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Orthopedic surgeon discussing revision surgery for recalled artificial hip
I get this question fairly often, and it’s a good one. It usually goes something like this: a person had a total hip replacement several years ago. A few years pass. Then out of the blue the individual receives a letter from the artificial hip manufacturer or from the implanting surgeon explaining that a recall has been issued for the artificial hip components implanted. (And these are the lucky patients; many people who receive an artificial hip that was later recalled never get notification from their doctor, the manufacturer, or anyone. They don’t discover they have a defective artificial hip until the pain, metallosis, or other injury develops.) If I were in this position, and I received a recalled artificial hip, I would want to know: Should I have the recalled hip removed? And should I have the hip removed immediately?

As with most things in life, the answer is not simple.

I have been a product liability lawyer for many years now, and in that time I have spoken with hundreds of people suffering from defective products. I have heard dozens of variations on a similar narrative. While this is not medical advice or legal advise, here are my suggestions:

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Smith & Nephew Birmingham hip replacement
Judge Catherine Blake, who is overseeing the Smith & Nephew Birmingham hip multi-district litigation in Baltimore, Maryland, recently issued an order setting out the bellwether trial schedule for the Birmingham Hip Resurfacing (BHR) cases.

Just to recap: there are two tracks of cases in the Smith & Nephew Birmingham hip litigation: BHR and THA. BHR refers to cases involving injured people who received Smith & Nephew Birmingham hip components as part of a resurfacing procedure. The BHR resurfacing system is a metal-on-metal (MoM) artificial hip, but in resurfacing procedures the  hip “ball” bone is resurfaced with a metal covering and a metal acetabular shell is implanted into the hip socket, thus creating a MoM articulation. Smith & Nephew used cobalt and chromium to construct both of these resurfacing components. As with all metal-on-metal artificial hips, the Smith & Nephew BHR has been shown to wear down and leach metals into the blood and tissue of the patient, a condition called metallosis.

The second track of cases involves total hip arthroplasties (THA) using Smith & Nephew Birmingham components. These total hip replacements are constructed with Smith & Nephew BHR components and non-BHR components, but instead of resurfacing the “ball-bone” with a metal covering the bone is removed and replaced with a metal ball component (a femoral head).

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I get these calls fairly often. The caller will explain that her lawyer just called out of the blue with an offer to settle an artificial hip or prescription drug case. The person believes the offer is too low. Well, is it? That’s a complex question, and it may be, but there are distinct reasons why the person believes the offer is too low. Let’s take a look at what may be happening:

What We Have Here is a Failure to Communicate

Lawyer explaining settlement terms to client
Often, the problem starts with the lawyer’s failure to communicate. People will tell me that they never hear from their attorney, and then suddenly, after many months or even years have passed, the lawyer will call and quickly explain the terms of a settlement offer then hurry off the phone. This is a mistake. The lawyer should take as long as necessary to fully explain why the settlement number is what it is. In fact, it is important for the lawyer to keep the client updated on developments throughout the litigation. For example, if another plaintiff in the larger litigation loses an important bellwether case, the lawyer should call and report the loss and what it may mean for the litigation and how it might impact settlement (obviously, it’s not good for all plaintiffs if a bellwether case is lost). If the client understands generally how the multi-district litigation is progressing, the client will be more prepared when a settlement offer finally arrives.

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Johnson & Johnson has 100,000 pending product lawsuits
Most of us pay our bills on time. If we break a neighbor’s rake, we promptly purchase a replacement. If our child dumps fruit punch on a friend’s carpet, we pay to have it cleaned. In fact, we don’t really think about these unwritten rules often; it’s just the right thing to do, so most of us do it instinctually: if we cause damage, we pay for the damage. But too often companies refuse to pay fair settlements to resolve product failure cases, even in the face of a mountain of evidence that (1) the product clearly failed and (2) the failure physically injured the person. For example, let’s say a sixty-eight year old retired schoolteacher learns her metal-on-metal artificial hip implant has failed; her doctor tells her that, in addition to the pain she feels in her hip and leg, she now suffers from dangerously high cobalt and chromium levels (a condition called “metallosis”). Thousands of other injured people have similar claims, but the manufacturer of the failed hip product simply won’t pay. Why not?

Well, I can’t know all the reasons, but let’s look at a few theories:

Companies Don’t Like to Pay Settlements

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Young woman vapingLike many parents, vaping and e-cigarettes caught my wife and me by complete surprise. Two years ago we asked our oldest child how many kids he knew in his high school who were vaping. He said, “it will be much faster to list the kids who aren’t vaping.” We were stunned. We knew very little about vaping, and at the time I assumed it was some kind of fringe product used by adults already addicted to nicotine.

Unfortunately, studies indicate that one in five high school kids have tried vaping, but in my unscientific observation I believe the number is higher. Still, there are more than fifteen million kids in enrolled in public high schools in this country, so even if the number is “only” one in five, this means over three million public high school children have either tried or are currently using vaping products like JUUL.

What we do know is that e-cigarettes are extremely popular and profitable for the companies selling the devices. The primary manufacturer, marketer, and seller of these vaping devices is a company called JUUL Labs, Inc.

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Settlement talks have begun in the Roundup non-Hodgkin lymphoma litigation
Last week news media outlets reported that Bayer AG and Monsanto had offered to settle United States Roundup cases for an amount up to $8,000,000,000. That’s eight billion dollars. If true, it would be welcome news, or at least a good start, as there are currently over 18,000 cases filed against the companies. These lawsuits allege that extended exposure to Roundup caused plaintiffs to develop non-Hodgkin lymphoma (NHL), a serious cancer that can spread to lymph nodes throughout the body. For plaintiffs afflicted with a serious illness like NHL, news that a global settlement has been achieved is always welcome, because these plaintiffs need compensation as soon as possible, and years of expensive litigation is not good for anyone (except maybe defense lawyers).

The news reports of settlement flashed across the Internet, as such things do, perhaps encouraged by recent statements made by Bayer’s CEO that the company would consider settling on reasonable terms if all United States cases could resolve. Further, Bayer and Monsanto recently lost a Roundup case where a California jury awarded a couple $2 billion dollars for the non-Hodgkin lymphoma they both contracted after using Roundup for years. You can read about that $2 billion Roundup verdict here.

Despite all that, on Friday Mediator Ken Feinberg issued a statement that “Bayer has not proposed paying $8 billion to settle all the U.S. Roundup cancer claims. Such a statement is pure fiction,” and that “[c]ompensation has not even been discussed in the global mediation discussions.” So there you have it. At this point I would recommend you listen to Mr. Feinberg’s statement, as he is a central figure in the Roundup settlement talks.

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If you’re reading this you probably know that over the past decade thousands and thousands of lawsuits have been filed by people injured by defective artificial hips. Several manufacturers have been involved, and while a few companies have resolved claims and moved on, thousands of other artificial hip lawsuits remain in courts across the country. Let’s take a look at active litigation involving artificial hips:

Smith & Nephew Birmingham Hip

Patient with Smith & Nephew BHR artificial hipThe Smith & Nephew “Birmingham” hip litigation is in full-swing. Plaintiffs in this litigation allege they were injured after receiving a Birmingham Hip Resurfacing (BHR) device, or a total hip arthroplasty (THA) utilizing Birmingham Hip components. In the resurfacing procedure, the  hip ball bone is shaped and resurfaced with a smooth metal covering and a metal shell is implanted into the hip socket, thus creating a metal-on-metal connection. Smith & Nephew uses cobalt and chromium to construct both of these resurfacing components. These metals have been shown to wear away and move into the blood and tissue of the patient, causing all kinds of symptoms and problems.

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Harmful Medical Devices on HBO's Last Week Tonight with John Oliver

I’ve been writing about dangerous medical devices on this site for four years. Over that time I’ve reached thousands and thousands of people injured by these harmful implanted medical products. John Oliver, host of Last Week Tonight, picked up the subject this week, and I am grateful to him and to HBO because he reached more people in twenty minutes than I have in four years. I want more people to get the word out about the serious problems with medical devices rushed to market and “cleared” through the 510(k) loophole because it’s a public health crisis. Too many companies are pushing too many untested medical devices to market, and the FDA is not doing enough to protect the public from these devices. John Oliver talks about all of this on the latest episode of his show. It’s funny (and profane), but he lays out accurately the way massive profits have driven companies to push harmful medical devices on to an unsuspecting public. You can check it out at the link below:

Warning: This is HBO. Oliver speaks freely: the language is salty and the subject matter adult. Companies and people other than me own the content linked above. The show is the property of HBO and whoever owns HBO. Neither HBO nor John Oliver has any affiliation with my website.

 

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Studies have linked Roundup to non-Hodgkins lymphoma
The makers of Roundup just lost another big case, this time involving a couple who used the weedkiller and were later diagnosed with non-Hodgkin lymphoma. This month, a jury in California awarded Alva and Alberta Pilliod more than two billion dollars. The jury found that Monsanto and Bayer acted negligently and failed to warn the plaintiffs of the dangers of using Roundup. The key active ingredient in Roundup, glyphosate, has been shown in studies to increase the risk of developing non-Hodgkin lymphoma (NHL). The jury then awarded Mr. Pilliod $18 million in “compensatory damages,” which is a money award for actual injuries suffered. The jury awarded Ms. Pilliod $37 million in compensatory damages, for a total of $55 million in compensatory damages. Finally, the jury awarded the Pilliods $1 billion each in punitive damages. The final jury award was $2,055,000,000. A truly astonishing number, and a major rebuke to the makers of Roundup.

The Pilliods testified that they used Roundup on their property for more than thirty years, from 1975 and 2011. They were diagnosed with NHL in 2011 and 2015.

Punitive damages play an important role in consumer protection. Punitives are awarded by a jury to punish or deter a bad-acting company, and similarly situated companies, from engaging in similarly awful conduct. Punitive damages are not common, and are usually awarded when a jury decides that the defendants had prior knowledge of a serious issue or problem and ignored this knowledge to the serious injury or detriment of other people.

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Oxycontin is a deadly drug
Three years ago I wrote this column: My Challenge to Medical Device and Drug Companies: Put Me Out of Business! The point was straightforward: if companies would do the right thing, and properly test their medical devices, and carefully monitor the drugs they sell, and try to help patients instead of merely chasing profits, then I will stop being a product liability lawyer. Well, turns out my line of work may be safe for a long time. This week several executives from Insys Therapeutics were found guilty of racketeering. The jury found that these executives conspired to push sales of a deadly fentanyl drug, by increasing dosages and prescriptions. These guys are going to jail. And they should. The story that emerged from the two-month trial was hideous, and it proves yet again that without careful oversight companies will often harm public health in their pursuit of massive profits.

Before I bullet point some of the evidence developed at trial, start with this: the Centers for Disease Control estimates that well over 200,000 people have died from prescription opioids since 1996. Sit with that for a moment. More than 200,000 people have died from opioid overdoses. It is heart-wrenching. Now, add to this tragic statistic the narrative that several opioid companies, and not just Insys Therapeutics, pushed for more prescriptions and higher doses for decades, solely to increase sales and profits and employee bonuses.

Let’s take a look at the evidence from the Insys criminal trial: