good morning i believe there are two critical issues that need to be addressed this morning concerning st when patty starr knew or should have known better injuries were wrongfully caused and  whether there is only one conclusion can be drawn from the undisputed facts now in a draft and it needs to critical issues i believe we st must look at the definition of elements to be addressed and wrong in determining whether or not the injury was wrongfully caused erst was the cause must be the plaintiff must have sufficient injury was wrongfully cause so misandry there who are i ask you a question about this on the wrongfully part because i think that's what this case is about i take it that your position is that the fact that mesh erosion was one of the potential adverse side effects of this product listed on on all of the warnings and she she knew about it that that alone was not enough to show that there was something to affective about the product something more than measured roshan had happened that's correct because she was told that that was a rescue of the surgery and that that was a risk and that was unknown complications so when the master roaded she figured st of all of this her body's response because she had an underlying wound healing disease that she had her entire life this is her you know and so understanding is correct so when her mask eroded she felt that it was her body's response to the mast and she also thought that this was a risk that the perceived or so she didn't think that there are was anything wrong or that there was a defect from the mass further she inquired to just like this court or actually just like the supreme court ruled in the no one case you know mister nolan had shortness of breath and long disease for twenty years he kept going back to the doctor and one point he was diagnosed with some an eerie fibrosis and it wasn't until about ten years later that he received a green sheet so this is going over the you know that there is this coming and going argument that the defense keeps bringing up they want to deny to this day even in their briefs they deny that their mass was defective but somehow they want patti stark they want to hold her to a higher standard she still said can i ask you this this question i take it when she went to see her doctors even though they used hedged language this it could have been ehlers downloads could have been you know her body basically no doctor ever said gee i've never seen mesh erode this quickly or this completely or you know that there's a that's kind of whatever said to her asking about the product that's correct what they did was say yes it could be related to your other stand now one doctor told her they thought it was the product itself that was a defect of the product so we have three board certified physicians that she went to that did not make that conclusion that it was a defect in the match in fact the doctor that originally put stryker that was decided in two thousand and eight where we have a plaintiff where the court how that due to the factual circumstances it was a question of fact or the the surgery her doctor said you know what erosion of this implant those are risks to the procedure so when and they also said because of the fact that you're young and that you're active you could have to have another surgery and this implant can loosen so when your implant in fact loosened and fact when she was told she needed to have the product removed and have another surgery she felt it was her body's response just like patti stark but it was her body's response it both had been it causes in a they're not he says that involve an alternate cause and he has an alternate cause they have alternative cause they have the courts have ruled that it's a question of fact because all of the circumstances need to continues to misapprehend the discovery role in illinois urging the court to require some type of notice a big effect before the statute of limitations begins to run in the illinois courts at the illinois supreme court and even this court has recognized that a concept that is not part of the discovery rule nd kind of fails to appreciate the very unique nature of the injury in this case where implanted mash has migrated where it should not be in her body it has it has a ro let me give you an analogy some people who have diabetes because of the nature of diabetes have cropped that don't their wounds don't heal the way a normal person's wounds would heal and that's that's true permanently that's just a condition of diabetes which people don't recover from and she's roughly saying that the same thing is that she was led to believe the same thing was true for her she's got this ehlers downloads syndrome her tissues don't behave the way a normal person's tissues behave so it's not that she doesn't know that the product is defective but she doesn't even have any reason given the advice she's received from physicians to believe that the injuries you just described stem from some wrongful act of another as opposed to her own body's vulnerabilit and i know you are in a difficult position because obviously i'm sure if push came to shove j and j would be here on the merits arguing there was nothing wrong with the mash fine put that to one side we're just here about whether she had any reason to think that the injuries she was experiencing from the mesh were wrongful in other words was it doing something more than was predicted or were they just risks that she had undertaken when she gave her consent has recognized that all of those could be contributing factors and here's the key none of those are alternative causes of this injury her injuries don't can't occur organically like in no and with the lung disease which could be organic or not my i don't understand because it's an interaction i mean she has this condition and you put the mesh in and so for people with this condition maybe doesn't work the way it's supposed to work for other people now obviously if no one ever put the mesh in she wasn't going to experience the deception which is a polite term for the tearing apart of her  but i don't know that you can assume away the fact that she agrees based on the information she's given to the surgery and she thinks that the reason she's having such phenomenally adverse effects from it has nothing to do with the quality of the product it has only to do with her own body's vulnerabilities well you know i think we have to go back to two things st we go back to the standard to be applied and the notice we're looking at  i would say a company selling a medical device that performs exactly as depicted on the inserts and in the material given to the f d a hasn't done anything wrong full that you know but if they have if the device is actually defective beyond that that's where you begin to have problems or you're in their illinois supreme court has defined wrongfully cause in the way that they define wrongfully cause is we know that it is when plain it has sufficient information concerning the injury and its cause to put a reasonable person on inquiry notice to determine whether any actionable conduct was involved and that means as to any defendant for  and so she's got this you know confounding u d s condition and she's got these known complications sometimes devices don't work surgery doesn't work why is that enough to say you got a stirred talking to lawyers there's a two part answer to that question on her st and in the withrow case which is the illinois supreme court case the birth control case that the court points to the i if you're the label warning in that case and says hey the warning in this case relates birth control to possibility of blood clots in your legs and the court says that is a notice that is notice that birth control is linked to blood clots and in that case the plaintiff was also told by her mother that birth control can be linked to blood clots and in the illinois supreme court says that's not a leak to put you on notice but but in this case it goes further than what she was told so when when she sees doctor elser in two thousand and eight doctor elser does tell or hey mash can cause erosion it can cause a regime even if you don't have complicating factors such as e d s or diabetes and smoking and i'm a stark signs the consent form that yes it can cause erosion but when we get to two thousand fifteen with doctor playtest much more than that has happened in two thousand and fifteen and this is where the crux of the year the answer to that question is if we look at plaintiff's claim failure to warn claim it rest on the fact that she says that no one warned her about the possibility of multiple surgeries the possibility that mesh could not be removed from her body and that it could be permanently eroded permanently disfiguring her she says she has no warning of that so in two thousand and fifteen when she wakes up from surgery and doctor fellate has tells her i am sorry this match is permanently embedded in your body that is deceptive your your rethread and it cannot be removed she is on notice she has an inquiry notice to determine what went wrong because clearly she actually has actual notice that something went wrong she didn't get a warning now it might be that she inquires whether it was her doctor who didn't want her or the manufacturer who didn't want want her which is what her allegation is and also she she's on duty to inquire whether in fact it's her surgeon that implanted her with this product when she had e d s but at that moment she has had a traumatic disease and these are stuff that happened in the know in case in the i'm on a case from the roper case the smith case you know we set those aside because they can have multiple etiologies true ultimate causes but when you have a traumatic injury and that's what we the illinois courts have said about that is a traumatic event alone puts plaintiff on notice a reasonable possibility the injury was wrongfully cost in your honor this is a horror holding there that is the hoffman case in which the  illinois court of appeals in which the plate of actually underwent a surgery and woke up in the i c u unexpectedly and in the i c u she finds out she has these complications and she has sepsis and the court were within the scope of the warnings for the device so they were expected that is actually on our right respectfully disagree her expert report doctor blade as which is part of the record specifically says  that as part of their claim good thing warnings do not include do not address the management of complication is the need for multiple surgeries or the difficulty and the risk involving attempting to remove the t it's also in her complete which is docket thirty four dollars paragraph forty to her queens and which we take is true which is that she was not warned that it could not be removed from her body and it would be a permanent  after would have defendants argument on several occasions just like the fact that counsel so what we need to just set aside all these cases anything that has an organic nature as an alternative cause that's exactly he starts case this would healing disease is an organic it's not it's not just some and what this abel's her body from and her tissue from healing now there's nothing wrong full about erosion there's nothing wrong full about inflammation there's nothing wrong feel about pain these are the risks that she took when she had the surgery these were known risks that were discussed with her and her doctors therefore when she woke up from surgery in two thousand and fifteen she didn't feel that this was some sudden dramatic event it was the exact same what happened in two thousand and eight in that her surgery failed and when a deposition why her surgery failed she said i thought it was my body's response and not at any time johnson and johnson or any of her reborn if i were certified physicians ever tell her there an act with the product thank you very much counsel the case was taken under advisement and the court will be in recess