A California jury heard opening statements on Friday in the fraud and negligence suit -- the first of thousands of similar suits to reach trial in the United States that involve an all-metal ball-and-socket hip joint that was pulled from the market two years ago.
A lawyer for plaintiff Loren Kransky showed jurors pictures from a surgery in which black material could be seen in the patient's hip socket. Attorney Michael Kelly said the material was from pieces of metal that had flaked off of the implant.
Kelly also played a segment of a doctor's audio deposition in which he said he feared that if the material wasn't removed, Kransky would have died. The pieces of metal were causing a form of metal poisoning, he said.
Kransky, a former North Dakota prison guard, sought hip replacement to relieve arthritic pain. He received the implant in 2007 and has since has had it replaced. He listened to opening statements Friday from a front row seat.
A lawyer for Johnson & Johnson's subsidiary, DePuy Orthopedics Inc., which manufactured the metal implant, said Friday that the 64-year-old Kransky had many pre-existing medical ailments. Attorney Alexander Calfo presented a list of 16 major diseases, including kidney cancer, diabetes, high blood pressure and vascular disease as well as exposure to Agent Orange during the Vietnam War.
"Mr. Kransky did not get worse because of the (implant) and did not get better when it was removed," he said.
He added, "Hip surgery is not perfect. No material to this very day has proven to be perfect."
Calfo said the metal implant had been designed to improve on plastic and ceramic implants.
The artificial hip socket was sold for eight years to some 35,000 people in the U.S. and more than 90,000 people worldwide. New Brunswick, N.J.-based Johnson & Johnson stopped making the product in 2009 and recalled it the next year.
However, documents unsealed in the court case last week indicated that Johnson & Johnson officials were aware of problems with the device at least as far back as 2008.
Also, according to a deposition from a DePuy official, a 2011 company review of a patient registry concluded that more than a third of the implants were expected to fail within five years of their implantation.
Johnson & Johnson has put aside around $1 billion to deal with the costs of the recall and lawsuits.
Last year, British experts at the world's biggest artificial joint registry said doctors should stop using metal-on-metal hip replacements after a study found that, after five years, about 6 percent of people who had used them needed surgery to fix or replace them.
That compares with just 1.7 to 2.3 percent of people who had ceramic or plastic joints.
Kelly said he will ask the jury to assess punitive damages at the end of the trial "to send a message to the defendants who failed to share with doctors what they knew."
He said that when DePuy Orthopedics learned the device they manufactured might be defective, "They acted in a manner that was indifferent."
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