there are a number of amicus briefs and on which the district court's decision is novel legally erroneous and should be reversed the divide infringement question here is whether the doctors exercise enough control over the actions of their patients that the doctors and the patients should be considered a single unit for purposes of infringement that the doctor should be healthy responsible for the actions of the patients they just took for help that it was that there was enough control here but on these facts instructing a patient to take an over the counter pill in one of many forms either a multi vitamin or any of the various commercially available folic acid supplements and on any five days within a period and within a wide range of amounts prescribed in the patient information that's not enough control to attribute the actions of the patients to the doctors and if the patient not what would be enough control i mean we hear lived through years of akamai in a discussion of love to action and control now and why isn't it enough i mean both experts i think experts on both sides testified that it was standard practice for doctors to withhold the treatment if patients didn't take the folic acid as well and i think there's lots of evidence these were instructions this was they were required to do they were compelled to do it the doctors wouldn't buy the treatment they didn't do it i mean unless we're going to have same standard in the doctor patient contacts that you would apply in other patent cases you look at whether there is a legally sufficient legally sufficient industry of control let me go right to what your question was about which is the withholding of treatment i want to point out that is not what the district court made findings on that is not with the district court premises decision on if you look at age twenty seven the district court says it was going to look at three things just record was going to look at the patent itself that's the first legal error that the district court made and i'm going to come back to that but also the patient information in the prescribing information there's nothing in either of those documents that talks about withholding treatment women i mean i don't know if you see there's a lot of people here i'm looking to call out in twenty seven a twenty maybe i'm looking at the wrong thing just good but it does say i'm not paid reading quickly if the patient feels to carry out the steps he was she will not receive the benefit of the patented method the better for the better now what the court what the court is saying there is not the doctor won't give you the treatment the court in the court is saying you won't get a reduction of potentially life threatening toxicities in other words that's just saying if you don't take folic acid it's not whether you follow the patent steps but if you don't take folic acid you'll be at risk of toxicity that's just assuming the conclusion that's that's saying that here's a step in the patented method and if you after number one here the patient don't perform this step well then you won't share in doctors insisting that their patients take folic acid if there is no evidence about the the range in for to insisting on the range in particular and saying for example if you've come in and you've taken one thousand and one we don't think that that that broad ranging is that you can take you can take any amount within a live range first of all directing the patient didn't do that isn't enough direction or control because of the other aspects of this case that give the patient a lot of freedom about what to take do you take a multi vitamin and you take it and you take one of the many commercially available alternatives when do you take it and what this court cases have said is that direction has to be over the manner and timing of the pull of performance we don't think that just saying take somewhere between four hundred thousand micrograms is enough we doctors give an awful lot of advice to patien then that's my question if the doctor gives advice outside the loop in other words the doctor says my practice is to do something more than the label requires me to do  micrograms or a thousand and two micrograms or eleven hundred micrograms then the doctor is an exercise in the level of control over the pain over how much the patient takes which is necessary for the patients selection of you know of a particular within the range which would be necessary for infringement to be attributable to the doctor right this is this whole exchange as it is turned on whether the doctor is insisting that the patient do very specific things or giving to i think that i think the doctor would have to say that and to follow through on it in other words to one set of verify not only the other that not only the taking if you did you take some folic acid but all but also to verify the amount that i think would be and that it was the other side's burden to establish not only that but also that even if you know they could find a doctor who exercise that level of control over the particular amount that they would have to show that our client was right or responsible for that that they've introduced the doctors to do that and the district court found that inducement in the labeling and nowhere else said that the mere fact  labeling in particular if someone has has a healthy full weight level in their blood but they've taken slightly too little or slightly too much folic acid and there are lots of other ways to to get full late it's it's it's in a lot of food it's in you know it's supplemented and preserved foods there are reasons why a doctor would not say i'm not going to give you this life i want you i got the doctor would not say i'm not going to give you this life threatening the life saving treatment because you took just a little bit too much folic acid at the doctors and there's no it's the doctors are so focused on the amounts if i may i'd like to say a little bit about the  that the patent uses vitamin b twelve in different ways and it's it is common ground i think that there are different ways except in the art th that word i can't pronounce fanuc about it and no your honor you know that this is a very important point i'm glad you brought it up but the findings first of all the other side's expert testified not just about what the ordinary meaning was if you look at thirty eight twenty one of the appendix you'll see that the expert was declaring what he thought the meaning in the claims to be in other words he was being an expert not about just ordinary meaning but he was actually trying to interpret the patent and that's just the it's extrinsic but after all in tether itself or the disc the debate intended itself was whether there are different different ways to to determine of the meaning of a particular testing method and you couldn't tell based on the fact tell by looking at this vest if occasion which one was meant and this court said that's not a property for the extrinsic evidence we will not defer to it we will instead because the because the intrinsic evidence is in conflict we will hold the patent faithfully indefinitely that was this court's holding on to remain and to have the and further explained in dour look likewise the pattern was found indefinite and your other question chief judge was about whether sign a column is the only one used as a supplement that simply is not so intrinsic record itself if you look at the claims there is b twelve and there is scientific about them and you know which would tell someone reading the claims that these are different things they are not synonymous and that is backed up by the by the lengthy discussion i think i guess sections were there is you know it says vitamin b twelve refers to it as a long list of substances including and refers to the chemical derivatives as well and what a person of skill in the art needs to know is can they design around  claim by using a vitamin b twelve variant that is not one of the ones specified but that would be picked up by that broader reading or is vitamin b twelve just sign of element there's no way to tell that from the intrinsic record you information and the patient information that taking full gas and in the manner specified is a condition of the patient's participation in pemba tracks a treatment as described in the past that is a finding based on the undisputed evidence at trial the end a context because there's been no actual sales if the label this is the court's astra zeneca in which i believe your honor author if the label encourages or recommend steps that would cause at least some users to infringe from that we infer intent to induce infringement by the party using that label and selling the product and in this case if you look at the physician label it's multiple times in the label from the first page twice but i'll take you to a one one two five eight section five point one of the label of the heading is a requirement for premedication and can comment medication to reduce toxicity and it's undisputed this is directed to the physician and is the instructions to the physician about how to mr the drug and it says prior to treatment with a limp to initiate supplementation with oral full of acid and also b twelve i skipped that to reduce the severity of humor the logic and gastrointestinal toxicity of all meant and it goes evidence about what happens in the real world in response to mislabel because unlike some of this court cases of the defense of cite where the generic card something out of a label and the question was was there some sort of vague intimation that would sort of bring in the thing that was car defendant's label is identical to the olympic level that's why the trial was conducted on the basis of the olympics and we have years of real world experience about what the label induces physicians to do in treating patients with have attracted both sides experts there's a bit of a red herring going on here about whether the doctor says a specific dose within the label range or four hundred to one thousand or the dr says go ahead take anything within the range of four hundred two thousand the chest what's the range  patient's life in relation to that helped and here the requirement is that they take a certain amount of full gas in our particular schedule as directed by the doctor well how do they force that requirement that's bad of app and why you can't just absolutely and they enforce that requirement because they inquire of the patient have you done this and the label tells them to do that it says you have to initiate folic acid before you the doctor who are in unique control of giving him a truck said because it's prescription and it's  infusion before you get that kind of tracks that you must initiate full gas the testimony was in the district court found that the inverse of that if you're going through from a label that if you haven't successfully initiated full gasp if the patient hasn't taken it don't give them and the reason for that is very logical the whole reason anyone is doing this and it's set forth right in weight is that patients were dying in the face three clinical trial when they were not supplemented in advance with  seven so we're ok say i want to one final point on infringement then i want to move to the nautilus issue we heard a couple arguments about how doctors say go ahead take an aspirin and eat better than give all kinds of instructions this is not that kind of instruction people were dying in the clinical trial and the way that the f d a will you agreed to address that was to say doctors you have to give them full of acid and b twelve before they get this medicine and you have to instruct the patient they have to do it and the label tells both patient and doctor you have to do it and the idea that the argument that we're getting from the defendants is what all the label really induces is for the doctor say the vision takes some full gas in my otherwise wash my hands of the situation i think is not a credible reading of the label the just report may be fact finding regarding the label there was testimony about the label i absolutely correct the evidence before the trial court was that in the context of giving a vitamin supplement to a patient when a physician say b vitamin b twelve they mean sinope about there  if you look back at the expert's report he testified as to both the ordinary understanding of the term and the art and also the ultimate conclusion of what the prescription of contention that's a true stick the district court though accepted the factual testimony regarding what the ordinary meaning of the art is as clear from her opinion the fact that his testimony on the ultimate issue may not be entitled to deference the testimony that led to the finding that the ordinary meaning in this context is sign about me was made by the just court entitled to clear view and they've established no clear air now that distinguishes this case from both doubt and have both of which were about terms of measurement that could have different meanings in the let me briefly touch on this issue about the specification and column five again but the vitamin b twelve refers to a paragraph that mr j mentioned and no one is arguing that this is an express redefinition of the term vital to the just were found that it wasn't and then found that are you want to feel that it was such that it should be applied and either broader or network but in the context of the pap which is about a ministration of a supplement to a patient it has one and only one meaning and that is sign up about and that is supported by the structure of the cla properly construed to mean the same thing then so be it that's what they mean here they're to establish meanings no one has ever suggested that there is a third meaning and they both lead to redundancy which tells you that looking for redundancy isn't going to resolve this question for you but looking at claim point about the labeling mr pearl relied on the word requirement in the in the prescribing instructions you know and but if if the argument worry that everything in the prescribing instructions is telling you that if  this isn't precisely followed withhold and the tracks it including the including the quantity and everything else then you wouldn't have what you have in the patient instructions because the prescribing instructions say take it every day the patient instructions say take it five out of every seven days and that's in there because patients missed doses i and so you just can't get out of the prescribing instructions that absolutely everything in here is a scenic one known it has to be followed exactly or you will withhold treatment you certainly can't can't say that if there are individual doctors who follow you know they go overboard and do what is supported on the page of mr pearl are a lot on do things like require patience to have pill diaries brilliant empty bottles and prove that they've taken i've taken their pills even if there are doctors who do that that is not required by the labeling that's not something that is the induced by tever and it's not something that can be attributed  alleged induced infringer it's certainly true that you don't have to control the other person's entire life in order to be deemed as the same unit for directional control purposes under under divided into infringement what you do have to control is the manner and timing of what the person does and that's why the court and i can lie for example was emphasizing that limelight was directing its customers to follow these precise steps if there isn't that level of direction and there isn't that level i you know judgeships colloquy with with my friend brought out the importance of the quantities in the claims that lilly chose to assert they could have tried to go to trial one claim one of which doesn't have the quantities in it but they chose instead to go to trial on the claims you know prehaps for validity reasons that have a specific quantity in it they have to live with that choice if they had wanted to if they were concerned about the divine infringement there are ways to draft claims that avoid the divide infringement question that something that this court has emphasized in all of its methods claim cases and the same is true here they focus on if you focused on the advice of the doctor rather than the patient administering the folic acid then you wouldn't have this issue good tips switch to switch gears and go to the  indefinite this issue i'll just say that cullen my friend said that column five doesn't redefine b twelve well that's exactly the point column five recognizes that b twelve has a has another meaning a broader meaning that includes all of these pharmaceutical derivatives and that is where for example hydroxy cobol and is called b twelve right there in the patent and the for the very fact that there are two meanings and the intrinsic record can't doesn't allow you to select between them and the redundancy if anything