Zimmer Biomet Holdings, Inc. and the U.S. Department of Justice (DOJ) are going to reach a settlement over Biomet, Inc.’s alleged bribery of state-employed healthcare providers in Argentina, Brazil and China.
Zimmer Biomet to Settle Foreign Bribery Charges

According to a court filing submitted by the DOJ on December 8, 2016, the settlement will be reached in the next four weeks.
Biomet and the DOJ first reached a settlement in 2012 over the allegations. But last June, according to the prosecutors, the company came forward with new allegations of misconduct in Mexico and Brazil. So, this new agreement will replace the old agreement.
Brazilian authorities have been investigating device makers and allegations of bribery over the last couple of years. The investigation and ensuing lawsuits by Brazilian insurers have referred to device companies under investigation as the “Prosthetic Mafia.”
Biomet entered into a 2012 deferred prosecution agreement (DPA) to settle allegations that the company paid bribes to state-employed healthcare providers in Argentina, Brazil and China in order to secure business with hospitals. According to the government, Biomet disguised the alleged bribes in its financial reports as “commissions, ” “consulting fees, ” “royalties” and “scientific incentives.”
As part of the original DPA, Biomet agreed to pay a $17.3 million criminal penalty, along with a $5.4 million civil settlement to the U.S. Securities and Exchange Commission, and to maintain a compliance program to prevent future misconduct.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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