Tag Archives: medical devices

Evidence-based reporting leads to award-winning exploration of robotic surgery

Tara Haelle

About Tara Haelle

Tara Haelle (@TaraHaelle) is AHCJ's medical studies core topic leader, guiding journalists through the jargon-filled shorthand of science and research and enabling them to translate the evidence into accurate information.

Laura Beil

Robotic surgery has exploded in popularity in recent years, but is that because it actually improves patient outcomes over traditional surgery methods or because of marketing campaigns? That is one of the questions Laura Beil dove into in her award-winning story for Men’s Health, “What’s Wrong With Robotic Surgery?

In a story that involved months of reporting, Beil “used FDA and legal documents to explore concerns over the safety” of a prostate robotic surgery procedure and wove together her findings “into one concise narrative that engaged and informed Men’s Health readers.”

The reporting required FOI requests for adverse events from surgery (along with documents related to recent inspections and findings), legal documents from malpractice lawsuits and a class action suit against the manufacturer, and dozens of scientific studies to determine whether robotic surgery represented an advance in treatment.

Beil also describes the pushback after publication, adding that posting corporate responses online is a powerful way to expose unjustified pushback. Read about how she did her reporting.

Controversy over breast implants spreads across Europe

John Lister

About John Lister

John Lister, European web coordinator for AHCJ, has been a journalist for 35 years, specializing in reporting health policy in England. He is the author of "Health Policy Reform: Driving the Wrong Way?," a critique of market-style reforms, and "The NHS After 60: for Patients or Profits?," a critical history of the British National Health Service.

British clinics delivering cosmetic surgery were thrown into crisis by the decision last month of the French government to fund the removal of thousands of breast implants manufactured by the now-closed French company Poly Implant Prostheses (PIP). The implants were found to have used industrial grade silicone made for use in mattresses. Continue reading

New Wisc. rules lead to interesting disclosures

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Thanks to new disclosure requirements from the University of Wisconsin’s doctor group, the Wisconsin State Journal‘s David Wahlberg was able to report that 10 UW-Madison doctors received $48,000 or more from drug and device companies.

Thomas Zdeblick, M.D., pulled in almost $1.7 million. In fact, most of them were orthopedic surgeons, a fact which shouldn’t surprise anyone who’s been following the State Journal‘s conflict-of-interest work, as well as that of the Journal Sentinel‘s John Fauber.

Before 2010, doctors only had to report that they’d received more than $20,000 from such industry associations. Now, they have to disclose specific amounts. The disclosure requirements are currently the most prominent component of the schools’ crackdown of conflicts of interest, but activists say conflict disclosure is only half the battle.

A policy adopted in 2009 by the UW Medical Foundation, the university’s doctor group, bans doctors from doing promotional speeches for companies and accepting gifts such as free meals. Surgeons, however, can use materials created by device companies to conduct government-required training sessions, Golden said.
The foundation’s policy prohibits doctors from receiving royalties for using products at UW Health, which removes any incentive to use the doctors’ products instead of others, Golden said.

An interesting side note: UW clinics post signs detailing how patients can obtain their doctor’s disclosure form, but such requests have been few and far between, Wahlberg found “14 in 2009, 18 in 2010 and seven” in 2011.

Fauber finds ‘failed back surgery syndrome’ after off-label use of Medtronic’s Infuse

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

John Fauber follows up his previous investigations into the myriad problems and conflicts of interest surrounding Medtronic’s Infuse product with a story on the emerging national epidemic of what pain specialists are calling “failed back surgery syndrome.” One local pain specialist Fauber contacted said that a full 10 percent to 15 percent of his patients suffered from the condition.

To bring the whole thing full circle, Fauber spends much of the body of this latest installment explaining how conflicts of interest and other questionable ethical situations, including off-label use, propelled the early and sustained success of Medtronic’s spine-fusion blockbuster and set the stage for the emerging pain epidemic.

Fauber’s Medtronic coverage is a joint project between the Milwaukee Journal Sentinel and MedPage Today.

NYT reporters tease hip replacement numbers from difficult data

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism, and he has blogged for Covering Health ever since.

Writing for The New York Times, Barry Meier and Janet Roberts analyzed a particularly tricky batch of federal reports detailing a variety of complaints with popular metal-on-metal hip replacements. They found that, since January, the FDA has received more complaints (5,000-plus) about the devices than it did, total, from 2007 to 2010.

kidsPhoto by Michael Simmons via Flickr

While processing the data, the paper’s staff did their best to parse duplicate reports, international filings and other inconsistencies, but the reporters make it clear that the numbers are still best viewed in general terms. Even so, they demonstrate that the surge in complaints and lawsuits involving metal-on-metal hips — and the resulting mass defection of doctors who once implanted them — signals a broad shift in hip replacement surgery, one of the most common such procedures in the country. It also signals another blow for device manufacturers and patients, and a related windfall for the legal profession.

The vast majority of filings appear to reflect patients who have had an all-metal hip removed, or will soon undergo such a procedure because a device failed after only a few years; typically, replacement hips last 15 years or more.

The mounting complaints confirm what many experts have feared — that all-metal replacement hips are on a trajectory to become the biggest and most costly medical implant problem since Medtronic recalled a widely used heart device component in 2007. About 7,700 complaints have been filed in connection with that recall.

As problems and questions grow, most surgeons are abandoning the all-metal hips, saying they are unwilling to expose new patients to potential dangers when safer alternatives — mainly replacements that combine metal and plastic components — are available. Some researchers also fear that many all-metal hips suffer from a generic flaw. Current use of all metal devices has plummeted to about 5 percent of the market, though a few of the models are performing relatively well in select patients.