So, after some people have complained that a lawsuit I blogged about “was urban legend” (which it was not but I can’t ethically divulge the name of the doc involved) I will discuss a case that I can reference that I recently read about. See here. And here. The surgeons at my hospital perform a fair amount of gastric bypasses for morbidly obese people - usually to their benefit (like the docs in this case). However, it IS a dangerous surgery with a significant rate of complications as this case demonstrates. The big question is whether it is appropriate to perform the operation on people who are obese but have not yet suffered the complications of it.
These doctors were sued at this hospital in New Jersey because a 19 year old died of post op complications from a gastric bypass. Evidently, the patient was quite overweight but being only 19, was not yet stricken with hypertension and diabetes. He apparently wanted to have the operation because he wanted to fit into a movie theatre seat! Still, the guy was probably on the road to illness given his near 450 pound weight. I cannot comment on whether the doctors properly informed the patient as to the risk (but I can’t believe they did not), however one this is clear. This patient just had one of these bad outcomes (albeit a very sad one). His family’s lawyer claimed the patient was not given a CT scan when he presented back to the ER when he was clearly sick and in distress. Why? HE WAS TOO DAMN FAT!!!!! Most CT scanners top out at 325 -375 pounds! How could he get one! So what did he get instead? Better than a CT can - he got operated on! He was just too septic to save! Clearly, this is a sad case and very unfortunate - but ALL surgeries carry risk - sometimes you can die. YES, DO YOU HEAR ME! YOU CAN DIE! It is part of the deal. No one likes to think about it and I know life is supposed to be all rosy when you are 19 but sometimes bad things happen! They just do! Despite the best efforts of doctors, patients do die. Does that mean the doctors have to have a 1 million dollar settlement on their records? Their insurance rates will skyrocket - but the insurance company (who I am sure forced the docs to settle) figured it was cheaper to settle for 1 mil than to risk the decision of a lay jury (who in my opinion have no business in deciding malpractise verdicts, period)).
So that is it. Get really obese - and risk death. One way or the other.
Canadian Pharmacy
I agree!! How come people are so evasive to own up their own responsibility for their own life??!! And I think the american system of having all sorts of unqualified people giving verdicts (Layman’s jury) is ridiculous! Take the O.J Simpson case..people decide what is right, not in the light of what happened but because they have a bloody opinion about history and want to see justice done for those who died in the jurassic age to set an example over all!!
Since gastric bypass surgery is so complex and risky, why don’t people get lap-bands instead? Are they not as effective? Do they result in a smaller pay-out for the surgeon?
They do lap bands much more frequently nowdays. This case was from 2003 when they were not as common.
DUH- complications can result from any surgery-
Even a common c-section!
Once again, Jackpot Justice!
You aren’t supposed to weigh 450 lbs. when you are 19 either, or for that matter at any age. People who allow themselves to become that obese have really taken themselves to a place where normal expectations, like not dying at age 19 don’t obtain the way they might otherwise, like someone who abuses narcotics can’t really have the normal set of expectations about health and life expectancy.
I’m sure the trial lawyer didn’t see it that way. The deceased was painted as someone with hopes and expectations just like everyone else, except for the not-so-small fact that he was an active agent in thwarting those very hopes.
It is a shame for all concerned.
The jury is the only friend of the doctor in the court. Even in judicial hellholes, their verdicts favor the doctor 70% of the time. If the doctors thought they had done nothing to harm this patient, they had a duty to refuse to settle. It is not their money. They likely preferred to not bother with the effort and risk of a trial. If forced to settle without medical justification, they should sue their insurance company for bad faith.
So,
The issue here is that the hospital did not have the facilities to treat this man (appropriate CT scanner) and that because they did not have the facilities, this man had treatment that differed to what a ‘thin’ person would receive which resulted in his death.
Seems like discrimination here. The hospital should never have taken the patient if they did not have a full complement of machines/facilities to treat him.
Regardless whether or not you think the CT was necessary, if he were thinner he would have gotten one. The question is ‘how long was the delay between symptoms and treatment and was that influenced by the negligence of the hospital - ie not having an appropriate CT machine’.
Sorry - they do not make CT scanners to accomidate people of 450 lbs - except at veterinary hospitals.
If Vets can have scanners for animals that big, wouldn’t you consider getting a scanner for big fat people or shipping them to the vets office for an emergent CT scan. I am sure they could drink the contrast on the way to the vets office. Would it be reasonalble to transfer the Pt to a farm or vets office? Maybe he should have exercised sometime during his life instead of drinking soda and watching TV on the couch.
Wow, the stereotypes, they burn.
Well, the point is that since he could not get a CT scan, he was explored (ie operated on). Unfortunately, he could not be saved, the infection was too far spread. A CT scan would have done nothing to save him.
I’ve successfully had Gastric Bypass Surgery (I’m 200 lbs below my operative weight from January 2002), so I obviously believe it is a worthwhile surgery (while understanding that there are risks, just as in any surgery).
However, my friend worked with a Bariatric Doctor, and kept stats on the outcomes of surgery. I wonder how many “bad outcomes” are due to non-compliance? She said there were instances of patients presenting to the ED shortly after surgery with abdominal pain, and when they scoped them, they found partially digested food such as peanuts, pretzels, etc., at a time when the patient should still only be eating yogurt and eggs.
You have to wonder though. Should a hospital do “a fair amount” of gastric bypass surgery, if they can’t provide essential services for these patients? If no CT exists for this weight, are patients made aware of the risks?
3+speckled, I believe they ARE made aware of the risks, including the limitations of medical equipment with regard to size and weight. As part of my orientation I went through training and actual patient sessions that covered all the areas my hospital specializes in, one of which is bariatric surgery, and I do know that the patients are made aware of what is and is not medically possible for them related to their size and weight, especially CT scans, because that’s a major issue.
If he weighed 443 pounds and looked like that, he must have been well over 6 feet tall.
I once worked at a hospital that did bariatric surgery and had some interaction with the surgeon, and he turned people away all the time even if their insurance approved the procedure because he felt they were not good candidates, for whatever reason. The general public thinks these people have their surgery, go home, lose weight, and live happily ever after, but it’s a lot more complicated than that.
Man these stereotypes are toxic!! Too bad that weight has been determined to be more genetically influenced even then height. 70% to be exact according to the latest double-blind twin studies. Why, even the NIH admits that 95-98% of people who lose more than 75 lbs by dieting gain it back within 3 years. There’s even a lot of thought going around that the negative health effects associated with obesity, besides being inadequately documented, are related more to patterns of yo-yo dieting than the weight itself. Maybe if we have to permanently maim part of a persons body to make them lose weight they’re just meant to be that size in the first place? Or of course, it could be related to the weight gain that generally takes place after being on a diet, y’know once you permanently alter your metabolism through starving yourself. But don’t worry, you likely will never have to worry about it, since there is also virtually no way to make a naturally skinny person permanently fat.
R, I have known identical twins who remained pretty much the same size all through their adult lives. Genetic factors play a bigger role than many people realize.
That’s what I said. I said that genetics play about a 70% role according tothe latest studies, which is greater than the role genetics plays in height.
[…] patients come in to the ER with abdominal pain with +/- vomiting. As I described in a prior post (this one), the complications can be catastrophic (and fatal). In addition to that case, I have seen […]
Is it weight that’s determined by genetics? Or addiction to food that’s determined by genetics. Or perhaps lack of responsibility is determined by genetics. Food for thought.