Mayor & City Council Of Baltimore vs. Purdue Pharma L.P. et al

Case Background

On March 16, 2018, the Plaintiff Mayor & City Council of Baltimore filed a Personal Injury lawsuit in the Maryland State, Baltimore Circuit Court (Case number: 1:18cv800). This case was assigned to  Chief Judge George Levi Russell, III.

Cause

The opioid epidemic devastated Baltimore as manufacturers, distributors, and prescribers engaged in unlawful promotion and distribution of prescription opioids. Beginning in the early 2000s, pharmaceutical companies launched aggressive marketing campaigns that misrepresented the risks and benefits of long-term opioid use. The FDA mandated black box warnings about addiction and fatal respiratory depression risks, but manufacturers systematically downplayed these dangers through deceptive marketing practices.

Studies revealed alarming statistics: between 30% and 40% of long-term opioid users developed opioid use disorder. Despite lacking reliable scientific evidence supporting extended opioid use for chronic pain management, manufacturers promoted both long-acting opioid medications like OxyContin and short-acting opioids like Actiq. The manufacturers knew that no clinical trials had proven the safety and efficacy of opioid use beyond 12 weeks for chronic pain treatment.

The opioid manufacturers targeted doctors through misleading educational materials, treatment guidelines, and continuing medical education programs. They deliberately obscured the connection between physical dependence and addiction while promoting the concept of “pseudoaddiction.” This deceptive marketing led to widespread overprescribing as doctors received distorted information about opioid risks and benefits.

Injuries

Baltimore suffered devastating public health impacts from the prescription opioid crisis. The city experienced record-high rates of opioid abuse, addiction, overdose, and death, which tore families and communities apart. Emergency rooms faced a surge in opioid-related visits, while treatment centers struggled to meet the growing demand for addiction services. The crisis strained Baltimore’s healthcare system as costs skyrocketed for treating opioid use disorder and related medical complications.

The epidemic’s ripple effects hurt Baltimore’s workforce and economy, causing lost productivity, higher absenteeism, and increased healthcare costs for employers. A thriving black market emerged for diverted prescription opioids, forcing law enforcement to expand drug trafficking investigations and emergency response capabilities. The crisis also worsened homelessness as opioid addiction drove more residents into poverty and housing instability.

The distortion of medical standards resulted in dangerous overprescribing patterns across Baltimore. Doctors, influenced by years of deceptive marketing, prescribed powerful opioids for conditions where risks outweighed benefits. This created a pipeline of opioid addiction that devastated neighborhoods already struggling with poverty and limited access to healthcare.

Damages

Baltimore incurred massive financial damages from the prescription opioid epidemic. The city spent millions on employee health insurance claims for opioid addiction treatment, rehabilitation services, and medical care for opioid-related illnesses and injuries. Emergency response costs surged as first responders dealt with opioid overdoses, while law enforcement expanded operations to address opioid trafficking.

The epidemic drained Baltimore’s resources through fraudulent prescription payments, lost tax revenue due to reduced workforce productivity, and expanded social services for affected families. The city allocated nearly $11 million for homeless services as opioid addiction drove housing instability. Treatment programs, prevention initiatives, and public health campaigns required substantial funding to address the opioid crisis.

The damages extended beyond direct costs to include broader economic impacts. Businesses faced higher insurance premiums and lost productivity. Communities suffered decreased property values and tax revenues as the opioid epidemic took its toll. The city’s reputation and quality of life deteriorated as it struggled to contain the devastating effects of widespread opioid addiction.

The city sought comprehensive remedies, including monetary damages, civil penalties, and injunctive relief requiring defendants to cease deceptive practices and help abate the public health crisis they created.

Key Arguments and Proceedings

Legal representation

  • Plaintiff(s): Mayor & City Council of Baltimore
    • Counsel for Plaintiff: Andre M. Davis | Lydie Essama Glynn | Christopher Russell Lundy | Suzanne Sangree | Bill Carmody | Seth Ard | Sy Polky | Adam Carlis | Cory Buland | David Peterson | Edgar Sargent | Geng Chen | Rocco Magni | Michael Kelso | Krisina Zuñiga | Max Straus | Betsy Aronson | Alicia Lai | Tom Boardman
  • Defendant(s): Johnson & Johnson | McKesson | Cardinal Health | AmerisourceBergen Drug Corp. | Cencora Inc.  | Walgreens | CVS | Teva
    • Counsel for Defendants: John Arak Freedman | Kevin B. Collins | Anne McKenzie Roller Rucker

 Claims

Baltimore filed suit alleging four major causes of action against the opioid manufacturers, distributors, and prescribers. The first claim alleged that all defendants created a public nuisance, endangering community health and safety through deceptive promotion and distribution of prescription opioids. The second claim alleged negligence, asserting that defendants breached their duties to market truthfully and monitor suspicious orders.

The third claim targeted manufacturing defendants for violating Maryland’s Consumer Protection Act through deceptive marketing practices that misled doctors and patients about opioid risks and benefits. The fourth claim accused manufacturers of violating Maryland’s False Claims Act by causing submission of fraudulent claims for opioid prescriptions to government healthcare programs.

Defense

The defendants in this case presented several defenses:

Regulatory Compliance Defense:

They argued they adhered to FDA regulations and guidelines for opioid medications, ensuring all marketing materials were FDA-approved and included necessary warnings.

Prescriber Intervention Defense:

They claimed that doctors, as independent professionals, were responsible for the opioid prescriptions, and that they followed FDA guidelines, making the prescribing decisions outside their control.

Multiple Intervening Causes Defense:

The defendants pointed to other factors like illegal drug trafficking and pre-existing substance abuse as contributing to Baltimore’s opioid crisis, rather than their marketing practices.

Statute of Limitations Defense:

They contended that Baltimore’s claims were time-barred, as the city was aware of the opioid risks long before filing suit.

Causation and Damages Defense:

The defendants challenged the city’s ability to prove that their marketing caused the damages, arguing the link was too speculative.

Preemption Defense:

They claimed federal law, particularly FDA approval, preempted state law claims, making them immune from liability.

First Amendment Defense:

The defendants argued that their marketing of opioids was protected under the First Amendment. They claimed it was commercial speech. They asserted they had the right to provide truthful information about FDA-approved medications.

Lack of Misrepresentation Defense:

They denied making false claims about their opioids, stating their marketing was based on scientific evidence and met industry standards.

Jury Verdict

On November 12, 2024, the jury ruled in favor of the Plaintiff, holding McKesson Corporation and Cencora jointly and severally liable for damages. The jury determined that McKesson Corporation violated applicable laws and regulations, awarding $192,000,000 in damages. The jury also found that Cencora violated applicable laws and regulations, assessing damages of $74,000,000. The total damages awarded by the jury amounted to $266,000,000.

Court Documents:

Available Upon Request