Knox judge refuses to dismiss opioid lawsuit

Knoxville News Sentinel USA TODAY NETWORK - TENNESSEE

A Knox County judge is refusing to dismiss a lawsuit filed on behalf of Tennessee taxpayers against the makers of the most widely abused form of opioid on the market.

Knox County Circuit Judge Kristi Davis has rejected a bid by Purdue Pharma, the makers of OxyContin, to dismiss a lawsuit filed last year by Tennessee Attorney General Herbert Slatery III on behalf of taxpayers that lays blame for the state’s opioid epidemic at the drugmaker’s doorstep. Purdue had insisted the state had no right to blame Big Pharma for the opioid epidemic. The family-owned firm that has made millions from Oxy-Contin — the most widely abused drug on the market — says the drug has been approved by the Food and Drug Administration, and Purdue has complied with FDA labeling requirements.

Purdue blames opioid addicts and over-prescribing doctors for the epidemic, not its drug.

But Davis ruled the state isn’t suing Purdue for labeling and selling the drug as authorized by the FDA.

Judge: It’s the lies, not the labels

Instead, she wrote, the state alleges Purdue’s sales representatives lied about the drug’s addictive properties and approved uses, targeted undertrained and overworked doctors in a push to increase prescriptions and even provided pill mill customers coupons for the drug.

“Synthesized, Purdue’s argument is that the FDA … controls prescription medication warning labels; that Purdue’s labels complied with the (FDA) requirements; and that the state is seeking to impose state law liability on Purdue when federal law controls,” Davis wrote.

“The court finds that Purdue’s argument is based upon a mischaracterization of the state’s complaint, which is not grounded in the content of the medication labels but rather the conduct of Purdue and its pharmaceutical sales representatives,” she continued.

Slatery praised Davis’ ruling in a statement released Wednesday.

“Needless to say, we are pleased with the ruling,” Slatery said. “Our office filed the complaint after an extensive investigation into Purdue’s highly aggressive marketing practices and other unlawful conduct.

“We continue to believe Purdue’s conduct has been unconscionable and that the company helped cause one of the most devastating public heath crises in Tennessee’s history,” he said. “We intend to hold Purdue accountable as we move forward with the litigation.”

A Purdue representative was not immediately available for comment.

Purdue accused of deceit, trickery

Slatery’s office filed the lawsuit last year. Purdue tried to bar citizens from seeing it, but USA TODAY NETWORK Tennessee successfully intervened to make it public.

The lawsuit uses Purdue’s own company records and its staffers’ own words to show the firm’s founders and executives pushed medical providers to prescribe increasingly high doses of Oxy-Contin for longer periods — even after Purdue promised the state it would stop.

It lays bare a marketing campaign that was highly regimented and highly profitable, built upon a foundation of lies and trickery, and specifically targeted Tennessee’s most vulnerable medical providers and patients, including the elderly and veterans.

At the same time, records show, Purdue staffers were lying to medical providers, and corporate executives and even family members of company founders were using OxyContin profits to pay doctors to give lectures, intentionally lying about the opioid’s dangers and addictive properties.

One of those doctors coined the “pseudoaddiction” phrase that became widely accepted as truth in Tennessee and elsewhere, the records showed.

The firm funded the creation of advocacy groups with names such as the American Pain Society and American Pain Foundation, and pamphlets, videos and social media campaigns to convince Tennesseans that OxyContin was a wonder drug — even as the number of fatal overdoses tied to it began to skyrocket.

The FDA, a USA TODAY NETWORK Tennessee investigation showed, relied upon the claimed expertise of the American Pain Society in turning aside a request by doctors to limit the use of Oxy- Contin to the gravely ill and victims of major trauma.

The firm specifically targeted veterans with a web campaign titled “Exit Wounds” and called OxyContin the “gold standard” for pain treatment, the lawsuit alleges.

Lawsuit: Purdue targeted pill mills

The lawsuit reveals Purdue’s sales staffers were instructed to ignore police warnings, indictments and overdose deaths involving Tennessee medical providers and to continue to call on them to hand out high-dose OxyContin — the firm’s most profitable brand — so long as they still had prescription pads.

The lawsuit and Purdue’s internal records link the firm’s sales staffers to some of Tennessee’s most notorious pill mill doctors, including one of the largest such operations in East Tennessee.

Purdue staffers called one medical provider, who is not identified in the lawsuit, 48 times — after law enforcement told the firm the provider had prescribed fatal doses of OxyContin and was running a cash-for-pills clinic.

Sales staffers also were ordered to fend off resistance from medical providers leery of prescribing OxyContin, call notes showed.

The lawsuit spans 272 pages and includes a slew of internal records from Purdue.

Lawsuits are being filed against Purdue and other Big Pharma drugmakers and distributors across the country and in smaller communities, including several in East Tennessee.

But Tennessee’s lawsuit appears to be the first that cites internal records from Purdue.

Tennessee is one of the hardest-hit states in the nation’s opioid epidemic, and one of Purdue’s most profitable.

Tennessee already had sued Purdue a decade ago for failing to police its sales force. Purdue promised to create a program to ensure OxyContin prescriptions went down and over-prescribing medical providers were reported to authorities.

As part of that settlement, Purdue was required to turn over internal documents to the Tennessee attorney general.

The current lawsuit alleges Purdue did nothing to curb the opioid epidemic and, in fact, only grew more aggressive in its marketing tactics.

Purdue Pharma has sold more than $27 billion worth of the powerful painkiller OxyContin since its introduction in 1996. LIZ O. BAYLEN/LOS ANGELES TIMES/MCT

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