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What are Hernias?
A hernia is a bulge or tear caused by the weakened inside layers of the abdominal wall. The inner lining of the abdomen pushes through the weakened area and forms a small bubble. Sometimes part of an intestine or abdominal tissue enters the bubble. When this happens, serious complication and severe pain are the likely result. Many hernias are congenital (present at birth) while others develop later in life. Neither type of hernia can heal on its own. The three most common types of hernia occur in the groin (inguinal hernia), around the belly button (umbilical hernia), and near the location of a previous surgery (incisional hernias).
Hernia Repair
Each year, between 600,000 and 750,000 hernia operations are performed in the United States. There are two main methods to perform such an operation. The first is the traditional “open” method. The other is a newer method called laparoscopic hernia repair. This new method uses a mesh patch that is inserted through a small incision and then guided with the help of tiny cameras that views the inside of the body. The laparoscopic technique typically reduces recovery time for the patient, induces less postoperative pain, and promises a quick return to normal activity.
Kugel Mesh Hernia Patch
One such laparoscopic device is the Davol/Bard Composix Kugel Mesh Hernia Patch. This patch is a self-expanding mesh patch that is used to repair what is known as “ventral hernias.” These types of hernias (also called incisional hernias) are caused by thinning or stretching of the scar tissue that forms after surgery. The patch is made up of two materials: monofilament polypropylene and polytetrafluoroethylene (ePTFE). The surgeon places the folded patch through an incision behind the hernia defect. The patch then springs open with the help of a “memory recoil ring.” The “memory recoil ring” then holds the patch open, so it can lay flat, sealing the hernia. There is no need to use a tiny camera to guide the device; this makes the procedure less invasive than a traditional laparoscopy.
The Kugel Mesh Hernia Patch is made by Davol and its parent company Bard, Inc. Davol touted the Kugel Hernia Patch as the next step in hernia repair, replacing other laparoscopic procedures. Davol advertises the Kugel Mesh Hernia Patch as the “next step” in hernia repair and claims that it has the following advantages over traditional laparoscopy and the older, open procedures: |
- Early return to activities
- Can be performed under local anesthesia
- Lower cost than laparoscopy
- More complete repair than the open technique
Defective Rings
Davol markets the Bard Composix Kugel Hernia Patch in several sizes and shapes. In 2002, the company began to receive complaints about their extra large version of the device having broken rings. Some of the complaints claimed that the broken rings were causing serious complications and injuries. At the time, the company thought that there were too few complaints to warrant any action. In 2005, however, they received ten complaints about broken rings over a three-month period. One of these reports included a near-fatality. Because three of those reports came from the same doctor in Germany, the company determined that doctor error was causing the rings to break, so it began revising the device's instructions and holding training sessions for the doctors. In the mean time, they continued to sell the patch and doctors continued to use it.
By the end of 2005, after running tests on the failed device, the company found that the breakages were caused “by a failure at the ring weld.” Bard/Davol had the extra-large versions of the patch recalled. Later, they broadened the scope of the recall to include large versions of the patch as well.
FDA Recall
The initial Class I recall was issued on December 22, 2005, with updates on March 31, 2006 and January 24, 2007. The recalled product in a Class I recall poses a serious danger to patients using it. The reason cited on the recall notice is as follows:
The "memory recoil ring" that opens the Composix® Kugel® Mesh Patch after it has been inserted into the intra-abdominal space can break. This can lead to bowel perforations and/or chronic intestinal fistulae (abnormal connections or passageways between the intestines and other organs).
The table below lists the lots that have been recalled so far: |
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Product
Code
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Description
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Lot Numbers Recalled
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Date
Recalled
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0010206
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Bard®
Composix® Kugel® Extra Large Oval, 8.7” x 10.7”
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All Lot
Numbers manufactured before January 2006
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December
2005 and January 2006
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0010207
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Bard®
Composix® Kugel® Extra Large Oval, 10.8” x 13.7”
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All Lot
Numbers manufactured before January 2006
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December
2005 and January 2006
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0010208
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Bard®
Composix® Kugel® Extra Large Oval, 7.7” x 9.7”
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All Lot
Numbers manufactured before January 2006
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December
2005 and January 2006
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0010209
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Bard®
Composix® Kugel® Oval, 6.3” x 12.3”
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All Lot
Numbers manufactured before March 2006
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March, 24,
2006
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0010202
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Bard®
Composix® Kugel® Large Oval, 5.4” x 7.0”
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Lot Numbers
manufactured before October 2005*
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January 10,
2007
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0010204
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Bard®
Composix® Kugel® Large Circle, 4.5”
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Lot Numbers
manufactured before October 2005*
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January 10,
2007
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* Product codes 0010202 and 0010204 were recalled for the following lots:
- All lots with the letter "O" in the fourth position
- All lots with the letter "P" in the fourth position and the letters “A” through “I” in the third position.
The Food and Drug Administration (FDA) has warned that “surgeons and hospitals should stop suing the recalled product and returned the unused units to the company.” To view the recall notice from the FDA, click on the following link: http://www.fda.gov/cdrh/recalls/recall-122205.html
The FDA has warned implanted patients who experience unexplained or persistent abdominal pain, fever or tenderness at the implant site or other unusual symptoms to seek medical attention immediately. The FDA also warns that the new re-designed, safe products can be identified by a label reading “Redesigned for improved ring integrity.” Lots with this label do not need to be returned to Davol.
An FDA inspection in early 2007 of Davol's Rhode Island headquarters discovered serious shortcomings with Davol's quality assurance programs. The FDA determined that the programs were so inadequate that Davol was unable to track complaints or conduct timely investigations, and that this failure was to blame for the delays in Davol’s response to the Kugel Mesh Patch fiasco.
To view an article from the New York Times entitled “History of Hernia Patch Raises Questions on Implant Recalls”, click on the following link: http://www.nytimes.com/2007/03/16/business/16hernia.html?pagewanted=1&_r=1 |
Lawsuits Against Davol and Bard
Many lawsuits relating to the defective Kugel Mesh Hernia Patch have already been filed against Davol and Bard in Federal District Court. The Judicial Panel on Multidistrict Litigation of the United States Courts has consolidated all federal cases on the matter, including ones not associated with the recall. The consolidated cases have been transferred to the District of Rhode Island.
Medical device manufacturers, distributors and their parent companies must make sure that their products are not unreasonably dangerous. If they are, like in this case, they can be held liable under both strict liability and negligence for the injuries caused by the defective, dangerous device. If you or a loved one have been injured by the Kugel Mesh Hernia Patch, you should contact an experienced attorney to protect your rights.
Cases involving defective medical devices such as the Kugel Mesh Hernia Patch are complex and require an attorney who has a thorough understanding of the issues involved and is experienced in successfully handling cases involving the defective product. You need an attorney with the right combination of legal experience and medical knowledge to advise you about your legal rights and treatment alternatives to ensure that your rights are properly protected. Cases involving defective medical devices are extremely time sensitive; it is imperative that measures be taken to ensure your proper diagnosis and treatment, preserve evidence, prove the nature and extent of your injuries, and enable experts to establish the cause of your injuries. If you or a loved one has been injured by the Kugel Mesh Hernia Patch, call the Law Offices of Leandros A. Vrionedes at 866-540-0982 for a free evaluation of your claim. |
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381 Park Avenue South,
Suite701
New York, New York 10016
Phone: (212) 889-9362
LAV@VrionedesLaw.com |
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Queens County,
42-14 Astoria Boulevard
Astoria, New York 11103
Phone: (718) 777-5895 |
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