Ms. Cavness, art by Akre
Mesh News Desk, October 6, 2015 ~ Carol Cavness did testify to the jury in her trial on the afternoon of September 28th. Previously Mesh News Desk had reported she appeared by voice only.
On Monday, she lost her product liability trial against Ethicon/ J&J. This was the first jury decision for the pelvic mesh maker that faces in excess of 30,000 defective product cases filed over its family of pelvic meshes.
The Plaintiffs may have the option to appeal the verdict but vow this case is not yet over.
Here is an excerpt from her testimony from the witness chair before the jury rendered its decision.
She is short, with short spiky hair wearing a dark grey suit. She is obviously nervous. Plaintiff Carol Cavness lives in Greenville, Texas where she recently moved after her divorce. She and Graham were married 15 years.
For almost 24 years she has worked as an airline mechanic at L-3 Communications. She started as a trainee and then advanced through the system to become the highest level, an A mechanic.
Bill Blankenship, Lawyer, Dallas
Attorney Bill Blankenship for the Plaintiff questioned the Plaintiff. His questions are leading because she is brief and hesitant in her delivery.
In April 2012, Ms. Cavness experienced pelvic organ prolapse as she lifted a heavy concrete pot out of the trunk of her car. She told jurors she experienced a sharp "ouch" pain. She went to work the next day then on Saturday, also at work, she kept going to the rest room. One time she felt something coming out of her body. She has an inspection mirror and saw something pink coming out of her vagina. Her female supervisor told her to to the emergency room.
Cavness said she felt a lot of pressure. It was uncomfortable while she was talking. On cross- the Defense would try to describe that as intense pain.
Ms Cavness speaks in a halting way. She is very nervous. The ER doctor told her bladder was falling out of her vagina. But days later visiting Dr. Kowalczyk she was told it was her colon descending in her body. ” I remember her saying she could fix that," Ms. Cavness said of Dr. K.
Surgery was performed April 24, 2012 and Dr. Kowalczyk implanted a Prosima pelvic mesh made by Ethicon. She also did a native tissue repair at the same time. After surgery she had typical surgery pain but after six or seven weeks, Ms Cavness said she experienced a different kind of pain - sharp stabbing pain.
Q: Had you ever had that type of pain before? No.
Since Dr. Kowalczyk didn't see anything wrong and she didn’t understand what was causing the pain, she sent her patient to pain management. Ms Cavness sought another surgeon. Dr. Carley gave her steroids but they didn't help. He told her what he thought was causing the pain. He said he thought it was the mesh and Dr. Carley recommended it come out. He did surgery to try and take mesh out but Dr. Carley said he couldn’t remove it all because it was embedded in tissue and muscles. He retrieved about 65% of the mesh. It did not relieve that pain.
She had a lot of urinary tract infections and had leakage of urine. She had discharge and odor and Ms. Cavness winces when she says that. How many UTI's since the mesh? About ten of them and she was hospitalized 3 times as a result. Dr. Carley did a second surgery to try and remove the rest of the mesh but was unsuccessful. The pain continued. Then a visit to a new doctor, Dr. Phillippe Zimmern of Dallas.
Even though she is not computer savvy, Ms. Cavness found Dr. Zimmern, a well known mesh removal doctor. “I wanted this pain to stop, I wanted the mesh out," she said emphatically. Dr. Zimmern saw the mesh and performed removal surgery in December 2014. But the surgery was very brief. By the time her family went to the cafeteria, they were paged. She was coming out of surgery. Dr. Zimmern did not remove any mesh.
"I was devastated because I knew the pain wouldn’t stop."
Q: "Do you continue to have vaginal pain today?"
Q: The same type you told us about earlier, the stabbing cutting pain you described?
Ms Cavness is involved with pelvic therapy at UT Southwestern where a therapist massages pelvic muscles and tissues. Is it painful? She wipes her eyes with a tissue and answers yes.
What followed was a series of questions by Mr. Blankenship about injuries on the job. Yes, there had been many, shoulder surgery, elbow, ankle surgery. She also took time off to care for her husband after he was burned. She was always able to return to the same level of performance as before.
Today, to make accommodations at work, her co-workers help her and she is transferred to phase 4 interior finishing where she doesn't have to do a lot of heavy lifting or crawl into cells. "I just cant do the things I used to do," she said. That includes climbing on ladders and shooting rivets into a bucket bar.
She is prevented from taking hydrocodone on the job so instead she takes ibuprofen and Aleve. Work now leaves her in pain and exhausted. "I love my job" she said more than once and is afraid of losing it, especially at her age of 60. Ms. Cavness frequently squints like the light is too strong, like she is in pain.
Before the mesh was implanted what did you enjoy? I enjoyed life, everything I did a lot of house remodeling landscaping, do it yourselfer, I did everything with the grandkids, swimming, fishing, biking, playing games.
Are you able to remodel around the house now, she was asked. No she is not.
Q: "What do you enjoy now in your spare time?
"I don’t much of anything. I'm with my daughter and her family. We watch movies."
As far as her husband, Ms. Cavness said there was no affection, closeness, and the couple stopped doing things together like gardening, family get-togethers, barbecuing, fishing and hunting. Her chin quivers. She appears to be holding back tears.
How has the pain effected how you feel about yourself, Mr. Blankenship asks.
"I’m sad, I’m depressed I don’t feel like a woman anymore," she said.
Your ability to eat and sleep? Your relationship with your family, is it all affected?
"I'm not active with them anymore I don’t want to be around them and show my weakness, things like that," she says wiping her eyes.
Q: "Carol why do you blame J&J and Ethicon for this?
"Because they made a bad product that’s inside of me." She is holding back tears now.
Q: "And are you asking this jury for punitive damages to punish J&J?"
"Yes, so no other woman has to go through this."
Kat Gallagher, Ethicon attorney
For the Defense, J&J and Ethicon, attorney Kat Gallagher jumps in. She asks about the day of the initial prolapse and asked if Ms. Cavness had described her pain as a 7 out of 10. I was having pressure, she said correcting her.
Ms. Cavness saw no brochures or videos of the Prosima before agreeing to an implant, and she didn't seek a second opinion.
Gallagher then went through the litany of on-the-job injuries and a previous hysterectomy in 1985 though the abdomen. She had back pain had taken her out of work for awhile but it got better. And didn't Dr. Carley recommend physical therapy? Yes, she said but she was afraid of losing her job and didn't go. Did he also recommend psychiatric therapy to help with the pain? "I don't remember that." said Ms. Cavness.
Gallagher then suggested Ms. Cavness and her husband had marital problems before the Prosima and pointed to her deposition, page 31. She also asked how much she smokes (half a pack a day) and asked if she had been a smoker since high school (yes).
Q: "They warned you smoking could hurt your recovery?"
A: "I didn’t smoke a lot during my recovery."
Q: "You smoke today?"
On a final redirect, Bill Blankenship established that Mr. and Mrs Cavness lived together as husband and wife until December 2014 when they divorced. Her husband had accompanied her to all of her procedures and surgeries. "We had our ups and downs but we worked them out," she said. She filed for divorce. she didn't want to be around her husband with the unpleasantness of UTI's and other mesh complications.
Her face tightens and she softly cries.
Q:"Are there times you were confused in your deposition?" "Yes."
Q: "Were you and Graham considering divorce before April 2012?"
"Never. I still loved him and I still do today," she cries and wipes her eyes.
Q: "Are you worried about the future? About losing your job?"
"Yes, because there's restrictions there if I can’t do my job, I can’t work there. I'm too old to do anything else."
She's crying now. Kat Gallagher concludes her questioning and Ms. Cavness leaves the witness stand.