Preview Newsletter
Ethicon Media Monitoring 5/16/2017
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(Audio) Concern grows over side effects of pelvic mesh implants
May 16, 2017 | ABC Online
By Amanda Smith
Imagine that a procedure that was supposed to make you better actually resulted in crippling pain, a destruction of your sex life and still did not solve your problems. -
‘Scottish transvaginal mesh implant review has implications for clinical practice across the UK’ says physio
| Chartered Society of Physiotherapy
By Louise Hunt
The case for specialist physiotherapists to be more involved in treating women with pelvic dysfunction has been strengthened by the long-awaited publication of an independent review into the use of transvaginal mesh implants, Elizabeth Crothers, who represented the CSP on the review board, told Frontline. -
Can You Change Your Law Firm?
May 15, 2017 | Mesh Medical Device Newsdesk
Can you change law firms if you are unhappy with your representation? Get your retainer agreement and look at the fine print is a first place to start. -
Breast Implants and a Rare Cancer Possible Link to Biofilms
May 15, 2017 | Mesh Medical Device Newsdesk
... In transvaginal mesh biofilms have been found to grow around some polymeric materials protecting bacteria. They thrive in high humidity. See the Mesh News Desk story here.
Client Attorney Privileged/Attorney Work Product/At Request of Counsel
Online Sources
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(Audio) Concern grows over side effects of pelvic mesh implants
May 16, 2017 | ABC Online
By Amanda Smith
Imagine that a procedure that was supposed to make you better actually resulted in crippling pain, a destruction of your sex life and still did not solve your problems.
Many women are alleging that this has happened to them, following surgery that saw polypropylene mesh inserted in their bodies to redress problems with incontinence and prolapse.
A new survey is highlighting to extent of problems being experienced by women in Australia
http://www.abc.net.au/radionational/programs/lifematters/concern-grows-over-side-effects-of-pelvic-mesh-implants/8529196
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| Chartered Society of Physiotherapy
By Louise Hunt
The case for specialist physiotherapists to be more involved in treating women with pelvic dysfunction has been strengthened by the long-awaited publication of an independent review into the use of transvaginal mesh implants, Elizabeth Crothers, who represented the CSP on the review board, told Frontline.
The final report was published by the Scottish government on 27 March.
It comes as a BBC investigation in April revealed that more than 800 women are suing the NHS and mesh implant manufacturers after developing serious and life changing complications from surgery involving the plastic devices. If successful, their cases could amount to tens of millions of pounds in compensation.
Scotland is further along the road in responding to this issue after a group of mesh implant sufferers successfully petitioned the government to suspend the use of the plastic devices in surgery for incontinence and pelvic organ prolapse in 2014.
Although the review was ordered by the Scottish government, Ms Crothers said it would have implications for clinical practice across the UK.
The final report did not go as far as banning implants, but concluded that mesh must not be routinely offered as a treatment and that women should have access to clear advice to help them make informed choices.
Ms Crothers, who worked for the NHS as a specialist women’s health physiotherapist before retiring, said the recommendations would enable physios to make the case for providing more pre-surgery physiotherapy classes.
‘There is evidence that physiotherapy can effectively decrease the effects of pelvic organ prolapse and can potentially avoid the need for surgery,’ she said.
She argued that as physiotherapists are part of multidisciplinary teams helping women with these problems, the document should ‘put physiotherapists in a stronger place to negotiate for funding to provide the services women should expect’.
Physios should be seeking funding to attend multi-disciplinary team meetings; receive training to recognise and report instances of mesh erosion as reporting is now mandatory. ‘Physios are often the first to examine a woman vaginally after referral from a GP or self-referral and reporting is mandatory,’ she said. And funding should be identified to ensure that physiotherapy is considered within the development of gynaecology and uro-gynaecology treatment pathways.
The independent review expert panel, with input from Doreen McClurg representing the CSP’s Pelvic, Obstetric and Gynaecology Network, will be putting together an information leaflet, ‘to help women in the decision-making process’, added Ms Crothers.
http://www.csp.org.uk/press-releases/2014/08/18/suspension-mesh-surgery-...
http://www.csp.org.uk/news/2017/05/12/scottish-transvaginal-mesh-implant-review-has-implications-clinical-practice-across-
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May 15, 2017 | Mesh Medical Device Newsdesk
Mesh Medical Device News Desk, May 15, 2017 ~ Can you change law firms if you are unhappy with your representation? Get your retainer agreement and look at the fine print is a first place to start.
When you research whether you can leave your law firm, most references are for attorneys. At least once in a career, a lawyer may want to change firms.
But what if you, the client, are not happy with your representation and want to shop for another law firm to take your case?
Is that allowed?
A TEAM
In an ideal world, you and your law firm form a “team” based on mutual trust and respect. That means you must provide the law firm with the information it asks for and stay in touch if you move. You must always be reachable.
In turn, the law firm should be able to answer your questions and have someone appointed to be your liaison. This should be a paralegal, or someone familiar with the law.
Check out the American Bar Association’s Model Rules of Professional Conduct here.
Your law firm must provide you with your case number and where your case is filed so you can look it up and verify that it actually has been filed.
You editor is hearing lately of cases that were never filed with the court, instead, they were prepared for settlement. What sort of message does that send to the defense side? A case worked for trial indicates resources were put into the merits of the case, one that counsel was prepared to present to a jury. As readers know, those have resulted in multi-million dollar verdicts, with very few exceptions.
LEGAL REFERRAL SERVICES
Is your case with a trial lawyer? Many 800 #’s led the unsuspecting injured plaintiff to a legal referral center that sells or “refers” your case to another firm for a set amount or percentage.
Since one has to be a lawyer to head a legal referral service, you may think you signed up with a law firm (and you did) but they may have had no intention of keeping the case. Unless you know that, you may waste previous time asking the referral service for an update on your case.
Some plaintiffs were promised theirs was a “million dollar case” when they signed up. That is a red flag. No one knows the value of a case.
Mesh News Desk has heard from plaintiffs who only find out years later that the initial referral firm no longer has their case.
This is a formula for disaster.
No communication can mean that cases fall by the wayside and the plaintiff forgets about it and goes on with their life. That’s what happened in the recent story Women Who Are Missing, who had their cases dismissed by the court when both sides failed to communicate with each other.
Is changing law firms even allowed? Remember – Your case belongs to you.
Read the fine print of your firm’s retainer agreement. That may contain language that will guide you if you are not happy with your current representation.
If the law firm wants to end the relationship, the replaced lawyer will file a notice of withdrawal with the court. They must return your original files and papers and property and refund any unused retainer.
Make sure you do not get into a battle over paying them before your files are turned over to the next firm.
The American Bar Association’s Model Rule 1.16(d) (here) says your firm must surrender papers and property as soon as the representation is terminated. There may be a similar rule in your state bar association
If the firm is owed fees, it will file a lien on whatever award you eventually receive from either a jury award or a settlement.
Make sure the fees and costs are “reasonable” and not excessive. Ask for an invoice with details on the expenditure in your case.
If you never receive anything in a settlement, do you still owe that law firm something? It’s in the fine print.
Give careful thought to firing your attorney. Are you on the eve of trial? Has the firm communicated with you but your real frustration is with the industry you are suing? What are you expectations and are they realistic?
That is the million dollar question when it comes to mesh litigation because the dollars being offered by the mesh industry do not consider a lifetime of pain and medical care, loss of consortium, lost wages, medical care mesh-related but that are not revisions, pain and suffering.
So what is realistic?
As yourself, is this firm acting in a professional manner and do they still have your trust?
A sit down meeting to air your grievances may answer your questions. ###
LEARN MORE:
From Martindale-Hubbell, How to fire your attorney here.
http://www.meshmedicaldevicenewsdesk.com/can-change-law-firm/
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Breast Implants and a Rare Cancer Possible Link to Biofilms
May 15, 2017 | Mesh Medical Device Newsdesk
Mesh Medical Device News Desk, May 15, 2017 ~ Breast Implants, particularly textured variety, have been linked to biofilm and a small cell lymphoma.
The FDA has been taking in accounts since 2011.
The New York Times on May 14th tells the story of a woman who had breast reconstructive surgery after a double mastectomy, only to find six years later that a rare malignancy of the immune system was caused by the very implants she used to rebuild her chest.Her disease is breast implant associated anaplastic large-cell lymphoma (ALCL) and the FDA has been tracking cases for six years.
This rare T-cell cancer is linked to textured breast implants because the cancer has been found around the implant site of breast implants with a textured surface.
Breast implants with a textured surface are used by plastic surgeons to reduce the rate of capsular contracture (hardening around the implant) and to stabilize the implant and reduce the risk of movement.
The U.S. Food and Drug Administration (FDA) has received 359 reports of possible cases of breast implant-involved ALCL but the exact number is unknown.
The Times reports the texturing is an abrasive that may cause inflammation, and that leads to cancer, on an average of eight years after implant, but cancers can develop from 2 to 28 years after the implant surgery.
In the early stages this cancer is often curable, if it has not spread. The first line of defense is removing the implant.
BACTERIAL BIOFILMS
Another theory is that bacterial biofilm may cling to the texture of the implant that irritates the immune system with persistent inflammation. The silicone or saline component of the implant seems to make no difference in incidents of ALCL.
In transvaginal mesh biofilms have been found to grow around some polymeric materials protecting bacteria. They thrive in high humidity. See the Mesh News Desk story here.
Other types of lymphoma result from chronic infections.
Allergen, a maker of textured implants, is studying bacterial biofilms, inflammatory and immune response to implants, said an email spokesman to the NYT. Mentor, too, says it is monitoring reports about its implants and the link to lymphoma.
SYMPTOMS OF ALCL
Symptoms of lymphoma include swelling and fluid buildup or lumps in the breast or armpit. The times reports that a diagnosis involves draining fluid from the breast to test it for CD30, an indicator of lymphoma.
In 2011, the FDA suspected a possible association between the development of ALCL and breast implants, but at that time, there were not enough cases to raise warnings.
By February, the FDA had identified 231 reports of cancer and ALCL and of those, 203 implants were reported to have textured surfaces while 28 were reported to be smooth implants.
The Times reports that as late as 2015, only about one in three plastic surgeons even discussed cancer with patients.
About 10 million women worldwide have received breast implants. Annually about 400,000 U.S. women receive breast implants with 300,000 for cosmetic enhancement and 100,000 for reconstruction after cancer.
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http://www.meshmedicaldevicenewsdesk.com/breast-implants-biofilm/
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