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According to her contract, which is part of the court record, Buzzell owes 39 percent annual interest, payable if her lawsuit settles. As of August, the total will be $46,500.

Based on AMS’s $1.9 billion fund and the number of eligible claims, the average amount available per plaintiff is approximately $39,000, although actual payments are confidential and vary based on individual facts.

“I’m screwed on it as far as paying it back, I know that,” Buzzell testified. “But for me to get rid of my pain that I wanted to get rid of, it was worth the trip down and back to get it done.”

Buzzell declined to comment for this story.

LawCash general counsel Lew Fidler said his company advanced money only to patients who “were desperate for surgery, needed surgery and complained about their circumstances.”

According to court filings, Buzzell’s surgery was arranged by another company that acted as a matchmaker between patients and doctors and received a commission from LawCash. Buzzell’s surgeon in Georgia, Michael Hulse, worked frequently with that intermediary, Surgical Assistance. Hulse received about $10,000 for Buzzell’s procedure.

Hulse did not respond to requests for comment. Blake Barber, who runs Surgical Assistance, said he encouraged women who contacted him for mesh removal surgery to first seek care from local physicians and use their health insurance.

AMS contends the heart of the “illicit enterprise” was a Florida-based marketing company that found potential mesh plaintiffs and supplied client leads to Surgical Assistance. The company, Law Firm Headquarters, bills itself as a “legal marketing and support organization.” As Reuters has reported, AMS subpoenaed Law Firm Headquarters, and several related law firms in March.

An attorney for Law Firm Headquarters, Abbe Lowell, said the company was trying to help women harmed by AMS’s products.

“(AMS’s) tactics will only delay resolution of these cases, to the further detriment of those who have been injured,” Lowell said.