Subcommittee on the constitution and Civil Justice will come to order. Without objection were authorized to declare recess in the committee at any time. We welcome everyone in todays hearing on the examining and now i recognize myself for an opening statement. Todays hearing will examine the ethical responsibility related to attorney advertising. Id like to start out by showing an ad by the law firm possession laskey, llc and theyll be projected. A blood thinner predaks a may call serious and internal injury. The manufacturer of predaks a link since 2010. If you or a loved one took this and suffered from bleeding, vehicle bral hem imagining or death you may receive compensation 1800 bad drug to sieve a consultation. Ladies and gentlemen if youve watched television in years or seep one like it. It includes a toll free number. One information thats not warning the patient being talking to the doctors before discontinuing use of the medication. Indeed, even if that warning is in tiny low contrast text at the bottom of the t. V. Screen, studies show these ads are reaching a broad audience. A recent survey states nearly three quarterers of americans say they have seen ads by law firms about pharmaceutical lawsuit in the last year. Three quarters of american. The same survey found that one and four people, say they would immediately stop taking the medicine without consulting the doctor. American medical association reported a similar effect. According to a press release last year patient were more likely to discontinue the use of prescribed fda suit calls after seeing television quotes, emphasis side effects while ignoring the benefit that the medication is fda approved, close quotes. A study ploushed in a journal stated that patients who were prescribed the antikoeing a lent tso real toe suffered serious injuries or have died. According to the author, 75 of Patient Experience add stroke. Two patients passed away including a 45yearold man. These only account for those that have been reported to the food and sbrug administration. There may be many more cases that have or many other drugs. Todays hearings are intended to examine the effective of these drugs and present more loss of life. I will call the witnesses for their testimony and i look forward to your perspectives on this issue. The chair recognize mr. Cohen. Thank you. Our hearing last week the new topic for us but its one in a new bottle. Its another attack on trial lawyers, advocates, or others as we have advocates argue for us in court and the beneficiaries that the attack on plaintiffs bar are wellhealed corporate interest that would benefit greatly and prefer not having attorneys at all. In this committee has unfortunately the constitution and subcommittee in riching the rich and attacking the plaintiffs bar. Rather than doing what we should be doing in representing and advocating for the constitution. Just this week, nearly 200 members of Congress Filed a legal action which we have to resort to do for this subcommittee and our full committee have not taken up any attacks on the constitution such as the clause, article 1section 9 and no foreign power shall give a gift amon yumt of any kind to someone serving in the United States without the consent of congress. We know that the current president has taken hundreds of thousands of dollars from government saudi holy here and leases at the trump hotel for the saudis and god knows where else. Land our ancestors native land ireland and he asked counsel if he could accept a zip, it was deemed so and he didnt accept it. Thats the difference, and many president s over the years have asked for and turned down, some even just small items. Know were dealing with attacking the plaintiffs bar once again. Last week we had the majority from plaintiff at government regulation of business and businesss ability to communicate with the public, somewhat a robo call advocacy, if you can can believe we have that, one of the most hated forms of communication thats been created, because attorneys were illegalities by robo companies and calling and calling and pestering people and bothering peep. Make no mistake this hearing may be framed of one as concern about healthcare, about the potentially harmful effects of attorney advertising on drug cases to the public. But the reality is the aim to protect companies from being held accountable from harmful drugs. Its consistent though with the healthcare that the majority has given the company which is not a healthcare in which president obama has correctly says its more about tax breaks for the rich and less about healthcare. This bill is clear why some would want to post greater restrictions on the able attorneys to communicate with the public about the able of Legal Services. But they would the First Amendment which we should be concerned about as the Constitution Committee and we should be protected the First Amendment and advertising the constitution of protecting free speech. Only with the advertising false or misleading may it be prohibited and only in limited services. So far theres billion little evidence to determine that attorney advertising is false and misleading under further law there are attempts to restrict these advertisements are constitutionally suspect at best. This is once again intruding on state sofrpty off the mantra of that side and socalled tort reform. Regulation lawyers are followed in the authority of Supreme Court, state bars or states in general. Surely the legislator has better use of its time then trying to supplement on matters traditionally. But weve done that on or doing that on gun laws, taking that from the province of states when it purr suits the political convenience of that side. It is a suggest that we could seek to limit attorney advertising in the name of protecting consumer and given the amount. Lawyer drug minute century serves on the danger of medications and the availability of Legal Services for those who are injured. Yet i note that while 114 million may have been spent on attorney drug advertising in the year ending 2016, that fails in comparison to the 6. 4 billion by Drug Companies on advertising in 2016 alone. 114 million by attorneys, 6. 4 billion by Drug Companies. Thats the real threat to consumers is drug advertising getting people drugs and going to their doctors and say, like huey lewis in the news, i need a new drug. We shouldnt try to manipulate patient choices about what medication they should be taking. Our broadcast and online media are full of pharmaceutical ads that its impossible to escape ads from medication and address everything from i reck tile dysfunction and a four hour any other of the day even when children may be watching. Those are areas that should be looked at and screened than drug advertisement. The prescription on which a person should be taken a medication on the risk of doing so should be left to the patient and consultation of a healthcare profession. They should not be looked at by Drug Companies telling you when youre in the moment use our drug. Of the availability of Legal Services and Legal Recourse and where ads are actually false or misleading equipped to take disciplinary action. Congressman and women should stay out of away and protect the First Amendment. I yield back the balance of my time. Thank the gentleman from tennessee for his opening statement. And i mcmr. Good ladder for his opening. Thank you mr. Chairman. On march 2017 and two companies that aggregate plaintiffs for law firms. Based on the responses we received so far from state bars there are fewer reported complaints regarding these commercials. The lack of complaint duds not diminish the fact that severe injury and death resulting from these commercials are being reported to the food and Drug Administration. Id like to read a portion submitted for todays hearing dr. Peacock from texas who created such a case. He states my patient being 66 years old, a female with a history of high Blood Pressure and diabetes has a 4. 8 risk of having a stroke in the next year that would leave her debilitated, upable to speak wearing diapers in a nursing home for the rest of her life rather than taking a pill with a risk of fatal bleed. So summarize it, the patient had a 4. 8 annual sproek risk versus. 0009 of fatal bleeding risk. In medicine we call this a nobrainer and picked the lower of the risks. I went to the patientee bedside to have what a thought would be a relatively straightforward conversation, usually this is a five Minute Exchange about what ate owe fib ral is and what would be a treatment. I answered the questions wrote a prescription and move on to the next patient. That is not how it went. It went to the bedside and said her test showed she had ate owe fibrillation but instead of her asking me what that is she said i know. The obvious next question for me was what antikoeing a land are you talking. She couldnt answer me as she broke down in tears. When she could take she related a story that made me so angry that she had felt tired and weak and had a fluttering feeling in her chest. She when to a physician who did an elect troe cardiogram and diagnosed cart owe fiblation. He found the same problem i had. He spent 30 minutes teaching here about ate owe fibrillation, the risk benefits, the treatment options, answered her questions and gave her a prescription and discharged her home. On wednesday afternoon my patient filled the prescription, went home and took it, all was well until thursday which while watching television she saw the one, the first, 1800 bad drug commercial that implied the drug prescribed was a dangerous drug. Having taken it as instructed with appear dinner she called the doctor and got a friday came, she called her doctor but he didnt have a opening until the following week. She called the 1800 bad number again and got in instructions. She did not take her medication that night. On saturday morning in my er i spent an hour talking with this patient. This was an extremely educated intelligent woman who felt abused by our system. Her physician of many years prescribing a drug to save her life and lawyers coming into her house by way of her television to destroy the doctorpatient relationship and prompt her to engage in behavior that could be fatal. My patient left my er by midday he took her medication before she left. Nobody would know what had happened had she waited to take her medication. Would she be dead from a massive stroelk or in a nursing home at that minutism what if it had been a different patient that just listened to the t. V. And didnt come to my er. Dr. Peacock statement shows these attorney advertisements are having a real world impact. Not only do they create a barrier between doctors and patients but they are endangerering these patients lives. I want to thank or witnesses that appeared today and i look forward to your testimony. Thank you the chairman for his opening statement. The chair recking mr. Conniers for his statement. Thank you mr. Chairman. Top of the morning witnesses for coming. My colleagues without doubt most prescription drugs save lives. Yet its also a fact that some result in injury and death. Even properly prescribed medications cause on average, almost two million hospitalizations every year. Worse yet, 128,000 people die from these medications, annually making prescription drugs the fourth leading cause of death in the United States of america. The Many Americans are injured as a result of taking even food and Drug Administration approved medications. Accordingly attorney advertisements that truthfully inform consumers of the dangers of such medications, as well as the availability of for those who have been injured by such drugs, perform invaluable educational function for our society. Nevertheless, there are those who claim that these advertisements cause some consumers to stop taking their medications and argue that they must be more aggressively regulated. But before we take any such measures we must keep a few points in mind. To begin with, truthful and nonmisleading attorney advertising is protecting in the First Amendment in the constitution. Its wellsettled law that the constitution protects commercials speech including attorney advertising. Only where there is a substantial government interest, may regulation on attorney advertising be upheld. Those complaining about attorney drug advertisements do not contend that such advertisements are false or misleading under current law. In light of this, proposals to lim or restrict attorney advertising may be unconstitutional. In addition, even if attorney drug injury advertisements could be false or misleading, there are already mechanisms to deal with the problem. Every single state as rules of professional conduct for lawyers, that prohibit false or misleading advertising. And every state has a process by which consumers may complain about attorney conduct, should they come across an offending advertisement. Ultimately, the onuss own physicians and the fell professions to be proactive advertising their patients about both the benefits and risks of medications. That burden should not be shifted to attorney advertisements that truthfully, i li to highlight the risk of those medications. Finally, we must view this hearing in the context of other evidence to lim, or even deny access to justice for those harmed by defective medical products. I just must note the hypocrisy of seeking restrict advertising in the name of promoting Public Health and Patient Safety when the house will consider mal practice legislation next week. That bill is unjustifiably broad Legal Protection of Healthcare Providers including completely legal immunity or such providers in any Product Liability lawsuit concerning the provision of drugs or medical devices. Such protections for Healthcare Providers will deny injured patients the ability to be made whole. Further regulation of attorney drug injury advertisements combined with enactment of medical mal practice of the medical mal practice bill would mean that consumers potentially be denied full information about their access to Legal Services concerning defective medications on the front end, and then deny their day in court on the back end. Public health consumer, welfare and the interest of justice will not be served by such an outcome. So, i welcome the witnesses and i look forward to their testimony. And i thank you the chairman. I thank the Ranking Member from michigan from his statement and without objection other members statements will be made part of the record. Before i introduce the wendys i ask for the consent to introduce into the record 13 documents that we received from various individuals. Without objections, so ordered. Now id like to spruce the witnesses. Our first witness is dr. Alana, shes the director of ate yall defiblation services. Second witness is dr. Sean h fleming. Hes a vascular surgeon. Third witness is linda shely. Whos a partner at the shely farm. Our fourth witness is tip pit. These are the witnesses, wherein statement will be written into the record in its entirety. I ask the witnesses to shorten their testimony to five minutes or less. That light will turn green whether you start to speak and yellow at the end of four minutes and 60 seconds wed ask you to wrap up your testimony in a cogent way if you could possibly. Before i recognize the witness its the tradition that you be sworn in. Id ask if you please stan to be sworn in. Raise your right hand. Do you swear that the testimony before you that youre about to give before this committee is the truth, whole truth and nothing but the truth so help you god . Thank you you may be seated. Let the record reflect that all the witnesses have responded in the affirm tifr. Ill recognize our first witness, dr. Ka ten ski. Youll see shortly after you turn on your microphone doctor. You are recognized. Chairman king, Ranking Members of the subcommittee. My name is dr. Lana ive practiced medicine for two check dads. My goals today is to explain why attorney advertising related to medical treatment should be required to represent trans pattern fair, medical views of medical issues and should contain a disclaimer the ad is not presented by a medical professional. Im here to offer the concerns of a concerned doctor, i was not paid to be here and will not receive a financial benefit of any kind. The fact that i sure with you do not come from a survey or think tank. My testimony is based on personal experience, the doctors whose witnessed the harm of uncare less advertisements. My own patients have refused and discontinued prescriptions because they were frightened by false advertisements. The misrepresentations of facts made in mass tort ads causes fear in patients and can lead to treatment noncompliance. Irresponsible attorney advertising undermines the patientphysician relationship. To offer an idea of what ive seen ill describe an incident involving an elderly patient of mine who was diagnosed with ate yall defiblations. I have many examples like this. To reduce her likelihood of stroke i recommended she began a regiment of anticoagulation prescription. Its the physicians responsibility to counsel patients about the side effects. This particularly elderly patient was resistant because of the the potential pleading effects. After several Office Visits involving long discussions, and one on one education i built a Strong Enough relationship with the patient that she agreed and she understood that the risk of her stroke was high and that the benefit of treatment with an anticoagulation agent sufficiently outweighed her bleeding risks. She agreed to take the medicine. She did not want to have a stroke and lose her independence. Three years later she presented to the hospital with a massive stroke. I was confuse requested spoke with her family, they informed me two weeks prior to her admission she received a flier in the mail from