Hand v. Smith & Nephew, Inc.

CourtDistrict Court, D. Maryland
DecidedMay 17, 2022
Docket1:17-cv-00935
StatusUnknown

This text of Hand v. Smith & Nephew, Inc. (Hand v. Smith & Nephew, Inc.) is published on Counsel Stack Legal Research, covering District Court, D. Maryland primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hand v. Smith & Nephew, Inc., (D. Md. 2022).

Opinion

IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF MARYLAND

IN RE: SMITH & NEPHEW MDL No. 2775 BIRMINGHAM HIP Master Docket No. 1:17-md-2775 RESURFACING (BHR) HIP IMPLANT PRODUCTS JUDGE CATHERINE C. BLAKE LIABILITY LITIGATION THIS DOCUMENT RELATES TO THE FOLLOWING BHR TRACK ACTIONS:

Marla H. Hand et al. v. Smith & Nephew, Inc., Civil Case No. 1:17-cv-935-CCB

MEMORANDUM Pending before the court is Smith & Nephew’s motion for summary judgment in BHR track action Marla H. Hand et al. v. Smith & Nephew, Inc., No. 1:17-cv-0935. Smith & Nephew seeks summary judgment (ECF 644 in 17-cv-0935; ECF 3574 in master docket 17-md-2775) as to all remaining claims brought by Hand and her spouse James Nyeste (together, “Hand”) — breach of express warranty, a variety of negligence-based claims, punitive damages, and (for Nyeste) loss of consortium. Hand responded in opposition (ECF 655), and Smith & Nephew replied in support of its motion (ECF 663). The court heard oral arguments on May 4, 2022. For the reasons stated herein, the court will grant Smith & Nephew’s motion. BACKGROUND This case concerns injuries suffered by plaintiff Marla Hand and her spouse, James Nyeste, as a result of Hand’s use of the Birmingham Hip Resurfacing Device (“BHR”), an artificial hip implant developed, designed, manufactured, and sold by defendant Smith & Nephew. The BHR The Birmingham Hip Resurfacing (BHR) system is a Smith & Nephew prosthetic hip replacement product that, unlike a traditional total hip replacement, trims and caps — that is, resurfaces — the head of the femur. That femoral head component fits into a hemispherical acetabular cup that fits into a patient’s hip socket. The two pieces rub against one another during

movement of the patient’s hip joint; both are made of cobalt and chromium metal alloys, and the BHR is thus a “metal-on-metal” product. The BHR received Pre-Market Approval from the U.S. Food and Drug Administration on May 9, 2006. The friction between the metal components allegedly can cause metal debris to accumulate within the joint and bloodstream of the patient. Metal debris from the device can then cause pain, metallosis, and other serious complications that may require corrective surgery or revision to a different device. In June 2015, about nine years after initial approval, Smith & Nephew voluntarily recalled some BHR devices due to unreasonably high failure rates (including for complications

due to metal debris) for certain demographic groups, including women, men age 65 or older, and men with femoral head sizes 46 millimeters or smaller. Marla Hand and the Lead-up to Surgery Hand, 66, and Nyeste are residents of Illinois. Hand had long had problems with her right hip, beginning in the late 1990s and including a hip dysplasia diagnosis and four surgical procedures from August 1998 to sometime before May 2001. These difficulties with her right hip were unrelated, however, to her left hip. She first saw Dr. Craig Della Valle in November 2004 with complaints of left hip pain. He noted mild dysplasia on the left side, and Hand underwent non-surgical treatment for several years. By May 2007, however, her left hip pain had advanced to the point where she was significantly disabled and could no longer walk her dog or exercise. Dr. Della Valle recommended a hip resurfacing for Ms. Hand’s left hip. He had been trained on the BHR by Smith & Nephew in November 2006 and had by then performed 20 to 30 BHR implants, about two of which, he estimated, had been for women. (ECF 644-6, Ex. D, Della

Valle Dep. at 10–11). In making recommendations or treatment decisions, Dr. Della Valle relies most on “peer-reviewed published data and peer-reviewed publications” as well as his experience, training, and conferences he has attended. (Id. at 99). Hand and Dr. Della Valle had several discussions about the risks and benefits of a BHR and how it compared to a traditional total hip replacement; Hand also attended a patient education class and sought a second opinion from Dr. Scott Sporer. (ECF 644-5, Ex. C, Hand Dep. at 71, 84–86; ECF 644-6, Ex. D, Della Valle Dep. at 45). Dr. Della Valle told Hand that, compared to total hip replacement, resurfacing would preserve more of the femoral head, that the recovery theoretically would be easier, and that resurfacing could keep a young patient like her

active. (ECF 644-5, Ex. C, Hand Dep. at 75). He did not guarantee the BHR’s outcomes. (Id. at 82). Dr. Della Valle warned Hand that, as a female, she was at a higher risk for revision. (ECF 644-6, Ex. D, Della Valle Dep. at 138–39). He was aware of this higher risk at the time and discussed the risk with his female patients. (Id. at 13–14, 110–11). At the time, that higher risk appeared specifically tied to femoral neck fractures, which tend to occur early, not long after implantation. At the time, Dr. Della Valle also was aware that the BHR’s metal-on-metal configuration might result in the release of metal ions into the bloodstream as a result of wear between the components. (Id. at 140–41). At the time of Hand’s implant surgery, Dr. Della Valle’s custom and practice with resurfacing procedures was to tell patients that a metal-on-metal bearing carried additional risks such as this. (Id. at 41, 45). During the second opinion consultation with Hand, Dr. Sporer discussed the potential for increased metal ion concentration. (ECF 644-5, Ex. C, Hand Dep. at 78–79; ECF 644-7, Ex. E, May 23, 2007, Office Visit Notes with Dr. Scott

Sporer). The Patient’s Guide Before her BHR implant surgery, Hand read the Smith & Nephew BHR Patient’s Guide, which Dr. Della Valle gave her in order to show her illustrations of resurfacing compared to total hip replacement. In a section describing the BHR’s bearing surface, the Patient’s Guide explained: There may be risks associated with metal-on-metal implants, though. While no evidence has been established on the subject, some are concerned that the increased level of metal ions found in the blood of metal-on-metal hip recipients may have negative effects on the human body. For this reason, some surgeons may not implant such a device in a patient with kidney disease (since healthy kidneys filter ions from your body) or in women who are or may become pregnant. (ECF 655-10, Patient’s Guide at 13) (emphasis added). In a “Frequently Asked Questions” section addressing the expected outcomes of a BHR implant, the Guide explained: It is impossible to say how long your implant will last because so many factors play into the lifespan of an implant. In the case of resurfacing, for instance, the metal-on-metal bearing surfaces of your new joint may extend its life longer than that of a traditional total hip replacement, but failure to comply with your physical rehabilitation regime may cause your implant to fail within months. A clinical study showed the BIRMINGHAM HIP Resurfacing implant had a survivorship of 98.4-percent at the five-year mark, which is comparable with the survivorship of a traditional total hip replacement in the under-60 age group. (ECF 655-10, Patient’s Guide at 22) (emphasis added). A 98.4% five-year survivorship rate in the under-60 age group represents a 1.6% revision rate. Hand’s Surgery and the Aftermath Hand received a 42mm-head BHR implant in her left hip on June 25, 2007, when she was age 51.1 Within several weeks, she had much less pain than before the surgery and had resumed

exercise and dog-walking. She was back doing aerobics by October 2007. Her left hip was pain- free for almost ten years, but at a May 2013 annual BHR follow-up appointment, she reported new pain in her right (non-BHR) hip. (ECF 644-5, Ex. C, Hand Dep. at 112–15; ECF 644-6, Ex. D, Della Valle Dep. at 129). A blood test revealed elevated metal ion levels. (ECF 644-5, Ex. C, Hand Dep. at 112:10–114:22).

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Hand v. Smith & Nephew, Inc., Counsel Stack Legal Research, https://law.counselstack.com/opinion/hand-v-smith-nephew-inc-mdd-2022.