Failure to Diagnose Plaquenil Toxicity

Holding providers responsible for failing to diagnose retinal toxicity

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Plaquenil® (hydroxychloroquine), an anti-malarial medication, is often used to treat inflammatory or autoimmune disorders like lupus, juvenile idiopathic arthritis, and rheumatoid arthritis. Autoimmune conditions occur when the body’s immune system attacks healthy cells, causing vulnerability to infections.

Among the disease-modifying anti-rheumatic drugs (DMARDs), Plaquenil reduces the immune system’s response to potential infections, but in some cases, it can cause permanent vision damage. This side effect hasn’t always been noticed or diagnosed despite warnings. Some doctors and eye care specialists have failed to check Plaquenil patients regularly for toxic damage to the retina, the light-sensitive tissue at the back of the eye.

At the recommended dose, Plaquenil or retinal toxicity is rare. It might not always cause symptoms, especially in its early stages. Toxicity symptoms can include:

  • skin rashes
  • blurred vision
  • color changes in vision
  • seeing halos or streaks of light
  • blindness

These side effects can mainly harm patients who take high dosages, who have lost weight while on Plaquenil, have used it for five years or more, or who already have retinal damage or kidney or liver disease. Elderly patients may seem to be at higher risk, however, a recent study found no major links between age and the potential for retinal toxicity.

If you take Plaquenil, have an ophthalmologist (an eye disorder specialist), check your retinas regularly before serious vision damage occurs.

Berman & Simmons is handling medical malpractice claims involving people who took Plaquenil and suffered complications because their doctor or eye care specialist failed to check for toxic damage to the retina. Several plaintiffs seeking damages for their injuries, medical expenses, and lost wages have filed lawsuits against providers for not following recommended Plaquenil treatment guidelines and/or failing to diagnose Plaquenil toxicity.

If you think you have a Plaquenil toxicity case, contact us today.

Properly Diagnosing Plaquenil Toxicity

Some doctors have failed to carefully monitor the dosages they prescribe to patients and some ophthalmologists haven’t checked their patients for symptoms or adverse reactions to this drug. Patients have been unaware of the potentially devastating consequences.

The American Academy of Ophthalmology suggests ophthalmologists regularly check their patients for Plaquenil toxicity with photos and the following tests:

  • a visual field test to check if blind spots have developed in the field of vision
  • OCT imaging, a three-dimensional image taken to look for early retinal damage
  • a multifocal ERG test to see how retinal cells respond to light and to check for damage

FDA Warning About Plaquenil

In 2006, the U.S. Food and Drug Administration (FDA) warned that irreversible retinal damage had been observed in some patients who received long-term or high dosages of Plaquenil for lupus or rheumatoid arthritis. They recommended that doctors familiarize themselves with the medication label before they prescribe Plaquenil.

The FDA also suggested that patients who experience blurriness, color changes, light flashes, or streaks in their vision not connected to existing conditions stop taking the drug and be observed for worsening of these symptoms.

They also stated that the symptoms could progress after patients stop taking Plaquenil, and they should also be monitored periodically for muscle weakness. Rheumatoid arthritis sufferers who didn’t see reduced joint swelling or increased mobility in six months were recommended to discontinue use. The FDA also recommended testing for toxic damage to the retina.

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Maine and other states have strict statutes of limitation for filing medical malpractice complaints, so it’s critical to consult with us as soon as possible if you think a dangerous drug or a medical error may have harmed you or a loved one.

If complications from Plaquenil have harmed you or someone you know, a lawyer at Berman & Simmons can help. We have the expertise and resources to make sure you receive full compensation and to hold manufacturers and medical practitioners responsible. You might be entitled to the following:

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Plaquenil FAQs

  • What is Plaquenil®?

    Plaquenil, also known as hydroxychloroquine or HCQ, is an antimalarial medication often used to treat these and other inflammatory or autoimmune conditions:

    • fibromyalgia
    • lupus
    • juvenile idiopathic arthritis
    • osteoarthritis
    • shingles
    • Kawasaki disease (aka mucocutaneous lymph node syndrome)
    • vasculitis
    • rheumatoid arthritis

    In these disorders, the body’s immune system attacks healthy cells, making them more open to infections. Among the disease-modifying anti-rheumatic drugs (DMARDs), Plaquenil reduces the immune system’s response to potential infections. It’s commonly prescribed and isn’t generally considered dangerous.

  • What is Plaquenil® toxicity?

    Damage to the retina, the light-sensitive tissue at the back of the eye, can occur from long-term, high doses of Plaquenil. Retinal or Plaquenil toxicity symptoms include blurred vision, seeing halos, streaks of light, or color changes, and in some cases, blindness occurs. Unfortunately, the damage is usually permanent. In some cases patients don’t notice any symptoms.

  • How does Plaquenil® or retinal toxicity happen?

    The main ingredient in Plaquenil, hydroxychloroquine sulfate (HCQ), binds to melanin, which produces eye color and is the same pigment that forms your skin tone. The HCQ then builds up in the retinal pigment epithelium (RPE) of the eye, damaging and weakening its cell layer. The RPE nourishes the fragile nerve tissue of the retina. The decaying RPE cells then move to the outer retina and eventually to the photoreceptors that transmit light into signals sent to the brain, causing damage.

  • How do I know if I have Plaquenil® or retinal toxicity?

    If you’ve been taking 200 milligrams or more of Plaquenil regularly for a long time, such as five years, your eye doctor should have had your eyes tested for damage to the retinas even if you haven’t noticed any vision changes. Retinal or Plaquenil toxicity symptoms include blurred vision, seeing halos, streaks of light, or color changes, and in some cases, blindness occurs. The risk factors for Plaquenil toxicity can include short stature, obesity, liver, kidney, or macular disease.

  • What are the recommended tests for Plaquenil patients?

    The American Academy of Ophthalmology (AAO) recommends that an ophthalmologist (eye care disorder specialist) check Plaquenil patients for retinal toxicity with photos and the following tests:

    • a visual field test to check if blind spots have developed
    • OCT imaging, three-dimensional photography done to look for early retinal damage
    • a multifocal test (electroretinography) to see any retinal decay and how the cells respond to light
  • Why are people filing lawsuits against medical providers over Plaquenil® toxicity?

    Studies have shown that many eye doctors and medical specialists have failed to check their patients’ eyes regularly for signs of toxic retinal damage from long-term, high doses of Plaquenil. Many people have suffered harmful vision damage, some of it permanent, through these breaches of medical standards of care. Several plaintiffs seeking damages for their injuries, medical expenses, and lost wages have filed Plaquenil toxicity lawsuits against providers for not following recommended Plaquenil treatment guidelines.

    Jury verdict or settlement awards to plaintiffs in these cases can potentially send a message to medical practitioners who prescribe Plaquenil that they need to follow standard treatment guidelines or face consequences for medical malpractice.

  • Do I have a Plaquenil® toxicity lawsuit?

    The American Academy of Ophthalmology (AAO) recommends that doctors keep daily dosages of Plaquenil to less than five milligrams per pound of a patient’s body weight except for “rare instances” when a higher dosage is needed to treat a life-threatening disease. The pills are 200 milligrams each and some doctors prescribe the full amount to their patients.

    If you’ve taken high doses of Plaquenil for a long time, even if you haven’t noticed any vision changes, you might have a medical malpractice case if your eye doctor hasn’t discussed potential retinal damage or had your eyes tested for it.

    Maine has strict statutes of limitations for filing medical malpractice complaints against doctors, so it’s critical to consult with us as soon as possible if you think you have a medical malpractice case.

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