UNITED STATES DISTRICT COURT DISTRICT OF MASSACHUSETTS
TYCO INTERNATIONAL (U.S.), INC.; ) TYCO HEALTHCARE GROUP, L.P.; and )THE KENDALL HEALTHCARE PRODUCTS )COMPANY
MEMORANDUM AND ORDER
In this proposed nationwide class action, Plaintiffs allege
that defendant Tyco1 engaged, and continues to engage, in
anticompetitive conduct to foreclose competition in the United
States market for sharps containers. Sharps containers are
products or systems used to dispose of needle-inclusive biohazard
products such as syringes, blood collection devices, and IVs.
Tyco manufactures disposable sharps containers, and its
1 Defendants are Tyco International, Ltd., Tyco
International (U.S.), Inc., Tyco Healthcare Group, L.P. (nowCovidien), and The Kendall Healthcare Products Company(collectively, “Tyco”).
containers comprised approximately 70% of the sharps containers
sold in the United States during the proposed class period.
Plaintiffs claim that Tyco violated Sections 1 and 2 of the
Sherman Act, 15 U.S.C. §§ 1-2, because Tyco used its market share
to impede competition from other firms that produce both
disposable and reusable sharps containers. Plaintiffs allege
that Tyco’s anticompetitive practices allowed it to maintain
supra-competitive prices for its sharps containers without any
pro-competitive justification. Plaintiffs seek treble damages
under Section 4 of the Clayton Act for the overcharges that
resulted from Tyco’s anticompetitive scheme. See 15 U.S.C. § 15.
Specifically, Plaintiffs allege that Tyco violated the
antitrust laws by: (1) imposing market share purchase
requirements tied to maintaining or increasing Tyco’s market
share; (2) bundling its products for exclusionary purposes; (3)
entering into exclusionary contracts with Group Purchasing
Organizations (“GPOs”), which negotiate contracts on behalf of
large groups of hospitals and similar entities; and (4)
conspiring with other manufacturers to impose rebate penalties on
purchasers relating to a bundle of Tyco and non-Tyco products.
Plaintiffs seek to certify a nationwide class of all direct
purchasers who have purchased sharps containers from Tyco during
the proposed class period. The proposed class period is from
October 4, 2001 through the present. The proposed class of
direct purchasers includes end users of Tyco’s sharps containers
and distributors that purchased sharps containers for resale.
Tyco contends that Plaintiffs’ claims are not suitable for
class treatment under Fed. R. Civ. P. 23 because the proposed
class representatives, Natchitoches Parish Hospital Service
District (“Natchitoches”), a hospital and sharps container end
user, and J.M. Smith Corp. (“Smith Drug”), a sharps container
distributor, cannot adequately represent a class that contains
distributors that, on net, economically benefitted, and continue
to benefit, from Tyco’s allegedly anticompetitive scheme. Tyco
also contends that Plaintiffs have no viable method for
establishing an antitrust violation and resulting injury on a
classwide basis, and thus Plaintiffs do not satisfy the
requirement under Rule 23(b)(3) that issues common to the class
predominate over individual issues unique to each class member.
After hearings and a review of the briefs and the extensive
record, the Court finds that Plaintiffs have met the requirements
of Fed. R. Civ. P. 23(a), but defers ruling on Plaintiffs’ motion
to certify (Docket No. 52) until it reviews the final expert
reports to determine whether Plaintiffs have established
predominance under Fed. R. Civ. P. 23(b)(3). I. THE PROPOSED CLASS
Plaintiffs propose to certify a class comprising:
All persons who purchased Sharps Containers inthe United States directly from Tyco at anytime during the period October 4, 2001 throughthe present (and continuing until the effects
of Tyco’s anticompetitive conduct cease) (the“Class Period”). The Class excludes Tyco,Tyco’s parents, subsidiaries and affiliates.
(Compl. ¶ 16). By definition, the proposed class contains only
direct purchasers of Tyco’s sharps containers in the relevant
market during the proposed class period, and thus all class
members have standing to assert claims for damages under the
Clayton Act. See Illinois Brick Co. v. Illinois, 431 U.S. 720,
728-29 (1977); Hanover Shoe, Inc. v. United Shoe Mach. Corp., 392
II. FACTUAL BACKGROUND
The facts set forth below are drawn largely from the
Complaint and are presumed true for purposes of ruling on this
motion. The Court also relies on expert reports and other
affidavits submitted by both parties. Many of the facts are
THE MARKET Sharps Containers
Sharps containers are used for the disposal of “sharps,”
which are needle-inclusive bio-hazard medical products such as
syringes, blood collection devices, and IVs. Hospitals and other
healthcare providers use sharps containers to prevent accidental
needle-stick injuries. Needle-stick injuries, which number in
the hundreds of thousands annually in the United States, put
healthcare workers at risk of diseases such as hepatitis C and
Generally, sharps containers are either sold as disposable
products for one time use, or provided as reusable products as
part of a waste disposal service, such as the “Daniels Sharpsmart
Solution,” a reusable service developed by sharps container
supplier Daniels Sharpsmart (“Daniels”). Defendant Tyco
manufactures and markets disposable sharps containers through its
subsidiary Kendall Healthcare Products Company (“Kendall”). Direct Purchasers
For the most part, disposable sharps containers are sold to
two different types of direct purchasers: end users and
distributors. End users include acute care facilities such as
hospitals; alternative site health care providers such as nursing
homes, dentists’ offices, labs, and veterinary clinics; various
governmental entities; and research laboratories. In some
instances end users purchase disposable sharps containers
directly from the manufacturer. The purchase can be made either
pursuant to a price negotiated by a Group Purchasing Organization
or to a price negotiated directly by the hospital, a hospital
In most instances, however, disposable sharps containers are
purchased by distributors for resale to end users. Distributors
purchased approximately 88% (in terms of dollars purchased) of
all of Tyco’s sharps containers during the class period. In
fact, during the class period, three distributors -- Cardinal,
Owens & Minor, and McKesson -- accounted for approximately 59% of
all of Tyco’s sharps containers purchases. Tyco does not have an
exclusive contract with any distributor.
Many end users, such as hospitals and other health-care
entities, rely upon Group Purchasing Organizations (“GPOs”) to
negotiate medical supply pricing and evaluate products.
Approximately 68% to 98% of hospitals in the United States belong
to at least one GPO. Due to consolidation in the mid-1990s, a
handful of large GPOs dominate the market. Major GPOs include
Broadlane, Novation, Consorta, HPG, Amerinet, Premier, and
GPOs are organizations that negotiate standardized contracts
with manufacturers and suppliers of medical devices on behalf of
their members. GPOs pool the purchasing power of their members
and leverage that power to negotiate lower prices. GPOs do not
purchase any products, nor do they sign or otherwise enter into
the contracts that they negotiate on behalf of their members.
Instead, GPOs negotiate standard form, or model, contracts that
the members themselves sign and enter into with manufacturers.
In addition, GPOs independently evaluate medical devices sold by
manufacturers to provide the best products for their members.
Thus, GPOs provide brokerage services for the sale of medical
supplies from manufacturers to the GPOs’ members.
Due to amendments made to the “anti-kickback” provisions of
the Social Security Act in 1986, manufacturers are permitted to
pay the administrative fees of GPOs up to a specified percentage
of sales made. As a result, GPOs are financed by the same
manufacturers, including Tyco, that GPOs are supposed to
negotiate with at arm’s length and evaluate independently.
Not all end users of sharps containers utilize GPOs to
negotiate pricing and contracting. Larger hospitals and hospital
chains tend to negotiate contracts directly with manufacturers.
Other hospitals belong to “Integrated Delivery Networks” (“IDNs”)
or “Integrated Hospital Networks” (“IHNs”) that negotiate prices
and terms with manufacturers and suppliers. Most non-acute care,
alternative site facilities, such as nursing homes and dentists’
offices, do not rely upon GPOs. Tyco contends that over 40% of
the Kendall sharp container sales during the class period were
Significantly, distributors (as opposed to end users)
purchase sharps containers from Tyco at volume-based list prices.
Distributors earn revenue based on a distribution fee negotiated
either directly with the end user, or by a contract between the
distributor and a GPO. The distribution fee is generally derived
on a “cost-plus” basis, or based on a percentage markup over the
product’s purchase price. For example, two of the three major
distributors of sharps containers -- Owens & Minor and McKesson -
- sell sharps containers on a cost-plus basis. There is some
evidence that Cardinal also operates on a cost-plus basis.
If a distributor resells a sharps container to a customer
that has negotiated a lower price -- either directly or through a
GPO -- the distributor sells the container at that lower price,
plus a distribution fee. The distributor then receives a
“credit” from Tyco equal to the difference between the
distributor list price and the lower customer price. Reusable Sharps Containers
Reusable sharps containers, in contrast, are generally sold
directly to end users as part of an overall waste disposal
service or system. As a result, reusable sharps container
manufacturers tend not to sell to distributors for resale. For
example, Stericycle/Biosystems and SureWay, both reusable sharps
containers suppliers, do not have any contracts with distributors
with respect to their reusable sharps containers. Likewise two
of the three largest distributors of Tyco’s disposable sharps
containers, Owens & Minor and McKesson, do not have any contracts
to sell or distribute reusable sharps containers.
There is some evidence, however, that manufacturers of
reusable sharps containers sometimes use distributors. At least
one of the three largest distributors, Cardinal, entered into an
agreement to serve as marketing, sales, and billing agent for
Daniels in connection with its Daniels Sharpsmart System. In
addition, Tyco itself explored a relationship with Owens & Minor
to provide distribution services for Tyco’s StarServe program,
Tyco’s nascent reusable sharps containers business.
TYCO’S SCHEME TO FORECLOSE THE MARKET Tyco Dominates the Market
Beginning in the mid-1990s, hospitals had a sharp increase
in their use of sharps containers due to a growing awareness of
the dangers of sharps. This awareness spurred efforts to pass
safety legislation to either mandate or encourage the use of
During the mid-to-late 1990s various firms, including Tyco,
manufactured sharps containers. Alert to pending safety
legislation regarding needle-stick injuries, Tyco began to
acquire other sharps container manufacturers. For example, on
November 2, 1998, Tyco acquired Graphic Controls Corp, and two
years later, on May 5, 2000, Tyco acquired the sharps container
product line of rival Sage. Tyco’s acquisition of the Graphic
Controls and Sage sharps container product lines allowed Tyco to
assume Graphic Controls’ and Sage’s previous exclusionary
On November 6, 2000, President Clinton signed the
Needlestick Safety and Prevention Act, which modified the
Bloodborne Pathogens Standard, 29 C.F.R. 1910.1030. Among other
things, the Act directed hospitals and other employers with
workers occupationally exposed to bloodborne pathogens to
consider and use effective engineering controls, including safer
medical devices such as sharps containers, to reduce the risk of
injury from needle-sticks and other sharp medical instruments.
Plaintiffs allege that these changes became effective on April
By the time the Act became effective Tyco had amassed a
significant share of the sharps container market, although the
parties disagree on the precise percentage. Since October 4,
2001, the start of the class period, Plaintiffs claim Tyco has
had a 70% or more share in the sharps container market in the
United States. Tyco claims that in the last quarter of 2005
Kendall had a 57% U.S. market share for sharps containers, Becton
Dickinson, a rival, had 20%, and reusable manufacturers
Stericycle and Daniels had 14% and 4% respectively. Plaintiffs’
expert Prof. Einer Elhauge states that Tyco had a market share of
81-85% in acute care facilities and 58-73% overall based on his
preliminary document review. (Elhauge Decl. ¶ 27).
Plaintiffs contend that Tyco obtained its market share
largely at the expense of rivals who provided reusable sharps
containers. For example, Tyco rival Daniels received FDA
approval for a sharps container system, Daniels Sharpsmart
Solution, that provides reusable containers and utilizes an
automatic robotic decanting and sanitization process called
“Washsmart.” Daniels began marketing its system in the United
States in 2000. Daniels claims that its system reduces
needlestick injuries at or below Tyco’s prices. Plaintiffs cite
one study that found that the Daniels Sharpsmart Solution reduced
container related sharps injuries (“CRSI”) by approximately 87%
for the hospitals that participated in the study, although the
lead author of the article worked for Daniels at the time.
(Compl. ¶ 32 (citing Grimmond T. et al., Sharps Injury Reduction
Using Sharpsmart – A Reusable Sharps Management System, 54 J.
Hosp. Infection 232 (2003))). Despite the effectiveness of its
system, Daniels has only obtained a 2% share in the United States
market. In contrast, Daniels has obtained 30% to 80% market
shares in other countries such as Australia, New Zealand, Great
Foreclosed
Plaintiffs assert that Tyco substantially foreclosed
imposing market share purchase requirements tied to maintaining or increasing Tyco’s market share;
bundling Tyco products for exclusionary purposes;
entering into exclusionary contracts with GPOs; and
conspiring with other manufacturers to impose rebate penalties on purchasers relating to a bundle of Tyco and non-Tyco products.
Plaintiffs allege that the above practices support two separate
and independent theories of market foreclosure. Plaintiffs
allege that the first, second, and fourth practices -- market
share purchase requirements and bundling -- foreclosed the sharps
containers end user market from rival competition. Plaintiffs
allege that the third practice -- GPO exclusionary contracts --
foreclosed the GPO brokerage services market in sharps containers
from rival competition. (Elhauge Decl. ¶ 14; Elhauge Reply Decl.
Plaintiffs maintain that Tyco’s sharp practices, either
alone or in combination, allowed Tyco to impose supra-competitive
prices for its sharps containers without any pro-competitive
Market Share Purchase Requirements
Tyco’s scheme to foreclose the sharps container market
included entering into contracts with purchaser end users --
either directly or brokered by GPOs -- that contained market
share purchase requirements. Unlike volume-based purchase
requirements, which are based on the amount purchased by an end
user regardless of the amount purchased from rivals, market share
purchase requirements are based on the amount end users purchase
from Tyco to the exclusion of Tyco’s rivals. Plaintiffs further
allege that Tyco used its payment of administrative fees and
other payments to GPOs to induce GPOs to put such requirements in
For example, in some contracts, Tyco required purchasers to
commit to buying a specific percentage of all of their sharps
containers needs from Tyco in order to get the best pricing. One
such contract negotiated between Tyco and Premier required
Premier’s members to purchase at least 90% of their “PRODUCT
REQUIREMENTS . . . PER CALENDAR YEAR,” along with other volume-
based commitments, to receive the best pricing. (See Elhauge
Decl. ¶ 36 n.45 Ex. 11 at TYN0001092). Another contract between
Tyco and Consorta required members to have “90% compliance” and
sign a “Letter of Commitment” to qualify for “Level II Committed
Tyco also penalized purchaser end users who failed to meet
its market share purchase requirements. A January 2001 agreement
negotiated between Tyco and Novation, a GPO, imposed substantial
penalty prices should Novation’s members fail to buy 80% to 90%
of their sharps containers from Tyco. Other penalties imposed by
Tyco for failing to meet market share purchase requirements
included both (1) not paying rebates for sharps containers
already purchased, and (2) forcing a purchaser to pay back past
rebates already received from past container purchases. Tyco’s
contracts, in fact, generally required end user purchasers to
forfeit and repay all rebates on sharps containers already
purchased should an end user decide not to meet Tyco’s
Tyco monitored its market share purchase requirements. For
example, under the January 2001 agreement Tyco negotiated with
Novation, Tyco’s sales representatives reviewed member purchases
to determine each member’s market share level and eligibility for
associated discounts. The agreement also required Novation
members to disclose their sharps container purchases to Tyco for
Tyco’s market share purchase requirements significantly
deterred end user purchasers from purchasing sharps containers
from any other manufacturer but Tyco. Because Tyco employed
market share purchase requirements with some, if not all, of the
contracts it negotiated with GPOs, Plaintiffs contend these
requirements had the effect of significantly foreclosing the
sharps containers market from competition. Bundling Tyco Products for Exclusionary Purposes
In conjunction with its market share purchase requirements,
Tyco also foreclosed the sharps containers market by bundling its
sharps containers with other Tyco products. Under such bundling
arrangements Tyco tied rebates to meeting market share
requirements on each and every product within the bundle. A
purchaser would lose rebates for all products in the bundle
should the purchaser fail to maintain market share purchase
requirements for any one bundled product. Tyco contends that
approximately 15% of Kendall sales were made through these
bundling programs, and that bundling stopped entirely in mid-
For example, Tyco instituted with Novation a “Tyco
Enhancement Program” that bundled discounts on sharps containers
with products relating to incontinence, wound care, pulse
oximetry, and electrodes, among other products. Tyco also
bundled its sharps containers with its needles and syringes.
Many of Tyco’s rivals were smaller firms that could not
offer the same range of products that Tyco offers. Consequently,
in many instances Tyco’s rivals could not offer offsetting or
greater discounts to compensate for all of the rebates an end
user would lose by switching to the rival.
iii. GPO Exclusionary Contracts
Tyco also allegedly foreclosed the sharps containers market
by entering into sole-source or dual-source contracts with GPOs.
Under these contracts, made between Tyco and the GPO itself, the
GPO agreed to broker only sharps containers from Tyco (or Tyco
and one other rival) to its members. These sole-source and dual-
source contracts were the result of a competitive bidding process
in which GPOs would award such contracts based upon proposals
submitted by sharps containers manufacturers. Tyco, however,
used its payments of administrative fees and other payments to
induce GPOs to enter into such multi-year agreements with Tyco.
A 2003 internal document showed that, at the time, Tyco had
either sole-source or dual-source contracts with six of the seven
(Elhauge Decl. ¶ 35 n.42, Ex. 2 at TYN0009139).
These sole-source and dual-source contracts, coupled with
the internal policies and practices of the GPOs, coerced GPO
members to enter into exclusionary contracts with Tyco that
included market share purchase requirements and bundling. For
example, Premier has adopted a general policy of commitment that
requires its members to sign a letter of intent to comply with
any commitment contracts that Premier negotiates with suppliers.
Any member who refuses to sign the letter of intent risks
expulsion from Premier and lost rebates from other products.
Other GPOs have similar coercive policies.
Tyco’s sole-source and dual-source contracts with GPOs
discouraged members from purchasing sharps containers from Tyco’s
non-GPO-approved rivals. The result was to foreclose other
sharps containers manufacturers from selling their products to
Conspiracy with Manufacturers to Impose Rebate Penalties
Finally, Tyco foreclosed the sharps containers market by
conspiring with the manufacturers of other medical device
products to assist each other in foreclosing rivals. The
conspiracy involved various GPO programs, and utilized the same
bundling tactics Tyco used with its own products. In essence, a
GPO member would lose rebates for other manufacturers’ products
purchased should it fail to maintain market share purchase
requirements for Tyco’s sharps containers. GPO members would not
only lose rebates from present and future purchases, but in some
instances be forced to pay back past rebates already received
For example, Tyco participated in Novation’s
Opportunity/Spectrum I and Opportunity/Spectrum III portfolio
purchasing programs. Both programs conditioned rebates for
Novation’s members on meeting purchase requirements for a
portfolio of Tyco and non-Tyco products. Specifically, the
“TERMS OF SUPPLIER’S PARTICIPATION IN OPPORTUNITY® COMMITTED
PORTFOLIO” provide that “[o]ne criteria that must be satisfied by
[the Novation member] for payment of Incentives is the criteria
that the [member] has purchased at least ninety-five percent
(95%) of its projected purchase volume for Supplier’s Portfolio
Categories.” (See Elhauge Decl. ¶ 36 n.46 Ex. 18 at TYN0001040).
To participate in the program, Tyco paid, among other things, an
additional fee totaling 7% of all sales revenue received from the
The Opportunity/Spectrum programs, moreover, penalized
members who evaluated rival products. Under the program Novation
members that perform evaluations of competitive products may lose
the Novation discounts within 30 days of the start of the
evaluation. Penalties in the form of loss of past, present, and
The effect of the conspiracy, as with Tyco’s other alleged
anticompetitive practices, was to substantially foreclose the
sharps containers to Tyco’s rivals. The alleged conspiracy
discouraged member hospitals from purchasing sharps containers
from rivals or risk losing significant rebates. The conspiracy
also made it economically challenging for smaller rivals to
provide offsetting discounts and rebates to compete with Tyco. The Anticompetitive Effect of Tyco’s Alleged Scheme
Plaintiffs claim that Tyco engaged in its scheme with the
intent of substantially shutting its rivals out of the market.
One internal e-mail concerning the threat of reusables put the
intent of Tyco’s scheme bluntly: to prepare for
“Stericycle/BioSystems national ‘Reusable’ attack,” Tyco must
“[m]ake it a priority to negotiate maintenance and/or growth
clauses in every GPO/IDN agreement upon renewal” and “[i]nclude
additional non-published value price tiers that stipulate [that]
disposable sharps must be used for eligibility.” (Elhauge Decl.
¶ 37 n.49 Ex. 24 at TYN0004234). Plaintiffs allege that Tyco’s
scheme, in whole or in part, had the effect of creating
artificial barriers to entry that substantially foreclosed and/or
impaired competition (and the threat of such competition) from
lower-priced and/or superior quality sharps containers. Absent
Tyco’s scheme, both potential and actual rivals would have:
Obtained greater sales by offering cheaper and/or superior products;
Achieved lower costs by having access to the most efficient sources of inputs or distribution, such as the GPO brokerage services market; and
Acquired a greater share of the market as a result and achieved greater economies of scale, scope, innovation,and learning -- what can be called economies based onmarket share, or economies of share -- that would havefurther lowered the costs and prices of their sharpscontainers.
(See Elhauge Decl. ¶ 29). With its scheme, Tyco punctured
potential or actual competitive pressure to lower the prices of
Tyco’s sharps containers. Therefore, according to Plaintiffs,
the price of Tyco’s sharps containers was artificially inflated
as compared to the price of Tyco’s sharps containers in the “but-
for world” -- that is, the competitive price for Tyco’s sharps
containers that would have existed “but-for” Tyco’s scheme. (See
Compl. ¶ 77; Elhauge Decl. ¶¶ 15, 48-49). Plaintiffs allege that
they sustained damages from Tyco’s scheme in the form of the
overcharges they paid in purchasing Tyco’s sharps containers at
the “artificially inflated” price, the “overcharges” understood
as the difference between the price of sharps containers
resulting from Tyco’s scheme and the price of the containers in
the “but-for” world. (See Compl. ¶ 78). THE CLASS REPRESENTATIVES Natchitoches
Proposed class representative Natchitoches, a direct
purchaser of Tyco’s sharps containers, is a 199-bed hospital and
nursing home facility located in Natchitoches, Louisiana.
Natchitoches began purchasing its sharps containers from Tyco in
1999 after becoming dissatisfied with sharps containers it
purchased from Becton Dickinson. It is a member of GPOs
MedAssets, Amerinet, and Novation. Natchitoches has not
evaluated or purchased any reusable sharps containers.
Prior to the filing of the Complaint, Mark Marley, CEO of
Natchitoches, had a general belief that there may be overcharges
in the sharps containers market due to GPO contracting. He also
reviewed and edited the Complaint prior to filing, and briefed
the board of directors of Natchitoches on the Complaint. Smith Drug
Proposed class representative Smith Drug, a direct purchaser
of Tyco’s sharps containers, is a distributor of medical supplies
and products, with a similar product mix and customer base as
larger distributors McKesson and Cardinal, but not Owens & Minor.
Smith Drug has annual revenues of approximately $2 billion.
Smith Drug purchased approximately $32,000 worth of sharps
containers in 2006, or approximately 0.002% of its total revenue.
Sharps containers are also a small percentage of the total
revenues for Cardinal, McKesson, and Owens & Minor. Smith Drug
does not utilize cost-plus arrangements in which the distributor
charges a percentage mark-up to customers. Instead, Smith Drug
sells Tyco sharps containers at cost and is compensated by
receiving prompt pay discounts from Tyco that are based upon the
purchase price. Approximately 25% of Smith Drug’s sharps
containers customers are hospitals and 50% are independent
pharmacies. Smith Drug does not have any relationships with any
reusable sharps container suppliers.
Smith Drug’s corporate designee, Dr. William L. Brice, has
read the Complaint in this action and concluded that “there was a
very distinct possibility that there were [over] charges made to
Smith Drug Company in the case of Sharps Containers; we were
anxious to pursue that.” (Tamoshunas Suppl. Reply Decl. Ex. A.,
III. DISCUSSION
Plaintiffs move for class certification under Fed. R. Civ.
P. 23(a) and (b)(3). Tyco contends that the court should not
certify the class for two principal reasons.
First, Tyco relies upon the Eleventh Circuit’s decision in
Valley Drug Co. v. Geneva Pharmaceuticals, Inc., 350 F.3d 1181
(11th Cir. 2003), to argue that a fundamental conflict exists
between (1) distributor class members who, on net, have an
economic stake in perpetuating Tyco’s allegedly unlawful scheme,
and (2) others that were harmed by the scheme. In Tyco’s view,
the proposed class representatives cannot overcome this
fundamental conflict to adequately represent the class, as
Second, Tyco argues that the Plaintiffs have provided no
viable method for proving an antitrust violation and injury on a
classwide basis, and thus fail to satisfy the requirement under
Rule 23(b)(3) that issues common to the class predominate. PLAINTIFFS’ CLAIMS
Plaintiffs claim that Tyco’s allegedly anticompetitive
conduct violated Sections 1 and 2 of the Sherman Act, 15 U.S.C.
§§ 1-2. Plaintiffs seek to recover overcharges under Section 4
of the Clayton Act, 15 U.S.C. § 15, which allows persons
“injured” by violations of federal antitrust law to “recover
threefold the damages . . . sustained,” as well as the costs in
Section 2 of the Sherman Act (Count I)
Plaintiffs claim that Tyco violated Section 2 of the Sherman
Act because Tyco’s scheme to foreclose the sharps containers
market was an unlawful exercise of its monopoly power to maintain
and increase its monopoly in the sharps containers market.
Section 2 of the Sherman Act makes it unlawful to
“monopolize, or attempt to monopolize, or combine or conspire
with any other person or persons, to monopolize any part of the
trade or commerce among the several States.” 15 U.S.C. § 2.
Despite its sweeping language, to recover under Section 2, a
plaintiff must prove that “(1) the defendant has monopoly power
and (2) the defendant ‘has engaged in impermissible
‘exclusionary’ practices with the design or effect of protecting
or enhancing its monopoly position.’” CCBN.com, Inc. v. Thomson
Fin., Inc., 270 F. Supp. 2d 146, 156 (D. Mass. 2003) (citing
Coastal Fuels of P.R., Inc. v. Caribbean Petroleum Corp., 79 F.3d
182, 195-96 (1st Cir. 1996)); see also Verizon Commc’ns Inc. v.
Law Offices of Curtis V. Trinko, 540 U.S. 398, 407 (2004) (“[T]he
possession of monopoly power will not be found unlawful [under
Section 2] unless it is accompanied by an element of
Courts have recognized Section 2 claims based upon
exclusionary conduct similar to the allegations in this
complaint. See, e.g., LePage’s Inc. v. 3M, 324 F.3d 141, 154-60
(3d Cir. 2003) (upholding jury verdict that found that defendant
3M’s scheme of (1) bundling its rebates with other 3M products
and (2) entering into exclusive dealing contracts with large
customers to foreclose the transparent tape market violated
Section 1 of the Sherman Act (Count II)
Plaintiffs claim that Tyco violated Section 1 of the Sherman
Act by conspiring and entering into agreements with GPOs and
other manufacturers to unlawfully maintain and increase its
monopoly power in the sharps containers market. (Compl. ¶¶ 85-
91). Plaintiffs do not contend that these agreements are per se
Section 1 of the Sherman Act makes unlawful “[e]very
contract, combination in the form of trust or otherwise, or
conspiracy, in restraint of trade or commerce among the several
States.” 15 U.S.C. § 1. To succeed on a claim under Section 1
of the Sherman Act, a plaintiff must prove “(1) the existence of
a contract, combination, or conspiracy (2) that unreasonably
restrains trade either per se or under the rule of reason and (3)
that effects interstate trade or commerce.” In re Carbon Black
Antitrust Litig., No. 03-10191, 2005 WL 102966, at *5 (D. Mass.
Jan. 18, 2005) (citing Lee v. Life Ins. Co. of N. Am., 829 F.
Supp. 529, 535 (D.R.I. 1993), aff’d, 23 F.3d 14 (1st Cir. 1994)).
Courts have recognized Section 1 claims based upon similar
exclusionary contracts. See, e.g., Masimo v. Tyco Health Care
Group, L.P., No. 02-4770, 2006 WL 1236666, at *7-10 (C.D. Cal.
Mar. 22, 2006) (sustaining jury verdict against Tyco that found,
among other things, a Section 1 violation based upon sole-source
contracts with GPOs in the oximetry market). RULE 23 STANDARD2
Under Rule 23(a), a class may be certified only if:
(1) the class is so numerous that joinder ofall members is impracticable;
(2) there are questions of law or fact commonto the class;
(3) the claims or defenses of therepresentative parties are typical of theclaims or defenses of the class; and
(4) the representatives will fairly andadequately protect the interests of the class.
Plaintiffs further seek damages under Rule 23(b)(3), which
provides that an action may be maintained only if, additionally,
the court finds that the questions of law orfact common to class members predominate overany questions affecting only individualmembers, and that a class action is superiorto other available methods for fairly andefficiently adjudicating the controversy. Thematters pertinent to the findings include:
(A) the class members’ interest inindividually controlling the prosecution ordefense of separate actions;
(B) the extent and nature of any litigationconcerning the controversy already begun by oragainst class members;
(C) the desirability or undesirability ofconcentrating the litigation of the claims inthe particular forum; and
2 Effective December 1, 2007, the language of Rule 23 was
amended “to make style and terminology consistent throughout therules. These changes are intended to be stylistic only.” Fed. R. Civ. P. 23 advisory committee’s note 2007 Amendment (emphasisadded). For the sake of clarity, the Court will cite to theamended language.
(D) the likely difficulties in managing aclass action.
A district court must determine whether a proposed class
meets the exacting prerequisites established by Rule 23. Smilow
v. Sw. Bell Mobile Sys., Inc., 323 F.3d 32, 38 (1st Cir. 2003).
In “determining the propriety of a class action, the question is
not whether the plaintiff or plaintiffs have stated a cause of
action or will prevail on the merits, but rather whether the
requirements of Rule 23 are met.” Waste Mgmt. Holdings, Inc. v.
Mowbray, 208 F.3d 288, 298 (1st Cir. 2000) (quoting Eisen v.
Carlisle & Jacquelin, 417 U.S. 156, 178 (1974)). However, “a
district court must formulate some prediction as to how specific
issues will play out in order to determine whether common or
individual issues predominate in a given case.” Mowbray, 208
F.3d at 298; see also Tardiff v. Knox County, 365 F.3d 1, 4-5
(1st Cir. 2004) (“It is sometimes taken for granted that the
complaint’s allegations are necessarily controlling; but class
action machinery is expensive and in our view a court has the
power to test disputed premises early on if and when the class
action would be proper on one premise but not another.”).
Plaintiffs bear the burden of demonstrating that the Rule’s
prerequisites have been satisfied. Amchem Prods., Inc. v.
Windsor, 521 U.S. 591, 613-15 (1997); Smilow, 323 F.3d at 38. Numerosity
Plaintiffs allege that the class “is composed of over 1,500
members.” Tyco concedes that “[t]here's no doubt that there's
numerosity” as to the class. (Sept. Tr. at 45). Given the low
threshold for numerosity, Plaintiffs easily meet this prong of
Rule 23. See, e.g., Holton v. Rothschild, 118 F.R.D. 280, 282
(D. Mass. 1987) (holding that a class of 50 or 60 is sufficiently
Commonality
Under Rule 23(a)(2), a class has sufficient commonality “if
there are questions of law or fact common to the class.” The
threshold of commonality is easily penetrated. “[T]he rule
requires only that resolution of the common questions affect all
or a substantial number of the class members.” Jenkins v.
Raymark Indus., Inc., 782 F.2d 468, 472 (5th Cir. 1986) (citation
omitted). “The test or standard for meeting the Rule 23(a)(2)
prerequisite is qualitative rather than quantitative; that is,
there need be only a single issue common to all members of the
class. Therefore, this requirement is easily met in most cases.”
1 Herbert B. Newberg & Alba Conte, Newberg on Class Actions §
3.10 (4th ed. 2002) (emphasis added). In the antitrust context
“courts have held that the existence of an alleged conspiracy or
monopoly is a common issue that will satisfy the Rule 23(a)(2)
prerequisite.” Id. (citing cases).
Plaintiffs readily meet the commonality requirement, as
Plaintiffs identify a number of issues related to whether a
violation of the antitrust laws occurred that are common to the
whether Tyco obtained, maintained, and/orpossessed market and/or monopoly power in themarket for Sharps Containers in the United Statesduring the Class Period;
whether Tyco obtained and/or maintained its marketand/or monopoly power through willful,anticompetitive and/or unlawful activity;
whether Tyco engaged in illegal agreements,contracts, combinations, and/or conspiracies, thepurpose and effect of which was to unreasonablyrestrain competition in the Sharps Containersmarket; [and]
whether Tyco’s sole-source contracts with GPOs, aspart of its overall scheme to monopolize, areunreasonable restraints on trade and competitionin violation of the federal antitrust laws. Typicality
Rule 23(a)(3) provides that a class action may be maintained
only if the claims of the representative parties are typical of
Typicality determines whether a sufficientrelationship exists between the injury to thenamed plaintiff and the conduct affecting theclass, so that the court may properlyattribute a collective nature to thechallenged conduct. In other words, when sucha relationship is shown, a plaintiff’s injuryarises from or is directly related to a wrongto a class, and that wrong includes the wrongto the plaintiff. Thus, a plaintiff’s claimis typical if it arises from the same event orpractice or course of conduct that gives rise
to the claims of other class members, and ifhis or her claims are based on the same legaltheory.
In re Am. Med. Sys., Inc., 75 F.3d 1069, 1082 (6th Cir. 1996)
(quoting 1 Herbert B. Newberg & Alba Conte, Newberg on Class
Actions § 3.13 (3d ed. 1992)). “The typicality requirement ‘is
designed to align the interests of the class and the class
representatives so that the latter will work to benefit the
entire class through the pursuit of their own goals.’” In re
Warfarin Sodium Antitrust Litig., 391 F.3d 516, 531 (3d Cir.
2004) (citation omitted). “[T]ypicality, as with commonality,
does not require ‘that all putative class members share identical
claims.’” Id. at 531-32 (citation omitted).
Plaintiffs have proposed Natchitoches, a hospital end user
of sharps containers, and Smith Drug, a distributor, as
representatives for the direct purchaser class. Both have
purchased sharps containers from Tyco during the relevant class
period. Moreover, Plaintiffs contend that the class
representatives’ claims, like the claims of the other class
members, all “arise out of a common wrong: a core pattern of
alleged anticompetitive conduct that would have similarly injured
each of them by artificially inflating the price of Tyco’s Sharps
Containers.” (Pl. Mem. at 18). The Court finds this sufficient
to establish typicality. See In re Relafen Antitrust Litig., 218
F.R.D. 337, 342-43 (D. Mass. 2003) (typicality established in
antitrust action where “claims arise from the same course of
conduct that gave rise to the claims of the absent [class]
members.”) (citations and internal quotations omitted).
Tyco argues separately that Smith Drug is not typical of the
distributors in the class because (1) Smith Drug does not have
the same cost-plus arrangements as other distributors in the
class and (2) it primarily sells sharps containers to pharmacies
rather than end users. Thus, Tyco contends that Smith Drug is
not at risk of being by-passed by reusable sharps containers.
Tyco styles this objection as one of the “adequacy” of Smith
Drug, but these specific objections relate to typicality. See
Rental Car of N.H., Inc. v. Westinghouse Elec. Corp., 496 F.
Supp. 373, 377 (D. Mass. 1980) (in price-fixing case, noting that
courts have equated typicality requirement with adequacy of
representation requirement, citing cases).
The Court finds otherwise. Smith Drug is compensated by
receiving prompt pay discounts from Tyco that are based upon a
percentage of the purchase price, and thus is paid, like
distributors with cost-plus arrangements, on a percentage basis.
In addition, since Smith Drug sold approximately 25% of its
sharps containers to end user hospitals, Smith Drug was also at
risk of losing business from reusable sharps containers that
would by-pass Smith Drug. Significantly, Tyco had the
opportunity to take class discovery, but presented no evidence to
the Court as to whether Smith Drug received a net economic
benefit or harm from Tyco’s allegedly unlawful scheme. While
there are differences between Smith Drug and the other
distributors in the class, they are not sufficient to destroy
Adequacy of Representation
“The adequacy inquiry under Rule 23(a)(4) serves to uncover
conflicts of interest between named parties and the class they
seek to represent.” Amchem, 521 U.S. at 625.
The [adequacy] rule has two parts. The movingparty must show first that the interests ofthe representative party will not conflictwith the interests of any of the classmembers, and second, that counsel chosen bythe representative party is qualified,experienced, and able to vigorously conductthe proposed litigation.
Andrews v. Bechtel Power Corp., 780 F.2d 124, 130 (1st Cir.
1985). “The conflict that will prevent a plaintiff from meeting
the Rule 23(a)(4) prerequisite must be fundamental, and
speculative conflict should be disregarded at the class
certification stage.” In re Visa Check/Mastermoney Antitrust
Litig., 280 F.3d 124, 145 (2d Cir. 2001), overruled on other
grounds by In re Initial Pub. Offering Sec. Litig., 471 F.3d 24
(2d Cir. 2006) (internal quotations and citations omitted).
As an initial matter, Tyco argues that the proposed class
representatives cannot adequately represent the class because of
their “limited personal knowledge of the facts underlying this
suit, as well as their apparently superfluous role in this
litigation.” In re Sepracor, Inc., Sec. Litig., 233 F.R.D. 52,
55 (D. Mass. 2005) (quoting Greenspan v. Brassler, 78 F.R.D. 130,
133-34 (S.D.N.Y. 1978)). However, a class representative in an
antitrust action only needs a “working knowledge” of the action.
See J.B.D.L. Corp. v. Wyeth-Ayerst Labs., Inc., 225 F.R.D. 208,
216-17 (S.D. Ohio 2003) (in antitrust action, finding that class
representative had sufficient knowledge despite memory lapse).
Moreover, in the context of antitrust, a plaintiff is not
required to understand complex economic theories or have an
expert’s knowledge of the market. Morelock Enters. v.
Weyerhaeuser Co., No. 04-583, 2004 WL 2997526, at *4 (D. Or. Dec.
16, 2004); see also In re Relafen Antitrust Litig., 231 F.R.D.
52, 69 (D. Mass. 2005) (“In complex actions such as this one,
named plaintiffs are not required to have expert knowledge of all
of the details of the case.”). Both Natchitoches, through its
CEO Mark Marley, and Smith Drug, through its corporate designee
Dr. William L. Brice, have demonstrated a working knowledge of
the case by reading the Complaint and understanding the basic
claims of the case. No more is required.
Tyco also contends that the interests of some large
distributors conflict with end user class members because some of
them enter into sole- and dual-source contracts with GPOs, which
are similar to (though not the same as) the sole- and dual-source
contracts challenged here. Plaintiffs disagree, arguing that
there is no evidence that any distributor has monopoly power,
that the market for distributors is competitive, or that existing
distributor/GPO contracts are not exclusionary. Plaintiffs,
moreover, do not allege that the exclusionary GPO contracts at
issue in this case are per se illegal. As the case progresses,
different litigation positions on this liability issue might
surface and require subclassing. At this stage, however, there
is no evidence of a fundamental conflict.
Tyco primarily argues that the proposed class
representatives cannot adequately represent the class because the
class contains a fundamental conflict between (1) distributors
who received a net economic benefit from Tyco’s allegedly
anticompetitive scheme and (2) others, such as end user
hospitals, who were harmed by the scheme.
Tyco identifies two ways in which distributors benefitted
from Tyco’s scheme. First, Tyco argues that distributors, in
particular the three largest distributors of Tyco’s disposable
sharps containers -- McKesson, Owens & Minor, and Cardinal --
sold Tyco’s sharps containers on a “cost-plus” basis, and thus
may have received larger profits due to Tyco’s allegedly higher
prices. Second, Tyco argues that the chief rivals to Tyco’s
disposable sharps containers, providers of reusable sharps
containers, “by-pass” distributors altogether, and thus
distributors like McKesson, Owens & Minor, and Cardinal may
receive a net economic harm should Tyco’s allegedly
anticompetitive scheme cease. Therefore, on net, some
distributors in the class may have benefitted from Tyco’s scheme.
Because of what can be called the “cost-plus” and the “by-
pass” theories of net economic benefit, Tyco argues that the
existence in the class of distributors that received a net
economic benefit from Tyco’s scheme creates a “fundamental
conflict” among class members such that the class representatives
would not be able to vigorously prosecute the action.
Consequently, the argue, both class representatives and class
counsel cannot adequately represent the class as required under
Tyco pins its hopes on Valley Drug Co. v. Geneva
Pharmaceuticals, Inc., 350 F.3d 1181 (11th Cir. 2003), in which
the Eleventh Circuit vacated and remanded the allowance of class
certification because of substantially similar, though not
identical, conflicts. Courts have been divided on its
persuasiveness.3 Because it is directly on point, the Court
3 Some courts have found Valley Drug’s “reasoning
persuasive.” In re Relafen Antitrust Litig., 221 F.R.D. 260, 270(D. Mass. 2004) (citing prior order that followed Valley Drug andexcluded from indirect purchaser end payor class those that“suffered no economic harm.”); see also Grimes v. FairfieldResorts, Inc., No. 06-14363, 2007 WL 245128, at *2-3 (11th Cir. Jan. 30, 2007) (reaffirming Valley Drug); Allied OrthopedicAppliances, Inc. v. Tyco Healthcare Group, L.P., -- F.R.D. --,No. 06-06420, 2007 WL 4698599, at *21 (C.D. Cal. Dec. 21, 2007)(denying certification because of, among other things,fundamental conflict between those that suffered net benefit andthose that suffered net harm, citing Valley Drug); DeHoyos v. Allstate Corp., 240 F.R.D. 269, 290 (W.D. Tex. 2007) (notingcertification “extraordinarily difficult” if some class members
After an analysis and application of Valley Drug to the
facts of this case, the Court does not find conclusive evidence
of a fundamental conflict. Accordingly, the Court finds that the
class representatives can adequately represent the proposed class
Valley Drug
Valley Drug concerned defendant Abbott Laboratories
(“Abbott”) and its patent for the drug terazosin hydrochloride,
marketed under the brand name “Hytrin.” Valley Drug, 350 F.3d at
1183-84. Co-defendants Geneva Pharmaceuticals (“Geneva”) and
Zenith Goldline Pharmaceuticals (“Zenith”), manufacturers of
generic versions of Hytrin, both challenged Abbott’s patent, and
benefitted from alleged conduct, citing Valley Drug); Bert v. AKSteel Corp., No. 02-467, 2007 WL 184746, at *3 (S.D. Ohio Jan. 19, 2007) (citing Valley Drug with approval); Boca Raton Cmty. Hosp., Inc. v. Tenet Healthcare Corp., 238 F.R.D. 679, 695 (S.D. Fla. 2006) (quoting Valley Drug for proposition that a classcannot be certified if it contains “members who benefit” fromalleged unlawful acts); In re Urethane Antitrust Litig., 237F.R.D. 454, 461-63 (D. Kan. 2006) (following Valley Drug indiscovery dispute).
Other courts have criticized Valley Drug. See, e.g.,
Meijer, Inc. v. Warner Chilcott Holdings Co. III, Ltd., 246F.R.D. 293, 2007 WL 3257015, at *9 (D.D.C. Oct. 22, 2007) (notingthat the holding in Valley Drug “fails to appreciate the trueimport of the Hanover Shoe rule”); In re K-Dur Antitrust Litig.,No. 01-1652, Slip Op. at 22-23 & n.12 (D.N.J. Jan. 2, 2007)(special master report denying downstream discovery, criticizingValley Drug); In re Hypodermic Prods. Direct Purchaser AntitrustLitig., MDL No. 1730, 2006 U.S. Dist. Lexis 89353, at *16 (D.N.J. Sept. 7, 2006) (citing with approval magistrate judge ruling thatValley Drug’s “narrow reading of Hanover Shoe is neither sharedby this Court nor this circuit.”).
litigation ensued. Id. at 1185. Abbott eventually entered into
separate settlement agreements with Geneva and Zenith that
delayed the entry of their generic versions of Hytrin. Id. at
1186. The settlement agreements were terminated in response to
an investigation by the Federal Trade Commission. Id. The
plaintiffs, regional wholesalers that purchased Hytrin directly
from Abbott while the settlement agreements were in effect,
brought suit alleging that the settlement agreements, in delaying
entry of the generic versions of Hytrin, constituted per se
violations of Section 1 of the Sherman Act. Id.
The plaintiffs thereafter moved for class certification on
behalf of all direct purchasers of Hytrin from Abbott during the
period when the settlement agreements were in effect. Id. The
proposed class comprised both end user purchasers of Hytrin and
wholesalers who, like the distributors here, resold Hytrin to end
users. In fact, three national wholesalers -- McKesson,
Cardinal, and Bergen-Brunswig -- accounted for 50% of all Hytrin
direct purchases. See id. at 1190 & n.18. The district court
certified the class, and the defendants appealed.
On appeal, the defendants argued, among other things, that
“the district court erred by foreclosing discovery on the
question whether some class members benefitted from the conduct
alleged to have harmed the class members on the whole.” Id. at
1187. The Valley Drug court agreed, holding that the district
court abused its discretion in failing to address whether
adequacy of representation could be satisfied despite the fact
that the most significant members of the certified class
“arguably make more money on the sale of the branded product than
on the generic product.” Id. at 1191.
As in this case, the defendants argued that the wholesalers
in Valley Drug benefitted on net from Abbott’s monopoly on Hytrin
by the same “cost-plus” and “by-pass” theories. Wholesalers sold
drugs on a “cost-plus” basis, and thus received higher revenues
from selling the branded Hytrin over the much cheaper generic
alternatives. Id. at 1190-91. The Eleventh Circuit emphasized,
however, that this fact alone is “insufficient to prove net
economic benefit if it were not for the specific nature of the
product and the industry involved in this case.” Id. at 1191.
In particular, the Court noted that demand for terazosin
hydrochloride was “inelastic,” such that a drop in the price of
the drug could not be offset by an increase volume of sales. Id.
Any drop in price, defendants argued, would result in a net loss
for wholesalers. Moreover, the defendants presented evidence
that purchasers of terazosin hydrochloride, in particular retail
pharmacies, “bypassed” wholesalers “for many generic sales.” Id.
Thus, wholesalers would lose even further volume from a switch
from branded to generic terazosin hydrochloride.
The plaintiffs provided no evidence to rebut the evidence of
“cost-plus” and “by-pass” provided by the defendants. Id. at
1190, 1196. Instead, the plaintiffs argued that allowing
discovery of the wholesalers’ sales practices (so-called
“downstream discovery”) would contravene Hanover Shoe and
Illinois Brick, which forbid such downstream discovery since it
is irrelevant to whether a direct purchaser has standing. Id. at
The Eleventh Circuit rejected the argument, reading Hanover
Shoe as only applying to a direct purchaser’s standing and
damages, and not limiting the requirement that a court must
determine whether Rule 23(a)(4) has been satisfied. Id. at 1193.
Moreover, the Eleventh Circuit concluded that such an inquiry did
not dull the law enforcement objectives of the Hanover Shoe rule,
and that the limited downstream discovery for such an inquiry
would not be “unduly burdensome” to plaintiffs. Id. at 1195-96.
Accordingly, the Court vacated the grant of class certification
and remanded the case to the district court. Id. at 1196.
The parties in Valley Drug ultimately settled, and moved for
a single settlement class. In approving the settlement, the
Court found the “fact of settlement” a “changed circumstance that
directly addresses the Court’s prior concern that led to denial
of the Sherman Act Plaintiffs’ motion for class certification.”
See In re Terazosin Hydrochloride Antitrust Litig., Case No. 99-
MDL-1317, Slip. Op. at 6 (S.D. Fla. Mar. 18, 2005) (order
granting certification of direct purchaser class). Application of Valley Drug
Based on Valley Drug, this Court permitted downstream
discovery to determine whether a fundamental conflict exists
between distributor class members and end user class members.
The parties took additional discovery of Cardinal, Owens & Minor,
and McKesson. In response to the Court’s concerns, Plaintiffs
added Smith Drug as a distributor class representative.4 Thus,
as compared to the court in Valley Drug, this Court has a fuller
record of the purported conflicts in this case.
To counter the “cost-plus” theory of net benefit, Plaintiffs
argue that any overcharge recovered in this case would far
outweigh any net loss from the termination of Tyco’s scheme.
Plaintiffs rely on the deposition of Tyco’s expert Prof. Janusz
Ordover, who, based upon plausible assumptions provided by the
Plaintiffs, estimates that the potential overcharge recoverable
could be approximately 45-75 times any potential net benefit from
Tyco’s scheme. (See Cebulash Decl. Ex. N, Ordover Dep. at 101-
06). Plaintiffs also show, based on other evidence in the
record, that the potential recovery could be several times any
potential loss due to the enjoining of Tyco’s allegedly unlawful
scheme. (See Pl. Suppl. Mem. at 12-14).
To rebut the “by-pass” theory of net benefit, Plaintiffs
4 Plaintiffs did not move to amend their Complaint before
adding Smith Drug as a class representative pursuant to Fed. R. Civ. P. 15(c). However, because Plaintiffs did so at thesuggestion of the Court, and because Tyco does not object thatSmith Drug was not properly added, the Court will treat SmithDrug as a proper class representative.
present evidence that reusable sharps containers do not
necessarily by-pass distributors. Plaintiffs point to an
agreement entered into between Cardinal and Daniels to serve as
marketing, sales, and billing agent for the Daniels Sharpsmart
System. Plaintiffs also point out that Tyco has explored a
relationship with Owens & Minor to provide distribution services
for Tyco’s StarServe program, Tyco’s entry into the reusable
sharps containers market. (Tamoshunas Suppl. Decl. Ex. H at
TYN0146246). To be sure, Tyco has presented some evidence that
the Cardinal and Daniels agreement has been disappointing.
(Steiner Suppl. Decl. Ex. X at DI_00437288). Still, this
evidence demonstrates that distributors will not stand idly by
while reusable sharps containers enter the market, but will
The Court finds this evidence persuasive in demonstrating
that a fundamental conflict does not exist in this case at least
with respect to liability issues because distributors are likely
to gain an economic net benefit from the litigation. Plaintiffs
presented evidence that distributors have explored opportunities
to participate in the reusable market in an attempt to offset any
potential losses from a by-pass. Plus, any potential loss in
distributor revenue could be significantly outweighed by the
potential treble damages that the distributors could collect
should the Court find Tyco liable. This is particularly true
given the specific nature of the product and industry in this
case, where the evidence has shown that sharps containers
constitute only a small percentage of the total revenues of
Cardinal, Owens & Minor, and McKesson.
distributors/wholesalers happily participated in settlement
classes with end user direct purchasers. See, e.g., In re
Relafen Antitrust Litig., No. 01-12239 (D. Mass. Apr. 9, 2004)
(order and final judgment certifying settlement class of all
direct purchasers). In fact, the very fundamental conflict that
destroyed certification in Valley Drug was overcome at the
Despite this evidence, Tyco vigorously contends that a
fundamental conflict exists. The Court, in fact, permitted
downstream discovery to enable the parties to find out whether
Cardinal, Owens & Minor, and McKesson have a conflict or object
to this suit. Tyco provided no such evidence. While the
distributors and end users do not have identical economic
interests in the market, there is no evidence in this record of a
fundamental conflict in this litigation.
In any event, should any fundamental conflict arise, a ready
mechanism exists to protect it -- the opt-out provision. The
opt-out provision in Rule 23(c)(2)(B) “is an important method for
determining whether alleged conflicts are real or speculative.
It avoids class certification denial for conflicts that are
merely conjectural and, if conflicts do exist, resolves them by
allowing dissident class members to exclude themselves from the
action.” 1 Herbert B. Newberg & Alba Conte, Newberg on Class
Actions § 3.30 (4th ed. 2002); see also Smilow, 323 F.3d at 43
(because opt-out was an option, “hypothetical conflict provides
no basis for decertification.”). Sophisticated players such as
distributors and large hospitals can determine for themselves
whether a fundamental conflict exists within the class.
Moreover, in the event of a settlement, the Court can offer a new
opportunity for class members to request exclusion pursuant to
In addition, the Court has the right to require subclassing
if fundamental conflicts do in fact arise. Fed. R. Civ. P.
23(c)(5) provides that “[w]hen appropriate, a class may be
divided into subclasses that are each treated as a class under
this rule.” “Subclasses must be created when differences in the
positions of class members require separate representatives and
separate counsel.” Manual for Complex Litigation (Fourth) §
21.23 (2004). Subclasses can be created after an initial grant
of class certification. See Fed. R. Civ. P. 23(c)(1)(C) (“An
order that grants or denies class certification may be altered or
Another role of subclassing would be to provide structural
guaranties that a proposed settlement is fair. See 1 Herbert B.
Newberg & Alba Conte, Newberg on Class Actions § 3.31 (4th ed.
2002) (“When the class members are united in interest on the
liability issues but have potential conflicts regarding the
nature of the relief or the division of a monetary award, the
court may avoid the potential conflict by creating subclasses”);
cf. In re Relafen, 221 F.R.D. at 270 n.8 (“With respect to
settlement . . . an uninjured end payor might be willing to
accept a far lesser sum than would an injured end payor with an
entirely different economic situation.”). For example, there
might be a question as to how to allocate a settlement fund
between end users and distributors.5 In this event, a subclass
could be readily provided because Smith Drug has been added as a
class representative, and separate counsel could be appointed for
At this stage, though, the Court concludes that the wiser
course is to defer any subclassing unless and until fundamental
conflicts in fact arise in this case. See In re Visa Check, 280
F.3d at 145 (in determining adequacy of representation under Rule
23(a)(4), noting that “[i]n the event that the district court
does find conflicts [as to damage calculation] . . . there are a
variety of devices available to resolve the problem [including]
the possibilities of . . . creating subclasses.”). At least one
court has suggested pre-emptive subclassing as a way to forestall
5 Indeed, in the multi-district litigation this Court has
handled, separate counsel represented the consumers and thethird-party payors during mediation to ensure that the class fundwas divided fairly. This approach provided assurance to theCourt that the funds were fairly allocated.
any conflicts. See, e.g., In re Warfarin, 391 F.3d at 532 & n.14
(3d Cir. 2004) (suggesting subclasses to forestall “conflicts,”
but finding that subclasses not needed in settlement since
“[a]ppellants have only asserted, rather than established, an
inherent conflict among consumers and between consumers and
TPPs”). Still, “[s]ubclassing should not be resorted to unless
it serves a necessary purpose since it adds to the cost and
complexity of a class action.” Schwab v. Philip Morris USA,
Inc., 449 F. Supp. 2d 992, 1105 (E.D.N.Y. 2006). Predominance
“Predominance is a test readily met in certain cases
alleging violations of the antitrust laws.” Amchem, 521 U.S. at
625 (citations omitted). In antitrust cases, “common liability
issues such as conspiracy or monopolization have, almost
invariably, been held to predominate over individual issues.” 6
Herbert B. Newberg & Alba Conte, Newberg on Class Actions § 18.25
(4th ed. 2002) (citing cases). “Even where there are some
individualized damages issues,” common issues may predominate
“when liability can be determined on a class-wide basis.” In re
Visa Check, 280 F.3d at 139; see also Smilow, 323 F.3d at 40
(noting that “where . . . common questions predominate regarding
liability, then courts generally find the predominance
requirement satisfied even if individual damage issues remain,”
citing In re Visa Check). Thus, for purposes of this motion the
Court focuses on the Plaintiffs’ proposed methodologies to prove
classwide antitrust liability -- that is, a classwide antitrust
violation and resultant classwide injury.
To determine predominance, a court need not plunge into the
weeds of an expert dispute about potential technical flaws in an
expert methodology. See Smilow, 323 F.3d at 41 (“If later
evidence disproves [the expert’s proposed methods], the district
court can at that stage modify or decertify the class.”) “The
important question in a class certification context is whether
after a sneak preview of the issues, the expert approach appears
fundamentally flawed -- an issue usually vetted more fully at a
Daubert hearing based on a more detailed record.” In re Pharm.
Indus. Average Wholesale Price Litig., 230 F.R.D. 61, 90 (D.
To establish predominance as to proving an antitrust
violation and resulting injury, Plaintiffs rely on expert
declarations submitted by Professor Einer R. Elhauge, a professor
at Harvard Law School who teaches, among other things, antitrust
and health care policy, co-authored the Areeda Antitrust Treatise
volume on tying and other books and articles on antitrust
subjects, and is an economic consultant with Criterion Economics.
Although not an economist, Professor Elhauge has specific
expertise on the antitrust economics of medical device suppliers’
exclusionary agreements between GPOs and purchasers.
Prof. Elhauge opines that common antitrust injury “flows
naturally from establishing . . . five premises,” proof of which
would be common to all class members. (Elhauge Reply Decl. ¶¶ 3,
(a) Market Definition. It must be shown that there is an economically relevant U.S. sharps container market. For the second foreclosure theory . . . it must also be shown that there is an economically relevant GPO brokerage services market.
(b) Market Power. It must be shown that Tyco has market power in the sharps container market.
(c) Substantial Foreclosure. At least one of two market foreclosure theories must be shown. The first theory is that Tyco used
exclusionary commitment contracts with end- users (either direct or brokered through GPOs) to foreclose a substantial share of the sharps container market to Tyco’s rivals. The second foreclosure theory is that Tyco used exclusionary sole or dual-source contracts with GPOs to foreclose a substantial share of the GPO brokerage services market to Tyco’s rivals in the sharps container market. These market foreclosure claims are separate: the first foreclosure could exist without the second, and vice versa.
(d) Diminished Rival Competitiveness. One must show that at least one of the above marketwide foreclosures made Tyco’s rivals in the sharps container market less competitive than they would have been without that foreclosure. If both market foreclosures are proven, one would cumulatively assess their effect on the competitiveness of Tyco’s rivals.
(e) Lack of Redeeming Efficiencies. The exclusionary contracts causing the market foreclosure in question must not be shown to have efficiencies that (a) could not have been achieved through less anticompetitive
alternatives, and (b) were passed on toconsumers in sufficient magnitude to offsetany anticompetitive effect on price.
(Id. ¶ 2). Tyco primarily, though not exclusively, focuses on
the third through fifth premises, arguing that Prof. Elhauge
cannot prove substantial foreclosure and a resulting injury on a
To prove market foreclosure, Prof. Elhauge details various
methodologies that could be used for calculation of market
foreclosure and for proving the share of the GPO market that was
foreclosed (Id. ¶¶ 12-14). Specifically, to prove foreclosure by
Tyco’s exclusionary dealing with end users, he plans to rely on
“electronic transactional data on the prices paid by each end
user.” (Id. ¶ 12 & n.2 (relying on using Tyco’s “transaction-by-
transaction sales data for each year from 2001 to 2006” to
“calculate foreclosure” resulting from exclusionary dealing with
end user purchasers)). According to Prof. Elhauge, under this
methodology, dividing the committed quantity by the total market
provides the share of the container market foreclosed. (Id. ¶
12). To determine foreclosure of the GPO brokerage services
market, Prof. Elhauge also proposes to review terms of contracts
between Tyco and GPOs and calculate how many sales Tyco made
under exclusionary contracts as compared to non-exclusionary
To determine anti-competitive impact on rivals, Prof.
Elhauge proposes, among other things, to compare how rivals
actually did selling in the foreclosed part of the market
compared to how they did selling in the unforeclosed part of the
market, or to examine how rivals did selling before foreclosure
happened compared to how they did afterwards. (Elhauge Reply
Decl. ¶¶ 13-14 (emphasis added); see also Elhauge Reply Decl. ¶¶
37-40 (proposing to “cross-check . . . foreclosure figures
against other evidence to confirm the inference that any
substantial foreclosure share had an anticompetitive impact on
the market”)). Prof. Elhauge proposes other general empirical
methods to determine “the extent to which [Tyco’s scheme] altered
Tyco’s market power and prices.” (Elhauge Reply Decl. ¶ 16).
Tyco challenges Plaintiffs’ expert declarations as too
general and preliminary, failing to articulate a “plausible but-
for world.” (Ordover Decl. ¶¶ 48, 52; Ordover Sur-Reply Decl. ¶
2). As a result, Tyco argues that Plaintiffs’ expert has not
established a viable method of establishing, on a classwide
basis, (1) substantial foreclosure of the sharps container market
and a resulting (2) classwide impact. (Ordover Sur-Reply Decl.
To support their position, Tyco has submitted the expert
declarations of Professor Janusz A. Ordover, a Professor of
Economics and former Director of the Masters in Economics Program
at New York University. Professor Ordover is a Founding Director
of Competition Policy Associates, an economic consulting firm.
During 1991-1992, he was the Deputy Assistant Attorney General
for Economics at the Antitrust Division of the United States
Department of Justice where he was the Chief Economist. His
areas of specialization include industrial organization,
antitrust, and regulation economics.
As to foreclosure, Prof. Ordover argues that the proposed
methods of determining classwide injury may overstate overcharges
because Plaintiffs do not have a viable method of determining
which buyers were coerced into buying sharps containers and which
purchased sharps containers for pro-competitive reasons. (See
Ordover Decl. ¶ 58). Prof. Ordover challenges Prof. Elhauge’s
core assumption that the quantities of Kendall sharps containers
that were sold under the accused contracting practices (like
share commitment contracts) comprise the portion of the market
that has been foreclosed. He argues that “one would at a minimum
examine whether healthcare customers that purchased under such
contract terms were, in fact, able to secure better overall terms
for sharps containers than those who did not.” (Ordover Sur-
Reply Decl. ¶ 3). For example, in Tyco’s view, if a hospital is
a member of a GPO that offers a market share discount, and the
buyer obtains a significantly reduced price by buying 100%
Kendall, the buyer has chosen Kendall for legitimate, pro-
competitive reasons. Prof. Ordover also contends that Prof.
Elhauge’s foreclosure theories “fail to acknowledge active
competition that exists among sharps container manufacturers to
win a contract from any particular GPO and to gain sales at any
hospital or other healthcare facility.” (Id. ¶ 4).
As to classwide impact, Prof. Ordover challenges Prof.
Elhauge’s assertion that a common, classwide injury would result
even assuming substantial foreclosure. Prof. Ordover notes a
number of differences among end user class members that may
suggest that the extent of antitrust damages (if any) varies
among the class. Prof. Ordover, in particular, notes differences
among class members such as differences among products and class
member needs; the size of the end users and the availability of
volume-based discounts and contracting leverage; whether class
members belong to IDNs that can mitigate any overcharge; and the
geographic location of the class members and the availability of
reusable waste services. (Ordover Decl. ¶¶ 59-63; Ordover Sur-
Reply Decl. ¶¶ 10-16). To show that these differences among
class members argue against a common injury, Prof. Ordover
Assume that Seller (S) attemptsanticompetitive exclusion of rival R (R). This requires that it denies R access to asubstantial portion of the available demand(as postulated by Plaintiffs here). In orderto accomplish this, it offers a net price of$10 per container to several large IHNs inexchange for a 90% commitment. By assumption,R cannot beat this offer. Other purchaserspay $15 per container. Also by assumption,because exclusion is successful R cannot beatthe $15 offer either. In the but-for worldexclusionary contracts are not permitted. Again, by assumption, this leads to a loweraverage price of $12, say. Plainly, absentthe exclusionary conduct, some end buyers gainwhile others lose.
(Ordover Sur-Reply Decl. ¶ 10 n.13). In sum, Prof. Ordover
argues that even if Prof. Elhauge can prove an average antitrust
injury, it does not follow that each class member suffered
injury. (Ordover Decl. ¶¶ 70, 84; Ordover Sur-Reply Decl. ¶ 10);
see also Allied Orthopedic Appliances, 2007 WL 4698599, at *9-14
(rejecting methodology to prove common impact relying on average
prices given reality of customized contracting and product
Prof. Elhauge disagrees. With respect to foreclosure, Prof.
Elhauge argues, “What causes the purchaser’s injury is not
whether it was individually ‘coerced,’ but the effect the
marketwide foreclosure has on Tyco’s market power and market
prices.” (Elhauge Reply Decl. ¶ 4). He responds that as a
matter of standard antitrust economics, “buyers have incentives
to agree to exclusionary contracts even when they have an anti-
competitive effect because most of the harm of individual
agreements is externalized onto those who are not party to that
particular agreement.” (Id. ¶ 31) (emphasis added). He also
disagrees factually, arguing there is no evidence that vigorous
competition to enter into GPO sole-source and dual-source
contracts actually occurred in this case. (Id. ¶ 32).
With respect to common injury, Prof. Elhauge argues that the
differences that Prof. Ordover identifies either (1) rely “on the
mistaken proposition that anticompetitive conduct would persist
in the but-for world,” (2) already have been considered, (3) are
irrelevant, or (4) go to the merits and thus are classwide
issues. (See Elhauge Reply Decl. ¶¶ 19, 51-52). Prof. Elhauge
gives the following hypothetical to explain his position:
Assume that the but-for price for a sharpscontainer would be $10 absent Tyco’sexclusionary conduct, but that because thatconduct forecloses a substantial share of themarket, the actual market price is $20. Toinduce purchasers to agree to its exclusionaryprogram, Tyco has charged committed buyers 10%less than uncommitted buyers and set theuncommitted price at $20. Each buyer wouldhave individual incentives to commit, becausethen it would pay $18 rather than $20. Inthis situation, both the committed price ($18)and the uncommitted price ($20) in the actualworld are higher than the but-for price ($10). Thus, even though some class members sufferdamages of $10 and other [sic] suffer damagesof $8, the marketwide increase in pricescaused by Tyco’s anticompetitive conduct hashad a common impact on both. ProfessorOrdover’s claim is effectively that thecommitted prices paid by the bulk of buyersmight be less than $10. But he offers noexplanation why any rational profit-maximizingfirm like Tyco would adopt a commitmentprogram that results in lower revenue than itcould have earned without the program. Moreover, this amounts to an argument thatthese commitment contracts efficiently lowerprices. Such efficiency issues . . . arefully amenable to classwide resolution. IfProfessor Ordover’s argument on this claim isaccepted on the merits, it would mean that thecommitment contracts are not antitrustviolations, and thus would exist in the but-for world as well as the actual world, inwhich case they cannot undermine classwideassessment of impact.
(Id. ¶ 68 (emphasis added); see also Elhauge Decl. ¶¶ 55-56).
In sum, according to Prof. Elhauge, even “[i]f the Tyco
containers that a particular purchaser actually bought are
precisely the same containers as that purchaser would have bought
in the but-for world, that purchaser would still be injured
because it paid higher prices for those containers than it would
have paid without the anticompetitive market foreclosure.”
(Elhauge Reply Decl. ¶ 4). Consequently, Plaintiffs argue that
proof of individual coercion is largely irrelevant, and any risk
of overstating damages can be mitigated by the cross-checks Prof.
Elhauge proposes. (See Elhauge Reply Decl. ¶¶ 37-40). Thus,
Plaintiffs contend that regardless of the differences among
purchasers as to coercion, the key to determining an antitrust
violation and injury is to determine whether a substantial share
of the market was foreclosed, and whether this substantial
foreclosure led to increased market prices.
The class record is not sufficiently developed to resolve
this robust economic debate between these two highly qualified
antitrust titans with respect to the impact of the alleged
exclusionary contracts on the sharps containers market. The
Court is persuaded, however, that Prof. Elhauge’s methodology is
amenable to classwide resolution with respect to his calculation
of substantial foreclosure of the market and his analysis of
The preliminary nature of Prof. Elhauge’s analysis, however,
is troubling. He has not rendered even a preliminary opinion
based on preliminary evidence that Tyco’s conduct has in fact
violated the antitrust laws and resulted in an antitrust injury.
Rather, he has outlined a general methodology: maybe-I’ll-try-
this-or-maybe-I’ll-try-that. Some courts have denied
certification where the experts simply relied on a theory of
“presumed impact.” See, e.g., Am. Seed Co., Inc. v. Monsanto
Co., 238 F.R.D. 394, 400 (D. Del. 2006) (denying certification
where plaintiffs’ expert “cites absolutely no factual authority
in his declaration in support of his theory of common injury and
damages”); In re Med. Waste Servs. Antitrust Litig., No.
2:30MD1546, 2006 WL 538927, at *5 (D. Utah Mar. 3, 2006) (denying
certification where plaintiffs’ expert “impermissibly asked the
court to rely on his presumption of violation and impact without
any consideration of whether the markets or the alleged [conduct]
at issue [t]here actually operated in such a manner so as to
justify the presumption”) (citation and internal quotations
omitted). Here, however, Prof. Elhauge does not even argue that
there is presumed impact. Instead, Prof. Elhauge argues that any
methodology would be classwide, even though he does not yet have
an opinion as to whether there is any anticompetitive impact.
Prof. Elhauge fairly explains that he has not had the
opportunity to assess full discovery on the merits and therefore
has not reached any conclusions on the merits of the Plaintiffs’
claims. (Elhauge Decl. ¶ 4). Prof. Elhauge proposes viable
classwide methods to prove foreclosure and injury that have been
admitted in similar cases. (See Elhauge Decl. ¶ 7; Elhauge Reply
Decl. ¶ 12). As of the time of filing the briefs on class
certifications, Prof. Elhauge had done an independent, though
partial, review of the facts and documents in this case which
formed the basis for his understanding of the sharps containers
market, such as, for example, the interchangeability of reusables
However, some of Prof. Elhauge’s statements have troubled
the Court. For example, he states, “Further tests can be done at
the merits stage to assess issues of market definition, shares
and power.” (Elhauge Reply Decl. ¶ 26). These issues not only
involve the merits, but will also have an impact on the
definition of the class itself. While the common issues as
outlined by the experts likely predominate over the individual
issues, Prof. Elhauge has not rendered any opinion as to whether
there has been a violation of the antitrust laws, or as to the
appropriate definition of the foreclosed market.
As such, the Court will defer a final decision on class
certification until the Court reads the final expert reports.
Plaintiffs’ expert report was due before Christmas, although it
has not yet been submitted to the Court. It makes more sense to
determine whether Plaintiffs have satisfied the predominance
requirement under Rule 23(b)(3), at this later stage of the
litigation -- after the close of discovery and after a review of
the final expert reports. If Prof. Elhauge renders a final
opinion which demonstrates predominance, and it is not
fundamentally flawed, the Court will certify a class.6 The Court
emphasizes that, for purposes of this limited inquiry, the issue
on class certification is not whether Plaintiffs will prevail on
the merits, but whether common issues predominate.
The parties shall submit final briefs on class certification
within two weeks of the close of expert discovery. The briefs
shall be limited to 20 pages a side. Within two weeks, replies
shall be filed limited to 10 pages a side. There shall be no
sur-replies, additional expert submissions, or other attachments.
The briefs shall be limited to the issue of predominance. S/PATTI B. SARIS United States District Judge
6 Although the Court need not address the issue here, if the
Court finds that the Plaintiffs establish predominance, the Courtlikely will also find that the Plaintiffs satisfy the superiorityrequirement of Rule 23(b)(3). Distributor class members may bereluctant to bring actions against manufacturers, and thus “aclass action may be the only practical method for resolving theirclaims.” See In re Industrial Diamonds Antitrust Litig., 167F.R.D. 374, 386 (S.D.N.Y. 1996) (finding class action superiormethod of adjudicating case where, among other things, some classmembers “still depend on [the defendants] for their supply ofindustrial diamond products and may be hesitant to disrupt thoserelationships.”); 6 Herbert B. Newberg & Alba Conte, Newberg onClass Actions § 18.41 (4th ed. 2002) (“Class actions perform animportant function in cases where individual franchisees orpurchasers are reluctant to sue because they fear economicreprisal,” citing cases).
GRIPPE A (H1N1) Déclaration par les professionnels de santé des événements indésirables graves susceptibles d’être dus au vaccin grippal A(H1N1) ou à un médicament antiviral Date de notification : I I I I I I Gravité de l’événement : Entraînant une invalidité ou une incapacité NOTIFICATEUR Autre profession de santé Préciser : Code pos
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