Paula Kuyat v. BioMimetic Therapeutics, Inc.

747 F.3d 435, 2014 WL 1259607, 2014 U.S. App. LEXIS 5738
CourtCourt of Appeals for the Sixth Circuit
DecidedMarch 28, 2014
Docket13-5602
StatusPublished
Cited by113 cases

This text of 747 F.3d 435 (Paula Kuyat v. BioMimetic Therapeutics, Inc.) is published on Counsel Stack Legal Research, covering Court of Appeals for the Sixth Circuit primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Paula Kuyat v. BioMimetic Therapeutics, Inc., 747 F.3d 435, 2014 WL 1259607, 2014 U.S. App. LEXIS 5738 (6th Cir. 2014).

Opinion

OPINION

ROGERS, Circuit Judge.

In this securities fraud action, the plaintiffs contend that BioMimetic Therapeutics, Inc. misled investors about Augment Bone Graft’s prospects for Federal Drug Administration (FDA) approval. According to the plaintiffs, the FDA privately *437 communicated to BioMimetie that the FDA expected the device’s clinical trials to prove that Augment was effective based on an analysis of all of the study’s participants. The clinical trials did not achieve those results. But if BioMimetie removed from its analysis study participants that did not actually receive treatment, then the data did indicate that the device was effective. Based on these two analyses, BioMimetie expressed optimism about Augment’s chances for FDA approval to investors. The plaintiffs claim that those statements were misleading because BioM-imetic did not tell investors everything it knew about the FDA’s expectations — particularly the FDA’s desire for the trials to show that the device was effective based on an analysis of the entire study population. However, the plaintiffs’ complaint does not plead a strong enough inference of scienter, and therefore the district court did not err in granting BioMimetie’s motion to dismiss the plaintiffs’ complaint.

BioMimetie develops and manufactures products that help heal damaged bones and muscles. Augment is one of the company’s flagship products; it is designed to encourage bone growth in patients that undergo foot and ankle surgeries. Historically, doctors treated these damaged bones and muscles by transplanting healthy tissue from one part of the patient’s body to the damaged area via a process known as an autograft. Augment is different from an autograft because the device promotes bone growth via drugs and can be done in a single operation, while autografts require conducting a second surgery to harvest the material from another part of the patient’s body. If Augment works as intended, the device will obviate the need for a surgeon to conduct the second surgery.

Before BioMimetie can sell Augment in the United States, the FDA must approve the device. Obtaining FDA approval requires a company (known as a sponsor in this context) to navigate the complex pre-market approval process. To receive pre-market approval, a sponsor must conduct clinical trials that demonstrate the device’s efficacy and safety. Before obtaining permission to conduct the clinical trials, the sponsor must receive FDA clearance to test the device on humans. And before the FDA will grant its permission to conduct those tests, the sponsor must submit a proposed study plan that governs how the study will be performed and its data analyzed. This plan is known as a protocol. Sometimes the FDA will object to the initial protocol proposed by the sponsor and will issue a conditional approval letter that allows the trials to begin but that requires refinement of the protocol. In those cases, the sponsor will need to supplement its proposed protocol to address the FDA’s concerns.

After the sponsor completes the clinical trials, it can submit an application for pre-market approval to the FDA. If the agency detects potential problems with the application, it can issue a “deficiency letter” that asks the sponsor to address any problems the letter identified. The FDA can also choose to refer the premarket approval application to a panel of outside experts. After a public meeting, these experts vote on whether they think the device is safe, effective, and whether its benefits outweigh its risks. If the device makes it through all of these steps, then the FDA itself will decide whether or not it will approve the device. The FDA is not bound by the expert panel’s recommendation and can choose to approve the device or declare it “not approvable.”

BioMimetie filed for permission to conduct clinical trials in June 2005. The protocol submitted with that application proposed that the “primary effectiveness analysis” (i.e., the analysis that would de *438 termine whether Augment was effective relative to a control group of patients receiving a traditional autograft implant) would be conducted based on an intent-to-treat (ITT) population. An ITT population includes every patient that is randomly assigned to a treatment group (in this case, either Augment or an autograft). By contrast, a modified intent-to-treat (mITT) population is a subset of the ITT population that excludes individuals that meet certain criteria (e.g., patients that are initially assigned a treatment group but that do not actually receive treatment).

The FDA approved Augment for clinical trials, but wanted BioMimetie to revise its protocol. BioMimetie submitted a supplement that included an amended definition of “intent to treat” on April 16, 2007. The supplement stated: “The IntenD-to-Treat (ITT) population is defined as all randomized subjects who received treatment post randomization. Patients who are randomized and unable to be treated will be considered as surgical screening failures and will not [be] included in the Intenb-to-Treat (ITT) patient population.” This was not a standard definition of ITT. Because the proposed definition excluded patients that were randomly sorted into treatment groups, the definition did not actually describe an ITT population. Rather, the population that BioMimetie proposed to analyze for its primary effectiveness analysis would more accurately be described as an mITT population. Thus what BioMi-metic was proposing to do, albeit in a somewhat roundabout way, was analyze an mITT population rather than an ITT population.

BioMimetic’s proposed change was not lost on the FDA. In a May 18, 2007 letter, the FDA wrote that BioMimetie had “corrected the deficiencies cited in our ... conditional approval letter,” and approved the April 16 supplement (which contained the proposed change from ITT to mITT). But the letter also explicitly addressed the new definition of ITT. The FDA wrote:

You should also give serious consideration to the following items which are considered essential for the analysis of your data for the purposes of determining safety and effectiveness for a future PMA application: ...
2. The Intent-to-Treat population should be defined as all randomized subjects in the treatment groups to which they were assigned, regardless of whether they actually received the assigned treatment or not. All subjects should be analyzed as randomized even if no treatment or other treatment was actually received. You may analyze additionally a group of patients excluded from the ITT due to “surgical screening failure” ...; however, this should be considered and referred to as a “modified ITT” population versus the “ITTD” population (i.e., “true ITT” population) defined above. You should plan to analyze the true ITT population. You may also analyze a modified ITT (i.e., patients with “surgical screening failures” who are excluded from the ITT) and the per-protocol population.

BioMimetie proceeded to conduct clinical trials over the next couple of years. The trials ended and BioMimetie issued a press release summarizing the study’s results on October 13, 2009. That date is the beginning of the class period. According to the release, Augment was effective when an mITT population was analyzed (i.e., the trial produced statistically significant results), but not when the analysis was conducted on the ITT population.

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Bluebook (online)
747 F.3d 435, 2014 WL 1259607, 2014 U.S. App. LEXIS 5738, Counsel Stack Legal Research, https://law.counselstack.com/opinion/paula-kuyat-v-biomimetic-therapeutics-inc-ca6-2014.