Good intentions
Forum Replies Created
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I realized that the page I had been linking here had articles about other manufacturers involved in other lawsuits.
Pretty fascinating how the wave is growing. I am just passing in fo along as it becomes available.
Here are a few new ones. Surgimesh. I provided a link about it in my other thread about Types of Mesh.
Surgimesh is part of a new polypropylene material lawsuit. This is from March 2022. They all seem to be calling out the polypropylene material. Still not calling out the mature of the mesh. The mechanics of the mesh in the body. They should focus on that too.
Typical mesh implanted, major problems, mesh removed.
https://www.lawsuit-information-center.com/surgimesh-hernia-mesh-lawsuits.html
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Surgimesh is part of a new polypropylene material lawsuit. This is from March 2022.
Typical mesh implanted, major problems, mesh removed.
https://www.lawsuit-information-center.com/surgimesh-hernia-mesh-lawsuits.html
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I just came across a type of mesh that I had not seen before. Some of these new products get introduced but don’t get much publicity. Hard to compete with the big guys.
Dr. Ramshaw was involved. The video is from seven years ago. It’s not clear if “Advanced Hernia Solutions” was a side venture. 2016.
The mesh is made via a non-woven method. Fibers are spun (molten material squirted from a spinneret) in a random pattern. The fibers stick together to form a flat sheet.
https://surgimesh.com/products/
https://surgimesh.com/videos/ramshaw-laparoscopic-lih-repair/
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Chuck, I have written quite a bit on the forum about the recovery from mesh removal. I don’t have any strength issues. Over the years the only thing holding me back had been the knowledge that I would be sore for a few days after extended activities. Instead of hiking five miles I would only hike two, for example. Plus there was some concern about recurrence but my view is that I will just live the life I want and if I get a recurrence I’ll deal with it.
In addition, because of the stiff bulging belly left behind, certain clothes were uncomfortable. And certain motions, like working with my arms extended overhead, caused soreness in the lower abdomen. It has taken quite a while to loosen up.
Otherwise, especially when I was getting a home ready to sell and needed to do lots of lifting and moving for long periods of time, I was fully functional. I just spent more time being sore.
I also did quite a bit of physical work with the mesh implanted, over the course of a year, and I could feel that damage was happening, internal wear and tear, that eventually led to other specific physical manifestations that I’ve also written about. The more active I was the worse it got. Removing the mesh was the only possible solution for me so I have no second thoughts about it. If I have future problems, I will take appropriate actions.
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Is it possible that the pain and swelling is the result of external forces causing internal irritation? Like the elastic band pressure of whatever you are wearing? I had found that certain clothes caused irritation because the waist height caused pressure at the bump left by the original direct hernia area. In my case though, there is still a piece of mesh at that spot. This lasted for years and has only resolved recently.
In other words is there a correlation between clothes and discomfort. I remember that you run a lot of miles on a regular basis. A small force might have large consequences. It might explain the seeming randomness of the problem.
I am just past five years since mesh removal and the last six months have been pretty dramatic in terms of improvement. I am doing much more and feeling fewer delayed after-effects. It might be both heartening and disheartening to suggest that you wait. If you do find a correlation with clothing or certain activities it might be worthwhile to avoid those for months at a time then retry later. See what happens.
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Dr. Nguyen might be worth a call. I don’t know what exactly is involved when one doctor sells their practice to another. He might be a run-of-the-mill laparoscopy surgeon, or he might be carrying on Dr. Brown’s non-mesh work. Or maybe he uses laparoscopy for athletic pubalgia (sportsmens’s hernia) and non-mesh for inguinal hernias. Not clear.
Good luck.
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I just came across an older article about litigation in General Surgery News. One of the Top 5 articles of 2022.
Dr. Voeller is interviewed and argues both sides of the issue. He points out that the 510(k) process has allowed untested materials in to the market, for transvaginal mesh products. But he seems to forget the fact that the hernia repair products got there the same way. He also implies that the law firms involved were attracted by the potential money involved, like that’s a bad thing. He kind of ties a knot around himself, as he seems to do when he talks about the problems with mesh. He doesn’t seem to understand the purpose of litigation in a free market, especially when regulation enforcement is as lax as it is in the United States. If a corporation injures people with poor products, they have to pay damages. Without litigation in a poorly regulated environment corporations are free to damage as many people as profits will allow.
Worth reading, even if you’ve already read it. Published March 21, 2022.
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Andy Elliot, you really should get your medical records. There are many different types of mesh and some of them might be made of a material that explains your symptoms. Progrip has polylactic acid, which is meant to degrade over time and be absorbed by the body. Atrium’s mesh had an Omega-3 fish oil coating on it, which has been shown to cause problems. Later they polymerized the fish oil and that also caused problems. There are materials with anti-bacterial metals in them. Some materials are prone to infection, like the biologics.
The more you know the better off you will be. Most surgeons never solve the problems that their own mesh implantation caused. They end up working on other surgeon’s problems. Often, problems like yours will just be classified as a “mesh reaction”. The body’s rejection reaction can be very strong.
Anyway, I’m not sure that many surgeons actually frequent this forum so you probably won’t get an answer. Here is a link that might help you find specific experiences like yours. Sometimes doctor will publish about the odd cases that they come across.
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I really do wish that I could post some news of progress. I just can’t find any. Professional researchers keep confirming that mesh repair causes chronic pain at rates in the teens. But it seems to be accepted as normal now.
This seems to be the “Collection” that Dr. Campanelli refers to. There’s not really much there.
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Meanwhile, more suits are being filed. 23 in the last 8 days.
“January 2, 2022 Update
Rhode Island state court – the venue for the big Trevino verdict – is continuing to pile up new hernia mesh lawsuits. Twenty-three new suits against Bard were filed in Rhode Island since Christmas.”
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If the litigation results are broad-based, for instance if damages are awarded based on the polypropylene material, then any polypropylene-based mesh will be at-risk for future litigation. If the litigation fails, then the flood-gates for new products can re-open.
In the meantime, sales continue using old products.
Mass tort is supposed to show that a product is defective and should be removed from the market. In this case though, the damages will probably just be used to set the price of future products.
What is supposed to happen, is the FDA is supposed to get involved and remove the product from market. But the FDA page about hernia mesh still has years old text implying that now recalled mesh products were the cause of hernia mesh problems. The FDA gets weaker and weaker as the years go by.
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Here is the essence of what bothers me about Dr. Felix.
Dr. Campanelli, among many others, a surgeon who was involved in the creation of the hernia repair Guidelines, that promote the use of mesh, has acknowledged that chronic pain from hernia repair is real and the problem needs to be addressed in a professional manner.
At the same time, Dr. Felix is traveling the world, telling medical students and surgeons that the chronic pain problem is not significant and should be ignored.
One doctor is saying that the pain needs to be dealt with, the other is actively saying don’t worry about the pain.
What kind of physician, or even person, tells his students to ignore a patient’s pain? That is not a doctor. It is a businessman.
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My recent Topic about Dr. Felix, and Dr. Towfigh’s reply, reminded me that the Editor of Hernia, Dr. Campanelli, had talked about a special Forum and a publication about chronic pain from inguinal hernia repair. Has anybody seen anything? Things seem exactly the same.
https://link.springer.com/article/10.1007/s10029-022-02576-z
“In the course of 2022, we are planning to organize a Forum and subsequent Special Issue and Topical Collection devoted to this hot topic, and will be inviting internationally renowned experts to contribute.”
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I might have confused recurrence with chronic pain rate in one of my comments above. Here is a recent reference to a paper confirming the high chronic pain rate for TEP.
The focus on recurrence begs the question of “why did the patient see the physician in the first place?” To have their pain removed. That’s why Dr. Felix’s presentations are so frustrating to see. He completely ignores the Hippocratic oath. He will become known as the Father of Chronic Pain, I think, not the Father of Lap Mesh Placement.
Doctors seem so caught up in the bright lights of technology that they’ve forgotten why they became doctors.
New paper evaluating glue versus tacks fixation in LAP TEP – 13% pain rate
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A true physician does not downplay the pain that their work causes and has caused like Dr. Felix does in his presentations. Too many surgeons seem to be so focused on spreading the neat new techniques and technologies that they are willfully ignoring the fact that mesh is over-used and has real problems associated with its use. There is no study out there that has suggested that improper mesh placement is the cause of chronic pain. To the contrary, efforts to find the cause besides the mesh itself have all failed. And, also contrary to the the recurrence myth that is being spread, recent studies are showing that laparoscopic mesh placement has a significantly higher recurrence rate than what is being propagated. I posted a paper about it recently, I will relink it below.
It would be great if somebody could truly show a clear path to reducing the risk of chronic pain and recurrence. But people like Dr. Felix are out there suggesting that patients who complain of pain and discomfort are just weak, as he does in his “Let’s be honest…” presentation. To paraphrase Dr. Felix – “let’s be honest, mesh is not the great panacea that it is being promoted as”. It just isn’t.
The mesh makers are still selling the products that the Guidelines recommend against. The Guidelines “update” seems to be delayed for some reason, even though professionals in the field have published papers to help create better Guidelines.
I am sure that you are aware that nothing of significance at all has happened in the five years since the Guidelines have been published, except advancements in ways to get more mesh in to more patients. And besides Atrium getting sued for their fish-oil coated mesh, and Bard getting sued for their polypropylene mesh plugs. Chronic pain was identified as the number one problem in the hernia repair field just a few short years ago. Right about the time that Dr. Felix started his 10 Commandments tour. Chronic pain and mesh removal is now normalized as part of mesh implantation, with new pain center businesses created to handle the new business. It’s insane.
https://herniatalk.com/forums/topic/the-state-of-teaching-hernia-repair-dr-felix/
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Another interesting paper that mentions “HerniaSurge” even though the group does not seem to exist anymore.
Also interesting in that they refer to their work as assisting in the update of the Guidelines, but note that the recurrence rates for hernia repair are still very high. The whole premise of laparoscopic mesh repair is that recurrence rates are lower. References 4-7 are all from 2018 – 2020.
It wouldn’t be a surprise if EHS or the “HerniaSurge” group have found themselves in a bind, where the review of new data shows that the 2018 Guidelines are seriously flawed. The delay and lack of communication is telling.
“The routine use of mesh in groin hernia surgery has engendered substantially decreased recurrence risk.1,2 However, current long-term reoperation rates for recurrence are still disappointing, in the range of 8% to 15%.3-7”
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Dr. Koeplin’s page is a very standard “minimally invasive” hernia repair page. Boilerplate text about strangulated hernias and death and types of hernias. The page does not mention mesh but laparoscopic procedures today all use mesh. So you will almost certainly get run-of-the-mill placement of a large piece of mesh, and most likely a piece on the other side also. There’s always something on the other side.
Good luck. They both look like “state-of-the-art” hernia repair surgeons. ~15% chance of chronic pain.
https://michaelkoeplinmd.com/general-surgery/hernia-surgery/
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It depends on what you mean by “good”. They both do laparoscopic procedures so their hernia repair method is very likely based on the use of mesh. Dr. Panait seems to be very active in research so is probably very aware of the latest issues in the field, but he is also very active in new technology like robotic-assisted surgery.
His web page has a lot and he has a Youtube channel. He holds positions in the Americas Hernia Society. Dr. Towfigh probably knows him. If you see him you will almost certainly get a synthetic mesh repair. He also does mesh removal (of course).
One of his videos shows robotics removal of a mesh plug followed by immediate placement of a large piece of flat mesh. It was a recurrence.
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Dr. Martindale at OHSU in Portland Oregon might be worth contacting. He seems to be involved in some very difficult abdominal wall reconstruction efforts, and also various associated side effects of surgery.
https://www.ohsu.edu/people/robert-g-martindale-md-phd
Here is a search of some of his recent publications. I chose “abdominal” as a specific search word. From 2018.
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This big lawsuit against C. R. Bard (now owned by Becton Dickinson) gets more interesting, and bigger. The initial description seems flawed, typical of many of these types of suits, in that they are trying to show that there was a specific defect in a product instead of showing that the product design itself is defective. But, regardless, as the suit proceeds, the extend of the damage will become more apparent.
The downside is that, according to a friend from way back who works in venture capital now, new product development is being delayed, because the corporations are waiting to see where the litigation ends up.
Here’s the latest –
“December 16, 2022 Update
As hernia mesh settlement rumors mount, the C.R. Bard hernia mesh MDL continues to add new cases as we slowly inch closer to a pivotal 3rd bellwether trial in May 2023 (recently postponed from February).
The class action lawsuit added 273 new hernia mesh cases to the MDL over the past month, increasing the total pending Bard mesh lawsuits to 18,227. The Bard hernia mesh MDL grew by 23% in 2022, adding 3,380 cases.
It is still the second largest mass tort behind only the 3M earplugs MDL.”
Here’s the original court document for MDL-2846 –
https://www.ohsd.uscourts.gov/multidistrict-litigation-2846
“Introduction – MDL 2846
This Multidistrict Litigation (“MDL”) was created by Order of the United States Judicial Panel on Multidistrict Litigation (“JPML”) on August 2, 2018. In its August 2, 2018 Order, the JPML found that the actions in this MDL “involve common questions of fact, and that centralization in the Southern District of Ohio will serve the convenience of the parties and witnesses and promote the just and efficient conduct of this litigation.” The JPML continued that, “[a]ll of the actions share common factual questions arising out of allegations that defects in defendants’ polypropylene hernia mesh products can lead to complications when implanted in patients, including adhesions, damage to organs, inflammatory and allergic responses, foreign body.” “