Carl Brandenfels v. Margaret M. Heckler, Secretary of Health and Human Services

716 F.2d 553
Court of Appeals for the Ninth Circuit·Decided September 22, 1983·No. 82-7279·Published·Cited by 2 cases

Opinion

POOLE, Circuit Judge:

We affirm the decision of the Commissioner of the Food and Drug Administration withdrawing approval of petitioner’s new drug application.

FACTS

Brandenfels Scalp and Hair Applications and Massage is an aqueous solution of 0.25% sulfanilimide and an aqueous solution of 1.5% lanolin. The labeling reviewed by the Food and Drug Administration’s (FDA) scientific panels claimed that the treatment tends to soften the scalp, to remove dandruff scales, and to aid the scalp and hair generally. The treatment consists of topical applications of the solutions accompanied by massage along the arteries leading to the scalp. It has been marketed since the 1940’s and is sold principally by mail. As per the requirements of the 1938 Food, Drug, and Cosmetic Act, 21 U.S.C. § 301 et seq., the treatment was found to be safe by FDA in 1948.

Brandenfels was the subject of a Post Office investigation in 1946 for alleged misrepresentation of his treatment’s effectiveness. The proceeding was dismissed without prejudice in 1958.

In compliance with the 1962 amendments to the Act, petitioner in 1964 filed with the Bureau of Drugs four volumes of evidence in support of the efficacy of his treatment. Such evidence was not reviewed by the FDA’s scientific panels, apparently because of an oversight. In 1970, the Commissioner classified Brandenfels’ treatment as “possibly effective,” which meant Brandenfels had 6 months to submit “substantial evidence” of effectiveness. At the end of that time, the FDA would evaluate the data to determine whether to withdraw approval of the New Drug Application (NDA) under § 505(e) of the Act, 21 U.S.C. § 355(e). Brandenfels requested and received an extension, and in the process of granting that extension the FDA notified Brandenfels that it would also review the data submitted by Brandenfels in 1964. In early 1972, the FDA reclassified the treatment as one “lacking substantial evidence of effectiveness.” The stated reason for the reclassification was the failure of Brandenfels to submit any evidence satisfying FDA definitions of what constituted “substantial evidence.” Brandenfels was given 30 days to notify the FDA as to whether he would seek a hearing, and, if he did want a hearing, he was required to provide reasons and analyses of the data supporting his position. Brandenfels filed his hearing request later that year.

Nearly nine years later, the Acting Director of the FDA concluded that “there was no genuine and substantial issue of fact requiring a hearing, and that the legal objections are insubstantial.” The agency’s summary judgment procedures under 21 C.F.R. § 314.200(g) were invoked to deny Brandenfels’ request for an evidentiary hearing. The decision was based on a determination that none of the four studies *555 submitted by Brandenfels to show efficacy were “adequate and well-controlled” within the meaning of 21 C.F.R. § 314.111(a)(5)(h). Furthermore, the Acting Director found that statements submitted by two experts did not represent the consensus of current medical opinion and were, in any event, in the nature of unscientific testimonials not constituting substantial evidence of effectiveness as contemplated by Congress and required by the Act. Also rejected were citations to medical literature, found not to be related to the product, and testimonial letters, photographs, and the results of a questionnaire given to users, all found to lack sufficient detail to permit scientific evaluation.

Brandenfels subsequently filed a petition for reconsideration asking that the withdrawal be stayed pending reconsideration or, in the alternative, that it be vacated. The petition was denied in its entirety. The Commissioner reiterated that the studies were not adequate and well-controlled and rejected Brandenfels’ procedural arguments. This petition followed.

I. Petitioner’s Evidence of Efficacy

With respect to Brandenfels’ evidence of efficacy, we agree with the FDA that the Commissioner’s findings accurately reflected Brandenfels’ studies and data, and that the deficiencies found by the Commissioner “conclusively render the studpes] inadequate ... in light of the pertinent regulations,” as required by Weinberger v. Hynson, Westcott & Dunning, Inc., 412 U.S. 609, 622, 93 S.Ct. 2469, 2479, 37 L.Ed.2d 207 (1973). A study submitted by Brandenfels from the University of Oregon Medical School, for example, did not conform to any of the requirements of 21 C.F.R. § 314.-ll(a)(5)(ii), in that it failed to explain the method of selection of subjects observed who used the treatment, or the methods of observing and recording results; it did not provide a system for quantifying symptom severity; and did not adequately establish a “control group” for the study. The other studies similarly suffered from a variety of infirmities, any one of which would be sufficient to uphold the Commissioner’s decision.

We reject petitioner’s request that we ignore FDA regulations defining “substantial evidence” of efficacy in favor of an ad hoc judicial inquiry into what constitutes such evidence. Determining reliable scientific data is not the judicial function. Congress vested that responsibility in the FDA and we will not preempt its presumed expertise. Accord, Cooper Laboratories, Inc. v. Commissioner, FDA, 501 F.2d 772, 778 (D.C.Cir.1974); Upjohn Co. v. Finch, 422 F.2d 944, 954 (6th Cir.1970).

II. Petitioner’s Allegations of Procedural Error

A. Notice

Petitioner contends that the notice of opportunity for hearing charged him with failure to furnish any evidence of efficacy, but that the withdrawal order found that his evidence was insubstantial. He contends, therefore, that the notice of hearing did not give him notice of the actual grounds for withdrawal.

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Carl Brandenfels v. Margaret M. Heckler, Secretary of Health and Human Services, 716 F.2d 553 (9th Cir. 1983).

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