Compensation for DES-victims and the Dutch collective settlement

DES mothers who developed (or will develop) breast cancer should be compensated, taking into account the attributable risk

Compensation for diethylstilbestrol injury and Dutch DES-victims, an opinion.

Flora E van Leeuwenemail, Elisabeth JM van Erp, Theo JM Helmerhorst, Peter AM Heintz, April 2007.

As members of the Dutch Expert Committee on DES-related Health Effects, we respond to the Comment by Ellen ‘t Hoen and Graham Dukes on compensation for diethylstilbestrol injury.

Contrary to the opinion expressed by ‘t Hoen and Dukes, we, as well as the Dutch DES Centre, strongly believe that the recently agreed collective settlement of diethylstilbestrol claims in the Netherlands is unique and highly beneficial for Dutch diethylstilbestrol victims. Our opinion is based on the large number of diethylstilbestrol-related disorders covered and the fact that individual women do not have to start an expensive and emotionally difficult legal procedure with uncertain outcome, which could last several years. Individual women can now be compensated on the basis of medical evidence of diethylstilbestrol exposure and the presence of a diethylstilbestrol-related disorder covered by the settlement.

In close collaboration with the DES Centre, a careful procedure was followed before a settlement was proposed. The Expert Committee first reviewed published data on diethylstilbestrol-related health effects and decided for which disorders a causal association with diethylstilbestrol was established. We believe that no causal association has been established for breast cancer and early age at menopause in women whose mothers took diethylstilbestrol during pregnancy (“DES daughters”) because increased risks were reported in only one study. Subsequently, we determined the relative risk associated with diethylstilbestrol, on the basis of all available published data.

A unique aspect of the Dutch collective settlement is that it also allows compensation for diseases with a weak but established association with diethylstilbestrol. DES mothers (those who took diethylstilbestrol during pregnancy) have a 1·35-fold increased risk of breast cancer. This implies that the attributable risk is 26%—ie, among DES mothers with breast cancer, one in four cases can be attributed to diethylstilbestrol. Since there is no way to identify the one woman whose breast cancer was indeed caused by diethylstilbestrol, it was agreed that all (living) DES mothers who developed (or will develop) breast cancer should be compensated, taking into account the attributable risk.

The proposed collective settlement was widely publicised among those exposed to diethylstilbestrol, and, of more than 100 000 affected, the Amsterdam court received only four objections. The court validated the diethylstilbestrol agreement and ruled against the four defendants. We regret that this information was not included the Comment.

We declare that we have no conflict of interest. ”

Flora E van Leeuwen, Elisabeth J M van Erp, Theo J M Helmerhorst, Peter A M Heintz,
Department of Epidemiology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, Netherland.

Sources (c) DES Centrum 2015,
DES Fonds 1e regelingcompensation for diethylstilbestrol injury.

More DES DiEthylStilbestrol Resources

Market Share Liability for DES (Diethylstilbestrol) Injury

A New High Water Mark in Tort Law: Sindell v. Abbott Laboratories

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University of Nebraska College of Law review, 1981

Abstract

In Sindell v. Abbott Laboratories, the California Supreme Court discussed intra-industry liability for adverse effects of drugs and adopted the market share liability theory for DES injuries. Although the majority purported to shift only the burden of proving causation from the plaintiff to the defendants, the effect of its adopting the intra-industry joint liability concept (or, more specifically, the market share doctrine) is to guarantee that the plaintiff will prevail on the causation issue. By departing from traditional tort doctrine and effectively eliminating causation as an issue, “‘[m]arket share’ liability thus represents a new high water mark in tort law.” This Note analyzes Sindell and the various approaches taken to overcome the obstacle of product identification in DES cases. In addition, it examines the legal, social, and economic ramifications of intra-industry joint liability.

Sources
  • Market Share Liability for DES (Diethylstilbestrol) Injury: A New High Water Mark in Tort Law: Sindell v. Abbott Laboratories, 26 Cal. 3d 588, 607 P.2d 924, 163 Cal. Rptr. 132, cert. denied, 101 S. Ct. 285 (1980), Barbara J. Koperski, University of Nebraska College of Law.
  • Full text, Nebraska Law Review, Volume 60 | Issue 2 Article 9, 1981
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Conseils Juridiques aux Victimes du Distilbène DES

Interview de Maitre Karim Felissi, avocat et conseiller de la FNATH

Fin 2013, Maitre Karim Felissi, avocat et conseiller de la FNATH, nous avait expliqué quels éléments sont vraiment nécessaires pour qu’un dossier soit suffisamment étayé. Maintenant que les conclusions de l’étude 2013-2014 Réseau DES France 3 Génération Distilbène viennent d’être publiées, il nous explique quels impacts nous pouvons imaginer sur le plan judiciaire. Vidéo publiée le 18.12.2014 par Réseau DES FRANCE DISTILBENE.

Le Distilbène DES, en savoir plus

Preconception tort liability: recognizing a strict liability cause of action for DES GrandChildren

Courts should recognize the validity of preconception tort liability and allow a strict liability cause of action in third-generation DES cases

Abstract:

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This 1991 Note addresses the validity of preconception tort liability in the context of third-generation DES cases.

DES cases are breaking new ground in tort litigation. In March 1990, J. David Roberts filed a $ 2,000,000 lawsuit in the United States District Court for the District of Columbia against drug manufacturer Eli Lilly and Company,  alleging that his in utero exposure to DES caused his daughter’s cancer.  Roberts sued under theories of strict liability, emotional distress, breach of warranty, negligence and misrepresentation. He also alleged that DES manufacturers conspired to produce the drug after they knew of its dangers.

Over the past decade more than 1,000 “DES daughters” have filed lawsuits against the manufacturers of DES, alleging that their in utero exposure to the drug caused various reproductive tract abnormalities, including cancer. Plaintiffs now allege that their grandmothers’ use of DES during pregnancy caused genetic damage leading to cancer in third generations. This Note addresses the validity of preconception tort liability in the context of third-generation DES cases. Plaintiffs in preconception tort liability cases have sought recovery under both negligence and strict liability causes of action. Courts should recognize the validity of preconception tort liability and allow a strict liability cause of action in third-generation cases.

Sources

  • Preconception tort liability: recognizing a strict liability cause of action for DES grandchildren, NCBI, PMID: 1812769, 1991;17(4):435-55. LexisNexis, Excerpt, 1991.
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DiEthylStilbestrol Resources: DES Lawsuits

NCBI advances science & health by providing access to biological information

DES Lawsuits

Law Papers and Theories (in Reference to DES Cases)

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NCBI PubMed DiEthylStilbestrol Resources: Lawsuits and Various Studies.

DES Cases

For different topics (than law-related), go first to Diethylstilbestrol DES Studies.

More DES DiEthylStilbestrol Resources

Theories of recovery for DES damage: is tort liability the answer?

The Journal of Legal Medicine, Volume 4, Issue 2, 1983

Abstract:

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The most equitable solution to problems with the tort system is legislation which deals with the toxic tort problem as a whole and not just on a case-by-case basis.

An estimated 1000 individual or class action products liability lawsuits have been filed against the pharmaceutical manufacturers of diethylstilbestrol (DES). The field of potential plaintiffs is estimated at 500,000-6,000,000 and there are 150-300 potential defendant manufacturers.

This article addresses the question of whether the current system of tort liability dispenses fair, timely, and uniform justice both to DES claimants and manufacturers and presents a historical perspective on the basis for liability.

Traditional theories of tort recovery are based on negligence, breach of warranty, and strict liability. They place the burden of proof on the claimant to specifically identify the product manufacturer and establish proximate causation. Novel theories of recovery have had to be applied in DES lawsuits, including concert of action and alternative liability. Most of these theories have been unaccepted by trial and appellate courts because of the inability to identify the manufacturer. Even if DES manufacturers were to be held liable under a theory of industry-wide or market share liability, defendants would be called upon to allocate liability among themselves. Many believe that any departure from traditional tort principles should be accomplished by the legislature, not the judiciary. There is not currently a bill before the US Congress dealing specifically with compensation for damages to DES victims. Any model toxic tort legislation should aim to eliminate the benefit inequities as between claimants and the cost inequities in delivering benefits to qualified recipients by the responsible parties. The claimant’s burden of establishing fault should be eliminated in exchange for a claimant’s surrender of a right to sue a third party, and a standardization of compensatory damages. The requirements of specific product identification, duration of exposure, and degree of fault would be eliminated. Jurisdictional requirements and statues of limitation must be drafted to permit recovery for previously unknown injuries. Finally, there should be an overall goal of promptness in recovery. The most equitable solution to problems with the tort system is legislation which deals with the toxic tort problem as a whole and not just on a case-by-case basis.

Sources

  • Theories of recovery for DES damage. Is tort liability the answer?, NCBI, PMID: 6604118, 1983 Jun;4(2):167-200.
    Full text: Journal of Legal Medicine, PDF, Volume 4, Issue 2, 1983.
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Statutes of limitations: the special problem of DES suits

Two methods that DES plaintiffs may be able to use to overcome the potential statutes of limitations bar are discussed

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This Note discusses two methods that DES plaintiffs may be able to use to overcome the potential statutes of limitations bar: (1) the discovery rule, and (2) state provisions which toll the statute of limitations for minors.

In 1971, medical studies determined that DES causes a rare type of vaginal cancer in a small number of daughters of mothers who took DES during pregnancy. Subsequently, medical studies determined that exposure to DES can cause other vaginal abnormalities in the daughters, some of which may be precancerous.

As a result of these discoveries, many lawsuits have been filed by these daughters against DES manufacturers. Many DES suits may be barred by statutes of limitations, both because the number of years between the daughters’ exposure to DES in utero and the discovery that DES can cause injuries exceeds the statutory period, and because the cancer or other injuries caused by DES may not develop for many additional years.

This Note discusses two methods that DES plaintiffs may be able to use to overcome the potential statutes of limitations bar:

  1. the discovery rule,
  2. and state provisions which toll the statute of limitations for minors.
  • The Note contends that courts should apply an expanded discovery rule to DES suits to avoid the unfair result of barring a claim before the plaintiff could have known that she had a cause of action.
  • In addition, the Note argues that the injury which causes the statute of limitations to begin to run in DES suits should not be rigidly defined.
  • Finally, the Note urges that courts allow eligible DES plaintiffs to take advantage of applicable state provisions that toll the statute of limitations for minors.

Sources

  • Statutes of limitations: the special problem of DES suits, NCBI, PMID: 7258194, 1981 Spring;7(1):91-106.
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Payton v. Abbott Laboratories: an analysis of the Massachusetts DES class action suit

A landmark ruling for plaintiffs seeking class certification in DES suits

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The first case in which a judge has interpreted the requirements of Rule 23 of the Federal Rules of Civil Procedure to allow women exposed in utero to DES to sue as a class to determine liability for their injuries

In Payton v. Abbott Laboratories, U.S. District Court Judge Walter J. Skinner recently granted class certification to an action brought by twenty-seven Massachusetts women against major manufacturers of DES.
This is the first case in which a judge has interpreted the requirements of Rule 23 of the Federal Rules of Civil Procedure to allow women exposed in utero to DES to sue as a class to determine liability for their injuries.

  • This Note reviews the Payton certification in light of prior class action decisions involving DES and other types of claims, and of legal commentary on Rule 23.
  • This Note contends that Judge Skinner’s application of the Rule 23 requirements in Payton was procedurally correct, and recommends the class action device as an effective method for litigating such controversies.
  • Finally, this Note analyzes the implication of this landmark ruling for plaintiffs seeking class certification in DES suits and in suits presenting analogous factual situations.

Sources

  • Payton v. Abbott Laboratories: an analysis of the Massachusetts DES class action suit, NCBI, PMID: 7468600, 1980 Summer;6(2):243-82.
  • Full text on HeinOnline.
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Sandrine et le Distilbène: mon parcours, mon procès, ma victoire

On ne “s’improvise pas” victime du distilbène si on n’a pas au moins un élément prouvant un lien avec celui ci

Ci-dessous un “guest-post” reprenant le parcours médical de Sandrine Jean et ce qui a été retenu au délibéré du jugement. Bravo à Sandrine pour son courage et sa persévérance.
Une exclusivité DES Daughter Network.

Mon procès a débuté en avril 2011, le délibéré à été rendu en juillet 2014. Quant à l’expertise médicale elle a eu lieu en mars 2012.

Il a été retenu :

image de Sandrine Jean
On ne “s’improvise pas” victime du distilbène si on n’a pas au moins un élément prouvant un lien avec celui ci
dit Sandrine

La chose qui a joué un rôle très important au cours du procès c’est que j’avais les ordonnances de ma mère stipulant la prescription du DES (Stilboestrol = nom de la molécule fabriquée par le laboratoire Novartis, Distilbène = nom de la molécule fabriquée par UCB Pharma).

Sur les ordonnances apparaît que ma mère a pris du Stilboestrol depuis avril 1969 à début février 1970 (un comprimé quatre fois par jour) et ensuite du 7 février 1970 jusqu’à avril 1970 (lorsque je suis née – à deux comprimés par jour).

Il faut noter que dans mon malheur j’ai eu l’avantage que le laboratoire concerné était Novartis qui sont plus “arrangeants” que UCB Pharma. UCB fait systématiquement appel, Novartis pas forcément. Dans mon cas il n’y a effectivement eu aucun appel.

L’avocat de Novartis a reconnu lui même qu’il ne pouvait rien face à mon dossier et que c’était la deuxième fois en quinze ans de plaidoirie qu’une victime du Distilbène allait jusqu’au procès. Autrement dit, les autres victimes ont soit laisser tombé avant la fin, soit accepté un arrangement à l’amiable.

Au cours des six mois précédents le procès, Novartis m’a par trois fois proposé un arrangement à l’amiable. Ce qui prouve que le laboratoire était donc en faute. On ne propose pas de l’argent à quelqu’un comme ça, quand on n’a rien à se reprocher. C’est pour cela que je suis allée sereinement jusqu’à la fin du procès, refusant catégoriquement leur arrangement à l’amiable. Sachant que la somme proposée était bien inférieure à ce que je devais attendre.

En définitive j’ai obtenu 104.873€, Novartis m’avait proposé une moindre somme à l’amiable. J’ai eu pour 20.000€ de frais environ.
Sur ces 104.873€, mon père a obtenu 6.000€. Ma mère aurait eu droit au double mais elle est décédée deux mois avant l’issue de mon procès. L’avocate a fait valoir cela lors du procès également. Car c’est une affection supplémentaire qui m’empêche de “savourer” pleinement ma victoire. Si j’ai gagné c’est grâce à ma mère qui a gardé les ordonnances et elle est décédée sans savoir si j’avais réellement gagné.

Le Stilboestrol lui avait été prescrit car elle faisait des fausses couches a répétition. Comme elle a eu beaucoup de mal pour avoir des enfants et que c’était son désir le plus cher elle a gardé tout ce qui était en lien avec ses grossesses, voilà pourquoi elle avait gardé les ordonnances.
Il faut donc noter essentiellement pour celles qui voudraient s’engager dans une procédure que l’ordonnance est évidemment un élément des plus important mais également le lien direct avec le Distilbène.
J’avais en ma possession une radio où l’on voit nettement mon utérus typique distilbène.

Je recommande au cours de l’expertise d’être assisté par le professeur Blanc de la Timone à Marseille, qui s’est spécialisé dans le Distilbène. Son intervention a été aussi un facteur très important pour le procès. Il a un coût bien sûr (1.000€) mais ça en vaut vraiment la peine.

Il est évident qu’on ne “s’improvise pas” victime du distilbène si on n’a pas au moins un élément prouvant un lien avec celui ci. Ca serait trop facile, la partie adverse faisant valoir que l’infertilité peut être dû à bien d’autres choses que le Distilbène.

Je recommande également à celles qui souhaiteraient engager une procédure de demander conseil au Réseau DES France, une association de très bon conseil et d’une aide très précieuse. De mon côté si certaines souhaitent des renseignements complémentaires je me tiens à leur disposition (gratuitement bien entendu).

Sandrine JEAN

Le Distilbène DES, en savoir plus

GlaxoSmithKline fined £300 Million by China in Bribery Case

GSK admits it is at fault, will not appeal, and issued a statement of apology to the people of China

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The Chines GSK case involved accusations of criminal bribery to persuade hospitals and doctors to administer or sell the company’s pharmaceuticals to their patients.

In July 2012, the U.S. State Department had fined GSK $3 billion for marketing drugs for unapproved uses.

September 2004, after a one-day secret trial, a Chinese court has fined the giant British pharmaceutical company GlaxoSmithKline (GSK) £297 million (3 billion RMB at a currency exchange rate of 10.0980). for bribing hospitals and doctors to use their products.

The court also sentenced GSK’s former country manager Mark Reilly as well as four additional managers to prison time of up to four years. However, the sentences were suspended, and the managers will avoid prison with good behavior–though Reilly must leave the country.

GSK admits it’s at fault, will not appeal, and issued a statement of apology.

Sources and More Information:

  • China Fines GlaxoSmithKline Nearly $500 Million in Bribery Case, NY Times, SEPT. 19, 2014.
  • GSK China Investigation Outcome, GSK press release, 19 September 2014.
  • GSK statement of apology to the people of China, GSK media/526041, 19 September 2014.