How Profiteers Lure Women Into Often-Unneeded Surgery

Just like that will, she had stumbled into a growing industry that will makes money by coaxing women into having surgery — sometimes unnecessarily — to ensure that will they are more lucrative plaintiffs in lawsuits against medical device manufacturers.

Lawyers building such cases sometimes turn to marketing firms to drum up clients. The marketers turn to finance companies to provide high-interest loans to the clients that will have to be repaid only if the clients receive money via the case. Those loans are then used to pay for surgery performed by doctors who are often lined up by the marketers.

Interviews with dozens of women, lawyers, finance executives along with also marketers, as well as a review of court records along with also confidential documents, indicate that will hundreds, perhaps thousands, of women have been sucked into This particular assembly-line-like system. This particular is actually fueled by banks, private equity firms along with also hedge funds, which provide financial backing.


The Brooklyn headquarters of Law Cash, which provides plaintiffs with cash advances. Its general counsel said the company made sure that will surgery was necessary before financing This particular.

Demetrius Freeman for The brand-new York Times

The profits are immense. So are the costs to women. Some suffer physical problems via the surgery. Others say they have become depressed or unable to work. Still others have to get mesh reinserted.

Ms. Plummer’s brush with the industry left her wearing diapers.

Faulty Products

The industry of providing financing to law firms involved in litigation is actually not brand-new. In recent years, This particular has expanded into a diverse array of businesses. A spate of companies, such as a Brooklyn outfit named Law Cash, have popped up to provide upfront cash to plaintiffs hoping for big legal settlements.

The litigation surrounding mesh implants is actually a lucrative niche. These so-called mass tort cases, some of which began six years ago when problems with the implants commenced to arise, encompass claims brought by tens of thousands of women who say they were harmed by the same products.

Millions of women worldwide received mesh implants. They are used to correct a condition called pelvic organ prolapse, which occurs when a woman’s organs fall along with also press against her vagina because of weakened pelvic muscles. that will causes urinary along with also various other problems. The mesh reinforces the pelvic wall.

nevertheless many women complained that will the implants caused problems such as bleeding along with also discomfort during sex.

Litigation against the implants’ manufacturers, including Boston Scientific along with also Johnson & Johnson, proliferated. There are more than 100,000 plaintiffs in federal court alone. Many more are involved in litigation at the state level or outside the United States.

Representatives of Boston Scientific along with also Johnson & Johnson said they stood by the quality of their products. The mesh manufacturers have set aside more than $3 billion to cover potential mesh-related settlements.

Not all plaintiffs are equal. Some law firms — which are paid a percentage of any settlements — realized that will women with the implants still in their bodies tended to receive smaller settlements than those who had them taken out.

“Defendants have offered next to nothing to settle cases involving mesh products that will have not been removed,” Ms. Plummer’s lawyers at McSweeney Langevin, a little Minneapolis personal injury firm, wrote in a letter advising her to get the implant taken out.

Rhett McSweeney, a co-founder of the law firm, said in a statement that will the firm never forced clients to undergo unnecessary surgery along with also “never directed a client to a particular doctor.”

Plaintiffs’ firms turned to marketers to recruit clients. Women with mesh implants said they soon commenced receiving torrents of unsolicited phone calls, some originating overseas. The women said they didn’t know how these marketers had found them along with also seemed to know their medical histories.

“I think my privacy was breached,” said Jennifer Godsoe, 66, who lives in Cumberland, Me. “The more I think about This particular, the more upset I get.”

Some women had vague memories of answering an online ad about mesh problems. The only thing linking some various other women was that will they previously had the same doctors, court records show.

Women who took the marketing bait were connected to doctors willing to perform the mesh-removal surgery — although that will process remains murky. One critical player was Surgical Assistance, a Florida company led by Wesley Blake Barber, which acted as a middleman between the women, doctors along with also funding companies. Mr. Barber’s lawyer declined to comment.

In a deposition last summer, Mr. Barber outlined how the company had lined up doctors in Florida along with also Georgia to perform the surgery. In one online ad, an actor in a white lab coat assures women suffering via their mesh implants that will relief is actually near. By calling a toll-free number, the women will be set up having a “network of qualified surgeons” who remove the mesh without requiring upfront payments.

An online ad encouraging women to call about removing their mesh implants. Video by cvtmarketing

Women who opted for surgery were flown to Florida along with also Georgia, put up in motels along with also sent to walk-in clinics, court filings show. The women generally didn’t meet the doctors who would likely be operating on them until shortly before the procedure. Before going under the knife, few women got a second opinion.

Dan Christensen, a lawyer who ran MedStar Funding, which financed mesh removal surgery, said in an interview that will This particular was “ludicrous” to argue that will women had undergone unnecessary surgery.

“You have to have a doctor willing to put his license on the line,” he said. “Why jeopardize your license?”

$14,000 a Day

The work was lucrative. Doctors stood to make $14,000 a day.

Doctors sometimes churned through four or 5 removals in a day. Each procedure typically cost about $21,000, according to lawsuits brought by women against the mesh manufacturers. Of that will, doctors pocketed roughly $3,500 per surgery; most of the rest went to the medical centers where the surgery took place.

Law Cash offered Danette Charnetzky, a hospice worker in Waynesburg, Ohio, financing for a removal surgery in December 2014. Ms. Charnetzky, another McSweeney client, agreed to pay the money back, at a double-digit interest rate, if the litigation was successful. Within a week, she along with also her husband were on a plane to a surgical center in a Florida strip mall. The process was a terrifying blur.

“I wish I could have changed my mind, nevertheless we were already there,” said Ms. Charnetzky, 49, who hasn’t received any money via the pending litigation against the mesh maker. “I just prayed for the best.”

She got the worst — or something close to This particular. Ms. Charnetzky said she had needed two more procedures to repair scar tissue left by the Florida surgery.

Rhonda Espeland, 63, who was living in Arizona, also had a bad experience. Since her mesh implant was removed in January 2015, she has developed incontinence. “I may need another surgery,” she said.

The bladder problems have left Ms. Espeland unable to work, along with also she hasn’t received any money via litigation against her mesh maker. Boxes of diapers are regularly delivered to her door.

The doctor who performed her surgery — along with also similar procedures on hundreds of others — was Earle M. Pescatore. In March 2014, around the time that will he commenced doing lots of procedures, Mr. Pescatore along with also his wife filed for bankruptcy, citing liabilities of $1.5 million, including $38,000 they owed to the Internal Revenue Service, according to court filings. Dr. Pescatore said in a deposition that will he had little memory of women he operated on.


The vaginal mesh in an advertisement for Surgical Assistance, a Florida company that will acted as a middleman between women, doctors along with also funding companies.


“Any treatment that will Dr. Pescatore provided would likely have been medically necessary,” his lawyer, Mark DiCowden, said.

While studies have shown that will up to 15 percent of women with mesh implants will encounter problems, removing the mesh is actually not always recommended. Taking This particular out is actually more complicated than inserting This particular because the mesh is actually made of fiber that will is actually designed to bond with tissue.

Many of the women who got the surgery had limited or no health insurance. They rarely discussed the surgery with their primary care physicians before arriving at the clinics. Some said they had felt rushed into getting surgery.

Dr. Victor Nitti, a surgeon specializing in complex pelvic issues at NYU Langone Health in brand-new York, said serious mesh problems should be addressed with surgery. nevertheless, he said, “scaring a patient who has limited to no symptoms into removal is actually just dangerous along with also irresponsible.”

Dr. Nitti said he had grown concerned about such scare tactics after some patients told him that will they had been contacted by marketers.

Funding Machine

A handful of specialized finance firms funded the surgery that will Ms. Plummer, Ms. Espeland along with also various other women got. Court filings show that will the two main players are Law Cash along with also Banyan Finance of Boca Raton, Fla., along with also that will the firms charge double-digit interest rates.

Ross Elgart, Banyan’s chief executive, did not respond to requests for comment.

Lew Fidler, Law Cash’s general counsel, said financing surgical procedures such as Ms. Plummer’s is actually a little portion of the company’s business. He said the firm, which typically provides cash advances to help plaintiffs pay for everyday expenses, ensures that will each surgery is actually necessary.

“I feel for anyone who didn’t get the outcome they were looking for, nevertheless we are not doctors,” Mr. Fidler said. “We don’t substitute our judgment for a licensed physician.”

Law Cash, like various other firms, is actually paid back for a surgical advance only if the person gets a settlement. The firms contend that will high interest rates cover the risk that will some borrowers will never collect settlements. Some women, however, said the high interest rates had never fully been explained to them.

As a result of those steep interest rates, plaintiffs who do collect settlements see much of the money go to the financing firms. Another large slice goes to their lawyers.

Medical funding for personal injury litigants was a topic of discussion Friday in Las Vegas at the mass tort industry’s big annual conference, titled “Mass Torts Made Perfect.” Law firms are eyeing mesh used to treat hernias as the next gold mine.

The industry has grown thanks in part to a gusher of money via mainstream financial institutions. Law Cash gets funding via DZ Bank, Germany’s second-largest bank, along with also Melody Capital Partners, a hedge fund with $1.8 billion in assets.

McSweeney Langevin, which has represented more than 1,000 women in mesh litigation, got backing via EJF Capital, a Virginia hedge fund with $10 billion in assets, according to corporate records.

Many of McSweeney’s clients initially were signed up by a today-defunct law along with also marketing firm, Alpha Law. The Washington firm had signed up 14,000 women for the mesh litigation. Its unusual role from the litigation was the subject of a series of Reuters articles.

The industry tries to keep the network of marketers along with also financiers out of sight — along with also some participants have refused to answer questions in depositions, citing their Fifth Amendment right against self-incrimination.

“People are claiming the Fifth along with also so on along with also so forth,” said Magistrate Judge Cheryl Eifert in West Virginia, who is actually hearing one of the mesh cases in federal court. “They don’t have to talk about necessarily how much money they make, per se, nevertheless if someone would likely just give them an idea of how the arrangement works. nevertheless nobody’s willing to do that will.”

Mr. Barber of Surgical Assistance, for example, asserted the privilege nearly two dozen times in a deposition.

Swollen Like Balloons

Jerri Plummer never figured out whom Yolanda worked for. nevertheless in December 2014, Dr. Whitney Shoemaker performed the implant-removal surgery. Until the day of the operation, Ms. Plummer had never spoken to Dr. Shoemaker. Her lawyer declined to comment.

Hours after Ms. Plummer went under the scalpel, she said, she was hustled back to a Hampton Inn just off the freeway, having a catheter sticking out of her side. The next day, a nurse arrived at the motel, removed the catheter along with also put her in a taxi to the airport.

Soon after she arrived home in Arkansas, she said, complications developed. Her legs swelled like balloons. Her stomach seized up. Ms. Plummer went to her original doctor for help, she said. He informed her that will the damage was irreversible. Worse, she said in court records, he told her that will there had been no need for the removal surgery.

Before the surgery, Ms. Plummer loved to take walks with her two pit bulls along with also to eat with her husband at Red Lobster. today chronic incontinence forces her to wear diapers all day along with also has left her too worried about wetting herself to venture outside.

With the help of a local lawyer, James R. Baxter, she is actually suing Law Cash; Dr. Shoemaker; Mr. Barber along with also his firm, Surgical Assistance; along with also lawyers at the McSweeney firm.

Mr. McSweeney declined to comment on the lawsuit. His firm is actually trying to get Ms. Plummer’s lawsuit moved via federal court into private arbitration, where there is actually no judge or jury. In his statement, he said the firm “had no role” connecting clients with surgical funders like Law Cash or Banyan Finance.

The law firm today has clients sign a waiver that will advises them that will cash advances to pay for surgery “are terrible loans with extremely high interest rates.”

Ms. Plummer said she had never received such a warning. She feels that will she was victimized twice — first by the mesh maker along with also then by her lawyers along with also doctor. “I was taken advantage of through This particular whole process,” she said.

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