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Serevent (life-threatening complications)
Please complete this claim form to request a free case evaluation from a lawyer listed on BigClassAction.com.
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Defendant:
(who caused the harm?)
Serevent, Advair, Seretide (life-threatening complications)
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Describe your complaint:
(briefly describe the damages you have suffered)
Have you taken one of these asthma medications? Serevent
Yes
No
Seretide
Yes
No
Advair
Yes
No
Other product containing Salmeterol
Yes
No
Have you or a loved one experienced a life-threatening asthma attack?
Yes
No
Have you or a loved one experienced worsening or deterioration of asthma?
Yes
No
Have you or a loved one experienced a heart attack, edema of the heart, congestive heart failure, or other cardiac emergencies?
Yes
No
Have you or a loved one experienced any life-threatening respiratory problems including bronchospasm?
Yes
No
Has a loved one experienced sudden or unexplained death?
Yes
No
Have you or a loved one experienced rash, hives, or other signs of allergic response?
Yes
No
Have you or a loved one experienced reactions of the larynx (voice) or choking?
Yes
No
Do you have a copy of your medical records?
Yes
No
Can you get a copy of your medical records?
Yes
No
*
First name:
*
Last name:
*
Email address:
*
Confirm email address:
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Phone number(s):
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Zip/Postal Code:
Best time & way to contact you:
I would like to be interviewed by a journalist.
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