Weight loss surgery has dangerous potential complications
Surgeon delayed diagnosis and treatment of hole in stomach of gastric sleeve patient, leaving her with a feeding tube
I have handled a lot of bariatric surgery medical malpractice cases in my legal career, but recently was hired on a case that took me by surprise.
Weight loss surgery malpractice
In my experience, most bariatric malpractice cases involve gastric outlet obstruction, a condition that is often caused by a surgical error that makes it difficult or impossible for food to pass through the esophagus and stomach, into the intestines.
This can create a miserable situation for patients, where they experience never-ending nausea and vomiting, and overall inability to hold anything down. The nausea and vomiting typically lead to massive weight loss and malnutrition, which cause a host of other medical problems.
Experts will tell you that just because a patient develops gastric outlet obstruction does not automatically mean that the surgeon made a mistake or was negligent. I have handled cases where an expert said yes, there was negligence in the way the weight loss surgery itself was performed, and others where the expert said that there was no negligence in that regard.
What is clear, though, is that the standard of care requires weight loss surgeons to be on the lookout for unusual amounts of pain, nausea, vomiting, and dry heaving, which are signs of gastric outlet obstruction. When these signs are present, surgeons will frequently use radiology tests like an upper GI (barium swallow), MRI scan, or CT scan, to see if they can identify a problem.
If there is a kink, twist, or obstruction, the bariatric surgeon will likely need to take the patient back to surgery as soon as possible, to avoid long-term problems.
Hole in the stomach
When I recently spoke with a new client about her bad experience with a bariatric surgeon, I expected to hear about something like this. What she told me was different, though, and it really shocked me.
This person lives in Jefferson County, Texas, and saw a surgeon there about having bariatric surgery. Overall, she was pretty healthy for her age and held down a steady job. She decided to have a gastric sleeve procedure, because she hoped it would eliminate, or at least help, her diabetes.
She was admitted to a Port Arthur hospital for the gastric sleeve procedure. After the surgery, her blood work came back abnormal.
Two days after the gastric sleeve, she was taken back to the operating room to check for blood clots. Any time you have a surgery, there is an increased risks of forming blood clots, particularly in the deep veins of the legs, where blood tends to pool. If a clot breaks off and travels to the lungs, it is called a pulmonary embolism, which can be deadly.
Five days after the gastric sleeve, her doctors ordered an upper GI study (barium swallow) and an MRI to see if there was any evidence of a leak. Her surgeon told her that they had found a hole in her stomach, but they could not fix it.
Three days later, she was taken by ambulance to a hospital in Houston’s Texas Medical Center. They did an upper GI that verified a large hole in her stomach. The Houston doctors described her stomach as “basically mush” from infections and scar tissue and told her that there was nothing that they could do until it healed.
She was kept in the hospital for a week and a half, and then discharged on antibiotics, with drain tubes in place, and a feeding tube for nutrition. The last time that she was able to eat anything other than ice chips was before her gastric sleeve.
It will likely take months before her stomach heals enough for surgeons to be able to take her back to surgery and repair the hole in her stomach. By then, it is hard to tell what additional problems she will have developed.
Timing is important
Any weight loss surgery involves restriction or modification of your normal gastrointestinal (GI) anatomy. If there is a problem during or after the procedure, things can get bad very quickly, and may require a prompt return to the operating room.
While some level of pain is always expected after surgery, you need to be sure to inform your doctors and nurses of any unusual pain. A good time to start thinking about pain levels if before the surgery, when the surgeon tells you what to expect. If the pain that you experience is different than the range that you were told to expect, then tell your nurse and doctor. Similarly, if the pain seems to getting worse, rather than better, over time, that is information that your surgeon needs to hear.
Experts explain that some degree of nausea and vomiting is normal, but if it lasts more than 24-48 hours after surgery, something may be wrong. Surgeons also are particularly concerned about dry heaving after a bariatric procedure.
Another serious cause for concern that should be communicated to the surgeon is any unusual bleeding or clotting after a surgery.
When speaking to a surgeon, doctor, or nurse about these symptoms, be clear and precise about what has happened. Ask what tests can be done to see if there is a problem—things like a barium swallow (upper GI) or MRI.
If you are still hospitalized and have not seen your surgeon despite ongoing problems, be polite, but firm, with the nursing staff in your request to have the surgeon paged to come and see you. If necessary, ask to see a nursing supervisor or administrator, to get your surgeon’s attention.
We are here to help
If you or someone you care for has been seriously injured from bariatric or weight loss surgical malpractice, then call 281-580-8800, for a free consultation with an experienced Texas medical malpractice attorney at Painter Law Firm.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC, based in Houston, Texas. He exclusively represents patients and their families in cases involving medical negligence by doctors, surgeons, and hospitals. Robert Painter brings unique perspectives to the cases that he handles, from his previous background as a hospital administrator and as an attorney who represented doctors, hospitals, and medical schools at a large law firm, at the beginning of his career. He is a past editor-in-chief of The Houston Lawyer magazine, and currently serves on the editorial board of the Texas Bar Journal.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
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This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine
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