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#WAOpioidTrial Day 46 of WA v McKesson, et al begins at this link. Defense resumes their case today. BUT FIRST. Apparently the state changed up their plan for rebuttal witnesses. Judge wants to address it today before the weekend break. He is unthrilled?
#WAOpioidTrial So that is going to be interesting this afternoon! Just after the lunch break: discussing state's changed-up plans. Hmm.
Meanwhile: defense calls an IRL witness . . but before they get on the stand, state wants to argue about it. State's mad.
Meanwhile: defense calls an IRL witness . . but before they get on the stand, state wants to argue about it. State's mad.
#WAOpioidTrial State just wanted to notify the judge that they plan to object to stuff this witness MAY say. Cool?
Defense calls Dr. James Hughes, economist. He's also testified at previous opioid trials.
So ... state should know what's coming?
bates.edu/faculty-expert…
Defense calls Dr. James Hughes, economist. He's also testified at previous opioid trials.
So ... state should know what's coming?
bates.edu/faculty-expert…
#WAOpioidTrial Day 45 of State of WA v McKesson, et al is beginning at this link for the AM session. Note that this is the last day of the trial week; no trial on Fridays. Next scheduled trial date is Monday, 3/28/2022 at 9am.
Defense resumes this AM.
Defense resumes this AM.
#WAOpioidTrial Current housekeeping measure under discussion about how to recall DEA's Rannazzisi - state intends to recall him via Zoom to rebut, but no one seems clear on that. Defense is predicting wrapping up their case Monday or Tuesday . . maybe.
#WAOpioidTrial It's complicated because there are THREE defendants here - much of their case is similar/unified, but there are specifics for each company which take time. Timing and estimates for how long witnesses and depos will take .. it's complex.
#WAOpioidTrial Day 43 of the state of WA v McKesson, et al resumes at this link this morning. The trial began Nov. 15, 2021 and the state rested their case on day 34 (3/1/2022) and then there were motions to dismiss and FASCINATING arguments each way.
#WAOpioidTrial Defense began presenting their case the afternoon of day 36, on March 8, 2022.
We resume defense's case this morning with a live witness Dr. Chris Gilligan, an anesthesiologist out of Boston. Looks like he testified in the WV trial wvgazettemail.com/news/health/do…
We resume defense's case this morning with a live witness Dr. Chris Gilligan, an anesthesiologist out of Boston. Looks like he testified in the WV trial wvgazettemail.com/news/health/do…
#WAOpioidTrial His opinions on treating pain with RX opioids: forthcoming.
So far we're defining 'categories of pain' based on duration:
Acute < six weeks
Chronic Cancer Pain
Chronic Non-Cancer Pain
PRO-TIP: The FDA has declared there is NO difference between those last two.
So far we're defining 'categories of pain' based on duration:
Acute < six weeks
Chronic Cancer Pain
Chronic Non-Cancer Pain
PRO-TIP: The FDA has declared there is NO difference between those last two.
#WAOpioidTrial Day 29 is starting at this link.
OH HEY did anyone else notice that the CDC released their draft of their REVISED opioid prescribing guidelines this morning? BECAUSE THEY DID.
Any impact on the trial? Dunno.
painnewsnetwork.org/stories/2022/2…
OH HEY did anyone else notice that the CDC released their draft of their REVISED opioid prescribing guidelines this morning? BECAUSE THEY DID.
Any impact on the trial? Dunno.
painnewsnetwork.org/stories/2022/2…
#WAOpioidTrial Aaaand after some housekeeping measures, McKesson's defense counsel resumes their cross of Dr. Caleb Alexander ... . PROP affiliate. Good times, good times.
#WAOpioidTrial McK: In your report you said 'rogue MDs and 'doctor-shoppers' account for only a small amount of harms, right?
Dr. A: <long meandering paragraph which doesn't answer the question>
Courtroom: 🙄
Dr. A: <long meandering paragraph which doesn't answer the question>
Courtroom: 🙄
#WAOpioidTrial Day 28 beginning. Random thought: Are bench trials far more stressful for judges than jury trials? In a jury trial judge has to make sure the jury hears appropriate/admissible evidence, then jury decides. Bench must do same AND then rule.?
#WAOpioidTrial Regardless, we resume with the state of WA and their witness Dr. Caleb Alexander . .. notoriously PROP-affiliated, anti-opioid, 'everyone using opioids for pain is at risk of addiction' doctor who is here with a plan to 'abate' the epidemic in WA. Sigh.
#WAOpioidTrial To be clear: people in the know in WA are reasonable and appropriate. The Washington Medical Commission. The WA Dept. of Health. Assorted agencies. They recognize that people in pain deserve individualized care and that providers should be protected/encouraged.
#WAOpioidTrial Day 27 is starting at this thread. Yesterday's trial day ended w/Dr. Jakki Mohr, Marketing expert/professor/Doctorate/wizard somewhat defensively arguing about opioid manufacturing/distributing marketing practices. Cross by McKesson starts
#WAOpioidTrial McK: "All marketing activities you described were conducted for ALL products, not just opioids, correct? Many different products beyond opioids. We gotta fill pharmacy orders across all products, right?"
Mohr: Yes.
Mohr: Yes.
#WAOpioidTrial Dr. Mohr previously served as an expert in a case against Purdue by the state of Montana.
Interesting. McKesson is attempting to introduce the State of WA vs. Purdue lawsuit.
This suit. 🤔
agportal-s3bucket.s3.amazonaws.com/uploadedfiles/…
Interesting. McKesson is attempting to introduce the State of WA vs. Purdue lawsuit.
This suit. 🤔
agportal-s3bucket.s3.amazonaws.com/uploadedfiles/…
#WAOpioidTrial Day 26 is beginning this morning at this link.
We are starting with the arguments for/against striking all of former DEA's Ruth Carter's testimony (which was SO MANY hours). It's a defense motion to strike. Let's watch.
We are starting with the arguments for/against striking all of former DEA's Ruth Carter's testimony (which was SO MANY hours). It's a defense motion to strike. Let's watch.
#WAOpioidTrial Defense says Carter missed a bunch of things, admitted on cross she'd never reviewed WA-state-specific things, etc. State is saying it was all finde etc. But the judge ... seems to be troubled about state's position on all this. Is he going to strike Carter?! 🤯
#WAOpioidTrial In a nutshell: 'Carter did not lay the proper foundation, did not do the proper research to CONCLUDE the things she stated categorically on the stand.' There were lots of holes. Expert witnesses are expected to seriously connect the dots. We shall see . .
#WAOpioidTrial Day 24 is now starting at this link. State will continue to assert their case - after some housekeeping measures to be discussed. !
#WAOpioidTrial Lots of housekeeping measures discussed. I don't think there were any rulings?
Regardless, state resumes questions with Dr. Cutler, starting with neonatal abstinence syndrome. When babies are born with addictive substances in their system. NAS for short.
Regardless, state resumes questions with Dr. Cutler, starting with neonatal abstinence syndrome. When babies are born with addictive substances in their system. NAS for short.
#WAOpioidTrial Dr. Cutler is discussing the financial impact for caring with babies with NAS, later issues with potential foster care placement, treatment for the mother, etc.
So far zero differentiation between licit or illicit use trends. Because I don't think we have it.?
So far zero differentiation between licit or illicit use trends. Because I don't think we have it.?
#WAOpioidTrial Day 23 is now starting. Good morning!
Here's the AM link. Also it is snowing here this morning, WTF??
Here's the AM link. Also it is snowing here this morning, WTF??
#WAOpioidTrial IANAL here but it seems like the state just got admonished a bit for trying to pull some exhibit back OFF the record after defense went to the expense of reviewing; state doubles down and says they are SURE it will be in; then tried to pull it. Judge said nope.
#WAOpioidTrial And now we resume McKesson's counsel cross-examining Dr. Daniel Ciccarone, MD, MPH. He's a widely respected harms reduction expert (among many other things). He's been testifying about the uptick in heroin/fentanyl use, generally.
#WAOpioidTrial Day 22 is now starting; WA state vs. McKesson, et al can be watched here for the morning session (then the link disappears at the lunch break).
We resume with the depo from a Cardinal employee being played; most of which we saw last Thurs.
We resume with the depo from a Cardinal employee being played; most of which we saw last Thurs.
#WAOpioidTrial Once again the questions are about how the pharmaceutical distributors offered marketing/ad opportunities to the manufacturers.
Which somehow makes the distributors liable for the 'opioid crisis' which is almost exclusively polypharma heroin/fentanyl/meth. M'kay.
Which somehow makes the distributors liable for the 'opioid crisis' which is almost exclusively polypharma heroin/fentanyl/meth. M'kay.
#WAOpioidTrial The rules of evidence remain ... elusive.
Somewhat lengthy technical discussion about whether the witness in the depo could refer to 'notes' about facts about a doc she had not seen.
Cardinal's objection is sustained! (I have no idea about why, but okay!)
Somewhat lengthy technical discussion about whether the witness in the depo could refer to 'notes' about facts about a doc she had not seen.
Cardinal's objection is sustained! (I have no idea about why, but okay!)
#WAOpioidTrial Day 21 is now starting. Here is this morning's link, good only as long as the court is in this morning's session. It will disappear at around noon when the court adjourns for lunch.
Will the 'not-an-expert-witness' shenanigans continue? 🤔
Will the 'not-an-expert-witness' shenanigans continue? 🤔
#WAOpioidTrial Oh that is interesting - Dr. Banta-Green just closed that the attorney I assumed was 'his' is actually representing the University of Washington .. . from the WA State Attorney General's office.
Um. It's the AG who is the plaintiff. Well. That's curious.
Um. It's the AG who is the plaintiff. Well. That's curious.
#WAOpioidTrial McKesson's counsel is cross-examining Dr. Banta-Green. Showing this site from ADAI. Specifically THIS chart. Showing hospitalization rates ... by substance. Most of which . . . are not RX opioids.
adai.uw.edu/wadata/opioid_…
adai.uw.edu/wadata/opioid_…
#WAOpioidTrial Day 20 is about to begin; here's the AM link for today.
SEVERAL big issues to be decided upon this morning by the Judge; who will have reviewed a few briefs from counsel this morning before court adjourns. WHAT will happen?? Stay tuned.
SEVERAL big issues to be decided upon this morning by the Judge; who will have reviewed a few briefs from counsel this morning before court adjourns. WHAT will happen?? Stay tuned.
#WAOpioidTrial The first big question: Will the Judge allow these subjective surveys to be admitted - dancing around whether Dr. Banta-Green is a fact witness (which means the surveys COULD be hearsay) or if he's a dang expert (which he clearly is, but not for this trial?)
#WAOpioidTrial The judge - sort of bemused about how state keeps referring to Dr. Banta-Green as a 'fact witness' - has asked both parties for BRIEF oral arguments about admitting the surveys.
Hopefully defense brings up that it was a teeny survey of one county by syringe users.
Hopefully defense brings up that it was a teeny survey of one county by syringe users.
#WAOpioidTrial resumed earlier this morning - I'm feeling bleah so I'm late on the updates. We finally, finally wrapped up testimony/cross/re-everything with Ruth Carter with only three things which stood out. Also here's the AM link until lunch.
#WAOpioidTrial Also it's day 19.
1st: Counsel inquired about various things Ms. Carter had missed or excluded or got wrong in specific documents. There were quite a few things in various redirect/cross where that happened ... all of which painted the defense negatively. Hmm
1st: Counsel inquired about various things Ms. Carter had missed or excluded or got wrong in specific documents. There were quite a few things in various redirect/cross where that happened ... all of which painted the defense negatively. Hmm
#WAOpioidTrial Second: When Ms. Carter was asked about a benzo in a document, she replied: "Yes but that's not an opioid, it's a benzodiazepine, and those are also widely sought after by DRUG ABUSERS."
She has continually called people who use RX or illicit substances this.
She has continually called people who use RX or illicit substances this.
#WAOpioidTrial Day 18 has begun this morning! As suspected the unscheduled trial break was because one of the key players got COVID. It was the judge!😳 He's back now.
State has resumed their redirect of their witness, former DEA Ruth Carter.
AM link:
State has resumed their redirect of their witness, former DEA Ruth Carter.
AM link:
#WAOpioidTrial We're spending a ton of time looking at distributor reports from 2008 (and such) about percentage of controlled substances ordered by specific pharmacies. With zero context about the population(s) those locations served, proximity to cancer centers, surgery, etc.
It's not possible to call something a "red flag" w/o having that context. State's argument is distributors should've flagged all kinds of things w/o guidance, regulatory requirements etc.
Also that RX opioids caused the overdose crisis. Which they didn't. painnewsnetwork.org/stories/2021/1…
Also that RX opioids caused the overdose crisis. Which they didn't. painnewsnetwork.org/stories/2021/1…
#WAOpioidTrial Day 15 has just begun. In a confusing twist, yesterday's trial stream started on the channel about 15 mins before court started. So we NOW join today's trial in progress at THIS link, below. McKesson continuing cross with DEA's Carter.
"Has DEA ever publicly stated the appropriate amount of medically-necessary opioids needed for the nation, or for WA?"
Well no - I'm not a medical doctor. I couldn't make that calculation.
CORRECT.
Well no - I'm not a medical doctor. I couldn't make that calculation.
CORRECT.
McKesson's counsel is asking Carter about earlier trial depo transcript - DEA regs changed 'drastically' in 2006-2007, so that instead of distributors notifying DEA of suspicious orders AND still shipping them, they should hold those orders. That was standard prior to 2006-2007.
#WAOpioidTrial Day 14 has begun; this morning's link below.
We resume with former DEA unit chief Ruth Carter, state's witness, still on the stand IRL discussing various alleged issues with the 3 defendants' diversion control issues over the years.
We resume with former DEA unit chief Ruth Carter, state's witness, still on the stand IRL discussing various alleged issues with the 3 defendants' diversion control issues over the years.
Oh for . . . 'Cardinal stepped up reporting suspicious orders (undefined) to DEA in 2012; but if a pharmacy's order was held bc it they'd reached their order threshold, but then the threshold reset because time passed - THEY WOULD STILL SHIP NEW ORDERS.' Right. Because ....
The only reason that order was suspicious/held was because it exceeded their previously-determined order limit. Not because it was "suspicious". Then when that pharmacy needed to fill scripts PER USUAL, they placed their usual order. DEA wanted patients to suffer/go without? 🤯
#WAOpioidTrial Day 13 has begun! We open this morning with state re-arguing some objections which did not go their way last week on foundation. Let's watch and see how this goes. The three prongs (apparently) are:
Authentic
Relevant
Admissible
Authentic
Relevant
Admissible
Judge Scott has retiterated many times - and pretty much begged state to stop saying - it's not about authenticity, it's about foundation & relevance. Literally Judge said "please stop saying authenticity" AND THEN STATE SAID IT AGAIN and the Judge literally put a "wait" hand up.
Literally state is continuing to stay AUTHENTIC - it had the company's logo on it on every page .. .. .
While IANAL . .. I think the judge is going to maintain his earlier rulings on the series of objections from last week. Interesting stuff.
While IANAL . .. I think the judge is going to maintain his earlier rulings on the series of objections from last week. Interesting stuff.
