MEMORANDUM AND ORDER
Plaintiff Judith Redd underwent a hip replacement using a prosthesis manufactured by defendant DePuy Orthopaedics, Inc. Approximately four years later, the replacement failed and Redd was diagnosed with a broken femoral component (stem) of her prosthesis. Redd has sued DePuy, alleging that the failure was caused by the prosthesis’s defects and De-Puy’s failure to warn of the risks. She brings four state common law claims under negligence and strict liability theories.
This action is now before me on DePuy’s Rule 12(b)(6) motion to dismiss. DePuy argues that Redd’s claims are preempted by the 1976 Medical Device Amendments (MDA) to the Food, Drug and Cosmetic Act. It also argues that even if the claims are not preempted, Redd has failed to state a plausible claim for relief. Because I find that the claims are not preempted and that they meet federal pléading requirements, I will deny DePuy’s motion.
I. Motion to Dismiss Standard
The purpose of a motion to dismiss under Rule 12(b)(6) is to test the legal sufficiency of the complaint. When considering a 12(b)(6) motion, the court assumes the factual allegations of a complaint are true and construes them in favor of the plaintiff. Neitzke v. Williams,
Rule 8(a)(2), Fed.R.Civ.P., provides that a complaint must contain “a short and plain statement of the claim showing that the pleader is entitled to relief.” In Bell Atlantic Corp. v. Twombly, the Supreme Court clarified that Rule 8(a)(2) requires complaints to contain “more than labels and conclusions, and a formulaic recitation of the elements of a cause of action.” 550
II. Background
DePuy designed, manufactured, and sold the AML Total Hip System, including the AML Small Stature stem. Redd’s left hip was replaced with the System in April 2008. Approximately four years later, she was diagnosed with a broken stem, which had caused her hip replacement to fail. She claims that the stem was subject to premature and sudden fatigue fracture because the alloy used had inadequately low fatigue strength and limited ductility and because the manufacturing process did not adequately anneal the alloy. She brings the following four claims under Missouri common law: Strict Liability — Product Defect; Strict Liability — Failure to Warn; Negligence — Product Defect; and Negligence — Failure to Warn.
III. The Medical Device Amendments
In 1976, Congress passed the Medical Device Amendments to the Food, Drug and Cosmetic Act. See 21 U.S.C. § 360c et seq. The amendments authorized the FDA to “regulate the safety and effectiveness of medical devices.” In re Medtronic, Inc.,
The MDA classifies medical devices into three groups (Classes I, II, and III) based on the degree of risk they pose. In general/Class III devices — as the most dangerous — are subject to the highest level of scrutiny by the FDA. This manifests in a rigorous, comprehensive inquiry called “premarket approval.” See Lohr,
The MDA also expressly preempts certain state laws. Subject to some unrelated exceptions, “no 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.”
21 U.S.C. § 360k(a).
The Supreme Court has articulated a two-part test for applying the express preemption principles codified in Section 360k of the MDA. See Riegel,
The contours of this test are further illuminated by the Supreme Court’s holdings in Lohr and Riegel. In Lohr, a divided Supreme Court held that the petitioner’s state common, law claims concerning a device brought to market through the § 510(k) process were not preempted under Section 360k. Id. at 481, 494-95,
In Riegel, the Court held that similar state common law claims were preempted when they involved devices that had undergone the rigorous premarket approval process.
In addition to its holdings in Lohr and Riegel, the United States Supreme Court weighed in on the preemptive effects of the MDA a third time in Buckman Co. v. Plaintiffs’ Legal Committee,
IV. Express Preemption: Whether The Hip System Is Subject to Federal “Requirements ”
The first question in this case is whether DePuy’s AML Total Hip System, including its small stature stem, is subject to federal requirements that could expressly preempt Redd’s claims. See Rie-gel,
The Hip System came to market through the § 510(k) process and is a Class II device.
Defendant DePuy argues that the Hip System here is subject to certain special controls, which constitute federal “requirements” that preempt Redd’s state common law claims. The two special controls Defendant DePuy references are a regulation
Redd responds that the regulation contains only a “generic description and identification” of certain hip devices and “mandates nothing about the specifics of the annealing process or prevention of mid-shaft fractures.” She argues that the Guidance Document does not specifically address her claims either, but rather, merely lays out a set of recommendations that, if followed, will “lead to a timely § 510(k) review and clearance.” (Def.’s Ex. 4, Doc. 13-4, p. 1.) Redd contends that because neither the regulation nor the Document imposes any true obligation stricter than the § 510(k) substantial equivalence process, they are not federal “requirements.” Therefore, Redd argues, Lohr controls and her claims are not preempted.
The regulation DePuy relies on does little more than identify characteristic features of the Hip System and other prostheses like it. It reads, in full:
Hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis.
(a) Identification. A hip joint metal/polymer/metal semi-constrained porous-coated uncemented prosthesis is a device intended to be implanted to replace a hip joint. The device limits translation and rotation in one or more planes via the geometry of its articulating surfaces. It has no linkage across the joint. This generic type of device has a femoral component made of a cobalt-chromium-molybdenum (Co-Cr-Mo) alloy or a titanium-aluminum-vanadium (TÍ-6A1-4V) alloy and an acetabular component composed of an ultra-high molecular weight polyethylene articulating bearing surface fixed in a metal shell made of Co-Cr-Mo or TÍ-6A1-4V. The femoral stem and acetabular shell have a porous coating made of, in the case of Co-Cr-Mo substrates, beads of the same alloy, and in the case of TÍ-6AI-4V substrates, fi- , bers of commercially pure titanium or TÍ-6A1-4V alloy. The porous coating has a volume porosity between 30 and 70 percent, an average pore size between 100 and 1,000 microns, interconnecting porosity, and a porous coating thickness between 500 and 1,500 microns. The generic type of device has a design to achieve biological fixation to bone without the use of bone cement.
Classification. Class II.
58 Fed.Reg. 3227-01 (Jan. 8, 1993) (codified at 21 C.F.R. § 888.3358). The identification or classification of the Total Hip System is not enough to trigger federal preemption.- See James v. Diva Int’l,
Turning to the Special Controls document identified by Defendant, I first note that its title is “Class II Special Controls Guidance Document: Hip Joint Met
Furthermore, a review of the CFR sections identifying and classifying other hip prostheses reveals that a separate regulation contains the identification and classification for the device named in the Special Controls document. 21 C.F.R. § 888.3310 is titled “Hip joint metal/polymer constrained cemented or uncemented prosthesis.” Subsection (b) of this regulation reads as follows:
(b) Classification. Class II (special controls). The special control for this device is the FDA guidance document entitled “Class II Special Controls Guidance: Hip Joint Metal/Polymer Constrained Cemented or Uncemented Prosthesis.”
In short, it appears that the Special Controls document cited by DePuy, while certainly providing guidance for a prosthetic hip device, does not provide guidance or requirements for the particular hip prosthesis that was implanted in Plaintiff Redd. DePuy has failed to point to any device-specific federal requirements applicable to the Hip System.
Just as in Lohr, the Hip System here was cleared for market through the § 510(k) process as opposed, to the rigorous PMA process and is apparently subject only to the FDA’s “general controls.” Therefore, the Hip System is not subject to any federal requirements, and the first prong of the express preemption test articulated .in Riegel has not been met. See Riegel,
V. Whether Plaintiff Redd Has Stated a Plausible Claim for Relief
DePuy also also argues that Redd’s claims must be dismissed because she cannot satisfy the pleading requirements established under Bell Atlantic Corp. v. Twombly,
A. The Strict Liability Claims.
In Missouri, the theory of strict liability is broken down into liability for defective design and liability for failure to warn of an inherent danger in the product. These two theories have been codified pursuant to Mo.Rev.Stat. § 537.760. Sperry v. Bauermeister, Inc.,
(1) The defendant, wherever situated in the chain of commerce, transferred a product in the course of his business; and
(2) The product was used in a manner reasonably anticipated; and
(3) Either or both of the following:
(a) The product was then in a defective condition unreasonably dangerous when put to a reasonably anticipated use, and the plaintiff was damaged as a direct result of such defective condition as existed when the product was sold; or
(b) The product was then unreasonably dangerous when put to a reasonably anticipated use without knowledge of its characteristics, and the plaintiff was damaged as a direct result of the product being sold without' an adequate warning.
Mo.Rev.Stat. § 537.760.
The only issue before this Court at the motion to dismiss stage is whether Plaintiff has alleged enough facts “to raise a right to relief above the speculative level....” Coleman v. Dental Org. for Conscious Sedation, LLC, 4:10CV798 TIA,
DePuy cites Gross v. Stryker,
B. The Negligence Claims
Under Missouri law, “in an action for negligence, generally, a plaintiff must allege ultimate facts which if proven, show: (1) the existence of a duty on the part of the defendant to protect the plaintiff from injury; (2) failure of the defendant to perform that duty; and (3) injury to the plaintiff resulting from such failure.” Menz v. New Holland N. Am., Inc.,
DePuy argues that Redd has failed to allege sufficient facts showing what warning was provided as to the Hip System or how it was inadequate. DePuy, as manufacturer of the Hip System, should already have notice of the contents of any existing product warnings. Furthermore, although Redd does not identify any particular warning language that she feels was missing or misleading, it is clear she is alleging that the warning was deficient as to the specific product defects or hazards described in the complaint. I find the level of detail Redd conveys in describing the stem’s alleged defects provides DePuy sufficient notice as to purported deficiencies in the Hip System’s product warnings. Cf. Bohnenstiehl v. Wright Medical Group, Inc., No. 4:13-CV-853 (CEJ),
DePuy further argues that Redd “does not allege any facts tending to make it plausible that DePuy had or should have had” knowledge that the design and manufacturing characteristics of the femoral stem created a premature risk of it breaking. However, Redd alleges that DePuy manufactured and designed the femoral stem, which makes it plausible that DePuy had or should have had knowledge of any design or manufacturing defects.
Finally, DePuy claims Redd’s pleading is insufficient as to both of her failure to warn claims because she has failed to allege facts sufficient to show that the learned intermediary doctrine does not bar them. The learned intermediary doctrine provides that a drug manufacturer has a duty to warn a physician of the risks involved with its product. The physician then acts as a “learned intermediary” between the manufacturer and the physician’s patient so that any warning given to the physician is deemed a warning to the patient. Kirsch v. Picker Int’l, Inc.,
DePuy claims Redd was required, in her initial pleading, to allege facts tending to show her doctor’s knowledge (or lack thereof) regarding the alleged defect in order to defeat the learned intermediary doctrine. However, none of the cases cit
Ultimately, the facts Redd alleges in her complaint give DePuy fair notice of what Redd’s claims are and the grounds upon which they rest. See Erickson v. Pardus,
Accordingly,
IT IS HEREBY ORDERED that the defendant’s motion to dismiss [# 11] is DENIED.
IT IS FURTHER ORDERED that plaintiffs motion to file supplemental memorandum of law in opposition to defendant’s motion to dismiss [# 17] is DENIED.
This case will be set for a Rule 16 Scheduling Conference by separate Order.
Notes
. The facts that follow are taken from the allegations set out in Redd’s complaint. They are considered true for the purpose of this Memorandum and Order. See Ashcroft v. Iqbal,
. The Court has jurisdiction over this action pursuant to 28 U.S.C. § 1332.
.Under the MDA, devices marketed before 1976 are grandfathered "until such time as the FDA initiates and completes" premarket approval. Id. (citing 21 U.S.C. § 360e(b)(l)(A); 21 C.F.R. § 814.1(c)(1)). Therefore, a new Class III device may also be marketed if it is substantially equivalent to a grandfathered device, though neither has undergone premarket approval.
. DePuy requests I take judicial notice that the AML hip stem at issue is a medical device subject to regulation by the U.S. Food and Drug Administration under the MDA. DePuy’s memorandum in support of its motion to dismiss also cites to several FDA documents and web pages containing public records. "Generally, the Court must ignore materials that are outside of the pleadings, however, district courts may take judicial notice of public records and may thus consider them on a motion to dismiss.” Stahl v. U.S. Dept, of Agriculture,
. A review of cases discussing Missouri's learned intermediary doctrine indicates that it is typically asserted by a defendant as an affirmative defense to a failure to warn claim. See, e.g., Alpha Therapeutic Corp.,
