Bariatric surgery, is recognised by NICE as one of the most cost-effective healthcare interventions to reduce the risk of obesity related diseases and death. The NHS statistics on obesity, physical activity and diet, published on 5 May 2020 show that hospital admissions directly attributable to obesity have been increasing year on year since 2014. Furthermore, the number of obesity related bariatric surgery admissions in the NHS has been increasing. The goals of surgery are to achieve significant weight loss and to improve and, in some cases, reverse obesity related conditions, such as high blood pressure and type 2 diabetes.
Despite the increasing number of bariatric procedures performed on the NHS, those patients who are not eligible for NHS treatment are increasingly paying the private health care costs for bariatric surgery.
Weight-loss surgery medical negligence claims
Many patients find bariatric surgery to be a very effective solution to weight management. However, bariatric surgery requires a lifelong commitment to lifestyle changes for the results to be permanent.
Surgery is not without risks and mistakes can and do happen, the consequences of which can be very serious and life changing. If you have undergone weight loss surgery and believe negligent treatment has resulted in further suffering, or if you were not adequately informed of any potential complications prior to surgery, you need to take action within three years of the negligence to bring a claim. We have expert solicitors who can help you take the next step.
Sarah Stocker Solicitor in Tees, medical negligence team, explains the various risks and complications that can occur.
Considerations Prior to Surgery
You should only be considered for weight loss surgery if you have a body mass index (BMI) of 40 or more, or a BMI of 35 to 40 if you have a serious health condition that could be improved by weight loss, such as high blood pressure or diabetes.
The surgery is usually only ever provided on the NHS when certain conditions are met or agreed to. These include:
- You have tried all other forms of non-surgical treatment, including improvements in diet and exercise, but this has not resulted in a beneficial level of weight loss being achieved for six months or more
- You are healthy enough to undergo the surgery
- You agree to certain long-term follow-up treatments and lifestyle changes after your surgery
- A psychological assessment to assess suitability for surgery and motivation to make and maintain the required lifestyle changes.
Types of Bariatric surgery
Bariatric surgery is surgery of the digestive system to enable weight loss. The digestive system is altered so it takes less food, meaning the patient feels fuller quicker after eating. There are several types of weight loss surgery.
The most common types in the UK are:
- Gastric band insertion – Where an adjustable silicone band is placed around the stomach, creating a small pouch towards the top, to reduce the amount of food needed to feel full. The band is connected to a small device under the skin so that the band can be tightened after surgery. The band is tightened by injecting the device with a saltwater solution.
- Gastric bypass - Where the top part of the stomach is stapled to create a small pouch. The pouch is then joined to the small intestine, bypassing the remainder of the stomach. This makes a person feel full sooner and fewer calories are absorbed from food.
- Sleeve gastrectomy - Removal of a large part of the stomach, to make the stomach smaller than it was before. The procedure is irreversible and there is at present limited long-term data on the outcomes in terms of weight regain
Bariatric surgery, what are the risks?
The risks of any surgery need to be considered against any risks of not undergoing surgery. In the case of weight loss surgery, the risks of the operation must be considered against the long-term health risks of being severely overweight such as: strokes, heart attack, cancer, and complications of diabetes, amongst others. However, the type of bariatric surgery undertaken should also take account of your previous medical history and any conditions which may be improved or at risk of being made worse by surgery. The type of surgery should be carefully considered by the patient and surgeon together in order to decide on the most appropriate procedure for that patient.
As with all operations there can be side effects, the generic risks of bariatric surgery are:
- Anaesthetic risk
- blood clots in legs or lungs
- Internal bleeding
- Damage to internal organs
- Nutritional deficiency
- Development of gallstones from rapid weight loss
- Psychological problems are common after weight loss surgery e.g. depression
- Other types of self-harm can develop in the patient to replace the over-eating.
It is critical that bariatric patients undergo a fully informed consenting process. This consists of pre-operative counselling by the operating surgeon as to the risks and benefits of their specific surgery and any material risks specific to that patient.
- Gastric band insertion - the patient should be made aware that the band will require multiple adjustments and be counselled as to the risks of infection of the band, tubing and the port site as well as the risk of the band tubing fracturing or disconnecting leading to a loss of fluid and restriction in the band. Finally, the patient must be aware of the long-term risks of band slippage and erosion necessitating revision surgery.
- Gastric bypass - the patient needs to be aware of the risk of dumping syndrome, anastomotic leak and that there is a long-term risk of internal herniation and they will require vitamin supplementation and regular blood test monitoring for life.
- Sleeve gastrectomy - the patient needs to be aware of the risk of staple line leakage and that the procedure is irreversible.
All patients should be counselled that there is a significant chance of weight regain after any bariatric procedure and their expected weight loss will be determined by a number of factors, including the technical performance of the operation and the patient’s willingness to alter their behaviour in terms of the dietary intake following surgery. All patients should also be warned that they will have a significant risk of loose overhanging skin after surgery which may require plastic surgical intervention.
Common bariatric surgery negligence claims:
- Not performing the weight loss surgery to an accepted standard
- Failure in identifying or delay in treating complications; post-operative infections and malnutrition, in a prompt manner
- Failure to recognise and treat promptly any damage to internal organs that have occurred during surgery
- Incorrect placement of a gastric band causing blockages and requiring further procedures;
- Failure or delay in identifying and correcting band slippage; Stapling of the joins in gastric bypass surgery incorrectly
- Incomplete gastric bypass resulting in a leak
- Delay in identification of a leak following gastric bypass resulting in complications and further surgery.
As well as compensation for physical and psychological injuries, claims may also include financial losses and expenses incurred as a direct result of the accident.
- Loss of earnings
- Transport costs
- Private medical expenses
- Care, support and assistance costs.
Making a medical negligence claim
We understand that complaining about medical treatment can feel overwhelming and distressing, but there are many good reasons for making a complaint and possibly, in addition, a claim for negligence.
If you have suffered injury or financial loss or need compensation to help you cope with the results of what has occurred, then you should consider bringing a medical negligence claim.