Update Concerning Transvaginal Mesh Litigation

To date, over 30,000 transvaginal mesh (TVM) lawsuits have been filed in the U.S. Distric Court for the Southern District of West Virginia as part of a Multidistrict Litigation (MDL).  An MDL has been formed for each of six TVM manufacturers, who are C.R. Bard, Inc., American Medical Systems, Inc., Boston Scientific Corp., Ethicon, Inc. (Johnson & Johnson), Coloplast Corp., and Cook Medical Inc.  Several thousand more cases are pending into consolidated state court litigations against these manufacturers and other TVM manufacturers around the country.

The TVM discovery process has disclosed an increasing amount of complications and severe injuries associated with Trans-Obturator Tape (TOT) mesh slings compared to retropubically placed slings.  Before the development of TOT slings, mesh slings placed to repair stress urinary incontinence were implanted retropubically by placing the mesh through a vaginal incision and pulling the mesh behind the pubic bone to two stab incisions made in the lower abdomen.  In an attempt to minimize the potential for bladder and bowel injuries associated with retropubic approach, the transobturator approach was developed.

The transobturator approach includes the passage of mesh through the obturator foramen on the sides of the groin.  The mesh is then pulled through two stab incisions made on each side of the patient’s groin.  Although intended to minimize injuries during implantation, the transobturator approach introduces increased risks for vascular and nerve injury by the passing the mesh tools used to implant the mesh through the nerve-rich obturator foramen.  Additionally, these increased injuries, which occur at time of placement, increase risks of nerve injury and irritation after placement have also been associated with TOT slings as compared to slings implanted using the retropubic approach.

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