The following is an excerpt from an expose article which appeared in the Fresno Bee, Dec 30, 2001.  It appears to include the results of a study done by one of the large hospitals which has announced that they intend to stop doing gastric bypass surgery due to the high percentage of complications:

Former nurse Cathy Ardemagni seemed like an unlikely candidate for the operation. At 5 feet and 192 pounds, she could hardly be considered severely overweight. Her body-mass index was 37.5, below the recommended 40. But she suffered from back pain, and doctors told her the surgery could help.

She had the surgery three years ago at Fresno Community Hospital. Gladen was her surgeon.

After the operation, things went terribly wrong.

According to a lawsuit filed by Ardemagni, she developed an intestinal leak that carried toxins throughout her body, threatening to kill her. She endured four operations within a week. A fifth operation followed months later.

She survived, but for months Ardemagni had to use a wheelchair. She was unable to eat solid food for six months. Today, at age 50, she walks with a limp and can't stand for more than 15 minutes without back pain. She never returned to her job at Sierra Kings District Hospital in Reedley.

Her back pain is worse.

"This is not a surgery to be taken lightly," she said. "It backfired on me."

The doctors, when they explain the surgery, don't impress upon you that you can die, she said. They don't dwell on the terrible side-effects.

"They don't tell you that you heave up your toe-nails ... or the horrible pain that comes from not chewing your food thoroughly," Ardemagni said.

She sued Gladen and recently reached an out-of-court settlement. Ardemagni signed a confidentiality agreement and won't disclose specifics of the case.

Dr. Edward Livingston, the UCLA surgeon, said gastric leaks are common and manageable. If surgeons are doing their job correctly, they should be able to detect them, he said.

"The real difference between a real good surgery and not real good surgeries," he said, "is how you deal with the complications."

Deaths reviewed in The Bee's investigation show a majority of the patients died from gastric leaks following their surgery.

Livingston said surgeons should provide adequate post-surgery care, but some are taking on too many patients and can't monitor them all properly in the critical days and weeks following the operation, when complications are most likely to set in.

"Do the math," he said. "How are you are going to see 1,000 new patients a year and monitor them all?"

Tova Winrow, 28, of Fresno, suffered serious complications from a gastric leak before her death last year.

Winrow was a strikingly beautiful woman. At 5-foot-4 and 250 pounds, she had been unhappy with her weight for years. A single mother, she had four children and put on weight with each pregnancy.

Gladen performed Winrow's gastric bypass surgery at UMC on March 15, 2000. She went home two days later but returned to UMC on March 20 after complications set in, including a gastric leak at one of the stapled intestinal connections.

Winrow's parents are suing Gladen on behalf of her children, who all are younger than 12. The parents declined to be interviewed on the advice of their attorney. Gladen declined comment about the lawsuit.

According to court documents, doctors operated on Winrow three times as her problems escalated. Blood clots developed in her right leg. Doctors decided to amputate the leg just below the knee on March 27, 2000. Winrow died the next day.

Winrow's death certificate lists "failed gastric stapling" leading to "complications of sutural leak" following gastric bypass surgery.

Herman Praszkier, whose St. Louis law firm is handling five wrongful death lawsuits related to gastric bypass surgeries, none of them in the Valley, says many hospitals and surgeons are ill-equipped or too busy to deal adequately with patients suffering complications.

In many cases, hospitals don't have a large enough CAT scan machine to accommodate these overweight patients. CAT scans are the only sure-fire way to detect a potentially deadly leak, he said.

A leak affects all other areas in the body, including the circulatory system, then the organs. Said Praszkier: "It's a leak of gastric content with the pH of battery acid."

He believes the number of fatalities caused by these operations is higher than most people realize: "Nobody knows how many people have died from this. Nobody wants to."

Published Dec 30, 2001

http://fresnobee.com/bypass/story/1391404p-1467981c.html

more info:  http://gastricbypass.netfirms.com