/ Health

Who should pick up the bill for a failed metal hip replacement?

hip replacements

The medical devices regulator has told patients with metal-on-metal hip replacements about potential problems with the prostheses and to undergo tests. Guest author and expert in product liability law, Brian McFerran, joins us to explain more…

It’s estimated that 56,000 people in the UK have been fitted with metal-on-metal (MOM) hip replacements. They were introduced to the UK in the 1990s and promoted as offering better function and longevity than the traditional metal ball and plastic socket prostheses.

Manufacturer DePuy launched its ASR MOM prostheses in the UK in 2003. However, after only a few years, surgeons began raising concerns about the devices, noticing a pattern of early failure potentially caused by a reaction to metal debris coming from the hip replacement.

Failed hip replacements

In 2010, the UK medical devices regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), issued a medical device alert recommending surgeons keep MOM patients under close surveillance. On 24 August the same year, the ASR prosthesis was voluntarily recalled by DePuy.

Now, the MHRA has issued a new alert for all MOM prostheses, expanding the pool of patients thought to be at risk of suffering an adverse reaction to their metal hip replacement and recommending additional tests, even where patients aren’t suffering any symptoms.

In some circumstances, patients can bring claims for compensation if their metal hip fails early. However, these are subject to very strict time limits, meaning patients may be prevented from bringing claims if they’ve missed one of these deadlines.

Paying the bill

Of course, the burden of the pain and suffering caused by this type of reaction and revision surgery is borne by the patient and their loved ones.

But what about the financial burden? Consultations with surgeons, x-rays, MRI scans and blood tests don’t come cheap and a revision surgery (where the hip replacement is removed and replaced) can cost upwards of £15,000.

Most people will have treatment on the NHS, but should the tax payer be footing the bill for this?

The NHS is already stretched and it has been reported it’s limiting the number of hip-replacement operations offered. Patients are left on ever-lengthening waiting lists and ultimately prolonging their pain.

DePuy scheme

DePuy implemented a scheme for its ASR prosthesis in 2010. This meant that patients could opt for private treatment and could recoup their reasonable expenses associated with the revision surgery.

Regrettably, DePuy is changing the terms of the scheme. This means that, while it will consider covering the costs of revision surgeries that take place within 10 years of implantation, after 24 August 2017, it will no longer pay for the necessary pre-revision medical tests and exams.

The stark result will be increased pressure on the NHS at the very same time the regulator is recommending more check-ups and a lower threshold for revision surgery.

That’s why the consumer law firm Leigh Day is calling on DePuy to continue to pay for medical tests for at least another three years. This will relieve pressure on the NHS and ensure patients are treated promptly.

This is a guest post by Brian McFerran of Leigh Day, an expert in product liability law. All views expressed here are Brian’s own and not necessarily those also shared by Which?.

Do you agree that DePuy should extend its scheme? Who do you think should foot the bill for failed hip replacements?


I am due for hip replacement shortly and this worries me. My Mother broke her hip in the eighties and the operation failed due to blood supply being damaged. She went through a very hurried hip replacement 2 years later in which the anaesthetic had repercussions on her health. I have fears about having a general as my health is poor. I certainly don’t want TWO if I can possibly help it. With my superficial understanding of engineering MOM’s seem risky where you can’t give the surfaces a dose of oil. Perhaps a metal to nylon is th answer?

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i wouldn’t worry yourself too much about your upcoming hip surgery. during your pre op assessment you can voice your worries with the doctors and they will do all they can to make sure the same problems dont happen. i had my hip replacement at the age of 22 and i was terrified that i would end up crippled at an early age as hips dont last forever and you cant have more than 3 on each side. even though it didnt take all the pain away, i am due to have my second replacement within the next year. its lasted over 20 years which is good considering i have fallen on it a lot etc. As long as you have a good orthopod doing your surgery, i would try and keep the worrying down as its not good for you. all of the times i have spent on orthopaedic wards, there are a lot of very good surgeries than bad. i was born with a hip condition so i have experienced a lot of hip surgeries. im sure your hip replacement will turn out fine josephine. good luck xxxx

I have had two hip replacements one 9 years ago which was a parcial replacement MOM the second 2 years later this was a full replacement. After the second I had 2 years of follow up XRay, blood tests etc. all was well. I have had the follow up letter to consult my GP he has suggested follow up is not needed but it is my choice. I have decided to not have the tests as I do not have any symptoms.
However I do belive that DePuy should be responsible for all cost involved with checking and if required replacement. This is fundamental doctors and surgeons have personal liability insurance for this sort of claim and should also hold some responsibility. XRays and blood tests need to be covered by Depuy.

If the original hip replacement was faulty then it would seem appropriate for DePuy to pick up the entire tab. It certainly shouldn’t be down to the NHS or to individuals. So well done Leigh Day, and it’s to be hoped the company responds quickly and effectively. Major surgery’s bad enough, without having to endure the fallout from faulty components.

First of all the patient should find (perhaps online or word of mouth) a really good surgeon. Don’t just accept any person your GP tells you. For instance, there is a brilliant orthopaedic hospital in Birmingham. My son has unfortunately had to have both his hips replaced and one surgeon there has perfected a different strategy. I cannot mention a name for legal reasons but advise a call to the Birmingham Orthopaedic Hospital. It is online.
Good Luck.

I would think the costs of replacement surgery, which it seems DePuy will pay for, should well outweigh the costs of the initial investigation and tests. It would be useful to know why they have reduced the period within which you can have these paid for.