The obturator internus muscle has motor function at the hip during gait and can be the source of pain from injury.

On December 20, 2022, Dr. Jaime Sepulveda testified in a Dallas TVT-O mesh trial that the obturator internus muscle does not contract and does not spasm which was designed to mislead the jury as there is no basis in the literature for that opinion. Dr. Sepulveda has testified he is an ‘Ethicon-made millionaire’ and this statement, and others that he has made, will be the subject for peer review by the American Urogynecological Association (AUGS),” states Greg Vigna, MD, JD, national pharmaceutical injury attorney.

The testimony of Dr. Sepulveda is as follows:
Q. And you’ve previously testified that for your consulting work — and just to be clear I’m not talking about what Ethicon pays you to testify here today. Just your non-litigation work. You’ve previously testified that you’ve been paid at least a million dollars by Ethicon, right?

Q. You didn’t agree that you’re an Ethicon-made millionaire?
A. It was just a question that I wanted to get it over with, I say yes to that. But it wasn’t a trial. I thought my answer wasn’t great.

Dr. Greg Vigna, MD, JD, mid-urethral sling attorney, states, “Johnson & Johnson, and its subsidiary Ethicon, was recently nailed by the People of the State of California when the Supreme Court denied an appeal by the company, and Ethicon will now have to pay a $302,000,000 judgment that was ordered by the Fourth District Court of Appeals in San Diego which found ample evidence that Ethicon had knowingly deceived doctors and patients.” (case number: 37-2016-00017229-CU-MC-CTL)

As reported by the San Francisco Chronicle, California Attorney General Rob Bonta said, ”For years, Johnson & Johnson has refused to take responsibility for misleading patients and their doctors about the risks of a permanent and irreversible implant.”

Dr. Vigna adds, “Unfortunately, Ethicon continues to pay medical consultants, like Dr. Sepulveda, for defense expert opinions against women who claim to have serious injuries caused by Ethicon’s products. Dr. Sepulveda like most of Ethicon’s defense experts previously participated and profited as paid consultants in the marketing of Ethicon’s products as proctors during the years that were the subject of the 302 million dollar verdict against Ethicon and Johnson & Johnson for violations of California’s Unfair Competition Law and False Advertising Law.”

Dr. Vigna continues, “Going forward, I will be reporting to the American Urogynecology Society (AUGS) for review under their Expert Witness Policy the following: 1) Trial testimony of defense experts that reject the findings of fact made by the California Court, or 2) Trial testimony of defense experts that reject internal documents of Ethicon agents that have been admitted into evidence in a public trial, or 3) Trial testimony of defense experts that reject the 30b6 depositions of Ethicon’s corporate agents that have been admitted into evidence in a public trial, or 4) Trial testimony that reject the recommendations and authoritative literature that serves as the basis for the 2020 AUGS-IUGA Joint Position Statement on the Management of Mesh-Related Complications for the FPMRS Specialist.”

The AUGS Expert Witness Policy forbids: “Participating in communications to AUGS, the public, or as part of a judicial process which convey false, untrue, deceptive, or misleading information through statements, testimonials, photographs, graphics, or other means, or which omit material information without which the communication is deceptive.” (reference:

“Ethicon to this day has not warned of the specific risk of pudendal, obturator, and ilioinguinal neuralgia that can develop years after proper placement of their mid-urethral slings.” — Greg Vigna, M.D., J.D.

Dr. Vigna goes on, “Ethicon to this day has not warned of the specific risk of pudendal, obturator, and ilioinguinal neuralgia that can develop years after proper placement of their mid-urethral slings. Women require revision surgery for painful complications of mid-urethral slings at an astounding rate of 7.9 percent at 15-years, and many of those women suffer from serious life-altering neurological pain. The California court found that when faced with an FDA Warning regarding the serious risks of their devices, Ethicon hired doctors to write a public rebuttal of the FDA’s warnings. No surprise, really. Today Ethicon continues the practice of stuffing money into the pockets of their stable of physician consultants, some of whom will utterly say anything under oath for a paycheck no matter how false and no matter how harmful to women.”

Dr. Sepulveda’s testimony given on direct examination by an Ethicon attorney was designed to deceive the jury and is, flat out, false:
Q. Can the obturator muscles contract?
A. No. No, they have — we have — we have considered that question. Those obturator muscles don’t contract.

Q. And by contract, what does that mean physically?
A. There’s — they’re thin muscles. They’re not like — they’re not like a bicep, which has a lot more fibers. They’re thin, thin muscles.

Q. And what’s the significance of that?
A. They don’t contract.

Q. And by not contracting, does that mean – what does that mean? Can they spasm?
A. No.

Q. Why not?
A. Because they’re — they don’t have the characteristical — characteristics for spasming. They’re too thin. They’re too thin of muscles. They’re muscles of stability; they’re not muscles of – of support.

Dr. Vigna explains, “As a medical student we are taught that the obturator internus muscle has motor function at the hip during gait and can be the source of pain from injury. The literature supports this and to testify otherwise to jurors in a public trial under oath, for money, without a reliable basis is disgraceful. False and deceptive testimony will be subject to peer review process by AUGS and will be made public going forward.”

Dr. Vigna concludes, “Victims of Coloplast’s Altis and Aris slings, Boston Scientific’s Obtryx and Solyx, and Ethicon’s Abbrevo and TVT-O are fighting back, and future lawsuits will be filed against their implanting physicians and manufacturers. The trial testimony and internal documents from corporate witnesses that go to the manufacturers’ knowledge of the truth will be available to all going forward along with the testimony from the highly compensated defense experts that will be sent to the Board of Directors of AUGS for review.”

Dr. Vigna shares RED FLAG WARNING SYMPTOMS of neurological injury or the myofascial pain syndromes including Complex Regional Pain Syndrome from mid-urethral slings include:

  1. Groin pain
  2. Hip pain
  3. Inability to wear tight pants
  4. Clitoral pain or numbness
  5. Severe pain that makes vaginal penetration impossible
  6. Tailbone pain
  7. Anorectal pain
  8. Painful bladder
  9. Pain with sitting

Dr. Vigna is a California and Washington DC lawyer who focuses on catastrophic injuries and the neurological injuries caused by mid-urethral slings including pudendal neuralgia, obturator neuralgia, ilioinguinal neuralgia, and complex regional pain syndrome. Ben Martin is a national pharmaceutical injury attorney in Dallas, Texas. The lawyers represent women in courts across the country.

Learn more on the anatomical basis for TOT complications including obturator and pudendal neuralgia and the treatments of obturator and pudendal neuralgia.

Read a FREE BOOK on Vaginal Mesh Pain and for articles, video resources, and information visit the Pudendal Neuralgia Educational Portal.

To learn more on the Supreme Court denied appeal by Johnson & Johnson, visit:

To learn the function of the obturator internus muscle, visit these resources:

To learn more about the TVT-O adverse events to MAUDE, visit:


Greg Vigna, MD, JD
Vigna Law Group
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