Johnson & Johnson headquarters/photo by Emile Wamsteker/Bloomberg Johnson & Johnson headquarters (Photo: Emile Wamsteker/Bloomberg)

Johnson & Johnson has agreed to pay $120 million to attorneys general in 46 states and Washington, D.C., to resolve marketing claims brought over its hip implants.

The settlement, announced on Tuesday, is the largest agreement that New Jersey-based Johnson & Johnson has made with attorneys general over its ASR XL and Pinnacle Ultamet hip implants, made by its Medical Device Business Inc. division, formerly known as DePuy Orthopaedics Inc. In 2014, Johnson & Johnson paid $4 million to settle a case brought by the Oregon Department of Justice over its ASR hip implants.

“Doctors and their patients need to have accurate and up-to-date information to ensure that patients are receiving appropriate health care,” said Letitia James, attorney general of New York, which will receive nearly $4.7 million under the deal. “Companies should never be allowed to freely mislead the public, especially when there are health concerns involved. This settlement serves as an important message that deceptive and false medical practices will never be tolerated.”

California Attorney General Xavier Becerra said his state would receive $8 million under the agreement.

“Johnson & Johnson is alleged to have deceived vulnerable patients in need of hip replacement and undermined their ability to recuperate quickly and safely,” he said. “There’s no excuse for Johnson & Johnson to have violated its customers’ trust, as well as California consumer protection laws, but we worked to hold them accountable.”

Johnson & Johnson spokeswoman Mindy Tinsley said the $120 million will be distributed among the states. “The settlement involves no admission of liability or misconduct on the part of the companies,” she wrote in an emailed statement. “DePuy Synthes remains committed to meeting the current and future needs of orthopedic surgeons and patients.”

Johnson & Johnson paid $2.5 billion in 2013 to settle civil lawsuits filed over its ASR hip implants, which it recalled, and is settling thousands of cases brought over its Pinnacle devices after losing jury verdicts totaling more than $1.75 billion.

Attorneys general alleged that Johnson & Johnson made misleading advertising claims about the “longevity” of its hip implants, which the National Joint Registry of England and Wales reported had higher failure rates. In some cases, patients had to have the devices surgically removed after suffering pain and finding metal in their blood.

Under the consent judgment, Johnson & Johnson agreed to base its claims on the latest scientific data and revise its complaint procedures.

The states of Texas and South Carolina led the investigation. In addition to those states, and New York and California, the agreement includes attorneys general from 42 other states, including Connecticut, Delaware, Florida, Georgia and Pennsylvania.

The agreement comes on the same day that Johnson & Johnson announced its fourth quarter revenues of $20.4 billion and a sales forecast for 2019 that failed to meet expectations. During last quarter, litigation expenses doubled to $1.29 billion for Johnson & Johnson, which faces additional lawsuits over its baby powder and several pharmaceutical drugs.