Physician and Attorney Discusses Depuy Hips Failure and Further Risks


. By Jane Mundy

Attorney and Physician Dr. Shezad Malik represents a number of plaintiffs whose DePuy ASR hips and DePuy Pinnacle hips have failed, and many of these people are facing revision surgery. Dr. Malik explains how they are facing a "three-fold risk."

Both the DePuy ASR and DePuy Pinnacle are metal-on-metal (MOM) devices and were designed for more mobility. And more mobility was DePuy's marketing tool. But Dr. Malik, along with several other medical device experts and orthopedic surgeons, believe that more mobility is the cause of failure. More mobility means that the joint is sacrificed by causing metal-on-metal rubbing and grinding. This grinding causes metal microscopic particles to get into tissues and muscles around the joint, causing pain, inflammation and toxic injury. "While the body needs small amounts of these metals—cobalt and chromium—to operate, these amounts [from the MOM hips] are like industrial levels of absorption, which causes metallosis," says Dr. Malik. (Metallosis symptoms are typically pain, swelling and difficulty walking.)

And both the DePuy ASR and Pinnacle hips have a much shorter shelf life than anticipated. "There is a premature failing of these hips—less than 15 years," Dr. Malik explains, "and these folks are looking at a second, or revision, surgery." A second hip replacement should last 15 years and a third hip five years. But people with their first MOM hips are finding that they only last five or 10 years at the most. "Instead of having three hips over a period of 50 years, some patients are having three hips over just 15 or 20 years." And revision surgery presents its own problems.

"Every time you have surgery, there is a small risk of death, perhaps one in a thousand," says Dr. Malik. “And you shave off some bone every time a surgery is performed so you wind up with a shorter leg. And you may develop infection, bleeding in the joint or pneumonia during the post-op period in hospital, so if you are only supposed to get one hip surgery and now you are looking at three surgeries, your risk has gone up three-fold."

DePuy ASR and Pinnacle Litigation

Dr.Malik's law firm is involved with the DePuy ASR case, which has been centralized and consolidated in the Northern district of Ohio, and the DePuy Pinnacle case, which has been consolidated in Dallas as part of a multidistrict litigation, or MDL. "Pinnacle is basically one year behind ASR, but we are looking at the same process, the same allegations (i.e., defective design) and inadequate warnings about complications," Dr. Malik says, adding that they are now in the discovery phase and the next step will be depositions.

"After that, we anticipate the scheduling order for the Bellwether trials to be made sometime in 2012," Dr. Malik says. These trials will determine whether or not the defense (i.e., DePuy, a subsidiary of Johnson & Johnson) will be in a position to settle the cases. Say that 10 cases will be tried. If DePuy loses eight cases out of these 10, the company will be more inclined to settle en masse, and that is very likely because DePuy has already acknowledged that its product is defective (after pressure from the FDA, the ASR was recalled last year).

"I have chosen to represent these people because of my background as a physician—I don't have to worry about the science," says Dr. Malik, "and I believe these lawsuits are going to be straightforward."

More than 500 lawsuits have been filed in Northern District of Texas federal court over DePuy Pinnacle hip replacements problems. The plaintiffs allege that DePuy hips caused them to experience severe pain and early failure of their artificial hip implant. According to court documents released October 6, there are now at least 538 complaints consolidated before US District Judge James E. Kinkeade in the DePuy Pinnacle MDL.


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