumps called H2 pumps.
H2 receptors, you don’t need
to understand what that is.
But what makes the acid the part of your
body that makes the acid, they stop it,
interfere with it, making the acid in your
stomach, to reduce
the acid in your stomach.
They’re called acid reducers not
antacids like Tums or Alka Seltzer.
Now, the problem with
Zantac and ranitidine is that they were
already known to be nitrosatable drugs
. And I know that’s a big word.
All that means is it’s a drug,
that because of its chemical structure,
it can convert, in other words break apart
the molecule that the drug is,
can break apart.
And part of it can become something else.
And that something else
that a nitrosatable drug can become
is called a N-Nitros compound.
And I know that, again, I’m using words,
but I’m going to simplify it.
The particular compound
that has been discovered that
Zantac and ranitidine brake
down into Is called NDMA.
NDMA is known to be highly carcinogenic.
It’s mutagenic.
It actually mutates
the cells in your body.
All cancer is, is a mutated cell that then
replicates itself again and again.
Because it’s mutagenic, it mutates cells,
NDMA can also cause birth defects as well
as organ damage, kidney damage,
liver damage and other organ damage.
Now,
as I said, the makers of these drugs have
known for a long time that this was
possible that these drugs would convert
in your stomach acid.
The very first thing that struck me about
this litigation,
what I started looking at the science
behind it was that of the other
nitrosatable drugs,
drugs that could convert to NDMA,
none of them were created specifically
for people who had very acidic,
closer to battery acid, stomach acid.
Well, why is that relevant?
Because acid, the more acidic your stomach
is, the more breakdown of the drug
into the carcinogenic NDMA occurs.
But that’s not what
started this litigation.
Ultimately two outside laboratories
that study drugs,
took samples of
Zantac and ranitidine that had been
in people’s shelves,
have been in different places.
And they tested them
just to see how much…
see if it was converting to NDMA before
you swallowed it and it went into your
stomach, and found massive amounts of NDMA
in many of the products.
The
allowable amount in drinking
water of NDMA is .096 nanograms.
That’s one drop of water in
an Olympic-sized swimming pool.
But what they found in these products was
thousands and thousands of times that.
So essentially, not only was the drug
turning into this carcinogenic mutagenic
substance when you swallowed it,
when it was sitting at room temperature
in your home, on a truck, anywhere else,
it was already beginning to convert.
So the longer it sat,
the more it was no longer what it started
out as, but nothing but a cancer pill.
And and women who took it during
pregnancy, which many women have stomach
problems obviously during pregnancy,
it meant
it could cause birth defects and
stillbirths. The child to be born dead.
So this was a very dangerous drug that’s
been on the market that sold billions
and billions and billions of dollars.
One of the best selling
drugs of all time, and
also sold over the counter.
And
had the makers of these products
cared to do what they obviously needed
to do is far as adequately testing them.
The people who’ve been harmed,
people who have cancer,
children have been born with birth
defects, people who suffered organ damage
in children who apparently have suffered
their child being born dead,
all that could have been avoided.
So that’s what this litigation is about.
OK, and John, you mentioned
ranitidine and that is the generic
version?
And you mentioned NDMA and
the cancer that
it has been alleged to create that Zantac
and ranitidine.
Can we talk a little bit about those
types of cancers and other side effects?
I know you mentioned birth
defects and stillbirths.
I believe there’s also kidney and liver
problems that are allegedly being caused.
Can you talk a bit about those
side effects?
Absolutely.
Well, first of all,
let’s just go back for a minute.
I don’t know if we made this clear,
but Zantac started out as only a
prescription, many, many, many years ago.
Then it went, as many drugs do,
to a generic form.
And from there, it went to many
over-the-counter forms.
In fact, I’m sure some of you out there
just started taking it over
the counter. You may have bought
the Walgreen’s brand of Zantac.
You may have bought the CVS
brand, the Wal-Mart brand.
Almost every major retailer in the country
had an over-the-counter version of Zantac.
It was basically the same product.
Recently, very recently,
the FDA asked the manufacturers of Zantac
to please voluntarily
pull it from the shelves.
Because as of recent, most of the drugs
being sold was over the counter.
In fact, the prescription form
of the drug, as soon as
the generic form was made,
they stopped making the brand.
Well the sales dropped.
Yes.
So please understand that this has been
going on for upward of 25 years or more.
You could have started
on the prescription, moved to the generic
and then move to the over the counter.
So I just want you…
I want to make a real distinction between
prescription, generic,
and over-the-counter.
But regardless, the FDA recently asked
the manufacturers to pull all the product
off the market, which they did,
which then began our litigation,
because when something that drastic,
the FDA rarely takes an action like that.
So that’s really what
started this litigation.
Just so you understand,
when the FDA “asks” a drug manufacturer
to do something, that’s because
in order to force them to do it,
they have to sue them.
They have to take them to court.
Or they “ask”.
So you hear FDA recall,
surely the FDA first “asks”
because that’s the easier route.
And the manufacturers all complied because
they knew the gig was up.
So it wasn’t really that the FDA
was giving them a choice.
The FDA was giving the
option “we’re asking you to do this.
If you don’t, we’re going to sue you.
We’re going to make you do it.”
And
I appreciate that historical perspective
on what’s occurred and where
we’re at right now.
You started to address the issue
of the other side effects and what it is
that we’re looking at,
what people should be aware of.
You know, if they’re concerned that, “oh,
my gosh, I was taking this for some period
of time and I’ve had certain ailments”.
Well, what are those ailments that they
really could potentially have a claim for?
Well, let me start with the
three broad categories.
And I’m going to let John
fill in the details.
First and foremost, cancer in adults.
Now, obviously, that can mean many,
many different types of cancers.
We are specifically looking…
and it’s not to say from this list
that there may be other
cancers that we will accept.
But most importantly and in the
forefront: esophageal cancer,
bladder cancer, liver cancer,
stomach cancer, and pancreatic cancer.
Now that’s kind of obvious based
on the way it’s ingested,
but we will also at this time accept
prostate cancer, testicular cancer,
colorectal cancer.
And obviously, you can tell by the list
I’ve just recited, it’s the center of your
body and your digestive
system, if you will.
So that’s our first category,
which would be cancer in adults.
We also, sadly, have a category
of cancer in children.
Now, I just want to say with the adults,
you have to have three years of use.
And what do we mean by use?
Well, generally, it’s a minimum of three
hundred milligrams per week. And
for children,
it’s only one year of ingestion and one
hundred and fifty milligrams a week.
So cancer in adults,
cancer in children because there are
pediatric Zantac products, obviously.
And then lastly,
we’re looking at midline birth defects,
sadly enough, and stillbirths and mothers
who take the product while pregnant.
Now, what does that mean by “take
it while they’re pregnant”?
That means that they have to have taken it
for at least six months
during their pregnancy.
And again, the minimum is three hundred
milligrams per week for an adult.
So those are our three baskets of injury.
And I’ll let John fill in.
Yeah, one of the things that makes…
There going to be a lot
of cases filed in this litigation,
and part of the reason is,
is Zantac and other similar drugs are
known to have what’s
called a rebound effect.
In other words, you take them and they
affect the anatomical structure
that produces acid. Well,
it stops doing what it’s supposed
to do and then rebounds.
It produces more than it normally would.
So it’s not addiction, like being a
ddicted to an opioid, it’s physical,
a physical rebound effect.
You need to take it again because it stops
your problem, the pain you were
having from your stomach acid.
But then as soon as the drug was no longer
affecting those receptors,
they tried to make up for lost
time and produced even more.
And so you had to take more.
So most people who took it
eventually became,
I don’t want to use the word addicted, but
they developed an ongoing need for it
and took it over a longer time.
In other words, the same dosage that they
once took was no longer effective.
So they started taking more.
In fact, we have a personal friend
who basically we had to wean
him off of it a bit.
And I don’t suggest you do this,
but it was to the point where he needed so
much of it to get the same effect, h
e was taking it more than prescribed,
which I don’t suggest anybody ever do.
And if you did and you
had the same effects
that we’re talking about here,
we just want you to understand
that unfortunately that was normal for
people who took Zantac or any form of it.
Now, there’s a couple of really important
points I want to make about this.
If you did
have any of the adverse events that we
just described,
be it the cancer or the birth defects,
please understand that your last dose
has to be 10 years less or prior to.
So in other words, you could have stopped
taking it 10 years before your
cancer diagnosis and you’re OK.
But if you took it and it was 11 years,
then you don’t have a claim.
That 10 years is a long time,
but I just want you to understand that
you have to have had your diagnosis
of cancer or any other adverse event
in this litigation after 10 years.
That can be that’s what we
call the latency period.
It can only be 10 years. I don’t
know if I explain it very well.
But most people what we find when people
call law firms, like VanDerGinst Law,
is that people were on this drug a really
long time for some of the reasons
John just described.
They needed more and more
of it to feel better.
So you’ll find many of you out there were
probably on the drug 5 years,
10 years, 15 years and more.
And as we spoke about before,
you may have started
on the on the prescription form
and moved to over the counter.
So let me then move into another important
subject you may be asking yourselves:
“well, my goodness, there’s going
to be so many of these cases”.
Well, please understand that
as a claimant,
we’re suing the manufacturers,
all the pharmaceutical companies,
of which there are many.
We are suing the distributors and we are
suing all of the retail
outlets that sold this drug.
And so we have many, many,
many defendants here.
So…
Who can afford to pay the claim.
I didn’t want to say that.
Yes, there are many defendants.
There will be many claims,
but there are many, many defendants
for whom we will be suing.
And I think that’s a great
point to make, because in a lot of these
types of litigations,
there may be just a couple or
a handful of potential defendants.
And the concern becomes,
if there are a lot of claimants out there,
well, is there enough to adequately
compensated those people
who have been injured?
But as you pointed out here,
there are a lot of potential defendants.
This has been going on for many,
many years, as you’ve also pointed out.
So there should and will be
ample
assets, I guess,
with respect to compensation.
Now, let’s talk a little bit about
where we’re at.
What has occurred as a result
of discovering these side effects,
these potential side effects.
I know in other discussions that we’ve
had, we talk about
distinctions between class actions,
mass tort actions,
multi-district litigation, et cetera.
So could one or both of you speak
to that as far as what we do with these
potential claims once they come
into our office, for instance.
I’m sure Kitka is going to go over this.
But this is what we call an emerging
litigation because the FDA just asked
the manufacturers to stop
selling it a short time ago.
So we call this emerging litigation.
It just began.
So right now is a great time to call
because we will get your claim processed.
We will update you as to what’s
going on in the litigation.
We have yet to have trials,
though will be scheduled shortly.
Still, again, the chances of your claim
being chosen to go
to trial are almost zero.
But that’s a good thing.
I don’t want you to look
at that as negative.
It’s actually a very good thing.
So what happens is most of the claims will
be filed with the court,
which is here in Florida.
That’s where it’s consolidated.
And then VanDerGinst Law will update after
your claim is filed and keep you updated
on what’s going on in the litigation.
Now, please understand,
because it is emerging litigation
and they’re going to be a lot of claims, w
e may not get to the settlement
phase for many years.
But during the processing of your claim,
please, please work with VanDerGinst Law,
answering all of their questions so
that they can file your
claim and you’ll be on file.
So when they do settle the case,
you’ll be all set and ready to go.
And a multi-district
litigation was granted.
So the simpler form of filing does exist.
Simpler for the plaintiff,
not necessarily for the law firm,
but simpler for the plaintiff,
has been granted.
And because there are so many defendants
and every major retailer in the country
decided to make their own version of this
drug, there are a lot of defendants.
From a legal standpoint,
the fact that the FDA
drug asked that the drug be recalled
is very positive for plaintiffs.
There are a very long list of defendants
that have to be dealt with.
The litigation is going to be complicated
and that may make it take
longer than it otherwise would.
And that’s a very, very good litigation.
I’m sure most of you are
familiar with the term “fraud”.
And in the complaint that we’ve made
to all of these defendants,
there are a lot of fraud charges.
So it’s a very,
very interesting litigation.
And I think it’s important to point out,
Barb mentioned the litigation
being consolidated in Florida.
I want everyone to know, well,
first of all, VanDerGinst Law is
located in Illinois and Iowa.
Unfortunately, we’re not in Florida,
although I wish I were
at this point in time.
But we’re handling cases
from all over the country.
So the fact that it’s consolidated
in Florida is really not important.
And of course, we have
Mass Tort Nexus right there.
But in any event,
it’s also important for everyone
to understand that we do this work
on a contingent fee basis.
So there’s no risk.
If you feel that you might have
a potential claim,
certainly reach out to us.
And I’m going to let Kitka talk
about that a little bit in a moment.
But reach out to us and know that unless
we’re able to get you compensation,
there’s no attorney fee.
You’re certainly not asked for any kind
of retainer for costs or
anything along those lines.
You’re never going to be out of pocket
a dime, unless we get
a recovery on your behalf.
So that’s important.
I know for for anyone listening
in or watching this to know.
So along those lines,
I guess Kitka I’ll have you speak a little
bit about what it is that we are doing
with the inquiries that are coming
in with respect to this Zantac litigation
and how we are vetting those files.
Yeah,
Zantac, it’s kind of been in the news.
So I know a lot of people have questions.
W
hat I want to say is if you took Zantac
and you were diagnosed with cancer,
or your child was, or your child was
born with birth defects, give us a call.
We are going to ask you some questions.
In order for us to build a case to file
your claim with the MDL,
we need some facts.
So we’re going to have to order
medical records.
We’re also going to do some digging to
prove that you actually took the product.
It’s a little bit different than having
a medical device implanted where
I’ve got operative reports.
We’re going to have to
track some things down.
It’s not impossible.
So don’t feel like, “well,
I took the Walgreens brand of Zantac,
but I don’t still have the product or
I don’t have a prescription for it”.
We’ve got some ways to to track
down that proof of use.
So we’ll put all that
information together.
We’ll get your medical records.
We’ll determine that proof of use,
and then we will put that case together.
Build it up and file into the MDL.
As Barb and John and
you guys have all said,
this is a baby tort right now.
It’s brand new.
So we’re going to be working on this
for a few years.
That doesn’t mean that we just leave you
high and dry. We try very hard to keep in
constant contact with all of our clients.
We’ll be in touch about once a month.
Sometimes that’ll be to tell you nothing
happened this month, but we’re still
here and we’re still working on it.
And yes, you do have a case,
and here’s your case number.
And as soon as something happens,
we will let you know.
And I’m glad Kitka has mentioned that.
That we do reach out to everyone
at least once a month,
even if there’s not really anything
to report, because we know how anxious
people can be when involved
in these types of situations.
And it’s good to know
that we’re very communicative.
I think that’s always important whenever
we’re dealing with claims
and or litigations that
are resulting as of, because of,
injury or illness caused by products
and or situations that arise.
So thank you for bringing that up.
As is the case with the other torts
that we’ve had the pleasure
of discussing with Barb and John.
I want to give them
the final say here and talk to anything
about this litigation that they
might like as far as the summary.
The Zantac litigation or…
Yes, please.
The Zantac litigation, I would say,
the statement made by the FDA
on April 20th of 2020 is
conclusive
of ranitidine (Zantac) converting to NDMA
simply by exposure to room temperature (
in other words, the temperature in your
home) is what made it almost impossible
for the defendants to mount a serious
defense in this litigation.
Because the product was not shipped
from overseas, generally,
in refrigerated containers.
Obviously
when you received a prescription or
over the counter, you were not told
keep this drug in the refrigerator.
Some drugs do, you know it says
keep them in refrigerator.
This one was not.
And because
all that needs to occur in order for those
tablets to start converting partially
into this extremely hazardous substance,
that’s an EPA classification,
that’s EPA speak for poison,
is exposure to room temperature.
And it was always exposed to room
temperature from the moment
it was made until
it was completely used or thrown away.
That
is kind of hard for the
defendant to defend.
They can’t say, no, it didn’t.
Not with any honesty.
“No, no.
Our drug doesn’t convert to this
poison, this carcinogen”.
And the FDA
was slow considering
the evidence to take action.
But once they took action,
the statements made by the FDA were
very damning for these defendants.
And I’d just like to say this.
Please understand
that not all lawyers understand how
to file pharmaceutical or
pharmaceutical device claims.
VanDerGinst Law is very well
versed in filing these claims.
It’s very important that you understand.
Don’t just go to some local lawyer who
who really doesn’t handle these cases.
You have to be under the guidance
of someone who understands the ins
and outs of these cases
the way VanDerGinst Law does.
So please, if you believe you have a claim
against Zantac, call VanDerGinst Law,
because they know how to file these claims
and they will stay in communication
with you and help you along
every step of the way.
Well, thank you, Barbara, saying that.
And I want to thank both Barb and John
for joining us, as well as Kitka.
I want to thank you all for joining us.
And again, if you have questions or would
like us to explore a potential claim
on your behalf, please feel free to reach
out to us online at vlaw.com. Or
give us a call at 800-960vlaw(8529).
Thank you again.
And everyone, have a good day.
I’d like to thank John and Barb once again
for providing us with that insightful information on
the Zantac litigation.
And if you feel like you may have a case,
feel free to reach out to VanDerGinst Law for a free consultation.
We’re not here to solicit cases,
but we’re more than happy to help should you need us.
Again, I’d like to remind you all if you haven’t already done so
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and in the meantime have a great day,
stay safe, and I love you all.