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Pfizer and Endo Pharmaceuticals settled with the State of Texas to pay $50 million to settle a lawsuit accusing these drug companies of falsifying drug prices to bleed Texas’ Medicaid program.

As often happens, the case stemmed from a whistleblower lawsuit, this one by Ven-A-Care, who has a history of filing these claims against pharmaceutical companies.

Ven-A-Care is basically four guys who have become professional witness blowers that have made hundreds of millions of dollars for their companies. These guys lie low: they don’t talk to the media and have not spoken publicly since 2004.

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On Monday, the 2nd Circuit ruled that the plaintiff in the Zyprexa lawsuit knew (or should have known) that Zyprexa potentially caused his diabetes more than two years before he sued Eli Lilly.

Plaintiff was told by his doctor that he had diabetes in the late 1980s or early 1990s. He was prescribed Zyprexa in 1997 and continued taking it until late 2001 when his doctor took him off the drug because of weight gain.

Plaintiff’s lawsuit (filed in 2006) claimed that while taking the drug, his glycemic control significantly worsened and that towards the end, he developed diabetes-related complications.

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The U.S. Supreme Court yesterday shot down a petition by a Johnson & Johnson to hear a case in which J&J sought a ruling that preemption should be extended to failure to warn claims involving over-the-counter drugs.

Drug and medical device defendants continue to think preemption is some magic elixir around their negligence.

Hey, you Republicans out there. Does it bother you that state tort rights are being tossed in the ground by the overly intrusive federal government? If you answered yes, you are a real Republican. I have a Barry Goldwater sticker for you. The rest of you are just Republicans when it is convenient for you.

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Plaintiff’s only expert on causation in a Zometa jaw injury case was excluded last week when an Alabama court determined that an oral surgeon was unqualified to offer a causation opinion.

If you are not familiar with these cases, Plaintiff’s lawsuit reads like many of these tragic cases. Plaintiff alleges that she developed Avascular osteonecrosis of the jaw because of taking Zometa for post-cancer treatment of bone loss or osteoporosis. That’s the worst, right? You slay the beast that is cancer only to get another awful condition, arguably from the drug that was supposed to help you.

Plaintiff’s lawyers designated her treating oral surgeon as the plaintiff’s only expert on specific causation. Right off the bat, this sounds dangerous. Unless the treating surgeon just has the experience and expertise to speak to this issue, you are risking having an expert that lacks credibility with the jury or, worse, is not permitted to testify. Plaintiff’s lawyer later tried to add more experts after the deadline, but the court shot that effort down.

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A Maryland federal judge last week put some tough limitations on plaintiffs’ expert in the Aredia/Zometa jaw injury case that was remanded back to Maryland from the MDL.

In Zimmerman v. Novartis Pharmaceuticals, plaintiffs brought a wrongful death lawsuit in the MDL. Plaintiff asserted strict liability and negligence claims against Novartis. Plaintiff was prescribed Aredia and Zometa, two bisphosphonate drugs that are administered intravenously to treat cancer patients for hypercalcemia, a potentially fatal elevation of calcium in the blood. Plaintiff developed osteonecrosis of the jaw which caused her death.

The case sat for years in the MDL in Tennessee but has since been remanded to Maryland to be tried before Judge Roger W. Titus. Novartis sought to exclude the testimony of a key plaintiff’s expert. The expert, a doctor, is a key witness for the plaintiff because she was, at one time, a medical officer with the FDA in the Office of Health Affairs. Defendants use the tacit backing of the FDA at every trial – WE WERE FDA APPROVED! – is a common theme banged over the heads of the juries. So having a doctor who worked for the FDA sometimes helps plaintiffs considerably.

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The Pennsylvania Supreme Court shot down generic Reglan manufacturers and the maker of Reglan’s request to flip the trial court’s decision to deny their preemption summary judgment motion.

Reglan is used to treat short-term heartburn caused by gastroesophageal reflux disease (GERD). It is also used to speed up gastric emptying in diabetes patients. Because the drug is a dopamine antagonist, it increases lower esophageal sphincter pressure.

The problem with Reglan – plaintiffs allege – is that it causes tardive dyskinesia, an often irreversible and just plain awful neurological disorder with symptoms that include involuntary grimacing, protrusion of the tongue, lip-smacking, rapid eye blinking, and movement of the extremities. There is no treatment for this disorder.

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Drug wholesaler McKesson Corp. has settled charges against it, agreeing to pay more than $190 million for government claims that it reported inflated drug prices that caused federal government – specifically Medicaid – to overpay for drugs.

McKesson put out the same press release that goes out in every single one of these cases:

We did not manipulate drug prices and did not violate any laws. However, when we weighed our conviction that we did not violate any laws against the inherent uncertainty of litigation, we determined that this settlement was in the best interest of our employees, customers, suppliers and shareholders.

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Zoloft can allegedly cause serious birth defects to developing fetuses when ingested during pregnancy. These defects include pulmonary atresia,  deformed limbs, patent ductus arteriosus, ventricular and septal defects, hypoplastic heart syndrome, aortic and ventricular outflow tract obstruction defects, craniosynostosis, omphalocele, gastroschisis, spina bifida, and cleft palate. The lawsuits filed throughout the country allege that Pfizer failed to adequately warn patients and healthcare professionals of these risks. Pfizer denies the association.

Lawsuits alleging birth defects caused by the antidepressant Zoloft/sertraline were consolidated on Tuesday before Judge Cynthia M. Rufe in the U.S. District Court for the Eastern District of Pennsylvania. About 92 federal lawsuits – and counting – will be included in this MDL.

What does this mean for Zoloft birth injury plaintiffs? The cases are technically not a class action, but the cases are merged together for discovery on issues common to all the Zoloft birth defect lawsuits. The upside for individual Zoloft birth defect lawyers is the efficiency of pulling together resources to really discover what Pfizer knew about the harmful effects their drugs had on unborn children whose moms were on Zoloft.

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Though widely hailed as breakthrough medical devices when they first came onto the market, experts now recommend that patients avoid them. The onslaught of problems (which seems to span all metal hip implants, regardless of manufacturer) is one reason that Johnson & Johnson has been phasing out their DePuy ASR implants. Of course, the phase-out allows a manufacturer to retire a device gracefully, despite the fact that a full-blown hip implant recall is warranted in these cases.

What did Johnson & Johnson (DePuy) Do Wrong To Cause Hip Implant Injuries?

As the authors of the British Medical Journal, The Lancet, said, the problems with metal hip implants that surgeons have discovered, could have been determined with adequate pre-market studies and regulation. If Johnson & Johnson did their homework, there would be a lot fewer people with these hip implant problems. The reality, though, is that a medical device manufacturer always makes more money by sending a defective device to the market than they do by canceling a project.

In 2009, the FDA told Johnson & Johnson that it was rejecting the DePuy ASR hip resurfacing system. That letter went one step further by telling Johnson & Johnson that all the DePuy metal-on-metal implants were suspect because of metal poisoning problems (See Hip Device Phaseout Followed FDA Data Request, New York Times). Regardless, these implants are still being implanted into patients.

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The idea of an MDL is to consolidate discovery, figure out what the cases are about, and whether they can be settled without a gazillion trials. So you do some discovery and, more often than not, you try a few cases and see if you can limit or even eliminate trials getting sent back to their home jurisdictions for trial.

But in any piece of mass tort litigation, the quality of the individual cases is going to vary wildly. There are a lot of reasons for this that are case-specific, but one value driver thread that runs through every case is the quality of the plaintiff. There is no question that juries are going to pay more (and may even be more likely to find liability) in cases where you have a plaintiff that the jury likes and respects. So that begs the question: which cases get tried first? Plaintiffs’ lawyers look for good facts with a Mother Teresa-like plaintiff and defendants look for confounding facts Idi Amin-like. This we know.

So which cases are chosen to go first? One of the authors of the defense-oriented Drug and Device Law Blog crashed the plaintiffs’ attorneys’ seminar, Mass Torts Made Perfect, and listened to what the judges who spoke there had to say. This was their summary: