Titanium Mandibular Plate Failure

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Lowell Steiger - 18 Aug 2007 20:37 GMT

Hello,

A potential client just called with the following situation: In 2005,
he was diagnosed with a very rare form of cancer of the jaw. The
mandible was removed, bone was taken from his hip and grafted into his
jaw. This first surgery failed because the flap was not sufficient
and the graft did not take.

A second surgery was performed in November 2006. A titanium
Mandibular Reconstruction Plate was implanted. In July 2007, the
titanium Mandibular Reconstruction Plate spontaneously broke in half.
Client will be undergoing a third surgery within the next two weeks.

Does anyone have any input in terms of the durability of such a device
and whether it is reasonable for such a device to fail within such a
short period of time?

Thank you in advance for your input.

Lowell

Lowell Steiger, Attorney at Law
8383 Wilshire Blvd. #830
Beverly Hills, California 90211
(323) 852-1100
(323) 852-1033 fax

Please visit my Personal Injury blog at:

http://steigerlaw.typepad.com/

Please visit our website at:

http://www.steigerlaw.com

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The Webby - 18 Aug 2007 21:24 GMT

> Hello,
>
[quoted text clipped - 3 lines]
> jaw. This first surgery failed because the flap was not sufficient
> and the graft did not take.

How large a portion of the mandible was removed? In what area was this
bone removed?

Thanks.
W.

> A second surgery was performed in November 2006. A titanium
> Mandibular Reconstruction Plate was implanted. In July 2007, the
[quoted text clipped - 22 lines]
>
> http://www.steigerlaw.com

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Dartos - 20 Aug 2007 13:50 GMT

I have never been involved with such a case directly, but it would
be pretty easy to estimate that these are extremely complicated.

Many people fail to recognize that there are no standards to design
these one-of-a-kind prostheses. It is also impossible to measure the
forces that are going to be applied to them once installed. Stating
that the midline of such a case should have a minimum width and
thickness is probably unknown and would vary with individual patients.

The complexity of the castings and metal work also add their own
challenges to deliver a 'perfect' appliance. What actual alloy
should be used? Were there undetected voids in the castings?

Being able to stand back and say, "That should easily last 10 years"
is impossible.

JMO,
D

> Hello,
>
[quoted text clipped - 30 lines]
>
> http://www.steigerlaw.com

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Amatus Cremona - 22 Aug 2007 19:28 GMT

> A potential client just called with the following situation: In 2005,
> he was diagnosed with a very rare form of cancer of the jaw. The
> mandible was removed, bone was taken from his hip and grafted into his
> jaw. This first surgery failed because the flap was not sufficient
> and the graft did not take.

Perhaps not sufficient for the particular healing problems which occured
with this unique patient, but would have been more than adequate
normally????

> A second surgery was performed in November 2006. A titanium
> Mandibular Reconstruction Plate was implanted. In July 2007, the
> titanium Mandibular Reconstruction Plate spontaneously broke in half.
> Client will be undergoing a third surgery within the next two weeks.

Mechanical failure of manufactured devices happen every day. This type of
custom fabricated prosthetic is very new to the world and has not had 20
years of testing.

> Does anyone have any input in terms of the durability of such a device
> and whether it is reasonable for such a device to fail within such a
> short period of time?

Try to understand the biomechanics of what this device is being asked to
perform and under what conditions.

> Thank you in advance for your input.
>
[quoted text clipped - 9 lines]
>
> http://steigrlaw.tyepad.com/

Aren't lawyers supposed to pay for professional opinions offered on legal
cases?

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