Preview Newsletter
Ethicon 3/11
-
Medical Device Defendant Probes Origin of Mesh Claims
Mar 10, 2016 | Reuters
By Alison Frankel
A major defendant in the 100,000-case pelvic mesh litigation has subpoenaed the mid-sized Houston law firm AkinMears, as well as several smaller law firms and a company that sells personal-injury claims, seeking documents and testimony related to AkinMears’ acquisition last summer of the smaller firms’ mass torts practices. -
Question & Answer Interview with Unfairly Terminated J&J Employee
Mar 10, 2016 | Mesh Medical Device News Desk (Reprinted from News Brunswick Today)
By Dave Schatz
Consumer healthcare giant, Johnson & Johnson, recently made the National Association for Female Executives’ 2016 list of “Top 60 Companies for Executive Women.” -
Anti-Inflammatory Diet for Pelvic Pain Management
Mar 10, 2016 | Mesh Medical Device News Desk
By Jaane Akre
Thanks to Still Standing for her series on the management of pelvic pain following a mesh implant. Her contribution as someone who has studied and teaches pain management professionally, is very much appreciated.
Client Attorney Privileged/Attorney Work Product/At Request of Counsel
Online Sources
-
Medical Device Defendant Probes Origin of Mesh Claims
Mar 10, 2016 | Reuters
By Alison Frankel
A major defendant in the 100,000-case pelvic mesh litigation has subpoenaed the mid-sized Houston law firm AkinMears, as well as several smaller law firms and a company that sells personal-injury claims, seeking documents and testimony related to AkinMears’ acquisition last summer of the smaller firms’ mass torts practices.
The subpoenas – issued Tuesday by American Medical Systems in the consolidated federal court mesh litigation in Charleston, West Virginia – are an unusual development in the long-running case because the medical device company has already agreed to settle most of the claims against it. AMS announced in 2014 that it would pay about $1.6 billion to resolve more than 40,000 filed and unfiled claims by women who alleged its mesh implants caused bleeding, infection and other painful side effects.
Despite the settlement, the company’s defense lawyers have begun challenging some recently filed claims. They contend in court filings that plaintiffs may have undergone unnecessary surgical procedures to make them candidates for bigger settlements. The wide-ranging new subpoenas ask the Florida marketing company, AkinMears and the other law firms to produce documents that may link them to doctors, surgical centers and private investors involved in funding medical procedures for mesh plaintiffs.
AMS is also interested in the origin of thousands of claims filed after its settlement was announced. The mesh maker wants to know how a Florida-based legal marketing business called Law Firm Headquarters acquired the potential claims it referred to several one- and two-lawyer shops, which in turn transferred claims to AkinMears last summer. AMS is demanding to see Law Firm HQ databases, client leads, telephone scripts and tapes, and logs of Internet communications with potential clients. The subpoenas also seek (among many other things) documents showing the relationship between Law Firm HQ and the small law firms to which it referred cases.
In July, four of those firms – Alpha Law, Sigma Law, MartindaleVoight and the Albert Lazo Law Firm – transferred their mass torts practices to AkinMears, which ordinarily specializes in advertising for personal injury clients. Most, but not all, of the claims AkinMears acquired in the transaction involved pelvic mesh. Neither AkinMears nor the Alpha Law firms have disclosed the number of claims transferred to AkinMears, but an Alpha Law principal told Reuters in an interview last April that his firm had more than 10,000 mesh claims on its docket.
AkinMears said in an email statement that it will oppose the new AMS subpoena, which it called “a transparent attempt by AMS to distract from the fact that its defective product caused devastating, life-altering injuries to our clients We pursue only meritorious cases. We never associate with doctors, surgical centers or medical finance firms. Our clients are real women who have suffered real harm.”
A representative for Law Firm HQ said he had no immediate comment on the AMS subpoenas. We did not receive a response to a telephone message left for Lonny Bramzon, a lawyer now listed as the executing officer of Alpha Law, Sigma Law and MartindaleVoight.Albert Lazo did not respond to our email and phone messages. The AMS lawyer who signed the subpoenas, Michael Scott of Reed Smith, also did not respond to our email.
Before the AMS subpoenas were issued, we had been reporting on Law Firm HQ and the small firms to which it referred cases as part of an inquiry on how law firms acquire and screen claims in mass torts litigation. In particular, we were interested in Law Firm HQ’s relationship with overseas call centers in countries such as India, Mexico and the Philippines, where labor costs are lower than in the U.S.
It is not uncommon (or improper) for legal marketing companies to use offshore call centers to screen prospective clients who make “inbound” calls in response to legal advertising, an online survey or email. Some offshore call centers, however, make unsolicited “outbound” calls to prospective clients who fit such criteria as age and gender. Lawyers are not permitted under state bar rules to solicit clients to bring lawsuits. Filing a claim on behalf of a plaintiff whose case began with an outbound call from a telemarketer could run afoul of ethics rules.
Law Firm HQ co-owner (and non-lawyer) Michael Chhabra told us in an interview in November that the company purchases client leads from offshore call centers, in addition to generating claims through sophisticated marketing tactics like Internet advertising and online surveys. Chhabra said Law Firm HQ’s screening processes are designed to filter out any cases improperly generated by other call centers.
Chhabra acknowledged, however, that some of Law Firm HQ’s former call center partners used improper tactics such as asking prospective clients to wire them money or urging potential plaintiffs to sue. Of the 75 call centers that sold client leads to Law Firm HQ, Chhabra said, Law Firm HQ eventually terminated relationships with 37.
“Sad to say, some were trying to cheat clients,” said Chhabra, who said that after Law Firm HQ received complaints from some plaintiffs, the company hired a private investigator to check out its call center partners. (AMS has subpoenaed Chhabra and his father Vincent, who founded the business in 2014 but is no longer an owner. Their representative did not comment on the subpoenas.)
Chhabra confirmed to us that his company had referred cases to Alpha Law and the other small firms that transferred their mass torts practices last summer to AkinMears. He also confirmed what we knew from business records in Washington, D.C., where three of the firms were registered: He was a founding partner at two of the small firms. Washington has an idiosyncratic bar rule that permits non-lawyers like Michael Chhabra to serve as law firm partners. Chhabra was not a partner at Alpha Law, but a non-lawyer friend of the Chhabra family was one of Alpha’s founders.
By the time AkinMears bought the small firms’ mesh practices, Law Firm HQ had generated leads for, by its own account, more than 20,000 potential personal injury suits in a variety of mass tort cases, including mesh, Bayer birth control pills and the blood thinner Xarelto. If that number is correct, Law Firm HQ’s lead generation productivity far outpaced that of well-established legal marketers that spend hundreds of millions of dollars a year on advertising for personal injury clients.
AkinMears allegedly paid $45 million to Alpha Law, Sigma Law, MartindaleVoight and Albert Lazo for their mass torts practices, according to a Texas state court lawsuit filed in September 2015 by a former AkinMears business development officer. AkinMears said the lawsuit, in which the executive said he was insufficiently compensated for the deal, misstated the price, which Reuters could not confirm independently. Partners from the small firms on the other side of the transaction either declined to comment on the terms of the deal, citing confidentiality agreements, or did not return calls for comment.
The former AkinMears employee’s lawsuit also asserted that the transaction was financed by Gerchen Keller, a $1.4 billion litigation fund headed by two former U.S. Supreme Court clerks and a former Goldman Sachs banker. Gerchen Keller declined to comment on the allegations in the suit, which has since settled on confidential terms.
AkinMears told us in December that it was not aware Law Firm HQ had purchased client leads from offshore call centers. In a written statement responding to questions from Reuters, AkinMears said Alpha Law and the other firms that transferred their practices specifically “represented to AkinMears that no foreign call centers were utilized” to generate claims.
In the aftermath of the deal between AkinMears and the firms in the Alpha Law network, AkinMears said it received complaints from a small number of transferred clients who claimed they had been solicited by non-lawyer case generators without giving consent. Michael Chhabra of Law Firm HQ said sometimes clients do not realize they have consented to receive legal marketing calls by responding to online inquiries or surveys. He also said relatives of prospective clients sometimes give consent on behalf of potential plaintiffs.
AkinMears told Reuters that a significant percentage of former Alpha Law network clients refused to allow the Houston firm to take over their cases. Some sought new lawyers; others did not sign forms consenting to AkinMears’ representation. The rate of dropped claims “has been significantly higher than what we expected,” the AkinMears statement said.
AkinMears declined to tell us what has become of the claims that clients agreed to transfer. Asked how many claims have resulted in filed lawsuits or settlements, the firm said: “We are not at liberty to discuss litigation strategy.”
Meanwhile, three of the law firms that sold their mass torts practices to AkinMears, including Alpha Law, effectively ceased operations after the sale last summer, according to lawyers from the firms-a little more than a year after Alpha Law opened for business. The lawyers associated with Alpha, Sigma and MartindaleVoight at the time of the AkinMears deal have all parted ways with the firms, Law Firm HQ and Law Firm HQ’s parent company.
Law Firm HQ remains in business. It bills itself as “one of the preeminent legal marketing and support organizations in the U.S., working in conjunction with a national group of highly reputable and experienced attorneys and law firms,” and says on its website that it has generated more than 30,000 cases.
-
Question & Answer Interview with Unfairly Terminated J&J Employee
Mar 10, 2016 | Mesh Medical Device News Desk (Reprinted from News Brunswick Today)
By Dave Schatz
Consumer healthcare giant, Johnson & Johnson, recently made the National Association for Female Executives’ 2016 list of “Top 60 Companies for Executive Women.”
But the following interview with former female employee “Annie,” 33, illustrates a bit of the company’s dark side, not often reported in the media.
As a classically trained medicinal chemist, Annie started her career in the research area, before moving to a development role as an analytical chemist.
She was employed by J&J’s Janssen Pharmaceuticals subsidiary at the Malvern, Pennsylvania site for more than two years as an analytical chemist before losing her job in the fall of 2014, when her “Family Leave” ended and the company would not approve an extension for a rare situation involving her infant daughter.
NBT: As a former J&J employee who was a multiple Encore award winner, Lean Cup award winner, and working mother, have you felt supported at Johnson and Johnson?
ANNIE: As a scientist, I enjoyed the academic rigors of my position and positively impacting patients’ lives but as a working mother, I feel that the company is moving in the wrong direction and away from [supporting] families. Caring for employees and their families is an important part of being a member of the community.
When my daughter was born, she had a congenital birth defect which required surgery as an infant. I applied for an extension of my maternity/family leave to cover her care before and after surgery but it was denied. I appealed the denial but that was also denied, stating that the business would be adversely affected by a longer leave and my position would be back filled if the leave was extended.
I had enjoyed working for J&J but when I needed to care for my daughter, J&J was not supportive. The Family Leave was created specifically for situations like these, yet when I needed it, it was not available. This is no benefit.
J&J strayed from their CREDO and their lack of accountability is unacceptable. It is not appropriate for J&J to treat their working mothers this way. The family leave policy is much too subjective which leaves it open to abuse and interpretation. (See the J&J Policy here).
NBT: This year, J&J rolled out a new program, STEM2D, to encourage both young girls and college-aged women to pursue STEM-related careers in science, technology, engineering, math, manufacturing and design. What advice would you give women who will enter the workforce working for companies such as J&J?
ANNIE: As a scientist and a mother of three daughters, including twin daughters, I fully encourage young girls and college-aged women to pursue STEM fields if that is their passion. Completing an internship in the field that you are pursuing is an important way to determine whether or not you enjoy working in that field. If possible, complete internships in different parts of the field to see where your interest lies.
Young women should look for employers who champion working mothers by providing on-site childcare, accessible family leave, and flexible work hours, paid maternity leave, comfortable breastmilk pumping rooms and most importantly, a supervisor who is a good mentor and one who is willing to help you find your path in the company. If you know women who already work at the company, ask them about their experience. As STEM fields tend to be male-dominated, it’s important to get a woman’s perspective about the working environment.
NBT: Three-fourths of the women who work at J&J reportedly use flexible schedules at some point during each year. Are flexible schedules a benefit J&J offers? Were you able to take advantage of flexible schedules?
ANNIE: Yes, J&J does offer flexible hours (and core hours). Depending on the position, work from home options might be available as well. If the position is strictly a laboratory position, then work from home options are usually not available, which gives working mothers in these STEM positions less options.
The flexible hours are helpful but on-site childcare is extremely beneficial to working parents. J&J offers on-site childcare at some locations only. This is something that could be improved at the Malvern, Pennsylvania site. Parents need to feel that they have a safe environment for their children while they are at work and they will be more productive knowing their children are well taken care of and close by in-case of emergencies if childcare is provided on-site.
Another area that could use major improvement is the on-site breast milk pumping room. The one at our site was a modified closet room off of the cafeteria that was unfortunately poorly planned. It is optimal if this room is comfortable, private, relaxing, has access to electrical outlets as well as a sink for washing pump parts and a microwave for sterilizing them. Mothers who feel comfortable will produce more milk and the mother/baby dyad will benefit. Because this room lacked functionality at our J&J site in Malvern, some mothers pumped milk in empty office rooms while others pumped in their car and used the break-room sink and microwave for cleaning/sterilization. Others decided not to breastfeed at all because of the logistics of bringing their pump, bottles, supplies and pumping multiple times per day. In order to breastfeed our babies, proper rooms and management support for breastmilk pumping while at J&J is critical. I would love to design a proper breastfeeding room for J&J!
NBT: You told NBT that J&J made the “Best Companies for Working Mothers” for 30 years, but that the company actually seems to care more for their bottom-line than the health of its workers’ families. Please tell NBT readers more about your own experience.
ANNIE: During my pregnancy with my youngest daughter in 2014, I sat down many times with my line management and our HR representative to discuss not only my daughter’s birth but my father’s terminal cancer illness. They agreed to allow me four months of maternity leave to care for both my newborn and my father (paid and unpaid time). I asked about taking more time off as part of their generous un-paid Family Leave policy. The HR representative said that they would back-fill my position and let me go if I tried to take more time off.
In May 2014, when my daughter was born, she spent a week in the NICU with IV’s and intense phototherapy for ABO incompatibility. My father was being cared for in the same hospital so I spent that week going back and forth between my father’s bedside and my newborn’s bedside, while recovering myself from her birth. If that wasn’t enough, she was also born with a congenital birth defect which we did not know about prior to discussing my maternity leave with management and HR. The doctors at DuPont recommended surgery when she was 6-9 months old. I asked my management for additional unpaid family leave to cover her pre-surgery appointments, surgery and post-recovery period but I was denied. I appealed the decision with documentation from the surgeon but was again denied. I asked the surgeon if we could move up her surgery date so that my current maternity would cover it but they said that due to safety concerns around administering anesthesia to newborns, they would not operate until my daughter was 6 months old. My employer had provided my family’s health insurance but they were not willing to allow me the family leave to take time off to care for my daughter’s so that she could get the surgery.
As a multiple award winner in the department and a seemingly valued employee, I was shocked that when I needed to use the “Family Leave” benefit, it was unavailable to me. In effect making me choose between taking care of my family and continuing my employment with them. With my employer providing my family’s health insurance, it made the decision to leave all that more difficult, knowing the medical care that my newborn needed. My beloved father passed away a few weeks after my daughter was born and we arranged his viewing, funeral service and burial. We put our children on CHIP health insurance and my daughter received the surgery she needed as well as pre-op x-rays and post-op visits and physical therapy. At 6-months old, she was in a cast for three weeks after her surgery (Nov-Dec 2015), which required a higher level of care than a daycare was equipped to handle. This reinforced my decision that the choice I was forced to make between my job and caring for my family was the right one. When I needed support from Johnson & Johnson, they neglected their responsibility and unfairly denied my repeated applications for Family Leave.
The appeal denial stated that, “The business would be adversely affected by a leave that lasted past the approved date. Any extension to the leave would necessitate a back filling of your position to cover the work commitments of your position.”
The J&J CREDO [a document written by the founder more than 70 years ago] proclaims that J&J must be mindful of ways to help employees fulfill their family responsibilities yet I was given an ultimatum instead of working with me to help my infant get the care she needed.
As a mom to three daughters, it is important that I share my story as they might one day become working mothers themselves and I hope they don’t suffer the same neglect and indifference that I experienced.
Gorsky speaking Nov 2011
NBT: Last year Alex Gorsky was honored by the Appeal of Conscience Foundation, and interfaith organization, as a man of integrity and social responsibility. Does J&J foster an environment of social commitment?
ANNIE: Social and environmental responsibility is important in our community. I am passionate about science and I hope to improve the quality of people’s lives through discovering and developing new cures and treatments. Caring for other people and their families will make the world a better place. While working at J&J, I volunteered my time to clean up the environment at our J&J site in Malvern. I strongly believe in helping others through volunteering.
At a previous pharmaceutical company, I also volunteered through our collaboration with Habitat for Humanity to re-build houses in the community and at our department’s CSI Chemistry Exhibit for Take your Kids to Work Day. In graduate school, I volunteered my time at the local public library for Kid’s Chemistry Day as a part of National Chemistry Week to encourage a love of learning science in our youth. As a scientist, research ethics is also an important part of social responsibility that apply to the profession and one that I champion.
-
Anti-Inflammatory Diet for Pelvic Pain Management
Mar 10, 2016 | Mesh Medical Device News Desk
By Jaane Akre
Thanks to Still Standing for her series on the management of pelvic pain following a mesh implant. Her contribution as someone who has studied and teaches pain management professionally, is very much appreciated. Still Standing cannot be identified because she is involved in litigation. Last month, she authored Medical Management of Mesh Complications (here).
Notes on anti-inflammatory diet for pain management, by Still Standing
Sometimes, when our pain is so intense, especially in the pelvic area, it is hard to step back and look at some of the systemic things that are going on even at the cellular level that can impact the chronic nature of pain. Understanding these systemic processes will not make pain magically disappear, but applying knowledge about pain and inflammation can have an impact on our daily experience of pain. Making some dietary changes can have a significant impact on inflammation, which drives pain.
Pain, is the result of inflammation. Inflammation is what happens when your body senses a threat and unleashes its immune function. Inflammation can take place anywhere in the body and generally it is the result of some kind of physical trauma. But, as seen in pain that becomes chronic, inflammation and pain can develop away from the area of the original trauma. Mesh women well understand this and can have diagnoses of fibromyalgia, TMJ, Interstitial Cystitis, chronic UTI, auto immune disorders, even depression. While there is not hard scientific evidence that links mesh to auto-immune disorders, many mesh implanted women report that they have developed one post mesh.
Prolift partial explant
Think for a minute about inflammation that you can see. Think about a cut you have had on a finger. Over the next few hours, your body responds by sending in chemicals that help stop the bleeding initially? You might then see redness around the cut. You will most probably feel pain. This is a signal that your immune system is responding to the cut by segmenting that area off and targeting it with white blood cells. Over time, the cut heals, the redness goes away and you forget about the injury.
When you have chronic pain, your immune system gets stuck on high alert and even though the initial trauma has healed, your body’s immune system continues the attack on your body which can trigger higher pain.
Your body does not like intrusions, like a cut, or mesh. The immune system goes into high alert to try to get rid of the intruder. Bringing down inflammation by looking at some common things that increase inflammation and learning ways that lower inflammation can help. It is commonly recognized that being overweight increases inflammation. Exercise generally helps reduce inflammation.
Stress increases inflammation, calm reduces it.
One important, but sometimes overlooked contributor to inflammation and pain is diet. There are foods that definitely increase inflammation. These are, of course, the foods that we turn to for comfort–high fat (pizza, red meat, mayonnaise), high sugar, processed carbohydrates (such as cookies, cakes, donuts, pasta, white bread, chips). Another major driver of inflammation in our diet is dairy (milk, ice cream, cheese, and yogurt. Aspartame, found in my favorite Diet Coke is also high on the list as well.
Image from Amazon
Eliminating, or at least reducing these things in our diets can reduce inflammation throughout our body while eating more anti-inflammatory foods can help decrease pain. Here are some good anti-inflammatory foods: fish, nuts, fresh vegetables especially dark and leafy ones like broccoli, kale, spinach, and fruits, flaxseed, whole grains, and other things that aren’t nearly as appealing as the high inflammatory ones.
One food I love that is, in small quantities, good for you is chocolate, YEAH! Not milk chocolate, but very dark chocolate. Dark chocolate bars can be found in most box stores. Trader Joes has really good ones, but I have bought some at Dollar General that are also quite good. Two or three squares is the approximate daily limit, but I’ve been known to stretch that amount.
Once you decide to try to eliminate, or at least reduce, these foods, you may find that your pain is less intense.
I tried to go cold turkey on all of the major inflammatory foods: wheat, dairy, sugar, eggs, red meat as well as some other foods I tested highly sensitive to. Pork, rice, oats, tomatoes, peanuts. I did ok for a couple of weeks, then I stepped off the deep end of food cravings into a land of donuts, hamburgers, angel food cake, and that was just in one day. So I have had to step back,, forgive myself for the breakdown, and do a slower elimination.
Dark chocolate, Apex nutrition
This on again, off again approach will not be as successful, but it keeps me from derailing completely. Anything that you can do to reduce inflammation is a step forward, so do what you can. If you could just pick one of the major drivers of inflammation–sugar and dairy—and commit to not having one or both over two or three weeks, you might see an amazing difference in how you feel. You really have nothing to lose, except some pain, so it is definitely worth the investment of time.
Since the mesh, I have developed cysts on my nails at the cuticles that break open and ooze and other knots in my finger joints. Going dairy and sugar free has absolutely eliminated these areas of inflammation. Stepping back into sugar and dairy…especially dairy brings them back again, so I am gradually losing my taste for both. I use cashew milk for my protein smoothies and coconut milk for cooking. If you have any of these external signs of inflammation, you can be sure that the same process is going on in the body tissues you can’t see.
Client Attorney Privileged/Attorney Work Product/At Request of Counsel
Online Sources
Add recipients
Suggested