Levaquin Blog

Here is an interesting story from NY Daily News contributors’ Drs. Positano (DPM) and Dines (MD), who practice sports medicine at the Joe DiMaggio Sports Medicine Center at The Hospital for Special Surgery and at the NY Presbyterian/Weill Cornell Medical Center. In a discussion about a sports injury to Indianapolis Colts safety Bob Sanders, they explain the various treatments and concerns when dealing with a ruptured biceps tendon.

X-Ray Vision: Distal biceps tendon tear more than likely leads to surgery

As if the Colts secondary has not been tormented by enough injuries this season, we recently learned that safety Bob Sanders will be out with a distal biceps tendon rupture at the elbow which will require season-ending surgery. The surgery was performed by the renowned orthopaedist Dr. James Andrews earlier this week.

The biceps muscle is an important muscle in the upper arm. The distal tendon of the biceps muscle transmits all of the forces of the muscle to the forearm at its insertion (radial or bicipital tuberosity), thereby contributing to an athlete’s ability to forcefully flex the elbow as well as rotate their forearm in turning the palm upward (supination).

The distal biceps tendon can tear, preventing the transmission of forces from the muscle to the forearm bones. While it can happen from repetitive injury in athletes, it more commonly results from a single traumatic event in which the flexed elbow is resisted or even traumatically extended as in Sander’s case. The event is usually accompanied by a “popping sensation” and sense of sharp tearing around the elbow crease.

Once a distal biceps tendon is ruptured, it unfortunately will not heal on its own. Rather, the tendon will continue to retract away from the bone and slide up the arm as the muscle contracts without resistance. Over time, the tendon will be come stiff and scarred as well. This loss of biceps muscle function results in a loss of elbow flexion (bending the elbow) and forearm rotation strength.

Usually the presentation of a distal biceps tendon is not subtle in the athlete. When compared to the normal arm, the tendon can no longer be palpated at the elbow flexion crease. Frequently, there is swelling and bruising around the elbow flexion crease.

The diagnosis can be made by taking a history from the patient and performing a physical exam. An MRI often can confirm a complete tear of the tendon as well as to assess any potential retraction of the tendon. Over the past few years, surgical techniques and implants have improved, which, when combined with people trying to stay more active, has led to an increasing number of distal bicep tendon repairs being performed.

In the past, 2 incisions were typically needed to repair the tendon whereas now 1 is often used. Patients are protected in a brace for the first 6 weeks after surgery after which they progressively work on strengthening exercises before returning to sports. The best results are achieved when surgery is done within three weeks of the initial injury.

Source: http://www.nydailynews.com/sports/football/2009/11/15/2009-11-15_xray_vision_.html?print=1&page=all

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I would just like to extend our warm wishes for a Happy Thanksgiving to all of those in the LevaquinBlog community. We wish you health and happiness in this holiday season and beyond. Take the time to be thankful for all that is good, and the tough times shall get better.

Mike

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Johnson & Johnson (the manufacturer of Levaquin) is trying to prevent the first Levaquin lawsuits from being consolidated into a single trial. Plaintiffs’ attorneys want to have the first three “Bellweather” cases tried together. They claim that these cases are very similar; since the plaintiffs have similar injuries, claims, and situations, it is more efficient for the court to handle them as a single trial.

Attorneys for J&J disagree, arguing that the potential differences in the plaintiffs’ medical histories and their unique injuries suffered may confuse the jury.

There are now hundreds of cases pending against Levaquin in state and federal courts. The first cases to go to trial in products liability cases such as this are often the most important ones for both plaintiffs and defendants – if plaintiffs lose, future plaintiffs will find an emboldened defendent and face an uphill battle. However, if the first plaintiffs prevail, oftentimes the defendants may rethink their strategy and might find settlement to be a viable option. (Thus these first cases are referred to as Bellwether cases.)

The majority of the lawsuits allege that the antibiotic medication caused the plaintiffs tendon ruptures, tendonitis, and other tendon injuries.

In July of 2008, the U.S. Food and Drug Administration mandated the manufacturers of the fluoroquinolone class of antibiotics (including Levaquin, Cipro, Avelox & others) to include a “black box” warning label, which states clearly that there is significant risk of tendon injuries for users of these drugs. Prior to that date, any warnings of such injuries were not clearly displayed (allegedly buried in a long list of potential side effects. Currently, the language is clear:
WARNING
Fluoroquinolones, including LEVAQUIN®, are associated with an increased risk of tendinitis and tendon rupture in all ages. This risk is further increased in older patients usually over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants [See WARNINGS AND PRECAUTIONS].

Source: http://www.injuryboard.com/printfriendly.aspx?id=274696 (Author: Scott Kappes)

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Here is the conclusion to the excellent documentary Certain Adverse Events. Does it sound familiar when Greg here finds out, 1 year after his adverse effects start, that there’s a link between Levaquin and his pain? For the full documentary, click here. If you would like to purchase this video, you can do so here.

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Here is a brief summary of the warning signs of tendonitis and tendon ruptures after taking Levaquin. If you or someone you know has taken Levaquin and would like to learn more about the possibility of joining a lawsuit against the manufacturers (Ortho-MacNeil and Johnson & Johnson), visit Legaltube or call our sponsor firm, Slater Rosenberger & Schulman, at 1-800-251-6990.

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