Welcome to PritzkerOlsen, P.A.

Fleet Lawsuit Questionnaire

Colonoscopy Lawsuit Update: Our law firm is representing dozens of people who suffered kidney failure after using a Fleet Phospho-Soda product prior to a colonoscopy or surgical procedure. Please contact us about our Fleet lawsuits and your right to compensation for your injuries: 1-888-377-8900 (toll free) or complete our free consultation form. After you have made contact with us, you can fill out this questionaire and send it to us, or we can mail you a questionaire along with our other Fleet lawsuit information.

Acute Phosphate Nephropathy Questionnaire/Screening Tool

Thank you for your interest in having Pritzker | Olsen, P.A. represent you in your claim for kidney damage resulting from use of Fleet or Visicol (oral sodium phosphate bowel preparation).

Throughout the questionnaire OSPS is used to mean oral sodium phosphate solution, generally Fleet or Visicol.

1. Name of patient: _________________________________

2. Address: _______________________________________

3. Phone Number: __________________________________

4. Email address: _________________________________

5. Age of patient at time ARF (acute renal failure) recognized:
_________________________________________________

6.  How was the patient advised to purchase and use OSPS (e.g. received printed handout from office of doctor performing colonoscopy):
_________________________________________________
 
7. When was the OSPS purchased: ______________________ 

8.  What was the name of the store or pharmacy at which the OSPS was  purchased:
_________________________________________________

9.  What evidence is there of OSPS purchase (i.e. sales receipts, the empty box or container, credit card receipt, frequent shopper card):
__________________________________________________

10.  What was the date on which the OSPS (Fleet or Visicol) was taken:  _________ 

11.  Was the OSPS (Fleet or Visicol) used as recommended?  Y or N (circle one).
If yes, explain: _______________________________________
(Note: We will need any printed instructions or other written material about the purchase or use of OSPS that were given to the patient.) 
  
12.  Was there a baseline (pre-ARF; pre-use of OSPS) creatinine level? Y or N (circle one).
If so, what was it: ____________________________________

(Note: Our attorneys will need to have appropriate medical records that document when the colonoscopy procedure was done, where it was done, and by whom it was performed.)  

13.  When did the patient first develop symptoms consistent with ARF?
__________________________________________________ 
(Note: We will need the lab results to find information regarding urine protein, serum calcium, and serum phosphorus.) 
 
14.  Was a kidney biopsy done?  Y or N (circle one).  If yes:

  • When was it done?______________________________
  • Where was it done?______________________________

(Note: Our attorneys will need all medical records relating to the kidney biopsy to determine if the biopsy indicated acute and/or chronic tubular injury with abundant tubular calcium phosphate deposition.  We will also review the biopsy medical records to determine what the creatinine level was at time of biopsy.)

15. Was the patient using any of these classes of medications before use of OSPS (Fleet or Visicol) which could result in inadequate hydration (ACE-I, ARB, diuretics and NASIDS all exacerbate volume depletion)?  Please circle any of the following medications the patient was using before use of OSPS (Fleet or Visicol):

  • ARB.  The following is a list of currently available ARBs: candesartan (ATACAND), eprosartan (TEVETAN), irbesartan (AVAPRO), telmisartan (MYCARDIS), valsartan (DIOVAN), and losartan (COZAAR).
  • ACE Inhibitors:  captopril (Capoten), benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil, Zestril) fosinopril (Monopril), ramipril (Altace), perindopril (Aceon), quinapril (Accupril), moexipril (Univasc), and trandolapril (Mavik).

16. Did the patient have a history of Hypertension (high blood pressure) before use of OSPS? 
(Note:  We will need medical records relating to the hypertension.)

17.  Pre-existing chronic kidney disease? Y or N (circle one).
(Note:  We will need medical records relating to the pre-existing chronic kidney disease.)

18.  Did the patient have a history of diabetes before use of OSPS?  Y  or N (circle one).
(Note:  We will need medical records relating to the diabetes.)

19. Did patient have evidence of pre-existing electrolyte disorders?  Y or N (circle one).
(Note: We will need lab records showing pre-existing electrolyte disorder (check labs prior to use of OSPS). Normal levels of electrolytes are:

  • Sodium. 135-145 mEq/L (serum)
  • Potassium. 3.5-5.5 mEq/L (serum)
  • Calcium. 8.8-10.4 mg/dL (total Ca; serum); 4.7-5.2 mg/dL (unbound Ca; serum)
  • Magnesium. 1.4-2.1 mEq/L (plasma)
  • Chloride. 100-108 mEq/L (serum)
  • Phosphate. 2.5-4.5 mg/dL (plasma; adults))

FLEET LAWSUIT INFORMATION - Pritzker | Olsen, P.A., A PREMIER PERSONAL INJURY LAW FIRM, IS MAKING PREPARATIONS FOR VISICOL AND FLEET LAWSUITS.  IF YOU OR A FAMILY MEMBER HAS EXPERIENCED KIDNEY DAMAGE, INCLUDING KIDNEY FAILURE, AFTER THE USE OF FLEET OR VISICOL, FILL OUT THIS FLEET LAWSUIT QUESTIONNAIRE AS BEST YOU CAN.  YOU DO NOT HAVE TO ANSWER EVERY QUESTION.  IF YOU HAVE ANY QUESTIONS ABOUT A VISICOL OR FLEET LAWSUIT, PLEASE CALL TOLL-FREE AT 1-888-377-8900.


Free Case Consultation





Logos

Firm News

Fred Pritzker Listed in The Best Lawyers in America

Fred Pritzker has been notified that he will again be listed in The Best Lawyers in America for his work in personal injury litigation.

 

Attorney Elliot Olsen Speaks at Conference

Attorney Elliot Olsen recently spoke at the Seventh Annual LifeScience Alley Conference in Minneapolis on Preemption and the Future of Medical Device Litigation.  He appeared with Randall Pattee of Lindquist and Vennum and Jean Lance, VP of corporate legal and general counsel for Boston Scientific. 

 

ADHD Medication and Cardiac Death

ADHD Medications that may be associated with sudden death in healthy children, according to the FDA: Focalin, Focalin...

 

Zicam Lawsuits

On June 16, 2009 FDA altered consumers to the risk of anosmia (loss of smell) with the use of certain Zicam products marketed by Matrixx Initiatives. ...

 

Denture Cream Lawsuit

Denture users throughout the nation are suing denture cream manufacturers Proctor & Gamble Co. and GlaxoSmithKline PLC, alleging that Fixodent ...

 

Super PoliGrip Lawsuit

People who use dentures should be aware that lawsuits have been filed alleging that use of PoliGrip and other denture creams caused zinc poisoning, wh...

 

Medtronic Recall and Medtronic Lawsuit

FDA has annonced a Medtronic Spring Fidelis defibrillator lead recall. Two of our clients with defective Medtronic leads were shocked over twenty times before medical professionals were able to turn off the defibrillator.

 

Fleet Lawsuit

We are representing several people who experienced kidney failure (acute phosphate nephropathy) after use of Fleet Phospho-soda solution or Fleet Accu-Prep solution for bowel cleansing.

 

Ortho Evra Lawsuit: Ortho Evra Birth Control Patch

The Ortho Evra birth control patch has been linked to an increased risk of blood clots that can lead to pulmonary embolism, stroke and heart attack.

 

Trasylol Recall

Bayer has agreed to a marketing suspension of Trasylol, a drug used to control bleeding during heart surgery, pending detailed review of preliminary results from a Canadian study that suggested an increased risk for death.

 

Fentanyl Lawsuit and Fentanyl Recall

There have been a number of recalls regarding fentanyl due to the risk of a fentanyl overdose.

 

Fosamax and Osteonecrosis

Several cases of bisphosphonate-associated osteonecrosis of the jaw have been associated with the use of oral bisphosphonates, including Fosamax®, Actonel®, and other medications. 

 

NuvaRing Death

Lawsuits have been filed alleging death and serious injury associated with NuvaRing, a contraceptive product make by Organon. Contact us about NuvaRing stroke, NuvaRing pulmonary embolism, NuvaRing heart attack, and an Organon NuvaRing lawsuit.