Part one of x can be found here: http://www.mydepuyhiprecall.com/2013/06/time-is-running-out-in-ny-to-file-suit.html. My questions are noted in that post.
Part Two: http://www.mydepuyhiprecall.com/2013/06/time-is-running-out-in-ny-to-file-suit_18.html
Part Three: Questioning of Dr Schmalzried part One (I shortened the questions and answers for expediency. So these are not quotes unless quotes are present.)
Part Four: Schmarlzried (Dr S) part Two of his testimony (below)
There were a number of discussions about various surgeons who were having problems with the ASR and Dr S was asked to talk to them as a member of the ASR design team to discuss the issues they were having. The implication in the questioning was if Dr S was working with the marketing folks from Depuy, how could he objectively discuss other physician's problems with the product if Dr S were working on a commission/override basis? Is there not a in inherent conflict of interest?
The ASR recall was in August of 2010. When did you stop using the ASR?
- A year before that
- "I learned they were going to discontinue it [The ASR] in September of 2009"
- He learned that there was going to be a phase out.
- Because I wouldn't be able to get parts if something needed replaced.
[ From Connie: The questioning then turned to the contacts whom Dr S used at Depuy to communicate information. Essentially, it was clear that Dr S's contacts were for the most part, marketing folks especially re the revisions. Is that unusual? No. Generally in most of the medical companies the chain of reporting is:
- Dr has a problem
- Problem goes to the sales rep
- Sales rep reports the issue to marketing
- Marketing goes to medical affairs
- Question is answered or event reported and the response goes right back down the line in the same manner it went up.
- If there is a big problem, medical affairs might contact the physician directly. I did not find this to be out of the ordinary standard of practice but I suppose the question is: Should the communication process work in this manner? Should a physician report to marketing re concerns from other surgeons when their remuneration is sales commissions? Likely not but it is the way things are done....at least when I was in this business.]
- No [Connie: but he did make the point earlier that this information did get communicated to marketing I believe.]
Oh, an answer to my question above: Was he paid commissions on the runoff inventory? The answer appears to yes given he was paid quarterly checks through at least the Q1 2013. So that means, he had to be receiving commissions on that inventory run off so I surmise. ]
Mid day break and I will pick this up tomorrow.
Connie's comments: Disappointing. Dr S is a teacher and a researcher. He has a moral and ethical responsibility to inform his colleagues of information that he himself would want to know, notwithstanding the patient population who might have been subjected to this hip during that last year unnecessarily. It appears to me that not only did he not step up to the ethics required by the medical profession but he received commissions on the devices sold before the market and his colleagues knew of the recall ...
So at this juncture/he failed my: "What did he know, when did he know it?" He did not seem to use the information known to him to do the right thing for the general patient population and his colleagues. He did do the right thing for his patients though in stopping the use of these devices.
I hope I got all of this wrong. Very disappointing indeed. Perhaps there is redemption to come during the afternoon examination? I hope so. Could be that I misinterpreted all of this..... but it surely doesn't appear that way to me.
I am no expert in court room law but I am sure there is a reason why questions like this didn't get asked:
- Did you continue to receive commissions on inventory sold after the recall was announced?
- How did you feel when you attended orthopedic meetings knowing that the recall was in process and the medical community was not yet informed?
- Did you have any other physicians with whom you consulted during the time you were made aware of the recall and the actual market announced recall?
- Did this advance knowledge cause you any concern?
- If so why?