A Closer Look At PAGCL: What Is It & Who’s Responsible?

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Jeffrey Johnson is a legal writer with a focus on personal injury. He has worked on personal injury and sovereign immunity litigation in addition to experience in family, estate, and criminal law. He earned a J.D. from the University of Baltimore and has worked in legal offices and non-profits in Maryland, Texas, and North Carolina. He has also earned an MFA in screenwriting from Chapman Univer...

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Written by Jeffrey Johnson
Insurance Lawyer Jeffrey Johnson

UPDATED: Jul 16, 2021

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What is it?

Postarthroscopic glenohumeral chondrolysis, or PAGCL, is a debilitating condition that occurs in the shoulder when cartilage between the ball and socket of your shoulder has broken down to such a degree that bone actually meets bone. While there are many possible causes of PAGCL, the one it is most commonly linked to is the use of a pain pump after someone has had shoulder surgery.

There are generally two ways to manage pain after shoulder surgery – oral pain killers or pain pumps. Both will do the job, but oral pain killers require administration by someone else. Pain pumps, on the other hand, are small devices which can be surgically implanted in the shoulder joint so that the painkiller medication can be delivered immediately – and don’t require someone else to act. While the latter would seem to be a better choice, medical experts have concluded that pain pumps may cause permanent damage to the shoulder by eating away at the patient’s cartilage.

Recent studies from the American Academy of Orthopedic Surgeons and the American Journal of Sports Medicine seem to corroborate that theory. In the first study, shoulder surgery patients who developed PAGCL had all used a pain pump after their surgery. In the second study, Dr. Charles Beck, an orthopedic surgeon and senior author of the study, stated that there is a, “…strong association between the intra-articular (inside the joint space) use of high volume pain pumps following arthroscopic shoulder surgery and an otherwise unexplainable loss of hyaline cartilage in the shoulder joint.” Beck went further and said that approximately 63 percent of patients that use pain pumps after surgery develop PAGCL.

Who’s responsible?

Companies that manufacturer pain pumps are alleged to have known about the risk of developing PAGCL years ago, but kept that information to themselves because this “new” way of administering pain medication became extremely popular. Manufacturers such as Stryker, DJO Inc., I-Flow or BREG Inc., all sold these devices, but only I-Flow warned about the risks of PAGCL.

Product liability lawyers say that while the FDA approved pain pumps for certain treatments, it never approved them for use directly into a patient’s synovial cavity – which is exactly what is happening. Manufacturers know this and most still haven’t warned about the risks of PAGCL. Hundreds of lawsuits have now been filed against these manufacturers and legal experts predict that many more will be filed in the future.

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