Urogynecologist Credibility Under Attack in Missouri Pelvic Mesh Death Trial

Jane Akre
January 13, 2015
Christy Jones, from Linda Gross trial Feb 2013

Christy Jones, from Linda Gross trial Feb 2013

As it seemed from this court observer, Dr. Anne Weber was a credible and knowledgeable witness on the stand Monday.

Camden Co. Missouri is the center of the first death case of a mesh-implanted woman. Butke v Ethicon.

Johnson & Johnson, the parent company, must show that it's Prolift System pelvic mesh implant was not to blame for a cascade of infection that eventually ended 77-year-old Joan Budke's life in August 2009.

Dr Weber had poured over thousands of pages of documents as an expert for the plaintiffs' attorneys - Adam Slater and Ben Anderson.

And that is the problem.

Yesterday on the stand, she said she made just $88,000 as an expert witness for 240 hours of work.

Before the jury arrived, the defense told Judge Hass it needed to open the door to the hundreds of thousands of dollars she had actually made as an expert witness in hundreds of cases, which goes to her credibility as a witness. Weber has been paid in the range of $800-thousand to review all of the documents in the case and as the basis of her expert opinion in Slater's 300 other pelvic mesh cases.

But how would the defense do that without opening the door to the 30,000 cases Ethicon is currently facing over its pelvic meshes?

In other words- How do you have it both ways?

Judge Joseph Goodwin

Judge Joseph Goodwin

In the federal multidistrict litigation, Judge Goodwin has asked evidence of expert witness compensation to only appear per each individual. Just do what Judge Goodwin does, suggested the plaintiffs' attorneys.

Judge Hass didn't want to "open a can of worms," in this litigation. Leaving it somewhat nebulous how everyone would proceed.

The case continued with Ethicon attorney Christy Jones continuing her examination of urogynecologist, Dr. Anne Weber on the stand all morning.

Christy Jones

Christy Jones

Back and Forth

Jones established that Dr. Weber was no longer practicing medicine, she was not longer board certified, she had not attended a Prolift surgery, certainly had never performed one, and never attended any professional education given by industry. Correct said Dr. Weber,an unnamed medical condition forced her out of medicine, she said.

Going down the road to compensation, Jones established that Dr. Weber made $300 an hour as an expert and $1,000 an hour to be here today. She had worked with attorney Slater since January 2010 and since then had review hundreds of thousands of documents. Correct said Dr. Weber.

Dr. Anne Weber, from Linda Gross trial

Dr. Anne Weber, from Linda Gross trial

“I reviewed those documents so I could learn what Ethicon knew and withheld from the public.” Objection said Jones. Please disregard that statement- says Judge Hass.

The ACOG Bulletin

Returning to the topic of the ACOG practice bulletin which Anne Weber wrote to convey in that the mesh placement practice should be considered "experimental." Jones wanted the jury to hear that ACOG removed the word 'experimental' after hearing from a number of doctors concerned about the characterization of the innovative use of pelvic mesh. Dr. Weber called that evidence of industry influence and said a small number of physicians had complained.

"They were concerned about insurance not paying for the word 'experimental,' they were concerned about their income."

On the recurrence of prolapse, Jones and Weber again tangled as the doctor tried to answer fully but was not allowed to.

Jones - "Did you publish a study in 2001 that said there is a 30% recurrence rate in colporrhapy?

Weber - "That’s right."

Jones - "You published in 2004 another study there was 58% reccurrence.

Weber - "That's about the anatomic position of the organs, not how a woman is feeling… that’s what doctors are looking at (position of anatomy) not of whats most important to women.”

The French TVM team wanted a better more permanent cure for prolapse too, suggested Ms. Jones.

Jones- 'Those doctors watched each other and came up with an appropriate mesh treatment for prolapse, correct?"

Weber- "They were experimenting with the procedure and this was obtained by Ethicon and proposed for widespread commercial use. They were still very unhappy with the long-term complications and they told Ethicon for years a new mesh was required."

Jones- "Your honor I move to strike."

Slater- "They’re complicated questions your honor."

Judge- "And they’re complicated answers, stick to the question."

When Dr. Weber said the TVM French doctors objected to Ethicon over and over again about the mesh because "It failed to fulfill expectations and should be considered experimental," Weber said quoting the French team working with Ethicon.

Judge Hass frustrated now shouted, "Stop." "I’m trying to answer," said Dr. Weber.

She does not appear to be combative, but thorough.

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