Three years after Johnson & Johnson recalled its all-metal hip implants worldwide, less than 10% of the 4,500 Indian patients have approached the company for redress.
The Indian response, the Times of India reports, highlights how little most patients know about implant procedures or the health implications. Mahesh Zagade, commissioner of India’s Food and Drug Administration suggested that non-governmental organizations (NGOs) should step in to educate patients. “We also need specialized courts and compensation laws in the country to tackle these emerging issues better,” Mahesh said.
Even before the Johnson & Johnson hip implant was recalled, researchers had noticed an unusually high revision surgery rate. Revision surgery is performed to remove and replace a failed medical device, in this case a failed metal-on-metal hip implant. In the United States, high failure and complication rates with all-metal hips have led to thousands of lawsuits, and Johnson & Johnson’s DePuy Orthopaedics unit recently announced a multi-billion-dollar settlement to compensate patients for the failed hips. Patients who received the J&J all-metal hips allege they have experienced hip dislocation, bone fracture, infection, nerve damage, device loosening or breakage, bone loss, tissue damage, and excess metal levels in the bloodstream
Indian experts say patients there know little about proposed implants and do not question their doctor’s recommendation. A senior doctor from one of Mumbai public hospitals said, “It is ironical, but people do more research before buying a mobile phone or television set than for an implant that will remain inside them,” according to the Times of India.
Surgeons say most Indian patients are content with the choice of implant if it is an imported device. Dr. Arvind Goregaonkar, head of Sion Hospital’s orthopedic department, said patients do not seem to care about the implant’s make, projected longevity, quality, or other issues, as long as the device was manufactured by a foreign company. “We cannot blame the uneducated patients for blindly relying on doctors,” Goregaonkar said, according to the Times of India.