The state of Ohio announced Thursday that Johnson & Johnson has agreed to pay nearly $117 million to settle an investigation into their deceptive marketing of transvaginal mesh devices.

Ohio attorney general Dave Yost said the agreement orders Johnson & Johnson, as well as its subsidiary Ethicon, to pay $116.9 million to the 41 participating states and the District of Columbia.

“Patients can’t make the best decision for their health unless they and their health care providers know all the pros and cons of a product,” Yost said in a statement. “These companies didn’t paint a clear picture of the device’s medical risks, preventing patients from making well-informed decisions.”

Transvaginal mesh, made of synthetic material, is surgically implanted through the vagina to repair damaged tissue in a woman’s pelvic area. Investigators say Johnson & Johnson and Ethicon misrepresented the product’s effectiveness, which is a violation of state consumer protection laws.

In addition to Ohio, the following states were a part of the settlement: Alabama, Alaska, Arizona, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, Missouri, Montana, Nebraska, Nevada, New Jersey, New Mexico, New York, North Carolina, North Dakota, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia and Wisconsin.

Under the settlement, the companies can no longer claim the device is “FDA approved” as it was not certified as such.