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.

I’ve been robbed since I was 49: Malpractice - surgical error

An operation nearly two decades ago left her incontinent and in pain, shuffling from one medical appointment to the next in search of a way to repair a hole in her bladder. She says several subsequent surgeries and procedures failed to correct the problem.

For the past 17 years, Frances Borrow has lived with a plastic bag constantly strapped to her stomach that collects her urine, the legacy of a 1990 hysterectomy during which her bladder was accidentally sliced. "I've been robbed since I was 49 years old. From then on, it's been a nightmare. I was a very outgoing, happy person. It was like my whole world turned around. Nobody should have to live that way."

Frances is one of more than three dozen women who now say they suffered lasting physical and emotional injuries after surgery by a Scarborough obstetrician and gynecologist.

They all wonder if they could have avoided years of hardship had they known about his surgical complication rate, a string of malpractice suits against him and a pattern of patient complaints.

The documents, filed as part of a $500,000 lawsuit by one former patient in 2003, show that surgeon had complication rates for total abdominal hysterectomies (the surgical removal of the uterus by an incision in the abdominal wall rather than the vagina) of 30% in 2000, 30% in 2001, 9% in 2002 and 10% in 2003.

A 1992 Ohio study of 160,000 hysterectomies found a complication rate of 9% was the average for that operation.

The Ontario provincial government announced this week it will require hospitals to report unexpected death rates and infection rates alongside the wait times posted on a government website for procedures in five key areas, to be posted by Spring, 2008.

The government will not, however, publish the complication rates of individual surgeons.

Advice to patients about to undergo surgery: Find out the surgeon’s complication rate first.

Read another of our surgical error stories, or read the source story by Robert Cribb and Tanya Talaga on medical secrecy.

They’ve taken their grief and turned it into something powerful: A surgical error story

He was an only child, healthy, strong, and at age 22, planned on being a pediatric nurse.

 "Michael passed out," Michael's mother Patty Skolnik said. "And he woke up in the dining room." 

Michael's parents took him to the emergency room as a precaution. An X-ray of his head showed a three millimeter dot on his brain. It was a cyst. Patty sought out expert opinion from a neurosurgeon. She said there was no time for a second opinion.

 He kept saying 'die.' You're so lucky he didn't die. We have to do this right away," Patty said. "And it was like there was no choice. It was like a train wreck happening." Patty said a three hour surgery turned into six hours, and when it was over, the doctor came out and said he never found the cyst.

Months passed and Michael was moved to Craig Hospital where the family learned the realistic prognosis.

 "He is 50% blind in both eyes to the left," Patty said. "He has no short term memory. He has severe seizure disorder, and he's psychotic." What had happened to their son? 

"Everything was primarily done from the deep brain operation. That's what caused all of this to begin with," Patty said. Michael developed multi-organ failure, then later suffered a seizure, developed pneumonia, and almost three years after the operation, passed away.

"It never should've happened. It was an unnecessary surgery," Patty said. 

The Skolniks have filed a complaint with the State Board of Medical Examiners, and the case is in review.

Unknown to the Skolnicks, the surgeon had two pending malpractice cases at the time. Michael’s parents are pressing for legislation in Colorado that would make such information publicly available.

The Skolniks suffered an incredible loss, but they've taken their grief and turned it into something powerful.

Advice to patients facing surgery: Check your surgeon's credentials beforehand.

See the short, powerful videotape of the CBS news segment or its transcript, or read another surgical error story.

But the magazine said he was a Super Doctor: An overdose lawsuit

The cancer doctor’s web site touts the fact that he was named in Texas Monthly as a so-called “Super Doctor" in December, 2005. But earlier that year he had lost the biggest malpractice suit in the county’s history--$600 million!--and a month later, another patient died from a chemo overdose under his care.

How does a physician become a Texas Monthly “Super Doctor?” Or for that matter, a Best Doctor for D Magazine?

“Super Doctors” is actually the trademark of Minneapolis-based Key Professional Media, which has made a business of publishing “Super” lists. Key Media is secretive about how its “Super Doctors” are chosen, and would not disclose how many doctors vote, saying that number is “proprietary.” Every voter can vote as many as ten times. Lorelei Calvert of Texas Monthly says Key basically buys a section of the magazine, labels it a “special advertising section” and sells the advertising space to doctors.

D Magazine asks “Which Dallas Doctors would you trust to send your loved ones to for medical care?” Rogers says the D survey is announced to hospital PR staffs before it is mailed to doctors. This allows them to stump for votes among their own staffs. Each surveyed doctor could cast as many as 117 votes over 39 different specialties. D says it got about 25,000 responses from 1,014 doctors, and selected 640 people as “Best Doctors.” Doctors are offered the chance to buy an ad in D Magazine to “maximize their exposure” when they’re notified they’ve been chosen as a “Best Doctor.” It is the best selling issue of the year.

Advice on finding a super doctor: Start by checking the profile yourself, if you can. In Massachusetts, you should first look them up in the Board of Registration in Medicine’s web site.

Read the article by Byron Harris.

How Could Billy Have Known?: A surgical error lawsuit

In November 1999, Billy Karl Boone had an ear infection and white, pus-like drainage in his left ear. His primary care doctor referred him to an ear, nose and throat surgeon, who determined that his life was in danger because of a rare condition in which skin cells proliferate and debris collects within the middle ear, usually as a result of a long-term middle-ear infection (a cholesteatomoa). The surgeon suggested surgery—a revisionary masteoidectomy--to be done at his own outpatient surgical center. The next day, Billy started having difficulty reading, remembering names, and recalling words. An MRI scan and a CT scan of his brain revealed heavy internal bleeding, and an apparent opening in his skull at the site. The surgery had punctured a hole in his brain, causing serious and permanent brain damage.

Billy won a jury verdict of almost $1 million. The final appeals, concerning informed consent, were decided last month. The surgeon had not informed him beforehand that he had only performed one such operation in the last three years. Billy didn't ask, and the surgeon didn't tell.

Advice to patients and advocates: If you need surgery, find a surgeon who has extensive recent experience in performing that operation.

Read about another surgical error story. Or read the final court opinion, or the Maryland malpractice lawyer's blog.

Your Spine Can Be their Profit Center: A surgical error lawsuit

Patricia Kennedy's back hurt so much that she looked for a surgical solution. A spine surgeon in Philadelphia performed a disk replacement operation in late 2002. The surgery was not successful; indeed, Patricia says her condition is even worse now. The former competitive skater says she has gone from taking Tylenol to morphine for her pain and can no longer work for a living.

At the time she chose surgery, she did not realize that the replacement disk was experimental. She is suing both her surgeon for malpractice, and the manufacturer of the ProDisc for product liability. Her case will go to trial in March 2007. Adding insult to injury, the surgeon had not told her that he was a part owner of the device maker. This gave him--the lead researcher on a study of the ProDisc's effectiveness--an incentive to recommend and use the replacement disks, and to report favorably on them. "I'm filling out a questionnaire and saying that my pain level is an '8' on a scale of one to 10," with 10 being the worst, Kennedy says. "And my doctor is writing down that I have 'mild pain.' I don't think so," she says in Melissa Davis' TheStreet article. "I've really been guinea pigged and betrayed," she told Reed Abelson, as reported in today's New York Times.

Advice for patient advocates: Ascertain the success rate of that type of surgery, from that surgeon, before you let someone go under the knife. Ask the surgeon's office, or the vendor, whether the surgeon has a financial stake in using the device.