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Legal Claims Involving Lariam (Mefloquine)

Few cases have been litigated in the United States regarding the side effects that mefloquine can cause. In other countries, including the United Kingdom and Australia, the amount of litigation surrounding mefloquine has increased, recently. In the United States, few cases surrounding melfoquine and its side effects have been reported as most have been settled subject to confidentiality agreements.

According to United Press International (UPI), the U.S. Labor Department awarded two Peace Corps volunteers worker's compensation for mefloquine-induced psychoses - one lasting three days, the other an entire year. In Arkansas, an employee whose duties included overseas travel attempted to collect worker's compensation after suffering mefloquine side effects. The court that reviewed the denial of his claim did not address the merit of his claim regarding the cause of his illness. The court dismissed his case because he failed to file his claim within the required time period.

The other notable case involving melfoquine concerns a former United States Representative who attempted to use mefloquine-induced psychosis as a defense to fraud charges. A federal judge in Philadelphia rejected former U.S. Rep. Edward M. Mezvinsky's defense, after conducting a hearing at which both sides presented extensive expert testimony. The judge, Stewart Dalzell said Mezvinsky's mental health defense was "founded on a miasma of ifs, hypotheses and conjectures" that have no relevance to his alleged misconduct.

Mezvinsky has also filed a lawsuit against Roche, the maker of Lariam, his treating physician, a hospital, and two pharmacists. Mezvinsky bases his suit on these parties' failure to warn him of the potentially severe side effects of mefloquine. Mezvinsky alleges failure to warn, fraud and intentional misrepresentation against Roche; negligence against Presbyterian Medical Center and the two pharmacies; and medical negligence against his doctor. The case had not yet gone to trial.

The growing awareness of doctors and experts regarding the potential dangers of mefloquine, as well as the recent studies linking melfoquine to serious neuropsychiatric reactions makes it more likely that individuals suffering affects from mefloquine can collect damages through a lawsuit. Due to the lack of consensus in the medical community, a plaintiff may have difficulty establishing a malpractice claim against the prescribing physician.

Since malpractice claims must assert that a doctor failed to act as a reasonable, qualified doctor in the community would act, the fact that doctors prescribe mefloquine to hundreds of thousands of people a year may make the claim untenable. If state law allows, however, a plaintiff could claim that the doctor failed to warn of the dangers and therefore failed to acquire informed consent before treatment.

A claim against the pharmaceutical companies that market mefloquine based either on a products liability claim or a negligence claim may also allow a plaintiff to collect damages. For both theories of liability, the plaintiff faces the difficult task of establishing that the pharmaceutical could have reasonably provided a safer product. The fact that the FDA has approved and the Centers for Disease Control (CDC) endorse the use of mefloquine may make if difficult to establish a claim. The mounting evidence linking melfoquine to severe neuropsychiatric reactions, including studies performed in Europe and the United States, may increase the likelihood of a claim resulting a the awarding of damages, including pain and suffering, compensation of lost wages, medical expenses, and perhaps, if the plaintiff can establish that the pharmaceuticals' behavior was egregious, punitive damages.

An individual who take mefloquine because employment responsibilities require travel to areas in which there is an increased risk of contracting malaria, the individual may have a Workers' Compensation claim. In these cases, in order to qualify for workers' compensation, the individual must establish that the ingestion of the mefloquine occurred in as a result of and in the course of employment. The individual must also establish that as a result of his or her use of melfoquine the individual can no longer perform the required duties of his or her employment.

Regardless of the theory under which an individual makes a claim, litigation will most likely require the use of experts. Doctors and researchers who can establish a relationship between the neuropsychiatric reactions and mefloquine will play a pivotal role in convincing the trier of fact that the underlying claim has merit.

As long as mefloquine maintains FDA approval and remains the malaria prophylaxis of choice, any potential litigation faces difficult, though not insurmountable obstacles. As more individuals who suffered as the result of mefloquine file claims against those responsible for its availability, the obstacles may diminish.

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