An analysis of bariatric surgery claims, published by the Medical Defence Union (MDU), reveals that there has been a dramatic rise in the number of cases notified in the past two years.
The MDU said that while the numbers of medical negligence claims arising from bariatric surgery, notified by its members working in independent practice, remains relatively low, with 35 cases notified since 2003, more than half of these were notified during 2008 and 2009. Common problems highlighted by the MDU analysis include post-operative complications such as infections; bands slipping or leaking and delays in diagnosing these problems, difficulties and complications in adjusting bands; and alleged failure to obtain consent from patients, for example about the risks involved or the post-operative diet required. The MDU has issued risk management advice to its members performing bariatric surgery including:
• Patients should be given information, in a format they can understand on the recognised risks of the procedure, post-operative diet and weight loss expected.
• If the surgeon delegates responsibility for getting consent to a colleague, that person should be qualified and experienced enough to understand the procedure, its risks and any complications so that he or she can fully answer the patient’s questions.
• If there has been a time lag between the initial discussion and the date of surgery, it is important to check the patient still consents to procedure and that it remains appropriate.
• The consent discussion must be documented.
• Surgeons need to be aware of nationally recognised clinical guidelines, such as the NICE guidelines, and be prepared to justify their actions if they do not follow them.
• Surgeons need to ensure they are adequately trained and experienced to undertake bariatric surgery and that training grade doctors are adequately trained and supervised.
• The surgical team should include staff with relevant experience and expertise and it is advisable to have protocols, which define appropriate standards or care and roles and responsibilities.
• Patients need to have information about what to expect in terms of the recovery time and process, what problems may occur and what to do if they have any difficulties. Patients’ GPs should be kept informed.
