Mesh cuts into mar­i­tal in­ti­macy

A woman, so dam­aged from vagi­nal mesh her hus­band was ad­vised to wear two con­doms to pre­vent be­ing cut dur­ing sex, can­not sue the man­u­fac­turer be­cause of ACC rules. Cate Broughton re­ports.

The Dominion Post - - News -

Awoman, so dam­aged from vagi­nal mesh her hus­band was ad­vised to wear two con­doms to pre­vent be­ing cut dur­ing sex, can­not sue the man­u­fac­turer be­cause of ACC.

Jan*, 58, says the mesh has all but de­stroyed the in­ti­macy in her mar­riage.

‘‘It’s af­fected me a lot be­cause if my hus­band and I go to have re­la­tions, it’s al­ways . . . I’m think­ing am I hurt­ing him.

‘‘At one stage the doctor sug­gested we use dou­ble con­doms and you know we’re in our 50s and we’re not in­ter­ested in do­ing that.’’

In­ter­na­tion­ally, other cases have emerged of women suf­fer­ing cat­a­strophic in­juries from sur­gi­cal mesh in­clud­ing ‘‘a per­ma­nently de­stroyed vagina’’.

Jan joined about 20 Kiwi women to sue the man­u­fac­turer, Ethicon, owned by John­son & John­son in the US in 2014.

‘‘I had no con­fi­dence that any­one in New Zealand could re­move it and my hope was that I would get enough money to go to the US and have it removed.’’

But the Kiwi women’s claims were dis­missed by US dis­trict judge Joseph Good­win af­ter a chal­lenge by Ethicon, mainly on the ba­sis that they were el­i­gi­ble for cover by ACC.

‘‘I am re­ally pissed off that New Zealand tax­pay­ers, ACC, dis­trict health boards . . . are pay­ing for what I con­sider a faulty prod­uct,’’ Jan said.

MESH RE­MOVAL

Jan, who was im­planted with a mesh de­vice in 2010 to treat stress uri­nary in­con­ti­nence (SUI), had part of the mesh cut out of her ure­thra last year.

How­ever, she sus­pects the re­main­ing mesh is erod­ing be­cause of wors­en­ing pain.

Her doctor, one of 21 gy­nae­col­o­gists deemed to meet re­cent Aus­tralian stan­dards for the pro­ce­dure, did not put in a treat­ment in­jury claim to ACC as he did not be­lieve any­thing was wrong.

Af­ter a re­cent re­quest by the Min­istry of Health to ensure tighter cre­den­tialling re­quire­ments, 21 sur­geons in nine dis­trict health boards and an un­known num­ber in pri­vate hos­pi­tals are per­form­ing mesh pro­ce­dures for SUI.

In­for­ma­tion pro­vided to ad­vo­cacy group Mesh Down Un­der by the min­istry con­firmed just two sur­geons are qual­i­fied to fully re­move mesh de­vices.

PAIN MAKES SEX VIR­TU­ALLY IM­POS­SI­BLE

Caro­line Evans was also among the women who tried to sue Ethicon. She had mesh pro­ce­dures for SUI and pelvic or­gan pro­lapse in 2006 and 2009.

Both re­sulted in ag­o­nis­ing pain, in­fec­tion, dis­abil­ity and men­tal an­guish.

For years doc­tors told Evans they didn’t know why she had such se­vere pain, and sex had be­come vir­tu­ally im­pos­si­ble as a re­sult.

Welling­ton gy­nae­col­o­gist Han­ifa Koya removed some of the mesh but Evans paid $50,000 to travel to the US for high-risk surgery to re­move the SUI ‘‘sling’’.

The surgery, which was suc­cess­ful, was made pos­si­ble by Evan’s mother who re­mort­gaged her home to raise the money, a debt Evans was still repaying three years later.

Evans said her ACC claims were de­clined be­cause the mesh dam­age did not meet the cri­te­ria for phys­i­cal in­juries.

ACC has spent $16.7 mil­lion on treat­ment and weekly com­pen­sa­tion for sur­gi­cal mesh in­juries be­tween 2005 and June this year. How­ever, 22 per cent of claims for mesh in­juries were de­clined.

Next year, Evans will take her fight for ACC cover to the dis­trict court. She said it was wrong she could not sue the man­u­fac­turer. ‘‘I was an­gry, prob­a­bly, an­gry that be­cause we sup­pos­edly have a sys­tem that works – but it doesn’t work – that makes it OK.’’

CAT­A­STROPHIC IN­JURIES

US court ev­i­dence show­ing that med­i­cal de­vice man­u­fac­tur­ers knew sur­gi­cal mesh could cause cat­a­strophic in­juries in­clud­ing ‘‘a per­ma­nently de­stroyed vagina’’ was pro­vided to New Zealand politi­cians on a health se­lect com­mit­tee in 2014.

Lawyer Adam Slater, the lead lit­i­ga­tor for the first pelvic mesh trial against Ethicon, a sub­sidiary of John­son & John­son, wrote to the health se­lect com­mit­tee in 2014 to share in­for­ma­tion pro­vid­ing ‘‘a clear pic­ture of the se­vere dam­age these de­vices cause to women’’.

Thou­sands of New Zealand women have been im­planted with pelvic mesh de­vices to treat pelvic or­gan pro­lapse and SUI.

Among ex­am­ples Slater pro­vided to the com­mit­tee was a 2009 email from a urog­y­nae­col­o­gist to an Ethicon prod­uct direc­tor for pelvic floor re­pair in which he de­scribed com­pli­ca­tions that he was treat­ing in one woman with a Pro­lift pelvic mesh de­vice im­planted by an­other doctor.

‘‘She will likely lose any [sex­ual] func­tion as her vagi­nal length is now 3cm and there is mesh ex­trud­ing lit­er­ally ev­ery­where.

‘‘There is a large stone in the blad­der from a blad­der per­fo­ra­tion with the an­te­rior (mesh) arm . . this pa­tient will have a per­ma­nently de­stroyed vagina, and I am only hop­ing to get her out of this with­out more mor­bid­ity.’’

In a 2005 email, an Ethicon staff mem­ber ad­vised the med­i­cal direc­tor about uri­nary re­ten­tion prob­lems that he and other doc­tors were see­ing with pa­tients af­ter im­plan­ta­tion, which they could not ex­plain.

‘‘But if this starts get­ting re­ported, it is go­ing to scare the day­lights out of the doc­tors.’’

Slater said there had been more than 100,000 law suits against mesh man­u­fac­tur­ers in the US alone.

Most of the women had set­tled with the com­pa­nies but he still had sev­eral hun­dred cases pend­ing. One of his clients died be­fore her case went to trial when in­fec­tion from the mesh trav­elled to her lung.

Ev­i­dence pre­sented in court for a class ac­tion trial by 1200 Aus­tralian women against Ethicon in­cluded an email from a con­sult­ing French doctor who in­vented a pelvic mesh de­vice.

‘‘I would not want my wife to un­dergo this pro­ce­dure. And I don’t think I’m alone in that.’’

The women were seek­ing dam­ages in the hun­dreds of thou­sands of dol­lars, their lawyer, Tony Ban­non, of Shine Lawyers, told the court.

A ver­dict is ex­pected early next year.

Slater said it was ‘‘un­fair’’ that New Zealand women could not sue the man­u­fac­tur­ers and the laws needed to be changed.

* Stuff has agreed not to iden­tify Jan.

Jan joined a class ac­tion against man­u­fac­turer Ethicon in 2014 with the hope of win­ning enough money to pay for surgery in the US to have her mesh removed.

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