TRANSCRIPT:

B: I'm Ben C.

V: I'm Doctor V.

The medical legal guys... spring training edition!

V: So what have we been doing Ben Martin, over the past couple of weeks? What kind of comes to mind?

B: Well, we've been handling up on coloplast.

V: While the case Baltimore. And we're about to amend a complaint against coloplast and again catastrophic pain syndrome.

B: Pudendal neuralgia. 

V: Stiffness mesh worse outcomes with safer alternative designs.

B: This is a mid urethral sling. So what’s a mid urethral sling?

V: While mid urethral sling is used for women after they have childbirth they developed stress urinary incontinence as they get older. 

B: And it doesn't just have to do with childbirth. People, male and female can have a stress urinary incontinence, which means they leak. Okay, the case of many women, it comes forth after childbirth, age, gravity and so the mid urethral slings here to supposedly help that issue those issues. And mid urethral sling is made of polypropylene. If it's a coloplast sling and that's a plastic. And, tell us a little bit about the Arif device.

V: The aris is there trans operator sling it. Basically it's a sling that supports the mid urethra. And you have a vaginal component, and arm component that goes in the leg.

B: Used to lift up the urethra, which is the tube that goes from the bladder and out the body to its failure. That right?

V: Yeah. Polypropylene. The days of polypropylene are kind of on their way out because.

B: Polypropylene is on the ropes.

V: Basically. And it's because they're safer materials that don't include the plastic weave of mesh that causes inflammation and pain and erosions. And they have other materials that don't have that as they have less inflammation, they have less erosions, and the degree of inflammation is markablly less. And that other type of mesh is called PVD. And it doesn't shrink. Polypropylene shrinks. And if you have muscles under tension, a nerve is under tension. You could have muscle and nerve pain and unfortunately, those are the women that we represent. And we believe that this device, the outcomes show that it's the worst device. And warnings do not fully capture the frequency of risk and the severity of risks. And I don't think any doctor would choose polypropylene over PDVF.

B: And Dr. V, a doctor who knows who has told the truth about this product, we say, wouldn't put in the product, or at least is going to tell the patient about the product. And once the patient is told the truth about the product, then the patient has a decision to make. And patients, if told the truth, will make the decision not to have this link. 

V: So the big problem with this, in terms of pain, it causes 2.8 times the amount of frequency of dyspareunia. And that's kind of goes to the heart of the safety of the device because it's placed vaginally. But it also causes some extreme pain syndromes because it inserts on the obturator internist muscle, which is very close to various nerves. And that could cause muscle spasm, dystonia, pulling on nerves, and some serious pain syndromes. In PDF, it's gaining market share. And in Europe this PDF has been tested 1 to 1 against polypropylene trans obturator slings and was superior in terms of pain and erosions. And it's a better material. And so we're suing the manufacturer for failure to warn doctors of the specific increased risk of pain and dyspareunia, the severity of risks, but also that this is a design defect because there are safer materials that need to get to the market. And the Aris sling and the Altis device, they seem to be the worst.

B: All right. So there's your co-op class. We could go on for hours for days, but, that's the general update on what these cases are about. 

V: So we also filed a case. It's very important in Wisconsin okay. And it involves time is brain okay. And so it's a serious injury case.

B: The time is brain doesn't have anything to do with the colo plast. Doesn't have anything to do with the med rurethral sling. So let's talk about a new case we filed in Wisconsin. And other cases exist that are similar to this case.

V: Time is brain is now the standard of care. When a person presents to a hospital with symptoms or signs of a stroke, and there are certain tests that need to be done within a certain time frame, and interventions must be provided or offered because the outcomes are superior. When a person comes with an eschemic stroke from a blood clot in the brain. 

B: Eschemic stroke.

V: Yes.

B: And hemorrhagic stroke two types of strokes and doctor V just explained hemorrhagic hemorrhagic. Very nice. And there's also the eschemic brain that involves a loss of oxygen because of a lack of blood flow or a lack of oxygen. That's an ischemia, stroke and a hemorrhagic stroke. Which doc was talking about in time is brain is the type where you actually have a bleed, vessel bleed in the brain, and that's a bad thing. 

V: That's a bad thing. And obviously you want to get, proper care, proper blood pressure management, earlier treatment, the better, obviously, in terms of preventing complications. But clearly with ischemic strokes, you're on the clock, okay, to get this done. And our client unfortunately presented to the hospital had symptoms and signs we allege of a stroke. And then they didn't run the diagnostic test despite a code stroke that a nurse had significant concerns that a person was having a stroke and they didn't follow through on the policies and procedures. We allege in terms of the standard of care for the next test, which is to give a CT angiogram to see if there is a clot that can be either extracted with via thrombectomy, a catheter that can grab that clot and so that the blood flow can return, and or the thrombus lytic or blood clot clusters by veins. So it's really a sad situation. And then unfortunately, this gentleman then developed to a very big grade for bed sores.

B: Alright.

V: It's a nightmare hospitalization and could have been saved. He had other medical problems that would have been taken care of. 

B: So Time is brain. And that's what this is all about. The faster you get to the patient, faster you understand what's going on with the patient, faster you diagnose the possible problems, and then the faster you get to the problem. It's very important because the faster you get, the better opportunity there will be to save that patient's health.

V: And this occurred in the hospital within 12 hours, the change in neurological status. So it's kind of a bad story.

B: It is a bad story. But I want to talk about with doctor V today is just kind of some of the general aspects of time is brain and general aspects of what kind of diagnoses are made, what kind of, indicators are there, what kind of diagnostic tests are there to make a determination as to whether or not somebody coming in with symptoms that are consistent with a stroke actually may be undergoing a stroke? And why time is brain is so, important.

V: You know, these are serious. When you have a large vessel blood clot, that's like a hose that goes to various other parts of the brain. Okay. So it gets this hose and you lose a lot of brain, and the prognosis is significant. And the missed the large vessel stroke is very bad. And also small vessel stroke. There is benefit from thrombolysis better outcomes.

B: You had to do them. You had to do the diagnostics to see what kind of thing was going on, what kind of things are going on with the patient. That's called doc V. We talked about this before. That's called making a differential diagnosis. And you see in medical records a lot argue that means rule out this particular condition, this other condition, this other particular condition.

V: You know, a better code stroke. You know a nurse is ringing the bell. An ambulance driver is ringing the bell that they have a code stroke. And everyone in that hospital knows what should be done and what is next. Okay. It's a highly predicted diagnostic plan with certain minutes and and hours and windows where it shows outcomes are different. So there should have been nurses to say, hey, what about this? Okay. I mean, you have to think critically and understand, hey, this is what normally happens. Why why why not this case. Yeah. And ring the bell again.

B: That code we're talking about. So that's important because once usually once a code is call, then it's being called because this patient is suffering from something that is likely to be a stroke or something else. Very serious. Don't call code if somebody is not having a serious problem. Is that right?

V: Yeah. Yeah. There's coordination of care. There's expectations. You know, that the point that they then didn't identify or that there was a problem with the code strobe for two days.