Friday, February 4, 2011

Warsaw v. Globus The Saga Continues


On January 26th, 2011 the United States Court of Appeals for the Federal Circuit rendered a nonprecedential decision in the case of WARSAW ORTHOPEDIC, INC., MEDTRONIC SOFAMOR DANEK USA, INC., MEDTRONIC PUERTO RICO OPERATIONS COMPANY and MEDTRONIC SOFAMOR DANEK DEFFENDORF, GMBH, v. GLOBUS MEDICAL. 

Globus Medical appealed a final judgement by the U.S. District Court for the Eastern District of Pennsylvania relating to the patent infringement suit brought by Warsaw Orthopedic. Warsaw asserted three claims of US Patent No. 6,530,929, “the 929 patent,” and two claims of U.S. Patent No. 7,008,422, “the 422 patent.”  The trial jury found each of the five asserted claims valid and infringed.  Following the trial, Globus moved for a “JMOL.”   JMOL is an acronym for judgment as matter or law, meaning that the asserted claims are invalid as anticipated and are not infringed.   The U.S. District Court for the Eastern District of Pennsylvania denied Globus’s motion without opinion.  On appeal, Globus challenged the judgment of infringement based on the district court’s claim construction. Globus challenged the courts denial of its JMOL based on anticipation.  Anticipation of an invention occurs if the later invention is an adaptation of an earlier patent.  The adaptation would be obvious to a skilled person who would need to exhibit some mechanical skill to develop the same adaptation.  Globus appeal was centered around the court’s construct of the terms at issue on appeal.  The appellate court reversed the denial of motion for JMOL with respect to claim 45 of the “929 patent,” and claim “42 of the 422 patent.”  The appellate court also affirmed the courts denial to claims 47 and 74 of the “929 patent.” And claim 48 of the “422 patent.”  The appeal was remanding to the district court to consider whether the damages award should be revisited in light of the decision.

The two patents in suits are entitled “Instruments for Stabilization of Bony Structures” and share a common specification.  The embodiment or principle pertained to the Sextant.  Globus argued that the claims were limited to the single embodiment disclosed in the common specification.  The court disagreed stating nothing in the specification indicates that the invention is limited to that embodiment.  In addition, the “Summary of the Invention” described various “aspects” of the invention in sufficiently general terms to embrace devices that embody the concept of the invention but are not identical to the particular embodiment described in detail.  Without getting into the minutiae of the suit, the trial court “expressly rejected the contention that if a patent describes only a single embodiment, the claims of the patent must be construed as being limited to that embodiment.  Since the specification does not clearly indicate that the patentee intended to deviate from the ordinary, broad meaning of the various terms at issue and limit the scope of the claims to disclose the embodiment, indeed, the specification clearly indicates that the claims are not so limited, therefore rejecting Globus’s restrictive reading of the claims as limited to the preferred embodiment depicted and described in the specification.

Globus challenged the trial court’s claim construction were tied to its theory that claims are limited to the preferred embodiment as described in the specification.  Globus argued that the court gave unduly broad constructions to the terms “instrument” and “inserter” as well as the phrase “an instrument associated with the connecting element.”  Globus had urged the trial court to construe the term “insertion instrument” to mean “a unitary device for implanting a rod or brace that includes a brace inserter, and which has a pivot axis relative to the anchors that is located outside the body.”  On appeal, Globus contends that the term “instrument” as used in the asserted claims, must include at least “two or more support arms (rods) that are pivotally connected to a brace inserter and each of which is connected to an anchor extension, or a brace inserter that is connected to two or more support arms which are pivotally secured to two or more anchor extensions (pedicle screws).”  The trial court rejected this complex formulation and instead construed the term “insertion instrument” to mean “an implement used for inserting something.” (Claims in “422 Patent)  Globus argued that it should be construed as a “unitary device for implanting a rod or a brace that includes a brace inserter and a brace, and which has a pivot axis relative to the anchors that is located outside the body.” Again the court rejected the detailed and narrow definition, but concluded instead that the phrase refers to “an implement operable to place the connecting element in a predetermined location.”  The court thus construed the phrase to mean “an implement for maneuvering the connecting element.   The Appellate Court agreed with Warsaw that the patents do not assign a specific narrow meaning to the challenged terms and that the trial court therefore properly construed those term in light of their ordinary meaning.  Therefore, the Appellate Court rejected Globus’s challenge to the trial court’s construction of particular terms used in the asserted claims upholding the portion of the trial court’s judgment that Globus’s accused system infringes those claims.

Globus argued in the alternative that if the claims are given the broad construction that Warsaw urged for them during the Markman proceedings, the district court should have granted its motion for JMOL of anticipation as to all asserted claims.  The two broadest claims were claim “45” of the “922 patent” and claim “42” of the “422 patent.”  Globus utilized Dr. Paul McAfee as their expert witness, and Warsaw utilized Dr. Scott Tromanhauser.  Globus’s position on claims “45” and “42”was that the claims as construed require only the instrument assist the surgeon in positioning the connecting element so that it connects the first and second pedicle screw.  Warsaw’s position was that the claims require that the instrument be able to place the connecting element (aka rod) without guidance from the surgeon.  Warsaw argued that the Sextant places the connecting rod in the proper orientation without the need for the surgeon to guide the rod between the two screws.  The critical question for purposes of validity inquiry is whether the claims require that the instrument, rather than the surgeon, perform the function of directing the connecting element along the path between the first and second screws.  Warsaw’s argument was that the instrument has an operation and that the claim explained the capability of the instrument not the capability of the surgeon.  Because of disclosure of all elements in claims “45” and “42” the Appellate Court reversed the district court’s denial of Globus’s JMOL for invalidity on the basis of anticipation.  The Appellate Court took a different view as to the remaining claims and affirmed the trial court’s decision to deny Globus’s motion for JMOL with respects to claims “47” and “74” of the “922 patent,” and claim “48” of the “422 patent.”  In sum the Appellate Court reversed the judgment as to claim “45” of the “922 patent” and claim “42” of the “422 patent.”  The Appellate Court affirmed the judgment as to claims “47” and “74” of the “922 patent,” and claim “48” of the “422” patent.  In closing , the Appellate Court remanded this case back to the district court to determine if the calculation of the damages must be reevaluated in light of the modification of the judgment.  The bottom line:

“You win some, You lose some, but you gotta suit up for all of them!”

101 comments:

  1. Outstanding summary of the battle.... Thank you.

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  2. According to the NASS disclosures, PCM has 1,000,000 shares of GM. Expert witness ... You could make a case. Ulterior motives...? With out a doubt. NUVA will learn soon that GM will fight and never settle. History has proven that this is not the wisest approach. MDT should continue to pick fights with GM for our amusement.

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  3. We all know why Nuva is going after GM. Because GM has taken over 10 million of lateral business over night. That is the only reason.

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  4. Agree with the above, Nuva has to go after them. After Cohen in Florida, a die hard Solas proctor changed all business to Globus nuva had no choice. That was a 5 million dollar account that disappeared overnight. I don't work for either company, but that one was big.

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  5. When is Globust going public?

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  6. The Globus lateral expandable cage will add some additional hurt to the pain that they've already inflicted to NUVA's lateral business.

    Funny how Nuvasive hasn't gone after anyone else who's now competing in the lateral space,, wonder why that is??

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  7. The Cohen lateral business moving to Globus had more to do with the rep than the product. If it wasn't Globus the business would have probably moved to DePuy, it just depended on where the rep went. Regardless, it still is reason enough to get NUVA to look at their bottom line.

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  8. To be fair to Globus in this one case, the MDT 929 patent is absurdly broad. It was issued at a time right at the beginning of the IP explosion in spine and the USPTO was caught off guard. MDT was issued claims to essentially any percutaneous rod insertion into screws, whether there is a sextant-type device or not. Amazingly, this even included freehand insertion (though MDT's lawyers ultimately denied that was the intention).

    The 929 has been a major challenge for anyone developing MIS screw systems, and many companies are potentally infringing. At least one benefit of this litigation is to have the the 929 brought into reality - unfortunately it is taking the courts to achieve it.

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  9. Who is Dr. Cohen's rep?? Is she hott?? What city does Dr Cohen practice in?

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  10. NUVA and Globus are made for each other - they are both the product of seedy people doing unethical things. One just happened to go public back when it was easy.

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  11. How is NUVA unethical?

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  12. her name is melissa cherby

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  13. miami, google him and his South Florida Spine Institute

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  14. that is not her name

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  15. Perhaps Nuvasive ( & Integrity Medical) were showing too much love to Dr. Hyde?

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  16. That was probably the case. Hyde makes roughly 1 mil from Nuva a year. O wait wait, no, Nuva would never do that! They don't pay surgeons. No, no, the super ethical Nuvasive.

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  17. 4:28

    You'll love this:

    http://southfloridaspine.com/about.shtml

    Hyde's bio should just read: "I get paid by NUVA to use their products."

    Horrible,,

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  18. wow...a lot of NUVA haters on here

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  19. NuVa is tha' shiznit!!

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  20. XLIF was launched in 2003 at NASS. 8 years later, Nuva is now #4 in spine and will leapfrog Synthes in the next 1.5 years. If you Can't beat em, join em like I did.

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  21. Heard Rick Kinzle VP of sales at Globus was fired last week. Probably because of sagging sales. Regarding Mcafee as expert witness, that's laugh out loud funny.

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  22. ...shame. I liked Rick. He'll land on his feet.

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  23. Funny,, For all those pundits who CONTINUE to be convinvced that Globus is going public this year,, Why would you can your VP of Sales now if you were trying to go public?

    Nothing like sending a message to The Street "that all is good w/ sales in Audobon, PA".

    Well, looks like TSB has some good blog material for the week.

    R.I.P.

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  24. Rick got canned? LOL perhaps Demski consulted the Lord on that one...or asked his mistress?

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  25. Usually when one of the triumvirate is axed, there's trouble in paradise, contrary to what the remaining members of the Holy Trinity have to say.

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  26. Once again I ask - how is NUVA unethical, or MORE unethical than anyone else in this market?

    Follow up question, who is ethical?

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  27. So what you're saying is that we work in an unethical industry and it's just a matter of what level does your respective company take it to, DOJ we're ripe for the pickin.

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  28. Yep, it's official!! Globus VP of Sales has been fired. Poor performance in Q4 of 2011.

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  29. Metronic deserves to be the leader in Spine. They invest more in R&D, which does include some of the best minds in Spine...Lenke, Zdeblick, Foley etc....These surgeons deserve 7 figure passive income from the Mother Ship of Spine. Companies like GM and Nuva have no right to infringe on their business nor design or promote technologies like XLIF or any MIS system that infringes on Sextant Patents which will have a negative impact on royaties for the elite surgeons of our industry. MDT May Your light shine on in perpetuity!

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  30. to 7:42am, to answer your question about "how is Nuvasive unethical?" I am sure I am not aware of all of the ways in which they operate unethically, but I do know of one for sure. The sales reps are warned that any one of them that is caught attaching the neurovision electrodes on a patient will be immediatly fired. (heard this one personally from upper level mgmt.) Since these sales reps do not have allied health privileges they are not ever allowed to physically touch a patient. That being said, the sales reps get constant sh*t from circulators, PA's techs etc. that are not willing to put the needles in the patients for the reps. End result......sales rep pulls down the blinds over the O.R. window and starts putting in the needles! Now I would bet top dollar that not one single Nuvasive rep has EVER been fired for doing this. Okay now 2nd way they are unethical....NUVA reps teaching the docs and their practice mgrs. how much money they can make by having the surgeons read the intraoperative monitoring for one another. News flash NUVA reps this is called billing fraud. I wouldn't be suprised to find out that a whistleblower lawsuit has not already been filed by a disgruntled employee! And if not, all you other NUVA reps out there that want to make more $$$, and are tired of chasing that quota.... go file a whistleblower suit, cause that sh*t is not only unethical, it is illegal and someone is gonna go to jail!

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  31. The mother ship of spine is not really Medtronic its SOFAMOR DANEK or if you know your history DANEK. There are reasons for that with all that was done and how they did it. Medtronic just bought a big fat cash cow.

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  32. And to add to 12:41pm's point. Medtronic didn't even develop Sextant. That technology was acquired. BMP was acquired. Kyphoplasty was acquired. Not sure if they have developed one single market changing technology internally. Am I forgetting about something?

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  33. Sent on behalf of Dave Demski

    It is with mixed emotions that I write to inform you that effective today, Rick Kienzle will no longer be employed by Globus. Brett Murphy will become the Executive Vice President of US Sales for Globus Medical. Rick plans to pursue other, earlier stage, entrepreneurial opportunities within medical devices, and he has graciously agreed to stay on in a consulting role with Globus and assist us with any transition issues that may arise due to his departure.

    Rick Kienzle joined Globus in October 2003 and has been an integral part of our success since then. We have seen our sales grow from a trickle in the fall of 2003 to over $288M in 2010 under his leadership. Our exclusive sales force now numbers over 300 people, a great many of whom were recruited to Globus by Rick. Rick has also been a valuable member of our Executive Team, helping to guide the company’s strategy over the years as we introduced an unprecedented 60 new products, fended off legal challenges, raised capital and built Globus into what it is today. I personally relied on Rick’s insight, understanding and support in many difficult situations over the years. We wish him all the best in his future endeavors. I speak for the company and myself in saying that he will be missed.

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  34. Looking forward, I am excited by the tremendous opportunity that we have to grow the company with Brett Murphy leading our US sales force. Brett joined Globus in June, 2005 as an Area Director and was promoted to Zone VP in 2006. In that role, he has been largely responsible for growing our organization west of the Mississippi. These areas contributed the highest sales growth for Globus in 2010 and represent a significant upside for us in the future. Brett brings over 18 years of spine experience to his new position. Brett’s discipline, commitment, energy, experience and technical knowledge will continue to serve him well in his new, expanded role. I speak for the Executive Team and Board of Directors in saying that we are confident in his ability to lead the sales organization and that we look forward to continued success and growth in 2011 and beyond.

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  35. TSRH-3D, although it is a piece of sh*t, it was developed within the Danek family.

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  36. I think it was originally acquired from Texas Scottish Rite Hospital

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  37. Beyond the original transverse connector Danek has not developed much. They became big by making whatever the doctor asked, which at some point led to them having at least 10 different pedicle screw systems all for the same indication. The smartest thing they did was to buy Sofamor, because that was the one company where real brains resided: Cotrel, Dubousset, Chopin, etc.

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  38. Sheesh! What in the world is going on over at Globus?!?! There's got to be more to the story on this one. Let's hear it!

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  39. Brett Murphy! OMG-what an incredibly stupid move! Lack of integrity, lack of character, lack of honesty-Steal, lie, cheat, sell your firstborn for a case-Fits right in with the Globus culture.

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  40. Oooppsss! That looks like a biggest yet hole for Globus Ship and those shoes look like they won't be filled!

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  41. Right on 3:55!! Looks like a rough road ahead for the gloBUS.

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  42. What's going on at Stryker Spine?

    Doc Watson went from AVP East to VP of Sales.

    Ed Macey was promoted to AVP

    Ben Pitcher was promoted to Area Sales Director Northeast

    Tommy O'Hara went to a Sales Distributor in TX

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  43. I don't buy all of this BS about Rick Kienzle "moving on to pursue other, earlier stage, entrepreneurial opportunities within medical devices". If this was the case, Globus would have orchestrated a much more smooth transition of power. No press release? You make the announcement on TSB (no offense MM!!)?! Sounds like this Demski guy is just trying to put out a fire.

    Anybody out there know what really went down?

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  44. To the NUVA haters: remote neuro monitoring is how the independent companies operate and bill. There is nothing unusual or illegal about it. A surgeon can not monitor his own case but another physician in his/her group can. Whistle blower hater must own a dog whistle.

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  45. Has anyone seen Globus' new interspinous process plate? The damn thing looks almost IDENTICAL to NuVasive's Affix II plate, and it even utilizes the same ratcheting lock-mechanism. I mean, I'm not a huge fan of NuVasive either, but these plagiarizing A-holes have got to be stopped!! EVERY SINGLE PRODUCT THEY HAVE IS A COMPLETE KNOCK-OFF!! How are these guys still in business?

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  46. 7:57- If you actually knew what is involved in neuromonitoring you might really understand how it works. There is a tech component and a professional component. Nuvasive encourages the partners of their surgeons, or other Nuvasive surgeons read for each other and bill for the interpretation (pro fee). Sure, nothing wrong with that......except how many of these surgeons truly know WTF they are reading and interpreting?!? I guess you probably think it is okay for these guys to perform plastic surgery as well by the virtue of their M.D. I guess by your logic it is okay for them to bill out a 3 level fusion as a 4 level fusion, after all they are just codes on a billing sheet..... who will ever know? Tell me how many of these surgeons are sitting in front of a monitor and watching in real time (cause that is the only legit way this is done)electrodiagnostic signals! These docs are either out doing surgery themselves or on the golf course.... it is a f*cking scam and just a way for NUVA reps to funnel money to their docs. A simple audit of there patient files will bear this out. Attorney: Dr. Jones, how is it possible for you to be on vacation in Barbados when it shows here that you were billing for monitoring a surgery in Cleveland? Doc: But I had a connection via my computer that let me watch the signals from afar! Attorney: Do you have any documentation for that or any written report because that patient woke up with anterior thigh numbness and a foot drop? There is nothing legal about this, oh and BTW the fine for fraudulant billing on a medicare case is $10,000. Multiply that out over thousands of patients and you are going to get to a big number in a hurry! You know the OIG is kinda like the IRS, they may not catch you cheating on your taxes for the first couple of years, but eventually they catch you. I guess my retirement is going to be pretty nice after all.

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  47. 7:57

    Your still touching the patient aren't you? Thank god for my camera phone.

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  48. Brett Murphy?? LMAO! Proof positive that corrupt ties reign over real results. Ask Brett how Globus performed out west under his "leadership". How many reps (and MDs) turned and burned in the Northwest and northern Cal. What a joke.

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  49. 4:46 - That is bad form man! Don't be a dick. If Brett took your business do something about it. Trashing him on TSB is weak.

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  50. 2:37 & 3:38,, both excellent posts!!

    As for 7:57, just keep believing EVERYTHING Alex, et al tells you.

    As for billing in a "legit" fashion on the IOM model,, according to Medicare guidelines, the interpreting surgeon (who is actually billing the insurance company) "has to be solely dedicated to the act on monitoring/ interpretation during the time of the procedure".

    There is NO WAY that a surgeon's partner is sitting in the practice office or in front of a computer somewhere for 3-4 hrs. during a 4 level XLIF w/ hardware, or for any case in that matter.

    The billing surgeon in most cases is allowing the operative surgeon to make his own decisions re: interpretation as the NeuroVision unit is in the O.R. room. Oh, sorry, I guess you can't call it NeuroVision any longer due to the lawsuit over the name,, so let's just call it JJB/ M5,,

    Anyway, THIS is where the fraud is occuring and where the DOJ & the insurance companies need to focus their efforts. As for the remote monitoring device that Nuvasive offers to provide for a small fee,, it still doesn't matter as no surgeons are taking the time to be dedicated "to the sole act of monitoring" while their partner is operating in the O.R.

    SCAM plane & simple.

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  51. I do not know how these spine docs sleep with themselves. I have a group that actually feeds the monitoring signal to an unused computer terminal in their schedulers office. While I am there scheduling cases with one of their legit partners. I asked them what that was all about and they said they did not know, but they are always required to turn it on and nobody ever looks at it.

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  52. I look forward to seeing Alex sweat out this one and give an explanation in front of the DOJ panel and Senator Grassley. I'm sure he'll say he had no idea it was going on and selling out all of his minions, I mean reps.

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  53. I used to work for NuVa and have moved on to greener pastures, however, one thing I will say, is that they need to be very very careful when it comes to this monitoring thing. It IS taught to the reps at training that the remote monitoring is a revenue generator as well as a way to get more metal business, and it IS taught at training to "lay no hands". However, EVERY rep lays hands, including myself, when I worked there. Even if the rep doesn't initially put the electrodes on, what happens if you loose a myotome introperatively? Let me assure it is NOT the circulator under the table putting the needle back in. And let me assure you it is NOT the surgeon breaking scrub putting the needle back in.

    My office bought a computer that was specifically for remote monitoring, none of the surgeons knew any of the password, nothing about the computer. One of the surgeons nurses would turn on the remote monitoring computer every morning and at the end of the day, the billing lady was "trainied" by Nuva to go into the computer and print the reports off. The doc was then asked to sign by the arrow that he was watching and remote monitoring, and that was that.

    IT IS FRAUD. SURGEONS ARE GETTNG IN BIG TROUBLE, DON'T DO IT!!!!!!!! As a rep, take the high road, as a surgeon, do you wanna go to jail or pay $10,000 for every case that you have billed this way?

    I quit because of this shit. I suggest that anyone thinking about working at NuVa take a long hard look at this. The last two years have been great for me from a ethical standpoint, not having to deal with this monitoring BS.

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  54. 9:06
    Your Funny....It is completely Legal...look at the law..The fraud is, you did not know how to manage your accounts and expectations. Which explains why you know longer work for NUVA.

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  55. NOTE:

    If the interpreting surgeon is in a "remote location" (Ex. the practice office) and is seeing patients on their chedule while their partner's case is going on in the O.R.(and they should ONLY be monitoring the case), then in turn billing Medicare or any other insurer for that patient's visit in the office,, the interpreting surgeon is then not "solely dedicated to the act of monitoring" and therefore committing fraud if they are billing for both their time seeing patients in the office as well as their interpretation of monitoring.

    Double dipping is this manner is a BIG reason for concern in this scenario.

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  56. Question for the ex-NUVA employee: Did they actually give you the codes for billing to relay to the surgeons? I would love to have an audit done of those. Docs are probably billing out for SSEP, EEG, TcMEP, EMG, Ped. screw stim. and the whole shooting match
    Question for NUVA Lover: What did you do when there were no surgeon partners to read?? go without? I am sure those patients still got billed for those phantom reads. You say we need to "look at the law" maybe you should look at the definition of the false claims Act. Did you know there is a federal agency with the title HEAT (Healthcare Enforcement Action Team) You should be expecting a visit from them real soon!

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  57. This just in:

    MDT to have second round of layoff's in 2 years. Memphis to be hit hardest.

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  58. 10:14
    Does not have to be a Surgeon Partner. Can be any physician in the practice.

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  59. And what is supposed to happen if things aren't going right in the case? Does the remote surgeon ring the OR phone and tell them they're too close to a nerve? Seriously, how does the communication work? I've not seen it in action.

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  60. Their "sales job" to the surgeons is "come on doc, you don't really need a neurologist or a Dr. actually trained in this bullshit to take a piece of the action, keep it for yourself" Most times if things are going bad in the case the spine surgeon says turn that piece of shit off.

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  61. Since the spine blogger has been outed, has he stopped posting?

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  62. how do we know he was "outed"?

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  63. Maybe he is too busy defending all the slander suits to grace us with his witty and insightful moralizing.

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  64. Just as an observer of your shady industry, I don't remeber reading anything particularly slanderous written by TSB, the slander and vitriol is in anonymous comments.

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  65. Let's have a highlights of John's libelous comments, shall we? As for anonymous posters, let's assume alphatec, globus, and NUVA counsel are smart enough to subpoena his emails, and then we can all know who some of the posters may be. Think any of those managers might be pissed? Also, John provides the forum for this libelous bile, he is liable. Adios house and career. Better start looking for a cardboard box

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  66. As an attorney reading this blog, as an FYI for you amateur lawyers please apply to law school to understand the definitions of slander and libel, everything that is blogged on this site is in the public domain..

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  67. Mr attorney, do you by chance specialize in Qui Tam? you might be able to drum up some business if any of my fellow reps out there are in need.

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  68. "fended off legal challenges" aka "got away with stealing Synthes' intellectual property..."

    Yeah, big round of applause, Globus. Enjoy the oncoming onslaught of karma heading your way.

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  69. Just for fun,, If Globus & Nuvasive merged:

    1. GloVasive?
    2. NuVobus?
    3. GlobuNuva?
    4. NuGlosive?
    5. GloNuvabus?

    Which do you prefer?

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  70. Thanks Mr. Attorney. If wikipedia is to be believed, to be defamatory (whether slander or libel) one's statement has to be either untrue, or a disclosure of an offensive private matter. Sounds like if the statements they are making are true and there's no assumption of confidentiality, posters are on safe ground.

    Signed - one of the amateur non-attornies who isn't slandering or libeling anyone, but enjoys reading the banter.

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  71. I like GloVa - maker of the latest craze in adult toys.

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  72. If Globus and Nuvasive combine the ex-stryker energy would be so strong they should be called
    NuStrykus.

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  73. NuVasive and Globus hate each other. They would never merge.

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  74. Thanks 5:12

    I'm sure your the hit at all the parties with your dynamic wit and insight.

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  75. Not true. Glovasive is the company of the futures in spine. Alex and DP are currently collaborating on an artificial spinous process implant that should be starting clinical trials in Krakistan early Q3.

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  76. Medtronic hated Kyphon too,,, How'd that play out?

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  77. AI, OMG! Did you see Justin Beeber is dating Brit? I heard he kissed Hanna Montana!!!! OMG! Can you believe it? I almost dropped DOD! Like, OMG! Ya know....LOL>>>LOL Does anyone have an answer to Math take home quiz #5. It is sooooooo hard, I can't concentrate! My dad keeps yelling for me! I just said OMG leave ME ALONE!!! LOL CU L8R :-)~

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  78. And that spinous process implant will cure your kyphosis, provided you have one put in percutaneously while doing nerve monitoring at T2, 3, 4, 5, and T7, 8, 9 10, and 11. Make sure they size them right. The first new new thing after Botox!!

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  79. Medtronic still hates Kyphon...That's how that played out.

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  80. YES! I almost DIED! It was crAz! He will dump that BEOCH. He is sooooo cute. I want to marry him! LOL PICK me Justin, not Brit!!! Or Aston Cusher! I'm probably too young for him, but like OMG! BUT I LUV him toooooooo much. MOM SHUT UP! i"M LIKE bloggin!! leave me alone!!! gosh! I hate my parents!! LMAO!!! If you know what I mean!!! Pease Out home slice! :-)~~~~~~

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  81. Check this out Technique video. You tell me if it is a knock off spinous process plate or not! This is BS!!

    http://www.youtube.com/watch?v=R7yfISlGLNU

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  82. why or how was he outed?

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  83. Meatloaf!! MOM, Where is the frikin MEATLOAF?

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  84. Wow... Even if that is him, I would be mad if someone posted that much info about me anywhere on the internet. MM, prepare for the identity theft!!

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  85. Don't know why but how.....Dorthy said a horse of different color ....till the rubber band broke! Weird huh?

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  86. i hope 6 48 posted from an anonymous proxy otherwise his isp could be supoenaed if indeed this john dude's id falls victim to bad things

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  87. 6:48 its one thing to post up dude's name and company he works for but to start clipping off that kind of personal info is F'd up?

    Agree with 8:33, you better have posted from a portal server or else yo ass is about to get SERVED fo shizzle!!

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  88. I guess MM removed that. What were the comments that 6:48 left about him?

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  89. Regarding this:

    "Anonymous said...

    i hope 6 48 posted from an anonymous proxy otherwise his isp could be supoenaed if indeed this john dude's id falls victim to bad things"

    Bah!

    You have to track down the identity theft, and then if they got their information from this blog you may have something. But you CANNOT go in reverse, that is, just because information was posted here, that this was the only place to get that information, and that the person who ultimately steals his ID got that info here, not somewhere else...

    There, your free legal advice for the day!

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  90. As for using the court system to track down internet users' ids is harder than you think, I know, I am doing it right now for something else - your first step is finding legal counsel who even understands the laws. Have fun! oh, and get some 6-digit checks ready.hahaha

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  91. Court Confirms Globus Device Infringes Medtronic Patents

    MEMPHIS, Tenn.--(Healthcare Sales & Marketing Network)-- Medtronic (NYSE:MDT ) announced today that the United States Court of Appeals for the Federal Circuit affirmed that the Pivot system offered by Globus Medical infringes two patents owned by Medtronic.

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    “We are pleased by the Court’s ruling,” said Doug King, vice president and general manager of Medtronic’s Spine business. “The decision validates the solid patents we have protecting our minimally invasive portfolio and we remain committed to vigorously defending important intellectual property brought to us through inventing surgeons.”

    The decision validates a jury's previous finding in October 2008 that the claims of specific Medtronic CD HORIZON® SEXTANT® patents are valid and were infringed by Globus Medical.

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    Any forward-looking statements are subject to risks and uncertainties such as those described in Medtronic’s periodic reports on file with the Securities and Exchange Commission. Actual results may differ materially from anticipated results.

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  92. 5:59- Now that is very funny. Thanks for the laugh.

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  93. Yep, I remember Bradly Paddock bragging about how Kyphon was going to overtake MDT one day....

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  94. As an FYI if MM is tracking traffic the site can track your ISP address

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  95. That's normal, isn't it? Revealing who is using the IP address is the part you'll need some help with, legally that is, after all, if I didn't care about the law I could pay a teenager to keep this site offline just for fun....low orbit ion cannon anyone?

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  96. "Anonymous said...

    As an FYI if MM is tracking traffic the site can track your ISP address"

    Indeed, and if someone felt like they had some legal issue with something written here, they'd have to get MM to give them that information.

    Usually this request is handled through the subpoena process unless MM wants to help them.

    Even if a subpoena is issued and complied with, there is simply a bunch of #'s, you need to hire a qualified expert to certify those, testify to them, and withstand a cross examination.

    If the IP is on a network in a company, it may be even more involved to get the help of that company to identify the user, again another subpoena.

    If the person is at Kinko's, hahaha

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  97. On to the next topic the skins on your drum set are worn out

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  98. Skipped a step.

    Once you get MM's traffic, you have to sue the ISP/Telecom to get their records, then the person's employer to get their ID....

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