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Ethicon Media Monitoring 4/9/2018
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Questions remain for doctors after vaginal mesh Senate report handed down
Apr 7, 2018 | ABC News
By Sophie Scott and Alison Branley
It should have been a landmark day for women suffering from chronic pain from the use of pelvic mesh for prolapse and incontinence. -
Australia bans mesh after Scots’ evidence
Apr 8, 2018 | The Sunday Post
By Marion Scott
A Senate Inquiry in Australia has ruled mesh implants can only ever be used as a last resort. -
Claims against pelvic surgeon Anthony Dixon subject to new NHS dispute resolution protocol
Apr 9, 2018 | Claims Media
By Mark Dugdale
Women who believe they were left with life changing complications following surgery performed by the UK’s most influential pelvic surgeon, Anthony Dixon, have until 1 August to take advantage of an NHS protocol that has been adopted to coordinate the claims process.
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Questions remain for doctors after vaginal mesh Senate report handed down
Apr 7, 2018 | ABC News
By Sophie Scott and Alison Branley
It should have been a landmark day for women suffering from chronic pain from the use of pelvic mesh for prolapse and incontinence.
Instead, it triggered more concerns.
A Senate report has been handed down and put on the national record a validation of everything so many injured patients have been saying for years.
But as inquiry spearhead Senator Derryn Hinch noted, "there are still a lot of questions to be answered".
Buried in the report is a recommendation that the Federal Government works with the medical profession to ensure there are systems in place to prevent the "payment of inducements to medical professionals and teaching hospitals".Lamborghinis 'used to market mesh implant'
It raises the question: what inducements?
The Medical Board of Australia's Code of Conduct specifically asks doctors to "inform patients when you have an interest that could affect, or could be perceived to affect, patient care".
It led these writers to ask, has anyone ever been to a doctor who has declared to them they receive payments from a company whose products they are about to recommend?
Disclosures made by medical professionals are listed through the Medicines Australia website, but that only covers payments for speaking and educational events for pharmaceutical products.
The Medical Technology Association of Australia has a code of conduct that stipulates issues such as not using "any inappropriate inducement … in order to promote or encourage the use of its products".
But this code is only binding for those device companies that are association members, from Abbott Australasia to Zimmer Biomet.
As the ABC reported earlier this year the marketing for mesh products was intense with images of Lamborghinis and ski trips to the Swiss Alps used to oversell surgeons on the benefits of using pelvic mesh.
There's been no evidence, in court or in the Senate committee, of direct kickbacks, incentives or commissions being paid to any medical professional. However the issue of inducements does appear to have come up more than once during the parliamentary inquiry.
Many women said they felt pressured to have a device, with one woman telling the committee that she experienced a peculiar reaction from her doctor during a routine pap smear when she mentioned having mild incontinence.
"Straightaway, like a Jack in the Box, he popped his head up from between my legs, 'I can fix your urinary stress incontinence', and subsequently did his utmost to convince me that I needed what he described as, 'a safe and simple straight forward, minimally invasive, uncomplicated and effective surgery'," she told the inquiry.
She went on:
"I made it clear that should I agree, I wanted the surgery done privately, but he discovered I had no private health cover and said, 'I do the very same surgery in the XXX [sic] so I'll do it there.'"'Unusual eagerness' for vaginal mesh surgery
Another woman told senators that her doctor had shown "an unusual eagerness" to perform mesh surgery even though she was "not aware that she had any symptoms".
"There was pressure on me to agree on that same day to the transvaginal mesh surgery," she told the inquiry.
"It was explained to me that if I declined and that surgery was still needed, it would be a lengthy delay before I could reapply to have it done."
Uro-gynaecologist associate professor Christopher Maher told the committee it was important to look at the role that makers had in getting doctors to start using new devices.
He said those who were "early adopters" of mesh did so with the best of intentions, but that it may have contributed to overuse.
He described a situation where makers would actively promote those specialists who used their products to GPs.
"Sponsoring companies are also actively involved in the education and provision of training to medical specialists," he said.
The Royal Australian New Zealand College of Gynaecologists says the vast majority of surgeons didn't have any financial incentive to use particular transvaginal mesh products.
The anecdotes above certainly cast some serious doubts on that.
While there is no evidence of kickbacks, incentives or commissions being paid, it is certainly understandable why some people might believe there is much more to this scandal than just overzealous marketing.
http://www.abc.net.au/news/2018-04-08/vaginal-mesh-senate-report-questions-remain/9626170
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Australia bans mesh after Scots’ evidence
Apr 8, 2018 | The Sunday Post
By Marion Scott
A Senate Inquiry in Australia has ruled mesh implants can only ever be used as a last resort.
Politicians there have been “shocked” at the crippling injuries suffered by women, with one describing mesh implants as “a torture device”.
Scottish mesh victims and Ayrshire & Arran NHS consultant Wael Agur were among those who gave evidence to the inquiry which estimates the country has at least 15,000 women injured by the controversial devices.
Australian Senator Derryn Hinch said: “No wonder these slings have been called torture devices.”
The inquiry has issued a scathing report on the use of mesh implants to treat bladder and pelvic organ prolapse, ordering a register to be set up to track all implant and mandatory reporting of all complications, and help for affected women.
The results of the Australian inquiry has strengthened calls for action from Scottish MSPs who described our government’s £4500 mesh safety inquiry a “whitewash” after The Sunday Post revealed each of the medical experts used had previously received funding from manufacturers.
Scottish Mesh Survivor Olive McIlroy said some implants withdrawn in the US are still being offered here.
She added: “Despite Australia using the evidence we gave them on the dangers of mesh, our own government is still lagging behind in taking the decisive action needed to protect patients.”
https://www.sundaypost.com/fp/australia-bans-mesh-after-scots-evidence/
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Claims against pelvic surgeon Anthony Dixon subject to new NHS dispute resolution protocol
Apr 9, 2018 | Claims Media
By Mark Dugdale
Women who believe they were left with life changing complications following surgery performed by the UK’s most influential pelvic surgeon, Anthony Dixon, have until 1 August to take advantage of an NHS protocol that has been adopted to coordinate the claims process.
Clinical negligence and personal injury law firm Fletchers Solicitors has been instructed to handle a number of claims against Dixon, who allegedly subjected patients to overly complicated procedures without fully informing them of all the risks.
NHS Bristol NHS Trust’s investigations into his practices, particularly around the mesh rectopexy and Stapled Transanal Resection of the Rectum (STARR) operations he performed, are currently ongoing. In August 2017, the General Medical Council also placed restrictions on his practice, preventing him from carrying out STARR procedures until November of this year.
In anticipation of more legal claims against Dixon, a new protocol that operates as a form of alternative dispute resolution has been adopted by the NHS to coordinate the process, in a bid to control costs and deal with claims promptly, with clients expected to receive an initial decision on their case within a matter of months of notification. For claimants to take the benefit of the protocol, their claim must be notified by 4pm on 1 August.
Amy Hughes, the litigation executive dealing with the case of Valerie Evans, who suffered from severe complications following surgery at the hands of Dixon in 2016, said: “We are representing a number of clients, including Mrs Evans, in connection with treatment provided by Mr Dixon over a period of time, whilst he worked for both the NHS and as a private consultant at the Spire Bristol Hospital.”
“Mr Dixon aimed to pioneer mesh rectopexy in the UK, but surgeries involving mesh have come under intense scrutiny due to the high number of complications associated with them. We are now investigating on behalf of our clients whether Mr Dixon’s recommendations to proceed to surgery, and the way his procedures were carried out, was appropriate, given the incredibly poor outcomes they have suffered.”
http://www.claimsmag.co.uk/2018/04/claims-pelvic-surgeon-anthony-dixon-subject-new-nhs-protocol/10690
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