Intuitive Surgical has agreed to pay $450 million to resolve a hospital class-action lawsuit accusing the medical technology company of monopolizing the market for servicing its da Vinci surgical robots, marking a major development in a yearslong antitrust battle. The agreement, disclosed Tuesday in the company’s third-quarter earnings report, still requires approval from a federal judge in California.

The proposed settlement combines a one-time payment with court-ordered injunctive relief for the class. Intuitive Surgical, however, is not admitting liability or wrongdoing as part of the deal.

“The settlement remains subject to preliminary and final Court approval, and there can be no assurance the Court will approve it or that individual class members will not object,” the company said in its filing.

Attorneys representing the parties did not immediately respond to requests for comment.

Intuitive Surgical $450M Settlement Follows Years of Antitrust Disputes

The agreement is the latest turn in litigation that began in May 2021, when health care customers accused Intuitive Surgical of using allegedly anticompetitive contracts to drive up service costs for thousands of providers across the country.

The hospital customers brought the class action, while Surgical Instrument Service Co. Inc., a competitor, launched a separate antitrust lawsuit against Intuitive Surgical that same month. The parallel case remains ongoing, leaving another legal front open for the company.

At the center of the dispute is the da Vinci surgical robot system, which Intuitive Surgical developed for minimally invasive soft-tissue procedures. The company also manufactures EndoWrist surgical instruments that attach to the robot’s mechanical arms.

Those instruments rely on fine wire cables threaded through a complex pulley system, allowing surgeons to maneuver them with exceptional precision. But the technology’s specialized design has become part of a broader fight over who gets to maintain and repair the equipment — and at what price.

Hospitals Challenge Restrictions on Independent Repairs

The plaintiffs allege Intuitive Surgical unlawfully maintained a monopoly in the market for servicing da Vinci systems. According to the hospitals, the company imposed and enforced agreements requiring customers to rely exclusively on Intuitive Surgical for maintenance and repairs.

The alleged restrictions also prevented hospitals from servicing the robots themselves or hiring independent repair companies, which the plaintiffs contend can offer lower-cost alternatives.

The lawsuit brought claims of tying, exclusive dealing and monopolization under Sections 1 and 2 of the Sherman Act, the federal law used to challenge anticompetitive business practices.

After the case survived multiple rounds of challenges to the pleadings, both sides filed competing motions for summary judgment, seeking rulings that could resolve certain claims before trial.

Court Rulings Strengthened the Hospitals’ Case

In March 2024, the court granted the hospital plaintiffs partial summary judgment, concluding that the da Vinci surgical robot and its EndoWrist instruments constituted separate products. However, the judge declined to resolve the market-related questions raised by the hospitals and rejected Intuitive Surgical’s competing summary judgment motion.

The litigation gained another significant milestone in March 2025, when U.S. District Judge Araceli Martinez-Olguin of the Northern District of California certified a class potentially encompassing thousands of entities.

The judge found that the lawsuit presented common antitrust questions that could be addressed collectively, allowing the plaintiffs to pursue their claims through a class action rather than requiring each affected entity to litigate separately.

The proposed $450 million resolution now offers a possible path toward ending the hospital customers’ case, although judicial approval and any objections from individual class members could affect the settlement’s progress.

Legal Teams Represent Both Sides

The hospital class is represented by Jeffrey J. Corrigan and Jeffrey L. Spector of Spector Caldes & Corrigan PC; Gary I. Smith Jr., Samuel Maida and Reena A. Gambhir of Hausfeld LLP; Daniel McCuaig, Manuel J. Dominguez and Christopher J. Bateman of Cohen Milstein Sellers & Toll LLP; and Michael J. Boni of Boni Law Firm LLC.

Intuitive Surgical is represented by Paul D. Brachman, William B. Michael, Crystal L. Parker, Daniel A. Crane and Joshua Hill Jr. of Paul Weiss Rifkind Wharton & Garrison LLP, along with Allen Ruby.

For now, the settlement remains a proposed resolution rather than a final judgment. The outcome will depend on the court’s review, while the separate lawsuit brought by Surgical Instrument Service continues. The dispute highlights a central question in the market for sophisticated medical equipment: whether the companies that build complex surgical systems can also restrict who maintains them and how much providers must pay.