Joint replacements are the #1 expenditure of Medicare. The process of approving these medical devices is flawed according to the Institute of Medicine. It is time for patients' voices to be heard as stakeholders and for public support for increased medical device industry accountability and heightened protections for patients. Post-market registry. Product warranty. Patient/consumer stakeholder equity. Rescind industry pre-emptions/entitlements. All clinical trials must report all data.
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Showing posts with label POP. Show all posts
Showing posts with label POP. Show all posts

Saturday, July 22, 2017

Surgical Mesh Lawsuits Proliferate as Industry Suppresses Patient Outcome Harm






Female Pelvic Med Reconstr Surg. 2017 Jun 27. doi: 10.1097/SPV.0000000000000433. [Epub ahead of print]
Abstract
OBJECTIVES:
Following Food and Drug Administration communications about the safety of transvaginal prolapse, more than 73,000 patients with complications from treatment of pelvic organ prolapse (POP) or stress urinary incontinence (SUI) have filed product liability claims. This research analyzes the transvaginal mesh claims filed in the United States to identify key characteristics that may inform clinical decision-making.
METHODS:
We evaluated a 1% random sample from the Bloomberg Law Database: 2000 to 2014 and associated legal documents. Outcomes and measures used included annual rate of claim, mesh type, time interval between surgery and claim, defendants, and surgeon training.
RESULTS:
The search returned 76,865 results, and 2979 were excluded, leaving 73,915 claims. Of 739 claims (1%), 63.3% involved slings for SUI, 13.3% mesh for POP, and 165 (23.2%) involved both. The mesh named most often in claims was retropubic slings at 30.3% and transobturator slings at 27.1%. The number of cases filed increased significantly from 730 in 2011 to 11,798 in 2012, which then almost tripled in 2013 to 34,017. The interval from surgery to claim filing ranged from 4.8 to 5.3 years. Only 12% of implanting surgeons were or became board certified in Female Pelvic Medicine and Reconstructive Surgery. Only 4 cases named providers as codefendants.
CONCLUSIONS:
Most legal claims involved slings for SUI and began after the 2011 Food and Drug Administration communication about mesh for POP. The rise in lawsuits does not reflect the acceptably low complication rates for slings for SUI reported in the literature.

PMID: 28657986 DOI: 10.1097/SPV.0000000000000433

Monday, June 30, 2014

Catastrophically harmed by surgical mesh? Justice in settlements?


By: Austin Kirk | Published: June 25th, 2014
As hundreds of Coloplast mesh lawsuits continue to move forward through the federal court system, the parties are continuing to make progress in settlement negotiations to resolve the litigation, according to a recent court update.
Coloplast Corp. currently faces nearly 1,500 federal transvaginal mesh and bladder sling lawsuits, which have all been consolidated for pretrial proceedings before U.S. District Judge Joseph R. Goodwin in the Southern District of West Virginia as part of an MDL, or multidistrict litigation.
All of the complaints involve similar allegations that women suffered severe and debilitating complications after receiving Coloplast mesh for surgical repair of pelvic organ prolapse (POP) or female stress urinary incontinence (SUI), where the mesh eroded through the vagina, caused infections or other injury.
According to a pretrial order (PDF) issued by Judge Goodwin on June 16, “substantial progress” has been made toward settling the Coloplast cases and a follow up status conference has been scheduled for August 7, at which time the parties will meet with Judge Goodwin in chambers to provide an updated report.
In March, it was reported that a Coloplast mesh settlement was reached to resolve about 400 cases for $16 million.
In addition to lawsuits against Coloplast, Judge Goodwin is also presiding over thousands of similar cases brought against manufacturers of other transvaginal mesh products, including C.R. Bard, American Medical Systems (AMS), Ethicon, Boston Scientific, Cook Medical and Neomedic.
Endo Health Systems reported last month that it has agreed to pay $830 million to settle AMS mesh lawsuits brought by about 22,000 women, making it the largest settlement reported to date in the litigation.
C.R. Bard has also reached a number of individual settlements involving cases that were scheduled to come up for trial, but no global settlement agreement has been reached.
Vaginal Mesh Litigation Update
According to the latest case list (PDF) released by the U.S. Judicial Panel on Multidistrict Litigation (JPML) on June 16, Judge Goodwin is currently presiding over 17,812 AMS mesh lawsuits, 18,176 Ethicon mesh lawsuits, 12,004 Boston Scientific mesh lawsuits, 8,555 Bard Avaulta mesh lawsuits, 1,468 Coloplast mesh lawsuits, 195 Cook Medical mesh lawsuits and about 52 Neomedic mesh lawsuits.
The combined total of 58,262 vaginal mesh claims pending in the federal court system represents a nearly 35% increase in the number of cases pending since March 2014, when the U.S. JPML reported that a combined total of 43,173 cases were centralized before Judge Goodwin. In addition, thousands of other cases are pending in various state court systems throughout the country.
As part of the coordinated pretrial proceedings in federal court, Judge Goodwin has scheduled a series of early trial dates involving several of the manufacturers. Known as “bellwether” cases, such test trials are designed to help the parties gauge how juries may respond to certain evidence and testimony that may be repeated throughout the litigation.
In August, a trial involving a lawsuit filed against Ethicon by Jo Huskey is scheduled to go before a federal jury. Huskey alleges that she suffered injuries after receiving an Ethicon TVT-O bladder sling for stress urinary incontinence.
Later this year, a combined trial involving 11 Boston Scientific mesh cases is set to go before a jury starting in October 2014. That case involves women who experienced problems after receiving a Boston Scientific Obtryx sling for repair of stress urinary incontinence.
Last year, a series of three Bard Avaulta trials were set for trial in the MDL, with the first case going before a federal jury in July 2013, involving a lawsuit filed by Donna Cisson. That trial resulted in a $2 million damage award against Bard, including punitive damages designed to punish the company for the actions during the manufacture and sale of the product. The second and third trials were each settled shortly before they were set to begin, with terms of the deals withheld.
Given the lack of progress towards settling additional cases by some manufacturers, Judge Goodwin recently ordered that a second wave of Bard Avaulta cases and Boston Scientific mesh cases be prepared for trial, with hundreds of cases going through case-specific discovery over the remainder of this year so that they can be trial-ready by early 2015.
If the manufacturers fail to reach vaginal mesh settlements to resolve the majority of cases against them, they could face hundreds of individual trial dates scheduled throughout the country next year.
Related Articles


- See more at: http://www.aboutlawsuits.com/coloplast-mesh-settlement-update-66621/#sthash.6t8X8Wjf.dpuf

Tuesday, April 29, 2014

Surgical Mesh: High-Risk Device via FDA




FDA issues proposals to address risks associated with surgical mesh for transvaginal repair of pelvic organ prolapse

The U.S. Food and Drug Administration today issued two proposed orders to address the health risks associated with surgical mesh used for transvaginal repair of pelvic organ prolapse (POP). If finalized, the orders would reclassify surgical mesh for transvaginal POP from a moderate-risk device (class II) to a high-risk device (class III) and require manufacturers to submit a premarket approval (PMA) application for the agency to evaluate safety and effectiveness.

POP occurs when the internal structures that support the pelvic organs such as the bladder, uterus and bowel, become so weak, stretched, or broken that the organs drop from their normal position and bulge (prolapse) into the vagina. While not a life-threatening condition, women with POP often experience pelvic discomfort, disruption of their sexual, urinary, and defecatory functions, and an overall reduction in their quality of life.

“The FDA has identified clear risks associated with surgical mesh for the transvaginal repair of pelvic organ prolapse and is now proposing to address those risks for more safe and effective products,” said William Maisel, M.D., M.P.H., deputy director of science and chief scientist at the FDA’s Center for Devices and Radiological Health. “If these proposals are finalized, we will require manufacturers to provide premarket clinical data to demonstrate a reasonable assurance of safety and effectiveness for surgical mesh used to treat transvaginal POP repair.” 

Surgical mesh is a medical device that is used to provide additional support when repairing weakened or damaged tissue. Many mesh products come in kits that include instruments specifically designed to aid in insertion, placement, fixation, and anchoring of mesh in the body. Instruments provided in kits will be reviewed as part of the regulatory submission for the mesh product. Instruments are also provided separately from the mesh implant, and the FDA is proposing that this urogynecologic surgical instrumentation be reclassified from low-risk devices (class I) to moderate-risk devices (class II).

Beginning in Jan. 2012, the FDA issued orders to manufacturers of urogynecologic surgical mesh devices to conduct postmarket surveillance studies (522 studies) to address specific safety and effectiveness concerns related to surgical mesh used for transvaginal repair of POP.

In Sept. 2011, the FDA’s Obstetrics and Gynecology Devices Panel recommended that surgical mesh for transvaginal POP be reclassified from class II to class III and require PMAs.

In July 2011, the FDA provided an updated safety communication about serious complications associated with transvaginal placement of surgical mesh used to treat POP. At that time, the FDA also released a review of urogynecologic surgical mesh adverse events and peer-reviewed scientific literature that identified serious safety and effectiveness concerns. The FDA previously communicated about serious complications associated with transvaginal placement of surgical mesh to treat POP and stress urinary incontinence (SUI) in an Oct. 2008 FDA Public Health Notification.

Surgical mesh indicated for surgical treatments of SUI, abdominal POP repair with mesh, hernia repair, and other non-urogynecologic indications are not part of this proposed order.

The FDA will take comments on the proposed order for 90 days.

For more information:
               FDA Medical Devices
               FDA: Urogynecologic Surgical Mesh Implants
The FDA, an agency within the U.S. Department of Health and Human Services, protects the public health by assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation's food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.
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For Immediate Release: April 29, 2014  
Media Inquiries: Susan Laine, 301-796-5349, susan.laine@fda.hhs.gov 
Consumer Inquiries: 888-INFO-FDA, DICE@fda.hhs.gov

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Monday, April 7, 2014

Plaintiff awarded $1.2M by Texas jury for defective surgical mesh product




 April 04, 2014 at 11:38 AM

Johnson & Johnson was ordered by a Texas jury to pay $1.2 million to a woman who alleged one of the company’s lines of vaginal-mesh implants to treat incontinence was defectively designed, in the first verdict against the company over those devices.
Jurors in state court in Dallas concluded the design of the TVT-O mesh sling implanted in Linda Batiste was flawed and the 64-year-old woman deserved $1.2 million in compensatory damages, her lawyers said. They argued Batiste suffered pelvic pain when the device eroded inside her.
J&J, based in New Brunswick, faces more than 12,000 lawsuits accusing its Ethicon unit of making improperly designed vaginal inserts, such as the slings, that damaged women’s organs and made sex painful. Most of the cases have been consolidated before a federal judge in West Virginia for pretrial information exchanges while other cases are being heard in state courts.
The U.S. Food and Drug Administration has ordered J&J, C.R. Bard Inc. and 31 other vaginal-implant makers to study rates of organ damage and complications linked to the implants after manufacturers faced a wave of lawsuits over the devices.
Doctors inserted more than 70,000 mesh devices in the U.S. in 2010 alone, threading them through incisions in the vagina to fortify pelvic muscles that failed to support internal organs or to treat incontinence, according to court filings.
Appeal Planned
J&J officials noted the Dallas jury rejected Batiste’s claims that Ethicon didn’t provide proper warnings about the slings’ health risks and declined to award punitive damages.
“The jury’s verdict on design defect is disappointing, and we believe we have strong grounds for appeal,” Matthew Johnson, an Ethicon spokesman, said yesterday in an e-mailed statement.
J&J officials decided in 2012 to stop selling some lines of vaginal-mesh implants after being hit with a wave of lawsuits over the devices. The TVT-O sling Batiste, a former nurse, received is still on the market, Thomas Cartmell, one of her lawyers, said in a phone interview.
“This verdict represents the first time an impartial jury had the opportunity to decide whether Ethicon’s sling products are defective and they found exactly that,” Bryan Aylstock, a plaintiffs’ lawyer helping to oversee cases gathered before U.S. District Judge Joseph Goodwin in West Virginia, said in a phone interview. “We believe this is the first of many more verdicts to come over this dangerous product,” he added.
NJ Verdict
Last year, a New Jersey jury ruled J&J must pay $11.1 million in damages to a woman who blamed a Prolift device for her injuries in the first case over any of the company’s implants to go to trial. The Prolift implants help support sagging organs.
Lawyers for J&J, the world’s biggest maker of medical products, argued in court papers that the TVT-O slings are safe and effective and the company properly warned consumers about their risks.
In February, Goodwin threw out a woman’s claims that another line of the company’s sling inserts was def


Updated April 24, 2014

WOMAN WITH SURGICAL MESH STILL SUFFERING, YEARS AFTER SURGERY  (Video)  

FiDA Highlights
by JANET ST. JAMES
WFAA TV  Dallas, TX
Posted on April 24, 2014 at 10:37 PM
Updated yesterday at 10:43 PM

DALLAS — It's not just walking that's painful for 64-year-old Linda Batiste. Life, in general, is a physical struggle.
"I have pelvic pain," she said through tears. "It actually does feel like a scouring pad in your body. You can feel in your women parts, what it is. It's there."
The condition that brought Batiste to tears is embarrassing for her discuss. That feeling comes from a product left inside her body to fix urinary incontinence.
More than 20-million women in the United States suffer from urinary incontinence and/or pelvic prolapse. In thousands of cases — including Batiste's — doctors use a pliable, gauze-like mesh sling to support the bladder and other organs.
But what Batiste got from her 2011 procedure was not relief.
"I have never been pain-free since then,” she said.
Surgical mesh is a synthetic material manufactured by several companies and routinely used for urinary incontinence, pelvic prolapse, and hernia operations.
Attorney Tim Goss, a parner at the Dallas law firm Freese & Goss, represented Batiste in a product liability case against the Johnson & Johnson subsidiary Ethicon. It was the first mesh cast to go before a Texas jury.
"The polypropylene mesh, it degrades, it disintegrates, it extrudes, it frays, it ropes, and it has particle loss,” he said. “And all of those problems cause other problems — like scarring, chronic pain, for example."
The American Urogynecologic Society says mesh is "safe, effective, and has improved the quality of life for millions..."
"It can be a bend-over pain, where it will be a sharp stab," he said.
Samples was forced to travel out of state for surgery to remove the mesh. The procedure was not a complete success, and Samples continues to have some pain, even now.
The FDA first issued a "Public Health Notification" in 2008, saying it had received "over 1,000" reports of "adverse events" "for surgical mesh devices."
In 2011, The FDA sent out another warning, saying "serious complications associated with surgical mesh" "are not rare" and that mesh "may expose patients to greater risk" than traditional procedures.
Since then, women across the country have formed organizations and online support groups trying to get mesh removed from the market.
Linda Batiste won a $1.2 million judgment against the maker of her mesh, Ethicon.
"It's significant because there are almost 100,000 other cases pending around the country regarding this type of product,” said Goss, who represents 9,000 mesh cases.
Goss said the lawsuits have the potential to become the largest mass-tort in history — bigger than the Phen-Fen diet drug mess.
A statement from Ethicon spokesman Matthew Johnson called the Dallas verdict mixed:
"A jury in the 95th Judicial District Court of Dallas County, Texas, returned a mixed verdict today in a product liability trial concerning Ethicon’s TVT-O pelvic mesh, which is used as a minimally invasive treatment for women suffering from stress urinary incontinence (SUI).
"The jury found Ethicon properly informed of the known risks associated with TVT-O. The jury also found that the product was defectively designed. The jury awarded $1,200,000 in compensatory damages. The jury declined to award punitive damages.
“We believe the evidence showed Ethicon’s TVT-O pelvic mesh was properly designed and that Ethicon acted appropriately and responsibly in the research, development and marketing of the product. The jury’s verdict on design defect is disappointing, and we believe we have strong grounds for appeal.
“We empathize with all women suffering from SUI, which can be a serious and debilitating condition, and we are always concerned when a patient experiences adverse medical events,” Johnson continued. “TVT-O has been deemed safe and effective by regulators and practitioners alike, and it continues to be an important option for treating physicians to offer to women suffering from SUI.”
In the meantime, Linda Batiste has had several surgeries to try to remove the mesh, which is embedded in her tissue. Her original problem of incontinence is back.
"And it's compounded the pain that I normally would have had,” she said. “I never wish for any other woman to feel this way or to have it happen to them."