On Dec. 5, 2007, plaintiff Loren Kransky, 60, underwent a left hip replacement operation, performed by Dr. Peter Wendt, at Fort Harrison VA Medical Center in Montana. Wendt implanted a DePuy ASR model artificial hip implant, manufactured and sold by DePuy Orthopaedics Inc., a subsidiary of Johnson & Johnson Inc. Kransky claimed that beginning in 2009, he started feeling pain and experiencing limitations in his left hip. He alleged these symptoms were caused by the ASR implant shedding excessive metal debris and metal ions into his hip joint. As a result, he underwent tests that showed the level of metal ions in his blood were 50 to 100 times normal. In August 2010, DePuy announced that it was recalling the ASR implant because new data had come to the company’s attention that showed a higher than expected rate of failure (defined as a surgery to replace the ASR with a new implant). On Feb. 12, 2012, Kransky underwent an operation in Montana, during which Dr. Jeffrey Hansen removed the ASR and replaced it with a different model hip implant. Kransky subsequently made a full recovery from that procedure in about four months. Kransky sued DePuy Inc.; DePuy Orthopaedics Inc.; Johnson & Johnson Inc.; and Johnson & Johnson Services Inc.; as well as those also involved in the design and sale of the ASR implant, Thomas Schmalzried M.D., SPG Medical Inc., Thomas Vail M.D., and Vail Consulting LLC. (Sandra Ellis was also originally named as a plaintiff, also making a claim about ASR device, but she was severed from the case early on. Thus, the matter proceeded on Kransky’s claims only.) Schmalzried’s residency in California allowed Kransky, a Montana resident, to file his lawsuit in Los Angeles County Superior Court. The lawsuit was then added to the coordinated proceedings (DePuy ASR Hip System Cases, JCCP No. 4649) assigned to San Francisco Superior Court Judge Richard Kramer. (Approximately 2,500 other DePuy ASR cases are pending before Judge Kramer. Also, at least 8,000 similar DePuy ASR cases are pending in other jurisdictions, including about 7,000 assigned to the federal Multi-District Litigation, over which United States District Judge Richard Katz (Ohio) is presiding.) However, Kransky suffers from unrelated, advanced-stage kidney cancer. As a result, he requested a trial preference under C.C.P. § 36. Kramer granted the preference motion over DePuy’s opposition and sent the case to the Los Angeles Superior Court for trial. Thus, the Kransky lawsuit was the first DePuy ASR case in the nation to go to trial. Prior to trial, DePuy moved for summary adjudication of several of Kransky’s claims. Kramer granted the motion in part, dismissing a consumer claim and a claim for negligent failure to recall, and denied it in part. In doing so, he held that Montana law governed Kransky’s claims. (Kransky initially argued for the law of either Montana or California, while DePuy argued that the law of North Dakota, Indiana or New Jersey applied.) In addition, Kransky dismissed all defendants except for DePuy. He asserted three theories of liability at trial: strict liability for a product defect; failure to warn surgeons of the ASR’s risks; and negligence. At trial, Kransky’s counsel contended that the ASR was defective because its groove, and other unproven and unique design features, caused it to shed excessive amounts of metal debris and metal ions. Counsel also contended that the defect was evidenced by the fact that some centers and regulators have reported that more than 40 percent of patients with the ASR implant needed to undergo device replacement operations within seven years or less of their initial surgery, compared to five percent or less for other hip implants. Kransky’s counsel cited DePuy’s confidential internal analysis, which projected that 37 percent of ASR patients will need a follow up operation within 4.5 years. Counsel also introduced into evidence a document, signed by DePuy’s president and other executives, which stated that the ASR was a “defective product that would affect product performance and/or could cause health problems.” In addition, Kransky’s counsel contended that DePuy failed to warn Kransky’s surgeon of the model’s unique risks. Thus, counsel argued that DePuy was negligent in the design and marketing of the ASR, and that DePuy’s executives knew that the ASR was unreasonably dangerous before the date of his initial operation, but kept this information secret from doctors. DePuy contended that the ASR was not defective, that it had properly warned Kransky’s surgeon of the ASR’s risks, and that it was not negligent. It also contended that it had carefully designed and thoroughly tested the ASR before it was sold, and that it acted responsibly at all times, including when it voluntarily recalled the ASR from the market. DePuy’s counsel attributed the ASR’s high failure rates, reported by some regulators and centers, to publicity surrounding the recall, including intense lawyer advertising. Counsel also argued that Wendt implanted the ASR cup in Kransky’s pelvis at an angle steeper than recommended and that this caused it to wear at a higher rate. DePuy’s counsel further argued that Kransky’s gait mechanics contributed to the high wear, and that an infection, not metal debris, was the reason Kransky experienced pain and needed to undergo a second operation., Kransky claimed that the defective ASR implant caused constant hip pain, difficulty in walking, elevated and potentially toxic levels of metal ion in his blood, and damage to his hip joint. He claimed the issues led him to undergo a second surgery to remove the ASR implant and replace it with another model. Kransky claimed he developed a hematoma after the second surgery, which had to be removed surgically. He also claimed he spent several months recuperating in a nursing home following these procedures. Thus, Kransky’s counsel asked the jury to award Kransky $338,116 in damages for his medical costs, and $5 million in damages for his pain and suffering. Counsel also asked that the jury to award Kransky up to $179 million in punitive and exemplary damages. Kransky did not make a lost earnings claim, and his wife, Sheryl Kransky, dropped her loss of consortium claim prior to trial. DePuy’s counsel argued that the need to replace Mr. Kransky’s ASR implant was due to Wendt implanting the ASR cup in Mr. Kransky’s pelvis at an angle steeper than recommended, causing it to wear at a higher rate. Counsel also argued that Mr. Kransky’s gait mechanics contributed to the high wear, and that an infection, not metal debris, was the reason Mr. Kransky experienced pain and needed to undergo a second operation. In addition, DePuy’s counsel argued that Mr. Kransky’s long history of smoking, his exposure to Agent Orange during the Vietnam War, and his unrelated, but serious, health problems contributed to his complaints and symptoms. Thus, DePuy’s counsel asked the jury to return a defense verdict and award no damages.