The Dark Secrets of Johnson & Johnson by Gardiner Harris Summary
Hey there. You're tuned in to the deep dive and today we're peeling back the layers on a company you probably think you know inside out: Johnson and Johnson. Absolutely. I mean, for most of us J&J is just—well, it's everywhere, isn't it? It really is as American as apple pie. You could say woven into daily life: that baby powder smell, Band-Aids, Tylenol, even really critical medicines.
And they've got this reputation, right? Consistently ranked among the world's most admired corporations for decades, touching over a billion people daily, they say. Exactly. Which brings us to the core of today's deep dive. It's this fascinating, maybe deeply disturbing paradox. How can this company, so beloved, so trusted for generations with its famous credo about never putting profits before people, also be at the center of these huge ethical scandals?
These massive legal battles, accusations of putting the bottom line first, sometimes with devastating consequences for people, for patients, consumers. It's a jarring contrast. It really is. So, our mission today is to unpack this really complex, often troubling story of Johnson and Johnson. We want to move beyond that polished public image using our source material to reveal a much more nuanced history.
And what's interesting is how this whole thing started for the reporter behind our main source. It wasn't some big expose from the get-go. No, not at all. He was just assigned to cover the pharma industry. And then, bit by bit, he started uncovering a story completely different from the one we all thought we knew—a company hiding in plain sight, ever-present but in some ways invisible.
So how did these cracks start to show? For our source, it kicked off with this random encounter in an airport bar of all places. He's a drug reporter sitting next to a pharmaceutical sales rep from Janssen, J&J's big drug unit. He tells her what he does. She kind of makes a face. But then she tells him a story, a story that apparently fueled his reporting for years to come.
And it's a really revealing story, isn't it? This sales rep's confession. Totally. She talks about her 10-year-old nephew. He gets into a schoolyard fight. The principal insists he sees a shrink. And because she sells Risperdal, this heavy-duty drug for schizophrenia, she offers to get him in quick with one of her “favorite” psychiatrists.
She expected the kid would just get a talking-to. Instead, the doctor immediately gives her sister free samples of Risperdal—the same samples the sales rep herself had probably just dropped off days before. And this psychiatrist was one of her whales, the big prescribers who drive bonuses. Precisely. And J&J paid this guy, paid him well, to give marketing talks about Risperdal to other doctors. So he was essentially on their payroll, pushing their drug.
She was shocked, regretted it instantly. She told her sister, “Think a minute before giving him that medicine.” But it was too late. Over the next year, her nephew gained 25 pounds, became so embarrassed about his size, he stopped going swimming with her. It's heartbreaking. Her confession saying J&J's claims that Risperdal was safer were misleading came too late—for so many kids and adults, too.
And this really highlights J&J's strategy: marketing Risperdal way beyond what the FDA actually approved it for, which was schizophrenia. The drug itself was 40 times more expensive than older drugs but no more effective. And the side effects were serious: rapid weight gain, diabetes risk, strokes, and awful neurological problems like tics and tremors—extrapyramidal side effects, they call it—which could last even after stopping the drug.
So how do you sell a drug like that, for a condition that doesn’t affect a huge percentage of the population? J&J figured out a way. They came up with a strategy: sell to the symptoms. Basically ignoring FDA rules, kind of defying the law. They told their sales teams, look, schizophrenia can have almost any psychiatric symptom. Therefore Risperdal could be marketed for everything—depression, agitation, you name it. Classic off-label promotion.
And they particularly targeted children and the elderly. That’s where they saw the growth potential. Illegal potential, but as the source puts it: limitless and perilous. That phrase really sticks. Limitless and perilous.
She says that J&J told their sales reps, “Find psychiatrists who see a lot of kids. They’ll diagnose them with ADHD, bipolar, oppositional defiant disorder. Get Risperdal into that pipeline.” And so these kids, some as young as four and five, were put on a drug that was never meant for them.
And the same thing happened with elderly patients in nursing homes. J&J targeted doctors and facilities there, knowing that staff wanted an easy way to quiet down difficult patients with dementia. The problem? Risperdal increased the risk of death in elderly dementia patients. And J&J knew it. Internal emails showed that they were aware of this and still pushed forward.
This marketing campaign was massive. J&J’s sales of Risperdal and its sister drug, Invega, reached billions. It was one of the company’s biggest blockbusters. But the consequences were devastating—boys developing breasts (a condition called gynecomastia), patients suffering strokes, diabetes, or uncontrollable tremors. Families were blindsided, never warned of these risks.
Eventually, lawsuits piled up. One case after another exposed the tactics J&J used. Marketing to children, pushing off-label uses, paying doctors to promote the drug. The Department of Justice stepped in, and in 2013, J&J paid over $2.2 billion to settle criminal and civil charges related to Risperdal. At the time, it was one of the largest healthcare fraud settlements in U.S. history.
But what’s shocking is how little impact this seemed to have on the company overall. $2.2 billion was huge, but J&J made tens of billions annually. It was just the cost of doing business. They never admitted wrongdoing, and they kept that wholesome family-friendly image intact. The brand, the logo, the baby shampoo—all of it remained untouched in the public eye.
And Risperdal was only one scandal. Think about the talc and baby powder lawsuits. For decades, J&J denied that their iconic baby powder contained asbestos. Yet internal documents showed that they had known since the 1970s about the contamination risks. Women came forward saying the powder caused ovarian cancer. Thousands of lawsuits followed, and courts ordered J&J to pay billions in damages.
Then there’s the opioid crisis. J&J wasn’t the biggest player compared to Purdue Pharma, but they played a role. They supplied the raw narcotic ingredients, marketed opioids, and were accused of downplaying addiction risks. In 2019, they were ordered to pay $572 million in Oklahoma for their part in fueling the epidemic.
And yet, through all this, Johnson and Johnson’s reputation somehow endured. Their credo—written in 1943—emphasized responsibility to doctors, nurses, mothers, fathers, and children before shareholders. It was their shield, their brand halo. Even after massive scandals, recalls, and lawsuits, J&J remained in the top ranks of the most admired companies list.
Part of that is because they had these moments of corporate heroism, like the Tylenol crisis in 1982. When cyanide-laced capsules killed seven people, J&J pulled 31 million bottles off shelves nationwide. They introduced tamper-proof packaging and set a gold standard for crisis management. People still point to that as an example of integrity and responsibility.
But the darker truth is that this same company was capable of hiding data, misleading doctors, and putting profits over people when it came to other products. The contrast is staggering.
And it’s not just drugs and powders. J&J has faced scandals over medical devices too. Hip implants that failed and left patients in agony. Surgical mesh that caused debilitating pain. Blood glucose monitors that malfunctioned. One failure after another, leading to recalls, lawsuits, and billions in settlements.
Each time, the pattern was similar: deny, delay, and defend. J&J would fight the cases for years, often appealing verdicts, dragging things out until victims either gave up or accepted smaller settlements. And when they did pay, it hardly dented the company’s bottom line.
One of the most disturbing aspects is how close J&J has been to regulators like the FDA. Many former FDA officials went on to work for the company, and critics argue that the watchdog agency was far too lenient. Dangerous products often stayed on the market for years before action was taken. Patients were the ones who paid the price.
And through all of this, J&J’s public image barely wavered. Ads still showed smiling babies, happy families, clean white bandages. That logo in its flowing cursive script still evoked trust. For most consumers, the scandals were distant headlines. The brand loyalty was unshaken.
The company’s sheer size and diversification also protected it. With divisions in pharmaceuticals, medical devices, and consumer products, even when one area was hit by lawsuits, the others carried the business forward. J&J was simply too big, too ingrained in everyday life, to topple.
Still, the contradictions are hard to ignore. A company that presented itself as the gold standard of ethics, with a credo about putting patients first, was at the same time responsible for some of the biggest corporate scandals in healthcare. Lives were ruined, trust was betrayed, and profits kept rolling in.
The story of Johnson and Johnson is really the story of modern American healthcare—innovation and lifesaving products on one side, deception and exploitation on the other. It’s a reminder that no brand, no matter how trusted, is above scrutiny.
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