Michigan Gov. Gretchen Whitmer said Monday she’s “unequivocally supportive of Israel” after drawing backlash from critics who contended one of her weekend social media posts about Hamas’ attack on the Jewish state was too vague.
Asked if she regretted the post, Whitmer told reporters at an event in downtown Grand Rapids that her Saturday message on the platform X, formerly known as Twitter, came as the “serious” situation in Israel was “evolving.”
“I am grateful that I’ve got so many wonderful friends and counsel in the Jewish community who keep me apprised, and I’m unequivocally supportive of Israel,” Whitmer said. “And they have a right to defend themselves.”
Hamas, a militant group that governs the Gaza Strip, launched an attack on Israel over the weekend, spurring a military response from Israel. By Monday, the Associated Press reported about 700 people, including 73 soldiers, had been killed in Israel. Meanwhile, the Gaza Health Ministry said 493 people, including 78 children and 41 women, were killed in the territory, the AP reported.
Israel’s rescue service said Monday it had retrieve 260 bodies from the grounds of an open-air music festival that Hamas attacked in what’s being described as the country’s worst civilian massacre ever, AP reported Monday.
At 5:34 p.m. Saturday, as the attack was making international headlines, Whitmer posted on X, “I have been in touch with communities impacted by what’s happening in the region. It is abhorrent. My heart is with all those impacted. We need peace in this region.”
The post immediately spurred criticism on social media for not mentioning Israel by name or the specifics of the situation, which included the taking of civilian hostages. The post also didn’t name the region she was referring to.
“Why even issue a statement if this is the best you can do?” replied Tim Murtaugh, who was director of communications for former President Donald Trump’s unsuccessful reelection campaign in 2020.
Aryeh Lightstone, former senior adviser to David Friedman, who served as U.S. ambassador to Israel under Trump, also denounced Whitmer’s initial post.
“I hosted you for Thanksgiving in Israel just a few years ago,” Lightstone wrote to Whitmer. “I am embarrassed for you and by you & disappointed that I opened my home and my family to you.
Less than three hours after her initial post, Whitmer sent out a new and more specific message: “The images that continue to come out of Israel on the anniversary of the Yom Kippur War are devastating. The loss of lives in Israel — children and families — is absolutely heartbreaking and appalling. There is no justification for violence against Israel. My support is steadfast.”
Palestinian militant groups claimed to be holding over 130 people abducted in Israel and dragged into Gaza, the AP reported Monday. The State Department said at least nine American citizens have been killed in the weekend Hamas attacks on Israel, raising the toll from four, according to the AP.
Whitmer took questions from reporters after a panel discussion on abortion rights at Fountain Street Church in Grand Rapids.
The governor said there had been a “massive loss of life” in Israel.
“It’s heartbreaking to see this happening and the images coming out of Israel,” she added.
Cher says that she did not orchestrate the alleged abduction of her son Elijah Blue Allman, in the wake of kidnapping allegations made by her estranged daughter-in-law in court documents.
“[T]hat rumor is not true,” the music superstar said Wednesday. The “Believe” singer declined to comment further on the November 2022 allegations but confirmed to People that the private family matter was related to her son’s addiction issues — issues that were alluded to in December court documents reviewed last month by the L.A. Times.
A representative for Cher did not immediately respond Wednesday to the L.A. Times’ request for comment.
The allegations stem from Allman’s ongoing divorce proceedings with Marieangela King, the 36-year-old recording artist known as Queeny King whom Allman wed in 2013.
Allman, 47, whose father is late rocker Gregg Allman, filed for divorce from King in November 2021. However, during an attempt to reconcile on their anniversary about a year later, King alleged in court documents filed in December that four men came to the New York hotel room where they had been staying and “removed [Allman] from our room.” She said she was told by one of the men that they were “hired by [Allman’s] mother,” referring to Cher, for an alleged intervention. She claimed in the December court documents, which she filed over spousal support payments, that she was “currently unaware” of Allman’s well-being or whereabouts.
King’s attorney, Regina Ratner, told the L.A. Times last month that her client was still concerned for the health and safety of her estranged husband. After the alleged abduction, Allman was taken to a treatment facility and King was not allowed to contact him, the court documents said. He was expected to end his treatment by March and, King stated, had been receiving medical care since August 2022.
Cher had been worried about her son’s health and had been planning an intervention after he apparently collapsed at the Chateau Marmont hotel in Hollywood last year, according to the Daily Mail, which was the first to report on the court filings last month.
The Oscar, Grammy and Emmy winner did not address the allegations until Wednesday in her statement to People. In it, however, the “If I Could Turn Back Time” singer focused on her son’s struggle with substance abuse.
“I’m not suffering from any problem that millions of people in the United States aren’t,” the 77-year-old entertainer said.
“I’m a mother. This is my job — one way or another, to try to help my children,” she added. “You do anything for your children. Whenever you can help them, you just do it because that’s what being a mother is. But it’s joy, even with heartache — mostly, when you think of your children, you just smile and you love them, and you try to be there for them.”
The singer’s statements come ahead of the release of her first-ever holiday album, “Christmas,” on Oct. 20. In a separate People article, she opened up about her yearlong relationship with 37-year-old music producer Alexander “A.E.” Edwards, who worked on her upcoming album.
“Alexander’s got diamond teeth, tattoos, white hair, and he’s way younger. He’s a beautiful man,” she said. “Also, I think it’s fun to be interested in somebody else’s love life!”
The singer said she was “not surprised” by the internet’s obsession with their pairing, which happened after a brief meeting at a Paris Fashion Week event and after a friend gave him her phone number.
“I had been telling all my friends, ‘We’re too old to go out with really younger men, and I will never fall in love on text.’ So I did what I said not to do!” she told the mag, explaining that she broke her own rule “because he’s just so special.”
“No matter what happens, I love being with him,” she added. “He makes me laugh, and we have fun. What I learned is that it’s never too late. If you wrote out all the statistics, you would go, ‘Well, this is doomed.’ But we’ve been together a year, and if it was just a year, it would’ve been worth it. I’ve had the best time.”
Robert F. Kennedy Jr., the former Democratic candidate for president who this week said he would seek the White House as an independent, brought his long-shot campaign to Miami on Thursday, attracting a small crowd of anti-establishment supporters.
Addressing a few dozen people at the Adrienne Arsht Center for the Performing Arts near downtown Miami, Kennedy — the nephew of assassinated president John F. Kennedy — delivered a meandering 45-minute speech that touched on a variety of issues ranging from housing prices, economic inequality and the U.S. military-industrial complex.
Miami Beach City Commissioner Ricky Arriola, left, flexes as he tells the crowd how fit Robert F. Kennedy Jr. is as he approaches the podium. (Al Diaz/Miami Herald/TNS)
He criticized America’s past and current military decisions, claiming that the U.S. has spent trillions on wars, created the Islamic State terrorist group and destabilized Europe in the process. He also said that the U.S. government is using Ukraine aid as a “money laundering scheme” for military contractors, but then later went on to express that the U.S. should support Israel following last week’s attacks by Hamas.
“We don’t have strategic interests for being in Ukraine, but we have an absolutely critical existential strategic interest for being in Israel, for supporting them. Israel has never asked for troops. They never will. What they want is our support and they need some of our weapons,” said Kennedy.
Kennedy, whose critics have labeled him a conspiracy theorist — he has said that WiFi causes “leaky brain” and that chemicals in drinking water are leading kids to identify as transgender — also said that U.S. politicians are using divisive tactics like “culture wars” to keep Americans fighting among themselves.
“It’s like the jangling keys, all these culture wars, so as you look over here, they’re robbing the bank over there,” said Kennedy.
He finalized his speech by comparing his supporters to the masses overthrowing a monarchy.
“They know as long as we’re all fighting each other, that nobody’s coming up the castle wall. And what I want to do with this campaign, and my presidency, is to put aside those squabbles and let’s all go over that castle wall.”
Kennedy’s Supporters
Polls of the Democratic presidential primary consistently showed President Joe Biden with a strong majority of support in his party for a second term. Kennedy had averaged about 15% support among Democrats prior to announcing Monday that he would run as an independent.
Though Kennedy’s own siblings have condemned his campaign, he said he believes that he can win because his appearances on podcasts and long-form interviews have proven that he has the ability to convert viewers quickly and gain support from unexpected demographics.
The crowd for his speech on Thursday was no more than a few dozen. Those who showed up included vaccine skeptics and those disgruntled with the state of politics in the U.S.
“This guy, he’s got chutzpah. He’s asking the tough questions and he’s fighting the good fight,” said Chuck Muldoon, a Miami resident who considers himself a “monetary reform activist.”
Muldoon, 54, said he became interested in Kennedy after seeing him question the “crimes of banking” and “pharmaceuticals.”
Lianette Laria, 46, came to the event decked in Kennedy gear and brought with her a small Kennedy poster and a mini American flag. She said that she and her husband, John Lewis, 55, became interested in Kennedy long before his announcement to run for president because of his warnings about vaccines. (Kennedy’s claims about vaccines include the debunked assertion that they cause autism, and once led the social-media company Meta to pull down Facebook and Instagram accounts of Kennedy’s Children’s Health Defense.)
“RFK Jr. is a hero. He’s been fighting for the most vulnerable segment of our population which is our children,” said Lewis. “It’s unfortunate that he gets labeled as an anti-vaxxer, I’m not anti-vaxxer but I’m anti-scientism.”
Jalen Martin, 23, attended Kennedy’s event because, although he voted for Donlad Trump in the past, he doesn’t want to vote for him in the upcoming election. With Trump and President Joe Biden looking to be the respective candidates for the Republican and Democratic parties for the presidential election, Martin is interested to see how far Kennedy can go.
“We’re all here for an independent voice,” said Martin. “I think this is an interesting route we have forward with Kennedy, and I think we need someone who’s going to pull a lot of people in.”
The U.S. is sending a group of warships to the eastern Mediterranean as Israel strikes back following a deadly holiday attack by Hamas militants that left hundreds dead.
Defense Secretary Lloyd Austin said Sunday that following discussions with President Joe Biden, he directed the USS Gerald R. Ford Carrier Strike Group to the region. The group includes an aircraft carrier, a guided missile cruiser and guided missile destroyers.
Austin also said that the Pentagon would be sending additional aircraft to fighter squadrons in the region to enhance deterrent efforts. He said the U.S. will be “rapidly” providing the Israeli military with additional equipment and supplies, including munitions, which will “begin moving today and arriving in the coming days.”
This aid “underscores the United States’ ironclad support for the Israel Defense Forces and the Israeli people,” Austin said in a statement. “My team and I will continue to be in close contact with our Israeli counterparts to ensure they have what they need to protect their citizens and defend themselves against these heinous terrorist attacks.”
Earlier Sunday, Secretary of State Antony Blinken said the U.S. was considering Israeli requests for additional military aid after the sweeping attack by Hamas.
The U.S. also is looking into reports that U.S. citizens were killed or taken hostage and into whether Iran may have been directly involved in the surprise attack, though there’s no immediate evidence of that, he said in interviews with multiple U.S. networks on Sunday.
“In this moment, we don’t have anything that shows us that Iran was directly involved in this attack, in planning it or in carrying it out,” Blinken said on NBC’s Meet the Press. “But that’s something we’re looking at very carefully, and we’ve got to see where the facts lead. But we do know that Iran’s had a long relationship with Hamas, long support.”
A key question is how the U.S. could militarily help after the attack, which has killed more than 600 Israelis and prompted the country to formally declare it’s at war.
Blinken cited a memorandum of understanding signed under former President Barack Obama to provide Israel with $3.8 billion a year in U.S. military assistance, suggesting that immediate action by Congress — where the House’s Republican majority is embroiled in an election for the chamber’s new speaker — might not be needed.
“There’s a tremendous amount of aid and assistance already in the pipeline,” Blinken said on NBC. “At the same time, Israel has come to us and asked for some specific additional assistance.”
Biden said Saturday he made it clear to Prime Minister Benjamin Netanyahu that the U.S. is ready “to offer all appropriate means of support” to Israel’s government and its people.
“These are early days,” Blinken said on CBS’s Face the Nation. “Israel has to, first and foremost, ensure the security of its people in Israel, and then it’s determined to take steps to try to make sure that this doesn’t happen again.”
On ABC’s This Week, Blinken put the number of Hamas militants who infiltrated Israel at about 1,000. At the same time, he called for Israeli restraint.
“Whatever Israel does in Gaza, as always, we look to it to do everything possible to avoid civilian casualties,” though there’s “absolutely no comparison” to Hamas’ deliberate targeting of civilians, Blinken said on CBS.
U.S. Republican lawmakers expressed confidence that aid to Israel has bipartisan support in Congress, even as the party battles over its leadership in the House after last week’s vote that removed Kevin McCarthy as speaker.
Existing Law
“Right now, the president has plenty of authorities under existing law to transfer a weapon or to provide mission planning or intelligence support to Israel,” Senator Tom Cotton, a Republican member of the Armed Services Committee, said on Fox News’ Sunday Morning Futures.
Support could include supplies such as missile interceptors, artillery shells or small arms ammunition, Cotton said. It might also mean help with mission planning or intelligence support.
Representative Jim Jordan, an Ohio Republican running for House speaker, said his first action, if elected to the post, would be to bring Israeli aid to the floor.
“I want to give them what they need to win,” Jordan said on the Fox News show. “This is our great friend and great ally, the state of Israel. So I think that’s what’s front and center.”
A St. Louis County officer on Tuesday was awarded a police Purple Heart for his actions during a pursuit in January.
Officer Cody Reider was severely injured in January as he chased a suspect who was running from him and another officer after a lengthy vehicle pursuit. As Reider attempted to cuff the man, the suspect pushed them both off the ledge of a 10-foot retaining wall.
Reider landed on his head. He would later find out he had broken his back and neck and suffered a concussion.
On Tuesday, he received the police version of a Purple Heart, an award given to members of the U.S. military who are killed or injured in service.
“All I can say, Cody, is that I can’t believe you’re standing here,” Capt. Pete Morrow said Tuesday at the St. Louis County Police Commissioners meeting. “Those injuries, for most people, I think they would have been done. There’s a lot of mental toughness here, a lot of discipline in your comeback and in your recovery.”
Morrow said Reider was out on Jan. 9 with a detective in West Florissant near Interstate 270 when they spotted a stolen car and tried to stop the vehicle. The car sped away, and they chased it.
“So about three collisions later, the suspect vehicle ended up catching on fire … right around the airport,” Morrow said.
Reider chased the suspect who ran from the car down a “heck of an embankment,” Morrow said. The officer closed the gap between him and the suspect, and then Reider tried to arrest him. But the man pulled him down, and they both fell over the wall.
After they fell, Reider was able to keep the suspect from running while he called for help on the radio despite his injuries.
The man was arrested and booked on a $1 million bond. Morrow said officers found two handguns and fentanyl in the backpack he was carrying.
Several other officers were also honored during Tuesday’s meeting.
Officers Nicholas Ullo and Nathan Potthoff received a chief’s commendation for their work earlier this year on MetroLink trains. In three months, the two arrested 33 people, including two homicide suspects and one carjacking suspect. They also recovered 24 firearms, 12 of which were part of federal prosecution.
Two other officers, Neil French and Quintton Williams, were recognized for their actions in June 2022 when a U.S. postal worker was robbed at gunpoint.
Lifesaving awards went to officers Darnell Wallace and Neil French, who on separate occasions performed CPR on people who would have otherwise died before paramedics could arrive.
National Guard officer and state Sen. John C. Velis has been deployed to assist with the high numbers of incoming migrants in the Bay State.
Velis was among about 250 Massachusetts National Guard members activated Oct. 3 by Gov. Maura T. Healey to provide basic services for the migrant families arriving here. They are placed at hotels as emergency shelter.
Velis’ office said that he could not answer any questions from The Republican while deployed, but his office said it is operating normally through his activation.
Don Veitch, state public affairs officer at the Massachusetts National Guard, said Velis will serve as the general legal advisor for the mission.
In 2010, Velis joined the U.S. Army and deployed to Afghanistan as part of Operation Enduring Freedom, according to his campaign website. Since his return, he has served with the Army Reserve.
In August 2017, he spent a month near the North Korean border, where he participated in joint military exercises with the South Korean forces. On Velis’ second deployment to Afghanistan in 2018, he was promoted to major, his campaign states.
In his latest deployment, Velis is assisting the Guard with coordination of food, transportation, medical care and other basic needs for the rapidly rising numbers of migrant families.
In a statement issued on Aug. 8, Healey said the arriving families caused the state’s emergency shelter system to expand to an unsustainable level. While the administration continues to add new shelter sites to meet demand, service providers have been stretched thin.
According to the statement, more than 6,000 families are in emergency shelters across the state as of this week. Guard members were assigned to specific hotel shelter sites to make sure families placed there have access to basic services.
In addition, the Guard’s response teams will prep sites to open, inform migrants about placements, arrange public benefits and support partner agencies.
The Healey administration recently met with the Department of Homeland Security Secretary Alejandro Mayorkas to discuss federal support, after appealing to him in an Aug. 8 letter. Healey wrote about the number of families coming to the state with no way to find or pay for shelter.
Additionally, Healey further appealed to the federal government for assistance with streamlining work authorizations and funding.
“These new arrivals desperately want to work, and we have historic demand for workers across all industries,” Healey wrote.
The state of emergency stemmed, Healey wrote, from federal policies on immigration and work authorization, scarce production of affordable housing and the end of pandemic related relief programs.
According to Healey, some families drawn to the state are fleeing imminent threats, and the commonwealth has been a beacon of hope to those in need.
With more than 1,800 families already living in hotels and motels across 80 cities and towns across the state, with the new influx, Massachusetts does not have the tools needed to meet the demand for shelter.
According to Healey’s letter to Mayorkas, in the last six months, the need for shelter has skyrocketed.
In March, about 68 families came to Healey’s office for assistance. By July, the number jumped to 100 each day, compared to last March, when only 25 families a day who sought assistance.
Shelter entries per month are more than double the number of entries per month during the pandemic, and about one third higher than pre-pandemic levels. At the same time, the number of families leaving the shelter for permanent housing has declined by two-thirds since 2019, Healey wrote.
The state is spending $45 million a month for programs to help families, but the fear is that soon the state will not be able to keep up.
Healy said a federal crisis of inaction has been in the making for many years.
Police reports released Thursday shed new light on a harrowing knife attack that left three people injured at Hartsfield-Jackson International Airport, including a taxi driver, a Delta Air Lines employee and an Atlanta police lieutenant.
Terrified travelers waiting to get through airport security dropped to the ground Wednesday afternoon as officers tried to subdue 44-year-old Damaris Milton, who authorities say was armed with a knife near the south terminal checkpoint.
According to Atlanta police reports, Milton stabbed her cab driver in the chest along I-285 near the airport after being picked up at the Kensington Marta Station. She then grabbed his cellphone and threw it out the window onto the southbound lanes of the interstate, according to police.
The bloodied cab driver, who works for Alphabet Taxi Company, followed the woman into the airport after dropping her off in an effort to warn travelers and alert law enforcement, authorities said.
“He came in after her and was screaming, warning other passengers she was armed with a knife,” Atlanta police spokesman Officer Anthony Grant said. “That’s how we got alerted.”
Two Atlanta police officers, including a lieutenant, spotted the woman inside the airport and followed her to the south terminal. That’s when a Delta employee was stabbed on the left side of her chest, authorities said.
An officer tried using his Taser on Milton, striking her in the leg. But police said that didn’t work because she had on multiple pairs of pants.
“Ms. Milton continued to walk toward door S2 and then made a left turn back toward the south terminal corridor near the window area of the main checkpoint area still armed with the knife,” officers wrote in their report. “Commands for the subject to drop the knife were given to the female subject. The subject did not drop the knife.”
A second police officer tried to use a stun gun on the woman, and the lieutenant deployed his pepper spray, according to the incident report. That lieutenant then slipped on the pepper spray and fell to the ground, at which point Milton stabbed the officer in his left thigh, authorities said.
Another officer tackled the woman and took her into custody, putting an end to the threat, Atlanta police said. Meanwhile, a tourniquet was tied around the lieutenant’s leg to stop the bleeding and a chest seal was placed over the cab driver’s wound.
The taxi driver and lieutenant were both taken to Grady Memorial Hospital, and the Delta employee was taken to Emory University Hospital, authorities said.
The lieutenant has since been released from the hospital and is recovering, according to Atlanta police, who said they have increased patrols throughout the airport in the wake of Wednesday’s stabbings.
Milton was booked into the the Clayton County Jail on four counts of aggravated assault with a deadly weapon.
Milton, who has an Orlando address listed in online records, was taken to the Clayton County jail, where she remained held without bond Thursday. She faces four counts of aggravated assault with a deadly weapon.
It’s still unclear whether Milton had an airline ticket.
Ron Irby expected the artificial knee implanted in his right leg in September 2018 would last two decades — perhaps longer.
Yet in just three years, the Optetrak implant manufactured by Exactech in Gainesville, Florida, had worn out and had to be replaced — a painful and debilitating operation.
“The surgery was a huge debt of pain paid over months,” said Irby, 71, a Gainesville resident and retired medical technologist with the Department of Veterans Affairs.
Ron Irby had an Optetrak artificial knee implanted in his right leg in September 2018. (Matt Pendleton/KFF Health News/TNS)
Irby is one of more than 1,100 patients suing Exactech after it began recalling artificial knees, hips, and ankles, starting in August 2021. A letter Exactech sent to surgeons blamed a packaging defect dating back as far as 2004 for possibly causing the plastic in a knee component to wear out prematurely in about 140,000 implants. Many patients argue in hundreds of lawsuits that they have suffered through, or could soon face, challenging and risky operations to replace defective implants that failed.
Although Exactech does not offer an express warranty on its products, the company stresses the durability of its implants in advertising, even suggesting they likely will outlive their human recipients.
Exactech, which grew over three decades from a mom-and-pop device manufacturer into a global entity that sold for $737 million in 2018, declined comment, citing the “ongoing litigation,” said company spokesperson Tom Johnson. In court filings, Exactech has argued that its products are not defective and have “an excellent history.”
A KFF Health News review of thousands of pages of court filings in patient lawsuits, a pending whistleblower lawsuit, and other government records shows that the company is being accused of downplaying or concealing evidence of product failures from patients and federal regulators for years. In hundreds of instances, according to government records, the company took years to report adverse events to a federal database that tracks device failures.
Ron Irby had an Optetrak artificial knee implanted in his right leg in September 2018. (Matt Pendleton/KFF Health News/TNS)
In his suit, Irby alleges that Exactech “knew or should have known” that the Optetrak “had an unacceptable failure and complication rate.” He said Exactech used packaging materials of “an inferior grade or quality.”
“I think they were cutting corners to improve their bottom line,” Irby told KFF Health News.
Exactech denied the allegations in a legal filing in Irby’s suit, in which it described the Optetrak device as “safe and effective.”
A Family Affair
Surgeon William “Bill” Petty chaired the orthopedics department at the University of Florida in Gainesville, when he, his wife, Betty, and Gary Miller, a biomedical engineer and fellow faculty member, formed Exactech in November 1985. The Pettys served in corporate roles until retiring in early 2020. Their first hire was their son David in 1988, who remains on Exactech’s board of directors.
Ron Irby had an Optetrak artificial knee implanted in his right leg in September 2018. (Matt Pendleton/KFF Health News/TNS)
Exactech’s fortunes started to take off in 1994, when it inked a major deal to license and market the Optetrak knee implant based on designs by surgeons and engineers at the prestigious Hospital for Special Surgery in New York City. That alliance won Exactech instant credibility in the fiercely competitive device industry.
So did its pedigree as a “surgeon-focused” business with a family-run vibe, small enough that surgeons considering its wares could meet the owners and tour its Florida plant.
Building on that goodwill, Exactech’s sales shot past $124 million in 2007, about half generated by the Optetrak knee system.
“It’s not just a road we’re on, it’s a trail we’re blazing,” the company boasted in sales literature aimed at surgeons.
Exactech’s corporate confidence belies years of warnings and doubts about the durability of the Optetrak, according to whistleblowers — one whistleblower called it an “open secret” inside the company. Notably, there were concerns about the fragility of a finned tibial tray, one of the four pieces of the knee replacement that fits into the shin bone, according to the whistleblower lawsuit.
A diagram of the Optetrak knee replacement system is shown as part of a July 2023 filing in a New York Supreme Court case against the device’s manufacturer, Exactech. (Legal filings from Phyllis Schnitzer and Robert Schnitzer v. Exactech Inc./KFF Health News/TNS)
For starters, several surgeons complained that the knee implants loosened prematurely, causing patients pain and limiting their ability to move around, court records allege.
While 95% of artificial knees should last at least a decade, surgeons had to pull out and replace many Optetrak components — a complex operation known as revision surgery — much sooner, according to allegations in patient lawsuits.
Christopher Hutchins, a Connecticut orthopedic surgeon who relied on the Optetrak finned devices for more than 350 knee surgeries, said in a court deposition that some loosened in as little as two to three years. He called that “awfully premature” and “extraordinary.”
Hutchins vented his frustrations in a brief meeting with Exactech co-founder Bill Petty at a Rhode Island hospital in either 2006 or 2007, according to his deposition. Petty told him at the meeting he “realized that it was a problem” with the device, according to Hutchins.
A photo submitted to a federal court with an Exactech vice president’s affidavit shows a view of manufacturing of the Optetrak Logic finned tibial tray at Exactech’s Gainesville, Florida, headquarters. (Legal filings from United States of America et al. ex rel. Brooks Wallace, Robert Farley, and Manuel Fuentes v. Exactech Inc./KFF Health News/TNS)
“I was somewhat struck that if they knew there was a problem why it wasn’t being addressed and why the product wasn’t being pulled from the market,” Hutchins testified in the November 2021 deposition.
“There was no disclosure or transparency.”
Older patients not only suffered physical pain, but also felt an “emotional burden” from facing revision surgery in which results often are “not as good as the first go around,” Hutchins explained during his deposition testimony.“I’m in the business to try to make people better, and when things fail, I take it to heart.”
Hutchins was not the only surgeon alarmed by what he says were early failures of the Optetrak devices and the company’s tepid response.
‘Popping Out’
In August 2005, Maine orthopedic surgeon Wayne Moody told company officials that Optetrak had loosened and needed to be revised in 25 out of 385 operations he had performed over the previous four years, according to meeting minutes filed in court.
One knee implant gave out in just nine months, Moody told the group, according to the minutes.
In a deposition, Robert Farley, a former Exactech sales agent who filed a whistleblower lawsuit in 2018 alleging fraud by the company, alleged that he heard two colleagues joke about Moody’s tribulations at a national sales conference.
Moody “probably had 50-something revisions. … They’re just popping out right and left,” the sales agent said, according to Farley’s suit.
Fellow whistleblower Manuel Fuentes, a former Exactech senior product manager, testified in a deposition that pulling the product off the market around 2008 “would have been the ethical and moral thing to do.”
At a meeting in early 2008 attended by the company’s top brass, including Bill Petty, the company’s marketing director at the time, Charley Rye, floated the idea of a recall, Fuentes said. Company executives shot that down as “financially detrimental,” Fuentes testified in a sworn declaration filed with the court.
Asked about the meeting during a December 2021 deposition, Petty replied, “I don’t recall that anyone suggested a recall.”
‘Silent Recall’
Exactech discussed the loosening problem in an internal memo that said between 2006 and 2009 the company “began to get some negative feedback” about the Optetrak “that was at times confounding and difficult to process,” court records show.
The discouraging reports ranged from complaints of early revisions from at least 10 U.S. surgeons and surgery practices in several of the more than 30 countries where Exactech sold the implant, court records show.
The results did little to dim Exactech’s prospects. From 1994 through April 2022, Exactech sold 58,763 Optetrak devices with finned trays for use by 514 surgeons nationwide, according to an affidavit by a company official.
Many lawsuits argue that instead of warning patients and surgeons about the loosening problem, Exactech replaced the finned tray component in its newest products, a strategy device industry critics refer to as a “silent recall.” Exactech denies that and said in a court filing that design changes it made were part of a “natural evolution” of the Optetrak.
Even as Exactech rolled out newer generations of the Optetrak, the company faced lawsuits and other criticism alleging it had failed to come clean about unusually high surgical revision rates.
Late Notices
The Food and Drug Administration runs a massive, public, searchable databank called MAUDE to warn the public of dangers linked to medical devices and drugs.
Manufacturers must advise the FDA when they learn their device may have caused or contributed to a death or serious injury, or malfunctioned in a way that might recur and cause harm. Those reports must be submitted within 30 days unless a special exemption is granted.
But court and government records show that reports of adverse reactions tied to Exactech’s implant sometimes took years to show up in the government database — if they were reported at all.
Exactech failed to advise the FDA of dozens of Optetrak early revision complaints lodged by orthopedic surgeons Moody and Hutchins, a company representative acknowledged in a court filing.
KFF Health News downloaded the FDA data and found about 400 examples in which Exactech reported adverse events to the MAUDE database two years or more after learning of them.
FDA inspectors who combed through Exactech’s internal files in 2017 cited the company for failing to undertake an “adequate investigation” of complaints, according to FDA records cited in court filings.
In court filings, Exactech steadfastly denied Optetrak has any defects. Instead, it blamed the loosening problem on surgeons, saying they had failed to cement the knee implants into place correctly or misaligned them.
The company said it had no obligation to report poor outcomes tied to mistakes by surgeons — even though the FDA requires companies to report injuries involving “user error.” In 2022, a federal judge in the whistleblower case, in denying a motion to dismiss, found that Exactech was “hard-pressed” to claim it was not obligated to report the adverse events.
The three whistleblowers are accusing Exactech of fraud for allegedly selling defective products to Medicare and other federal health care programs. The case is pending in federal court in Alabama and Exactech has denied any wrongdoing. Exactech in mid-August filed a motion to dismiss the case.
Lawyers for more than 300 injured patients suing in Alachua County Circuit Court in Florida are pressing for full disclosure of 2,435 complaints to the company alleging deficiencies with Exactech knee products, which the company admits receiving as of the end of April.
In other pending lawsuits, patients argue the company pointedly ignored evidence of chronic safety issues to fuel profits.
Keith Nuzzo, of Litchfield, Maine, is one. He alleged that Exactech “cut corners, utilized inferior manufacturing practices … [and] only disclosed information or took corrective action if contacted by regulatory authorities.”
Nuzzo had a right knee replacement done by orthopedic surgeon Moody in February 2012 and a left knee implanted a week afterward.
His right knee became painful and wobbly about four years later and a second surgeon replaced it in August 2016. The left knee gave out in November 2020, also requiring replacement, according to the suit.
Despite the revisions, Nuzzo lives with “daily knee pain and discomfort,” which limits his “activities of daily living and recreation,” according to the suit. The case is pending. As of mid-September, Exactech had not filed an answer.
No Guarantees
In advertising directed at surgeons, Exactech boasts about the long life of its implants.
One sales brochure states that the Optetrak “demonstrated 91-99 percent implant survival rates” over just under a decade. That is consistent with, if not superior to, industry standards, though as a rule of thumb many surgeons expect implants to last 15 to 20 years, sometimes longer.
The mounting legal claims allege many Exactech knee and hip implants have worn out well before their time.
The KFF Health News analysis of more than 300 pending cases in Alachua County found that surgeons removed about 200 implants after less than seven years. Some people in the sample, whose surgeries spanned more than two dozen states, were awaiting revision procedures. In the federal court sample, patients alleged that half of the 400 implants that were removed lasted less than six years.
Advertising materials aside, Exactech is circumspect in describing the reliability of its implants when it speaks to courts. In a 2021 filing, the company noted that the Optetrak comes with no express warranty.
How long it lasts “depends on a multitude of factors, including those pertaining to surgical technique and the particular patient,” the company said.
Promoting the Products
Exactech’s focus on its surgeon customers includes paying handsome consulting fees to some orthopedists who have used the company’s implants in the operating room or promoted them in advertising.
Exactech paid surgeon consultants $23.2 million combined from the start of 2013 through the end of 2022, the most recent year available, according to a government database called Open Payments.
In promoting the Optetrak in sales materials, Exactech touted “excellent results” achieved by orthopedic surgeon Raymond Robinson. Left unsaid: Exactech paid Robinson more than $900,000 in consulting fees and other payments from 2013 through 2022. In a court filing, Exactech denied any consultants “were compensated in exchange for product promotion.” Robinson could not be reached for comment.
Exactech’s sales brochures also boast that surgeons “around the world have documented excellent results with the Optetrak knee system.”
Yet Exactech bottled up a succession of sharply negative reports from other countries, while working to discredit others, according to internal company records filed in court by the whistleblowers.
One surgery group in France concluded in 2012 that nine of 110 Optetrak procedures required revision due to loosening in under three years, for instance. Exactech disputed the findings in a published response, and in a court filing said the conclusions were “based on incorrect information and a flawed understanding of the true causes.”
A hospital in Buenos Aires, Argentina, reported that 25% to 30% of Optetrak knees required revisions in under two years, according to whistleblower Fuentes.
The Australian implant registry criticized Optetrak’s reliability as early as 2007 and in several later years. In response, Exactech executives said in depositions and court filings that they traced many of the poor results to a single hospital and three surgeons who failed to align the implants correctly.
The Australian registry pegged Exactech’s revision rate at 19.4% at seven years and 22% at 10 years, the worst of any knee implant on the market, which led the government health system to stop purchasing it, court records allege. Exactech denied the allegations in a court filing.
James Brooks, a retired Texas orthopedic surgeon, said in a court affidavit that he believed Exactech had an obligation to tell surgeons about the poor outcomes overseas rather than touting rosy results tied to doctors on its payroll.
In the 2021 affidavit, Brooks recalled implanting the Optetrak knee in a Dallas man in 2011, only to confirm from X-rays that it was failing in 2017 and needed to be replaced two years later. Brooks said he would have steered clear of Optetrak had he known of its “much higher failure rate than comparable products.”
Clicking Sounds
Laura Grandis is suing Ohio orthopedic surgeon and Exactech consultant Ian Gradisar, who received $132,720 from the company, including research payments, from 2013 through 2022, according to government records.
Gradisar’s father, Ivan, also an orthopedic surgeon, served on the original Optetrak design team. In 2008, Ian Gradisar helped his father with an audit of “patient outcomes” commissioned by Exactech. The audit showed that 12 of 47 Optetrak patients operated on over the course of 15 months required revisions, giving the son “first-hand knowledge of the failing and defective Optetrak,” Grandis alleges in her suit.
Ian Gradisar put an Exactech implant in Grandis’ left knee in Akron, Ohio, in November 2020.
In early 2021, she had “severe” pain in her knee and needed a cane or a walker to get around, according to the suit.
Gradisar told her the knee had failed, which he said was “very rare and only happened 5% of the time,” according to the suit.
Grandis had revision surgery in July 2021 with an Optetrak implant. Some seven months later, she felt pain that worsened throughout the day. She tried ice and rest, but that did not work. Her knee hurt when she put weight on it and started making a clicking sound when she moved, according to the suit.
In June 2022, Grandis received a “Dear Patient” form letter from the hospital where her surgery was performed notifying her of the Exactech recall.
Gradisar’s office told her the surgeon could not see her until October 2022 “as he was inundated with phone calls from patients about the Exactech recall,” according to the suit.
In response to the suit, Exactech denied the allegations, including that its knee implants had “increased failure rates.” The case is pending. Gradisar and his lawyer did not respond to requests for comment.
But in a court filing, Gradisar denied any defects in the implant and said he “provided quality care and treatment” to Grandis.
In December 2022, Grandis ended up having a second revision operation that kept her hobbling around on crutches for six weeks, according to her suit.
Total Recall
Two years after the initial recall, Exactech and its owners — past and present — face a rush of lawsuits demanding accountability for alleged patient injuries.
Most of the suits in the Alachua County group name Bill, Betty, and David Petty and Miller as defendants for their roles at Exactech. Their attorney did not respond to requests for comment, but in May, the defendants jointly filed a motion to dismiss, arguing that the suits fail “to allege sufficient facts to impose liability.”
Many suits in the federal court cluster also name as a defendant TPG Capital, a Texas-based private equity firm that paid $737 million to acquire Exactech in February 2018. TPG declined to comment but has filed a motion to dismiss the cases.
In one recall letter sent to surgeons, Exactech acknowledged that the data from the Australian registry confirmed that Optetrak had “statistically significant” higher rates of revisions than knee implants made by other companies — a conclusion it had previously disputed.
The letter adds that Exactech is “uncertain” if the packaging defect is the “root cause” of Optetrak’s poor performance. An FDA “safety communication” issued in March said the agency is working with Exactech to assess whether other implants packaged in the defective bags pose similar risks.
Exactech lawyers say the company may not be to blame for every implant that wears out unexpectedly.
In a November 2022 hearing, Exactech attorney Michael Kanute said wear of polyethylene implant components is a “known risk no matter who makes them.” He said the patient’s size and activity level as well as the technique of the surgeons could also be factors.
First lady Jill Biden will be in South Florida for two days starting on Sunday, the White House announced Thursday.
She will be traveling with Veteran Affairs Secretary Denis McDonough.
Biden and McDonough will arrive at Lauderdale-Hollywood International Airport on Sunday evening.
On Monday morning, as part of President Joe Biden’s Cancer Moonshot initiative, the first lady and McDonough will speak at a Cancer Survivorship Summit in Davie hosted by U.S. Rep. Debbie Wasserman Schultz, D-Weston.
On Monday afternoon, as part of the first lady’s Joining Forces initiative and continued support for the military community, Biden and McDonough will visit Patrick Space Force Base in Brevard County to meet with military spouses and families.
The lives of both Biden and Wasserman Schultz have been touched by cancer.
Wasserman Schultz is a breast cancer survivor.
Beau Biden, the first lady’s son, died of an aggressive brain tumor known as glioblastoma in 2015.
President Joe Biden was vice president at the time, and then-President Barack Obama asked him to lead the cancer moonshot, a White House initiative aimed at accelerating progress in fighting cancer.
Jill Biden will be the keynote speaker at the Cancer Survivorship Summit, which will run from 9 a.m. to 4:30 p.m. at the Rick Case Arena at Nova Southeastern University, 7200 Mary McCahill Drive.
Survivor Martina Navratilova will also deliver remarks.
Top national medical experts, advocates and survivors will also speak at the summit to address the challenges for those emerging from a cancer diagnosis and treatment.
During a recent interview, iconic action film actor Arnold Schwarzenegger claimed that Democrats “want to f-ck up every city in America.”
Schwarzenegger, who was the governor of California from 2003-2011, shared his perspective of how the Democratic Party seems to be trying to “ruin” American cities on a recent episode of “Literally! With Rob Lowe.”
During the interview, Lowe asked Schwarzenegger what it means for a person to be considered a Republican. As an example, he pointed to comments by former Rep. David Dreier (R-Calif.).
“Okay, let me ask you this, and I ask people this all the time,” Lowe said. “David Dreier, good friend of ours and a good man. Surfer for many, many, many years. He used to have the greatest, ‘what makes me a Republican,’ and he had I think four or five things. I think it was, in no particular order, strong military, low taxes, less government, more personal freedoms. There might have been one more, but it makes sense to know…”
READ MORE: Schwarzenegger owns up to ‘failures,’ apologizes for affair and groping scandal in new docuseries
Schwarzenegger quickly interjected that “strong law enforcement” was the other major policy platform supported by Republicans. After Lowe agreed with Schwarzenegger, he continued, “And then I’d like to know, I always ask Democrats what it means to be a Democrat in that way…”
Before Lowe could finish his train of thought, Schwarzenegger interrupted, suggesting that Democrats would answer the question by saying, “ruin your cities.” When asked again what Democrats would say, Schwarzenegger repeated that he believed Democrats would answer, “ruin your cities.”
Schwarzenegger went on to say, “That’s what the Democrats would say. We are about ruining the cities. We want to f-ck up every city in America. That seems to be the theme right now.”
When asked why Democrats are trying to ruin American cities, Schwarzenegger replied, “I have no idea.”
