Wednesday, December 1, 2010
First Follow up Appointment with my Surgeon re the Recall
Three things occurred on the first hip recall visit with my surgeon:
1) X-ray of my hip
2) Orders for blood tests for the Chromium/cobalt levels and a soft tissue scan (ultra sound)
3) Discussion re my questions
Overall, I was pleased with the manner in which the visit progressed. As expected, the surgeon didn’t have much information on the 6 alleged claims (see prior post) re the medical implications of the recall. He was very up front stating that there was not much information available. I was surprised that Depuy had not provided them with information to answer the medical claim allegations questions, likely because they don’t have the answers either. I felt my surgeon was on his own to conduct his own research about the recall implications over the long term anyway- he said as much. He did mention that he spoke with Depuy representatives at all levels and felt comfortable that Depuy was not out to blame the physicians for poor placement as has been alleged by the litigators. He was clear that his impression was that Depuy was stepping up to bat and were viewing this “purely as a product defect” and would treat the expenses surrounding the medical treatment as such. Very comforting. We’ll see.
Upon review of my x-rays (were taken at his office), my hip placement looked great. No evidence of any problems based on this x-ray.
My questions and his responses to them:
(1) My symptoms: any one experiencing symptoms of any sort will be tested for the chromium/cobalt levels. If the levels are considerably elevated, action will be taken. He explained that there are three levels of the presence of these metals in the body. A normal baseline presence, a somewhat elevated level in the patients with metal hip joints and an abnormal level. Once the tests are completed, expect more comments on the blog. I have a follow up in 3 weeks.
(2) Should the devise be replaced regardless of the manifestation of symptoms? He said some of his symptom free patients requested the removal of the joint already. He did not seem to advocate this kind of action. Given that the allegations regarding the long term problems associated with the hip may not surface for years, this question of getting this hip removed now is a very reasonable. We need to investigate this further as the evidence from the hip registries in Europe surface. The surgeon did not know whether the long term effects should warrant keeping or removing the joint absent any symptoms. His inclination was to recommend against removal if a patient is asymptomatic. His position was that most (not all) of the 6 medical implications surrounding this implant would result in symptoms.
(3) What tests should be conducted re the 6 medical allegations? It was clear that his protocol was to focus first on (1) x ray of the hip (2) blood test for the metal levels (2) soft tissue scan. It was my impression that these tests, would lead to others if there were indications to take further steps. If these tests did not provide indications, I would be put on a monitoring schedule which we didn’t discuss yet.
(4) What are the indicators of removing the hip? He said there are no clear cut indicators. It was a patient by patient review and decision. There is no magic indicator for replacement.
(5) What are you intending to do with my medical records? They will not be released to anyone including DePuy without my signature. There are clear laws around the release of medical records.
(6) Where you offered any funds to refer patients to register claims with depuy as has been alleged by the litigators? An emphatic NO! He further commented that even if an offer were made, he would never accept that kind of money.
(7) If you were me and you had to decide whether to register your claim with Depuy, what would you do? He did not indicate he would or would not register the claim (even though the letter he sent out recommended that his patients register the claim with Depuy prior to the first visit with him.) He said, “It’s sticky…” He certainly recognized that the litigators were advising that no one should be signing anything with Depuy. He suggested I call Depuy and discuss this with them. I will be calling Depuy this week to discuss the implications of “registering” with them. Does registering involve turning over your records to them? I don’t know yet.
(8) Who wrote the letter to the patients you sent out? Depuy did but he said they revised it a bit. I commented that I felt they understated the problem in that letter: “a small number of patients with the hip implant you received have experienced problems….” I asked him how he thought a 400% increase in problems with this hip vs. problems with other hips could be construed as a small number of patients. He honestly did not have a good answer.
The most important thing I took away from this appointment was reconfirming my trust in my surgeon. I felt he was open and honest and readily admitted that the information surrounding this recall is not complete (my words not his.)
Posted by Connie at 4:49 AM