A Maryland federal judge has once again ruled that Alfasigma failed to comply with the terms of a permanent injunction tied to a $15 million jury verdict in a long-running legal battle over a proprietary probiotic formula.

U.S. District Judge Theodore Chuang found that the biomedical company did not demonstrate “good faith substantial compliance” with his 2019 injunction, which barred Alfasigma and other companies from making certain claims about “VSL#3,” a probiotic developed by researcher Claudio De Simone. The injunction followed a 2018 jury verdict finding that Alfasigma and two other drugmakers had unlawfully used De Simone’s formula and violated false advertising laws.

In a ruling issued Monday, Judge Chuang pointed to posts on Alfasigma’s website and responses to healthcare provider inquiries as clear violations of the injunction. He ordered the company to pay ExeGi Pharma’s reasonable attorney’s fees for bringing the motion, describing Alfasigma’s actions as “completely unacceptable.”

“The court finds that the failure to subject such content to review by Alfasigma personnel for compliance with the permanent injunction to be completely unacceptable,” Judge Chuang wrote.

This marks the third time ExeGi Pharma has accused Alfasigma of violating the injunction. In 2020, the court found that Alfasigma and VSL Pharmaceuticals, another company involved in the case, breached the order through misleading Facebook posts about their products. However, a separate 2021 effort by ExeGi to secure a similar finding was denied.

Alfasigma acknowledged that its website posts violated the injunction but claimed the breach was inadvertent. The company attributed the issue to a contractor tasked with developing a new healthcare provider section on its website, arguing that oversight during the webpage approval process led to the non-compliant language.

“Alfasigma asserts that it engaged a contractor … and that the language … was overlooked during the webpage approval process,” Judge Chuang noted, adding that the company had effectively abdicated its responsibility to ensure compliance with the court order.

Judge Chuang rejected ExeGi’s claims that Alfasigma’s training materials for new hires and sales staff also violated the injunction, finding them “legally inappropriate” but concluding that there was no evidence the materials were distributed to or used with consumers.

While ExeGi sought millions of dollars in disgorgement, Judge Chuang limited the sanction to attorney’s fees. Alfasigma’s attorney, Mark Weissman of Offit Kurman PA, expressed relief over the decision, noting that the court denied ExeGi’s broader demands and efforts for further discovery.

“Although our client made substantial efforts to comply with the injunction, we understand that the court found that our client’s efforts fell short,” Weissman said in a statement. “We are also glad that the court denied ExeGi’s request for continuing discovery, so that this matter can finally be put to rest.”

ExeGi representatives did not immediately respond to requests for comment.

The case is De Simone v. VSL Pharmaceuticals Inc. et al., case number 8:15-cv-01356, in the U.S. District Court for the District of Maryland.