It's estimated that 140,000 people had this procedure in 2004, with the number expected to grow even higher this year. And for the majority of patients, this surgery is a lifesaver, but not for all, reports The Early Show correspondent Melinda Murphys.
Like many people who seek out this surgery, Dave Weindel had been morbidly obese for most of his life. So he was eager to have surgery to help him lose weight, get healthy, and live longer to watch his four young children grow.
"I graduated from eighth grade a couple years later," Christy Weindel says, crying. "And he wasn't there for that. And he wasn't there for prom. And I just got married in September. And he wasn't there for that. It's really tough.
Christy Weindel lost her father when she was 12 years old. Dave Weindel died three weeks after having gastric bypass surgery.
"I had to come home and had to tell the kids that their dad died. Was very, very hard," says, Cathy Weindel. According to Weindel's wife, it wasn't supposed to turn out this way.
She says, "Well, they told us it was major surgery. But they said, 'You know, you're going to be home in three days.' "
Weindel's surgery was July 17, 1998. His stomach was reduced to the size of an egg and his intestines were re-routed. The surgeon told Cathy Weindel the operation went well. But within days, Weindel's health worsened.
He was transferred to a second hospital, where a CT scan revealed a large abscess. Weindel was treated, but his health continued to decline.
Cathy Weindel says she thinks her husband knew what was happening to him.
"I still remember, and I still see this in my mind," she says very emotionally. "When they're shutting everything down and there was nothing else they could do. I was talking to him. And I saw a tear come out of his eye. And, I mean, it still stays with me."
Dave Weindel died three weeks after his surgery. He was 38. The official cause of death: abscess, pneumonia and a pulmonary embolism.
Was Dave Weindel's case a complete anomaly? Not really.
A recent study by researchers at the University of Washington found that 1 in 50 people die within one month of having gastric bypass surgery, and that figure jumps nearly fivefold if the surgeon is inexperienced.
Attorney Herman Praszkier says, "You want to know, basically, as much information about the surgeon's background as you can. Anyone who evades your question, get up and walk out."
Praszkier represented Cathy Weindel in her lawsuit against her husband's surgeon and the hospital. It was settled days into the trial and was the first of a dozen gastric bypass malpractice cases he's handled.
Praszkier explains, "The most common problem in bariatric surgery in the cases I take (which are only death cases) is that the post-operative care was insufficient."
Nora Malone is Praszkier's most recent client. She tried to talk her husband, Ron, out of the surgery.
"I said, 'Let's go. Let's just go.' And he said, 'Oh, I'll be OK, honey. You'll be so proud of me when I get out of here,' " Malone recalls.
Nora Malone met her husband when he was a naval officer stationed in the Philippines in 1973. They had three daughters.
Their daughter. Liberty. says, "When they went to talk to the doctors, they came back thinking it was a good thing. You know, he'd get off his high blood pressure medicine, his diabetes medicine."
Malone had laparascopic gastric bypass surgery just before Thanksgiving 2003.
"They said there's no risk," Nora Malone says.
But days after the surgery, Ron Malone became very ill. Doctors told his family there was a leak - and operated again. He didn't improve.
Nora Malone recalls, "And I said, 'I think you have to do something, doctor.' And he said, 'Mrs. Malone, trust me, your husband is OK.' "
On Dec. 9, 2003, Ron Malone died during his third surgery. The official cause of death: cardiac arrest. More accurately, Malone died from complications of gastric bypass surgery.
Dr. Harvey Sugerman says, "There is a risk of a leak following gastric bypass that can be fatal."
Dr. Sugerman is a retired bariatric surgeon and the president of the American Society for Bariatric Surgery (ASBS). He says early diagnosis of a problem is the key.
"I think some doctors got into it without adequate training and experience and felt that they could do this," Dr. Sugerman says, "The ASBS is very concerned about deaths after obesity surgery. And we are doing everything we can to improve quality care by establishing the Center of Excellence program."
This program will have stringent guidelines that must be met in order for a bariatric surgery facility to be called, "a Center of Excellence." When the program launches in June, information will be posted on a Web site to help patients find quality doctors and hospitals. Unfortunately, it comes too late for Ron Malone.
And too late for Dave Weindel, whose wife no longer believes in the surgery.
"I don't think it's worth it," Cathy Weindel says "It tears your family apart."
CLICK here to watch gastric bypass video
Still not convinced?
More on the Actual Gastric Bypass Death Rate
A helpful blog reader send me the full PDF version of the study of the
long term outcome of weight loss surgery in Pennsylvania which was cited
in the previous blog post.
Death Rates and Causes of Death after Bariatric Surgery for Pennsylvania Residents 1994-2004. Bennet I. Omalu et. al. Arch Surg. 2007;142(10):923-928.
Typically when a surgeon tells you the mortality rate for a surgery, he tells you only the percentage of those who died within 30 days of the surgery. This study looked both at the actual deaths within 30 days after surgery and in the death rate in the years after the surgery.
As the study reports, in the 16,683 people who had weight loss surgery in Pennsylvania between 1994 and 2004, .9% died within 30 days of the surgery. That translated into 150 people.
But wait. That statistic was taken from the group as a whole. When the population is broken out by age, a much scarier statistic emerges: In the age group 55-64 1.53% were dead within 30 days, or 15 out of 1000 who had the surgery. And for the age group of those 65 and older, 3.1% died within 30 days, or 3 out of every hundred.
But that was just in the first 30 days after surgery. The study looked at time since surgery, and with each passing year the number of dead grew greater.
By one year after surgery, 2.1% of the group had died. (Twenty-one out of every thousand.) By two years, 2.9%. Then things got worse. Three years after they had had the surgery, 3.7% were dead. By four years, 4.8% and by five years, 6.4%.
The authors of this study remark that they did not follow up on the results of subsequent surgeries. But other studies have found that many people who have weight loss surgery require one or more follow up surgeries in the years that follow the initial surgery. It is likely that each subsequent surgery raises the risk of further complications and death.
Another chilling statistic emerged from the analysis of this data. In a population of the same size of the same demographic make up, the expected number of suicides would be 2. However, in this group, there were 16 suicides and an additional 14 drug overdose deaths. Most of these occurred at least one year after the surgery. The authors of the study speculate that many of the drug overdoses were probably suicides too, and flag this as a serious problem that requires more study.
What was missing in this study was one important piece of information: the weight loss achieved by the people who died. The authors assume that the high death rate is due to health conditions contracted while obese or due to weight regain. But this is only speculation. They did not review any statistics about the size of the people at death, which would have been difficult to do since only about 1/3 of these victims were autopsied.
But based on stories I have heard and cases like Mrs. Yamin's it may be premature to assume that the deaths were caused by obesity. Mrs. Yamin weighed 100 lbs at her death. Instead deaths may have been caused by long term malnutrition--i.e. starvation. Though the most common cause of death listed on death certificates after a year was cardiovascular (i.e. heart attacks) that is what kills a lot of people with anorexia and starvation. When the body is no longer absorbing nutrients the electrolytes can become dangerously unbalanced and that causes heart attack. Without independent autopsies, it is very hard to know what really happened.
Doctors don't like autopsies, because a patient who didn't have an autopsy is a patient whose family is going to have a much tougher time suing for malpractice. So if a heart stops beating, well, write it down as cardiovascular death, and since the person was once fat, who is going to challenge it?
But folks, please take these statistics seriously. And please note that the things that killed people within the first 30 days were NOT necessarily caused by obesity. Among the biggest killers were pulmonary embolism (20.7% of all early deaths)and sepsis (i.e. infection that spread through the body causing organ shut down). Sepsis killed 11.3% of those who died in the first 30 days. One out of four died of vaguely specified "therapeutic complications" which is a catchall term entered on the death certificate that included things like sepsis, bleeding, ruptured surgical wounds, etc.
One last word. Many people erroneously believe that before a doctor can perform a specific kind of surgery, that surgery must undergo the same kind of safety testing and approval process that drugs get. This is not true. Surgeons can perform any surgery they want, as long as they are licensed surgeons.
There is only one limitation on what kind of surgeries are performed: whether or not insurance companies will pay for them. Most insurers won't pay for operations that have a poor safety record--once they have enough data to know that the operation isn't safe.
But weight loss surgery is usually NOT paid for by insurers. Like plastic surgery, it is a surgery that patients pay for out of their own funds. This is one reason surgeons promote it so strongly. There are no forms for them to to fill out, no limit on what they can charge, and most importantly, no evaluating the patient's suitability for the surgery by pesky insurance review boards. All the doctor has to do is sell the patient on the operation, and the fun can begin.
So don't let yourself become a victim of a surgeon who has found a dandy way to make himself a multi-millionaire. And don't trust that the doctor who stands to make $25,000 for a few hours of work has your welfare in mind when he assures you that a surgery is no more dangerous than crossing the street. Remember, surgeons rarely track the outcome of their surgeries beyond six weeks. But as the Pennsylvania study suggests weight loss surgery keeps on killing for years after the initial surgery.
Death Rates and Causes of Death after Bariatric Surgery for Pennsylvania Residents 1994-2004. Bennet I. Omalu et. al. Arch Surg. 2007;142(10):923-928.
Typically when a surgeon tells you the mortality rate for a surgery, he tells you only the percentage of those who died within 30 days of the surgery. This study looked both at the actual deaths within 30 days after surgery and in the death rate in the years after the surgery.
As the study reports, in the 16,683 people who had weight loss surgery in Pennsylvania between 1994 and 2004, .9% died within 30 days of the surgery. That translated into 150 people.
But wait. That statistic was taken from the group as a whole. When the population is broken out by age, a much scarier statistic emerges: In the age group 55-64 1.53% were dead within 30 days, or 15 out of 1000 who had the surgery. And for the age group of those 65 and older, 3.1% died within 30 days, or 3 out of every hundred.
But that was just in the first 30 days after surgery. The study looked at time since surgery, and with each passing year the number of dead grew greater.
By one year after surgery, 2.1% of the group had died. (Twenty-one out of every thousand.) By two years, 2.9%. Then things got worse. Three years after they had had the surgery, 3.7% were dead. By four years, 4.8% and by five years, 6.4%.
The authors of this study remark that they did not follow up on the results of subsequent surgeries. But other studies have found that many people who have weight loss surgery require one or more follow up surgeries in the years that follow the initial surgery. It is likely that each subsequent surgery raises the risk of further complications and death.
Another chilling statistic emerged from the analysis of this data. In a population of the same size of the same demographic make up, the expected number of suicides would be 2. However, in this group, there were 16 suicides and an additional 14 drug overdose deaths. Most of these occurred at least one year after the surgery. The authors of the study speculate that many of the drug overdoses were probably suicides too, and flag this as a serious problem that requires more study.
What was missing in this study was one important piece of information: the weight loss achieved by the people who died. The authors assume that the high death rate is due to health conditions contracted while obese or due to weight regain. But this is only speculation. They did not review any statistics about the size of the people at death, which would have been difficult to do since only about 1/3 of these victims were autopsied.
But based on stories I have heard and cases like Mrs. Yamin's it may be premature to assume that the deaths were caused by obesity. Mrs. Yamin weighed 100 lbs at her death. Instead deaths may have been caused by long term malnutrition--i.e. starvation. Though the most common cause of death listed on death certificates after a year was cardiovascular (i.e. heart attacks) that is what kills a lot of people with anorexia and starvation. When the body is no longer absorbing nutrients the electrolytes can become dangerously unbalanced and that causes heart attack. Without independent autopsies, it is very hard to know what really happened.
Doctors don't like autopsies, because a patient who didn't have an autopsy is a patient whose family is going to have a much tougher time suing for malpractice. So if a heart stops beating, well, write it down as cardiovascular death, and since the person was once fat, who is going to challenge it?
But folks, please take these statistics seriously. And please note that the things that killed people within the first 30 days were NOT necessarily caused by obesity. Among the biggest killers were pulmonary embolism (20.7% of all early deaths)and sepsis (i.e. infection that spread through the body causing organ shut down). Sepsis killed 11.3% of those who died in the first 30 days. One out of four died of vaguely specified "therapeutic complications" which is a catchall term entered on the death certificate that included things like sepsis, bleeding, ruptured surgical wounds, etc.
One last word. Many people erroneously believe that before a doctor can perform a specific kind of surgery, that surgery must undergo the same kind of safety testing and approval process that drugs get. This is not true. Surgeons can perform any surgery they want, as long as they are licensed surgeons.
There is only one limitation on what kind of surgeries are performed: whether or not insurance companies will pay for them. Most insurers won't pay for operations that have a poor safety record--once they have enough data to know that the operation isn't safe.
But weight loss surgery is usually NOT paid for by insurers. Like plastic surgery, it is a surgery that patients pay for out of their own funds. This is one reason surgeons promote it so strongly. There are no forms for them to to fill out, no limit on what they can charge, and most importantly, no evaluating the patient's suitability for the surgery by pesky insurance review boards. All the doctor has to do is sell the patient on the operation, and the fun can begin.
So don't let yourself become a victim of a surgeon who has found a dandy way to make himself a multi-millionaire. And don't trust that the doctor who stands to make $25,000 for a few hours of work has your welfare in mind when he assures you that a surgery is no more dangerous than crossing the street. Remember, surgeons rarely track the outcome of their surgeries beyond six weeks. But as the Pennsylvania study suggests weight loss surgery keeps on killing for years after the initial surgery.
