Surgical mesh costs millions

By Chloe Johnson

Hundreds paid ACC compo for pain and suffering after surgery goes wrong.

Heather Anderson has been in severe pain for years after surgical mesh was implanted in her abdomen. Photo / Kellie Blizard
Heather Anderson has been in severe pain for years after surgical mesh was implanted in her abdomen. Photo / Kellie Blizard

A surgical mesh that is the subject of international lawsuits and health warnings is still being implanted in hundreds of New Zealanders.

The mesh is often used for hernia repairs and prolapsed pelvic organs and muscles, despite ACC paying $3.1 million in treatment and compensation to people with post-surgical complications.

Heather Anderson has been in pain for eight years since the mesh was implanted in her lower abdomen.

She said it was like a cheese grater cutting through her internal organs.

In the US thousands of women complained of severe pain, infections, excessive bleeding and organ perforation.

The Food and Drug Administration revealed women had died from complications after mesh surgery for prolapsed pelvic organs.

In New Zealand, there have been 600 ACC claims since 2008. Of those, 389 have been accepted. The injured patients have been paid compensation, as well as large sums for treatment and rehabilitation.

Anderson, of Auckland, had mesh surgery for a hernia on her lower abdomen eight years ago. She said the mesh was wrongly placed under her breasts, causing her to vomit several times a day.

Anderson, 61, said she had excruciating pain because the mesh was too tight. She had another operation to loosen it but still had complications, including pain, discomfort and difficulty breathing.

Anderson's complaint to the Health and Disability Commission was dismissed, but she is seeking compensation through ACC.

Mary, a nurse in Wellington, had mesh implanted five years ago after her pelvic floor muscles collapsed. A month after surgery she could feel pain and something pulling on her organs. She had nerve pain in her legs, bowel pain and spasms. She also had severe incontinence that stopped her from socialising or playing sport for years.

Mary said she was not warned of the possible complications and risks. She has sought legal advice and is seeking physical and emotional compensation.

Sue, of Tauranga, had surgery for severe incontinence 10 years ago. She said the mesh perforated her scar tissue after two months, causing pain and discomfort.

Sue, 57, had another operation to fix the ripped tissue. But last year she got whooping cough which caused further complications. She has incontinence each day.

Jenny, 55, of Waikato, had mesh implanted last year to fix a prolapsed uterus. Within days after the surgery, major complications began. Her feet swelled so badly she has gone up a shoe size and can no longer stand for long periods.

She has bowel complications and said it felt like something was tugging against her organs. An ACC claim was turned down because her complications were considered a "consequence of the operation".

Paul, 50, had a hernia repaired in his abdomen in 2009. Surgical mesh supported the weak tissue but complications began in hospital. Fluid built up around the wound and a second lump appeared, which he suspected was the mesh bunching.

Paul said he was not well informed about the use of mesh. He complained to the Health and Disability Commissioner.

In May, Johnson & Johnson - one of the providers of surgical mesh - withdrew five products from its Gynecare range in New Zealand, amidst legal action involving products overseas. Bloomberg News reported Johnson & Johnson faced 600 claims from US patients.

Johnson & Johnson spokeswoman Donne Newbury said the removal of the products was not related to safety issues. "Our decision to discontinue these kits was based on their commercial viability in changing market dynamics and were not related to safety or efficacy."

Medsafe compliance management manager Derek Fitzgerald said investigations into reported complications found the product was not harmful when implanted correctly.

He said the investigation used material from Australian and New Zealand specialists.

A lost year of life

Monique Knox feels she lost a year of her life after a gynaecologist botched up her surgery.

The 57-year-old office administrator underwent mesh surgery four years ago to fix her prolapsed pelvic floor muscles. During the four-hour operation, the gynaecologist "nicked" her bladder and punctured her bowel with a finger, she says.

Six months later, she felt like her organs had prolapsed again so she went back to the gynaecologist, but was told she hadn't prolapsed.

She had "a horrible couple of years", losing her father and being made redundant so it "went on the back burner," Knox said.

But after three years of stomach and back pain she went to see another gynaecologist, Hanifa Koya, who found her bladder was severely infected and Koya could feel the mesh bunched inside her body.

A scan revealed the mesh had been wrongly placed inside her bladder. Eight months ago she underwent a 12-hour operation to have it removed. The surgeon also "hitched" the prolapsed muscles into place using conventional methods and performed a hysterectomy.

She must wait at least another four months before she can attempt to pick up her newborn grandson or go back to the gym.

"I've lost a year. I feel fragile and I'm scared of anything going wrong again."

Knox has laid a complaint with the Health and Disability Commissioner against her original gynaecologist. That specialist is already the subject of an adverse HDC finding for failing to provide post-op care to a patient who subsequently died.

Mesh errors 'common'

Gynaecologist Paul Macpherson says he repairs at least one mesh-related surgery error each week.

Surgical mesh was a controversial product and comes with risks and warnings. But Macpherson, a member of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, supports the ongoing use of mesh to repair severe or recurring tissue weakness.

Macpherson said the way the mesh was implanted into the body could cause complications.

"If it is too close to the bladder it will irritate it. If mesh is put in too tight it will stay there. It is a difficult operation to do and best done by people who have undergone training and have done a reasonable number of them."

He said only about 10 doctors in New Zealand were trained to operate with surgical mesh and there were strict guidelines on who could use it.

Wellington gynaecologist Hanifa Koya said she was against the use of mesh due to a lack of research and non-stringent regulatory processes. She said medical products, apart from drugs, were often put on the market without comprehensive testing.

- Herald on Sunday

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