I've only ever owned two double rifles, both European. One was in .405 Winchester (Belgian), a rimmed cartridge, and the other in .250-3000 (German), a rimless cartridge. The .250-3000 had the spring loaded pawl. Both extracted flawlessly. While I might have concerns on a dangerous game rifle, if only because the consequences could be fatal if extraction failed, I would not be too concerned about the issue on a medium game rifle.
That being said, Chapuis offers a number of rimmed cartridges that are quiet suitable for medium game and you might look at them. SIACE also made an interesting hammer double in a number of suitable calibers and I see them listed for sale from time to time.
