New U.S. health crisis looms as patients without COVID-19 delay care

By Sharon Bernstein

(Reuters) – A Texas man who waited until his brain tumor was softball-sized; a baby who suffered an ear infection for six days; a heart patient who died: The resurgence of COVID-19 is creating another health crisis as hospitals fill and patients are fearful or unable to get non-emergency care.

With U.S. coronavirus infections reaching new heights, doctors and hospitals say they are also seeing sharp declines in patients seeking routine medical care and screenings – and a rise in those who have delayed care for so long they are far sicker than they otherwise would be.

“I had one lady who had delayed for five days coming in with abdominal pain that was getting worse and worse,” said Dr. Diana Fite, who practices emergency medicine in Houston. “When she finally came in, she had a ruptured appendix.”

After the pandemic was declared a national emergency in March, many states banned non-essential medical procedures, and the number of patients seeking care for other ailments took a nosedive. Hospitals and medical practices were hit hard financially.

Emergency department use dropped by 42% during the first 10 weeks of the pandemic despite a rise in patients presenting with symptoms of the coronavirus, data from the U.S. Centers for Disease Control and Prevention show. In the same period, patients seeking care for heart attacks dropped by 23% and stroke care by 20%.

As the initial outbreak leveled off in the weeks that followed, healthcare experts planned to handle primary care differently should infections rise again, making sure minor procedures like cancer screenings were still allowed and assuring patients that hospitals and clinics were safe.

But the recent surge in cases has swamped hospitals in many states, including Texas, Arizona, Florida and parts of California.

CANCER MORTALITY RATES

Texas has again banned many non-emergency procedures, though cancer surgeries are still allowed, and a hospital in California’s San Joaquin Valley for several days admitted only COVID-19 patients.

Patients without COVID-19 – either out of fear, confusion or because of difficulty in obtaining the care they need – are again staying home.

The result is a healthcare crisis in the making, said Austin oncologist Dr. Debra Patt, who said she expects mortality rates from cancer to skyrocket in the years after the pandemic because patients have delayed their care.

“They’re scared to go in the hospital unless they absolutely have to,” said Patt. “And even when the patients are willing, it’s hard to get things done.”

Patt in recent days treated a man who waited to come in for headaches and dizziness until he had lost 35 pounds and had a softball-sized tumor in his head.

Fite, who is president of the Texas Medical Association, cared for a baby whose parents waited six days before bringing him in with a severe ear infection.

Patt said screening mammograms are down by 90% in Austin, where she specializes in breast cancer and serves as executive vice president of Texas Oncology. That means some tumors will be missed, and women who develop aggressive cancers might not know about it until the disease is more advanced and more likely to be deadly.

“It’s an impact we will see on cancer survival for years to come,” she said.

Dr. David Fleeger, a colorectal surgeon in Austin and a past president of the Texas Medical Association, said he has had numerous patients cancel colonoscopies in recent days.

“The delays in colonoscopies that are occurring right now ultimately will lead to more cancers and more deaths,” he said.

‘IN A HOLDING PATTERN’

Patt’s patient Helen Knost had to put off surgery for breast cancer in early spring because it was considered non-emergency in Texas and barred at the time, and she was treated instead with the medication Tamoxifen.

“It’s very strange to know you have cancer and you’re just hanging out with it, just in a holding pattern,” said Knost, who did ultimately undergo successful surgery.

In California, doctors at the 150-bed Adventist Lodi Memorial Hospital in the San Joaquin Valley were determined that a second surge in coronavirus cases would not bring a repeat of the pandemic’s early days, when emergency room visits dropped in half. Emergency medical technicians also reported a 45% rise in the number of heart patients who died before they could be brought to the hospital.

Hospital CEO Daniel Wolcott led a campaign to inform the community that the medical center was open and safe, even speaking to people about it in the grocery store.

But with new COVID-19 cases swamping the hospital, sickening nearly 30 staff members and forcing it to divert non-coronavirus cases to other facilities for several days, Wolcott fears that again patients with heart conditions and other illnesses will stay away.

“We won’t know for years how many people lost their lives or lost good years of their lives for fear of coronavirus,” he said.

(Reporting by Sharon Bernstein in Sacramento, California; editing by Bill Tarrant and Cynthia Osterman)

Bayer puts part of Roundup settlement on hold

FRANKFURT (Reuters) – Bayer <BAYGn.DE> has agreed to delay part of a proposed settlement of allegations that its widely used weedkiller Roundup caused cancer after a U.S. judge questioned its plan to deal with future claims.

The German company said on Wednesday that lawyers representing those preparing a class action had withdrawn a request for court approval of the $1.25 billion scheme, part of a broader $10.9 billion agreement to settle close to 100,000 U.S. lawsuits related to Roundup.

The move would give the parties more time to address questions raised by Federal District Court Judge Vince Chhabria of the Northern District of California who presides over the federal Roundup litigation, Bayer said in a statement.

“Bayer remains strongly committed to a resolution that simultaneously addresses both the current litigation on reasonable terms and a viable solution to manage and resolve potential future litigation”, it added.

It declined to comment on the impact of the withdrawal on the timetable for the rest of the settlement.

Bayer is seeking to end legal disputes it inherited with its $63 billion takeover of Monsanto in 2018.

Bayer shares were down 1.2% by 1307 GMT.

On Tuesday, Bayer shares had fallen more than 6% after Chhabria said that the court was inclined to oppose the part of the proposed settlement that deals with future claims. The case was due to be considered again on July 24.

Bayer had planned to create an independent panel of scientific experts to help assess whether glyphosate caused cancer.

But in a filing published on July 6, Chhabria had questioned the idea of delegating the decision from judges and juries to a panel of scientists.

Chhabria also questioned whether potential claimants would want to remain bound by a ruling reached by the proposed scientific panel if research is still ongoing.

Regulators including the U.S. Environmental Protection Agency and the European Chemicals Agency, have determined glyphosate to be non-carcinogenic, supporting Bayer’s claim that the active ingredient in its Roundup product is safe for agricultural use.

However, in 2015, the World Health Organization’s cancer research arm determined the herbicide to be a “probable carcinogen”, and since 2018, three consecutive U.S. juries, who listened to scientific evidence from both sides during trials, found that Roundup causes cancer.

(Reporting by Arno Schuetze; Editing by Keith Weir)

9/11 We will not forget!

By Kami Klein

On September 11th, 2001, we witnessed the worst of humanity; an evil we could not imagine. Over 3000 lost their lives that day when a group of terrorists shook our nation to its core. The loss of so many rippled throughout the world.  Families were torn apart within a few hours. The grief was unimaginable and America’s heart was broken. 

 After the attacks, countless stories unfolded revealing extraordinary acts of courage, sacrifice, kindness, and compassion. In the aftermath of the World Trade Center in New York City alone over 16.000 people performed rescue, recovery, demolition and debris cleanup.  These amazing men and women did not know or care about the dangers of their task but rose up in tremendous courage to show the best of what America stands for. 

Ground zero contained toxic dust that held heavy metals and asbestos and other dangerous chemicals.  We are seeing the aftermath years later as countless of these heroes of 9/11 have died or are very sick from illnesses related to this tragedy.  Scarring in the lungs has effected hundreds of responders and experts say this is only the beginning.   

So far, 156 New York City police officers have died from 9/11 related illnesses. 182 in the Fire Department. Countless others are facing debilitating lung disease and aggressive cancers. 

We cannot forget those who lost their lives on 9/11.  We cannot forget now, those that are still giving their lives for our country because of that day and the days following 9/11.  

Eighteen years ago, the nation turned to God.  The churches were filled and prayers were said all over the world. We embraced each other no matter what political belief or religious faith. We were not offended by each other because together we were at war with evil. 

We are still at war but somehow we have turned on one another. 

The attack of 9/11 is not over.  Our heroes from that day are the victims now. We must remember those who are still suffering and fill our churches with faith and prayer. We the people of the United States must feel called upon to honor these brave men and women.  May we come together again, as we did on that day when Love won over hate, Good over evil, and all of us remembered that we are Americans and were willing to sacrifice for each other.

The Lord worked through the very best of us that day and continued doing so during the months and years that have passed. In our prayers, in our memories, and in the stories that we must pass on, these are the people and heroes we cannot afford to ever forget!   

 

U.S. trial tests claims Roundup weed killer caused cancer

By Jim Christie

(Reuters) – Bayer AG on Monday faced a second U.S. jury over allegations that its popular glyphosate-based weed killer Roundup causes cancer, six months after the company’s share price was rocked by a $289 million verdict in California state court.

The lawsuit by California resident Edwin Hardeman against the company began on Monday morning in federal rather than state court. The trial is also a test case for a larger litigation. More than 760 of the 9,300 Roundup cases nationwide are consolidated in the federal court in San Francisco that is hearing Hardeman’s case.

Bayer denies all allegations that Roundup or glyphosate cause cancer, specifically non-Hodgkin’s lymphoma, saying decades of independent studies have shown the world’s most widely used weed killer to be safe for human use and noting that regulators around the world have approved the product.

During the first phase in the trial, the nine-person jury is asked to weigh scientific evidence to determine whether Roundup caused Hardeman’s lymphoma.

Aimee Wagstaff, a lawyer for Hardeman, told a packed courtroom during her opening statement on Monday that chemicals in Roundup made the weed killer more toxic than glyphosate alone, causing the man’s cancer.

But U.S. District Judge Vince Chhabria, who presides over the federal litigation, repeatedly scolded her for “crossing the line” by referring to internal corporate communications the judge has said have no bearing on the science in the case.

“You completely disregarded the limitations,” Chhabria said.

In a January ruling, Chhabria called evidence by plaintiffs that the company allegedly attempted to influence regulators and manipulate public opinion “a distraction” from the scientific question of whether glyphosate causes cancer.

If the jury determines Roundup caused Hardeman’s cancer, the judge said such evidence could be presented in a second trial phase.

Plaintiffs criticized Chhabria’s order dividing the trial and restricting evidence as “unfair,” saying their scientific evidence allegedly showing glyphosate causes cancer is inextricably linked to Monsanto’s alleged wrongful conduct.

Evidence of corporate misconduct was seen as playing a key role in the finding by a California state court jury in August that Roundup caused another man’s non-Hodgkin’s lymphoma and that Bayer’s Monsanto unit failed to warn consumers about the weed killer’s cancer risks. That jury’s $289 million damages award was later reduced to $78 million.

Bayer’s share price dropped 10 percent following the verdict and has remained volatile.

Brian Stekloff, a lawyer for Bayer, in his opening statement attacked the idea of a link between Roundup and cancer. He noted U.S. rates of non-Hodgkin’s lymphoma have remained steady over time, even when Roundup use began to soar in the 1990s.

Hardeman began using the Roundup brand herbicide with glyphosate in the 1980s to control poison oak and weeds on his property and sprayed “large volumes” of the chemical for many years on a regular basis, according to court documents. He was diagnosed with non-Hodgkin’s lymphoma at the age of 66 in February 2015 and filed his lawsuit a year later. Hardeman is currently in remission.

But Stekloff on Monday said Hardeman’s age and his history of chronic hepatitis C were known risk factors for developing lymphoma. The lawyer also said the majority of non-Hodgkin’s lymphoma incidents are idiopathic, or have no known cause.

(Reporting by Jim Christie in San Francisco, Writing by Tina Bellon; editing by Anthony Lin, Lisa Shumamker and Tom Brown)

U.S. Justice Ginsburg released from hospital after cancer surgery

FILE PHOTO: U.S. Supreme Court Associate Justice Ruth Bader Ginsburg is seen during a group portrait session for the new full court at the Supreme Court in Washington, U.S., November 30, 2018. REUTERS/Jim Young/File Photo

WASHINGTON (Reuters) – U.S. Supreme Court Justice Ruth Bader Ginsburg, 85, has been released from the hospital after undergoing cancer surgery, a court spokeswoman said on Wednesday.

“Justice Ginsburg was discharged from the hospital yesterday and is recuperating at home,” spokeswoman Kathy Arberg said in a statement.

The liberal justice underwent surgery at Memorial Sloan Kettering Cancer Center in New York on Friday to remove two cancerous nodules in her left lung.

There was no evidence of any remaining disease after the removal of the two nodules, both of which were found to be cancerous, Arberg said on Friday, citing the thoracic surgeon, Dr. Valerie Rusch. No further treatment was planned, she said.

Ginsburg, one of the court’s nine justices, broke three ribs in a fall last month. The nodules were found as part of the tests the justice underwent after the fall, Arberg said.

As the oldest justice, Ginsburg is closely watched for any signs of deteriorating health. Ginsburg, appointed by Democratic President Bill Clinton in 1993, also is the senior liberal member of the court, which has a 5-4 conservative majority.

If she were unable to continue serving, Republican President Donald Trump could replace her with a conservative, further shifting the court to the right. Trump already has put two conservatives on the court since becoming president in January 2017 and a potentially dominant 6-3 conservative majority would have major consequences for issues including abortion, the death penalty, voting rights, gay rights and religious liberty.

Ginsburg has recovered from previous medical issues. She was treated in 1999 for colon cancer and again in 2009 for pancreatic cancer but did not miss any argument sessions either time. In 2014, doctors placed a stent in her right coronary artery to improve blood flow after she reported discomfort following routine exercise. She was released from a hospital the next day.

The justices are scheduled to hear their next round of arguments on Jan. 7.

In recent years she has become something of a cult figure for liberals and known by the nickname “Notorious RBG,” after the late rapper Notorious BIG.

A documentary film, “RBG,” was released earlier this year and a feature film about her life, “On the Basis of Sex,” made its debut in theaters this week.

(Reporting by Lawrence Hurley; Writing by Mohammad Zargham; Editing by Tim Ahmann and Bill Trott)

U.S. judge affirms Monsanto weed-killer verdict, slashes damages

Monsanto's Roundup weedkiller atomizers are displayed for sale at a garden shop near Brussels, Belgium November 27, 2017. REUTERS/Yves Herman

By Tina Bellon

(Reuters) – A U.S. judge on Monday affirmed a verdict against Bayer AG unit Monsanto that found its glyphosate-based weed-killers responsible for a man’s terminal cancer, sending the German company’s shares down 8 percent.

In a ruling by San Francisco’s Superior Court of California, Judge Suzanne Bolanos said she would slash the punitive damages award to $39 million from $250 million if lawyers for school groundskeeper Dewayne Johnson agreed.

Bayer said in a statement the decision to reduce the damages was a step in the right direction, but it would still file an appeal with the California Court of Appeal because the verdict was not supported by the evidence presented at the trial.

“According to an earlier hearing, the judge toyed with the idea of dropping the damages altogether,” brokerage alpha said in a note to clients. “Now, however, the judge made a U-turn and confirmed the jury’s previous verdict.”

Monsanto, which denies the allegations, had asked the judge to throw out the entire original $289 million verdict or order a new trial on the punitive damages portion.

A jury on Aug. 10 found the company’s glyphosate-based weed-killers, including RoundUp and Ranger Pro, had caused Johnson’s cancer and that the company failed to warn consumers about the risks.

The verdict wiped 10 percent off the value of the company and marked the first such decision against Monsanto, which faces more than 8,000 similar lawsuits in the United States.

Plaintiff Dewayne Johnson leaves the courtroom following a post-trial hearing at the Superior Court in San Francisco, California, U.S., October 10, 2018. REUTERS/Jim Christie

Plaintiff Dewayne Johnson leaves the courtroom following a post-trial hearing at the Superior Court in San Francisco, California, U.S., October 10, 2018. REUTERS/Jim Christie

The German company, which bought Monsanto this year for $63 billion, says decades of scientific studies and real-world use have shown glyphosate to be safe for human use.

Lawyers for Johnson in a statement on Monday said they were still reviewing whether to accept the reduced award or retry the punitive damages portion.

“The evidence presented to this jury was, quite frankly, overwhelming,” the lawyers said.

The amount of punitive damages is limited by law, and Bolanos said California’s constitution did not permit a higher award. If Johnson accepts the reduced damages, the final verdict would order Monsanto to pay a total of $78 million, split equally between compensatory and punitive damages.

Bolanos’ Monday decision is a turnaround from a previous tentative ruling she issued on Oct. 10.

In that preliminary order, Bolanos said she was considering ordering a new trial on punitive damages, saying Johnson had failed to meet his burden of producing clear and convincing evidence of malice or oppression by Monsanto, a requirement for allowing a jury to award punitive damages.

But following that tentative ruling, at least five of the jurors who delivered the Aug. 10 verdict sent letters to the judge, urging her to uphold their decision. Bolanos did not directly refer to the jurors’ letters in her Monday ruling but said the jury was entitled to its findings.

In September 2017, the U.S. Environmental Protection Agency concluded a decades-long assessment of glyphosate risks and found that the chemical was not a likely carcinogen to humans.

However, in 2015, the cancer unit of the World Health Organisation classified glyphosate as “probably carcinogenic to humans.”

Johnson’s case, filed in 2016, was fast-tracked for trial due to the severity of his non-Hodgkin’s lymphoma, a cancer of the lymph system, that he alleged was caused by years of glyphosate exposure.

(Additional reporting by Ismail Shakil in Bengaluru and Arno Schuetze in Frankfurt; editing by Robert Birsel)

Three decades after nuclear disaster, Chernobyl goes solar

Visitors walk past solar panels at a solar power plant built on the site of the world's worst nuclear disaster, Chernobyl, Ukraine October 5, 2015. REUTERS/Gleb Garanich

By Pavel Polityuk

CHERNOBYL, Ukraine (Reuters) – Ukraine unveiled a solar plant in Chernobyl on Friday, just across from where a power station, now encased in a giant sarcophagus, caused the world’s worst nuclear disaster three decades ago.

A new Safe Confinement arch covering the damaged fourth reactor of the Chernobyl nuclear power plant is seen near a newly built solar power plant in Chernobyl, Ukraine October 5, 2018. REUTERS/Gleb Garanich

A new Safe Confinement arch covering the damaged fourth reactor of the Chernobyl nuclear power plant is seen near a newly built solar power plant in Chernobyl, Ukraine October 5, 2018. REUTERS/Gleb Garanich

Built in a contaminated area, which remains largely uninhabitable and where visitors are accompanied by guides carrying radiation meters, 3,800 panels produce energy to power 2,000 apartments.

In April 1986, a botched test at reactor number 4 at the Soviet plant sent clouds of nuclear material billowing across Europe and forced tens of thousands of people to evacuate.

Thirty-one plant workers and firemen died in the immediate aftermath of the accident, mostly from acute radiation sickness.

Thousands more later succumbed to radiation-related illnesses such as cancer, although the total death toll and long-term health effects remain a subject of intense debate.

“It’s not just another solar power plant,” Evhen Variagin, the chief executive of Solar Chernobyl LLC, told reporters. “It’s really hard to underestimate the symbolism of this particular project.”

The one-megawatt solar plant is a joint project by Ukrainian company Rodina and Germany’s Enerparc AG, costing around 1 million euros ($1.2 million) and benefiting from feed-in tariffs that guarantee a certain price for power.

An employee walks past solar panels at a solar power plant built on the site of the world's worst nuclear disaster, Chernobyl, Ukraine October 5, 2015. REUTERS/Gleb Garanich

An employee walks past solar panels at a solar power plant built on the site of the world’s worst nuclear disaster, Chernobyl, Ukraine October 5, 2015. REUTERS/Gleb Garanich

It is the first time the site has produced power since 2000, when the nuclear plant was finally shut down. Valery Seyda, head of the Chernobyl nuclear plant, said it had looked like the site would never produce energy again.

“But now we are seeing a new sprout, still small, weak, producing power on this site and this is very joyful,” he said.

Two years ago, a giant arch weighing 36,000 tonnes was pulled over the nuclear power station to create a casement to block radiation and allow the remains of the reactor to be dismantled safely.

It comes at a time of sharply increasing investment in renewables in Ukraine. Between January and September, more than 500 MW of renewable power capacity was added in the country, more than twice as much as in 2017, the government says.

Yulia Kovaliv, who heads the Office of the National Investment Council of Ukraine, said investors want to reap the benefits from a generous subsidy scheme before parliament is due to vote on scrapping it in July next year.

“Investors expect that in the renewable energy sector facilities launched before 2019 will operate on the current (beneficial) system of green tariffs,” she told Reuters on the sidelines of a conference in Odessa in September.

“And that is why investors want to buy ready-to-build projects in order to complete construction before that time.”

(Additional reporting by Natalia Zinets in Odessa; writing by Matthias Williams; Editing by Dale Hudson)

In Missouri, J&J faces biggest trial yet alleging talc caused cancer

FILE PHOTO: A Johnson & Johnson building is shown in Irvine, California, U.S., January 24, 2017. REUTERS/Mike Blake/File Photo

By Tina Bellon

NEW YORK (Reuters) – A lawsuit by 22 ovarian cancer patients against Johnson & Johnson went to trial on Wednesday in Missouri state court, marking the largest case the company has faced over allegations its talc-based products contain cancer-causing asbestos.

The women and their families suing in the Circuit Court of the City of St. Louis say decades-long use of J&amp;J’s Baby Powder and other cosmetic talc products caused their disease. They allege the company knew its talc was contaminated with asbestos since at least the 1970s but failed to warn consumers about the risks.

J&amp;J denies both that its talc products cause cancer and that they ever contained asbestos.

J&amp;J is battling some 9,000 cases brought by users of its Baby Powder and Shower to Shower talc products, the latter of which was sold to Valeant Pharmaceuticals in 2012.

The majority of those lawsuits claim talc caused ovarian cancer in women who used it for feminine hygiene. A smaller number of cases allege talc contaminated by asbestos in the mining process caused mesothelioma, a tissue cancer closely linked to asbestos exposure.

The cases that went to trial on Wednesday effectively combine those claims by alleging the women’s ovarian cancer was caused by asbestos in J&J talc products.

J&amp;J lawyer Peter Bicks told the jury on Wednesday that the causes for ovarian cancer are often unknown, according to an online broadcast of the trial by Courtroom View Network.

He said gene mutations and a family history of cancer played an important role and that asbestos was not known to cause ovarian cancer.

Bicks added that testing done by independent laboratories, universities, government agencies, talc suppliers and J&amp;J itself has shown that there is no asbestos in the company’s talc.

But plaintiff’s lawyer Mark Lanier said asbestos and talc, which are closely linked minerals, are intermingled in the mining process, making it impossible to remove the carcinogenic substance. Lanier said there was “no doubt” that talc caused his clients’ ovarian cancer.

“This case is as simple as asbestos breathed in or put inside of you,” Lanier told the jury.

J&J has lost two talc mesothelioma jury trials in the past weeks. Those cases are currently under appeal.

Juries in California and Missouri have also issued verdicts in ovarian cancer cases totaling more than $720 million in damages. Those decisions have either been tossed out or are still under appeal.

(Reporting by Tina Bellon; Editing by Cynthia Osterman)

J&J Baby Powder litigation takes new focus with asbestos claims

FILE PHOTO: Bottles of Johnson & Johnson baby powder line a drugstore shelf in New York October 15, 2015. REUTERS/Lucas Jackson/File Photo

By Tina Bellon

NEW YORK (Reuters) – A $117 million verdict against Johnson & Johnson and a supplier in favor of a man who said his asbestos-related cancer was caused by long-term use of J&J’s Baby Powder could open a new front for thousands of cases claiming the widely-used product caused cancer, legal experts and plaintiffs lawyers said.

J&amp;J has been battling some 6,000 cases claiming its baby powder and Shower to Shower products cause ovarian cancer. The $117 million verdict by a New Jersey jury last week, however, involved a different form of cancer that is clearly linked to asbestos.

Plaintiffs lawyers claim that internal J&amp;J documents seen in that trial show that baby powder had been contaminated with asbestos. They now plan to use the documents in upcoming ovarian cancer trials to allege that the asbestos contamination also caused that form of cancer.

J&amp;J and Imerys Talc America, a unit of Imerys SA, have vowed to appeal the New Jersey verdict and deny asbestos has ever been present in their products or that their talc can cause any form of cancer.

The case of Stephen Lanzo, a New Jersey resident who claimed he developed mesothelioma after using baby powder since his birth in 1972, was the first time a jury saw the internal J&amp;J documents which plaintiffs claim show that J&amp;J knew since the 1970s that the talc in its baby powder was contaminated by asbestos during the mining process.

J&J says the documents present no such evidence, but merely show the company’s caution.

Peter Bicks, a lawyer leading J&J’s talc asbestos defense, said that in the early 1970s, the company was looking at how it could potentially remove asbestos from talc if the two became intermingled in the mining process. He says no contamination was ever found, citing decades of testing by independent laboratories and scientists.

Bicks called the claims of a link between talc and asbestos “junk science.”

Mesothelioma, a rare and deadly form of cancer closely associated with exposure to asbestos, affects the delicate tissue that lines body cavities.

While the link between asbestos and mesothelioma is sufficiently established, scientists are divided on whether asbestos exposure can cause ovarian cancer. Some studies have shown an association between the two, while other studies have found no such link.

Elizabeth Burch, holder of the Charles H. Kirbo Chair of Law at the University of Georgia, said it remained an open question whether talc contained asbestos and that each case would turn on the facts.

But J&J, which had $76.5 billion in sales in 2017, gives the plaintiffs’ bar an enticing new target, said Nathan Schachtman, a lecturer at Columbia University who used to defend asbestos cases.

Some 3,000 people are diagnosed with mesothelioma each year, according to the American Cancer Society, a number that Howard Erichson, a law professor at Fordham University who specializes in mass tort litigation, called significant from a legal standpoint.

But the roughly 22,000 women who were diagnosed with ovarian cancer last year, according to the National Cancer Institute, provide lawyers with a potentially much larger pool of plaintiffs to tap.

“This is just the tip of the iceberg,” said Mark Lanier, one of the lawyers representing consumers, who said plaintiffs would file thousands of additional mesothelioma and ovarian cancer cases.

New Jersey-based J&J in a statement after the Lanzo verdict said plaintiffs’ attorneys had shifted their strategy to focus on asbestos after a series of losses at trial and in court rulings over previous allegations that the talc itself causes cancer.

Of the six ovarian cancer trials to date, juries found J&amp;J liable five times, but a Missouri appellate court threw out the first verdict and a California judge tossed another. Appeals of the other cases are pending.

J&J in November also won the first trial over allegations that its talc contained asbestos and caused a woman’s mesothelioma. Plaintiffs lawyers say the jury in that case did not see the documents presented during the Lanzo trial.

But Erichson said the widespread use of J&amp;J’s consumer products generally make the company an attractive litigation target.

“Baby powder is as ubiquitous a product you can think of and there are lots of people who can testify they’ve been exposed to it,” he said.

(Reporting by Tina Bellon; editing by Noeleen Walder and Leslie Adler)

Starbucks coffee in California must have cancer warning, judge says

FILE PHOTO - A woman holds a Frappuccino at a Starbucks store inside the Tom Bradley terminal at LAX airport in Los Angeles, California, United States, October 27, 2015. REUTERS/Lucy Nicholson

By Nate Raymond

(Reuters) – Starbucks Corp and other coffee sellers must put a cancer warning on coffee sold in California, a Los Angeles judge has ruled, possibly exposing the companies to millions of dollars in fines.

A little-known not-for-profit group sued some 90 coffee retailers, including Starbucks, on grounds they were violating a California law requiring companies to warn consumers of chemicals in their products that could cause cancer.

One of those chemicals is acrylamide, a byproduct of roasting coffee beans that is present in high levels in brewed coffee.

Los Angeles Superior Court Judge Elihu Berle said in a decision dated Wednesday that Starbucks and other companies had failed to show there was no significant risk from a carcinogen produced in the coffee roasting process, court documents showed.

Starbucks and other defendants have until April 10 to file objections to the decision.

Starbucks declined to comment, referring reporters to a statement by the National Coffee Association (NCA) that said the industry was considering an appeal and further legal actions.

“Cancer warning labels on coffee would be misleading. The U.S. government’s own Dietary Guidelines state that coffee can be part of a healthy lifestyle,” the NCA statement said.

In his decision, Berle said: “Defendants failed to satisfy their burden of proving by a preponderance of evidence that consumption of coffee confers a benefit to human health.”

Officials from Dunkin’ Donuts, McDonald’s Corp, Peet’s and other big coffee sellers did not immediately respond to requests for comment.

The lawsuit was filed in 2010 by the Council for Education and Research on Toxics (CERT). It calls for fines as large as $2,500 per person for every exposure to the chemical since 2002 at the defendants’ shops in California. Any civil penalties, which will be decided in a third phase of the trial, could be huge in California, which has a population of nearly 40 million.

CERT’s lawyer Raphael Metzger did not immediately respond to a request for comment.

Starbucks lost the first phase of the trial in which it failed to show the level of acrylamide in coffee was below that which would pose a significant risk of cancer. In the second phase of the trial, defendants failed to prove there was an acceptable “alternative” risk level for the carcinogen, court documents showed.

Several defendants in the case settled before Wednesday’s decision, agreeing to post signage about the cancer-linked chemical and pay millions in fines, according to published reports.

(Reporting by Nate Raymond; Additional reporting by Lisa Baertlein; Writing by Andrew Hay; Editing by Richard Chang and Leslie Adler)