On June 12, 2026, a three-justice panel of the Illinois Fifth District Appellate Court reversed a jury verdict against Mead Johnson — the maker of Enfamil — in a necrotizing enterocolitis (NEC) case, and ordered the case to be tried again. The decision, Watson v. Mead Johnson & Company, LLC, 2026 IL App (5th) 240936, threw out a 2024 verdict a St. Clair County jury had returned for a mother, Jasmine Watson, whose premature baby developed NEC after being fed cow’s-milk-based formula.
For families following this litigation, a headline like “appeals court dumps NEC verdict” can be alarming. It sounds like the cases are collapsing. They are not. A reversal on appeal is a specific, technical event with a specific meaning — and understanding it is the difference between reading the news accurately and being frightened by it. This article explains what actually happened in Watson, what the learned intermediary doctrine is, and what a “new trial” order does and does not mean for the roughly 810 families whose cases remain active in the federal litigation.
What did the appeals court actually decide?
The Illinois Fifth District did not decide that cow’s-milk formula is safe, that Mead Johnson did nothing wrong, or that Jasmine Watson has no case. It decided that the jury was given the wrong legal instructions before it deliberated, and that the error was serious enough to require a do-over. Under Illinois law, when an instructional error “tainted the entirety of the trial proceedings,” the remedy is a new trial — not a dismissal. The court sent the case back so it can be tried again in front of a new jury, this time with corrected instructions.
In plain terms: the referee blew a call, so the game gets replayed. Nobody was told the plaintiff loses. The specific call the appellate panel faulted was the trial judge’s refusal to instruct the jury on the learned intermediary doctrine.
The core distinction. A verdict can be undone two very different ways. A court can rule the plaintiff never had a legally sufficient case (that ends it), or it can rule that a fair trial requires fixing an error and trying again (that restarts it). Watson is the second kind — a reset, not a defeat.
What is the learned intermediary doctrine?
The learned intermediary doctrine is a rule that shows up throughout prescription-drug and medical-device litigation. It holds that when a product is prescribed and administered through a trained medical professional, the manufacturer generally satisfies its legal duty to warn by warning the treating physician — the “learned intermediary” — rather than warning the patient or parent directly. The theory is that the physician stands between the manufacturer and the patient and is the person positioned to weigh the risks and make the call.
The notable move in Watson is that the Illinois court applied this prescription-drug rule to NICU infant formula. Specialized cow’s-milk-based fortifiers and preterm formulas are ordered by the neonatology team and administered inside the hospital, not chosen off a store shelf by a parent. The appellate panel reasoned that because the product was, in its words, prescribed and administered by physicians, any duty to warn ran to those physicians — and the jury should have been told so. One widely read defense-side legal analysis summarized the ruling as treating NICU formula as a “prescription in all but name.”
“A reversal on a jury-instruction question is a fight about the rules of the trial, not about whether these babies were hurt,” says Alex Alvarez, Managing Partner of The Alvarez Law Firm and a Board Certified Civil Trial Lawyer. “The learned intermediary doctrine doesn’t make a case go away. It reshapes who the warning was supposed to reach — and in a NICU case, that puts the hospital record, the informed-consent conversation, and what the manufacturer told the neonatologists squarely at the center of the retrial.”
Why the doctrine can help plaintiffs as much as defendants
It is easy to read the learned intermediary doctrine as a shield for manufacturers. But applied honestly, it raises a question that can cut hard against a formula maker: what, exactly, did the company tell the physicians? If the duty is to warn the treating team, then the strength of the warning the manufacturer actually gave the NICU — on the label, in the product literature, in communications with the hospital — becomes the whole ballgame.
“When the case turns on the warning given to the medical team, the discovery focus shifts to the neonatology chart and the company’s own communications with hospitals,” says Herb Borroto, M.D., J.D., the firm’s Medical-Legal Expert. “What risk information reached the physicians who ordered the feeds? Was the NEC risk for cow’s-milk formula in very-low-birth-weight infants disclosed in a way a clinician would act on? Those are answerable questions, and the answers live in records we know how to read.”
Was the reversal an outlier — or a sign the cases are weak?
It was not a sign of weakness. The most useful context is that a second appellate court reached the opposite result within roughly the same window. On May 5, 2026, the Missouri Court of Appeals affirmed a St. Louis jury’s verdict against Abbott (the maker of Similac) in Gill v. Abbott Laboratories, rejecting Abbott’s challenges to causation, negligence, and the size of the award. The Missouri panel described “compelling evidence” that Abbott understood its formula posed heightened risk to infants under 1,500 grams. That verdict stands.
So within about five weeks, one appeals court reversed an Enfamil verdict on an instructional issue and ordered a new trial, and another appeals court upheld a Similac verdict on the merits. Read together, the two outcomes tell you the litigation is being contested seriously on appeal, decision by decision — not that it is falling apart. As a matter of law, an instructional reversal in Illinois does not bind courts in the federal MDL or in other states, each of which applies its own instruction rules.
What does this mean for the federal MDL and the bellwether trials?
The Watson case was a state-court case in Illinois. The largest block of NEC cases sits in a separate federal proceeding — the multidistrict litigation, MDL 3026, before U.S. District Judge Rebecca Pallmeyer in the Northern District of Illinois, where roughly 810 cases were pending as of July 2026. The federal bellwether trials proceed on their own schedule and under federal instruction practice.
We cover the federal picture in depth in our companion pieces on the 2026 NEC bellwether trials and the first federal Enfamil trial. The short version: bellwether trials are test cases chosen to show both sides how juries respond to the evidence, and their results shape how the rest of the litigation is negotiated and tried. A state-court reversal like Watson is one more data point the parties will study — particularly on how instructions get framed — but it does not reset the federal calendar.
What families should take from all of this
Three practical points.
First, a reversal is not a dismissal. When you see a headline that a verdict was “thrown out,” read one layer deeper: was the case ended, or ordered retried? In Watson it was ordered retried. The plaintiff keeps her right to present the case to a jury.
Second, the medical evidence is untouched. Nothing in the Illinois ruling questioned the body of neonatology research linking cow’s-milk-based formula to NEC in premature infants, or the American Academy of Pediatrics’ long-standing recognition of human milk’s protective role. The reversal was about who the warning legally reached, not about whether the harm is real. If you want the underlying science, see the science linking cow’s-milk formula to NEC.
Third, deadlines keep running regardless of appellate headlines. Whether a particular verdict is affirmed or reversed on appeal has no effect on the statute of limitations that governs your own family’s potential claim. Those deadlines turn on your child’s dates and your state’s law, and they are often shorter than parents expect. If you have been waiting to see “how the cases turn out” before speaking with a lawyer, understand that the clock does not wait for the appeals to finish.
Past results do not guarantee future outcomes. The verdicts described here are reported as news of specific case events. Every case is different, and no prior verdict — affirmed or reversed — predicts what would happen in any other family’s case.
How The Alvarez Law Firm reads a case like this
When a firm evaluates an NEC claim, the appellate back-and-forth in Watson and Gill is a reminder that these cases are won or lost on the details of the record: what was fed, when, to a baby of what gestational age and birth weight; what the NICU documented; and what the manufacturer told the treating physicians about the risk. That is the work — not the headline. Our team, led by Board Certified Civil Trial Lawyer Alex Alvarez and supported by Medical-Legal Expert Herb Borroto, M.D., J.D., reviews these records for families nationwide at no cost.
Free, confidential case review. No fees unless we recover compensation for you.
- See where the federal litigation stands: NEC bellwether trials in 2026.
- Read the first federal Enfamil trial preview: Inman v. Mead Johnson.
- Understand how the injury is graded: Bell staging of NEC.
- See if your family qualifies: Do I qualify for an NEC lawsuit?
Frequently asked questions
Does a reversed verdict mean the NEC lawsuits are failing?
No. The Illinois appellate court reversed the Watson verdict because of an error in the jury instructions, not because the underlying NEC claim was invalid. The court ordered a new trial rather than dismissing the case. In the same period, the Missouri Court of Appeals affirmed a separate NEC verdict against Abbott, and roughly 810 cases remain active in the federal MDL.
What is the learned intermediary doctrine?
The learned intermediary doctrine is a product-liability rule holding that a manufacturer of a prescription or physician-directed product satisfies its duty to warn by warning the treating physician rather than the patient directly. The Illinois Fifth District applied it to NICU cow’s-milk formula, reasoning that the formula was prescribed and administered by the medical team, so any warning duty ran to the physician.
What happens after a verdict is reversed and a new trial is ordered?
A new-trial order sends the case back to the trial court to be tried again, this time with corrected jury instructions. The plaintiff keeps the right to present the case to a new jury. A reversal is a procedural reset, not a final loss, and past results do not guarantee future outcomes.
Does the reversal change the science linking cow’s-milk formula to NEC?
No. The reversal turned on a jury-instruction question about who the warning was owed to, not on the medical evidence connecting cow’s-milk-based formula to necrotizing enterocolitis in premature infants. The scientific record cited by neonatology researchers and the American Academy of Pediatrics is unaffected by the ruling.
Sources
- Illinois Fifth District Appellate Court — Watson v. Mead Johnson & Company, LLC, 2026 IL App (5th) 240936 (June 12, 2026). Opinion (reversed and remanded for new trial). courtlistener.com
- American Academy of Pediatrics — AAP News, “Court reverses $60 million verdict in NEC case.” publications.aap.org
- Missouri Court of Appeals — Gill v. Abbott Laboratories (verdict affirmed May 5, 2026). Coverage: harrismartin.com
- U.S. District Court, Northern District of Illinois — In re: Abbott Laboratories, et al., Preterm Infant Nutrition Products Liability Litigation, MDL No. 3026 (Judge Rebecca Pallmeyer). ilnd.uscourts.gov
- American Academy of Pediatrics — Policy on human milk and the reduction of NEC risk in preterm infants. aap.org
- NIH National Library of Medicine / PMC — Peer-reviewed research on cow’s-milk formula and necrotizing enterocolitis. ncbi.nlm.nih.gov/pmc