mctlaw Privacy Policy Contact Us Now Contact Us Now "*" indicates required fields Name* First Last Email* PhoneAreas of Practice*Please Select…Vaccine InjuryMetal on Metal Hip ClaimExactech Hip RecallExactech Knee RecallKratom LawsuitsGovernment ContractsFederal TakingsRails to TrailsIndian LawPhilip CPAP RecallOtherIs This About a COVID-19 Vaccine Injury?*Please Select..YESNODid you get any of these vaccinations in the 45 days before or after the COVID-19 shot? Flu, Tetanus, Pneumonia, Measles, Mumps, Rubella, MMR, Chickenpox/Varicella, Diptheria, Pertussis, DtaP, Rotavirus, Hepatitis A or B, Meningitis, HPV.*Please Select..YESNOApproximate month and/or year of vaccination:* Name of Vaccine:* Have you seen a doctor or medical professional for treatment?Please Select..YESNOWhat was your diagnosis? Name/Brand of Hip Implant:*Please Select..BiometJohnson & Johnson DePuy PinnacleDePuy ASRZimmerStrykerWright MedicalOtherI Don’t KnowYear of Original Hip Replacement Surgery:* Did your doctor talk to you about metallosis, pseudotumors, high metal levels in your blood, bone loss, osteolysis, or joint loosening?Please Select..YESNODid You Have Revision Surgery or Are You Scheduled for Revision Surgery?*Please Select..YESNODate of revision surgery or upcoming revision surgery Did you get a recall letter or notification?Please Select..YESNODid You Have Revision Surgery or Are You Scheduled for Revision Surgery?*Please Select..YESNONames of the kratom brands used Type of Injury from KratomPlease Select..Death of Family Member or FriendMedical Reaction Like Seizures, Heart Problems, Organ Failure, Etc.Addiction For Which You Are Getting TreatmentOtherIf there is an autopsy report, what was the cause of death? If there is a toxicology report, what substances are listed? Have you seen a medical provider about the kratom injury?Please Select…YESNOWhat is your medical diagnosis? Are you still using kratom?Please Select…YESNOHave you gotten treatment for addiction or gone to rehab?Please Select…YESNOAre you a member of a tribe?Please Select..YESNOIs your question about a tribal matter?Please Select..YESNOWhat is the name of the tribe: What is the tribe's location? How long did you use the recalled Philips CPAP, BiPap or Ventilator?Please Select..Less than 1 year1-2 years2-3 years5 years or longerHave you seen a doctor about an injury/reaction from the recalled device?Please Select..YESNOWhat is your diagnosis/injury after using the machine?Please Select..CancerAsthmaCOPDRespiratory DiseasePneumonitisPulmonary FibrosisAcute Respiratory Distress Syndrome (ARDS)Chronic BronchitisLung DamageSomething ElseWhat is your injury if not listed above: Please give us more details about your situation.I agree to the Terms and Conditions outlined in this link by submitting this information to mctlaw.EmailThis field is for validation purposes and should be left unchanged. "*" indicates required fields Name* First Last Email* PhoneAreas of Practice*Please Select...Vaccine InjuryMetal on Metal Hip ClaimExactech Hip RecallExactech Knee RecallKratom LawsuitsGovernment ContractsFederal TakingsRails to TrailsIndian LawPhilip CPAP RecallOtherIs This About a COVID-19 Vaccine Injury?*Please Select..YESNODid you get any of these vaccinations in the 45 days before or after the COVID-19 shot? Flu, Tetanus, Pneumonia, Measles, Mumps, Rubella, MMR, Chickenpox/Varicella, Diptheria, Pertussis, DtaP, Rotavirus, Hepatitis A or B, Meningitis, HPV.*Please Select..YESNOApproximate month and/or year of vaccination:* Name of Vaccine:* Have you seen a doctor or medical professional for treatment?Please Select..YESNOWhat was your diagnosis? Name/Brand of Hip Implant:*Please Select..BiometJohnson & Johnson DePuy PinnacleDePuy ASRZimmerStrykerWright MedicalOtherI Don’t KnowYear of Original Hip Replacement Surgery:* Did your doctor talk to you about metallosis, pseudotumors, high metal levels in your blood, bone loss, osteolysis, or joint loosening?Please Select..YESNODid You Have Revision Surgery or Are You Scheduled for Revision Surgery?*Please Select..YESNODate of revision surgery or upcoming revision surgery Did you get a recall letter or notification?Please Select..YESNODid You Have Revision Surgery or Are You Scheduled for Revision Surgery?*Please Select..YESNONames of the kratom brands used Type of Injury from KratomPlease Select..Death of Family Member or FriendMedical Reaction Like Seizures, Heart Problems, Organ Failure, Etc.Addiction For Which You Are Getting TreatmentOtherIf there is an autopsy report, what was the cause of death? If there is a toxicology report, what substances are listed? Have you seen a medical provider about the kratom injury?Please Select...YESNOWhat is your medical diagnosis? Are you still using kratom?Please Select...YESNOHave you gotten treatment for addiction or gone to rehab?Please Select...YESNOAre you a member of a tribe?Please Select..YESNOIs your question about a tribal matter?Please Select..YESNOWhat is the name of the tribe: What is the tribe's location? How long did you use the recalled Philips CPAP, BiPap or Ventilator?Please Select..Less than 1 year1-2 years2-3 years5 years or longerHave you seen a doctor about an injury/reaction from the recalled device?Please Select..YESNOWhat is your diagnosis/injury after using the machine?Please Select..CancerAsthmaCOPDRespiratory DiseasePneumonitisPulmonary FibrosisAcute Respiratory Distress Syndrome (ARDS)Chronic BronchitisLung DamageSomething ElseWhat is your injury if not listed above: Please give us more details about your situation.I agree to the Terms and Conditions outlined in this link by submitting this information to mctlaw.NameThis field is for validation purposes and should be left unchanged.