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Failure of artificial hips expected to cost billions

New all-metal implants are not holding up

NEW YORK - The most widespread medical implant failure in decades - involving thousands of all-metal artificial hips that need to be replaced prematurely - has entered a new phase, the money one.

Medical and legal specialists estimate the hip failures may cost taxpayers, insurers, employers, and others billions of dollars in coming years, contributing to the soaring cost of health care. The financial fallout is expected to be unusually large and complex because the episode involves a class of products, not a single device or company.

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The case of Thomas Dougherty represents one particularly costly example. He spent five months this year without a left hip, largely stuck on a recliner watching his medical bills soar.

In August, Dougherty underwent an operation to replace a failed artificial hip, but his pelvis fractured soon afterward. The replacement hip was abandoned and then a serious infection set in. Some of the bills: $400,776 in charges related to hospitalizations, $28,081 in doctors’ bills, $5,823 for laboratory tests, and $2,995 in home nursing visits.

“I’m sitting here on a La-Z-Boy meant for someone who is 80, and I’m 55,’’ said Dougherty, who lives in Groveland, Ill. His bills are “five times as much’’ as he paid for his home.

The so-called metal-on-metal hips like Dougherty’s, in which the ball and joint of a device are both made of metal, are failing at high rates within a few years of implant instead of lasting 15 years or more, as artificial joints normally do. The wear of metal parts against each other is generating debris that is damaging tissue and crippling patients.

The incidents’ soaring costs have set off a financial scramble. Recently, lawsuits and complaints against makers of all-metal replacement hips passed the 5,000 mark. Insurers are alerting patients that they plan to recover their expenses from any settlement money that patients receive. Medicare is also expected to try to recover its costs.

Device producers have taken differing stances to covering patient expenses. Zimmer Holdings, which says its all-metal implants are safe, has quietly settled hundreds of patient claims, lawyers involved in those cases say.

Dougherty underwent a procedure this month to get a new hip implant and hopes to spend next year back on his feet and at work, rather than in a chair.

“You can’t do anything,’’ he said. “You see your wife doing everything for you. It is just not right.’’

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