Letter to Insurance Carriers Over Mesh Mess

//Letter to Insurance Carriers Over Mesh Mess

Letter to Insurance Carriers Over Mesh Mess

Mesh Medical Device News Desk, May 2, 2018~ Many readers were led to their first mesh implant by an insurance provider. It was the preferred method to have a 20-minute procedure during which a mesh was implanted rather than have a more extensive bladder tack or a hernia surgery using sutures alone.

Image: Big Insurance, from Knowledge Safari

Never mind the harvesting of one’s own fascia to create a bladder sling that is natural to the body should not spark any foreign body response.  But now we see very clearly that the expedience of a procedure, that resulted from insurance falling into lockstep with industry, does not always yield the best results for the patient. 

So now reader, it is up to you to advocate for your own care and often that means revisiting your insurance provider and becoming a squeaky wheel!

Please consider using this letter, or anything strongly worded, to request big insurance deal with the realities of what this manufacturer-generated problem has created.

You may be seeking a mesh revision or a consult.  You need your insurance provider to pay for your visit to the best possible expert you can find, not just the closest doc in your  zip code!

You need to consult with someone who specializes in complications!  Period.  Here is the original MND article with the letter.

To Whom It May Concern-

Here is a suggested Open Letter to insurers to help them gain some understanding of this mesh mess.

I’m writing as a mesh-injured woman who is desperately trying to seek help from a doctor experienced in mesh-related injuries. This might include a urologist or urogynecologist who has experience in removing pelvic mesh that has migrated, eroded, broken apart, perforated organs, folded, frayed and perforated nerves, not to mention the systemic issues such as autoimmune disease that often erupts after being implanted with polypropylene pelvic mesh. 

There are very few competent medical doctors around the country who are dealing with the hundreds of thousands of women who are now experiencing the complications from this mesh. Through the mesh-injured community, we are becoming aware of these doctors.

I am seeking a referral to a doctor who has experience in removing polypropylene mesh from the pelvic region, not just the closest and most cost-effective for the insurance company. This may be a matter of life or death – mine.

As you know this mesh was implanted in me and thousands of others to hold up pelvic organs that may be falling through the vagina. Like thousands of others, it has only caused problems that can be described as life-altering. As I write this, the mesh is migrating toward my bowel, a condition that can lead to fatal sepsis (this is one example, use your own).

There are currently at least 120,000 lawsuits filed against mesh manufacturers for marketing a defective product without any FDA clearance for safety and efficacy. These are not lawsuits generated by hysterical women. The injuries are real and not imagined. In many cases they are permanent.

Juries across the country have determined that pelvic mesh was defectively designed, yet many meshes remain on the market. Some doctors still mistakenly refer to them as the “Gold Standard.”  Clearly marketing and medicine have married to create this huge disconnect.  No Gold Standard would wound so many.  Remember it was frequently the insurance companies that led women to doctors who implanted these products.  Doctors have admitted on the stand they were unaware of the dangers and had been made false promises by sales reps from the major mesh makers.

All of the problematic mesh, whether for prolapse (POP) or incontinence (SUI) is made from polypropylene and they are all substantially similar. They were all approved by the Food and Drug Administration as substantially equivalent to a “predicate device,” the ProteGen, which was eventually taken off the market for being defective.

I should not be in this position. I should never have had mesh implanted for a condition, not a disease. I should have received true informed consent. I did not. There are safer alternatives that have been known for decades, before mesh manufacturers began coaching doctors on this new “minimally-invasive” technique that would yield them greater profits in the shortest amount of time.

Insurance companies supported this procedure we now know was experimental and never underwent clinical trials for safety. I should never have to beg for my insurer to send me to the proper professional who very well may save my life.

But that is where I find myself.

A friend recently made signs and, along with supporters, petitioned in front of the insurers’ hospital to receive a referral to UCLA’s urology department, considered the most experienced in the world for mesh removals. Within about 20 minutes, she received that referral.  Is that what it takes?

I remain adamant that I receive a referral to the specialist of my choice based on the recommendations of others who have had successful mesh removals.  Together we can work on determine the best doctor to address my problems, as soon as is reasonably possible. 

I encourage the insurance company to gain a better understanding of the breadth of the problem because women are requiring multiple surgeries when the first doctor, the one closest to the patient who is the most cost-effective, may leave remnants of polypropylene behind to wreak havoc, migrate, shrink and continue to incite a foreign body response. That creates a “ticking time bomb” as the long-term effects have never been studied in clinical trials. We are essentially the lab rats.  

As is typical, one partial removal leads to another and then another adding unnecessary cost to the insurer and a burden to my quality of life.  Isn’t it preferable to get the best surgical outcome in as few surgeries as possible?   

Since insurers initially paid for these mesh implants, it is now time to step up and do the right thing- cover explant surgeries by reliable, experienced surgeons. 

Please advise me on the next step needed. I look forward to talking further with your representatives who have direct authority over my case and have the authority to issue a referral. Time is of the essence here.

To deny them the proper medical care adds insult to these horrendous injuries.

Sincerely,

(your name here)

I am supplying you with stories that will back up my assertions here. Please read them and become knowledgeable about this issue.

 

Learn More Here:

 

Dr. Veronikis on Mesh injuries

https://www.meshmedicaldevicenewsdesk.com/removing-mesh-and-getting-healthy/mnd-interviews-dr-veronikis-mesh-injuries-explants/

 

Doctors Speak out on Mesh Injuries

https://www.meshmedicaldevicenewsdesk.com/get-the-mesh-out-doctors-react-to-patients-following-fdas-july-warning-about-surgical-mesh/

 

By | 2018-05-07T16:49:05+00:00 May 2nd, 2018|Op-Ed|4 Comments

About the Author:

I’m National News Editor, Jane Akre and I began Mesh Medical Device News Desk aka Mesh News Desk (MND) in the summer of 2011 just after the Food and Drug Administration issued an explicit warning to the public that complications associated with surgical mesh used for prolapse repair (POP) and incontinence (SUI) are NOT rare! That was the starting point for the litigation you see today and thousands of lawsuits have been filed by women whose lives have been altered, some permanently, by the use of this petroleum-based product.

4 Comments

  1. Wren May 2, 2018 at 2:11 pm - Reply

    Hip-hip hoorah. I applaud the writer of this profoundly written article. This is newsworthy and it should have a huge backlash to the very industries that have stuck there necks into a professional physicians right to practice medicine as they see fit. Insurers have been demanding how doctors can run their business far too long and this is a direct result of what damage can and will continue to occure. Patients and physicians alike should sign there names to this letter and send to all insurance companies.
    A side note and my opinion only is that GIANT industries such as BIG pharmaceuticals are supported by the Republican parties. Their purpose is only to generate big profits, not support what is ethical practice many times. Check out who President Trump nominated to the head of FDA! Do your research be a smart voter in our upcoming elections. Hold our politicians to a higher standard for better health care. It does start at the top.

  2. Cathy May 3, 2018 at 5:02 pm - Reply

    Wren, I agree with you 100%. GIANT industries and BIG pharmaceuticals OWN politicians these days and we must be vigilant when fighting for our rights. Educate yourselves and become advocates for women’s healthcare and rights. Health insurance companies will always look for the cheapest way to pay claims. Excellent letter, kudos to the author! Stand Up Ladies and be STRONG!

  3. Louise May 14, 2018 at 4:31 pm - Reply

    DOES IT INCLUDE CANADIAN WOMEN ? MY DR. SAID THAT MY GROIN PROBLEMS WERE NOT RELATED TO MESH…I TOLD HER, IT IS…BECAUSE OF MY GROIN PROBLEM I HAD TO GET SURGERIES FOR A HIP REPLACEMENT…BECAUSE OF ABCESSES AND INFECTIONS THEY OPERATED 3 TIMES ON THE SAME LEG. I HAD NURSES AT HOME FOR NEARLY 2 YEARS…MY ATTORNEY SAID THAT I WON’T GET MORE THAN 10 THOUSANS DOLLARS AND HE SENT ME PAPERS FOR ME TO SIGN…I TRUSTED HIM, HE’S THE ATTORNEY, NOT ME…. I ALSO HAVE FIBROMYALGIA AND SEVERE PSORIASIS. I WENT TO GET THE MESH SURGERY AND MY INCONTINENCE AND IT’S WORST AND ALSO I HAVE STOOL INCONTINENCE EVER SINCE THE MESH, WHICH I DIDN’T HAVE BEFORE…I CALLED MY ATTORNEY AND SAID THAT I WANT MORE COMPENSATION AND HE ANSWERED IT’S TOO LATE SINCE I SIGNED THE PAPERS I THINK I’VE BEEN HAD BY MY ATTORNEY…PLEASE HELP ME

    • Jane Akre May 14, 2018 at 10:53 pm - Reply

      Please read papers and understand what you are signing. A legal document is binding. The best you may be able to do is to get your lawyer to reconsider or lower his fee,,, but don’t hold your breath. I’m sorry… I’m not a lawyer but that is my understanding about any legal document. Please be a good consumer when you hire a lawyer and negotiate the fee and conditions.

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