Manufacturers that specialize in metal-on-metal hip implants are struggling with recalls and litigation costs that have stacked so high they’re even making an impact on companies’ bottom lines.

Johnson and Johnson, for example, noted that the hundreds of millions of dollars in legal expenses were a major setback in the first quarter of the year. The company’s DePuy ASR hip system that had been recalled in the previous months resulted in total litigation costs of nearly $1 billion. According to DrugWatch, the biggest issues that led to the higher costs for J&J included metal poisoning, serious patient pain and discomfort and dislocation of the product. 

Once these problems set in, the devices failed much earlier than the manufacturer had intended, which resulted in mandatory recalls that not only came with high legal costs, but tarnished reputations. 

With so many reports of high failure rates for these devices, the public and the U.S. Food and Drug Administration are both questioning the long-term implications of metal-on-metal hip implants in general – including those made by device manufacturers that haven’t yet experienced problems. 

However, companies that focus on the metal testing phase of production can greatly lower the chances of high costs down the road.