Ranitidine Class Action

Register for Ranitidine Class Action

By registering, Charney Lawyers will update you on developments in the class action and will notify you if the matter settles. The information collected about potential class members on this system will assist counsel in prosecuting the class action and assessing what damages were suffered by the class as a whole. There are no fees to register.

Note: You are not obliged to fill in this form to participate in this class action. If you choose to do so, you are not retaining Charney Lawyers PC to act on your behalf. Providing the information requested does not make you a client of Charney Lawyers PC. All information submitted will be treated as confidential, and will only be released as required by law or as you may consent. By registering with Charney Lawyers you consent to receiving email notifications about the class action, the law firm's services and information about class actions where Charney Lawyers is counsel to the email address you have provided.

Please note that you should only register if you are a Canadian resident.

Full Legal Name*

Contact Email Address*

Street Address*

City or Town*

Province or Territory*

Country*

Contact Phone Number*

Have you purchased or ingested one or more of the ranitidine products for sale in Canada from January 1, 2010 to present?*

Yes

Who manufactured the ranitidine product(s)? Please select all that apply:*

Apotex

Pro Doc Limitee

Sandoz Canada

Sanis Health Inc.

Sivem Pharmaceuticals ULC

Sanofi Consumer Health Inc.

Teva Canada Limited

Other

I don't know

What is name of the ranitidine product(s)?*

What is the DIN of the ranitidine product(s) and/or the lot number(s)? Please note: a Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada. It is located on the label of prescription and over-the-counter drug products that have been evaluated and authorized for sale in Canada.*

Where did you purchase the ranitidine product(s)? Please select all that apply:*

Brunet / Brunet Plus / Brunet Clinique / Clini Plus

London Drugs

PCJ Jean Coutu / PCJ Health (PJC Jean Coutu Sante) / PCJ Healt Buaty (PCJ Jean Coutu Sante Beaute))

Pharmasave

Rexall / Rexall Pharma Plus

Shoppers Drug Mart / Pharmaprix / Shoppers Simply Pharmacy

Uniprix / Uniprix Sante / Uniprix Clinique

Other

I don't know

How long have you been taking the ranitidine product(s)?*

Have you stopped taking the ranitidine product(s)?*

Yes

What is the strength of your most current dosage?*

How frequently are/were you taking the ranitidine product(s)?*

When did you last take the ranitidine product(s)?*

Did you pay for the ranitidine product(s)?*

Yes

How much have you paid for the ranitidine product(s) since 2010?*

Have you been contacted by the pharmaceutical company that made your ranitidine product(s)?*

Yes

Have you tried to contact the pharmaceutical company that made your ranitidine product(s)?*

Yes

Did you have a prescription for the ranitidine product(s)?*

Yes

Did you have insurance or a government plan that paid for your ranitidine product(s)?*

Provinicial Plan

Federal Plan

Private insurance

None

If yes, please identify the payor:

If yes, did the payor pay 100% of the cost of the ranitidine product?

Yes

Did you purchase over-the-counter ranitidine product(s) (e.g. Zantac®, store brands, etc.)?*

Yes

If yes, do you have receipts or credit card bills?

Yes

Do you still have the pills? *

Yes

Have you had any adverse side effects from the ranitidine product(s)?*

Yes

Have you contracted any form of cancer since taking the ranitidine product(s)?*

Yes

Have you been diagnosed with liver damage or liver disease since taking the ranitidine product(s)?*

Yes

Are you experiencing anxiety and/or mental distress as a result of the recall?*

Yes

Please describe how this recall has affected you emotionally.*

Have you contacted your family doctor about the recall?*

Yes

If yes, what did your family doctor tell you about the risks of taking the contaminated medication?

Have you seen a doctor or health practitioner because of the recall?*

Yes

Have you paid for counseling related to this recall?*

Yes

Have you spent any time doing any of the following in responding to the recall:*

A. Changing your medication, including travel time?

Yes