Physiomesh Lawsuit

There are currently 2,597 Physiomesh lawsuits filed in Federal court nationwide. In March of 2017, consolidation for a Physiomesh Multi District Litigation (MDL) was requested. The Judicial Panel on Multidistrict Litigation (JPML) heard consolidation arguments on May 25, 2017. On June 2, 2017, MDL 2782 was created and all Physiomesh cases filed in Federal court were consolidated into the Northern District of Georgia under the Honorable Richard W. Story.

There are also over 20 Physiomesh cases filed in NJ State court, which is the home of both defendants Ethicon and Johnson & Johnson. In February of 2018, consolidation for an Ethicon multi-layered hernia mesh multicounty litigation (MCL) was request. On July 17, 2018, the New Jersey Supreme Court created a MCL for all pending and to be filed lawsuits in New Jersey state court alleging injuries arising from the use of Physiomesh. The New Jersey Physiomesh MCL was assigned to Atlantic County under Judge John C. Porto for centralized management. Attorney C. Brett Vaughn of the Hollis Law Firm continues to play an active role in the New Jersey Physiomesh MCL. Lawyers at the Hollis Law Firm have filed Physiomesh cases in both the MDL and MCL, depending on the specific facts of each plaintiff’s Physiomesh lawsuit.

The Physiomesh lawsuit is against Ethicon, a subsidiary of Johnson & Johnson. The Physiomesh is made from polypropylene and is intended for hernia repair. Ethicon has been battling lawsuits for years against its transvaginal mesh products, which are also made from polypropylene. Ethicon continues to deny the life-threatening complications that polypropylene causes. However, Ethicon issued a market withdrawal on the Physiomesh in May of 2016.

The US FDA has NOT Recalled the Physiomesh

Contrary to popular belief, the US FDA has not recalled the Physiomesh. Below is an excerpt that the Hollis Law Firm received in September of 2016 from Ethicon’s legal counsel, Butler Snow. A full version of the letter from Butler Snow can be viewed here.

Apparently Ethicon didn’t recall the Physiomesh in the United states, because the FDA didn’t require them to. Instead, the FDA allowed Ethicon to perform a market withdrawal. Ethicon “voluntarily withdrew” the Physiomesh after independent studies revealed high rates of complications associated with the Physiomesh. The previous high rates of patient and surgeon complaints were never enough to sway Ethicon or its parent company Johnson & Johnson into removing the Physiomesh from the market. Ethicon and Johnson & Johnson did not want to recall the Physiomesh and lose all of the profits that the Physiomesh was generating. Prior to removing the Physiomesh from the market, Ethicon created the Physiomesh Open in an attempt to fix the defects of the original Physiomesh. Ethicon submitted a 510(k) application for the Physiomesh open on June 12, 2014, and received clearance on October 23, 2014. Ethicon gave the Physiomesh Open about half a year to gain market traction before they finally decided to “voluntarily withdrawal” the regular Physiomesh from the market.

What is the Difference Between a Recall and a Market Withdrawal?

A recall is to be issued by the company on its own initiative, by FDA request, or by FDA order under statutory authority when the product may cause adverse health consequences. A market withdrawal is appropriate only when there is no evidence of manufacturing or distribution problems. Additionally, safety alerts are sent to hospitals, physicians, and patients to notify them of the potentially dangerous side-effects of a product when it is recalled, but not when a product is simply “withdrawn from the market.”

The FDA has three different classification for recalled medical devices. The FDA’s recall definition page can be viewed here and the excerpts are below. Read the definitions below, then the adverse events later in this article, and determine if the FDA was justified in allowing Johnson & Johnson and its subsidiary Ethicon to conduct a market withdrawal instead of a recall.

Was a Medical Device Safety Alert Issued in the United States for the Physiomesh?

No, a medical device safety alert was never issued in the United States for the Physiomesh. The FDA notes that a medical device safety alert should be issued if a device may present an unreasonable risk of substantial harm.

Ethicon, Johnson & Johnson, and the FDA didn’t think that the American public deserved to be made aware of the substantial risk of injury associated with the Physiomesh. However, an urgent field safety notice was issued in Switzerland on May 25, 2016, noting that reoperation and recurrence rates after laparoscopic ventral hernia repair using the Ethicon Physiomesh Composite Mesh were higher than the average rates. Ethicon even believed that the higher rates of reoperation and recurrence could be do the the characteristics of the Physiomesh. Unfortunately, Ethicon admitted to physicians that they were unable to instruct how to reduce the failure rate of the Physiomesh. A full version of the Switzerland urgent field safety notice can be viewed here.

After Ethicon withdrew the Physiomesh, the Getinge Group (parent company of Atrium Medical Corporation) sent a letter trying to convince doctors to start using Atrium’s C-Qur Hernia Mesh. Atrium has already faced several lawsuits from the FDA and consumers regarding the C-Qur hernia mesh. Having the Physiomesh off the market is great, but replacing it with another defective hernia mesh does no good.

FDA Clearance of Ethicon’s Physiomesh

The FDA originally cleared Ethicon’s Physiomesh on April 9, 2010. Ethicon used the FDA 510(k) clearance program for the Physiomesh. The 510(k) clearance program allowed Ethicon to skip rigorous pre-market research and studies, which are required for PreMarket Approval (PMA). Ethicon claimed that the Physiomesh was substantially similar to the Proceed hernia patch, which Ethicon also manufactures. Ethicon submitted a modified version of the Physiomesh (Physiomesh Open) for FDA 510(k) clearance on June 12, 2014. The FDA approved a second model of the Physiomesh on October 23, 2014. However, the FDA noted that 510(k) clearance did not mean that the Physiomesh complied with any Federal statutes, regulations, acts, the FDA or other regulatory agencies.

Physiomesh Components

Ethicon utilizes a light-weight polypropylene (plastic) to manufacture the base layer (middle) of the Physiomesh. Polypropylene is the same material that Ethicon makes their trans-vaginal mesh and bladder slings from. Ethicon has faced thousands of lawsuits over its trans-vaginal mesh and bladder slings made from polypropylene. Ethicon added an absorbable film coating to each side of a polypropylene sheet to create the Physiomesh. The coating on each side of the Physiomesh is made of polyglecaprone, which is intended to be absorbed by the body after implantation. The polyglecaprone coatings alone are not able to adhere to the polypropylene. A polydioxanone film is utilized on each side of the polypropylene to bond the polyglecaprone coatings to the polypropylene mesh. In total, there are 5 layers to the Physiomesh. Every layer except the polypropylene in the middle of the Physiomesh is intended to be absorbed by the body after implantation.

Physiomesh: A Defective Design

The Physiomesh is one the most defect hernia meshes that the Hollis Law Firm has investigated to date. Ethicon has been aware that the Physiomesh was defectively designed and dangerous to implant in patients since its creation. There are numerous defects that physicians have been reporting to Ethicon (Johnson & Johnson) and the FDA since the product was released! Below are several design defects of the Physiomesh, backed up by Physician FDA adverse event reports.

The Physiomesh is Too Weak, Resulting in Mesh Rupture

The Physiomesh utilizes a lighter weight polypropylene than Ethicon previously used it its hernia mesh products. A “light-weight” polypropylene mesh simply means that less polypropylene is utilized to make the mesh. Manufacturers started using less polypropylene in hopes that there would be less complications associated with hernia mesh. The “light-weight” polypropylene is also significantly weaker than the old “heavy-weight” polypropylene. As a result, many patients have experienced the Physiomesh tear apart inside of them. Physicians frequently report patients experiencing their bowels blowing through the middle of the Physiomesh! Somehow, the United States Food and Drug Administration still has NOT recalled the Physiomesh!

Is the FDA Aware that the Physiomesh is Too Weak?

Dual-Sided Coating Prevents Adequate Incorporation

Unlike all other coated hernia meshes, the Physiomesh has a thick coating on both sides of the polypropylene. If the Physiomesh is not coated on both sides, the coating easily slides off of the polypropylene. Utilizing a dual-sided coating enabled each coating to stick to the other coating and not just the polypropylene. The coating is intended to prevent the bowel from being exposed to the underlying polypropylene. Polypropylene will essentially stick or adhere to any tissue or organs in the human body. If the polypropylene sticks to the bowel, it can cause severe injuries such as a bowel obstruction. However, if a mesh is coated on both sides, the mesh will not properly incorporate into the abdominal wall. The inability of the Physiomesh to properly incorporate results in the mesh free floating and moving around in the patient’s abdominal cavity. Hernia recurrence, severe pain, and even bowel complications are common in patients in which the Physiomesh fails to incorporate.

Is the FDA Aware that the Dual-Sided Coating Prevents Incorporation?

Coating Does Not Protect the Bowel from Adhesion Formation

Our hernia mesh lawyers learned something very significant from the Physiomesh; it takes less inflammation/irritation for adhesions to form between the mesh and the bowel than it does for the mesh to incorporate into the abdominal wall. Adhesions and incorporation are describing the same process, the development of internal scar tissue, occurring on opposite sides of the mesh. The bowel is much more sensitive than the abdominal wall, and as a result, scar tissue forms easier between the mesh and bowel than the mesh and abdominal wall. This was something that initially surprised both our hernia mesh attorneys and our medical experts. It intuitively makes sense that the bowel would be more sensitive to scar tissue formation, but somehow it’s something that’s not been previously studied. Regardless, the physician adverse event reports to the FDA supply all the necessary evidence.

Is the FDA Aware that the Physiomesh’s Coating is Ineffective?

Apr 2017: Physiomesh FDA Adverse Event Report MDR# 6465145 “Six weeks later the patient was sent to pain management due to continuing serious pain. In 2014 the patient was rushed to er due to incarcerated loop of small bowel within ventral hernia and the mesh… Patient has been on disability since 2012 and had to go to pain management for seven years.”

Physiomesh FDA Adverse Event Report MDR# 6465145 “Six weeks later the patient was sent to pain management due to continuing serious pain. In 2014 the patient was rushed to er due to since 2012 and had to go to pain management for seven years.” Jan 2017: Physiomesh FDA Adverse Event Report MDR# 6264418 “Within a week or two after the procedure, the patient was seeing a doctor for abdominal pain. In 2016, the patient developed severe abdominal pain after eating and ct scan of abdomen showed a partial small bowel obstruction. The patient was admitted for observation and treatment with hydrated iv antibiotics. Five days later the patient required exploratory laparotomy. Surgical findings were acute and chronic inflammation, multiple adhesions, hemorrhage and ischemia in the small bowel. During the open bowel resection, ninety centimeters of small bowel was removed. The patient was on pca dilaudid for four days. Weight loss was twenty five pounds…. The patient is still not feeling well with episodes of vomiting.”

Physiomesh FDA Adverse Event Report MDR# 6264418 “Within a week or two after the procedure, the patient was seeing a doctor for abdominal pain. In 2016, the patient developed severe abdominal pain after eating and ct scan of abdomen showed a The patient was admitted for observation and treatment with hydrated iv antibiotics. Five days later the patient required exploratory laparotomy. Surgical findings were acute and chronic inflammation, multiple adhesions, hemorrhage and ischemia in the small bowel. During the The patient was on pca dilaudid for four days. Weight loss was twenty five pounds…. The patient is still not feeling well with episodes of vomiting.” Oct 2016: Physiomesh FDA Adverse Event Report MDR# 6057564 “Hospitalization was prolonged for the patient who possibly developed severe complications requiring operation. During reoperation, loose adhesions of the greater omentum to the upper edge of the mesh and tangential to its surface were found.”

Physiomesh FDA Adverse Event Report MDR# 6057564 “Hospitalization was prolonged for the patient who possibly developed During reoperation, and tangential to its surface were found.” May 2016: Physiomesh FDA Adverse Event Report MDR# 5650261 “Six months after surgery, the patient experienced severe stomach pains… it was noted that the small intestine was stuck to the mesh.”

Prone to Folding Over After Center Stripe Degrades

Medical device manufacturers are also obligated to inform the FDA when studies or literature reveal complications or defects in their products. In November of 2015, Ethicon reported a literature review to the FDA. In the study, a patient experienced bowel complications after being implanted with the Physiomesh and “adhesions were found on the majority of the mesh surface. Recurrence presented in the long [axis] of the mesh in the line of the stripe built into the mesh… It was opined by the study authors that recurrence occurred at the time point the stripe underwent degradation. It was also opined by the study authors that stiffness of the mesh in the long [axis] could be an independent factor causing recurrence.”

Packaging Prone to Micro Perforations and Tears

The Physiomesh utilizes a foil package to keep the hernia mesh sterile. The foil packaging of the Physiomesh is prone to excessive wrinkling, which weakens the sterile packaging and allows micro perforations to form. The small holes that form in the sterile packaging of the Physiomesh are extremely hard to detect and greatly increase the risk that a surgeon implants a contaminated medical device. As a result, high rates of infection have been observed with the Physiomesh. As can be seen in the photos, the holes in the packaging of the Physiomesh are difficult to detect until the packaging is held up to a light source. With the packaging defect being so hard to detect, it’s surprising that so many adverse events have been reported on this specific defect.

Is the FDA Aware that the Packaging of the Physiomesh is Prone to Micro Perforations?

Physiomesh Complications

The Physiomesh has been associated with high rates of bowel obstructions, seromas, fistulas, infections, rashes, pain, hernia recurrence, mesh shrinkage, and mesh failure. The hernia recurrence rate is high with the Physiomesh due to poor incorporation and the mesh tearing easily. Subsequent surgeries are typically required due to complications related to the Physiomesh.

Scientific Articles on Ethicon’s Physiomesh:

June 2017: The Importance of Registries in the Postmarketing Surveillance of Surgical Meshes.

Data from the Herniamed German Registry, one of two large independent hernia registries that found high rates of complications associated with Ethicon’s Physiomesh. The analysis compares the 1-year follow-up data collected for all patients with incisional hernia who had undergone elective laparoscopic intraperitoneal only mesh repair either with Physiomesh (n=1380) or with other hernia meshes (n=3834). Patient’s implanted with the Physiomesh were approximately 250% more likely to suffer a hernia recurrence. The study authors concluded by noting “The importance of real-world data for postmarketing surveillance of surgical meshes has been demonstrated in this registry-based study. Randomized controlled trials are needed for premarket approval of new devices. The role of sponsorship of device studies by the manufacturing company must be taken into account.

August 2016: Tissue Integration and Inflammatory Reaction in Full-Thickness Abdominal Wall Repair Using an Innovative Composite Mesh.

Physiomesh was compared to two other composite hernia mesh products. The Physiomesh resulted in the development of more seromas and less tissue integration than the other studied hernia mesh products.

June 2016: Outcomes of Bridging Versus Mesh Augmentation in Laparoscopic Repair of Small and Medium Midline Ventral Hernias.

A study comparing various techniques utilized to close a hernia defect with Physiomesh. Many patients experienced hernia recurrence regardless of the technique utilized.

March 2016: Comparison of Two Different Concepts of Mesh and Fixation Technique in Laparoscopic Ventral Hernia Repair: A Randomized Controlled Trial.

25 patients were implanted with Physiomesh. Within 6 months of hernia mesh implantation, 20% of those implanted with Physiomesh had experienced a hernia recurrence in the first 6 months and then the study was terminated. The authors of the study concluded that “Although this clinical trial was terminated prior to the preplanned recruitment goal, the obtained results from the enrolled patients indicate that the [Physiomesh] system associated with significantly greater hernia recurrences and postoperative pain…”

August 2015: Long-Term Evaluation of Adhesion Formation and Foreign Body Response to Three New Meshes.

Physiomesh was compared to two other new hernia mesh products. Physiomesh demonstrated significantly lower incorporation strengths than the other hernia mesh products. Fractioning of the the Physiomesh coating was also observed over time, which lead to scar plate formation, but little to no abdominal wall adherence.

October 2014: Biaxial Analysis of Synthetic Scaffolds for Hernia Repair Demonstrates Variability in Mechanical Anisotropy, Non-Linearity and Hysteresis.

The mechanical properties 13 hernia mesh products were evaluated, including Physiomesh. Significant differences were observed depending on which mesh was implanted and how it was secured. The authors noted that hernia mesh materials are currently utilized as if they are uniform and interchangeable, when that is simply not the case. Additional instructions and training from Ethicon could have resulted more successful hernia repairs.

October 2013: Ventralight ST and SorbaFix Versus Physiomesh and Securestrap in a Porcine Model.

5 animals were implanted with Physiomesh and 5 animals were implanted with Ventralight. Animals implanted with Physiomesh exhibited significantly more inflammation, fibrosis, and hemorrhage.

Sept 2012: Biomechanical and Histological Evaluation of Abdominal Wall Compliance with Intraperitoneal Onlay Mesh Implants in Rabbits: A Comparison of Six Different State-of-the-Art Meshes

The Physiomesh was found to be the least comfortable of the six hernia meshes.

Should the FDA Recall the Physiomesh?

After reviewing all of the above information, what do you think? Was the FDA justified in allowing Johnson & Johnson and Ethicon to conduct a market withdrawal instead of recalling the Physiomesh? Remember, a market withdrawal is only appropriate if there is no evidence of a defect. If you think that the FDA should have recalled the Physiomesh, let us and everyone else know by sharing this page on social media and commenting that the FDA should recall the Physiomesh on our Physiomesh YouTube video. Additionally, call your state representatives and other elected officials, and ask them why the FDA is protecting Johnson & Johnson instead of the public. The FDA must be reformed or the American public will lose even more faith in our medical industry.

Physiomesh Device Tags (Product Stickers)



The hernia mesh device tags are necessary to prove which hernia mesh was utilized during an operation. It is not uncommon for an operative report to use a generic name instead of the brand name when describing a hernia mesh. Many surgeons use the name of a company’s original polypropylene mesh to describe any hernia mesh made by that company. For instance, some surgeons will call all Ethicon hernia meshes “prolene” and all Bard Davol hernia meshes “marlex.” There are so many new hernia meshes constantly coming to the market that many surgeons can’t even remember which one they are implanting.

Device tags are not always easy to locate. Some hospitals do not maintain or include device tags as part of the medical record chart. At times, it is necessary to contact the surgical department directly. Obtaining medical device tags can be a frustrating and time consuming process, luckily the Hollis Law Firm has staff trained and experienced in tracking down medical device tags.

Device tags are also known as “product stickers” and the “Product Traceability Label.” The device tags note that Ethicon is the manufacturer of the Physiomesh. This particular Physiomesh was 15x20cm. The PHY1520V is the catalog number (also known as the reference number), which is used for when ordering a particular Physiomesh. The expiration date for this Physiomesh was October, 2014. This Physiomesh’s LOT number was EM8DDQA0. The LOT number corresponds to a group of Physiomeshes that were manufactured at a particular location at a particular time. LOT numbers are useful in determining if a product defect is an isolated incident or a systemic problem. The Physiomesh’s defects are a systemic problem.

Johnson and Johnson’s subsidiary Ethicon withdrew all LOT numbers of the Physiomesh from the market. The Hollis Law Firm’s Physiomesh lawyers are reviewing injuries associated with all Physiomesh LOT numbers.

Physiomesh: Ethicon Hernia Mesh Lawsuit

Please call us to speak to one of our trained hernia mesh team members. An attorney and a medical professional will look over your Physiomesh case and let you know what they believe the best course of action is for you. The specific facts of your lawsuit will determine if your lawsuit is compensable and to what amount. The Hollis Law Firm represents hernia mesh victims nationwide. All case evaluations and consultations are FREE, CONFIDENTIAL, and carry NO RISK or OBLIGATION. Call 1-800-701-3672 for an Ethicon Physiomesh lawsuit evaluation.

Physiomesh lawsuits are starting to mount across the nation. Many attorneys have finally realized that the Physiomesh is a defective hernia mesh. The hernia mesh lawyers at the Hollis Law Firm understand that the problem is larger than just Physiomesh. Visit our general hernia mesh lawsuit page for more information on other hernia meshes. Follow our Physiomesh Lawyer FaceBook page to stay up-to-date on everything Physiomesh.

Content Created By:

C. Brett Vaughn RN, BSN, JD