California Attorney General Xavier Becerra outside the U.S. Supreme Court in Washington after oral arguments in the consolidated cases "Department of Homeland Security v. Regents of the University of California," on Nov. 11, 2019. Photo by Diego Radzinschi/ALM

In the first verdict to come out of an attorney general's lawsuit over transvaginal mesh devices, a San Diego judge ordered Johnson & Johnson on Thursday to pay nearly $344 million to the state of California.

The 88-page statement of decision by San Diego Superior Court Judge Eddie Sturgeon found that Johnson & Johnson and its subsidiary, Ethicon Inc., misled doctors about the safety of their devices by downplaying the risks through a "combination of false statements, misleading half-truths, and omissions."

He ordered Johnson & Johnson to pay statutory penalties, with a briefing on potential injunctive relief due by Feb. 18.

In his decision, Sturgeon concluded that the "nature and seriousness of the misconduct were grave."

"J&J's deception had real consequences for real people," he wrote. "The court concludes that the nature of the deceptive marketing conduct is egregious and that penalties are warranted to vindicate the public wrong that has been done within the state of California."

California Attorney General Xavier Becerra, in a statement, called the decision groundbreaking.

"Johnson & Johnson intentionally concealed the risks of its pelvic mesh implant devices. It robbed women and their doctors of their ability to make informed decisions about whether to permanently implant the products in patients' bodies," Becerra said. "Johnson & Johnson knew the danger of its mesh products but put profits ahead of the health of millions of women."

A Johnson & Johnson representative did not respond to a request for comment.

California filed its suit in 2016, alleging Johnson & Johnson failed to inform consumers about the risks of its transvaginal mesh devices, used to treat stress urinary incontinence and pelvic organ prolapse in women. The devices have caused urinary problems and recurrent pain, particularly during sex, according to the suit. Johnson & Johnson, which sold more than 30,000 pelvic mesh products in California from 2008 to 2014, is one of several manufacturers of the devices hit by individual lawsuits that, at one time, peaked at nearly 100,000.

Many of those cases have since settled.

Last year, Washington state settled its case against Johnson & Johnson for $9.9 million on the first day of trial, while 41 other states and the District of Columbia reached a $117 million settlement in October.

In California's case, a bench trial began on July 15, with the state asking for $700 million in penalties.

In his statement of decision, the judge leaned on plaintiffs' experts in his ruling rather than on Johnson & Johnson's, some of whom he called biased and "contradicted by the company's own admissions and knowledge regarding their own products," noting that there was "substantial evidence from company documents and testimony confirming the dangerous properties of mesh."

He also emphasized the consistency and length of Johnson & Johnson's wrongdoing.

"J&J persisted in its deceptive conduct for 17 years even in the face of internal and external calls for change, amounting to hundreds of thousands of knowing, illegal statements targeted at California consumers," he wrote.

In awarding the total dollar figure, the judge calculated a specific number of Johnson & Johnson's various marketing efforts in California, such as distribution of product brochures, dinners with doctors and professional education and training events, and multiplied the total by the $2,500 per violation in penalties provided under California's Unfair Competition Law and False Advertising Law.

"J&J engaged in serious, knowing, and willful misconduct over a period of close to twenty years, and likely committed far more violations in California during the statutory period than are captured in those figures," he wrote. "The amount also represents less than 1 percent of J&J's $70.4 billion total net worth and is not unconstitutional excessive or disproportionate."