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Cavness Testimony – A Life Today of Pain

Ms. Cavness, art by Akre

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

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.

Dr kSurgery 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?”

“Yes.

Q: The same type you told us about earlier, the stabbing cutting pain you described?

Every day.

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?cropped prosima

“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

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?”

A: “Yes.”

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.

 

 

32 Comments

  1. Josie says:

    Hi lawyers are really ignorant not letting her take the stand so that the very good here are those really poor on their part it is sad this gives Johnson and Johnson ammunition to keep fighting they will never come to a settlement agreement at least in this lifetime

  2. stopmeshimplants says:

    Her story is like so many of us. She should have won this case. I am not sure why that didn’t happen but I know she and all of us are devastated by this trials results. I am so sad for her and all of us.

  3. Mamohio says:

    I think her attorney’s failed her and should appeal her case with no addl costs to Ms. Cavness. That’s the least they could do since they failed her.

  4. Worried says:

    I think the lawyers should of been more prepared. There’s a lot of us with most of her same problems now thinking are we going to be facing the same questions and most likely we are but are we facing same answers from the jurors? I sure hope not, and what about the ones that settled with a m s ? When will they see their money owed to them, I thought once signed the company is supposed to pay before the people start thinking about refusing n complaining.

  5. Still Standing says:

    I dont think an attorney would take on the huge financial gamble for NO COMPENSATION unless they were prepared. It will be interesting to see if they will double down with an appeal. That would be a tough call. I think it is unkind to say her attornies failed her. We dont know the whole story, havent seen all the discovery that took a place. Once again, many mesh women are depending on their attorneys to get financial compensation for them, but then turn around and call the attorneys incompetent. Kind of dont bite the hand that (potentially will) feed you……

    I think the biggest concern from this verdict is that fewer attorneys will be willing to gamble on a jury trial for their mesh women and will push more for settlements.

    The evidence that hit me , as well as the jury, was the fact that she did not follow through on pelvic floor physical therapy. That was a direct medical recommendation that was ignored. Physical therapy doesnt have to have daily visits to be beneficial. A Physical therapist can teach, and give exercises the patient can do at home. I think her unwillingness to follow medical advice was very detrimental to her case and will be to any case that is sent to trial from here on out. I lived 200 miles rt from pt. It was such a difficult drive and financial burden, but I followed through because that is what my medical expert recommended. And, because it helped me a great deal. Showing a willingness to put in some personal healing work is important, not just to recover money, but more importantly,to recover health.

    • Jane Akre says:

      Agreed about the attorneys…. no one spends that kind of money to bring a case to trial… $500k to $1 million average…. if they intend to put on a less than stellar case! They do the best they can. PT however I understand may be contraindicated if pelvic tissue is being sawed by polypropylene mesh. They are simply incompatible, I’ve been told…. perhaps best for muscle strength .

      • kitty says:

        Again …Jane—I got a lot of good from pelvic floor therapy. The gentle massage and other excercises were helpful. I took it a step further and did excercises in bathtub under water.The pain was unbearable when I got out of the tub. Maybe it was the mesh—hardened by years pressing on the nerves.

        • Jane Akre says:

          I’m glad it worked for you Kitty…… it offers hope to others.

        • Bejah Blue says:

          Thanks for sharing this Kitty, I wish I could try it but I am afraid to because of other pelvic issues I have. I am sure it will give others the courage to try it though. Sharing kind of intimate details to try to help others, pretty awesome, Kitty.

          Bejah

          • Johanna Zalagh says:

            I had physiotherapy tried with me when having the mesh, I got horrible pain for trying to excercise muscles as the mesh ripped my body of every movement. Now I am mesh/free for 7 weeks but cannot yet start physio cause still healing from the huge open surgery to remove the rest of the mesh and 6 titan screws.

            So really some pain makes it impossible even to move at all when the mesh is ripping there.

        • Still Standing says:

          Kitty, buy the book Healing Female Pain by Isa Herrera. She has a pelvic floor PT practice in NYC. It became my bible for self care. Some of her techniques described with the foam roller were too intense, but I truly believe that keeping pelvic muscles as supple and fluid as possible, especially with the mesh, is absolutely vital to decrease pain. The mesh pain makes us brace, and as we brace into the pain, muscles get shorter,which creates hypertonic muscles, then more pain and shorter muscles. The mesh creates the acute pain the, primary trauma;, pelvic floor dysfunction is a secondary cause that , left untreated, becomes chronic. Once this cycle begins,it takes a great deal of personal effort to relax those muscles. We absolutely have to treat the muscle dysfunction ,even if it starts with gentle stretching before getting out of bed, in order to start to address some of the pain layers.

  6. Barb says:

    Why would they bring up the issues of why she and her husband divorced?? Do they have a right to do a back ground check on these woman? Their tactics sure are from the bottom of the barrel, I know the defense uses everything they can to get that reasonable doubt however shouldn’t this only be focused on her medical issues?? Maybe there was a reason at the time she could not do pelvic therapy. I was given a prescription for pelvic floor, and organ prolapse sui however this doctor denied everything that had already been discovered by other specialist and testing! However I only saw her 3 times the first initial visit she had no clue why I was there, she had not asked my PCP for paper work showing organ prolapse sepsis intertestial cycstis all infections bladder, yeast, uti’s I counted over 30 since 2008 then was put on bactrum to prevent infections however still had them, it also noted each time a specimen was taking there was so much blood you could see in the container, the sever pain and before he examine I slightly mentioned is it possible that my issues could be caused from the mesh that I had been reading about needless to say she did an internal roughly said she could feel the mesh and it was fine! Then the statement I feel no doctor should ever say “what are you a Joe Bornstein client just wanting to sue someone” She did a urodynamics test laughing literally sating I know your not SUI not half way through the test she said well much to my surprise you are!! Mind you the position you have to be in I asked her why 5 people in the room well 3 are training!! I told her she should have asked me if it was okay before exposing myself!! She has yet sent me my results or the new surgeon after multiple request…………….said I did not have any medical issues……….really that was the last time I had her and seaked out another specialist who performed every test yes sever SUI, Organ prolapse one stage 2, the other stage 3. The new surgeon did several test to rule out any other issues befre coming to the conclusion all health issues is mesh related!!

    • Jane Akre says:

      They divorced after her mesh implant so it goes to her injuries so it is part of her damages…

      • Johanna Zalagh says:

        Jane Acre, have you come across with any mesh/ladies in North/Europe . I am here alone with my mesh/case. Do you think if I had any chance of suing the manufacturer Bard for my Alyte -mesh? I got problems immediatelly when the mesh was set in me so there has never been any doubt what has caused my problems. I have a finnish lawyer to start to help me but no-one here knows nothing about pelvic mesh problems, I mean in public. Ofcourse docs do but will not talk about the probs.

        I have been 20 months on a sick-leave because horrible pains. I was a teacher.

    • Bejah Blue says:

      God, this is exactly why I did not even go to the pelvic floor physical therapist recommended by one Urologist. The last thing we need is some idiot hurting us more, emotionally and physically. I have had at least two doctors, BTW, tell me “Everything looks fine”…infuriating, never went back. What they meant was that the mesh was still where it had been put and they did not want to be involved…and did that mean that it had not changed form, had not hardened, had not moved a millimeter, and what of the scar tissue, these “doctors” said NOTHING about scar tissue but the experts I saw later told me that there was so much scar tissue the mesh could not be removed due to high risk of death….which is sort of funny actually since IMHO it is killing me anyway. I have NO respect for doctors any longer, I walk in being protective and suspicious. They have to earn my trust and these days that is pretty hard to do. Barb I am so sad reading what you went through. I think we have to be extremely careful about these physical therapists…just as we are with explant experts. Any doctor can claim they are an expert at something and pay a few people to post glowing reports on the internet about them. The same is true with physical therapists who specialize in treating patients with our profiles.

      Bejah

      • Barb says:

        Thank you my dear BEJAH!! I also knew and felt I did have mesh erosion and in no way was going to go through any more pain and GOD only knows if I even tried would I be able to drive an hour and 45 min back?? Let alone it would have been over a 3 hour trip!!! Thanks mesh friend!!

        • Barb says:

          And let’s put the icing on the cake BEJAH! I had already been to 2 other specialist who had diagnosed me with the same issues that this surgeon claimed NO INJURIES!!! She wouldn’t even check to see if any erosion, and I didn’t think that the monarch tout and the TVT-O could be felt as she said she could and said it was working fine!! When I demanded again from my PCP that i had had enough of being tossed around and the other surgeons felt there were just too many complications and the outcome possibly could open up a new set of issues! And on the firs visit to the new surgeon she found erosion right away call it a womans intuition but I knew!! First impressions says alot! For you Maria I have been on a pain scale of eight majority part of first implant 8 years ago, I did feel better the first 2 weeks after my invasive surgery July 17 2015 where 5 procedures were done however I have been diagnosed with more mes issues related! My pain in description is like being in labor ready to deliver, goes from left to right, around my lower back and down my legs I can say along with organ prolapse I’m trying to find out why excuse my language why I have constant sharp knife feeling in my vagina 24/7. I wonder if its anything to have to do with the mesh that eroded between my vagina and bladder was cut away! Deff some sort of nerve issue. I would like to hear from anyone hopefully Dr. V should all woman who still have, 2 defective devices TVT-O, Monarc tout hammock health wise should we all seek a have fully removal?? The other question concerning rectocele/cycstocele prolapse never noted until 2012 so this was caused from the mesh dropped bladder behind my vagina one at stage 2 the other stage 3 at what point should these issues be addressed and is surgery the only way? I’m reading all I can to educate however I have not come accross when organ prolapse should be addressed. Thank you all mesh family.

          • Bejah Blue says:

            Hi Barb, It sounds like there may have been damage to those very sensitive and exotic nerves running through and around the pelvis. In Dr. Vignas original interview with Jane he talked about these things, and there is so much information there I just can not recall what nerves you might be most concerned about but he has more data on his website and that will lead you to a couple of specialist pelvic floor therapists who sound very good….a lot more data at a couple of their websites…try to have a printout of these pelvic nerve systems in front of you when you read this material (Maybe from Greys Anatomy (I am thinking about buying my own copy) but you should be able to download specific images through the images section of Google….so much information sometimes I feel my brain is going to explode. Make sure you have a good file system with very logical retrieval set up. Also, read about Vulvodynia…as soon as I had the implant surgery this horrific pain began for me. I think in part because I have the urge to empty an empty bladder so much the urine must be making my tissues there raw so have been bathing area post any effort to empty bladder with cool clear water and it helps. Also application digitally of a finger of estrogen cream seems to help a little for awhile. Anyway do read about Vulvodynia as well. Make sure you read at least basics about Intersistial cystitis also. I diagnosed myself with this a few months post implant and only later did the surgeon (who never replied to any of my emails) add it to my surgical file as if it were her diagnosis. But being furious is not what we need, not what will help us….the release of cortisol could cause additional problems so very important to stay calm and use the energy of rage to learn and help yourself. Now if some Urologist tells me that there is nothing wrong I will demand additional tests and I know what to ask for and if they refuse I will report them to their professional societies, to the hospital they work with, to the state medical board, demanding answers. We have to be informed, educated and demanding. What probably will happen is you will be blacklisted as a trouble maker and others will even refuse to see you and you may need to look for an independent physician, not a good old boy. I can not tell you how fed up I am. They think we do not know anything. We have to make it very clear we know a lot. Make them prove to you (and your attorney) why you do not need a certain diagnostic procedure and get it in writing. They will probably refuse in most cases. This time my primary care doctor has by back. If the results of the CT I just had come back and the ordering Urologist gives me the same line…all is well, no change, etc. and if the extensive lab work proves there are anomalies (Ordered by trusted primary care dr. I will go back to that Urologist and demand answers and I will have supporting documents. I made sure imaging was ordered at an independent hospital (not a private facility the Urologist works with) and I have already ordered a copy of the hand selected Radiologists report and CD of imaging to be sent to my home. Make no mistake, this is WAR. Wishing you peace and at least some freedom from the pain.

            Bejah

            PS Also you probably already know that plain room temp yogurt applied to the vulva area provides some relief as well.

          • Bejah Blue says:

            I should also add that application of estrogen cream should probably not be done more than three times a week. There was a time when I would have suggested you check with your doctor on that but no more, those days are over. Make sure you are also taking HRT unless you have heart issues but take no more than .625 at a time to keep you safe.

            The results from my CT done Friday, the first for about three years or more….the doctor told me nothing but ordered a Cystogram which they have scheduled at the end of November! So all I know is that he found some reason to justify ordering additional test…one…I guess we are going to do one test at a time suggesting he is not in a big hurry to address my increasing pain. Are they taught in medical school to not inform patients what tests show? I am glad I had results and images sent to primary and to myself. Here in Palm Springs the winter people are back until late spring taking up all the medical appts making it hard for people who really live here to see doctors. My copies of CT results should come in the mail tomorrow and then I will decide what to do. I may insist that I need to have additional tests sooner than the end of November. This is one reason why we need to always have copies of everything sent to us.

            BTW I just read an article about Chronic Fatigue Syndrome in a recent issue of Neurology (free subscription for patients with related issues). It makes me wonder if this may be another autonomic response of the body to the implant of this material (FBR?). Perhaps the mesh is triggering this in some people. Still very little is known about the cause(es) of severe fatigue despite what sounds like considerable research. At least it sounds like it is being taken more seriously. This is another example of something that doctors believed women were inventing to explain what they felt was a psychological issue. An interesting discussion of what the triggers might be for CFS.

            Bejah

            Personal note:

            I woke this morning about 3am in horrific pain and feel a dizziness and vague nausea, not only no appetite, the sight of food makes me feel ill. I will not call “911” I realize if it seemed appropriate because I have become terrified of hospitals. Would I rather die than go to a hospital ER now? If I needed to call for help, would I have the courage to do so? Not sure. Not sure where does one go from here. No settlement, no trial, no justice, and the probability of ever increasing pain. Is that a life worth living? Hard questions to consider. In Oregon assisted suicide is legal. Vicar at church says GOD will not be upset where suicide occurs due to unbearable pain. How bad will it get? I can not remember any of us saying they were getting better. I looked at photos of adhesions on Google yesterday. It was like looking at HELL. If we have surgery to remove mesh we risk increase in the number of adhesions…horrible. Not only do they cause pain, I think they get worse over time and so I guess does the pain. Treatment for pain costs money and as with everything else the more money you have the better your options for pain management. The poor, those with only MediCAL or living only on Social Security….how is their pain treated, who cares for them? So many questions. And the courts….maybe it is true that the one with the most money wins. If Linda Gross dies now from her suffering will her estate lose her award? Sometimes I wonder even if GOD has abandoned us. I guess a crises of faith comes with the territory.

  7. Maria Garcia says:

    I read that the jury was back tracking on Monday because a juror said Ms. Cavness was a “7” on the pain scale before implant surgery and a “7” after. A juror also stated that Ms. Cavness was told to go to physical therapy twice by her doctors but she did not go until 2015 which is 1.5 years later. When was the last time anyone had surgery of any kind and weeks, months and years later they are still at the same pain level. I have had seven major surgeries myself and each and every one of them repaired my issues and relieved my pain. My multiple mesh products surgery however damaged my nerves and left me in the same pain I had before surgery just like Ms. Cavness. Isn’t it possible for pre-surgery pain and post-surgery pain to be the same number on the pain scale for different reasons? The juror who spoke up about the verdict said that at first they were about to rule in favor of Ms. Cavness. When the Judge gave his last minute instructions, he really created confusion and frustration within the jury.

  8. Anonymous says:

    My mesh had perforated I was 9 or 10 weeks post op .My dr said it was only a tiny piece but hubby and I had attempted to be intimate and it was more than one little piece. It was horribly painful for me and scratched him up . It felt like barbed wire in me. It was trimmed in office. I had to make another appointment due to terrible pain. At that appointment I was told it wasn’t the mesh. I was just very tense and I should use a vibrator to relax. Basically I was brushed off and mortified. I haven’t been back to that dr. I have a apt with a specialist in November. Hopefully to remove this. I can’t stand up for any length of time. It hurts to much. I’m so sad and angry. If they had been truthful about what this could do to me I would have never consented to this surgery.

    • Jane Akre says:

      Your first doctor is a fool and you should keep up with him so he cannot tell anyone else “I’ve had no complications.” Too many docs are let off the hook. Let us know your specialist…. I hope this one is not such an idiot. Thank you for writing.

  9. Anonymous says:

    Jane,

    I just read through my medical records from surgery and checked into my tvt. It had expired 5 months before my surgery. I’m not sure what recourse I should take. Ian madder than a wet hen. The pain kept me up last night until 3 a.m. I want to throat punch somebody.

  10. Barb says:

    Jane do you know what the people who have AMS are being told when they don’t take the settlement?? Does anyone know exactly what injuries they are associating with the mesh with in the category’s? They are not including first surgery correct?

    • Jane Akre says:

      No not the first implant surgery is my understanding. its revisions under anesthesia…. the more, the greater the tier. Of course, if you did not have surgery or couldn’t afford surgery, or didn’t have insurance, your case is valued as less…. as if that has any bearing on your situation. Beginning at perhaps $6,000 and going up from there. The multiple surgery cases will be negotiated separately with settlement counsel on an individual basis is my understanding. If you don’t take it and you have a good law firm, they will stick with you. Other lawyers may be thinking about dropping you as a client. check with the Bar in your state to see if they can do that.

  11. Anonymous says:

    Jane

    I emailed you.

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