The Pain Brokers: How Con Men, Call Centers, and Rogue Doctors Fuel America's Lawsuit Factory

by Elizabeth Chamblee Burch

Selling the Dream meets Empire of Pain in this shocking, never-told-before story of three women caught in a web of telemarketing scammers, shady doctors, and profit-hungry lawyers who turned fears surrounding a faulty medical device affecting millions of women into a goldmine.

For decades, late-night television has blared a familiar If you or a loved one has been injured by X product…

But behind those ads lies a lesser-known world where elaborate scams revictimize the injured. Why else would thousands of women with health insurance take out loans with astronomical interest rates and fly to south Florida to have their pelvic mesh surgically removed at a chiropractor’s clinic?

The Pain Brokers, by law professor Elizabeth Burch, is a damning investigation of a scheme made possible by a medical and legal complex that too often views women’s bodies as cash machines and fails to take their pain seriously.

As Burch unfurls each level to the scheme, we meet an enthralling cast of characters, from a world class scam artist who reaped tens of millions of dollars at a south Florida call center, to the ultimate white shoe power lawyer who defended Big Pharma but became an unlikely hero, to a newly minted small-town Arkansas attorney who advocated for the unseen and unheard. But at the center are three women, Jerri, Barb, and Sharon, whose lives were upended by the very procedure they were told would save them.

A page-turning, urgently necessary work of public service journalism, The Pain Brokers is not only a chilling exposé of a legal system gone awry, but a wake-up call to the ways in which it harms those it is meant to help.

Genres: Nonfiction, True Crime, Health, Audiobook, Business

352 pages, Hardcover

Published January 13, 2026

About the author

Elizabeth Chamblee Burch is an award-winning scholar and the Fuller E. Callaway Chair of Law at the University of Georgia School of Law. A prolific author on mass tort lawsuits, she is also a frequent commentator in national news media such as NPR, The New York Times, The Wall Street Journal, Forbes, USA TODAY, and the Los Angeles Times.

Reviews

[Brendan (History Nerds United) · Rating 5 out of 5]

I'm not allowed to curse in reviews, but the first words that popped into my head after finishing Elizabeth Chamblee Burch's The Pain Brokers rhymed with "bucking bell." (Yes, in Gordon Ramsay's voice.) Fair warning, I go nuts with the parentheticals in this one. I'm not sorry.

To be clear, my dismay has nothing to do with the execution of the book. Burch nails a very complicated story in her first foray into "not super boring legal briefs." (If you are a lawyer and you are insulted by that, please be honest with yourself.) Anyway, we will get back to Burch's successes. Let's jump to the failure of humans as a species.

The Pain Brokers is about the pain and anguish caused by...well it's not even one thing! Do we want to start with the pharma companies that put highly defective vaginal mesh devices in women? Not enough? How about the lawyers trying to crush the very legitimate lawsuits? Nope, not done yet. How about the web of companies that grab these mass tort cases (not a food, but it sounds delicious, and is actually a case that resembles class action lawsuits, kinda)? (Again, for the lawyers, yes I know they are not exactly the same, that's why I said "resembles." Stop harassing me, I'm talking to my fellow normies.) Where was I? Oh yeah, we can get to the final level of hell with the lawyers who are going to sue the other lawyers to finally find justice for these women but refuse to because they can't make enough money off them. I didn't even mention the doctors!!

Now, listen, I know we went on a whole adventure there. Good news, Burch explains this all way better and much simpler than I did. Burch is a super fancy lawyer herself, but she never reverts to legalese when good old-fashioned plain language will do. She does a fantastic job making all the characters (and there are a ton) stand out. Some because they are slimy Florida types (not bashing Florida, that's just literally where they are) who want to seem like gangsters but are more likely to just pick your pocket. Her most important work is bringing to life the pain of the women who are caught in the maelstrom. Without spoiling anything, Jerri is going to break your heart.

I should warn readers that this is a deeply involved true crime book as opposed to a quick recap of a violent crime and its investigation. For comparison, this is like the difference between Only Murders in the Building and Breaking Bad. One of those shows is a lighthearted romp where your attention is not fully expected and it's all over in about 30 minutes. Breaking Bad is meticulously written, paced and may leave you feeling enraged or sad. I love both of them, but you need to know what you are getting into. The Pain Brokers is a must read so make sure you find time for it.

(This book was provided as an advance reader copy by NetGalley and Atria Books.)

[CatReader · Rating 4 out of 5]

Elizabeth Chamblee Burch is an American lawyer and full professor at the University of Georgia School of Law; her academic research focuses on mass torts. Her 2025 book The Pain Brokers explores the convoluted and opportunistic industry of mass torts involving pelvic mesh removal, in which (as these medicolegal issues often go) patients ultimately suffered the most harm.

This is a very well-researched, comprehensive and compelling book. I listened to the 13-hour audiobook version, and at times the very large cast of characters was difficult to keep straight. Though Burch clearly has a bias in her telling (a bias that'll likely be shared by most readers), she does a good job of humanizing even the villains of the story.

As a physician, I am often forced into a professionally circumspect take on books that feature other physicians acting in less than ideal ways, and the use of medicine, pharmaceuticals, medical devices, etc. being utilized in ways that prioritize profit over long-term safety and efficacy. So I felt conflicted through much of this book. Though I'm not in a surgical speciality and haven't personally ever used pelvic mesh on patients, I understand that pelvic mesh has in recent years fallen out of favor due to a mix of safety risks, litigation risks, and available alternative treatments; still it's important to note that when drugs, medical devices, etc. pass regulatory hurdles and appropriate trials and are approved for use, the there are still many unknowns on how they'll perform in all patient populations and over time. This is a hard concept to explain to laypeople as they decide whether or not to try a certain treatment, yet through the process of informed consent we need to do the best we can to communicate all the nuances.

Further reading: medicolegal issues broadly
The Danger Within Us: America's Untested, Unregulated Medical Device Industry and One Man's Battle to Survive It by Jeanne Lenzer
No More Tears: The Dark Secrets of Johnson & Johnson by Gardiner Harris
Death in Mud Lick: A Coal Country Fight against the Drug Companies That Delivered the Opioid Epidemic by Eric Eyre
False Claims: One Insider’s Impossible Battle Against Big Pharma Corruption – A Mother and Whistleblower's Decade-Long Fight for Truth by Lisa Pratta
Toms River: A Story of Science and Salvation by Dan Fagin
The Genome Defense: Inside the Epic Legal Battle to Determine Who Owns Your DNA by Jorge Contreras
Wonder Drug: The Secret History of Thalidomide in America and Its Hidden Victims by Jennifer Vanderbes
To Dye For: How Toxic Fashion Is Making Us Sick--and How We Can Fight Back by Alden Wicker

My statistics:
Book 41 for 2026
Book cumulatively

[Ashley · Rating 4 out of 5]

(4.25/5, rounded up bc I make the rules here)

I knew going in that pelvic mesh is to gynecological/urological tech as talc+baby powder is to cosmetics/hygiene products, but I didn't realize just how many bad apples were in the mix. I thought it was a concentrated, straightforward issue: docs putting mesh in when they really shouldn't. But noooope, 𝙩𝙪𝙧𝙣𝙨 𝙤𝙪𝙩 𝙩𝙝𝙚𝙧𝙚 𝙬𝙚𝙧𝙚 𝙚𝙣𝙩𝙞𝙧𝙚 𝙘𝙤𝙢𝙥𝙖𝙣𝙞𝙚𝙨 𝙘𝙧𝙚𝙖𝙩𝙚𝙙 𝙛𝙤𝙧 𝙩𝙝𝙚 𝙥𝙪𝙧𝙥𝙤𝙨𝙚 𝙤𝙛 𝙛𝙪𝙧𝙩𝙝𝙚𝙧𝙞𝙣𝙜 𝙩𝙝𝙞𝙨 𝙩𝙚𝙧𝙧𝙞𝙗𝙡𝙚 𝙥𝙡𝙤𝙩. I am absolutely appalled & unable to shake these beautiful women's stories.

& I am SO grateful to Jerri, Sharon & Barb for sharing these raw, heartbreaking moments & sad truths w Elizabeth. These stories are extremely hard to hear, so I can't even begin to imagine how hard they are to have lived—and continue to have to fight through. 𝐖𝐞, 𝐚𝐬 𝐫𝐞𝐚𝐝𝐞𝐫𝐬, 𝐡𝐚𝐯𝐞 𝐭𝐡𝐞 𝐨𝐩𝐭𝐢𝐨𝐧 𝐭𝐨 𝐩𝐮𝐭 𝐭𝐡𝐢𝐬 𝐛𝐨𝐨𝐤 𝐝𝐨𝐰𝐧 𝐰𝐡𝐞𝐧 𝐢𝐭 𝐠𝐞𝐭𝐬 𝐭𝐨𝐨 𝐠𝐧𝐚𝐫𝐥𝐲. 𝘑𝘦𝘳𝘳𝘪, 𝘉𝘢𝘳𝘣 & 𝘚𝘩𝘢𝘳𝘰𝘯 𝘯𝘦𝘷𝘦𝘳 𝘩𝘢𝘥 𝘵𝘩𝘢𝘵 𝘭𝘶𝘹𝘶𝘳𝘺.

I know better than to think this kind of terrible, terrible thing happens inside a vacuum. But when I read some of this took place in my home state? I was shocked. Tbh, I thought FL just was wildin' per usual (sorry @hussy_for_hardbacks & @kristen__arnett, I've changed I swear 😅)...but no, this spans across multiple states over multiple years.

& idt I'm spoiling anything by saying this, if anything it's a warning: ONE OF THE "DOCS" STILL FKING PRACTICES! THAT SHOULD TERIFY YOU!
If nothing else, let this review serve as a reminder to check & double check...thennnn maybe even triple check your providers before going under the knife. I don't mean on their own websites, bc this sh!thead's website STILL makes him sound like god's gift to women 🤢 Check reviews beyond the scope they have access to. Be careful about who, what & where you trust. I don't say this to shame or speak poorly of the women impacted by 𝙏𝙝𝙚 𝙋𝙖𝙞𝙣 𝘽𝙧𝙤𝙠𝙚𝙧𝙨—it could have happened to any of us (see quote included about trusting lawyers, docs, etc). I just say it as a soft reminder, in case you don't end up picking this up for yourself.

Thank you bunches to NetGalley, One Signal, Atria & Elizabeth Chamblee Burch for the #gifted physical ARC & DRC ❣️

[Daulton Freeman · Rating 5 out of 5]

Phenomenally written and an example for how other non fiction writers should write. Really appreciate reading the book as a narrative and being able to learn so much. It’s absolutely sickening though to see the flaws in our medical, legal, and justice system, but imperative for others to read and learn.

[Howard · Rating 4 out of 5]

Thanks to NetGalley and One Signal Publishers/Atria, an imprint of Simon & Schuster, LLC [the publisher] for an eARC of The Pain Brokers: How Con Men, Call Centers, and Rogue Doctors Fuel America’s Lawsuit Factory by Elizabeth Chamblee Burch, with an expected publication date of January 13, 2026, in return for an honest review.

This is an important book, and Burch, the author (and law professor) does an excellent job of describing a complex topic, with numerous players, in an understandable manner. I believe there are 34 people listed in the cast of characters at the beginning of the book, for an easy reference to all the moving parts. The book is broken down into four parts: The Players and the Game, Scrambling for Cover, The Chase, and The Reckoning. The Pain Brokers is the specific story of litigation involving surgical mesh implants to reverse incontinence in women. Typically in a story involving medical devices the lawyers defending the manufactures are portrayed as the bad guys, fighting to prevent the righting of a wrong. But that is not this story. The lawyers defending the manufacturers [along with a few journalists] are fighting to uncover the exploitation of women that have been recipients of these meshes.

It's a complicated story. First, we have to understand the world of mass tort litigation, where product liability cases are often rolled into one huge case, so that one judge or judicial panel can become expert on the litigation and prevent 10,000 individual cases, for example, instead of one. We learn about a loop hole in the District of Columbia which allows for law firms with no lawyers. We learn about the networks which have arisen, often overseas, to call and accumulate plaintiffs. We also learn about the financing of these mass torts, which often inspires shady medical practices and exploits the plaintiffs.

Next, we learn about the specifics of this issue. The concern that the FDA came to have with meshes used to hold organs in place, but not necessarily those that reduced/prevented incontinence. Unscrupulous call centers [exploiting violation of US HIPPA privacy laws] cold call women, tell them they are at risk of dying, and tell them two extremely disreputable things: they need the mesh removed immediately and that can only be done by their doctors, and they cannot use insurance. The stories of the women victimized by these tort lawyers are heartbreaking.

Third, Burch tells the story of the defense lawyers as they uncover the fraud and work to shut down the networks. With limited success, they ultimately turn it over to the Department of Justice and a lawyer representing patients suing the doctors and financiers. While there are heroes and villains, unfortunately, this is not a story with a great happy ending.

I rated this book four stars because of how it tells the overarching story of mass tort lawsuits. The author is either explicitly biased in favor of the Democratic party or allows her “characters” to be so. For example there are a couple of instances where it is bemoaned that the cases are before judges appointed by Republicans rather than by Obama or Clinton. Because of this apparent bias, the book never touches on the sway that the tort attorneys have with the legislators, and how the law is often written to benefit them. As a result, we have a system which benefits the lawyers, the insurers to some extent, and at the bottom of the pile are the plaintiffs.

So I recommend The Pain Brokers for what it does, but wish it might have been more. This is a sad and disgusting story, and I’m glad that Burch has told it in a very clear and understandable way.

[Emily · Rating 5 out of 5]

This was excellent and very well done. The author does a fantastic job laying out how this scheme worked and exactly how egregious and harmful it was. The amount of greed and total lack of empathy just boggles the mind.

It did start to feel a little long in the final section of the book. I (perhaps stupidly) was hoping for a neater or happier ending, too, but here we are 🤷🏼‍♀️ Sigh. This country is a bunch of greedy con men in a trench coat.

Thank you to the publisher for the ARC!

[Laura · Rating 4 out of 5]

This took some time to get through, but it was worth it. Fascinating!

[Macey Dyer · Rating 5 out of 5]

This is actually probably closer to a 4/5 for me but the story is just so compelling and absolutely needed to be told. It’s crazy this shit went on and continues to happen with other MDLs/mass torts lit and it’s honestly super disheartening to know people are taken advantage of in this way just bc of greed. Love Ms Barbara for doing what she needed to do and the three women who told their stories about how the surgeries completely changed their lives (in a very bad way). The book just had so many players that it was a bit hard to follow but I think Burch outlined it as best as she could’ve. Overall super interesting and important read.

[Deah]

I liked reading this book, although not quiiiiiite as much as Johnson and Johnson: No More Tears (if you want a book that will really shake your faith in the medical system, read that one). This book will just reinforce what we already know: there are actors in the medical and legal realm that will bend, break, and ignore the law to make big bucks, and as a result, innocent people are hurt. Almost no legal recourse is afforded to them, and very few people get punished. But hey, someone got rich.

[Caryn · Rating 3 out of 5]

Well written, informative, but so frustrating. Yes, just like No More Tears and Empire of Pain. But for whatever reason, I had a hard time holding interest. I do think a lot had to do with the amount of people covered and how they were all connected. That felt hard to follow. I think if I saw this on screen it would be much easier. I can’t believe the type of people who would choose to let women suffer over their own greed but that truly is made clear in this book.

[Bethany Mock (bethanyburiedinbooks) · Rating 5 out of 5]

Thank you @crownpublishing @simon.audio #partner for the gifted copies of this book!

It seems every time I pick up a nonfiction book I unknowingly (or maybe knowingly?!) set myself a personal goal to become completely enraged. I don’t know.

Mission. Accomplished. Elizabeth. 👏🏼👏🏼

Holy hell. Truly. Reading this shortly after No More Tears has officially made me lose what little faith in humanity I had left. Like… where does the greed stop? WHERE. Because apparently the answer is nowhere.

If you remember me ranting about Johnson & Johnson knowingly putting pelvic mesh into women despite knowing the damage it caused — buckle up. This book focuses on the aftermath and somehow it gets even darker. Instead of just harmful products, we’re talking about doctors, lawyers, call centers, and absolute bottom feeders of society preying on women who already suffered. Names illegally obtained. Women manipulated into surgeries. Paperwork they didn’t understand, couldn’t read, or never even received. All driven by the same motivation as always: money. Greed. Profit over people.

Once again, it’s women who had already endured far too much paying the price.

Did this book make me see red? Absolutely.
Did it make my blood pressure spike? Probably.
Am I still incredibly grateful I read it? 100%.

As rage inducing as this was, I’m thankful for the education. Books like this only reinforce why I question everything when it comes to my health. I refuse to “just do it because everyone says so,” and stories like these are exactly why.

So…thank you, Elizabeth, for the educational session I didn’t know I needed...even if it left me staring at the wall afterward questioning humanity 🫠

Important, infuriating and necessary reading.

[Ryan Carrow · Rating 5 out of 5]

This will just piss you off!

[Barb Novak · Rating 3 out of 5]

I came into Elizabeth Chamblee Burch’s well-researched expose - The Pain Brokers - with a little bit of knowledge about pelvic mesh gained from No More Tears: The Dark Secrets of Johnson & Johnson (Gardiner, 2025) and with my limited legal knowledge coming from adolescent reading of early John Grisham or various Law & Order spin-offs. I guessed that a lot of the settlement in an individual case in a mass-torte most likely went to legal fees and not the defendant. I was walloped by the intricate, greedy, and devastating scam that can be related to mass-tort detailed in The Pain Brokers.

The Pain Brokers focuses on the mass-tort brought by women whose lives were negatively impacted by pelvic mesh. (A mass-tort is a collection of similar cases by different plaintiffs against the same defendant). To personalize the scam and legal battle, Burch focuses on Jerri, Sharon, and Barbara, three very different women for whom pelvic mesh resulted in pain, depression, sexual challenges, worsened incontinence, and financial cost.

The three women each received an unexpected phone call where the caller provided personal details about each woman’s pelvic mesh insertion followed by claims that the mesh was dangerous and needed to be removed immediately. The caller then connected each woman to a concierge to arrange the procedure with a knowledgeable doctor. The concierge booked travel to the doctor, arranged a loan to cover the cost of travel and the procedure (which couldn’t be covered by insurance), and provided a lawyer to engage the woman in the mass torte.

The call was accompanied by a massive DocuSign contract, and the travel and procedure happened immediately. Concealed within the DocuSign contract were exorbitant fees (up to 38% interest) for the travel loan, inflated costs for the removal procedure, and high legal fees all of which would be paid from the woman’s settlement from the mass torte case. For Jerri, Sharon, and Barbara the costs far exceeded their mass torte awards, leaving each not only with worsened medical conditions but also owing money.

The cast of characters - mostly villains - in The Pain Brokers is enormous and listed at the beginning of the book. Burch takes efforts to make The Pain Brokers read like a legal thriller than a journalistic expose. About 30% into The Pain Brokers, I was morally outraged and invested in the outcome of the mass-tort and punishment for the bad actors. But, the very details intended to make The Pain Brokers more compelling (like backstory of each person involved and the details included to set the scene) began to feel uninteresting. I skimmed the majority of The Pain Brokers, focusing on outcomes of the various legal proceedings. I ended feeling simultaneously glad to have learned about this scandal and horrified that much of what happened was legal and continues to be used in mass-torts.

Thanks to NetGalley, Atria, and Elizabeth Chamblee Burch for the advance copy in exchange for an honest review.

[Mary · Rating 4 out of 5]

Thank you to NetGalley and Atria/One Signal Publishers for providing me with an advanced copy of this book in exchange for my honest review!
----------
For decades, late-night television has blared a familiar refrain: If you or a loved one has been injured by X product…

But behind those ads lies a lesser-known world where elaborate scams revictimize the injured. Why else would thousands of women with health insurance take out loans with astronomical interest rates and fly to south Florida to have their pelvic mesh surgically removed at a chiropractor’s clinic?

The Pain Brokers, by law professor Elizabeth Burch, is a damning investigation of a scheme made possible by a medical and legal complex that too often views women’s bodies as cash machines and fails to take their pain seriously.

As Burch unfurls each level to the scheme, we meet an enthralling cast of characters, from a world class scam artist who reaped tens of millions of dollars at a south Florida call center, to the ultimate white shoe power lawyer who defended Big Pharma but became an unlikely hero, to a newly minted small-town Arkansas attorney who advocated for the unseen and unheard. But at the center are three women, Jerri, Barb, and Sharon, whose lives were upended by the very procedure they were told would save them.

A page-turning, urgently necessary work of public service journalism, The Pain Brokers is not only a chilling exposé of a legal system gone awry, but a wake-up call to the ways in which it harms those it is meant to help.
----------
Malpractice attorneys advertising their services to fight against things like cancer from asbestos or talcum powder exposure or medical mesh (the topic of this book) on late night television always gave off a feeling of "ick" to me. And it turns out I was not wrong, as I learned in this book from Elizabeth Chamblee Burch. Although I am not of the opinion that all lawyers are bad, there are definitely members of the profession that are unsavory, and we meet some of them in her book. While this is the story of three different women and their search for justice, it is also an indictment of a system that allows them to be exploited in the first place. While you might expect such a work to be dry and difficult to work through, as some nonfiction books can tend to be, Burch's style and focus on the humanity at the center of this story makes this a very readable book, and I found myself invested in the stories behind her cast of characters as much as in the very scheme that she came to expose.

[Adam K · Rating 4 out of 5]

The healthcare system in the United States leaves countless thousands of people in dire straits with grave regularity. The health insurance companies and their Byzantine modus operandi is a daily source of frustration and suffering across the nation. In the face of all of this, there are still people who look at the system and ask themselves, "How else can I exploit people for even more money?"

That is who this book is about. Crooked middle men and their agreements with doctors, lawyers, and other con artists to take advantage of vulnerable people by either skirting the law or just straight up breaking it.

The con outlined in this book is essentially this:
1. Find women who had pelvic mesh implants.
2. Scare them into believing they’re in danger
3. Send them to a specific clinic for surgery
4. Slip legal contracts and loans into digital paperwork
5. Inflate the cost of the surgery
6. File lawsuits that generate fees
7. Everyone in the pipeline gets paid except the patient

The women with these mesh implants are already struggling with their physical health. The pelvic mesh implants likely do not pose an immediate danger, but they are hounded by urgent phone calls convincing them that they are. These women are then fed into a conveyor belt system where everyone along the chain siphons off as much money as they can from the victim with no thought to their well-being.

Instead of helping injured patients, this system treats them as financial assets. The goal is not medical care or legal justice. The goal is to manufacture valuable lawsuit claims and extract fees from them. Even if a lawsuit against the medical manufacturer is successful, almost all of the settlement money goes back to the middle men with the victim seeing little to nothing. They are left with no money and maybe even ruined bodies from irreversible surgical procedures that they were scared into getting.

Author Elizabeth Chamblee Burch heavily implies in the introduction that this is not uncommon, and that the pelvic mesh example that this book focuses in on is just one of many scams out there. The criminals in this book (and many of them are actually convicted criminals), are truly bottom feeders who take and only give misery in return.

Though the nature of the story being told lends itself to a frustrating read, I think this is another important bit of American society people need to be aware of. My only gripe with the book itself is that Burch tends to parcel out the story in smaller pieces, likely for narrative effect. However, for me personally, it ended up muddling the overarching explanation of the scam itself among all the details. Still, I think this is worth reading for the light it sheds on this industry and the lives of the victims left in its wake.

[Andrew · Rating 4 out of 5]

For me the title suggested a connection between this book and the over-prescription of pain killers that triggered the ongoing opioid epidemic. But this book is not about addiction, but rather greed. When verdicts began to come in awarding plaintiffs awards for damages caused by surgical mesh, an industry sprang up to exploit the emerging MDL (multi-district litigation). The goal was to recruit patients who had had mesh implants to join the litigation, increasing the potential pay out when the mass tort was resolved. These entities would then collect their cut of the award. Where things got truly awful was when they recognized that having the mesh removed increased the potential award. This triggered a concerted effort to pressure or trick patients into having potentially unnecessary surgery, performed by doctors that were part of the scheme, and financed by funders who were also part of the scheme. In the end, the patients were often far worse off than they started and burdened with a debt that would ultimately consume any litigation award they might win. This book chronicles this terrible abuse, and the efforts of a few lawyers to bring those responsible to justice. While this book is informative (and has me looking at commercials advertising for patients that might qualify for court ordered compensation in an entirely new light), it was absolutely infuriating to read. The cruelty inflicted on the patients in pursuit of profit is a true subversion of both the legal and medical systems.

[W C · Rating 2 out of 5]

I made it about 85 pages in when I couldn't take the medical inaccuracies anymore. Page 11 states, "She'd given birth to her first child by cesarean section, and though neither her nor her doctor realized it, he nicked her uterus, leaving a pin sized hole." During a C section, you purposely cut open the uterus pretty wide to deliver the baby and then suture it up. The space between the sutures are holes (just by the nature of sewing something up...). I'm not sure what this author means by this sentence.

The author also conflates the different pelvic mesh products available and their indications for use. There are transvaginal mesh (which is banned by the FDA currently), transabdominal pelvic mesh (currently in use), and mid urethral sling mesh (currently in use). She points out that there are surgeries for incontinence and pelvic organ prolapse that do not use mesh and states that they aren't used because they don't involve mesh and hence no profits, but there are studies that compare long term success and also invasiveness in these different techniques-there's a reason why mesh would be used that she does not cover.

This book is supposed to paint the story of the victims and the lawsuit injury, but the medical foundation its based on is shaky and takes away from the story. Yes, there is true greed and women who have been exploited, but I can't read this book when she gets the basic tenets incorrect.

[Cari · Rating 5 out of 5]

Advanced copy received from Edelweiss.

Apologies for any mistakes I might make in this review - the situation is winding and complex, and I didn't fully understand it even after going over it a bunch of times. This book is about mass torts, where a company is sued for damages by thousands of plaintiffs together. It is absolutely insane to me what happened to the women spotlighted in the book. They were targeted by a call center that had their medical information. Cold callers reached out to those women and got them scared about recalls on vaginal mesh that would have been installed for incontinence purposes. This got them into the predatory lawsuit against the negligent company, where they signed papers to enter extremely high-interest medical loans so that lawyers would make more money on the lawsuit if/when it happened. The medical loans were then used to send them to a shady hospital where they would have their vaginal mesh removed, often making the problem ten times worse than it was before. As the women wait for a court ruling, often unsure who their lawyers even are, these suits and medical information get bought and sold. The con artists behind these convoluted circumstances are making bank on people's suffering. It's fascinating but so, so awful, and I'm glad to know about it now in case I can save anyone I know from harm.

[Montana Reid · Rating 5 out of 5]

4.5 Stars - Thank you to Atria Books for this giveaway in exchange for a review

This is a very important piece of journalism and I hope it ends up getting a documentary for the sake of more mainstream visibility. This must have taken an insane amount of tedious work to put all the names, cases, organizations (both real and fake), etc. together coherently. I could barely follow all the subterfuge and various parties involved, and all I had to do is read it - I couldn't imagine trying to collate all of it.

Everything about this issue stems from greed. The pelvic mesh is supposedly designed to stop incontinence and keep organs in place. The companies who sell women on the pelvic mesh implant aren't concerned with its efficacy, long-term viability, or whether or not alternatives would be preferable. The individuals (often hiding behind fake company names, using legal loopholes, hiding cash, and engaging in general obfuscation) are nominally lawyers (actually just call centers) who funnel these women into corrupt doctors (who don't accept insurance and who get financial kickbacks), and insist with a false sense of urgency that the mesh must be removed or they risk death (because the cases are worth more only if surgery is performed and the mesh is removed). And the reality is that the mesh often doesn't work as it's supposed to and can cause serious issues. The FDA failed to take note of this for a significant period of time. The procedure itself is supposed to be a delicate one that takes 6-8 hours; in reality, the mesh is ripped out by one of the so-called doctors in ~15 minutes. The victims are led to believe that they will end up with a significant settlement and that they won't end up owing anything for the removal once all is said and done. At the end of the day, the women are left worse off than they would've been had they not undergone the mesh removal surgery, and, due to more corruption, end up with either no money, or owing on the insane high interest medical loan that was supposed to be paid off from the hypothetical settlement with the mesh manufacturer.

It really is a sad case of of corrupt rich freaks (who have already been in legal trouble for past scams) benefiting from the negligence and corruption of corporations (the mesh manufacturers) and due to all of the loopholes to which only the financial elites have access, which is ultimately to the massive detriment of regular, everyday people who have no solid recourse to attain anything resembling justice. This has ruined lives. White-collar criminals need to be held accountable. The more people that read and learn about this topic, the better.

[Jen Juenke · Rating 4 out of 5]

This story is disgusting on so many levels. The most important was preying upon innocent women who had vaginal mesh implanted in them, then greedy people turned their misery into a profit making mill for themselves. There really was NO concern about the women.

The first part of the book is hard. Its hard because I had no clue what was going on or who was involved. The author really needed a flow chart for me to understand what was happening and who was apart of it.

After the first part, it got a bit easier to understand what was happening. BUt not by much.

When Arkansas came into the story, and the NEw York Times, it got so much better.

Finally I was able to fully comprehend what had happened to these poor women. I wish that the author had said how much the women had got, did the courts ever recover some of the damages that it had ordered and ways to prevent this abuse in the future.

Overall this book is wonderful at what happened during the vaginal mesh lawsuits and how greedy attorneys, doctors, and 1800 numbers got rich off the fears of women.

Thank you to the publisher and to netgalley for the ARC in exchange for this honest review.

[Carol Lynn · Rating 5 out of 5]

A new question that might indicate a nonfiction book is good: Am I going to be assassinated for reading this? Elizabeth Chamblee Burch does a great job describing how quickly greed can spread when sharks smell that there is blood in the water. It's terrifying how many people could be involved with a "mesh removal mill" that butchers women's undercarriages to crank out higher lawsuit profits. Doctors, Big Pharma, call centers, lawyers... every time a new player entered the game, I kept thinking "this will be the guy that hits the brakes". No, too many people in khakis were (are?) willing to take a paycheck over a morals evaluation. More people should've been trying to poke holes in this balloon. It was staggering to see how the rich could convince themselves they were raking in injury lawsuit profits because of their "family" or "for the victims' sake". This sort of journalism is desperately needed in our broken system. Five stars for getting the job done!

[AT · Rating 4 out of 5]

It is a bad sign when I, as a layperson without much medical knowledge, could tell that the author was making specious statements as soon as she started writing about the pelvic mesh and resulting complications. I believe a lot of Part 1, especially towards the beginning, is factually untrue, especially regards to current medical knowledge and best practice. My wife, who is in the medical profession and who has specialized knowledge of some of the procedures outlined in the book, started reading after me and could not get past the first 20 pages without going on a rant about how inaccurate everything was.

With that being said, when the book actually gets to the fraud and law portions, it gets a bit better. The web of lies, intrigue, and shell companies almost reads like a fictional network of villains. Unfortunately, it's all true!

Towards the end, the momentum kind of sputters out, but I still found it to be a worthwhile read.

[Edie · Rating 4 out of 5]

I had initially decided to not give feedback on this book, but I took my time, re-visited it and went through at a much slower pace. It is all about the details and a part of the law that I am not familiar with. I was a Paralegal for a state legislature for 30 years and my late Husband was a practicing attorney for 40 years after graduating from an Ivy League Law School.

The author brings long overdue attention to the failure of both medicine and law. While I would rate this book a 3, I am giving it 4 stars because of the victims that were taken advantage of. It was not a book that I would purchase.

Still...I thank NetGalley for the opportunity to read it in exchange for a fair and honest review.

[MICHEAL DOANE · Rating 5 out of 5]

The Pain Brokers by Elizabeth Chamblee Burch is a precise and unsettling examination of how legal, medical, and financial systems can converge to exploit the very individuals they are meant to protect.

The book’s strength lies in its structural clarity. By mapping the interconnected roles of telemarketers, medical practitioners, and legal actors, it exposes not isolated misconduct, but a coordinated ecosystem driven by profit and enabled by systemic gaps.

At its core, this is a work of accountability. It reframes personal tragedy as institutional failure, positioning the narrative as both an exposé and a broader critique of how vulnerable populations are commodified within complex systems.

[Darnell · Rating 3 out of 5]

A fascinating account of a cynical and exploitative scheme. So many of the people involved are near caricatures, down to one lawyer who ran an abusive puppy mill on the side. The author did a fairly good job of managing an intentionally convoluted scheme, though the book could have used fewer "characters", which leads me to my major complaint.

The author thanks an MFA program in the acknowledgment and I'd like to anti-thank them for pushing her toward narrative nonfiction instead of what could have been an excellent book. This doesn't fall among the worst of that godforsaken genre, at least in part because dispositions are one of the few good sources of "dialogue".

[Amanda · Rating 4 out of 5]

Fascinating and infuriating - a bit of a slow start but gained momentum as it went on and read like a thriller by the end, though without the justice served/evil punished element of fiction, unfortunately. I can’t believe I was (kind of) cheering for a product liability defense attorney early on, but here we are.

I’m a nerd who would have liked a bit more about MDL and product liability and how to stop all these terrible people from taking advantage of laypeople from start to finish, but also it’s not like there’s any political appetite to stop the powerful and well-off from enriching themselves at all costs, so I might as well say I’d like a pony, I guess.

[Alexis · Rating 4 out of 5]

This was an infuriating read and so many ways and speaks too many faulty systems within our country.

Absolutely devastating to read about all the women affected by these con artists. The scheme starts at all levels and is not bias.

I enjoyed the authors writing style, and how the chapters were broken up with fun titles given the heavier topic.

I think it’s good to stretch our minds and read something from time to time that we don’t know that much about. I am reminded just how scary this world can be.

[Kitsa · Rating 5 out of 5]

I can not imagine not being both scared & angry after finishing this book. It is truly unbelievable how some people view you as nothing more than something to prey on & make a profit from. Nothing more.
Before reading this book I was completely unaware that this sort of thing was going on. I knew that those mass class action lawsuits seldom benefit the people that it should, but to think they have now perfected a way to seek out victims, simply to exploit them to leave them so much worse off with nothing. While the lawyers make millions, it's criminal, and sadly unpunished.

[Jacob Blott · Rating 5 out of 5]

As someone who doesn’t even enjoy non-fiction, this book is actually quite wonderful. Not only does this book perfectly capture the absurdities of the legal system, but the agency and voice these brave women have in this novel is incredible. Burch’s tone and authorial voice are so enjoyable to read and I really see this book blowing up! Can’t wait for the documentary that’ll come from this amazing story.

[Trista Cremeans · Rating 3 out of 5]

This is very reportage-heavy, focusing more on the systems and people involved than on a narrative throughline.

It’s informative and covers an important topic, especially if you’re interested in the ways medicine and profit can intersect in harmful ways, but it’s not the kind of book you read for flow or immersion.

Overall, a worthwhile read for the subject matter, even if the style didn’t fully engage me.