Email Message ndy Engh [andy@andersonclinic. com] Sent: Saturday, June 05, 2010 8:06 PM To: ‘Berman, Paul [DPYUS} Subject: RE: DePuy Ranked #1 MoM Brand by Surgeons Paul, In my opinion DePuy should relax on the MOM issue. At meeting after meeting and panel after panel of hip Arthroplasty experts the trend is away from MOM. I was surprised to get an Sphere brochure under my hotel room door at current concepts: It would have been better to ‘market COP rather than fight the uphill battle against MOM. My recommendation is to not push MoM at this time, let it rest and let the dust settle. The problem with MOM is the complication although rare is an early complication and a catastrophic complication. We do nat have enough data to determine ifthe incidence is lat or increasing. | have seen this complication with Ultamet in patients that have perfectly oriented components. While design and component position are a factor there are other factors that we do not understand. There is no question that MOM and hard on hard bearings are less forgiving that polyethylene bearings. The MRG report does not move me, If DePuy needs to continue to push and market MOM then there should be more patient and surgeon education about the risks of the procedure. There should also be education about evaluation ofa MOM that is painful. ! have over 1500 of these implants at my center and whenever one of those patients has pain | need to include a MOM reaction in the differential. | have to tell the patient and once | have ruled out back problems and loose implants or tendonitis , | have to draw ion levels, image the hip and often aspirate(an invasive procedure) the hip. | do not have to do this with poly patients because | am not worried about a ‘catastrophic complication. ‘Andy From: Berman, Paul [DPYUS] [mailto:PBermanGits.jnj.com] Sent: Saturday, June 05, 2010 1:40 PM ‘Subject: DePuy Ranked #1 MoM Brand by Surgeons, DePuy Hip Consultants ~ FYE: Millennium Research Group (MRG) recently held an analyst call on “Metal-on-Metal Hip Implants: Bad Idea, or Just Bad Press?” Their insights were based on a survey among 150 surgeons. The overall tone of this call was very positive toward MoM bearings. Attached are their slides and below is a link to the analyst call. A fow key takeaways, 41.) DePuy is the #1 ranked MoM brand (subsequent ranking; Biomet, SNN, WMT, SYK Exactech and Zimmer) 2.) Despite recent negative press on MoM, respondents still fee! MoM is a safe and effective bearing 3.) Ona 10 scale, MoM received a satisfaction rating of 7.9, which was higher than CoC and MoP. 4), Implant design and surgical technique are the most commonly stated reason for MoM complications. Regards, Paul EXHIBIT PROTECTED DOCUMENT. DOCUMENT SUBJECT TO PROTECTIVE ORDER ENGHJR000007755, PLT-00030-00001hitps:vimea.webes pASP=ECBrID=411021328rKoy=19491Bca4se19e6c Paul M, Berman Director, US Hip Marketing DePuy Orthopaedics, Inc., a Johnson & Johnson Company 974-372-7020 PROTECTED DOCUMENT. DOCUMENT SUBJECT TO PROTECTIVE ORDER. ENGHJR000007756 PLT-00030-00002