Pharmaceutical Phonies: The Entanglement of Fraud, Third-Party Payors, and Proximate Cause in Civil RICO Cases

This Case Note analyzes the Ninth Circuit’s approach to the issue of whether patients and doctors destroy proximate cause in cases where third-party payors (“TPPs”) sue drug companies for fraudulently misrepresenting the health risks associated with their products. In the 2019 case Painters & Allied Trades District Council 82 Health Care Fund v. Takeda Pharmaceuticals Co., the Ninth Circuit held that TPPs suing to recover damages from a pharmaceutical company for the fraudulent omission of a drug’s health risks could satisfy the proximate cause requirement for a civil cause of action under § 1964(c) of the Racketeer Influenced and Corrupt Organizations Act (“RICO”). The Ninth Circuit’s decision is satisfactory in that it faithfully (1) observes the Supreme Court’s direct relation test and (2) follows precedent establishing that a plaintiff satisfies the proximate cause requirement when their alleged injury is a foreseeable and natural consequence of the defendant’s fraud. As a matter of public policy, this holding is positive because it hamstrings pharmaceutical companies’ ability to escape liability by hiding behind patients, doctors, and other actors inhabiting the chain of causation. Additionally, the Ninth Circuit’s holding is positive in that it adheres to Supreme Court precedent and helps deter future injurious conduct. In support of these assertions, this Case Note begins by examining the factual background and procedural posture of Painters. The Note continues by analyzing the majority’s opinion with respect to related case law and closes by suggesting ways to address some of the potential problems that could stem from the Ninth Circuit’s decision.

The red-beard evolutionary explanation of human sociality

Recent evolutionary studies on cooperation devote specific attention to non-verbal expressions of emotions. In this paper, I examine Robert Frank’s popular attempt to explain emotions, non-verbal markers and social behaviours. Following this line of work, I focus on the green-beard explanation of social behaviours. In response to the criticisms raised against this controversial ultimate explanation, based on resources found in Frank’s work, I propose an alternative red-beard explanation of human sociality. The red-beard explanation explains the emergence and evolution of emotions, a proximate cause, rather than patterns of behaviour. In contrast to simple evolutionary models that invoke a green-beard mechanism, I demonstrate that the red-beard explanation can be evolutionary stable. Social emotions are a common cause of a social behaviour and a phenotypic marker and therefore cooperative behaviour cannot be suppressed without also changing the marker.

Recent increases in tropical cyclone precipitation extremes over the US east coast

The impacts of inland flooding caused by tropical cyclones (TCs), including loss of life, infrastructure disruption, and alteration of natural landscapes, have increased over recent decades. While these impacts are well documented, changes in TC precipitation extremes—the proximate cause of such inland flooding—have been more difficult to detect. Here, we present a latewood tree-ring–based record of seasonal (June 1 through October 15) TC precipitation sums (ΣTCP) from the region in North America that receives the most ΣTCP: coastal North and South Carolina. Our 319-y-long ΣTCP reconstruction reveals that ΣTCP extremes (≥0.95 quantile) have increased by 2 to 4 mm/decade since 1700 CE, with most of the increase occurring in the last 60 y. Consistent with the hypothesis that TCs are moving slower under anthropogenic climate change, we show that seasonal ΣTCP along the US East Coast are positively related to seasonal average TC duration and TC translation speed.

All sugars ain't sweet: selection of particular mono-, di- and trisaccharides by western carpenter ants and European fire ants

Ants select sustained carbohydrate resources, such as aphid honeydew, based on many factors including sugar type, volume and concentration. We tested the hypotheses (H1–H3) that western carpenter ants, Camponotus modoc, seek honeydew excretions from Cinara splendens aphids based solely on the presence of sugar constituents (H1), prefer sugar solutions containing aphid-specific sugars (H2) and preferentially seek sugar solutions with higher sugar content (H3). We further tested the hypothesis (H4) that workers of both Ca. modoc and European fire ants, Myrmica rubra , selectively consume particular mono-, di- and trisaccharides. In choice bioassays with entire ant colonies, sugar constituents in honeydew (but not aphid-specific sugar) as well as sugar concentration affected foraging decisions by Ca. modoc . Both Ca. modoc and M. rubra foragers preferred fructose to other monosaccharides (xylose, glucose) and sucrose to other disaccharides (maltose, melibiose, trehalose). Conversely, when offered a choice between the aphid-specific trisaccharides raffinose and melezitose, Ca. modoc and M. rubra favoured raffinose and melezitose, respectively. Testing the favourite mono-, di- and trisaccharide head-to-head, both ant species favoured sucrose. While both sugar type and sugar concentration are the ultimate cause for consumption by foraging ants, strong recruitment of nest-mates to superior sources is probably the major proximate cause.

Insurer's liability under concurrent causation: English law and Chinese law compared

This paper examines the different regimes of insurer liability under concurrent causation in English law and Chinese law. The analysis shows that neither English law nor Chinese law is satisfactory in terms of the insurer's liability in such cases. It is argued that only one proximate cause should be identified among multiple causes except in the circumstance where an excluded risk and an insured risk concurrently and independently cause a loss of the subject matter insured. Under this exception, the liability in apportionment approach might be an appropriate solution to the question of the insurer's liability under concurrent causation. This approach, however, is not suggested for concurrent causation where an uninsured risk is one of the proximate causes.

UCEDE

This chapter examines the failure of the UCEDE in Argentina, and compares it to the success of the UDI in Chile. The first section discusses the long history of conservative party weakness in Argentina. The second section asks why no “Argentine UDI” emerged from the 1976–1983 military regime, arguing that its poor governing performance—including, notably, its defeat in the 1982 Falklands/Malvinas War—made the formation of such a party unviable. The third section examines the emergence of the UCEDE, emphasizing its much weaker starting position relative to the UDI. The fourth section discusses the fall of the UCEDE, which suffered a series of schisms and a sharp drop in electoral support after newly elected President Carlos Menem (1989–1999), a Peronist, began to implement much of its economic program. While the proximate cause of the UCEDE’s collapse was the Menem government, the chapter argues that the deeper cause was the party’s various built-in weaknesses.

The Self-Constrained Hand-to-Mouth

Many studies have shown that consumption responds to the arrival of predictable income (excess sensitivity). This paper uses a buffer stock model of consumption to understand what causes excess sensitivity and to test which parametrization is consistent with empirical excess sensitivity estimates. Using high frequency granular data from a personal finance app, it finds that while liquidity constraints are a proximate cause, preferences are the ultimate cause of excess sensitivity. Furthermore, it finds that for feasible parameters, a quasi hyperbolic version of the model is more consistent with the level of excess sensitivity relative to a standard exponential model.

A comparative analysis of the InterVA model versus physician review in determining causes of neonatal deaths using verbal autopsy data from Nepal

Background: Verbal autopsy is a common method of ascertaining the cause of neonatal death in low resource settings where majority of causes of deaths remain unregistered. We aimed to compare the causes of neonatal deaths assigned by computer algorithm-based model, InterVA (Interpreting Verbal Autopsy) with the usual standard of Physician Review of Verbal Autopsy (PRVA) using the verbal autopsy data collected by Morang Innovative Neonatal Intervention (MINI) study in Nepal. Methods: MINI was a prospective community intervention study aimed at managing newborn illnesses at household level. Trained field staff conducted a verbal autopsy of all neonatal deaths during the study period. The cause of death was assigned by two pediatricians, and by using InterVA version 5. Cohen's kappa coefficient was calculated to compare the agreement between InterVA and PRVA assigned proximate cause of death, using STATATM software version 16.1. Results: Among 381 verbal autopsies for neonatal deaths, only 311 (81.6%) were assigned one of birth asphyxia, neonatal infection, congenital anomalies or preterm-related complications as the proximate cause of death by both InterVA and PRVA, while the remaining 70 (18.4%) were assigned other or non-specific causes. The overall agreement between InterVA and PRVA-assigned cause of death categories was moderate (66.5% agreement, kappa=0.47). Moderate agreement was observed for neonatal infection (kappa=0.48) and congenital malformations (kappa=0.49), while it was fair for birth asphyxia (kappa=0.39), and preterm-related complications (kappa=0.31); but there was only slight agreement for neonatal sepsis (kappa=0.19) and neonatal pneumonia (kappa=0.16) as specific causes of death within neonatal infections. Conclusions: We observed moderate overall agreement for major categories of causes of neonatal death assigned by InterVA and PRVA. The moderate agreement was sustained for the classification of neonatal infection but poor for neonatal sepsis and neonatal pneumonia as distinct categories of neonatal infection. Further studies should investigate the comparative effectiveness of an updated version of InterVA with the current standard of assigning the cause of neonatal death through longitudinal and experimental designs.

Trophic consequences of terrestrial eutrophication for a threatened ungulate

Changes in primary productivity have the potential to substantially alter food webs, with positive outcomes for some species and negative outcomes for others. Understanding the environmental context and species traits that give rise to these divergent outcomes is a major challenge to the generality of both theoretical and applied ecology. In aquatic systems, nutrient-mediated eutrophication has led to major declines in species diversity, motivating us to seek terrestrial analogues using a large-mammal system across 598 000 km 2 of the Canadian boreal forest. These forests are undergoing some of the most rapid rates of land-use change on Earth and are home to declining caribou ( Rangifer tarandus caribou ) populations. Using satellite-derived estimates of primary productivity, coupled with estimates of moose ( Alces alces ) and wolf ( Canis lupus ) abundance, we used path analyses to discriminate among hypotheses explaining how habitat alteration can affect caribou population growth. Hypotheses included food limitation, resource dominance by moose over caribou, and apparent competition with predators shared between moose and caribou. Results support apparent competition and yield estimates of wolf densities (1.8 individuals 1000 km −2 ) above which caribou populations decline. Our multi-trophic analysis provides insight into the cascading effects of habitat alteration from forest cutting that destabilize terrestrial predator–prey dynamics. Finally, the path analysis highlights why conservation actions directed at the proximate cause of caribou decline have been more successful in the near term than those directed further along the trophic chain.