Carmel Berry awoke after a uterine prolapse repair feeling as though someone had left a needle inside her. It took two years before doctors realised surgical mesh had triggered an ongoing foreign body response.
The condition has left Ms Berry on so much pain medication, she shakes.
Ms Berry and fellow surgical mesh sufferer Charlotte Korte petitioned Parliament in 2014.
In Parliament last week, health minister Jonathan Coleman tabled his response to a health select committee interim report on their petition. Dr Coleman said the Government would:
• investigate options for a centralised surgical mesh registry to record complications
• communicate with medical colleges to review best practice around informed consent for surgical mesh patients
• encourage health providers to ensure coding information is consistent so complications can be identified and monitored
• encourage adverse events reporting as applicable
• endorses ongoing education for surgeons on use of surgical mesh and mesh removal surgery, and
• consider expanding Medsafe’s role to assess the quality and safety of medical devices.
Ms Berry and Ms Korte are disappointed by the “soft” wording in both the committee’s report and Dr Coleman’s response.
The minister agrees with the report, Ms Berry notes, but she says the Government has set no timeline and no accountability or key performance indicators. A registry should have been set up two years ago, but they are only now “investigating options” for one.
The women also want mandatory reporting of mesh-related adverse events.
ACC accepts more than 600 claims
ACC has accepted more than 600 claims for injury related to surgical mesh, but it says only about 10 per cent of sufferers make claims, Ms Berry says. Some have private insurance, others do not think they have a treatment injury.
A Medsafe adverse event report shows the agency received 101 reports into adverse events surrounding surgical mesh between 2005 and 31 May 2016. Only 16 were from patients themselves, two from health professionals, 56 from ACC, and the rest from manufacturers and suppliers.
Survey shows almost 90 per cent not warned
In a survey released by the group Mesh Down Under, of which Ms Berry and Ms Korte are members, very few of the 57 respondents were warned of the potential risks associated with surgical mesh.
Ninety-one per cent were not offered any alternative treatment, a media release from Mesh Down Under says.
It says 80 per cent required one or more revision surgeries, and one person needed 71 operations; 44 per cent said mesh hadn’t cured their condition. Despite this only 20 per cent had reported their cases to Medsafe.
The survey also showed that of those patients who told their GP about their problems with mesh, 75 per cent found their GP had little or no knowledge of mesh complications.
Specialty well aware of risks
Chair of the NZ Committee of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists Ian Page says the specialty is well aware of the risks and benefits of “all treatments for the conditions we are asked to treat”.
“Mesh is not particularly different in that regard,” Dr Page says in a statement for New Zealand Doctor.
He points out that the college and other medical bodies have clear guidelines around consent, with specific information sheets relating to the issues around mesh, including the lack of robust evidence for its use in pelvic organ prolapse.
Dr Page encourages patients who feel they haven’t been adequately informed to go to the health and disability commissioner.
A plea for GPs
Ms Berry asks that GPs finding their patients still have pain at their six-week check-up after surgery to “please take it seriously”.
She would also like GPs referring patients to specialists, to be able to explain the risks of mesh, refer them to research and invite patients to come back and talk to them if there are any complications.
Baddock supports registry
NZMA GP Council chair Kate Baddock says she has been in support of a surgical mesh registry for some time.
Dr Baddock says there can occasionally be complications with non-gynaecological use of mesh, but in pelvic repairs, the mesh is generally much closer to the surface and the tissue can become eroded allowing the mesh to poke through.
She believes there is now much greater shared decision-making around surgical mesh for gynaecology, and surgeons are much more thoughtful and careful about using it and explaining the risks to patients.
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