| The 22-year history of breast implant | | | | June, 1994: Mayo Clinic epidemiologists published a |
| litigation provides us with a most important lesson. | | | | report in the New England Journal of Medicine which |
| Specifically, scientific study must preceed commerce | | | | finds no increased risk of connective tissue disease in |
| and marketing. Even if the scientific data is provided | | | | women with silicone breast implants. 1995: The |
| “after the fact”, it does not stop a legal | | | | American College of Rheumatology issued a |
| disaster from unfolding. The lack of this data in the | | | | statement that the evidence is “compelling” |
| 1990s led to a 14-year ban on silicone gel implants, | | | | that implants do not cause systemic disease. May, |
| billions spent in two class action suits, over 20,000 | | | | 1995: Dow Corning filed for Chapter 11 Bankruptcy, |
| individual lawsuits, and the temporary collapse of an | | | | with over 20,000 individual lawsuits pending. Over |
| entire industry. The following attempts to | | | | 410,000 have filed claims in the class action |
| summarize this story: 1977: A Houston attorney | | | | settlement. The bankruptcy essentially halted all |
| won the first breast implant lawsuit for a Cleveland | | | | litigation. November, 1995: A new global |
| woman who claimed her implants had caused pain | | | | settlement was developed without Dow Corning. |
| and suffering. She received a $170,000 settlement | | | | December, 1995: More than 20 scientific studies and |
| from Dow Corning and the case received little | | | | abstracts have been published showing no causal |
| publicity. 1980s: Raph Nader’s Public Citizen | | | | relationship between silicone implants and a variety of |
| Research Group sent out warnings that silicone | | | | auto-immune diseases. September, 1996: The |
| breast implants cause cancer. 1984: A California | | | | California Court of Appeals upheld a decision |
| attorney won a case for Maria Stern who claimed | | | | dismissing Dow Corning from 1,800 lawsuits. |
| that her autoimmune disease was caused by her | | | | December, 1996: An Oregon Federal Judge ruled |
| breast implants. Evidence was introduced from Dow | | | | that plaintiff’s lawyers cannot present evidence |
| Corning’s own internal documents that they had | | | | that silicone implants caused disease because it is |
| been aware of high rupture rates and gel bleed with | | | | scientifically invalid. Seventy claims were dismissed. |
| the 2nd generation implants. “Expert | | | | January, 1997: The American Academy of |
| witnesses” theorized the silicone–immune link | | | | Neurology reviewed existing studies and reported |
| for the first time. The San Francisco court awarded | | | | that there is no link between silicone breast implants |
| $211,000 in compensatory damages and $1.5 million in | | | | and neurological disease. March, 1997: A Michigan |
| punitive damages. 1990: A television program, | | | | Judge ruled that Dow Corning is not liable for |
| “Face to Face with Connie Chung” aired, | | | | hundreds of women in the state. September, 1997: |
| discussing the dangers of silicone gel filled breast | | | | The Journal of the National Cancer Institute |
| implants. Public concern mounted, and a | | | | published a review of scores of medical studies that |
| Congressional hearing was held on the safety of | | | | concludes breast implants do not cause breast |
| breast implants. July, 1991: Dow Corning | | | | cancer. The researchers described the evidence for |
| released 329 studies to the FDA. In a separate | | | | linking implants to any other disease as "borderline." |
| lawsuit against Baxter/Heyer-Schulte, an Alabama | | | | April, 1998: Two large scientific studies failed to |
| court awarded a $5.4 million settlement to Brenda | | | | show that silicone implants are linked to neurological |
| Toole, who showed only preliminary symptoms of | | | | disease. December, 1998: After two years and |
| systemic autoimmune disease, but had silicone in her | | | | $800,000, a panel of four independent experts |
| lymph nodes. “Expert witnesses” stated | | | | appointed by Judge Sam C. Pointer, overseer of |
| that she was thus at increased risk of developing | | | | implant lawsuits in the Federal courts, concluded that |
| autoimmune disease. December, 1991: Attorney | | | | scientific evidence so far has failed to show that |
| Dan Bolton, who won the case for Maria Stern, won | | | | silicone breast implants cause disease. June, 1999: |
| another case for Mariann Hopkins who claimed that | | | | The Institute of Medicine released a 400-page |
| her mixed connective tissue disease was linked to | | | | report prepared by an independent committee of 13 |
| her ruptured silicone breast implants. February, | | | | scientists. They concluded that although silicone |
| 1992: A class action lawsuit was filed in Cincinnati by | | | | breast implants may be responsible for localized |
| Stan Chesley. The hope was to compensate | | | | problems such as hardening or scarring of breast |
| women at a faster rate than filing individual lawsuits. | | | | tissue, implants do not cause any major diseases |
| The FDA Panel recommended that the further use | | | | such as lupus or rheumatoid arthritis. The Institute |
| of silicone implants be limited for reconstruction only. | | | | of Medicine is part of the National Academy of |
| The panel also concluded that no causal link has yet | | | | Sciences, the nation's most prestigious scientific |
| been established between autoimmune disease and | | | | organization. Congress had asked the Institute to |
| silicone breast implants. March, 1992: Dow Corning, | | | | set up the committee. August, 2004: August |
| Bristol-Myers Squibb and Bioplasty all left the breast | | | | of 2004 was the deadline for registering for the |
| implant business. Dow Corning set up a fund for | | | | re-negotiated global settlement with Dow Corning, |
| further research into the safety of breast implants. | | | | which they established after coming out of chapter |
| April, 1992: The FDA placed a ban on the use of | | | | 13 bankruptcy. By this time, most all individual |
| silicone breast implants outside of an FDA-approved | | | | lawsuits against Dow Corning had been thrown out or |
| research study. The only women allowed to receive | | | | dropped. The breast implant litigation era ended |
| implants were those undergoing breast | | | | with little media fanfare. November, 2006: The |
| reconstruction. All of the implant recipients must | | | | FDA lifted the ban on silicone gel filled implants, 14½ |
| become part of a scientific protocol. March, 1994: | | | | years later. By now, silicone implants sold are |
| A class action lawsuit was finalized by the | | | | “4th generation” implants which are much |
| manufacturers, including Dow Corning, Baxter, | | | | improved over the “2nd generation” implants |
| Bristol-Meyers Squibb/MEC, and 3M. At $3.4 billion, it | | | | with the thin walls and high “gel bleed” that |
| was then the largest class action lawsuit in history. | | | | led to all the media attention. The further improved |
| Women would be allowed to drop out of the | | | | “5th generation” implants are still not FDA |
| settlement if they choose. Companies could also | | | | approved, but are available in other countries. |
| “opt out” if too few women register claims. | | | | |