APRIL L. HILL v. BAYER CORPORATION, et al.
Case No. 19-CV-12198
UNITED STATES DISTRICT COURT EASTERN DISTRICT OF MICHIGAN SOUTHERN DIVISION
September 8, 2020
HON. GEORGE CARAM STEEH
ORDER GRANTING DEFENDANTS’ MOTION TO DISMISS [ECF Nо. 12] AND GRANTING DEFENDANTS’ SECOND REQUEST FOR JUDICIAL NOTICE [ECF No. 27]
I. Overview
Plaintiff April Hill brought this products liability suit arising out of injuries allegedly caused by an Essure permanent birth control device manufactured by Defendants. Plaintiff has sued Defendants Bayer Corp., Bayer Healthcare, LLC, and Bayer Healthcare Pharmaceuticals Inc. (collectively “Bayer“). Now before the court is Defendants’ motion to dismiss for failure to state a claim under
II. Factual Background
The recitation of the facts below comes from the allegations of the Amended Complaint or from those documents that the parties agreed may be judicially noticed by the court. (ECF No. 4). Essure is a permanent female birth control device that is intended to cause a blockage of the fallopian tubes by the insertion of micro-inserts into the fallopian tubes which then anchor and elicit tissue growth. Id. at PageID.99, ¶ 15. The micro-inserts are comprised of two metal coils which are inserted using hysteroscopic (camera) guidance. Id. at PageID.105, ¶ 33. Plaintiff alleges the device migrates from the fallopian tubes and perforates organs. Id. at PageID.99, ¶ 15. The device is inserted as part of a “non-surgicаl” outpatient procedure to be done without anesthesia. Id. at PageID.106, ¶ 41.
Essure had Conditional Premarket Approval (“CPMA“) by the Food and Drug Administration (“FDA“). Id. at PageID.99, ¶ 17; ECF No. 13-1. As a Class III medical device, Essure required premarket approval (“PMA“) by the FDA. Id. at PageID.107, ¶ 48. Class III devices receive the most
Plaintiff was implanted with the Essure device on or around December 21, 2011. (Amended Complaint, ¶ 97). Plaintiff alleges that as a result of the implantation of Essure she has suffered abdominal pain, depression, fatigue, heavy bleeding, pain during intercourse, weight fluctuations, severe back pain, migraines, urgent and frequent urination, heart palpitations, loss of libido, bowel issues, pelvic pain, and hot flashes.
Plaintiff‘s Amended Complaint alleges five counts: (I) negligent training, (II) negligent risk management, (III) breach of express warranty, (IV) negligent misrepresentation, and (V) negligent failure to warn. Defendants argue that Plaintiff‘s claims are preempted and inadequately pled.
III. Standard of Law
IV. Analysis
A. Judicial Notice
Defendants request that the Court take judicial notice of the 2009 Patient Information Booklet, approved by FDA in 2009 and in force at the time that Plaintiff received Essure.
B. Preemption under the FDCA
The FDCA includes an express preemption clause that provides, in relevant part:
[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.
The Supreme Court addressed the meaning of
If the conduct is prohibited by the FDCA, then a state-law claim premised on that conduct is not expressly preempted by
In sum, Riegel and Buckman create a “narrow gap” through which a plaintiff‘s state-law claim must fit if it is to escape express or implied
C. Negligent Training
Defendants argue that Plaintiff‘s negligent training claim pled in Count I should be dismissed because it is preempted by federal law, and lacks sufficient factual allegations to be plausible on its face but is merely boilerplate. Defendants complain Plaintiff has not alleged facts supporting a plausible inference that her own doctor was negligently trained in violation of federal standards, her doctor erred in placing her device, or her alleged injuries were causаlly linked to physician error arising from inadequate training. Defendants fault Plaintiff for not even identifying her own doctor.
To survive a preemption challenge, Plaintiff‘s negligent training claim must depend on allegations that Bayer breached FDA-approved training
Device to be used only by physicians who are knowledgeable hysteroscopists; have read and understood the Instructions for Use and Physician Training Manual; and have successfully completed the Essure training program, including preceptoring in placement until competence is established, typically 5 cases.
2013 IFU at 1 (ECF No. 13-7, PageID.404). Plаintiff‘s Amended Complaint alleges violations of those requirements. (ECF No. 4, PageID 144, ¶ 155). Specifically, the Amended Complaint alleges that Bayer breached FDA approved guidelines by (1) not ensuring that the implanting physicians completed the requirement preceptoring in Essure placement until competency, (2) not ensuring that the implanting physicians had read and understood the Physician Training Manual, and (3) not ensuring that the implanting physicians had “successful completion of Essure Simulator Training.” Id. Because Plaintiff‘s negligent training claim is based on breach of FDA training requirements, Plaintiff‘s claim is not preempted by federal law. Unlike DeLaPaz v. Bayer Healthcare, LLC., 159 F. Supp. 3d 1085, 1096 (N.D. Cal. 2016), relied upon by Bayer, this case involves
Bayer also faults Plaintiff for not pleading facts to show a causal link between her alleged injury and the alleged failure to train her implanting physician and argues her negligent training claim is mere boilerplate. Plaintiff alleges generally that the alleged failure to train caused the implanting physician‘s technique to cause the coils to migrate, perforate, fracture or cause other injury. (ECF No. 4, PageID.144-45, ¶ 156). But Plaintiff has not even identified her own doctor let alone pled facts suggesting a viable failure to train claim. It is not enough to set forth a “formulaic recitation of the elements of a cause of action,” D‘Ambrosio, 747 F.3d at 383. Plaintiff‘s failure to plead plausible facts in support of her failure to train claim is fatal, and having failed to satisfy the dictates of Iqbal and Twombly, that claim (Count I) shall be dismissed. See McLaughlin v. Bayer Corp., 172 F. Supp. 3d 804, 817-18 (E.D. Pa. 2016) (dismissing
D. Negligent Risk Management (Count II) and Negligent Failure to Warn (Count V)
Count II alleges negligent “risk management” and Count V alleges negligent “failure-to-warn.” The two claims parallel each other as both are premised on Bayer‘s alleged failure to comply with federal reporting and other regulatory conditions. Thus, the court аnalyzes them together. In Count V of her Amended Complaint, Hill alleges that Bayer is liable for negligent failure-to-warn for failing to make disclosures to herself, her implanting physician, and the FDA. Despite the heading “negligent failure-to-warn,” the Amended Complaint cites to a lengthy list of alleged federal regulatory violations, the vast majority of which do not involve warning requirements at all, but rather involve the alleged failure to make certain reports including adverse events to the FDA, and various other alleged violations as required by FDA regulations for the Conditional Premarket Approval (“CPMA“). (Amended Complaint, ¶¶ 199(a)-(z)). For the reasons discussed below, these claims shall be dismissed as preempted as supported by decisions of the Sixth, Eighth and Eleventh Circuits.1
The Sixth Circuit has not addressed the narrow issue presented here, and courts are divided on the issue. But the Sixth Circuit‘s decisions in Kemp, supra, and Cupek v. Medtronic, Inc., 405 F.3d 421 (6th Cir. 2005) suggest that the Court of Appeals would not recognize a state law failure-to-warn tort claim for a medical device manufacturer‘s alleged failure to report adverse events to the FDA. In Kemp, the Sixth Circuit held that plaintiff‘s claim for fraud-on-the-FDA arising out of an allegedly defective pacemaker was preempted because permitting “a fraud claim premised on false representations to the FDA during the PMA process would conflict with well-established precedent that no implied private right of action exists under the FDCA.” Id. at 236 And in Cupek, which involved allegedly defective pacemaker leads, the Sixth Circuit found that statе law failure-to-warn claims are expressly preempted because those failure-to-warn claims would require defendant to comply with state requirements “different from” or “in addition to” federal requirements. Id. at 424. The Sixth Circuit
Although Kemp and Cupek support the conclusion that Hill‘s failure-to-warn claim premised on Bayer‘s alleged failure to report adverse events to the FDA are preempted under Buckman, because they did not squarely address the issue, the court discusses below the arguments of counsel and the relevant decisions that have done so.
Bayer argues that under the Supreme Court‘s holding in Buckman, a claimed violation of the FDCA, enforceable only by the government under
Hill, on the other hand, relies solely on McLaughlin v. Bayer Corp., 172 F. Supp. 3d 804, 838 (E.D. Pa. 2016). Indeed, the district court in that case faced with the identical issue presented here did find that Plaintiff‘s failure to warn claim premised on Bayer‘s alleged failure to report adverse events to the FDA was not preempted. The court relied on an en banc
a supplier‘s duty to warn is discharged by providing information about the product‘s dangerous propensities to a third person upon whom it can reasonably rely to communicate the information to the ultimate users of the product or those who may be exposed to its hazardous effects.
Id. Plaintiff has cited to no Michigan law in support of her failure to warn claim.
In sum, the Fifth and Ninth Circuits have recognized a failure-to-warn claim arising out of a medical device manufacturer‘s failure to provide adverse event reports to the FDA, while the Eighth and Eleventh Circuits have held to the contrary. Below, the court sets forth a brief summary of the rationale offered by the courts in support of these divergent conclusions.
First, let us consider the Supreme Court‘s holding in Buckman that plaintiff‘s fraud claims for alleged misrepresentations to the FDA were impliedly preempted because there was no parallel state tort law which predated the federal enactments in question. 531 U.S. at 353. The Court explored the policy reasons behind its implied preemption dоctrine in the case of medical devices and found that the FDA is empowered to punish and deter any fraud against the administration, and allowing state tort
In deciding the question now before the court, some courts have held that the federal requirement that a drug manufacturer, like Bayer, report adverse events to the FDA parallels state requirements that a manufacturer warn third parties of the dangers of its product because the FDA is required
Hаving summarized some of the various conflicting positions federal courts outside this Circuit and around the country have taken on the issue of whether a negligent failure-to-warn claim premised on a medical device manufacturer‘s alleged failure to report adverse events to the FDA is
In order to state a negligent failure-to-warn claim in a products liability case under Michigan law, a plaintiff must prove that the product was rendered defective by the manufacturer‘s “failure to warn about dangers regarding the intended uses of the product, as well as foreseeable misuses” of the product. Gregory v. Cincinnati Inc., 450 Mich. 1, 11 (1995). “Thе Michigan Legislature has codified a product manufacturer‘s duty to warn end-users about dangers associated with a product‘s use.” Mitchell v. City of Warren, 803 F.3d 223, 226 (6th Cir. 2015). The statute provides:
a product liability action brought against a manufacturer or seller for harm allegedly caused by a failure to provide adequate warnings or instructions, a manufacturer or seller is not liable unless the plaintiff proves that the manufacturer knew or should have known about the risk of harm based on the scientific, technical, or medical information reasonably available at the time the specific unit of the product left the control of the manufacturer.
Mitchell, 803 F.3d at 226–27 (quoting
Under the “narrow gap” requirement, Hill‘s negligent failure to warn claim is only viable to the extent she seeks to recover for a claimed violation of a traditional state tort law that aligns with a federal requirement. Here, Hill has not alleged any Michigan requirement that a manufacturer report adverse events to the FDA. And based upon her response brief, Plaintiff relies solely on Bayer‘s alleged failure to warn the FDA of adverse events in support of her failure to warn claim. Accordingly, Hill‘s negligent misrepresentation and negligent failure-to-warn-FDA claims are impliedly preempted under Buckman and must be dismissed. In addition, even if the
E. Breach of Warranty (Count III) and Negligent Misrepresentation (Count IV)
The court now considers Hill‘s breach of warranty and negligent misrepresentation claims which are largely duplicative. Bayer argues that Hill‘s breach of express warranty claims and negligent misrepresentation claims must be dismissed because all of the alleged misrepresentations were statements from the approved labeling, which the FDA determined were not false or misleading.
First, as to her breach of warranty claim,
Here, Hill alleges she relied on certain representations on Bayer‘s website and in Essure advertisements in determining to have Essure implanted. She alleges the following representations were false: (1) zero pregnancies in clinical trials and pregnancy cannot occur, (Amended Cоmplaint, ¶¶ 177(a)(b)(h)(o)); (2) physicians must be signed off to perform Essure procedures and must perform at least one Essure procedure every six to eight weeks, id. at ¶¶ 177(c)(i); (3) Essure is “worry free,” id. at ¶¶ 177(d)(j)(l); (4) Essure is more effective than tying your tubes or a vasectomy, id. at ¶ 177(f); (5) correct placement is performed easily because of design of micro-insert and does not irritate the lining of the uterus, id. at 177(m)(s), and the tip of each insert remains visible to your doctor to confirm placement, id. at ¶ 177(k); (6) Essure is a surgery-free permanent birth control, id. at 177(g), and eliminates the risks, discomfort,
Hill‘s negligent misrepresentation mirrors her breach of warranty claim. In order to state a claim for negligent misrepresentation under Michigan law, a plaintiff must show: (1) justifiable and detrimental reliance on (2) information provided without reasonable care (3) by one who owed a duty of care. Chesterfield Exch., LLC v. Sportsman‘s Warehouse, Inc., 572 F. Supp. 2d 856, 866 (E.D. Mich. 2008) (citing Law Offices of Lawrence J. Stockler v. Rose, 174 Mich. App. 14, 33 (1989)). In support of her negligent misrepresentation claim, Plaintiff alleges the following misrepresentations: (1) qualifying Essure physicians must perform at least one Essure procedure every six to eight weeks (Amended Complaint, ¶ 188(a)); (2) pregnancy cannot occur, id. at ¶ 188(b); (3) the viewable portion of the micro-insert serves to verify placement and does not irritate the lining of the uterus, id. at ¶ 188(c); (4) there was no cutting, no pain, no scars, id. at ¶ 188(d). These are included in the same claims set forth in her breach of warranty claim. All are addressed together below.
1. Zero Pregnancies
Hill seeks to hold Bayer liable for a statement on the Essure website that there were zero pregnancies in clinical trials, and pregnancy cannot occur. (Amended Complaint, ¶¶ 177(a)(b)(h)(o), ¶ 188(b)). These stаtements were consistent with FDA-approved statements in the PIB that “In the Essure clinical studies, zero (0) pregnancies were reported in women who had the Essure inserts for up to 5 years.” (ECF No. 13-8, PageID.421; 13-9, PageID.449). They are also consistent with the PIB FDA-approved statement that “During the first 3 months following the procedure, your body and the micro-inserts . . . form a tissue barrier . . . so that sperm cannot reach the egg. This prevents you from getting pregnant. You will need to use another form of birth control during this time.” (ECF
2. Physician Sign-Off and Frequent Performance Requirement
Hill also seeks to hold Bayer liable for a statement on its website that physicians must be signed off to perform Essure procedures, and must perform at least one Essure procedure every six to eight weeks. (Amended Complaint at ¶ 177(c)(i), ¶ 188(a)). Bayer argues the sign-off requirement is virtually identical to an FDA-approved statement in the IFUs that, “[t]his device should only be used by physicians who are knowledgeable hysteroscopists, have read and understood the information in this Instructions for use and in the Physician Training Manual, and have successfully completed the Essure training program. Completion of the Essure training program includes preceptoring in Essure placement until competency is established, which is typically expected to be achieved in 5
Hill next complains that the statement, “to be identified as a qualified Essure physician, a minimum of one Essure procedure must be performed every 6-8 weeks” was misleading. (Amended Complaint, ¶ 177(i); ¶ 188(a)). Bayer responds that Hill has not adequately pled a claim where she does not allege any facts to support a plausible inference that (1) her own dоctor was “identified as a qualified Essure physician,” who (2) did not perform one placement every 6-8 weeks, and (3) made errors in placing her device, (4) because of his or her infrequent performance of the Essure procedure, which (5) actually caused her injuries. The court agrees and finds that this claim fails for failure to plead plausible facts in support.
3. Worry Free
Hill also seeks to hold Bayer liable for three statements on the Essure website and advertising that the device is “worry free.” (Amended Complaint, ¶¶ 177(d)(j)(l)). One of the statements reads, “Once your doctor confirms that your tubes are blocked, you never have to worry about unplanned pregnancy,” id. at ¶ 177(d), another that states, “You will never have to worry about unplanned pregnancy again,” id. at ¶ 177(j), and a third that stаtes simply “worry free.” Bayer responds that those statements are consistent with FDA-approved a statement in the PIB that “Essure may be right for you if . . . [y]ou would like to stop worrying about getting pregnant.” (ECF No. 13-9 PageID.441). At least two courts that have considered similar claims, have found that the statements that Essure was “worry free” were expressly preempted. De La Paz, 159 F. Supp. 3d at 1098; McLaughlin, 2017 WL 697047, at *13. This court reaches the same conclusion.
4. Most Effective Birth Control
Hill also argues that Bayer‘s statement on its website that Essure is more effective than tying your tubes or a vasectomy, id. at ¶ 177(f) is a fraudulent misrepresentation. But Bayer has shown that this statement is consistent with FDA information in the IFU which compares Essure with
5. Correct Placement and Irritate Lining of the Uterus
Hill also argues that the statement on Bayer‘s website that correct placement is performed easily because of the design of the micro-insert and that it does not irritate the lining of the uterus, (Amended Complaint, ¶¶ 177(m)(s), 188(c)), are fraudulent misrepresentations. Hill also seeks to hold Bayer liable for statements made in an advertisement that the tip of each insert remains visible to your doctor to confirm placement. Id. at ¶¶ 177(k)(m), 188(c). Bayer responds that those statements were consistent with FDA-approved statements in that the IFU provides that during the “Essure Micro-Insert Placement Procedure,” “[e]xpanded outer coils of the Essure micro-insert trailing into the uterus indicates ideal placement.” (ECF No. 13-12, PageID.510). Thus, Hill‘s claim that
6. Surgery Free and Permanent
Hill also argues that the statements that Essure is a surgery-free permanent birth control on its website, (Amended Complaint, ¶ 177(g)), and the statement in advertising that the device eliminates the risks, discomfort, and recovery time associated with surgical procedures like having your tubes tied, id. at ¶¶ 177(p)(q), is a fraudulent misrepresentation. Bayer, on the other hand, points to FDA-approved statements in the PIB that Essure is “non-surgical” and “does not require surgery or exposure to its potential risks,” (ECF No. 13-9, PageID.441), does not require “cutting into the body.” (ECF No. 13-11, PageID.491). Other courts have considered the same statements and ruled that they are consistent with, and largely equivalent to FDA-approved statements, and thus, any fraudulent misrepresentation claims based on these statements are expressly
7. Long Protective Barrier
Hill also seeks to hold Bayer liable for a statement in advertising materials that Essure forms a long protective barrier against pregnancy. (Amended Complaint, ¶ 177(m)). This statement is consistent with FDA-approved statement that, “your body will form tissue around the Essure inserts. This will develop a natural barrier within the fallopian tubes.” (ECF No. 13-9, PageID.443). Also, the IFU provides, “[t]he insert expands upon release to conform to and acutely anchor in the tubal lumen.” (ECF No. 13-7, PageID.404). Accordingly, the alleged misrepresentation is expressly preempted.
8. Safe, Trusted Material
Hill also argues that Bayer should be held liable for a statement that Essure inserts are made from trusted materials, the same as used in heart stents. (Amended Complaint, ¶¶ 177(n)(r)). But Bayer has shown those representations are consistent with FDA-approved statements in the PIB that “[t]hese same materials have been used for many years in cardiac stents and other medical devices placed in other parts of the body.” (ECF No. 13-9, PageID.448, 13-11, PageID.489).
9. No Cutting, Pain, or Scars
Finally, Hill also argues that Bayer should be held liable for the statement in an advertising booklet that there is no cutting, pain, or scars, (Amended Complaint, ¶¶ 177(t); ¶ 188(d)). FDA-approved PIB, however, states that there is “[n]o cutting into the body.” (ECF No. 13-11, PageID.491). The PIB also states that, “[t]he Essure procedure does not involve cutting into or puncturing your body, and does not cut, crush or burn your fallopian tubes . . . Since there is no incision, you will have no scarring.” 2009 PIB (ECF No. 27-1, PageID.794). It further states, “[i]s the procedure painful? Generally, no.” (ECF No. 27-1, PageID.797). This language in FDA-approved statements that there is no cutting and no pain or scars is expressly preempted.
V. Conclusion
For the reasons set forth above, Defendants’ motion to dismiss (ECF No. 12) is GRANTED in its entirety. Defendants’ request for judicial notice is also GRANTED (ECF No. 27).
Dated: September 8, 2020
s/George Caram Steeh
GEORGE CARAM STEEH
UNITED STATES DISTRICT JUDGE
