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Johnson and Johnson ordered to pay $572m in
landmark opioid liability case
Owen Dyer
An Oklahoma judge has ruled that Johnson and Johnson helped
to fuel the state’s opioid crisis, in the first case where a US court
has found an opioid maker liable in America’s addiction
Thad Balkman, Cleveland County district judge, ordered the
company to pay Oklahoma $572m (£467m; €516m) to fund
treatment programmes, law enforcement, and other costs
associated with the epidemic.
“The opioid crisis has ravaged the state of Oklahoma and must
be abated immediately,” Balkman said, reading his decision.
“As a matter of law, I find that defendants’ actions caused harm.”
The ruling comes as Purdue Pharma, the maker of OxyContin
and a company frequently accused of promoting excessive
opioid use by physicians, is mulling a global settlement of over
2000 consolidated lawsuits that could see its owners, the Sackler
family, relinquish control of the company.
Purdue was originally one of three defendants in the Oklahoma
litigation, along with Johnson and Johnson and Teva
Pharmaceuticals. But Purdue and Teva both settled before the
trial began, paying $270m and $85m, respectively.
The $572m awarded against Johnson and Johnson was only a
fraction of the $17.5bn that Oklahoma sought to fund its
response to the opioid crisis over 30 years. The state had failed
to provide enough evidence of its needs beyond the first year,
said the judge.
Nevertheless, Mike Hunter, Oklahoma attorney general, hailed
the ruling as a precedent that other states could follow. “That’s
the message to other states: We did it in Oklahoma. You can
do it elsewhere,” he said. “Johnson and Johnson will finally be
held accountable for thousands of deaths and addictions caused
by their activities.”
Although Johnson and Johnson’s opioid subsidiary Janssen
Pharmaceuticals only made two opioid products that had
minimal market share, Oklahoma’s attorneys said that the
company was a hidden “kingpin” of the opioid trade because
its poppy farming subsidiaries, Noramco and Tasmanian
Alkaloids, grew the raw ingredients found in 60% of prescription
opioids sold in the United States.
The state also argued that Johnson and Johnson actively took
part in an industry effort to change doctors’ reluctance to

prescribe opioids by mounting an aggressive misinformation
campaign that targeted the least knowledgeable physicians.
Lawyers for the company said that they would appeal the ruling.
“Johnson and Johnson did not cause the opioid abuse crisis here
in Oklahoma or anywhere in this country,” Sabrina Strong,
Johnson and Johnson’s attorney, told a news conference after
the trial.
The extent to which the Oklahoma ruling sets a precedent for
other cases remains to be seen. The state made novel use of a
law normally used against disruptive neighbours, brothels, and
polluters to claim that Johnson and Johnson caused a public
nuisance to citizens. A similar suit filed by North Dakota against
Purdue Pharma was dismissed in May. Forty states have filed
suits against opioid makers in state courts.
More than 2000 counties and municipalities have filed federal
litigation against opioid makers. Most of these cases have been
consolidated in a federal court in Cleveland, Ohio, with hearings
set to begin in October.
The judge in that case, Dan Polster, has urged the parties to seek
settlements outside court. A meeting called by the judge last
week drew representatives of Purdue and numerous state
attorneys general to Cleveland, where they discussed a global
settlement of claims against the company.
NBC News and the Washington Post reported that Purdue was
offering a settlement of about $10bn, or about $12bn if Purdue’s
owners, the Sackler family, sell their international company
Mundipharma. The family would contribute $3bn, or $4.5bn if
they sell Mundipharma, and would cease running the company.
Purdue would declare bankruptcy and be run by a court
appointed “public benefit trust.” It would continue selling
OxyContin but proceeds would go towards the settlement fund.
Purdue did not discuss details but acknowledged in a statement
that it was negotiating a settlement: “While Purdue Pharma is
prepared to defend itself vigorously in the opioid litigation, the
company has made clear that it sees little good coming from
years of wasteful litigation and appeals. The people and
communities affected by the opioid crisis need help now. Purdue
believes a constructive global resolution is the best path forward,
and the company is actively working with the state attorneys
general and other plaintiffs to achieve this outcome.”

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BMJ 2019;366:l5319 doi: 10.1136/bmj.l5319 (Published 29 August 2019) Page 1 of 1



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