Gentile v. Biogen Idec, Inc.

33 Mass. L. Rptr. 607
CourtMassachusetts Superior Court
DecidedJuly 28, 2016
DocketNo. 1181CV03500
StatusPublished

This text of 33 Mass. L. Rptr. 607 (Gentile v. Biogen Idec, Inc.) is published on Counsel Stack Legal Research, covering Massachusetts Superior Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Gentile v. Biogen Idec, Inc., 33 Mass. L. Rptr. 607 (Mass. Ct. App. 2016).

Opinion

Krupp, Peter B., J.

Plaintiff Gerald Gentile (“plaintiff’) has sued defendants Biogen Idee, Inc. (“Biogen”) and Elan Pharmaceuticals, Inc. (“Elan”) (collectively “defendants”) to recover for injuries his wife, Diane Gentile (“Mrs. Gentile”), suffered after taking defendants’ drug, Tysabri (“Tysabri”). The case is before me on defendants’ motion for summary judgment and plaintiffs motion to amend his Second Amended Complaint. For the following reasons, defendants’ motion for summary judgment is ALLOWED and plaintiffs motion to amend is DENIED.

BACKGROUND

A. Record Facts

The summary judgment record, viewed in the light most favorable to plaintiff, contains the following facts material to this motion.

In 1981, Mrs. Gentile was diagnosed with multiple sclerosis (“MS”). MS is a chronic, progressive, disabling autoimmune disease of the central nervous system. It can lead to brain atrophy and cognitive impairment, confine an individual to a wheelchair or bed, and result in death. MS has no known cure.

In 2004, the United States Food and Drug Administration (“FDA”) first approved the prescription drug Tysabri for the treatment of relapsing forms of MS. Tysabri is intended to decrease the number of MS relapses and reduce and delay nerve damage and resulting disability.

Defendants collaborated on aspects of research, development and commercialization of Tysabri. Bio-gen, a Delaware corporation with its headquarters in Massachusetts, manufactured the drug and held the FDA license and regulatory responsibilities associated with it. Elan, a Delaware corporation with a principal place of business in California, distributed the drug and also marketed it to treat Crohn’s disease.

In February 2005, defendants received reports that two patients involved in clinical trials ofTysabri, who also concurrently used Avonex, another MS medication, developed progressive multifocal leukoencephalopathy (“PML”). PML is a rare viral brain infection caused by the J ohn Cunningham virus (“JCV”). A significant portion of the adult population has been exposed to JCV, which is typically harmless.3

On February 28, 2005, following the reports of the PML cases, Biogen withdrew Tysabri from the market and suspended its clinical trials.4 Defendants attempted to better understand and quantify the risk of PML. In March 2006, an FDA advisory panel considered Biogen’s proposal to put Tfysabri back on the market. On June 5, 2006, the FDA approved returning Tfysabri to the market, subject to conditions and requirements to address the PML risk. One of these conditions required that Tfysabri only be prescribed in accordance with a mandatory risk evaluation and management strategy program, also known as the Tfysabri Outreach: Unified Commitment to Health (“TOUCH”) Program. The TOUCH Program was intended “to assess the risk of [PML] associated with [Tysabri], minimize the risk of PML, minimize death and disability due to PML, and promote informed risk-benefit decisions regarding TYSABRI® use.”

The TOUCH Program required, among other things: (1) prior to prescribing Tfysabri, a physician must acknowledge, in writing, that the physician understands the PML risk and must obtain a written acknowledgment of the risk from the patient; (2) prior to each Tfysabri infusion, a specially trained nurse must confirm that the patient has read the Medication Guide that includes the PML warnings; and (3) the nurse must also question the patient about the patient’s understanding of the PML risk and any new symptoms that could be early signs of PML.

Another condition for the reintroduction of Tfysabri to the market was the requirement of a “black box" warning to inform prescribers that Tfysabri use increases a patient’s risk of developing PML. The black box warning stated, in part:

[PML], an opportunistic infection caused by the JC virus that typically occurs in patients that are im-[609]*609munocompromised, has occurred in 3 patients who received TYSABRI® in clinical trials (see BOXED WARNING). Two cases of PML were observed in 1869 patients with multiple sclerosis treated for a median of 120 weeks. The third case occurred among 1043 patients with Crohn’s disease after the patient received 8 doses. The absolute risk for PML in patients treated with TYSABRI® cannot be precisely estimated, and factors that might increase an individual patient’s risk for PML have not been identified. There are no known interventions that can reliably prevent PML or adequately treat PML if it occurs. It is not known whether early detection of PML and discontinuation of TYSABRI® will mitigate the disease. There is limited experience beyond 2 years of treatment. The relationship between the risk of PML and the duration of treatment is unknown.
All three cases of PML occurred in patients who were concomitantly exposed to immunomodulators ... or were immunocomprised due to recent treatment with immunosuppressants . . . Ordinarily, therefore, patients receiving chronic immunosuppressant or im-munomodulatory therapy or who have systemic medical conditions resulting in significantly compromised immune system function should not be treated with TYSABRI® However, the number of cases is too few and the number of patients treated too small to reliably conclude that the risk of PML is lower in patients treated with TYSABRI® alone than in patients who are receiving other drugs that decrease immune function or who are otherwise immunocompromised.

The warnings also provided in the “Indications and Usage” section that “TYSABRI® increases the risk of [PML], an opportunistic viral infection of the brain that usually leads to death or severe disability (see BOXED WARNING AND WARNINGS, [PML]).” (Bold in original). Defendants also included this warning in Tysabri’s Medication Guide, which was provided to patients prior to enrolling in the TOUCH Program. The Medication Guide also stated that “PML usually happens in people with weakened immune systems. No one can predict who will get PML. There is no known treatment, prevention, or cure for PML.”

In early March 2006, in response to FDA’s request, Biogen submitted a report on the results of antibody testing conducted on available serum samples of patients who participated in the Tysabri clinical trials. The report concluded “there is no consensus on a clinically relevant cut off for the ELISA assay or JCV antibody detection.” Biogen continued to research the significance of the presence of JCV antibodies on the risk of developing PML.

Mrs. Gentile resided in New York. In November 2006, Mrs. Gentile’s doctor, Bianca Weinstock-Gutt-man, M.D. (“Dr. Guttman”), an MS specialist at the Jacobs Neurological Institute in Buffalo, New York, prescribed Tysabri for Mrs. Gentile. Before doing so, Dr. Guttman performed a JCV DNA test looking for JCV in Mrs. Gentile’s bloodstream. Mrs. Gentile tested negative. Also, in accordance with FDA requirements, Mrs. Gentile signed the TOUCH enrollment forms, which warned against PML, and acknowledged that “[m]y chance of getting PML may be higher if I am treated with other medicines that can weaken my immune system, including other MS treatments” and that “[i]t is also not known if treatment for a long period of time with TYSABRI can increase my chance for PML.”

At the time she prescribed Tysabri to Mrs. Gentile, Dr.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Wyeth v. Levine
555 U.S. 555 (Supreme Court, 2009)
Martin v. Hacker
628 N.E.2d 1308 (New York Court of Appeals, 1993)
Bushkin Associates, Inc. v. Raytheon Co.
473 N.E.2d 662 (Massachusetts Supreme Judicial Court, 1985)
LaLonde v. Eissner
539 N.E.2d 538 (Massachusetts Supreme Judicial Court, 1989)
Brogie v. Vogel
205 N.E.2d 234 (Massachusetts Supreme Judicial Court, 1965)
Parent v. Stone & Webster Engineering Corp.
556 N.E.2d 1009 (Massachusetts Supreme Judicial Court, 1990)
Kourouvacilis v. General Motors Corp.
575 N.E.2d 734 (Massachusetts Supreme Judicial Court, 1991)
Flesner v. Technical Communications Corp.
575 N.E.2d 1107 (Massachusetts Supreme Judicial Court, 1991)
Castellucci v. United States Fidelity and Guaranty Co.
361 N.E.2d 1264 (Massachusetts Supreme Judicial Court, 1977)
Goulet v. Whitin MacHine Works, Inc.
506 N.E.2d 95 (Massachusetts Supreme Judicial Court, 1987)
Cohen v. McDonnell Douglas Corp.
450 N.E.2d 581 (Massachusetts Supreme Judicial Court, 1983)
Wolfgruber v. Upjohn Co.
72 A.D.2d 59 (Appellate Division of the Supreme Court of New York, 1979)
Reckis v. Johnson & Johnson
28 N.E.3d 445 (Massachusetts Supreme Judicial Court, 2015)
Meiselman v. Crown Heights Hospital, Inc.
34 N.E.2d 367 (New York Court of Appeals, 1941)
Wolfgruber v. Upjohn Co.
417 N.E.2d 1002 (New York Court of Appeals, 1980)
Sosna v. American Home Products
298 A.D.2d 158 (Appellate Division of the Supreme Court of New York, 2002)
Cottam v. CVS Pharmacy
764 N.E.2d 814 (Massachusetts Supreme Judicial Court, 2002)
North American Expositions Co. v. Corcoran
452 Mass. 852 (Massachusetts Supreme Judicial Court, 2009)

Cite This Page — Counsel Stack

Bluebook (online)
33 Mass. L. Rptr. 607, Counsel Stack Legal Research, https://law.counselstack.com/opinion/gentile-v-biogen-idec-inc-masssuperct-2016.