Today we are talking about the decision in Govea v. Medtronic, Inc., 2025 WL 3467214 (C.D. Cal. Nov. 26, 2025). Plaintiff claimed the case was about off-label promotion. But thanks to the court taking judicial notice of PMA supplements, it’s mainly a case about on-label use and a plaintiff who waited far too long to sue.
The device at issue is an implantable stimulator used to regulate incontinence. It is prescribed when patients do not tolerate more conservative treatments and medications. The process starts with a two-week trial run where only a lead is implanted and the generator is worn outside the body. After a successful trial, the device is fully implanted. Plaintiff was prescribed the device to treat urinary incontinence. Her trial lasted only one day because the lead wire stuck to her bandage. Her physician recommended she go forward with the implant anyway and she did. Plaintiff alleges that after the implantation in 2011, she received no relief, but instead her condition worsened and she experienced painful shocks. She started asking to have the device removed in 2016. It was eventually explanted in 2018, but her surgeon did not completely remove the lead. Plaintiff claims she was unaware that the lead remained until it was revealed by x-ray in January 2024. Id. at *3. Plaintiff filed suit in December 2024 bringing claims for misrepresentation, breach of express warranty, manufacturing defect, and negligence.
At the core of all of plaintiff’s claims are allegations that the manufacturer promoted the device for an off-label use. Plaintiff claimed the device was only approved for fecal incontinence, not urinary. However, the court granted defendant’s request to take judicial notice of multiple PMA supplements and approvals which showed FDA approval of the device for both forms of incontinence. Because urinary incontinence was approved by PMA, “arguing that [the device] is inappropriate for use in that context is, in effect second-guessing the PMA process.” Id. at *9. So, plaintiff’s misrepresentation claims based on that allegation are preempted.
However, the device’s labeling states it is contraindicated in patients who “have not demonstrated an appropriate response to test stimulation.” Id. Plaintiff alleged that her device failed prior to completion of the test stimulation, that she informed defendant’s representative of that fact, and the representative recommended permanent implantation anyway. Id. at *10. Finding that was a sufficient allegation of promotion for an unapproved use, the misrepresentation claims based on that allegation were not preempted. Likewise, the same allegations were enough for the court to find plaintiff’s breach of express warranty claims not preempted. Id. at *12.
On her manufacturing defect claim, plaintiff failed to allege any violation of a specific FDA requirement for the device. She didn’t even try to rely on CGMPs. Rather, plaintiff relied on allegations that either the device had been improperly implanted or that it must be defective because the wire migrated and could not be fully removed. The former has nothing to do with the manufacture of the device and the latter is res ipsa loquitur—with the Ninth Circuit has rejected. Id. at *11. Therefore, plaintiff’s manufacturing defect claim was expressly preempted.
The court’s final preemption analysis was on the negligence claim. First, the court found that there is no state law duty to refrain from off-label promotion. The prohibition on off-label promotion is solely a function of the FDCA. So, to the extent plaintiff’s negligence claim was based on alleging such a duty, it was an impliedly preempted private attempt to enforce the FDCA. The only negligence claim that survived preemption was based on allegations of misrepresentations made during the off-label promotion. So, the claim has to be premised on false statements, not whether the statements were on or off label.
While some of plaintiff’s claims survived preemption, for any to survive the statute of limitations challenge, plaintiff would have to significantly re-write or back off several of her current allegations.
According to the complaint, plaintiff experienced pain which she attributed to the device the entire time it was implanted. Further, she alleges she never received any relief of her symptoms from the device, but rather her incontinence worsened. Id. at *17. She also alleges that she continued to experience pain at the incision cite following explant. What the complaint fails to allege is that plaintiff took any steps to follow up with any physician following the explant surgery, or indeed “that she took any other actions that would constitute reasonable diligence.” Id. at *16. She relies exclusively on learning in 2024 that the wire was still implanted as the point in time when she “discovered” her injury.
Plaintiff’s injury didn’t just sneak up on her in 2024. According to her own account, it announced itself early and often. Yet plaintiff waited six years after explant to file suit. The court was unmoved by arguments that she didn’t connect the dots sooner. When a plaintiff alleges immediate and ongoing pain following a medical procedure, the law generally expects some curiosity. At least enough to ask, “Should I look into this?” The statute of limitations doesn’t pause indefinitely while a plaintiff hopes the answer will change. Being on notice doesn’t require knowing every legal theory or scientific detail. It requires awareness of an injury and a possible connection to its cause. Plaintiff had both—and still waited.
Preemption plus time-bar is a powerful one-two punch. Either is often enough; together, they end the fight early.