Mr Arunkalaivanan (‘Arun’) Claims

How much compensation you receive for an injury caused by a defective medical product will depend on various factors related to your injury, its circumstances, and the support and rehabilitation you need. The amount of compensation you could claim will depend on many factors, including:

• Current and future loss of earnings from being unable to return to work
• Medical and travel expenses you've had to pay
• Your care and support needs – both now and in the future
• Whether you need modifications to your home
• Whether you need mobility aids or specialist equipment
• Your pain and suffering, and the nature of any ongoing problems you have.

Many of our cases are funded with a No Win No Fee agreement. This means that there’s no financial risk to you when making a compensation claim.

At the start of your case, we’ll discuss funding options with you, advising you which we think is the most suitable. If you have legal expenses insurance (LEI) or are covered by a trade union policy, these may be best for you. Legal expenses insurance is included in many household insurance policies, so it’s always worth checking whether you’re already covered.

If we think you’re best supported by a no win no fee agreement, we’ll explain the process clearly. This involves setting up an insurance policy that will protect you, at no cost to you. You’ll only have to pay anything when your claim is successful – your opponent will pay most of our fees.

Should you be advised to make a group claim, this may mean you’ll be able to pool together with other people impacted by Mr Arun, reducing your legal fees.

If the claim goes to court as part of a group claim, it also means you might not have to discuss what happened to you. The court will only select a couple of individual claims to listen to, rather than listening to every individual claim.

Trans-vaginal meshes (TVMs) are products historically used by specialist uro-gynaecological surgeons when treating a condition known as pelvic organ prolapse in women. Potential symptoms that TVMs can cause include:

• Pain and discomfort
• Bleeding
• Erosion of tissue
• Perforation into surrounding organs
• Difficulty having sexual intercourse
• Recurrent prolapse
• Incontinence.

It has been found that the removal of the mesh to try and improve symptoms has also proved to be difficult, since the mesh was designed to stay in the body indefinitely. Patients often need several revision surgeries to attempt to remove the mesh. In many circumstances, complete removal is not possible.

The use of mesh is controversial to many in the medical community because there is so little information about the long-term use and risks of the mesh product.

NICE, the regulator for health technology used in England and Wales, has stated that "insufficient information" is available about the effectiveness and safety of trans-vaginal mesh use in prolapse surgery in women, and has called for a review. Scottish health ministers have called for TVMs to be banned or their use suspended.

In Europe, the Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) has recommended that, due to the risks posed, trans-vaginal mesh surgery should only be used when other surgical options have either failed or are expected to do so.

The Food and Drug Authority (FDA) in the USA issued a public health notification to medical professionals in 2008 warning of serious TVM complications such as erosion, pain, discomfort, recurrent prolapse problems and incontinence, amongst others. In 2011 the FDA issued an update advising that these complications are “not rare”. They have re-categorised TVMs from Class II to Class III, which indicates they pose a higher risk to patients.

Some studies have found that trans-vaginal mesh is associated with a high rate of complications, with a risk of over 30% of patients becoming permanently disabled or experiencing long term symptoms, even with complete mesh removal. Similarly, The Royal College of Obstetricians and Gynaecologists (RCOG) advised in 2013 that the risks and benefits of mesh are unclear and it is currently recommending that operations using mesh are only performed as part of an audit.

In light of this mounting concern, many NHS Trusts have taken the decision not to offer trans-vaginal mesh as a first surgical repair treatment when pelvic organ prolapse has occurred. This was the concern and the decision taken by Sandwell & West Birmingham Hospital NHS Trust.