OB/GYN Experts May Discuss FDA Warning Labels for IUDs

ByWendy Ketner, M.D.

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Updated onApril 7, 2020

OB/GYN Experts May Discuss FDA Warning Labels for IUDs

Court: United States District Court for the Western District of Missouri, Western DivisionJurisdiction: FederalCase Name: Sellers v. Bayer Healthcare Pharms. Inc.Citation: 2016 U.S. Dist. LEXIS 188476

Facts

The plaintiff filed a suit against the defendant, a pharmaceutical company, alleging she developed idiopathic intracranial hypertension/pseudotumor cerebri (IIH/PTC) after using the defendant’s intrauterine contraceptive. IIH/PTC is an increased pressure around the brain that causes vision problems and headaches. The plaintiff claimed the label for the contraceptive did not contain an IIH/PTC warning as a possible side effect. The defendant retained two obstetrics/gynecology (OB/GYN) expert witnesses to support their case.

The OB/GYN Expert Witnesses

The defendant’s OB/GYN experts testified to give the jury an understanding of the technical aspects of contraceptive options. The experts also explained how physicians consider those choices when advising patients and whether the plaintiff’s proposed IIH/PTC warning would affect the assessment and representation of those options.

The plaintiff sought to exclude the defendant’s experts from testifying about drug labeling, IIH/PTC, endometrial, and epidemiological studies under Federal Rules of Evidence 403 and 702. The plaintiff argued that the OB/GYN experts provided reports that each contained almost verbatim opinions about the aforementioned topics. The plaintiff contended that the opinions were cumulative, irrelevant, unhelpful, unreliable, unfairly prejudicial, and misleading. The plaintiff further asserted that the defendant’s OB/GYN experts developed their opinions based on sources provided by the defendant, despite medical and scientific literature available in support of the plaintiff’s allegations.

The defendants argued their OB/GYN experts relied on their knowledge, training, and experience to form their testimony. The defendant further argued that the experts’ reports were bolstered by their review of the related practice guidelines and peer-reviewed literature. The defendant asserted their OB/GYN experts were qualified to assess a patient’s individual needs and to contemplate the benefits and risks of the various contraceptive options when prescribing.

Discussion

The court noted that one of the defendant’s experts had cited 121 references in support of her opinion and presented a meticulous analysis pointing to her conclusions. Similarly, the second expert report cited 68 publications. The court concluded that even though their opinions were opposed to that of the plaintiff’s experts, that did not make them inadmissible under Daubert. The court further explained that the presentation of contrary evidence, careful instruction on the burden of proof, and vigorous cross-examination were the proper means of challenging the methodology and opinions of the OB/GYN experts.

The court also noted that according to Rule 403, the experts’ testimony would only be excluded if its probative value was substantially outweighed by needlessly presented cumulative evidence, wasted time, or risk of undue delay. The court did not find that the risk outweighed the probative value and the testimony was, therefore, admissible.

Held

The motion to exclude the defendant’s OB/GYN expert witnesses was denied.

About the author

Wendy Ketner, M.D.

Wendy Ketner, M.D.

Dr. Wendy Ketner is a distinguished medical professional with a comprehensive background in surgery and medical research. Currently serving as the Senior Vice President of Medical Affairs at the Expert Institute, she plays a pivotal role in overseeing the organization's most important client relationships. Dr. Ketner's extensive surgical training was completed at Mount Sinai Beth Israel, where she gained hands-on experience in various general surgery procedures, including hernia repairs, cholecystectomies, appendectomies, mastectomies for breast cancer, breast reconstruction, surgical oncology, vascular surgery, and colorectal surgery. She also provided care in the surgical intensive care unit.

Her research interests have focused on post-mastectomy reconstruction and the surgical treatment of gastric cancer, including co-authoring a textbook chapter on the subject. Additionally, she has contributed to research on the percutaneous delivery of stem cells following myocardial infarction.

Dr. Ketner's educational background includes a Bachelor's degree from Yale University in Latin American Studies and a Doctor of Medicine (M.D.) from SUNY Downstate College of Medicine. Moreover, she is a member of the Board of Advisors for Opollo Technologies, a fintech healthcare AI company, contributing her medical expertise to enhance healthcare technology solutions. Her role at Expert Institute involves leveraging her medical knowledge to provide insights into legal cases, underscoring her unique blend of medical and legal acumen.

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