$1M Settlement For Gastric Leak Following Sleeve Gastrectomy: A Massachusetts woman had to have her entire stomach and duodenum removed as well as the left lower lobe of her lung as a result of a gastric leak that went untreated following laparoscopic sleeve gastrectomy that was performed in October 2016.
Several months after the laparoscopic sleeve gastrectomy procedure, the woman began experiencing symptoms that were consistent with a gastric leak. A CT scan was ordered in February 2017 that was read as showing findings that were consistent with a gastric leak. The surgeon was advised of the CT scan findings by the radiology department but the surgeon never discussed the findings with the woman during her next office visit or during routine annual follow-up visits.
The woman began experiencing serious symptoms three years later. In June 2020, a broncho-gastric fistula was discovered that required the surgical removal of her entire stomach, her duodenum, and part of her left lung.
The woman filed her Massachusetts medical malpractice lawsuit alleging that had the gastric leak been diagnosed and treated in 2017, she would not have suffered the complications that she endured including the surgical removal of her organs.
The defense argued that the surgeon did not breach the standard of care by using a conservative wait-and-watch approach.
The defendant settled the medical malpractice case for his $1 million medical malpractice insurance policy limit after the Massachusetts medical malpractice lawsuit was filed but before any discovery took place. The woman’s health insurance had paid $1.1 million for her medical bills and agreed to accept $106,000 to satisfy its subrogation lien.
Laparoscopic Sleeve Gastrectomy Complications
Sleeve gastrectomy was introduced in 1990 as an alternative method for distal stomach resection with duodenal switch to reduce the complication rate. The first laparoscopic procedure took place in 1999.
Laparoscopic sleeve gastrectomy (LSG) is a procedure in which the greater curvature is resected, reducing the volume of the stomach by about 80%, which leads to significant limitation of food intake. Additionally, removal of the stomach fundus decreases the number of cells producing ghrelin (the hunger hormone). The reduction in plasma ghrelin concentration promotes the feeling of satiety and restrains food intake.
LSG is an essential bariatric procedure performed in obese patients, which provides significant weight loss and has a positive impact on obesity-related diseases. The complications that can arise in patients following LSG are divided into acute (diagnosed within 30 days after the surgery) and late. Early complications that require rapid management include hemorrhage (intraluminal or extraluminal), leak in the staple line, and abscess formation. Late complications include gastric stenosis, nutrient deficiencies, mediastinal pouch migration, and the development or exacerbation of gastroesophageal reflux diseases.
The incidence of postoperative complications for LSG is 2.12%. The mortality rate for LSG varies from 0.18% to 0.27% and depends on age, sex, comorbidities, and the center where the surgery is performed. The most common complications after LSG are leakage, bleeding in the staple line, gastric pouch stenosis, mediastinal pouch migration, wound infection, and nutrient deficiencies. Less frequently acute pancreatitis, partial spleen infarction, and pulmonary embolism are encountered.
Bleeding is the most frequent complication occurring after LSG, which is observed in 1.16–4.94% of all cases. Leakage after LSG is a life-threatening complication that occurs in 1–3% of patients undergoing primary surgery, and up to 10% in patients after revision procedure. Leaks may occur anywhere along the staple line; however, in 85% of cases they form just below the gastroesophageal junction, which is probably associated with the increased intragastric pressure due to impaired peristalsis and ischemia.
If you or a loved one may have been injured (or worse) as a result of medical negligence involving laparoscopic sleeve gastrectomy in Massachusetts or in another U.S. state, you should promptly find a Massachusetts medical malpractice lawyer, or a medical malpractice lawyer in your state, who may investigate your laparoscopic sleeve gastrectomy medical malpractice claim for you and represent you or your loved one in a laparoscopic sleeve gastrectomy medical malpractice case, if appropriate.
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