MDL 2441 Stryker Rejuvenate ABG II Modular Hip

MDL 2441 Stryker Rejuvenate & ABG II Modular Hip Implants Update on Settlement Issues Peter J. Flowers Meyers & Flowers (Chicago, IL) Annesley H. De. Garis Law (Birmingham, AL) Genevieve M. Zimmerman Meshbesher & Spence (Minneapolis, MN) Tony J. Nemo Meshbesher & Spence (Minneapolis, MN)

How to Enroll Claims for the Base Award Genevieve Zimmerman Anthony Nemo gzimmerman@meshbesher. com tnemo@meshbesher. com

Claims Processor Website http: //www. strykermodularhipsettlement. com

Prepare the Claim Form, Release and Stipulation for Dismissal

Gather the Required Documents What documentation must be submitted in support of the Base Award Claim?

What the MSA Says:

Product ID

Voluminous Records

Required Submissions

What HOC and Garden City Group Require:

Upload the Base Award Claim Package There are two acceptable ways to do so: • Prepare and upload a single, annotated, and bookmarked PDF containing all Required Submissions and the Claim Form; or • Prepare and upload separate PDFs of the Claim Form and each Required Submission

Annotate and Highlight Records

Bookmark if Submitting a Single PDF

The “Certification” Document The Certification (which is the Client and Attorney signature page) must only be updated if you are filing multiple claims on the bulk filing spreadsheet (which is similar to the registration process), or if you filed a claim on the online portal. In either of those cases, Garden City Group requites a personal signature (ink) on the Certification.

Unresolved Disputed Issues Involving Enhancements Genevieve Zimmerman Anthony Nemo gzimmerman@meshbesher. com tnemo@meshbesher. com

Two-Stage Infected Total Hip Arthroplasty Revisions One-Stage Revision: Femoral stem is removed and a revision stem is implanted Two-Stage Revision: Femoral stem is removed and interval antibiotic-loaded femoral stem is implanted (Stage 1). Once the infection is resolved, the interval stem is removed and a permanent revision stem is implanted (Stage 2).

Facts Client is found to have a cobalt elevation and undergoes a revision surgery (in the U. S. , more than 180 days after implantation, but before November 3, 2014). At that time, an ABG II femoral stem and neck are explanted. Infection is found, and a Prostalac femoral stem is placed. The Prostalac stem is implanted as the revision stem during the Qualified Revision Surgery because: 1) there is no sinus tract communication with the joint, but the surgeon suspects Infection; or 2) there is a sinus tract. The Revision Surgery is not an Excluded Infection-Related Revision Surgery because of the cobalt elevation.

Non-Dispute: Base Award Eligible Under these facts, there is no dispute that the Client is entitled to a Base Award for a Qualified Revision Surgery under MSA § 1. 2. 55.

Second Revision At some point after the Qualified Revision Surgery (whether three months or three years later) the actual or suspected Infection has resolved, the Client returns to surgery, and the Prostalac femoral stem is explanted and a new femoral stem is implanted.

Does explantation of the temporary stem constitute a Re-Revision? Stryker says: NO LCC says: YES Rationale: The surgery to explant the Prostalac stem and implant a new femoral stem where there is no Infection present surgery is not an Infection. Related Open Surgical Procedure under Past Matrix II. c. It is simply a surgery to remove/replace the previous revision stem made necessary by placement of a temporary stem during the Qualified Revision Surgery. Past Matrix Level I. a. i. 1 defines a surgery “made necessary by the Qualified Revision Surgery” and requiring “removal of the revision femoral stem component” as a “Re. Revision Surgery”.

Reattachment/Repair of a Damaged “Abductor Muscle Complex”

Foot Drop: “use of crutches, a cane or walker”

Broadspire Genevieve Zimmerman Anthony Nemo gzimmerman@meshbesher. com tnemo@meshbesher. com

Deductions from Base and Enhancement Awards • A Claimant who receives any reimbursement from Broadspire for lost wages will receive a dollar-for-dollar offset against any Enhancements issued to the Claimant for lost wages pursuant to the Enhancements Benefit Program (6. 1. 2. 1) • A Claimant who files a Broadspire Claim between November 3, 2014 and her Enrollment Date will have the claim paid by Broadspire, but the Claimant’s Base Award will be off-set by the amount paid. (6. 1. 2. 2)

Deductions from Base and Enhancement Awards • Any Broadspire Claim that was in process before November 3, 2014 will be paid and will not be subject to a credit against the Base Award received (except for lost wage payments) (6. 1. 2. 2) • Broadspire claims paid directly to a surgeon performing a Qualified Revision Surgery or the hospital where the Qualified Revision Surgery took place will not off-set the Base Award (6. 1. 2. 2)