Houston
3200 Travis : 3rd Floor
Houston, TX 77006
(713) 529-0025
(713) 751-0412 (fax)

Galveston
(409) 762-9090

Toll Free
888-529-4688

andrewsteinberg@lawyer.com
www.thesteinberglawfirm.com

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* Have you been diagnosed with NSF (Nephrogenic Systemic Fibrosis) or NFD (Nephrogenic Fibrosing Dermopathy)?
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If Yes, when?
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Did you or a loved one had and MRI or MRA?
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Was an injectable contrast agent dye used during the MRI or MRA?
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Which contrast agent was used during your procedure?
Omniscan
MultiHance
Magnevist
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Following the MRI or MRA, have you or your loved one experienced any of the following symptoms?
Burning, itching, swelling, tightening or hardening of the skin
Red or dark patches on the skin
Skin feeling woody, appearance of an orange peel
Locking or contracting joints
Yellow spots on the white of the eyes/plaques near the eyes
Pain in the hip bones or ribs
Muscle weakness
Other
No Symptoms
Did you have kidney failure, kidney function deficiency, or other kidney problems at the time the scan was done?
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