Home >

January 22, 2019

For More Information, contact:
Mike Lewis (334) 353-2199
Steve Marshall
Joy Patterson (334) 242-7491
Page 1 of 2
Alabama Attorney General

Attorney General Steve Marshall Announces Multistate Settlement
with Johnson & Johnson and Medical Device Business Services Inc.
Regarding Deceptive Practices in Promotion of Hip Implant Devices
(MONTGOMERY)–Attorney General Steve Marshall announced today that he and 45 other
Attorneys General reached a $120 million Consent Judgment with Johnson & Johnson and
Medical Device Business Services Inc. to resolve allegations of unlawful promotions of
metal-on-metal hip implant devices, the ASR XL and the Pinnacle Ultamet. Medical Device
Business Services Inc., a subsidiary of Johnson & Johnson, is the consolidation of several
companies formerly known as DePuy Inc., DePuy Orthopedics (or Orthopaedics) Inc.,
DePuy Products Inc., DePuy Synthes Inc., and DePuy Synthes Sales Inc., which are
collectively referred to in the settlement document as DePuy.
The Attorneys General allege that DePuy engaged in unfair and deceptive practices in its
promotion of the metal-on-metal hip plant devices, ASR XL and Pinnacle Ultamet, by
making misleading claims about their longevity, also known as survivorship. Specifically,
DePuy advertised that the ASR XL hip implant had a survivorship of 99.2 percent at three
years when the National Joint Registry of England and Wales reported a seven percent
revision rate at three years. Similarly, DePuy promoted the Pinnacle Ultamet as having a
survivorship of 99.8 percent and 99.9 percent survivorship at five years when the National
Joint Registry of England and Wales reported a 2.2 percent three-year-revision rate in 2009
increasing to a 4.28 percent five-year-revision rate in 2012.
Some patients who required hip implant revision surgery to replace a failed ASR XL or
Pinnacle Ultamet implant experienced persistent groin pain, allergic reactions, tissue
necrosis, as well as a build-up of metal ions in the blood. The ASR XL was recalled from the
market in 2010. DePuy discontinued its sale of the Pinnacle Ultamet in 2013.
“It is imperative for surgeons and their patients to have reliable, honest and accurate data to
determine which hip implants are appropriate for a serious procedure such as this,” said
Attorney General Marshall. “I am pleased that this agreement puts in place reformed
practices to provide information upon which doctors and their patients may better rely.”
501 Washington Avenue * Montgomery, AL 36104 * (334) 242-7300
www.ago.state.al.us Page 2 of 2

As part of the Consent Judgment, DePuy has agreed to reform how it markets and
promotes its hip implants. Under the Consent Judgment, DePuy shall:

  • Base claims of survivorship, stability or dislocations on scientific information and the most
    recent dataset available from a registry for any DePuy hip implant device.
  • Maintain a post-market surveillance program and complaint handling program.
  • Update and maintain internal product complaint handling operating procedures including
    training of complaint reviewers.
  • Update and maintain processes and procedures to track and analyze product complaints
    that do not meet the definition of Medical Device Reportable Events.
  • Maintain a quality assurance program that includes an audit procedure for tracking
    complaints regarding DePuy Products that do not rise to the level of a Medical Device
    Reportable Event but that may indicate a device-related serious injury or malfunction.
  • Perform quarterly reviews of complaints, and if a subgroup of patients is identified that has
    a higher incidence of adverse events than the full patient population, determine the cause
    and alter promotional practices as appropriate.
    Under the settlement, the State of Alabama shall receive $2,030,825.91.
    The investigation was led by the Attorneys General of Texas and South Carolina with an
    Executive Committee consisting of the Attorneys General of Florida, Indiana, North
    Carolina, Ohio, Pennsylvania, and Washington. Also participating in the settlement are
    Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District
    of Columbia, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine,
    Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, Nevada,
    New Hampshire, New Mexico, New York, North Dakota, Oklahoma, Rhode Island, South
    Dakota, Tennessee, Utah, Vermont, Virginia and Wisconsin.