The Greatest Loss

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Interview with WLS surgeon who has had several patients who died after gastric bypass:

From 60 minutes - Australia

Reporter: Liam Bartlett

Producers: Mick O’Donnell

Some people will do just about anything to lose weight. Weird diets, exhausting exercise regimes, even surgery.

That's when weight loss can get dangerous.

Take the case of Queensland surgeon, Russell Broadbent.

He promises he can make you thin and there's no doubt he can. But there's also no doubt that it's a risky business.

In fact, six of his patients have died and more are still suffering after undergoing his treatment.

A particularly drastic form of surgery that involves cutting out a huge chunk of the stomach.

No wonder other surgeons shy away from this operation, and some hospitals have banned it.

Transcript

LIAM BARTLETT: Russell Broadbent is a Gold Coast surgeon with extraordinary confidence, great self belief. And right now he needs it. This is a man under siege. His controversial weight-loss surgery is under investigation following disturbing claims of deaths and complications. Do you deserve to lose your licence?

DR RUSSELL BROADBENT: I won't lose my medical practising licence, don't be stupid.

LIAM BARTLETT: Won't happen?

DR RUSSELL BROADBENT: It won't happen. I'm a good doctor, I'm a good surgeon and I care for my patients and always have done.

LIAM BARTLETT: But the alarming truth is six of Dr Broadbent's patients have died within a year of his drastic surgery. Others like Hannah Marsden claim they only just survived after Dr Broadbent's operation.

HANNAH MARSDEN: I have gone to hell and back. I've walked on death's row. He nearly killed me and I then suffered and continue to suffer to this day, complications because of what he did.

LIAM BARTLETT: Why do you want Dr Broadbent investigated?

LEESA MacLEOD: I don't want this to happen to anybody else, I don't want anybody else to suffer like my mother.

LIAM BARTLETT: Dr Broadbent has been carrying out his radical procedure for the past 12 years, but it wasn't until Leesa MacLeod raised the alarm about her mother's traumatic death, that health authorities began investigating.

LEESA MacLEOD: All of her skin had broken down and it was like, it was like she didn't even have any skin and it was she was all discoloured, like a purple colour, and, um, she was bleeding from her mouth and bottom.

LIAM BARTLETT: Ursula MacLeod was 57 when she died — just three months after Dr Broadbent operated on her.

LEESA MacLEOD: It was a horror movie. She had septicaemia and other infections, she was just constantly oozing this awful stuff and she couldn't even hold her head up.

LIAM BARTLETT: Was she in pain?

LEESA MacLEOD: Yeah, yeah, she was just the whole time, she was crying, and not just crying — screaming in agony.

LIAM BARTLETT: It seems incredible, but what Dr Broadbent did to Ursula was literally cut out three-quarters of her stomach and a whole lot more. It's called bilio pancreatic diversion and this is how it works - The first step of the operation removes most of the stomach, leaving only a narrow tube to hold food. Then the surgeon cuts the small bowel to a fraction — about a 10th of its original size — and re-attaches it to the stomach. The short length of bowel means when the patient eats less fat is absorbed but there's also less nutrients going into the body. And that is the big problem. patients can literally die from a whole host of complications caused by malnutrition. When you performed the operation on Ursula MacLeod, what went wrong?

DR RUSSELL BROADBENT: Nothing went wrong with the operation, the operation went perfectly normally.

LIAM BARTLETT: Are you telling me that the surgery you performed on Ursula MacLeod did not cause her death?

DR RUSSELL BROADBENT: Yes, I am. I did not kill Mrs MacLeod.

LIAM BARTLETT: You you know as a medical man that's a cop out?

DR RUSSELL BROADBENT: It's not a cop out.

LIAM BARTLETT: You know that.

DR RUSSELL BROADBENT: It's not, no, it's not.

LIAM BARTLETT: So you cut out three-quarters of her stomach ...

DR RUSSELL BROADBENT: Yes.

LIAM BARTLETT: … in radical surgery, she died as a result of not getting enough nutrients, and you say that surgery had nothing to do with it?

DR RUSSELL BROADBENT: She did not die of not getting enough nutrients, she died of septicaemia and renal failure.

LIAM BARTLETT: It's there in the notes, Doctor, in all the hospital's notes the fact that she was completely malnourished comes up time and time again.

DR RUSSELL BROADBENT: I don't think that's the case.

LIAM BARTLETT: For the overweight who have tried and failed with everything else, Dr Broadbent promises a remarkably effective solution, and after years of struggling with her obesity, Ursula MacLeod desperately wanted to be thin.

LEESA MacLEOD: I think Dr Broadbent painted a very good picture.

LIAM BARTLETT: You feel he made it sound more rosy than it really is?

LEESA MacLEOD: I think so.

LIAM BARTLETT: And in that way somehow convinced her that it was the way to go?

LEESA MacLEOD: Yes, and if she didn't have this surgery that she would most likely die within the next couple of years.

LIAM BARTLETT: But soon after the operation, things started going wrong. Three times she was re-admitted to hospital, and fed through an intravenous tube, but her condition only worsened.

LEESA MacLEOD: I said, 'You know you're going to be alright, aren't you, Mum?' and she said, 'Yeah, I am, I'm going to be alright' and like she was trying, she was really trying so hard. She was trying to survive, she hadn't given up at that point.

LIAM BARTLETT: Did she realize that she'd made a big mistake by having the operation?

LEESA MacLEOD: Yeah, I'm sure that she did, yeah.

LIAM BARTLETT: How much responsibility do you take for the death of Ursula MacLeod?

DR RUSSELL BROADBENT: Miss MacLeod, I ... I... There must be some responsibility fall on me in some way, but, uh, and possibly the real mistake is perhaps in operating on her in the first instance.

LIAM BARTLETT: You shouldn't have done it?

DR RUSSELL BROADBENT: Well, if I'd known the outcome, that's quite right.

LIAM BARTLETT: You and the other surgeons here at this hospital won't do it?

DR MICHAEL TALBOT: No.

LIAM BARTLETT: Why not?

DR MICHAEL TALBOT: Because the complication rate we know will be higher than the complication rate that we're prepared to accept.

LIAM BARTLETT: Sydney surgeon Michael Talbot won't do bilio pancreatic diversion surgery.

DR MICHAEL TALBOT: It's such a hard procedure to get right sometimes I think which is why so few people do it.

LIAM BARTLETT: But more and more, he and his colleagues are undoing the operation, reversing — as best they can — this dangerous procedure.

DR MICHAEL TALBOT: It's at least 10-20 times riskier than some of the more common procedures and that's made it a difficult thing for most people to do in the real world.

LIAM BARTLETT: Would you describe yourself as a risk taker?

DR RUSSELL BROADBENT: I wouldn't say I'm a risk taker, we ... everything in life is a risk, everything in surgery is a risk. Most of the patients I deal with, and I deal with thousands of patients, want to accept the risks of what we are doing for them in order to obtain the benefits.

LIAM BARTLETT: He didn't highlight any of the problems?

HANNAH MARSDEN: No, he mentioned that there could be complications, but he played that down. I asked him about that death mortality rate and he told me he'd never lost a patient.

LIAM BARTLETT: It was Dr Broadbent's confident talk of safe weight loss that attracted Hannah Marsden. At 125kg she was obese. Hannah was able to lose 35 kilos by dieting but when she had the operation serious complications followed.

HANNAH MARSDEN: What I didn't realise was that my body was critically ill.

LIAM BARTLETT: Shutting down?

HANNAH MARSDEN: It was shutting down, slowly shutting down. I was either vomiting up black bile that looked like tar or I was diarrhoeaing — I'll be honest — orange, iridescent orange fluid out of my body, and so it was coming out of all sorts of places.

LIAM BARTLETT: In the following months, things got much worse. Hannah's weight plummeted to 42kg. She went from obese to a stick-thin anorexic, barely able to walk. Her family couldn't believe how sick she became.

HAYDEN MARSDEN: You can only listen to your mum and that screaming in pain and throwing up for so long.

HANNAH MARSDEN'S DAUGHTER: The smell was really scary and it just felt like she wasn't going to be around much longer.

HANNAH MARSDEN: He took me back into surgery He didn't fix it again. He actually didn't know how to fix it, he told my relatives, including my children, to prepare for me not to make it through. DR

RUSSELL BROADBENT: Are you suggesting Hannah was actually on her death bed?

LIAM BARTLETT: She was very close to death, yes.

DR RUSSELL BROADBENT: That's nonsense, absolute nonsense.

LIAM BARTLETT: Why do you say it's nonsense?

DR RUSSELL BROADBENT: Well, it was. Did she allege she was close to death?

LIAM BARTLETT: Most certainly.

DR RUSSELL BROADBENT: What's it ... she was not.

LIAM BARTLETT: She was fine? She was fine, was she?

DR RUSSELL BROADBENT: She was … that was a gross exaggeration of the picture.

HANNAH MARSDEN: One evening, he came in and he held my hand, and he apologised to me and he told me he was trying ...

LIAM BARTLETT: He said sorry?

HANNAH MARSDEN: He said 'sorry' and that he was trying — trying to get me well, and that's when I plummeted. I ... I have my children to think of, and when I was in and out of consciousness, I was listening to my son cry, and that's when I was determined that I had to get well.

LIAM BARTLETT: Why did you apologise to her?

DR RUSSELL BROADBENT: Why did I apologise to her?

LIAM BARTLETT: Mmm, why did you say sorry?

DR RUSSELL BROADBENT: This young lady spent more time in hospital than she anticipated. I said sorry to all my patients. Just saying sorry to a patient is not an admission of guilt of any sort.

LIAM BARTLETT: Hannah Marsden was in hospital at the same time Leesa MacLeod's mother, Ursula, was dying.

HANNAH MARSDEN: I was sitting with your mum only weeks before.

LIAM BARTLETT: Now Hannah and Leesa have joined forces to warn others about the dangers of Dr Broadbent's operation.

HANNAH MARSDEN: … to try and, not only get justice for my mother's death but to stop this from happening to others.

LIAM BARTLETT: As more and more people like Hannah and Leesa tell their stories, Queensland Health Authorities have been forced to act, to investigate. And Russell Broadbent's been forced to defend himself. The Queensland Medical Board found, and I quote, 'serious deficiencies' in your practice, doctor?

DR RUSSELL BROADBENT: And in ... in what practice?

LIAM BARTLETT: Serious deficiencies in your practice ...

DR RUSSELL BROADBENT: In what practice?

LIAM BARTLETT: … which may place other patients at serious life-threatening risk. That's a decision by the Queensland Medical Board, and according to them you're a menace, aren't you?

DR RUSSELL BROADBENT: Well, according to that, but that is wrong, of course, and, of course, that is being appealed and it will eventually be reversed simply on the ground it is totally illogical.

LIAM BARTLETT: They're wrong, too?

DR RUSSELL BROADBENT: Well ...

LIAM BARTLETT: Everyone's wrong?

DR RUSSELL BROADBENT: That is ... that is definitely wrong.

LIAM BARTLETT: With so much controversy, Dr Broadbent wanted us to meet what he claims is one of his many success stories, and Margaret Nelson, and her family, are certainly pleased with her results. Did anybody say, 'Hey, Mum, this is pretty radical surgery? Are you sure you've thought about this?'

MARGARET NELSON'S DAUGHTER: Not really, we were more worried about her weight.

LIAM BARTLETT: She lost 40kg after her operation, and says she's had no negative side effects.

MARGARET NELSON: Apart from my family the best thing I ever did was have the surgery. Nothing else worked for me and it has improved my life so much that I am now happier and healthier than being overweight with a limited life span and major health problems most probably.

LIAM BARTLETT: The only minor inconvenience for Margaret is the strict regime of vitamin supplements she needs to keep her healthy. If you didn't have these twice a day every day of your life, what would happen?

MARGARET NELSON: You could develop deficiencies and that will make you sick.

LIAM BARTLETT: But things are completely different for Hannah Marsden. It's four years on from her operation, but there are still never-ending complications and constant reminders of just how frail she is, especially at meal times.

HANNAH MARSDEN: And I will probably only eat half of that.

LIAM BARTLETT: Half of that?

HANNAH MARSDEN: And it will be cold because I process different. If I eat that hot, I will vomit it up.

LIAM BARTLETT: And even worse, her violent bouts of sickness can happen at any time.

HANNAH MARSDEN: We can be out at events or I'll be driving the car and suddenly I will say, 'Somebody take the steering wheel because I'm vomiting', and I just have to vomit.

LIAM BARTLETT: What even now?

HANNAH MARSDEN: Even now, yeah.

HANNAH'S HUSBAND: Pretty scary when you're driving along the road and your partner's vomiting her heart out.

LIAM BARTLETT: Now this story is far from over. The Gold Coast hospitals where Russell Broadbent operates have banned the procedure because they can't get insurance to cover the risk. Meanwhile, the Queensland Health Practioners' Tribunal is continuing its investigation, and Dr Broadbent is hoping he'll be exonerated so he can keep doing what he says is giving real hope to the obese.

DR RUSSELL BROADBENT: These are the people who John West would reject if they were fish. These are the patients that no other surgeon will tackle. I don't see too many obesity surgeons lining up to do these operations because they're difficult.

LIAM BARTLETT: So you're a trailblazer, are you?

DR RUSSELL BROADBENT: Well, I have been a trailblazer. Just watch this space, Liam.

IAM BARTLETT: You'll prove them all wrong?

DR RUSSELL BROADBENT: I will … and just watch it.