A US jury has ordered Johnson & Johnson to pay a record $4.69 billion to 22 women who alleged the company's talc-based products, including its baby powder, contain asbestos and caused them to develop ovarian cancer.
The verdict is the largest J&J has faced to date over allegations that its talc-based products cause cancer.
The company is battling some 9,000 talc cases. J&J denies both that its talc products cause cancer and that they ever contained asbestos.
It says decades of studies show its talc to be safe and has successfully overturned previous talc verdicts on technical legal grounds.
The massive verdict, handed down in the Circuit Court of the City of St Louis, was comprised of $550m in compensatory damages and $4.14 billion in punitive damages.
J&J in a statement called the trial "fundamentally unfair" and said it would appeal the decision.
The jury's decision followed more than five weeks of testimony by nearly a dozen experts on both sides.
The women and their families said decades-long use of Baby Powder and other cosmetic talc products caused their diseases.
They alleged the company knew its talc was contaminated with asbestos since at least the 1970s but failed to warn consumers about the risks.
"Johnson & Johnson is deeply disappointed in the verdict, which was the product of a fundamentally unfair process," the company said in a statement.
The company said it remained confident that its products do not contain asbestos or cause cancer.
"Every verdict against Johnson & Johnson in this court that has gone through the appeals process has been reversed and the multiple errors present in this trial were worse than those in the prior trials which have been reversed," J&J added, saying that it would pursue all available appellate remedies.
J&J has successfully overturned talc verdicts in the past, with appeals courts pointing to a 2017 decision by the US Supreme Court that limits where personal injury lawsuits can be filed.
Of the 22 women in the St Louis trial, 17 were from outside Missouri, a state generally regarded as friendly towards plaintiffs.
The practice of combining plaintiffs in such jurisdictions, commonly criticised as "forum shopping" by defendants, will be challenged on appeal.
The majority of the lawsuits that J&J faces involve claims that talc itself caused ovarian cancer, but a smaller number of cases allege that contaminated talc caused mesothelioma, a tissue cancer closely linked to asbestos exposure.
The cases that went to trial in St Louis effectively combine those claims by alleging asbestos-contaminated talc caused ovarian cancer.
Previous talc trials have produced verdicts as large as $417m.
But that 2017 verdict by a California jury, as well as other verdicts in Missouri, was overturned on appeal, and challenges to at least another five verdicts are pending.
The U.S. Food and Drug Administration commissioned a study of various talc samples from 2009 to 2010, including of J&J's Baby Powder. No asbestos was found in any of the talc samples, the agency said.
But jurors were told during the trial that the agency and other laboratories and J&J have used flawed testing methods that did not allow for the proper detection of asbestos fibres.
Talc, the world's softest rock, is a mineral closely linked to asbestos and the two substances can appear in close proximity in the earth.
Plaintiffs claim the two can become intermingled in the mining process, making it impossible to remove the carcinogenic substance.
J&J denies those allegations, saying rigourous testing and purification processes ensure its talc is clean.
