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All case studies

Catastrophic failureHealthcare2010

DePuy Orthopaedics (Johnson & Johnson)

DePuy ASR Hip Implant Recall

Estimated impact: $2.5B in settlements; 93,000 patients affected worldwide

F14

Decision Quality Index

Critical — 5 biases detected, 2 toxic combinations

J&J recalled the DePuy ASR metal-on-metal hip implant after failure rates reached 13% within 5 years. Internal documents showed J&J knew about elevated metal ion levels and high revision rates but delayed recall, settling 8,000+ lawsuits for $2.5B.

Decision context

Whether to recall the ASR hip system when internal data showed failure rates significantly above the industry average, or wait for more definitive evidence.

Deep hindsight-stripped analysis coming soon. This case is part of our ongoing backfill to reconstruct what the platform would have flagged at decision time. The summary and bias profile below are drawn from primary sources.

Biases present in the decision

Confirmation Bias★ Loss AversionSelective PerceptionStatus Quo BiasCognitive Misering

3D Decision Knowledge Graph

DePuy Orthopaedics (Johnson & Johnson) — 5 biases, 2 toxic combinations

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Decision

Critical

High

Medium

Toxic

Bias Intensity Profile

Severity × confidence across 5 detected biases

Toxic combinations

Status Quo Lock
Echo Chamber

Reference class base rates

Across all 146 curated case studies in our library:

90%

base failure rate

10%

base success rate

Lessons learned

Loss aversion around a profitable product line delayed a recall that internal data warranted years earlier
Selective perception in interpreting post-market surveillance data allowed J&J to dismiss adverse signals
Metal-on-metal hip implants were adopted industry-wide based on theoretical advantages without adequate long-term human data

Source: FDA Class II Recall of DePuy ASR Hip System (2010); BMJ Investigation by Deborah Cohen (2011) (FDA Action)

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Lessons learned

Loss aversion around a profitable product line delayed a recall that internal data warranted years earlier

Selective perception in interpreting post-market surveillance data allowed J&J to dismiss adverse signals

Metal-on-metal hip implants were adopted industry-wide based on theoretical advantages without adequate long-term human data