If you believe that you or someone close to you may have a personal injury or wrongful death claim, please fill out and submit the form below for a free evaluation.

There is no charge for this evaluation

Injured Person Information:

Whom are you inquiring on behalf of? Minor Other Self

If you are NOT inquiring on your own behalf, what is your relationship?

Is the person deceased? Yes No

If deceased, the cause of death as stated on the death certificate:  

Was there an autopsy performed? Yes No   n/a

Baycol

During what period of time was Baycol taken?
Start End

List names/addresses of any doctors who prescribed Baycol:

Was Gemfibrozil (Lopid) taken while taking Baycol?
Yes No  

Were any other medications taken while taking Baycol?
Yes No  

If yes, please list any other medications taken while taking Baycol:

Has Rhabdomyolysis been diagnosed? Yes No  

Have any of the following problems occured while taking Baycol?

Muscle Pain Yes No  

Liver Problems Yes No  

Kidney Problems Yes No  

General Weakness Yes No  

Dark Urination? Yes No  

Malaise? Yes No  

Nausea Yes No  

Death Yes No  

Describe any other injuries or negative effects associated with Baycol use:

Other Information: