Some cases feel brand new. Others feel like a remake you didn’t ask for—but somehow know all the lines to already. This one is firmly in the latter category. For those of us who have been around long enough to remember dial-up internet and the original pedicle screw litigation, this case reads like a throwback. In fact, one of this blogger’s very first cases (working with Bexis) was the Bone Screw MDL—the one that gave us Buckman Co. v. Plaintiffs’ Legal Committee. So, Elowson v. Alphatec Spine Inc., 2026 U.S. Dist. LEXIS 13591 (D. Ariz. Jan. 26, 2026), a negligence per se claim based entirely on alleged FDCA violations, involving pedicle screws, gave us a distinct sense of déjà vu. Spoiler alert: Buckman still wins.
The plaintiff underwent spinal surgery in 2019 to remove a tumor on her lumbar spine. Part of the procedure required spinal fusion using a plate-and-screw system. Things went along just fine—no complaints, no complications, no litigation—for half a decade. Then, in 2024, plaintiff began experiencing pain. An x-ray revealed that one screw had broken at some point before the bone fully fused. Id. at *1.
Cue the lawsuit. Never mind that the device lasted five years. Never mind that the product warnings expressly state that screws may fail if fusion does not occur. Never mind that pedicle screws are subject to the immutable laws of physics. Plaintiff sued anyway, alleging among other things negligence per se based entirely on supposed violations of the FDCA and FDA regulations.
That claim did not survive defendant’s motion to dismiss. And for good reason. Plaintiff’s negligence per se theory was simple in concept and fatal in execution. According to plaintiff, the manufacturer had a duty to update the device design because it was based on an allegedly “outdated” “European style of design” and because U.S. manufacturers supposedly use a design that reduces the risk of fracture. Id. at *4-5. Plaintiff alleged that the “source” of that duty was the FDCA and its regulations, id. at *5-6, rather than any traditional state-law tort principle. That is a problem. A Buckman-sized problem.
As the court correctly held, negligence per se claims premised exclusively on alleged FDCA or FDA regulatory violations are preempted. Full stop. The Supreme Court settled this decades ago. Id. at *7. If Buckman had a walk-on song, this would be its moment.
The negligence per se claim here would not exist without the FDCA. Plaintiff did not identify any independent state-law duty requiring manufacturers to update designs based on evolving regulatory expectations or comparative international practices. Instead, plaintiff attempted to bootstrap FDA regulations into a state tort claim. That is exactly what Buckman forbids: private litigants bringing private enforcement actions of the FDCA under the guise of state law.
Negligence per se is not a free-floating cause of action. It applies only where a defendant violates a “specific legal requirement, not a general standard of care.” The plaintiff’s problem was that the only “specificity” she could point to came from FDA regulations. Without those regulations, there was no duty, no breach, and no claim.
Courts have consistently recognized that claims not tied to traditional state tort duties—but instead dependent on federal regulatory schemes—are preempted. Allowing them to proceed would invite juries to second-guess FDA regulatory decisions and enforcement priorities. That, again, is Buckman territory. The court declined that invitation.
The court did, however, allow plaintiff’s strict liability design defect claim to survive the pleadings stage. Defendant argued that Arizona follows either the Second or Third Restatement of Torts and that under either it would reject strict liability design defect for a medical device. On the former, the court concluded that whether comment k applies—whether defendant’s screws are unavoidably unsafe—is a question of fact that can’t be resolved on the pleadings. Id. at *11-12. On the latter, the court disagreed with defendant that Restatement Third §6c was Arizona law. Under §6c, a strict liability design defect claim would require plaintiff to plead that a reasonable health-care provider, knowing the risks and benefits of the medical device, would not prescribe the device to any class of patients. Id. at *12. The Arizona Supreme Court, however, in a case that pre-dates the Restatement Third, adopted the standard risk/utility test for strict liability design. As a federal court sitting in diversity, the Elowson court was bound to apply that standard. Id. at *13. Plaintiff’s allegations sufficiently alleged a design defect (the “outdated” European style); an alternative design (the “smooth” U.S. style), and that defendant’s “failure to design screws that remain intact and do not break caused her injuries.” Id. at *15. That was enough to survive a TwIqbal challenge.
But perspective is important. Pleading survival is not victory—it is a timeout. The case now proceeds with discovery, expert scrutiny, and the inconvenient reality that spinal fixation devices, by their very nature, carry a risk of mechanical failure. To date, no bone screws—whether designed in the U.S., the U.K., or on Mars——are immune from breakage, especially in the absence of fusion. Gravity and biomechanics remain undefeated. Warnings here explicitly addressed the precise risk that materialized. The device functioned for five years. And the alternative design theory exists, for now, only on paper. In other words, this looks far more like a temporary setback than a turning point.
The more important takeaway is that this decision reinforces a familiar but critical principle: plaintiffs cannot manufacture negligence per se claims by repackaging alleged FDCA violations. Buckman remains the OG pedicle screw case—and it still has teeth. Sometimes, the old rules still work—much like those screws did, for half a decade.