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Randal L. Hoyt, 11 January 2018

BHR indexThis article is to expose the actions of an orthopedic surgeon who in 2007 recommended the Birmingham Hip Resurfacing (BHR) from Smith and Nephew, which then completely destroyed my life.

I was not a “trauma” patient in 2007, but have been “in trauma” since the BHRs were first recommended and implanted, completely mutilating both of my hips starting in 2007 to the point that I am disabled, unable to sit, drive, stand, or walk without debilitating pain.  It’s only by the “Grace of God” that I am still alive today trying fight this battle for a solution.

My name is Randal L. Hoyt.  I was born in 1958 to the most loving and caring parents, Glenroy and Anita Hoyt.  I have 3 younger sisters, with the youngest born with cerebral palsy in 1968, who is still alive at 49 years old due to the care of my parents for 35 years in home and then in an “independent supervised living home” with 24/7 care since October 2003.  She is an angel who never had a chance in life, born with only 1/2 of a functioning  brain that was discovered in the 2000’s.

I grew up on a farm north of Laddonia, MO where I was taught to work hard, try to do my best at all times, and not to depend on a “hand out” for living.  My parents built a successful farm operation with little to no help.  I started working with my father on the farm at 9 1/2 years old since I was the only son.  My parents tried to give us children what they could, but their life was hard.  I played sports in high school and worked hard to try to be the best I could, as did my sisters.  I graduated Valedictorian in 1977 and went the to University of Missouri-Rolla receiving a BS in mechanical engineer, summa cum laude, in Dec 1981.  During college I was a dorm assistant and went through the Co-op program with John Deere Harvester Works in East Moline, IL.  I tried to lessen the financial load on my parents.  I began work, full-time in Feb 1982 at John Deere Harvester, was married in 1985, had 2 children, was divorced in 1997 and fell into alcohol abuse for several years until I got sober in November 2002.  I am currently 15 years sober.  In transferred to the Waterloo Tractor Works in 2005 and then to the Ottumwa Works in December 2006, finally taking early retirement due to my health in October 2009.

My problems began in April 2006 in Waterloo with outside right hip pain and low left back pain.  I was working a lot of hours on 3rd as a supervisor/engineer and believed it was just fatigue, but the pain became intolerable, so I went to a doctor in Sept 2006.  He was a young doctor who diagnosed me as having hip bursitis, without Xrays, and I received a cortisone shot in the right hip bursa and the symptoms lessened significantly.  I transferred to Ottumwa in Dec 2006 and by Feb 2007 the symptoms returned, including groin pain, which intensified with my going to a local doctor in Apr 2007, who took Xrays of my right hip and referred me to a local orthopedic.  I sought a second opinion from a D.O., who referred me to an Iowa orthopedic group.  I also sought help at a Missouri orthopedic group, with my first appointment in Jun 2007 with a hip orthopedic, who felt that my problems were in my spine, ordered an MRI which showed lumbar degeneration in the SI, L3, L4, L5, and ordered an injection in the L4/L5 disc.  He believed that my primary issues were radicular pain due to my lumbar degeneration.  He spent little time with me, no explanation, and did not refer me to a spinal orthopedic.  Not convinced, I went to an IA orthopedic group that my D.O. referred me to for evaluation.  After seeing numerous orthopedics in IA with tests, MRI’s, shots, etc. a singular cause of the pain could not be determined.

An IA orthopedic reported that “I told Randy I definitely did not feel he was a candidate for hip replacement at this time as his arthritis is only mild.  In addition he is young and there are compounding factors such as his back and labral tears.  I certainly would not want to get into a situation where he had a hip replacement as a young man and still had the pain that he had preoperatively“.  He referred me to another IA orthopedic who stated that “the hip cartilage degeneration was only 50% and that hip replacements would be a difficult decision/situation in a man of my younger age.”

Up to this point, all of the doctors and orthopedics had been cautious with Xrays, MRI’s, and shots.  They all had adhered to the basic tenet of the Hippocratic Oath ‘Primum non nocere’, translated as ‘Above all, do no harm!’

Everything changed when I made a late telephone call in October 2007 around 6:30 pm to the original Orthopedic Group in Missouri, not expecting a receptionist, but one answered, and I asked to make an appointment with the “Best Hip Orthopedic” for an opinion on whether my pain issues were due to my right hip or my lumbar spine.  I felt that if any surgical intervention was necessary that I would have to recover in Missouri at my mother’s house, so I was referred to whom I was told was the “Best Orthopedic” at this group for his opinion on what my issues were.

I didn’t realize that I had made the MOST TRADGIC call of my life and that my life would become a “Living Hell of a Disaster” upon meeting with this Orthopedic, who took a few Xrays and then RAVED about the Birmingham Hip Resurfacing implants for both hips, exclaiming how great they were for young, active, healthy men of my age, 48 years old.

I gave him the reports from the Iowa orthopedics and he had access to the original MRI and reports from my Jun2007 appointment.  I know he ignored all the previous reports and MRIs and decided that he, as the orthopedic “KNEW BEST – THE GOD COMPEX”!  I asked him “Why don’t all hip orthopedics use these BHRs and he stated that “he was more progressive’ than most.”  His statement should have put the “Fear of God in Me”. He also led me to believe that he had done these implants for the past 10 years!!!  It wasn’t until after the damage was done that I learned the history of the BHR implant and the fast-track FDA approval in May 2006 for the USA.  A FATEFUL DECISION FOR ME!!!

At this point, I had been “off work” for the past 5 months and had been searching for a solution to my pain and disability and believed that he was recommending the procedures in “My best interest”, so I took his advise and was scheduled for Bi-lateral BHR implants in December 2007.  He implanted the BHR in my right hip, but during surgery I bled too much and he stopped at that point.  Upon awakening and during the next several months, I was in so much pain that my family and friends couldn’t believe the lack of progress in healing of the right BHR.  I could barely walk, couldn’t straighten the right leg fully, and was on continual narcotic pain killers for the excruciating pain.  I had no clue what was going on with my right hip and the surgeon just kept telling me that “I JUST NEEDED TO GIVE IT MORE TIME.”  That was always his answer “JUST GIVE IT MORE TIME TO HEAL”.

Since I had originally been scheduled for both hips to be revised to the BHR implants, I went on with the left BHR implant in February 2008 and my fate was sealed.  I was unable to sit and could barely walk, was in the WORST pain of my life, and now my low left back was just killing me.  The pain in both hips, my back, and my groin were INTOLERABLE!  When I questioned him about the lack of progress, he just kept telling me “TO GIVE THEM MORE TIME.”  I had never known anyone who had hip replacements and was still in so much pain, and my friends and family couldn’t believe the lack of progress and intolerable pain, either.  I hobbled around for several months with a cane, in so much pain, but decided to go back to work because I had been off work for almost a year and didn’t want to go onto long term disability.  I struggled at work, even with the pain medication, and was given an engineering desk job.  I could barely stand the pain of sitting and missed a lot of work due to pain.  I also saw a pain specialist and a physical therapist, who determined that my left leg was over 5/8″ longer than the right, whereas both legs had been the same length before.

I kept complaining to the orthopedic and to Smith and Nephew about “what the hell was going on”.  My hips were killing me and so was my low back.  I was referred to a spinal orthopedic in the fall of 2008 and he didn’t believe I had spinal problems, even though he had the original spinal MRI of 2007.  The hip orthopedic was perplexed and decided that a revision of the left BHR to a Total Hip was the answer and again I followed “like a lost sheep.”  I believed that he was going to remove all of the BHR components and convert to a THR with a ceramic or poly insert–a normal total hip replacement.  The surgery was in Jan 2009.  Again, I was in worse pain and when I saw the left hip Xray I was LIVID because he had converted to the Smith and Nephew version with a 2″ steel ball, not what I had agreed to.

I saw him a few times after, but had lost complete trust in him.  He was absolutely clueless as to my pain issues and now I couldn’t straighten either leg completely.  The low left back pain was irate by now, so I went back to the spinal orthopedic from 2008 and this time he said I needed L4/L5 fusion.  In 2008 he said I was fine and in Aug2009 I had L4/L5 fusion.  I was in such pain afterwards with both hips and spine, that I wanted to just give up.

In Apr 2010, I saw a local general orthopedic for spinal injections, who had left the medical practice due to family emergencies and then returned.  He took xrays of my hips and “said they tried these 30 years ago and they didn’t work”, but since I couldn’t straighten either leg fully, he did a bilateral IT band release on both hips so that I could straighten my legs.  Yet another extremely painful surgery.  I was told in the fall of 2010 by another spinal orthopedic that I should have had L3/L4/L5/S1 spinal fusion with rods and a cage in 2009.

In 2011 I saw a diagnostic spinal surgeon at the original orthopedic group where all the surgeries had been done and after months, he performed a lamanectomy and said that the recovery would be 2 years, if it worked at all and that I would never be able to work at any type of physical job again in my life.  I was still in exasperating pain and basically bed-ridden for the next 2 years.

In 2012, I had a pain pump implanted by a pain specialist that used Prialt (non narcotic, 1000 times more potent than morphine) that didn’t help and had it removed in 2013 by a recommended neurosurgeon.  I showed him my hips and he said that I had nerve damage, especially in the left hip.

In 2015, the head of the orthopedic group would not meet with me to discuss all of the damage done by the BHR hip orthopedic and said in a telephone conversation “that no surgical spinal surgeries would help my back because my entire physical structure had been changed dramatically due to the BHR hip revisions”.  I kept going back to the diagnostic spinal orthopedic who tried many non invasive procedures to try to help with the extreme hip and spinal pain.  He recommended another orthopedic group and hip surgeon on the belief that my hips were the main issue with unexplained inflammation in my pelvis.  He even reported that the BHR hips “did not have a glorious past”.  I then went to another pain specialist and had a spinal cord stimulator implanted in 2016 that didn’t work and I had it removed in 2017.  The pain specialist believed that my biggest issue was pain in the ligaments of my low back connected to my hips.

Looking back, a seemingly small issue with my right hip and left lumbar in 2006 escalated to a bigger problem in 2007, with no definitive solution, a misguided telephone call to an overzealous hip orthopedic who had just began implanting Smith & Nephew’s Birmingham Hip Resurfacing implants turned my life into a living “hell”.  I have to pinch myself at times to see if this is truly the “nightmare” that it has turned into over the past 10 years.

I keep looking for a surgeon to remove and rebuild my BHR/THR M.o.M hips into regular, workable hips.

These BHR implants put me into early disability retirement in 2009.  The chronic pain has been completely intolerable at times.  I have lost practically everything – physical, emotional, mental, spiritual, and financial health.

If you have experienced or know of someone with these types of issues, please call a regional Smith & Nephew office, ask for help, or file a complaint with the company.  I have called and an internal investigation is occurring.  Only God knows how any of this will turn out for me and I keep trying to fight the fight to expose the Smith & Nephew BHR implants that should never have been FDA approved in the U.S.A. or anywhere else.  May God help us all!!!

Randal L. Hoyt, 11 January 2018