For Rosa Pena, gastric bypass surgery turned into liver failure due to a doctor’s negligence.

When Rosa Pena of Houston walked into a physician’s office to discuss surgical removal of her gall bladder, she couldn’t have imagined that the surgeon’s advice to also have gastric bypass surgery would lead her down a 10-month path of starvation, resulting in permanent damage to her liver.

Originally designed as a treatment for morbid obesity, gastric bypass surgery, when performed by skilled surgeons, can be a life-saving solution. Even in the hands of competent physicians, however, the surgery is risky due to potential complications.

“In Rosa Pena’s case, the surgeon implied that he had performed gastric bypass surgery before and was highly competent in the procedure. In fact, he had never performed this surgery,” said Mike Davis, who successfully represented Pena in her claim against the surgeon. The case was resolved in May for an undisclosed amount.

“Even worse, the surgeon indicated that he was going to perform the Roux-en-Y surgical technique, the most widely-approved form of gastric bypass surgery. Instead, he used a technique that did not conform to any standard. It more closely resembled the jejunoileal bypass technique that is no longer performed in this country due to excessive complications,” Davis said.

Starving to death

“Over the next 10 months of follow-up visits to the surgeon, Rosa Pena presented classic signs of malnutrition: dramatic weight loss, elevated liver enzymes and hair loss. Despite an earlier test that showed elevated liver enzymes, the surgeon did not do further liver testing,” Davis said.

“By the time she returned for a follow-up visit in November 2000, she was critically ill and, in the doctor’s own words, ‘in a shocking state,’” Davis said.

Pena had lost 173 pounds in 10 months, had jaundice, dramatic hair loss and was breathing heavily. The surgeon put her in the hospital, where she lapsed into a coma.

Too little, too late

After being transferred to another hospital in Houston, Pena had corrective surgery. According to the operating surgeon, she had been left with only about 150 centimeters of absorptive small intestine and only 32 centimeters of common channel.

“In layman’s terms, her body had no way to absorb nutrients and she was starving to death,” Davis said.

As a result, Pena’s liver failed. Initially, she was placed on a liver transplant list. Although her condition has stabilized somewhat, it remains precarious.

“Rosa remains at substantial risk of future deterioration which would require liver transplantation. She will need to see a liver specialist for the rest of her life,” Davis said.

The last resort

Gastric bypass surgery was originally designed to treat persons who are morbidly obese. Unfortunately, the surgery is being marketed by some medical practitioners as a weight-loss option for the general public.

“Gastric bypass surgery is the latest chapter in the American public’s quest to lose weight at any cost. We’ve already seen the outcomes of dangerous diet pills like FenPhen, which killed or injured thousands of individuals. Even liposuction surgery has been connected to patient deaths from complications or surgical errors,” said Mike Davis.

“No matter how skilled the physician, the complexity of gastric bypass surgery and the related risk factors outweigh the benefits when performed on individuals who are not morbidly obese. The only way to lose weight safely is through diet and exercise,” Davis added.

Risks

The following complications and side-effects are sometimes associated with gastric bypass surgery:

• Atelectasis (partial collapse of a part of the lung)


• Pneumonia


• Pulmonary embolism (a blood clot that blocks the arteries in the lungs)


• Abscess or wound infection


• Urinary tract infection


• Hemorrhage


• Bowel obstruction from scarring


• Leakage of bowel connections


• Obstruction of the stomach outlet


• Chronic nutritional problems


• Protein deficiency


• Vitamin or mineral deficiency


• Nausea and food intolerance


• Changed bowel habits


• Transient hair loss


• Loss of muscle mass

Surgical options for Obesity

Roux-en-Y Gastric Bypass
The most common procedure for obesity, this operation creates a very small stomach pouch from which the rest of the stomach is permanently divided and separated. A laparoscopic version of this surgery is also available.

Gastric Banding/Adjustable Banding
This operation limits food intake by placing a constricting ring completely around the top end (fundus) of the stomach, creating an hour-glass effect. Sometimes a special band is used as an adjustable device.

Laparoscopic Adjustable Gastric Banding (LapBand)
Using laparoscopy, an implantable silicone rubber band is placed around the outside of the upper stomach to create an hour-glass shape and produce a small pouch with a narrow outlet. The band contains a balloon that can be adjusted.

Gastroplasty (Stomach Stapling)
In this technically simple operation, surgeons staple the upper stomach to create a thumb-sized pouch into which food flows after it is swallowed. The pouch’s outlet is restricted by a band of synthetic mesh which slows emptying of the stomach.