CRAIG FOSTER; KAREN FOSTER, as parents and next friends, Guardians and/or Administrators of the Estate of Brandy Foster, Plaintiffs-Appellants, v. AMERICAN HOME PRODUCTS CORPORATION, Defendant-Appellee, and BARRE-NATIONAL CORPORATION, Defendant. CRAIG FOSTER; KAREN FOSTER, as parents and next friends, Guardians and/or Administrators of the Estate of Brandy Foster, Plaintiffs-Appellees, v. AMERICAN HOME PRODUCTS CORPORATION, Defendant-Appellant, and BARRE-NATIONAL CORPORATION, Defendant. No. 93-1627, No. 93-1664 UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT 29 F.3d 165; 1994 U.S. App. LEXIS 17232; CCH Prod. Liab. Rep. P14,041 March 7, 1994, Argued July 14, 1994, Decided PRIOR HISTORY:
States District Court for the District of Maryland, atBaltimore. M. J. Garbis, District Judge. (CA-91-2996).
[*166] OPINION DISPOSITION:
American Home Products Corporation/Wyeth-Ayerst
("Wyeth") is a prescription drug manufacturer. Craig and
COUNSEL: Argued: Richard L. Duncan, GILREATH &
Karen Foster brought suit against Wyeth when their
ASSOCIATES, Knoxville, Tennessee, for Appellants.
daughter Brandy died after being given the generic
equivalent of one of Wyeth's brand name prescription
drugs. The district court granted summary judgment for
Wyeth [*167] as to the Fosters' products liability countsbecause Wyeth did not manufacture the drug Brandy was
On Brief: Karl J. Nelson, WHITEFORD, TAYLOR &
given, but it allowed the Fosters to proceed on a negligent
PRESTON, Towson, Maryland, for Appellee.
misrepresentation theory. It later granted Wyeth summaryjudgment on the negligent misrepresentation [**2] claim
JUDGES: Before NIEMEYER and HAMILTON, Circuit
on the ground that the Fosters failed to show reliance.
Judges, and CHAPMAN, Senior Circuit Judge. SeniorJudge Chapman wrote the opinion, in which Judge
This appeal presents two issues: whether the district
court correctly held that a manufacturer of a brand nameprescription drug may be held liable on a negligent
OPINION BY: CHAPMAN
misrepresentation theory for a death caused by anothercompany's generically equivalent drug; and, if so,
whether the district court correctly dismissed the Fosters'
29 F.3d 165, *167; 1994 U.S. App. LEXIS 17232, **2;
claim for failure to show reliance. We hold that a name
misrepresentation, and the district court agreed. 1 The
brand manufacturer cannot be held liable on a negligent
district court then granted Wyeth summary judgment on
misrepresentation theory for injuries resulting from use of
the negligence, strict liability and breach of warranty
another manufacturer's product, and therefore do not
promethazine at issue, however, it allowed the negligentmisrepresentation claim to stand. The district court stated
that it was assuming for summary judgment purposes thatWyeth was promoting the use of promethazine in general,
Phenergan is a brand name prescription drug
as opposed to only its own product, Phenergan. It further
manufactured and sold by Wyeth. On August 28, 1988
Dr. Martin Berger prescribed Phenergan Syrup Plain forinfant twins Brandy and Bradley Foster, who were
Promethazine Syrup Plain, a generic equivalent of
Phenergan manufactured and sold by My-K Laboratories,
Inc. The active ingredient in both Phenergan Syrup Plain
for Brandy Foster, then Wyeth may beliable for any harm caused to Brandy as a
promethazine several times over the next few days, [**3]
last on the night of September 10, 1988. The following
morning, six-week-old Brandy was found dead in hercrib. The autopsy report attributed Brandy's death to
Sudden Infant Death Syndrome ("SIDS"). A pediatrician
misrepresentation claim to be distinct from the Fosters'
from the Maryland SIDS Center at the University of
products liability claims and therefore unaffected by the
Maryland opined that Brandy's death was caused by the
fact that [**5] Wyeth did not manufacture the product
The Fosters brought suit in state court against Wyeth
Although we have some question whether the
and Barre-National Corporation. At that time the Fosters
Fosters' complaint actually alleged negligent
thought Barre-National had manufactured the generic
misrepresentation, as there was no such count and
promethazine Brandy was given. Wyeth removed the
case to federal court on grounds of diversity of
"negligent misrepresentation," we address this
citizenship, and the district court granted Barre-National
appeal on the assumption that it did because the
summary judgment when it was determined that My-K
Laboratories manufactured the generic promethazineBrandy took. The Fosters then brought suit against
Wyeth then filed a motion for summary judgment on
My-K, but agreed to a dismissal with prejudice for
the negligent misrepresentation claim, arguing that the
Fosters had not shown reasonable reliance. With itsmotion Wyeth filed an affidavit signed by Dr. Berger
The Fosters' complaint against Wyeth contained four
stating that he prescribed Phenergan for Brandy based
counts: Negligence -- Wrongful Death, Negligence --
only on his own experience with the drug and did not rely
Survivorship, Strict Liability, and Breach of Warranty.
on any representations made by Wyeth. The district court
Wyeth moved for summary judgment on all counts,
granted Wyeth's motion for summary judgment on the
arguing that it could not be liable for Brandy's death
ground that the Fosters had not shown that Dr. Berger
because it did not manufacture the promethazine [**4]
relied on representations made by Wyeth in his decision
to prescribe Phenergan for Brandy and Bradley.
At the summary judgment hearing, the Fosters
The Fosters now appeal the district court's dismissal
argued that their complaint also sounded in negligent
29 F.3d 165, *168; 1994 U.S. App. LEXIS 17232, **5;
of their negligent [**6] misrepresentation claim, and
to being held liable for such injury.
determination that Wyeth could be held liable on a
negligent misrepresentation theory for injuries caused by
The Fosters insist, however, that the fact that Wyeth
did not manufacture the promethazine should not shield
Wyeth from an action for negligent misrepresentation. This argument, as well as the district court's assumption
We review the district court's decision granting
summary judgment de novo. Moore v. Winebrenner, 927F.2d 1312, 1313 (4th Cir.), cert. denied, 112. S. Ct. 97
products, appears to stem from certain practices of the
generic drug industry and from the federal regulatoryscheme governing generic drug manufacturing and sales,
Although there is no recognized cause of action
The following description oversimplifies the
federal statutory and regulatory scheme for drug
manufacturer for injuries stemming from use of another
premarketing approval, but is sufficient for
manufacturer's product, the district court allowed the
Fosters' negligent misrepresentation action to proceedbecause he viewed it as distinct from the Fosters'
[*169] The Food, Drug and Cosmetics Act requires
products liability claims. We are unable to see any
that manufacturers obtain regulatory approval for drugs
validity in this distinction. Although actions for negligent
prior to marketing them. 21 U.S.C.A. § 355(a) (West
misrepresentation arise in many contexts other than
[**9] Supp. 1994). For drugs that have never before been
products liability, in this case the allegations of negligent
marketed, the approval process requires submission of a
misrepresentation are an effort to recover for injuries
new drug application ("NDA"), which in turn mandates
caused by a product without meeting the requirements the
costly and time-consuming studies of the drug's safety
law imposes in products liability actions. Maryland law
and effectiveness. See 21 U.S.C.A. § 355(b)(1) (West
requires a plaintiff seeking to recover for an injury by a
Supp. 1994). As a result of the Drug Price Competition
and Patent Term Restoration Act of 1984, Pub. L. No.
manufactured the product at issue. See Tidler v. Eli Lilly
98-417, 98 Stat. 1585, generic drugs can now gain
& Co., 271 U.S. App. D.C. 163, 851 F.2d 418, 424
approval pursuant to an abbreviated new drug application
(D.C.Cir. 1988) (federal court applying Maryland law
("ANDA"), which permits the applicant to provide data
refused to adopt non-identification theories of product
demonstrating that the generic drug is the same as a
liability because such theories had not been recognized
previously approved drug in terms of its suggested usage,
by Maryland courts); Lohrmann v. Pittsburgh Corning
active ingredients, method of administration, dosage,
Corp., 782 F.2d 1156, 1163-64 (4th Cir. 1986) (verdict in
strength, and bioequivalence 3 in lieu of the studies
favor of asbestos manufacturers affirmed when plaintiff
necessary for an initial NDA. 21 U.S.C.A. § 355(j)(2)(A)
did not demonstrate exposure to defendants' products);
(West Supp. 1994). Thus, a manufacturer is not required
Jensen v. American Motors Corp., 50 Md. App. 226, 437
to perform safety and effectiveness studies if it can prove
A.2d 242, 247 (Md. Ct. Spec. App. 1981) ("Regardless of
its drug is equivalent to a previously approved drug for
the recovery theory, the plaintiff in product litigation
which such testing has already been performed. The
must satisfy three basics from an evidentiary standpoint:
generic manufacturer must use the same labeling as the
(1)the existence of a defect; (2)the attribution of the
defect to the seller; and (3)a causal relation between the
U.S.C.A. § 355(j)(2)(A)(v) (West Supp. 1994). However,
defect and the injury."). The Fosters are attempting to
manufacturers of generic drugs approved pursuant to
hold Wyeth liable for injuries caused by another
ADNAs may alter a drug's labeling "to add or strengthen
manufacturer's product, and we are persuaded that the
a contraindication, warning, precaution or adverse
Maryland courts would reject this effort to [**8]
reaction" or "to delete false, misleading or unsupported
circumvent the necessity that a defendant be shown to
indications for use or claims for effectiveness" without
have manufactured the product that caused an injury prior
prior FDA approval. 21 C.F.R. §§ 314.70(c)(2), 314.97
29 F.3d 165, *169; 1994 U.S. App. LEXIS 17232, **10;
We do not accept the assertion that a generic
misrepresentations on its product labels if it did not
significant difference between the rate and extent
initially formulate the warnings and representations itself.
of absorption of two drugs with the same active
When a generic manufacturer adopts a name brand
ingredients administered at the same molar dose
manufacturer's warnings and representations without
under similar experimental conditions, or when a
independent investigation, it does so at the risk that such
difference in the extent of absorption in such
warnings and representations may be flawed. In cases
circumstances is not medically significant and
involving products alleged to be defective due to
certain other requirements are met. 21 U.S.C.A. §
inadequate [*170] warnings, "the manufacturer is held
355(j)(7)(B) (West Supp. 1994).
to the knowledge and skill of an expert . . . . Themanufacturer's status as expert means that at a minimum
For economic reasons, generic manufacturers accept
without question the studies performed by name brand
discoveries, and advances and is presumed to know what
manufacturers and simply copy verbatim the [**11]
is [**13] imparted thereby." Owens-Illinois v. Zenobia,
name brand drugs' package circulars. Although generic
325 Md. 420, 601 A.2d 633, 639 (Md. 1992) (quoting
manufacturers do not advertise, they still are able to
Borel v. Fibreboard Paper Prods. Corp., 493 F.2d 1076,
generate sales, as pharmacists often substitute generic
1098 (5th Cir. 1973), cert. denied, 419 U.S. 869, 42 L.
drugs for name brand prescriptions because the generics
Ed. 2d 107, 95 S. Ct. 127 (1974)). The same principle
cost less. Unless a physician affirmatively indicates that a
applies in the instant case; as an expert, a manufacturer of
prescription is to be dispensed as written, the pharmacist
generic products is responsible for the accuracy of labels
may substitute a lower priced generic equivalent for the
placed on its products. Although generic manufacturers
name brand drug actually prescribed. Md. Heath Occ.
must include the same labeling information as the
Code Ann. § 12-508 (Michie Supp. 1993).
equivalent name brand drug, they are also permitted toadd or strengthen warnings and delete misleading
The Fosters argue that because generic drugs are
statements on labels, even without prior FDA approval.
required by federal law to be equivalent to their name
21 C.F.R. § 314.70 (1993). The statutory scheme
brand counterparts, any representations Wyeth makes
governing premarketing approval for drugs simply does
when advertising Phenergan also apply to generic
not evidence Congressional intent to insulate generic
promethazine, and name brand manufacturers, such as
drug manufacturers from liability for misrepresentations
Wyeth, know that generic manufacturers rely on their
made regarding their products, or to otherwise alter state
studies and duplicate their labeling, and that if the name
products liability law. Manufacturers of generic drugs,
brand manufacturer does not issue a warning, it will
like all other manufacturers, are responsible for the
simply not be made. Wyeth is also aware that when
Phenergan is prescribed, the patient may actually receive
We also reject the contention that a name brand
The Fosters make two assertions regarding this
manufacturer's statements regarding its drug can serve as
scenario. First, a plaintiff will be unable to recover from
the basis for liability for injuries caused by another
undertake the expense of developing pioneer drugs,
manufacturer did not formulate any of the representations
performing the studies necessary to obtain premarketing
it made regarding its product, but simply duplicated the
approval, and formulating labeling information. Generic
name brand manufacturer's representations regarding the
manufacturers avoid these expenses by duplicating
name brand drug. Second, if a doctor prescribes
successful pioneer drugs and their labels. Name brand
Phenergan in reliance on misrepresentations made by
advertising benefits generic competitors because generics
Wyeth, and generic promethazine is substituted and
are generally sold as substitutes for name brand drugs, so
causes injury to the patient, Wyeth should be held
the more a name brand drug is prescribed, the more
responsible because such a result was entirely foreseeable
potential sales exist for its generic equivalents. There is
no legal precedent for using a name brand manufacturer's
29 F.3d 165, *170; 1994 U.S. App. LEXIS 17232, **14;
statements about its own product as a basis for liability
Cross Keys is distinguishable from the instant case,
for injuries caused by other manufacturers' products, over
as the architects in Cross Keys used U.S. Gypsum's plan
whose production the name brand manufacturer had no
but failed to follow its specifications, while the Fosters
control. This would be especially unfair when, as here,
did not use Wyeth's product at all, and the language
the generic manufacturer reaps the benefits of the name
[**17] on which the Fosters rely is dicta.
brand manufacturer's statements by copying its labels andriding
In sum, the Fosters offer no authority for their
assertion that one manufacturer can be held liable for
injuries stemming from another manufacturer's product,
approved drugs cannot be construed to create liability of
and demonstrate no basis in the federal drug approval
a name brand manufacturer when another manufacturer's
scheme for treating drug manufacturers differently from
other manufacturers in products liability actions.
The Fosters offer no case in which one manufacturer
has been held liable on a negligent misrepresentation
The Fosters' negligent misrepresentation action
theory for injuries caused by another manufacturer. They
against Wyeth also fails because Wyeth is under no duty
contend, however, that Village of Cross Keys v. U.S.
of care to the Fosters. The elements of the tort of
Gypsum Co., 315 Md. 741, 556 A.2d 1126 (Md. 1989),
negligent misrepresentation under Maryland law are:
supports their theory of liability. In Cross Keys, architectsdesigned a "curtain wall" system for a building based on
1) the defendant, owing a duty of care tothe plaintiff, negligently asserts a false
556 A.2d at 1129. The specifications
required U.S. Gypsum materials, some of which hadunique designs specially suited for curtain wall systems. Id. at 1130. The architects' design varied somewhat from
statement will be acted on by the plaintiff;
the U.S. Gypsum specifications and did not use theunique U.S. Gypsum products. Id. When the curtain wall
system leaked, the architects sued U.S. Gypsum claiming
they relied on U.S. Gypsum's design and the design was
statement which, if erroneous, will cause
faulty. Id. at 1127. The Maryland Court of Appeals held
that the architects could not [**16] recover against U.S. Gypsum for negligent misrepresentation because they had
4) the plaintiff, justifiably, takes action
not adhered to the U.S. Gypsum specifications, including
the use of U.S. Gypsum products, and therefore could notshow reasonable reliance on the publication. Id. at 1135.
Alternatively, U.S. Gypsum had no duty to the architects
because they had not adhered to the U.S. Gypsum
specifications and therefore had not used the U.S. Gypsum system. Id.Martens Chevrolet v. Seney, 292 Md. 328, 439 A.2d
The language on which the Fosters rely pertains to
534, 539 (Md. 1982) (emphasis [**18] supplied). An
U.S. Gypsum's argument that it did not have a sufficient
action for negligent misrepresentation will not lie unless
nexus with the architects to result in liability because it
the defendant owes the plaintiff a duty of care. Weisman
did not deal directly with the architects. Id. at 1134. The
v. Connors, 312 Md. 428, 540 A.2d 783, 790-92 (Md.
court specifically declined to determine the validity of
this argument, but expressed strong doubts regarding it,because the architects
The Fosters contend that a duty exists in this case
publication's intended and foreseeable audience and the
purpose of the publication was to generate profits through
misrepresentations regarding Phenergan could result in
the sale of U.S. Gypsum products. Id.
personal injury to users of Phenergan's generic
29 F.3d 165, *171; 1994 U.S. App. LEXIS 17232, **18;
equivalents. They point to Jacques v. First National
users of other manufacturers' products, a negligent
Bank, a negligence action, which noted:
misrepresentation action cannot be maintained against iton the facts of this case.
creates a risk of economic loss only, courts
have generally required an intimate nexus
As a federal court sitting in diversity, we must apply
between the parties as a condition to the
the applicable state law as it now exists. Erie R.R. Co. v.
imposition of tort liability. This intimate
Tompkins, 304 U.S. 64, 78, 82 L. Ed. 1188, 58 S. Ct. 817
nexus is satisfied by contractual privity or
(1938); Tritle v. Crown Airways, Inc., 928 F.2d 81, 84
its equivalent. By contrast, where the risk
(4th Cir. 1990). Under current Maryland law, we find no
created is one of personal injury, no such
basis for a negligent misrepresentation action on the facts
direct relationship need be shown, and the
of this case and hold that the negligent misrepresentation
claim [**20] should have been disposed of along with
the Fosters' other products liability claims. Therefore, it isunnecessary to consider whether the district court
515 A.2d 756, 759-60 (Md. 1986). We think to impose a
properly dismissed that claim for failing to demonstrate
duty in the circumstances of this case would be to stretch
that Dr. Berger relied on representations of Wyeth in
the concept of foreseeability too far. The duty required
prescribing Phenergan for [*172] Brandy Foster. We
for the tort of negligent [**19] misrepresentation arises
affirm the district court's grant of summary judgment to
when there is "such a relation that one party has the right
Wyeth, but on the ground that Maryland law does not
to rely for information upon the other, and the other
giving the information owes a duty to give it with care."
misrepresentation against one manufacturer for injuries
Weisman v. Connors, 540 A.2d at 790 (quoting Holt v.
caused by another manufacturer's product. Kolker, 189 Md. 636, 57 A.2d 287, 288 (Md. 1948)). There is no such relationship between the parties to this
case, as Brandy Foster was injured by a product thatWyeth did not manufacture. As Wyeth has no duty to the
Robert S. Berry, M.D. Because of the charitable nature of the clinic, I had consideredmaking it a non-profit to take advantage of tax breaks and to raiseThe greatest benefit of an insurance-free practice is justmoney for my own salary. After several discussions with myattorney, I was inclined to decide against it. He pointed out thatMore than three years ago, I left emergency medicine to s
Isolation of Caffeine from Tea Introduction A number of interesting, biologically active compounds have been isolated from plants. Isolating some of these natural products , as they are called, can require interesting extraction strategies. Caffeine, shown below along with some of its close relatives, is a nitrogen-containing compound. Since nitrogen containing organic compounds behave