Mesh Medical Device News Desk, November 28, 2016 ~ He has been profiled by Mesh News Desk (also an advertiser at one time) and DrugWatch. Urogynecologist, Dr. Christopher Walker is considered one of the more well-known and competent mesh-removal doctors in the country. (See MND (here and here) and DrugWatch. (here).
But this year he’s be suffered a setback to his 30 to 40 mesh-removal a month schedule.
Even though he is not being sued and is considered a non-party, Dr. Walker and his staff have been aggressively pursued by mesh maker American Medical Systems (AMS) through a series of depositions. The company believes a host of middlemen are profiting by encouraging women to obtain unnecessary mesh-removal surgeries that up the stakes on the mesh settlements.
Dr Walker did surgeries on two out-of-state patients who obtained legal funding to undergo mesh-removal surgeries.
*Court Update* On December 6, AMS and the doctor agreed to financial sanctions to be imposed on AMS for going beyond the parameters of discovery in questioning Dr. Walker and his staff. (Doc #31 Case 2:14-cv-28142) and for violating a Protective Order.
The sanctions will cover the cost of Dr. Walker’s attorney who filed a protective order and a motion for sanctions. (Doc #34).
Orlando attorney, Carlos Burruezo, who represents Dr. Walker tells MND, “AMS has been very aggressive with discovery requests that have gone above and beyond the scope of a treating physician. It was beyond the parameters of the underlying product liability case. The sanctions should mean they are done with him and it should end any involvement.”
Payments will be made by AMS within the week and Dr. Walker reserves the right to petition the Court if the terms of the settlement are not satisfied.
These are the allegations according to AMS – medical marketers get leads on women who have received mesh implants and refer them to litigation funding companies then to doctors who perform medically unnecessary mesh removal explant surgeries at a significant markup.
A concierge facilitator, makes travel arrangements and everyone, it’s alleged, gets a kickback from the litigation funding company.
The woman receives her surgery even though she may have had insurance to cover the surgery closer to home. The alleged pitch is she will get removal surgery from one of the few in the country who specialize in the procedure.
The downside is a 39% interest rate on her loan. AMS alleges the often unsophisticated consumer pays top dollar for her care. The company believes up to 80 women may have been solicited this way.
Some, AMS believes, had no mesh complications, but are convinced to undergo the knife then sue the manufacturer, joining the 20,000 defective product lawsuits currently pending against AMS in federal litigation.
Even though there is no indication of wrongdoing, Dr. Walker was deposed by AMS lawyers last May concerning surgeries on two out-of-state women – Ms. Greenier and Ms. Elliott. Both were allegedly told not to use insurance and that a concierge, Surgical Assistants, would take care of their travel needs to Orlando.
For years now, mesh maker, American Medical Systems (AMS) has pursued these allegations of wrongdoing, which Dr. Walker denies.
Instead, working at his UroGyn Specialists of Florida, he has been one of the more vocal doctors speaking out against the use of pelvic mesh as a first-line treatment and offering women a complete or partial transvaginal mesh removal as well as non-mesh treatments for incontinence and prolapse.
After AMS was sold to Endo International and renamed Astora Women’s Health, the company couldn’t find a buyer and finally closed its doors last March to “reduce the potential for product liability related to future mesh implants.” See the MND story here.
Ironically, for a company facing the financial weight of litigation, AMS has been paying a legion of high-priced corporate lawyers to fight its perceived enemies.
Led by Barbara Binis, of Reed Smith of Philadelphia, she and her team have been working for years to uncover the workings of various alleged illicit schemes to inflate the damage claims of women implanted with the AMS transvaginal mesh.
DR WALKER’S DEPOSITION
AMS lawyer Ms Binis deposed Dr. Walker on May 3, 2016 in Orlando.
Dr. Walker spoke of his Hippocratic oath as a surgeon to first do no harm. He’s removed mesh from nine women for no charge he told Ms. Binis.
“At the end of the day I consider myself a humanitarian. These are human beings who are suffering.
“Because they have no money and I have a skill set, then, you know, it’s my duty to help.”
That wasn’t really the line of questioning she was pursuing.
Dr. Walker says he’s had three women who have come to him with no mesh in their body, convinced it was causing complications. Instead of performing surgery, he turned them away.
Other women have no clinical need to have mesh removed, he said.
Binis pursued how the Orlando business works in a complicated, lengthy back and forth.
Surgery through Med/Surge can run $5,000. One hospital lowered Dr. Walker’s surgical rate to $3,500.
Other surgeries are funded by LawCash, a legal funder, which sends the office a check for $25,000 per patient. LawCash charges interest to the patient and will collect from her settlement from AMS.
After services are paid Dr. Walker collects about $10,000 per patient, which is not out of line with what other mesh removal doctors charge.
Patient Greenier “had never complained to any doctor about pelvic pain for nine years,” Binis stated in Walker’s deposition, so how did you know she needed removal?
Because her pain was ten out of ten, he answered, and she demonstrated evidence of a chronic inflammatory process.
Binis: “Were you aware that some of these funding contracts come with a 39% annual interest rate compounded monthly?”
Walker: “I don’t know those issues, mam.”
Binis asks why were $500 surgeries not the norm while some were $3,500? No one can expect a surgeon to collect $500 on a very complication time consuming surgical procedures, said Dr. Walker.
Binis is very argumentative.
Binis: “What kind of service were you giving that was worth seven times more than what you would have done had the patient come to you in a regular practice?”
Walker: “I’m certainly not aware of any surgeon who can accept $500, that’s less than what I pay my plumber,” said Dr. Walker in response.
AMS wanted to depose office personnel about the cost of surgeries. After one deposition, it sought another. That’s when he filed a motion for a Protective Order and to Quash the Subpoena.
Lawyers for Walker argued the subpoenas are “unreasonably cumulative, duplicative, unduly burdensome and harassing and that the new inquiries do not relate to the explant of Ms. Greenier and Elliott and instead the non-parties suspect “that AMS’s intent in seeking further discovery from (the CFO) is to build a case against Dr. Walker, not to investigate any of the plaintiffs’ damage claims in these actions.”
According to a November 8 filing, (Doc #31 here), Magistrate Judge Cheryl Eifert denied the further deposition and instead allowed sanctions to be filed against AMS for overreaching a protective order.
Ms Binis is not done. She has filed notices to depose seven women in Florida before the end of the year, as well as Women’s Health Center of South Florida and Beth Israel Surgical Center of Broward Outpatient Center.
Ironically, her law firm, Reed Smith, is facing accusations of questionable practices of its own, as reported by ReedSmithWatch.com, which says partners, including Binis, bill around $700 an hour. ##