MARJORIE GLOVER ET AL. v. BAUSCH & LOMB, INC., ET AL.
SC 20607
Supreme Court of Connecticut
June 7, 2022
Robinson, C. J., and McDonald, D’Auria, Mullins, Kahn, Ecker and Keller, Js.
Argued October 22, 2021—officially released June 7, 2022
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Syllabus
Pursuant to the Connecticut Product Liability Act (CPLA) (
Pursuant further to the CPLA (
The plaintiffs, M and her husband, sought to recover damages from the defendants in federal court in connection with two surgical procedures in which a medical device manufactured and marketed by the defendants, known as the Trulign Lens, was implanted in each of M’s eyes for the purpose of treating her cataracts. M began to experience vision loss after the procedure, and her surgeon diagnosed her with a postoperative complication known as Z syndrome. M underwent multiple procedures to remove the artificial lenses and to correct her vision, but fragments of the lenses remained, causing permanent impairment to her eyesight. The plaintiffs alleged, inter alia, that the defendants were negligent and had failed to warn M and her surgeon of the inherent dangers of the Trulign Lens. In support of those claims, the plaintiffs alleged that the defendants were aware that the Trulign Lens had caused Z syndrome in numerous cases, that the defendants had failed to report all of those cases to the federal Food and Drug Administration (FDA) in a timely manner, as required by the Federal Food, Drug, and Cosmetic Act (FDCA) (
- The facts alleged by the plaintiffs, if accepted as true, gave rise to a cognizable claim under
§ 52-572q based on the defendants’ alleged failure to report adverse events associated with the use of Trulign Lens to the FDA in order to prevent harm to users such as M: because the language of§ 52-572q does not clearly and unambiguously indicate whether the CPLA, which embodies preexisting common-law causes of action, provides for a cause of action based on a manufacturer’s alleged failure to report to a regulator adverse events related to a product, this court looked to case law construing the scope of the CPLA, as well as general common-law principles governing the existence of a duty to use care, and concluded that the defendants had a duty under the CPLA to comply with federal statutes and regulations requiring them to report to the FDA adverse events associated with the Trulign Lens and to comply with the FDA’s postapproval requirements with respect to that product; moreover, nothing in the CPLA or in the case law construing the CPLA suggested that only physicians and other healthcare providers could be found to be in the best position to prevent harm to users of medical devices and, thus, the duty to warn was not limited to such individuals, it was appropriate to read the CPLA broadly to accomplish its remedial purpose of preventing injury from defective products, including medical devices that are inherently dangerous and that accordingly must be accompanied by adequate warnings, and the plaintiffs’ allegations, when taken as true, which they must at this stage of the proceedings, were sufficient to raise the inference that the defendants knew or should have known that harm of the general nature that M suffered was likely to result from their failure to provide to the FDA in a timely manner information about the adverse effects of the Trulign Lens, as required by federal law; furthermore, other public policy factors supporting the imposition of a duty weighed in favor of the plaintiffs, and this court found the decisions of those jurisdictions construing product liability laws of various states as creating a duty to comply with federal law requiring manufacturers to report to the FDA adverse events associated with inherently dangerous medical devices to be more persuasive than the cases on which the defendants relied; accordingly, this court concluded that the plaintiffs could prevail at trial if they established that it is more likely than not that, if the defendants had complied in a timely manner with the requirements of federal law that they report adverse events to the FDA and perform a postmarket safety study, the FDA would have required the defendants to change the labeling of the Trulign Lens or otherwise have made the substance of the reports available to healthcare providers before M’s surgeries, and if the plaintiffs also established that, as a result, she and her surgeon would not have chosen that device. - The exclusivity provision of the CPLA barred the plaintiffs’ CUTPA claim that the defendants unscrupulously marketed and promoted the Trulign Lens for use despite knowing that it presented a substantial risk of injury: this court’s precedent established that
§ 52-572n does not bar CUTPA claims based on the sale of a product when the plaintiff does not seek a remedy for personal injury, death, or property damage that was caused by a defective product, or when the plaintiff seeks a remedy for personal injury, death, or property damage that was caused by the unscrupulous advertising of a product that was not defective, and the plaintiffs’ CUTPA claim in the present case, which sought damages for personal injuries that allegedly were caused by unscrupulous advertising of the allegedly defective Trulign Lens, did not fall within the scope of either of those exceptions; moreover, this court declined to recognize an additional exception to the exclusivity provision for CUTPA claims, such as the CUTPA claim asserted in the present case, that seek damages for personal injuries caused by a defective product.
(One justice concurring separately)
Argued October 22, 2021—officially released June 7, 2022
Procedural History
Action to recover damages pursuant to the Connecticut Product Liability Act, and for other relief, brought to the United States District Court for the District of Connecticut, where the court, Dooley, J., denied the plaintiffs’ motion to amend the complaint and granted the defendants’ motion to dismiss and rendered judgment thereon, from which the plaintiffs appealed to the United States Court of Appeals for the Second Circuit, which certified certain questions of law to this court.
Wendy R. Fleishman, pro hac vice, with whom were Daniel E. Seltz, pro hac vice, Hugh W. Cuthbertson and, on the brief, Glenn A. Duhl and Leslie A. Brueckner, pro hac vice, for the plaintiffs (appellants).
Jeffrey R. Babbin, with whom were Daniel Smulian, pro hac vice, Robert M. Langer and, on the brief, Lori G. Cohen, pro hac vice, for the defendants (appellees).
Sarah A. Ricciardi filed a brief for the Connecticut Trial Lawyers Association et al. as amici curiae.
John W. Cerreta, James H. Rotondo and Matthew J. Letten filed a brief for the Product Liability Advisory Council, Inc., as amicus curiae.
Opinion
ROBINSON,
The plaintiff appealed from the judgment of dismissal to the United States Court of Appeals for the Second Circuit. That court determined that the resolution
The record reveals the following factual allegations made by the plaintiff, which we construe in her favor for purposes of answering the certified questions of law, and procedural history.5 See, e.g., Burton v. Dominion Nuclear Connecticut, Inc., 300 Conn. 542, 550, 23 A.3d 1176 (2011) ([i]n ruling [on] whether a complaint survives a motion to dismiss, a court must take the facts to be those alleged in the complaint, including those facts necessarily implied from the allegations, construing them in a manner most favorable to the pleader (internal quotation marks omitted)). The defendants manufacture a product known as the Trulign Lens, which was designed and marketed as a medical device that is surgically implanted in a patient’s eye to treat cataracts. In September, 2014, the plaintiff, who resides in Connecticut, underwent two successive cataract surgeries during which her physician surgically implanted one Trulign Lens in each eye. Several weeks later, she began to experience significant loss of vision. Her physician ultimately diagnosed her vision problems as Z syndrome, a postoperative complication unique to the Trulign Lens in which part of the lens moves forward toward the surface of the eye and part of the lens stays in place or moves backwards, creating a distinctive Z shape. The plaintiff was required to undergo multiple surgeries and other medical procedures and treatments in an unsuccessful attempt to correct the damage to her vision. Part of each lens was surgically removed, but fragments of the lenses remain, causing permanent impairment of both eyes.
The plaintiff brought this action against the defendants in the United States District Court for the Central District of California, where the defendants operated various offices and facilities. After the action was transferred to the United States District Court for the District of Connecticut, the plaintiff amended the complaint to include a claim that the defendants had violated
The defendants moved to dismiss all of the plaintiff’s claims on the ground that they were preempted by federal law. Thereafter, the plaintiff moved for leave to amend the complaint to include a CUTPA claim based on allegations of unscrupulous marketing. The District Court granted the defendants’ motion to dismiss as to all counts. With respect to the failure to warn claim under the CPLA, the court observed that federal law expressly preempts state law claims [when] . . . (1) the FDA has established requirements applicable to the particular medical device; and (2) the state law claims would impose requirements with respect to the device that are different from, or in addition to the federal requirements that relate to either . . . (i) safety or effectiveness; or (ii) any other matter included in a requirement applicable to the device. (Internal quotation marks omitted.) Doe v. Bausch & Lomb, Inc., 443 F. Supp. 3d 259, 272 (D. Conn. 2020). In addition, the court observed that a litigant’s [state law] claim may be impliedly preempted when the [state law] claim is in substance (even if not in form) a claim for violating the FDCA—that is, when the state claim would not exist if the FDCA did not exist. (Emphasis in original; internal quotation marks omitted.) Id. Accordingly, the court concluded that, to the extent that the plaintiff claimed that the defendants had a duty to warn consumers or physicians of the dangers of the Trulign Lens, the claim was expressly preempted by federal law because it imposed a requirement that the FDCA did not imply. Id. With respect to the plaintiff’s claim that the defendants violated the CPLA by failing to comply with federal law requiring them to report adverse events to the FDA, the court concluded that, under Connecticut law, manufacturers do not have a duty to report adverse events to regulatory entities such as the FDA. Id., 273. The court therefore concluded that the claim was impliedly preempted because it was wholly derivative of the FDCA. Id. With respect to the plaintiff’s CUTPA claim, the court concluded that, because the claim was premised on the allegation that the defendants had inadequately warned of the dangers associated with the Trulign Lens, and because the plaintiff had not alleged that the warnings provided deviated from those approved by the FDA, the claim was expressly preempted by the FDCA. Id., 275.
The plaintiff appealed from the judgment of dismissal to the United States Court of Appeals for the Second Circuit, contending that Connecticut law recognizes claims based on a failure to comply with (1) laws and regulations requiring a defendant to warn a government regulator, such as the FDA, of a product’s known safety risks, and (2) the regulator’s postapproval safety requirements. The plaintiff contended that, because this require-ment of Connecticut law was both independent of and coextensive with the requirements of the FDCA, the failure to warn claim was neither impliedly nor expressly preempted. The plaintiff further claimed that amending the complaint to add a CUTPA claim would not be futile because it was based on allegations that the defendants had deceptively marketed and promoted the Trulign Lens despite knowing that it presented a substantial risk of injury.
The Second Circuit observed that the federal courts of appeals are split on the issue of whether federal law preempts failure to warn claims based on allegations that a defendant has failed to comply with
Turning to the plaintiff’s contention that the District Court had incorrectly determined that allowing her to amend the operative complaint to include a CUTPA claim would be futile because that claim would also be preempted, the Second Circuit observed that the defendants contended that the claim was barred by the exclusivity provision of the CPLA. See id., 243. Because that claim involved a question of state law for which there is no binding precedent, the Second Circuit certified the following question of law to this court: Whether the [CPLA’s] exclusivity provision . . . § 52-572n, bars a claim under [CUTPA] based on allegations that a manufacturer deceptively and aggressively marketed and promoted a product despite knowing that it presented a substantial risk of injury. Id., 244. This court accepted both certified questions of law.8
I
We begin with the first certified question: Whether a cause of action exists under the negligence or failure-to-warn provisions of the [CPLA, § 52-572q], or elsewhere in Connecticut law, based on a manufacturer’s alleged failure to report adverse events to a regulator like the FDA following approval of the device, or to comply with a regulator’s [postapproval] requirements. Id. We answer this question yes.
We note preliminarily that the certified question requires us to determine only whether the facts alleged by the plaintiff give rise to a cognizable claim under the CPLA and does not require us to determine whether any such claim
The FDA’s [premarket] approval process of a Class III device is rigorous. The FDA performs a risk-benefit assessment of the device and determines the adequacy of the manufacturer’s proposed label. The FDA then denies, approves, or approves with conditions on distribution, marketing, or sale. Once the FDA approves a device, the manufacturer is required to report any information that reasonably suggests that the device (1) may have caused or contributed to a death or serious injury or (2) has malfunctioned and that any recurring malfunction would be likely to cause or contribute to a death or serious injury. (Internal quotation marks omitted.) Doe v. Bausch & Lomb, Inc., supra, 443 F. Supp. 3d 271, quoting Stengel v. Medtronic, Inc., 704 F.3d 1224, 1226–27 (9th Cir. 2013), cert. denied, 573 U.S. 930, 134 S. Ct. 2839, 189 L. Ed. 2d 805 (2014).
Causes of action brought pursuant to state law involving Class III medical devices, such as the Trulign Lens, may be expressly or impliedly preempted by federal law. First, the MDA contains an express preemption provision:
[N]o State or political subdivision of a State may establish or continue in effect with respect to a device intended for human use any requirement—
(1) which is different from, or in addition to, any requirement applicable under this chapter to the device, and
(2) which relates to the safety or effectiveness of the device or to any other matter included in a requirement applicable to the device under this chapter. Doe v. Bausch & Lomb, Inc., supra, 443 F. Supp. 3d 271, quoting
21 U.S.C. § 360k (a) (2018) .
In Riegel v. Medtronic, Inc., 552 U.S. 312, 321–23, 128 S. Ct. 999, 169 L. Ed. 2d 892 (2008), the [United States] Supreme Court [quoting
In addition, federal law impliedly preempts state law claims if those claims are based solely on violations of FDCA requirements. [See] Buckman Co. v. Plaintiffs’ Legal Committee, 531 U.S. 341, 353, 121 S. Ct. 1012, 148 L. Ed. 2d 854 (2001); see also Norman v. Bayer Corp., Docket No. 3:16-cv-00253 (JAM), 2016 WL 4007547, *2 (D. Conn. July 26, 2016) ([a] state claim is impliedly preempted under the FDCA if the conclusion that the state law has been violated is based solely on a violation of the FDCA . . .). (Internal quotation marks omitted.) Doe v. Bausch & Lomb, Inc., supra, 443 F. Supp. 3d 272. In Buckman Co., the United States Supreme Court held that the plaintiffs’ claims that the manufacturer had misled the FDA during the approval process were preempted because those fraud-on-the-FDA claims exist[ed] solely by virtue of the FDCA disclosure requirements and permitting such claims to proceed would [skew] . . . [the] delicate balance of statutory objectives the FDA seeks to achieve in enforcing the FDCA’s requirements.10 . . . To avoid implied preemption . . . claims must be based not on the FDCA, but on traditional state tort law [that] . . . predated the federal enactments in [question]. (Citation omitted; footnote added; internal quotation marks omitted.) Glover v. Bausch & Lomb, Inc., supra, 6 F.4th 237.
In other words, a litigant’s [state law] claim may be impliedly preempted when the [state law] claim is in substance (even if not in form) a claim for violating the FDCA—that is, when the state claim would not exist if the FDCA did not exist. (Emphasis in original; internal quotation marks omitted.) Doe v. Bausch & Lomb, Inc., supra, 443 F. Supp. 3d 272, quoting McConologue v. Smith & Nephew, Inc., 8 F. Supp. 3d 93, 101 (D. Conn. 2014).
Between those claims that are expressly preempted and those that are impliedly preempted is an extremely narrow class of claims that are not preempted. The plaintiff must be suing for conduct that violates the FDCA (or else his claim is expressly preempted by [
With these background principles of federal law in mind, we turn to the question of whether the facts alleged by the plaintiff give rise to a cognizable claim under the CPLA. Because [this] issue presents a question of statutory interpretation, our analysis is guided by General Statutes
We begin with the text of
(b) In determining whether instructions or warnings were required and, if required, whether they were adequate, the trier of fact may consider: (1) The likelihood that the product would cause the harm suffered by the claimant; (2) the ability of the product seller to anticipate at the time of manufacture that the expected product user would be aware of the product risk, and the nature of the potential harm; and (3) the technological feasibility and cost of warnings and instructions.
(c) In claims based on this section, the claimant shall prove by a fair preponderance of the evidence that if adequate warnings or instructions had been provided, the claimant would not have suffered the harm.
(d) A product seller may not be considered to have provided adequate warnings or instructions unless they were devised to communicate with the person best able to take or recommend precautions against the potential harm.
Nothing in the language of
We begin with a review of our case law construing the CPLA. The Appellate Court previously has recognized that the CPLA was intended to merge the various [common-law] theories of [product] liability into one cause of action. (Footnote omitted.) Gajewski v. Pavelo, 36 Conn. App. 601, 611, 652 A.2d 509 (1994), aff’d, 236 Conn. 27, 670 A.2d 318 (1996). A principal purpose of the [CPLA] is to protect people from harm caused by defective and hazardous products. In order to meet this purpose, it is necessary that the statute be read to reach all conduct [that] affects the safety of a product prior to its entry into the stream of commerce. (Emphasis in original; internal quotation marks omitted.) Id., 614. The CPLA defines product liability claim broadly to include all claims or actions brought for personal injury, death or property damage cause by the manufacture, construction, design, formula, preparation, assembly, installation, testing, warnings, instructions, marketing, packaging or labeling of any product. . . . (Emphasis added.) General Statutes
Certain products, such as prescription drugs and medical devices, are inherently unsafe. See Hurley v. Heart Physicians, P.C., 278 Conn. 305, 317, 898 A.2d 777 (2006). A manufacturer of such products can avoid liability under the CPLA for injuries that they cause only if the products are properly prepared and accompanied by proper directions and warnings. See id., 315. Generally, a manufacturer’s duty to warn of dangers associated with its products pertains only to known dangers and runs to the ultimate user or consumer of those products. (Internal quotation marks omitted.) Id., 316. This court has recognized an exception to this general rule, however, for warnings related to prescription drugs and medical devices. Id. The exception, known as the learned intermediary doctrine, provides that adequate warnings to prescribing physicians obviate the need for manufacturers of prescription products to warn ultimate consumers directly. The doctrine is based on the principle that prescribing physicians act as learned intermediaries between a manufacturer and consumer and, therefore, stand in the best position to evaluate a patient’s needs and [to] assess [the] risks and benefits of a particular course of treatment. (Internal quotation marks omitted.) Id. Thus, the doctrine is a specific application of the more general rule set forth in
Because the CPLA embodies preexisting common-law causes of action, general common-law principles governing the existence of a duty to use care are also instructive in determining the scope of the duty set forth in
Our law makes clear, however, that [a] simple conclusion that the harm to the plaintiff was foreseeable . . . cannot by itself mandate a determination that a legal duty exists. Many harms are quite literally foreseeable, yet for pragmatic reasons, no recovery is allowed. . . . The final step in the duty inquiry, then, is to make a determination of the fundamental policy of the law, as to whether the defendant’s responsibility should extend to such results. . . . As we have explained, in making that determination, our courts consider the following four factors: (1) the normal expectations of the participants in the activity under review; (2) the public policy of encouraging participation in the activity, while weighing the safety of the participants; (3) the avoidance of increased litigation; and (4) the decisions of other jurisdictions. . . . [This] totality of the circumstances rule . . . is most consistent with the public policy goals of our legal system, as well as the general tenor of our [tort] jurisprudence. (Citation omitted; internal quotation marks omitted.) Raspberry Junction Holding, LLC v. Southeastern Connecticut Water Authority, 340 Conn. 200, 215, 263 A.3d 796 (2021).
In the present case, the plaintiff contends that these principles governing the scope of the CPLA and the existence of a duty to use care demonstrate that the defendants should be held liable for [their] failure to communicate the potential harm of the Trulign Lens to the FDA via adverse event reports and the required safety study. Common sense dictates that, when it comes to a medical device, the person best able to take or recommend precautions against the potential harm includes the federal agency that regulates the device and [that] doctors rely on as the source of updated safety information. (Internal quotation marks omitted.) The plaintiff points out that this court recognized in Vitanza v. Upjohn Co., supra, 257 Conn. 384, that there are times when warnings may be directed to someone other than the ultimate user. Accordingly, the plaintiff contends that identifying the person best able to take or recommend precautions is a question of fact that must be determined on a case-by-case basis, taking into account all of the relevant circumstances, including any practical or legal limitations on a manufacturer’s obligations to provide warnings to a specific class of persons who otherwise would be in the best position to take or recommend precautions. Because the state law requirement that the defendants provide warnings about the Trulign Lens to
The defendants contend, to the contrary, that, under the learned intermediary doctrine, the duty to warn about the known dangers of medical devices is limited only to physicians and other healthcare providers. In support of this contention, the defendants rely on this court’s statement in Vitanza v. Upjohn Co., supra, 257 Conn. 365, that
Thus, the primary dispute between the parties is whether, under the circumstances of the present case,
First, nothing in the CPLA or our case law construing that statute suggests that, as a matter of law, only healthcare providers can be found to be in the best position to prevent harm to users of medical devices. Section
Second, and relatedly, the CPLA must be read broadly to accomplish its remedial purpose of preventing injury from defective products, including products such as medical devices that are inherently dangerous and that, therefore, must be accompanied by adequate warnings. See Gajewski v. Pavelo, supra, 36 Conn. App. 614. Under the defendants’ construction of the statute, users who are injured by an inherently dangerous medical device because the manufacturer failed
Third, our conclusion in this respect is fortified by the principles that animate our legal doctrine regarding the imposition of a duty of care more generally. This court has recognized that [a] duty to use care may arise from a contract, from a statute, or from circumstances under which a reasonable person, knowing what he knew or should have known, would anticipate that harm of the general nature of that suffered was likely to result from his act or failure to act. (Internal quotation marks omitted.) Grenier v. Commissioner of Transportation, supra, 306 Conn. 539. The plaintiff has alleged that (1) the defendants knew of numerous cases of Z syndrome caused by the Trulign Lens before she had her surgery, (2) they failed to report all of these adverse events to the FDA in a timely manner, as required by federal law, (3) they failed to conduct the required postmarket safety study related to the occurrence of Z syndrome until after her surgery, (4) if she and her physician had known about the true frequency of Z syndrome, they would not have selected the Trulign Lens, and (5) after the defendants reported the adverse events to the FDA, the labeling of the Trulign Lens was changed to include accurate information about the frequency of Z syndrome and instructions for minimizing risk and for treatment. As we have indicated, at this stage of the proceedings, we must assume the truth of these allegations and read them in the light most favorable to the plaintiff, giving them the benefit of all reasonable inferences.17 See, e.g., Burton v. Dominion Nuclear Connecticut, Inc., supra, 300 Conn. 550. These allegations are sufficient to raise the inference that the defendants knew or should have known that harm of the general nature that was suffered by the plaintiff was likely to result from their failure to provide information about the adverse effects of the Trulign Lens to the FDA in a timely manner, as required by federal law.
Although [a] simple conclusion that the harm to the plaintiff was foreseeable . . . cannot by itself mandate a determination that a legal duty exists, the other four factors that this court considers when making that determination, namely, (1) the normal expectations of the participants in the activity under review; (2) the public policy of encouraging participation in the activity, while weighing the safety of the participants; (3) the avoidance of increased litigation; and (4) the decisions of other jurisdictions, also weigh in the plaintiff’s favor. (Internal quotation marks omitted.) Raspberry Junction Holding, LLC v. Southeastern Connecticut Water Authority, supra, 340 Conn. 215. With respect to the first factor, both users and manufacturers in this state would normally expect that the manufacturers would be required to take all reasonable steps to
characteristics, claim that defendant had failed to comply with postmarket approval reporting requirements listed in MDA constituted “a traditional state law tort cause of action“), transfer denied, Missouri Supreme Court, Docket No. SC96969 (April 3, 2018).24 We acknowledge that, in some of these cases, the court‘s analysis was somewhat cursory. Nevertheless, we find the cases persuasive because their reasoning is generally consistent with ours
In contrast, we find the cases cited by the defendants to be unpersuasive. The two cases from our local United States District Court that the defendants cite for the proposition that “there is no general or background duty under Connecticut law to report risks to a regulatory body“; (internal quotation marks omitted) Pratt v. Bayer Corp., supra, 2020 WL 5749956, *8; accord Norman v. Bayer Corp., supra, 2016 WL 4007547, *4; did not engage in a full analysis of the CPLA or this court‘s cases construing that statute. Nor did they engage in any analysis of this state‘s jurisprudence governing the existence of a duty to use care. Rather, they relied primarily on the decisions of other federal courts construing the product liability laws of other states—also without fully analyzing those laws. Moreover, the courts in Pratt and Norman intertwined their abbreviated analyses of Connecticut law with their analyses of the issue of federal preemption—an issue that is distinct and, as we have explained; see footnote 9 of this opinion; is not before us in the present case. See Pratt v. Bayer Corp., supra, *8 (citing Doe v. Bausch & Lomb, Inc., supra, 443 F. Supp. 3d 273, for proposition that plaintiff‘s claim that defendants failed to comply with FDA reporting requirements was impliedly preempted because “it is wholly derivative of the FDCA” (internal quotation marks omitted)); Norman v. Bayer Corp., supra, *4 (“To avoid preemption, a claim must be premised on the type of conduct that would traditionally give rise to liability under state law—and that would give rise to liability under state law even if the FDCA had never been enacted. . . . The failure-to-warn claim arises solely from the MDA‘s reporting requirements, and therefore is subject to implied preemption.” (Citation omitted; internal quotation marks omitted.)).25 Although
We also do not find persuasive the other cases cited by the defendants addressing the existence of a state law duty to report an adverse event associated with a medical device to the FDA. Many of those cases held more or less conclusorily that the learned intermediary doctrine requires manufacturers to provide warnings only to healthcare providers, not to the FDA. See Brooks v. Mentor Worldwide, LLC, 985 F.3d 1272, 1278 n.1, 1281 (10th Cir.) (applying Missouri law), cert. denied, U.S. , 142 S. Ct. 477, 211 L. Ed. 2d 289 (2021); Plourde v. Sorin Group USA, Inc., 517 F. Supp. 3d 76, 91 (D. Mass. 2021) (applying Massachusetts law); Hill v. Bayer Corp., 485 F. Supp. 3d 843, 854 (E.D. Mich. 2020) (applying Michigan law); Noel v. Bayer Corp., 481 F. Supp. 3d 1111, 1121 (D. Mont. 2020) (applying Montana law); English v. Bayer Corp., 468 F. Supp. 3d 573, 580 (W.D.N.Y. 2020) (applying New York law); Conklin v. Medtronic, Inc., 245 Ariz. 501, 507–508, 431 P.3d 571 (2018) (applying Arizona law). Similarly, a number of courts have held that the state product liability law under review required only that manufacturers warn consumers of the known dangers of their products. See McNeil-Williams v. DePuy Orthopaedics, Inc., 384 F. Supp. 3d 570, 576 (E.D.N.C. 2019) (applying North Carolina law); Kubicki ex rel. Kubicki v. Medtronic, Inc., 293 F. Supp. 3d 129, 183–84 (D.D.C. 2018) (applying District of Columbia law); Pinsonneault v. St. Jude Medical, Inc., 953 F. Supp. 2d 1006, 1015 (D. Minn. 2013) (applying Minnesota law). In none of these cases, however, did the court confront a state product liability law imposing a “duty . . . to provide suitable warnings to the person best able to take or recommend precautions against the potential harm.” (Internal quotation marks omitted.) Vitanza v. Upjohn Co., supra, 257 Conn. 382. Accordingly, regardless of whether the cases were correctly decided under the relevant state‘s law, for the reasons that we have already explained, we do not read the CPLA so narrowly. We conclude, therefore, that the defendants had a duty under the CPLA to comply with federal statutes and regulations requiring them to report adverse events associated with the Trulign Lens and its predecessor products to the FDA and to comply with the FDA‘s postapproval requirements in a timely manner.
The defendants contend that the law of this state does not impose such a duty because the submission of an adverse event report to the FDA does not constitute
We are not persuaded. As we explained, the plaintiff has alleged that, if the defendants had complied with their obligations under federal law to report adverse events to the FDA and to conduct the postmarket safety study in a timely manner, the labeling of the Trulign Lens would have been altered to include warnings about Z syndrome and instructions for minimizing risk and for treatment before the plaintiff‘s surgery. The plaintiff further alleged that, if the labeling had been changed before the surgery, she and her physician would not have used the Trulign Lens. Although the CPLA does not define “warning,” it is implicit in
II
We next address the second certified question: “Whether the [CPLA‘s] exclusivity provision . . .
The following additional procedural history is relevant to our resolution of this issue. While the defendants’ motion to dismiss was pending in the United States District Court, this court issued its decision in Soto v. Bushmaster Firearms International, LLC, 331 Conn. 53, 202 A.3d 262, cert. denied sub nom. Remington Arms Co., LLC v. Soto, U.S. , 140 S. Ct. 513, 205 L. Ed. 2d 317 (2019), holding that (1) the CPLA‘s exclusivity provision does not bar CUTPA claims based on the “unethical, oppressive, immoral, and unscrupulous” marketing of products that are not defective; id., 107; and (2) a claim for personal injuries is cognizable under CUTPA, at least with respect to wrongful advertising claims. See id., 116. Believing that Soto had “made available a cause of action and category of damages that had not been previously available” to her, the plaintiff filed a motion for leave to amend her complaint to add a CUTPA claim based on the defendants’ alleged unscrupulous marketing of the Trulign Lens. The plaintiff alleged in the proposed amended complaint that, among other things, the “[d]efendants knew, or should have known, that the [Trulign Lens], when used in the intended manner, would be likely to inflict serious injuries and harm. Despite this knowledge, the defendants unethically, oppressively, immorally, and unscrupulously marketed and promoted these lenses for use.” She further alleged that this conduct “was a substantial factor resulting in [her] injuries, suffering, and damages . . . .” As we already explained, the District Court did not reach the issue of whether the plaintiff‘s proposed CUTPA claim is barred by the CPLA‘s exclusivity provision because it concluded that the claim was indistinguishable from a claim that the FDA approved labeling of the Trulign Lens was deficient under state law and, therefore, that amending the complaint would be futile insofar as the claim would be expressly preempted by federal law.
Whether the exclusivity provision of the CPLA bars the plaintiff‘s CUTPA claim is a question of statutory interpretation. See, e.g., Gerrity v. R.J. Reynolds Tobacco Co., 263 Conn. 120, 124, 818 A.2d 769 (2003). The principles that guide our statutory analysis are set forth in part I of this opinion.
We begin with the language of the relevant statutory provision.
This court has recognized, however, that not all actions arising from the sale of products that cause injury are barred by the CPLA‘s exclusivity provision. In Gerrity, the plaintiff brought a wrongful death action, alleging that the defendants had violated the CPLA by selling defective cigarettes that were “unreasonably dangerous because they are addictive and cause lung cancer.” Gerrity v. R.J. Reynolds Tobacco Co., supra, 263 Conn. 123. In addition, the plaintiff alleged that the defendants had violated CUTPA when they “issued false public statements [regarding the safety of cigarettes], failed to disclose evidence of the addictive nature of cigarettes . . . neutralized warnings of smoking related health hazards, and targeted minors in advertising their products.” Id., 124. As the result of these deceptive practices, the plaintiff “alleged that the decedent was forced to pay a higher price for the defendants’ cigarettes than she would have had to pay in the absence of the” deceptive conduct. Id., 130. This court concluded that, because the plaintiff‘s CUTPA claim “[did] not seek a remedy for personal injury, death or property damage,” which is a required element of a claim under the CPLA, the exclusivity provision of the CPLA did not bar the CUTPA claim. Id., 129.
More recently, in Soto v. Bushmaster Firearms International, LLC, supra, 331 Conn. 53, we considered whether the CPLA‘s exclusivity provision barred a CUTPA claim alleging that the defendants had “wrong-fully marketed the [Bushmaster XM15-E2S semiautomatic rifle that was used during the mass shooting at Sandy Hook Elementary School in Newtown] by promoting the gun‘s use for illegal purposes—offensive, military style assault missions . . . .” Id., 107. The plaintiffs in Soto made no claim that the gun at issue was defective in any manner but did claim that the defendants’ wrongful marketing had caused the death of the shooting victims. See id., 109. This court concluded that the
Thus, standing together, Gerrity and Soto stand for the proposition that the CPLA‘s exclusivity provision permits a CUTPA claim based on the sale of product when (1) the plaintiff does not seek a remedy for personal injury, death or property damage that was caused by a defective product,28 or (2) the plaintiff seeks a remedy for personal injury, death or property damage that was caused by the unscrupulous advertising of a product that was not defective. In the present case, the plaintiff‘s CUTPA claim seeks damages for a personal injury that was caused by unscrupulous advertising of the allegedly defective Trulign Lens.29 It is clear, therefore, that the CUTPA claim does not fall within Gerrity—because it seeks damages for personal injury—or Soto—because it seeks damages caused by an allegedly defective product. See Hunte v. Abbott Laboratories, Inc., 556 F. Supp. 3d 70, 94–95 (D. Conn. 2021) (Soto did not apply to CUTPA claim seeking damages for decedent‘s personal injuries and death allegedly caused by defective infant formula because plaintiff claimed product was defective under CPLA, and Gerrity did not apply because plaintiff sought damages for wrongful death); Appiah v. Home Depot U.S.A., Inc., Docket No. 3:20-cv-00489 (VLB), 2020 WL 6263544, *5 (D. Conn. October 23, 2020) (”Soto made clear that the exclusivity provision of the [CPLA] applies to those claims seeking to recover damages caused by a defective product” (emphasis in original)).
Although the plaintiff‘s claim clearly does not come within the scope of either Gerrity or Soto, we acknowledge that this court has never directly addressed the issue of whether a CUTPA claim seeking damages for personal injury caused by a defective product is barred by the exclusivity provision.30 We further acknowledge, as
The plaintiff contends that “[a]llegations of aggressive marketing—particularly of a product [the] conditions of approval [of which the defendants] had violated and ignored—are separate and distinct from those that go solely to a failure to warn of a product‘s defect, and would be cognizable under CUTPA absent allegations of a product defect. The plaintiffs should be permitted to pursue damages related to such marketing in conjunction with damages caused by [the defendants‘] negligence and failure to warn of the Trulign Lens’ defects.” We are not persuaded. Although a claim alleging that a defendant unscrupulously advertised a defective or inherently dangerous product is arguably distinguishable from a run-of-the-mill failure to warn claim alleging that the defendant had marketed a defective or inherently dangerous product, the difference is a matter of degree rather than a matter of kind and does not warrant different treatment for purposes of the CPLA exclusivity provision. Accordingly, we conclude that the answer to the second certified question is “yes.”
The answer to the first certified question, namely, whether a cause of action exists under the negligence or failure-to-warn provisions of the CPLA,
The answer to the second certified question, namely, whether the CPLA‘s exclusivity provision,
No costs shall be taxed in this court to either party.
Notes
The plaintiff also contends that the court in Hughes v. Boston Scientific Corp., 631 F.3d 762, 769-71 (5th Cir. 2011), held that a claim that a manufacturer failed to comply with FDCA reporting requirements for adverse events is cognizable under Mississippi product liability law, as construed by Mississippi courts. The court in Hughes, however, appears to have merely assumed that that was the case for purposes of conducting its preemption analysis. See id., 769 (“[a]ssuming that a failure to warn claim may be pursued under Mississippi law . . . it is clear that such a claim is preempted only to the extent that it purports to impose liability despite . . . compliance with FDA regulations“). We also note that the United States District Court for the Southern District of Mississippi later observed that the Mississippi Supreme Court held after the Hughes decision that, in light of certain amendments to Mississippi statutes governing product liability law in 2014, Mississippi law provided the exclusive remedy for failure to warn claims. See Knoth v. Apollo Endosurgery US, Inc., 425 F. Supp. 3d 678, 694-95 (S.D. Miss. 2019). The court in Knoth also observed that the court in Hughes had held only that the plaintiff had a cognizable claim “under a theory of negligence“; id., 694; despite the fact that the court in Hughes expressly cited the Mississippi product liability law. See Hughes v. Boston Scientific Corp., supra, 769. The court in Knoth concluded that an allegation that the defendant had not provided timely adverse event reports to the FDA, as required by its regulations, did not constitute a claim that the “product was defective because it failed to contain adequate warnings or instructions,” as provided by Mississippi product liability law. (Internal quotation marks omitted.) Knoth v. Apollo Endosurgery US, Inc., supra, 695. Because we find the reasoning and conclusions of both Hughes and Knoth to be somewhat unclear, we do not find either case persuasive.
Several of the other cases that the defendants cite in support of their claim that there is no state law duty to report adverse events to the FDA also concluded that any state law duty to report adverse effects of a medical device to the FDA would be the equivalent of the fraud-on-the-FDA claim that the court in Buckman Co. v. Plaintiffs’ Legal Committee, supra, 531 U.S. 353, determined to be impliedly preempted, without determining whether a state law duty existed in the first instance. See Mink v. Smith & Nephew, Inc., 860 F.3d 1319, 1330 (11th Cir. 2017) (claim under Florida common law that defendant violated duty to warn of dangers of medical device by failing to report dangers to FDA was impliedly preempted under Buckman Co.); In re Medtronic, Inc., Sprint Fidelis Leads Product Liability Litigation, supra, 623 F.3d 1205-1206 (claims in multidistrict litigation that defendant did not timely file adverse event reports with FDA, as required by federal regulations, were “simply an attempt by private parties to enforce the MDA” and were preempted under Buckman Co.); Green v. Bayer Corp., 522 F. Supp. 3d 492, 502-503 (E.D. Ark. 2021) (because, unlike Arkansas law, federal law does not require manufacturers to provide warnings to healthcare providers and consumers, plaintiff‘s failure to warn claim was expressly preempted); Hafer v. Medtronic, Inc., 99 F. Supp. 3d 844, 860 (W.D. Tenn. 2015) (“to the extent that [the] [p]laintiffs seek recourse for [the] [d]efendants’ failure to file adverse event reports with the FDA, the [c]ourt finds such claim [to be] impliedly preempted under Buckman [Co.]“); Dawson v. Medtronic, Inc., Docket No. 3:13-cv-663-JFA, 2013 WL 4048850, *7 (D.S.C. August 9, 2013) (applying California law and concluding that any state claim related to violation of federal regulations requiring manufacturer to provide information to FDA would be impliedly preempted); Cornett v. Johnson & Johnson, 211 N.J. 362, 387-89, 48 A.3d 1041 (2012) (under New Jersey statute providing that manufacturer will not be liable for failure to warn if it “communicates adequate information on the dangers and safe use of the product, taking into account the characteristics of, and the ordinary knowledge common to, the persons by whom the product is intended to be used,” claim that defendant submitted fraudulent representations to or withheld material information from FDA was impliedly preempted under Buckman Co. (internal quotation marks omitted)).
Because the issue of federal preemption is for the United States Court of Appeals for the Second Circuit to decide; see footnote 9 of this opinion; we do not address the defendants’ claim that federal laws and regulations preempt any state law duty to report the adverse effects of a medical device to the FDA that did not “preexist” the enactment of those laws and regulations. We note, however, that the duty that we recognize in this opinion is based on well established state law principles governing the statutory and common-law duty to provide warnings about a product to the person in the best position to take or recommend precautions and the general duty to use care.
This assumes, of course, that the Second Circuit determines that the plaintiff‘s claim under the CPLA is not preempted by federal law.
At least one court has held to the contrary. In Kubicki ex rel. Kubicki v. Medtronic, Inc., supra, 293 F. Supp. 3d 129, the court concluded that the plaintiffs’ failure to warn claims “ultimately relie[d] on sheer speculation: [The] [p]laintiffs contend that, if [the defendant] had complied with the federal requirement to report adverse events to the FDA, and if the FDA had directed [the defendant] to update the label of the [medical device at issue] based on these reported events, then [the defendant] would have had the duty to provide adequate warnings to consumers, as [District of Columbia] common law requires. But it is by no means certain that the FDA would have directed [the defendant] to give consumers different or additional information about the [medical device] if the agency had been made aware of other incidents that predated [the] . . . injury. And unless such label changes would necessarily have occurred as a result of [the defendant‘s] failure to notify the FDA, [the] [p]laintiffs’ contention that [the defendant‘s] failure to notify the agency is the functional equivalent of failing to warn consumers in violation of state law cannot be sustained.” (Emphasis in original.) Id., 184. We fail to see why, at least under Connecticut law, a plaintiff making a claim based on a defendant‘s failure to comply with federal law requiring it to report adverse events to the FDA must establish that it is “certain” that reporting the events would “necessarily” have resulted in a label change for the claim to survive a motion to dismiss. As we explained, the plaintiff need only make a showing that a reasonable fact finder could conclude that it is more likely than not that, if the defendant had complied with the reporting requirements, the substance of the reports would have been made available in some form to the plaintiff‘s healthcare providers and the plaintiff‘s injuries would not have occurred.
In Soto, this court characterized Gerrity as concluding that the plaintiff‘s “claim that [the] tobacco companies violated CUTPA by targeting minors with their cigarette advertising did not allege [a] product defect and, therefore, was not precluded by [the CPLA] . . . .” Soto v. Bushmaster Firearms International, LLC, supra, 331 Conn. 109. This characterization was based on the statement in Gerrity that “[t]he language of the exclusivity provision . . . suggests that it was not designed to serve as a bar to additional claims, including one brought under CUTPA, either for an injury not caused by the defective product, or if the party is not pursuing a claim for personal injury, death or property damage . . . .” (Emphasis added; internal quotation marks omitted.) Gerrity v. R.J. Reynolds Tobacco Co., supra, 263 Conn. 128. The emphasized portion of this statement was dictum because the plaintiff in that case did claim that the cigarettes that caused the decedent‘s death were defective. See id., 123.
As we have explained, an inherently dangerous medical device is deemed to be defective if it is not accompanied by adequate warnings. See, e.g., Hurley v. Heart Physicians, P.C., supra, 278 Conn. 315 (“[a] product may be defective due to a flaw in the manufacturing process, a design defect or because of inadequate warnings or instructions” (internal quotation marks omitted)).
As we explained, the plaintiff in Gerrity did not seek damages for personal injury, death or property damage in his CUTPA claim, and the plaintiffs in Soto did not allege that the product was defective. Thus, in neither case did the CUTPA claim subsume a CPLA claim.
