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Reuters News Service reports that Johnson & Johnson has blamed “lax cleaning procedures” for its massive recalls of over the counter medicines and artificial joint replacements. “Insufficient equipment cleaning procedures and instances where people failed to adequately document cleaning procedures” are among some of the identified cleaning issues. The company has cited to “label irregularit(ies)” as well.

Johnson & Johnson has recalled nearly 200 million bottles of over the counter medicine products in the past year. Benadryl, Tylenol, and Rolaids are among the brands affected. Some batches of Softchews Rolaids were found to have wood and metal bits in the tablets. What’s more, odors have been reported in some of the other products. In light of Johnson & Johnson’s lack cleaning procedures, one may wonder what sort of research went into the DePuy ASR hip implants. DePuy, a division of Johnson & Johnson, announced in August 2010 a nationwide recall of the ASR hip replacement systems. The artificial hips contain design flaws stemming from too-shallow cups that don’t properly house the ball associated with the joint replacements. Complications of this design flaw include metallosis caused by microscopic metal shavings and substantial loss of mobility, to name a few symptoms. Moreover, pseudotumors have been reported in some recipients of DePuy’s ASR joint replacement products.

In light of Johnson & Johnson’s quality control flaws, and resulting defects, the federal government is beginning to pay attention. The Justice Department is considering potential charges against the corporation. The F.D.A. has initiated an investigation. Congressman Darrell Issa has expressed concern, too. At least one shareholder has filed suit against Johnson & Johnson’s board of directors in response to the manufacturing errors the company have committed recently.

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In a recent post, we reviewed the Nolan v. Mabray case which discussed the requirement under Louisiana law that an insurance company must mail a written notice of its intent not to renew an existing policy at least thirty days prior to the policy’s expiration. La.R.S. 22:636.6. The purpose of the notice is to provide the insured sufficient opportunity to obtain insurance with another company before the existing policy expires. In the event of a dispute, the insurer faces the initial burden to prove that it mailed the required notice. Then, the property owner may rebut this presumption by offering evidence that the notice was never delivered. The ultimate factual determination must be made by the jury. The recent case of Johnson v. Louisiana Farm Bureau Casualty Insurance Co. offers another look at the rule’s application.

In 2001, Janice Johnson bought a homeowner’s insurance policy from the Louisiana Farm Bureau Casualty Insurance Company (“Farm Bureau”) for her home in Campti. She set up a bill-pay debit arrangement with her bank under which her monthly premiums were automatically paid to Farm Bureau. In 2006, after completing a routine inspection of Johnson’s property, Farm Bureau decided not to renew the policy when it expired the following July. Accordingly, on May 2, 2007, Farm Bureau mailed a written notice of non-renewal to Johnson and the policy expired on July 10, 2007. Tragically, Johnson’s house was destroyed by fire on November 7, 2007. Farm Bureau rejected Johnson’s subsequent claim for total loss on the grounds that she did not have a policy in place at the time of the incident. Johnson filed suit on July 24, 2008 seeking monetary relief for the losses she sustained in the fire. In her petition, Johnson asserted that she was covered by the
policy and that she was not notified that the policy had expired until after the fire. Farm Bureau responded with a general denial, arguing that Johnson was provided with written notice of non-renewal and that the policy was not in effect at the time of the fire. At the conclusion of a jury trial, the jury found Farm Bureau had properly mailed the non-renewal notice on May 2, 2007 as required under Louisiana law. However, it also found that the notice had not been delivered to Johnson. The trial court entered judgment in favor of Johnson and awarded her damages in the amount of the policy limits: $297,000 less a $500 deductible. Farm Bureau appealed, contending that the jury “committed manifest error” and was “clearly wrong” in determining that the non-renewal notice had not been delivered.

The Third Circuit Court of Appeal reviewed the trial record which contained the evidence Johnson offered to rebut the presumption of delivery. Johnson testified that she always opens every piece of mail she receives except for her bank statements, and that she never received the notice Farm Bureau. Johnson’s testimony was corroborated by her sister, who often picked up Johnson’s mail from the post office box which was Johnson’s registered address on her insurance policy. In response to Farm Bureau’s argument that Johnson should have known that her policy was expired because the company stopped withdrawing payments in May 2007, Johnson stated that she did not routinely open mail from her bank or reconcile her checking account. The court noted that “the jury was able to take [all of this] testimony into consideration” in making “a determination of the credibility of the witnesses.” Mindful of its duty to “afford great deference to the factfinders’ determinations,” the court concluded that, “although some of the testimony presented is questionable,” it could not find “manifest error in the jury’s credibility determination nor in their determination that the notice of non-renewal was not delivered to Johnson.”

The Johnson case, much like the Nolan case, turned on the critical role that the jury plays in settling issues of fact. Even if an appellate court believes after reviewing the record that its credibility determination is more accurate than the jury’s, it cannot substitute its own view unless it finds that the jury’s conclusion was based on testimony “so absurd that a reasonable person would not credit it.” Clearly, in this case, Johnson’s even somewhat suspect testimony did not rise to this level.

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In August 2010, DePuy recalled thousands of its ASR hip implant units after medical watchdogs discovered the product was structually unsafe and caused many recipients metallosis, substantial loss of mobility in joints, and other symptoms. Thousands of lawsuits immediately followed, with most still pending.

Hip implants aren’t the only product produced by DePuy, and its parent division, Johnson & Johnson, that have contained flaws. According to a January 2011 New York Times story, 288 million Johnson & Johnson products, including 136 million bottles of liquid Tylenol, Motrin, Zyrtec and Benadryl, have been pulled from store shelves. Foreign bits of metal and moldy odors are among some of the chief reasons behind removal of these items. And in December 2010, 13 million packages of Rolaids, another Johnson & Johnson product, were pulled from shelves after they were contaminated with metal and wood particles.

Johnson & Johnson’s manufacturing errors have led government regulators to more closely scrutinize the company and its subdivisions. The F.D.A., for instance, has expressed that it is baffled as to why company executives have not been able to identify, prevent, or explain the recent emergence of problems that plague the medical manufacturer’s products. Even the State of Oregon has filed a lawsuit against Johnson & Johnson, claiming the company has misrepresented the quality and efficacy of its products. A shareholder’s lawsuit was filed against the company’s board of directors in December 2010 in response to the billions of dollars lost in damages payments to victims of Johnson & Johnson’s defective products.

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The sad fact is that everyday accidents happen on our nation’s roads. Especially tragic are ones where a family member is killed. Combined with the pain of losing a
loved one comes the burden of dealing with insurance policies, who is insured and who is uninsured at the time
of the accident and trying to get coverage. In prior posts. we have discussed how liability is hard to assign at times, especially when it takes a fact-finder to establish who is at fault. In this Louisiana court case, an insurance company refused to pay uninsured/underinsured motorist (UM) liability coverage to the daughter of the deceased driver of a vehicle which was struck by an oncoming motorist.

In March of 2006, Donald Anderson was killed in a car accident when his car was hit by an oncoming motorist, Gordon Pugh, Jr. During the time of his death, Donald Anderson was within the scope of his employment with Labor Finders. Labor Finders had a liability insurance policy issued by National Union which was in effect at the time of Anderson’s accident. After the accident, Anderson’s daughter filed a survival and wrongful death action naming Pugh and his insurer as the defendants. Several months later in December, Anderson amended her petition to include National Union as the defendant. Anderson claimed that since her father was insured under the liability policy issued by National Union to Labor Finders at the time of the accident, then he was entitled to the mandated uninsured/underinsured motorist (UM) insurance. National Union denied this fact while Anderson was able to settle the claims with Pugh’s insurer. National Union filed for summary judgment and the trial court stated that their policy was clear, unambiguous and that under the terms the policy provided, Donald Anderson was not an insured at the time of the accident to whom it could afford coverage. Therefore, the trial court granted summary judgment in favor of National Union leaving Anderson with nothing after her father’s death.

Summary judgments are reviewed based on material facts in order to avoid a full scale trial. The courts grant this motion when there is no issue as to material facts, and the moving party is entitled to judgment as matter of law. In this case, it was up to the Anderson to show that the insurance company was not entitled to judgment as a matter of law.

Insurance policies in the state of Louisiana function much like contracts, and are, therefore, interpreted as such. When the court interprets an insurance policy, it generally interprets the intent of the parties in forming the contract. In order to get to the common intent of the parties, the court looks primarily at the language of the insurance policy; Louisiana courts have struggled with this because at times, the technical meaning of the words is hard to differentiate from the generally prevailing meaning. If words in an insurance contract have a “technical meaning” then this meaning must be applied when the contract is interpreted. In addition to interpreting the meaning of words, each provision and section of this contract must be interpreted in light of the other provisions. Matters become more complex here because one provision cannot and should not be interpreted at the expense of another. Should the court find that words in an insurance contract are clear and explicit, it must strictly apply those words as written. Things become more difficult when ambiguities in the contract still remain even after the general rules of the contract have been applied; this may cause problems for both the policy holder and the insurance company.

All liability insurance policies issued in the state of Louisiana are required to issue UM coverage equal to the amounts in liability coverage when there is no express waiver of reduction of the UM coverage. This type of policy only requires that the person be injured by a UM. To simplify this complexity, there exists a test to determine whether a person qualifies for UM coverage under liability insurance. The test is to determine whether this person would be covered if they were liable for the accident.

In this case, National Union maintained that Donald Anderson was not an insured under the original terms of the National Union Policy. A section of the policy clearly stated that all Labor Finders’ employees (which Anderson was at the time of the accident) were insured as long as they were within the score of their employment at the time of the accident (Anderson met this criteria as well). A reader can see that the plain language of the contract points to the fact that Anderson was insured at the time of his accident, unless there was some exclusion.

The caveat here is that insurers have the right to limit coverage in any way they desire as long as these limitations are clearly set forth in the contract. It is at times like these that you need a professional in the field who will know how to maximize coverage. Coverage exclusions are construed strictly against the insurer. In the current case, the policy contained an Endorsement which stated that National Union shall not pay for any damage which arises out of aircraft, auto or watercraft injury owned or operated by the insured. Anderson fell into this exclusion because his injury and subsequent death arose out of the operation of his own vehicle. While Anderson fell into a clearly stated exception in the policy, many other endorsements are more ambiguous and require thorough interpretation and scrutiny.

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Insurance policy coverage can be very confusing regardless of how simple televisions commercials may claim it can be. Sometimes insurance companies limit their liability by setting a time period within which the policy applies. In other circumstances, insurance policies limit their liability by creating categories of actions that can be instituted against it. For example, if an insurance policy states that it protects a health care provider for one year after the policy begins, this may mean that 366 days later a patient is out of luck if the doctor performs malpractice. Some insurance companies create distinctions on the types of actions that fall under the policy. For example, coverage can extend either based on occurrence or claims.

The distinction here is important, especially as it relates to the time period to bring a claim. If an insurance policy begins on January 1 and ends on December 31, the malpractice occurs on November 10, and the plaintiff files suit in March of the next year, the definitional difference is important. If the policy is occurrence based, the plaintiff will likely have no problem. In an occurrence based policy, coverage extends to any malpractice which occurred within the policy period. In our set of facts, since the malpractice occurred on November 10, it is covered because it is within the policy period. In a claims based policy, coverage extends to any claim that is filed within the insurance coverage period. In this case, although the malpractice took place within the time period of the insurance policy, the claim was not filed until after the coverage period had extinguished. Thus, in out facts, if the policy was claims based, the insurance company would not be liable for the malpractice.

In a recent case, Dewayne Wright v. Willis-Knighton Medical, the plaintiff, Ms. Wright suffered cramps, a coma, insulin shock, and stroke as a result of medical malpractice. The mother of the plaintiff filed suit on behalf of Ms. Wright. She filed initial suit against the facility, Willis-Knighton Medical. At a later date she amended her brief and added the ER doctors to the suit as well. Later, the plaintiff discovered that the insurance policy did not include the health care facility and only included the medical practitioners who decided to join under the coverage. The doctors that she added under the amended brief were originally protected by the coverage.

The problem for the plaintiff begins, though, when the insurance company that she sued later based its policy with the doctors on a claims based basis. Only the claims that were filed within the insurance coverage period were covered. Unfortunately for Mr. Wright, the period ended the day before the brief was amended. Mr. Wright argued that because the doctors were employed by Willis-Knighton, they were solidary defendants. However, because the policy did not cover the medical facility there is no legal basis to extend the coverage of the policy more than the contract states. Thus, because the coverage period had expired by the time the claim was brought against the insurance company and doctor, the claim failed to meet the requirement within the policy’s scope and thus must fail in court to make the insurance provider liable for the alleged malpractice.

This case shows that if you feel that your rights have been violated or that you have been injured because of medical malpractice that you should seek legal counsel as soon as possible. By waiting before speaking to an attorney you increase the chance that time may run out on your ability to protect your rights.

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The purpose behind having insurance is to help injured parties get relief. In a world without insurance, every accident has the potential to be the financial ruin of the party judged to be at fault. Insurance policies have the effect of creating a large pool of money that can be used to provided financial backing in the post accident period. However, insurance policies will not have the effect of covering every accident that occurs in every circumstances. For example, can we expect to allow an individual who uses his vehicle as a weapon to gain the benefits of his car insurance policy? Answering questions like this are at the cornerstone of lawsuits seeking compensation when tragedy strikes in unfortunately complex ways.

Strong public policy in Louisiana indicates that any accident that occurs in the course of committing a crime should not be protected by insurance. In fact, for obvious business reasons, most insurance policies limit the insurance company’s liability with a crime exception. The Ruston City Court, Parish of Lincoln, State of Louisiana, had this concept in mind when it made a recent decision.

The defendant, Shedrick Green, was driving down a road while he was feuding with another individual in another car. At one point, the party in the other vehicle pulled into a parking lot, at which time Mr. Green pulled out a gun and began shooting. After shooting at the other vehicle, he got back into his car and continued driving. At the next stop sign, he drove into the intersection without stopping at the stop sign and his vehicle collided with the vehicle that the plaintiff, Latasha Potts, was driving. At the trial court level, Ms. Potts sued both Mr. Green and his insurance company. The trial court ruled that driving through the intersection was part of a continuation of a criminal activity. The insurance policy on the vehicle driven by Mr. Green stated that the policy did not extend to criminal actions. Thus, the trial court ruled that the insurance company was not liable because of the criminal nature of the vehicle’s use.

However, upon appeal, the appellate court looked at the circumstances differently. Mr. Green was arrested for assault and battery. According to the facts set out by the trial court, the assault and battery were completed when Mr. Green shot at the other vehicle and drove away. Any action taken after that was not in the course of a criminal activity. If Mr. Green had been charged with fleeing the scene of a crime, there could be a chance that the accident with Ms. Potts was a criminal activity. Parties who are involved in an accident expect to be protected against normal acts of negligence on the part of a driver. In this case, Mr. Green drove down the road and negligently failed to realize that he needed to stop at the stop sign. Thus, the accident with Ms. Pott was as a result of Mr. Green’s negligence, not his prior criminal actions. Criminal law should not be used as a tool to limit civil liablity. Thus, the appellate court overturned the trial court decision.

Insurance policies have the potential to deal with many different areas of law. The facts of this case show an interlocking of civil, contract, and criminal law all in one case. Thus, it is essential or any person who has been involved in a car accident to seek legal advice. Simply settling with an insurance company may not be the most effective way to retain your rights. By consulting with an attorney, finding where the law is flexible or is not as simple as first glance can mean a significant amount, like in this case.

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In January 2011 the Washington Post reported on the recent trend of younger patients opting for joint replacement surgery. In 2008, of the 277,000 hip replacements performed in the United States, 27 percent were conducted on patients ages 45 to 64. That represents an increase of 78 percent for that age group.

One orthopaedic surgeon believes the trend stems from younger peoples’ proactive approach to pain and aging. “Younger people are less willing to accept physical disability than older generations,” Dr. Mary O’Connor, president of the American Association of Knee and Hip Surgeons, said. “[Younger people] don’t want to hear that they should use a cane or they can’t walk or play golf…”

But with increased joint replacement surgeries comes increased risk. Because most replacement joints are expected to last 15 to 20 years, many younger patients will outlive their artificial knees and hips. And when the usefulness of those joints diminishes, a second surgery, known as a revision, is necessary to replace the failing artificial joint with a new one. Revision surgery carries with it increased complications. “If you need a [revision surgery], that surgery is a little more difficult,” Dr. Mary O’Connor explained. Usually when [the implant] fails, it fails because one of the parts loosens…every time you have to revise it, there’s a higher risk of complications.”

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Medical literature has showcased several problems with metal-on-metal hip implants, such as the DePuy ASR line that was recalled in August 2010. Among the various problems, soft tissue reactions and high risks associated with metal-on-metal implant materials emerge to the top. For example, some hip implant recipients are especially sensitive to cobalt and chromium, two metal alloys commonly found in metal-on-metal hip implants. Doctors have observed “soft tissue breakdown and pseudo-tumors” in patients who exhibit these types of sensitivities, as well as other symptoms. Further discussion of these symptoms can be found here.

Additionally, physicians are beginning to balk at the use of metal-on-metal implants due to the newly uncovered information on the devices just now bubbling to the surface. As a result of recent lawsuits against DePuy in relation to the company’s flawed manufacturing processes, physicians are just now realizing some of the inherent risks associated with the metal-based units. Some medical observers predict the popularity of metal-on-metal implants could decrease as a result. Not only are physicians worried about personal liability for implanting a faulty metal-on-metal product, they are increasingly concerned with the proper maintenance of their patients’ wellbeing and health as well. Certainly, the use of metal-based devices in patients can run counter to such goals.

As metal-on-metal implants have been subjected to much scrutiny, physicians are turning to alternative joint implant materials, such as ceramics or plastic. One plastic model, known as the ADM X3 Mobile Bearing Acetabular System, has a ninety-four percent reduction in wear compared to metal-on-metal implants. Although the potential risks associated with plastic hip devices are not entirely known, they do not seem to carry the same risks of metallosis or soft-tissue poisoning that occurred in the DePuy metal-on-metal implants.

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The Fourth Circuit Court of Appeals in New Orleans recently affirmed that a policyholder was covered by his Homeowner’s policy for injuries inflicted during a brutal accident where another was seriously injured. While leaving a party, Hurst – the policyholder – fashioned a lock pick out of wire to open the door of his truck in which he had locked his keys. After gaining access, he flung away the wire and it bounced off the back of his truck and into the open window of another departing guest, Ms. Baker, injuring her severely.

Hurst held two liability insurance policies with Liberty Mutual: a $300,000 Homeowner’s policy and a $30,000 Automotive policy. The injured Baker sued Hurst, Liberty Mutual Insurance, and her own Uninsured Motorist carrier: Allstate. Through procedural motions, both Baker and Liberty Mutual asked the lower court to make a determination as to whether Hurst was covered by the higher limit homeowners’ policy at the time of the accident.

The Homeowners’ policy included a provision excluding coverage for personal liability and medical payments for bodily injury “arising out of the ownership, maintenance, use, loading or unloading of motor vehicles.” The heart of the issue became whether Hurst’s use of the wire to gain access to his vehicle and throwing it into his truck bed was “use or loading of the vehicle” such that it would bar the coverage of the Homeowners’ policy.

The lower court ruled that Hurst’s throwing of the metal object onto the hard surface of the truck bed had no connection to the use of the truck; it was the disposal of the object itself that was negligent. This is because courts consider the role the vehicle played in the entire scheme. Here, the Fourth Circuit reasoned that the vehicle must be central to the theory of liability and that here it was not – the flinging of the wire was at the heart of Hurst’s liability for injuring Baker. Applying the relevant legal standard from a case called Carter, the Court considered whether (1) the conduct of the insured was a proximate cause of the injury (it was); and (2) whether it was a use of the automobile (it was not). The Court therefore ruled that the exclusion for automobile use did not apply and Hurst’s conduct at the time of the accident.

Homeowners’ policies often include higher limits for liability than do automotive or other policies that people who injure you might have. Given the tragic nature of Ms. Baker’s injury, it is somewhat clear why she sought the Homeowners’ $300,000 policy coverage and why Liberty Mutual sought to deny coverage on that claim.

Legal expertise is very often required to achieve the best outcome for your injuries because insurance companies like Liberty Mutual will skillfully and zealously attempt to limit the amount payable to injured persons – as they did here.

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Automobile insurance policies are a means of protecting car drivers and accident victims. It creates a pool of money so that any party at fault can make the victim of his or her negligence whole. When a business holds itself out as a car dealer, policy terms are a little different based on each party and insurer. An insurance policy agreement between the insurer and the insured is a contract between the parties. Under Louisiana law, words in a contract are presumed to have the plain and ordinary meaning they are generally given. The basic intent of the parties is construed through the words of the contract, and no court can disturb the intent of the parties. If an insurer is attempting to show that a certain provision in an insurance policy exempts coverage, the insurer has the burden to prove any exception.

In a recent case, a court discussed how insurance policy language will be interpreted. The facts giving rise to the cause of action in McKay v. W & J Farms, are as follows:

The plaintiff, Connie McKay, was driving South on Highway 153 in Richland Parish. As she travelled through an intersection, her vehicle was struck on the side by a tractor driven by Kyle Mills. Ms. McKay claims that an insurance policy held by the seller of the tractor extended to Mr. Mills when he was driving the tractor. The way in which Mr. Mills came to be driving that vehicle at the very moment are interesting and are crucial in relation to the cause of action. Mr. Mills works on a farm with his brother and another individual, Mr. Livingston. The three individuals decided that it was important that they purchase another tractor to increase productivity on the farm. Mr. Livingston and Mr. Mill’s father went to a Peterbuilt tractor dealership in order to check prices of tractors. Mr. Livingston brought a tractor to the farm to test it out. Mr. Mills was advised to drive the tractor from the farm to the elevator. During this fateful drive, he struck Ms. McKay at the intersection with Highway 153.

Ms. McKay argued that the Peterbuilt dealer’s insurance coverage extends to Mr. Mills as he was driving the tractor. The insurance company’s policy with the Peterbuilt dealer states in relevant part:

The following are insured for covered autos…anyone else while using with your permission a covered auto you own, hire, or borrow, except…Your customers, if your business is shown in the Declarations as an auto dealership.

In the Peterbuilt dealers business declaration, the business was declared a car dealership. Ms. McKay argued that there is a distinction between auto dealership, as is stated in the insurance policy, and car dealership, as is stated in the declaration. There is obviously no real distinction between these terms. From a logical perspective, a person reading these two terms would find that they are identical. The next question is whether Mr. Mills was a customer of the Peterbuilt dealer. The facts in the case showed that Mr. Mills’ brother was going to be the actual purchaser of the tractor. However, under Louisiana law, a person test driving a vehicle in order to help a purchaser make a decision of whether to purchase that vehicle is considered an extension of the purchaser. This means that the test driver is a customer in the eyes of the law. Therefore, when Mr. Mills was driving the tractor he was a customer and under the terms of the dealer’s contract with the insurance provider, Mr. Mills was not covered under the policy.

Insurance policies are difficult and complex contractual agreements. In order to understand policies, a general understanding of the law is essential. If you have been involved in an accident, you are likely going to have to deal with an insurance company.

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