Heather Wanke v. Invasix Inc.

CourtDistrict Court, M.D. Tennessee
DecidedMay 19, 2020
Docket3:19-cv-00692
StatusUnknown

This text of Heather Wanke v. Invasix Inc. (Heather Wanke v. Invasix Inc.) is published on Counsel Stack Legal Research, covering District Court, M.D. Tennessee primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Heather Wanke v. Invasix Inc., (M.D. Tenn. 2020).

Opinion

UNITED STATES DISTRICT COURT MIDDLE DISTRICT OF TENNESSEE NASHVILLE DIVISION

HEATHER WANKE, ) ) Plaintiff, ) ) v. ) Case No. 3:19-cv-0692 ) Judge Aleta A. Trauger INVASIX INC. and INMODE LTD., ) ) Defendants. ) )

MEMORANDUM

Invasix Inc. (“Invasix”) has filed a Motion to Dismiss (Docket No. 67), to which Heather Wanke has filed a Response (Docket No. 74), and Invasix has filed a Reply (Docket No. 83). InMode Ltd. (“InMode”) has filed a separate Motion to Dismiss (Docket No. 69), to which Wanke has filed a Response (Docket No. 75), and InMode has filed a Reply (Docket No. 84). Wanke filed a Motion for Leave to File a Second Amended Complaint (Docket No. 80), to which Invasix and InMode have jointly filed a Response (Docket No. 85), and Wanke has filed a Reply (Docket No. 86). For the reasons set out herein, Wanke’s motion will be granted, InMode’s motion will be granted in part and denied in part as moot, and Invasix’s motion will be denied as moot. I. BACKGROUND1 “The Medical Device Amendments of 1976 (‘MDA’), 21 U.S.C. §§ 360c–360k, 379–379a, establishes the framework for federal regulation of medical devices. As amended, the MDA requires the FDA to place a device into one of three classes reflecting different levels of regulation.” Kaiser v. Johnson & Johnson, 947 F.3d 996, 1003 (7th Cir. 2020). “The devices

1 Unless otherwise indicated, these facts come from Wanke’s Proposed Second Amended Complaint (Docket No. 80-12) and are taken as true for the purposes of the pending motions. receiving the most federal oversight are those in Class III, which include,” among other things, “replacement heart valves, implanted cerebella stimulators, and pacemaker pulse generators.” Riegel v. Medtronic, Inc., 552 U.S. 312, 317 (2008). A device is placed in Class III based on the risk entailed in its use and the lack of available information ensuring that it can be safely sold

without prior review for safety and effectiveness. See 21 U.S.C. § 360c(a)(1)(C). Generally speaking, Class III medical devices are subject to a “rigorous regime of premarket approval” administered by the FDA. Riegel, 552 U.S. at 317. In select situations, however, it is permissible to bring a Class III device to market without completing the full FDA approval process. Specifically, the MDA “grandfathered many [devices] that were already on the market,” allowing those devices to “remain on the market until the FDA promulgates, after notice and comment, a regulation requiring premarket approval.” Id. (citing 21 U.S.C. §§ 360c(f)(1), 360e(b)(1)). The MDA’s grandfathering provision applies not only to the specific devices that pre- dated the MDA, but also any “substantially equivalent” devices. Id. If a company seeks to sell a Class III device as “substantially equivalent” to a grandfathered

device, it must submit the device to an FDA review “known as the § 510(k) process, named after the statutory provision describing the review.” Id. Although the § 510(k) process does entail submitting the device to some degree of regulatory scrutiny, it is generally understood that a § 510(k) review, because it is focused only on substantial equivalence, will be less comprehensive and onerous than a premarket review for a non-grandfathered Class III device. InMode is an Israeli medical device corporation. Invasix is a Canada-based Delaware corporation that allegedly “acts as the North American division” of InMode. (Docket No. 80-12 ¶¶ 6, 8.) InMode and Invasix sell a Class III medical device under the trade name “Fractora,” which, according to Wanke, is “designed, manufactured and sold in North America by Invasix.” (Id. ¶ 1.) The Fractora device consists of a console and a handheld applicator, with a disposable tip, designed to deliver radiofrequency electrical current to human skin. (Id. ¶ 14.) The Fractora device is used to “vaporize columns of skin,” which in turn “stimulates the body’s production of collagen” in order to “leave[] the skin looking and feeling smoother.” (Id. ¶ 15.) Invasix submitted

a § 510(k) application for the Fractora device around late May of 2011, and it was ultimately approved as substantially equivalent to a grandfathered device. (Id. ¶ 12 n.1) According to Wanke, however, the approval of the Fractora as a substantially equivalent device was the result, at least in part, of improper actions by the defendants during the device’s § 510(k) review. In particular, the defendants’ § 510(k) application described the intended application of the Fractora device in a manner that differed, in several key ways, from the uses for which the defendants ultimately marketed the device. (Id. ¶¶ 24–26.) As a result, Wanke alleges, the defendants were able to take the least challenging available route to approved sales of a Class III device—intended exclusively for devices that had already been used for many years or slight variations thereon—only to then market the Fractora as a “revolution in medical devices” to be used in ways that the FDA never considered.2 (Id. ¶ 13.)

Wanke had a Fractora procedure performed on her face in Nashville on June 15, 2017, by Dr. Paulino E. Goco. She characterizes the procedure as “only to refresh her skin, which was virtually wrinkle-free with small pores and a healthy-looking olive complexion.” (Id. ¶ 43.) Dr. Goco had told Wanke that the procedure was “a very safe, cutting edge, painless and non-invasive alternative to face lift and [laser] procedures.” (Id. ¶ 44.) Dr. Goco used “extremely aggressive treatment parameters” during the procedure, meaning that Wanke was subjected to a particularly strong bombardment of tissue-destroying radiofrequency current. (Id. ¶¶ 44, 46–47.) Dr. Goco

2 Wanke alleges several additional types of wrongdoing related to the promotion of the Fractora device. The details of those allegations are immaterial to the issues presented by the pending motions . relied on a January 2015 Quick Reference Guide issued by Invasix to formulate his approach. (Id. ¶ 48.) Rather than leaving Wanke looking and feeling rejuvenated, the Fractora procedure administered by Dr. Goco ultimately resulted in “severe, clawlike scarring on her right cheek, ice

pick-like scarring to her entire face and changes to the texture of her skin, leaving her with an orange peel look.” (Id. ¶ 45.) Because it is not uncommon for cosmetic procedures to require some healing time, there is some dispute regarding when Wanke realized that the procedure had injured her permanently, rather than simply having required a more difficult than expected recovery period. According to Wanke’s original Complaint in this case, Dr. Goco told Heather to expect less than five days downtime[,] so Heather knew something had gone terribly wrong when she remained swollen with puncture mark wounds all over her face at day 3 and 4 of her recovery. She remained housebound at day 7. Her skin looked even worse beginning at day 10—as the swelling subsided, Heather’s smooth, clear skin came to look and feel like orange peel, the skin under her eyes darkened[,] and burns left claw and moon shaped [scarring] on her cheeks, upper lip and chin and between her brow.

(Docket No. 1 ¶ 55.) According to that Complaint, Dr. Goco shared Wanke’s concerns, and Dr. Goco’s notes mention “hyperpigmentation” from the procedure no later than July 12, 2017, shortly after the procedure had been performed. (Id. ¶ 56.) On that date, he performed a “Facial Assessment Report” that showed that Wanke’s skin was in observably worse condition than it had been before the procedure.

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