Four medical implants that escaped FDA scrutiny

April 30, 2012 by MassDevice

Surgical Mesh

Implantable surgical mesh acts a reinforcement structure for internal organs, and is often used to treat pelvic organ prolapse or stress urinary incontinence in women.

The FDA first cleared vaginal mesh in the late 1990's based on its similarity to earlier products used to fix internal hernias. Despite using a different method of implantation (inserted through the vaginal wall, rather than with abdominal surgery) and for an entirely different part of the body, surgical mesh "kits" were advertised as a new and improved method to treat urinary incontinence.

In 1999, Boston Scientific voluntarily recalled its surgical mesh product called the ProteGen Sling, after numerous complaints of pain, infections, and injuries. Over a decade later, Johnson & Johnson faced hundreds of lawsuits over a surgical mesh device that was substantially similar (in fact had been cleared based on its similarity) to the Protogen Sling.

In 2008 the FDA said that surgical mesh complications were serious, but rare. Over the next two years, complaints grew to the thousands, and doctors and patients reported five times as many mesh complications as previous years. According to a 2011 FDA report, total "adverse event" reports for all medical devices – not just mesh – have risen an average of 15 percent a year for the past decade.

In the case of vaginal mesh, the most common problem was mesh eroding and sticking through the walls of the bladder or vagina, causing burning and pain. A study in the journal Obstetrics and Gynecology found that 15 percent of the women treated with vaginal mesh had complications, and that the mesh was no more helpful than other repair treatments. Boston Scientific has repeatedly stated that mesh is a safe and effective treatment option.