Case 3:18-cv-00347-CAB-MDD Document 307-6 Filed 02/16/21 PageID.29724 Page 1 of 11
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`EXHIBIT 5
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`TO THE DECLARATION OF BRIAN J.
`NISBET IN SUPPORT OF DEFENDANTS’
`OPPOSITION TO NUVASIVE’S MOTION
`FOR PARTIAL SUMMARY JUDGMENT
`AND MOTION TO EXCLUDE
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`

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`Case 3:18-cv-00347-CAB-MDD Document 307-6 Filed 02/16/21 PageID.29725 Page 2 of 11
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`Scott Robinson· 30(b)(6), Attorneys Eyes OnlyScott Robinson· 30(b)(6), Attorneys Eyes Only
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`November 04, 2020November 04, 2020
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`· · · · · · · · ·UNITED STATES DISTRICT COURT
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`· · · · · · · · SOUTHERN DISTRICT OF CALIFORNIA
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`· · · · · · · · · · · SAN DIEGO DIVISION
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`· ·
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` · ·NUVASIVE, INC., a Delaware
`· · ·corporation,
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`··
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` · · · · · · ·Plaintiff,
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`··
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` · · · · · · ·v.· · · · ·Case No. 3:18-CV-00347
`· · · · · · · · · · · · · · · · · ·-CAB-MDD
`· · ·ALPHATEC HOLDINGS, INC., a
`· · ·Delaware corporation and
`· · ·ALPHATEC SPINE, INC., a
`· · ·California corporation,
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`· · · · · · · ·Defendants.
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`· · ·_______________________________________________________
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`· · · · · HIGHLY CONFIDENTIAL - ATTORNEYS' EYES ONLY
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`· · · · · · VIDEOTAPED DEPOSITION OF SCOTT ROBINSON
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`· · · · ALPHATEC’S HOLDINGS, INC. RULE 30(b)(6) WITNESS
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`· · · · · · · · · · ·SAN DIEGO, CALIFORNIA
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`· · · · · · · · · · · ·NOVEMBER 4, 2020
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`· ·
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` · ·Reported By:
`· · ·PATRICIA Y. SCHULER
`· · ·CSR No. 11949
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`· · · · ·
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`U.S. Legal Support | www.uslegalsupport.comU.S. Legal Support | www.uslegalsupport.com
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`EXHIBIT 5 - PAGE 78
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`Case 3:18-cv-00347-CAB-MDD Document 307-6 Filed 02/16/21 PageID.29726 Page 3 of 11
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`Scott Robinson· 30(b)(6), Attorneys Eyes OnlyScott Robinson· 30(b)(6), Attorneys Eyes Only
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`November 04, 2020November 04, 2020
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`·1· · · · · · · ·UNITED STATES DISTRICT COURT
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`·2· · · · · · · SOUTHERN DISTRICT OF CALIFORNIA
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`·3· · · · · · · · · · SAN DIEGO DIVISION
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`Page 2
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`·4
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`·5· ·NUVASIVE, INC., a Delaware
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`· · ·corporation,
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`·6
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`· · · · · · · ·Plaintiff,
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`·7
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`· · · · · · · ·v.· · · · · · ·Case No. 3:18-CV-00347
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`·8· · · · · · · · · · · · · · · · · · ·-CAB-MDD
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`· · ·ALPHATEC HOLDINGS, INC., a
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`·9· ·Delaware corporation and
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`· · ·ALPHATEC SPINE, INC., a
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`10· ·California corporation,
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`11· · · · · · ·Defendants.
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`12· ·_______________________________________________________
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`13· · · · Videotaped deposition of SCOTT ROBINSON, taken
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`14· ·on behalf of the Plaintiffs via ZOOM, San Diego,
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`15· ·California, at 10:04 a.m. and ending at 1:58 p.m.,
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`16· ·on November 4, 2020, before PATRICIA Y. SCHULER,
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`17· ·Certified Shorthand Reporter No. 11949.
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`18
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`19
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`20
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`21
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`22
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`23
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`24
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`25
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`·1· ·APPEARANCES:
`·2· ·FOR PLAINTIFF:
`·3· · · · · · ·WILSON SONSINI GOODRICH & ROSATI, P.C.
`·4· · · · · · ·BY:· WENDY L. DEVINE, ESQ.
`·5· · · · · · ·BY:· CHRISTINA DASHE, ESQ.
`·6· · · · · · ·One Market Plaza, Spear Tower
`·7· · · · · · ·Suite 3300
`·8· · · · · · ·San Francisco, California· 94105
`·9· · · · · · ·wdevine@wsgr.com
`10· ·FOR DEFENDANTS:
`11· · · · · · ·WINSTON STRAWN LLP
`12· · · · · · ·BY:· SARANYA RAGHAVAN, ESQ.
`13· · · · · · ·BY:· NIMALKA R. WICKRAMASEKERA, ESQ.
`14· · · · · · ·333 South Grand Avenue
`15· · · · · · ·Los Angeles, California 90071-1543
`16· · · · · · ·nwickramasekera@winston.com
`17
`18· ·Also Present:
`19· · · · · · ·Jason Hamilton
`20· ·Videographer:
`21· · · · · · ·Michael Spade
`22
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`Page 4
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`·1· · · · · · · · · · · · ·I-N-D-E-X
`·2· ·WITNESS:· · · · · · · · · · · · · · · · ·EXAMINATION
`·3· ·SCOTT ROBINSON· · · · · · · · · · · · · · · · · PAGE
`·4· ·MS. DEVINE· · · · · · · · · · · · · · · · · · · · ·7
`·5
`·6
`·7· · · · · · · · · · · E-X-H-I-B-I-T-S
`·8· ·PLAINTIFF'S· · · · · · · · · · · · · · · · · · ·PAGE
`·9· ·Exhibit 1· · ·NuVasive's 3rd Amended Notice of· · 11
`· · · · · · · · · ·Rule 30(b)(6) Deposition
`10
`· · ·Exhibit 2· · ·Defendants' Supplemental· · · · · · 17
`11· · · · · · · · ·Responses to Plaintiff NuVasive,
`· · · · · · · · · ·Inc.'s Interrogatories (Nos.
`12· · · · · · · · ·1,2,3,7,8, and 17)
`13· ·Exhibit 3· · ·Zimmer Biomet Timberline Lateral· · 47
`· · · · · · · · · ·Fusion System Surgical Technique
`14· · · · · · · · ·Guide Bates-stamped
`· · · · · · · · · ·ATEC_LLIF000965436 through 487
`15
`· · ·Exhibit 4· · ·Alphatec Spine Management· · · · · ·59
`16· · · · · · · · ·Presentation Bates-stamped
`· · · · · · · · · ·ATEC_LLIF000854436 through 524
`17
`· · ·Exhibit 5· · ·Battalion Lateral Implant Guide· · ·64
`18· · · · · · · · ·Bates-stamped ATEC_LLIF000004935
`· · · · · · · · · ·through 942
`19
`· · ·Exhibit 6· · ·Battalion LLIF Design Team· · · · · 76
`20· · · · · · · · ·Feedback Analysis dated 6.26.15
`· · · · · · · · · ·Bates-stamped ATEC_LLIF000854919
`21· · · · · · · · ·through 956
`22· ·Exhibit 7· · ·Battalion LLIF Implant System· · · ·79
`· · · · · · · · · ·Project Memo Project No. 15-004
`23· · · · · · · · ·dated 12.16.16 Bates-stamped
`· · · · · · · · · ·ATEC_LLIF000292275 through 295
`24
`25
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`·1· · · · · · · · E-X-H-I-B-I-T-S (CONTINUED)
`·2· ·PLAINTIFF'S· · · · · · · · · · · · · · · · · · ·PAGE
`·3· ·Exhibit 8· · ·Product Development Agreement· · · ·83
`· · · · · · · · · ·dated 3.14.13 Bates-stamped
`·4· · · · · · · · ·ATEC_LLIF000895078 through 166
`·5· ·Exhibit 9· · ·Alphatec Direct Lateral Cage· · · · 84
`· · · · · · · · · ·Concepts & Key Features dated
`·6· · · · · · · · ·2.4.13 Bates-stamped
`· · · · · · · · · ·ATEC_LLIF000004530 through 573
`·7
`· · ·Exhibit 10· · Alphatec Protocol: Evaluation of· · 87
`·8· · · · · · · · ·Tyber Medical & In'Tech Medical
`· · · · · · · · · ·Lateral Lumbar Interbody Fusion
`·9· · · · · · · · ·Systems Doc No. TP100505
`· · · · · · · · · ·Bates-stamped ATEC_LLIF000855575
`10· · · · · · · · ·through 604
`11· ·Exhibit 11· · Transcend LIF Lateral Approach· · · 95
`· · · · · · · · · ·Implant Guide Bates-stamped
`12· · · · · · · · ·ATEC_LLIF000964710 through 717
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`EXHIBIT 5 - PAGE 79
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`Case 3:18-cv-00347-CAB-MDD Document 307-6 Filed 02/16/21 PageID.29727 Page 4 of 11
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`Scott Robinson· 30(b)(6), Attorneys Eyes OnlyScott Robinson· 30(b)(6), Attorneys Eyes Only
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`November 04, 2020November 04, 2020
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`Page 6
`·1· ·SAN DIEGO, CALIFORNIA; WEDNESDAY, NOVEMBER 4, 2020
`·2· · · · · · · · · · · · 10:04 a.m.
`·3· · · · · · ·THE VIDEOGRAPHER:· We are now on the
`·4· ·record.· Participants should be aware that this
`·5· ·proceeding is being recorded, and as such, all
`·6· ·conversations held will be recorded unless there is
`·7· ·a request and agreement to go off the record.
`·8· ·Private conversations and/or attorney-client
`·9· ·interactions should be held outside the presence of
`10· ·the remote interface.
`11· · · · · · ·For the purpose of creating a
`12· ·witness-only video, the witness has been
`13· ·spotlighted on your video screen.· We ask that the
`14· ·witness not be removed from the spotlight as it may
`15· ·cause other people to appear in the final video.
`16· · · · · · ·For anyone who does not want the witness
`17· ·to take up a large part of your screen, you may
`18· ·click the "gallery view" button in the upper right
`19· ·corner.
`20· · · · · · ·This is the remote videorecorded
`21· ·deposition of Scott Robinson being taken by counsel
`22· ·for the Defendant.· Today is Wednesday, November 4,
`23· ·2020, and the time now is 10:04 a.m. in the Pacific
`24· ·time zone.· We are here in the matter of NuVasive
`25· ·against Alphatec Holdings.· My name Michael Spade,
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`Page 8
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`·1· ·address?· Work or home is fine.
`·2· · · · A.· ·1281 -- 1-2-8-1, -2 Crest Drive,
`·3· ·Encinitas, California 92024.
`·4· · · · Q.· ·Do you recall that you were deposed just
`·5· ·about a year ago in this same matter?
`·6· · · · A.· ·I recall being deposed.· I believe the
`·7· ·topics of that deposition were different than the
`·8· ·topics to be discussed today.
`·9· · · · Q.· ·Do you have an understanding of what
`10· ·matter you're here to be deposed about today?
`11· · · · A.· ·I believe it's the nonprivileged
`12· ·testimony related to implant development.
`13· · · · Q.· ·Do you have an understanding of -- well,
`14· ·do you understand that I represent NuVasive?· You
`15· ·know that?
`16· · · · A.· ·Yes.
`17· · · · Q.· ·And do you understand that NuVasive has
`18· ·sued Alphatec for patent infringement?
`19· · · · A.· ·Yes.
`20· · · · Q.· ·And do you understand that your
`21· ·deposition here today is related to that lawsuit?
`22· · · · A.· ·Yes.
`23· · · · Q.· ·Since your deposition last October, have
`24· ·you been deposed, other than sitting here today?
`25· · · · A.· ·No.· This is, thankfully, my first time
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`Page 7
`·1· ·remote video technician with U.S. Legal Support. I
`·2· ·am not related to any party in this action.
`·3· · · · · · ·At this time, will the reporter,
`·4· ·Patricia Schuler, with U.S. Legal Support please
`·5· ·swear in the witness.
`·6
`·7· · · · · · · · · · · SCOTT ROBINSON,
`·8· · having been administered an oath, was examined and
`·9· · · · · · · · · ·testified as follows:
`10
`11· · · · · · · · · · · · EXAMINATION
`12· ·BY MS. DEVINE:
`13· · · · Q.· ·Good morning, Mr. Robinson.
`14· · · · A.· ·Good morning, Wendy.
`15· · · · Q.· ·Can you hear me?
`16· · · · A.· ·I can hear you just fine, thanks.
`17· · · · Q.· ·Great.· If you can't hear me at any
`18· ·point, would you please just let me know?
`19· · · · A.· ·Will do, yes.
`20· · · · Q.· ·Sure.
`21· · · · · · ·Would you please state and spell your
`22· ·name for the record?
`23· · · · A.· ·Scott Robinson, S-C-O-T-T,
`24· ·R-O-B-I-N-S-O-N.
`25· · · · Q.· ·And would you please state your current
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`Page 9
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`·1· ·back.
`·2· · · · Q.· ·And since your deposition last year, has
`·3· ·your job changed?
`·4· · · · A.· ·No.· My job is the same.
`·5· · · · Q.· ·So your title is the same?
`·6· · · · A.· ·Yes, Manager, Research and Development,
`·7· ·Alphatec Spine.
`·8· · · · Q.· ·Got it.
`·9· · · · · · ·And your job responsibilities, would you
`10· ·say they are the same as they were in October of
`11· ·last year?
`12· · · · A.· ·Generally the same, yes.
`13· · · · Q.· ·So I won't spend a bunch of time going
`14· ·over logistics for today because we just did this
`15· ·last year.· But just briefly, do you understand
`16· ·that you need to give a verbal answer to questions?
`17· · · · A.· ·Yes, I do.
`18· · · · Q.· ·And if you don't understand my question,
`19· ·would you please let me know?
`20· · · · A.· ·Yes, I will.
`21· · · · Q.· ·And do you understand that if you do not
`22· ·let me know that you do not understand the
`23· ·question, that I will accept that you did
`24· ·understand the question?
`25· · · · · · ·Does that make sense?
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`Case 3:18-cv-00347-CAB-MDD Document 307-6 Filed 02/16/21 PageID.29728 Page 5 of 11
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`Scott Robinson· 30(b)(6), Attorneys Eyes OnlyScott Robinson· 30(b)(6), Attorneys Eyes Only
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`November 04, 2020November 04, 2020
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`Page 30
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`·1· ·improve or design.
`·2· · · · · · ·We did a lot of impact testing.· You
`·3· ·know, through our research we had learned that
`·4· ·competitors' cages, Medtronic, NuVasive,
`·5· ·specifically, had a relatively high failure rate in
`·6· ·the field.· You know, a MOD database search would
`·7· ·reveal that.· It was a very common failure mode for
`·8· ·lateral interbodies at the time.· We ran a lot of
`·9· ·simulated impaction testing to try to reduce the
`10· ·likelihood of that failure mode.· That drove some
`11· ·changes between our first prototypes and our
`12· ·commercial product.
`13· · · · · · ·You know, we would -- we would put these
`14· ·in our cadaver lab.· We would invite surgeons who
`15· ·were familiar with the lateral procedure.· They
`16· ·would basically go through a mock surgery in our
`17· ·cadaver lab.· They would look at these implants,
`18· ·evaluate how they functioned, how they interact
`19· ·with other instruments within the system, and that
`20· ·output would potentially draw changes to an
`21· ·interbody.
`22· · · · · · ·You know, that is an incomplete list, but
`23· ·a partial list of the things that would potentially
`24· ·drive updates to a design of an interbody.
`25· · · · Q.· ·You mentioned that there was a high
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`Page 32
`·1· ·would get bowing in the walls, and you would
`·2· ·usually get bowing in the wall always at a
`·3· ·particular point.· This also kind of ties back to
`·4· ·exactly how it's used clinically and at what point
`·5· ·during implantation it is most likely to fail.
`·6· · · · · · ·So I would say that that drove some
`·7· ·decisions on our part where we would add material;
`·8· ·we, you know, would just thicken up, a particular
`·9· ·part of the interbody, to add strength.· You know,
`10· ·we don't have -- we don't have a lot of levers to
`11· ·pull.· You know, we have the constraint of size,
`12· ·obviously, and a conflicting desire to maximize
`13· ·graft aperture.· And our materials are generally
`14· ·somewhat limited.· You know, interbodies are
`15· ·generally fairly generic in shape and material.· So
`16· ·you have titanium and variants of titanium, and you
`17· ·have PEEK.· And there aren't a whole lot of options
`18· ·of what you can do with that.· There is, like,
`19· ·silicon nitride from a company called Amedica as
`20· ·well, but, like, we weren't using that.
`21· · · · · · ·So if you are designing a PEEK interbody,
`22· ·you can really only pull a few levers to optimize
`23· ·that design.· And one of -- like, the primary one
`24· ·would be where and how material was distributed
`25· ·around the implant.
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`Page 31
`·1· ·failure rate with NuVasive and Medtronic implants.
`·2· · · · · · ·Did I get that right?
`·3· · · · A.· ·They are easier to find because they were
`·4· ·the major players in the space at the time, and so
`·5· ·a -- there's a -- what they call a MOD database,
`·6· ·which is reportable complaints from the O.R.· And a
`·7· ·quick search would reveal, in that time frame, a
`·8· ·lot of failures during impaction of these implants.
`·9· ·The ones that come to mind are NuVasive and
`10· ·Medtronic because they were so common.
`11· · · · Q.· ·And how did awareness of those failures
`12· ·drive the design of the Battalion lateral implant?
`13· · · · A.· ·I'm sorry.· Can you repeat that?
`14· · · · Q.· ·Sure.
`15· · · · · · ·Let me ask it this way:· Did awareness of
`16· ·those failures during impaction of Medtronic and
`17· ·NuVasive implants influence how you designed the
`18· ·Battalion lateral implant?
`19· · · · A.· ·I would say it did, yes.
`20· · · · Q.· ·Okay.· How?
`21· · · · A.· ·You would potentially make -- you would
`22· ·add material in areas that were likely to fail.· We
`23· ·know if you have a shape that's generally
`24· ·rectangular and you apply an impact load to one end
`25· ·along one of the longer lengths of a rectangle, you
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`·1· · · · Q.· ·You mentioned that you used PEEK for the
`·2· ·Battalion lateral implant; is that right?
`·3· · · · A.· ·That is correct, yes.
`·4· · · · Q.· ·Why did you use PEEK?
`·5· · · · A.· ·PEEK is -- for the better part of the
`·6· ·2000s and early 2010s, you know, PEEK was the most
`·7· ·common, like, orthopedic spine -- orthopedic
`·8· ·material being used for interbody devices.
`·9· ·Titanium was very popular in the 90s.· Titanium
`10· ·fell somewhat out of favor through the first decade
`11· ·of the 2000s and into mid-2010s.· And, now, with
`12· ·some of the improvements in manufacturing and
`13· ·modification techniques that we have, titanium is
`14· ·coming back into favor.· But generally PEEK was --
`15· ·PEEK was what everyone used.
`16· · · · · · ·Every interbody device that -- every
`17· ·polymer interbody device on the market was
`18· ·basically the exact same mixture of a polymer
`19· ·called polyetherketone, and most of it came from
`20· ·one company called Invivio.· Everybody used the
`21· ·same material.· And so it was just seen as generic.
`22· ·No one was selling their interbody based off of the
`23· ·fact that they featured PEEK as the material.
`24· · · · Q.· ·Was it ever considered during the design
`25· ·the Battalion lateral implant to make the implant
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`Case 3:18-cv-00347-CAB-MDD Document 307-6 Filed 02/16/21 PageID.29729 Page 6 of 11
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`Scott Robinson· 30(b)(6), Attorneys Eyes OnlyScott Robinson· 30(b)(6), Attorneys Eyes Only
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`November 04, 2020November 04, 2020
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`Page 34
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`·1· ·out of titanium?
`·2· · · · A.· ·It was considered, yes.
`·3· · · · Q.· ·Okay.
`·4· · · · A.· ·We may have even submitted designs for a
`·5· ·titanium interbody.· We also considered a PEEK with
`·6· ·a titanium coating, a, like, vapor deposition
`·7· ·titanium coating process that puts a thin film of
`·8· ·titanium across the surface.· You know, I think
`·9· ·all -- all material -- all viable materials were at
`10· ·some point considered.
`11· · · · Q.· ·Why did Alphatec not choose to go with an
`12· ·all-titanium implant for the Battalion lateral
`13· ·implant?
`14· · · · A.· ·It would have just been a question of
`15· ·what they -- what we perceive the market dynamics
`16· ·to be.· You know, what clinical benefit was there
`17· ·to one material versus another.· You know, we were
`18· ·looking to enter into the space for the first time,
`19· ·and we didn't want to overcomplicate it.· And PEEK
`20· ·was being used by the majority of the surgeons that
`21· ·we were talking with.· I mean, PEEK was
`22· ·generally -- I mean, our other interbody lines at
`23· ·the time were PEEK.· We had the most experience
`24· ·manufacturing it.· Like, we were still
`25· ·manufacturing in-house.· We had a lot more
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`Page 36
`·1· ·surgeons about the design of the Battalion lateral
`·2· ·implants, you didn't ask them what they were
`·3· ·presently using?
`·4· · · · A.· ·I would not have asked that in that
`·5· ·capacity.· If there was a discussion around that I
`·6· ·wasn't a part of it.· Most of these surgeons had
`·7· ·had broad experience with lateral surgery, but I
`·8· ·would be speculating as to say which interbody
`·9· ·system they preferred or used in their practice at
`10· ·the time.
`11· · · · Q.· ·Why did Alphatec not choose to move
`12· ·forward with a titanium-coated implant for the
`13· ·Battalion lateral implant?
`14· · · · A.· ·It really -- it has to do mostly with the
`15· ·number of configurations that you have with the
`16· ·lateral interbody.· It's a -- you have to make
`17· ·little individual fixtures to hold each different
`18· ·interbody configuration for coating.· You do some
`19· ·additional -- you have to do some additional
`20· ·testing for that coating.· It's an additional
`21· ·complicated expensive step to do, you know, so
`22· ·there is -- there are some logistical reasons.· But
`23· ·at the end of the day, I just don't think we
`24· ·perceived it as having the clinical benefit that it
`25· ·might have with a PLIF or TLIF, a posterior
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`Page 35
`·1· ·experience manufacturing interbodies out of PEEK
`·2· ·than any other material.· I think all of those
`·3· ·factored into our decision to use PEEK for our
`·4· ·lateral interbodies.
`·5· ·BY MS. DEVINE:
`·6· · · · Q.· ·You mentioned that PEEK was being used by
`·7· ·the surgeons that you were talking to.· Do you mean
`·8· ·they were using competitor products made out of
`·9· ·PEEK?
`10· · · · · · ·MS. RAGHAVAN:· Objection.· Form.
`11· · · · · · ·THE WITNESS:· Sorry.· They would have
`12· ·been using a competitor's product, not necessarily
`13· ·PEEK.· I don't know what they were all using in
`14· ·their practice at that time.· There were many other
`15· ·competitive systems that offered PEEK implants, as
`16· ·well as titanium implants, for lateral surgery.
`17· ·BY MS. DEVINE:
`18· · · · Q.· ·When you were designing the Battalion
`19· ·lateral implants, were you talking with surgeons
`20· ·and getting feedback from surgeons that were using
`21· ·NuVasive CoRoent implants?
`22· · · · A.· ·I wouldn't be able to say that for sure.
`23· · · · Q.· ·Okay.
`24· · · · A.· ·I don't know what were -- what they used.
`25· · · · Q.· ·So when you were sourcing feedback from
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`·1· ·approach device.
`·2· · · · · · ·The tradeoff between surface area and --
`·3· ·surface area of the implant to surface area of
`·4· ·graft aperture just is not there for lateral.
`·5· · · · · · ·So from, you know -- we tried to always
`·6· ·look to the clinical requirements to best decide
`·7· ·how to move forward with design, and eventually
`·8· ·commercialization.· And in a PLIF procedure where a
`·9· ·good disc prep might clear 50 percent, 25 percent,
`10· ·30 percent of the disc, a good lateral disc prep
`11· ·will take 80 percent of the disc.· And your
`12· ·interbodies are much, much larger.· Those larger
`13· ·interbodies contain larger volumes of bone graft.
`14· ·You know, the goal of surgery is fusion through
`15· ·those windows, you know, with a TLIF device, a PLIF
`16· ·device.· The window is very small, so you want to
`17· ·maximize the integration of that interbody to the
`18· ·interbody space.
`19· · · · · · ·A small graft window sometimes is not
`20· ·good enough on its own.· So you want a titanium
`21· ·surface on a PLIF device or a TLIF device.· You
`22· ·start looking at a titanium-coated surface for a
`23· ·lateral interbody, the tradeoff just isn't there.
`24· ·Like, there isn't -- I don't think there is a
`25· ·significant clinical benefit to using a titanium
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`Case 3:18-cv-00347-CAB-MDD Document 307-6 Filed 02/16/21 PageID.29730 Page 7 of 11
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`Scott Robinson· 30(b)(6), Attorneys Eyes OnlyScott Robinson· 30(b)(6), Attorneys Eyes Only
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`November 04, 2020November 04, 2020
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`Page 66
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`·1· ·right?
`·2· · · · A.· ·Um-hmm.· That's correct.
`·3· · · · Q.· ·Down at the bottom half of the page,
`·4· ·there is a number of dimensions listed.
`·5· · · · · · ·Do you see that?
`·6· · · · A.· ·Top half of the page?
`·7· · · · Q.· ·Sorry.· I said bottom half of the page.
`·8· · · · A.· ·You mean the table?
`·9· · · · Q.· ·You see where it says -- yes --
`10· ·"18 millimeter width parallel."
`11· · · · · · ·Do you see that?
`12· · · · A.· ·Yes.
`13· · · · Q.· ·And do these tables reflect the
`14· ·dimensions of various embodiments of the Battalion
`15· ·lateral spacer?
`16· · · · · · ·MS. RAGHAVAN:· Objection.· Form.
`17· · · · · · ·THE WITNESS:· It is not a complete list,
`18· ·but those are a subset of the configurations within
`19· ·the lateral interbody family, Battalion interbody
`20· ·family.
`21· ·BY MS. DEVINE:
`22· · · · Q.· ·And would you agree that these
`23· ·configurations all have an elongated rectangular
`24· ·shape?
`25· · · · · · ·MS. RAGHAVAN:· Objection.· Form.
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`Page 68
`·1· ·width delineated and a height delineated, correct?
`·2· · · · A.· ·Yup.
`·3· · · · Q.· ·Is that how you would define length,
`·4· ·width, and height?
`·5· · · · A.· ·For this, yes.· For our interbody, that
`·6· ·is how it is defined.
`·7· · · · Q.· ·So you're telling me that this length,
`·8· ·width, and height delineated in this figure, there
`·9· ·are Battalion lateral implants that do not have a
`10· ·length that is longer than the width, right?
`11· · · · A.· ·I believe that to be correct, yes.
`12· · · · Q.· ·Do those implants, are they designed to
`13· ·span the ring apophysis when implanted?
`14· · · · A.· ·That would be dependent on the anatomy.
`15· · · · Q.· ·How so?
`16· · · · A.· ·I mean, all of our -- we design a very
`17· ·broad range of implant configurations with a wide
`18· ·variety of lengths and widths and heights in
`19· ·lordoses to -- to fit appropriately with whatever
`20· ·the clinical requirements are there in surgery.
`21· ·The implants are designed such that they sit on the
`22· ·ring apophysis, but how -- that implant selection
`23· ·for that patient would dictate whether or not that
`24· ·was true.
`25· · · · Q.· ·But the implants -- the Battalion lateral
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`·1· · · · · · ·THE WITNESS:· They are generally
`·2· ·rectangular.
`·3· ·BY MS. DEVINE:
`·4· · · · Q.· ·And each of these configurations of the
`·5· ·Battalion lateral spacer has a length that is
`·6· ·longer than the width; is that right?
`·7· · · · A.· ·The configurations listed here, I
`·8· ·believe, would all have a -- depending on which
`·9· ·dimensions you were taking, would all have a length
`10· ·greater than a width, but this is not encompassing
`11· ·of all of our interbody designs.
`12· · · · Q.· ·No.· But we're just talking about the
`13· ·Battalion lateral spacer, right?
`14· · · · A.· ·Within the Battalion lateral spacer,
`15· ·there are configurations that have a shape or a
`16· ·length that is less than the width depending on how
`17· ·you define it.
`18· · · · Q.· ·Depending how you define what?
`19· · · · · · ·MS. RAGHAVAN:· Objection. form.
`20· · · · · · ·THE WITNESS:· The length or the width?
`21· ·BY MS. DEVINE:
`22· · · · Q.· ·Well, if we look at this picture at the
`23· ·top here --
`24· · · · A.· ·Uh-huh.
`25· · · · Q.· ·-- there is a length delineated and a
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`·1· ·implants are designed such that they sit on the
`·2· ·ring apophysis?
`·3· · · · · · ·MS. RAGHAVAN:· Objection.· Form.
`·4· · · · · · ·THE WITNESS:· I believe they are designed
`·5· ·for that purpose, yes.
`·6· ·BY MS. DEVINE:
`·7· · · · Q.· ·It's on a couple of pages of this.· We
`·8· ·can go to Page 2.· There is reference at the top
`·9· ·under "Implant Features," the second bullet:
`10· ·"Chevron tooth pattern provides anti-migration
`11· ·support."
`12· · · · · · ·Do you see that?
`13· · · · A.· ·I do, yes.
`14· · · · Q.· ·What's a chevron tooth pattern?
`15· · · · A.· ·It is basically a -- a pattern of
`16· ·features cut into the surface of our lateral
`17· ·interbody such that they help prevent migration of
`18· ·the implant or movement of the implant in either a
`19· ·pathway -- along the pathway of insertion or in an
`20· ·anterior-posterior direction.· The teeth are
`21· ·basically cut at 90 degree angles to each other
`22· ·like a chevron -- like a chevron on a -- like a
`23· ·soldier's lapel.
`24· · · · Q.· ·And what part of the anatomy do those
`25· ·teeth come into contact with?
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`Case 3:18-cv-00347-CAB-MDD Document 307-6 Filed 02/16/21 PageID.29731 Page 8 of 11
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`Scott Robinson· 30(b)(6), Attorneys Eyes OnlyScott Robinson· 30(b)(6), Attorneys Eyes Only
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`November 04, 2020November 04, 2020
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`·1· · · · A.· ·Under normal circumstances, they aren't
`·2· ·designed to be really in contact.· They are only
`·3· ·kind of a -- they're an anti-migration feature that
`·4· ·would come in contact if the implant was -- was
`·5· ·migrating.
`·6· · · · Q.· ·So when the implant is placed into the
`·7· ·disc space, are you saying that there is some sort
`·8· ·of air pocket or space between the teeth and the
`·9· ·bone?
`10· · · · · · ·MS. RAGHAVAN:· Objection.· Form.
`11· · · · · · ·THE WITNESS:· And so we discussed this a
`12· ·little bit earlier where the goal of -- or there
`13· ·are three goals of surgery.· You know there's
`14· ·decompression of the nerves, so you want to restore
`15· ·foraminal clearance of that nerve so you reduce the
`16· ·pain or the motor deficit.· You want to get
`17· ·sagittal alignment, you want to get, you know,
`18· ·global alignment of the patient, and you want to
`19· ·achieve fusion.
`20· · · · · · ·So the interbody is really meant to just
`21· ·hold a biologic or adequate bone substitute in
`22· ·place such that that bone -- a column of bone can
`23· ·grow from one end plate to the next -- from one end
`24· ·plate to the adjacent end plate.· The -- like bone
`25· ·only -- there is a biological term called Wolff's
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`·1· ·alternative to what existed on the market, with the
`·2· ·primary focus of loading that graft material to
`·3· ·facilitate bone growth.
`·4· ·BY MS. DEVINE:
`·5· · · · Q.· ·But didn't you testify earlier that the
`·6· ·bone material is not always loaded?
`·7· · · · A.· ·I said in some very rare circumstances
`·8· ·that would not be clinically ideal.· Under almost
`·9· ·all circumstances, especially in the United States,
`10· ·some bone substitute is used.· In countries where
`11· ·they can't afford additional biologic in a lateral
`12· ·procedure, sometimes they're left with no choice.
`13· ·Sometimes there are size limitations, you know,
`14· ·that prevent graft material from being held
`15· ·appropriately.
`16· · · · · · ·But ideally there is graft material that
`17· ·is contained within those windows, and that is what
`18· ·is ideally loaded under correct placement of the
`19· ·interbody device.
`20· · · · Q.· ·And if I'm understanding correctly, that
`21· ·graft material is what contacts the bone such that
`22· ·your anti-migration -- I believe you called them
`23· ·piece -- does not touch the bone; is that right?
`24· · · · A.· ·The idea is that under proper use that
`25· ·the anti-migration features on our devices are not
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`Page 71
`·1· ·Law that basically says that unless -- you could
`·2· ·have all of the right ingredients to grow bone, but
`·3· ·if that bone material is not loaded appropriately,
`·4· ·you never -- you never actually get bone growth.
`·5· · · · · · ·So that biologic material needs to be
`·6· ·loaded.· So the way this implant is designed to be
`·7· ·used is to go into the space and hold that graft
`·8· ·material so that that graft material is in contact
`·9· ·with the end plates of the two adjacent vertebrae
`10· ·and the ring apophysis is supported on the ends of
`11· ·the implant, you know, past where some of those
`12· ·teeth are cut into the interbody.
`13· · · · · · ·Those teeth are intentionally cut
`14· ·sub-flush to the surface of that interbody to
`15· ·promote loading of the graft material to facilitate
`16· ·better fusion.· You know, I think that's -- there
`17· ·are several implants on the market prior to this
`18· ·one that had much more convexity.· It had tooth
`19· ·profiles that sat proud.· Those would often cut
`20· ·into end plates and potentially cause subsidence
`21· ·and generally detract the space away from that
`22· ·biologic material.· And we believed that, like, a
`23· ·flat -- you know, a flat end plate contour on an
`24· ·interbody with a very open graft window and
`25· ·sub-flush teeth was a clinically superior
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`Page 73
`·1· ·in contact with the end plate when the implant is
`·2· ·correctly positioned and loaded with graft
`·3· ·material.
`·4· · · · Q.· ·But in order to prevent migration, to
`·5· ·actually function to prevent migration they would
`·6· ·have to be in contact with the end plate, right?
`·7· · · · A.· ·They would, but, I mean, the implant,
`·8· ·once it would -- you know, let's say that the
`·9· ·implant were to move, let's say it were to move
`10· ·laterally one direction toward the patient's -- one
`11· ·side to the other side, side to side, those teeth
`12· ·would then come in contact with the ring apophysis,
`13· ·which is generally -- generally there is some
`14· ·convexity to an end plate, to a vertical end plate,
`15· ·and so the loading is really only on the distal
`16· ·margins of that interbody device.
`17· · · · · · ·And so if the device were to sort of
`18· ·migrate laterally, those teeth would come in
`19· ·contact with that ring apophysis.· If the implant
`20· ·were to migrate anteriorly, again, those teeth
`21· ·would come in contact with the ring apophysis.
`22· · · · Q.· ·Going back to the document on Page 2, do
`23· ·you see on the right-hand side, the right-hand
`24· ·picture, there is something that is labeled "Large
`25· ·Graft Chambers."
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`Case 3:18-cv-00347-CAB-MDD Document 307-6 Filed 02/16/21 PageID.29732 Page 9 of 11
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`Scott Robinson· 30(b)(6), Attorneys Eyes OnlyScott Robinson· 30(b)(6), Attorneys Eyes Only
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`November 04, 2020November 04, 2020
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`Page 98
`·1· · · · · · ·MS. DEVINE:· Okay.· Thank you for your
`·2· ·time, Mr. Robinson.
`·3· · · · · · ·THE WITNESS:· Yep.· Thank you, Wendy.
`·4· ·Good to see you.
`·5· · · · · · ·MS. DEVINE:· Good to see you, too.
`·6· · · · · · ·THE VIDEOGRAPHER:· Would you like to go
`·7· ·off the record, counsel?
`·8· · · · · · ·Okay.· Going off the record.· The time is
`·9· ·1:58 p.m. Pacific.· We are now off the record.
`10· · · · · · ·(The videotaped deposition of
`11· · · · · · ·SCOTT ROBINSON concluded at 1:58 p.m.)
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`·1· · · · · · ·I, PATRICIA Y. SCHULER, a Certified
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`·2· ·Shorthand Reporter of the State of California, do
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`·3· ·hereby certify:
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`·4· · · · · · ·That the foregoing proceedings were taken
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`·5· ·before me at the time and place herein set forth;
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`·6· ·that any witnesses in the foregoing proceedings,
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`·7· ·prior to testifying, were duly sworn; that a
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`·8· ·verbatim record of the proceedings was made by me
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`·9·