As the first trial for Johnson & Johnson’s DePuy ASR continues, the company can no longer hide the fact that they were well aware of the risks and issues with their metal-on-metal hip implant devices as early as 2007, three years before DePuy issued a recall for its ASR XL total hip arthroplasty (THA) product. One particularly damning piece of evidence appeared in the form of a PowerPoint presentation that was previously presented at a company conference in Chicago in which the manufacturer explicitly stated that the metal-on-metal public backlash was a “threat” to the company.

The evidence appeared today in the on-going California trial, which is the first to take place against the DePuy ASR XL metal-on-metal hip implant. Loren Kransky’s trial was expedited and allowed to proceed because the Plaintiff is currently dying of cancer. The PowerPoint was offered as evidence today, as Randy Kilburn, world-wide VP of Marketing for DePuy took the stand in the California case for Kransky v. DePuy Orthopaedics. Kransky, a 65 year-old retired prison guard, had the ASR XL device implanted in 2007 and then revised 5 years later due to his elevated levels of metal ions (Cobalt and Chromium). According to Kransky’s surgeon, Dr. Trotsky, the device had to be removed despite the fact that he felt his patient might not live through the surgery. He stated, “I was convinced Mr. Kransky would die from toxicity if the hip weren’t removed.”

Even if DePuy executives had wished to continue to feign ignorance about the dangers of their ASR hip implant, this document blows that defense right out of the water. The presentation could not have stated more clearly that DePuy was aware of the issues with metal ions. The PowerPoint presentation was delivered to a meeting of DePuy’s world-wide hip business team in 2007, which was attended by many of the top DePuy executives, including VP of Marketing, Randy Kilburn. On a slide entitled “Threats” is listed “MoM backlash,” “Metal ions,” and “Negative publications on metal ions.” Another slide with the title “What’s around the corner?” states “We are getting deeper into MoM – high complications are shown.” The next slide , “What scares us the most in the year ahead?” lists “Metal ion backlash,” again in the number-one spot.

Finally, from this document, we can see just why DePuy did not remove their ASR XL hip implant from the market until August of 2010. It is touted as the “Key growth driver today and into the future,” and as the device with the highest sales price of any other DePuy hip implant product. Randy Kilburn also testified today that the ASR was DePuy’s top-selling product. The problem with large corporations like DePuy is that they have been allowed to get away with putting profit over safety, and the ones who are made to suffer for it are the average consumers like Kransky, and thousands of hip implant recipients world-wide, who will now have to live the rest of their lives with the debilitating effects of having been implanted with a faulty and dangerous product.

Alisha Mims is a writer and contributor to Ring of Fire.