Adding my two cents to the mega mesh mess surrounding transvaginal mesh complications…

Is it your Doctor’s fault if you have mesh complications?

Doctor Skill?  Or defective product?

Its-Your-Fault-Doctor

Many pro-mesh people, will argue that it’s not the mesh, but it is the skill of the doctor that does the surgery that determines if your mesh surgery will be successful or not.  They will tell you that if you go to a reputable doctor that puts the mesh in, you should be fine.

Mesh manufacturers would like you to believe this, because that gets them off the hook, and they are the ones being sued primarily (the manufacturers, not the doctors).  There are now over 100,000 lawsuits against six different manufacturers – not the doctors. This is also why many lawyers representing those who have pending mesh lawsuits, will warn their clients to be very careful about publicly blaming their doctors. It could ruin their case. 

When so many doctors are not giving the full warnings about mesh,  and even seem to be in the dark themselves, it is understandable that patients are upset with their doctors.

But, lets just talk about the doctor’s SKILL for a bit, and ask:

“If you go to a doctor that is well trained, and SKILLED in placing mesh, does that mean you will not have severe mesh complications?”

AUGS (American Urogynecologic Society) , and Urogynecologists  (a “fairly new sub-specialty of doctors”) spreads this belief that it’s the doctor, not the product that makes all the difference.  This encourages their services, verses going to a traditional Urologist or Gynecologist.   Telling people that YOU need to choose the right doctor, also is a way of putting the blame back on the patient as well – for “not picking a better doctor”.

I mention this information in part of #7 in the article at: https://meshmenot.wordpress.com/top-10-things-to-know-about-mesh-before-surgery-for-pop-sui/.

And, this topic is also discussed in the following post: https://meshmenot.wordpress.com/2014/04/16/augs-addressing-mesh-complications-and-helping-patients-or-just-defending-mesh/, where it mentions:

“Pro-mesh people want us to believe that it is the DOCTOR, not the product that is at fault for mesh complications.   I’m guessing a lot of doctors who implant mesh might disagree…  but, the manufacturers of mesh? Well, they love this idea because if you can prove it’s the doctor’s fault, that gets them off the hook, and they (the manufacturers) are the ones being sued most frequently. Also, it sort of puts the blame back on the patient, doesn’t it?

Recently, the founder of APOPS (Association for Pelvic Organ Prolapse Support) also supported this idea, telling me that,

every woman needs to screen her practitioner for experience and then ask the right questions.

Personally, I disagree.   I disagree because:

#1) I don’t see how the product itself can be safe when it is made out of polypropylene (plastic) and literally hardens once in your body, and erodes/cuts through your most delicate tissues (see #6 in my Top 10 Things I Wish I knew post).  I’ve felt that pain firsthand.  I believe mesh products are high risk.  Which is, by the way, also what the FDA warns.   Most doctors have finally agreed that mesh for POP is undeniably high risk, yet many are clinging to the idea that it is still safe for SUI. This makes no sense.  It is the SAME material, going in the same areas. It can, and IS, causing the same horrific complications.  The FDA warnings also may have been geared towards mesh for POP, but they also still very much reported and warned of complications from mesh used for SUI. (see: https://meshmenot.wordpress.com/2015/01/06/mesh-for-sui-but-too-risky-for-pop/)

#2)   I also disagree that it is just a matter of the patient doing their homework and finding the RIGHT, or better skilled doctor.  Realistically, how many people even know the right questions to ask?   Besides even when the right questions are asked, the wrong answers are often given.  This is also discussed in the MDND article, “Top 10 Myths Woman are Told Today about Pelvic Mesh“.  They are  making it next to impossible for any patient to make a well educated decision when the information out there is all based on the sales and marketing of the products, and NOT about patient safety and the facts.

and #3)  Lastly, I disagree because MY implanting doctor came highly recommended. I knew people personally that went to him, and were not having problems.  In fact, he was in charge of training other doctors on the procedures.  I’ve also talked to many other women who went to very reputable doctors for their mesh implants that STILL had complications. Yes, this included many who even had the mesh implanted by a reputable UroGynecologist.

One woman even stated;

“I had an excellent surgeon place the mesh. When I was examined by a different doctor, she was visibly shaken when she saw who did the mesh placement. She referred to the surgeon by their first name and said she knew their work, and if **I** was having problems, then anyone can have problems.”

As with ANY surgery, I’m sure the skill of the doctor is a factor, and I encourage anyone to check their doctors patient reviews, etc.  However, they also need to know about the product they plan to use, AND the procedure itself.   Especially when that product has FDA Warnings, over 100,000 lawsuits against it, many more reported complications, not to mention how many UN-reported.

Lawsuits are NOT aimed at Doctors

Please understand that all the lawsuits you hear about regarding mesh complications, are not usually against the doctors, but instead they are targeting the manufacturers of the mesh.   The cases revolve around the mesh products being defective, high-risk, AND that they were advertised to the doctors falsely.  Basically, they are stating the doctors were told incorrect data…. and then they in turn tell the patient said data.

There are now six different manufacturers, that now have over 100,000 lawsuits against them collectively, for a wide wide variety of different mesh products.  This is JUST lawsuits, and does not count all those who have complications but do NOT have lawsuits.   These lawsuits are also for mesh products that are very much SILL IN USE TODAY.  It is another common myth that only the “older” mesh is “bad”, and that the “new mesh” is good.  Not true.  Most mesh was NOT recalled, and is still on the market.

Doctors in the cases that have gone to trial (against the manufacturers), usually plead ignorance.

CS78740054

“A US surgeon told the court he wouldn’t have used mesh implant if had known the risks” – dailyrecord

The same doctors who tell their patients how safe mesh is,  wind up claiming in court, when push comes to shove, that they did not know the mesh products they used were faulty or “high risk”.  They will claim they believed the information and data that the manufacturer sales reps told them.   Studies done BY the companies making, and marketing the mesh.  Can you say, “conflict of interests”?  They also listen to AUGs, which again seems more concerned about the research and sales, than patient safety.

The Blame Game

drs_vs_industry
So, the doctors blame the manufacturers.
The manufacturers try to blame the doctors, and/or the patients.
The lawyers mostly just want to go after the manufacturers of certain TVT devices that they think they can win on, despite the fact there are tons of people with complications from other mesh products too.
In the mean time,  the patients are the ones who keep suffering the consequences while the others make a ton of money.

But, don’t those with complications get rich?

Don’t be fooled into thinking everyone and anyone with mesh complications is going to be able to file a lawsuit and make it rich.  That is another big misconception. Not everyone can, or will file a lawsuit.  Those who do have lawsuits, often find themselves waiting years for any compensation.  Only a few cases have gone to trial so far, and when fighting big companies like Johnson and Johnson it is not so easy.  The manufacturers can, will, and do drag it out.  Even those who win large settlements, will wind up waiting through appeal after appeal. Then, because there ARE so many lawsuits, many of those people will NOT even get any money, or not nearly enough to cover the multiple surgeries, loans, etc., they have as a result of mesh. Not to mention that ultimately,  no amount of money will give someone back their quality of life once it is gone.  Many who suffer complications, are permanently disabled, and lives are changed forever.

 

So, if Doctor SKILL is not to blame, should doctors be blamed for not knowing & telling the facts?

This is maybe a better question in my book.  It’s also still one that anyone should approach with care, and probably is more complicated than it seems.

With all the FDA warnings, recent studies, and data coming out that warns about mesh complications – one would think that it would be less and less acceptable for doctors to just keep pleading the 5th when it comes to mesh, and even promoting it’s use.  ?  I mean, how can they keep recommending it, and using it, especially when more and more people keep coming forward with complications?

Well, it does not help that the FDA has NOT banned or recalled many mesh products, and it seems that there are many loopholes that allow for the widespread advocacy and use of mesh to continue,  along with confusion and ignorance surrounding mesh topics to thrive.   The doctors are being misinformed as well.   It is, quite the “mesh MESS”.

So, please please please… do try to do your homework.   Be careful about blaming your doctors… but, also Do NOT just go by what your doctor tells you.  Get second and third opinions – not just from doctors that use mesh, but also from doctors that do NOT use mesh.   Talk to other people who have actually had mesh, both the pro’s and the cons of it.  Research the product/device itself,  NOT just the doctor.  Is it worth the risks?   Once you really know some of the facts, I hope you will decide against it.

==============Related Links================

==============Support Groups================

Perhaps even more helpful than articles, is talking to a variety of others who are suffering from mesh complications, and are in various stages of treatment.   Three of the larger support groups I found helpful are: 

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2 Responses »

  1. Have the FDA warnings ALWAYS been on the mesh and parts? What about early placements re: 2003?? Mine was done by a very well respected doc in DC area. I was just wondering if the warnings were there and Doc ignored or were they not known at that time??

    Like

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