The U.S. Supreme Court has ruled that medical device manufacturers cannot be sued for injuries caused by their products if those products were pre-approved for use by the FDA.
The court ruled that Charles Riegel, who was injured in 1996 when a balloon catheter made by Medtronic Inc. burst while being inserted into one of his coronary arteries during an angioplasty, could not sue the company for damages. In doing so, the Supreme Court upheld a ruling by a U.S. appeals court and an earlier ruling by a trial court in New York.
Hiding behind a legal technicalityMedtronic, which no longer makes the balloon catheter in question, said that the fault was with the doctor, who used the device contrary to the operating instructions. The company also said that the doctor made an error in using that type of product for a patient in Riegel's condition. But rather than ruling in Medtronic's favor merely for the one specific instance, the court dismissed the case entirely, saying that federal law prohibits suing device manufacturers in state courts if the device was approved as safe by the FDA. The decision is expected to have ramifications for a large number of pending lawsuits against manufacturers of devices such as breast implants, defibrillators, artificial heart pumps and valves, drug-coated stents, spinal cord stimulators, and prosthetic hips and knees.
Because there is no federal law that allows consumers to sue medical device manufacturers for damages, state courts have become a common venue for such suits.
The legal reasoning behind the court's decision centered on the wording of the 1976 Medical Device Amendments law. The law, which set in place an FDA pre-approval process for medical devices, explicitly prohibited states from putting in place "any requirement" that is "different from, or in addition to" FDA requirements. In an 8-1 majority, the court ruled that allowing citizens to sue device companies in state courts amounts to "a requirement" that undermines the FDA approval process.
Writing for the majority, Justice Antonin Scalia wrote that the FDA may approve devices "that present great risks if they nonetheless offer great benefits in light of available alternatives." In other words, there is no requirement that devices actually achieve any reasonable level of safety for all patients. To receive FDA approval and be immunized from lawsuits, medical devices merely have to keep alive slightly more people than they kill.
It would be inappropriate to empower juries second-guess these FDA decisions without full access to data about the benefits of technologies, Scalia said. This is the Supreme Court's way of saying that medical device safety is define solely by the FDA, and if the FDA says something is safe, the fact that such devices actually kill people does not in any way disprove the device's safety.
A jury "sees only the cost of a more dangerous design, and is not concerned with its benefits; the patient who reaped those benefits are not represented in court," he wrote. This is a clever way of saying that products that kill some consumers -- but not all -- are safe enough to be granted blanket immunity because there are some survivors. It's a ridiculous position, of course, and it's never applied to natural remedies.
Note that if an herb kills even ten people in the entire country, the FDA immediately leaps to the conclusion that the herb is "unsafe at any dose." (Google the history of the FDA's ephedra ban for details.) But medical devices and pharmaceuticals are held to an entirely different standard: They must only avoid killing more people than they kill! The fact that some people survived the treatment is apparently sufficient to justify all those who died! This is precisely what Justice Scalia is saying in this decision.