Leading General Surgeon Discusses Defective Hernia Mesh

This case involves a patient who had inguinal hernia repair using Composix Kugel mesh. The patient is currently disabled and has suffered chronic, debilitating pain. The plaintiff alleges that the defendant knew the mesh was not suitable for this application, knew it causes chronic foreign body reactions, knew it degrades, shrinks and hardens, knew its instructions for use were inadequate, and knew that promotional material sent to physicians was inadequate and inaccurate.

Question(s) For Expert Witness

1. Please discuss your background researching or working with hernia mesh such as the one described in the case summary.

Expert Witness Response E-008925

I am a board certified General Surgeon with extensive experience with inguinal hernia repairs, having performed hundreds in my career so far. In addition, I do have extensive experience with polypropylene meshes, as they are the ones I use the most in my day to day practice. I am familiar with a good number of studies regarding the use of meshes for inguinal herniorrhaphies, and light polypropylene is the current material of choice for optimal comfort and the least amount of recurrence for patients with clean, primary inguinal herniorrhaphies. A recent review article published on the New England Journal of Medicine states how common the issue of post-herniorrhaphy groin pain is - it sounds like this is what the plaintiff is suffering from. Polypropylene meshes are supposed to and expected to form a foreign body reaction, and lead to scar tissue formation around them ('harden'); it is exactly these properties that make their use desirable in herniorrhaphies, as these characteristics lead to negligible recurrences. It is unfortunate that the plaintiff has to deal with these symptoms - perhaps they should have been stressed more during the pre-operative consenting process - but they are a common occurrence after groin hernia repairs.