Medical Defence Union Sees Doubling In Bariatric Surgery Cases, UK

Main Category: Cosmetic Medicine / Plastic Surgery
Also Included In: Litigation / Medical Malpractice
Article Date: 22 Jan 2010 - 1:00 PDT

email to a friend   printer friendly   opinions  

An analysis of bariatric surgery claims, published by the Medical Defence Union, reveals that there has been a dramatic rise in the number of cases notified in the past two years.

The MDU says that while the numbers of medical negligence claims arising from bariatric surgery, notified by its members working in independent practice, remains relatively low, with 35 cases notified since 2003, more than half of these were notified during 2008 and 2009.

These claims involve a relatively new type of surgery, where the stomach is banded or bypassed to produce weight loss in obese patients. Not all of the cases will lead to compensation being paid to patients, as many are likely to be discontinued, but the MDU says it has identified some common themes that may help surgeons avoid problems.

Dr Christine Tomkins, MDU chief executive, said:

"We are starting to see the emergence of medical negligence claims being notified by our surgeon members working in independent practice who perform bariatric surgery. This is not surprising given that this type of surgery is fairly new and there is usually a time lag between an incident occurring and a claim being made. However, given that this type of surgery is likely to increase in popularity, we want to try to help our members to avoid some of the common problems our analysis has highlighted."

Common problems highlighted by the MDU analysis include post-operative complications such as infections; bands slipping or leaking and delays in diagnosing these problems, difficulties and complications in adjusting bands; and alleged failure to obtain consent from patients, for example about the risks involved or the post-operative diet required.

While most problems were not life-threatening, in a handful of cases the outcomes were severe for the patients concerned. In at least one case the patient died following an infection, which it is alleged was caused by perforation of the gut. In another case a patient had to be placed on a ventilator after a leak following a gastric bypass led to an infection.

The majority of the claims are still ongoing and many will not result in compensation being paid to patients, but the estimated value of active cases ranges from £2,500 to £500,000.

The MDU has issued risk management advice to its members performing bariatric surgery including:

- Patients should be given information, in a format they can understand, about the recognised risks of the procedure, the post-operative diet required and weight loss to be expected.

- If the surgeon delegates responsibility for getting consent to a colleague, that person should be qualified and experienced enough to understand the procedure, its risks and any complications so that he or she can fully answer the patient's questions.

- If there has been a time lag between the initial discussion and the date of surgery, it is important to check the patient still consents to procedure and that it remains appropriate.

- The consent discussion must be documented.

- Surgeons need to be aware of nationally recognised clinical guidelines, such as the NICE guidelines, and be prepared to justify their actions if they do not follow them.

- Surgeons need to ensure they are adequately trained and experienced to undertake bariatric surgery and that training grade doctors are adequately trained and supervised.

- The surgical team should include staff with relevant experience and expertise and it is advisable to have protocols which define appropriate standards or care and roles and responsibilities.

- Patients need to have information about what to expect in terms of the recovery time and process, what problems may occur and what to do if they have any difficulties. Patients' GPs should be kept informed.

Source
Medical Defence Union

• Additional
• References
• Citations