A recent $417 million verdict, awarded to California ovarian cancer patient Eva Echeverria, was considered a victory for the hundreds of women who used Johnson & Johnson’s Baby Powder.

Researchers have tracked the possible carcinogenic effects of talcum powder on a woman’s body for decades, but a Los Angeles judge overturned the verdict, citing “insufficient evidence.”

Despite the setback, the struggle to protect women from the potential carcinogenic risks of talcum powder is far from over.

Studies, Science + Legal Disputes

Why The Talcum Powder Verdict Was Reversed

The California case signifies a more public continuation of the legal and scientific battle for women who may have developed ovarian cancer from using talcum powder. Mined by sometime co-defendant Imerys Talc America Inc., talcum powder trials kicked off in New Jersey and St. Louis, Missouri.

New Jersey courts dismissed talcum lawsuits due to a lack of scientific evidence. But in St. Louis, juries awarded damages totaling $300 million in three of five cases. Charges included conspiracy, breach of implied warranty, and negligence.

Talcum Powder Cases

  • Swann v. Johnson & Johnson (case number 1422-CC09326-01)
  • Michael Blaes et al. v. Johnson & Johnson et al. (case number 1422-CC09326-01)
  • Estate of Jacqueline Fox v. Johnson & Johnson et al., (case number ED104580)
  • Gloria Ristesund v. Johnson & Johnson (case number 1422-CC09012-01)
  • Giannecchini v. Johnson & Johnson et al. (case number 1422-CC09012-01)

The first case to be tried in California played out differently. The trial brought multiple questions to the forefront, the most important being whether talcum powder products can cause ovarian cancer. Other important questions are centered around J&J’s knowledge of the potential link, and whether it took steps to adequately inform and warn consumers.

Echeverria’s lawsuit, filed in July 2016, was tried in the Los Angeles County Superior Court. Her case alleged talcum powder in the famed Baby Powder product caused her to develop ovarian cancer in 2007. Multiple medical experts testified on her behalf.

Toxicologist and pharmacologist Laura Plunkett testified under oath that small doses of talcum powder used over time have a toxic effect on tissue. She said her training, experience, and review of the scientific literature led her to conclude that talcum powder is toxic when used near a woman’s genitals. She argued talcum particles can migrate into the vaginal tracts, cause chronic inflammation, and lead to an increased risk of ovarian cancer.

Annie Yessaian, gynecological oncologist and University of Southern California gynecology assistant professor, treated Echeverria’s cancer. Yessaian said if Echeverria hadn’t used J&J talcum powder products daily on her genital area for decades, she would not have developed ovarian cancer. J&J unsuccessfully tried to have her testimony excluded before the trial.

Another expert witness, pathology expert John Godleski is a retired Harvard Public Health professor. He examined Echeverria’s reproductive tissue after it was surgical removal as a part of her treatment. He found 11 talc particles in her tissue samples and said one particle can indicate that the tissue may contain hundreds of particles.

Echeverria’s attorneys discussed the severity of reproductive injuries and how that would impact J&J’s wholesome, family-first image. The trial outlined studies, regulations, and internal communications that indicate J&J may have known about the link between talcum powder and increased risk of ovarian cancer.

Echeverria, who died in August 2017, was the first to win a talcum powder case in California.

Two months later, Los Angeles Superior Court Judge Maren Nelson disagreed the science was sufficient enough to establish a clear link between talcum powder and ovarian cancer. In a 51-page opinion, the judge viewed the testimony as speculation that didn’t take into account other factors, like obesity and age. The judge viewed the evidence as “extremely limited.”

J&J won the exclusion of several areas of expert testimony offered by Echeverria’s experts.

A Timeline of Talc Research + Regulation

Since the early 1970s, researchers have been investigating the link between talcum powder and ovarian cancer.

1971
Talcum particles “deeply embedded” in 10 of 13 ovarian tumors.
The Journal of Obstetrics and Gynaecology of the British Commonwealth
1982
Link between talc use and ovarian cancer statistically proven.
Cancer
1993
Carcinogenesis studies reported “clear evidence of carcinogenic activity” in female rats.
The National Toxicology Program
2006
Talcum is classified as a 2B carcinogen.
World Health Organization, International Agency for Research on Cancer
2016
Talc use may result in a 33 percent increase risk of ovarian cancer.
Epidemiology
2017
Federal investigation focused on talc and ovarian cancer.
U.S. Food and Drug Administration

Many studies found a notable association between talcum powder and ovarian cancer, but the results weren’t strong enough to prove direct causation. The mixed results add fuel to the fiery dispute, centered around a staple household product manufactured by a beloved American company.

“An additional 20 epidemiological studies have found that long-term perineal talc use increases the risk of ovarian cancer by about 33 percent,” according to a Bloomberg exposé. “Yet other research has found no association.”

Despite numerous studies indicating that talcum powder and ovarian cancer may be connected, deciding what evidence will be admissible is up to the courts.

Talc Ovarian Cancer Trials Continue

Echeverria, who passed away after developing ovarian cancer, has become a representation of anti-talcum advocacy. Like Echeverria, hundreds of women would not have used talc had a warning been included on the label. California law Proposition 65 requires labeling of potential carcinogens. The lack of this warning is what women believe warrants damages to be awarded.

Attorneys for Echeverria are appealing the reversal, and experts say the ruling isn’t final for women who may have been injured by talcum powder.

Jean Eggen, an emeritus professor at Widener University Delaware Law School, told Law360 that talcum powder litigation is in “early stages.”

As the FDA investigates talcum powder risks, an estimated 4,800 women with ovarian cancer have filed against J&J. Once the evidence is reconsidered by the state appeals court, the requirements of causation may be met.

The story is still unfolding.