The mesh scandal: Where are we now?
The pelvic mesh scandal isn’t going away with many women reporting severe adverse effects of the product. Reece Armstrong has been following events and outlines where we are now.
In July 2017, 60 women marched towards Westminster to meet with MPs to discuss the life-changing effects that had occurred due to mesh implants.
While not the first public admission about the devastating effects of mesh, it was perhaps the most symbolic. Women shared their harrowing stories about how mesh had changed their lives for the worse, detailing chronic pain, psychological damage and even the removal of organs after mesh had eroded in their body.
Mesh implants are made from polypropylene and are used to treat pelvic organ prolapse (POP) and stress urinary incontinence (SUI) after childbirth. The meshes, a common treatment for SUI and POP, are designed to provide extra artificial support for weakened or damaged tissue.
Shortly after that meeting in July, the NHS published its Mesh Oversight Group Report [1] stating that the use of ‘mesh to treat women with SUI and POP is a safe option’.
While the report outlined recommendations to help improve access to information, consent and clinical guidance, it ultimately resulted in patient leaflets being available in GPs and a change in the way that problems caused by the mesh are reported.
The campaign group, Sling the Mesh, which organised the parliamentary meeting responded with criticism about the report.
The group’s leader, Kath Samson, said: “They should have looked at product safety, not at ways to fix women once things have gone wrong. How can a major study of mesh not look at mesh safety?
Since the report, diligent campaigning from women all over the world has brought attention to the mesh implants with multiple court cases being brought against the device manufacturers.
In October last year, Johnson & Johnson, one of the major manufacturers of the mesh implants, was taken to court by a woman in the US for injuries caused by the company’s mesh implant.
Ella Ebaugh had a mesh implant operation in 2007 after suffering from incontinence. After her condition didn’t improve, she had a second mesh device implanted. However, Ebaugh suffered from a range of complications such as pelvic pain and urethral erosion and had to undergo three corrective surgeries.
Ebaugh ended up receiving $57 million in damages from Johnson & Johnson after the court ruled that the company was liable for causing injury and that its devices were negligently and defectively designed.
Unfortunately, mesh implants have been the result of much worse complications for a certain number of women. Between 2008 and 2010 for instance, the FDA found that there were ‘seven reported deaths associated with POP repairs’[2]. More so, in November last year a 42-year-old woman from Canada died from sepsis caused due to what her family believes was mesh related troubles.
In that same month here in the UK, health watchdog NICE recommended that vaginal mesh products be banned from treating prolapse due to safety concerns. The news came as a small victory for women even after calls for a public inquiry into the devices was rejected by the parliamentary under-secretary of state for health, Jackie Doyle-Price.
About the news, Owen Smith, chair of the All Party Parliamentary Group on Surgical Mesh Implants, said he was “pleased that NICE have listened to women” but added that “they should have gone further and followed the example set by New Zealand this week in banning mesh altogether for pelvic operations.” [3]
Whilst the NHS doesn’t have to act on the recommendations set out by NICE, it may suggest that a ban on the devices is on the horizon. Currently, NICE is developing guidelines into the use of mesh for SUI and POP, though this won’t be published until 2019.
A long time to wait but it does seem like the UK and indeed the rest of the world is pushing towards better regulation and clinical use of mesh products. What we can hope for is that the UK follows examples set by Australia and New Zealand, both of which have banned the devices due to concerns over safety. Until then, women need to be made aware of the health and psychological problems that can be caused by mesh, though thankfully we have a number of strong and altruistic campaigners raising awareness here in the UK.
[1] https://www.england.nhs.uk/wp-content/uploads/2017/07/mesh-oversight-group-report.pdf
[2] FDA: Urogynecologic Surgical Mesh: Update on the Safety and Effectiveness of Transvaginal Placement for Pelvic Organ Prolapse: 2011
[3] https://slingthemesh.wordpress.com/