A week ago the first of what is expected to be an avalanche of lawsuits came through in Oregon with the jury awarding $4.75 million dollars to Matthew Beale, a father of four residing in Portland, Oregon, from I-Flow, a post surgical pain pump manufacturer. It is one lawsuit out of what the New York Times reported as 119 more cases involving 412 patients for which I-Flow, is a defendant.
The dispute was over whether the I-Flow pump caused Beale to contract postarthroscopic glenohumeral chondrolysis (PAGCL) or chondrolysis, a loss of cartilage in the joint.
The Cause
In the late 90’s the pain pump was introduced as a safe and effective way to control joint, in particular shoulder, post-surgery pain for sports injuries. Joints are held together by cartilage, which is comprised of cells called chondrocytes.
The pump is inserted in the area and dispenses a local anesthetic, regulating the use mechanically so to eliminate the need for monitoring by a nurse or doctor. This reduces time in the hospital and most importantly, cost.
The problem is that to maximize the relief, the anesthetic was pumped directly into the joint rather than the area. According to studies done by Dr. Constance R. Chu of the McGowen Institute of Regenerative Medicine in the University of Pittsburg, certain anesthetics, when applied locally, kill chrondrocytes.
Bupivacaine is an anesthetic that is produced by AstraZeneca, another defendant in a series of lawsuits regarding this issue. Apparently bupivacaine is the commonly used anesthetic used by pain pumps.
When the anesthetic is applied directly to the joint, according to Dr. Chu, the reaction is rapid. The cartilage is killed leaving the joint to function bone on bone causing excruciating pain, limiting the use of the whole limb, and reducing the patient to a lifetime of associated problems.

Follow the Wagging Blame Finger
In 2006, when the research spearheaded by Dr. Chu came down, including an important patient study and one done on rabbits , I-Flow changed the directions on its packaging inserts and posted a bulletin on their website in August of 2008.
Unfortunately their product was already in use for a decade by the time their warning came out and more than two years after the initial study done by Dr. Chu was published. This is part of the argument of the lawsuits that they were far too slow to react to the studies and allowed their product to continue to effect patients.
The California based I-Flow was purchased for $325 million last year by household good behemoth Kimberly-Clark Corp. (producer of Kleenex and Huggies brands) who, according to the Oregonian, made just over $2 billion dollars in 2009. A spokesman for the company told the Oregonian that they are very disappointed about the outcome and plan to appeal.
AstraZeneca told the New York Times that they deny permitting the use of their product in pain pumps and plan to fight any lawsuits.
According to Beale’s attorneys, the doctor that applied pain pump to the joint was encouraged by I-Flow to apply the catheter of the pump directly to the joint for a more effective treatment and a way to lower costs. I-Flow of course deny that allegation.
The FDA, posted a warning on their website in 2009. According to the New York Times, they had been approached by another pain pump manufacturer, but had not approved the procedure applying the anesthetic directly to the joint.
The Solution
On top of the $4.75 million dollar settlement that went to Matthew Beale, $1.275 was also awarded to his wife Krista Beale because from now on she literally has to be his right hand. Though Matthew Beale still maintains a job at a brokerage firm he contends that he will not be able to sustain his career to retirement age because of his ailment.
If you have had a procedure to your joint since 1998 and used a pain pump and are now affected by pain, discomfort, limited movement, loss of movement, loss of livelihood, or your personal life has been adversely changed by this procedure contact Phillips Webster to find out your legal options.
Written by Jeremy Cairns