Patient Suffers Multi-Organ Failure Following Unfit Bariatric Surgery

ByVictoria Negron

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Updated onApril 10, 2018

Patient Suffers Multi-Organ Failure Following Unfit Bariatric Surgery

This case involves a woman in her mid-30s with a who underwent a gastric sleeve procedure. She had previously undergone a Nissen fundoplication procedure which had failed. EGD studies revealed the wrap coming undone and evidence of a stomach hernia with reflux. The patient sought the opinion of a different bariatric surgeon than the one she had seen for her surgery. This surgeon suggested the patient undergo a vertical sleeve gastrectomy as a revision of the previous surgery. During the procedure, it was suspected that the gastroesophageal junction was perforated. The surgeon conducted an intraoperative air test to confirm the staple line was stable and there was no bleeding. The week after the operation, the patient went into multi-system organ failure. It was alleged that due to the patient’s history, she should have received a Roux en Y gastric bypass as a revision rather than a sleeve procedure. An expert in bariatric surgery with experience in revision surgery was sought to review the case and opine on the standard of care.

Question(s) For Expert Witness

1. Please describe your background in bariatric surgery.

2. How often do you treat patients similar to the one described in the case?

3. Given the case summary, was the patient an ideal candidate for the gastric sleeve procedure?

4. Could the patient have received a more optimal procedure? Please explain.

Expert Witness Response E-001161

inline imageI am a fellowship-trained bariatric surgeon and an assistant professor of surgery at a major northeast university medical institution. I routinely take care of similar patients and I have not had a patient develop these types of complications. Patients who have failed a prior Nissen fundoplication usually have severe reflux as a result of the original pathology, and of the operation itself. Therefore, in revising a failed Nissen to a bariatric procedure, technical, anatomical, and patient-related issues need to be considered. I have revised Nissens, and I have performed revision bariatric surgery. However, I never revise a Nissen to a sleeve, due to the issues stated above. The patient should have undergone a Roux en Y gastric bypass, which may have been a simpler operation due to less scarring from the prior Nissen.

About the author

Victoria Negron

Victoria Negron

Victoria Negron has extensive experience in journalism and thought leadership in the legal space, with a background crafting content, whitepapers, webinars, and current event articles pertaining to the role of expert witnesses in complex litigation matters. She is a skilled professional specializing in B2B product marketing and content marketing. Currently, she serves as an Enterprise Product Marketing Manager at Postman, and previously held the position of Technical Product Marketing Manager at Palantir Technologies, where she developed her skills in launch strategies, go-to-market strategy, and competitive analysis.

Her expertise in content marketing was further refined during her tenure at the Expert Institute, where she progressed from a Marketing Writer to Senior Content Marketing Manager, and eventually to Associate Director of Content & Product Marketing. In these roles, she honed her abilities in digital marketing, SEO, content strategy, and thought leadership.

Educationally, Victoria holds a Master of Business Administration from the University of Florida - Warrington College of Business and a Bachelor of Arts in Literature, Art, and Hispanic Studies from Hamilton College. Her diverse educational background and professional experience have equipped her with a robust skill set in product marketing, content development, and strategic marketing initiatives.

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