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SOUTHERN CALIFORNIA RECORD

Wednesday, April 24, 2024

Doctor testifying for Johnson & Johnson says mesh kits made all the difference in prolapse treatment

State Court
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SAN DIEGO – In a trial to decide if Johnson & Johnson, through its subsidiary Ethicon, allegedly sold pelvic mesh kits it knew were causing harm to women, a doctor on Wednesday testifying for the company said the devices freed women from a crippled life.

“The condition (incontinence) went from a nuisance to being home-bound,” Dr. David Robinson, medical director at Ethicon, said in a taped deposition filmed in October 2017. “Now those people are able (because of mesh) to be in society and they are incredibly grateful.”

A major contention of attorneys defending Johnson & Johnson is that the mesh kits helped women escape the embarrassment and self-banishment from a leaking urinary tract caused by routine exertion or coughing.

The trial in the San Diego Superior Court is being streamed live courtesy of Courtroom View Network.

Closing arguments in the trial, which began on July 15, started Sept. 26.

The state of California, through its Attorney General Xavier Becerra, sued Johnson & Johnson over the Prolift pelvic mesh device, made by its subsidiary Ethicon, for allegedly causing vaginal injuries in women and allegedly for selling the product through the use of deceptive marketing practices. Prolift is a clear polypropylene mesh with several thin connecting arms.

The day’s questioning began with the appearance of Mark Schneider, a certified public accountant for Johnson & Johnson. Schneider reported that the company had generated $39.3 million in revenue selling mesh products in California between 2008 and 2019.

Schneider was dismissed a short time later after disagreement between attorneys whether he had the proper foundation to serve as a witness. Superior Court Judge Eddie Sturgeon said the important point was the number of (mesh kits) units sold more than the revenue generated.

Sturgeon indicated that if the court decides against Johnson & Johnson, the number of units sold would be used as a base to decide the penalties. Schneider was dismissed pending further information on the background sales data.

In the deposition tape, Robinson said he began using the mesh kits to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in the late 1990s because the older methods used were sometimes less than satisfactory.

He said he was doing three to five transvaginal tape (TVT) mesh implants per week.

Prior to that, a procedure called anterior colporrhaphy had been used. Another was called a Burch procedure. Expert witnesses for Johnson & Johnson have testified that both earlier treatments involved a bigger incision and a longer recovery time than did the mesh kits.

“With the colporrhaphy, we didn’t have a good result with the POP treatment,” Robinson said. “The Burch required an open incision and was not as effective. It was not uncommon to have voiding (leaking) patterns afterward.”

With the TVT mesh, Robinson said he was impressed with the shorter recovery period and the predictability of the devices.

“Its (mesh) durability was remarkable,” he said.

Robinson said one woman patient had six failures (reoccurring incontinence) with the old treatment and as a result of further procedures, no pelvic wall left.

“Her bladder was hanging out of her vagina,” he said. “We could repair it with the mesh. That was my most dramatic case.”

The case in San Diego is the first at trial by a state attorney general and seeks damages over allegations of unfair competition and violation of false advertising laws.

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