United States v. Boston Scientific Corp.

253 F. Supp. 2d 85, 2003 U.S. Dist. LEXIS 4828, 2003 WL 1656467
CourtDistrict Court, D. Massachusetts
DecidedMarch 28, 2003
DocketCIV.A.00-12247-PBS
StatusPublished

This text of 253 F. Supp. 2d 85 (United States v. Boston Scientific Corp.) is published on Counsel Stack Legal Research, covering District Court, D. Massachusetts primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
United States v. Boston Scientific Corp., 253 F. Supp. 2d 85, 2003 U.S. Dist. LEXIS 4828, 2003 WL 1656467 (D. Mass. 2003).

Opinion

MEMORANDUM AND ORDER

SARIS, District Judge.

INTRODUCTION

The government seeks the maximum possible civil penalty of $35 million against defendant Boston Scientific Corporation (“BSC”) on the ground that BSC violated a consent order of the Federal Trade Commission (“FTC”) that was designed to ensure competition in the intravascular ultrasound (“IVUS”) catheter market. The FTC argues that BSC’s transgressions decreased competition in the IVUS market by driving Hewlett-Packard Company (“HP”) out of the market, which reduced the number of IVUS competitors from three to two; that BSC’s violations impaired innovation in catheter technology; that BSC acted in bad faith; and that a large sanction is necessary to vindicate the authority of the FTC. Arguing no-harm-no-foul, BSC argues that any violations were minimal; that it did not profit from any violations; that innovation and competition flourished; and that HP would have left the market in any event. BSC urges a rock bottom fine.

After a trial on the penalties on August 5-9, 2002 and September 17-20, 2002, and review of the submissions, the court orders entry of judgment against BSC in the amount of $7,040,000.

FINDINGS OF FACT

Assuming familiarity with United States v. Boston Scientific, 167 F.Supp.2d 424 *87 (D.Mass.2001), I make the following findings of fact:

I. Background on Intravascular Ultrasound

A. Coronary Artery Disease and its Treatment

Coronary artery disease is the leading cause of death in this country. Many Americans build up cholesterol and other fatty substances in their arteries, which narrow the arteries and allow less room for blood to flow. The result of this buildup, called plaque, can be chest pain, a heart attack, or a stroke.

Angiography is the basic method of trying to assess the condition of a coronary artery. Angiography involves injecting dye into the coronary arteries and then taking an X-ray that produces a silhouette of how much blood is flowing though the artery. The two-dimensional projection provided through angiography is, however, of limited value in making a diagnosis and determining the best type of treatment. Although angiography shows the width of the artery that remains open, it cannot measure how much plaque has built up in the artery’s walls or detect the presence of calcium.

Intravascular ultrasound refers to ultrasound imaging from inside the vascular system, or arteries. IVUS produces a three-dimensional picture of the artery that precisely measures the degree to which the artery has narrowed, what type of plaque has collected, and the length and distribution of that plaque. IVUS reveals the coronary pathology and the coronary measurements with a much better level of precision than angiography. One study showed that 36% of the participants had plaque not seen on the angiograms. Many leading physicians believe that both ang-iography and IVUS should be used to diagnose the situation, determine whether treatment is necessary, guide which type of treatment is appropriate, and follow up afterward to determine whether the treatment was successful.

The two most common methods of treating diseased arteries are angioplasty and stents. Angioplasty involves the dilation of a balloon to further open the artery. A stent is a metal scaffold that is placed in the artery to prop it open. IVUS shows whether a stent was positioned properly, and enables the doctor to correct the misplacement. Catheters can also be used to cut through plaque.

In addition to diagnosing and treating artery disease that already exists, IVUS is an important tool for research aimed at preventing the disease. Because coronary artery disease is such a significant health problem, pharmaceutical companies are working to develop drugs to help prevent the accumulation of plaque, and the precise measurement that IVUS affords is being used to evaluate the effectiveness of new drugs in FDA-approved clinical trials.

B. How Intravascular Ultrasound Works

An IVUS console attaches to the patient interface unit (sometimes called a “motor drive unit”) that in turn connects to the IVUS catheter. The IVUS catheter is a flexible narrow tube that contains a hub on the near end, a drive cable, and a transducer on the far tip. The transducer sends out ultrasound waves that reflect off the artery’s walls; a receiver measures the amount of returned energy, producing the 360-degree image of the artery and blood vessel.

There are two forms of IVUS imaging technology. “Phased array” catheters use several stationary transducers. Endosonics Corporation (“Endosonics”) manufactured and sold phased array catheters. *88 “Mechanical” catheters contain a single transducer that is spun by a drive cable. The hub of the catheter plugs into the patient-interface unit, which spins the core of the catheter and transmits the electrical impulses. The console controls the catheter and processes the images that come back. BSC and Cardiovascular Imaging Systems, Inc. (“CVIS”) manufactured and sold mechanical catheters.

In an IVUS procedure, a guidewire is inserted into the guide catheter and advanced into the coronary arteries. The IVUS catheter then rides the guidewire like a railroad track into the coronary arteries and takes pictures of the artery. The IVUS catheter is pulled back, either manually by the physician or at a fixed rate of speed by an automatic pullback device. If angioplasty or a stent is used to treat the artery, the IVUS procedure often is repeated to determine the effectiveness of the treatment.

IVUS catheters are distinguished by their diameter size and ultrasound-wave frequency. A catheter’s diameter size is measured in “French” (e.g., “3.2 F”). One French is approximately one-third of a millimeter, which means that a 3 F catheter is about 1 millimeter in diameter. The smaller the catheter, the easier it is to maneuver inside the artery and the harder it is to incorporate a transducer that produces an adequate image. Ultrasound-wave frequency is measured in megahertz (e.g., “30 MHz”). Generally, the greater the wave frequency, the better the image.

IVUS catheters include both coronary catheters and peripheral catheters. Coronary catheters are used primarily by inter-ventional cardiologists who treat coronary artery disease; coronary catheters account for approximately 95% of the IVUS catheter market. Peripheral catheters are used primarily by vascular surgeons and inter-ventional radiologists in the larger, non-coronary arteries, such as the carotid and iliac arteries.

C. IVUS Competition before the BSC-CVIS-SCIMED Merger

Prior to 1995, HP was a leader in the sale of IVUS consoles, which it manufactured for use with BSC’s IVUS catheters. Before the merger, HP did not make catheters and BSC did not make consoles. CVIS made both catheters and consoles. The BSC catheters had hubs that, prior to the merger, were interfaced solely to the HP consoles. The CVIS catheters had hubs that, prior to the merger, were interfaced solely to the CVIS consoles.

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Bluebook (online)
253 F. Supp. 2d 85, 2003 U.S. Dist. LEXIS 4828, 2003 WL 1656467, Counsel Stack Legal Research, https://law.counselstack.com/opinion/united-states-v-boston-scientific-corp-mad-2003.