Los Angeles Jury Finds DePuy Liable for Defective ASR XL Hip Implant in First U.S. ASR Trial

Loren Kransky had a DePuy ASR XL hip implant put in during December 2007. The device was a metal-on-metal design: a metal cup set into the hip, a metal ball that turned inside it, and a stem attached to the ball. Soon after the surgery he had constant pain, clicking and popping in the joint, and began falling for no apparent reason. He lost weight and his energy and general health declined.

His primary care physician found high levels of cobalt and chromium in his blood and concluded that metal ions were leaking from the implant into his body. By then, Kransky's pain had become constant and stabbing. His daughter testified that he could no longer walk, needed a wheelchair, and could not shower or use the bathroom without help. His doctor described him at the time of surgery as mostly bones, ghostly in appearance and barely moving. Because his doctors feared he would not survive a second operation but believed he would die without it, a surgeon removed the implant in February 2012. The surgeon found classic signs of metal wear, and Kransky's pain eased and his mobility improved afterward.

The case was tried in Los Angeles County Superior Court before Judge J. Stephen Czuleger and lasted about five weeks, ending in March 2013. It was the first ASR trial in the country. Kransky's lawyers argued that the ASR XL was defectively designed. They presented evidence that the project manager had no prior experience developing hip implants, that DePuy's premarket testing and risk analysis fell below industry standards, and that the design caused excessive rim loading, which released harmful metal debris. They also showed the jury that registries in Australia, England and Wales recorded five-year revision rates of about 22 percent for the ASR XL, against roughly 4 percent for DePuy's other metal-on-metal implants. DePuy recalled the device in 2010. The trial court kept evidence of the implant's FDA clearance away from the jury.

DePuy argued that an infection, not metal toxicity, explained Kransky's condition. The jury found DePuy strictly liable under Montana law for a design defect, but not liable for failure to warn, and found that DePuy's negligence did not cause the injury. It awarded $338,136.12 for medical expenses and $8 million in noneconomic damages, a total of more than $8.3 million, and did not award punitive damages. Brian Panish of Panish, Shea & Boyle argued the damages to the jury. According to the appellate opinion, Kransky's counsel of record also included John H. Gomez of Gomez Iagmin Trial Attorneys, Martin Buchanan, Dean Goetz, and Michael Kelly of Walkup, Melodia, Kelly & Schoenberger.

DePuy appealed, challenging the exclusion of FDA evidence, the expert and treating-physician testimony, the sufficiency of the evidence, the consistency of the verdict and the size of the award. Kransky died on February 26, 2014, while the appeal was pending, and his widow, Sheryl Kransky, was substituted as personal representative of his estate. On July 21, 2016, the Court of Appeal for the Second District affirmed the judgment in full.