In 2018, the world’s attention was riveted in a courtroom in San Francisco, CA, where a landmark case, Johnson v. Monsanto, was heading to trial. The plaintiff, a school groundskeeper, had developed non-Hodgkin lymphoma after repeated use of a Roundup product in performing his job. Roundup is the world’s most widely used weed killer and its manufacturer, Monsanto, had spent decades declaring their product safe. Johnson’s lawsuit, expedited to accommodate his illness, was the first of many, and the combined cases filed against Monsanto would become one of the largest product liability lawsuits in U.S. history. Now, Dr. Chadi Nabhan, a cancer specialist who testified in the first three trials, including the Johnson case, has written the only book by an expert witness to these historic cases. TOXIC EXPOSURE: The True Story Behind the Monsanto Trials and the Search for Justice, takes readers behind-the-scenes of these blockbuster lawsuits – where life, death, and billions of dollars hung in the balance.
Dr. Nabhan spoke with DocWire News about his new book, and his important role in these trials of paramount importance.
TOXIC EXPOSURE: The True Story Behind the Monsanto Trials and the Search for Justice, was published by Johns Hopkins University Press, and is now available wherever books are sold.
DocWire News: Dr. Nabhan, please provide our audience with some background on yourself, and your specialty.
Dr. Chadi Nabhan: I am a hematologist and a medical oncologist. I specialize in taking care of patients with cancer with specific focus on non-Hodgkin’s Lymphoma. I practice in academia for many years, and then subsequently I left to Cardinal Health where I was Chief Medical Officer of Cardinal Health Specialty Solutions. Currently, I am the chairman of the Precision Oncology Alliance. It’s a large research network at Caris Life Sciences. In addition to this, I’m a podcaster. I have my own podcast, the Healthcare Unfiltered Podcast. I tackle many healthcare topics and I try to write about healthcare events as well as other happening things in the healthcare ecosystem.
Take us back to the Monsanto Trials – what prompted these massive lawsuits?
So just to level set for your viewers, Monsanto basically patented glyphosate, which is an herbicide, and it is the main ingredient in Roundup. Roundup is the most widely used herbicide in the world. And the first commercial use of Roundup was actually in 1974, and folks were just spraying it to kill weeds. It’s a weed killer. And in the mid-nineties, Roundup Ready Seeds became very popular. These are GMOs, genetically modified organisms where the seeds have been actually modified to be able to resist Roundup. So suddenly the farmers are able to actually spray and it doesn’t really affect the seeds and they’re able to harvest without any problems with that. The use of Roundup exploded and there has been some concerns about Roundup impact on the environment and on the development of cancer. But the EPA, the Environmental Protection Agency have changed their positions.
They initially thought it was possibly carcinogenic and then they said it’s safe and there are no issues. In March 2015, the IARC, which is the International Agency of Research on Cancer, it’s a division of the WHO, the World Health Organization, did a study and they published that. They actually looked at all of the epidemiological studies in humans, as well as animal studies, and mechanistic studies. And they determined that glyphosate, the compound we talked about is probably a human carcinogen, so it probably could cause cancer. And a lot of the studies that showed that association and linkage were in non-Hodgkin lymphoma. That led to a lot of lawsuits from patients who were diagnosed with non-Hodgkin lymphoma who sprayed Roundup. And they sued Monsanto because they were not aware. And they said, “You never told us that this could actually cause non-Hodgkin lymphoma or cancer, and we must have known.” So there were these lawsuits, and the first lawsuit was Johnson against Monsanto. In the summer of 2018, I was retained by the lawyers who were defending the patients as an expert witness and testified on behalf of the patients in the first three Roundup litigation trials. But that’s the background why these trials occurred, because we found evidence that it could ’cause non-Hodgkin lymphoma. Monsanto asserted that it’s safe, even some reports that you can drink it like water, there are no issues whatsoever. And that clash between those two opinions was litigated in court.
Take us back to the Monsanto Trials – what prompted these massive lawsuits?
Yeah, I mean, look, I never testified as an expert witness. I never knew or thought I was going to be an expert witness, but I agreed to help patients because after reviewing the evidence and doing the research, I became convinced that Roundup is linked and associated with the development of non-Hodgkin lymphoma in some patients. So the first trial was Johnson against Monsanto, and I explained to the jury the evidence and what happened in Johnson’s case who actually sprayed a lot of Roundup. He was a groundskeeper in California and he won his case against Monsanto. The second trial was Hardman against Monsanto and he also won. And the third trial was the Pilliod’s against Monsanto were two elderly couple who lived together. They were married and they both developed non-Hodgkin lymphoma and they also won. And the last trial, it was won by a record verdict of $2 billion, $1 billion per plaintiff.
What were the biggest challenges you faced in going up against Monsanto’s legal team?
I think that none of us, in my opinion, is prepared to be in a courtroom. Some of the challenge was really a personal challenge. I mean, I was nervous, I was scared. This was a new environment for me. I always contrasted this to throwing a patient, to throwing a person in a large hospital and a healthcare system. You feel lost. I mean, the hospital and the healthcare system is very large and people get intimidated, but to me it was like home. Being in a hospital is like being at home. Well, for lawyers and for judges, the courtroom is like home.
And for me, it was a very foreign environment. I had to overcome how scared I was. I had to overcome how intimidated I was by the scene. I also had no idea what to expect. I knew from reading a lot of things about these type of lawsuits that the first thing that they will do is to try to discredit me, and you have to overcome that because being discredited on the stand in front of the entire world, in front of the jury and in a trial where a lot of people are watching is very, very challenging. And you have to defend yourself and try to establish credibility to the jury. Ultimately the jury, they have to decide. And making sure that you really overlook some of the nuances of how the lawyers of Monsanto are trying to insinuate that you are not credible, that you’re doing this just for the money, that you’ve never really had this opinion, versus trying to understand how science evolves.
So I think these work challenges on a personal level as well as in the courtroom, and really not knowing what to expect, what they’re going to throw at you. A lot of these litigation trials, there’s an element of surprise they ask you, well read this paper, take a look at this study that you did not were not aware of, and things like that. It’s like a very foreign concept to me. So I didn’t know what to expect. Being afraid of what might happen is really critical.
And lastly, I would say I was very afraid of failing the patient. Ultimately, I realized that lawsuits are never won because of one individual effort. It’s always a team effort. I played a small role. There were many people who are way smarter than me and brilliant who testified on behalf of the patients. But I did have a role and I realized that you win as a team and you lose as a team. But I did feel that if we lose, it’s going to be because of me. And I was very worried about failing the patient and disappointing the patients.
Do you feel your testimony had an impact?
Well, I hope it does. It did. I think that, so I was the only medical oncologist. There were other specialists that were there. There was Dr. Weisenberger, who’s a hematopathologist and a pathologist. There was Dr. Beoteritz who’s an epidemiologist. There were toxicologists, there were other folks, but I was the medical oncologist. My role was to bring this to the jury that in this particular condition in this particular patient, the exposure and the heavy exposure to Roundup led to the development of non-Hodgkin lymphoma. So I did play a role. I did play a positive role. I was able to simplify things to patients in a very complicated environment and a very complex trial. And I explained why in these specific patients, these are case specific causation in these specific patients. The development of non-Hodgkin lymphoma was because of the exposure to Roundup. And I hope that the verdicts and the fact that patients won these three trials are an example or an illustration of the fact that I played a positive role and had a positive impact, stood with the other expert witnesses.
Talk to us about your book, Toxic Exposure: The True Story Behind the Monsanto Trials and the Search for Justice. What prompted you to write the book, how long did it take to complete, and what are the most salient points of the book you wish to highlight?
I’ve wanted to do this because I felt there’s a lot of things I wanted to share with the public, and I think it’s important. I recall in one of the trials, it was the Hardman trial, the second trial, I was on the stand. And one of the things that the opposing council that the lawyer from Monsanto challenged me on the stand, and he said, “Well, Dr. Nabhan you’ve never said to anybody ever in hospitals, for fellows, for trainees that Roundup causes non-Hodgkin lymphoma.” I actually did not know that I could do that, because I thought, as an expert witness, you shouldn’t do that. And the minute he said that, I told him, I said, “Well, I wasn’t aware I could do that, but now that you told me I will.” And I never forgot that time, I never forgot that particular moment on the stand.
And I really wanted to write a book and tell people about what actually happened. One, they need to know, people need to have a choice in making a decision about their actions. We all know smoking causes cancer, but if you want to smoke, you can smoke, but you understand the risks. So that’s really what we want. We want to give people a choice. I wanted to write the book because I wanted to make sure that everybody knows what happened to these patients for these patients. And hopefully it becomes a reference for folks who are interested in the environment, in pollution, in hazards, in Roundup, in farming. And they really understand how sometimes the little guys, the patients are able to stand up to the big guys, the corporate guys, and win at the end. That’s really the goal. So I enjoyed the process. It took me a lot of hours, and weeks, and days. And finally, I’m happy to say it’s going to be out. And Johns Hopkin’s University Press is my publisher. They endorsed the book, they stood behind it, and I’m very grateful for that.
Where can readers go to purchase your book?
The book is available in any bookstore outlet that folks consume books. They can go to Amazon.com and they put in the search button “Toxic Exposure Nabhan” and they will see it. They can go to Barnes and Noble, they can go to my publisher’s website, Johns Hopkin’s University Press, and they can also get it. It’s available in hard cover. It’s going to be available audiobook. I actually narrated the book, and I’m proud of this because I’m proud of narrating every single word I wrote. It’s going to be available also on Kindle, but any place that folks consume books, they can actually go and order it. And I hope they really learn something new that they were not aware of. I literally described everything that has happened from the day I was called in the spring of 2016 by the Miller Firm, a law firm in Virginia that retained me in the beginning until the 2019 when the last trial completed.
Any closing thoughts?
I really appreciate your interest and I hope that your viewers and listeners have something useful in the book, and I look forward to feedback. I would love to know what they think.
Chadi Nabhan, MD, MBA, is a board-certified hematologist and a medical oncologist who practiced oncology and treated lymphoma patients for years. He has over 300 peer-reviewed papers, abstracts, and book chapters. He has worked in diverse health care settings and is the creator and host of the Healthcare Unfiltered podcast.