Defense makes case for spontaneous illness in Johnson & Johnson mesothelioma trial

By John Sammon | May 13, 2019

ALAMEDA – Attorneys defending Johnson & Johnson and Colgate-Palmolive on Monday called as an expert witness an epidemiologist who said plaintiff Patricia Schmitz’s mesothelioma was a spontaneous event caused for no known reason, and not a result of using baby powder.

The trial in the Alameda County Superior Court is being streamed live courtesy of Courtroom View Network.

“Cancer can occur spontaneously from an accumulation of random (cell) mutations,” Dr. Suresh Moolgavkar, an epidemiologist and bio statistician with Exponent Inc., a scientific consulting firm based in Menlo Park, Calif., told jurors.

A central defense of Johnson & Johnson in this and past asbestos trials has been the contention that mesothelioma, a deadly cancer of the linings of the lungs, is a random event for which an exact cause cannot be pinpointed.

Schmitz is suing Johnson & Johnson for its baby powder and Colgate-Palmolive for a face powder product called Cashmere Bouquet claiming her 40-year use of the products caused her mesothelioma. Schmitz, 61, a mother of two with grandchildren who was a grade school teacher was diagnosed with the disease last year.

Doctors said they don’t expect her to survive past this summer.

The suit is one of hundreds pending against Johnson & Johnson across the country. Though many lawsuits have originated in Northern California, this is only the second case to be heard in Alameda County. Most previous asbestos trials have been heard in Los Angeles courts.

Called as a witness for the defense, Moolgavkar said mesothelioma like other cancers can occur spontaneously and the risk increases with age.

Defense attorney Pete Mularczyk asked what the rates for development of the different kinds of mesothelioma are.

Moolgavkar said pleural mesothelioma, the disease Schmitz has, increases with age at a much faster rate than pericardial mesothelioma. He added 80 to 90 percent of mesotheliomas in women could not be attributed to asbestos exposure.

“Of all cancers, 66 percent result from random (cell) mutations,” Moolgavkar said.

Moolgavkar said cancer develops when a cell mutates with an accompanying altered gene.

“The altered gene cannot be repaired,” he explained. “It (cell) divides into two (altered cells) and expands and there is a third mutation.”

The result, Moolgavkar indicated, are damaged cells dividing in the body multiplying again and again producing new altered cells.

“That is what we call a cancer,” Moolgavkar said.

Cell mutations in the body increase normally with age and by the time a person is a teenager many thousands of such mutations can take place that are not life threatening.

“I think I have more mutations than anybody else (younger) in this courtroom,” Moolgavkar noted.

Moolgavkar said cancer is a dose-response disease based on the amount of exposure to a carcinogen.

“The dose makes the poison,” he said. “You must have sufficient exposure. The higher the dose the higher the risk, however that does not mean that low doses cause cancer.”

Talc is a mineral mined for Johnson & Johnson in mines located in Italy, Vermont and more recently in Korea and China.

Moolgavkar indicated Italian studies of talc mine workers in that country where the workers were exposed to high levels of talc resulted in no cases of mesothelioma, though some developed a respiratory condition called "talcosis."

Moolgavkar said zero cases of mesothelioma among miners and millers digging the mineral had resulted. 

He agreed with a slide projected for the jury that stated, "There is no epidemiological evidence that high exposure to cosmetic talc increases the risk of mesothelioma."

"Based on your review have you seen any correlation between mesothelioma and exposure to cosmetic talc?" Mularczyk asked.

"I have not," Moolgavkar responded.

Denyse Clancy, attorney for Schmitz, on cross examination got agreement from Moolgavkar that he had said at an asbestos-related trade organization meeting in 2006 he was not an expert on asbestos.

"It was only after getting involved in (asbestos) litigation in 2002 that you specialized in any research on asbestos?" she asked.

Moolgavkar agreed he got involved in asbestos litigation after 2002.

Clancy asked Moolgavkar if he had a PhD in epidemiology.

"No ma'am I do not," Moolgavkar said.

"You're not a radiologist or a geologist?"

"Mo ma'am. I'm not."

Moolgavkar said his company bills $825 per hour for his time testifying and that his salary was $575,000 per year.

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