-
- Document #201
- 08/12/75
-
- KNOWLEDGE OF GEL BLEED
- MISCELLANEOUS - COMPLICATIONS
- TISSUE REACTION
-
- Dr. Upton (Cronin”s associate)
letter to Rathjen regarding capsular contracture.
Dr. Wilflingseder and Dr. Laub have been able to
demonstrate small particles of free silicone inciting inflammatory
reactions in adjacent soft tissue. They have noted the same
phenomenon. “Although the etiology of the problem is
multifaceted, I am sure, we still wonder if the surface of the
silicone polymer plays a significant role.”
CITE: DCD 173003034, Exhibit 27 to MDL Rathjen Deposition (used by
plaintiffsand Dow Corning), Exhibit 120 to Harris County Rathjen
Deposition. DUPLICATE: M190146. Dow Corning Trial Exhibit List
Abstracts
PENDLETON/PSC Attorney Work Product/Privileged & Confidential
-
-
- -----------------------
-
- Document #202
- 08/28/75
-
- TESTING
-
- Tony Abbott, Dow Corning, memo to
Bey and numerous other employees regarding “Mammary Gel
Biocompatability.” Abbott states that he now has a test
procedure (Tissue Cell Culture) for evaluating biocompatability of
products on a lot to lot basis. Each lot of mammary gel consists
of several drums of materials. “Test results show that there is
a difference in the biocompatability of the gel on a drum to drum
basis.” Abbott also recommends a permanent solution to the
problem with the butyl carbitol acetate solvent as a catalyst. Wil
Larson is working on this.
-
- CITE M 170101 - 170103. Dow Corning
Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
-
- -----------------------
-
-
- 09/03/75
- (NOT LISTED ON PLAINTIFF’S EXHIBIT
LIST)
- (this document is between #202 &
#203)
-
- Memo from Art Rathjen, Dow Corning,
to Drs. Anderson, Ashley, Barrett, Blocksma, Dingman, Dufourmoutel,
Edgerton, Epstein, Giannestine, Goulian, Murray, Orentreich, Rees,
Smith, Stark and Vinnik regarding “News Release - Silicone Fluid
Injection.” “Because of legal complications, any inquiries
from the media should be referred to Silas Braley or Joseph
Radzius at Dow Corning.” Rathjen encloses a Dow Corning news
release stating that it has filed a New Drug Application with the
FDA requesting approval to market silicone fluid for injections.
-
- CITE: M 350161 - 350163, Exhibit 29
to Harris County Rathjen Deposition. Dow
- Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
-
- -----------------------
-
- Document #203
- 09/10/75
-
- KNOWLEDGE OF LIQUID SILICONE DANGERS
-
- Silas Braley, Dow Corning,
Summarizes a phone call with Dr. Charles Vinnik in response to the
press release. Braley states that Dr. Vinnik: “wanted
to know what we were doing about preventing this use so that all
of the incapable people don’t get a hold of it for this kind of
use.... He said that the Moss subcommittee in Congress is all
poised waiting for Vinnick’s (sic) statement to jump on an
investigation of the silicone fluid injection story. He has been
keeping a lid on this all along.... He said he felt that the
information we have had given to us by the investigators is
faulty. That his information is much greater and much better and
shows that volumes of silicones under high pressure can cause all
kinds of things that we do not have in our study. He said that the
longest we had was four years in monkeys and even that showed fat
necrosis. He explained fat necrosis as being identical with the
situations he has seen in the patients that he has treated in Lass
Vegas. (emphasis
added).
-
- CITE: DCC 240000054. DUPLICATE: KKM
3364. Dow Corning Trial Exhibit ListAbstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
-
- -----------------------
- Document #204
- 09/29/75
-
- MISCELLANEOUS - COMPLICATIONS
- SILICA
- TISSUE REACTION
-
- Letter to Rathjen from Dr. Laud
regarding Dr. Wilflingseder’s discovery, and publication, of
silicon dioxide (silica) in breast capsule specimens and “I was
able to tell him what I had learned at Dow Corning.”
- CITE KMM 29957. Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
-
- -----------------------
-
- Document #205
- 10/06/75
-
- TESTING
-
- Abbott, Dow Corning, reports on
“biocompatibility Evaluation Of Mammary Gel.” “The problem
with biocompatibility is the butyl carbitol acetate solvent in the
catalyst.... There are localized high concentrations of BDA in the
gel. Evaluation of
the compatibility of the solvent with the gel has shown that BCA
does not mix in the formulation at a very desirable rate.” Also,
“Visual observations of uncured gel shows the presence of
globules or highly contracted pockets of the solvent.... The
permanent solution to the problem involves the replacement of the
present solvent with a different solvent or a different catalyst
system.”
- CITE: KMM 39105 - 39121. Dow Corning
Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
-
- -----------------------
-
- Document #206
- 10/30/75
-
- COHESIVENESS - LIQUID COMPONENT OF
GEL
- GEL MIGRATION
- KNOWLEDGE OF SYSTEMIC DISEASE
- TESTING
-
- Dow Corning Bioscience Research
Report No. 4509 by Lake and Radonovich entitled “Action of
Polydimethylsiloxanes on the Reticuloendothelial System of Mice:
-
- Basic Cellular Interactions and
Structure Activity.” The abstract for this report states that:
- “Because of their hydrophobic
character, dimethylpolysiloxanes of various viscosities are known
to distribute to the reticuloendothelial system (RES) in
association with phagocytes. The site, magnitude, specificity and
time course of murine RES response to high doses of various
dimethylpolysiloxane fluids has been studied to characterize the
basic cellular interaction and immunological consequences of
dimethylsiloxane administration. Type I interferon production and
clearance of colloidal carbon were used to assess RES function.
Linear 3,4 and cyclic 4,5 dimethylpolysiloxanes when given
parenterally to mice caused a transient response in
lymphoreticular tissues with a maximum at 48 hours. This response
was found to involve phagocytic cells (macrophages) such that
augmented amounts of Type I endotoxin-induced interferon are made.
Carbon clearance by the RES is also depressed with the same time
course as this hyper-reactivity to interferon induction.
Hexamethyldisiloxane and dimethysiloxanes greater than 5 siloxy
units do not cause these changes, but do cause a characteristic
eosinophilia at an intraperitoneal inoculation site.
-
- A consistent hypothesis for this
observed increase in early interferon production is that
dimethylsiloxanes in the 305 size range are sub-lethally surface
active in macrophages of the RES. Like lead acetate and mineral
oil-surfactant mixtures, which are known to augment early
interferon production, low molecular weight dimethylsiloxanes
decrease the phagocytic capacity of macrophages. Because endotoxin
is not cleared (phagocytosed) or detoxified, the viable but
phagocytically impaired macrophages undergo a prolonged and more
complete interaction with endotoxin. (OOT 42327)”
-
- CITE: OOT 42325 - 42352, Exhibit 1
to Radonovich Deposition (abstract only), Exhibit 23 to Harris
County Hayes Deposition, Exhibit to Harris County Tyler
Deposition, Exhibit 11 to Zimmer Deposition, Exhibit to Lake
Deposition, Exhibit to Isquith Deposition, and Exhibit 23 to
Harris County Rich Deposition.
- DUPLICATE: DCC 281001636 -
281001662; DCC 281061445 - 281061450. WITNESS:
- Radonovich. DISPOSITION:
Admitted in Toole (II) v. Baxter Healthcare. Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #207
- 11/03/75
-
- MISCELLANEOUS - COMPLICATIONS
- TISSUE REACTION
-
- Letter to Rathjen from Dr. Laub
regarding the Toronto meeting. “Dr. Bob Briggs from New Jersey
has seen several patients from the original study (mostly
Orentreich patients) who have had intractable swelling. ... This
case is similar to the ones reported at a meeting in Mexico City
several years ago by physicians from Buenos Aires. ... I have
followed patients myself in this are ‘suffering’ from the same
condition. ...”
-
- CITE: KKM 31788, Exhibit to MDL
Rathjen Deposition. Dow Corning Trial Exhibit List Abstracts
PENDLETON/PSC Attorney Work Product/Privileged & Confidential
-
- -----------------------
-
- Document (no number) dated 11/7/75
(this document is between #207 & #208)
- 11/07/75
-
- (NOT LISTED ON PLAINTIFF’S EXHIBIT
LIST)
- Memo from Larson, Dow Corning, to
Talcott with copies to Bey, Rathjen, and Kelley regarding
“Capsule Formation & Mammary Implants.” Larson states that
Stark commented in a staff meeting that “implanted silica causes
the formation of a very heavy tough capsule.... Possibly we could
minimize capsule formation around the mammary prosthesis if they
were over coated with a pure silicone polymer.... These are the
basis for the concept that maybe some exposed silica on the very
surface of the envelope rubber can cause excessive capsule
formation and that this might be minimized if the capsule were
formed and interfaced against pure silicone polymer.” On M
190174 there is a handwritten note from Talcott to Ron Kelley:
“I’d like more proof of silica at interface causing
problems.”
-
- CITE: m 190174 - 190175. NOTE: M
190175 is a duplicate of M 190174 but it has different
marginalia on it. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #208
- 11/18/75
-
- MISCELLANEOUS - COMPLICATIONS
- MISCELLANEOUS - RECKLESS/CONSCIOUS
DISREGARD TESTING
-
- Memo to Boone, Leach, Meads,
Polmanteer & Talcott from Bey regarding capsule contracture
studies. “Our TS&D budget situation for 1976 is simply this,
we have considerably less discretionary spending money for 1976
than we had in 1975. I can’t see any way we can support these
proposals in 1976. I suggest we discourage the proposals as much
as possible....”
-
- CITE: M 190186, Exhibit to MDL
Rathjen Deposition. Dow Corning Trial ExhibitList Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #209
- 12/10/75
-
- KNOWLEDGE OF LIQUID SILICONE DANGERS
-
- Telephone call report by Silas
Braley regarding a call with Richard Samuels about a grand jury
investigation being done on Hal Ellison for doing injections of
silicone fluid. Ellison had been receiving Dow Corning fluid
through a company called Silaco. Braley states that, “I told Mr.
Samuels that we had been fighting, the breast injections since we
had heard about them and were trying to get the information across
to people. We find now that people are very confused about breast
injections vs. breast implants and I explained that the latter are
both ethical and legal and that the problems of injections do not
apply. I asked for his help in differentiating between these two
procedures so that those women who have had surgical augmentation
will not worry when they read about the horrors of injections.”
(emphasis added). The call report notes that additional phone
calls from Mr. Samuels occurred throughout the morning. Joe
Radzius, Dow Corning legal counsel, advised Braley that Dow
Corning’s position “from here on in” was “no comment.”
-
- CITE: KKM 3537 - 3538 Dow Corning
Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #210
- 12/12/75
-
- KNOWLEDGE OF GEL BLEED
-
- T. Talcott, Dow Corning, memo about
a telephone call from Dr. Frank Gerow. Gerow attended a meeting in
Phoenix recently and reported that “the general tone to him was
something is coming through the envelope to the tissue.” Gerow
concluded that Dow Corning needed a “100% tied up gel now.”
Talcott writes that he’s inclined to agree that something’s
coming through the envelope. “Could it be miscellaneous
contamination during our manufacturing process? Do we need an
audit of the process?’
-
- CITE: F 636, Exhibit to Frisch
Deposition, Exhibit to MDL Rathjen Deposition, and Exhibit 64 to
Harris County Rathjen Deposition. DUPLICATE: M 170143;
- M190203; FDA 32914; DCC 242031351 -
242031352. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #211
- 12/12/75
-
- TESTING
-
- Franklin and Annelin, Dow Corning,
report on “Subcutaneous Implants Of Developmental Prosthetic
Gels In Monkeys And Rats: Examination Of Tissue Deposition And
Urinary, Fecal, And Respiratory Elimination Routes.” “In the
rats, dosed with the new production gel, only the axillary lymph
showed an increase in total silicon; a similar increase in hexane
extractable silicon was not observed.: In the monkeys, “the low
cross-linker formulation moved along tissue planes and formed only
a very thin capsule.”
-
- CITE: KMM 140087 - 140104, Exhibit
to Frisch Deposition, Exhibit 42 to Hinsch Deposition (used by Dow
Corning), Exhibit to LeVier Deposition, Exhibit 45 to Harris
County Peters Deposition, Exhibit 115 to Harris County Rathjen
Deposition, Exhibit 88 to Harris County Talcott Deposition,
Exhibit 92 to Bennett Deposition (used by Dow Corning), Exhibit 15
to MDL Rathjen Deposition (used by Dow Corning), and Exhibit to
Isquith Deposition.
-
- DUPLICATE: P 17497 - 17515. Dow
Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #212
- 12/12/75
-
- SHELL STRENGTH - THICKNESS
- RUPTURE
- ACKNOWLEDGEMENT OF NEED FOR TESTING
-
- Rathjen, Dow Corning, memo to
various Dow employees regarding Breast Symposium in Phoenix,
Arizona on November 23-26, 1975. Reports that Dow has lost the
number one position as “the innovator.” He states:
- “Surgery was performed by members
of the faculty, put on tape, edited and viewed during the three
day course. Each manufacturer donated implants for this use.
Dr. Eugene Courtiss and Dr. Robert Winslow used our
prostheses. In both instances the doctors broke an implant during
their surgery. Fortunately these were edited from the tape; but
ours were the only ones to break, and they really let us know
about it. The Medical Products Business should consider a full
scale research program to fully evaluate the current status of our
gel (chemistry, toxicology) and to begin a concentrated program to
develop a dry gel (dry to touch, cohesive, non-adhesive with
absolutely no bleed). I would also like to see the development of
a radio-opaque envelope which would allow the examination of an
implant “in situ” if and when capsular contracture is
suspected. How contracture develops by observing an implant “in
situ” could contribute to a better design of an implant.
(emphasis added).
-
- CITE; M 190200 - 190202, Exhibit to
Mantle Deposition, Exhibit 80 to Harris County
Rathjen Deposition, and Exhibit to MDL Rathjen Deposition. Dow
Corning Trial Exhibit List
Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #213
- 00/00/76
-
- FRAUD/MISREPRESENTATION
-
- Dow Corning brochure, “Facts You
Should Know About Your New Look,” Which contains the following
question and answer: “How long will the implants last?
Based on laboratory findings and human experiences to date,
a gel-filled breast implant should last for a lifetime.”
(emphasis added).
- CITE: M 650012 - 650019, Exhibit to
Harris Country Jakubczak Deposition, 27 to Harris County Peters
Deposition (used by Dow Corning), Exhibit to MDL Rathjen
Deposition, and Exhibit 77 to Harris County Rathjen Deposition.
-
- NOTE: From 1963-73, Dow Corning only
“warned” of fluid accumulation and foreign body
reactions in its product inserts. From 10/74 - 09/76, Dow Corning
added to its product inserts
the following for the Silastic implant: capsular contracture/firmness,
pain or discomfort from surgery, ptotic breasts, additional
surgeries/implantations, and the risks associated with surgery.
See PSC World of Warnings for
Dow Corning and Dow Corning Wright. Dow Corning Trial Exhibit
List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
-
- -----------------------
-
- Document #214
- 01/07/76
-
- FRAUD/MISREPRESENTATION
- KNOWLEDGE OF LIQUID SILICONE DANGERS
- MISCELLANEOUS - COMPLICATIONS
- STERILIZATION/CONTAMINATION
- TISSUE REACTION
-
- Testimony of Joseph Radzius to the
California legislature regarding silicone injections. He states
that DC’s study “absolutely contraindicates injection of the
fluid in the mammary area.”
-
- CITE: M 350149 -350155, Exhibit 33
to Harris County Rathjen Deposition, and Exhibit
to MDL Rathjen Deposition, NOTE: The document also has the Bates
Numbers DCD 173002728
-173002734 on it. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #215
- 01/15/76
-
- SHELL STRENGTH - THICKNESS
-
- Tom Talcott memo to Kelley and
Rathjen, Dow Corning, discusses the recent Phoenix Breast
Symposium in which Dow Corning introduced its new mammary. During
the taped implantation surgery, two of Dow Corning’s implants
ruptured/broke. Talcott
expresses dismay that at Dow Corning the consensus was that the
envelope was “good enough” despite finding:“gross thin spots
and flaws in the form of significant bubbles.... The allowable
flaws are written into our current specifications.... When will we
learn at Dow Corning that making a product “just good enough’
almost always leads to products that are ‘not quite good
enough’? It is unfortunate that the thinner dispersion, four dip
method proved by Bartolo and Vallender in early 1974 appeared too
expensive to plant personnel to even try, although a much higher
acceptance rate would be obtained. I sincerely hope this
experience will convince us to support programs for ‘high
quality’ rather than ‘just enough quality’ in the future.
(emphasis added).
-
- CITE: F 534, Exhibit 65 to Harris
County Rathjen Deposition. Exhibit to MDL Rathjen
Deposition. DUPLICATE: DCC 8003157; M 600007; KMM 140185; KMM
380078. Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #216
- 01/22/76
-
- TESTING
-
- Dow Corning stated a Two-Year
Implant Study with Q7-2159A and MDF-0193 at Industrial Bio-Test
Laboratories (IBT).
-
- CITE: Referenced in KMM 390371.
NOTE: See 02/03/78 entry. Dow Corning Trial Exhibit List Abstracts
- PENDLTON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #217
- 01/23/76
-
- ACKNOWLEDGEMENT OF NEED FOR TESTING
-
- Art Rathjen, Dow Corning, memo to
numerous Dow Corning employees (Mammary Task Force) regarding “Research/Testing
- Mammary Gel/Envelope.” Rathjen states, “I have suggested
verbally and in writing that we better get going on a basic long
range project relative to gel, its formulation, toxicology, etc.
over and above what is now underway. The same goes for the
envelope. The complaint report from Dr. Horowitz Manchester,
Conn., is just one more flag.” (emphasis added).
-
- CITE: F 809, Exhibit to MDL Rathjen Deposition, and Exhibit
76 to Harris County Rathjen Deposition. DUPLICATE: M 170171: M
580066: KKA 152383: DCC 17016569: KKA88865: KMM 447050. Dow Corning
Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #218
- 02/16/76
-
- Rathjen, Dow Corning, memo to the
IND 2702 clinical investigators - Ashley, Blocksma, Dingman,
Edgerton, Goulian, Murray, Orentreich and Rees - regarding
“Proposed California Legislation To Control Injection Of
Silicone Fluid.” Dr. Ashley
disagrees with regulating injections and states that breast
injection should be a contraindication to the use of liquid
silicone.
-
- CITE: M 350147 - 350148, Exhibit 33
to Harris County Rathjen Deposition. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
-
- -----------------------
-
- Document #219
- 03/03/76
-
- TISSUE REACTION
- RUPTURE
-
- Dr. Terino presents a paper on
“Technique and Results of 50 Breast Capsule releases” at the
California Society of Plastic Surgeons. He reports a 36.5% rate of
contracture. Also, a Dow Corning implant was removed 10 years
post-op. “Upon opening the capsule bilaterally there was a thick
sticky layer of silicone outside the envelope. On taking the
implants out bilaterally there was no perforation from the
envelope whatsoever, but there was clearly silicone on the
outside. And pathology showed extensive foreign body giant cell
granulomas.”
-
- CITE: M 290302 - 290306.
-
- -----------------------
-
- Document 220
- 03/17/76
-
- TISSUE REACTION
- KNOWLEDGE OF GEL BLEED
-
- Art Rathjen, Dow Corning, memo to
numerous Dow Corning employees regarding a paper presented by Dr.
Edward Terino at the California Society of Plastic Surgeons on
03/03/76. The paper discussed a Dow Corning Silastic implant
removed 10 years post-op. Silicone was found on the outside of the
implant and “pathology showed extensive foreign body giant cell
granulomas.... This event, as described by Dr. Terino, cannot be
ignored. An attempt must be made to get an answer or explain this
phenomenon before the manuscript is submitted to the Journal for
publication. If we don’t, everyone of the 350 member audience,
the Journal readers, and the lawyers may interpret this as proof
that our gel causes problems.”
- CITE; F 833 - 834, Exhibit 36 to
California Braley Deposition, Exhibit 66 to Harris County Rathjen
Deposition, and Exhibit to MDL Rathjen Deposition.
-
- DUPLICATE: M 190247 - 190248; M
250038 - 250041; KMM242493 - 242494; DCC 240000437 - 240000438. See 03/03/76,
03/19/76 and 03/26/76 entries. The implants were from lot number H0209. Dow
Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #221
- 03/19/76
-
- KNOWLEDGE OF LIQUID SILICONE DANGERS
- CONCEALING FROM FDA
-
- Dow Corning’s New Drug Application
submitted pursuant to Section 505(b) of the FDA Act, for the
preparation Dymasyl (dimethylpolysiloxane) Fluid is not approved.
The FDA reviewed the application and found that the information
presented is inadequate. The application fails to report adequate
animal studies in support of the safety of the drug.
-
- Presently reported carcinogenic
studies in animals are inadequate to determine the carcinogenic
potential of dimethicone. It is recommended that new studies be
initiated in accordance with our current guidelines for testing of
products for carcinogenic potential.
-
- The FDA also found that Dow
Corning’s application failed to report the clinical studies in
full detail, that there was no long-term data or patient
follow-up, that manufacturing instructions are ambiguous, that
sterility tests were not submitted, and that information on
laboratory tests was not submitted. As a result of this, the FDA
has closed Dow Corning’s NDA file. The Director, J.
Richard Crout, states, “(T)he only potentially acceptable
indications for use of dimethicone, on a benefit/risk basis, are
for the major facial defects and severe acne scars. We regard the
benefit/risk ratio of dimethicone for minor cosmetic uses as
unacceptable.” (emphasis added).
-
- CITE: DCC 106006714 - 106006719,
Exhibit 29 to California Braley Deposition, and Exhibit to MDL Rathjen Deposition.
Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
-
- -----------------------
-
- Document #222
- 03/19/76
-
- ACKNOWLEDGEMENT OF NEED FOR TESTING
- GEL MIGRATION
- KNOWLEDGE OF GEL BLEED
-
- Art Rathjen, Dow Corning, reports on
the “backlash” from Dr. Terino’s paper to the California
Society of Plastic Surgeons. Dr. Barker approached Rathjen after
Dr. Terino’s presentation and stated he was also studying
capsular contracture. “He
(Dr. Baker) also subscribes to the possibility that the migration
of fluid or low moleculars through the envelope which causes the
greasy feel to the envelope may be contributing to the contracture....
Nevertheless, the question remains in his mind, as it does in a
number of other plastic surgeons around the country “Dr. Baker
wants to take Dow Corning’s Silastic implants in a centrifuge to
collect what is forced through the envelope. The quantity of what
comes through should then be implanted in animals in a very small
quantity to see what kind of tissue reaction develops. Rathjen
thinks that it would be in the best interest of Dow Corning if
they were to “take the initiative” and attempt to do something
of a similar basis first. He states in this internal memo: I think it would be embarrassing for
Dow Corning and for any of our research expertise if we find that
this type of testing has to be left to a doctor in this field. If
he were to come up with something detrimental, I think we ought to
be prepared for it. (emphasis added).
-
- CITE: M 160001 - 160002, Exhibit to
MDL Rathjen Deposition, Exhibit 67 to Harris County Rathjen Deposition.
DUPLICATE: M 190249 - 190250; DCC 17031054. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #223
- 03/19/76
-
- SILICA
-
- Hinsch, Dow Corning , memo to Criger,
Hoyt and Leach with copies to Bey, Petraitis, Larson and Rathjen)
regarding a conversation with Dr. William Jervis.
Dr. Jervis claims that “silica (a component of the bag
and gel of a mammary prosthesis) is an irritant. Tom also said
(according to the doctor) that the silica in the silicone can be
released from its entrapped state by over-curing and that the bag
of a gel implant was more over-cured than that of inflatables.
Tom admitted that some inflatables also probably had some
of this silica on them. Tom speculated to me later that a final
polymer coating might help retain the silica if that is in fact
what is happening.” (emphasis added).
-
- CITE: KMM 74769, Exhibit to Frisch
Deposition, Exhibit 49 to Hinsch Deposition (used by Dow Corning), and Exhibit
to MDL Rathjen Deposition. DUPLICATE: M 190251; KMM 120458. Dow Corning
Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #224
- 03/22/76
-
- KNOWLEDGE OF GEL BLEED
- GEL MIGRATION
-
- Handwritten note to Milt Hinsch from
Greg Bicket, both of Dow Corning, discussing the bleed question
and Dr. Terino’s presentation. Bicket notes that many persons
are asking questions about, “What is that stuff on the outside
of DC’s implant.... Do you want that bleeding into your
patient’s body ... will it cause capsule contracture. We say
they all do it; McGhan must be cleaning their implant very
carefully.” He lists 8 questions including whether the gel
migrates and, if so, to what parts of the body and with what
effects. Bicket feels “uncomfortable” since he can’t answer
all of the questions. He notes that McGhan is raising these
questions with doctors.
-
- CITE: M 160026 - 160027, Exhibit to
Petraitis Deposition, and Exhibit to MDL Rathjen Deposition. DUPLICATE: GEG
4026 - 4027; M 190255 - 190256, KMM 3831 - 3832. NOTE: This date is approximate
and is based on the date on the top of the page from the ASPRS meeting on
03/22/76. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #225
- 03/26/76
-
- KNOWLEDGE OF GEL BLEED
- FRAUD/MISREPRESENTATION
-
- Art Rathjen, Dow Corning, letter to
Dr. Terino with blind carbon copies to numerous Dow Corning
employees. Despite Rathjen’s knowledge that gel bleeds through
the envelope, Rathjen tells Dr. Terino that this is “physically
impossible” from a polymer chemistry standpoint. He attempts to
cast doubt on Dr. Terino’s claims that the substance on the
outside of the Dow Corning implant Dr. Terino examined was
silicone gel, particularly since the implant was not torn or
ruptured. Rathjen suggests that Terino shouldn’t publish his
paper stating, “I truly think it would be to the best interest
of all concerned if we try to get some answers before there is any
further dissemination of information which might be erroneous....(Rathjen)
would like to ... help solve the mystery, if that is possible,
before your presentation is submitted for publication.” He
requests that Dr. Terino send him any explanted Dow Corning
prostheses with “a strange color or a questionable envelope
surface or seem to have a change in the normal physical
qualities.”
-
- CITE; M 250018 - 250019, Exhibit to
MDL Rathjen Deposition, and Exhibit 68 to Harris Country Rathjen Deposition.
DUPLICATE; DCC 240000435 -240000436; M 570126 · 570127. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #226
- 03/31/76
-
- ACKNOWLEDGEMENT OF NEED FOR TESTING
- SHELL DEGRADATION
-
- Art Rathjen, Dow Corning, memo to
Overton, Bey, Bennett, Harlow, Hinsch, Lewis, Stark, and VerVoort
regarding “Your Request For Information, i.e., Radiation
Treatments Of The Breast Following Implantation - Dr. John
Lindsay.” He states: “I want to re-affirm again that
Dow Corning personnel cannot become involved in medical judgments
relative to patient care.... The following information is
conjecture. Depending on the amount of x-ray or gamma radiation,
one could expect the gel to stiffen with no major change to the
physical properties of the envelope. It can be suggested that some
chemical reaction might take place with the prosthesis, but we
absolutely do not know what affect such a reaction would have on
tissue or systemically. It is also an assumption that the implant
would act as a screen for the tissue against the posterior side of
the implant. Obviously,
the screening effect would be in relationship to the thickness
and/or density of the implant.... (In) no way do I agree that this
be used to endorse or suggest the safety and efficacy of radiation
therapy following augmentation using our SILASTIC Mammary
Prosthesis. (emphasis added)
-
- CITE: KMM 29699, Exhibit to MDL
Rathjen Deposition. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #227
- 04/00/76
-
- ACKNOWLEDGEMENT OF NEED FOR TESTING
-
- A study entitled “Mammary Capsular
Contraction (A Situation Analysis 1976)” by P.A. Walters of
Health & Human Services. Eldon Frisch, Dow Corning, receives
the report. Walters recommends the following:
- “Concentrate the initial research
effort in the one area Dow Corning knows best, i.e. materials. Do
not terminate any existing clinical programs with respect to data
generation on mammary capsule contracture. However, I would
recommend postponing Dow Corning’s involvement in any new
clinical program(s) until some very basic research questions are
answered. I realize that rejecting some clinical proposals is very
difficult because of the political and economic implications, but
participating also carries some very high risks. There is a 50/50
chance that the data may be bad data, i.e., damaging by
implicating a product.... Remember, a product which is implicated
with bad data requires additional expenditures of time, personnel
and money to generate defensive research. There are several data
gaps which should be investigated before any long-term clinical
involvements are undertaken. ”Walters recommends further studies
on gel bleed and elastomer formulation.(emphasis added).
-
- CITE: KMM 4113 -4129, Exhibit 77 to
Harris County Rathjen Deposition. DUPLICATE: M 290021 - 290037. Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #228
- 04/05/76
-
- MISCELLANEOUS - COMPLICATIONS
- MISCELLANEOUS - PRODUCT LABELING
- RUPTURE - CLOSED CAPSULOTOMY
- TISSUE REACTION
-
- FDA: The FDA, after receiving
information that some persons had experienced serious problems
with silicone mammary and testicular implants, met with Dow
Corning to inspect their files. Mr. Radzius, Dow Corning’s Food
and Drug counsel, and Milt Hinsch, Product Supervisor, Dow
Corning, claim to John Nicholson, FDA, that current data shows
approximately 18% of mammaries implanted will cause a contracture
problem. Of this 18%, somewhat less than 10% will require
corrective surgery or other techniques. Hinsch also states that a
new technique of manually breaking the capsule has recently been
developed and shows promise as a solution to contracture. Hinsch
also stated that it has always been a policy of Dow Corning to
include “adverse reactions” as part of its labeling but,
recently, competitors have been using this statement in the
literature as a tool to convince surgeons not to use Dow
Corning’s products.
-
- CITE: FDA 17180 - 17182. NOTE:
HINSCH was aware that the contracture data was much higher than 18%, i.e., see Dr.
Terino’s paper presented 03/76. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #229
- 04/13/76
-
- KNOWLEDGE OF GEL BLEED
-
- Milt Hinsch, Dow Corning, discussed
how the market place is telling Dow Corning that improvements can
be made to the current production line including to the envelope,
gel, and design of the prosthesis. One suggested improvement would
be that the gel should be a no bleed gel with very low viscosity,
“Doctors are now being sensitized to the oiliness of our current
prosthesis....” Hinsch wants Dow Corning to place its name and
product size on the mammary in case it needs to be removed and
replaced for any reason. “This is a consideration which will
become more important as time goes on.”
- CITE: M 160007 - 160008. DUPLICATE:
GEG 4343; M 160079 - 160080; KKH 2632. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #230
- 04/14/76
-
- KNOWLEDGE OF GEL BLEED
- ACKNOWLEDGEMENT OF NEED FOR TESTING
-
- Eldon Frisch, Dow Corning, responds
to Milt Hinsch’s memo on Greg Bicket’s questions on gel bleed.
“The material which bleed from a mammary implant is a
polydimethylsiloxane, or more appropriately a silicone fluid. It
comes from within the gel.... Since the gel starts as a fluid,
these materials are also fluids, and they tend to migrate about in
the gel, eventually dissolving in the envelope and passing through
it.... We have no scientific data to indicate whether or not the
presence of the fluid polydimethylsiloxane which bleeds through
the envelope increases or decreases the problems of capsular
contracture.” He questions whether Dow Corning’s field
inventories are getting too old, allowing “the bleed (to become)
more evident.” Frisch also talks about injected silicone fluid
studies which showed absorption of the silicone fluid into the
body. “We have no scientific evidence to indicate whether or not
the presence of the fluid polydimethylsiloxane which bleeds
through the envelope increases or decreases the problems of
capsular contracture.”
-
- CITE: M 190259 - 190261, Exhibit 13 to
California Braley Deposition (used by Dow Corning), Exhibit to
Petraitis Deposition, Exhibit to MDL Rathjen Deposition.
DUPLICATE: KKH 1561 - 1565; GEG 4023 -4025; M5700445 -
570047, KMM 3828 - 3830; GEG 4246 - 4250. Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #231
- 04/19/76
-
- COHESIVENESS - LIQUID COMPONENT OF
GEL
- MISCELLANEOUS - SALES
- RUPTURE
- TESTING
-
- Robertson memo to Blackmore, Coyne,
Fredricksen, Pryor, Trischler, Doolittle, Flora, Hauser, McLellan
and Murray regarding a discussion with Donald McGhan on 04/14/76.
McGhan is now receiving Dow Corning silicone. For the gel uses
McGhan prefers the GE product which has a lower level of low
molecular weight components. McGhan mammary implants are also more
consistent than Heyer-Schulte’s because of the mandrel molding
technique used - the madrels are polyester and cast individually.
-
- CITE: MMM 1445 - 1450, Exhibit 6 to
D. McGhan Deposition, Exhibit to Horgan Deposition, Exhibit 43 to Harris
County D. McGhan Deposition, and Exhibit 68 to Harris County Coyne Deposition.
DUPLICATE: MMM 666 -671. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #232
- 04/20/76
-
- SHELL STRENGTH - THICKNESS
- RUPTURE
-
- Milt Hinsch, Dow Corning, memo to
Brodhagen, et al., regarding demonstration implants used at the
“Aesthetic Show in Atlanta on April 11-15, 1976. He writes,
“Of these 23 (demonstration implants), 5 had large bubbles in
the gel, 1 broke when picked up, and 3 others developed bubbles in
the gel around the patch area during the show. We were unable to
show the entire line as planned.”
- CITE: KMM 219977. Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #233
- 04/22/76
-
- Kelley, Dow Corning, memo to Hinsch
with copies to C. Lentz, Criger, Leach, Meads, Becker, Petraitis,
Bey and Rathjen regarding “Milt Hinsch Memo of April 13 -
Attached “Gel Filled Mammaries Of The Future.’” Kelley notes
that the attached memo from Hinsch documents specific marketplace
requirements for the mammary prosthesis line.
-
- CITE: KKH 2633 Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #234
- 05/04/76
-
- KNOWLEDGE OF GEL BLEED
- GEL MIGRATION
- TISSUE REACTION
-
- Greg Bicket, Dow Corning, reports
that he met with Dr. Richard Phares regarding the Silastic Mammary
Prosthesis. He is “interested in reports of freshly healed
augmentations failing to adhere with subsequent loss of implant. (Phares)
experienced this, and was upset to hear others reports of this at
the Southeastern meeting. Apparently, the theory is that the
opposing faces of the wound are closed, and in ten to fifteen days
no appreciable healing has taken place. The suture lines then
break down, and the implants are not retained.
‘Greasy implants” sliding into the pocket, providing a
release agent against healing, were postulated to be the cause.”
-
- Further, “The second area of
concern was the reported actions of migrating gel/fluid of other
manufacturers’ gel. Giant cells, granulomae, and siliconomae
were reported in and around the locations where the migrating
gel/fluid was said to have come to rest.” Phares proposes a dog
study.
-
- CITE” M 600009 - 600010, Exhibit
to MDL Rathjen Deposition, and Exhibit 79 to Harris County Rathjen
Deposition. DUPLICATE: F 713 - 714; KMM 380053; DCC 80010141 -
80010142. NOTE: Dow Corning never followed through with a dog
study. See 06/08/76 entry. Dow Corning
Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #235
- 05/11/76
-
- SHELL STRENGTH - THICKNESS
- SHELL DEGRADATION
-
- Neal Langley and Jon Swanson, Dow
Corning, report on the “Effects Of Subcutaneous Implantation,
Through Two Years, On The Physical Properties Of Medical Grade
Tough Rubber (MDF-0198).” MDF-0198 is a “new high performance
medical grade elastomer for orthopedic (sic) devices.... Questions
to be answered were: do physical properties change during
implantation; are body fluid absorbed into the elastomer; and is
PDMS leached into the body during the two year subcutaneous
implantation period?” Langley and Swanson state that there was
little change in tensile strength, tear resistance and ultimate
elongation. “Maximum
loss of PDMS into the body ranged from 0 to 0.7% of the sample
weight after 32 weeks and from 0 to 1.3% after two years.... This
degradation may become important over longer periods.” There
were significant changes in the flaw propagation life after
implantation, a 10% decrease in tensile strength and flaw
propagation life, a 20% decrease in elongation and a 5% increase
in modulus. “Differences to be noted between this study and
service conditions include the absence of flexing during
implantation, and any differences between the subcutaneous
environment in dogs Vs the various locations in the human body
where the devices are in service.”
-
- CITE: T 21431 - 21444. DUPLICATE:
KKH 68344 - 68357; DCC 204001179 -204001192. Dow Corning Trial Exhibit List
Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #236
- 05/17/76
-
- ACKNOWLEDGEMENT OF NEED FOR TESTING
-
- Art Rathjen, Dow Corning, memo to
Bey and C. Lentz regarding a capsular contracture study proposed
by Dr. James Penoff. “We are engulfed in qualified speculation -
nothing to date is truly quantitative or qualitative; therefore,
Dr. Penoff’s suggestions for a course of action merit some
serious consideration.” (emphasis added). Phase I of the
proposed study includes:
-
- A.
Is there something in the implant that migrates out or off
the mammary prosthesis? yes or no!
- B.
Does it continue for the life of the implant or is it
limited or controlled for a period of time?
- C.
Does it come from the gel or envelope or both?
- D.
What is it?
- E.
Considering the evolution of the mammary prosthesis, have
changes in both the gel and envelope altered the degree or changed
what might migrate through or off the prosthesis?
- Phase II would be pre-clinical
implant testing to determine whether components of the envelope
and gel migrate. Phase III is human implantation.
-
- CITE: F 715 - 716, Exhibit to MDL
Rathjen Deposition, and Exhibit 78 to Harris County Rathjen Deposition DUPLICATE:
FDA 31438 - 31439; M 210001 - 210002. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #237
- 06/00/76
-
- GEL MIGRATION
- TESTING
- TISSUE REACTION
-
- Frugard’s Dow Corning trip report
from Heyer-Schulte’s library. Includes 08/06/76 memo from J.
Erhardt to T. Talcott regarding confidentiality agreement with Dow
Corning requiring all information being confidential for a period
of ten years from the date of disclosure of delivery. Frugard’s
trip report was sent to S. Koorajian and is dated 07/14/76.
Frugard reports that there are both positive and negative aspects
of his trip to Dow Corning. On
the positive side, he feels that he was successful in bringing
back a comprehensive summary of all of Dow Corning’s animal
data; or at least “all that I was given access to”. The
negative aspect is that the data does not answer the key questions
concerning migration and its consequences. Many of the experiments
were not well controlled. The animal studies indicate no
significant pathological findings and, in cases were there were,
they were attributed to experimental procedures.
-
- Frugard concludes that: “due to the fact that there was no
apparent difference in reaction to any of the gels, the
inflammatory response must be considered to depend solely on
tissue injury and not upon gel migration. This conclusion is
tenuous at best considering there were no controls. Perhaps all
gels were reactive.... Gel migrates into the capsule....
Unfortunately, the data collected in this study does not answer
questions concerning migration, even though that was the main
objective. I regret the fact that Dow Corning’s data was lacking
in quality and left many questions unanswered.”
- CITE MD 114416 - 114428. Dow Corning
Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #238
- 06/02/76
-
- SHELL STRENGTH - THICKNESS
- RUPTURE
-
- Mazelin, a Dow Corning sales
representative, files Complaint Report F76023 for a rupture of a
Silastic Round mammary implant. Dr. Kellett, the implanting
physician, noted that this was the second rupture in the past few
weeks. He “feels ‘thinner’ envelope weakens it (the implant)
significantly.”
- CITE: CR 3172 - 3173. Dow Corning
Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #239
- 06/07/76
-
- GEL MIGRATION
- MISCELLANEOUS - COMPLICATIONS
- RUPTURE
- TISSUE REACTION
-
- Braley, Dow Corning, telephone
report concerning a conversation with Dr.
Nicholas Georgiade. Dr. Georgiade’s patient developed a
mediastinal node enlargement and lung lesions and suspects gel
migration from a ruptured implant.
He notes that the patient’s husband is a “smart ass”
trial lawyer and wants to know how to handle this. He wants a
letter from Dow Corning so that he has “enough information to
counteract any feelers that this lawyer may put out.”
- CITE: M 250053, Exhibit 35 to Hinsch
Deposition (used by Dow Corning), Exhibit 87 to Harris county Rathjen
Deposition, Exhibit 39 to California Braley Deposition, Exhibit to MDL Rathjen
Deposition. NOTE: for Rathjen’s response, see M 250050 - 250052 dated 07/12/76 Dow
Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #240
- 06/08/76
-
- ACKNOWLEDGEMENT OF NEED FOR TESTING
-
- Art Rathjen memo to Al Bey, C. Lentz
and others, all of Dow Corning, regarding
- “G. Bicket Trip Report No. 504,
May 4, 1976, i.e., Dr. Phares, St. Petersburg,
- Florida.” Rathjen states: “I have proposed again and again
that we must begin an in-depth study of our gel, envelope, and
bleed phenomenon. Capsule contracture isn’t the only problem.
Time is going to run out on us if we do not get underway.
Believe me when I tell you that the A.S.P.R.S. is also going to
begin their own investigation. A committee will be organized, and
they will come to the manufacturers asking questions. It would
certainly be to our advantage to be ready for them. (emphasis added).
-
- CITE: F 712, Exhibit to MDL Rathjen
Deposition, and Exhibit 79 to Harris County Rathjen Deposition. DUPLICATE: M
600011; GEG 003999; KMM 242518; DCC 80061401; M600008. Dow Corning Trial Exhibit
List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #241
- 06/10/76
-
- COHESIVENESS - LIQUID COMPONENT OF
GEL
- GEL MIGRATION
- KNOWLEDGE OF GEL BLEED
-
- Study by Brill titled “Development
Of A Low Oiling Gel For The External Breast Prosthesis.” The
resulting gel caused substantially less swell of the silicone
rubber envelope and gave a low rate of migration of silicone
material through the envelope compared to existing silicon gels
formed from low viscosity fluids and plasticizers. It was also
shown that gels and fluids based on methyltrifluoropropyl polymer
as well as silicone organic copolymers could produce a very low
order of elastomeric swell and bleed with polydimethylsiloxane
envelope rubber.
-
- CITE: KKH 63280 - 63299, Exhibit to
Petraitis Deposition, and Exhibit to MDL Rathjen Deposition. Dow Corning
Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #242
- 06/11/76
-
- MISCELLANEOUS
-
- W. Larson and Y. Peters, both of Dow
Corning Corporation, issue an internal Dow Corning report entitled
“Medical Products, Technical Service and Development”.
-
- The authors report that: “The mammary gel, MDDF0193, often
develops a yellow color which detracts from the appearance of the
prosthesis. The cause of this problem has been traced back to the
catalyst, XY173. Four catalysts were evaluated on the basis of
color, XY173. Four catalysts were evaluated on the basis of color,
XY173, XF95504, PtII and MDDFoo69. The color intensity of the gels
was found to decrease in the following order: XY173 >XF95504
>PtII > MDF0069.
-
- The results indicated that the
easiest solution to the problem was to switch to MDF0069.”
- CITE: KMM 8596 - 8605. NOTE: The
first page states that this document is Dow Corning Proprietary and that neither
this document nor the information contained in it may be reproduced except in
TIS, nor distributed outside the company without permission from the Director
of Technical Service and Development. Dow Corning Trial Exhibit List Abstract
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #243
- 06/25/76
-
- SHELL STRENGTH - THICKNESS
- RUPTURE
-
- John Gallagher, Dow Corning, memo to
Bob Becker regarding the “large increase in rupture returns in
the past month....” Gallagher states that: “All the doctors claim that the
ruptures are happening from 90% of the prosthesis with the creases
and large air bubbles. I had a discussion with Milt Hinsch today
and he told me he has had three telephone calls, one from Tom
Mazelin, one from Greg Whittaker, and one from Jim Reisma (sic -
Reitsma), all having the same problem - an excessive amount of
ruptures. I wanted to bring this to your attention because I have
one customer that has had a return of thirty ruptures in the last
three months.... We have enough problems with competition without
worrying about ruptures constantly.
-
- CITE: CR 3272. Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #244
- 07/07/76
-
- FRAUD/MISREPRESENTATION
- GEL MIGRATION
-
- Rathjen, Dow Corning, letter to
Nicholas Georgiade responding to expressed concerns regarding gel
migration. Rathjen states: “The first silicone gel-filled
mammary prosthesis was implanted in a patient of Dr. Tom
Cronin’s in 1962, and as of July 1976, she still has them, and
her course during the past 14 years has been uneventful. Since
that time, mammary implants numbering in the hundreds of thousands
have been used for augmentation and reconstruction of the breast.
-
- The percentage of complications has
been minimal, and very frankly, gel migration due to breakage of
the silicone envelope has not been a problem nor can I recall when
a surgeon has questioned us about this, relative to a Dow Corning
Product.
-
- We also have test data on the
implantation of our materials; and there is, to my knowledge, no
indication or proof that phagocytes pick up the material and carry
it off. I agree with Si on that Point - the size and consistency
of the gel, and even more specifically, our gel used in 1970 does
not make it feasible.”
- CITE: KMM 354956 - 354957.l Dow
Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #245
- 07/12/76
-
- FRAUD/MISREPRESENTATION
- GEL MIGRATION
-
- Rathjen, Dow Corning, letter to Dr.
Nicholas Georgiade stating that he has never heard of a problem of
gel migration “relative to a Dow Corning product.” (emphasis
added). He notes that the gel is “very cohesive.” Rathjen also
claims that Dow Corning does not have any test data or knowledge
showing that phagocytes pick up the silicone and carry it through
the body, claiming that this is not “feasible.”
- CITE” M 250050 - 250052, Exhibits
36 and 37 to Hinsch Deposition (used by Dow Corning), Exhibit 40 to California
Braley Deposition, Exhibit 63 to MDL Rathjen Deposition (used by plaintiffs and
Dow Corning), Exhibit 88 to Harris County Rathjen Deposition, and Exhibit 40
to California Braley Deposition. NOTE: There are numerous instances of gel
migration noted in Dow Corning’s internal and external tests as well as in letters
from physicians. See, e.g., 04/00/67 - GEG 4301 - 4304; 04/01/67 - PSC Medical
Articles CDE, J 157 - 166; 04/11/67 - T38842 - 38866; and 08/02/71 -
KMM419744). NOTE: Also see 06/07/76 telephone
- report, M 250053. Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #246
- 07/14/76
-
- DOCUMENT DESTRUCTION
- TESTING
-
- Milt Hinsch, Dow Corning, memo to
Rathjen, Kelley, Leach, Lentz, Bey, Bennett, Hoyt, Mantle, and
Nelson regarding “The Milt Hinsch Grant.” Hinsch turned down a
request for funding by Dr. Tanski which Rathjen supported and then
agreed to fund a similar study by Drs. Horton and Rasato. Rathjen
has suggested that Drs. Horton
and Rasato had gone “shopping” for funding and were turned
down by Heyer-Schulte already. Hinsch responds that it was a
marketing sponsored decision to support Horton and Rasato because
they are product champions. In response to Rathjen’s question
about what to do with the data Horton and Rasato generate, Hinsch
states, “Question number 9 about what will we do with the data
depends upon the data which is generated, Art. It may turn out
that we will take the paper on which this data is printed, roll it
up and light pipes and cigars with it.” (emphasis added).
-
- CITE: M 190344 - 190345, Exhibit to
MDL Rathjen Deposition, and Exhibit 82 to Harris county Rathjen Deposition.
Dow Corning Trial List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #247
- 07/15/76
-
- KNOWLEDGE OF SYSTEMIC DISEASE
-
- Pulley memo to LeVier regarding
“Patent Memo 4240 - Insecticidal Activity of Silicone Oils and
Emulsions.” The subject patent is being placed in our inactive
files in the Patent Department. Note: The referenced patent memo
is not attached.
-
- CITE: DCC 281041374 (Temporary Dow
Corning Bates Number 16359 - 16379), Exhibit to Bennett Deposition, Exhibit to
Isquith Deposition, Exhibit to Lake Deposition, Exhibit to LeVier
Deposition. Dow Corning Trial Exhibit List Abstracts
- Pendleton/PCS Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #248
- 07/23/76
-
- CONCEALING FROM FDA
- FRAUD/MISREPRESENTATION
-
- FDA: A hearing is held by the FDA
Panel on Review of General and Plastic Surgery Devices. On the
issue of breast implants, J. Radqius, Dow Corning, states that he
has evidence that doctors may be altering the breast implants by
injecting an antibiotic into the prosthesis which is gradually
released through the membrane of the implant.
-
- CITE: This document also has the
Bates numbers KMM 489852A - 4900119A (This document also has Bates numbers KMM
545507 - 545555, 547162, 545556 - 545557, 547163 - 547164, and 545558 - 545671
on it.) DULICATE: FDA 160 - 161 (Pages 150 and 151 only). Dow Corning Trial
Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
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- Document #249
- 08/02/76
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- ACKNOWLEDGEMENT OF NEED FOR TESTING
- KNOWLEDGE OF SYSTEMIC DISEASE
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- Hobbs, Dow Corning, memo to Atwell,
Bey, LeVier, Radzius, Ryan, Smith, Stark, Gamon, Lentz, Maneri,
Tyler, Wehrly, and Weyenberg regarding “2,6-cis Toxicity.”
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- Hobbs states: “A six month chronic toxicity
study conducted on 2,6-cis has demonstrated possible relationship
between the appearance of mammary tumors in the (word is cut off)
and the feeding of the chemical. This possibility may have
implications which involve products other than 2,6-cis. There are
three major questions we must answer concerning this possible
effect:
-
- 1.
Is the occurrence of mammary tumors an absolute response in
the rat when fed 2,6-cis?
- 2.
Do any of our products contain 2,6-cis?
- 3.
Is the production of these tumors a result of the
estrogenic activity of 2,6-cis or is it related to certain low
molecular weight silicone compounds?
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- CITE: KMM 482556 - 482557, Exhibit
to Tyler Deposition, Exhibit to Ryan Deposition. NOTE: The right hand
side of the page is cut off. Dow Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
-
- -----------------------
-
- Document #250
- 08/03/76
-
- KNOWLEDGE OF SYSTEMIC DISEASE
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- Pulley, Dow Corning, memo to LeVier
concerning the inactivation of Patent Memorandum 4320. Because
LeVier represents “that the project which supported the subject
disclosure in on the shelf and that Dow Corning would probably not
reactivate work in this area in the near future,” the patent
memo is inactivated, to be reactivated “whenever you consider it
appropriate.” CITE; DCC 281061472, Exhibit to Bennett
Deposition, Exhibit to Isquith Deposition, Exhibit to Lake
Deposition, and Exhibit to LeVier Deposition.
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- NOTE; Refer to entry dated 01/31/75. This
was listed on Plaintiffs’ Exhibit List in Carter as “No Bates Number.” Dow
Corning Trial Exhibit List Abstracts
- PENDLETON/PSC Attorney Work
Product/Privileged & Confidential
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- TO
DOCUMENTS: 251 - 300
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