Multidistrict litigation (MDL) cases now comprise a majority of the federal docket. And MDLs often are one of the only means of providing victims of mass-torts with the possibility of redress. But even after Federal Rule of Civil Procedure 16.1 took effect on December 1, 2025, there is limited guidance for courts, lawyers, and litigants. Despite this, as Nora Freeman Engstrom identifies, “These decisions can affect hundreds of thousands of litigants and, in many cases, the legitimacy of the civil justice system itself.” Unsurprisingly, MDLs provide a frequent subject for legal scholars.
Even the best scholarship frequently misses a vital component, however—the on-the-ground experiences and stories of the litigants themselves. Elizabeth Chamberlee Burch’s new book builds on her earlier work to address this gap, providing a unique window into the pelvic-mesh MDLs and how unscrupulous lawyers, doctors, and con artists preyed on vulnerable women.
Beginning in the late 1990s, transvaginal mesh was used to treat pelvic organ prolapse in women. Thousands of women experienced significant complications from the treatment. Eventually the FDA banned its use. Many affected women sued the makers of the pelvic mesh, with the lawsuits consolidated into an MDL. Crooked lawyers targeted these women, persuading them to undergo unnecessary surgeries to remove the mesh– ostensibly for their health but really to boost the economic value of their cases and trap them in high-interest loans.
Burch reviewed thousands of court records and interviewed more than a hundred people to tell the full story of this scandal, pairing her legal expertise with deeply insightful reporting that centered the stories of three plaintiffs who fell prey to the predatory tactics. Humanizing the legal issues makes the book especially powerful in several ways.
First, the plaintiffs’ experiences demonstrate the vast gap between the formal rules and the lived reality of the law. In one interview, Burch described her students’ questions about the book “because everything they’re learning in all their other classes say you can’t do this.” I confess to having the same reaction. At dozens of points in the book, I stopped reading to silently rant about the professional-conduct and procedural rules that were broken. But I had the advantage of knowing these rules, being able to take a break from the book, and not suffering any of the harms.
In contrast, the three profiled plaintiffs—Sharon Gore, Barbara Shepard, and Jerri Plummer—never got to step away. And that leads to the second key contribution: the stories make salient the breaches of trust by their original lawyers as well as the lack of any real oversight or accountability from the legal system. Burch and other scholars have covered the potential disconnect between MDL lawyers and their clients; these personal accounts breathe real life into the issues. And the popular media has picked up on this, with Burch’s book garnering a detailed positive review in The New Yorker.
Third, Burch’s reporting and analysis highlights the complexity of legal reform. While loosening regulations on legal practice is often viewed as promoting access to justice, it carries real risks Some of the worst actors were non-lawyers who ran the “law firms” that were, in fact, call centers soliciting vulnerable women.
Fourth, Burch challenges some conventions of legal academia by demonstrating the power of storytelling. In this way, it leans in the direction of the emerging participatory legal scholarship movement and centers the voices of those most directly affected by the law, not just Ivory Tower experts.
In her New Yorker review, Casey Cep called Burch “the Jane Goodall of complex litigation.” And The Pain Brokers is an important contribution to the literature, offering a fresh perspective on evergreen themes—how economic resources interact with access to justice, how procedural rules influence outcomes, the effectiveness of the legal profession’s self-regulation, and more.
[Editor’s note: For another review of The Pain Brokeers, see Anthony Sebok, The Shame of Mass Torts, JOTWELL (April 15, 2026).]
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