Speculation Surrounding DePuy Kickbacks to Doctors Who Recommended Recalled Device

The New Haven Independent reported in December 2010 that DePuy, the company responsible for manufacturing thousands of defective hip implants, spent millions of dollars in attempts to woo doctors toward the use of its products on patients. DePuy, a division of Johnson & Johnson, recalled hundreds of thousands of the hip implant devices it had manufactured after a serious design defect was discovered in August 2010. Just as many patients are currently faced with potential complications or the prospect of revision surgery. Some question whether patients could have been saved from these consequences had doctors not been prompted, via kickbacks, to surgically implant DePuy devices into hip replacement patients.

DePuy discloses payments to doctors on its website, but it categorizes such pay as “product royalty payments, “compensation for research,” “meals,” “airfare,” and other expenses. DePuy paid nearly $50 million to surgeons in 2009, with some physicians receiving as much as $1 million from the company. Even if doctors in good faith believe that payments from DePuy do not compromise their medical judgment, health consumer advocates disagree. “…[T]he reality is, it’s human beings,” Jean Rexford, executive director of the Connecticut Center for Patient Safety, said. “We are influenced. If somebody does something nice for me, I’m nicer to them than someone who hasn’t done something nice to me.”

Another expert, Gregory E. Demske, an assistant inspector general, testified before the Senate that “…[I]n an environment where physicians routinely receive substantial compensation from medical device companies through stock options, royalty agreements, consulting agreements, research grants and fellowships, evidence suggests that there is a significant risk that such payments will improperly influence medical decision-making.”

In response to calls by watchdogs for greater transparency, the American Academy of Orthopaedic Surgeons mandated a disclosure system meant to shed light on potential conflicts of interest between doctors and medical manufacturers in 2010. According to the academy’s website, such disclosure was necessary because of “increasing public and governmental scrutiny of the relationships between orthopaedic surgeons and industry.” By exposing potentially dangerous relationships between doctors and manufacturers, the disclosure system can aid medical overseers in ensuring that doctors are not unduly influenced into giving patients faulty products, such as the recalled DePuy ASR hip implants.

While some payments exchanged between DePuy and physicians may have been for legitimate research purposes, the sheer amount of dollars spent by the company is nevertheless troubling. Given that DePuy had received reports about above-average failure rates in its hip implants for years leading up to the recall, one might speculate whether physician compensation was nothing more than a ploy by DePuy to encourage doctors to look the other way. As the discovery proceedings in DePuy lawsuits unfold, the answer to this question may eventually emerge.

Keep checking in with this blog for updates on the level of knowledge DePuy officials had while they continued to manufacture defective hip implants.

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