ARTICLE
14 October 2012

Hips and PIPs - and what to do when a patient asks for an explanted implant?

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Barry Nilsson

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Barry Nilsson is an award-winning national law firm of more than 550 staff, with offices in all six states. Our Insurance & Health and Family Law, Wills & Estates practices combine extensive industry knowledge with local expertise to deliver trusted, practical advice. We partner with our clients, evolving our services to meet changing needs, while fostering a strong internal culture that supports our people and community. Our Insurance & Health team includes 250+ specialist insurance lawyers advising across all major lines of insurance and a broad range of industries. From policy drafting and claims management to legislative and regulatory advice, we work alongside insurance clients and stakeholders to tailor strategies designed to achieve the best outcomes. Our Family Law, Wills & Estates team provides a full range of family law and estate planning services for local, international, and expatriate clients. We combine expertise with empathy to deliver advice tailored to individual circumstances.
Hospitals should consider all possible risks from the release of these implants for actual or potential class actions.
Australia Consumer Protection
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In previous Healthfiles articles we have discussed the alleged defects in the DePuy Orthopaedics metal on metal hip replacements and the silicone breast implants manufactured by Poly Implant Prosthese (PIP).

The devices in question remain topical. The hip replacements are the subject of a class action in the Federal Court in Sydney, with NSW based Maurice Blackburn managing principal Ben Slade estimating the value of the Australian damages claim at more than $200 million.

The state of play with respect to the PIP breast implants is less clear. The TGA continues investigation and testing, but testing to date has not identified toxic or irritant chemicals in either the shell of the implant nor the gel. Tests on the strength of the shell and the consistency of the gel have apparently met relevant standards. In the words of the Chief Medical Officer “So far, scientific tests have identified some differences between the PIP breast implants and other brands of silicone breast implants, but these differences are small and do not indicate that there is an increased safety risk associated with PIP implants.” 1

At least two plaintiff law firms are still contemplating class actions in relation to the PIP breast implants and lawyers from at least one firm have travelled to Europe to seek further information.

The actual and potential class actions have also given rise to legal issues even for parties unlikely to be directly involved. Where patients with PIP implants have chosen to have them removed, they have requested that they be either returned to them or delivered to a laboratory for forensic testing. Many hospitals as a general policy discourage the return of explanted prosthetic devices to patients given possible infectious disease risk (particularly in the case of a silicone implant, which cannot be heat-sterilised). Such material might also be routinely categorised as “medical waste”, and therefore subject to (in Queensland) the restrictions contained in the Environmental Protection (Waste Management) Regulation 2000.

This approach taken to such requests will potentially bring a hospital into conflict with a patient who wishes to obtain their implants in order to investigate legal proceedings. While the issue does not appear to have been specifically considered, where patients have paid for their implants, on general principles the implants would be considered to be their property. Given the potential value of the implants as evidence, it seems likely that a court would have little difficulty confirming this position, and the use of the implants as evidence may well take them outside the definition of ‘waste’ in the Queensland Regulations.

Hospitals should however still consider the possible risks arising from the release of the material and be sure that consent and waiver forms properly reflect the potential risks involved in handling the material and the patients acceptance of those risks.

Footnotes

1 A recent English review however indicated that the implants were between two and six times more likely to rupture than other brands (although it also concluded that the substances contained in the implants were not toxic) and a report published today states that new figures show a dramatic rise in recorded ruptures between January and September this year.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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