Before DePuy Hip Implant Recall, Device Maker Paid Doctors Millions

<"">DePuy Orthopaedics, maker of the recalled ASR XL Acetabular Hip Replacement System, has paid millions of dollars to doctors to promote its products. According to The New Haven Independent, DePuy, a division of Johnson & Johnson paid a whopping $80.8 million since 2009 to about 200 US doctors for promotion, as well as research and consultation.

DePuy discloses such payments on its website, the Independent said. According to that information, the hip implant maker paid $47.9 million to physicians in 2009, and $32.9 million through September of this year. This year alone, as concerns were being raised about Depuy’s defective ASR XL Acetabular Hip Replacement System, some surgeons collected in excess of $1 million from the company. The fact that significant payments continued raises questions about whether they compromised relationships between patients and their doctor, the Independent said.

According to the Independent, the DePuy disclosures were required under an agreement with the US Justice Department. In 2007, the Justice Department filed criminal complaints against four major medical device companies – DePuy, Biomet Orthopedics, Smith & Nephew, Zimmer Holdings and Stryker Corporation – alleging they were paying kickbacks to doctors for using their products. The charges were dropped last year after the companies paid fines and agreed to pay physicians only for legitimate consulting services. DePuy paid a fine of $84.7 million.

Jean Rexford, executive director of the Connecticut Center for Patient Safety, told the Independent that doctors “can think they’re not influenced” by the companies that give them money. “But the reality is, it’s human beings,” she said. “We are influenced. If somebody does something nice for me, I’m nicer to them than someone who hasn’t done something nice to me.”

In August, DePuy issued a worldwide recall of the ASR XL Acetabular System, a hip socket used in traditional hip replacement, and the ASR Hip Resurfacing System, a partial hip replacement that involves placing a metal cap on the ball of the femur. The <"">DePuy hip replacement recall was issued after data from the National Joint Registry of England and Wales showed that 1 out of every 8 patients (12%-13%) who had received the recalled devices had to undergo revision surgery within five years of receiving it. A hip implant should last for 15 years or so.

Since it was introduced in 2003, DePuy has sold nearly 100,000 units of its ASR XL Acetabular Hip System, which was designed for younger and more active patients. A metal-on-metal hip implant made of chromium and cobalt, the device consists of a cup that’s implanted into the hip with a ball joint that connects to the leg. It is believed that many of the complications linked to the DePuy ASR XL Acetabular hip implant are caused by wearing of the metal components, which can allow metal shavings to make their way into patients’ bloodstreams.

According to a report by ABC News, the resulting metal poisoning could increase the risk of a number of heath problems, including dementia and heart failure. DePuy now recommends that implant patients have a blood test to check for high levels of chromium and cobalt.

Since the recall, around 150 lawsuits have been filed against DePuy by victims of the ASR hip implant, and many more such suits are expected. Last week, all federal lawsuits involving the DePuy ASR XL Acetabular Hip Replacement System were consolidated in a multidistrict litigation in the US District Court for the Eastern District of Ohio.

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