A CASE STUDY

BECTON DICKINSON

&

NEEDLE STICKS

NANDA KRISHNAN S K

BBA LLB
 Introduction

Business ethics are moral principles that guide the way a business behaves. The same principles
that determine an individual’s actions also apply to business.

Acting in an ethical way involves distinguishing between “right” and “wrong” and then making
the “right” choice. It is relatively easy to identify unethical business practices. For example,
companies should not use child labor. They should not unlawfully use copyrighted materials
and processes. They should not engage in bribery.

However, it is not always easy to create similar hard-and-fast definitions of good ethical
practice. A company must make a competitive return for its shareholders and treat its
employees fairly. A company also has wider responsibilities. It should minimize any harm to the
environment and work in ways that do not damage the communities in which it operates. This
is known as corporate social responsibility.

In this case study, we will analyze and evaluate the ethical dilemma of Becton Dickinson, a
medical technology company and provide possible solutions.

Becton Dickinson is a medical technology company. BD manufactures and sells a range of

medical supplies, devices, laboratory equipment and diagnostic products. It was founded in
1897 and headquartered in New Jersey, USA.

BD is a company which employees more than 30000 people in more than 50 countries
throughout the world.

It is of great significance that it was one of the first companies to sell US made glass syringes. It
was pioneer in production of Hypodermic needles.
 Facts

Becton Dickinson has been in the middle of the controversy regarding the manufacturing, sale and
monopoly of safety syringes used by hospitals, clinics, and doctor and dentist offices. When the
epidemic of AIDS and other lethal and infectious diseases spread across the nation, healthcare workers
were still using a conceptualization of the original type of syringe created over 150 years ago (Holding
and Carlsen, 1998; Holding and Carlsen, 1998).

The healthcare workers realized that they were no longer safe and fought to get safer standards and
equipment for use in the work place.

By 1998, the federal patent office has given patents to over 1000 designs for safety syringes. However,
only a few were on the market and their initial cost was exorbitant. Even with the Occupational Safety
and Health Administration’s (OSHA) enactment of the Bloodborne Pathogen Standard in 1991, and the
Needlestick Safety and Prevention Act little has been truly done to protect the healthcare workers
(Holding & Carlsen, 1998; Holding and Carlsen, 1998, Armstrong, 1991; Vadgama, 2002; Workers at risk,
2002).

A prime example was in 2002 when it was approximated that 1600 healthcare workers could contract
HIV through needle sticks in that year (Vadgama, 2002), with a rough estimate cost of $255,000 for the
direct and indirect costs associated with that one needle stick (Armstrong, 1991).

The fact that Becton Dickinson purchased a number of the patents for safer syringes, they only offered
on size when they finally started to manufacture the syringe. The 3cc was fine for a few tasks in
hospitals and clinics, but the 5cc and 10cc were used more often.

Becton Dickinson did not offer the shielded syringes in this size, and by buying patents and negotiating
with medical supply companies they did not need to make any other size.

They continued to sell their original syringes (Holding & Carlson, 1998; Holding & Carlsen, 1998). These
actions defined by the utilitarian approach shows that the company was doing what was good for the
company. In essence, Becton Dickinson was basing their decisions on the corporate population rather
than the public.

(After court battles and settlements the Becton Dickinson Company has finally begun to manufacture all
types of safety syringes. While they are not recommended, they are made and sold.)
The technology for safety needles took a giant step forward in 1998 when Retractable
Technologies, Inc., unveiled a new safety syringe that rendered needle sticks a virtual
impossibility.

During the 1990s, hospitals and clinics had attempted to cut costs by reorganizing themselves
around a few large distributors called Group Purchasing Organizations or GPOs. A GPO is an
agent that negotiates prices for medical supplies on behalf of its member hospitals.

When Retractable tried to sell its new syringe, which was recognized as the best safety syringe
on the market and as the only safety syringe capable of completely eliminating all needlesticks
in a nursing environment, it found itself blocked from doing so. In 1996, Becton Dickinson had
gotten Premier GPO to sign an exclusive, 7 ½-year, $1.8 billion deal that required Premier’s
member hospitals to buy at least 90 percent of their syringes and needles from Becton
Dickinson. Around the same time, Becton Dickinson had signed a similar deal with Novation

Continuing to find itself locked out of the market by Becton Dickinson’s contracts with Premier
and Novation, Retractable sued Premier, Novation and Becton Dickinson in federal court
alleging that they violated antitrust laws and harmed consumers and numerous health care
workers by using the GPO system to monopolize the safety needle market

In 2003, Premier and Novation settled with Retractable out of court, agreeing to henceforth
allow its member hospitals to purchase Retractable’s safety syringes when they wanted. In
2004, Becton Dickinson also settled out of court, agreeing to pay Retractable $ 100 million in
compensation for the damage Becton Dickinson inflicted on Retractable. During the 6 years
that Becton Dickinson’s contracts prevented Retractable and other manufacturers from selling
their safety needles to hospitals and clinics, thousands of health workers continued to be
infected by needlesticks each year.
 Ethical Dilemma

In general, an ethical dilemma is a complex situation a person (business) faces in which a

decision must be made about the adequate action to be taken. A dilemma may derive from the
conflict between the rightness and wrongness of the actions and the goodness or badness of
the consequences of the actions. In other words, doing what is morally right apparently results
in a bad outcome and doing what is morally wrong seems to lead to better effects. From
another perspective, an ethical dilemma is a conflict between at least two ethical principles
both of which could lead to an equally good or equally bad outcome. In such a situation,
obeying one principle leads to transgressing another, whereas both principles seem equally
valid.

Here in this case, the ethical dilemma of BD must be identified.

BD had to go by marketing strategies or perform by its corporate social responsibility.

Each year, hundreds of thousands of workers and health workers are exposed to deadly
diseases like HIV and hepatitis C through needle stick injuries and sharps. With the technology
that exists today, nurses should not face such a risk. The American Nurses Association is
dedicated to working with nurses throughout the country to reduce such significant needle
stick and sharps injuries. Nurses should not put at risk their lives every time they use a needle
or sharp instrument.

Then the problem was identified that the only way the issue could be resolved is through safe
syringes. Around 70 percent of all the needles and syringes are made by Becton Dickinson. As
the issue was crucial and urgent Becton Dickinson refuse to bring change in their syringes.

The dilemma of harmful actions is a significant case of ethical dilemma and assumes a situation
in which each of the options identified in the process of ethical decision making will cause harm
or injury. It has been seen that they did not showed any curiosity to solve the problem. It was
also observed that the new design implementation was not the difficult task for the Becton but
they have to face the competition with the flagship product. In the era of 1972 to 1986 Becton
did not change anything in their product.

In this case, BD had the moral obligation to provide safety needles for which they had a patent
when it was necessary.

Blocking the superior technology or Retractable from the market with its influence in GPOs
could be analyzed as an unethical market strategy.
 Solution

Becton Dickinson’s case poses a question of business ethics. It is very important to discuss
because it involves serious issues. Safety of medical practitioners and doctors are very
important in their field of work and it is not ethical for BD to use patents and their influence in
the name of marketing strategy to disregard their safety.

BD must have acted ethically.

The fact is that while Becton Dickinson was fighting to keep the new safety syringes from the
public, Retractable Technologies, Inc created a better and safer syringe with top
recommendations for safety and ease of use. If Becton Dickinson would have acted ethically
and manufactured and researched safety syringes, they would be at the top of the industry.

Since a new design implementation was an easy task and they had patents for better models of
safety syringes, it must have been that they introduced them to the market.

The safety syringes would have increased or bettered their position in the market. Their
unethical actions, not legally but morally, has brought bad reputation and money loss.

They had to give compensation to Retractable and all parties that suffered due to their action.

Therefore, it is the most obvious solution in this case that both from the outlook of market and
their ethics that if they had acted ethically, that is use the better designs of safety syringes and
not use ill means to hinder other corporations, they would be in a much better position.
 Conclusion

Becton Dickinson, Premier and Novation were working with GPO’s in a monopoly. They had
such control of the market that organizations that had far better ranked products, were unable
to enter the market at the level that would’ve been if the GPO’s didn’t exist. It was argued that
because the GPO’s actually got paid by the manufacturer, rather than the consumer of the
medical supplies, which increases my interpretation of this being characterized as a monopoly.
It would’ve been too expensive for the consumers or the GPO’s to exit the contact, which
caused them to stay in contracts with these companies who firstly, weren’t providing the best
of the market products, secondly, increased the number of workers who were affected by work
injuries due to the use of these “not recommended” products.

The whole situation was disturbing. It is very unfair for such a large organization to take such
little interest in the purpose their product is used for, the potential life threatening dangers
associated with the use of it. I am pleased to know that they had to pay out such large sums of
money to those who it caused harm to. I wouldn’t say it was personally potential, but any
reasonably prudent person, especially management within an organization has to know the
demands and risks incorporated with their product and the industry they are in.
 Sources

1) https://smallbusiness.chron.com/causes-ethical-dilemma-conducting-business-23439.html
2) BUSINESS ETHICS: ETHICAL DECISION MAKING AND CASES, FRAEDRICH J & FERELL, 9th
Edition
3) http://businesscasestudies.co.uk
4) https://www.scu.edu/