Monies Set Aside for Pinnacle and ASR Hip Implant Lawsuits Continues to Increase

As the number of lawsuits against DePuy and its parent company Johnson & Johnson increase, one can only wonder if this increased litigation is responsible for the huge amount of money Johnson & Johnson continues to set aside. The DePuy ASR hip implant was recalled in 2010 after it was found the metal components were rubbing against one another, causing tiny metal ions to shear away from the hip implant and become lodged in the surrounding tissue or enter the bloodstream. The cobalt and chromium ions in the tissues led to hip failure, necrosis, bone loss, inflammation and chronic pain in many recipients of the ASR and Pinnacle systems.

Other recipients of the hip implants develed metal toxicity from the cobalt and chromium which migrated to the bloodstream. Symptoms of metal toxicity are serious, and the heavy metals can build up to dangerous levels in a recipient’s body before without their realizing it. Once the damage has been done by these toxic metals, there is little way to undo it other than have the implant recipient undergo a revision surgery to remove the metal parts which are causing the adverse health problems. 

As of a few short months ago over 6,000 people across the United States filed lawsuits against DePuy and Johnson & Johnson regarding the ASR while another 1,800 have filed suit claiming the DePuy Pinnacle hip implant to be defective as well. Following the recall, DePuy indicated it might consider reimbursement for medical expenses the company deemed “reasonable,” however in order to receive this nominal compensation, hip implant victims were forced to sign away very important rights. 

The DePuy metal-on-metal hip implants which have caused the problems—the Pinnacle and ASR—could lead to many recipients having to undergo a second surgical procedure to remove the defective hip. This past August, DePuy and Johnson & Johnson entered into the first agreement to settle an ASR lawsuit, ending a case brought by three people in Nevada state court. Another state court case is scheduled to begin in early 2013 in Maryland, and the combined multi-district litigation ASR cases will begin in May, 2013, with the second round starting in July, 2013. 

The DePuy ASR Metal-on-Metal Hip Implant: A Scientific Analysis of its Problems

The last ten years have seen surgical replacement of hip joints with an artificial prosthesis increase significantly. The main reason for this surge in hip replacement surgeries is our aging population. With people living longer, more active lives, degenerating hip joints can put a halt to that activity. From 1997 through 2004, the number of hip replacement surgeries increased nearly 50% and if the trend continues it is estimated that the annual number of hip replacements in the United States will reach 600,000 by 2015.

Factors in Hip Replacement Surgery

Primary reasons for patients undergoing hip replacement surgery include chronic pain, impairment of daily functions and severe arthritis in the hip joint. The most common type of arthritis leading to total hip replacement is osteoarthritis and is generally seen with aging or trauma to the hip joint. In some instances necrosis of the hip can be present, usually caused by a fracture, alcoholism, lupus, or taking steroid drugs such as prednisone. Patients may experience progressively worsening chronic pain which prohibits them from walking, climbing stairs or even getting up from a sitting position.

Types of Hip Implants

There are many different types of hip replacement implant including the metal-on metal, metal-on-polyethylene and metal-on-ceramic as well as the implants which are 100% ceramic or polyethylene. Other than the materials the implant is constructed with, the only other major difference is in how the implant is affixed—it can be cemented to the bone or attached in such a manner that it grows into the patient’s remaining bone. The idea behind the cobalt and chromium metal-on-metal hip implant was to create an implant which would not have to be re-done for fifteen to twenty years—unlike the ceramic and polyethylene hip implants which last approximately 8-12 years.

While metal-on-metal hip implants were actually used as far back as 1955, they were not FDA approved until 1999. Crude attempts at implanting stainless steel devices in the hip joint actually first occurred in 1937 using stainless steel components fitted to the bone with bolts and screws.  According to an article by John M. Restaino titled The Science, Medicine, Epidemiology and Liability Analysis of the DePuy ASR Metal-on-Metal ProstheticImplants, between October 1, 2005 and December 31, 2006 approximately 35% of the hip replacement surgeries implemented a metal-on-metal implant.