Recalls in July 2010

By Jon Hood
ConsumerAffairs.com

The suit, filed this week in New York, says that fully 76 percent of hand soaps contain the chemicals triclosan or triclocarbon, a result based on testing of 395 kinds of soap. The complaint also cites a recent study by the U.S. Center for Disease Control that found residues of triclosan in 75 percent of Americans over the age of 6.

The suit accuses the FDA of failing to effectively regulate the chemicals, pointing out that the department proposed banning them from consumers soaps in 1978. Unless and until the 32-year-old rule is finalized, the NRDC says, the chemicals can be widely used with no regulatory oversight.

As a result of the FDA's lengthy delay, consumers remain exposed to triclosan and triclocarban through a variety of over-the-counter drug products, such as antimicrobial hand soaps, that proliferate on the market, the complaint says.

Number of risks

The chemicals can cause a number of undesirable side effects, including damage to reproductive organs and lower levels of sperm and thyroid hormone. The latter can result in a number of additional problems, including reduced intelligence, decreased memory and learning disabilities.

In addition to the risks, the NRDC says that antibacterial soaps are no more effective than the standard variety.

Washing your hands with so-called antibacterial soap containing triclosan or triclocarban actually does nothing different than using regular soap and water, NRDC senior scientist Jennifer Sass said in a statement. Using soap containing these chemicals does not provide an additional benefit as consumers might think, but instead actually comes with potential health risks.

Indeed, the NRDC says that, in April, the FDA admitted that antibacterial soaps offer no additional protection, and also also expressed concern about the development of antibiotic resistance from using antibacterial products and about triclosans potential long-term health effects.

Antibiotic resistance -- the notion that bacteria find ways around antibacterial soaps by developing into new, more potent strains -- is the subject of ongoing debate. A 2007 study by researchers at the University of Michigan showed such resistance during in-house trials, but that result wasn't replicated in other settings. The study did, however, confirm the notion that standard-issue soap kills just as many germs as its antibacterial counterparts, based on skin testing of 238 families who used both types for a year.

The NRDC says it has twice met with FDA officials about the issue, without success. It asks the court to order the agency to finalize the 1978 regulations within 90 days.

The agency is currently considering a voluntary front-of-package food labeling program and is soliciting public comment.

The attorneys general from the 12 states said the regulations should be more than voluntary. They urged the FDA to require food package labeling to provide complete nutritional information -- both good and bad -- to help consumers make informed choices about the foods they buy for themselves and their families.

Nevada Attorney General Catherine Cortez Masto says the "Smart Choices" program was a voluntary labeling program designed by the food industry that claimed to help guide consumer choices by indicating, with a checkmark symbol, whether a product had met certain nutrition criteria.

In some cases, cereals qualified for the healthy symbol because they met the Smart Choices criteria for fiber and vitamins, despite containing 12 grams of sugar per one-cup serving -- approximately 40 percent of the serving by weight. Sugar was the most predominant ingredient in at least one cereal designated a Smart Choice. The attorneys general say a stronger, mandatory rule is needed.

"This labeling program will help people become aware of the nutritional value of food and assist them to choose wisely," Masto said.

Call for specifics

The attorneys general urged the FDA to follow specific principles in its labeling standards:

• Transparency of underlying standards. Any national front-of-package labeling system should be based on publicly-available standards, including an updated version of the Dietary Guidelines for Americans 2005, containing the best available nutritional criteria.

• Applicability. Front-of-package labels should apply to as many foods as possible and not require payment by food manufacturers beyond a reasonable licensing fee.

• Understandability. Labels should be readily understandable by people of varying educational levels, based on the best consumer research.

• Helpfulness. Labels should be designed to facilitate informed and healthy consumer choices.

• Uniformity. A national, uniform front-of-package label should be the sole nutritional label on the front of food packages. Competing graphics or messages may confuse or mislead consumers and undermine the effort to provide clear information.

"Only full disclosure of nutrition information will provide clear, consistent guidance to consumers," said Connecticut Attorney General Richard Blumenthal. "Full disclosure also will encourage food manufacturers to offer healthier alternatives by reformulating existing products and providing new ones."

The comments to the FDA were sent by the attorneys general of Arizona, Connecticut, Delaware, Maine, Maryland, Nevada, New Hampshire, New Jersey, Ohio, Oregon, Tennessee and Vermont.

July 29, 2010
The U.S. Food and Drug Administration is warning that inadvertent exposure to Evamist through skin contact with patients using this product has the potential for adverse effects in children and pets.

Evamist contains estradiol, an estrogen hormone, and is used in women to reduce hot flashes during menopause. The drug is sprayed on the skin between the elbow and wrist, on the inside of the forearm. The FDA said it is reviewing reports of adverse events in children and pets who were inadvertently exposed to this topical estrogen product.

Women using Evamist need to be aware of the potential risks to children who come in contact with the area of skin where this drug is applied, said Julie Beitz, M.D., director of the FDAs Office of Drug Evaluation III. It is important that people know to keep both children and pets away from the product to minimize exposure.

Evamist was FDA approved in 2007. From July 2007 to June 2010, FDA received eight post-marketing cases of unintended exposure to Evamist in children ages 3 years to 5 years.

Adverse events reported in unintentionally exposed children include premature puberty, nipple swelling and breast development in females, and breast enlargement in males. Since 2007, two reports of secondary exposure to Evamist in dogs also have been received by FDAs Center for Veterinary Medicine. Pets exposed to Evamist may exhibit signs such as mammary/nipple enlargement and vulvar swelling.

Patients using Evamist should not allow children to make contact with the area of the arm where Evamist is sprayed and should wash the childs skin with soap and water as soon as possible if contact does occur. Pets also should not be allowed to lick or touch the arm where Evamist is sprayed as small pets may be especially sensitive to the estrogen in this product.

If direct contact with the arm where Evamist was sprayed cannot be avoided, it is recommended that women wear a garment that covers the area where the drug was applied.

At this time, it is unknown whether unintended exposure can occur with other topical estrogen products. The FDA said it is continuing to review adverse event reports and evaluate ways to reduce unintended exposures to these products.

Consumers and health care professionals should report any side effects from Evamist by using the FDAs MedWatch Adverse Event Reporting program at www.fda.gov/MedWatch or by calling 800-332-1088.

The defect consists of an incorrect warning statement related to securing an unoccupied booster seat. This statement is inconsistent with Cybex recommended practice, which is to always secure an unoccupied booster with the vehicle seat belt.

If a caregiver follows the warning as written, there is an increased risk that the unoccupied booster seat could strike a vehicle occupant and cause injury in a severe crash.

The incorrect warning statement appears in the owner's manual and on the headrest warning label. In a sharp turn, crash, or sudden stop, an unsecured booster seat can be thrown around and could injure vehicle occupants.

Regal Lager will notify caregivers and provide a new label to be affixed over the old label and owners will also receive a new owners manual free of charge. The safety campaign is expected to begin on or about August 10, 2010.

Owners may contact Regal Lager toll-free at 1-800-593-5522 between 8:30 am and 5:30 pm EST. Regal Lager's recall campaign number is 2010-01.

Consumers may contact the National Highway Traffic Safety Administration (NHTSA) at 1-888-327-4236 (TTY: 1-800-424-9153) or at www.safercar.gov.

The firm has received 53 reports of fuel line damage. No injuries have been reported.

This recall involves gas-powered Husqvarna riding lawn tractors designed for residential use. The lawn tractor's model and serial numbers are printed on an identification plate located underneath the tractor seat. Models and serials numbers included in the recall are: GTH27V52LS lawn tractors with model numbers 96043009100 and 96043009900, with serial numbers 010810A00XXXX through 05061000XXXX.

The tractors, made in the United States, were sold by Husqvarna authorized dealers nationwide from January 2010 to May 2010 for about $3,000.

Consumers should immediately stop using the recalled riding tractors and contact Husqvarna to arrange a free repair.

For more information or to schedule a free repair, contact Husqvarna toll-free at (877) 257-6921 between 8 a.m. and 8 p.m. ET Monday through Friday, and between 8 a.m. and 3 p.m. ET Saturday. Consumers can also visit the firm's website at www.husqvarna.us/july2010Alert.

The recall is being conducted in cooperation with the U.S. Consumer Product Safety Commission (CPSC).

The company said the pump might not be properly activated under some conditions, which could result in engine cut-out with minimal warning.

Dealers will download revised software free of charge. Owners may contact Jaguar at 1-800-452-4827 about Recall No. J017.

Consumers may contact the National Highway Traffic Safety Administration (NHTSA) at 1-888-327-4236 (TTY: 1-800-424-9153) or at www.safercar.gov.

Excessive fuel leakage can cause a fire.

Dealers will attached a protector tube to the gasoline recirculation tube when the recall begins in August.

Owners may contact Nissan at 1-800-647-7261.

Consumers may contact the National Highway Traffic Safety Administration (NHTSA) at 1-888-327-4236 (TTY: 1-800-424-9153) or at www.safercar.gov.

The company said that due to a programming error, a lubrication hole within the transmission was omitted, possibly leading to transmission failure over time.

Dealers will drill an oil lubrication hole when the recall begins in August. Owners may contact Subaru at 1-800-782-2783 about Recall N. WVS-29.

Consumers may contact the National Highway Traffic Safety Administration (NHTSA) at 1-888-327-4236 (TTY: 1-800-424-9153) or at www.safercar.gov.

BMW has not yet set a date for the recall.

Owners may contact BMW at 1-800-525-7417.

Consumers may contact the National Highway Traffic Safety Administration (NHTSA) at 1-888-327-4236 (TTY: 1-800-424-9153) or at www.safercar.gov.

A federal judge shot down Coca-Cola's attempts to dismiss a lawsuit claiming the drink's labeling is deceptive, setting the stage for further litigation.

Judge John Gleeson, of the U.S. District Court for the Eastern District of New York, wrote a 55-page opinion asserting that Vitaminwater's name potentially "reinforce[s] a consumer's mistaken belief that the product is comprised of only vitamins and water," and ignores "the fact that there is a key, unnamed ingredient [sugar] in the product."

Judge Gleeson also said that labels touting the beverage as "healthy" violate the Food and Drug Administration's so-called "jelly bean rule." That rule, enacted in 1994, prohibits manufacturers from labeling a product "healthy" just because it has low levels of fat, cholesterol, and sodium. Rather, the "healthy" moniker is only acceptable if the product contains minimum levels of certain vitamins, protein, and fiber, among other things.

Drink comparable to Gatorade

The Center for Science in the Public Interest (CSPI), which is representing the plaintiffs, issued a statement endorsing the court's decision.

"Vitaminwater is no more than non-carbonated soda, providing unnecessary added sugar and contributing to weight gain, obesity, diabetes, and other diseases," the statement reads. "We look forward to representing all Americans whom Coke has deceived."

Indeed, despite Vitaminwater's health-conscious image, the truth is that the beverage isn't much better for you than competing sports drinks. Compare, for example, a 20-ounce bottle of grape-flavored Vitaminwater with an identical bottle of fruit punch-flavored Gatorade. An eight-ounce serving of either yields 50 calories -- meaning that a bottle of either drink packs 125 calories. (To put things in perspective, it takes a 150-pound woman, running a ten-minute mile, over ten minutes on the treadmill to burn that off.) And the Vitaminwater has only slightly less sugar per serving -- 13 grams to the Gatorade's 14.

Long line of CSPI suits

The suit is the latest in a long line filed by CSPI, which touts itself as the "organized voice of the American public on nutrition, food safety, health and other issues." The group gained publicity in June when it filed a lawsuit alleging that McDonald's heralded Happy Meals violate consumer protection statutes in several states by using toys to lure kids to eat "unhealthy junk food."

And last November, the organization named the Regal movie theater chain the "Best Supporting Actor in the Obesity Epidemic," after a CSPI-commissioned lab analysis found that a medium popcorn and soft drink from the theater contained 1,610 calories and 60 grams of saturated fat -- comparable, CSPI said, to "three McDonald's Quarter Pounders with 12 pats of butter."

In a July 22 letter, the Food and Drug Administration (FDA) reminds health professionals that using unapproved IUDs raises concerns about effectiveness and safety -- as well as the potential for fraud and counterfeiting.

"Federal law requires that IUD/IUSs (intrauterine systems) be FDA-approved prior to marketing. This law is designed to protect patients from products that are unsafe and ineffective," Theresa Toigo, FDA's liaison with health professionals, says in the letter. "The recent issue with patients in Rhode Island unknowingly receiving imported, unapproved IUD/IUSs highlights the unacceptable risk patients may be exposed to when a product's identity, purity, source, handling, and storage cannot be verified."

Still, patients can use their FDA-approved IUDs with confidence, Toigo says.

Many risks

FDA experts say women who received unapproved IUDs from practitioners in Rhode Island, Massachusetts, and Kentucky could be at an increased risk for unwanted pregnancy.

The small, T-shaped devices -- often made of flexible plastic or copper wire -- are inserted into a woman's uterus to prevent pregnancy. Some IUDs also deliver small amounts of hormone as added protection from pregnancy.

FDA says women should not try to remove IUDs by themselves. The agency is advising women who think they may have an unapproved IUD to use another form of birth control -- such as condoms, birth control pills, or the patch -- and contact their health care professional. Women may want to ask:

• What advantages are there for keeping my IUD in?

• Should I think about having my IUD removed?

• If I keep my IUD in, how long should I use another form of birth control?

• If I want my IUD removed, can I get a new, FDA-approved one?

• I don't want to use condoms. Will other birth control products, such as the pill, patch, or ring, be equally effective?

• Will this affect my ability to get pregnant in the future?

• What should I do if I think I'm pregnant?

Nationwide problem

What started out as a Rhode Island investigation has spread beyond the state's borders. The FDA is aware of the use of these unapproved products in several states and is continuing to investigate.

FDA says doctors, nurses, midwives -- and possibly patients themselves -- might buy unapproved products from what appear to be Canadian or other foreign websites in a bid to save money. Purchasing medical products from websites that are outside the U.S. may be illegal and may increase the risk of receiving a potentially harmful product, since many websites sell products that are not FDA-approved and could be manufactured in other countries.

"Unapproved products bring a lot of unknowns into the equation," says FDA compliance officer Kathleen Anderson. "An Internet ad may claim to sell IUDs made in Canada, but there's no way to be sure. They might have been made anywhere in the world and in unsanitary or undesirable conditions."

Advice for consumers

FDA investigators routinely monitor the Internet for the sale of unapproved drugs and devices in an effort to protect the public, but the rapidly growing number of websites trafficking in fraudulent medical products means consumers must remain alert.

Experts advise consumers to learn how to buy health-related products safely over the Internet. Legitimate Internet pharmacies are licensed by the appropriate state board of pharmacy and follow laws and regulations of the state where they operate.

Legitimate Internet pharmacies will also display a seal from the National Association of Boards of Pharmacy -- known as VIPPS seal or Verified Internet Pharmacy Practice Sites. There is also a list of VIPPS pharmacies.

FDA is also asking the public to report information about the distribution of unapproved IUDs to the agency's criminal investigators unit.

By Jon Hood
ConsumerAffairs.com

The ruling concerned factual findings from Engle v. RJ Reynolds, a Florida class action brought on behalf of consumers who smoked before warning labels were required on cigarette packages. In that case, the jury concluded that the cigarettes smoked by the plaintiffs were defective and addictive, and that the manufacturer failed to properly disclose the danger of smoking to consumers.

The Florida Supreme Court eventually decertified the Engle class but allowed individual plaintiffs to file suit by January 2008. As a result, nearly 4,000 such cases are now working their way through Florida federal courts.

In its decision, the court said that the findings must be given the same preclusive effect in this federal court case that they would be given if the case were in state court.

However, the court also said that the plaintiffs are charged with a considerable task -- to show with reasonable certainty that facts pertinent to their case were actually decided by the Engle jury. The nuanced ruling allowed both sides to spin the decision to their advantage.

The plaintiffs pointed out that the court left open the ability to use prior findings in new cases, provided that the plaintiffs meet the requirements set forth in the ruling. <

We believe that this is a victory for the thousands of injured smokers who have been denied their day in court for over a decade, said Woody Wilner, an attorney for the plaintiffs, in a news release.

Samuel Issacharoff, another of the plaintiffs' attorneys, branded himself delighted, and pointed out that the holding frees up thousands of cases, on hold pending the decision, to proceed.

Tobacco companies: No automatic and unlimited right to findings

But the tobacco companies said that the ruling created a steep hill for plaintiffs to climb. Altria Client Services Senior Vice President Murray Garnick said that the court rejected arguments by plaintiffs that they have an automatic and unlimited right to use the findings.

Some went even further and said that the ruling is grounds for throwing out all plaintiff verdicts in cases that arose from Engle.

The logic of this opinion supports our position that every Engle-related judgment to date against Reynolds in the Florida state courts should be reversed, said R.J. Reynolds general counsel Martin Holton III.

Philip Morris similarly said in a statement that [n]one of the plaintiffs who have obtained verdicts in state court have complied with the requirements set forth by todays rulings.

Indeed, tobacco manufacturers are in the process of appealing a number of verdicts against them, arguing that judges improperly read the Engle findings to juries and told them that they applied to the case at issue. In addition to the 4,000 federal suits directly affected by the recent ruling, there are 4,000 additional cases pending in Florida state court. Many state judges will likely apply the holding to those cases as well.

The company said it had received a report of a 5-year-old boy in Tacoma, Washington who became entangled in an unsecured continuous loop bead cord on a roller shade in May 2009. No medical treatment was required.

This recall involves all roller shades that do not have a tension device attached to the continuous loop cord and all custom, made-to-order Roman shades. Brand names include Smith+Noble, Christopher Lowell by Smith+Noble, Jessitt Gold, Shop Blinds and Window Elements.

The blinds were sold exclusively at Smith+Noble online and through catalog sales nationwide from 1998 through April 2010 for between $100 and $1,600, depending on custom size and options.

Consumers should immediately stop using the Roman shades and contact the Window Covering Safety Council (WCSC) for a free repair kit at (800) 506-4636 anytime or visit www.windowcoverings.org. Consumers should check the roller shades to make sure the tension device provided is attached to the continuous loop cord and installed into the wall. If not attached, consumers should attach the tension device securely to the wall. If they no longer have the tension device, consumers should immediately stop using the roller shades and contact WCSC to receive a free replacement tension device.

For additional information, contact Smith+Noble toll-free at (877) 228-7683 between 6 a.m. and 6 p.m. PT Monday through Friday and between 7 a.m. and 4 p.m. PT Saturday and Sunday, or visit the firm's website at www.smithandnoble.com/productrecallinformation.

The recall is being conducted in cooperation with the U.S. Consumer Product Safety Commission (CPSC).

The firm has received five reports of lacerations to fingers, including one that required stitches. Four of the injuries occurred when consumers were trying to retrieve a wick that had fallen into the canister.

The torches, made in China, were sold at CVS/Pharmacy, Rite Aid and Dollar Tree/Deals$ stores from February 2008 through March 2010 for between $3 and $5.

Consumers should immediately stop using the recalled torches and contact Atico International USA for instructions on obtaining a full refund.

This recall involves bamboo torches that have a black metal canister with a smooth black metal lid. The torches are used to light outdoor gatherings. The following are the UPC numbers included in this recall. The UPC number can be found on the tag.

For additional information, contact Atico International USA toll-free at (866) 448-7856 between 9 a.m. and 5 p.m. ET Monday through Friday or visit the companys website at www.aticousa.com

The recall is being conducted in cooperation with the U.S. Consumer Product Safety Commission (CPSC).

The pacifier has a ring-shaped handle and a round-shaped mouth guard. "Kario" is printed on the handle side of the mouth guard, and "Mygra" is printed on one side of the handle. The nipple is filled with corn syrup.

The pacifiers, made in Mexico, were sold at independent grocery stores in California and Texas from October 2009 through March 2010 for about 25 cents.

Consumers should immediately take the recalled pacifiers away from children and contact Antonio Flores for a refund or exchange.

For additional information, contact Antonio Flores collect at (619) 395-4543 Monday through Friday between 9 a.m. and 5 p.m. PT.

The recall is being conducted in cooperation with the U.S. Consumer Product Safety Commission (CPSC).

The firm has received five reports of lacerations to fingers, including one that required stitches. Four of the injuries occurred when consumers were trying to retrieve a wick that had fallen into the canister.

The torches, made in China, were sold at CVS/Pharmacy, Rite Aid and Dollar Tree/Deals$ stores from February 2008 through March 2010 for between $3 and $5.

Consumers should immediately stop using the recalled torches and contact Atico International USA for instructions on obtaining a full refund.

This recall involves bamboo torches that have a black metal canister with a smooth black metal lid. The torches are used to light outdoor gatherings. The following are the UPC numbers included in this recall. The UPC number can be found on the tag.

For additional information, contact Atico International USA toll-free at (866) 448-7856 between 9 a.m. and 5 p.m. ET Monday through Friday or visit the companys website at www.aticousa.com

The recall is being conducted in cooperation with the U.S. Consumer Product Safety Commission (CPSC).

The recalled circuit breakers labeled "Square D" or "SQD" have been determined to be counterfeit by Square D and can fail to trip when they are overloaded, posing a fire hazard to consumers.

The counterfeit circuit breakers are marked as Square D in the QO series. The models are QO115 (about 7,800 units), QO120 (about 26,300 units), QO130 (about 3,200 units), QO215 (about 350 units), QO220 (about 720 units), QO230 (about 1,780 units), QO240 (about 1,130 units), QO250 (about 1,150 units) and QO260 (about 1,150 units).

Genuine Square D QO breakers have the following: (1) the amp rating written on the handle in white paint on the front of the breaker, (2) the Square D insignia molded onto the breaker side; (3) a yellow chromate clip with half of the top of the clip visible. If your breaker does not match this description, it could be counterfeit.

The breakers were sold to electrical product distributors and wholesalers nationwide from March 2005 through July 2006. Single pole breakers sold for between $3 and $4, double pole breakers were sold for between $8 and $9.

Consumers should immediately contact Miami Breaker to determine if their circuit breaker is counterfeit and if necessary, arrange a free inspection and replacement.

Consumers can contact MBI at (800) 941-1112 between 9 a.m. to 5 p.m. ET Monday through Friday. Consumers can email the firm at info@miamibreaker.com.

The recall is being conducted in cooperation with the U.S. Consumer Product Safety Commission (CPSC).

The report provides detailed guidance on two classes of drugs to treat ADHD (stimulants and non-stimulants). In a related blog, Consumer Reports' medical adviser, Dr. Orly Avitzur, discusses how the ADHD label has evolved, as evidenced by the small fraction of parents -- only 22 percent -- who said it was problematic having a child labeled as having ADHD.

"The result is that students and surprisingly professionals in several fields, including medicine, are seeking out an ADHD diagnosis in order to excel through the use of drugs or accommodations, such as more time to take tests," said Dr. Avitzur. Eight percent of parents whose kids had received a diagnosis told Consumer Reports Health that getting accommodations for standardized tests, like the SAT., was a reason for seeking an ADHD diagnosis.

ADHD treatments

Consumer Reports Health found that most families with children with ADHD turn to medication -- a full 84 percent put them to use at some point -- with more than half of the kids in the survey trying two or more medications in the past three years. The average age of children who tried ADHD drugs was 13 years. Many children with ADHD, including those who are not treated, improve as they progress into their teenage years and into their 20s.

According to parents surveyed, children who tried medications had slightly better outcomes than those not trying medications. Medication helped the most with academic performance and behavior at school. Medication was less helpful with behavior at home, social relationships, and self esteem.

And while medication was cited as the strategy most helpful in managing ADHD, only 52 percent of parents agreed strongly that if they had to do it over again, they would have their kids take medications and 44 percent wished there was another way to help their child.

Consumer Reports Best Buy Drugs, a public education project that rates prescription drugs for more than 20 common conditions based on safety, efficacy, and cost, identifies the two main classes of medications that are available for ADHD. Stimulant medications, which include amphetamine and methylphenidate-based medications, are generally considered the first line of medical treatment for a typical child with ADHD. Children who do not respond well to stimulants, and those with co-occuring conditions such as tics or anxiety, are candidates for nonstimulant medications such as atomoxetine (Strattera) or guanfacine (Intuniv).

While medications can help children concentrate, feel calmer, and think before acting, ADHD medication side effects are considerable in number and frequency. The most prevalent side effects, in descending order, include decreased appetite, sleep problems, weight loss, upset stomach, and irritability.

Of all the treatments, 35 percent of parents said medication helped the most when it comes to academic performance and behavior at school. Medication helped well with behavior at home (was very helpful for 26 percent) and fairly well with social relationships (very helpful for 19 percent) and self esteem (very helpful for 18 percent).

Team approach

Parents told Consumer Reports Health that nondrug strategies (such as changing the child's school) also worked very well. Leading strategies for handling ADHD include:

• Switching to a school better suited to help with ADHD helped 45 percent.

• Giving one instruction at a time helped 39 percent.

• Having a private tutor or learning specialist work with the child helped 37 percent.

• Providing structure by maintaining a schedule of activities helped 35 percent.

Most children (58 percent) had seen two or more treatment providers in the last 12 months. Given that each provider may have strengths in different areas, visiting more than one practitioner may help some families achieve better results. The parent's role as coordinator of care is critical.

Consumer Reports Health suggests these steps for coordinating care:

• Obtain copies of any medical, psychological, and testing records related to your child's ADHD condition. The more information you can provide to new treatment providers, the better.

• When enlisting a new professional to help your child, request a baseline measure of your child's behavior and functioning. This is an important step for three reasons: It provides an objective indication of a child's diagnosis that parents can bring to schools or other places as proof of diagnosis; it helps professionals know that tests have been previously administered and may save time and money; and it allows parents and treatment providers to monitor a child's progress from the beginning of treatment.

• Keep a list of all treatment providers who have worked with your child.

• Maintain a list of all the strategies you've tried and the changes you detected as a result.

• Explore an ADHD treatment center (where different types of providers work together at the same location) if you are unable to take on the role of coordinator of your child's treatment.

Those voting against the drug, developed by Vivus, cited potential side effects, such as increased heart rate, birth defects, and psychiatric problems. Those voting in favor of the drug said obesity itself was a greater health risk.

The recommendation goes to the FDA, which may or may not follow it. The agency will make a decision in October and, because of the split vote, the decision is harder to predict.

"No one wants to conduct a large public health experiment on the population," said Dr. Elaine Morrato, a panel member from the University of Colorado, Denver.

Obesity drug obstacles

Drug companies have placed new emphasis on developing medications to promote weight control, as obesity has become a greater public health concern. The track record is not inspiring.

The last major weight control drug disaster was fen-phen, which was withdrawn from the market in 1997 after it was shown to cause heart valve damage. Qnexa includes phentermine, part of the phen-fen cocktail that was allowed to stay on the market. The drug company said people taking Qnexa in clinical trials reported success in losing weight.

The company said it is holding out hope the FDA will approve Qnexa in spite of the advisory panel's vote. CEO Leland Wilson held a conference call with reporters following the vote and said the company will not give up on the drug.

"The advisory committee vote is a recommendation, not a final step," he said.