In a fraud case closely watched by biotech and pharma companies, the US Supreme Court sided with investors suing a drug maker for not disclosing adverse events to them. In Matrixx Initiatives, Inc. et al. v. James Siracusano et al. investors claimed that Matrixx's failure to disclose adverse events (anosmia, or loss of smell) concerning its blockbuster cold remedy nasal spray Zicam led to investment losses. On March 22, a unanimous Supreme Court declined to adopt a bright-line rule that would protect Matrixx from liability. The company argued it had no duty to disclose because such events were not statistically significant (Nat. Biotechnol. 28, 1142, 2010). However the Court's opinion, written by Justice Sonia Sotomayor, said the absence of statistical data “does not mean that medical experts have no reliable basis for inferring a causal link between a drug and adverse events.” She continued, “This is not a case about a handful of anecdotal reports, as Matrixx suggests. Matrixx received information that plausibly indicated a reliable causal link between Zicam and anosmia. This included information about more than ten patients who had lost their sense of smell after using Zicam. Sotomayor added that the court's ruling did not mean that drug makers must disclose all reports: “[S]omething more is needed, but that something more is not limited to statistical significance and can come from the source, content, and context of the reports.” Michael Francisco