Johnson & Johnson failed to persuade a Missouri trial judge to set aside a July verdict awarding a record $4.69 billion to 22 women who blamed their ovarian cancer on asbestos in the company’s Baby Powder and other talc products.

The healthcare company faces thousands of lawsuits over the safety of talc in its Baby Powder, a fixture of its consumer products division that has been core to J&J’s reputation as a family-friendly company.

J&J has fought back, saying its talc is safe and has never contained asbestos or any carcinogens.

The trial was the first in which plaintiffs claimed that asbestos fibers in J&J’s talc caused ovarian cancer. It relied on unsealed internal company documents that the plaintiffs allege detail J&J’s knowledge of asbestos contamination since at least the 1970s.

St. Louis Circuit Court Judge Rex Burlison in the ruling on Wednesday denied a J&J request to toss the verdict, saying the jury’s decision and the large award of punitive damages was justified.

The judge said: “substantial evidence was adduced at trial of particularly reprehensible conduct on the part of defendants, including that defendants knew of the presence of asbestos in products that they knowingly targeted for sale to mothers and babies, knew of the damage their products caused, and misrepresented the safety of these products for decades.”

Reuters on Dec. 14 published a special report that the firm knew for decades that cancer-causing asbestos could be found in the product.

The company’s stock has dropped more than 13 percent since Friday, wiping out more than $45 billion in J&J’s market value.

Shares on Wednesday were up about 0.4 percent at $128.17.

J&J in a statement said the failed motion was merely a formal step required before appealing the verdict.

“The same judge has denied similar motions on prior verdicts in his court that were ultimately overturned by the appellate courts. We are confident this verdict will also be overturned on appeal,” J&J said.

The St. Louis jury in July awarded $550 million in compensatory damages and $4.14 billion in punitive damages.

Mark Lanier, the women’s lawyer during trial, in a statement said plaintiffs were pleased with Burlison’s decision.

Decades-Long Use

The women and their families said decades-long use of baby powder and other cosmetic talc products caused their illness. They allege the company knew its talc was contaminated with asbestos since at least the 1970s but failed to warn consumers about the risks.

While plaintiffs in the long-running litigation in the past had claimed talc itself causes ovarian cancer, plaintiff lawyers in recent months shifted their claims to allege asbestos in the talc causes mesothelioma, a cancer closely linked to asbestos exposure, and ovarian cancer.

J&J denies that its talc products ever contained asbestos and says decades of studies and regulatory assessments show its talc to be safe.

Missouri’s appeals court has overturned two prior ovarian cancer talc verdicts against J&J on technical legal grounds, saying the decisions could not stand following a 2017 U.S. Supreme Court decision limiting where companies can be sued for personal injuries.

The company in its September motion made a similar argument, telling Burlison that the women, the majority of whom were from out-of-state, had no right to sue in Missouri.

J&J also said Lanier during the trial “substituted proof and evidence with misleading and inflammatory graphics,” including an image depicting J&J pushing a woman off a cliff into ovarian cancer.

But Burlison in his Wednesday ruling said the cases rightly belonged in Missouri court due to J&J’s connection to the state.

More than 9,700 talc lawsuits, the vast majority of those J&J faces, allege asbestos-laced cosmetic talc caused ovarian cancer, while a smaller number claim its use led to mesothelioma.

J&J has won a total of four jury trials, involving both ovarian cancer and mesothelioma claims. A California trial court judge in October 2017 threw out a $417 million ovarian cancer verdict against the company, saying there had been insufficient evidence to support the award.

Juries in four additional mesothelioma trials could not reach verdicts, resulting in mistrials. (Additional reporting by Manas Mishra in Bengaluru.)