A 38-year-old female, gravida 2, para 2, presents with pelvic pain for several years. Pain is localized to the bilateral lower abdomen and pelvis. She describes it as dull, achy, constant, and of mild intensity. Pain occurs most days and is unrelated to menses. She has been reading on the internet that hysteroscopic sterilization devices have been removed from the market and she is concerned that her implants may be causing her symptoms. She reports fatigue but no nausea, vomiting, diarrhea, constipation, irregular bleeding, vaginal discharge, or bladder symptoms. She has no past medical history. Her surgical history is significant for Essure hysteroscopic sterilization 5 years ago. She is not taking any medication and has no known allergies.

Brooke Melton (GM), Michelle Pfeleger (Yasmin/Yaz), Linda Isner (Vioxx), Gene Weeks (Vioxx), Trudy Thomas (Kugel Mesh), Erika Langhart (NuvaRing), and David Foscue (Zimmer) are but a handful of the faces behind multidistrict litigation statistics. Stories like theirs lurk within many of the more than 312,500 actions included in this book’s dataset. In each case, it would be easy to pin blame on the lawyers, the FDA, the company, or the doctors. But targeting only one paints an incomplete picture and misses the point: there are problems with each that affect, reflect, and amplify failings elsewhere.