Open Letter to Insurers Concerning Mesh InjuriesMay 19th, 2014 | By Jane Akre | Category: Mesh Reading Room Resource
Often readers of Mesh News Desk find it impossible to have their insurance companies understand the importance of having a referral to a mesh specialist when they are facing a mesh-related complication. Very few doctors actually have the experience to even be able to assess these complications to determine if the mesh needs to be removed. If so, it’s a sensitive and delicate operation that should not be undertaken by anyone but an experienced mesh removal doctor.
As there is more and more awakening to mesh dangers and complications, insurers too need to be brought up to speed. Initially, many insurance companies steered women to these risky and dangerous procedures. And according to mesh removal experts, today, insurance companies want to compensate very little to have mesh removed or to send a woman to an experienced removal specialist. The following is a letter a woman can use to address her insurance company when it fails to recognize the seriousness of her complication and refuses to support her decision to seek out one of the few mesh removal experts in the U.S.
Here is a suggested Open Letter to insurers to help them gain some understanding of this mesh mess.
To Whom It May Concern-
I’m writing as a mesh-injured woman who is desperately trying to seek help from a doctor experienced in mesh-related injuries. This might include a urologist or urogynecologist who has experience in removing pelvic mesh that has migrated, eroded, broken apart, perforated organs, folded, frayed and perforated nerves, not to mention the systemic issues such as autoimmune disease that often erupts after being implanted with polypropylene pelvic mesh.
There are very few competent medical doctors around the country who are dealing with the hundreds of thousands of women who are now experiencing the complications from this mesh. Through the mesh-injured community, we are becoming aware of these doctors.
I am seeking a referral to a doctor who has experience in removing polypropylene mesh from the pelvic region, not just the closest and most cost-effective for the insurance company. This may be a matter of life or death – mine.
As you know this mesh was implanted in me and thousands of others to hold up pelvic organs that may be falling through the vagina. Like thousands of others, it has only caused problems that can be described as life-altering. As I write this, the mesh is migrating toward my bowel, a condition that can lead to fatal sepsis (this is one example, use your own).
There are currently at least 90,000 lawsuits filed against mesh manufacturers for marketing a defective product without any FDA clearance for safety and efficacy. These are not lawsuits generated by hysterical women. The injuries are real and not imagined. In many cases they are permanent.
Juries across the country have determined, after listening to the evidence, that mesh products made by the major manufacturers, Johnson & Johnson and Boston Scientific, were defectively designed, yet many of them remain on the market. It was frequently the insurance companies that led women to doctors to have these procedure. Doctors have admitted on the stand they were unaware of the dangers and had been made false promises by sales reps from the major mesh makers.
All of the problematic mesh, whether for prolapse (POP) or incontinence (SUI) is made from polypropylene and they are all substantially similar. They were all approved by the Food and Drug Administration as substantially equivalent to a “predicate device,” the ProteGen, which was eventually taken off the market for being defective.
I should not be in this position. I should never have had mesh implanted for a condition, not a disease. I should have received true informed consent. I did not. There are safer alternatives that have been known for decades, before mesh manufacturers began coaching doctors on this new “minimally-invasive” technique that would yield them greater profits in the shortest amount of time.
Insurance companies supported this procedure we now know was experimental and never underwent clinical trials for safety. I should never have to beg for my insurer to send me to the proper professional who very well may save my life.
But that is where I find myself.
A friend recently made signs and, along with supporters, petitioned in front of the insurers’ hospital to receive a referral to UCLA’s urology department, considered the most experienced in the world for mesh removals. Within about 20 minutes, she received that referral. Is that what it takes?
I remain adamant that I receive a referral to the specialist of my choice based on the recommendations of others who have had successful mesh removals. Together we can work on determine the best doctor to address my problems, as soon as is reasonably possible.
Because of the great number of mesh-related injuries, women are sharing stories of successful explants and competent mesh removal doctors around the country.
I encourage the insurance company to gain a better understanding of the breadth of the problem because women are requiring multiple surgeries when the first doctor, the one closest to the patient who is the most cost-effective, may leave remnants of polypropylene behind to wreak havoc, migrate, shrink and continue to incite a foreign body response. That creates a “ticking time bomb” as the long-term effects have never been studied in clinical trials. We are essentially the lab rats.
As is typical, one partial removal leads to another and then another adding unnecessary cost to the insurer and a burden to my quality of life. Isn’t it preferable to get the best surgical outcome initially? Not only do I want to minimize experimentation on my body by someone not experienced in mesh removals, but I absolutely need to minimize my repeated exposure to anesthesia.
Since insurers initially paid for these mesh implants, it is now time to step up and do the right thing- cover explant surgeries by reliable, experienced surgeons.
Please advise me on the next step needed. I look forward to talking further with your representatives who have direct authority over my case and have the authority to issue a referral. Time is of the essence here.
I will follow up this week with the individual who has been assigned to my case. Again, I cannot stress enough the seriousness of this situation. There are more mesh injuries coming so please begin to understand the scope of what you are about to face as an insurer of these women. To deny them the proper medical care adds insult to horrendous injuries.
(your name here)
I am supplying you with stories that will back up my assertions here. Please read them and become knowledgeable about this issue.
Learn More Here:
Dr. Veronikis on Mesh injuries