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In truth, this post is not so much a review as a full-throated endorsement.  We are telling colleagues that they need to read Elizabeth Chamblee Burch’s The Pain Brokers (One Signal Publishers 2026). Two things drive our enthusiasm for this book: cynicism and pride. 

First, let’s indulge our cynicism. The Drug and Device Law engages in no pretense of objectivity.  We are entrenched on the defense side and make no bones about it.  We represent product liability defendants and root for them to win even when we have no involvement in the case.  And we are sore losers.  We criticize what we consider to be bad decisions.  Sometimes we kvetch. Sometimes we find ourselves suspecting the other side of cheating.  

At this point we find ourselves making a callback to some recent posts. We quoted Abe Greenwald, an editor of Commentary, who often says that however bad you think things are, they are even worse. And in our post on the disqualification of a plaintiff firm in a talc case because that firm had hired a lawyer who formerly worked for the talc defendant, we grumbled that it was likely the tip of a rotten iceberg.  (Earlier this week the court denied the plaintiff firm’s request to pause the disqualification.) 

It is grindingly obvious that the problem with mass torts is that they are … massive. They are hard to handle. Moreover, mass torts offer opportunities for mass frauds.  For example, too many cases parked in Multidistrict Litigations never really get tested.  Product usage is sometimes faked, and injuries can be exaggerated to get a higher spot on the settlement grid.  

With little fondness, we remember the fen-phen litigation, where traveling echocardiogram doctors inflated the degree of heart valve regurgitation to gin up higher settlements.  Some doctors got in trouble.  But for every phony echocardiogram that was spotted, we bet another ten eluded detection. 

It’s not paranoia if they really are out to get you. 

The subtitle of The Pain Brokers is “How con men, call centers, and rogue doctors fuel America’s lawsuit factory.”  The particular lawsuit factory covered by the book was the vaginal mesh MDL in West Virginia. It was an enormous MDL, with several defendants, thousands of plaintiffs, some bellwether and remand trials, and large inventory settlements.  It ended up being a mass wealth transfer, crafted by a kakistocracy. As the book tells us, “[b]y 2014, pelvic mesh had become the holy grail of mass torts.”

The worse the injury, the higher the settlement would be.  That is the theory, anyway.  A plaintiff who had such serious problems (pain, infection, extrusion) with her mesh that she had to have it removed would be entitled to more money than someone who was living with the mesh intact.  It stands to reason, doesn’t it?

Enter a large cast of litigation villains with a scheme. Some were veterans of the wrong side of the criminal justice system. They (the “con men” in the subtitle) exploited what was then a back door unique to the District of Columbia, which permitted nonlawyers to have an ownership role in law firms.  The aim was to create mesh cases with high values. The intake procedure started with call centers armed with information about a woman’s mesh implantation.  (How they got that information is doubtless an ugly story.) They cold-called women and did everything possible to scare them into removing the mesh.  Following a script, the call centers told the women that the mesh was a ticking time bomb.  Some women thought the calls came from the mesh companies. Apparently nothing was done to disabuse the women of that mistake.  

The next step in the scheme was to connect the women to surgical centers that would arrange to fly the women (often across the country, usually to Florida) to undergo surgeries to “revise” or explant their mesh.  The women were told that they could not use medical insurance.  Instead, they were charged considerably more than going through insurance would have cost them. The women were sent agreements via Docusign, which permitted jumping through the documents to get right to the signature and initial pages. That jumping feature in Docusign can be convenient when you know what you are signing, but awful if you do not. Women ended up taking out high interest loans without even knowing it.  Their surgeries were performed with minimal medical consultation. There really were “rogue doctors” as stated in the subtitle. The women’s lawyers also seemed to offer them little legal consultation. (That fact had consequences for claims of attorney-client privilege.) Having their mesh removed, the women then entered the mesh litigation machine, lined up for settlement, and the subtitle’s “con men, call centers, and rogue doctors” took their cut. After that cut, some plaintiffs ended up with little money. 

Pelvic mesh plaintiff lawyers liked to call their clients victims. Some were. Some were victims because they had mesh removed from them that was performing perfectly well.  Their own, real treating doctors expressed surprise and disappointment that the patients had the pelvic mesh removed.  The problems (such as incontinence or prolapse) the women had that prompted the implants often returned. Often there was post-explant pain. Even if the mesh removal led to a higher settlement amount, the women were not getting much of whatever upside existed.  Instead, their health was harmed.  Also victimized were the defendants and the court system.  It is a depressing tale. 

Second, we arrive at our point of pride.  One of the heroes in the book is a former colleague, Barbara Binis.  She retired from Reed Smith a couple of years ago. She was a splendid trial lawyer and a master of litigation strategy. She had a way of getting after the truth. Her work unearthing the vaginal mesh fraud required sleuthing, persistence, and ingenuity.  Binis tracked down various players in the litigation scheme and took their depositions.  Some of those deponents were more than a little slippery, and some were defended by lawyers who took obstruction to new depths. Binis managed to expose the sleazy reality of the scheme. The wonder of it is that only one doctor was incarcerated.  Unfortunately, due to the statute of limitations, certain rigidities in the system, and some soft-hearted judges, most of the miscreants skated. 

But if the book might induce despair at the bent litigation lottery system (at one point one of the schemers mused over how to make a profit off of earplug, PFAS, and Camp LeJeune litigation), it also shows what a smart, determined lawyer can do to get to the truth.  The book’s documentation of Binis’s dogged pursuit of the schemers is inspiring.  Defense lawyers do not always have to play defense. If there is an opportunity for a defense lawyer to seize the initiative, do it. Meanwhile, the book also introduces us to a plaintiff lawyer who did his best to help some of the victimized women seek redress. It was an uphill run. No law school teaches the skills and strategies needed to nail fraud artists who manipulate the civil justice system.  

We want all our colleagues to read the book to know what is really going on in mass torts.  That knowledge will not merely feed cynicism; it will energize efforts to combat the schemers.  We also want judges and legislators to read the book.  Maybe understanding how the mass tort system lends itself to abuse might prompt decision-makers to try to stem such abuse. 

Meanwhile, some other jurisdictions opened up the same back door letting nonlawyers operate law firms.  Perhaps there were good intentions behind that move, but The Pain Brokers constitutes a cautionary tale. 

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This post is from the non-Butler Snow side of the blog.

Back in November, we told you the court in the In re Paragard IUD Products Liability Litigation wasn’t quite finished with plaintiffs’ effort to impose a post-sale duty to warn on a company that didn’t manufacture, sell, or even own the product when it was implanted. The court had dismissed the design defect claims against the successor company but requested supplemental briefing on causation for failure to warn. We suggested then that, absent wormhole technology, causation was going to be a problem. We recently came upon the warning ruling. Big surprise—summary judgment granted on causation.

As a reminder, the product was originally manufactured and sold by Teva. But in November 2017, the NDA was purchased by Coopersurgical. Coopersurgical moved for summary judgement in cases where plaintiffs’ IUDs were implanted prior to 2017, so manufactured and sold by Teva, but explanted after the change of ownership—at which time it was discovered the IUDs had broken. In re Paragard IUD Products Liability Litigation, 2025 WL 4092375, at *2 (N.D. Ga. Dec. 23, 2025).  

The claims at issue were brought under Florida law, so the court’s analysis started with recognizing that Florida is a learned intermediary state. That means the duty to warn runs to the prescribing physician, not directly to the patient. Plaintiffs attempted to sidestep that rule by arguing for a contraceptive exception—claiming that birth control products are uniquely marketed directly to patients and that physicians defer to patient choice. Id. at *3.  There is just one problem—Florida has not adopted a direct-to-consumer exception to the learned intermediary doctrine. In fact, two Florida courts have expressly rejected the concept. Plaintiffs only cited a Massachusetts case to support their argument. That may be interesting in Boston, but it is not binding in Florida.

So the learned intermediary rule applied. Which meant plaintiffs had to prove that a different warning to the physician would have changed something in a way that would have prevented their injuries.

Plaintiffs argued that by the time the successor company acquired the NDA, before the IUDs were removed, it knew the label did not adequately warn about device breakage. Therefore, say plaintiffs, defendant could and should have provided new warnings, before the IUDs were removed, via sales representatives, literature, dear doctor letters, etc. Then, say plaintiffs, their physicians would have reviewed the warnings, monitored for breakage, warned plaintiffs, attempted to mitigate the risk, and/or recommended early removal. Id. at *4.

But litigation does not run on plaintiffs say so. As it turns out, “[p]laintiffs’ allegations [were] not grounded in any evidence.” Id. Plaintiffs claimed that one of their physicians testified that had she known of the breakage risk she would have “been on the lookout” for it. However, the court actually read the testimony and concluded it did not say what plaintiffs claimed it said. Id. The doctor actually testified there was no resistance during her first attempt to remove the device. Plaintiffs’ spin was more aspirational than record citation. The actual testimony did not support finding causation. Id.

Plaintiffs offered no other factual support for their allegations. There was no testimony that a different warning would have caused a reasonable physician to notify the already-implanted patients of a breakage risk. No testimony that any alternative course of action would have been taken. No testimony that anything would have prevented these injuries. There was no evidence from which a reasonable jury could find that the defendant’s alleged failure to warn was the proximate cause of their injuries.

While the court did not wade into a broad rejection of post-sale successor duty to warn, it didn’t need to. Even assuming arguendo some duty could exist, plaintiffs still had to prove causation. And they couldn’t. Proof of causation requires actual evidence. Not speculation about what doctors might have done differently. On that point, the record was silent.

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As we’ve discussed before, Bexis was involved in the ALI proceedings that produced Restatement (Third) of Torts:  Liability for Economic Harm §8 comment g (2020), that disapproved of public nuisance claims against product manufacturers.

[T]he common law of public nuisance is an inapt vehicle for addressing the conduct at issue.  Mass harms caused by dangerous products are better addressed through the law of products liability, which has been developed and refined with sensitivity to the various policies at stake.

Id.  However, everything ALI does is persuasive, not binding, and not all courts choose to follow it, most notoriously the 2025 worst case of the year, City of Huntington v. AmerisourceBergen Drug Corp., 157 F.4th 547 (4th Cir. 2025).

But thanks to the Washington Legal Foundation, we’ve learned about a new Montana statute the fixed this problem, beyond the power of any wayward judge, by codifying the law of public nuisance to bar claims against the manufacturers of legal products (as well as prohibiting similar politicized claims).  The statute, passed in 2025, defines what can be a public nuisance

(1) A public nuisance is:

(a) a condition arising out of the use of real property that unlawfully interferes with a public right by endangering communal safety, being indecent to the community, or being offensive to the community; or

(b) a condition that unlawfully interferes with the public right to free passage or use, in the customary manner, of a navigable lake, river, bay, stream, canal, or basin or a public park, square, street, road, or highway.

Mont. Code §27-30-101(a).  That limits allowable public nuisance claims to their traditional scope − before the plaintiff lawyers started abusing mushy common law – injurious uses of land and interference with public means of transportation.

To make sure that there is no ambiguity, the statute also specifies what cannot be a public nuisance:

(2) The following nonexclusive list of actions or conditions may not be considered a public nuisance or be the basis for a public nuisance cause of action:

(a) an action or condition that is lawful;

(b) an action or condition that is authorized, approved, licensed, or mandated by statute, ordinance, regulation, permit, license, order, rule, or other similar measure issued, adopted, promulgated, or approved by a government entity. . . .

(e) the design, manufacturing, distributing, selling, labeling, or marketing of a product;

(f) the aggregation of individual injuries or private rights, including private nuisances. . . .

Id. at §27-30-101(b) (emphasis added).

This Montana statute should serve as a model in other states where plaintiffs have been allowed to hijack traditional public nuisance law in pursuit of novel and expansive industry-wide liability theories of liability.

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The Ninth Circuit has been grappling with specific personal jurisdiction ever since the Supreme Court altered the playing field ever so slightly in 2021 with Ford Motor Co. v. Montana.  That grappling includes an opinion published just last week, where the Ninth Circuit found specific personal jurisdiction over out-of-state medical providers.  The medical providers had not entered the forum state, and the care at issue occurred entirely outside the forum state.  But the providers had offices just outside state borders, and they transmitted prescriptions to pharmacies in the forum state.  That, according to the court, was enough to establish personal jurisdiction over the providers in a case alleging harm caused by those prescriptions.

The case is Cox v. Gritman Medical Center, No. 24-1947, 2026 WL 378500 (9th Cir. Feb. 11, 2026) (to be published in F.4th).  In Cox, a physician in Moscow, Idaho, treated a resident of Eastern Washington for six years and prescribed multiple prescription medicines over that time.  After the patient sadly died, allegedly because of a fatal overdose, her heirs sued the doctor and the clinic.  Again, the providers were entirely in Idaho, and they provided all the medical care at issue in Idaho, including determining which medicines to prescribe. 

The district court thus dismissed the complaint for lack of personal jurisdiction, but the Ninth Circuit reversed.  In the years leading up to Ford, the Supreme Court performed yeoman’s work in restoring discipline to the jurisprudence of personal jurisdiction.  The Bauman opinion in 2014 held that general personal jurisdiction would lie only where the defendant was “at home,” which for a corporation generally means the state of incorporation or its principal place of business.  The Supreme Court followed Bauman in 2017 with Bristol-Myers Squibb, which held that state courts cannot exercise specific personal jurisdiction over non-resident defendants for claims brought by out-of-state plaintiffs who did not buy or use the defendant’s product in that state.  

Then came Ford, which gave resident plaintiffs (not forum shoppers) some leeway in reaching out-of-state defendants based on forum contacts “related to” the alleged injury, as opposed to “arising out of.” 

For better or for worse, that leeway is what allowed the Ninth Circuit’s opinion in Cox.  According to the court, the Idaho physician and the Washington patient had a long-term relationship that “was intertwined with [the physician’s] relevant contacts with Washington.”  Cox, at *5.  What were those contacts?  Well, not much.  Sure, the physician treated the Washington patient for a long time, but the patient came to her in Idaho—not the other way around.  She also practiced at a clinic near Washington whose “business model includes serving patients throughout a rural region encompassing an area that spans Idaho and Washington.”  Id. at *6.  But such vague contacts are what Bristol-Myers Squibb shut down.  Even Ford famously cautioned that “relate to” does not mean “anything goes.”  To the contrary, the “relate to” prong still requires a close connection between the forum contacts and the injury. 

As far as we can tell, it came down to the prescriptions.  At the patient’s request, the physician electronically transmitted prescriptions to Washington pharmacies for the patient’s convenience.  Does that forum contact “relate to” the patient’s alleged injury?  We suppose it does, seeing as how the complaint alleged a prescription drug overdose.  It’s a stretch though.  An electronic transmission across state lines will not always be sufficient, but evidently it was here.  Compare Cox with another Ninth Circuit opinion that went the other way, Yamashita v. LG Chem, Ltd., which we covered here.  In that case, the out-of-state defendants shipped products through the forum state and sold products in the forum state, including some that contained components similar to those at issue.  Third parties sold the defendant’s product on the Internet, including in the forum state.  The Ninth Circuit, however, held that those forum contacts were not sufficient to support specific personal jurisdiction. 

It is difficult to square Cox with Yamashita.  Regardless, the practical impact of the Cox opinion is that it arguably expands the ways in which courts can exercise personal jurisdiction over out-of-state service providers.  So look out.  In the end, we take comfort in the Supreme Court’s admonition in Ford: “Some relationships will support jurisdiction without a causal showing.  That does not mean anything goes.  In the sphere of specific jurisdiction, the phrase ‘relate to’ incorporates real limits, as it must to adequately protect defendants foreign to a forum.”  Ford Motor Co. v. Montana Eighth Jud. Dist., 141 S. Ct. 1017, 1026 (2021).  The Ninth Circuit is still feeling out where those “real limits” lie. 

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Today’s guest post is from Nick Dellefave, an up and coming Holland & Knight litigator.  The Blog has rolled out a few posts on the latest edition of the Reference Manual on Scientific Evidence.  Nick adds to this opus with a dive into the intersection between scientific evidence, the role of trial judges, and this thing called “artificial intelligence,” which the Blog has also touched on from time to time.  As always, the guest poster deserves all of the credit and/or blame for the post.  (At a minimum, Nick gets some credit for allowing us to not have to write a post while on vacation.)

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As we covered last month, the new Reference Manual on Scientific Evidence is here, complete with a new chapter on Artificial Intelligence.  While the entire chapter should be required reading for litigators practicing in 2026, today we are focusing on one key subsection, titled “Judges as AI Gatekeepers.”  It offers a window into how courts will evaluate AI-generated evidence, and more importantly, where the pressure points are for both sides.  We thought it would be useful to pull out the key takeaways for practitioners who may be dealing with AI evidence sooner than they think.  This subsection has not drawn the attention of the climate science chapter, but it may end up being more impactful.

The Familiar Rules, Applied Unfamiliarly

Here is the good news: AI evidence will be evaluated under the evidentiary rules we all know and love.  The not-so-good news is that applying those rules to AI is anything but straightforward.  Under Federal Rule of Evidence 401, AI applications are essentially probability assessment tools, theoretically making them inherently relevant when offered to demonstrate whether something is “more or less probable.”  But Rule 403 gives courts plenty of room to exclude AI evidence when it risks unfair prejudice, confusion, or misleading the jury.  This is likely to be a prime battleground in determining the admissibility of AI evidence, as litigators and judges will rightfully ask whether the AI’s probative value is substantially outweighed by these dangers.

If you are challenging AI evidence, be ready to argue that certain outputs are too inaccurate or biased to be relevant, or that they are simply a poor fit for the purpose offered.  Courts may exclude AI evidence under Rule 403 precisely because juries tend to assume that if a computer said it, it must be true.  One need only look around at the epidemic of advertisers boasting “AI-powered” products to see this concept in action.  The imprimatur of “science” or “technology” can lend AI evidence a false authority it may not deserve.  Of course, with changes in jury attitudes about science and experts, it is hard to be sure how AI evidence will be received when its source is revealed.  If you are opposing AI evidence, hammer this point.  If you are the proponent, be prepared to show that the evidence is reliable and appropriately scoped for the purpose for which you are offering it.

Discovery Is Where the Action Is

The foundation for admissibility fights over AI evidence will be laid in discovery, which promises to generate its own fights.  Opponents seeking to challenge AI evidence will need access to the underlying algorithm, the training data, and knowledge of what is happening inside that machine-learning black box.  If you are challenging AI evidence, go after this information aggressively.  If you are the proponent, decide early on how you will address those requests, because rest assured, they are coming.  For more on this, see our recent discussion on Discovery of Artificial Intelligence Prompts. 

Of course, there is tension here with trade secret protection.  AI developers are not exactly eager to open up their proprietary algorithms for public inspection.  Courts have tools to navigate this: they can seal records, use protective orders, and exercise their general power to oversee how evidence comes in.  The Defend Trade Secrets Act (18 U.S.C. § 1835) also gives courts specific direction to protect trade secrets in relevant proceedings.  Attorneys should be prepared to negotiate protective orders and in camera review procedures.

Daubert, But Make It Complicated

Daubert as spelled out in the enhanced Rule 702 is, of course, the go-to framework for expert testimony, but applying its factors to AI is trickier than it sounds.  Every AI application is different: different algorithms, different machine learning methodologies, different training data.  This means AI issues are generally not going to be resolved the way DNA analysis was.  There will not be a single landmark case that settles the question of when AI evidence comes in.  Instead, expect adjudication for each application and each context.

The question of testability—the hallmark of Daubert/Rule 702 analysis—is complicated by the multiple inputs into an AI engine system.  The threshold question is: what exactly are we testing?  The sensors?  The algorithm?  The math?  The training data?  The system as a whole?  Similarly, credible peer review requires access to the underlying algorithm, parameter weights, and training data.  If the AI evidence being offered has not been meaningfully peer reviewed, and if that review did not include the underlying code and data, that is a vulnerability to exploit.

Error rates are another minefield.  Attorneys must ask whether error rates vary depending on whether the AI was tested using the relevant local population to which it will be applied, as opposed to a national population or idealized lab database.

Context and Bias: The Low Hanging Fruit

Attorneys should scrutinize whether the AI application is a good “fit” for the purpose for which it is proffered.  Is the AI application actually designed for the purpose it is being used for?  Some algorithms are built for one thing and then repurposed for another—with predictably dicey results.  The Manual’s authors cite the example of criminal risk assessment algorithms, which might be designed to determine who would benefit from alternatives to incarceration, but are probably inapt for use in sentencing determinations.  More applicable to readers of this blog, algorithms designed to model drug or device efficacy might be inapt for use in modeling the incidence of adverse effects.

Even when an algorithm is being used for its intended purpose, it may perform worse in certain contexts because of how it was trained.  An AI trained on one population may not achieve the same accuracy when applied to a different demographic.  If there is a mismatch between the training population and the population at issue in your case, that disparity is ripe for attack.

There is also the risk that neural networks rely on inapt factors—i.e., things they should not be considering—in making their predictions.  Judges are going to want to know whether inappropriate or unconstitutional factors were included, and whether any factors are working as proxies for suspect categories like race.  Demand disclosure of what factors are in the model and how they are weighted.  You may not get it easily, but in many cases, this is a fight worth having.

Deepfakes and the Importance of Witness Authentication

The Manual’s authors devote several pages to the problems posed by deepfakes.  Deepfake technology is only getting better, cheaper, and more accessible.  Practitioners should prepare for increased litigation over the authenticity of photos, videos, and audio recordings, as the mere availability of deepfake technology throws the authenticity of all types of evidence into doubt.

Under Rule 901, the proponent has to produce evidence sufficient to show the item is what it claims to be.  But here is the problem: your authenticating witness may not be able to tell whether the evidence is genuine or fake.  Deepfakes can shade human memory.  Archive systems can be hacked.  Digital forensic experts are going to be in high demand, and rightly so.

On the authentication front, there are some tools worth knowing about.  Federal Rules of Evidence 902(13) and 902(14), adopted back in 2017, provide for self-authentication of certified electronic records and certified data copied from electronic devices.  Items with cryptographic hashes may be authenticated under these rules, subject to the adverse party’s “fair opportunity to challenge.”  Although litigators may be accustomed to stipulating to the authenticity of electronic evidence, in this age of deepfakes, they should be increasingly wary of waiving these challenge opportunities without consulting a digital forensic expert.

So What Should You Actually Do?

If you are offering AI evidence, line up your expert testimony now.  As we have argued, admission of AI evidence likely requires the proponent to offer an expert who can speak credibly to the AI’s design, training, validation, and accuracy.  Your goal should be to simplify the foundational requirements and make the evidence as easy to admit as possible.  If you are opposing AI evidence, your job is the opposite: attack relevance and reliability, demand discovery of algorithms and training data, and prepare to cross-examine the software engineers who built the system.

We expect that AI evidence will continue to be an area where the rules are being written in real time.  Practitioners should understand that courts are going to face layered adjudicative challenges every time AI evidence comes up.  As the chapter’s authors put it, “the most important thing courts can do is ask careful and informed questions.”  That means the most important thing you can do as an advocate is be ready to answer them well.

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Who would’ve thought that Texas, of all states, would become a nannyocracy? The Lone Star State typically positions itself as the home of rough and ready folks who can take care of themselves.  Think Jim Bowie, Willie Nelson, or Bob Lilly, not Mr. Rogers, Mary Poppins, or Nanny McPhee. Texans don’t need the government telling them to steer clear of things that might pose risks.  Let California and Massachusetts hover over its meek, ready-to-be-victim citizens.  Texans are tough, and they’re fixing to get ready to clobber you if you lecture them on healthier lifestyles.  

So how to account for Section 9 of Texas Senate Bill 25, codified in Texas Health & Safety Code section 431.0815(a), which requires food and beverage companies to include conspicuous warnings on products that contain any of 44 listed ingredients (subject to some exceptions)?  As the folks on the excellent Commentary podcast would say, it gets even worse than that. Here is what the warning must say: “WARNING: This product contains an ingredient that is not recommended for human consumption by the appropriate authority in Australia, Canada, the European Union, or the United Kingdom.”  Since when do Texans care what effete, warm-beer drinking, Speedo-wearing, surrender-monkeys say about anything? [WARNING: We are joking.  We admire all those countries.  We like visiting them. If our nation was going to mimic another country’s health warnings, those places would probably be the best ones to mimic.  But (1) it should be the Food and Drug Administration (FDA), not various and sundry states or, worse, state juries, that should do the mimicking, and (2) it turns out that Texas is not even accurately mimicking those countries’ health determinations, which is another reason why the statute should be enjoined.]

Section 9 contains a federal preemption provision that calls off the warning requirement if the FDA or United States Department of Agriculture issue a law or regulation pertaining to one of the 44 listed ingredients prohibiting or conditioning use or determining it to be safe or imposing a particular labeling statement.  Section 9 was to take effect on January 1, 2027. 

In American Beverage Ass’n et al. v. Paxton, 2026 WL 395513 (W.D. Texas Feb. 11, 2026), a collection of nonprofit entities representing manufacturers and marketers of consumer packaged foods and beverages filed a lawsuit challenging the Texas law.  The defendant is the Attorney General of Texas.  He is running in the Republican primary against incumbent Senator Jon Cornyn.  Paxton aims to win by out MAGA-ing Cornyn.  MAGA now includes MAHA (Make America Healthy Again), and, somehow, right-wing politicians (who used to abhor anything smacking of “international law”) find themselves allied with a science-rejecting Health and Human Services Secretary who hates vaccines and seed oils, tinkers with bear corpses, and brags about how he sniffed cocaine off toilet seats.  As the Tommy Lee Jones character mutters near the end of No Country for Old Men (set in West Texas), “signs and wonders.”

Section 9 seems flat-out silly, but being silly is not ordinarily enough to strike down a law (though such silliness can be a factor in the court’s analysis).  The smart folks at the ABA (those are the liquor folks, not the lawyer folks) and other associations came up with a variety of legal arguments.  The one that persuaded the court to enjoin Texas’s ballyhooed attempt to impose its own ingredient labeling requirements (again, partly borrowed from NATO allies that our government keeps insulting and tariffing) was — tada! — free speech. The court reasoned that the plaintiffs would likely win on the argument that Section 9 is barred by the First Amendment.  That is an important result, because the First Amendment attack is often available when the government tries to force certain kinds of speech. Admittedly, when we frame a motion against such forced speech, the First Amendment argument usually does not come, er, first, because we expect to run into judicial skepticism.  Vagueness, over breadth, and preemption usually get higher billing. But maybe this recent case should prompt us to rethink that. 

The court held that the Texas non-FDA labeling requirements are a form of “compelled speech” over a subject matter that is anything but settled and non-controversial.   A lot of the arguments between the parties focused on whether the case involved a content regulation that called for strict scrutiny, or whether it was a commercial speech case that called for intermediate scrutiny. The implicit assumption was that strict scrutiny would mean that the statute was dead, while intermediate scrutiny would mean that the ABA’s lawsuit was dead.  (You’ve doubtless heard the rubric “strict in theory, fatal in reality.”) That dichotomy turned out not to be true here, and how the court got there was interesting. 

The court held that strict scrutiny “likely applies” because the Texas labeling law is a content-based regulation of speech.  The law requires the plaintiffs to speak a particular message that “alters the content of their” speech, here a government-scripted message on food labels and online that must be clear and conspicuous.   The plaintiffs pointed out that the required warning is not even true, since not one of the four jurisdictions referenced in the legislation (Australia, Canada, the European Union, or the United Kingdom – note that there isn’t a single SEC football team in any of those places, and they probably cannot barbecue decent brisket) actually states that any of the listed ingredients are “not recommended for human consumption.”  For the court, the key is that Texas showed neither the compelling state interest nor the narrow reach necessary to survive strict scrutiny.  Adios, silly, bossy statute.  

The court made the smart move of ruling on alternate grounds.  That makes the AG’s appeal more difficult. Even if the case was viewed through the lens of the Central Hudson commercial speech standard, the Texas labeling requirement would not “pass muster.” That is, it flunks intermediate scrutiny.  Yes, the state has a “substantial interest in supporting the health and well-being of its citizens by promoting better ingredients in foods sold in Texas.”  But compelling sellers to warn consumers of a potential risk never confirmed by any regulatory body or of a hazard not known to more than a small subset of the scientific community does not “directly and materially” advance the government’s interest.  Moreover, forced speech is not a “narrowly tailored” approach. The state could spend its own resources in its own advertising campaign rather than force the plaintiffs to speak.  Market based solutions, including the speech market, are usually better. 

Other arguments offered by the plaintiffs fared less well. But that’s okay — a win is a win. The court held that the vagueness and preemption arguments did not meet the preliminary injunction threshold.  The obstacle preemption argument faces the dreaded presumption against preemption, which would require adjudication of the falsity of the compelled statements. See you at summary judgment. For now, it is too early for that, and maybe the court will never get there, because, as the court held, the plaintiffs likely will prevail on the First Amendment ground.  

In any event, the deprivation of a First Amendment right constitutes irreparable harm, and an injunction protecting First Amendment rights is always in the public interest.  Accordingly, AG and senatorial candidate Paxton is enjoined from enforcing Section 9. 

The lesson here is for companies to take the First Amendment argument seriously, as we have advocated, particularly as to off-label use. That lesson is actionable.  Less actionable is another lesson: as has become the case all too often in this republic,  the executive and legislative branches do too much, or do not enough, or simply do dumb. More and more, the only adult in the room is the judiciary.  

If you are interested in this sort of thing – and why wouldn’t you be? – take a look at our post on American Beverage Ass’n v. SF.  It was another First Amendment challenge to a food warning law by the ABA.  Other recent First Amendment food posts are here and here.   

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The recent decision in Cousin-Sabra v. Smith & Nephew, Inc., 2026 U.S. Dist. LEXIS 25576 (E.D.N.C. Feb. 5, 2026) is short and straightforward. So too, therefore, will be this post. What we have is an ambitious plaintiff who filed a products liability/medical malpractice case against her doctors and the manufacturer of the device they used in her rotator cuff surgery– and, before the ink was even dry, asked for the keys to the warehouse.

Before the parties even held their Rule 26(f) conference—and while multiple Rule 12 motions to dismiss were pending—the plaintiff sought leave to serve sweeping, full-bore (aka expensive) discovery. Not targeted discovery. Not issue-specific discovery. We’re talking “categories” of all kinds of documents and records that the court struggled to even call proper “requests.” Id. at *4-5. 

Courts can authorize expedited discovery, of course. But only if the request is reasonable “in light of the totality of the circumstances.” And here, the totality was not the plaintiff’s friend.

First, procedural posture matters. A lot. Expedited discovery is particularly disfavored when Rule 12 motions are pending. There’s a reason for that. The whole point of Rule 12 is to test the legal sufficiency of the complaint before the parties incur the time and expense of merits discovery. If plaintiffs could demand costly discovery before a court rules on pleading-based motions, Rule 12 would become little more than an academic exercise—an expensive prelude to discovery instead of a gatekeeper. In this case, the broad discovery could not be said to be needed to assist in preparing a response to the motions to dismiss.  Id. at *3.

Second, the requests were anything but “narrowly tailored.” The court had no difficulty seeing that the proposed early discovery was “sweeping in scope” and indistinguishable from “full-blown merits discovery.” Id. at *7. This wasn’t a scalpel; it was a trawling net. When a party seeking expedited discovery can’t even pretend to aim narrowly at a discrete issue, that’s usually a tell.

Third, there was no irreparable harm lurking around the corner.  Plaintiff’s argument was that early discovery was needed because the documents are in the exclusive control of the defendants and she needs them to prepare the prosecution of her case.  That’s not irreparable harm.  That’s just discovery in a products liability case. Id. at *7-8. 

Finally, plaintiff could not show any risk that evidence would be lost absent immediate production. At best plaintiff speculated that “automated retention systems” could cause materials to become unavailable. But speculation about hypothetical loss of evidence won’t do. Particularly where defendants acknowledge, as they did here, their preservation obligations. Id. at *8-9.

In short, every relevant factor cut the same way—no expedited discovery. The most efficient ruling can also be the most obvious one. And the easiest way to discovery should be to survive a motion to dismiss first.

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Last month we were one of the first on the web with a review of the new Reference Manual on Scientific Evidence, Fourth Edition.  Since it was nearly 1700 pages long – literally longer than “War & Peace” – we did only the most cursory of analyses, describing differences in topics and authors and addressing some AI issues that we thought pertinent.

But then things started happening that were way over the heads of a few blogging defense hacks.  We had remarked that the last chapter (“Reference Guide on Climate Science”) seemed like an unusually narrow – we called it “niche” − topic compared to everything else the manual covered, all of which had trans-substantive application to litigation.  To us, it seemed a little like having a section on accident reconstruction, or fire causes and origins, or even pelvic mesh science.

But it turned out to be much worse than that.  The purported climate change chapter has been exposed as a pro-plaintiff hit job.  As the Wall Street Journal put it recently:  “The Federal Judicial Center tried to pass off one-sided propaganda as ‘settled science’” (behind paywall here).  Climate change is not really our area, so for all the gory details, we refer you to this letter that the Attorneys General of more than half the states recently sent to the director of the Federal Judicial Center (“FJC”) (which sponsored and published the Reference Manual).  Here’s a taste of what is in that heavily footnoted six-page letter:

The problems in the climate reference section seem to have started in selecting its authors.  Jessica Wentz and Radley Horton are both connected with climate studies programs at Columbia University.  And Columbia and its research partners have long viewed lawsuits against States, traditional energy producers, and others as “opportunities” to “resolve” what they see as “the pressing dangers created by climate change.”  Wentz and Horton themselves have applauded litigation as a tool to advance their preferred political objectives, complaining that the “political sphere in the United States continues to be clouded with false debates over the validity of climate change.”  As they see it, the courtroom provides a better venue.

Attorneys General letter at 2 (four footnotes omitted).

The Attorneys General’s letter requested that the FJC withdraw the “Climate Science” chapter.  Id. at 2, 5.  And that’s exactly what happened.  In early February – about a week after the AGs sent their letter − the FJC removed the Climate Science section from the free online copy of the Manual on Scientific Evidence we mentioned as being available in our initial post.  The table of contents (page xvi of the PDF) now says, and we quote:  “** The FJC omitted Reference Guide on Climate Science on 2/6/2026”  That statement is reiterated on p. 1561, where the section used to start.

Several of our readers had raised similar concerns to us, and we had started to research them, but events outran our own comparatively puny efforts.  We had planned to analyze both authors’ (Wentz & Horton) published works, and whether the citations in the 302 footnotes to the “Climate Science“ chapter were disproportionately to articles by authors who served as p-side experts in climate-related litigation.  Given that the chapter has already been withdrawn, there’s no need to complete that research – particularly since it’s tangential to the prescription medical product focus of the Blog.

But we did enough of our own research to determine that the criticisms of the Reference Manual’s “Climate Science“ chapter were 100% accurate.  First, and most obviously, the lead author has been affiliated for many years with the Sabin Center for Climate Change Law.  That entity is about as far from objective as it is possible to get, since, as the first page of their website states: “The Sabin Center develops legal techniques to combat the climate crisis and advance climate justice.”  They say it; not us.

What research we did into the authors’ published works led us pretty quickly to this article:  Jessica Wentz, Benjamin Franta, “Liability for Public Deception:  Linking Fossil Fuel Disinformation to Climate Damages,” 52 Envtl. L. Rep. (ELI) 10995 (2022).  The name says it all.  It’s a polemic in favor of increasing liability for precisely the topic that the Research Manual’s “Climate Science” chapter covers:

This Article examines how tort plaintiffs can establish a causal nexus between public deception and damages, drawing from past litigation, particularly claims filed against manufacturers for misleading the public about the risks of tobacco, lead paint, and opioids. . ..  The Article concludes with a discussion of the[] potential strategies and evidentiary sources.

Id. at 10995 (emphasis added).  We know exactly what the reference to “tobacco, lead paint, and opioids” means – pursuit of the same sort of broad, vague “public nuisance” litigation that we’ve been opposing ever since it first surfaced in firearms litigation more than twenty years ago.

Thus, it didn’t take us very long to confirm the worst of what our readers had indicated to us.  Ms. Wentz is an overt pro-plaintiff ideologue.  The Federal Judicial Center and the National Academy of Sciences had no business letting these p-side advocates anywhere near a project intended “to provide accurate, objective information and education” for judges.  Reference Manual, 4th ed. at iv.  We’re happy that the FJC pulled their blatantly biased chapter down so quickly, but we’re appalled that it happened in the first place.  That chapter had to be in the works for years.  Where was the FJC’s adult supervision?  Here, as well, we find ourselves in agreement with the concluding observations in the AGs’ letter:

Really, this issue transcends climate policy.  If the [FJC] can predetermine scientific questions in climate cases, what prevents it from doing the same for pharmaceutical liability. . .?  The precedent is dangerous regardless of one’s views on climate change. . . .  The Center should also establish procedures to prevent similar advocacy-based chapters in future editions.

AGs’ Letter at 4-5.  Something went badly awry in the Reference Manual’s internal editorial process – and stayed wrong for a long time.

We can’t say this breakdown in judicial neutrality is over and done with, however.  We direct our readers’ attention to chapter 2, entitled “How Science Works.”  While we agree with the chapter’s observation that “[s]cientific consensus is generally reached over the course of multiple studies conducted by different groups pursuing different lines of inquiry,” Reference Manual at 41, that chapter includes several citations to the works of a conspiracy theorist, Naomi Oreskes, who doesn’t believe that at all.  See Chapter 2 at nn. 2, 10, 85, 130 (three times).  One of her books is Merchants of Doubt:  How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Climate Change.  That book is cited four times in the “How Science Works Chapter – more than anything else referenced in that chapter, and no other author is cited anywhere near as often.  As is clear from its title, Merchants of Doubt is hardly the textbook-type publication we would expect to see prominently featured in a Reference Manual chapter.  Instead, it’s a screed against defendants in litigation, as is evidenced by its description on Amazon.com:

Merchants of Doubt has been praised-and attacked-around the world, for reasons easy to understand.  This book tells, with “brutal clarity” (Huffington Post), the disquieting story of how a loose-knit group of high-level scientists and scientific advisers, with deep connections in politics and industry, ran effective campaigns to mislead the public and deny well-established scientific knowledge over four decades.  The same individuals who claim the science of global warming is “not settled” have also denied the truth about studies linking smoking to lung cancer, coal smoke to acid rain, and CFCs to the ozone hole.  “Doubt is our product,” wrote one tobacco executive.  These “experts” supplied it.  Merchants of Doubt rolls back the rug on this dark corner of American science.

The “How Science Works” chapter cites Merchants of Doubt for the following propositions:

  • “Complicating matters, public relations campaigns have misled the public about the true state of scientific consensus regarding certain scientific issues.”  [fn.5]
  • “While the complex and iterative processes that went into establishing depletion of the ozone layer by CFCs are commonplace in science, the speed with which societal and political action followed scientific consensus in this case may be unusual.”  [fn.10]
  • “The problem of scientists with legitimate expertise in one field weighing in on a scientific question outside their area of expertise is a pernicious one that has affected public acceptance of science and policy on issues such as climate change and tobacco exposure.”  [fn.85]
  • “This [perception of scientific consensus] sometimes occurs as a result of strategic manipulation from stakeholders who stand to be harmed if the public were to understand the true state of scientific consensus surrounding the hypothesis, as has occurred with, for example, the health effects of tobacco, ozone depletion, and climate change.”  [fn.130 – also citing two other works by Oreskes]

Tobacco and climate change are matters that are still very much in litigation.  The “How Science Works” chapter of the Reference Manual thus suffers, to a lesser extent, from the same pro-plaintiff bias that permeated the now-withdrawn “Climate Science” chapter.  Why the new authors of “How Science Works” would choose to present a pro-plaintiff zealot’s work as reflecting “the true state of scientific consensus” in an FJC publication is beyond us.  We compared the chapter of the same name in the Third Edition of the Reference Manual (available here) to see if we had missed anything.  We did not.  The Third Edition contained none of the pro-plaintiff polemic or conspiracy theories that we have found in its Fourth Edition successor.

While we haven’t encountered plaintiffs in prescription medical product liability litigation using Ms. Oreskes’ work in attempts to bias judges and juries, we’re well aware of analogous efforts.  Plaintiffs have attempted to introduce a similarly scurrilous screed – with even a similar title – into evidence in cases of the sort we litigate, specifically D. Michaels, Doubt Is Their Product.  Again, the palpable pro-plaintiff bias of that book is evident from its Amazon description:

In this eye-opening expose, David Michaels reveals how the tobacco industry’s duplicitous tactics spawned a multimillion dollar industry that is dismantling public health safeguards.  Product defense consultants, he argues, have increasingly skewed the scientific literature, manufactured and magnified scientific uncertainty, and influenced policy decisions to the advantage of polluters and the manufacturers of dangerous products.  To keep the public confused about the hazards posed by global warming, second-hand smoke, asbestos, lead, plastics, and many other toxic materials, industry executives have hired unscrupulous scientists and lobbyists to dispute scientific evidence about health risks.  In doing so, they have not only delayed action on specific hazards, but they have constructed barriers to make it harder for lawmakers, government agencies, and courts to respond to future threats.  The Orwellian strategy of dismissing research conducted by the scientific community as “junk science” and elevating science conducted by product defense specialists to “sound science” status also creates confusion about the very nature of scientific inquiry and undermines the public’s confidence in science’s ability to address public health and environmental concerns.

Only once that we know of were plaintiffs in prescription medical product liability litigation successful in exposing a jury to this particular piece of pro-plaintiff propaganda.  The result was predictably horrific, and fortunately promptly reversed, albeit on other, even more serious, evidentiary grounds.  See In re DePuy Orthopaedics, Inc., Pinnacle Hip Implant Products Liability Litigation, 888 F.3d 753, 787 n.71 (5th Cir. 2018) (“We decline to address defendants’ remaining evidentiary challenges regarding . . . the Doubt is Their Product book. . . .  The district court should weigh carefully the applicability of Rules 403 and 404(b)”).  Other courts have recognized this disinformation for what it is and have excluded it when plaintiffs tried similar shenanigans.  First, it is inadmissible hearsay;

It seems that in addition to maybe offering this excerpt to impeach an expert on how they formulated their opinions, Plaintiffs are also attempting to offer the book to assert that [defendants’ experts] are corrupt, and anyone who relies on them is also corrupt.  Under this light, it does look like “classic” inadmissible hearsay.  Further, this likely does not fall into the learned treatise exception, as Doubt Is Their Product does not qualify as a reliable authority as required by the rule.  It appears through the briefing that the author of Doubt is Their Product has a clear goal throughout his book, which may speak to bias.  Accordingly, the Court finds that this book serves as inadmissible hearsay. . . .  

King v. DePuy Orthopaedics, Inc., 2024 WL 6953089, at *2 (D. Ariz. July 9, 2024) (citations omitted) (emphasis original).

Second, treating books like Doubt Is Their Product as evidence is grossly prejudicial to defendants:

Not only is this information irrelevant to [defendants’ products], and the facts underlying the case here, but it also has the goal of likening Defendants, and possibly their experts, to notable “corporate villains” that many of the jurors likely have heard of and formed negative opinions about.  Accordingly, because there is minimal probative value to this information [,] which is substantially outweighed by prejudice to the Defendant [it] will be precluded under Rule 403.

Id. (citing Pinnacle Hip).  Accord Sarjeant v. Foster Wheeler LLC, 2024 WL 4658407, at *1 (N.D. Cal. Oct. 24, 2024) (Doubt Is Their Product is “both hearsay that does not come within any exception, irrelevant, and highly prejudicial under Rule 403.  It is not the type of material that an expert in the field would rely upon to form their opinion under Rule 703”); see also Evans v. Biomet, Inc., 2022 WL 3648250, at *4 (D. Alaska Feb. 1, 2022) (quashing subpoena issued to defendant’s expert for material “related to Doubt Is Their Product”).

The way we look at it, Oreskes’ Merchants of Doubt is just as utterly plaintiff biased and unacceptable in a judicial proceeding as is Michaels’ Doubt Is Their Product.  We wish we could say that we were “shocked” at finding six citations to her work (more than to any other author) in the “How Science Works” chapter of the Reference Manual, but after the spectacular flame-out of the “Climate Science” chapter, we were actually not all that surprised.  The problems with the “How Science Works” chapter seem to be another manifestation of the same rottenness in the FJC’s version of the State of Denmark.  The FJC should pull these references from “How Science Works” and revise their internal editorial procedures to ensure that nothing like this happens again.

The role of the Federal Judicial Center, which created and published the Reference Manual, is “is to provide accurate, objective information and education” for judges.  “About the FJC.”  We don’t know how this mess came about, or who selected the authors and reviewed their work pre-publication.  To people like us – on the outside looking in − the entire process seems opaque and mysterious.  But as for “objectivity,” somebody or more likely several somebodies, badly dropped the ball.

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Since the beginning of the Blog, we have shilled for only one product:  Bexis’ “Drug and Medical Device Product Liability Deskbook” (published by Law.com and updated twice annually).  While Bexis is continuing the blog in 2026 (after he turned 70), he is not continuing to update this treatise.  Frankly, it’s a lot of work, and Bexis in his dotage no longer wants to write things with footnotes.

Over the last year, Bexis has informally attempted to find a successor willing to take over and continue his treatise, but without success.  It is a lot of effort, but it has its rewards, too.  It requires creating Lexis/Westlaw searches that will produce every prescription medical product liability litigation-related decision.  Then, an author must be read, and categorize by relevant chapter(s), all of these cases.  Then, when a chapter update is written, the author must read the cases (or the relevant parts) again, and add citations to each case in the footnote(s), and sometimes text, where it belongs.  Often, entirely new paragraphs suggest themselves.  ALM’s editors then run the changes and provide proofs for final, handwritten edits.  Repeat the process twice a year for different chapters.

The rewards are:  (1) suddenly knowing more than almost all other lawyers about what’s going on in prescription medical product liability litigation, and being able to pick up patterns and predict trends; (2) instant authority, as a name author of one of ALM’s most prominent publications; (3) helping your firm save clients lots of money by having pre-done research available; and (4) research synergies leading to numerous other publication opportunities.  It’s no accident that you can find Bexis’ name all over – the Blog, amicus briefs, DRI publications, 360, FDLI, ACI, PLAC – since he doesn’t have to reinvent the research wheel every time he writes about something.  Whoever took his place would have the same built-in advantages in the thought leadership arena.

Anyone taking over the project would also have some help.  Bexis is continuing with the Blog.  So he has to continue reading the cases that his own searches turn up.  It’s no big deal for him to continue adding new cases to the “chapter update” document that he’s been using for this treatise for the past 20+ years.  Bexis will happily work with any successor author.

So here is the pitch to our readers (and their firms):  If any of you would like to take over the editorial function for the Drug and Medical Device Product Liability Deskbook, feel free to contact Bexis directly.  Don’t kid yourselves, these semiannual chapter updates (at least the way Bexis did them) each take a month to prepare – it’s hard work.  But don’t sell yourself short, either.  All that work will increase your, and your firm’s, profile in the competitive and remunerative prescription medical product liability litigation defense field.

Bexis will put you in touch with his editors at Law.com, and you can take it from there.

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This post is not from the Reed Smith or Dechert sides of the blog.

We hope we’re not the only ones distracted by the Winter Olympics. We’re breathless from Breezy Johnson taking gold in the downhill, Jordan Stoltz emerging as the U.S. speed-skating phenom, Jessie Diggins battling bruised ribs to take bronze in the 10K cross country freestyle, and Ilia Malinin throwing in a back-flip in his skating routine just for kicks—despite it not earning him any points. Not to mention short-track skating, biathlon, luge, moguls, snowboard-cross, bobsledding, the Olympic debut of ski mountaineering, and all kinds of other ski and snowboarding events where the contestants either fly down mountains at cataclysm-embracing speeds or hurl themselves into the stratosphere while contorting themselves in twists and turns that make us dizzy. Combine that competition and athleticism with the Olympic themes of unity and sportsmanship, and you can see why we’ve got Olympic fever.

We were particularly enthralled with the U.S. mixed-double’s curling team. This is from humble bloggers who, other than every four years, have no idea what curling is. But when the Winter Olympics roll around, we’re watching to see who’s dominating the house and who has the hammer. The U.S. mixed doubles team had never taken home a curling medal. This year’s team, Cory Thiesse and Korey Dropkin, absolutely dominated the round robin and earned a spot in the medal round. After a magnificent shot in the last end (like a game winning home run in the bottom of the ninth), the U.S. defeated defending gold-medalist Italy for a chance to play for the gold medal. While “Corey and Korey” ending up taking home silver, it was the first ever medal for the U.S. in mixed curling and the first ever Olympic medal in curling for an American woman. What a run.    

One of the curling commentators noted that Korey Dropkin was one of the best sweepers in the game. While it may be a stretch to connect curling to the legal side of these posts, we think it is fair to note that mass torts defendants often engage in years of clean up after securing victories in mass torts. Call it sweeping the house if you will. Case in point is the Zantac litigation. The defendants secured litigation-ending rulings excluding plaintiffs’ general causation experts in the federal MDL (which we posted about here and here).  Plaintiffs then fled to Delaware (of all places to see mass torts plaintiffs flocking, we continue to be surprised and disappointed at this trend).  The Delaware trial court refused to follow the well-reasoned decisions from the MDL and appeared to give new life to the Zantac litigation (see this post), but the Delaware Supreme Court reversed and remanded with instructions for the trial court to apply Delaware’s Rule 702 consistently with the federal rule (see here).  

Continue Reading The Zantac Defense Has the Hammer in Delaware

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