THE New Zealand Government could tighten laws to improve medical device safety after a report on Thursday acknowledged health system failures that have left women with "confronting" pelvic mesh injuries, only weeks after Australian pelvic mesh victims won a landmark court case against Johnson & Johnson.
New Zealand Associate Health Minister Julie Anne Genter has acknowledged "the scale of changes needed" in response to a restorative justice report in which women savaged the New Zealand health system and a national no-fault compensation scheme that blocks legal claims against mesh manufacturers.
The report noted the view of many women that the Accident Compensation Corporation's "default response to mesh injury claims is 'deny, defer, defend'."
"Numerous people wanted mesh-injured New Zealanders to have the opportunity to sue the manufacturers of mesh products," said the report by the Victoria University of Wellington for the New Zealand Ministry of Health.
One woman told the report's authors: "We, the injured, hear all the time about massive pay-outs that people overseas have received, and yet we have to fight our way through Accident Compensation Corporation bulls... and hope for a lump sum, which is a pittance in comparison."
"My life as it was is over, I can't get it back. All I can do is try and make the most of what my body is now able to do, and money would most definitely help with this," the woman said.
The New Zealand Government has committed to reviewing pelvic mesh compensation claims denied in the past, credentialing specialists and reviewing the Therapeutic Products Bill so that "medical devices such as surgical mesh (could) be subject to more stringent conditions before being introduced".
But New Zealand women's advocacy group Mesh Down Under, backed by Mesh Injured Australia, has criticised the government response to a report which noted the need for a meaningful apology to mesh-injured women, acknowledgment of the harm done and compensation.
"Mesh Down Under feels strongly that these initial proposals and commitments fall extremely short of what is truly needed," spokesperson Charlotte Korte said.
"Our group has been lobbying successive governments since 2012 asking for practical help and changes in health care services, all based on well-documented evidence of patient safety and patient rights issues.
"A clear theme that emerged in the report was the lack of accountability for the harm caused to mesh-injured patients, many of whom, in hindsight, had not been given adequate information about the surgery they were having or whether their surgeon was properly qualified to be undertaking mesh procedures in the first instance."
The report included statements from surgeons who were bullied after challenging other surgeons about their competency to implant and remove mesh devices, and from theatre nurses who worked in "a culture of science" because "no surgeons welcome questions about mesh".
Mesh Injured Australia spokesperson Justine Watson said the issues of lack of informed consent, reporting of adverse events, medical professionals denying and dismissing mesh-related health issues, lack of medical and financial support services for mesh-injured women were consistent in both countries.
Women in both countries were "losing their will to live" because of severe, chronic, permanent and intractable pain and other serious complications that governments were not addressing, despite commitments to providing long-term specialist units, Ms Watson said.
The New Zealand report said women spoke of outcomes and experiences that were "traumatic" and "overwhelming", that had penetrated every part of their lives.
"Many participants in the report had contemplated or attempted suicide," the New Zealand report said.
Ms Watson said her group "supports our NZ sisters".
"All over the world women and men (experiencing complications after hernia mesh surgery) are suffering, and yet governments still deny and dismiss the global medical crisis that is mesh," Ms Watson said.
The New Zealand report heard from clinicians working with mesh-injured patients who expressed "distress at the lack of acknowledgement and ownership of the problem by some of their colleagues".
"They believed responsibility rested with the original surgeon. Two respondents suggested that accepting responsibility for treatment injury should be mandated in professional standards," the report noted.
"Several health professionals described how they had tried to raise concerns about a colleague's competence or ability to perform mesh surgery and were severely bullied. That has perpetuated a culture of denial which has resulted in the failing of basic patient care and safety standards."
The report noted that "the loss of trust that has occurred in the New Zealand healthcare system is significant".
The "ripple effect" of the trauma on people's lives after mesh surgery was "particularly evident in one woman's account of her son's suicide, which she attributed to the impact of mesh on her whole family".
Two people spoke of a woman's death after mesh surgery, and their struggle to gain acknowledgment from authorities that the death was mesh-related, while caring for the young children left behind.
"I can't move on. My daughter isn't coming back. I want to see mesh banned. I don't want to read that someone else has lost their daughter, their mother. I am forever going to look at my grandsons with no mum. Until it is banned you will feel us jumping up and down, because she is not here to do that for herself," the woman's mother told the report's authors.
The reported noted the view of one mesh-injured patient that "the indifference was perhaps the hardest thing to take".
"It is systemic, built into many different layers. Our system is focused on the needs of the services rather than the needs of the people using them," the patient said.
Ms Watson said while the comment was made by a New Zealand patient about the New Zealand health system, it mirrored the experience of thousands of women in Australia and other countries where mesh products were approved for use without evidence they were safe.