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Last December, the Pennsylvania Superior Court handed a sharp blow to pharmaceutical liability plaintiffs' lawyers in the state who have consistently argued that a 'heeding presumption' should apply to their failure-to-warn claims and, in effect, relieve them of the burden of proving causation. A unanimous three-member panel upheld the decision of the trial court awarding summary judgment to the defendant because the plaintiff 'presented no evidence that a different warning would have changed [the prescribing physician's] decision to prescribe [the drug at issue] for Appellant.' Lineberger v. Wyeth, 2006 PA Super. 35, at *24 (Pa. Super. Ct., Feb. 23, 2006). Relying on the appellate court's 1996 decision in Demmler v. Smith Kline Beecham, 671 A.2d 1151 (Pa. Super. Ct. 1996), the panel reasoned that failure-to-warn claims in the pharmaceutical context require the plaintiff to come forward with evidence showing that the alleged inadequate warning was the proximate cause of the resultant injury in order to state a prima facie case. Id. at *12, 23-24. Evidence that the manufacturer breached its duty to warn the medical community of the risk of harm associated with its product is insufficient in and of itself to impose liability on the manufacturer, the Pennsylvania appellate court explained, because under the standard articulated in Demmler, proximate cause is not presumed. Id. at *23. Hence, traditional negligence principles prevail in drug liability cases in Pennsylvania ' pharmaceutical plaintiffs cannot get their case before a jury unless they are able to make a prima facie showing as to each element of their negligence claims, including proximate cause.
Pennsylvania, like the majority of states, recognizes the 'learned intermediary doctrine' in all claims involving prescription drugs. See Incollingo v. Ewing, 282 A.2d 206, 219-20 (Pa. 1971). The learned intermediary doctrine operates to direct the pharmaceutical manufacturer's duty to warn to the prescribing health care professional, who, by virtue of specialized training and expertise, is uniquely qualified to decide whether the patient is an appropriate candidate for treatment with any given pharmaceutical drug. Id. at 220. Under this doctrine, there is no duty on the part of the pharmaceutical manufacturer to warn individual patients of the risks of harm attendant to the use of its drugs. Id.
In ruling that the 'heeding presumption' does not apply to pharmaceutical failure-to-warn cases, the trial court in Lineberger relied heavily on the fact that in Pennsylvania, theories of liability are predicated on negligence principles alone; the appellate court did not disturb this reasoning. See Lineberger, 72 Pa. D.&C.4th 35, 39 (Pa. Com. Pl. Ct. 2005); aff'd, 2006 PA Super. 35. Negligence, not strict liability, provides the exclusive basis for imposing liability on a drug manufacturer in Pennsylvania. Id. at *25 (affirming the trial court's grant of summary judgment). The liability inquiry in negligent failure-to-warn claims, therefore, centers on the reasonableness of the conduct of the manufacturer as it relates to the warning and its adequacy, ie, what the manufacturer knew or should have known about the drug's dangers at the time the plaintiff ingested the drug, and how that information was conveyed to the learned intermediary. Conversely, the primary focus in strict liability warning claims ' ie, the dangerousness of the drug risks in question relative to the drug's beneficial effects ' has little if any relevance in the liability analysis employed in negligent failure-to-warn cases.
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