Ramandeep Chawla (40) and Purushottam Lohia (58) are as different as chalk and cheese. Chawla is a government school teacher in Faridkot, Punjab; Lohia runs a real estate business in Pune. Both have joined hands to take on the US-based Johnson and Johnson (J&J) in the National Consumer Disputes Redressal Commission (NCDRC) after the articular surface replacement (ASR) hip implants in their bodies turned rogue.

While Ankylosing spondylitis rendered Chawla’s hips disabled in 2007, Lohia suffered a near-fatal accident on a highway in Maharashtra in 2008. Both underwent surgery and got themselves hip implants manufactured by J&J which eventually failed.

No reimbursement

While Lohia was reimbursed ₹3-4 lakh for a revision surgery by J&J, he still walks with a visible limp and experiences intense pain.

In Chawla’s case, J&J denied reimbursement. The school teacher had to cough up hospital expenses of ₹5 lakh even as 275 the other patients who had undergone revision surgery were provided reimbursement.

“I had undergone a surgery for both hips in February 2007. Until 2014, I was fine. It was only in 2015 that a sharp pain emerged in my legs. For two years, I was running from pillar to post seeking relief. I did not know that it was the implant which was causing the trouble. I spent close to a lakh in getting painkiller injections for a month, but to no avail,” Chawla told BusinessLine.

On August 9, 2017, he underwent blood tests financed by J&J at SRL Lab in Bhatinda after his hospital asked him to call the company’s ASR helpline. Much to Chawla’s horror, hazardous levels of chromium, up to seven times higher than normal, and high level of cobalt were noted in his body.The hip implant was prone to premature degradation and shedding toxic metal debris. Chawla then underwent MRI and ultrasound tests which showed severe damage to tissues around the hip joint, the formation of a huge cavity and staining of tissues with micro-metallic particles.

The expert committee noted that an internal company document admitted to the failure of the product would fail in as many as 40 per cent of the cases within five years. In Chawla’s case, it took seven.

The Indian Spinal Injuries Centre had signed J&J’s claim forms with proof of deterioration of Chawla’ s revision surgery, but yet was denied reimbursement.

“After the surgery, my doctor told me that my entire leg muscle had turned black and was poisoned. This could not have occurred overnight. The deterioration due to the hip implant had happened over years. How can the company not reimburse me if I claim reimbursement after 10 years?” he asked.

‘They call it windfall gain’

“All expenses have been borne by my retired parents. They have had to spend their pension, and break their savings to help me,” he said. He said that his claims, which the company calls ‘windfall’ gains, are actually rightful.

Even after the revision surgery, Chawla experiences pain and slouches while walking. He still teaches. “I cannot afford to leave my students in the lurch. But I am scared about my left hip. What if I have to undergo a surgery for that too? It would mean another ₹5 lakh. Risks related to the implant are very high and my future is bleak,” he said.

Chawla has spent over ₹11 lakh on surgery, revision surgery, diagnostic tests, painkiller injections, travel and loss of pay due to bed-rest for three months. He said the ₹20-lakh base compensation suggested by the Health Ministry is too low.

Also, J&J’s stand in the court — those patients who have to undergo revision surgery after 10 years of implant will not be eligible for reimbursement — is in direct violation of Health Ministry’s latest circular, which states that any person with a faulty ASR implant can apply to Central or State committees for a base compensation of ₹20 lakh. It can be enhanced after analysing the degree of disability, and the suffering on account of monetary loss. Further, the ministry has said that patients implanted with ASR within 10-15 years of the first surgery and are symptomatic, are eligible to apply.

Both Chawla and Lohia say their fight is not about the money, but justice. “No one can compensate us for the life-long pain and deterioration of quality of life.” They are in touch with many patients across India to unite for a larger legal battle.

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