How Attorneys Use Medical Record Review in Zantac Cancer Lawsuit

Joey Terry
Dec 3
6 min read

The Zantac Cancer lawsuit is a massive legal action involving tens of thousands of people who claim that taking the popular heartburn medication Zantac (and its generic form, ranitidine) caused them to develop cancer.

Zantac (ranitidine) was once one of the most widely prescribed and over-the-counter heartburn medications in the world. In 2019–2020, the FDA requested its removal from the market after independent laboratory testing revealed that ranitidine can degrade into high levels of N-nitrosodimethylamine (NDMA), a probable human carcinogen. Since then, thousands of lawsuits have been filed alleging that long-term Zantac use caused various cancers, including bladder, stomach, esophageal, liver, and colorectal cancer.

At its core, the lawsuit alleges that the drug's manufacturers knew or should have known that Zantac was unstable and could form a cancer-causing chemical called NDMA inside the pills and the human body, but they failed to warn the public.

What Cancers Are Linked to the Lawsuit?

The litigation focuses on cancers that scientific studies have linked to NDMA exposure in lab animals. The main cancers cited in the lawsuits include:

Bladder Cancer
Stomach Cancer (Gastric Cancer)
Colorectal Cancer (Cancer of the colon or rectum)
Esophageal Cancer
Liver Cancer
Pancreatic Cancer
Prostate Cancer (in some claims)

Key Drugs in the Zantac Cancer Litigation

1. Ranitidine

This is the active component in various generic versions of the brand-name medication Zantac. Ranitidine is a member of the H2-blocker medication class, which lowers stomach acid.
The ranitidine molecule is chemically unstable under some circumstances and can break down into a carcinogenic material, which is the basis of many lawsuits.

2. NDMA (N-Nitrosodimethylamine)

The plaintiffs contend that this chemical increases the risk of cancer.
NDMA is categorized as a "probable human carcinogen."
Independent lab testing reportedly discovered very high quantities of NDMA in ranitidine pills
Lawsuits claim that ranitidine (Zantac) can create NDMA, particularly under heat, humidity, or in the acidic environment of the stomach.

3. Nizatidine

Nizatidine, another H2-blocker that shares chemical similarities with ranitidine, is also mentioned in several complaints.
Nizatidine was apparently identified by the FDA for possibly inappropriate NDMA levels.
Therefore, even though Zantac was the main medication in dispute, generic and comparable medications also play a role in the lawsuit.

Why Medical Records Matter in Zantac Cancer Claims

Medical records matter in Zantac cancer claims because they provide the essential evidence needed to prove both exposure to the drug and the existence of a related cancer diagnosis. These records document when and how long a person used Zantac or ranitidine, the dosage taken, and the medical reasons for its use. They also confirm the type of cancer through pathology reports, imaging results, and physician notes, helping attorneys establish a clear timeline between drug use and the onset of disease. In addition, medical records reveal important background information such as family history, lifestyle factors, and other health conditions, which are critical for ruling out alternative causes. Without complete and accurate medical documentation, it becomes very difficult to demonstrate a legal and medical connection between Zantac and a cancer diagnosis, making these records the backbone of any Zantac-related claim.

Types of Medical Records Attorneys Review

Prescription records: Show that Zantac or ranitidine was prescribed and taken
Pharmacy records/receipts: Confirm dates, dosage, and refill history
Physician notes: Explain why Zantac was prescribed and track symptoms
Hospital records: Document admissions, treatments, and diagnoses
Oncology reports: Detail cancer type, stage, and treatment plans
Pathology reports: Confirm cancer at the cellular level
Diagnostic imaging: Includes CT scans, MRIs, endoscopies, and X-rays
Laboratory test results: Support diagnosis and monitor disease progression
Surgical records: Show cancer-related procedures and outcomes
Discharge summaries & follow-up records: Track recovery and long-term effects

Need help reviewing medical records for a Zantac Cancer Lawsuit Claims? Partner with us

Who Actually Performs the Review?

Most plaintiff firms do not have attorneys reading thousands of pages of records themselves. Instead, they rely on:

Legal nurse consultants
Third-party medical record review companies
Board-certified oncologists and gastroenterologists retained as consulting (non-testifying) experts

These professionals create medical chronologies, highlight key entries, flag missing records, and write causation summaries that become the roadmap for settlement negotiations or trial.

What attorneys are trying to accomplish with medical records

Provide the cancer diagnosis and treatment history. Attorneys use charts, pathology reports, oncology notes, and hospital/clinic records to establish what cancer the plaintiff had, precisely when it was diagnosed, stage, treatments received, and outcomes. (This is fundamental to any injury claim.)
Document Zantac/ranitidine exposure (timing, dose, duration). Pharmacy records, prescription histories, pill bottles/receipts, and PCP notes are used to show the plaintiff actually took ranitidine, when they took it, and for how long, an exposure timeline that must be matched against the cancer diagnosis.
Establish (or disprove) causation and alternative causes. Attorneys mine records for other cancer risk factors (smoking, alcohol, family history, occupational exposures, prior illnesses, other drugs) that could explain the cancer. Defense teams do the same to argue alternate causes, so discovery and detailed review are how both sides build their causation story.
Support damages calculations. Billing records, treatment receipts, disability notes, employer records, and VA/insurance files quantify medical expenses, lost wages, and future care needs. Those numbers come directly from the medical and billing records.
Prepare expert testimony and trial exhibits. Physicians and toxicologists rely on curated medical chronologies to form expert opinions (specific causation, prognosis, future care). Courts have been strict about scientific reliability in Zantac cases, so experts must tie their opinions to the medical record and accepted methodology. (Recent rulings have excluded experts whose methods didn’t meet court standards.)

How the review is done, practical steps attorneys take

Collect and centralize records. Counsel requests records from every health-care provider, hospital, imaging center, pathology lab, and pharmacy. Records are often scanned into a central document repository or e-discovery system and indexed by date and source.
Create a medical chronology. Reviewers build a date-ordered timeline of symptoms, diagnoses, tests, prescriptions (including ranitidine), exposures, and treatments. The chronology is the backbone of expert reports and deposition summaries.
Code and flag key entries. Review teams' tag records for important items: pathology reports, oncology notes, tobacco/alcohol history, family history, occupational exposure, medication lists, and gaps in documentation. This helps experts find the facts they need quickly.
Identify gaps and obtain supplemental records. If pharmacy data is missing, attorneys subpoena prescription histories or contact retail pharmacies for transaction logs. If a pathology slide is needed for independent review, counsel requests it. Attorneys use subpoenas or court orders when a provider won’t voluntarily produce records (with HIPAA procedures followed).
Use records to impeach or corroborate testimony. In deposition/trial, attorneys compare a witness’s memory to contemporaneous records to impeach inconsistent testimony or to corroborate the plaintiff’s account. Defense will do this, too.
Prepare experts with focused packets. Experts get a curated bundle (chronology + relevant records + literature) so their opinions are tethered to the record and to accepted science, crucial in light of recent admissibility rulings.

Case Study: Zantac Cancer Lawsuit Updates 2025

The Zantac lawsuit updates 2025 have been a wild ride with significant wins, disappointments, and surprising turns. This litigation has taken many turns, from the first discovery of NDMA poisoning to the collapse of certain suits and the revival of others. The timeline of significant developments that illustrate the changing character of the Zantac litigation and their implications for individuals impacted is provided below.

As most of you are aware, almost 80,000 Zantac lawsuits, which make up the great bulk of cases now pending in Delaware Superior Court, have been settled privately by GlaxoSmithKline. These settlements, which are anticipated to be completely executed by mid-2025, were reached with ten significant plaintiffs' law firms and might reach a total of up to $2.2 billion.

Some claimants remain active in the litigation, particularly those not represented by firms that participated in the settlement deals or have claims with other defendants, notably Boehringer Ingelheim, which wants to keep fighting, apparently.

Conclusion

In Zantac cancer claims, a medical record review service is an essential tool that attorneys use to transform a client’s personal medical history into solid legal evidence. By carefully analyzing prescription records, physician and hospital notes, diagnostic tests, and oncology reports, attorneys can establish exposure to Zantac, confirm a cancer diagnosis, and create a detailed timeline linking the two. Reviewing these records also helps identify other risk factors, supports expert testimony, and strengthens legal arguments for causation.

Ultimately, the thorough evaluation of medical records not only shapes case strategy but can significantly influence settlements and trial outcomes. For anyone pursuing a Zantac claim, comprehensive medical documentation is the foundation upon which a successful case is built.

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