Just Beginning Your Mesh Journey? A Suggested Roadmap

Trial by Jury Chaos in the Courtroom Gilbert and Sullivan, WikiCommons

Mesh Medical Device News Desk, November 14, 2016 ~ Mesh News Desk and its editor take calls around the clock from people who are desperately searching for a law firm or a doctor. They are just beginning their mesh journey.

Since transvaginal mesh is still being used every day, as well a hernia mesh at about one million implants a year, mesh complications are still a problem. Upward of 30% of recipients of polypropylene mesh used to treat both conditions have an adverse event, or complication.

Since I am not a doctor or lawyer but a journalist who has covered the issue for more than five years, I suggest some common sense actions. Being in pain and encountering doctors who do not believe you are in pain can be very bewildering and cause panic, which is not the ideal mindset to chart your future.

So I tell folks, first try not to panic. You are your own best advocate. You need to be prepared for what’s ahead.

First, you will need your medical records.

MEDICAL RECORDS

Some women who call Mesh News Desk do not even know what kind of mesh they have or its manufacturer. The medical notes will tell those involved in your care how the mesh was placed and what type it was, so it's very important.

Make sure you have taken charge of your medical records and that includes all of them - nurses notes, operative notes, notes sent to the insurance companies or Medicaid for reimbursement. Many patients give a law firm all of their notes only to find later on that they do not have a copy. Please retain a copy for yourself. Some readers keep notebooks by date with tabs for different encounters.

Retaining and organizing your medical notes is very important.

FINDING A DOCTOR

Even after attending the recent American Urogynecologic Society annual meeting, I got the feeling that not too many doctors are adept at handling complications, also known as adverse events, following a mesh implant.

Some doctors deny the pain is in your pelvis and think it’s in your head. You know better.

You know whether your complications started before your pelvic mesh implant or after. Some doctors recommend a trip to a psychiatrist. You need not spend time with these doctors.

MND has a list of doctors who others have reported having good outcomes. These would be the few around the country who deal often with mesh complications. Because you want to minimize the number of surgeries you undergo, and the exposure to anesthesia, you will want to seek an experienced doctor to diagnose what is happening to your body after your mesh implant.

If you have found a compassionate and knowledgeable doctor concerning your mesh implant, please let us know.

The complications can include chronic pain, chronic infections, including urinary tract infections. Mesh erosion, the most common problem, occurs when mesh erodes into the vagina. Cutting out a piece of it is a partial revision and often does nothing to improve the situation but rather, can make it worse. Mesh shrinkage, painful sex, known as dyspareunia, mesh erosion into the bowel, which is very dangerous, nerve injury during placement and nerve pain shooting down the leg, have all been reported. Bleeding fistulas and systemic autoimmune issues such as fibromyalgia and Lupus are not uncommon and have all been reported as have dental problems and unexplained rashes.

Mesh explanted after 3 mo.

Not all experienced mesh removal doctors are up-to-date on the autoimmune issues which may be related to polypropylene, the main component of mesh. You might tell them your doctor that UCLA is conducting an autoimmune registry to calculate the autoimmune reactions to mesh so the science is just beginning. UCLA has already taken the lead on identifying biofilm that forms around mesh implants.

The goal is to find a doctor who understands that the reaction is not in your head and who knows how to address it medically with the fewest number of surgeries.

Protesters, fed court Charleston WV

RETAINING A LAW FIRM

How do you find a law firm? Do you rely on late night ads with “Operators are standing by" slogans?

Of course not.

Word of mouth is best. If you don’t know someone, you might go to the Southern District of West Virginia and click on the Multidistrict Litigation. You will see the leading mesh manufacturers. Click on one - Bard for example - and see the small print on top. Click on Steering Committee, Lead and Liaison Counsel.

There are more than 100,000 mesh injured who have filed lawsuits in this country, so you are not alone.

Be aware - Not all law firms originally involved in mesh cases are taking new ones. You will have to ask. Post a q

uestion on MND Facebook page here and ask people if they were satisfied with their representation. Just because you hire a large firm, it does not mean they will seek the highest settlement for you or even be prepared to take your case to court. Some of the larger firms are instead clearing their inventory of mesh cases because the biggest manufacturers are the last holdouts to settlement, and are making it very difficult.

You also need to determine if the firm has experience with transvaginal mesh cases. Ask if they have settled cases or taken them to trial. Ask if they have the resources to take your case to trial if a settlement is not forthcoming. Will they partner with another law firm? Will they charge you for expenses on top of the percentage they charge? What is the percentage they charge and does it include reasonable expenses? What are reasonable expenses? Do they include five-star hotels and a private jet? Can you get an ongoing list of the expenses attached to your case? Know who you are hiring. Interview several law firms until you feel comfortable.

It is very expensive to work up a mesh case to be litigated. You might check out the law firms that DID take cases to court since they have the experience.

Be aware that any law firm that says yours is a Million Dollar Case or a sure thing in any regard. That is a red flag. No one can make that prediction with any certainty. No one. Often those words are uttered to get you to sign on the dotted line.

Also determine who your contact person will be. You will need a name, a cell phone number and an email. Promise not to hound them with too many contacts from your end, but tell them you do expect regular contact concerning your case, whether there is an update or not.

Just some suggestions to make your quest an easier one.

If you are the type of person who says "I don't believe in suing," know that you were implanted with a medical device that was not tested prior to being marketed, did not receive FDA approval for safety, was aggressively marketed to doctors, even paying them to promote its product, while the makers knew there would be complications! All of this has come out at trial.

Jane Akre, editor, Mesh News Desk

You could have have medical expenses connected to your injury for life. So knowing that suing is the only language that some corporations understand should be part of the consideration by those who do not believe in lawsuits.

As always, you can learn from the people who write on these pages and have been there!

Good luck.

Jane Akre, Editor

Mesh News Desk