June 15, 2021

The University of Missouri reportedly agreed to pay $16.2 million to settle several lawsuits earlier this year over a knee surgery procedure developed by an orthopedic surgeon in human medicine and a veterinary surgeon employed at the university’s Mizzou BioJoint Center.

According to news reports, the $16.2 million payout settles personal injury and false advertising claims brought by 22 plaintiffs between 2018 and 2020 against Mizzou BioJoint Center founder James Stannard, MD, and the center’s director of operations and research, Dr. James Cook, the veterinary surgeon.

Kaiser Health News obtained the settlement agreements in March—signed in February—through a public records request, the news agency reported April 21.

The KHN report states that plaintiffs claim they were not informed of the 86% failure rate of the “biological joint restoration” procedure they received at the center. Also marketed as osteochondral allograft transplantation, the surgery involves replacing parts of the knee with cadaver bones or cartilage to treat arthritis or joint damage. The patients received grafts that were stored in the Missouri Osteochondral Preservation System. Dr. Cook, chief of the Orthopaedic Research Division at Mizzou, led a team of scientists who developed the system “using a novel cartilage-preserving solution and specially designed storage conditions that allow osteochondral allografts to be stored for twice as long as traditional storage methods and still maintain necessary cell viability levels,” stated a 2020 press release from the BioJoint Center. According to the KHN report, court documents argued that the surgeries were “unproven” and “experimental” and sometimes led to follow-up procedures and knee replacements.

The lawsuits alleged that Dr. Stannard was negligent for allowing Dr. Cook to perform parts of the surgeries “without appropriate medical direction and supervision,” according to the KHN report. Some plaintiffs claimed they were unaware that Dr. Cook is a veterinarian.

Dr. Cook (Missouri ’94) was a diplomate of the American College of Veterinary Surgeons and charter diplomate of the American College of Veterinary Sports Medicine and Rehabilitation. He earned a doctorate in pathobiology in 1998 from Mizzou, then joined the College of Veterinary Medicine as a clinical instructor in small animal orthopedics. Most recently, he was listed on the Mizzou website as the chair in orthopedic surgery at the Mizzou School of Medicine and director of its Thompson Laboratory for Regenerative Orthopaedics as well as chief of the school’s Orthopaedic Research Division.

The defendants have denied the allegations, and the university admitted neither liability nor negligence on the part of its employees.

In a statement to JAVMA News, a university spokesperson said, “Every healthcare provider on the Mizzou BioJoint Center team is uniquely and specifically qualified to perform his or her role in each patient’s care, including James Cook, who has completed Orthopaedic Technologist and Orthopaedic Technologist-Surgery Certification through the National Board for Certification for Orthopaedic Technologists.” Dr. Cook recently received the 2021 Orthopaedic Research Society’s Marshall R. Urist, MD Award for his work in tissue regeneration research, the spokesperson added.

Correction: An earlier version of this article misstated that Dr. James Cook is a diplomate of the American College of Veterinary Surgeons. As of February 2020, he was not a diplomate.