I don't think the paper is flawed as long as the authors point out the biases that are inherent with this kind of a study. It's hypothesis generating at best, but for a rare condition that is hard to study prospectively is often a starting point. "Good" data will then always be needed to follow up on the *possible* association between drug and the AE. The media attention is not helpful of course because it's not presented properly most of the time. It's a lot less sensational a headline when you point out the biases in such a study and there may not in fact be any link when studied more rigorously