J&J Bankruptcy

Bankruptcy: The BEST Way To Address Mass-Tort Claims Against Johnson & Johnson (In re LTL)

 

https://tinyurl.com/bdfp2tde

         Plaintiff lawyers acting for women in class actions against Johnson & Johnson (J&J) have a significant conflict of interest. The actions are based on the disputed fact that ovarian cancer may follow the use of baby powder to the perineum. J&J face an estimated 40,000 claims for compensation with the result being an unstructured bankruptcy should all the claims proceed.

         In response J&J have sought chapter 11-bankruptcy protection in New Jersey, the state friendliest to big business. This attempt by J&J to isolate the damage from the litigation has been portrayed as a cynical attempt to deny sick women of their rights. The new entity; Long Term Liability LLC (LTL) has been granted protection by the bankruptcy court and the reasons are illustrative.

         The bankruptcy court lists it’s reasons for the decision as being based on the principles of fairness. There is they say no attempt by J&J to hide assets or deny liability. Obviously there is only a certain amount available for the women and management through the bankruptcy court ensures equal distribution. Lawyer’s fees are controlled; hence the protest, and the company’s employees are also protected. The decision will go to appeal but this seems the only way forward.

Cost-benefit surgery

The effect of major postoperative complications on recurrence and long-term survival after cytoreductive surgery for ovarian cancer

https://tinyurl.com/ytnpprur

 

         Surgery is always an end result of a cost-benefit decision. Will the patient be better or worse after the procedure? This retrospective study looks at the effect on survival for 549 women with ovarian cancer after major postoperative complications.

         Recently surgery for ovarian cancer is becoming more aggressive with extended complete resection frequently involving peritoneum and bowel. This debulking surgery may be performed immediately on presentation (PDS), or delayed for either 3 cycles of chemo (IDS), or 6 cycles of chemo (DDS). Patients who have (PDS) are twice as likely to have postoperative complications than those who have DDS.

         Postoperative complications have a significant impact on survival. For women who did not have adverse effect following surgery the PFS (Progression Free Survival) and OS (Overall Survival) are 20, and 56 months respectively. Those women who do experience complications have a PFS of 17, and OS, 48 months. Any process of informed consent needs to include details of possible complications.

Is traceback worthwhile?

Hospital-based ovarian cancer patient traceback program results in minimal genetic testing uptake

https://tinyurl.com/2ywc9r95

 

         Well-meaning actions may sometimes prove to be pointless. One such seems to be traceback for ovarian cancer patients. Traceback, a term first described in 2017 by the National Cancer Institute refers to the attempt to contact survivors and the families of ovarian cancer patients with the intent of performing genetic screening.

         This study looked at 598 instances where traceback was attempted for women who had ovarian cancer during the period 2006 -16.  Of these women 163 were thought to be survivors and for the rest an attempt to contact family was done.

         Results from this group showed only 14 (3%) made appointments for genetic screening. Less than 25% of contacts to family were successful, with many contacts seemingly causing distress due to anxiety or confusion. Best responses were with daughters of women affected. It seems that traceback is not an effective use of scarce resources

More BRCA

Expansion of Cancer Risk Profile for BRCA1 and BRCA2 Pathogenic Variants

https://tinyurl.com/4jjhnfj8

 

         Discovery of the genetic basis for the hereditary breast and ovarian cancer syndrome has led to great advances in treatment options together with possible risk reduction intervention. Mutation of the BRCA1/2 gene causes defective DNA repair, which increases the risk of these two cancers.

         Now with the availability of genetic profiling for many cancer patients it is possible to determine the extent of the BRCA1/2 mutation for patients who have other cancers. In a retrospective review of more than 63000 cancer patients compared to more than 37000 patients without cancer the impact of the BRCA mutation on many different cancers can be measured.

         It was already known that having the BRCA mutation increases the risk of developing cancer of the breast, ovary, prostate and pancreas. Data from this survey show additional increased likelihood of stomach, biliary and oesophageal cancer. This information needs to be included in the genetic counselling of patients found to be BRCA positive.