With about 10,000 metal hip lawsuits filed around the country, jury selection in the second trial involving the DePuy ASR (Articular Surface Replacement) hip is underway in Cook County, Illinois with opening statements to begin mid-month.

Courtesy of Antoine TaveneauxMeanwhile the jury is considering the evidence presented in Los Angeles Superior Court in Kransky v. DePuy, and preparing to render its decision in the first defective product case involving the controversial DePuy metal-on-metal (MoM) hip made by a division of Johnson & Johnson.

According to closing arguments in the case, J&J has been playing the blame game, blaming Mr. Bill Kransky for his medical conditions and pointing out that he smoked, had diabetes, a heart condition and kidney cancer.

A hip infection caused his problems, not the ASR hip implant said defense counsel, insisting DePuy is a good company.

During the six week trial, evidence has shown otherwise.

Metal ions entered Loren Kransky’s bloodstream from the friction created by the metal ball and cup of the ASR. A reasonable person would expect a medical device to do more good than harm, said counsel, and a reasonable person would expect that scientists would put patients first, not a rush to profits.

But the case has shown the ASR was kept on the market to maximize profits despite adverse reports coming in as early as 2005.

“In the US, the ASR XL cup design is our leading differentiator and is one of the key drivers of ASR XL’s 120 percent growth,” said company documents even as doctors understood complaints were coming in involving component loosening, misalignment, infection, fracture, dislocation and metal sensitivity.

Despite those consistent adverse events, the company said “a single root cause cannot be defined at this time.”

With failures of the hip prosthesis occurring in two to four years, DePuy kept selling the ASR without informing doctors about the failure rates, thereby denying patients informed consent.

Without this knowledge, 93,000 ASR devices were implanted in patients around the world before the device was recalled in August 2010.

Common sense dictates one in three metal hips should not fail in less than five years.

The defense told jurors there is no perfect hip. Plaintiffs stated that the DePuy ASR is not just imperfect, but is a public health disaster. Plaintiffs also argued that the company should be made to pay the bill instead of blaming Mr. Kransky for his less than perfect health, which was unrelated to his ASR hip.

Attorneys for Mr. Kransky are asking for $338,000 in medical expenses and $5 million for pain and suffering. As far as punitive damages, it’s estimated between two and five percent of J&J’s net worth is $72 to $178 million, reports Bloomberg.

About 500,000 Americans have received all-metal hip devices over the past decade and all eyes are on the outcome of this case and the many to follow.