Hernia Mesh Patient Advocate - Many Questions, Few Answers for those Patients

‍Mesh Medical Device News Desk, March 23, 2016 ~ They call every day. Mostly men but sometimes women who have had a hernia mesh implant and are experiencing complications.

What doctor will see me, they ask. Who is taking these lawsuits?

The answer is there are few answers for hernia mesh patients. For some reason, a number of people who receive a polypropylene hernia mesh are experiencing the same pain, infection and inability to move that pelvic mesh women are experiencing.

But unlike TVM cases – where are the lawyers?

Bruce Rosenberg, himself injured by hernia mesh, could be called an expert on the subject, but even he comes up empty. Rosenberg fields calls from Mesh News Desk and other sources. People tell him they have pain at the site of their hernia repair. He says it’s due to mesh erosion, migration, adhesion to nerves and the spermatic cord, the erosion of mesh into the bladder and into the colon.

Hernia mesh patients have just as many systemic issues as pelvic mesh women but consider that hernia mesh is generally larger than a “sling” used to support the urethra, they are facing a larger volume of inflammatory material in the body. Take a little strip of incontinence mesh and multiply it times 20-30.

As mesh expert Dr. M. Tom Margolis told the FDA in 2011, “The more mesh, the more mess.”

Rosenberg should know. Injured by hernia mesh years ago, today he is disabled. See his Profile here.

As a result he’s made it his business to understand polypropylene (PP) mesh and its complications. PP hernia mesh was fashioned into pelvic mesh by consultant/industry doctors in the 90's, so its not surprising the reactions are the same women are experiencing.

The mesh is the same as polypropylene pelvic mesh- made of the polymer polypropylene, the same plastic used in carpet backing and the top of a Tick Tac box.

Rosenberg regularly attends the American Hernia Society meetings and confers with doctors around the country who are dealing with complications. He has testified before and FDA expert panel on mesh and brought a vidotape to FDA regulators of Dr. Heniford, hitting a plasticized piece of explanted hernia mesh on a table in a Johnson & Johnson promotional ad for its new larger pore mesh.

Every week he fields at least a dozen calls from the injured community.

“It used to be a search for a removal doctor. Now the first question is about litigation. They’ve been to so many doctors they are exhausted. They are not getting better and they are running out of money, patience and time,” he says.

“The typical person says their life has been ruined and they need help they are tired of being in pain. They’ve lost everything is the most common statement I have heard. They have no life, relationships have been ruined, they have nothing.”~ Bruce Rosenberg, patient advocate.

Hernia mesh survivors believe filing a legal action will get them the medical care they need. Rosenberg points to the few doctors he knows who can help - Dr. Kevin Petersen, Dr. Bruce Ramshaw, Dr. David Chen at UCLA, Dr. John Galloway in Atlanta, Dr. Todd Heniford in Charlotte, NC, Dr. Richard Miller in Tennessee and Dr Peter Billings in Washington State.

Prolene hernia mesh removed after 1.5 yr.

Rosenberg says these are hernia surgeons who remove mesh and have had good outcomes, or at least some good outcomes.

Many injured patients have tried to return to their implanting physician, but oftentimes, says Rosenberg, "Their complaints fallen on deaf ears. They are told to go to pain management."

"They are told it’s in their head, it’s going to get better, all the while their statute of limitations is running out and their injuries are increasing due to mesh migration and failure."

Why are trial attorneys not jumping on the hernia mesh cases? There is money to be made, speculates Rosenberg. “They’ve been led astray by an FDA trying to cover its mishandling of this and additionally by the sheer marketing power of the industry.”

The volume is there. There are an estimated one million hernia implants a year, according to the American Hernia Society.

Court testimony in pelvic mesh cases have shown that hernia mesh seems to have the same reaction once implanted in the body – it contracts, shrinks, encapsulates nerves. The small pore size prevents tissue incorporation and allowing the mesh to curl, contract and degrade, according to expert testimony was given by hernia mesh surgeon Dr. Uwe Klinge in a number of pelvic mesh trials.

Dr. Klinge has collected hernia mesh explants to study what happened while in the body. He testified at the Linda Gross trial against Ethicon he knew the polypropylene mesh was defective and tried to warn Ethicon /J&J before it was sold. See the story here.

According to Dr. Heniford, the mesh shrinks with scarification and that in turn pulls the mesh with it. Even lightweight mesh has caused injury says Rosenberg, who himself is implanted with the Ethicon UltraPro, which was supposed to be an improvement over heavy weight mesh.

“The lightweight mesh is not the answer,” he says. "Patients still get infections and meshoma injuries.”

A meshoma is a mesh contraction moving away from the pubic bone and inguinal ligament causing the mesh to wrinkle or ball up which can cause the recurrence of the hernia. In Bruce’s case, the meshoma had eroded through the peritoneum, the lining of the abdominal cavity.

What is the answer?

Collagen fibers, University of Lancaster

A better product? A non-mesh repair? Sure, says Rosenberg, but that’s not for everyone. Some people do need a mesh, he believes. It’s identifying the patient who is appropriate, that’s the answer. Patients who might not do well without mesh are those who are obese, who smoke, who have a high activity level or work in jobs where there is heavy lifting. Rosenberg and others have observed those are factors that increase the chance of a failure.

Also some people naturally have a weak collagen matrix, the natural fibrous protein in connective tissue that supports skin and tissue.

Rosenberg has a nonprofit organization, The Meshoma Foundation. He says he needs to set up a website and work on doctor and patient education. “There needs to be a school that teaches tissue repair so residents could have the choice to learn that as part of treatment protocol, to learn both mesh and non-mesh repairs.”

And he plans to attend the American Hernia Society conference in Washington, D.C. March 30 to April 2, 2016. Rosenberg is a member of the group. Specifically you will find him in seminars that address chronic pain and he will look for any new devices patients can ask their doctor about so they are not subject to what is pushed on them.

The former social worker also continues to think about others. Too many patients cant afford to go for an initial medical consultant with an expert. He would like fundraising for that purpose to be part of the bigger plan. #

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