Dyer v. Danek Medical, Inc.

115 F. Supp. 2d 732, 2000 U.S. Dist. LEXIS 14054, 2000 WL 1405079
CourtDistrict Court, N.D. Texas
DecidedSeptember 26, 2000
Docket4:95-cv-00928
StatusPublished
Cited by16 cases

This text of 115 F. Supp. 2d 732 (Dyer v. Danek Medical, Inc.) is published on Counsel Stack Legal Research, covering District Court, N.D. Texas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Dyer v. Danek Medical, Inc., 115 F. Supp. 2d 732, 2000 U.S. Dist. LEXIS 14054, 2000 WL 1405079 (N.D. Tex. 2000).

Opinion

MEMORANDUM OPINION AND ORDER

LINDSAY, District Judge.

Before the court are Defendant Danek Medical, Inc.’s (“Danek”) Motion for Summary Judgment, filed May 15, 1998 1 ; Defendant Richardson Hospital Authority d/b/a Baylor/Richardson Medical Center’s (“RHA”) Motion for Summary Judgment, filed May 15, 1998; and Danek’s Motion to Strike or Preclude Testimony of Andrew Kucharchuk and Harold Alexander, filed July 8, 1998. After careful consideration of the motions, briefs, evidence submitted by the parties and applicable law, the court finds that no genuine issue of material fact exists regarding Plaintiffs’ claims. Accordingly, the court grants summary judgment for both Defendants.

I. Factual and Procedural Background 2

Debra Dyer originally injured her back in July 1990. Her physician, Dr. Abbass Sekhavat, performed spinal surgery in November 1990. After Ms. Dyer injured herself again in a fall, Dr. Sekhavat discovered a ruptured disk and performed a second surgery in May 1991, attempting to achieve spinal fusion. She again injured her back in November 1991. Despite this third injury, the spinal fusion performed in May 1991 was apparently initially successful, although Ms. Dyer experienced severe episodes of back pain. In September 1992, however, an examination revealed that the spinal fusion had failed. Dr. Sekhavat recommended instrumented spinal fusion surgery, which he performed in April 1993 at RHA. This involved the surgical implantation of a spinal fusion fixation device, designed to immobilize the patient’s spine and allow the vertebrae to fuse. The device was attached to Ms. Dyer’s spine by means of screws inserted into the pedicles, bony structures that extend posteriorly from each vertebra. In the process of inserting the screws, Dr. Sekhavat fractured the inferomedial wall of one pedicle on the right side of Ms. Dyer’s spine, and eventually was able to attach the device only to the left side of her spine. Four to six months after the surgery, Ms. Dyer began experiencing debilitating pain, much worse than she had experienced in the preceding three years. She also experienced medical problems that were not present before the surgery.

The device used by Dr. Sekhavat for the 1993 surgery, called the Texas Scottish Rite Hospital (“TSRH”) Spinal System, was manufactured by Danek. Such devices are subject to regulation by the Food and Drug Administration (“FDA”) in accordance with the Medical Device Amendments (“MDAs”) to the Food, Drug, and Cosmetic Act, 21 U.S.C. §§ 301 et seq. (“FDCA”). Under the MDAs, the FDA categorizes medical devices as either Class I (no unreasonable risk of illness or injury, and therefore subject only to general controls applicable to all medical devices), Class II (more likely to cause harm if defective or misused, and therefore subject to additional controls), or Class III (not approved for marketing until the manufacturer provides the FDA with adequate assurance that the device is safe and effective). Class III devices are approved for marketing through one of three different *736 procedures: a rigorous review by the FDA referred to as “premarket approval” (“PMA” process); a “grandfathering” provision for devices already on the market when the MDAs were enacted, pending completion of the PMA process; or a limited FDA review to establish that the device is “substantially equivalent” to a grandfathered device (“ § 510(k)” process) The PMA process often involves stringently controlled clinical trials under the Investi-gational Device Exemption (“IDE”) provisions of the FDCA. An IDE allows a device to be used only in supervised clinical trials, not for commercial marketing and distribution. 3

The TSRH system received marketing approval as substantially equivalent to a grandfathered device, through the § 510(k) process. This FDA clearance, however, only covered attachment of the device through “sacral screws” or “anteri- or screws.” 4 The FDA clearance had specifically excluded marketing the TSRH as a pedicular screw fixation device, as noted in the letter sent to Danek. At the time of Ms. Dyer’s surgery, the FDA had explicitly warned that the TSRH system could not be legally marketed for pedicular fixation, which is the method Dr. Sekhavat used; nevertheless, Danek intended the TSRH system to be used in that way and took extensive actions to promote such use, despite the FDA warning. These actions included agreements with selected spine surgeons to promote the system, organizing and funding courses and seminars, and agreements with manufacturers of similar devices to promote pedicular fixation devices as the standard of care for spinal fusion surgery. Danek and its agents promoted the TSRH system as safe and effective for use by pedicular fixation, but did not disclose that such use had not been cleared by the FDA. Similarly, there was no disclosure of financial relationships between Danek and the surgeons and hospitals who promoted the device. In essence, Plaintiffs contend that these actions created a “black market for pedicle screw fixation devices.” 5

Dr. Sekhavat is a board certified orthopedic surgeon. He has performed numerous spinal surgeries using instrumentation, and predominately uses the TSRH system when he decides to use instrumentation with pedicular fixation. He has attended lectures and courses regarding pedicular fixation devices, although none specifically about the TSRH system, and could not remember whether he had received any promotional material concerning the TSRH system. At the time of Ms. Dyer’s surgery, Dr. Sekhavat was aware of the possible complications arising from such fusion surgery and was aware that the surgery could fail and that the screws and rods could break. He considered that the device was FDA-approved; he was not aware that the FDA had not approved the system for use in this particular manner, or even that FDA would have to approve such specific use.

.Ms. Dyer and her husband filed suit against Danek and RHA in April 1995 in. state court for damages resulting from use of the TSRH system. The suit alleged five different bases for recovery: 1) strict liability based on design defect; 2) strict liability based on marketing defect; 3) breach of express warranty; 4) breach of implied warranty; and 5) violation of various provisions of the Texas Deceptive Trade Practices Act (“DTPA”), Tex. Bus. & Com.Code Ann. §§ 17.41 et seq. (West 1999). Defendants removed the case to *737 federal court in May 1995. In October 1995, the case (along with more than two thousand other cases) was transferred to the United States District Court for the Eastern District of Pennsylvania for multi-district litigation. In re: Orthopedic Bone Screw Products Liability Litigation, MDL Docket No. 1014. After the completion of MDL pretrial proceedings, the case was remanded to this court in December 1997.

II. Summary Judgment Standard

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Bluebook (online)
115 F. Supp. 2d 732, 2000 U.S. Dist. LEXIS 14054, 2000 WL 1405079, Counsel Stack Legal Research, https://law.counselstack.com/opinion/dyer-v-danek-medical-inc-txnd-2000.