Conti v. Ethicon, Inc. et al

Filing 120

MEMORANDUM OPINION AND ORDER (Daubert Motion re: Prof. Dr. Med. Uwe Klinge) The court DENIES in part, GRANTS in part, and RESERVES in part the Motion filed in MDL 2327 by Ethicon, Inc., Johnson & Johnson To Limit the Testimony of Prof. Dr. Med. Uwe Klinge in Wave 1 Cases, as more fully set forth herein. Signed by Judge Joseph R. Goodwin on 8/24/2016. (cc: attys; any unrepresented party) (REF: MDL 2327; Cases Listed on Exhibit) (mmw)

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF WEST VIRGINIA
CHARLESTON DIVISION
IN RE:

ETHICON, INC.
PELVIC REPAIR SYSTEMS
PRODUCT LIABILITY LITIGATION
MDL No. 2327
______________________________________________________________________________
THIS DOCUMENT RELATES TO:
Cases Identified in the Exhibit
Attached Hereto
MEMORANDUM OPINION AND ORDER
(Daubert Motion re: Prof. Dr. Med. Uwe Klinge)
Pending before the court is the Motion to Limit the Testimony of Dr. Med. Uwe
Klinge [ECF No. 1978] filed by Johnson & Johnson and Ethicon, Inc. (collectively
“Ethicon”). The Motion is now ripe for consideration because briefing is complete.
I.

Background

This case resides in one of seven MDLs assigned to me by the Judicial Panel
on Multidistrict Litigation concerning the use of transvaginal surgical mesh to treat
pelvic organ prolapse (“POP”) and stress urinary incontinence (“SUI”). In the seven
MDLs, there are more than 75,000 cases currently pending, approximately 30,000 of
which are in this MDL.
In this MDL, the court’s tasks include “resolv[ing] pretrial issues in a timely
and expeditious manner” and “resolv[ing] important evidentiary disputes.” Barbara
J. Rothstein & Catherine R. Borden, Fed. Judicial Ctr., Managing Multidistrict

Litigation in Products Liability Cases 3 (2011). To handle motions to exclude or to

limit expert testimony pursuant to Daubert v. Merrell Dow Pharmaceuticals, Inc.,
509 U.S. 579 (1993), the court developed a specific procedure. In Pretrial Order
(“PTO”) No. 217, the court instructed the parties to file only one Daubert motion per
challenged expert, to file each motion in the main MDL—as opposed to the individual
member cases—and to identify which cases would be affected by the motion. PTO No.
217, at 4.1
II.

Preliminary Matters

Before plunging into the heart of the Motion, a few preliminary matters need
to be addressed.
I am compelled to comment on the parties’ misuse of my previous Daubert
rulings on several of the experts offered in this case. See generally Sanchez v. Bos.

Sci. Corp., No. 2:12-cv-05762, 2014 WL 4851989 (S.D. W. Va. Sept. 29, 2014); Tyree
v. Bos. Sci. Corp., 54 F. Supp. 3d 501 (S.D. W. Va. 2014); Eghnayem v. Bos. Sci. Corp.,
57 F. Supp. 3d 658 (S.D. W. Va. 2014). The parties have, for the most part, structured
their Daubert arguments as a response to these prior rulings, rather than an
autonomous challenge to or defense of expert testimony based on its reliability and
relevance. In other words, the parties have comparatively examined expert testimony
and have largely overlooked Daubert’s core considerations for assessing expert
testimony. Although I recognize the tendency of my prior evidentiary determinations
to influence subsequent motions practice, counsels’ expectations that I align with

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identified the Wave 1 cases affected by this Motion in its attached Exhibit A [ECF No. 19781], which the court has attached to this Memorandum Opinion and Order. At the time of transfer or
remand, the parties will be required to designate relevant pleadings from MDL 2327, including the
motion, supporting memorandum, response, reply, and exhibits referenced herein.

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these previous rulings when faced with a different record are misplaced, especially
when an expert has issued new reports and given additional deposition testimony.
Mindful of my role as gatekeeper for the admission of expert testimony, as well
as my duty to “respect[ ] the individuality” of each MDL case, see In re

Phenylpropanolamine Prods. Liab. Litig., 460 F.3d 1217, 1231 (9th Cir. 2006), I refuse
to credit Daubert arguments that simply react to the court’s rulings in Sanchez and
its progeny. Indeed, I feel bound by these earlier cases only to the extent that the
expert testimony and Daubert objections presented to the court then are identical to
those presented now. Otherwise, I assess the parties’ Daubert arguments anew. That
is, in light of the particular expert testimony and objections currently before me, I
assess “whether the reasoning or methodology underlying the testimony is
scientifically valid” and “whether that reasoning or methodology properly can be
applied to the facts in issue.” Daubert, 509 U.S. at 592–93. Any departure from

Sanchez, Eghnayem, or Tyree does not constitute a “reversal” of these decisions and
is instead the expected result of the parties’ submission of updated expert reports and
new objections to the expert testimony contained therein.
Finally, I have attempted to resolve all possible disputes before transfer or
remand, including those related to the admissibility of expert testimony pursuant to

Daubert. Nevertheless, in some instances I face Daubert challenges where my
interest in accuracy counsels reserving ruling until the reliability of the expert
testimony may be evaluated at trial. At trial, the expert testimony will be tested by
precise questions asked and answered. The alternative of live Daubert hearings is

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impossible before transfer or remand because of the numerosity of such motions in
these seven related MDLs. As these MDLs have grown and the expert testimony has
multiplied, I have become convinced that the critical gatekeeping function permitting
or denying expert testimony on decisive issues in these cases is best made with a live
expert on the witness stand subject to vigorous examination.
In the course of examining a multitude of these very similar cases involving
the same fields of expertise, I have faced irreconcilably divergent expert testimony
offered by witnesses with impeccable credentials, suggesting, to me, an unreasonable
risk of unreliability. The danger—and to my jaded eye, the near certainty—of the
admission of “junk science” looms large in this mass litigation.
The parties regularly present out-of-context statements, after-the-fact
rationalizations of expert testimony, and incomplete deposition transcripts. This,
combined with the above-described practice of recycling expert testimony, objections,
and the court’s prior rulings, creates the perfect storm of obfuscation. Where further
clarity is necessary, I believe can only be achieved through live witness testimony—
not briefing—I will therefore reserve ruling until expert testimony can be evaluated
firsthand.
III.

Legal Standard

By now, the parties should be intimately familiar with Rule 702 of the Federal
Rules of Evidence and Daubert, so the court will not linger for long on these
standards.
Expert testimony is admissible if the expert is qualified and if his or her expert

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testimony is reliable and relevant. Fed. R. Evid. 702; see also Daubert, 509 U.S. at
597. An expert may be qualified to offer expert testimony based on his or her
“knowledge, skill, experience, training, or education.” Fed. R. Evid. 702. Reliability
may turn on the consideration of several factors:
(1) whether a theory or technique can be or has been tested;
(2) whether it has been subjected to peer review and
publication; (3) whether a technique has a high known or
potential rate of error and whether there are standards
controlling its operation; and (4) whether the theory or
technique enjoys general acceptance within a relevant
scientific community.

Cooper v. Smith & Nephew, Inc., 259 F.3d 194, 199 (4th Cir. 2001) (citing Daubert,
509 U.S. at 592–94). But these factors are neither necessary to nor determinative of
reliability in all cases; the inquiry is flexible and puts “principles and methodology”
above conclusions and outcomes. Daubert, 509 U.S. at 595; see also Kumho Tire Co.

v. Carmichael, 525 U.S. 137, 141, 150 (1999). Finally, and simply, relevance turns on
whether the expert testimony relates to any issues in the case. See, e.g., Daubert, 509
U.S. at 591–92 (discussing relevance and helpfulness).
At bottom, the court has broad discretion to determine whether expert
testimony should be admitted or excluded. Cooper, 259 F.3d at 200.
IV.

Discussion

Dr. Uwe Klinge, a native of Germany, practiced as a hernia surgeon. During
his practice, he used mesh products to surgically repair abdominal wall hernias.
a. Alternatives
Ethicon challenges the reliability of Dr. Klinge’s expert testimony about

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polyvinylidene fluoride (“PVDF”) mesh. As I have found before, this expert testimony
is reliable. In re Ethicon, Inc., No. 2:12-md-2327, 2014 WL 186872, at *7 (S.D. W. Va.
Jan. 15, 2014). To the extent Ethicon argues that Dr. Klinge’s testimony that PVDF
was a safer alternative is unreliable because PVDF was not cleared by the FDA, this
does not render Dr. Klinge’s testimony unreliable. This has no bearing on whether
PVDF mesh is a safer alternative to other mesh products. So Ethicon’s Motion is
DENIED on this point.
b. Degradation, Fraying, and Particle Loss of Prolene
Ethicon seeks to exclude Dr. Klinge’s opinion that the Prolene device is
defective because it degrades and is subject to fraying and particle loss. Ethicon
makes several arguments, which I address in turn.

First, Ethicon argues that Dr. Klinge’s testimony is irrelevant. In so doing,
Ethicon seems to assume the outcome of this litigation. Ethicon states that because
an opinion that states the device is defective is at odds with the medical community
and literature, any evidence about fraying and particle loss is immaterial. The court
does not subscribe to this logic and Ethicon’s Motion is DENIED on this point.

Second, Ethicon advances a similarly meritless argument about the relevance
of Dr. Klinge’s general opinions on degradation, fraying, and particle loss because he
cannot link these opinions to the facts of any specific case. A single expert need not
provide all the pieces of the puzzle for their testimony to be useful to the jury in
determining the ultimate issues in the case. See, e.g., Huskey v. Ethicon, Inc., 29 F.
Supp. 3d 691, 710 (S.D. W. Va. 2014) (rejecting a similar argument and stating

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“general causation opinions are helpful to the jury and fit the facts of the case
regardless of whether the plaintiff may ultimately fail to carry their burden to show
that [the plaintiff] was harmed”). The Motion is DENIED as to this matter.

Finally, Ethicon argues that Dr. Klinge’s opinions on degradation, fraying, and
particle loss should be excluded unless he can identify and explain their clinical
significance. Basically, Ethicon argues that degradation is only relevant if the expert
can link it to some type of complication. I reject this argument. A single expert need
not provide all the pieces of the puzzle for their testimony to be useful to the jury in
determining the ultimate issues in the case. See, e.g., Huskey v. Ethicon, Inc., 29 F.
Supp. 3d 691, 710 (S.D. W. Va. 2014) (rejecting a similar argument). Ethicon’s Motion
is DENIED in this regard.
c. Degradation, Fraying, and Particle Loss of Prolene Soft
Ethicon also seeks to exclude Dr. Klinge’s testimony that the Prolene Soft
device is defective because it is subject to fraying and particle loss. Ethicon argues
that Dr. Klinge relies primarily on studies examining mesh used to treat SUI rather
than POP. According to Ethicon, Prolene—used to treat SUI—and Prolene Soft—used
to treat POP—have different pore sizes and weights that might affect this analysis.
The parties have not provided the court with sufficient information to judge the
validity of this distinction or whether it has any bearing on opinions related to
degradation, fraying, and particle loss. Accordingly, I RESERVE ruling until this
matter may be probed further at trial.
Ethicon also argues that Dr. Klinge’s opinions about degradation should be

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excluded because he cannot reliably opine on the clinical significance of degradation
or tie degradation to any specific complication—suggesting it is therefore irrelevant.
As I explained above, this argument is without merit and Ethicon’s Motion is
DENIED in this regard.
d. Prolift+M
Ethicon also seeks exclusion of any testimony by Dr. Klinge on the Prolift+M
device. The plaintiffs concede that they “will not elicit testimony from Dr. Klinge in
cases involving the Prolift+M device.” Resp. 14 [ECF No. 2188]. Relying on this
representation, Ethicon’s Motion on this matter is DENIED as moot.
e. Prolene Sutures
Ethicon next argues that Dr. Klinge should either “not be allowed to use
Ethicon’s suture studies to support his opinion or Ethicon should be allowed to
impeach him with evidence of the FDA’s approval of sutures for implantation in the
human body.” Mem. 16 [ECF No. 1982]. Ethicon claims that any opinions regarding
Prolene sutures “would be preempted by federal law.” Mem. 16. This court knows of
no authority that supports the proposition that opinions may be preempted, and
Ethicon does not cite to any. See also Lewis v. Johnson & Johnson, 991 F. Supp. 2d
748, 757–59 (S.D. W. Va. 2014) (rejecting Ethicon’s arguments that the FDA’s
approval of the Prolene suture preempted products liability claims involving the
Prolene mesh TVT). Accordingly, Ethicon’s Motion on this matter is DENIED. Nor
should this ruling be construed to allow Ethicon to impeach Dr. Klinge with FDA
evidence, as FDA approval of Prolene has no bearing on Dr. Klinge’s reliance on

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Ethicon’s studies as evidence of degradation. Ethicon’s Motion is DENIED on this
matter.
f. Effective Porosity
Finally, Ethicon seeks to exclude Dr. Klinge’s opinions on effective porosity as
irrelevant. Ethicon argues that “pore size is only relevant if larger pores would work
better, and without a safer alternative design, any such testimony is purely
speculative.” Mem. 18. I reject this contrived relevance argument. The need to
demonstrate a safer alternative design as part of products liability claims varies by
state. Moreover, as I have explained above, an expert need not provide testimony on
all contours of defective design for any one aspect of testimony to be relevant.
Ethicon’s Motion is DENIED on this point.
V.

Recurring Issues

Many of the Daubert motions filed in this MDL raise the same or similar
objections.
One particular issue has been a staple in this litigation, so I find it best to
discuss it in connection with every expert. A number of the Daubert motions seek to
exclude FDA testimony and other regulatory or industry standards testimony. To the
extent this Motion raises these issues it is GRANTED in part and RESERVED in
part as described below.
I have repeatedly excluded evidence regarding the FDA’s section 510(k)
clearance process in these MDLs, and will continue to do so in these cases, a position
that has been affirmed by the Fourth Circuit. In re C. R. Bard, Inc., 81 F.3d 913,

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921–23 (4th Cir. 2016) (upholding the determination that the probative value of
evidence related to section 510(k) was substantially outweighed by its possible
prejudicial impact under Rule 403). Because the section 510(k) clearance process does
not speak directly to safety and efficacy, it is of negligible probative value. See In re

C. R. Bard, 81 F.3d at 920 (“[T]he clear weight of persuasive and controlling authority
favors a finding that the 510(k) procedure is of little or no evidentiary value.”).
Delving into complex and lengthy testimony about regulatory compliance could
inflate the perceived importance of compliance and lead jurors “to erroneously
conclude that regulatory compliance proved safety.” Id. at 922. Accordingly, expert
testimony related to the section 510(k) process, including subsequent enforcement
actions and discussion of the information Ethicon did or did not submit in its section
510(k) application, is EXCLUDED. For the same reasons, opinions about Ethicon’s
compliance with or violation of the FDA’s labeling and adverse event reporting
regulations are EXCLUDED. In addition to representing inappropriate legal
conclusions, such testimony is not helpful to the jury in determining the facts at issue
in these cases and runs the risk of misleading the jury and confusing the issues.
Insofar as this Motion challenges the FDA-related testimony discussed here, the
Motion is GRANTED.
A number of experts also seek to opine on Ethicon’s compliance with design
control and risk management standards. Some of this testimony involves the FDA’s
quality systems regulations, and some—likely in an attempt to sidestep my
anticipated prohibition on FDA testimony—involve foreign regulations and

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international standards. I find all of this proposed testimony of dubious relevance.
Although these standards relate to how a manufacturer should structure and
document risk assessment, the standards do not appear to mandate any particular
design feature or prescribe the actual balance that must be struck in weighing a
product’s risk and utility. Nor is it clear that the European and other international
standards discussed had any bearing on the U.S. medical device industry when the
device in question was being designed.
Nevertheless, because the nuances of products liability law vary by state, I will
refrain from issuing a blanket exclusion on design process and control standards
testimony, whether rooted in the FDA or otherwise. Each standard must be assessed
for its applicability to the safety questions at issue in this litigation, consistent with
state law. I am without sufficient information to make these findings at this time.
Accordingly, I RESERVE ruling on such matters a hearing, where the trial judge will
have additional context to carefully evaluate the relevance and potential prejudicial
impact of specific testimony.
Similarly, I doubt the relevance of testimony on the adequacy of Ethicon’s
clinical testing and research, physician outreach, or particular product development
procedures and assessments otherwise not encompassed by the above discussion.
Again, such matters seem to say very little about the state of the product itself (i.e.,
whether or not it was defective) when it went on the market. But because the scope
of relevant testimony may vary according to differences in state products liability law,
I RESERVE ruling on such matters until they may be evaluated in proper context at

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a hearing before the trial court or at trial.
Additional—and more broad—matters also warrant mention. While some of
these concerns may not apply to this particular expert, these concerns are raised so
frequently that they are worth discussing here.

First, many of the motions seek to exclude state-of-mind and legal-conclusion
expert testimony. Throughout these MDLs, the court has prohibited the parties from
using experts to usurp the jury’s fact-finding function by allowing testimony of this
type, and I do the same here. E.g., In re C. R. Bard, Inc., 948 F. Supp. 2d 589, 611
(S.D. W. Va. 2013); see also, e.g., United States v. McIver, 470 F.3d 550, 562 (4th Cir.
2006) (“[O]pinion testimony that states a legal standard or draws a legal conclusion
by applying law to the facts is generally inadmissible.”); In re Rezulin Prods. Liab.

Litig., 309 F. Supp. 2d 531, 546 (S.D.N.Y. 2004) (“Inferences about the intent and
motive of parties or others lie outside the bounds of expert testimony.”). Additionally,
an expert may not offer expert testimony using “legal terms of art,” such as
“defective,” “unreasonably dangerous,” or “proximate cause.” See Perez v. Townsend

Eng’g Co., 562 F. Supp. 2d 647, 652 (M.D. Pa. 2008).
Second, and on a related note, many of the motions seek to prohibit an expert
from parroting facts found in corporate documents and the like. I caution the parties
against introducing corporate evidence through expert witnesses. Although an expert
may testify about his review of internal corporate documents solely for the purpose
of explaining the basis for his or her expert opinions—assuming the expert opinions
are otherwise admissible—he or she may not offer testimony that is solely a conduit

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for corporate information.

Third, many of the motions also ask the court to require an expert to offer
testimony consistent with that expert’s deposition or report or the like. The court will
not force an expert to testify one way or another. To the extent an expert offers
inconsistent testimony, the matter is more appropriately handled via crossexamination or impeachment as appropriate and as provided by the Federal Rules of
Evidence.

Fourth, in these Daubert motions, the parties have addressed tertiary
evidentiary matters like whether certain statements should be excluded as hearsay.
The court will not exclude an expert simply because a statement he or she discussed
may constitute hearsay. Cf. Daubert, 509 U.S. at 595. Hearsay objections are more
appropriately raised at trial.

Finally, in some of the Daubert motions, without identifying the specific expert
testimony to be excluded, the parties ask the court to prevent experts from offering
other expert testimony that the moving party claims the expert is not qualified to
offer. I will not make speculative or advisory rulings. I decline to exclude testimony
where the party seeking exclusion does not provide specific content or context.
VI.

Conclusion

The court DENIES in part, GRANTS in part, and RESERVES in part the
Motion to Limit the Testimony of Prof. Dr. Med. Uwe Klinge [ECF No. 1978].

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The court DIRECTS the Clerk to file a copy of this Memorandum Opinion and
Order in 2:12-md-2327 and in the Ethicon Wave 1 cases identified in the Exhibit
attached hereto.
ENTER: August 24, 2016

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KLINGE

__________ Wolfe, Elizabeth Blynn

KLINGE