The rulings come after the firsttrial in the nation over the opioid crisis ended last week with a$572 million judgment against Johnson & Johnson..

A federal judge has refused to toss claims that a hostof pharmaceutical companies caused the opioid crisis.

U.S. District Judge Dan Polster of the Northern District of Ohioissued the order, along with several others, Tuesday,in preparation for the first federal trial in the nation, scheduledfor Oct. 21 in Cleveland. The orders are among numerous summary judgment rulings the judge has issuedahead of the trial, in which a jury must decide a case brought bytwo Ohio counties against more than adozen opioid companies, including Johnson & Johnson,Purdue Pharma and McKesson Corp.

The rulings are a setback for manufacturers, distributors andpharmacies, which sought to toss the claims ahead of trial. Theyalso could influence the outcome of nearly 2,000 other lawsuits inthe multidistrict litigation brought by cities and counties overthe opioid crisis.

Related: Purdue proposes $11.5B opioidsettlement

"Based on this evidence, a jury could reasonably conclude thatthe increases in prescription opioids proximately caused harm toplaintiffs," wrote Polster in his order denying motions for summaryjudgment on causation, a key defense for the opioid companies."Because plaintiffs have presented evidence that shows they havesuffered the sort of injury that would be an expected consequenceof the alleged wrongful conduct, plaintiffs have made a sufficientshowing to withstand summary judgment on this issue."

He also denied motions for summary judgment on federalpreemption, another defense, and refused to toss civil conspiracyclaims. Other claims over which he has yet to rule include publicnuisance and violations of the U.S. Racketeer Influenced andCorrupt Organizations, or RICO.

Lead plaintiffs counsel Paul Farrell of Greene, Ketchum,Farrell, Bailey & Tweel; Paul Hanly of Simmons Hanly Conroy;and Paul Hanly of Simmons Hanly Conroysaid in an emailedstatement: "We are pleased that Judge Polster's reasonedopinions have almost uniformly agreed with plaintiffs' positions onthe appropriate legal standards to be applied in these cases andthat the court has denied nearly all of defendants' motions forsummary judgment and for exclusion of testimony."

Most of the defendants did not respond to requests for comment.Representatives from Purdue and McKesson declined to comment, asdid Brien O'Connor of Ropes & Gray, who represents anothermanufacturer, Mallinckrodt Pharmaceuticals.

Sabrina Strong of O'Melveny & Myers speaking for Johnson& Johnson and its subsidiary, Janssen Pharmaceuticals, wrote ina statement, "Janssen's medicines play a unique role in the livesof those who need them, and the company responsibly marketedDuragesic, Nucynta and Nucynta ER, which since launch haveaccounted for less than 1% of total opioid prescriptions in theUnited States. Preparations continue for upcoming proceedings inthe MDL."

The rulings come after the first trial in the nation over theopioid crisis ended last week with a $572 million judgment against Johnson &Johnson. That trial, in a case brought by Oklahoma Attorney GeneralMike Hunter, was before a judge and involved a single claim ofpublic nuisance.

Another attorney general, Dave Yost, who has brought two caseson behalf of the state of Ohio over the opioid crisis, petitioned the U.S. Court of Appeals for theSixth Circuit on Friday to halt next month's trial in Cleveland. Heraised concerns that a potential settlement or verdict forthe Ohio counties would lead to misallocation of funds and hamperthe state's case.

In the federal trial in multidistrict litigation,Polster refused to dismiss claims last year.

In Polster's causation order, which affects all the claims, themanufacturers had argued that their alleged fraudulent marketing ofthe drugs did not result in increased opioid prescriptions, butplaintiffs countered with evidence of a substantial increase in thesupply.

"Construing this evidence in the light most favorable toplaintiffs, a factfinder could easily conclude the manufacturer'smisleading marketing activities resulted in a substantial increasein the supply of prescription opioids," Polster wrote.

As to the distributors, the distributors and pharmacieshad argued that the acts of others, such as criminals involved inopiate narcotics and doctors making illegal prescriptions, harmedthe Ohio counties—not their alleged failures to report suspiciousorders under the federal Controlled Substances Act.

Polster, however, wrote that a jury could find that"massive increases" in prescription opioids in both counties, andevidence of "a complete failure by the distributors and pharmaciesto maintain effective controls against diversion" could bea "substantial factor in producing the alleged harmsuffered by plaintiffs."

In his preemption order, Polster relied on his previousdecisions in refusing to grant motions by four separate groups ofdefendants, including manufacturers, distributors andpharmacies.

"The court has previously rejected manufacturers' narrowconstruction of plaintiffs' allegations as effectively demandingnothing more than label changes, and does so again," he wrote.

Addressing another judge's summary judgment decision that tossedthe state of North Dakota's entire opioid case against Purdue,Polster found the May 10 ruling to be, "by leaps and bounds, anoutlier on the question of preemption." In a footnote, he citedcontrary preemption holdings by judges in cases brought by thestate of Ohio, New Jersey, New Hampshire and Washington.

On the civil conspiracy claim, Polster found that plaintiffs'evidence of coordinated marketing strategies, timing of opioidorders and involvement in trade organizations should go before ajury.

"The court cannot conclude that no reasonable jury could findfor plaintiffs on the question of whether the manufacturerdefendants entered into a conspiratorial agreement or maliciouscombination," he wrote. As to the distributors, he wrote, "Areasonable jury could review the record evidence and find thatdistributor defendants shared a general conspiratorial objective,with themselves and with other defendants, to expand the opioidmarket and disregard regulatory obligations in order to achievethat goal."

Read more: 

• Lawyers in opioid suit seek nationwide classcertification
• New lawsuit unveils scope of Purdue's'extraordinary efforts' to push opioids
• Opioid manufacturers: A publicnuisance?