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Medical Monitoring Clears Legal Hurdle in Puerto Rico EtO Emissions Lawsuit Filed by Milberg

SAN JUAN, Puerto Rico, May 27, 2025 /PRNewswire/ — In a major step for environmental justice, a federal Magistrate Judge has recommended critical claims proceed in a landmark class action lawsuit alleging harmful exposure to ethylene oxide (EtO) in Puerto Rico. If adopted by the District Judge, the ruling would allow plaintiffs to advance claims against three major sterilizer facility operators and pursue the establishment of a court-supervised medical monitoring program, a rare and significant remedy in toxic exposure litigation.


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The case, Pérez-Maceira et al. v. Customed, Inc., et al., alleges the sterilization facilities operated by Customed, Medtronic, and Steri-Tech emitted dangerous levels of EtO into nearby communities for years, subjecting hundreds of thousands of residents, schoolchildren, and workers to elevated cancer risks.

The Report & Recommendation (“R&R”), issued by Magistrate Judge Camille Vélez-Rivé, found the plaintiffs sufficiently alleged facts to support negligence, public and private nuisance claims, and provided a significant opportunity for medical monitoring as potential relief.

“This recommendation is a breakthrough moment for our clients and communities across Puerto Rico,” said Marc Grossman, founding partner at Milberg Coleman Bryson Phillips Grossman, PLLC. “The Court has acknowledged that people exposed to dangerous industrial chemicals may be entitled not just to damages—but to ongoing healthcare and monitoring.”

EPA Identifies Elevated Cancer Risks from EtO in Puerto Rico

The lawsuit arises amid mounting concerns over EtO—a toxic gas used to sterilize medical equipment in industrial settings—emissions nationwide. According to the U.S. Environmental Protection Agency (EPA), EtO is 60 times more toxic to children and 30 times more toxic to adults than previously recognized.

Despite widespread knowledge of its toxicity, those behind EtO sterilization carried on without community warning, leading to large-scale, unconsented exposure—particularly in U.S. territories like Puerto Rico.

In 2022, the EPA identified multiple sterilizer facilities in Puerto Rico—including the defendants in this case—as “red flag” sites, where air modeling demonstrated excess cancer risks far exceeding federal thresholds.

EPA data shows elevated rates of breast cancer, non-Hodgkin lymphoma, respiratory illnesses, and other conditions in communities surrounding the facilities including Salinas, Villalba, Añasco, and Fajardo.

“These companies chose Puerto Rico as their dumping ground,” said Grossman. “They targeted vulnerable communities for chemical risk, and they did so with full knowledge of EtO’s toxic legacy.”

Next Steps and Legal Status

The R&R is not a final decision; the case now awaits review by the presiding U.S. District Judge, who will decide whether to adopt, modify, or reject the Magistrate Judge’s recommendations. No discovery will proceed unless and until the District Judge issues an order adopting the R&R.

While the Magistrate Judge has recommended dismissal of claims against Balchem Corporation, Mays Chemical, and Edward LifeSciences, the plaintiffs will formally object and seek reversal.

If the R&R is adopted, plaintiffs will move forward with discovery and seek class certification to establish a medical monitoring program, providing diagnostic testing and preventative care to those impacted by EtO exposure.

“This is an essential first step, not the finish line,” Grossman emphasized. “The people of Puerto Rico deserve accountability, medical support, and the right to live without fear of toxic air. We will continue fighting for all of that and more.”

About Milberg Coleman Bryson Phillips Grossman, PLLC
For over 50 years, Milberg and its affiliates have been fighting to protect victims’ rights and have recovered over $50 billion for clients. A pioneer in class action litigation, Milberg is widely recognized as a leader in defending the rights of victims of corporate wrongdoing.

Media Contact
Karine Lim
[email protected]

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SOURCE Milberg Coleman Bryson Phillips Grossman PLLC

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