Supporting pelvic mesh injuries
We provide cover for treatment injuries from pelvic mesh surgery. Learn about lodging a claim, reassessing previously declined claims and referring your patient to the Female Pelvic Mesh Service.
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Lodge a treatment injury claim
Under the Accident Compensation Act, we can cover pelvic surgical mesh injuries resulting from treatment or failure to provide clinically indicated treatment. Lodge a claim if you believe your patient’s mesh complications may be covered by us as a treatment injury.
Submit an ACC45 and ACC2152 and all claim-relevant clinical information. We’ll use information from your patient's current and previous treating health care providers to help inform our cover decision.
Treatment injury form (ACC2152) (DOC 183 KB)
Read the pelvic surgical mesh treatment injury guide to assess whether your patient is likely to be covered by us for a pelvic surgical mesh injury.
The guidance is based on the latest medical evidence and understanding of mesh injuries. It was developed with experts in urology, obstetrics and gynaecology, surgery, and pain.
Pelvic surgical mesh treatment injury cover guide (PDF 71 KB)
Reassessing declined surgical mesh claims
People with declined surgical mesh claims can have their cover decision reassessed based on current cover guidance.
We encourage health providers to discuss this with patients whose claim may benefit from reassessment.
We are not contacting people with declined claims. We know this may cause further trauma. Instead, we are making this information publicly available through:
- advocacy groups
- health professionals
- our website
- other public channels.
Here are examples of claims and how they may be reassessed under the current cover guidance.
Example 1
Jane had a surgical mesh repair for issues involving the vagina and parts of the bowel. Following the surgery, it was noted that there was a small area of mesh exposure in the vaginal wall and a claim was lodged.
Original decision
We declined Jane’s claim as there was no evidence of a physical injury caused by treatment other than the surgical incision and placement of the mesh.
Both the surgical incision and mesh placement are necessary parts of the treatment provided and were not considered an injury under ACC legislation.
Now
There is new medical evidence about mesh erosion/extrusion/exposure, what it is, and the impact it can have on the body.
The guidance indicates that this can be considered a personal injury. Depending on all the factors in Jane’s case, this claim may receive a different decision today.
If people like Jane wanted their claim reassessed, we would request current medical information about any ongoing symptoms to consider if there is an injury that can be covered.
Example 2
Alex had a mesh repair for pelvic organ prolapse. Then a few years later when Alex was going through menopause, mesh extrusion was found.
Original decision
We declined the claim as an ordinary consequence because Alex was going through menopause and the hormonal effects of menopause were thought to have caused the mesh extrusion.
Now
The evidence reflected in the new cover guidance tells us that age, menopause or use of oestrogen therapy aren’t relevant to the cause of surgical mesh injuries. Claims shouldn’t be declined due to these reasons alone.
People like Alex may benefit from reassessment based on this new understanding.
Example 3
Morgan had a mesh procedure to treat an incontinence problem. At the time, Morgan was 53 years old. Following the procedure, Morgan still had the incontinence problem.
Original decision
We declined Morgan’s claim because there was no physical injury caused by treatment and, therefore, it can’t be covered under ACC legislation.
The treatment didn’t achieve the desired result and is excluded from treatment injury cover.
Now
Situations like Morgan’s don’t meet the criteria for treatment injury cover as there is no injury caused by the treatment. The requirement for a personal injury is a key part of the cover criteria.
Example 4
Ashley had a mesh procedure to treat pelvic organ prolapse. Following the surgery, Ashley experienced numbness around the incision that was made, and a claim was lodged.
Original decision
We declined Ashley’s claim because the incision was a necessary part of the surgery and was completed correctly. The damage to superficial nerves around the incision site was necessary.
Now
Claims like Ashley’s do not meet the criteria for treatment injury cover as the only injury identified is a necessary part of the treatment.
The exclusions for injuries that are necessary remain a key part of the cover criteria. The decision declining the claim would not change.
Example 5
Sam had a surgical mesh procedure at 42 years old to repair a hernia in the groin area. Following the surgery Sam was diagnosed with persistent groin pain and applied for treatment injury cover.
Original decision
We declined Sam’s claim because there was no evidence provided of nerve damage, and therefore it could not be established that there was a physical injury caused by treatment.
Now
At the time of claim lodgement there was limited clinical information available about the exact nature of Sam’s pain and its cause.
New information suggests a specific nerve injury may be responsible.
Further investigations could benefit this client. If Sam asked for reassessment, we would likely arrange for Sam to have further medical assessment done to see if there is a physical injury that can be covered.
The reassessment process
We began accepting reassessment requests from 28 October 2020. Either clinicians or patients can contact us to start the reassessment process.
New surgical mesh injury claims should be submitted through the standard treatment injury lodgement process.
To request reassessment for a patient or find out more, contact us.
Phone 0800 735 566
Email surgical-mesh@acc.co.nz
Learn about surgical mesh claim reassessment
Why we are reassessing declined claims
In 2019 we were part of the surgical mesh restorative justice process commissioned by the Ministry of Health and run by Victoria University of Wellington. Looking back at a sample of declined claims, we found that some claims could potentially get a different decision today.
Learn more about why we are reassessing claims
The New Zealand Female Pelvic Mesh Service
Te Whatu Ora have established the New Zealand Female Pelvic Mesh Service. It is a nationwide, holistic, wraparound service. The service will support and care for women who have suffered pelvic surgical mesh injury.
It has been designed in partnership with mesh-injured consumers, Māori and Pacific health representatives and medical professionals, and in collaboration with us.
Learn more about this Te Whatu Ora service
Referring a patient
You can refer a patient to the Female Pelvic Mesh Service by submitting the digital FPMS referral form using your practice management system.
If your referral is accepted the service will develop an appropriate treatment and rehabilitation pathway for your patient.
If your patient's claim is covered as a treatment injury, we'll use the pathway information to inform an ACC-funded treatment plan. This will be delivered through our existing service providers.
We can also provide additional supports if required, such as weekly compensation, home and community support services. The recovery team member assigned to your patient will discuss what supports may be available to them for their injury.
If cover is declined your patient may be eligible for support, care and treatment with the New Zealand Female Pelvic Mesh Service.
Goodfellow Unit series: Surgical-mesh complications
We partnered with Manatū Hauora, the Ministry of Health, to fund an education programme.
Watch the webinar series organised by the Goodfellow Unit. The webinars give information to prevent, recognise, and manage surgical mesh harm.
Topics include:
- Identifying surgical mesh harm and optimising management
- Optimising management of female urinary incontinence
- Pelvic organ prolapse, – when to reassure and when to refer
- Recognising and responding to pain following surgical mesh surgery
Contact us
To find out more, contact us.
Phone 0800 735 566
Email surgical-mesh@acc.co.nz