Full opinion text
MEMORANDUM AND ORDER VRATIL, District Judge. Mark and Cheryl Miller claim that their 18-year-old son Matthew committed suicide because he took Zoloft — a prescription drug which Pfizer Inc. manufactured for treatment of depression. See Amended Complaint (Doc. # 92) filed December 16, 1999. The Millers seek to hold Pfizer liable for Matthew’s wrongful death. Count I of their complaint alleges that Pfizer is strictly liable for marketing defects and misrepresentations about Zoloft. Count II alleges that Pfizer is liable under common law negligence theories for failing to test and warn about the dangers of drug-induced suicide. See Pretrial Order (Doc. # 171) filed March 6, 2000. The matter comes before the Court on three motions for summary judgment: Defendant Pfizer Inc’s Motion For Partial Summary Judgment On Plaintiffs’ Claim Of Marketing Defect And Misrepresentation (Doc. # 505) and Defendant Pfizer Inc’s Motion For Partial Summary Judgment On Plaintiffs’ Failure To Warn Claim (Doc. # 504), both filed September 12, 2001, and Plaintiffs’ Motion For Partial Summary Judgment (Doc. # 528) filed October 23, 2001. This matter also comes before the Court on Defendant Pfizer Inc.’s Motion In Limine No. 15 To Exclude References To Its Financial Condition And Announced Merger (Doc. # 276) filed April 28, 2000. The Court has carefully considered the parties’ arguments and is now prepared to rule. Summary Judgment Standard Summary judgment is appropriate if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law. Fed.R.Civ.P. 56(c); accord Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 247, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986); Vitkus v. Beatrice Co., 11 F.3d 1535, 1538-39 (10th Cir.1993). A factual dispute is “material” only if it “might affect the outcome of the suit under the governing law.” Anderson, 477 U.S. at 248, 106 S.Ct. 2505. A “genuine” factual dispute requires more than a mere scintilla of evidence. Id. at 252, 106 S.Ct. 2505. The moving party bears the initial burden of showing the absence of any genuine issue of material fact. Celotex Corp. v. Catrett, 477 U.S. 317, 323, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986); Hicks v. City of Watonga, 942 F.2d 737, 743 (10th Cir.1991). Once the moving party meets its burden, the burden shifts to the non-moving party to demonstrate that genuine issues remain for trial “as to those dispos-itive matters for which it carries the burden of proof.” Applied Genetics Int’l, Inc. v. First Affiliated Sec., Inc., 912 F.2d 1238, 1241 (10th Cir.1990); see also Matsushita Elec. Indus. Co., Ltd. v. Zenith Radio Corp., 475 U.S. 574, 586-87, 106 S.Ct. 1348, 89 L.Ed.2d 538 (1986); Bacchus Indus., Inc. v. Arvin Indus., Inc., 939 F.2d 887, 891 (10th Cir.1991). The nonmoving party may not rest on its pleadings but must set forth specific facts. Applied Genetics, 912 F.2d at 1241. “[W]e must view the record in a light most favorable to the parties opposing the motion for summary judgment.” Deepwater Invs., Ltd. v. Jackson Hole Ski Corp., 938 F.2d 1105, 1110 (10th Cir.1991). Summary judgment may be granted if the non-moving party’s evidence is merely color-able or is not significantly probative. See Anderson, 477 U.S. at 250-51, 106 S.Ct. 2505. “In a response to a motion for summary judgment, a party cannot rely on ignorance of facts, on speculation, or on suspicion, and may not escape summary judgment in the mere hope that something wih turn up at trial.” Conaway v. Smith, 853 F.2d 789, 794 (10th Cir.1988). Essentially, the inquiry is “whether the evidence presents a sufficient disagreement to require submission to the jury or whether it is so one-sided that one party must prevail as a matter of law.” Anderson, 477 U.S. at 251-52, 106 S.Ct. 2505. Statement Of Uncontroverted Facts For purposes of summary judgment, the following facts are uncontroverted, deemed admitted, or, where disputed, viewed in the light most favorable to plaintiffs. • Matthew Miller In the spring of 1997, staff members at Harmony Middle School (including teachers, school counselors and the school psychologist) were concerned about Matthew Miller. Matthew had expressed suicidal ideation to both Roxanna Rogers, his special education classroom teacher, and his friends (Abby Meckna, Hillary Burton and Chad Brownell). At least two students had told Ms. Rogers that Matthew had spoken of suicide. The staff therefore recommended that Matthew’s parents seek professional evaluation and treatment for him, and that he see someone for counseling over the summer. Matthew’s parents, Mark and Cheryl Miller, were also concerned. On June 30, 1997, they took Matthew to see Dr. Douglas Geenens, who was board certified in psychiatry by the American Board of Psychiatry and Neurology and board certified in child and adolescent psychiatry by the American Board of Psychiatry and Neurology. Dr. Geenens had done a residency in psychiatry at the Men-ninger Clinic and received further training in child psychiatry at Harvard Medical School. Eighty per cent of Dr. Geenens’ practice involved the treatment of children and adolescents. During Matthew’s first visit, on June 30, 1997, Dr. Geenens diagnosed Matthew as suffering from “depression not otherwise specified.” Three weeks later, on July 21, 1997, Dr. Geenens saw Matthew a second time. At that time, based upon additional tests and further psychiatric evaluation, he concluded that Matthew was significantly depressed and prescribed Zoloft 50 mg. once a day. At the time, Dr. Geenens warned Matthew and his parents that nausea and insomnia were common side effects of Zoloft, and told them to report any problems or anything unusual that happened while Matthew was taking Zoloft. In allowing Matthew to use Zoloft, plaintiffs relied solely on Dr. Geenens’ advice. In prescribing Zoloft, Dr. Geenens relied solely on his education, training, review of medical and scientific literature, the Physician’s Desk Reference and his own clinical experience. Dr. Geenens testified that he does not review pharmaceutical marketing materials and, when he receives marketing, advertising or promotional materials from pharmaceutical representatives, he throws them away without reading them. He also testified that he did not read marketing, advertising or promotional materials about drugs in scientific and medical articles or journals. Finally, Dr. Geenens testified that Pfizer sales representatives have never encouraged him to prescribe Zoloft in conditions which the FDA has not approved, and that he knows more about Zoloft than Pfizer sales representatives. See id. at 59-60. In short, Dr. Geenens testified that Pfizer’s marketing efforts had no effect on his decision to prescribe Zoloft for Matthew. At the time he prescribed Zoloft for Matthew, Dr. Geenens knew that published case reports and adverse event reports at the Food and Drug Administration (“FDA”) had described instances in which patients who were undergoing treatment with antidepressants like Zoloft experienced suicidal ideation and committed suicide, or attempted to do so, while undergoing such treatment. In fact, Dr. Geenens was medically trained by Dr. Martin Teieher, the principal author of anecdotal case reports which involved suicidal ideation of patients on Prozac, an antidepressant drug which is similar to Zoloft. In his opinion, however, Zoloft was a safe and effective medication for the treatment of depression. In retrospect, even in the face of plaintiffs evidence Dr. Geenens would have given the Millers the same warning he gave them before concerning Zoloft. Plaintiffs did not contact Dr. Geenens about any side effects and to his knowledge, Matthew did not experience any clinically-significant side effects while he was taking Zoloft. Nonetheless, about six days after his second visit with Dr. Geenens, during the late night of July 27 or the early morning of July 28, 1997, Matthew died from asphyxiation. • Regulatory Approval Process For Zoloft The Federal Food Drug and Cosmetic Act (“FDCA”) requires that prescription medicines be approved as safe and effective before they may be sold. The first step to obtain approval for a new prescription drug is to file an investigational new drug application (“IND”). An IND is filed with the Food and Drug Administration after animal and laboratory studies have been completed. The IND describes in detail the product, the studies which have been performed, and a proposed plan for clinical trials with human volunteers. If the FDA approves the IND, clinical trials may proceed. If the clinical trials and other studies set forth in the IND are successfully completed, a new drug application (“NDA”) may be filed with the FDA. The NDA provides detailed safety and efficacy information about the medicine to the FDA. The FDA must reject a NDA for particular use if it “do[es] not include adequate tests by all methods reasonably applicable to show whether or not such drug is safe for use under the conditions prescribed, recommended, or suggested in the proposed labeling thereof; ... the results of such tests show that the drug is unsafe for use under the conditions prescribed, recommended, or suggested in the proposed labeling thereof; ... or ... [the] labeling is false or misleading in any particular.” To approve a new drug, the FDA must determine that it meets statutory standards for safety and effectiveness and labeling. FDA standards provide that “[a] new drug may not be approved for marketing unless is has been shown to be safe and effective for its identified uses.” On October 2, 1980, Pfizer filed an IND for sertraline for use in the treatment of depression. Sertraline is the generic name for Zoloft. The FDA approved the IND, and physicians thereafter conducted clinical trials at 150 clinical centers over a period of several years. On April 13,1988, Pfizer filed its NDA. The initial submission comprised 117 volumes of scientific information regarding the safety and efficacy of sertraline, as developed in laboratory and clinical testing programs. The FDCA directs the FDA to establish expert panels “[f]or the purpose of providing expert scientific advice and recommendations ... regarding a clinical investigation of a drug or the approval for marketing of a drug.” The statute requires that such panels consist of: (A) members who are qualified by training and expertise to evaluate the safety and effectiveness of the drugs to be referred to the panel and who, to the extent feasible, possess skill and expertise in the development, manufacture, or utilization of such drugs; (B) members with diverse expertise in such fields as clinical and administrative medicine, pharmacy, pharmacology, pharmacoeconomics, biological and physical sciences, and other related professions; (C) a representative of consumer interests, and a representative of interests of the drug manufacturing industry not directly affected by the matter to be brought before the panel; and (D) two or more members who are specialists or have other expertise in the particular disease or condition for which the drug under review is proposed to be indicated. On September 14, 1990, Pfizer submitted to the FDA a summary report of sertraline safety data for the Psychopharmacological Drugs Advisory Committee (“PDAC”), a summary report of sertraline clinical pharmacology, and a report on sertraline suicide attempts. Pfizer also submitted HAM-D Suicide Item No. 3, a portion of the Hamilton Depression Rating Scale which measured suicidal depression in the sertraline depression program, and a report on specific HAM-D scores in one clinical study of Zoloft. While the HAM-D has been found to be an insensitive barometer of treatment-emergent suicidality, the data demonstrated that sertraline was more effective than placebo and comparable to active controls with respect to rates of suicide attempts and changes in the depression rating scale item that related to suicide. In particular, the data showed that suicide attempts occurred no more frequently in Zoloft patients (0.3%) than in placebo patients (0.3%). These studies were not designed to detect or measure treatment-emergent suicidality. The FDA reviewed the data from the HAM-D study, and in fact reported it in the Summary Basis of Approval when it later approved Pfizer’s NDA for Zoloft. On November 19, 1990, the FDA convened the 33rd meeting of the PDAC for the sole purpose of reviewing Pfizer’s NDA for Zoloft. At the meeting, James F. Knudson, M.D. presented safety data (including suicide attempts during clinical studies for Zoloft) on behalf of the FDA. In doing so, he noted that “disproportionate numbers of suicide attempts do not occur among the 3 treatment groups [Zoloft, placebo and active control],” and that “all suicide attempts appeared in depressed patients, none in the obese [a separate patient population in which Zoloft had been studied].” At the conclusion of the PDAC meeting, the Committee determined (by a vote of six to one) that there was sufficient evidence that sertraline was effective for the treatment of depression. It also determined (unanimously) that there was sufficient evidence that sertraline was safe for the treatment of depression. At the meeting, however, Dr. Thomas Laughren (a senior FDA official) cautioned that “[w]e have no data for this drug in children.... I think it is important to point out that depression is an entity that exists in children and if this drug were to be approved, it is likely that some clinicians will want to use this drug in children.” By letter dated September 30, 1991, the FDA informed Pfizer that Zoloft was “ap-provable.” A determination that a medication is “approvable” means that the FDA will approve the application if specific additional information material is submitted or specific conditions are met. To its letter, the FDA attached a proposal for Zoloft labeling, stating “[w]e believe it presents a fair summary of the information available on the benefits and risks of sertraline.” The proposed labeling included the following precaution regarding the risk of suicide in patients undergoing Zoloft therapy: Suicide — The possibility of a suicide attempt is inherent in depression and may persist until significant remission occurs. Close supervision of high risk patients should accompany initial drug therapy. Prescriptions for Zoloft (sertraline) should be written for the smallest quantity of capsules consistent with good patient management, in order to reduce the risk of overdose. The FDA’s proposed label also included the following statement under the “adverse reactions” heading: Psychiatric Disorders — Infrequent: abnormal dreams, aggressive reaction, amnesia, apathy, delusion, depersonalization, depression, aggravated depression, emotional lability, euphoria, hallucination, neurosis, paranoid reaction, suicide attempt, teeth-grinding, abnormal thinking; Rare: hysteria, somnambulism, withdrawal symptom. On October 30, 1991, Pfizer responded to the FDA with a suggestion that the word “capsules” be changed to “tablets,” and that the “Psychiatric” subsection of the “Adverse Reactions” section be revised to include suicide “ideation” in addition to suicide “attempt.” Pfizer did not propose other changes to the suicide warning. On December 6, 1991, the FDA completed its review of the proposed package insert which would contain the Zoloft labeling and it accepted Pfizer’s recommendations. By letter dated December 30, 1991, the FDA approved Pfizer’s NDA for Zoloft. In doing so it stated: We have completed our review of this application, as amended, and have concluded that adequate information has been presented to demonstrate that the drug product is safe and effective for use as recommended in the draft labeling dated October 30, 1991, as revised below. Additionally, we refer to the December 5, 1991, teleconference between staff from FDA and Pfizer during which agreement was reached on final labeling revisions. Accordingly, the application, with these labeling revisions, is approved, effective as of the date of this letter. The FDA also stated: “These revisions [to the label] are terms of the NDA approval. Marketing the product before making the agreed upon revisions in the product’s labeling may render the product misbranded and an unapproved new drug.” The FDA has never approved Zoloft for treatment of pediatric depression. At the same time, the FDA specifically permits doctors to prescribe drugs for off-label uses, i.e. uses for which they have not been approved. At his deposition, Dr. Geen-ens testified that “[i]n child psychiatry we prescribe outside of FDA indication 99 percent of the time. It is the standard of care to utilize psychiatric medication in children and extrapolate from adult literature.” Indeed, the FDA’s approval letter of December 30, 1991 recommended that Pfizer conduct studies with depressed children and adolescents, stating that “[depression is common among these populations and it is likely the sertraline will be used in children and adolescents, despite the absence of any relevant data.” • Warnings Throughout the time that Pfizer has marketed Zoloft in the United States, Zoloft prescriptions have included a package insert which lists “Precautions” and “Adverse Reactions.” This package insert is reproduced in the Physician’s Desk Reference. Both the package insert and the PDR list precautions and clinical trial data on the risk of patients developing treatment-emergent suicidality, mania or hypomania, anxiety, nervousness, agitation, hyperkinesia, insomnia, apathy, emotional lability and other potential adverse events. The package insert and PDR with regard to suicide have not changed, and the warnings which were in effect in July 1997 (at the time of Matthew’s death) specifically noted: “Pediatric Use — Safety and effectiveness in children have not been established.” The package insert states in relevant part as follows: PRECAUTIONS General Activation of Mania/Hypomania — During premarketing testing, hypomania or mania occurred in approximately 0.4% of ZOLOFT (sertraline hydrochloride) treated patients. Activation of mania/hypomania has also been reported in a small proportion of patients with Major Affective Disorder treated with other marketed antidepressants. * * * Suicide — -The possibility of a suicide attempt is inherent in depression and may persist until significant remission occurs. Close supervision of high risk patients should accompany initial drug therapy. Prescriptions for ZOLOFT should be written for the smallest quantity of tablets consistent with good patient management, in order to reduce the risk of overdose. * * * ADVERSE REACTIONS Commonly Observed — The most commonly observed adverse events associated with the use of ZOLOFT (sertraline hydrochloride) and not seen at an equivalent incidence among placebo treated patients were: gastrointestinal complaints, including nausea, diarrhea/loose stools and dyspepsia; tremor; dizziness; insomnia; somnolence; increased sweating; dry mouth; and male sexual dysfunction (primarily ejaculatory delay). Associated with Discontinuation of Treatment — Fifteen percent of 2710 subjects who received ZOLOFT in pre-marketing multiple dose clinical trials discontinued treatment due to an adverse event. The more common events (reported by at least 1% of subjects) associated with discontinuation included agitation, insomnia, male sexual dysfunction (primarily ejaculatory delay), somnolence, dizziness, headache, tremor, anorexia, diarrhea/loose stools, nausea, and fatigue. Incidence in Controlled Clinical Trials— The table that follows enumerates adverse events that occurred at a frequency of 1% or more among ZOLOFT patients who participated in controlled trials comparing titrated ZOLOFT with placebo. Most patients received doses of 50 to 200 mg per day. The prescribed should be aware that these figures cannot be used to predict the incidence of side effects in the course of usual medical practice where patient characteristics and other factors differ from those which prevailed in the clinical trials. Similarly, the cited frequencies cannot be compared with figures obtained from other clinical investigations involving different treatments, uses, and investigators. The cited figures, however, do provide the prescribing physician with some basis for estimating the relative contribution of drug and non-drug factors to the side effect incidence rate in the population studied. Treatment-Emergent Adverse Experience Incidence in Placebo-Controlled Clinical Trials Adverse Experience (Percent of Patients Reporting) ZOLOFT Placebo (N=861) (N=853) Centr. & Periph. Nerv. System Disorders Headache 20.3 19.0 Dizziness 11.7 6.7 Tremor 10.7 2.7 Parethesia 2.0 1.8 Hypoesthesia 1.7 0.6 Twitching 1.4 0.1 Hypertonia 1.3 0.4 i}i ifc ❖ ‡ H5 Psychiatric Disorders Insomnia 16.4 8.8 Sexual Dysfunction Male 15.6 2.2 Somnolence 13.4 5.9 Agitation 5.6 4.0 Nervousness 3.4 1.9 Anxiety 2.6 1.3 Yawning 1.9 0.2 Sexual Dysfunction Female 1.7 0.2 Concentration Impaired 1.3 0.5 * * ❖ * * * Other Events Observed During the Pre-marketing Evaluation of Zoloft (sertra-line hydrochloride): During its pre-marketing assessment, multiple doses of ZOLOFT were administered to approximately 2700 subjects. The conditions and duration of exposure to ZOLOFT varied greatly, and included (in overlapping categories) clinical pharmacology studies, open and double-blind studies, uncontrolled and controlled studies, inpatient and outpatient studies, fixed-dose and titration studies, and studies for indications other than depression. Untoward events associated with this exposure were recorded by clinical investigators using terminology of their own choosing. Consequently, it is not possible to provide a meaningful estimate of the proportion of individuals experiencing adverse events without first grouping similar types of untoward events into a smaller number of standardized event categories. In the tabulations that follow, a World Health Organization dictionary of terminology has been used to classify reported adverse events. The frequencies reported, therefore, represent the proportion of the approximately 2700 individuals exposed to multiple doses of ZOLOFT who experienced an event of the type cited on at least one occasion while receiving ZOLOFT. All events are included except those already listed in the previous table and those reported in terms so general as to be uninformative. It is important to emphasize that although the events reported occurred during treatment with ZOLOFT, they were not necessarily caused by it. Events are further categorized by body system and listed in order of decreasing frequency according to the following definitions: frequent adverse events are those occurring on one or more occasions in at least 1/100 patients (only those not already listed in the tabulated results from placebo controlled trials appear in this listing); infrequent adverse events are those occurring in 1/100 to 1/1000 patients; rare events are those occurring in fewer than 1/1000 patients. Events of major clinical importance are also described in the PRECAUTIONS section. * * * Central and Peripheral Nervous System Disorders — Frequent: confusion; Infrequent: ataxia, abnormal coordination, abnormal gait, hyperesthesia, hyperkine-sia, hypokinesia, migraine, nystagmus, vertigo; Rare: local anesthesia, coma, convulsions, dyskinesia, dysphonia, hy-poreflexia, hypotonia, ptosis. * * * Psychiatric Disorders — Infrequent: abnormal dreams, aggressive reaction, amnesia, apathy, delusion, depersonalization, depression, aggravated depression, emotional lability, euphoria, hallucination, neurosis, paranoid reaction, suicide ideation and, attempt, teeth-grinding, abnormal thinking; Rare: hysteria, somnambulism, withdrawal syndrome. According to the dictionary of the World Health Organization (‘WHO”), “hyperkine-sia” is the preferred term for akathisia. At the time Pfizer issued the package insert warnings, they complied with FDA regulatory standards, and the FDA mandated and approved them. Under 21 C.F.R. § 201.57(e), however, “the labeling shall be revised to include a warning as soon as there is reasonable evidence of an association of a serious hazard with a drug,” and a causal relationship need not have been proved. • Association Between Zoloft And Suicide When it approved the NDA for Zoloft for treatment of depression, the FDA issued a 60-page report, entitled “Summary Basis of Approval,” which summarized the reasons and clinical data which supported its conclusion that Zoloft was safe and effective. The FDA specifically addressed suicidality in section 5.2.2.4.1, stating: In the sertraline development program there were 9 suicide attempts in the sertraline group, 5 in the placebo group, and 1 in the active control group: all of these suicide attempts were in therapeutic depression studies. Two of the suicide attempts in the sertraline group resulted in completed suicides. The incidence rates by treatment group for suicide attempts, corrected for differential therapy duration, were 1.77 per 100 patient years (95% confidence limits 0.8-3.4) for the sertraline group, 2.39 (95% C.L. 0.7-5.5) in the placebo group, and 1.10 (95% C.L. 0.0-6.2) in the active control group. The incidence rates of suicide attempts were thus generally similar in the 3 treatment groups, with broadly overlapping 95% confidence limits .... Review of the rates of events defined by baseline to endpoint shifts in HAM-D Item 3 scores [i.e., measurement of suicidal ideation] and baseline to endpoint changes in HAM-D Item 3 scores showed results favoring sertraline over placebo and supported the comparability of the sertraline and active control groups with respect to suicidality in therapeutic depression trials. According to Dr. Jonathan Cole, who gave deposition testimony in this case, such after-the-fact meta-analyses of clinical trial data are not designed to detect or measure treatment emergent suicidality. Zoloft is a selective serotonin reuptake inhibitor (“SSRI”) drug. In the early 1990s, several medical and lay media reports suggested that Prozac — another SSRI drug (generally known as fluoxe-tine) — caused violent and suicidal activity. In particular, in February of 1990, psychiatrists Martin Teicher, M.D., Ph.D. and Jonathan Cole, M.D. (with nurse Carol Glod, R.N., M.S.C.S.) published an article which described six patients who reported suicidal ideation while undergoing treatment with Prozac and other medications. The article theorized that their suicidal ideation was a paradoxical response to Prozac. After this article was published, the question whether SSRI antidepressants cause suicidal ideation or activity came to the forefront of public consciousness in the United States. This article, and the controversy which it created, engendered FDA regulatory action and captured the attention of the popular media. Initially this controversy was principally focused on Prozac — the only SSRI drug on the United States market at that time. On October 10, 1990, the Citizens Commission on Human Rights, a group established by the Church of Scientology, petitioned the FDA to withdraw its approval of Prozac. On August 1, 1991, after reviewing the Scientology Petition and all available evidence, the FDA found that “[t]he data and information available at this time do not indicate that Prozac causes suicidality or violent behavior.” Peck Letter (Exhibit X) in Def.’s Failure To Warn Ex., Vol. 2 (Doc. # 225). Accordingly, it denied the petition. On May 23,1991, Public Citizen, another group, petitioned the FDA to mandate a “black box” warning discussing the alleged causal connection between Prozac and suicide. Four months later, on September 20,1991, the FDA convened the 34th meeting of the PDAC to investigate the possibility that antidepressant drugs caused suicidal acts and thoughts, or other violent behavior. As part of its meeting, the PDAC conducted a public hearing which lasted about four hours. After the hearing, the committee heard presentations from Eli Lilly which manufactures Prozac and FDA personnel. Upon reviewing the evidence, the PDAC unanimously concluded that there was no credible evidence of a causal relationship between antidepressant drugs and the emergence and/or intensification of suicidality or other violent behavior. The PDAC voted (by a 6 to 3 vote) against recommending any change to package inserts for SSRI drugs. In that regard, Dr. Leber, Director of the FDA Division of Neuropharmacological Drug Products (later FDA Commissioner), stated that a change in antidepressant labeling might have a “net effect [of] a reduction in the use of antidepressants in the treatment of depression, and that result might cause overall injury to the public health.” Upon reviewing the PDAC report, the FDA determined that while there was no reasonable evidence of a causal relationship between Prozac and suicide, more testing was appropriate. At about the same time, in November of 1991, Dr. J. John Mann, an eminent suici-dologist and psychopharmacologist, published an article entitled Emergence Of Suicidal Ideation And Behavior During Antidepressant Pharmacotherapy. In that article Dr. Mann proposed a three-way, randomized, double blind, placebo-controlled clinical trial to evaluate whether an antidepressant such as fluoxetine (Prozac) causes the emergence of suicidal ideation or intensifies existing suicidal ideation in certain patients. He also proposed that future studies incorporate ratings for akathisia, anxiety, agitation, insomnia and other side effects to evaluate whether these side effects contributed to the emergence of suicidality in patients who received antidepressant therapy. In conclusion, Dr. Mann stated: Clinicians should be aware that emergence or intensification of suicidal ideation and behavior in patients receiving antidepressant treatment has been reported .... Whether certain antidepressants precipitate or aggravate suicidal ideation in a small, vulnerable subpopu-lation of psychiatric patients who require antidepressants is uncertain. In practice, whatever the antidepressant medication, the clinician should always monitor the patient to assess the severity of the depression and suicidal ideation, aggressive ideation or behavior, agitation and akathisia. Paradoxical suicidal ideation or behavior may be more frequent in nonresponders, patients with unrecognized akathisia, and patients with histories of attempted suicide. Therefore, the clinician should continue informing patients with depression who are being treated with antidepressant medications that depressive symptoms and/or a worsening or emergence of suicidal ideation may occasionally occur during treatment. The patient should be instructed to immediately inform the clinician should symptoms occur. The clinician can then judge whether the cause is the illness, the environment, or the treatment. After he wrote that article, Dr. Mann obtained sertraline placebo and active-control suicidal ideation and attempt data from randomized, double blind, placebo-controlled clinical trials by Pfizer — along with similar data for other SSRI and non-SSRI drugs. On March 2, 1992, four months after the earlier article, Dr. Mann co-authored a second article which was accepted as a consensus statement by the American College of Neuropsychopharma-cology (“ACNP”). In that article, Dr. Mann reviewed in detail the Pfizer data, with the similar data for other SSRI and non-SSRI drugs. Having done so, Dr. Mann and his co-authors reached the following conclusions in the ACNP consensus statement: In conclusion, case reports suggest that a small minority of patients may experience emergent suicidal thoughts or evince such behavior during the pharmacological treatment of depression. These reports do not distinguish between the relative potential contribution of the disease process, external stres-sors, or the medication. Of significance, there is evidence that such emergent suicidality is not specific to any one type of antidepressant and may therefore be largely a manifestation of the natural course of the illness.... There is no evidence that antidepressants such as the selective serotonin reuptake inhibitors, for example, fluoxetine [Prozac], trigger emergent suicidal ideation over and above rates that may be associated with depression and other antidepressants. What is clear is that most patients receive substantial benefit from treatment with this drug and related antidepressants. It is good clinical practice to monitor patients receiving treatment with antidepressants with regard to general clinical progress, and in particular, suicidal ideation and impulses. It is well known that depressed patients who are responding to treatment may occasionally have brief relapses lasting one or two days in which their symptoms may recur. Side effects such as akathisia may be associated with a worsening psychiatric state. Patients should be warned that suicidal ideation may occasionally worsen in the course of treatment, as may overall depression, and that such an event would be reason for immediately contacting their doctor. Applying this standard clinical to all patients would constitute a reasonable safeguard in the event that there are, indeed, a small minority of vulnerable patients who are at risk for emergent suicidal ideation. It should be recognized that such emergent suicidal ideation may be the consequence of the patient’s illness, adverse changes in the life situation, or, perhaps, in a few cases, because of an adverse effect of the antidepressant. At his deposition, Dr. Mann confirmed his personal belief that neuroleptic-induced akathisia (the classic form of akathisia which is associated with antipsychotic medication) is a risk factor for suicidal behavior. Questioned whether SSRI drugs cause akathisia in some patients, he responded: SSRI drugs in some patients cause some kind of feelings of agitation, which may include some motor manifestations. It’s not clear that it’s exactly the same syndrome that you see in people who take antipsychotic medications, which is where akathisia was classically described. There may be an overlap, but it doesn’t appear to be exactly the same type of thing. Dr. Mann also testified that the warning regarding suicide risk, along with the other adverse reaction information provided in the Zoloft package insert, was adequate to inform physicians’ clinical judgments in prescribing Zoloft and that Pfizer’s warnings were entirely consistent with the recommendation in the ACNP paper. Meanwhile, in March of 1991, Eli Lilly had drafted a study protocol on this issue and submitted it to the FDA. In the proposed study, Eli Lilly rejected the classic randomized controlled trial design in favor of a challenge-rechallenge study design to test whether antidepressants trigger emergent suicidal ideation or acts. On June 3, 1992, when no PDAC member agreed that “there is evidence to indicate that a particular drug or drug class poses a greater risk for the emergence and/or intensification of suicidal thoughts and acts and/or other violent behaviors,” the FDA denied the Public Citizen Petition. It accordingly concluded that a change in labeling was not warranted at that time. In 1998, the Textbook of Psychopharma-cology summarized the state of the matter as follows: Several reviews have examined the data relevant to the question of whether antidepressant pharmacotherapy is associated with the emergence of suicidal ideation and behavior. These studies indicate that although suicidal ideation may emerge rarely during antidepressant treatment of depressed patients, these responses occur with essentially all types of antidepressant drugs, and a causal relationship to antidepressant drugs has not been established. In 2000, plaintiffs’ expert, Dr. Morton Silverman, published a book which stated: Shortly after the market introduction of fluoxetine, a small number of case reports (e.g., Teicher, Glod, & Cole, 1990) noted the emergence of suicidal ideation in patients taking fluoxetine. A great deal of publicity in the media surrounded such reports, which hypothesized that fluoxetine may trigger emergent suicidal and homicidal ideation in a small proportion of patients taking this medication. Further study has clarified that there is no ‘increased risk of suicidal acts or emergence of substantial suicidal thoughts’ among depressed patients’ associated with the treatment of fluoxetine (Beasley et al., 1991). The American College of Neuropsychopharmacology Task Force review of suicidal behavior and psychotropic medication concluded that “new generation low-toxicity antidepressants, including SSRIs”, may carry a lower risk for suicide than older TCAs [tricyclic antidepressants]. There is no evidence that antidepressants such as the SSRIs, for example fluoxetine, trigger emergent suicidal ideation over and above rates that may be associated with depression and other antidepressants. What is clear is that most patients receive substantial benefit from treatment with this drug and related antidepressants. (Mann, Goodwin, O’Brien, & Robinson, 1993, p. 182) Other new agents have proven to be valuable additions to the antidepressant armamenta-rium. Sertraline (Zoloft), paroxetine (Paxil), bupropion (Wellbutrin), venlafax-ine (Effexor), nefazadone (Serzone), ci-talopram (Celexa), and mirtazapine (Remeron) appear to be equally effective in the treatment of depression and usually are well tolerated with relatively few side effects. In clinical testing of Zoloft, Pfizer has monitored reports of adverse events to determine whether there are epidemiological signals that Zoloft may cause suicide. Also, shortly after it launched Zoloft, Pfizer formed an internal “Issues Preparedness Committee.” The committee, which met approximately every two weeks in early 1992, examined allegations regarding SSRI drugs and suicide and violence in 1992, and specifically monitored adverse event reports regarding Zoloft and suicide. On a month by month basis, they tracked reports which associated suicidal ideation and attempts with Zoloft therapy, and compared the number of such reports with the rising numbers of Zoloft prescriptions and patients being treated with Zoloft, to assess whether reports of suicidality increased in proportion to the increasing use of Zoloft. As Zoloft prescriptions skyrocketed, reports of suicidal ideation and attempts remained consistently few in number; they did not rise at all, much less in proportion to increasing Zoloft usage. In May 1992, Pfizer again analyzed its clinical database, which by then included more than 3300 patients. Its analysis found a lower incidence of suicide attempts in Zoloft-treated patients (.28%) than in placebo patients (.32%). It also found consistent improvement in measures of suicidal ideation in Zoloft-treated patients. In June 1992, the results of this analysis were published and presented at the Collegium Internationale Neuro Psychopharmnacolo-gicum, an international medical conference. In addition, on June 19,1992, Pfizer assembled a group of leading outside experts to independently review the Zoloft safety databases, examine whether further analysis of existing data might be useful, and discuss options for generating new data. In early 1993 an eight-year-old boy was taking Zoloft in a clinical trial which began on January 21, 1992. Before he enrolled in the trial and began to take Zoloft, he had been clinically depressed, sad and irritable for a period of three years, beginning after his parents’ divorce. He had insomnia at least three times a week and was agitated, fidgety and restless. Just before he began the study, he told his mother, “I would be better off dead.” For the prior two and one-half years, he had been treated with psychotherapy without medication. His mother had a history of depression, and her 19-year-old brother had committed suicide. The child initially responded well to Zoloft. In late February of 1993, however, his behavior and mood remarkably changed — his mother said that he had increased energy, was very irritable and was “looking for a fight.” On February 27, his mother reported that her son had recently put a necktie very tightly around his neck, leaving marks on his neck, and cut his feet with razor blades. The boy was admitted to the hospital and a clinical investigator for Pfizer spoke to the admitting physician by telephone. The investigator made a written note that “[o]ver the phone, it seemed to me as if the patient had become manic on 200 mg of Zoloft.” Pfizer reported this information to the FDA. As of May 28, 1996, Pfizer had applied to the FDA for permission to market Zoloft for treatment of pediatric obsessive compulsive disorder (“OCD”). In that regard, on that date, Pfizer submitted reports which specifically reviewed the incidence of suicide ideation, gestures and attempts among Zoloft patients in adult and pediatric OCD development programs. Pfizer reported that in the adult program, eight of 1,581 patients who were treated with sertraline (0.51%) experienced serious suicide-related events (gestures, attempts or ideation), while three of 426 patients who received placebos (0.7 %) and three of 308 patients who received an active control drug (0.97%) experienced such events. In the pediatric program for patients with OCD but not depression, patients who were in the sertraline group experienced no serious suicide-related events; the placebo group experienced one event. In the pediatric OCD program overall (portions of which did not include placebo control, and which included pediatric patients with depression or both OCD and depression), six out of 220 sertraline patients, all of whom had multiple risk factors for suicidal behavior, reported suicide attempts or ideation. The frequency rate for this group (2.7%) was identical to the rate reported for suicide attempts requiring medical care in a nationwide sample of adolescents unselected for any psychiatric or behavioral problem. On October 10, 1997, the FDA approved Zoloft as safe and effective for treatment of pediatric OCD. Pfizer reported that the rate of suicidal events on Zoloft vs. placebo for children was 2.7:1 — the same as the rate of suicidal events in children who were not being treated for psychiatric or behavioral problems nationwide. In 1998, Pfizer’s Dr. Roger Lane wrote and published an article entitled SSRI-Induced Extrapyramidal Reactions and Akathisia: Implications For Treatment, which was pre-reviewed and approved by Pfizer’s Publications Committee. The article concluded that although no definite association had been estabhshed between SSRI drugs and extrapyramidal side effects (EPS), SSRI drugs “may occasionally induce” such side effects and/or akathisia. Table 3 of the article listed 28 references to akathisia, seven of which purportedly involve a report of akathisia in a patient taking Zoloft. In compiling those references, Dr. Lane employed “the loosest definition of akathisia” in order to include “all case reports .... even case reports where they didn’t actually say ‘akathisia,’ but that may have been construed as constituting what some people define as akathisia.” In July of 1999, at the request of the Irish Medicines Board (“IMB”), Pfizer conducted an analysis of its computer database of adverse events related to “suicide events,” which the analysis defined as actual suicides and suicidal ideation, gestures and attempts. On at least 54 occasions, the clinical investigator and/or internal Pfizer reviewer determined that a suicide was related to Zoloft, or that the cause of the suicide was unknown. After reviewing all 54 cases, Pfizer’s report for the IMB concluded that the events did not demonstrate a causal relationship between Zoloft and suicide. The IMB agreed, and found that the evidence did not warrant additional or different warnings or other regulatory action. Plaintiffs cite the most recent version of the American Psychiatric Association’s Diagnostic and Statistical Manual [DSM-IV-TR], which states that Serotonin-specific reuptake inhibitor antidepressant medications may produce akathisia that appears to be identical in phenomenology and treatment response to Neuroleptic-Induced Acute Akathi-sia.... The subjective distress resulting from akathisia is significant ... [and] may be associated with dysphoria, irritability, aggression, or suicide attempts. This language appears only in Appendix B, however, which lists the provisions that the DSM-IV task Force did not adopt. Plaintiffs’ expert, Dr. David Healy, has attested that some researchers have written that “there are grounds to suspect that some individuals may become suicidal on antidepressants.” Furthermore, he has opined that SSRI-induced akathisia sometimes leads to suicide and, in Matthew’s case, that it triggered his suicide. • Proceedings In This Case On January 24, 2000, plaintiffs filed their amended complaint in this matter. Count I alleges that Pfizer is strictly liable for marketing defects and misrepresentations concerning Zoloft. Count II alleges that Pfizer is liable under common law negligence theories for failure to test and warn about the dangers of Zoloft-induced suicide. In Kansas, product liability claims are governed by the Kansas Products Liability Act (“KPLA”), K.S.A. § 60-3301 et seq. The purpose of the KPLA is “to consolidate all product liability actions, regardless of theory, into one theory of legal liability.” Samarah, 70 F.Supp.2d at 1202; Patton v. Hutchinson Wil-Rich Mfg. Co., 253 Kan. 741, 756, 861 P.2d 1299, 1311 (1993). Under K.S.A. § 60-3302(c), “all legal theories of recovery, e.g., negligence, strict liability, and failure to warn, are to be merged into one legal theory called a ‘product liability claim.’ ” Samarah, 70 F.Supp.2d at 1202; Savina v. Sterling Drug, Inc., 247 Kan. 105, 127, 795 P.2d 915, 931 (1990) (KPLA provisions apply to actions based on strict liability as well as negligence, breach of express or implied warranty, and breach of or failure to discharge duty to warn or instruct). In the pretrial order, plaintiffs allege that Pfizer should have warned of the risks of “akathisia,” “emotional blunting or disinhibition,” “mania, hypomania, psychosis” and “serotonin syndrome,” and .the fact that these physical reactions to Zoloft “can cause some people to react in violent or suicidal ways.” Dr. Donald Marks, plaintiffs’ warnings expert, opines that Pfizer acted in an unreasonable manner by not providing “prominent and adequate warnings about the risks of akathisia and suicide and ... cautioning physicians that [Zoloft] had not been adequately tested or approved for use in children and adolescents.” According to Dr. Marks, Pfizer should have warned that “adverse events, including suicide, suicide ideation, akathi-sia and emotional blunting, ... have been found to occur in [a] small number of patients,” that these symptoms could be due to Zoloft rather than the underlying depression and that they should be treated as such. Dr. Marks admitted, however, that Dr. Healy’s report did not support a conclusion that Pfizer should have warned about or tested for emotional blunting, but he believed Pfizer should have tested for a causal relationship between Zoloft and suicide and suicidal ideation. Analysis I. Defendant Pfizer Inc.’s Motion For Partial Summary Judgement On Plaintiffs’ Claim Of Marketing Defect and Misrepresentations (Count I) (Doc. # 505) Plaintiffs assert that Pfizer “has gone to great lengths to reassure doctors that the violence and suicide problems which they have heard about, mainly with its chief SSRI competitor Prozac, would not occur with Zoloft, and to assuage patient’s concerns over the initial adverse effects which are frequently the harbingers of tragedy” and that this constitutes a misrepresentation of material facts. Pretrial Order (Doc. # 171) at 4. Plaintiffs do not more specifically identify a particular theory of fraudulent misrepresentation, nor do they more specifically explain any alleged so-called “marketing defect” claim. The Court therefore construes Count I as strictly a fraud count and finds that, so construed, the allegations do not satisfy the pleading requirements of Rule 9(b), Fed.R.Civ.P. Moreover, plaintiffs have cited absolutely no evidence of “great lengths” to which Pfizer has resorted to reassure doctors in general — or Dr. Geen-ens in particular — that “violence and suicide problems ... would not occur with Zoloft.” ■ Count I therefore suffers a fatal failure of proof. In seeking summary judgment, Pfizer first argues that plaintiffs cannot show detrimental reliance on any misrepresentation. To sustain an action for fraud or misrepresentation in Kansas, plaintiffs must establish among other things that they reasonably relied and acted on the allegedly false representations to their detriment. See PIK-Civil 3d 127.40 (reasonable reliance required for fraud), 127.43 (reliance required for negligent misrepresentation); Canterbury Ct., Inc., v. Rosenberg, 224 Kan. 493, 503, 582 P.2d 261, 269-70 (1978) (party to whom misrepresentation is made must rely and act upon it to his detriment); Todd v. Wichita Fed. Savings & Loan Assoc., 184 Kan. 492, 494, 337 P.2d 648, 650 (1959) (to secure redress for false representations, plaintiff must show that they were relied upon to his detriment); see also Samarah, 70 F.Supp.2d at 1209 (1999) (no evidence that treating physician relied on representations regarding suitability of medical device for particular use, plaintiff could not establish element of reliance necessary for recovery on claim for fraud). Pfizer notes that the pretrial order contains no allegation that Dr. Geenens relied on fraudulent materials and, indeed, Dr. Geenens has submitted sworn testimony that he did not rely on any marketing materials from Pfizer. Pfizer next claims that even if plaintiffs had evidence of reliance, the “learned intermediary” doctrine means that Pfizer only had a duty to provide information to Dr. Geenens, not plaintiffs. Pfizer asserts that it is entitled to summary judgment because plaintiffs have not alleged or proved that Dr. Geenens, their learned intermediary, relied on any misrepresentations by Pfizer. Plaintiffs respond that (1) they do not need to show reliance because Kansas has adopted a strict liability approach to products liability misrepresentation actions; (2) Kansas could also adopt Section 9 of the “Restatement (Third) of Torts: Products Liability” and hold manufacturers liable for innocent misrepresentations without proof of reliance; (3) the Kansas Supreme Court is likely to find that K.S.A. § 60-8305 has overruled the learned intermediary doctrine; and (4) if plaintiffs are required to prove reliance, they can do so. In support of their claim that they do not need to prove reliance because Kansas has adopted a strict liability approach to products liability misrepresentation actions, plaintiffs cite Hurlbut v. Conoco, 253 Kan. 515, 521, 856 P.2d 1313, 1320 (1993). Specifically, plaintiffs argue that in 1993, the Kansas Supreme Court mentioned strict products liability, particularly with regard to a misrepresentation claim, as a viable form of recovery. In Hurlbut, the Kansas Supreme Court noted that because plaintiff had alleged strict liability, he claimed that he did not need to determine which of two possible causes (only one of which involved defendant’s product) had produced the explosion that precipitated his lawsuit. See id. The trial court overruled defendant’s motion for summary judgment even though plaintiff had not set forth facts or calculations on which his experts relied to prove liability. See id. The case proceeded to trial and after a plaintiffs verdict, defendant appealed the denial of its summary judgment motion. See id. at 518-19, 856 P.2d at 1320. On appeal, however, causation rather than reliance was at issue. Therefore Hurlbut does not stand for the proposition that plaintiffs do not need to show reliance in product liability misrepresentation actions. In arguing that proof of rebanee is not necessary, plaintiffs also rely on Section 9 of the “Restatement (Third) of Torts: Products Liability,” which states that manufacturers could be bable for even innocent misrepresentations of material fact. Pfizer points out that Kansas has not adopted the Third Restatement (or otherwise imposed strict liability for innocent misrepresentations) and that even if it had done so, the Third Restatement requires proof that plaintiffs’ injury was “caused by the misrepresentation.” Citing Dela ney, 268 Kan. at 793, 999 P.2d at 946, plaintiffs argue that if Kansas has not imposed strict liability for innocent misrepresentations, it is only because Kansas favors an even more pro-consumer strict liability stance. In Delaney v. Deere, the Kansas Supreme Court declined to adopt Comment 1 of Section 9 of the Third Restatement because Section 9 would have required Kansas to adopt the reasonable alternative design standard — and an exclusive risk/utility analysis of that reasonable alternative design — to determine whether a subject product is defective. See id. The Kansas Supreme Court decided that in Kansas, “[t]he ultimate determination remains whether the product is defective and dangerous beyond a reasonable consumer’s expectations.” Id. In this case, however, plaintiffs’ argument is unavailing because the Third Restatement requires proof that plaintiffs’ injury was “caused by the misrepresentation,” and the Kansas Supreme Court has noted that “[t]he rebanee element of misrepresentation serves the function of causation in fact: that the misrepresentation causes someone to act or refrain from acting.” Tetuan v. A.H. Robins Co., 241 Kan. 441, 468, 738 P.2d 1210, 1230 (1987) (quoting Restatement (Second) of Torts § 546, Comment B). For plaintiffs to recover for misrepresentation under Kansas law, they must show rebanee. Regarding Pfizer’s learned intermediary argument, that doctrine has been summarized as fobows: Under the learned intermediary doctrine, a prescription drug manufacturer’s duty to warn “is satisfied when the prescribing doctor is informed of a drug’s inherent risks.” Nichols v. Central Merck., Inc., 16 Kan.App.2d 65, 67, 817 P.2d 1131, 1133 (1991). According to the Kansas Supreme Court, the “rule is based upon the theory that the physician acts as a learned intermediary between the drug manufacturer and the patient.” Humes v. Clinton, 246 Kan. 590, 600, 792 P.2d 1032, 1039 (1990). Because “prescription drugs are available only to a physician, it is the physician’s duty to inform himself or herself of the characteristics of the drugs prescribed and to exercise his or her judgment of which drug to administer in bght of the drug’s propensities and the patient’s susceptibilities.” Id. The learned intermediary doctrine abows the manufacturer to “assume a patient places reliance on the physician’s judgment and relieves the manufacturer of a duty to assist the physician in communicating with patients.” Id. at 601, 792 P.2d at 1039. In analyzing whether a warning is sufficiently adequate to inform the treating physician, a court must determine “whether the warning is ‘reasonable under the circumstances.’ ” Id. at 606, 792 P.2d at 1043. Samarah, 70 F.Supp.2d at 1204. In support of their claim that the Kansas Supreme Court is likely to find that K.S.A. § 60-3305 has overruled the learned intermediary doctrine, plaintiffs again cite Delaney, 268 Kan. at 779, 999 P.2d at 938-39. In that case the Kansas Supreme Court declined to apply K.S.A. § 60-3305 to manufacturing and design defect claims because to do so would restrict plaintiffs’ abibties to recover for dangers which are open and obvious. Plaintiffs also cite Green v. Smith & Nephew AHP, Inc., 245 Wis.2d 772, 629 N.W.2d 727, 743 (2001), as evidence of a national trend to re-emphasize consumer expectations in strict liability cases. Plaintiffs’ argument that Kansas has jettisoned the learned intermediary doctrine, or is about to do so, is without merit. Since 1981 — when Section 60-3305 was enacted — Kansas courts have repeatedly applied the learned intermediary rule. See Humes v. Clinton, 246 Kan. 590, 602, 792 P.2d 1032, 1040 (1990); see also Savina, 247 Kan. at 122, 795 P.2d at 928; Johnson v. American Cyanamid Co., 239 Kan. 279, 286, 718 P.2d 1318, 1324 (1986). Federal courts applying Kansas law have done likewise. See, e.g., Ralston v. Smith & Nephew Richards, Inc., 275 F.3d 965, 974 (10th Cir.2001); Wright ex rel. Trust Co. Of Kansas v. Abbott Lab., Inc., 259 F.3d 1226, 1233-34 (10th Cir.2001). Plaintiffs’ final argument is that “[d]e-spite his contrary protestations and affidavit, ... testimony indicates that Dr. Geen-ens, in all likelihood, bought in — hook, line and sinker — to the subliminal Pfizer marketing message.” Plaintiffs’ Misrepresentation Response (Doc. # 516) at 10. In particular, plaintiffs assert that “Pfizer knew that it could influence prescribing physicians specifically about the suicide-causing potential of Zoloft and other SSRI drugs in subtle ways, and that it formulated its marketing plan in a manner which would capitalize on that knowledge.” Id. Plaintiffs have cited no evidence, however, which raises a genuine issue of material fact whether Dr. Geenens relied on subtle and subliminal marketing influences, unknown to even himself, which were fraudulent. Plaintiffs do not cite a single statement or representation which Pfizer arguably knew was false when it was made. Also, Dr. Geenens has unequivocally testified that he did not review any documentation which Pfizer representatives gave him and said that if Pfizer gave him an article, “I will pick it apart ... I’m not interested.” Dr. Geenens evidently knew that Pfizer was trying to influence him and took measures to guard against such influence. Plaintiffs cite no evidence that Dr. Geenens’ testimony in this respect is untruthful; in fact, they admit that he does not read pharmaceutical marketing, advertising or promotional materials provided by any manufacturer or contained in any scientific and medical articles and journals. In the final analysis, because plaintiffs’ position is unsupported by record evidence, it rests on nothing but the hope that a jury may refuse to believe Dr. Geenens. Plaintiffs’ hope that something may turn up at trial, or that the jury will disbelieve Dr. Geen-ens, is insufficient to survive summary judgment. See Thompson v. Hubbard, 257 F.3d 896, 899 (8th Cir.2001) (plaintiffs may not stave off summary judgment armed with only hope that jury might disbelieve witnesses’ testimony); see also Corrugated Paper Products, Inc. v. Longview Fibre Co., 868 F.2d 908, 914 n. 7 (7th Cir.1989) (mere anemic hope that information contradicting deposition testimony would be elicited under cross-examination at trial insufficient to withstand motion for summary judgment); Natrona Serv., Inc. v. Continental Oil Co., 435 F.Supp. 99, 106 (D.Wyo.1977) (where plaintiffs have failed to turn up substantial evidence in support of their theory, and defendants have introduced evidence negating theory, unreasonable to assume trial would provide plaintiffs with any greater opportunity to prove their theory, especially when the most that can be hoped for is to discredit the defendants’ witnesses at trial). In Samarah, the district court stated: ... Dr. Poole’s deposition testimony indicates that, in each case, his decision to use pedicle screws was made after considering the information contained in the relevant medical literature, the factual circumstances underlying each particular patient’s medical condition, and his own medical j