The Jefferson County Health Department has joined a lawsuit against 44 makers and distributors of a class of medications known as opioids.
The lawsuit originally was filed in 2018 in St. Louis City Circuit Court, when Jefferson County joined a number of other cities and counties in Missouri to sue the opioid manufacturers and distributors.
The suite alleges that the companies have known for years “that opioids were addictive and subject to abuse, particularly when used long-term for chronic non-cancer pain and should not be used except as a last resort.”
It seeks “reimbursement of public costs expended fighting the opioid epidemic and for future costs to finance community efforts aimed at ending the crisis.”
Health Department Director Kelley Vollmar said the Health Department’s Board of Directors voted unanimously Aug. 26 to join the suit.
“We were originally approached to join the case when it was first filed, but that was soon after the PDMP (Prescription Drug Monitoring Program) decision, and we didn’t think it was the right time to be involved in the suit,” she said.
The year before, the Health Department agreed to subscribe to a regional (PDMP) run by the St. Louis County Department of Public Health after the Jefferson County Council voted against joining it.
“We were recently approached again, and we have been told that we would be required to provide a lot of information concerning our drug prevention efforts to the suit. Our board agreed that it would probably be a good idea to be at the table,” Vollmar said.
Jack Garvey of the Carey, Danis and Lowe law firm in Clayton, one of the lead litigators, also has asked Comtrea, which provides health care services around the county, to join the suit.
Sue Curfman, president and chief executive officer of that agency, said Sept. 10 that Comtrea’s board had not yet decided on a course of action.
“We’re working with them to provide the information they have asked for,” she said.
Garvey said the Health Department and Comtrea were approached to be part of the suit because they receive tax money and are on the front lines of the opioid addiction problem.
The case seeks to recover costs that “plaintiffs have paid for and will continue to pay the costs, including but not limited to, of law enforcement, public safety, incarceration, medical care, costs of treatment, counseling and withdrawal, family protective services and autopsies. These public expenditures could have been avoided,” according to court documents.
The case has changed jurisdictions several times since the cases were filed in 2018.
The Missouri case, which eventually took in 18 counties and two cities, was moved out of the St. Louis Circuit Court first to the Eastern District of the U.S. District Court of Missouri and then to federal court in Ohio.
Garvey said that court agreed to remove both Jefferson and Franklin counties from that larger case, and filed separate, but identical cases to the original in the state circuit courts in those counties.
In Jefferson County, the case has been assigned to Div. 1 Circuit Judge Joe Rathert.
Rathert has set a jury trial expected to last 12 to 16 weeks beginning April 4, 2023.
“We lobbied (for Jefferson County) to be split off,” Garvey said. “I can’t speak to why the judge ruled in favor of our position, but we feel that the overall position of Jefferson County gives it a different position. At one time, Jefferson County was No. 2 in the state in opioid cases per capita and No. 2 in deaths from opioid deaths.”
The 261-page suit accuses 44 defendants, including Purdue Pharma, Janssen Pharmaceuticals, Teva Pharmaceutical, Johnson and Johnson, Mallinckrodt Pharmaceuticals, McKesson Corp., Cardinal Health, Amerisource Bergen Drug Corp., Express Scripts, Walmart, Target, Caremark, United Healthcare of the Midwest, OptumRX, Walgreens and CVS. A doctor in St. Louis, characterized in the suit as running a “pill mill” that prescribed opioids at “a high rate,” also was named as a defendant.
The suit alleges that the targeted companies have known for years “that with prolonged use, the effectiveness of opioids wanes, requiring increases in doses and markedly increasing the risk of significant side effects and addiction.”
That widespread addiction, the suit states, leads to a number of societal ills.
“The misbranding and overabundance of opioids has caused death, abuse, addiction, crime and social and familial destruction,” the suit said.
Garvey concedes it’s a complicated issue.
“This may be one of the most complex cases ever,” he said. “There are a lot of parties involved.”
Garvey said four of the defendants – McKesson, Cardinal Health, Johnson and Johnson and Amerisource Bergen – have proposed to settle their parts of any cases involving Missouri entities, including the one in Jefferson County, for a combined $455 million.
“We’ve been speaking with (Missouri) Attorney General Eric Schmitt on what that’s going to look like, how much of a share each entity will get. Of any settlement, 85 percent must be used for opioid abatement programs.”
Garvey said the law firms involved will be paid from a special fund from any settlements or judgments.
“Even if Jefferson County loses, they won’t pay us any money for costs or fees,” he said.
Two other defendants, Perdue Pharma and Mallinckrodt, have filed for bankruptcy and under federal law, are not part of the active suit.
“We will still go after them in bankruptcy court,” Garvey said.
“We still have more than 30 defendants left, although some of them are subsidiaries of the ones that filed bankruptcy. So this still could go to trial,” he said.
To prepare for a trial, Garvey said attorneys from all parties are in the discovery process, in which information is sought and reviewed.
It’s one that Vollmar said is worth being part of.
“I think it’s a good thing that we’re part of this,” she said. “I believe this case will help to fight the impact that opioids have had on our society, and it’s important for us to be part of that fight in Jefferson County.”