For your delectation and delight, desultory dicta on the law of delicts.

The Webb of Unsophistication in Products Liability Law

May 29th, 2016

The Heart of the Matter

The classic early cases in products liability law were about consumers hurt by consumer products, sold by manufacturers or dealers directly to consumers. The key component of these cases was inequality of bargaining power, of knowledge about latent defects or hazards, and of control over the discovery of latent hazards or defects. American products liability law was created around consumer products.  Just think of Henningsen, Escola, and MacPherson.[1]  These were all consumer products for which the rhetoric about inequality of bargaining, knowledge, and control over design, manufacturing, and latent hazards sometimes makes sense. The paradigmatic model for products liability, however, frequently does not work for the three-way relationship of sales of products to large industrial employers. The model especially does not work when the product is a raw material used throughout a factory, or incorporated into another product.

Many courts have failed to come to grips with the inadequacy of the consumer model for products liability cases in instances of occupational harm to industrial employees.  Courts have been trying to ram this square peg into a round hole since the early asbestos litigation (which perhaps made some sense because there was inequality between Johns Manville and most vendees), but makes no sense when John Manville is itself the purchaser.

The Tangled Webb in California Law

The Webb case received some attention after the California Court of Appeals reversed a trial court’s entry of JNOV for defendant Special Electric on the so-called sophisticated intermediary defense.  SeeCalifornia Supreme Court Set To Untangle Webb” (July 7, 2013); “Big Blue & The Sophisticated User and Intermediary Defenses” (Sept. 27, 2014); G. Jeff Coons, What a Tangled Webb We Weave: Court Imposes Failure to Warn Liability On Supplier to Johns-Manville” (April 2013). Special Electric petition for review, and eventually the California Supreme Court called for full briefing and oral argument in the Webb case.

The wheels of justice grind slowly in California. Special Electric filed its opening brief on the merits, on September 10, 2013. Webb’s widow answered in December 2013, and Special Electric replied in February 2014. Several amici curiae joined the fray in April 2014. Mark A. Behrens filed a brief on behalf of the Coalition for Litigation Justice, Inc., Chamber of Commerce, NFIB Small Business Legal Center, and American Chemistry Council. The Pacific Legal Foundation also filed, as did Elementis Chemicals Inc.

After mulling over the briefs for two years, the California Supreme Court heard argument on March 1, 2016, and then in surprisingly short order, affirmed the intermediate appellate, earlier this week. The Supreme Court’s ruling upheld a Court of Appeal’s decision that reversed a judgment for defendant Special Electric, based upon a jury verdict in favor of William Webb, who was exposed to crocidolite sold by Special Electric, and which caused him to develop mesothelioma in 2011. The Supreme Court’s opinion[2] held that sophisticated intermediary doctrine was a complete legal defense, even potentially for an asbestos supplier, but declined to apply it to the benefit of Special Electric, which had misrepresented facts about crocidolite and offered no evidence that its purchaser was sophisticated about crocidolite asbestos and its unique relationship with mesothelioma. [Slip opinion cited here as Webb.] Webb v. Special Elec. Co., Inc., 2016 BL 163642, Cal., No. S209927, 5/23/16).

The majority opinion[3] fortunately was able to separate the poorly framed and supported defense by Special Electric from the basic tenets of tort law and the sophisticated intermediary defense. To the extent that anyone doubted the validity of the sophisticated intermediary defense, the Webb Court formally adopted the doctrine as the law of California, as set out in the Second and Third Restatements of Tort Law. Webb at 15-16. According to the Court, a defendant may set up sophisticated intermediary doctrine as a complete defense, to failure to warn claims for known or knowable product risks, sounding in negligence or in strict liability, when the defendant supplier:

“(1) provides adequate warnings to the product’s immediate purchaser, or sells to a sophisticated purchaser that it knows is aware or should be aware of the specific danger, and

(2) reasonably relies on the purchaser to convey appropriate warnings to downstream users who will encounter the product.”

Webb at 16 (emphasis in original).[4]

As an affirmative defense, the defendant supplier must carry its burden of showing that it adequately warned the intermediary, or that it knew the intermediary knew or should have known of the specific hazard, and that it reasonably relied upon the purchaser to transmit warnings. Id.

On appeal, the California Supreme Court held that defendant Special Electric failed to preserve its entitlement to the sophisticated intermediary defense because “it never attempted to show that it actually or reasonably relied on Johns-Manville to warn end users. Nor did Special Electric request a jury instruction or verdict form question on the sophisticated intermediary doctrine.” Webb at 23.

Alternatively, on the assumption that Special Electric preserved the defense, the Court held that this defendant failed to establish the defense as a matter of law because:

“[a]lthough the record clearly shows Johns-Manville was aware of the risks of asbestos in general, no evidence established it knew about the particularly acute risks posed by the crocidolite asbestos Special Electric supplied. In addition, plaintiffs presented evidence that at least one Special Electric salesperson told customers crocidolite was safer than other types of asbestos fiber, when the opposite was true.”

Webb at 23.

The Webb Court reviewed the Tort Restatements’ embrace of the sophisticated intermediary defense in both the Second and Third editions.  The Webb Court noted that the Third Restatement demonstrated the continued validity and vitality of the defense, as had been expressed in the Section 388 of the Restatement Second of Torts.[5] The Court noted and followed the Third Restatement’s recitation of guiding considerations for invoking and sustaining the defense:

“There is no general rule as to whether one supplying a product for the use of others through an intermediary has a duty to warn the ultimate product user directly or may rely on the intermediary to relay warnings. The standard is one of reasonableness in the circumstances. Among the factors to be considered are the gravity of the risks posed by the product, the likelihood that the intermediary will convey the information to the ultimate user, and the feasibility and effectiveness of giving a warning directly to the user.”

Webb at 15 (citing Restatement 3d Torts, Products Liability, § 2, com. i, at p. 30.) Citing California precedent, the Webb Court noted that

“[t]he focus of the [sophisticated intermediary] defense . . . is whether the danger in question was so generally known within the trade or profession that a manufacturer should not have been expected to provide a warning specific to the group to which plaintiff belonged.”

Webb at 9-10 (quoting from Johnson v. American Standard, Inc. 43 Cal.4th 56, 72 (2008).  The pertinent legal test is whether a reasonable supplier would have known of the intermediary’s sophistication with respect to the relevant risk. Webb at 20.[6] Of course, the existence of a pervasive regulatory control of risk creation, detection, and mitigation in the workplace would count heavily in this objective test.  “Every person has a right to presume that every other perform his duty and obey the law.” Webb at 21 (internal citation omitted) (emphasis added).

The Restatement factors, however, did not support Special Electric’s invocation of the defense in a case involving:

(1) crocidolite asbestos, one of the most hazardous substances known,

(2) defendant’s affirmative and blatantly false misrepresentations of the relative safety of crocidolite relative to chrysotile asbestos,[7] and

(3) a complete failure of proof that the purchaser, Johns Manville, knew that crocidolite was especially hazardous with respect to the causation of mesothelioma.

Webb at 23-24. Factors one and two were givens for defense counsel, but factor three speaks to unnecessary coyness on the part of the defense.  Showing that Johns Manville was well aware of the extraordinarily great hazard of crocidolite would have been relatively easy to do from past transcripts, articles, speeches, and litigation conduct of the Johns Manville companies. Despite the extreme hazards from uncontrolled asbestos exposures, the Webb case explained that the sophisticated intermediary defense was not per se inapplicable to asbestos cases, and went so far as to disapprove an earlier California Court of Appeals decision that refused to apply the defense in the asbestos personal injury context when no warnings had been given.[8] “Sophistication obviates the need for warnings because a sophisticated purchaser already knows or should know of the relevant risks.” Webb at 17-18.

The Webb case acknowledged that defective design claims against raw material suppliers are incoherent and invalid, whether for the raw material itself, or for downstream design defect claims against for the product with the incorporated raw material. “[A] basic raw material such as sand, gravel, or kerosene cannot be defectively designed.” Webb at 11-12 (quoting from Restatement 3d Torts, Products Liability, § 5, com. c, at p. 134).[9]

The Webb Court also evinced a healthy disrespect for the notion that tort law is only about spreading risk and compensating injured persons. The Court acknowledged that in some instances, there were competing policies of compensating persons injured by products and “encouraging conduct that can feasibly be performed.” Webb at 2. The Court also acknowledged that there were hazards to warning when none was needed or when the absence of a warning would not be a legal cause of harm:

“Because sophisticated users already know, or should know, about the product’s dangers, the manufacturer’s failure to warn is not the legal cause of any harm. A sophisticated user’s knowledge is thus the equivalent of prior notice. The defense serves public policy, because requiring warnings of obvious or generally known product dangers could invite consumer disregard and contempt for warnings in general.”

Webb at 9 (internal citations omitted) (emphasis added). Furthermore, the sophisticated intermediary defense balances the need for the worker-consumer’s safety with “the practical realities of supplying products.” Webb at 17.

The Webb decision puts California in line with the majority rule that recognizes the validity of the sophisticated intermediary defense, and embraces real-world truth that:

“[in] some cases, the buyer’s sophistication can be a substitute for actual warnings, but this limited exception only applies if the buyer was so knowledgeable about the material supplied that it knew or should have known about the particular danger.”

Webb at 17.[10] The Court noted and agreed with the Restatement Third’s observation that imposing liability upon raw material suppliers for failure to warn can be unduly and unfairly burdensome when such liability would require remote suppliers

“to develop expertise regarding a multitude of different end-products and to investigate the actual use of raw materials by manufacturers over whom the supplier has no control.”

Webb at 12 (quoting from Restatement 3d Torts, Products Liability, § 5, com. c, at p. 134).


Chief Justice Tani Gorre Cantil-Sakauye, along with Justice Ming W. Chin, concurred in the result, but dissented from the majority’s rationale as overly broad. The concurring justices insisted that a supplier reasonably relies upon its purchaser only when the purchaser has actual awareness of the product’s risks. Webb concurrence at 4. Even this stingier approach noted that one of the purpose of warnings is

“to enable the consumer or others who might come in contact with the product to choose not to expose themselves to the risks presented.”

Webb Concurrence at 3 (citing Restatement3d Torts, Products Liability, § 2, com. i, at p. 30).  In many sophisticated intermediary contexts involving occupational exposures to fumes, vapors, and dusts, workers (consumers) cannot appreciate whether they might come in contact with the product such that they have actual risks unless the sophisticated intermediary measures its specific workplace exposures, given its actual engineering, administrative, and person protection controls.


The Webb Court failed to address in any meaningful form how Special Electric could discharge a duty to warn Mr. Webb directly, when it sold blue asbestos to Johns-Manville, which then incorporated that fiber, along with other recycled asbestos into transite pipes. To this extent, the Webb decision carries forward the glib belief in efficacy of warnings, without any evidence or critical thought.

It is hard to imagine an industrial purchaser that was unaware of the special hazards of crocidolite by 1970, and yet Special Electric apparently failed to offer evidence on the issue whether Johns-Manville had such awareness. A court might take judicial notice of Johns-Manville sophistication, but there is not even the suggestion that Special Electric attempted to supplement the vacuous record with a request for judicial notice.

If the California Supreme Court’s recitation of the facts of the case is correct, then we are left with an unflattering inference about Special Electric’s trial strategy and execution.  Perhaps Special Electric was coyly trying to avoid a downside outcome in which it was responsible for 99.99% of the verdict because its blue asbestos was by far the most important cause of Mr. Webb’s tragic disease, a disease that would have almost certainly been avoided had never had exposure to blue asbestos. The propensity of crocidolite to cause mesothelioma is orders of magnitude greater than chrysotile, which by itself may not even be a competent cause of the harm suffered by Mr. Webb.

In the final analysis, the Webb Court correctly adopted the sophisticated intermediary principle as an essential limit to tort liability, but denied its benefit to Special Electric.  The sophisticated intermediary doctrine should not, however, be conceived of as an affirmative defense.  The scope of the rule is defined by the rationale for its existence, and the sophisticated intermediary situation lies outside the realm and rationale of protecting, by warning, consumers against latent hazards.  It is time that courts recognize that much litigation brought to its doors is really the result of labor-management issues within the workplace, and not the doings or responsibility of remote suppliers of raw materials.

[1] See, e.g, MacPherson v. Buick Motor Co., 217 N.Y. 382, 111 N.E. 1050 (1916) (holding that privity of contract did not bar suit and that product manufacturers could be liable to consumers for injuries); Henningsen v. Bloomfield Motors, Inc., 32 N.J. 358, 161 A.2d 69 (1960); Escola v. Coca Cola Bottling Co., 24 Cal. 2d 453, 150 P. 2d 436  (1944).

[2] See Steven Sellers, “California Ruling Defines Asbestos Supplier’s Duty to Warn,” BNA Product Safety & Liability Reporter (May 24, 2016).

[3] The majority opinion was written by Associate Justice Carol A. Corrigan, and joined by Associate Justices Kathryn Mickle Werdegar, Goodwin Liu, Mariano-Florentino Cuéllar and Leondra R. Kruger.

[4] See also Webb at 2 (“Under the sophisticated intermediary doctrine, the supplier can discharge this duty if it conveys adequate warnings to the material’s purchaser, or sells to a sufficiently sophisticated purchaser, and reasonably relies on the purchaser to convey adequate warnings to others, including those who encounter the material in a finished product. Reasonable reliance depends on many circumstances, including the degree of risk posed by the material, the likelihood the purchaser will convey warnings, and the feasibility of directly warning end users.”); Webb at 6 (“[T]he sophisticated intermediary doctrine provides that a supplier can discharge its duty to warn if it provides adequate warnings, or sells to a sufficiently sophisticated buyer, and reasonably relies on the buyer to warn end users about the harm.”). Webb at 17 (“If a purchaser is so knowledgeable about a product that it should already be aware of the product’s particular dangers, the seller is not required to give actual warnings telling the buyer what it already knows.”).

[5] See Webb at 15 (“The drafters intended this comment to be substantively the same as section 388, comment n, of the Restatement Second of Torts.”) (citing Restatement 3d Torts, Products Liability, § 2, com. i, reporter’s note 5, at p. 96; Humble Sand & Gravel Inc. v. Gomez, 146 S.W.3d 170, 190 (Tex. 2004). See also Webb at 9 (citing Restatement 2d Torts, § 388 (b), com. k, at pp. 306-307) (“Courts have interpreted section 388, subdivision (b), to mean that if the manufacturer reasonably believes the user will know or should know about a given product’s risk”).

[6] Relevant considerations may include the general dissemination of knowledge of relevant risks, the intermediary’s knowledge of those risks, and the intermediary’s reputation for care. Webb at 20.

[7] Webb at 3, 23.

[8] See Webb at 17-18 (disapproving of the holding in Stewart v. Union Carbide Corp., 190 Cal. App. 4th 23, 29-30 (2010)).

[9] See also Webb at 12 (quoting from Restatement 3d Torts, Products Liability, § 5, com. c, at p. 134) (“Inappropriate decisions regarding the use of such materials are not attributable to the supplier of the raw materials but rather to the fabricator that puts them to improper use.”).

[10] citing approvingly Cimino v. Raymark Industries, Inc., 151 F.3d 297, 334 (5th Cir. 1998) (holding that raw asbestos supplier did not need to warn asbestos product manufacturer Fibreboard, which was “a sophisticated, expert, and knowledgeable manufacturer” of insulation products, about asbestos risks); Higgins v. E.I. DuPont de Nemours & Co., 671 F. Supp. 1055, 1061-1062  (D. Md. 1987) (exculpating supplier when purchaser was a highly sophisticated manufacturer with knowledge from independent sources, as well as its suppliers), aff’d, 863 F.2d 1162 (4th Cir. 1988).

Credible Incredulity

May 19th, 2016

Has skepticism become a victim of political correctness and adversarial zeal?

In the last century, philosopher Bertrand Russell advanced intelligent skepticism against myriad enthusiams and mindless beliefs, political, religious, and pseudo-scientific. Russell saw unwarranted certainty as a serious intellectual offense:

“The fundamental cause of the trouble is that in the modern world the stupid are cocksure while the intelligent are full of doubt.”

Bertrand Russell, “The Triumph of Stupidity” (1933), Mortals and Others: Bertrand Russell’s American Essays, 1931-1935 , at 28 (1998).  When many American intellectuals were still in their love swoon over Stalin, Russell chastised the Soviet dictator for his betrayal of ideals and his enslavement of Eastern European. Stalinism’s certainty about politics and science was not a virtue, but a grave sin.  Or, in Russell’s words:

“One of the painful things about our time is that those who feel certainty are stupid, and those with any imagination and understanding are filled with doubt and indecision.”

Bertrand Russell, New Hopes for a Changing World at 4-5 (1951).

In the 21st century, ideologues of various stripes have tried to silence healthy skepticism and doubt by claiming that their critics have “manufactured doubt.”[1] This aggression against skepticism and doubt, joined with a biased conception of conflicts of interest, have become part of a concerted campaign to privilege tendentious scientific claims from critical scrutiny.

Philosopher Susan Haack, who has aligned herself on occasion with these politicized acolytes of certainty,[2] recently has pushed back, with a reminder that credulity for unwarranted claims, in all walks of life, is unethical.[3]  Haack’s essay is a delightful effort to clarify what credulity is, and to explore why credulity is an epistemologic vice and a social hazard, as well as the implications for citizens and scientists of living in an evidence-based, not a faith-based world.

Drawing inspiration from the the English mathematician and philosopher, William Kingdon Clifford, Haack has adopted one of Clifford’s bon mots as her motto:

“The credulous man is father to the liar and the cheat.”[4]

Indeed! And credulous judges and juries are the parents to specious claims and shyster lawyers.

Clifford’s essay should be required reading for politicians, judges, regulators, and legislators who evaluate the claims of scientist advocates.  Spurning ethical relativism, Clifford identified the key intellectual “sin” in an evidence-based world:

 “It is wrong always, everywhere, and for anyone, to believe anything upon insufficient evidence.”

William K. Clifford, “The Ethics of Belief,” 29 Contemporary Rev. 289, 295 (1877).

Professor Haack should be commended for her fulsome irony for publishing in a journal of one of the world’s more credulous institutions, and for reminding us that credulity is an intellectual vice.

[1] See, e.g., David Michaels, Doubt is Their Product: How Industry’s Assault on Science Threatens Your Health (2008); Naomi Oreskes and Erik M. Conway, Merchants of Doubt: How a Handful of Scientists Obscured the Truth on Issues from Tobacco Smoke to Global Warming (2010).

[2] See, e.g.,Bendectin, Diclegis & The Philosophy of Science” (Oct. 26, 2013).

[3] Susan Haack, “Credulity and Circumspection: Epistemological Character and the Ethics of Belief,” 88 Proc. Am. Catholic Philosophical Assn 27 (2015).

[4] citing and quoting William K. Clifford, “The Ethics of Belief ” (1877), in Leslie Stephen and Sir Frederick Pollock, eds., The Ethics of Belief and Other Essays 70, 77 (London 1947).

Ancient Truths

May 5th, 2016

David Sackett, in some paternity disputes called the “father of evidence-based medicine,” supposedly once claimed that:

“Half of what you’ll learn in medical school will be shown to be either dead wrong or out of date within five years of your graduation; the trouble is that nobody can tell you which half–so the most important thing to learn is how to learn on your own.”

See Ivan Oransky, “So how often does medical consensus turn out to be wrong?Retraction Watch (July 11, 2011). Sackett’s meta-statement was itself certainly not “evidence based,” but his point is well taken. Time ultimately erodes the authority of the truthiest sounding claims to medical knowledge. Sara Teichholtz, “The Differential: Half of What You’re Learning is Wrong,” (Dec. 14, 2013). Only lawyers and theologians would think that a statement in an old document or text, once authenticated, has some claim on us as the “truth.”

The Federal Rules of Evidence provide an exception to the rule against hearsay for statements made in ancient documents, those at least twenty years old. Rule 803(16). In 2015, the Judicial Conference’s Committee on Rules of Practice and Procedure proposed retiring the ancient document hearsay rule.[1] The exception created for documents authenticated as “ancient” (> 20 years old) is so inimical to the truth-finding function of trials, that courts strain to avoid finding the documents “authenticated.” See, e.g., Kalamazoo River Study Group v. Menasha Corp., 228 F.3d 648 (6th Cir. 2000).

The proposal to abolish this dangerous exception to the rule against hearsay has engendered resistance from some quarters over its ability to eliminate otherwise admissible evidence in cases involving long-past events, such as environmental or occupational disease litigation. The resistance, however, is misguided.  The Committee’s proposal would not affect the authenticity presumption of an “ancient document,” and such documents could still be used to show state of mind, intention, motive, or notice. If the asserted statement in the old document is actually true, then there is likely much more recent, robust evidence to support the statement. The rule as it now stands is capable of a great deal of mischief.  The fact that a document has survived intact in a place where one would expect to find it may add to its presumptive authenticity, but in many technical, scientific, and medical contexts, the “ancient” provenance actually makes the content likely to be false. Technical and scientific facts and opinions have changed too quickly to endorse statements simply because of they were written down somewhere, over 20 years ago. SeeTime to Retire Ancient Documents As Hearsay Exception” (Aug. 23, 2015).

Although many in the legal academy have voiced opposition to the proposal[2], one law professor, Daniel Capra, has astutely observed that we will soon have a flood of easily authenticated documents of doubtful veracity, called websites, and other electronic documents, which have reached the age of evidentiary majority. Daniel J. Capra, “Electronically Stored Information and the Ancient Documents Exception to the Hearsay Rule: Fix It Before People Find Out About It,” 17 Yale J.L. & Tech 1 (2015). The truth of a proposition requires more than the lapse of 20 years since some nincompoop wrote it down.

[1] Preliminary Draft of Proposed Amendments to the Federal Rules of Bankruptcy Procedure and the Federal Rules of Evidence (Aug. 2015); See also Debra Cassens Weiss, “Federal judiciary considers dumping ‘ancient documents’ rule,” ABA Journal Online (Aug. 19, 2015).

[2] Peter Nicolas, “Saving an Old Friend From Extinction: A Proposal to Amend Rather Than to Abrogate the Ancient Documents Hearsay Exception,” 63 UCLA L. Rev. Disc. 172 (2015).

The IARC Process is Broken

May 4th, 2016

Last spring, the International Agency for Research on Cancer (IARC) convened a working group that voted to classify the herbicide glyphosate as “probably carcinogenic to humans.” The vote was followed by IARC’s Press Release, a summary in The Lancet,[1] and the publication of a “monograph,” volume 112 in the IARC series.

IARC classifications of a chemical as “probably” carcinogenic to humans are actually fairly meaningless exercises in semantics, not science. A close reading of the IARC Preamble definition of probable reveals that probable does not mean greater than 50%:

“The terms probably carcinogenic and possibly carcinogenic have no quantitative significance and are used simply as descriptors of different levels of evidence of human carcinogenicity, with probably carcinogenic signifying a higher level of evidence than possibly carcinogenic.”

Despite the vacuity of the IARC’s “probability” determinations, IARC decisions have serious real-world consequences in the realm of regulation and litigation. Monsanto, the manufacturer of glyphosate herbicide, reacted strongly, expressing “outrage” and claiming that the IARC had cherry picked data to reach its conclusion. Jack Kaskey, “Monsanto ‘Outraged’ by Assessment That Roundup Probably Causes Cancer,” 43 Product Safety & Liability Reporter 416 (Mar. 30, 2015).

In the wake of the IARC classification, in the fall of 2015, the United States Environmental Protection Agency (EPA) reviewed the evidence for, and against, glysophate’s carcinogenicity. The EPA found that the IARC had deliberately failed to consider studies that did not find associations, and that the complete scientific record did not support a conclusion of human carcinogenicity. EPA Report of the Cancer Assessment Review Committee on Glyphosate (Oct. 1, 2015).

For undisclosed reasons, however, the EPA’s report was never made public until a couple of weeks ago, when it showed up briefly on the agency’s website, only to be pulled down after a day or so. See David Schultz, “EPA Panel Finds Glyphosate Not Likely to Cause Cancer,” Product Safety & Liability Reporter (May 03, 2016). No doubt the present Administration viewed a conflict between EPA and IARC, and disparaging comments about the IARC’s “process” to be national security issues.  At the very least, the Administration would not want to undermine the litigation industry’s reliance upon the IARC cherry-picked report.

All joking aside, the incident highlights the problematic nature of the IARC decision process, and the reliance of regulatory agencies on the apparent authority of IARC determinations. The IARC process is toxic and should be remediated.

[1] Kathryn Z Guyton, Dana Loomis, Yann Grosse, Fatiha El Ghissassi, Lamia Benbrahim-Tallaa, Neela Guha, Chiara Scoccianti, Heidi Mattock, Kurt Straif, on behalf of the International Agency for Research on Cancer Monograph Working Group, IARC, Lyon, France, “Carcinogenicity of tetrachlorvinphos, parathion, malathion, diazinon, and glyphosate,” 16 The Lancet Oncology 490 (2015).



The opinions, statements, and asseverations expressed on Tortini are my own, or those of invited guests, and these writings do not necessarily represent the views of clients, friends, or family, even when supported by good and sufficient reason.