Stevens Johnson Syndrome and Your Legal Options

February 16, 2011

What is Stevens Johnson Syndrome?

Stevens Johnson Syndrome (SJS) is a rare disorder that occurs when the body has an intense allergic reaction, usually to a medication or drug; however, the reaction also can be brought on by an illness or infection. The allergic reaction affects the skin and mucous membranes, especially around the mouth, eyes and nose.

Those who have SJS usually will experience flu-like symptoms first, including a sore throat, fever, cough and burning eyes. As the disorder progresses, a fast spreading red to purple rash will appear and blister on the affected areas. The rash can be very painful. Eventually, the top layer of skin will die and slough off, leaving the underlying area of skin exposed.

Toxic Epidermal Necrolysis (TEN)

If SJS is not treated immediately, it can develop into a much more critical condition called toxic epidermal necrolysis (TEN). The main difference between SJS and TEN is the amount of body covered by the rash: patients with 30 percent or more of their bodies covered by the rash are diagnosed with the more serious TEN. The patient mortality rate increases with the amount of body area covered by the rash; patients with TEN have higher death rates than those with SJS. On average, patients with TEN have a 30 to 35 percent mortality rate while those with SJS have a 5 to 15 percent mortality rate.

Patients who have SJS or TEN require emergency medical care and must be hospitalized as soon as possible to treat the condition. As the skin sloughs off, it leaves the underlying skin open and exposed to infection, which is the main reason why patients with SJS or TEN die. Because of the seriousness of their condition and the risk of death, patients with SJS and TEN are treated in the ICU or burn unit. If the attack was triggered by a medication, it is imperative that the patient stop taking the medication immediately. Patients may be given antibiotics, pain medications, antihistamines and topical steroids to treat SJS.

Some of the possible long-term effects of a SJS attack include:
- Cellulitis: as the skin sloughs off, patients can develop a skin infection (cellulitis) in the exposed areas, which then can lead to sepsis or meningitis if not properly treated.
- Internal organ damage: in some cases, SJS can result in lesions developing on the lungs, heart, kidneys or liver, which can result in long-term organ damage.
- Skin damage: SJS also can result in permanent skin damage, which may include discoloration, bumps, scarring and hair loss.
- Vision loss and other eye sight problems: SJS can cause inflammation of the eyes. In mild cases, it may cause irritation and dry eyes, but in more serious cases, it can cause tissue damage and scarring, which may result in partial or complete blindness in the affected eye.

Once a person has had SJS, it is important that he or she never take the medication that triggered the attack or any related medications again. Second attacks of SJS are often more severe than the first attack and are associated with a higher risk of death.

Which Medications Trigger SJS?

It is nearly impossible to know what will trigger SJS in any individual. However, certain prescription medications and over-the-counter drugs have been linked to SJS. These include:
- NSAIDS (non-steroid anti-inflammatory drugs), including Daypro, Feldene, Bextra and Aleve
- Ibuprofen and aspirin, including Advil, children's Advil, Motrin, children's Motrin and Nuprin
- Anti-gout medications, including allopurinol (Loprin)
- Anticonvulsants (seizure medications), including phenytoin (Dilantin), carbamazepine (Tegretol) and lamotrigine (Lamictal)
- Sulfonamides and antibiotics, including Bactrim, Septra and Ketek

In 2006, the Food and Drug Administration (FDA) required drug manufacturers to place a black box warning on certain medications to alert consumers of the associated risk of developing SJS. These medications included the NSAID prescription medication Tolectin and several over-the-counter drugs under the brand name of Advil and Motrin.

Unfortunately, for many patients these black box warnings came too late after they already had suffered a painful SJS attack.

Your Legal Options Following SJS or TEN

Patients who developed SJS or TEN after taking a prescription or over-the-counter medication have important legal rights. These rights include filing a product liability claim against manufacturers of dangerous drugs for failing to adequately warn patients of the risk of SJS. There have been several of these suits already filed against drug manufacturers, including against pharmaceutical giant Pfizer for the NSAID Bextra and anti-seizure medication Dilantin.

In some cases, those injured by SJS or TEN also may be able to file a medical malpractice and/or hospital negligence claim. For example, if a patient's physician failed to correctly diagnose or treat SJS, then he or she may be liable to the patient. The physician also may be legally liable for failure to obtain informed consent if he or she did not adequately warn a patient of all of the possible side effects of a medication. The hospital may share in a negligence claim if any of its staff, including staff physicians and nurses, failed to adequately treat the patient once admitted to the hospital, resulting in further injury.

Lastly, if a patient died after a SJS or TEN attack, then the patient's family may bring a wrongful death suit against the responsible parties. This may include the drug manufacturer, doctor and/or hospital.

Conclusion

For more information on your legal rights following a SJS or TEN attack, contact an experienced attorney today. There is a limited amount of time to take action against the parties who have harmed you. A lawyer knowledgeable in bringing these types of claims can help you understand your options.

Article provided by Mishkind Law Firm Co., L.P.A.
Visit us at www.mishkindlaw.com