TVM Case Screening Checklist: Factors to Consider at your Intake Evaluation

It seems likely that Tolling Agreements will be in effect in the near future after recent discussions in West Virginia, opening the door for thousands more plaintiffs suffering injuries from defective mesh products to join the ongoing litigation. With a waterfall of additional complaints expected, how can attorneys efficiently evaluate and qualify their TVM inquiries? Case Funding Inc. has seen its own influx of inquiries both from attorney’s seeking law firm loans based on their TVM cases & plaintiffs seeking medical funding for revision surgeries as well as living expenses. Below is our handy checklist for evaluating our own TVM claims:

How to Evaluate Transvaginal Mesh Cases
 How to use this table: The intake team at Case Funding uses this table to assist underwriters in evaluating claims. For Law Firms, qualifying cases for each A, B, and C category will give you a better understanding of what is in your inventory. “+” Attributes have been known to increase the significance of a case, while “-” attributes may make it more difficult to reasonably prove that the defective mesh/sling was the core reason for a plaintiff’s injuries. The effect of “+/-” attributes should be judged in conjunction with other case facts.
Stress Urinary Incontinence (SUI):

EST. STRENGTH OF CLAIM:

B

  • + Acknowledged defective mesh/sling device
  • + Proof of defect in medical records including: swelling, scarring, adhesion, shrinkage and/or erosion
  • - No revision surgery

LOW to MEDIUM

C

  • + Acknowledged defective mesh/sling device
  • + One or more explantation/revision surgeries completed & recommended
  • + Proof of defect in medical records including: swelling, scarring, adhesion, shrinkage and/or erosion
  • + One or more explantation/revision surgeries completed & recommended

MEDIUM to HIGH, increasing with # of Revisions

Pelvic Organ Prolapse (POP):

EST. STRENGTH OF CLAIM:

Basic Qualification for a POP Claim:

  • + Acknowledged defective mesh/sling device
  • + No complaints prior to implantation
  • + Plaintiff must have complaints post-implantation

A

  • - No revision surgery
  • - Implantation occurred after FDA warnings
  • - Combination of: Over 60, BMI over 30, Smoker, Pre-implant anxiety disorder diagnosis, STD, Diabetes, Endometriosis and/or Chemotherapy.
  • - No recorded medical evidence of defect -OR- Dr. diagnosis states “no defect”
  • - Statute of Limitations (SOL) criteria within 2yrs of July 2011 FDA TVM Warning (PENDING)

NONE to LOW

B

  • + Proof of defect in medical records including: bulging, scarring, adhesion, shrinkage, and/or erosion
  • + Additional complaints including: dysperunia (painful intercourse), ongoing pelvic pain, urinary incontinence, infection, and/or abscess
  • + Statute of Limitations (SOL) criteria within 2yrs of July 2011 FDA TVM Warning
  • +/- Surgery scheduled but not complete
  • - May be/have: Over 60, BMI over 30 (at implantation or post), Smoker, Pre-implant anxiety disorder diagnosis, STD, Diabetes, and/or Chemotherapy

MID-RANGE

C

  • + Proof of defect in medical records including: swelling, scarring, adhesion, shrinkage and/or erosion
  • + Additional complaints including: dysperunia (painful intercourse), ongoing pelvic pain, urinary incontinence, infection, and/or abscess
  •  + Disruption of marital enjoyment due to symptoms
  • + Residual mesh after excision attempt
  • + Return of symptoms of Pelvic Organ Prolapse
  • + One or more explantation/revision surgeries completed & recommended
  • + Statute of Limitations (SOL) criteria within 2yrs of July 2011 FDA TVM Warning

HIGH, increasing with # of Revisions Performed

 

Manufacturers and Mesh/Sling Types to Consider:

  • CR Bard: Align, Avaulta, InnerLace, Pelvicol, PelviLace, PelviSoft, Pelvitex, Uretex
  • Boston Scientific: Uphold, Pinnacle, Advantage, Lynx, Obtryx, Prefyx, Solyx
  • American Medical Systems: Apogee, Perigree, Mini-Arc, Monarc, Sparc, Bio-Arc, In-Fast, Elevate
  • Johnson & Johnson (Ethicon): Prolene, Prolene Soft, Gynemesh, Gynemesh PS, TVT, TVT-Obturator, TVT-Secure, TVT Exact, TVT Abbrevo, Prolift, Prolift +M, Prosima
  • Coloplast: T-Sling, Aris-Transobturator, Supris-Suprapubic, Novasilk, Exair-Prolapse, Restorelle, Smartmesh, Omnisure, Minitape

Case Type Brief:

With thousands of lawsuits filed around the country (21,500+), 2013 is likely to have the most impact on the Transvaginal Mesh Litigation (TVM) with back to back Bellwether trials scheduled to set the bar. Two substantial awards for plaintiffs have been decided at Trial so far, one in California and one in New Jersey. According to various reports, women implanted with mesh products to treat urinary incontinence and pelvic organ prolapse, are suffering from significant injuries caused from the mesh eroding and breaking down. From 2008, the FDA has issued repeated warnings, each more significant, about mesh devices and the serious complications associated with its use.

What’s on the docket in the transvaginal mesh multi-district litigation:

Litigation relating to the Avaulta mesh devices manufactured by C.R. Bard is moving forward in the District Court for the Southern District of Virginia with four trials scheduled for July 2013, beginning with Cisson, et al. v. C. R. Bard, Inc. 2:11-cv-00195.

In addition, of the many lawsuits currently pending in the Atlantic County Superior Court in New Jersey, another trial against C.R. Bard will commence in September 2013. If favorable plaintiff verdicts are reached, and if the awards are anywhere close to the recent verdict handed down in March, it would stand to reason that TVM manufacturers may look to settle this litigation sooner rather than later.

Convincing verdicts so far:

In March, a jury awarded more than $11 million to the Plaintiff in Gross v. Gynecare Inc., Atl-L-6966-10, Superior Court of Atlantic County, New Jersey (Atlantic City), including $7.76 million in punitive damages. The verdict was the first to be rendered in an Ethicon transvaginal mesh product case, and may bode well for future plaintiffs suing over Ethicon and non-Ethicon transvaginal mesh products. A 2012 judgement was issued against CR Bard Avaulta product in the amount of $5.5 million, including $500K to the plaintiff’s spouse in Scott v. Kannappan, S-1500-CV-266034-WDE, Superior Court for Kern County, California (Bakersfield).

How Case Funding can Help:

TVM cases can be expensive to litigate – having adequate legal funding in place is crucial. Case Funding Inc. can help your firm manage case costs and working capital expenses through our law firm loan and attorney financing solutions. Download our brochure, or schedule a private consultation with Richard or Leon online or at (888)-248-2866

Securing critical medical treatment for plaintiffs is also the cornerstone of a strong TVM case and will make all the difference when negotiating for settlements and judgments at trial that truly reflect the plaintiff’s needs. Case Funding’s Medical Funding programs can be customized to fit the unique needs of each plaintiff and each case to minimize the law office’s efforts in securing care and maximize a case’s viability. Speak with a Medical Funding Specialist today about our customizable solutions at (888)-248-2866.

litigation financing TVM Case Screening Checklist: Factors to Consider at your Intake Evaluation

Case Funding Inc. is a specialty finance company and industry leader in providing litigation funding solutions to attorneys, law firms and personal injury and product liability victims. Working capital loans enable attorneys to invest in their cases and to pay for items such as expert witnesses and litigation support costs, operating expenses, business development and marketing campaigns and better manage cash flow overall. Case Funding factors and purchases medical liens from doctors, surgery centers and radiology centers. Selling or factoring medical liens allows medical providers to immediately improve their cash flow, reduce overhead and eliminate bad debt risk while providing attorneys with the security that their plaintiffs will receive necessary medical care throughout the duration of their lawsuit. Plaintiffs can receive funding for personal and other living expenses while they wait for their case to settle so they aren’t pressured into settling their case for less than its full value.

Case Funding offers this information for illustrative purposes only and in no way should be relied upon or viewed as financial or legal advisement.