Plaintiffs David and Ganna Dearinger appealed a district court grant of summary judgment to defendant Eli Lilly and Company. The case arose from an intracerebral hemorrhage, or stroke, suffered by David Dearinger in January 2018 after taking Cialis, a prescription medication manufactured by Lilly. The Dearingers alleged that Lilly failed to adequately warn Dearinger's physicians of the risk of this stroke. The dispute centered on whether Lilly's warning label was sufficient under Washington's Products Liability Act and whether the plaintiffs could establish that a different warning would have changed the prescribing physician's decision, thereby causing the injury.
The Ninth Circuit reviewed the case de novo, focusing on the doctrine of proximate causation under Washington law. The court explained that the 'learned intermediary doctrine' dictates that a manufacturer satisfies its duty to warn a patient by properly warning the prescribing physician. To succeed, plaintiffs must demonstrate that if the physician had been adequately warned, they would have treated the product differently and avoided the harm. The court relied on undisputed deposition testimony from Dr. Bardin, the urologist who prescribed the 20mg dose of Cialis that caused the injury. Dr. Bardin testified that even with an alternative warning label, he would not have changed his decision to prescribe the drug to Dearinger. Consequently, the court found the plaintiffs failed to establish the necessary causal link between the alleged failure to warn and the injury. The court also addressed a secondary theory involving Dr. Horst, the primary care physician who prescribed a lower 5mg dose. While Dr. Horst testified he might have hesitated to prescribe to someone with Dearinger's family history, the court noted Dearinger stopped taking the pills shortly after the prescription. Furthermore, the court declined to extend the duty to warn to treating physicians who did not prescribe the medication, predicting that the Washington Supreme Court would not expand the doctrine beyond the prescribing physician.
This decision reinforces the strict application of the learned intermediary doctrine in Washington products liability cases involving prescription drugs. It establishes that plaintiffs must present evidence that the specific prescribing physician would have altered their treatment plan had they received a different warning. The ruling also clarifies that manufacturers generally do not owe a duty to warn treating physicians who did not make the initial prescription decision. The case is remanded with instructions to affirm the district court's summary judgment, effectively ending the litigation for the plaintiffs.