ParfumGigi@aol.com

BMJ 1994;309:626-627 (10 September)

News

C Dyer

A judge in Birmingham, Alabama, has approved a $4.25bn (pounds sterling2.83bn) compensation deal for more than 90 500 women worldwide with silicone breast implants. It is the biggest product liability settlement in legal history in the US. The deal was struck after thousands of women sued manufacturers, including Dow Corning, Bristol-Myers, and Union Carbide, for damages for alleged complications, including serious neurological and immune disorders.

Final approval by Judge Sam Pointer came just days after a hearing at which lawyers for foreign claimants argued that the settlement, which proposed to cap payment to foreigners, was unfair to their clients. The judge increased the total payable to women outside the US from $81m (pounds sterling 54m) to $96.6m (pounds sterling 64.4m). More than 90 500 women have agreed to the terms of the settlement. Of the 15 000 who opted out, half live outside the US, but some may now decide to join the settlement. The alternative is to seek damages in the US courts or the courts in their own country.

The 60 manufacturers providing the money had until 9 September to decide whether to accept the deal. Dow Corning, once the largest manufacturer of silicone breast implants, will put up the largest sum, $2bn (pounds sterling 1.3bn). American women who can show that they suffered from one of a range of illnesses will receive payments ranging between $105 000 (pounds sterling 70 000) and $114m (pounds sterling 933 000), depending on severity and age at onset. Diseases must fall into one of three categories: serious systemic diseases, such as lupus; neurological syndromes; and so called silicone disease. To claim compensation in the last category women will have to show at least five of a range of symptoms, including rashes, chronic fatigue, muscle weakness, and memory loss.

Compensation for foreigners will be at least 40% of American awards and may be up to 90%. Payments will be fixed on a country by country basis, with local court awards being taken into account and an overall cap of 3% of the fund.

Women with existing illnesses have been given deadlines of 16 September to file claims and 17 October to file medical documents. Those who have been free of symptoms so far but who want to be included on a register of possible future claimants have until 1 December to complete the forms. Claims may be made against the fund for up to 30 years.

British lawyers said that their clients would have little option but to accept the settlement because of difficulties in getting US courts to accept foreign claims. David Weatherburn, a solicitor from Newcastle upon Tyne, whose clients include a former topless model, said: "It's going to be difficult for these women to do anything other than accept."