Stevens-Johnson Syndrome Lawsuit Lawyer

How Schmidt & Clark, LLP Can Help

What is Stevens-Johnson Syndrome?

Stevens-Johnson syndrome is a serious condition marked by the rapid deterioration and detachment of skin tissue, primarily affecting the mucous membranes of the eyes, mouth, and genitals.

This life-threatening emergency usually begins with fever and flu-like symptoms, swiftly progressing to a painful red or purplish rash that forms blisters and leads to skin peeling.

Often starting on the face, the condition can spread, resulting in severe complications such as conjunctivitis, difficulty swallowing, and discomfort in the genital area.

How Common is SJS?

Stevens-Johnson syndrome is a rare disease that affects about 2 million adults each year in the U.S. However, the mortality rate of SJS is extremely high (30% of cases).

People with HIV and those with chronic inflammatory diseases like lupus are more likely to develop Stevens-Johnson syndrome than the general population. The reason for this increased risk is unclear, but a compromised immune system and exposure to multiple prescription drugs may have an effect.

Stevens-Johnson Syndrome Symptoms

Stevens-Johnson Syndrome (SJS) progresses in distinct phases, with symptoms increasing in severity over time:

Prodromal Phase (1-3 days)

• Flu-like symptoms (pyrexia, malaise, myalgia, arthralgia)
• High fever (>102.2°F or 39°C)
• Pharyngitis
• Nonproductive cough

Early Eruption Phase (1-3 days after prodrome)

• Erythematous macules on trunk and face
• Mucosal involvement (stomatitis, conjunctivitis, urethritis)
• Nikolsky sign may be positive

Acute Phase (4-6 days)

• Confluent macular rash progressing to vesicles and bullae
• Epidermal detachment (<10% BSA in SJS, 10-30% in SJS/TEN overlap, >30% in TEN)
• Severe mucosal erosions (oral, ocular, genital)
• Possible respiratory and gastrointestinal involvement

Recovery Phase (1-3 weeks)

• Re-epithelialization begins
• Risk of secondary infection remains high

Long-term Sequelae

• Ocular complications (keratinization, corneal opacification)
• Cutaneous scarring
• Possible pulmonary and gastrointestinal issues

Recovery timelines vary based on severity:

• Mild SJS: 2-4 weeks
• Severe SJS/TEN: 4-6 weeks or longer
• TEN: May take months for full recovery

Physicians may use terms like “febrile mucocutaneous syndrome” or “acute exanthematous pustulosis” when discussing SJS symptoms

What Medications Cause Stevens-Johnson Syndrome?

While any drug has the potential to trigger SJS, certain medications and categories are more frequently linked to this severe condition. Below is a complete list of the medications provided, grouped by type, with context on their risks and historical relevance.

Antibiotics

Antibiotics are a leading cause of SJS due to their widespread use and the immune system’s sensitivity to certain compounds.

• Sulfonamides (e.g., Bactrim, Septra): Sulfa antibiotics are among the most frequent causes of SJS, linked to 34% of cases globally. Risks were identified as early as the 1960s.
• Flagyl (Metronidazole): This infection-treating drug has been linked to SJS since the 1990s.

Anticonvulsants

Anticonvulsant medications are known to provoke severe allergic reactions, especially in individuals with genetic predispositions.

• Dilantin (Phenytoin): A well-known anticonvulsant, associated with SJS since the 1970s.
• Lamictal (Lamotrigine): Used for seizures and mood stabilization, with risks highlighted in FDA warnings in 2006.
• Topamax (Topiramate): Frequently prescribed for migraines and epilepsy, this drug has been associated with rare cases of SJS.
• Neurontin (Gabapentin): Primarily used for nerve pain, occasionally linked to SJS cases.
• Phenytoin (Dilantin): A commonly prescribed anticonvulsant for epilepsy, Phenytoin has been associated with SJS since the 1970s.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs are common triggers for SJS, particularly in children and older adults.

• Bextra (Valdecoxib): An NSAID pulled from the market in 2005 after numerous reports of severe adverse reactions, including SJS.
• Feldene (Piroxicam): Associated with SJS since the 1980s.
• Daypro (Oxaprozin): Identified as a risk in rare cases, particularly in the late 1990s.
• Dolobid (Diflunisal): Occasionally linked to SJS in pain relief applications.
• Diclofenac: This NSAID has been associated with rare but severe reactions, including SJS.
• Naprosyn (Naproxen): A widely used pain reliever linked to SJS in rare cases.
• Relafen (Nabumetone): Another NSAID with a potential connection to SJS, particularly in long-term use.
• Children’s Motrin and Advil (Ibuprofen): Over-the-counter NSAIDs implicated in several pediatric SJS cases since the early 2000s.

Gout Medications

Certain gout medications have been strongly associated with SJS, particularly in genetically predisposed individuals.

• Allopurinol (Zyloprim, Aloprim): Linked to SJS cases since the 1980s and a frequent cause in high-risk patients.

Antifungal Medications

Antifungal drugs are also known to provoke immune responses that lead to SJS.

• Diflucan (Fluconazole): An antifungal drug linked to SJS since the 1990s.

Immunosuppressants and Anti-Inflammatory Biologics

These drugs suppress the immune system and can lead to severe allergic reactions.

• Remicade (Infliximab): Used for autoimmune conditions, with reported SJS cases in the early 2000s.

Pain Relievers and Fever Reducers

Over-the-counter medications, particularly in children, have been linked to SJS in rare cases.

• Children’s Tylenol (Acetaminophen): Although rare, some pediatric cases of SJS have been reported with acetaminophen use.

Antimalarial Drugs

While rare, antimalarial medications have also been associated with SJS. These are more frequently used in regions where malaria is prevalent and require careful monitoring for adverse reactions.

Key Risk Insights

• High-Risk Medications: Sulfonamides, anticonvulsants, and NSAIDs are the most commonly implicated drug types in SJS cases.
• Onset Timing: Symptoms typically appear within 1-3 weeks of starting a high-risk medication.
• Mortality and Severity: SJS has a mortality rate of 5%, increasing to 40% in cases that progress to Toxic Epidermal Necrolysis (TEN).

If you or a loved one experience symptoms after taking any of these medications, seek immediate medical attention and consult an experienced attorney to explore your legal options.

Treatment

The goal of treatment for Stevens-Johnson syndrome is to relieve the symptoms and maintain good breathing and hydration levels. In some cases, treatment in an intensive care unit (ICU) may be required, especially if breathing support is needed. Hydration may need to be required using IV fluids.

The sore areas of skin on patients with SJS will be covered with a non-stick dressing to protect them while they heal.

Pain relief will also be administered, and mouthwash may also be used. The eyes will be treated with lubricant to stop the surface from drying out, as well as topical steroids and antibiotics to prevent any inflammation and infection.

Each skin lesion usually takes 1 to 2 weeks to heal; however, new sore areas may develop for several weeks after the condition first presents.

SJS Prognosis (Outlook)

Among patients who survive Stevens-Johnson syndrome, long-term effects of the condition may include:

• Changes in skin coloring (pigmentation)
• Dryness of the skin and mucous membranes (xerosis)
• Excess sweating (hyperhidrosis)
• Hair loss (alopecia)
• Abnormal growth or loss of the fingernails and toenails
• Impaired taste
• Difficulty urinating
• Genital abnormalities

A small percentage of people with SJS may also develop chronic dryness or inflammation of the eyes, which can lead to increased sensitivity to light (photophobia) and vision impairment.

What is Toxic Epidermal Necrolysis (TEN)?

Toxic Epidermal Necrolysis is a more severe form of Stevens-Johnson syndrome. Like SJS, TEN is typically caused by an immune reaction to medications. Toxic Epidermal Necrolysis is characterized by keratinocyte necrosis with separation of the epidermis from the underlying dermis.

Is SJS the Same as TEN?

Stevens-Johnson syndrome and Toxic Epidermal Necrolysis were previously thought to be separate conditions, but are now considered to be part of the same disease spectrum. SJS is at the less severe end of the spectrum, while TEN is much more severe. It is considered SJS when skin detachment involves less than 10% of the body surface and TEN when skin detachment involves more than 30% of the body surface. People with skin detachment involving 10-30% of the body surface are said to have “SJS/TEN overlap.”

Other Causes of SJS/TEN

Although an allergic reaction to medications is by far the most common cause of SJS/TEN, the conditions may also be induced by infections, vaccines, or even idiopathic (spontaneously arising). Other potential etiologies include mycoplasma pneumonia, hepatitis A and human herpesvirus 7, hepatocellular carcinoma, lung cancer, and the meningococcal vaccine. SJS/TEN has also recently been reported in COVID-19 patients, due to either the viral infection or the drugs used to treat the virus.

Who is Most Likely to Get SJS/TEN?

Studies have found that Asian and black patients are most likely to be diagnosed with Stevens-Johnson syndrome and/or Toxic Epidermal Necrolysis. Some studies have even reported a 2-fold risk increase in these populations.

There is also a clear female sex predilection to the diagnosis of SJS/TEN, with a female-to-male ratio of 1.5 to 1. Most people develop these conditions between the ages of 50 to 70. However, SJS/TEN can affect any age group. In most cases, adult diagnoses of Stevens-Johnson syndrome and/or Toxic Epidermal Necrolysis are drug-induced, while infections are the main cause in children.

Recent Developments in Stevens-Johnson Syndrome (SJS) Cases

Stevens-Johnson Syndrome (SJS) continues to be a critical focus in the medical and legal fields, with recent updates shedding light on medication risks, legal challenges, and significant lawsuit outcomes.

From new FDA warnings to landmark court rulings, these developments highlight the importance of staying informed about the condition and its implications.

Documentation Guide for Stevens-Johnson Syndrome (SJS) Cases

Proper documentation is essential for building a strong case in Stevens-Johnson Syndrome (SJS) claims. Below is a comprehensive guide on the types of evidence to gather and how to document it effectively.

Medical Records Requirements

Your medical records are the cornerstone of your SJS case. These should include:

• Diagnosis Details: Documentation from your healthcare provider confirming the SJS diagnosis.
• Treatment Records: Hospital and clinic records detailing treatments such as medications, surgeries, or skin grafts.
• Lab Results: Test results indicating reactions to specific drugs or ruling out other conditions.
• Follow-Up Care: Records showing ongoing care for long-term complications, such as vision or skin issues.

Prescription History Documentation

It is vital to establish the connection between your condition and the medication that caused it. Gather:

• Pharmacy Records: A detailed list of all prescribed medications, including names, dosages, and dispensing dates.
• Doctor’s Notes: Prescriptions and consultation records showing why the medication was prescribed.
• Warnings and Labels: Keep any medication packaging, including warning labels about potential side effects.

Photography Guidelines for Symptoms

Photographic evidence can illustrate the severity and progression of your condition. Follow these guidelines:

• High-Quality Images: Use a good camera or smartphone to capture clear, well-lit images of your skin, eyes, or other affected areas.
• Date Stamps: Ensure photos are time-stamped to establish a timeline of symptom development.
• Progression Documentation: Take regular photos to show how symptoms evolved, especially during the acute phase of SJS.
• Include Context: Capture images of how the condition affects daily activities (e.g., inability to perform tasks due to blisters or swelling).

Timeline Documentation Tips

A detailed timeline helps connect the medication to the onset of SJS. Include:

• Medication Start Date: Note when you began taking the drug associated with the reaction.
• Symptom Onset: Record when symptoms first appeared, including specific dates and times.
• Treatment Milestones: Document when you sought medical attention, received diagnoses, or began specific treatments.
• Work and Lifestyle Impact: Record days missed from work, activities you were unable to perform, and how your condition has disrupted your life.

Expert Testimony Requirements

Expert testimony strengthens your case by providing professional insights into your condition and its causes. Common experts include:

• Medical Professionals: Dermatologists, allergists, or ophthalmologists can link your symptoms to the medication.
• Pharmacologists: These experts can testify about the risks of the medication and its known side effects.
• Toxicologists: Their insights can confirm the chemical interactions that caused your reaction.
• Economic Experts: In cases involving lost wages or reduced earning capacity, financial experts can quantify the financial impact of your condition.

Related Articles:

• Allopurinol Stevens-Johnson Syndrome Lawsuit
• Bextra Stevens-Johnson Syndrome Case
• Children’s Tylenol Stevens-Johnson Syndrome

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FAQs

Who Can File a Stevens-Johnson Syndrome Lawsuit?

Individuals who have developed Stevens-Johnson Syndrome due to medication or other causes may be eligible to file a lawsuit. This includes those who have suffered severe health impacts, medical costs, and other related damages.

What Causes Stevens-Johnson Syndrome?

Stevens-Johnson Syndrome is primarily caused by adverse reactions to medications, including antibiotics, anti-seizure drugs, and pain relievers. Infections like herpes, pneumonia, and hepatitis can also trigger SJS, particularly in individuals with weakened immune systems.

How Can a Lawyer Help With a Stevens-Johnson Syndrome Lawsuit?

A lawyer can help by gathering evidence, filing legal documents, and representing you in court. They will work to prove the link between your SJS and the trigger, aiming to secure the maximum compensation for your medical costs, lost income, and suffering.

Get a Free Stevens-Johnson Syndrome Lawsuit Evaluation With Our Lawyers

The Pharmaceutical Litigation Group at Schmidt & Clark, LLP law firm is an experienced team of trial lawyers that focus on the representation of plaintiffs in Stevens-Johnson Syndrome lawsuits. We are handling individual litigation nationwide and currently investigating potential settlements in all 50 states.

Again, if you or a loved one was diagnosed with Stevens-Johnson Syndrome (SJS) or Toxic Epidermal Necrolysis (TEN), you should contact our law firm immediately for a free case review. You may be entitled to compensation by filing a suit for legal fees and our defective drug lawyers can help with a free case evaluation.