Veterans who took the antimalarial drug Mefloquine while deployed are launching individual lawsuits against the Canadian government. Law firms Howie, Sacks & Henry LLP and Waddell Phillips PC will represent veterans who allege they suffer long-term side effects from Mefloquine such as anxiety, depression and insomnia. The objective is to hold the government accountable for failing to properly inform military members of the drug's risks and obtain compensation for harms caused. A non-profit foundation has been established to promote awareness and research on conditions caused by Mefloquine poisoning.

1. MEFLOQUINE LITIGATION
OTTAWA TOWN HALL
MEETING
DATE: March 24, 2019
TIME: 12:00 to 15:00
LOCATION: Brookstreet Hotel, 525 Legget Drive, Kanata, ON K2K 2W2
The following is the property of Howie, Sacks and Henry LLP and Waddell Phillips PC. Any unauthorized use or disclosure is
prohibited. This presentation contains general legal information, and does not constitute independent legal nor medical advice.

2. John Dowe – Founder - International
Mefloquine Veterans’ Alliance
• John Dowe served with the Canadian
from 1990 to 2000 and took Mefloquine
while deployed in Somalia.
• Decades later, he is still dealing with side-
effects, including anxiety and insomnia
• Passionate advocate for Veterans affected
Mefloquine

3. Who Are We?
Howie, Sacks and Henry LLP
• 20 years of experience handling serious personal injury cases and mass
tort, class action litigation
• HSH is currently handling high-profile cases including serving as co-
counsel representing B.C. in its class action law suit against opioid drug
companies (August 2018), was co-lead counsel for the victims of the
2005 Air France crash at Toronto’s Pearson airport, and as
representatives for 14 Canadian diplomats injured in Havana, Cuba
• In addition, HSH has over 20 years of experience handling brain injury
cases
Paul Miller Michael Henry David Levy Valérie Lord Eman Khoshbin
(français)

4. Waddell Phillips PC
• Over 30 years of experience handling high-profile cases
• Advocacy before the Supreme Court and acted for Phil Fontaine
the Assembly of First Nations in the Residential Schools class action
resulting in the largest class action settlement in Canada and the
Truth and Reconciliation Commission
• Extensive experience dealing with the Government of Canada in
litigation cases,
John K. Phillips Margaret Waddell Patti Shedden Venessa Vuia Cory Wanless

5. What is Mefloquine and why are we
suing?
 During the 1990s, it was common for military personnel to be prescribed
Mefloquine, an antimalarial medication, when deployed to areas around
the world where malaria was prevalent
 Mefloquine has been reported to cause a number of symptoms in those
who’ve taken the drug, including anxiety, depression, suicidal and
homicidal thoughts, paranoia, delusions and hallucinations.

6.  In 2016, Health Canada updated the warning labels for Mefloquine,
highlighting serious side effects, including anxiety, paranoia, depression,
hallucinations, psychotic behaviour and thoughts of suicide –which can persist
for months or years after taking the drug
 Though the Canadian military conducted its own review which determined that
the drug doesn’t have any long-term effects, it now only prescribes Mefloquine
as a drug of last resort
 In June of 2017 the Department of National Defence announced that
Mefloquine would only be recommended for use if a CAF member requests it,
or if there are contraindications to the member being prescribed other anti-
malarials

7. Surgeon General Report
June 1, 2017
 “The Government of Canada is committed to protecting and enhancing the
health and well-being of Canadian Armed Forces (CAF) members. Today,
the Department of National Defence and the CAF announced the release
of the findings from the Surgeon General’s Review on the Operational Use
of Mefloquine. The review looked at available literature on mefloquine use
and how it is used in an operational setting.”
 “Mefloquine will now only be recommended for use if a CAF member
requests it, or if there are contraindications to the member being
prescribed other anti-malarials.”

8.  “The health and well-being of our people is directly linked to the operational
effectiveness of the Canadian Armed Forces. Because of this, I have a duty to
ensure everyone under my command has access to the best options for medical
care currently available. I am confident the Surgeon General’s recommendations,
which are supported by third-party evidence, are consistent with ensuring the
overall health of our women and men.”
 General Jonathan Vance, Chief of the Defence Staff
 “We are recommending mefloquine as a second line drug only, because of the
unique operational environment that we work in. This direction should not be
applied to a non-military environment. We will continue to monitor and review all
relevant scientific literature on mefloquine.”
 Brigadier-General Colin MacKay, Surgeon General

9.  Canadian Clinical Practice Guidelines for malaria prevention are consistent with other
national and international guidelines in that mefloquine is considered a first-line option.
 Compared to currently recommended alternatives, the body of evidence suggests
mefloquine is not consistently associated with an excess overall risk of adverse
nor is it associated with an excess risk of not being able to perform occupational
duties.
 No evidence was found (that met the inclusion criteria) that would suggest
long-term adverse effects of mefloquine on human health.
 The report also recommended caution for the CAF, because the deployment of large
numbers of personnel within a short period of time can pose challenges for adequately
screening individuals for potential contraindications. Additionally, the dispersed
deployment of personnel, limiting access to physicians on operations, may reduce
opportunities to assess for adverse effects and if necessary to provide alternative
medications to CAF personnel taking mefloquine. Also, the nature of the short term side
effects associated with mefloquine could impact an individual’s performance and could
be confused with usual responses to operational situations, which would in turn
complicate the management of adverse effects.

10. Why bring a lawsuit?
 By failing to inform our forces of the side effects, members of the military
have suffered debilitating medical symptoms, some serious with long-term
impact. HSH lawyers along with Waddell Phillips, want to hold the
Canadian Government accountable
 The objective of the Mefloquine lawsuit in Canada is to help its victims
receive compensation for the drug’s harmful effects. As a mass tort
litigation, cases proceed on an individual basis
 Both the lawsuits and the newly formed Quinism Foundation will help
promote education and awareness around the interplay of Mefloquine and
PTSD diagnosis

11. The Quinism Foundation
 Founded by Dr. Remington Nevin in January 2018, The Quinism Foundation is
a non-profit organization in Vermont that aims to promote and support
education and research on medical conditions caused by poisoning by
quinoline drugs including the antimalarial drugs Mefloquine
 The foundation’s goals are to:
 Prepare healthcare organizations to identify those exposed to quinolines and to
screen for symptomatic quinoline exposure
 Educate clinicians to diagnose chronic quinoline encephalopathy and other medical
conditions caused by quinoline poisoning
 Train researchers to distinguish the effects of quinism from those of other disorders,
including Post-traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI)
 Assist government agencies to recognize those suffering disability from quinism
 Identify risk factors for the disease and attempt to count all those affected

12. Mefloquine, Quinism and PTSD
 The term “Quinism” refers to a disease caused by poisoning by the class of
neurotoxic quinoline drugs, such as Mefloquine
 Symptoms of poisoning by Mefloquine and related quinoline drugs include:
 Tinnitus
 Dizziness
 Vertigo
 Paresthesias
 Visual disturbances
 Gastroesophageal and intestinal problems
 Nightmares, insomnia, sleep apnea
 Anxiety, depression, suicidal thoughts, paranoia and cognitive dysfunction
 Some symptoms of quinism can mimic those of PTSD

13. Where to get medical help?
 In September 2018, The Quinism Foundation sent correspondence to the
Honourable Seamus O’Regan, Canadian Minister of Veterans Affairs,
calling upon Veterans Affairs Canada (VAC) to implement universal
screening of recent Canadian veterans for a history of symptomatic
exposure to Mefloquine
 The Quinism Foundation has recently begun licensing its two-question
White River Mefloquine Instrument (WRMI-2) to assist in identifying
veterans who may be at risk of disability as a result of their exposure to
Mefloquine
 The Quinism Foundation can give your healthcare providers supplemental
information for appropriate treatment
 https://quinism.org/

14. Lifemark - Multiple locations across Canada
 Lifemark Health Group in Canada has licensed the two-question
White River Mefloquine Screening Instrument (WRMI-2) as part
of a pilot program to screen self-identifying veterans for a history
of symptomatic exposure to the antimalarial drug
Mefloquine. LifeMark has 175+ clinics throughout Canada to
service this need.
 Lifemark advocates for the provision of proper health care for
veterans and families affected by Quinism, or mefloquine toxicity;
including the development of clinical guidelines for diagnosis &
management, and comprehensive rehabilitation programs.
 https://www.lifemark.ca/services/dizziness-balance

15. Class Action vs. Mass Tort

16. We are not the Larmer Stickland Class
Action
 In 2001, lawyers at Larmer Stickland PC, in North Bay, ON, commenced a class
action lawsuit for soldiers who had served in Somalia only
 In April 2018, nearly 17 years later, the Ontario Superior Court of Justice dismissed
that class action lawsuit for delay
 The court did not comment on the merit of the case itself
 The limitation period for Somalia veterans was tolled by the class action lawsuit

17. What is Mass Tort Litigation
 Mass Tort refers to the simultaneous launching of multiple individual lawsuits, all
against one common Defendant, relating to a single common triggering event
 The advantages of pursuing a claim by way of a mass tort versus a class action are:
 We will have an opportunity to get into the Defendants documents faster
 Individual Plaintiffs will have a direct say into whether they wish to accept, counter, or
reject any settlement offers
 Mass Tort litigation retains the “power in numbers” advantage

18. Mass Tort:
The More Favourable Approach
 In these cases, we believe the Mass Tort approach is favourable over a
Class Action
 In a Class Action, individuals in the class do not have a say in whether
they believe the compensation is reasonable and fair. The court is only
concerned if the compensation is fair and reasonable to the class as a
whole
 In a Mass Tort, each client will be presented with an individual option

19. Retainer Process – How do I get
involved?

20. Timeframes
 1990-2017
 Any deployment where Mefloquine was ordered to be taken

21. 1. Contact Us
The first step is to send an email or call our team. We will ask you a series of questions involving
where and when you served and ask details of the side effects you believe you have
as a result of taking Mefloquine. We cannot include you in a lawsuit if you do not contact us. All
All information shared with us remains strictly confidential.
2. Retainer Call with a Lawyer
Once your information has been processed, a call with either Paul, Michael, Valerie or Eman will
set up. They will walk you through the Contingency Fee Agreement, how the litigation is going
proceed, what to expect, and answer any questions or concerns you may have.
3. Contingency Fee Agreement and Authorizations sent to you
Once you have spoken to a lawyer, the CFA and authorizations will be sent to you
via email or regular mail. You will have the opportunity to review the paperwork
ask us any further questions before signing it and returning it to us.

22. 4. Investigation
For those who retain us, we will obtain full medical/employment records and other
records as needed for the specifics of each case. We then review the records and
obtain records from other doctors as necessary.
We will work to identify injuries and areas of negligence to further categorize our
cases by severity of injuries.
Our goal is to always assess our cases from a position of strength, which is why we
require comprehensive access to all pertinent damage documentation to support
each claim.
A detailed summary of the case is prepared and is sent to one of our expert
physicians for an opinion.

23. 5. Litigation:
Unlike in a Class Action, where only the Representative Plaintiff(s) are named in the
claim, Statements of Claim for all individual cases will likely be required to be drafted,
issued with the court and eventually served on the Defendants.
We will be simultaneous launching multiple individual lawsuits, all against one
common Defendant, relating to a single common triggering event.
The overall litigation process in all personal injury cases can be unpredictable, both in
terms of outcome and time.

24. VAC and the Lawsuits
 “If I apply to be part of a Mefloquine legal action against the
Government of Canada, and is later successful, will I be asked
to pay back my PTSD Award and does it put any of my VAC Pensions or
benefits at risk?”

25. Response from VAC – March 21, 2019
“Dear Mr. X (redacted for privacy concerns)
Thank you for using My VAC Account and our secure email services.
Rest assured, joining a class action lawsuit will not affect
any compensation from the Department for your PTSD. If the class
action lawsuit is successful, the funding and financial compensation
are for 2 completely different reasons and handled by different
departments. The only way that your payments can be garnished
is by Court order,(more along the lines of civil matters such
as unpaid child support, damages, etc.) by order from the CRA
(If you are in collections with CRA for tax reasons, Etc., garnishment
can be ordered by CRA), and lastly, if you are in an overpayment
situation with Veterans Affairs Canada directly (example: More
income made through Earnings loss that was not reported, Veterans
affairs can look to use a portion to pay back overpayment). Again,
joining a class action will not affect any of your claims or
compensation with VAC. I hope this helps clarify.
Sincerely,
M. W.
National Contact Centre Network Analyst - Veterans Affairs Canada

26. Q&A: Legal Issues, Fees, Costs
• What are the risks?
• Am I out of time to sue? What is the limitation period in these cases?
• Will this affect my employment/my pension?
• What if we lose and we have to pay the other side’s legal costs?

27. Legal Contact Information
 Emails for intake:
 pmiller@hshlawyers.com
 mhenry@hshlawyers.com
 vlord@hshlawyers.com (French)
 https://www.hshlawyers.com/contact/
 Phone numbers for intake:
 First Time Callers– 1- 877-771-7006
 Current Clients – 1- 877-474-5997
In the News
‘It stole my life’: Veterans to sue gov’t
over military-issued drug, CTV
News, December 19, 2018
Two law firms to represent soldiers and
veterans who said they are suffering
from side effects of mefloquine, The
Globe and Mail, December 17, 2018