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The High Cost of Failing Hip Replacements
Posted by: Stephen Leshner
December 28, 2011
Topic: PRODUCT LIABILITY

The following article was published in today's New York Times.

The High Cost of Failing Artificial Hips

By BARRY MEIER

Published: December 27, 2011

The most widespread medical implant failure in decades, involving thousands of all-metal artificial hips that need to be replaced prematurely, has entered the money phase.

The case of Thomas Dougherty represents one particularly costly example. He spent five months this year without a left hip, largely stuck on a recliner watching his medical bills soar.

In August, Mr. Dougherty underwent an operation to replace a failed artificial hip, but his pelvis fractured soon afterward. The replacement hip was abandoned and then a serious infection set in. Some of the bills: $400,776 in charges related to hospitalizations, and $28,081 in doctors? bills.

I?m sitting here on a La-Z-Boy meant for someone who is 80 and I?m 55, said Mr. Dougherty, who lives in Groveland, Ill., and works at Caterpillar, the heavy equipment manufacturer. His bills are five times as much as he paid for his home.

The so-called metal-on-metal hips like Mr. Dougherty?s, ones in which a device?s ball and joint are made of metal, are failing at high rates within a few years instead of lasting 15 years or more, as artificial joints normally do. The wear of metal parts against each other is generating debris that is damaging tissue and, in some cases, crippling patients.

The incidents have set off a financial scramble. Recently, lawsuits and complaints against makers of all-metal replacement hips passed the 5,000 mark. Insurers are alerting patients that they plan to recover their expenses from any settlement money that patients receive. Medicare is also expected to try to recover its costs.

While his insurer has covered his bills so far, Mr. Dougherty said he was preparing to sue his surgeon, who may have implanted the device incorrectly, and Johnson & Johnson, which produced his artificial hip, to help recoup some of the insurer?s money.

All these payers want to be paid back said Matt Garretson, the founding partner of the Garretson Resolution Group, a firm in Cincinnati that manages product liability cases.

Until a recent sharp decline, all-metal implants accounted for nearly one-third of the estimated 250,000 hip replacements performed each year in the United States. Some 500,000 patients have received an all-metal replacement hip, according to one estimate. A new study found that no new artificial hip or knee introduced during a recent five-year period, implants that included some of the all-metal hips, were more durable than older devices, and 30 percent were worse.

One troubled all-metal model, implanted in 40,000 patients in the United States, was recalled last year by the DePuy division of Johnson & Johnson. As of October, some 3,500 patients had filed a lawsuit involving that device.

There is no data on the number of all-metal hips that have failed prematurely in this country because the outcomes of orthopedic procedures are not formally tracked by the government or private companies.

But extrapolating from overseas data and the estimate of metal hip use here, tens of thousands of patients in the United States may have to undergo operations over the next decade to replace the implants, said Dr. Art Sedrakyan, a researcher at Weill Cornell Medical College of Cornell University, who is studying the hip problem.

A decade ago, Sulzer Orthopedics paid a record $1 billion to settle claims by 6,800 patients who received artificial hips and knees that were contaminated with industrial oil during the manufacturing process. Wehave been dwarfed by this, said Teresa Ford, a lawyer who worked at Sulzer at the time and is now in private practice.

Device producers have taken differing stances to covering patient expenses. Zimmer Holdings, which says its all-metal implants are safe, has settled hundreds of patient claims, lawyers involved in those cases say. Also, DePuy is covering costs related to the device it recalled last year, the A.S.R., or Articular Surface Replacement.

DePuy would not comment on how much it had paid in recall-related costs. But a spokeswoman, Mindy Tinsley, said in a statement that DePuy was working with patients and insurers.

Things have not gone smoothly for everyone who has taken DePuy?s payment offer. One patient, Paula Laverty, received a hospital bill for $41,578 and a call from the facility warning her that the bill would be turned over soon to a collection agency.

Ms. Laverty, of Cape Elizabeth, Me., said she spent weeks calling the firm handling claims related to DePuy?s A.S.R. She said she eventually learned that the implant maker had paid the hospital $18,000 for her replacement procedure and that the $41,578 represented the remaining charges.

This month, DePuy made an additional payment to the hospital, according to Ms. Tinsley, the company spokeswoman.

Along with A.S.R.-related cases, DePuy also faces over 560 lawsuits in connection with the all-metal version of another hip model, called the Pinnacle, the device that Mr. Dougherty received. Because the company says that the model is performing well, costs for its replacement are being borne by Medicare, insurers or patients themselves.

To recoup their expenses, insurers typically notify patients through lawyers that they expect to be reimbursed from any settlement money that patients receive, rather than pursue their own lawsuits with the device makers. Also, Medicare is expected to enforce new laws next year that will make it easier for the agency to recover taxpayer dollars spent treating patients injured by problem drugs and medical devices, legal experts said.

Still, some patients are weathering some of the financial impacts on their own. While Charmin McCune, a teacher in Wylie, Tex., is recuperating well from a recent replacement operation, she said that she and her husband, also a teacher, have had more than $12,000 in expenses that have not been covered by insurance.

Mr. Dougherty, the Illinois patient, underwent a procedure this month to get a new hip implant. All went well, he said, so he hopes to spend next year back on his feet and at work.

You can?t do anything, he said of his current situation. You see your wife doing everything for you. It is just not right.

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North Valley Magazine Top Lawyer 2011
Posted by: Stephen Leshner
October 18, 2011
Topic: PHOENIX PERSONAL INJURY ATTORNEY STEVE LESHNER IS NAMED A ARIZONA "SUPER LAWYER"

Stephen I. Leshner of Phoenix, Arizona has been selected as a Top Lawyer 2011 in Personal Injury by North Valley Magazine.  Avvo, Inc.-the Seattle company that helps consumers make better health and legal decisions by offering free Q & A forums, backed by ratings and profiles for 90 percent of the doctors and lawyers in the U.S.-has teamed up with North Valley Magazine to present a list of top lawyers in the Phoenix area.  Lawyers are ranked based on their professional backgrounds according to Avvo?s proprietary algorithms.  The Avvo Rating is a score on a 10-point scale distilled from the raw rankings generated by Avvo.  The ratings and rankings were calculated August 9, 2011.  Steve Leshner has a perfect 10.0 Avvo rating, and is one of only five lawyers chosen in the category of Personal Injury

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Metal-on Metal Hips Continue to Fail
Posted by: Stephen Leshner
September 16, 2011
Topic: PRODUCT LIABILITY

An article in today's New York Times discusses the alarming failure rate of metal-on-metal (MoM) implants.  If you or someone close to you has complaints about a failed DePuy ASR, DePuy Pinnacle, Zimmer Durom, Zimmer NexGen, or Wright Medical hip or knee implant, please call Steve Leshner for a free consultation.

 Metal Hips Failing Fast, Report Says
By BARRY MEIER
A British registry found that all-metal artificial hips failed at a significantly higher rate than those made from other materials.

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Steve Leshner included in The Best Lawyers in America for Plaintiffs Personal Injury Litigation
Posted by: Stephen Leshner
September 02, 2011
Topic: PHOENIX PERSONAL INJURY ATTORNEY STEVE LESHNER IS NAMED A ARIZONA "SUPER LAWYER"

Stephen I. Leshner of Phoenix, Arizona has been selected for inclusion in the 2012 edition of The Best Lawyers in America^? in the practice area of Personal Injury Litigation - Plaintiffs. For nearly three decades, Best Lawyers has been regarded, by both the profession and the public, as the definitive guide to legal excellence in the United States.

Selection to Best Lawyers is based on an exhaustive and rigorous peer-review survey (comprising more than 3.9 million confidential evaluations by  fellow top attorneys) and because no fee or purchase is required to be listed, inclusion in Best Lawyers is rightly considered a singular honor. The annual, advertisement-free publication has been described by The American Lawyer as the most respected referral list of attorneys in practice.

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Transvaginal Mesh Patch (TVM) Injuries Noted by FDA
Posted by: Stephen Leshner
August 29, 2011
Topic: PRODUCT LIABILITY

A transvaginal mesh (TVM) patch is a surgically implanted device that stretches across the vaginal wall (which is also known as the pelvic floor) to add support to tissues damaged as a result of an injury, childbirth or surgery.  Transvaginal meshes have been used in the treatment of pelvic organ prolapse, a condition in which the bladder, uterus, vagina, urethra, bowels or rectum slides out of place due to weak pelvic floor tissues, or stress urinary continence, which is a lack of control over urination, which can cause women to urinate when laughing, sneezing or coughing.

In 2011, the FDA issued a public notice to doctors and TVM patients after 2,875 injuries relation to the mesh were reported between 2008 and 2011.  Reported complications included devices from nine (9) different manufacturers, including the Avaulto support system by C.R. Bard, Gyncare Prolift and Gynemesh Prolene by Ethicon (Johnson & Johnson), AMS Prolapse Repair System by American Medical Systems, Pinnacle Pelvic Floor Repair Kits by Boston Scientific, and Polyform Synthetic Mesh by Proxy Biomedical, Ltd.

Transvaginal mesh systems have been linked to a number of dangerous problems, including reports of infection, pain, urinary problems and bowel, bladder and blood vessel perforations. There have been complaints of recurrences of pelvic organ prolapse, and vaginal mesh erosion.  In fact, a 2009 clinical trial was stopped after 15% of the women implanted with the mesh suffered vaginal mesh erosion after only three months.

If you or someone close to you has suffered damages caused by a transvaginal mesh (TVM), please contact Steve Leshner for a free consultation and case evaluation.

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