The Surgeon General of the United States Public Health Service Has Bad News and Good News
The Surgeon General of the United States Public Health Service has stated, “We must take aggressive steps to protect our children from these highly potent products that risk exposing a new generation of young people to nicotine. The bad news is that e-cigarette use has become an epidemic among our nation’s young people. However, the good news is that we know what works to effectively protect our kids from all forms of tobacco product use, including e-cigarettes. We must now apply these strategies to e-cigarettes, including USB flash drive shaped products such as JUUL. To achieve success, we must work together, aligning and coordinating efforts across both old and new partners at the national, state, and local levels. Everyone can play an important role in protecting our nation’s young people from the risks of e-cigarettes.” (

Director for the Centers for Disease Control and Prevention Thomas R. Frieden, M.D., M.P.H. States that E-Cigarettes Are Not Safe
“Tobacco use among youth and young adults in any form, including e-cigarettes, is not safe. In recent years, e-cigarette use by youth and young adults has increased at an alarming rate. E-cigarettes are now the most commonly used tobacco product among youth in the United States.” (

The Major Conclusions of the 2016 E-Cigarette Use Among Youth and Young Adults Report (

  1. E-cigarettes are a rapidly emerging and diversified product class. These devices typically deliver nicotine, flavorings, and other additives to users via an inhaled aerosol. These devices are referred to by a variety of names, including “e-cigs,” “e-hookahs,” “mods,” “vape pens,” “vapes,” and “tank systems.”
  2. E-cigarette use among youth and young adults has become a public health concern. In 2014, current use of e-cigarettes by young adults 18–24 years of age surpassed that of adults 25 years of age and older.
  3. E-cigarettes are now the most commonly used tobacco product among youth, surpassing conventional cigarettes in 2014. E-cigarette use is strongly associated with the use of other tobacco products among youth and young adults, including combustible tobacco products.
  4. The use of products containing nicotine poses dangers to youth, pregnant women, and fetuses. The use of products containing nicotine in any form among youth, including in e-cigarettes, is unsafe.
  5. E-cigarette aerosol is not harmless. It can contain harmful and potentially harmful constituents, including nicotine. Nicotine exposure during adolescence can cause addiction and can harm the developing adolescent brain.
  6. E-cigarettes are marketed by promoting flavors and using a wide variety of media channels and approaches that have been used in the past for marketing conventional tobacco products to youth and young adults.
  7. Action can be taken at the national, state, local, tribal, and territorial levels to address e-cigarette use among youth and young adults. Actions could include incorporating e-cigarettes into smoke free policies, preventing access to e-cigarettes by youth, price and tax policies, retail licensure, regulation of e-cigarette marketing likely to attract youth, and educational initiatives targeting youth and young adults.

All of this news and talk is great… really it is. But when companies are making billions of dollars, they tend to want to increase, or at the very least maintain, that revenue. They tend not to care whether the products they manufacture and distribute cause harm. Regulatory laws, inconsequential fines, forced warning labels on products, and public education have little to no measurable effects in protecting the public. History proves that greedy companies run by unethical people will continue to cause disease and death as long as it is profitable to do so. We only need to look at what it takes to get the asbestos, tobacco, pesticide, and opioid corporations to change.

How does profit get affected? Civil lawsuits which can result in judgments of such magnitude that the “bottom line” is substantially lowered. One company, JUUL expects to hit $3.4 BILLION in revenue in 2019. “Juul Labs Inc. is expecting $3.4 billion in revenue this year, nearly triple its 2018 earnings.” ( JUUL makes money by caring about the well-being of the public, right? It pretty much says so right on their website. “We support reasonable regulation of nicotine products and comply with all relevant laws and regulations. We did not create JUUL to undermine years of effective tobacco control, and we do not want to see a new generation of smokers. We believe JUUL can accelerate cigarette displacement. We are committed to understanding JUUL’s performance and impact. Incorporating the latest research from leading scientists in the field drives our innovation.” (

Exactly What is a JUUL?
“JUUL devices heat up a cartridge containing oils to create vapor, which quickly dissolves into the air. The device is small enough to fit in a closed fist and has a sleek, tech-inspired design that resembles a USB flash drive. While its manufacturer says that JUUL is only for adults, it comes in flavors — including mint, mango and crème brulee — which are proven to appeal to young people and facilitate initiation of tobacco product use.” (

Each JUUL Has a Pack of Cigarette’s Worth of Nicotine and Other Stuff
A “single JUUL cartridge is roughly equal to a pack of cigarettes, or 200 cigarette puffs, according to the product website. Nicotine is an addictive chemical, and evidence suggests that nicotine use during adolescence and young adulthood has long-term impacts on brain development.” ( “The increased harm of juuls compared to other e-cigarettes is due to the concentration and contents of its juul pods. The e-liquid is 5% nicotine by volume, which is more than twice the concentration of nicotine in similar devices like the Blu e-cig cartridge (2.4% nicotine). This increases the risk of addiction; in fact, a study done by the UK’s Royal College of Psychiatrists showed that nicotine is about as addictive as cocaine and even more addictive than alcohol and barbiturates (anti-anxiety drugs).” ( It is pretty common to see people who have kicked recreational drugs smoking cigarettes. When you ask them why they still smoke after quitting cocaine or heroin, they answer that cigarettes are way more addictive. Oh, and in addition to nicotine, the liquid inside JUUL cartridges contains glycerol, propylene glycol, flavoring, and benzoic acid.

JUUL and New/Young Smokers
JUUL did not convert adult smokers looking to quit cigarettes into JUUL customers. JUUL acquired the lion’s share of the e-cigarette market by aggressively marketing its products to teens and children. JUUL engineers made their vape devices look like USB flash drives which allows high school and even middle school students to hide a JUUL in plain sight. “”I’d say that JUULing has really taken off due to the fact that it appears to be light and fun,” said Sean Christensen, a high school student from Towson, Maryland. “The flavors like creme brulee, mint and mango all contribute to the idea that JUULs are just toys that don’t have devastating effects on your body. Our generation has been educated on the danger of cigarettes, not on the dangers of JUULs. The fun flavors and lack of education means kids don’t associate JUULing with the dangers of smoking.” “The prevalence of JUULs has also been intensified due to marketing of JUULs to high schoolers. JUULs look like flash drives because kids must hide them. No adult needs to have a vape that looks like a flash drive; they don’t need to hide that,” Christensen added. “As of right now, 18-year-old seniors will legally buy JUULs and then take them to high school to sell to underclassmen. This creates a vicious cycle as the underclassmen get addicted, turn 18, and then become supplier that causes the cycle.”” (

What Can a Civil Lawyer Do for a Person Who Has Suffered from a JUUL?
There are lawyers who are looking at cases involving miscarriage, fetal injury and adolescent addiction related to the use of JUUL brand vaping devices and products. If you suffered a miscarriage or delivered a baby suffering from birth defects after using JUUL devices, or if your teenager has become addicted to JUUL vapes, contact one of these lawyers. It is our goal to help put an end to this crisis by helping the victims file civil lawsuits to recoup their losses. If you are located in the State of California and want help, please call Attorney and Physician Paul J. Molinaro, M.D., J.D. today for a free consultation.

* The above text may be considered an ad from a California law firm.

More Opioids = More Deaths by Opioids… Who Knew?

““We found that the counties that, several years ago had the highest rates of prescription opioids are now the ones that had the highest rates of fatal overdoses,”” ( Well, file that under “shocking and unexpected.”

ERs, Opioids, and Teenagers

“From 2005 to 2015, nearly 15 percent of teens and young adults received an opioid prescription during an emergency room visit, according to the study, published Tuesday in the journal Pediatrics. That’s compared with 3 percent among those who were seen in an outpatient clinic.” (


There has been a wave of governmental entities suing opioid manufacturers and distributors for the damages they caused by creating the opioid epidemic, and it is now time for individual patients to do the same!


When Paul J. Molinaro, M.D., J.D. Started Practicing Medicine

When he started practicing medicine in the early 1990s, physician and attorney Paul J. Molinaro, M.D., J.D. was taught that opioids were only to be used in special circumstances and very sparingly as they are addicting and dangerous. However, a couple decades ago, the opioid manufacturers and distributors crafted a plan to increase their customer base. These pharmaceutical companies capitalized on the known addictive properties of opiates by claiming to have reformulated the old-time opiates and marketing the new ones as safe, nonaddictive, and effective medications for patients of all ages and all types of pain. Their marketing included hiring “specialists” to create new pain societies and infiltrate existing ones, have these specialists “teach” other physicians about the benefits of treating chronic pain with long-term opiates, and promoting “guidelines” that created the notion that long-term opiates were the standard of care for the treatment of chronic pain. Their sales force promoted the notion that pain is the “fifth vital sign,” and their direct to consumer advertising taught patients that if their healthcare provider did not address and treat pain at every visit, he or she was not practicing good medicine. Most physicians knew better and resisted the economic pressure of refusing to prescribe potent narcotics when not absolutely necessary. Unfortunately, a large number of prescribers enjoyed immediate, and substantial, financial gains by prescribing opiates upon request.


Opioid Epidemic Facts

According to a New York Times article, United States drug overdose deaths in 2016 exceeded 59,000. ( In contrast, approximately 50,000 people in the United States died from drug overdose in 2015. In the Unites States, drug overdose has become the leading cause of death of individuals under the age of 50 years with sixty percent of these deaths being caused by opioid overdose.

The deaths should be enough to label the opiate problem an epidemic, but the financial impact is enough to label it a national disaster. One estimate of the yearly financial impact of the opioid epidemic puts the number over $500 billion. “The economic cost of the opioid crisis in 2015 was $504 billion, much higher than previous estimates, according to a new report from The Council of Economic Advisers, an agency that is part of the Executive Office of the President.” ( “In 2017, more than 47,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin, and illicitly manufactured fentanyl, a powerful synthetic opioid.1 That same year, an estimated 1.7 million people in the United States suffered from substance use disorders related to prescription opioid pain relievers, and 652,000 suffered from a heroin use disorder (not mutually exclusive).” ( “Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. Between 8 and 12 percent develop an opioid use disorder. An estimated 4 to 6 percent who misuse prescription opioids transition to heroin. About 80 percent of people who use heroin first misused prescription opioids.” (Id.).

In addition to the direct damages this epidemic is taking on addicts and their family and friends, society is bearing the burden of additional healthcare costs, emergency medical services, rehabilitation programs, increased crime, increased policing and imprisonment, and the degradation of entire neighborhoods. “The U.S. spent nearly $8 billion on criminal justice-related costs due to selling and consuming opioids, which was almost entirely a cost to state and local governments, according to the 2015 National Center for Injury Prevention and Control study published in the journal Medical Care. Worse, the recidivism rate for drug addicts is around 45% within three years of prison release.” ( President Donald Trump stated, “No part of our society * not young or old, rich or poor, urban or rural * has been spared this plague of drug addiction and this horrible, horrible situation that*s taken place with opioids.” The United States Centers for Disease Control and Prevention estimates the cost is approximately $75 billion per year.

Leaving the exact amount of dollars out, the Opioid Epidemic has drained cities and counties of money as well as resources lost to: (1) providing medical care, additional therapeutic and prescription drug purchases to treat opiate addiction and the secondary diseases and deaths; (2) providing treatment, counseling, and rehabilitation services; (3) providing treatment of newborns with opioid toxicity and addiction; (4) providing law enforcement and public safety; and (5) providing short-term and long-term care for children of opioid addicted parents.


Many Patients Trusted Their Physicians and Other Healthcare Professionals

You were taught to trust your doctor, and that your doctor had your best interests in mind. When you have surgery or another problem where you need to manage pain, you expect the person in charge of your medical care to take care of you and help you get better. Unfortunately, doctors often spend little time following up on a patient’s pain needs, after they have prescribed a potentially dangerous and addictive medication. Instead of monitoring your use of a dangerous medication, doctors let you develop a tolerance until you are taking larger and larger amounts. Attorney and Physician Paul J. Molinaro, M.D., J.D. was taught that opioids should be used with care, and very rarely. That is no longer the case, and we face a crisis with many individuals being addicted to opioids. Just since 1999, the number of deaths due to opioid use has more than quadrupled. You may have lost your health, your relationships, your job, or suffered other personal losses because of your addiction.


Representing Individuals Is More Challenging

Admittedly, representing individuals is more challenging than representing governmental entities and insurers. Many people view patients who become addicted to prescribed opiates as “drug addicts” or “junkies” no different than people who abuse recreational or “street” drugs. This belief causes those people to feel that the patient who becomes addicted to prescribed opiates is at fault, could have stopped at any time, and was certainly not a victim who is entitled to any “compensation” from the opiate manufacturers and distributors. However, such a belief is misguided as it completely ignores how these extremely addictive “pain killers” were marketed to patients across the United States. By intentionally and knowingly creating falsified studies, completely misleading advertisements, sending out self-proclaimed pain management specialists to conduct bogus lectures and seminars, and designing the drugs to be addictive, the opiate manufacturers and distributors created the prescription opiate epidemic. These greedy pharmaceutical companies knew they were killing patients and ruining the lives of entire families. Yet, they committed all of these illegal actions to make billions of dollars.

At Fransen & Molinaro, LLP, we understand that opioid addiction can happen to anyone. The patients we would like to help are ones who became addicted to prescription opiates that were prescribed by healthcare providers, patients who did not have a preexisting drug addiction, and patients who truly did not want to become addicted to opiates. As examples, the college athlete who underwent a successful knee surgery only to be prescribed Oxycontin for months on end, the middle aged warehouse worker with a minor low back injury for which some healthcare provider prescribed an endless supply of opiates, or the elderly patient with mild arthritis who is told by some practitioner that there is nothing to be done except for taking prescription opiates. When you put your trust in your doctor, you should receive proper care and your real needs should be met. You should not be dealt addictive pills and suffer because of the irresponsible prescribing of dangerous drugs.

Those who manufacture, distribute and prescribe these dangerous drugs have no reason to stop, because they are not the ones suffering the consequences. It is our goal to help put an end to this crisis by helping the victims file civil lawsuits to recoup their losses. If you want help, please call Attorney and Physician Paul J. Molinaro, M.D., J.D. today for a free consultation.



Opiate Opiates Epidemic Opioid Opioids Crisis Lawsuit California Manufacturer Distributor Class Action Multi District Litigation Drug Drugs Codeine Fentanyl Actiq Duragesic Fentora Abstral Onsolis Hydrocodone Hysingla Zohydro Lorcet Lortab Norco Vicodin Hydromorphone Dilaudid Exalgo Meperidine Demerol Methadone Dolophine Methadose Morphine Kadian Contin Morphabond Oxycodone OxyContin Oxaydo Percocet Roxicet Naloxone

* The above text may be considered an ad from a California law firm.

MDL – Multidistrict Litigation

When many plaintiffs suffer similar injuries as a result of defective prescriptions or medical devices, the United States federal court system will have the cases transferred to one courtroom under one judge. This process is commonly known as uses multidistrict litigation (“MDL”). This process allows common issues to be decided one time and in the same way. Discovery and motions are done one time. Thus, the cases benefit from speed, efficiency and uniformity of rulings. MDL cases. Pending MDL cases as of April 15, 2019 are listed here:

Does Essure Fail Every Test?

“It is estimated, however, that nearly 10,000 of U.S. Essure patients required additional operations after their original procedure. This is due to anything from severe side-effects, the device traveling to different areas of the body, or perforations and tears requiring medical procedures. Dr. Katy Moncivais, PhD, Medical Writer tells me: “Essure fails every test – it’s less safe, less effective, and more side effect prone than most other methods of birth control.” ” (