Daisy Bharucha’s family often described her as the rock that held them together – strong, independent and unshakable. Coming from a middle-class family, Daisy had built an impressive career, having worked at top multinational companies. Even at sixty-seven, while many of her age embraced retirement, Daisy was still travelling to her office, proving that her dedication and resilience knew no bounds.
Daisy lived in Dadar, one of Mumbai’s busiest neighbourhoods, and braved the city’s chaotic local trains daily, commuting from Dadar to Bandra Kurla Complex, a bustling business hub. The crowded compartments, the constant jostling and the blistering heat of Mumbai summers didn’t deter her. She had a purpose, a routine and a willpower that seemed unbreakable.
But on one fateful day in July 2007, everything changed. At the perpetually crowded Dadar Railway Station, where the cacophony of rushing trains and hurried footsteps filled the air, Daisy was making her way through the throng of commuters. Out of nowhere, someone carrying a long steel pipe rushed past, and it struck her lower body with brutal force.
‘She was just walking down the platform when it happened. That pipe hit her hard,’ recalls her daughter Jennifer, her voice trembling slightly as she relives the moment. Jennifer was in her thirties, working as an executive assistant at the pharma giant Pfizer when this happened. What followed was a true testament to Daisy’s strength. Despite the pain that gripped her, she didn’t say a word to her family that evening. She came home, carried on with her usual chores and hid her discomfort behind a stoic face.
‘That’s who she was,’ Daisy’s daughter Jennifer says, her eyes glistening. ‘She would never let us worry. Even when she was hurting, she’d always put on a brave front.’
It wasn’t until the next day, when the pain became unbearable, that Daisy finally confided in her husband.
‘She simply said, “The pain is getting worse,” like it was nothing. But we knew. We could see it in her eyes,’ Jennifer says, her voice breaking. ‘She never pampered herself, never asked for help. She always carried the weight of the world on her shoulders, even when it hurt.’
Daisy consulted a renowned surgeon, seeking clarity about her injury. After a thorough examination, the doctor diagnosed her with secondary osteoarthritis, a condition that can result from an injury, infection or other diseases. In Daisy’s case, the surgeon identified Avascular Necrosis (AVN) as the underlying cause – a condition where the bone tissue in the hip dies due to insufficient blood supply. The surgeon’s verdict was clear – her right hip was severely damaged, and a total hip replacement was the only solution. But Daisy wasn’t convinced.
‘Mom didn’t want it,’ Jennifer explains, remembering everything ever so vividly. ‘She was adamant. She kept saying, “After the implant, I won’t be able to bend my leg or sit down properly. How can I live like that?” For her, being mobile wasn’t just about getting around – it was freedom.’
The surgeon, however, offered a glimmer of hope, presenting an alternative – a new implant: the ASR.
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‘He assured her it was cutting-edge technology, something just launched by Johnson & Johnson,’ Jennifer recalls. ‘He promised it would allow at least 90 per cent of the mobility she cherished. We felt relieved. It was Johnson & Johnson, after all – a name we all trusted blindly. We thought, if anyone can deliver on such a promise, it’s them. That day, we left the clinic feeling optimistic.’
In August 2007, Daisy underwent the primary total hip replacement surgery. The family clung to hope as she began her recovery, each small step bringing them closer to a semblance of normalcy. But by October, things took a sharp, unexpected turn. Daisy began complaining of strange sensations in her hip – an unsettling cracking and snapping sound that seemed to echo within her.
‘She would sit quietly, then suddenly say, “It feels like my joint is coming apart.” It was unnerving to hear that,’ Jennifer says. ‘We couldn’t hear the sounds ourselves, but we could see her discomfort. She’d wince ever so slightly while walking, her usual determined gait faltering. Still, we tried to dismiss it, telling her, “It’s probably just part of the healing process.” But deep down, her words worried us.’ As days turned into weeks, Daisy’s unease grew.
‘She kept saying “I think my joint is dislocating again”, but we struggled to believe her. How could this happen so soon after surgery?’ Jennifer’s voice softens, tinged with guilt. ‘Looking back, I wish we had listened more closely.’
Daisy’s struggles began to escalate; commuting to the office became a daunting challenge. By February 2008, the pain and discomfort had grown unbearable. Clinging to hope, she visited her surgeon.
‘He assured Mom that she would be all right,’ Jennifer recalls. But those words, meant to comfort, proved to be hollow assurances. Nothing changed.
By July, desperation drove Daisy back to the surgeon. This time, the examination revealed a tumour lurking on the inner side of her right thigh.
‘He recommended immediate surgery,’ Jennifer says, the urgency of that moment still vivid in her memory. In August 2008, Daisy was wheeled into the operating room again. The tumour was removed, but relief remained elusive.
In her discharge summary, the surgeon explained that they had removed an inflamed sac near the hip joint and observed a ‘blackish’ discoloration near the head of the joint. Most importantly, tissue samples were taken for examination under a microscope.
Two days later, the surgeon informed the family via email, along with pictures, that she had experienced clicking in her right leg and upon further exploration of the hip, they discovered metallosis. This was the first evidence that the ASR implant was releasing metal ions into the body. However, in August 2008, the family did not suspect anything unusual about the implant and instead focused on Daisy’s recovery.
Within weeks, the pain returned, sharper than before.
‘Mom couldn’t sit for long, which made her office work nearly impossible. She had to rely on a walking stick, and travelling by train or bus was out of the question,’ Jennifer recalls.
By 2009, the pain wasn’t confined to her hip any more. It was as if her body was waging a silent rebellion. Doctors, unable to piece the puzzle together, failed to connect her symptoms to the ASR implant. New problems surfaced – headaches, unlike anything Daisy had ever experienced before.
‘They weren’t frequent, but when they came, they were unbearable,’ Jennifer says, her eyes clouding at the memory. ‘Mom would describe them as a throbbing pain, not like a normal headache. She said it felt so strange, almost like her head was being squeezed. Sometimes, she’d run cold water over her head just for a moment of relief.’
And then, as if her suffering wasn’t enough, tragedy struck. Daisy lost her husband in 2009.
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‘Losing Dad was devastating. Mom’s headaches worsened during that time. She was grieving too, but she had to keep going. We even did an MRI to figure out what was causing the constant pain,’ Jennifer shares, her voice heavy with emotion.
Despite her deteriorating health, Daisy refused to give up. Financial pressure weighed heavily on her shoulders, pushing her to keep working.
‘She stopped taking local trains and switched to taxis – it was the only way she could manage. That was in 2010,’ Jennifer says. By 2011, Daisy’s troubles took a completely unexpected turn. In February, she got a call from her surgeon’s assistant, asking her to come in for a check-up. Daisy thought it was just a routine visit. At the clinic, they took two X-rays of her hip, and everything seemed normal – until it wasn’t.
The assistant dropped a bombshell: her hip implant had been recalled. Daisy could barely process the news when the surgeon recommended another surgery to fix the issue. He assured her the company would cover all the costs, but that didn’t make it any easier to hear.
‘Everything looked fine, or at least that’s what he said,’ Jennifer recalls. But then he suddenly added, ‘We’ll have to do another surgery.’ I couldn’t believe it. I just blurted out, ‘Mom, why another surgery? Are you serious?’’ Jennifer’s voice grew softer as she added, ‘But the doctor warned us – if she didn’t go through with it, she might end up bedridden, and things could get worse fast.’
The family left the clinic in a daze, overwhelmed by the thought of another surgery and all the risks it brought. Unsure of what to do next, they decided to get a second opinion, hoping for some clarity in the middle of all the confusion.
‘We went to a senior surgeon,’ Jennifer says. ‘The moment we started speaking, he didn’t even need to hear the full story. He asked, “Which hip implant? J&J? ASR? It’s a faulty product. This is a recall. You have to get it removed.” His words hit us like a thunderclap.’
The surgeon didn’t mince his words. He explained how the ASR device, made entirely of metal, had corroded inside Daisy’s body, releasing dangerous levels of chromium and cobalt. The toxic metals were wreaking havoc on her system.
‘He urged us to act immediately. There wasn’t any time to waste,’ Jennifer recalls.
In March 2011, Daisy underwent revision surgery. The defective ASR implant was removed, but what the surgeons found during the procedure left the family shaken.
‘They discovered a tumour filled with blackish liquid,’ Jennifer says, her voice faltering. ‘It was clear that the metal had corroded so badly that it poisoned her body.’ On 2 April 2011, the results of the crucial blood tests arrived. They confirmed their worst fears – Daisy’s blood showed dangerously high levels of chromium and cobalt. Despite the alarming findings, the family clung to the hope that removing the implant would bring her some relief.
But that hope was short-lived. The revision surgery didn’t deliver the improvement they had desperately prayed for.
‘She couldn’t even sit for more than ten minutes,’ Jennifer recalls. Frustration and desperation led the family to dig deeper. They scoured the internet for information about the ASR implant and its failures abroad. ‘We found medical reports and stories from patients outside India. We even spoke to friends who could explain the clinical research. It was a grim picture,’ Jennifer recounts.
In January 2012, Daisy decided enough was enough. She sent a legal notice to the company, demanding compensation of Rs 30 million. But her hopes were dashed in March when the company flatly refused to pay.
Daisy refused to let the setback crush her resolve. In March 2013, she took her fight to the National Consumer Disputes Redressal Commission (NCDRC), India’s apex consumer forum. Her case was one of the first in India to challenge the company over the ASR implant. But life dealt Daisy another cruel blow – she was diagnosed with cancer. Despite the diagnosis, she fought bravely. Tragically, her battle ended on 29 April 2014.
Daisy’s passing didn’t end the fight. Her family vowed to carry forward her quest for justice. For over eleven years, they pursued her case relentlessly. Finally, in September 2024, the NCDRC delivered its verdict. The court acknowledged the truth that Daisy had long suspected: the ASR implant was ‘defective’.
‘In view of aforesaid evidence, we found that ASR hip implants, metal-on-metal manufactured by the OP suffer from inherent manufacturing defect and released a harmful amount of metal debris, which was poisonous. ASR hip implanted in right side of [the] hip of the complainant 09.08.2007, released metal debris of cobalt and chromium and due to Metallosis near the femur head, she had to go for surgery on 21.08.2008 and revision surgery on 29.03.2011,’ the court ruled.
The verdict was bittersweet. It came too late to change Daisy’s fate, but it validated her struggle. This wasn’t just any decision; it was a landmark ruling on a major medical device recall, carrying significant weight. The key questions were: what evidence did the court rely on to reach its decision? How did that evidence shape the final judgement? And, most importantly, how would this ruling impact other Indian patients who had filed similar cases and were still waiting for justice?
This excerpt from ‘The Johnson & Johnson Files’ by Kaunain Sheriff M has been published with permission from Juggernaut Books.