Case: 1:21-op-45032-DAP Doc #: 1 Filed: 03/01/21 1 of 58. PageID #: 1
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`UNITED STATES DISTRICT COURT
`NORTHERN DISTRICT OF OHIO
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`FEATHER RIVER TRIBAL HEALTH, INC.
`and RIVERSIDE-SAN BERNARDINO
`COUNTY INDIAN HEALTH, INC.,
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`
`MDL Member Case No. ______
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`COMPLAINT
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`JURY TRIAL DEMANDED
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`
`Plaintiffs,
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`vs.
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`MCKINSEY & COMPANY, INC.,
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`Defendant.
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`TABLE OF CONTENTS
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`Page
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`E.
`F.
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`INTRODUCTION ................................................................................................... 1
`JURISDICTION AND VENUE .............................................................................. 2
`PARTIES ................................................................................................................. 2
`PLAINTIFF FEATHER RIVER TRIBAL HEALTH, INC. ................................... 2
`PLAINTIFF RIVERSIDE-SAN BERNARDINO COUNTY INDIAN
`HEALTH, INC. ....................................................................................................... 4
`C.
`Defendant ..................................................................................................... 7
`FACTUAL ALLEGATIONS COMMON TO ALL CLAIMS ............................... 8
`A.
`The Corporate Integrity Agreement ............................................................. 8
`B. McKinsey's Role Following the Corporate Integrity Agreement ................ 8
`1.
`The Sacklers seek to divert money to themselves. ............................ 8
`2.
`McKinsey supplied Purdue with Granular Sales and
`Marketing Strategies and Remained Intimately Involved in
`Implementation .................................................................................. 9
`Project Turbocharge ................................................................................... 10
`C.
`D. McKinsey Knew About the Dangers of Opioids and Acted to
`Maximize OxyContin Prescriptions Anyway ............................................ 12
`Purdue's 2020 Guilty Plea and McKinsey's Recent Statement .................. 13
`Impact of Opioid Abuse, Addiction and Diversion on American
`Indians and Alaska Natives ........................................................................ 15
`The Impact of McKinsey’s Work with Opioid Manufacturers on
`Plaintiff FRTH ............................................................................................ 17
`The Impact of McKinsey’s Work with Opioid Manufacturers on
`Plaintiff RSBCIHI ...................................................................................... 21
`Tolling of Statutes of Limitations .............................................................. 24
`1.
`Equitable Estoppel and Fraudulent Concealment ........................... 24
`2.
`McKinsey and Purdue Persisted in The Fraudulent Scheme
`Despite a Guilty Plea and Large Fine ............................................. 25
`FACTUAL ALLEGATIONS PERTAINING TO CLAIMS UNDER THE
`RACKETEER-INFLUENCED AND CORRUPT ORGANIZATIONS
`(RICO) ACT: THE OPIOID MARKETING ENTERPRISE ............................... 26
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`G.
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`H.
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`I.
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`I.
`II.
`III.
`A.
`B.
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`IV.
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`V.
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`TABLE OF CONTENTS
`(continued)
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`Page
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`A.
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`B.
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`The Common Purpose and Scheme of the Opioid Marketing
`Enterprise .................................................................................................... 26
`The Conduct of the Opioid Marketing Enterprise Violated Civil
`RICO .......................................................................................................... 29
`Pattern of Racketeering Activity ................................................................ 31
`C.
`VI. CAUSES OF ACTION .......................................................................................... 35
`A.
`Racketeer Influenced and Corrupt Organizations (RICO) 18 U.S.C. §
`1961, et. seq. ............................................................................................... 35
`Negligence under California Law .............................................................. 44
`B.
`Public Nuisance - Cal. Civ. Code §§ 3479 and 3480 ................................. 45
`C.
`False Advertising Law (Ca. Bus. & Prof. Code § 17500) .......................... 49
`D.
`Unjust Enrichment ...................................................................................... 50
`E.
`Unfair Competition Law (Ca. Bus. & Prof. Code § 17200) ...................... 51
`F.
`VII. PRAYER FOR RELIEF ........................................................................................ 53
`VIII. JURY DEMAND ................................................................................................... 54
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`I.
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`INTRODUCTION
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`1.
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`This case arises from the worst man-made epidemic in modern medical history—
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`the misuse, abuse, and over-prescription of opioids. This crisis arose from the opioid
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`manufacturers’ deliberately deceptive marketing strategy to expand opioid use.
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`2.
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`McKinsey and Company, Inc. ("McKinsey" or "Defendant") played an integral
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`role in creating and deepening the opioid crisis.
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`3.
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`In the years following Purdue Pharma L.P.'s (“Purdue”) 2007 guilty plea for
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`misleadingly marketing OxyContin, McKinsey worked closely with Purdue to dramatically
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`increase OxyContin sales to the benefit of McKinsey, Purdue, and the Sackler family, the
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`wealthy family that has owned and controlled Purdue for decades. McKinsey specifically sought
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`to maximize OxyContin sales by working around the requirements of the Corporate Integrity
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`Agreement that Purdue entered as part of its guilty plea. McKinsey also performed related work
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`for other manufacturers of opioids, including Johnson & Johnson. Through the conduct described
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`in this complaint, McKinsey participated in and helped orchestrate a broad scheme to deceptively
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`market opioids.
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`4.
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`McKinsey knew of the dangers of opioids and of Purdue's prior misconduct, but
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`nonetheless advised Purdue to improperly market and sell OxyContin, supplying granular sales
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`and marketing strategies and remaining intimately involved throughout implementation of those
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`strategies. McKinsey's actions resulted in a surge in sales of OxyContin and other opioids that
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`fueled and prolonged the opioid crisis.
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`5.
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`In a series of agreements, McKinsey has recently settled opioid-related claims
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`with 49 states (including California), the District of Columbia, and five U.S. territories.
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`6.
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`The Plaintiffs are intertribal consortia responsible for providing healthcare
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`services to citizens of their constituent tribes. Native Americans have disproportionately borne
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`the toll of the opioid crisis. Plaintiffs bring suit to hold McKinsey responsible for its role in that
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`crisis, which has posed an existential threat to tribes and tribal communities.
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`II.
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`JURISDICTION AND VENUE
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`7.
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`This Court has subject matter jurisdiction over this action because the Plaintiffs
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`bring a federal cause of action that raises a federal question pursuant to 28 U.S.C. § 1331. The
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`Court also has supplemental jurisdiction over the Plaintiffs’ state law claims pursuant to 28
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`U.S.C. § 1367 because the state law claims are part of the same case or controversy.
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`8.
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`This Court has personal jurisdiction over McKinsey because at all relevant
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`times, McKinsey has purposely availed itself of the privilege of doing business in the State of
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`Ohio and in this District, including by engaging in the business of researching, designing, and
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`implementing marketing and promoting strategies for various opioid manufacturers, including
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`Purdue, in support of their sales and marketing of opioids in Ohio.
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`9.
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`Venue is proper in the United States District Court for the Northern District of
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`Ohio under 28 U.S.C. § 1391(g) and 18 U.S.C. § 1965, and pursuant to paragraph 6(a) of Case
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`Management Order 1, issued by this Court on April 11, 2018 in case number 1:17-CV-2804.
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`Plaintiff hereby asserts that, but for that Order permitting direct filing in this District, Plaintiffs
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`would have filed their cases in the U.S. District Court for the Central District of California
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`because a substantial part of the events or omissions giving rise to this action occurred in
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`California and because the Defendant is subject to the jurisdiction of the United States District
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`Court for the Central District of California.
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`III. PARTIES
`A.
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`Plaintiff Feather River Tribal Health, Inc.
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`10.
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`Feather River Tribal Health, Inc. (“FRTH”) is a Tribal government non-profit
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`Indian health program with its principal place of business in Oroville, California. FRTH was
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`formed in 1993 to address the stark disparities in health care services available to Native
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`American patients and Tribal communities in North-Eastern California. FRTH is a consortium of
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`three sovereign, federally recognized Indian tribes in California: (1) the Tyme Maidu Tribe of
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`the Berry Creek Rancheria; (2) the Mooretown Rancheria, Concow Maidu Tribe; and (3) the
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`Enterprise Rancheria, Estom-Yumeka Maidu Tribe.
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`11.
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`FRTH serves as the Tribal government health agency for its founding consortium
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`tribes. FRTH also serves members of other federally recognized tribes, including Native
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`American patients and their families who reside within its service area and are eligible for
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`FRTH’s services. FRTH’s constituent Tribes’ governing bodies have each authorized FRTH to
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`enter into a Self Governance Compact with the U.S. Secretary of the Department of Health and
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`Human Services as authorized by Title V of the Indian Self Determination Education and
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`Assistance Act (ISDEAA), and enter into a Funding Agreement under the Compact, on their
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`behalf. FRTH’s Compact with the Indian Health Service (“IHS”) confirms that FRTH has “the
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`power to decide how federal programs, services, functions and activities (or portions thereof)
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`shall be funded and carried out from the Indian Health Service to FRTH.”
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`12.
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`FRTH’s Board of Directors is comprised of tribal delegates from each of these
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`consortium tribes. The Board of Directors is comprised of nine members and three alternates
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`who are responsible for overseeing FRTH’s health programs, culturally appropriate services, and
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`quality of health care, including monitoring its funding and grants. Each Tribe appoints three
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`members and an alternate to serve on the board. The consortium tribes and their members rely on
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`FRTH’s health services. FRTH strives to provide culturally appropriate health care to its
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`consortium tribes, incorporating Maidu culture, customs, and traditions into its health care
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`services.
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`13.
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`FRTH provides a wide range of outpatient services to its Native American
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`patients and their families, which ranges from approximately 5,500 to 7,500 eligible patients per
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`year. FRTH provides comprehensive substance abuse and addiction treatment, domestic violence
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`programs, prisoner reentry programs, and mental health programs. FRTH provides patients who
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`suffer both directly and indirectly from alcohol and drug addiction, including opioid addiction,
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`specialized treatment through a portfolio of services. In addition to outpatient services, FRTH
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`contracts with third parties for inpatient rehabilitation programs, straining its limited
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`purchased/referred care dollars and diverting resources and funding away from other programs to
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`fight the opioid epidemic. FRTH provides these services to patients of all ages.
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`14.
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`The opioid epidemic has burdened FRTH with patients and their families who
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`require expanded patient services to treat and support opioid-related health, wellness and mental
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`health issues. These critical services often go unpaid and, in providing them, FRTH has
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`consequently incurred a considerable accumulation of unreimbursed costs. Additionally, FRTH
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`has incurred substantial costs fighting this epidemic by hiring additional staff and providers, as
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`well as providing pain management training and education to its staff and providers. With its
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`limited resources, FRTH has been forced to divert funds away from other priorities.
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`15.
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`FRTH directly and foreseeably sustained all economic damages alleged herein.
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`McKinsey’s conduct has exacted a financial burden for which FRTH seeks relief. These damages
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`have been suffered and continue to be suffered directly by FRTH.
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`16.
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`FRTH also seeks its future costs it will incur in caring for its patients as the
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`epidemic created by McKinsey’s wrongful and/or unlawful conduct continues.
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`B.
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`17.
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`Plaintiff Riverside-San Bernardino County Indian Health, Inc.
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`Riverside-San Bernardino County Indian Health, Inc. (“RSBCIHI”) is a Tribal
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`government Indian health program founded and operated by a consortium of federally
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`recognized, sovereign Indian tribes in California. RSBCIHI was originally formed in 1968 to
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`address the stark disparity in health care services available to Native Americans in Southern
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`California, and to provide culturally appropriate, high quality health care services to the under-
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`resourced and under-served Tribal members of the founding tribes.
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`18.
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`RSBCIHI is a consortium of nine tribes located throughout Riverside and San-
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`Bernardino Counties. The governing body of each consortium member tribe has duly authorized
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`RSBCIHI to enter into a Self-Governance Compact with the U.S. Secretary of the Department of
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`Health and Human Services, as authorized by Title V of the Indian Self Determination Education
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`and Assistance Act (“ISDEAA”), and into Funding Agreements under the Compact, on their
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`behalf. RSBCIHI provides delegated government health care on behalf of its consortium tribes
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`pursuant to its compact with the Indian Health Services (“IHS”) under federal law.
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`19.
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`RSBCIHI receives the majority of its funding from IHS. RSBCIHI’s Compact
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`with IHS transfers to RSBCIHI “the power to decide how federal programs, services, functions
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`and activities (or portions thereof) shall be funded and carried out from the Indian Health Service
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`to RSBCIHI.” RSBCIHI is the Tribal governmental health agency for its founding consortium
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`tribes. RSBCIHI is now incorporated as a non-profit Tribal consortium health program with eight
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`Indian Health Clinic locations both on and off Indian reservations throughout Riverside and San
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`Bernardino counties.
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`20.
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`RSBCIHI provides a wide range of outpatient services at each of its eight Indian
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`Health Clinic locations to approximately 17,500 Tribal member patients and their families. Some
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`of these tribal members are members of other federally-recognized Indian tribes throughout the
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`United States who are eligible for RSBCIHI’s services because they reside in the “two county”
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`service area of Riverside or San Bernardino County. RSBCIHI provides comprehensive
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`substance abuse and addiction treatment, domestic violence treatment and prevention, and
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`mental health programs. RSBCIHI provides patients who suffer both directly and indirectly from
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`alcohol and drug addiction specialized treatment through a portfolio of services, including its
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`Tribal Opioids Program. RSBCIHI provides these services to patients of all ages.
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`21.
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`RSBCIHI also contracts for needed in-patient and specialty care services,
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`including detoxification, inpatient rehabilitation, and specialty outpatient services, with third
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`party providers. The opioid epidemic has increased the demand for RSBCIHI’s substance abuse,
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`mental health, and specialty services. These services, especially costly in-patient detoxification,
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`rehabilitation and after-care programs, strain RSBCIHI’s limited funds for such expensive
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`services. In providing them, RSBCIHI has consequently reprioritized health care services in
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`other areas, and redirected already inadequate funds for ambulatory care to address the
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`consequences of opiate addiction.
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`22.
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`RSBCIHI provides culturally appropriate healthcare services for members of the
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`nine sovereign Native American tribes that oversee and operate RSBCIHI, including: (1) Agua-
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`Caliente Band Of Cahuilla Indians; (2) Pechanga Band Of Luiseño Mission Indians; (3) Ramona
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`Band Of Cahuilla Indians; (4) Cahuilla Band Of Indians; (5) Soboba Band Of Luiseño Indians;
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`(6) Morongo Band Of Mission Indians; (7) Santa Rosa Band Of Cahuilla Indians; (8) San
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`Manuel Band Of Mission Indians; and (9) Torres-Martinez Desert Cahuilla Indians.
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`23.
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`RSBCIHI’s Board of Directors is comprised of tribal leaders from each of these
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`nine tribes. The Board of Directors is responsible for overseeing all of RSBCIHI’s Indian Health
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`Clinic locations, programs, quality of care, culturally appropriate services, funding, and grants.
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`Under the Board’s leadership, RSBCIHI has implemented new policies and procedures to
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`address and monitor the opioid crisis, including: pain management agreements; providing
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`training; additional policies to monitor and address opioid prescription “shopping”; and the
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`addition of staff, providers, programs, and services for its patients. The Board has authorized
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`RSBCIHI to incur these additional, substantial costs to combat this epidemic. The Board has
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`further prioritized an expansion of RSBCIHI’s internal Behavioral Health staffing capacity by
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`hiring an additional psychiatrist, psychologist, licensed clinical social worker, medical assistant,
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`and pain management/addiction specialist. The Board has further authorized the hiring of
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`additional Behavioral Health staff to coordinate patient care and referrals between its Medical
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`and Behavioral Health Services Departments, ensuring that patients are seamlessly referred to
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`Behavioral Health as needed.
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`24.
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`RSBCIHI directly and foreseeably sustained all economic damages alleged
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`herein. McKinsey’s conduct has exacted a financial burden for which RSBCIHI seeks relief.
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`These damages have been suffered and continue to be suffered directly by RSBCIHI. With its
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`limited resources, RSBCIHI has been forced to divert funds away from other priorities.
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`25.
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`RSBCIHI also seeks its future costs it will incur in caring for its patients as the
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`epidemic created by McKinsey’s wrongful and/or unlawful conduct continues.
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`C.
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`26.
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`Defendant
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`Defendant McKinsey and Company, Inc. is a corporation organized under the laws
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`of the state of New York. McKinsey's principal place of business is located at 711 Third Avenue,
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`New York, NY 10017.
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`27. McKinsey is a worldwide management consultant company. From approximately
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`2004-2019, McKinsey provided consulting services to Purdue Pharma L.P., working to
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`maximize sales of OxyContin and knowingly perpetuating the opioid crisis. McKinsey has
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`provided related consulting services to other manufacturers of opioids.
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`IV. FACTUAL ALLEGATIONS COMMON TO ALL CLAIMS
`A.
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`The Corporate Integrity Agreement
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`28.
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`In May of 2007, Purdue Frederick Company, the parent company of Purdue
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`Pharma L.P. ("Purdue") pleaded guilty to charges for misleading regulators, doctors, and the
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`public regarding Purdue's opioid OxyContin. In pleading guilty, Purdue admitted to falsely
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`marketing OxyContin as a less addictive, safer alternative to other pain medications.
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`29.
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`In the global settlement resolution, Purdue and its parent company paid over $600
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`million and entered into a Corporate Integrity Agreement with the U.S. Department of Health
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`and Human Services Office of Inspector General.
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`30.
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`Under the Corporate Integrity Agreement, for five years, Purdue was required to
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`refrain from making any deceptive or misleading claims about OxyContin and was obligated to
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`submit regular compliance reports regarding its sales and marketing practices. Purdue was also
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`required to monitor, report, and attempt to prevent inappropriate prescribing practices.
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`B. McKinsey's Role Following the Corporate Integrity Agreement
`1.
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`The Sacklers seek to divert money to themselves.
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`31.
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`The Sackler family is among the richest families in the United States. Members of
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`the Sackler family have controlled Purdue at all times relevant to this complaint.
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`32.
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`Following the guilty plea, the Sacklers sought to insulate themselves from the risk
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`they perceived in Purdue. Email threads between the Sacklers in early 2008 indicate that the
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`Sacklers had become concerned about personal liability regarding opioid-related misconduct.
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`33.
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`The Sacklers considered selling Purdue or merging with another pharmaceutical
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`company as an option for limiting their risk. Mortimer Sackler Jr. advocated for a sale or merger
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`in a February 21, 2008 email to Dr. Richard Sackler (a former president and co-chairman of
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`Purdue) and several others, writing "[t]he pharmaceutical industry has become far too volatile
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`and risky for a family to hold 95% of its wealth in. It simply is not prudent for us to stay in the
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`business given the future risks we are sure to face and the impact they will have on the
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`shareholder value of the business and hence the family's wealth." The risk he referred to was, at
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`least in significant part, further liability related to misconduct in the marketing and sale of
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`OxyContin.
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`34.
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`Alternatively, the Sacklers considered extracting as much wealth as possible from
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`Purdue through distributions to themselves as shareholders. Such distributions would allow the
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`Sacklers to diversify their assets and make their wealth less vulnerable to judgments regarding
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`Purdue’s sales and marketing of opioids, including OxyContin.
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`35.
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`Either option -- a sale or significant distributions to shareholders -- would require
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`Purdue to increase profitability in the short term. Purdue turned to McKinsey, with which it had
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`an existing business relationship, for help maximizing sales of OxyContin given the
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`requirements of the Corporate Integrity Agreement and the scrutiny that came along with it.
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`2. McKinsey supplied Purdue with Granular Sales and Marketing
`Strategies and Remained Intimately Involved in Implementation
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`36. McKinsey touts its model of engaging in transformational partnerships with its
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`clients. Rather than giving one-off advice, McKinsey learns each client's business intimately and
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`provides tailored, granular strategies.
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`37. McKinsey had begun collaborating with Purdue by June 2009. McKinsey was
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`tasked with increasing OxyContin sales despite the Corporate Integrity Agreement, which
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`required, among other things, that Purdue comport with FDA requirements and also included
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`increased review and reporting obligations.
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`38. McKinsey provided sales and marketing strategies designed to sell as much
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`OxyContin as possible, at one point in 2010 telling Purdue that the new strategies McKinsey had
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`developed could generate as much as $400,000,000 in additional annual sales. McKinsey worked
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`with Purdue to implement the strategies, with McKinsey’s ongoing and extensive involvement.
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`39.
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`OxyContin sales grew dramatically, and the Sacklers diverted the resulting profits
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`into other holdings.
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`40.
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`In a 2009 report, among other sales strategies, McKinsey advised Purdue sales
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`representatives to push the highest dosages of OxyContin, which were the most profitable for
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`Purdue. In order to maximize dosages and improve targeting of the coordinated marketing
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`strategy, McKinsey investigated the prescribing habits of individual physicians.
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`41. McKinsey helped shape Purdue's OxyContin marketing, which misleadingly
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`centered on freedom and peace of mind for users. The marketing was tailored to avoid running
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`directly afoul of the Corporate Integrity Agreement, but it remained misleading given what
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`Purdue and McKinsey knew about opioids. One advertisement said, "we sell hope in a bottle,"
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`despite the fact that both McKinsey and Purdue already understood the addiction problems
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`associated with opioid use and abuse. McKinsey encouraged Purdue to tell doctors that
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`OxyContin would give their patients "the best possible chance to live a full and active life."
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`42. McKinsey urged Purdue to train and incentivize its sales representatives to
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`increase sales across the market for opioids, even if sales went to Purdue's competitors. This was
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`intended to serve the Sackler family's goal of increasing the marketability of Purdue for potential
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`mergers, but it had the effect of worsening the opioid crisis even beyond the portion of the crisis
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`directly attributable to sales and use of OxyContin.
`
`C.
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`43.
`
`Project Turbocharge
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`The Corporate Integrity Agreement expired in 2012. With this restriction lifted,
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`McKinsey devised additional marketing and sales strategies for Purdue to further increase
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`OxyContin sales.
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`44.
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`In the second half of 2013, McKinsey made recommendations to Purdue to
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`increase OxyContin revenue, including "Turbocharging Purdue's Sales Engine."
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`45. McKinsey's “Project Turbocharge” recommendations included revising the
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`existing process for targeting high-prescribing physicians, with a shift from targeting solely on
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`the basis of prescription deciles to considering additional factors. Based on its analysis,
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`McKinsey told Purdue that "[t]here is significant opportunity to slow the decline of OxyContin
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`by calling on more high-value physicians" and that "[t]he revenue upside from sales re-targeting
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`and adherence could be up to $250 million."
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`46.
`
`Also as part of the “Project Turbocharge” recommendations, McKinsey
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`determined and advised Purdue that the top half of prescribing physicians "write on average 25
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`times more scripts per prescriber" than the lower half.
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`47.
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`Despite knowing that then-recently-expired Corporate Integrity Agreement
`
`required Purdue to refrain from improperly incentivizing OxyContin sales, McKinsey also
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`recommended increasing incentive compensation for incremental OxyContin prescriptions,
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`advising Purdue that "[r]evision to incentive comp could better align reps to Purdue's
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`economics."
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`48.
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`At the same time, McKinsey recommended decreasing training by six days a year
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`in order to allow employees more time to make sales calls. Meanwhile, McKinsey advised
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`Purdue to exercise closer control over its sales staff in order to generate more efficient physician
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`targeting.
`
`49.
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`Physician targeting proved effective. McKinsey advised Purdue that visiting high-
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`prescribing doctors many times per year increased sales.
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`50. McKinsey recommended that Purdue circumvent pharmacies entirely with a mail
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`order program because enforcement by federal regulators was decreasing OxyContin dispensing
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`through Walgreens.
`
`51.
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`At the board level, McKinsey urged the Sacklers to impose a
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`"revenue growth goal" on management.
`
`52. With McKinsey’s ongoing involvement and advice, Purdue implemented
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`McKinsey's recommendations discussed above, but rebranded the program from Project
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`Turbocharge to Evolve to Excellence.
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`53. McKinsey's efforts had the effect the Sacklers had asked McKinsey to achieve.
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`Sales of OxyContin tripled in the years following the 2007 guilty plea, despite the restrictions
`
`imposed by the Corporate Integrity Agreement. According to the U.S. Department of Justice,
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`"[f]rom 2010 to 2018, Purdue's profits were almost entirely driven by its success in selling
`
`OxyContin."
`
`54.
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`The Sacklers did not sell Purdue or enter into a merger, but their goal of
`
`extracting wealth from the business was realized. The Sackler family has withdrawn over $10
`
`billion from Purdue since 2008, including $1.7 billion in 2009 alone. These distributions were
`
`made possible by McKinsey's services and came at the expense of a deepening national opioid
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`crisis.
`
`D. McKinsey Knew About the Dangers of Opioids and Acted to Maximize
`OxyContin Prescriptions Anyway
`
`55. McKinsey has a long history of consulting in the pharmaceutical industry. In
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`addition to its work with Purdue, McKinsey has performed "opioid-related work" for Johnson &
`
`Johnson, Endo International, and Mallinckrodt Pharmaceuticals. For instance, a McKinsey
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`PowerPoint presentation prepared for Johnson & Johnson recommended that Johnson & Johnson
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`aggressively target and influence doctors treating back pain in order to increase opioid sales.
`
`56.
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`Purdue’s 2007 guilty plea put McKinsey on notice of Purdue’s misconduct. By
`
`that time, McKinsey had access to public information indicating that OxyContin and other
`
`opioids pose significant risk of addiction and misuse.
`
`57. McKinsey's presentations to Purdue in 2013 included extensive discussion of
`
`doctors' concerns about opioid misuse and side effects, demonstrating McKinsey's awareness of
`
`the dangers of opioids. Rather than working to limit these disastrous effects, McKinsey treated
`
`doctors' misgivings as obstacles to confront with new messaging.
`
`58. McKinsey continued working with Purdue long after the severity of the opioid
`
`crisis was well known. In 2017, McKinsey proposed that Purdue pay CVS and other distributors
`
`of OxyContin rebates "for every OxyContin overdose attributable to pills they sold."
`
`59.
`
`A former McKinsey consultant described McKinsey's work with Purdue as "the
`
`banality of evil, M.B.A. edition...They knew what was going on. And they found a way to look
`
`past it, through it, around it, so as to answer the only questions they cared about: how to make
`
`the client money, and when the walls closed in, how to protect themselves."
`
`60.
`
`In a 2018 email thread, apparently fearing consequences for McKinsey's work
`
`with Purdue, two McKinsey senior partners who had participated in McKinsey’s work advising
`
`Purdue discussed deleting documents related to opioids.
`
`E.
`
`61.
`
`Purdue's 2020 Guilty Plea and McKinsey's Recent Statement
`
`In October of 2020, Purdue once again reached an agreement (the "2020
`
`Settlement Agreement") with the U.S. Department of Justice to enter a guilty plea related to its
`
`marketing of OxyContin. The agreement includes $8.3 billion in penalties from Purdue and $225
`
`million from the Sackler family.
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`62.
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`In the 2020 Settlement Agreement, Purdue pleaded guilty to defrauding health
`
`agencies, violating anti-kickback laws, paying illegal kickbacks to doctors, and "using aggressive
`
`marketing tactics to convince doctors to unnecessarily prescribe opioids--frivolous prescriptions
`
`that experts say helped fuel a drug addiction crisis that has ravaged America for decades."
`
`63.
`
`The 2020 Settlement Agreement was entered by Purdue and the United States
`
`government. It explicitly states that it does not release Purdue of "[a]ny liability for claims of the
`
`states or Indian tribes."
`
`64.
`
`The 2020 Settlement Agreement includes a provision specifically reserving
`
`claims regarding "[a]ny liability of entities other than the [Purdue Bankruptcy] Debtors,
`
`including consultants."
`
`65.
`
`On December 5, 2020, McKinsey issued the following statement regarding its
`
`work with Purdue:
`
`December 5, 2020—As we look back at our client service during the
`opioid crisis, we recognize that we did not adequately acknowledge the
`epidemic unfolding in our communities or the terrible impact of opioid
`m