Frequently Asked Questions

Basic Information

1) What is the lawsuit about?

The claims involved in this group settlement all arise out of the use of American Medical Systems' ("AMS") transvaginal mesh or bladder sling products. The transvaginal mesh or sling products are used in women to treat Pelvic Organ Prolapse ("POP") and/or Stress Urinary Incontinence ("SUI"). The United States Food and Drug Administration has issued a warning regarding the use of transvaginal surgical mesh to treat POP, noting that thousands of women have reported serious complications, including (but not limited to) organ perforation, extreme physical pain, bleeding, various types of infection, and urinary incontinence. In some cases, the bladder/pelvic sling or support mesh has eroded or shrunk after insertion, resulting in further complications and additional surgeries.

2) Who is American Medical Systems, Inc.?

American Medical Systems Holdings, Inc., Endo Pharmaceuticals, Inc., and Endo Health Solutions (collectively "AMS") is a pharmaceutical company that manufactures various sling and mesh products. AMS is headquartered in Minnesota. Although, there are several manufacturers of mesh, this settlement only resolves claims against AMS products, including (but not limited to) Mini Arc sling, Monarch, Apogee, and Perigee.

3) When and for how much did the parties settle?

On September 30, 2014, AMS announced that it had reached a Global Master Settlement Agreement to resolve substantially all existing claims against AMS. Here is the link to the Press Release:

4) What is an aggregate settlement?

An aggregate settlement occurs when an attorney, who represents two or more clients, settles the entire case on behalf of those clients without negotiating each case on behalf of any one client in particular. This type of settlement is permitted in instances where each client has consented to any proposed aggregate settlement after recognizing and evaluating information designed to help clients make an informed decision. This information includes disclosing the nature and existence of all the claims, as well as the nature and existence of each individual's participation in the settlement (based upon the amount of money each participant claimant may receive using objective criteria to establish participation in the settlement).

5) What are the advantages of aggregate settlements?

The relative bargaining position of an attorney who represents multiple clients is generally viewed as substantially superior to that of an attorney who represents a single or few clients. By representing multiple clients, an attorney has the ability to expend more time and resources to litigate the issues in the case and to retain top experts since costs are shared amongst a larger group.

6) What are the disadvantages of aggregate settlements?

Aggregate settlements may give rise to potential conflicts of interest because your lawyers simultaneously must be concerned with the interests of more than one client. The ethical rules that all lawyers must follow in a settlement involving multiple clients require that each client be given sufficient information to ensure that each client may reasonably determine if her respective settlement is fair.

7) What if I like the terms of the Settlement Agreement and want to participate?

Participation in the Settlement Agreement requires that you complete, sign and return all the documents in your settlement packet before the deadline. Please carefully review and follow the instructions provided in your disclosure packet.

8) What options do I have if I choose to opt-out of the Settlement Agreement?

No action is required to reject or opt out of the settlement. If you reject the settlement offer, your mesh claims against AMS will continue in the court system. By opting out, your case may proceed to trial where you may receive more or less, or nothing at all. Additionally, upon opting out you may delay a potential settlement for a long time. This will involve substantial additional delay and expense to you, and may also run the risk of ultimately receiving nothing for your claims against AMS. Please carefully review and follow the instructions provided in your disclosure packet.

9) What is the effect of a Confidential Release?

By signing and returning the Confidential Release and Indemnity ("Release"), you are releasing all of your claims against AMS and its related entities or individuals connected with your use of an AMS Pelvic Implant, whether known or unknown, arising out of, relating to, resulting from, or in any way connected with your use of an AMS Pelvic Implant. You are agreeing to accept your Gross Payment and, in exchange, you are giving up your right to a trial against the Released Persons, as that term is used in the Release. As typically happens in personal injury claims, if you accept this settlement, should your injuries become worse in the future, if you become aware of previously unknown injuries, or if you suffer additional damages that you believe are related to your AMS Pelvic Implant, you will have already released any claim against AMS and the Released Persons for those injuries and any additional future damages; provided, however, if you have a qualifying revision and explant surgery, you will receive the payment provided for by the Temporary Holdback Fund ("THF") as explained below. AMS is only paying money in return for a promise that it will never again have to face a claim from the Claimants who receive money in the AMS Mesh Settlement. Please note by signing these documents you and your spouse are also releasing any derivative claims, which may exist, but are not limited to, loss of consortium, loss of affection and loss of services.

However, to the extent you have been implanted with a non-AMS mesh product, the Release does not include any claims you may have against others relating to that non-AMS mesh product.

10) What if my condition worsens after I get my money?

Pursuant to your Release and disclosure packet, this settlement is your full and final recovery against AMS: this includes any future damages. If you anticipate the need for additional medical treatment related to your injury on or before December 31, 2016, you can appeal to the Temporary Holdback Fund for additional compensation. You can also choose not to participate in this settlement.

11) What about lost wages and pain and suffering?

Pursuant to your Release and disclosure packet, this settlement is your full and final recovery against AMS: this includes any lost wages and pain and suffering.

12) Will the settlement affect my government benefits?

Many public assistance programs that provide monthly income or payments for medical services and/or medical equipment have strict eligibility limits. In determining eligibility, "needs-based" programs consider your monthly income and the value of your assets that you own. Without careful planning, your settlement award could trigger a reduction in your benefits for a period of time, or in some cases, cause you to lose your eligibility entirely. It is important that you consider the specific type of needs-based assistance you are now receiving now, or could receive in the future. There are a number of different steps you can take to protect your government benefits. Please call The Settlement Alliance at 1-800-683-4872 to discuss your options.

13) Will I lose my Medicaid/SSI/Food Stamps/ Public Housing benefits?

If the benefit(s) you receive is needs-based, then the settlement award may have an adverse affect on your eligibility for those public assistance benefits. Please call The Settlement Alliance at 1-800-683-4872 to discuss your options.

14) Will I lose my Social Security Disability Income and/or Medicare benefits?

The settlement award should not have an adverse affect on your eligibility for those benefits that are entitlement-based. Please call The Settlement Alliance at 1-800-683-4872 to discuss your benefits.

15) How will medical liens impact my settlement?

The settlement of your transvaginal claim against AMS cannot be achieved without resolving liens and other reimbursements and subrogation-related claims (collectively "liens"), be they governmental liens such as Medicare and Medicaid liens, or private (i.e., non-governmental) liens. By law, if a governmental entity made any payment(s) to any healthcare provider (s) on your behalf in connection with your AMS-related injuries, it may have lien, or right of reimbursement, on a portion of your AMS settlement.

16) I don't have any liens, so why are you holding my money?

Federal law says that if you are eligible for Medicare or Medicaid, you are required to seek their approval before settling your claim. They have a right under law to seek a portion of your settlement proceeds, under the theory that those programs may ultimately be the ones paying for the future medical care associated with the injuries for which you are now being compensated. We are required by federal law to reach out to Medicare and Medicaid and to hold back a certain portion of your settlement to satisfy any potential liens until your claim is either cleared or the lien has been finally resolved. Please carefully read your disclosure packet and call Shapiro Settlement Solutions at (512) 382-5100 or visit their website for questions regarding your medical liens.

17) Does my bankruptcy filing affect the settlement award?

A bankruptcy filing may affect your ability to recover monies from this settlement. If it is determined this settlement award is an asset of your bankruptcy estate, the proceeds of the award could go toward satisfying the creditors of your bankruptcy estate. If you currently have an active bankruptcy case, please let your bankruptcy attorney know you have a transvaginal mesh lawsuit. As stated in your disclosure packet, The Settlement Alliance will attempt to resolve any pending bankruptcy issues.

Settlement Payment

18) How will my gross settlement offer be determined?

Your individual gross settlement offer will be determined by the court-appointed Special Master and will be based upon the information provided in your medical records and the settlement matrix, which is based on four Primary Injury Categories and three tier rankings within Injury Categories 2, 3 and 4. Objective criteria were used by the Special Master to determine the grid matrix placement for each Claimant. Please refer to the Special Master Process Letter for detailed information on the criteria.

19) What is the Administrative Cost Amount?

Your gross offer amount includes both your individual gross settlement offer from the Settlement Fund, as well as your per capita share of the Administrative Cost Fund. The Administrative Cost Amount shall be used for designated Administrative costs enumerated in your disclosure packet.

20) How will my "Net Settlement Amount" offer be determined?

Your gross settlement offer from the Settlement Fund will be reduced by certain fees, costs and liens to determine the "Net Settlement Amount" which is payable to you. Additionally, your per capita share of the Administrative Cost Fund may be reduced by certain administrative costs. Please carefully review your disclosure packet for a breakdown of the expenses and fees associated with your case.

21) When will I get my check?

Many things must happen before the global settlement becomes final, and the court approves paying claimants. Ultimately, we are bound by the Court overseeing the process. With that being said, we hope to meet the requirements of the settlement and be able to start paying claimants' initial awards as soon as possible. Temporary holdback claims and lien holdback refunds will take additional time to resolve and finalize.

22) How much money am I going to get?

Your gross settlement offer is provided in your individual disclosure packet. Remember this is the amount before any fees, expenses, assessments, or liens have been taken out.

23) How will the money be sent?

A check will be sent via priority mail including a track number unless you elect to have your money placed in a structured settlement or special needs trust.

24) Can I have my check made payable to another person?

If you elect to receive a lump sum payment, the check will be made payable to you. If you are worried about protecting your benefits that are based on your income, then you should select one of the other forms of payment: the Structured Settlement or the Trust Payment on the Settlement Award Election Form.

25) Can I get direct deposit?

Unfortunately, we cannot deposit your check directly into your bank account. The check will be mailed to the most current address we have for you. It is very important that you keep us informed of any address change.

26) Is the settlement taxable? And do I need to report it to the IRS?

Please consult a tax professional for advice regarding tax matters. However, it is our general understanding that in terms of personal injury recoveries, mental anguish, and pain and suffering damages are not taxable, but claims for loss of wages or income are taxable. The settlement does not distinguish between the various damages but most of the cases did not have claims for loss of wages or income. See IRS Publication 4345 (Settlements - Taxability).

27) Will I get a Form 1099?

No, you will not receive a Form 1099.

28) What happens if my mesh products erodes or causes problems after I elect to settle my claim?

Once you submit a valid executed release, you will not be able to pursue claims against AMS for any injuries resulting from the mesh, including erosion.

29) Can I tell my landlord, car dealer, banker, in-laws, etc. that I have money coming?

We do not recommend you making representations to third parties regarding a potential settlement that has not been completely approved and processed. Also, you must remember that the settlement is confidential and any breach of confidentiality may prohibit you from participating in the settlement. You are allowed to discuss the settlement with your attorney and financial advisor, including your government case worker.

30) What do I do if my loved one who underwent an AMS mesh implant is deceased and did not have a will?

You may be able to take part in the settlement if you are a rightful heir under the law of your state entitled to recover a settlement. If you have not already done so, please provide a copy of the death certificate and the contact information of the list of heirs to our office. As stated in your disclosure packet, any probate issues will be resolved by The Settlement Alliance.

Multi-Defendant Cases

31) What happens with cases involving multiple products with different manufacturers?

In cases involving multiple products with different manufacturers, your firm will continue to pursue your claims against the other manufacturers, and your claims involving those other manufacturers are not being settled as a part of this Settlement. We are only settling your AMS claim.

32) Will I be able to pursue my other manufacturer(s) if I opt out of the AMS settlement?

Yes, claims against other manufacturers will not be affected if you choose to opt-out of the AMS settlement.


33) What do I do if the Special Master missed an AMS-related surgery or did not properly categorize my claim based on the Settlement Matrix?

If you believe that the Special Master missed an AMS-related surgical intervention that you received on or before January 1, 2015, or that I otherwise did not properly categorize your claim based on the enclosed Settlement Matrix, you can formally request the Special Master to undertake a further review of your claim. Please note that if you request such a further review that you will not receive any settlement money for your claim until you complete the process of formally applying to the Special Master for a further review of your settlement offer amount, have received from me a final, total settlement offer based on further review of your claim, and have accepted your final, total settlement offer. It is important that you carefully read and follow the instructions provided in your disclosure packet regarding how to apply for a further review of your claim.

34) What is the Temporary Hold Back Fund ("THF")?

Approximately 10% of the total gross settlement funds to be paid by AMS are being set aside in a Temporary Holdback Fund. This Fund will be used to provide additional compensation to those Claimants who accept their settlement offer and who apply no later than December 31, 2016, for additional compensation for a qualifying AMS-related surgical intervention that occurs after January 1, 2015 but on or before December 1, 2016. Additionally, Claimants in any Injury Category may apply to the Temporary Holdback Fund for a Supplemental Payment if they can demonstrate any of the following extraordinary injuries related to their AMS mesh implant: (1) fistula/abscesses, (2) self-catheterization for life, (3) permanent disability, (4) permanent disfigurement, (5) permanent severe pain, (6) mesh-related death, (7) extraordinary loss of wages, and/or (8) other facts and circumstances not contemplated in the allocation methodology described herein. If you choose to apply for Supplemental Payment, you will not receive any settlement money for your claim until you complete the process of applying to the Special Master for a Supplemental Payment, have received from the Special Master a final, total settlement offer based on his review of your request, and have accepted your final, total settlement offer from the Special Master. If, after the Special Master's review of your request, you choose not to accept your final, total settlement offer from the Special Master, Settlement Counsel will discard your executed Release and all of your other settlement documents, and your Primary Counsel will then contact you to discuss your next step.

35) Who can apply to the THF?

You should apply to the Temporary Holdback Fund only if: (a) you had or have a surgical intervention after January 1, 2015, related to your AMS mesh product; or (b) you are requesting consideration for a Supplemental Payment based on medical records documenting one or more of the extraordinary injury factors listed above.

36) How do I apply to the THF?

In order to apply to the Temporary Holdback Fund, you must submit a written letter, along with your supporting medical record and documentation, by certified mail (to confirm receipt), to the Special Master. It is extremely important that you follow the instructions provided in your disclosure packet regarding instructions on how to apply to the THF.

37) What if I think the amount is not enough?

The decision whether to accept or reject the settlement belongs solely to you. Your Primary Attorneys and your Settlement Counsel recommend that you accept the offer to participate in the settlement. Should you choose not to participate in the settlement process, it is possible that your Primary Attorneys may seek to withdraw from your lawsuit and you may be required to find another law firm to prosecute your case. When considering whether or not to accept the settlement award, keep in mind that the trial process will take much longer, is very costly, and there is no guarantee of recovering any amount at all.

38) If I still want to sue, are you going to be my lawyer?

Your Primary Attorneys will review your case to determine if it has a chance to succeed in future litigation. Evidence requirements involved in litigating may be much more substantial than those of this settlement. Your attorneys may seek to withdraw from any cases they do not consider appropriate for continued litigation.

To contact the Claims Center please call 1-800-866-MESH or e-mail us at


Settlement Court in Hardin County, Texas
356th District Court
Judge Steven Thomas
Hardin County Courthouse
300 Monroe
P.O. Box 640
Kountze, TX 77625
Phone: 409-246-5155
Fax: 409-246-4700

Special Master in Chancery - Dean Brinkley
2090 Broadway
Beaumont, Texas 77701

Lien Resolution Administrator - Shapiro Settlements Solutions
11211 Taylor Draper Ln., Suite 210 Austin, TX 78759
512-382-5100 (phone)
512-382-5955 (fax)

Trustee & Fund Administrator - Settlement Alliance
5847 San Felipe Suite 4550
Houston, Texas 77057
Phone: (888) 284-0332

Claims Center - Aylstock, Bailey, Burnett, Junell, Potts & Witkin, PLLC
55 Waugh, Suite 803
Houston, Texas 77007