Subscriber Stories: When does “a small number” finally count?
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, who writes here on Substack and has kindly allowed me to share one of their articles. I would never attempt to write about women’s health myself, and that is exactly why this new Saturday Series matters. It gives readers the chance to write about the issues that affect them, and to have their work read by thousands. If you are a paid subscriber and want your own story told, get in touch.Subscriber Stories: When does “a small number” finally count? -
When does “a small number” become a significant number when it comes to avoidable harm in the medical system? The Dalkon Shield was a small number. Adiana was a small number. Mesh injuries were a small number. Now Essure is also dismissed as a small number. Yet each device has harmed women, caused life-changing complications, and left a trail of preventable suffering.
In the mid-1980s, the Dalkon Shield sparked a national movement to track down women and hold the manufacturer accountable. Adiana, “the plugs” used up until 2012, left little public information behind in New Zealand. Mesh victims pushed a petition in 2019 that eventually forced HealthNZ and ACC to establish care pathways. And in 2024, a petition reached Parliament calling for care and compensation for Essure users.
A little over twenty years ago, Essure entered the market as a permanent contraceptive. Although it was “not widely used” here before being recalled in 2017, it was used, and it has harmed an unknown number of New Zealand women. Essure continues a long, grim pattern of women’s medical devices causing unrecognised, untreated and poorly managed conditions. Many harmed women receive little understanding, even less help, and virtually no appropriate care from the health system.
Essure was sold as a quick, simple sterilisation procedure, often done without anaesthetic in about fifteen minutes. Two metal coils with a plastic core were inserted into the fallopian tubes. Women were told the device might “migrate” or “fall out” but would otherwise just irritate the tubes closed. The reality was the opposite. The coils were designed to cut into the tubes, and the micro plastic core triggered an inflammatory response that caused scarring.
Most physicians today are unaware that MedSafe issued a recall notice and asked for ongoing monitoring of recipients. MedSafe left it to implanting doctors to notify and follow patients up. No notification ever happened, and no meaningful monitoring occurred. Many gynaecologists have never even heard of Essure, do not understand how it functions, and have no idea of the wide range of harm it causes.
It took a petition to Parliament to get HealthNZ to pay attention. Over the past year there have been numerous hui about Essure injuries, potential injuries and the mishandling of the device. But the bureaucratic process has been painfully slow when it comes to actually supporting patients or informing doctors.
We do not know how many New Zealand women received Essure. But we do know the device has caused catastrophic, life-altering consequences for many, despite the manufacturer insisting that only “a small number of women” worldwide were affected. Essure has been the subject of lawsuits and investigations across Europe. Nearly 40,000 women received a settlement in the United States. Women in Australia, however, saw their lawsuit dismissed on the grounds that “all sorts of things cause pain and bleeding in women.”
How many could have avoided harm if action had been taken eight years ago, before the device broke apart, migrated through the uterus, corroded, caused toxicity, interfered with immune function, or led to neurological problems? Many women ultimately required hysterectomy just to remove the device, a procedure with its own lifelong consequences. No woman asked for this when seeking simple, permanent contraception.
Essure patients have been accused of drug seeking, dismissed as hypochondriacs, treated as time wasters and told it is all in their heads. Instead of proper care, they have been loaded up with painkillers, antidepressants and mental health referrals. Meanwhile, the manufacturer blamed Facebook for spreading “fear,” which is laughable when you see the condition these devices are in when removed. Mark Zuckerberg is not the one shoving a hand up there and snapping the coil in half.
Women should not be forced to hunt for their own treatment and then be criticised for it. The medical system’s favourite excuse, “not everything is right for everyone”, is used like a get out of jail free card. The truth is simple. They had no idea what to do when things went wrong. Our system is not equipped to manage injuries caused by permanently implanted devices, especially when the victims are dismissed as a statistical inconvenience.
Until there is a proper, robust, functional process for managing harm from medical devices, the medical fraternity should stop jumping to use them so enthusiastically. Because as soon as one harmful device disappears, another takes its place. There will be another Dalkon Shield. Another Adiana. More mesh. Another Essure.
And unless the system changes, there will be another “small number” of women forced to suffer through avoidable harm, unseen, unsupported and uncounted.
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Excellent piece. We need a complete review of the systems that the medical profession deploy to monitor medical devices and drug reactions. The current system allow products onto the market with inadequate safety data and completely fail patients due to an inbuilt bias towards the manufacturers when problems arise. This was witnessed with the reporting data from the covid vaccine where despite a large range of serious side effects, doctors were not required to mandatorily report side effects to Medsafe, ACC had no systems in place for a debilitating range of new symptoms that presented and patients suffering were repeatedly gaslit by the medical profession. It's just not good enough and I hope the victims of this product get their day in court.
Interesting piece thanks. Pretty awful too. I can see why you didn’t write it Matua, Boris is also no genius when it comes to ‘women’s stuff’ but I understand it enough to be horrified. How many times have we seen ‘Big Business’ (esp ‘Big Pharma’) fail to address genuine issues with their products. I acknowledge that ‘failures’ are often the price we pay for innovation (thus we need to progress carefully!), but failure to act when it goes wrong is criminal. ‘Empire of Pain’ about how the addictive threat of OxyContin was covered up after they realised is a good read.