A Pennsylvania appeals court upheld a $70 million verdict against Johnson & Johnson in a lawsuit charging its Risperdal anti-psychotic drug caused a man to grow female breasts and also ruled that punitive damages may be available in the case.

In addition to upholding the verdict for Tennessee resident Andrew Yount, the Pennsylvania Superior Court Tuesday sent back to the Philadelphia trial judge the issue of punitive damages in the case, potentially raising the stakes for J&J. The company was hit last month with $8 billion in punitive damages in another Philadelphia Risperdal case.

In upholding $70 million award to Yount, the three-judge appeals court panel noted the plaintiff had taken Risperdal since he was a toddler and his breast growth left him with a “severe and permanent disfigurement” that made him a target for bullies.

J&J and its Janssen unit said in securities filings this year the company still faces more than 13,000 suits claiming Risperdal use led to breast development. Plaintiffs allege J&J hid that potential side effect in an effort to turn Risperdal into a blockbuster drup for the company.

Jake Sargent, a J&J spokesman, said Tuesday the company will evaluate its options for further appeal of Yount’s case. “We continue to maintain that the verdict is contrary to both the facts of record and the applicable law,” Sargent said in an emailed statement.

In court filings, the company contends it properly disclosed Risperdal’s risks on its safety label and the trial judge in Yount’s case erred in blocking some of J&J’s experts from testifying in the case.

Court of Common Pleas Judge Arnold New, who oversees Philadelphia’s mass-tort program, ruled in 2014 none of the Risperdal cases warranted punitive-damage hearings. A Superior Court appeals panel concluded in January New erred in his assessment of the availability of punitive damages in such cases. The panel on Tuesday cited that January ruling in its decision.

J&J’s shares fell more than 2.4% Oct. 9 after another Philadelphia jury awarded $8 billion in punitive damages to a man who also blamed his female breasts on Risperdal use. Nicholas Murray, a Maryland resident who began taking Risperdal as a child to help battle autism, blamed his breast growth on the drug.

“We look forward to the punitive damage trial in this case,” Yount’s lawyers Tom Kline and Jason Itkin, said in an e-mailed statement. They, along with Philadelphia attorney Stephen Sheller, also represented Murray in the trial of his Risperdal suit.

Plaintiffs contend J&J and Janssen illegally marketed Risperdal to youngsters prior to 2007, when U.S. Food and Drug Administration officials approved its use for teens diagnosed with autism. The companies also face allegations they hid the risk the drug could cause breast development to protect billions of dollars in profits.

In 2013, J&J agreed to pay $2.2 billion to resolve criminal and civil probes into allegations that it illegally marketed the drug to children and the elderly. The settlement, which also includes marketing claims about two other J&J drugs, was one of the largest U.S. health-fraud penalties in history.

The case is A.Y. v. Janssen Pharmaceutical Inc., No. 3058, EDA, 2016, Superior Court of Pennsylvania (Philadelphia)