Today, I wanted to talk about a witness that the defense called to the stand. We are now ten weeks into this trial and the defendants are really putting on their case right now, and it’s basically a series of experts one after another. One of the witnesses they put on is a pathologist named Scott Nelson. Dr. Nelson works with a microscope in an orthopedic lab and reviews tissue samples. As a pathologist, he looks at tissue samples and describe what is causing a tissue reaction, and essentially what’s being observed. Not surprisingly, Dr. Nelson looked at tissue samples from the five plaintiffs that were taken out during their respective revision surgeries, and in his opinion, none of them had a reaction to the metal wear debris from their hips. There was only one exception; he said one of the plaintiffs did have a reaction to the metal wear debris but this was caused by a loose hip. According to Dr. Nelson, once again, this is not DePuy’s fault.
There is an interesting incident that we’ve seen in other cases. For one of the plaintiffs, the pathology showed a tissue reaction to metal wear debris but a very small amount of metal wear debris, according to the pathologist. We’ve seen this in other cases where DePuy argues that the patient has a hypersensitive reaction to the metal wear debris. DePuy characterizes the symptoms as an allergic reaction, placing blame on the individual and away from themselves. DePuy makes the comparison of someone who is allergic to peanuts, and if that person gets sick, they cannot sue the peanut company. This is DePuy’s story. However, there are lots of holes with this theory. This cannot be called an allergy since there are so many people who are having reactions to the metal wear debris. On cross examination, the pathologist admitted that it’s not really an allergy. For instance, one analogy is if someone gives you rat poison, and you got sick, we would not say you’re allergic to rat poison. Your body would adversely react but it is not considered an allergic reaction. So, this point is made on cross-examination of Dr. Nelson.
Dr. Nelson’s other opinion was that one of the plaintiffs suffers from sarcoidosis. Sarcoidosis is an inflammatory condition in which there is growth of inflammatory cells (granulomas) in different areas of the body- prevalent in the skin and other organs. Dr. Nelson states he saw granulomas on one of the plaintiffs’ tissue samples that was consistent with sarcoidosis. Problems with his diagnosis were made abundantly clear during cross examination. The plaintiff’s tissue samples were seven years old. So, the pathologist didn’t have only one slide of a granuloma that was definitive for sarcoidosis. He went back through the plaintiff’s medical records and said this patient has had it intermittently for years. He substantiated his diagnosis because the patient had a headache once, and another time he reported night sweats. The pathologist used this “evidence” as a sign that the plaintiff had sarcoidosis.
On cross- examination, the plaintiffs’ attorney did a very good job of laying the picture of the plaintiff’s medical history, a guy who is 70 years old, and stating that Dr. Nelson basically went through a mountain of medical records, found a couple ailments, and then diagnosed him with sarcoidosis. The most effective information revealed on cross examination was when the plaintiffs’ attorney pointed out that none of the five plaintiffs’ treating physicians had the same opinion as Dr. Nelson. All treating physicians testified under oath that what they observed during revision surgeries was consistent with a reaction to metal wear debris. All of them had seen this in other patients and they saw this reaction in the five plaintiffs. There are numerous doctors that treated the five plaintiffs and none of them had the same opinion as Dr. Nelson.
Dr. Nelson is a hired gun, paid $375,000 and funded by DePuy in the past to publish papers. The plaintiffs’ attorney described that Dr. Nelson was essentially hired to come up with a diagnosis, and say or do anything that would let DePuy off the hook. Today, was a good day for the plaintiffs because they did a good job of discrediting this expert.