Brooklyn Jury Finds in Favor of Bariatric Surgeons In Staple Line Leak Case

A 52 year-old female underwent a laparoscopic vertical sleeve gastrectomy (LVSG) and paraesophageal (Type 3) hiatal hernia repair by the two defendant bariatric surgeons in June 2013. The indications for the surgery (morbid obesity with BMI of 37, along with DM and hypertension) and informed consent were not challenged.

Two days after being discharged, the patient was readmitted with severe tachycardia, shortness of breath, abdominal and chest pain, and fever. CT scan and UGI were consistent with a leak in the proximal staple line in the chest cavity. The sleeve had slid or migrated back into the chest. Plaintiff contended that the defendants had not repaired the hiatal hernia correctly and failed to remove all of the attachments between the peritoneum and chest, causing the hiatal hernia to recur. Plaintiff contended that the measures taken by defendants to treat the presumed leak (defendants were not able to locate it during the reoperation), including over sewing of the staple line, placement of an omental patch, and placement of esophageal stent, were unnecessary measures and combined to cause or make the leak worse. Plaintiff further contended that defendants failed to properly reduce the migrated sleeve into the abdominal cavity, causing an incarceration of the sleeve and staple line, making it more difficult to heal. The plaintiff had a difficult four month postoperative course which included persistent leak, stent placement, migration and replacement, placement of ovesco clips, TPN, intravenous antibiotics, placement of JP drains, pigtail catheter, and thoracentesis in an effort to get the leak to heal and treat plaintiff's mediastinitis and sepsis. The leak did eventually heal and plaintiff was able to return to her usual activities 6-7 months after the sleeve gastrectomy.

A jury of 4 women and 2 males returned a verdict in favor of both bariatric surgeons after deliberating for an hour. The jury found that no departures were committed during either the LVSG or reoperation.

This was Mr. Gerspach's 55th victory in his last 59 verdicts taken.