scholarly journals Medicolegal basics and update on transvaginal mesh in Canada

2017 ◽  
Vol 11 (6S2) ◽  
pp. 108
Author(s):  
Brock Hengel ◽  
Blayne Welk ◽  
Richard J. Baverstock
Keyword(s):  
Pelvic Organ ◽  
Class Action ◽  
Transvaginal Mesh ◽  
Legal Proceedings ◽  
Legal Advice ◽  
The Us ◽  
Canadian Context ◽  
Health Canada ◽  
Female Pelvic Medicine ◽  
American Urogynecologic Society

In recent years, midurethral slings (MUS) and transvaginal mesh procedures have experienced blazing growth and popularity. However, the US Food and Drug Administration (FDA) and Health Canada regulatory advisories threw water on that fire and created a confusing environment surrounding their continued usage. MUS usage has continued in Canada and transvaginal mesh kits for pelvic organ prolapse have become a rarity. Several large organizations (the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction [SUFU], the American Urogynecologic Society [AUGS], and the Canadian Urological Association [CUA]) have developed “mesh statements” to clarify the issues surrounding mesh for patients and medical professionals; however, often the legal system sees things differently in either individual cases or class action lawsuits. In this update, some medicolegal basics are outlined and Canadian context on legal proceedings are highlighted. This summary does not constitute legal advice and physicians should contact experts in legal matters for help with consents, complaints, litigation, or questions.

scholarly journals Efficacy and patient satisfaction of pelvic organ prolapse reduction using transvaginal mesh: A Canadian perspective

2018 ◽  
Vol 12 (10) ◽  
Author(s):  
Mélanie Aubé ◽  
Marilyne Guérin ◽  
Caroline Rhéaume ◽  
Le Mai Tu
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Class Action ◽  
Transvaginal Mesh ◽  
Mesh Exposure ◽  
Complication Rates ◽  
Medical Chart Review ◽  
Repeat Operation ◽  
Canadian Perspective ◽  
Report Data

Introduction: Due to U.S Food and Drud Administration warnings and class-action lawsuits, the use of transvaginal mesh for pelvic organ prolapse surgery is controversial. We report data from two Canadian centres, focusing on recurrence and reoperation rates, complication rates, and patient satisfaction.Methods: A retrospective medical chart review was performed. Patients were also invited to a long-term followup clinic for a complete questionnaire and gynecological exam. Patients unable to present to clinic for followup had the option to answer the questionnaire via telephone.Results: A total of 334 patients were operated between 2000 and 2013. Median followup was 38 months for questionnaire and 36 months for physical exam. Thirty-seven patients (11.1%) required repeat operation, including 17 for recurrent prolapse and 10 for mesh exposure; 98.8% of patients reported feeling subjectively improved by their prolapse surgery.Conclusions: Midterm results are satisfactory and patient subjective satisfaction is high following transvaginal mesh repair of pelvic organ prolapse.

Legal Privilege and Third Party Disclosure: A Comparative Analysis of UK and the US Rules

2018 ◽  
Vol 16 (1) ◽  
Author(s):  
Zia Akhtar
Keyword(s):  
Research Question ◽  
Third Party ◽  
Weight Of Evidence ◽  
Legal Proceedings ◽  
Legal Advice ◽  
Wide Range ◽  
The Us ◽  
Privileged Communication ◽  
Legal Professional ◽  
The Uk

Abstract The rules of evidence in common law courts rely on the weight of evidence that is deduced by the court based on its admissibility and credibility. This is subject to the evidence that has been disclosed by the client to their lawyer either before or after the litigation is commenced in court. The availability of legal professional privilege is a substantive legal right (not a procedural rule) and it enables a person to refuse to disclose certain documents in a wide range of situations. There can be no adverse inference that can be drawn from a valid assertion of legal professional privilege on evidential grounds by the court. Under English law, privilege applies to the advice given by external lawyers and in-house lawyers (acting in their capacity as lawyers) in the case or in contemplation of litigation. Privilege in the US is broader than in the UK and may vary over time and according to locations/context but a privileged communication under UK law may not be privileged in the US. The Attorney-client confidentiality and work-product doctrine are the most common US types of privilege and this will protect investigation material if its primary purpose is to provide information to obtain a legal advice (i. e. if it is not for a business purpose). The research question in this paper is to what extent internal investigations need to be disclosed where the client confidentiality is not applicable and the court orders disclosure. It compares the framework under which privilege can be exercised, and how in the US a different interpretation allows greater margin for client confidentiality when investigations include another party if documents are compiled in contemplation of legal proceedings.

scholarly journals The efficacy and complications of using transvaginal mesh to treat pelvic organ prolapse in Taiwan: A 10-year review

2021 ◽  
Vol 60 (2) ◽  
pp. 187-192
Author(s):  
Mou-Jong Sun ◽  
Yu-Li Chuang ◽  
Hui-Hsuan Lau ◽  
Tsia-Shu Lo ◽  
Tsung-Hsien Su
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Organ ◽  
Transvaginal Mesh

scholarly journals Carnobacterium inhibens isolated in blood culture of an immunocompromised, metastatic cancer patient: a case report and literature review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carson Ka-Lok Lo ◽  
Prameet M. Sheth
Keyword(s):  
Metastatic Cancer ◽  
Immunocompromised Patients ◽  
Case Presentation ◽  
Gram Positive Bacteria ◽  
Disease Spectrum ◽  
The Us ◽  
History Of ◽  
Amoxicillin Clavulanic Acid ◽  
Live Bacteria ◽  
Health Canada

Abstract Background Carnobacterium species are lactic acid-producing Gram-positive bacteria that have been approved by the US Food and Drug Administration and Health Canada for use as a food bio-preservative. The use of live bacteria as a food additive and its potential risk of infections in immunocompromised patients are not well understood. Case presentation An 81-year-old male with a history of metastatic prostate cancer on androgen deprivation therapy and chronic steroids presented to our hospital with a 2-week history of productive cough, dyspnea, altered mentation, and fever. Extensive computed tomography imaging revealed multifocal pneumonia without other foci of infection. He was diagnosed with pneumonia and empirically treated with ceftriaxone and vancomycin. Blood cultures from admission later returned positive for Carnobacterium inhibens. He achieved clinical recovery with step-down to oral amoxicillin/clavulanic acid for a total 7-day course of antibiotics. Conclusions This is the fourth reported case of bacteremia with Carnobacterium spp. isolated from humans. This case highlights the need to better understand the pathogenicity and disease spectrum of bacteria used in the food industry for bio-preservation, especially in immunocompromised patients.

scholarly journals Changing the rules of the game: some necessary legal reforms to United Kingdom intelligence

2009 ◽  
Vol 35 (4) ◽  
pp. 943-955 ◽  
Author(s):  
IAN LEIGH
Keyword(s):  
National Security ◽  
The Political ◽  
Legal Proceedings ◽  
Legal Reforms ◽  
Political Independence ◽  
The Us ◽  
Protection Of Human Rights ◽  
The Government ◽  
The Uk ◽  
Rules Of The Game

AbstractThis article argues that there is a need to modernise the law governing accountability of the UK security and intelligence agencies following changes in their work in the last decade. Since 9/11 the agencies have come increasingly into the spotlight, especially because of the adoption of controversial counter-terrorism policies by the government (in particular forms of executive detention) and by its international partners, notably the US. The article discusses the options for reform in three specific areas: the use in legal proceedings of evidence obtained by interception of communications; with regard to the increased importance and scle of collaboration with overseas agencies; and to safeguard the political independence of the agencies in the light of their substantially higher public profile. In each it is argued that protection of human rights and the need for public accountability requires a new balance to be struck with the imperatives of national security.

scholarly journals Punishing Survivors and Criminalizing Survivorship: A Feminist Intersectional Approach to Migrant Justice in the Crimmigration System

2020 ◽  
Vol 2020 (14) ◽  
pp. 67-89
Author(s):  
Salina Abji
Keyword(s):  
Women Survivors ◽  
Access To Justice ◽  
Migrant Women ◽  
Gender Based Violence ◽  
Analytical Strategy ◽  
Migrant Populations ◽  
The Us ◽  
Canadian Context ◽  
Gender Based ◽  
And Gender

Scholars have identified crimmigration – or the criminalization of “irregular” migration in law – as a key issue affecting migrant access to justice in contemporary immigrant-receiving societies. Yet the gendered and racialized implications of crimmigration for diverse migrant populations remains underdeveloped in this literature. This study advances a feminist intersectional approach to crimmigration and migrant justice in Canada. I add to recent research showing how punitive immigration controls disproportionately affect racialized men from the global south, constituting what Golash-Boza and Hondagneu-Sotelo have called a “gendered racial removal program” (2013). In my study, I shift analytical attention to consider the effects of the contemporary crimmigration system on migrant women survivors of gender-based violence. While such cases constitute a small sub-group within a larger population of migrants in detention, nevertheless scholarly attention to this group can expose the multiple axes along which state power is enacted – an analytical strategy that foundational scholars like Crenshaw (1991) used to theorize “structural intersectionality” in the US. In focusing on crimmigration in the Canadian context, I draw attention to the growing nexus between migration, security, and gender-based violence that has emerged alongside other processes of crimmigration. I then provide a case analysis of the 2013 death while in custody of Lucía Dominga Vega Jiménez, an “undocumented” migrant woman from Mexico. My analysis illustrates how migrant women’s strategies to survive gender-based violence are re-cast as grounds for their detention and removal, constituting what I argue is a criminalization of survivorship.The research overall demonstrates the centrality of gendered and racialized structural violence in crimmigration processes by challenging more universalist approaches to migrant justice.

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