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Kransky v. DePuy Trial – Day Twenty February 26, 2013

The Kransky trial continued on February 26, 2013 with the resumed testimony of the Defendants’ infectious disease expert, Dr. Ballon-Landa.  Mr. Calfo continued the direct examination and Mr. Kelly cross-examined the doctor.

-On cross-examination, Mr. Kelly dissected Dr. Ballon-Landa’s testimony that Mr. Kransky’s hip was infected, which caused the pain and was the reason why it was ultimately removed.  Mr. Kelly asked the doctor if the statement “A hematoma can be infected when the hip itself is not,” was a true and accurate statement.  Dr. Ballon-Landa agreed it was.  He also admitted that Dr. Hansen in fact believed Mr. Kransky’s hematoma, not hip, was infected.

-Dr. Ballon-Landa then admitted that while its extremely important to note any significant findings in medical records, none of Mr. Kransky’s medical records ever stated he had an infected prosthesis.  None of Mr. Kransky’s doctors noted that they believed his hip was infected.

-Mr. Kelly then walked Dr. Ballon-Landa through the testimony of Dr. Hansen.  Dr. Hansen performed the process of differential diagnosis where the doctor looks at the patient and essentially goes through a mental checklist based on education, skill, and experience to form a medical opinion.  Dr. Ballon-Landa admitted that he believed Dr. Hansen to be both caring and competent, and that Dr. Ballon-Landa himself was never called into an operating room to assist in diagnosing an infection in hips.

-Dr. Ballon-Landa also  conceded that Mr. Kransky’s portacath was more likely to become infected than his artificial hip, and that the portacath in fact never became infected.

-Mr. Kelly discussed the fact that in November of 2012 there were case studies of individuals with metal hip implants and these findings stated “the clinical picture seen with metal hypersensitivity is not dissimilar to that of a hip infection.”  This means that in some patients who have had a reaction to the metals in the hip implant, such as cobalt and chromium, their reactions can mimic that of an infected hip.

-Defendants next called to the stand Dr. John Cuckler, an orthopedic surgeon who specializes in hip and knee replacement. Dr. Cuckler was involved in the design of another large head metal-on-metal device and testified that all metal devices release metal ions.  He further testified that at this time there is no data indicating adverse systemic effects from exposure to metal ions.

-Dr. Cuckler also testified regarding the wear testing DePuy performed with respect to the ASR.  He believed it was reasonable and that the device itself is not defective.

-Cross-examination of Dr. Cuckler by Plaintiff’s attorney is to take place tomorrow.  Closing arguments by both sides are expected to begin on Thursday.

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