Faulty Hip Replacements

Faulty Hip Replacements in the UK

There has been a lot of media attention over the past few years in relation to metal-on-metal faulty hip replacements in the UK, and the damage that can be caused by metallic particles being released into the blood stream which are subsequently responsible for hip replacement injuries – not just in the immediate hip area, but elsewhere in the body.

Not all metal-on-metal hip replacement systems are regarded as faulty hip replacements, and not all hip replacement recalls imply that the hip replacement is faulty. This article intends to provide further information about what is a faulty hip replacement, how to identify a faulty hip replacement, who is responsible for faulty hip replacements in the UK and how your may be able to claim compensation for faulty hip replacements.

Please note that this article is intended for information purposes only. If you experience any of the symptoms published below, you should consult with your doctor as a matter of urgency. Thereafter, if you feel that you have a claim for faulty hip replacements in the UK, you should seek individual legal advice from an experienced personal injury solicitor.

What is a Faulty Hip Replacement?

Hip replacements have given a new lease of life to those who, for various reasons, have suffered an injury or illness which has affected their hip mobility. Despite being a painful and invasive procedure, hip replacement surgery can improve a recipient´s quality of life at any age and is more cost effective than having to provide long term care for disabled people. It is estimated that approximately 7,000 people in the UK have a hip replacement each year.

A faulty hip replacement is any hip replacement system which “fails” within an unreasonable period of time or which has to be replaced due to not performing correctly. Twenty-first century hip replacements should have a minimum life expectancy of fifteen years, and any hip replacements which fail to last that long due to a design defect or manufacturing flaw are regarded as faulty hip replacements. The industry accepted failure rate for hip replacements systems is ≤ 5 per cent.

One of the reasons for the media´s attention being directed at faulty hip replacements is that, in August 2010, DePuy Orthopaedics Inc. – an American subsidiary of Johnson & Johnson – recalled two makes of faulty hip replacements when their failure rates were recorded as 12 per cent and 13 per cent respectively. However, the faulty DePuy hip replacements were just the latest in a string of medical device recalls which stretch back over a decade and includes faulty hip replacements manufactured by:-

  • Biomet Implants (2001 – St. Gobain Desmarquest, 2008 – Modular Microplasty Cup Inserter)
  • Wright Medical (2004 – Conserve® Plus and Conserve® Total Models)
  • Smith & Nephew (2007 – Birmingham Hip Resurfacing System)
  • Stryker Corp. (2008 – Trident Hip Implant System)
  • Zimmer (2008 – Durom Cup Hip Replacement)
  • DePuy Orthopaedics (2010 – ASR Articular Surface System and ASR XL Acetabular System)

The American Food and Drug Administration (FDA) also have a number of warnings issued concerning other faulty hip replacements, although not all of these hip replacement systems will have entered the UK market due to different criteria for allowing medical devices to be used in the UK.

How to Identify a Faulty Hip Replacement

Unfortunately, there is no way of identifying faulty hip replacements until such time as symptoms manifest which indicate a device failure. Symptoms can develop in many different ways depending on a recipient´s age, weight, gender, general state of health and level of activity. The most frequent early symptoms of faulty hip replacements are popping, clicking or grinding noises coming from the implant itself. This can indicate the loosening of the implant and will eventually lead to the dislocation of the hip replacement.

However, the sounds of faulty hip replacements are not always audible – allowing more potentially serious injuries to develop as the metal ball of the implant rubs against its retaining cup. The friction created by this movement releases miniscule particles of cobalt and chromium into the blood stream. Most frequently the metal ions collect together around the implant – causing an inflammation, pain or rash around the affected area – but they can also be dispersed into other areas of the body, resulting in unexplained leg pains or pains in the groin when lifting a heavy object or rising from a seated position.

One of the most alarming possibilities of metal debris floating around the blood stream is that they could congregate anywhere in the body. Indeed, the Health Service Executive in Ireland ordered brain scans on many patients implanted with faulty hip implants after the DePuy hip replacement recall of August 2010 to determine whether there was the potential for a neurological injury. Particles of cobalt and chromium – both identified as “probably” carcinogenic by the World Health Organisation – could effectively collect anywhere and be responsible for the development of cancer or leukaemia.

What are the Consequences of Faulty Hip Replacements?

The consequences of being implanted with a faulty hip replacement are that when the implant starts to show signs of failing, it will have to be replaced with a new implant. One of the biggest concerns for orthopaedic surgeons of faulty hip replacements is that, if the metal debris has got into the bones and tissues surrounding the hip, revision surgery becomes more complicated due to bone decay and tissue necrosis.

Subsequently, revision surgery on faulty hip replacements can mean a longer time on the operating table, a higher risk of infection or anaesthesia problems, and a far longer recovery period for the patient. Rehabilitation after revision surgery for faulty hip replacements has been known to take two years – a lengthy period of time throughout which the patient will continue to experience some pain. Patients undergoing revision surgery will also be unable to fully participate in day-to-day activities and leisure pursuits that they were able to enjoy before the failure of the faulty hip replacement and, if still of working age, may experience an extended period without an income.

All of these consequences have to be considered by a solicitor when compiling a claim for faulty hip replacements compensation. Any compensation claim for faulty hip replacements has to consider the emotion strain that the consequences of a faulty hip replacement place on a patient, and also the secondary victims of patients with faulty hip replacements – the partners, children and parents who may have to rely on the mobility of the patient to care for their own needs. For these reasons alone, no two compensation claims for faulty hip replacements are identical and, when you claim compensation for faulty hip replacements, you need to tell your solicitor about all the consequences of revision hip surgery to ensure that you receive a fair and adequate compensation settlement.

Are Just Faulty DePuy Hip Replacements to Blame?

Although the focus of the media has been on the faulty DePuy hip replacements and those specifically mentioned in the DePuy hip replacement recall of August 2010, only 10,000 DePuy ASR hip replacement systems were thought to have been implanted in UK patients from 2003 until the time of the recall. The current advice to have annual checks for system toxicity provided by the UK medical regulator – the Medicines and Healthcare products Regulatory Agency (MHRA) – has been aimed at 49,000 hip replacement patients in the UK who have received “large head” (≥36mm) metal on metal hip replacement systems.

Indeed, one of the hip replacement systems not featured in the DePuy hip replacement recall – although manufactured by the same company – was the focus of a special investigation by the BBC´s Newsnight and the British Medical Journal (BMJ). In their subsequent report, the BBC made faulty hip placement claims against the DePuy Pinnacle hip replacement system which is still widely used in the UK, and subject to a class action suit for faulty hip replacement compensation in the United States.

The BBC/BMJ investigation also found cause to point the finger of responsibility at the Medicines and Healthcare products Regulatory Agency (MHRA) for failing to act on information provided in 2006 by the Department of Health’s Committee on Mutagenicity, which reported that “some metal on metal (those using cobalt-chromium) hip replacements may be associated with increased DNA-changes, and increased genotoxicity in patients. [Metal on metal faulty hip replacements] may present a potential risk of carcinogenicity in humans”.

So, Who is Responsible for Faulty Hip Replacements in the UK?

There are two parties potentially responsible for faulty hip replacements in the UK – the faulty hip replacement manufacturers and the MHRA. In America, class action suits are currently in progress against DePuy (for both the Pinnacle and the ASR hip replacement systems), Wright Medical and Zimmer. Smith and Nephew were recently fined 22.2 million dollars in February 2012 for allegedly bribing doctors to promote their faulty hip replacements, while DePuy have already paid fines in excess of 70 million dollars for their own “marketing misdemeanours”.

In addition to its failure to act on information provided to it in 2006, the MHRA was also accused in the BBC/BMJ report of:-

  • ignoring evidence from the Food and Drug Administration that high levels of chromium were found in umbilical cords and the placental blood of women that had given birth after being implanted with faulty hip replacements,
  • accepting the recommendations of a benefit/risk assessment panel established in 2008 which included paid consultants and a director of product development from the faulty hip replacement manufacturing companies,
  • and for allowing the metal on metal faulty hip replacements to be introduced into the UK without any previous clinical testing.

Solicitors acknowledge that there is a better chance of their clients receiving a suitable settlement of faulty hip replacements compensation from companies such as DePuy Orthopaedics Inc (who had worldwide sales of 5.4 billion dollars in 2010 and who have already set aside 3 billion dollars to account for litigation costs) than a cash-strapped and under-resourced National Health Service who in 2011/2012 had to request an extra 185 million pounds from the Health Secretary to pay outstanding NHS medical negligence claims.

How to Claim Compensation for Faulty Hip Replacements in the UK

Once you have been diagnosed with an injury attributable to faulty hip replacements, speak with a personal injury solicitor at the earliest possible opportunity. You should provide the solicitor with details of your prognosis, what course of action has been recommended by your doctor and the make and model of your faulty hip replacement – with the identity number of your hip component if possible. In most claims for faulty hip replacements compensation it will be necessary that you have already undergone revision surgery or that revision surgery has been scheduled by your surgeon for a future date.

Compensation claims for faulty hip replacements in the UK are brought against the manufacturer of the medical device under the Consumer Protection Act 1987. In your claim for faulty hip replacements compensation it would have to be established that:-

  • the hip replacement you originally received was faulty
  • you sustained an injury due to the faulty hip replacement rather than any other cause (such as an incorrect surgical technique or an external infection), and
  • that the fault was present at the time the product was introduced to the market

Time limits exist on how long your solicitor has in which to file a claim for faulty hip replacements compensation. In most product liability cases the time limit is three years from the date on which it was established that you had suffered an injury; however claims must be brought within ten years from the date that the specific product was introduced to the market. Therefore, for patients who received a faulty DePuy hip replacement, claims for compensation will have to be raised before the end of 2013.

Further Information about Faulty Hip Replacements

For many people, this article will raise as many questions as it answers. How much compensation for faulty hip replacements will I receive, how much will it cost to pursue a claim for faulty hip replacements compensation and, how long will it take for my faulty hip replacements compensation claim to be resolved are questions which can only been resolved once you have spoken about your individual circumstances to a personal injury solicitor.

If you are unsure as to whether symptoms you are experiencing are attributable to faulty hip replacements, you should always speak with a doctor in the first instance. Inasmuch as you would not rely on a doctor to provide legal advice, you should have any medical questions answered by a doctor before discussing your claim for faulty hip replacements compensation with a solicitor. As mentioned at the very beginning of this article, the information provided above is for information purposes only and no substitute for seeking professional medical and legal advice.

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