Bariatric surgery is increasingly accepted across specialties as an integral treatment for not only type two diabetes and morbid obesity, but also degenerative joint disease of the knees and hips, obstructive sleep apnea, pseudotumor cerebri, severe hypertension, and a host of other obesity-related health problems. So, while the bariatric procedure is increasingly medically necessary, it sometimes can mean patients with increased risk factors are undergoing the gastric surgery and facing increased risks of complications. And because those complications occur in a vulnerable individual with more than the usual comorbid conditions, the consequences may be serious. Such complications may lead to medical malpractice litigation involving a bariatric surgery complications expert witness to opine on standard of care, breach of standard of care and/or causation. At issue for the bariatric surgery complications expert witness is often determining if any of the complications suffered were a result of a breach of the applicable standard of care.
Bariatric Surgery Complications: Specific and General
The types of complications after bariatric surgery fall into two general categories, those that are specific to the surgery and surgical anatomy, and those that are more general to the patient’s health conditions and other organ systems.
For example, the primary complications of sleeve gastrectomy, Roux en Y gastric bypass or duodenal switch include leak from the stomach or intestine causing peritonitis and sepsis, and postoperative hemorrhage from the surgical tissues. More generalized complications not specific to the surgical anatomy include pneumonia, respiratory failure, myocardial infarction, cardiac arrhythmias, pulmonary embolus, deep venous thrombosis, delirium, stroke, and kidney failure. During litigation a bariatric surgery complication expert witness may be employed to explain the root causes of these complications to the judge and jury.
Failure to Recognize and Respond to a Complication
In both categories there are often steps that may be considered before surgery to assess risk and mitigate that risk. After surgery there is often the need to identify and treat the problem within a timeframe that optimizes the results and minimizes any ongoing harm or disabilities. Allegations of failing to timely recognize and properly react to a complication can also be addressed by a bariatric surgery complications expert witness.
Bariatric Surgery Facility Liability
The hospital where the bariatric surgery took place may also become a party to litigation. Nationally-accredited centers, which used to be called “centers of excellence”, must adhere to rigorous requirements and undergo site inspections to maintain the accreditation. With that accreditation comes an adherence to policies that allow for timely and appropriate imaging, availability of suitable equipment and personnel, escalation of care decisions, and capabilities to deliver appropriate treatments.
An appropriately qualified bariatric surgery complications expert witness may also be called in to address the issue of the potential liability of the facility where the procedure took place. Each accredited center must have a Medical Director, a role assumed by a bariatric surgeon who oversees the hospital’s compliance with the accreditation standards. Hospitals or ambulatory surgery centers that do not have national accreditation specifically as a bariatric surgery center will nonetheless have similar responsibilities to protect patients and a leader to oversee the effort.
Conclusion
Like all medical procedures, bariatric surgery may lead to complications and allegations of medical malpractice against the treating providers and the facility where the procedure is performed. In such lawsuits the parties may utilize a bariatric surgery complications expert witness to assist the trier of fact to understand the evidence in the case.
Kent C. Sasse, MD is a bariatric surgery thought leader. Dr. Sasse has performed over 5,000 primary bariatric surgical procedures and 500 revisional bariatric procedures. He is a Medical Director of a nationally accredited bariatric surgery center and an award-winning teacher. Dr. Sasse is a widely published scientist and author of nine books as well as an inventor and patent holder of a bariatric surgical device. His clinical experience includes bariatric surgery and endoscopy, sleeve gastrectomy, gastric bypass, duodenal switch, reoperative surgery, revisional surgery, hiatal hernia, wound care, Barrett’s esophagus, hernia mesh, hernia mesh explantation, endoscopic stenting, leaks, Ambulatory Surgery Centers, and solving complications. Dr. Sasse is a prolific public speaker and he serves on the University of Nevada School of Medicine faculty. He is an experienced expert witness at both deposition and trial. Dr. Sasse can be contacted at 707.597.2999 or drsasse@sassesurgical.com.
