A Pennsylvania court has rejected a Johnson & Johnson subsidiary’s efforts to overturn a $13.5 million verdict over injuries a Philadelphia jury determined were caused by a pelvic mesh device implanted during surgery.

A unanimous three-judge Superior Court panel on April 11 affirmed the multimillion-dollar verdict in Carlino v. Ethicon, which a jury awarded in February 2016. The case was the second pelvic mesh trial in Philadelphia state court, and ended with a verdict of $3.5 million in compensatory damages and $10 million in punitive damages.