In 1978, the
Food and Drug Administration (FDA) approved an anti-inflammatory pain reliever called sulindac under the brand name
Clinoril. When the patent expired, the FDA approved several generic versions including one manufactured by Mutual Pharmaceutical. The drugs have serious side-effects including hypersensitivity skin reactions with
necrosis of the skin, toxic epidermal necrolysis, and
Stevens–Johnson syndrome. In 2004, the respondent Karen Bartlett was given Clinoril for shoulder pain. The pharmacist dispensed a generic form made by Mutual Pharmaceutical. Bartlett soon developed toxic epidermal necrolysis, with sixty percent of her skin destroyed. She underwent months in a medically-induced coma, 12 eye surgeries, and a year of tube-feeding. At the time of the incident, the label did not specifically refer to developed toxic epidermal necrolysis but did warn of severe skin reactions thoughtoxic epidermal necrolysis was listed on the package insert. ==District Court==