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Wednesday, July 18, 2007

Despite their best efforts: Round 2 of Charlie Weis’ malpractice lawsuit

The jury selection process began last Friday for the retrial of the medical malpractice suit brought by Notre Dame head coach Charlie Weis against two surgeons at a Harvard teaching hospital. Weis claims the two allowed him to bleed internally for 30 hours after the 2002 gastric bypass surgery, before performing a second operation to correct the complication. Weis nearly died while in a two-week coma and has a lingering limp with his right foot from the surgery.

The first hearing in February ended in a mistrial when a male juror collapsed during a medical expert’s testimony and the defendant doctors rushed to his aid, potentially influencing the other jurors and the outcome.

There are clear risks which patients should understand, according to bariatric surgeon Dr. John Romanelli. Bleeding, infection, leak from the stomach-intestine or intestine-intestine connection, ulcers in the stomach pouch, narrowing of the stomach-intestine connection, heart attack, pulmonary embolism, stroke, and longer-term vitamin and mineral deficiencies are all risks of the surgery. All of this needs to be explained to the patient in detail over a period of time where they can digest the information and ask questions about it, he said.

It is particularly important to consider the complications because they happen so frequently – in 30% of patients, according to Dr. Romanelli. The survival rate for gastric bypass surgery is 98%; as much as 2% of patients die, according to an article in the Journal of the American Medical Association in October 2005.

Regular follow-up with the surgeon is important because some problems can occur years later. For example, “vitamins such as B12, folic acid, thiamine, and minerals such as calcium and iron can become deficient in gastric bypass patients, and levels must be checked regularly. Ulcers, which are most commonly found in patients who smoke, can happen years later. Hernias can occur – either in the abdominal wall or in between the intestinal loops," says Dr. Romanelli.

In general, patients whose weight is 100 pounds over their ideal body weight might qualify for this kind of surgery, he added.

"Without knowing the case [of Charlie Weis] directly, one concern I have is that he opted to bypass many of the routine preoperative evaluations because he had a tight time window of availability away from the Patriots, and I know this from the media reports from the trial. I wonder if this exacerbated the problems that developed.

Complications like this can and do happen, despite the best efforts of well-trained doctors."

Advice to those thinking of gastric bypass surgery: Fully consider the risks, benefits and alternatives.

Read Part 1 of the story, or read John Haynsworth’s source story.

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