Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-azd-3_12-cv-08223/USCOURTS-azd-3_12-cv-08223-0/pdf.json

Nature of Suit Code: 365
Nature of Suit: Personal Injury - Product Liability
Cause of Action: 28:1332 Diversity-Product Liability

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WO 

IN THE UNITED STATES DISTRICT COURT 

FOR THE DISTRICT OF ARIZONA 

Paul Schenk, et al., 

Plaintiffs, 

v. 

Novartis Pharmaceuticals Corporation, 

Defendant.

No. CV-12-08223-PCT-NVW

ORDER 

 Before the Court is Defendant Novartis Pharmaceuticals’ First Motion to Strike 

Expert Report of Robert Marx, D.D.S. (Doc. 39), Plaintiffs’ Response (Doc. 42), and 

Defendant’s Reply (Doc. 44). Novartis made an error in uploading the exhibits 

supporting its First Motion to Strike (Doc. 39) and failed to include a copy of the report 

challenged by its First Motion. When the Court requested a copy of the missing report, 

Novartis instead chose to file a Second Motion to Strike Expert Report of Robert Marx, 

D.D.S. (Doc. 75). The Second Motion (Doc. 75) is identical to the First Motion 

(Doc. 39), except that the correct exhibits are attached. 

 Before the Court is also Novartis’ Motion to Exclude Dr. Robert Marx’s 

Specific Causation Opinions (Doc. 60). This Motion (Doc. 60) is substantially similar 

to the First Motion to Strike Expert Report of Robert Marx, D.D.S. (Doc. 39), as it also 

challenges whether Dr. Marx has supplied an adequate basis for his expert causation 

opinion. Although the Motion to Exclude Dr. Robert Marx’s Specific Causation 

Opinions (Doc. 60) is better reasoned than Novartis’ First Motion to Strike Expert 

Report (Doc. 39), the motions address the same core issue, and the Court would have 

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been better served if Novartis had taken the time to consolidate its arguments against 

Dr. Marx’s case-specific testimony into a single motion. 

 Despite the overlap, Novartis’ First Motion to Strike Expert Report of Robert 

Marx, D.D.S. (Doc. 39) and its Motion to Exclude Dr. Robert Marx’s Specific Causation 

Opinions (Doc. 60) will be granted. Novartis’ Second Motion to Strike Expert Report of 

Robert Marx, D.D.S (Doc. 75) will be denied as unnecessary and duplicative. 

I. FACTS 

 a. Background 

 This action is one of over eight hundred product liability suits currently pending 

against Novartis Pharmaceuticals its products Aredia and Zometa. Aredia and Zometa 

are bisphosphonate drugs primarily indicated for the prevention of bone fractures in 

patients with hypercalcemia of malignancy in cancers that have metastasized to the bone. 

All pending cases concern Novartis’ alleged failure to warn of the risk of osteonecrosis of 

the jaw associated with use of the two drugs. This action differs from the other cases 

filed because Plaintiff Paul Schenk was not prescribed Aredia and Zometa for 

metastasized cancer, but was instead prescribed the drugs off-label to prevent fractures 

associated with a rare genetic disease: osteogenesis imperfecta. This action is brought 

against Novartis by Paul Schenk and his wife. 

b. Dr. Marx’s Expert Report 

The Schenks served disclosures for six non-retained experts, including Dr. Robert 

Marx, on the final date for such disclosures, January 31, 2014. Some disclosures were 

general, such as the statement that they planned to rely on expert reports submitted in the 

multi-district litigation from which this case was remanded. See In re: Aredia and 

Zometa Prods. Liab. Litig., Dck. No. 3:06-MD-1760, pending in Middle District of 

Tennessee. Two disclosures were specific to Dr. Marx. One was for a case-wide report 

served in the class action stage of the multi-district litigation dated October 6, 2008. 

Another was for a case-specific causation report which discussed Mr. Schenk’s medical 

records and his genetic condition. The case-specific report was dated January 29, 2014. 

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On February 4, Novartis informed the Plaintiffs that Dr. Marx’s case-specific report was 

inadequate and that Novartis would move to strike it. In response, the Plaintiffs 

immediately submitted a second case-specific report from Dr. Marx, also dated January 

29, 2014. 

 Novartis also objected to the second report and proceeded to file this First Motion 

to Strike Expert Report of Robert Marx, D.D.S. (Doc. 39), alleging that neither Dr. 

Marx’s first case-specific report nor his second, revised report complies with the Federal 

Rules of Civil Procedure. Novartis’ First Motion to Strike (Doc. 39) seeks only to 

exclude Dr. Marx’s case-specific reports. It does not seek to exclude Dr. Marx’s more 

generalized, case-wide opinions in other reports. 

 Dr. Marx’s First Report (Doc. 39, Exh. 2) is a half-page letter stating that he has 

reviewed medical records and the deposition testimony listed the sheets attached to his 

letter. The letter states that after careful review of the record, combined with his 

knowledge of bisphosphonate bone toxicity, experience in over 350 cases, and his 

consideration of other possible causes of Mr. Schenk’s jaw problems, he has concluded 

that Aredia and Zometa were the root cause of Mr. Schenk’s osteonecrosis of the jaw, 

and that the osteonecrosis was not the result of Mr. Schenk’s genetic condition or any 

other cause. No other details, such as what 350 cases were reviewed or what specific 

facts or information led to his conclusion, are provided in the letter. The letter also states 

that Dr. Marx has not yet had a chance to review copies of Mr. Schenk’s “many sinus and 

jaw CT scans that were accomplished as well as long bone films” and that he reserves the 

right to amend the report after reviewing such films. (Doc. 39, Exh. 2).

 Attached to the letter is a single page with listings which appear exactly as 

follows: 

 Medical Records Reviewed 

 1. Medical records Craig Brady DO 8739-0177 to 8739-0188 

 2. Medical records Craig Brady DO 8739-0157 to 8739-0164 

 . . . 

 14. Shaw Low Medical Center 6360-0028 to 6360-0261 

(Doc. 39, Exh. 2). The list contains twelve nearly identical listings for “Craig Brady DO” 

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and four listings for records from medical centers. It is not possible to infer the content 

of the medical records reviewed from the information provided. The attachment also lists 

the names of people whose depositions were reviewed by Dr. Marx but provides not 

information concerning the subject matter or content of the depositions. 

 Dr. Marx’s Second Report (Doc. 75, Exh. 3) was submitted to Novartis four days 

past the disclosure deadline on February 4, 2014 but is dated the same date as his First 

Report: January 29, 2014. It is nearly identical to the First Report, except with two 

additions. The first is that Dr. Marx demonstrates his familiarity with Mr. Schenk’s 

genetic disease, osteogenesis imperfecta, by stating he has treated many cases of true 

osteomyelitis of the jaws caused by the genetic disease and has published on the disease 

in his textbook Oral and Maxillofacial Pathology. The second is that Dr. Marx states he 

has reviewed Mr. Schenk’s CT scans and has found they confirm that Mr. Schenk’s 

osteonecrosis is bisphosphonate induced and not a product of osteogenesis imperfecta or 

osteomyelitis. The Second Report is followed by the same single page attachment as the 

First Report. No additional support for his conclusions is provided. 

 Novartis seeks to strike both Dr. Marx’s First and Second Report based on the 

Reports’ failure to comply with the Federal Rules of Civil Procedure. Novartis also seeks 

to strike the Second Report because it was disclosed four days after the deadline for 

expert disclosures. Novartis alleges that although the Second Report is dated the same 

day as the First Report, it is unlikely the Second Report was prepared the same day 

because if Dr. Marx had been able to review Mr. Schenk’s CT Scans before the 

disclosure deadlines, the Schenks would have disclosed that information in a timely 

manner. 

II. APPLICABLE RULE 

 In its Motion, Novartis alleges Dr. Marx’s Reports fail to comply with Federal 

Rule of Civil Procedure 26(a)(2)(C). The Schenks, however, disclosed Dr. Marx as a 

witness under Federal Rule of Civil Procedure 26(a)(2)(B), not (C). (Doc. 39, Exh. 3). 

This distinction is important because subsections (B) and (C) distinguish between a 

“percipient witness who happens to be an expert and an expert who, without prior 

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knowledge of the facts giving rise to litigation, is recruited to provide expert opinion 

testimony.” Downey v. Bob’s Disc. Furniture Holdings, 633 F.3d 1, 3 (1st Cir. 2011). 

Experts under subsection (C) generally have actual involvement with the events giving 

rise to the litigation, and the disclosure required under Rule 26(a)(2)(C) “is considerably 

less extensive than the report required by Rule 26(a)(2)(B).” Fed. R. Civ. P. 26(a)(2)(C), 

Advisory Committee's note 2010. 

It is unclear whether Novartis’ mistake resulted from a typographical error or a 

genuine misunderstanding of the Rules of Civil Procedure. The Court only discovered 

the issue after trying to make sense of Dr. Marx’s expert report, given that Novartis’ 

Motion (Doc. 39) classified him as a treating physician expert. The Court presumes 

Novartis alleges Dr. Marx’s Reports fail to comply with Federal Rule of Civil Procedure 

26(a)(2)(B). 

III. APPLICATION TO DR. MARX’S REPORT 

A party planning to present a witness retained specifically to present expert 

testimony must provide a report prepared and signed by the witness along with the initial 

expert witness disclosure. Fed. R. Civ. P. 26(a)(2). This report must contain:

(i) a complete statement of all opinions the witness will express and the 

basis and reasons for them; 

(ii) the facts or data considered by the witness in forming them; 

(iii) any exhibits that will be used to summarize or support them; 

(iv) the witness’s qualifications, including a list of all publications authored 

in the previous 10 years; 

(v) a list of all other cases in which, during the previous 4 years, the witness 

testified as an expert at trial or by deposition; and 

(vi) a statement of the compensation to be paid for the study and testimony 

in the case. 

Rule 26(a)(2)(B). If a report is not submitted in accordance with Rule 26(a), the court 

has the discretion to exclude the evidence associated with the expert “on a motion, at a 

hearing, or at a trial, unless the failure was substantially justified or is harmless.” Fed. R. 

Civ. P. 37(c); see also Yeti by Molly, Ltd. v. Deckers Outdoor Corp., 259 F.3d 1101, 1106 

(9th Cir.2001) (noting that “[t]wo express exceptions ameliorate the harshness of Rule 

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37(c)(1): The information may be introduced if the parties' failure to disclose the required 

information is substantially justified or harmless”). 

It is undisputed that Plaintiffs did not include any of the information required by 

subsections (iv) & (v) of Rule 26(a)(2)(B) in Dr. Marx’s First or Second Report. 

Plaintiffs argue submitting this information was unnecessary because Novartis already 

had access to Dr. Marx’s qualifications and publications though his participation in 

related actions and the earlier, class-action stages of this case. While the error in failing 

to submit this information is likely harmless, as Novartis has clear access to the 

information required by subsections (iv) & (v), it must also be noted that the Schenks also 

had the same, clear access to the necessary information. Plaintiffs could have easily 

included the required information with the disclosure reports, thereby complying with the 

Rule and saving both the parties and the court this runaround. 

But it is not the omission of the information required by subsections (iv) and (v) 

that provides the impetus for striking Dr. Marx’s case-specific Reports. The Reports will 

be stricken because they are conclusory and fail to provide any factual support for the 

opinion they express. The entire text of Dr. Marx’s Second Report is as follows: 

As per your request, I have reviewed copies of medical records and 

copies of deposition testimonies as indicated in the attached sheets. 

I have also reviewed CT scans taken of Mr. Schenk at the Navopage 

facility. 

After careful review of these records combined with my knowledge 

of bisphosphonate bone toxicity and my experience in over 350 

cases as well as my experience and considering other possible causes 

of Mr. Paul Stephen Schenk’s jaw problems in differential diagnosis, 

I came to the conclusion that he suffered from bisphosphonate 

induced osteonecrosis of the jaws and not either his osteogenesis 

imperfecta, osteomyelitis, a dental or sinus infection, or any other 

diagnosis. 

I am familiar with osteogenesis imperfecta [Mr. Schenk’s genetic 

disease] and published on this disease in my textbook Oral and 

Maxillofacial Pathology. I have also treated numerous cases of true 

osteomyelitis of the jaws. Mr. Schenk’s clinical course and CT scan 

images are consistent with bisphosphonate induced osteonecrosis, 

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not either osteogenesis imperfecta or otesomyelitis. Therefore, 

Aredia and Zometa were the root cause of his osteonecrosis related 

to a significant accumulation of these bisphosphonates in his jaws 

from repeated doses. 

(Doc. 75, Exh. 3). Dr. Marx’s First Report (Doc. 39, Exh. 2) contains even less detail 

than the Second Report above, and the contents of the First Report are entirely subsumed 

into the Second. 

Dr. Marx’s Report fails because it does not include facts in support of his 

conclusion that Schenk’s jaw damage is the result bisphosphonate toxicity. Fed. R. Civ. 

P. 26(a)(2)(B)(ii) (requiring expert reports to include “the facts or data considered by the 

witness in forming them”). Dr. Marx states that he formed his opinion based on Schenk’s 

medical records but gives no indication of the content of the records reviewed. The 

records identified in the attachment to the Report are labeled only “Medical Records” and 

it is not possible to infer the type or quantity of medical records reviewed. 

Dr. Marx’s general assertion that he used a differential analysis is itself a bare 

conclusion. His letter merely identifies possible causes of osteonecrosis of the jaw and 

fails to show why each alternative diagnosis is unlikely. Dr. Marx provides no details 

regarding Mr. Schenk’s specific jaw condition and no explanation as to how he 

determined Mr. Schenk suffers from osteonecrosis related to a significant accumulation 

of bisphosphonates and not osteonecrosis caused by osteogenesis imperfecta. His reports 

offer nothing more than unsupported conclusions. 

Plaintiffs attempt to justify Dr. Marx’s noncompliance with Rule 26 by suggesting 

Novartis could gather the necessary supporting information from its depositions of Dr. 

Marx. But the prior depositions of Dr. Marx dealt with Dr. Marx’s case-wide opinions 

and opinions as to other plaintiffs, none of whom had Mr. Schenk’s genetic bone disease. 

Those depositions do not provide foundation for Dr. Marx’s specific causation opinion 

outlined in his report about Mr. Schenk. Its noncompliance with Rule 26(a)(2)(B) is 

neither harmless nor justifiable. Accordingly, both Dr. Marx’s First (Doc. 39, Exh. 2) 

and Second (Doc. 75, Exh. 3) Case-Specific Expert Reports will be stricken. It follows 

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that Dr. Marx’s specific causation opinions will be excluded from the remainder of this 

action. See Fed. R. Civ. P. 37(c).

IT IS THEREFORE ORDERED that Novartis Pharmaceuticals Corporation’s First 

Motion to Strike Expert Report of Robert Marx, D.D.S. (Doc. 39) is granted. 

IT IS FURTHER ORDERED that Novartis’ Motion to Exclude Dr. Robert Marx’s 

Specific Causation Opinions (Doc. 60) is granted. 

IT IS FURTHER ORDERED that Novartis Pharmaceuticals Corporation’s Second 

Motion to Strike Expert Report of Robert Marx, D.D.S (Doc. 75) is stricken. 

 Dated this 23rd day of July, 2014. 

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