Popular birth control sending healthy women to hospital, including Utah athlete

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Erika Langhart had a zest for life. By the time she finished college she had already visited 37 countries.

After graduating from college she was working in Washington and thinking about going to law school.

Her life was full of promise, but all that ended suddenly when she was just 24 years old.

In Phoenix, Karen Langhart was looking forward to her daughter coming home for Thanksgiving when she received a call from Erika’s cell phone.

In an interview with CNN, Erika’s mom said she “picked up the phone and answered it, ‘Hi Schmoo, can’t wait to see you’ — Schmoo-bear is our nickname for her — and it was Sean.”

With groceries in hand, Erika’s boyfriend, Sean Coakley, had arrived at her apartment to make dinner and found Erika collapsed on the floor.

The fire department and paramedics were already on the scene. The attendant at the front desk had heard Erika screaming for help and called 911.

“[The paramedics] tried to revive her with CPR and while they were in the apartment, I think she had a heart attack and then two more on the way to the hospital in the ambulance, and another one in the hospital, and she never woke up,” Erika’s father, Rick Langhart, said.

Karen knew it was serious when the emergency room doctor said they needed to come to the hospital in Arlington, Virginia.

She said the doctor asked her whether Erika was using any birth control.

According to Karen, when she told him Erika was using the NuvaRing,

“He said well there’s a link between NuvaRing and pulmonary embolisms,” Karen Langhart said.

Rick Langhart said doctors removed the NuvaRing immediately. “It was, it was a nightmare,” he added.

By the time Rick and Karen arrived at the Virginia Hospital Center, Erika was in a coma, in the ICU.

“They had determined that Erika had no brain activity and that because of her heart attacks they basically told us that she was brain dead and that’s it,” Rick Langhart said, fighting back tears.

Hospital records cited the NuvaRing as a risk factor for Erika’s multiple pulmonary embolisms.

Records confirm what Erika’s parents told CNN: that a blood clot started in an artery/vein in her right thigh and traveled to her lungs, causing “massive” pulmonary embolisms and “multiple episodes of cardiac arrest” on the way to the hospital and overnight.

The Langharts never heard their daughter’s voice again. She died on Thanksgiving.

“We miss her so much,” Karen Langhart said.

Megan Henry’s close call in Utah

Less than a year later, 2,000 miles away in Utah, Megan Henry had the scare of her life.

Henry, it turns out, was a classmate of Erika Langhart’s at American University. She’s training to compete in the Olympics in skeleton, a type of high-speed downhill sledding. The scare that shook her in August 2012 threatened her Olympic dreams.

Within weeks of starting the NuvaRing, Henry said she collapsed during training, unable to breathe.

“I mean I was struggling, I was struggling to breathe.” Henry said. “It’s like an elephant was sitting on my chest all the time.”

After seeing five doctors who were unable to tell her what was wrong, she finally got a diagnosis from a pulmonologist. He told her he thought she had blood clots in her lungs.

“I said, you know I started taking this birth control, is it related to this?” Henry said. “And he was like, yeah, I definitely think that you have blood clots and it’s from the birth control.”

X-rays, followed by an ultrasound and a CAT scan, revealed that Megan’s life was in danger.

“[The doctor] started to tell me, you have multiple pulmonary embolisms in both lungs,” said Megan. “They’re sending an ambulance, they’re going to come and they’re going to rush you to the emergency room … it just really took me by surprise and you know I knew it was something bad but I never imagined it would be something like that.”

According to her hospital discharge papers, the NuvaRing Henry was using “was probably the risk factor” for her pulmonary embolisms.

Henry went from peak physical condition to using a breathing machine. She was put on blood thinners, too. Her doctors told her it’s too risky to use hormonal birth control again.

“Easy. Safe. That’s really how it was presented — easy, safe, low-dose hormone — you know, and it turns out it wasn’t. It wasn’t that at all,” she said.

Even though NuvaRing has about the same risk for blood clots as newer birth control pills, Henry said she wishes she had known that the incidence of life-threatening blood clots is double with NuvaRing compared to older birth control pills.

“There are other options out there for birth control that have risks, but not doubling the risks,” Henry told CNN. “If I would have known that I never would have taken it.”

And thinking about what happened to her classmate, Erika, Henry said, “I think if I knew what I know now and, you know, if Erika had known that, a number of people, I think that they would have made a slightly different choice.”

NuvaRing

The NuvaRing is one of the most popular birth control products on the market. A flexible ring inserted vaginally, it releases a combination of hormones. By 2010 as many as 830,000 women were using the vaginal ring as a contraceptive method, according to the Guttmacher Institute, a nonprofit organization advancing sexual and reproductive health worldwide. At least 10.5 million women use hormonal birth control pills.

The NuvaRing was approved by the FDA in 2001 and became available to women in the United States in 2002. The Dutch pharmaceutical company, Organon, developed the device and manufactured it until 2007 when the company was sold to Schering Plough Corporation, which was then acquired by Merck in 2009. According to Merck, the NuvaRing is sold in more than 50 countries, and 44 million prescriptions have been filled for women in the United States alone.

The NuvaRing dispenses what’s called a third-generation progestin, or synthetic hormone. When it first came on the market, the device was touted as a breakthrough — inserted vaginally to release a “continuous low dose of hormones.” It stays in for three weeks, so no bother of taking a daily birth control pill. The ring was branded in a television commercial as “a different way to do birth control” and “Oh! It’s easy to use.”

Convenient? Absolutely. But safe? That depends on whom you ask.

The Langharts had no idea the NuvaRing birth control their daughter had been using for four years had already been linked to other women’s deaths, according to unconfirmed claims of problems reported to the FDA.

Merck acknowledges a very small risk of blood clots but stands by its product, saying, “There is substantial evidence to support the safety and efficacy of NuvaRing.”

While studies have shown that the number of severe adverse events is extremely low — fewer than 11 cases per 10,000 women who use it for a year — the families who have lost loved ones point out that the incidence of life-threatening blood clots is double with NuvaRing than with older birth control pills.

Since the mid-1990s there have been multiple studies suggesting that while third-generation progestins are generally safe, they are approximately twice as likely to cause blood clots than older, second-generation birth control pills.

Merck denied CNN’s request for an on-camera interview. Instead, it gave this statement: “While there is a very small risk of a blood clot when using NuvaRing or any combined hormonal contraceptive, this risk is much less than the risk of blood clots during pregnancy and the immediate post-partum period.”

Among 10,000 women, between five and 20 women run the risk of developing a serious blood clot during pregnancy; the risk increases to between 40 and 65 women during the 12-week postpartum period.

Among 10,000 women in a year using combination hormonal contraceptives — that includes birth control pills, the ring and the patch — the risk of developing serious blood clots ranges between three and 12 women.

NuvaRing users are on the higher end of that risk. Two studies conducted in 2011 and 2012 reveal the risk of developing a serious blood clot among NuvaRing users is 11.4 and 8.3 per 10,000 women in a year, respectively. The NuvaRing’s label was updated in 2013 by the FDA with information about both studies.

The Langharts, Megan Henry, and 3,800 others sued Merck. According to claims filed in federal and state courts, the lawsuits allege Organon, the original manufacturer of the NuvaRing, “failed to adequately warn consumers about a heightened risk of blood clots associated with the use of NuvaRing, even though the manufacturer was aware that NuvaRing posed greater risks than other hormonal contraceptives.”

In February, without admitting any wrongdoing, Merck agreed to pay $100 million in damages.

But the Langharts did not settle, insisting Merck be held accountable for what the family said was Merck’s failure to properly warn users of the risk. They believe what Merck is getting away with is “criminal.”

“I don’t understand why a company in the United States would allow that kind of product on the market. It’s not the way Americans do business,” Rick Langhart said. “And for them to do what they do in total disregard for what’s going on. It’s criminal to me.”

Instead, to honor Erika’s memory, they decided to create a nonprofit to inform women of the dangers they believe are related to the NuvaRing and the comparative risks of all forms of hormonal contraceptives. The nonprofit’s name, “Informed Choice for Amerika,” honors their daughter’s name.

By Randi Kaye and Shawna Shepherd for CNN

19 comments

  • Amanda

    I’m scared to ever get another PE! I can relate to these women. I was on the Nuvaring too. Im not even 21 yet and my doctors told me I should have died. I wish Nuvaring never existed!

  • Bob

    Sadly I know a man whose wife died from one of the patch birth control, they had two young twin boys. People need to realize this isn’t 100% safe your messing with the body’s natural functions. Mt wife won’t risk it after seeing stories like this. We will just stick to condoms.

  • Gustav

    Careful anyone reading this article. A lot of these figures comes from a questionable Vanity Fair article published a couple years ago. There’s a lot of questions that don’t go answered here and a lot of doctors really just aren’t that familiar with birth control as a whole, let alone the Nuvaring. The best thing to do is consult your OB/GYN and make sure to disclose everything about your personal health so they can best educate and perscribe for you.
    Here’s an even more informative article addressing the topic that is rehashed by this one.
    http://www.womenshealthmag.com/health/nuvaring
    Seriously, just talk to your gynecologist and physician rather than get all your perscription advice from Fox news.

    • Noelle

      Thanks for posting the women’s health article here, great article! Big points to take away from this: “double the risk” of other birth controls means a difference of ~0.05 percent to 0.1 percent– which is still negligible; the biggest risk for clots in women is pregnancy at closer to 0.2%– you could say that getting pregnant more than doubles your risk for clots than any birth control. Everyone should know the risks and signs/symptoms of blood clots (http://www.hematology.org/Patients/Clots/Pregnancy.aspx).

      Anything endorsed by Fox News (or any news outlet/media) should be fact-checked. They’re really into the sensational stories, but less concerned about accurate representation. In perspective, yes, loss of life is tragic, but stories like this wouldn’t exist if blood clots (DVTs, PEs, stroke, heart attack, etc.) weren’t adverse effects of drugs– somebody has to be that 0.08%. These stories aren’t incredibly common because the incidence is 1/1,000 to 1/10,000, when you clump all the sad stories together, it looks scary and more significant (statistically) than it really is. We take risks with these odds every day.

      • MariaConchita

        This article is reporting on a CNN news story. Lets get the defamation of “Fox News”-is-made-up-news-so-ignore-it out of the way to actually pay attention to concerning trends no matter what credible news source it comes from. Thanks.

    • Tina

      Seriously, get your information from all sources and use your own discernment to decide. I never rely on my doctor alone because most of their pharmaceutical education comes from the pharmaceutical companies. No one cares more about your health than you so own it!

  • Christina

    I read the literature that came with the prescription when I tried it quite a few years ago and it stated very clearly that this was a risk. People are really bad at reading the warnings and side effects that are possible and that’s why you get this kind of article happening (as well as the anti vax stuff). You get the information, you just didn’t bother to read it. Your doctor is not all seeing and all knowing and is not going to list every possible little thing that can happen to you – that’s why there’s the literature. Any foreign substance introduced to your body has the possibility of killing you in the right circumstances and you should effing read the paper insert before you use it instead of running around suing companies and blaming them. That’s why health care is so expensive in this country and that’s why there’s so much anti science.

    • Noelle

      I completely agree! A little research and reading the information that is available goes a long way. I think the trick is that there are horrible side effects to almost every drug but the incidence is usually ~0.5% or lower so the risk is pretty low… but that also doesn’t mean it won’t happen to you. It gets tough balancing your risk factors and the potential side effects of medications without becoming a paranoid lunatic! You can’t always predict it but that’s why it’s crucial to do the reading and talk with your doctor so you know early signs and get help when you should.

  • Karyn

    I too was a Nuvaring user and suffered a DVT due to it, over 10yrs ago. Luckily my doctors caught it in time before it became a PE.

  • Thea

    Never used NuvaRing, however, I am on Nexplanon. Birth control should be as safe as possible, since we are trying to prevent greater health risks.

  • christina Rodriguez

    This is happening to me right now I was on the patch and 3 weeks later I was in so much pain and come to find out I had a blood clot in my right lung. And I was scared for my life now I’m on blood thinners. My life is not the same anymore. I’m scared and justice need to be done cause I could of died from this blood clot. And I had pneumonia on top of it all.

  • The Yakima Kid

    Diaphragms are highly reliable, as long as they are used regularly. Highly motivated couples have a failure rate with the diaphragm of 2% or less. Condoms and foam used together are also highly effective.

  • Erin

    Read the whole article. It clearly states that your risk of developing a clot is much higher in pregnancy and postpartum than while on nuva ring. By keeping you from getting pregnant it’s actually decreasing your clot risk. Condoms and other barrier methods just don’t work as well as hormonal contraceptives

  • Stephanie

    I used Nuva Ring for a short amount of time. It didn’t give me PE, but I did have an abnormal exam and they couldn’t link the bacteria to anything specific. When asked what birth control method I had used, I told the doctor Nuva Ring, he said to stop it immediately. Scary!!

  • kenzie Wilson

    I used the nuva ring before I had my child no problem. So I decided to try it again. Put it in. Left it for the 3 weeks and like it made my period worse but want sure if it was because of that or having the baby. But decided not to put one back in. Shortly after that I started having chest pains. But wrote it off as assisting damage from a car accident I was in. But then it got so bad I couldn’t breathe so I went into the ER and they ran a million tests. Finally the CT showed multiple PEs. I was quickly life flighted out. And spent a week in the hospital. This is no joke. It’s a amazing that I’m still alive. They did every test know to man. And cam to the conclusion that the clots didn’t not form anywhere else and travel to my lungs but started in my lungs. No because of that I have to be on blood thinners the rest of my life. And that may not allowed me to safely ever have another child.

  • courtney

    Did either of them have a previous blood disease like factor five. This should be looked into before being put on any contraception, that will increase your risks tenfold. Most people don’t look into that either.

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