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.
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.