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Entries in Operations (5)

Friday
Nov042011

Woman Loses 130 Lbs. Months after Radical Stomach Surgery

ABC News(NEW YORK) -- For the first time in as long as she can remember, Holly Matherne is excited about shopping. Last October Matherne was a size 32. Today she's a size 18 and dropping. An addiction to clothes is replacing her previous addiction: food.

In an interview with ABC’s Nightline last October, Matherne said, "I've been fighting with weight since I was 6 years old. I've been on every diet, I've been to a nutritionist, Weight Watchers, reduce fat, reduce calorie, you name it, I've done it. I may lose weight here and there, but then it winds up creeping back on. It's all tied to emotion. I'm obviously an emotional eater."

Last fall Matherne weighed 370 pounds, and she knew she had to turn her life around before it was too late, she said. After years of unsuccessful dieting, Matherne decided to have sleeve gastrectomy, a surgical operation to remove most of her stomach. The procedure cost around $30,000 and is irreversible.

Dr. David Treen was Matherne's bariatric surgeon.

"The beauty of the sleeve gastrectomy is that the patients lose weight twice as fast as what we've seen with other surgical procedures," Treen said. "There is no question this is the single best option for patients who the weight has just gotten out of control."

The surgery takes less than an hour and sheds very little blood. A pouch is cut from the stomach and stapled shut, and the rest of the stomach -- about 85 percent -- is twirled out of a dime-size hole. With that part of the stomach goes a hormone called ghrelin.

"Ghrelin is a powerful appetite stimulant," said Treen, "and when you remove this part of the stomach, most of our patients tell us after surgery, they're not hungry. Ever."

Now, her recovery complete, Matherne has lost 130 pounds since the surgery.

"I find I'm a lot more outgoing," she said. "I always thought I was outgoing, that I had a good personality, but I find I'm less hesitant in social situations."

Copyright 2011 ABC News Radio

Thursday
Oct062011

Medicare Patients Get Costly Surgery before Death

Jupiterimages/Thinkstock(NEW YORK) -- Nearly one of every three Americans on Medicare undergoes surgery in their last year of life, according to a new study. Those numbers are leading some to question whether pursuing these costly and invasive procedures is the right thing to do for dying patients.

The study, published in The Lancet, analyzed more than 1.8 million claims for Medicare patients who died in 2008, and found that 32 percent of them had an operation in the year before they died. Nearly one in five had a surgical procedure in the last month of life and one in 10 went under the knife in the last week of life.

Dr. Ashish Jha, the study's author and an associate professor of health policy at the Harvard School of Public Health, said it's well known that patients get lots of health care at the end of their lives, but this study is the first to show how many of them are getting costly, invasive surgery, and then dying.

"This level of surgical intensity doesn't seem to be having much in the way of benefit for the population," Jha said. "Our sense is that there are probably lots of unnecessary procedures that go on at end of life."

The study found that a patient's likelihood of getting surgery varied greatly depending on their age and where they lived. Surgery was more common for 65-year-olds than for patients in their 80s and 90s. Operations also became more likely in regions with greater availability of hospital beds and higher levels of Medicare spending.

All this surgery didn't necessarily prolong life. Areas where doctors did lots of operations had higher patient death rates.

Ken Thorpe, a professor of health policy at Emory University, said doctors and health care systems should reevaluate the kinds of interventions they give to patients who may not live long enough to really benefit from their treatments.

"Researchers are finding that these aggressive procedures have the same outcomes as less invasive, less expensive treatments," he said. "This study shows us there's an enormous opportunity to basically save money and provide less intervention, and still have the same quality of care and life expectancy."

The study also suggests that more dying people have surgery not because they want it or need it to save their lives, but because American medical culture encourages aggressive care like surgery, even at the end of a patient's life.

Jha said it's impossible to tell from the Medicare claims analyzed in the study whether or not surgery was really necessary or whether patients and their families wanted an operation. But he said it underscores a general hesitation by doctors to discuss a difficult subject with their patients: that they might die.

"A lot of physicians struggle to talk about prognosis, whether people are going to live or die. Instead they focus on trying to make little things better," Jha said. "Some of these procedures are a distraction from what might really be important for patients, like being able to spend time with family, being able to say goodbye to people they love, or what their quality of life will look like."

Experts say this study highlights the need for doctors and patients to talk about palliative care options as well as more aggressive treatments like surgery.

"We need to provide patients options for how aggressive they want to be toward the end of life," Thorpe said.

Copyright 2011 ABC News Radio

Thursday
Aug182011

Doctors Face High Risk of Malpractice Claims

Jupiterimages/Thinkstock(BOSTON) -- Almost every physician in the U.S. will face a malpractice claim during his or her career, according to a new study published in the New England Journal of Medicine.

Researchers led by Dr. Anupam Jena, a physician at Massachusetts General Hospital and Harvard Medical School, analyzed malpractice data over a 14-year period for all physicians covered by a large malpractice insurance provider.  They estimated more than 75 percent of doctors in specialties with a low risk of malpractice and 99 percent of doctors in high-risk practices will be sued.

"If you consider a doctor who is 30 years old and just starting a career and in a high-risk specialty, there is about a 100 percent chance that by the age of 65 he will have faced a claim," said Jena.  "We find that across all specialities, the annual risk of a claim is substantial -- 7.4 percent of all physicians had a malpractice claim every year during the study period."

The study also found that while the risk of a malpractice claim is high, about 80 percent of claims never result in any payment to plaintiffs.  Average payments ranged from $117,832 for dermatologists to $520,923 for pediatrics.

Neurosurgeons, thoracic/cardiovascular surgeons and general surgeons face the highest risk of a malpractice claim, while general practitioners, pediatricians, and psychiatrists face the lowest risk.

While the monetary costs of claims are low compared to risks, Jena said doctors pay an extremely high price in other ways.

"There are substantial costs associated with those claims," Jena said.  "There are the costs of defending the claim [and] the losses in productivity while doctors spend time with their defense.  Patients may suffer by not being able to see their doctors, and there also [are] the effects of stress and potential damage to reputations."

Copyright 2011 ABC News Radio

Wednesday
Jun292011

Connecticut Veteran Wins Nearly $1M in 'Exploding Eyeball' Suit

Getty Images(WEST HAVEN, Conn.) -- A 60-year-old Army veteran has won $925,000 in a settlement with the Department of Veterans' Affairs following a botched cataract operation.

Jose Goncalves was blinded in his right eye in 2007 when a resident at the Veteran's Administration Hospital in West Haven, Conn., injected too much anesthetic too fast, causing his eyeball to literally explode.

The outpatient surgery to remove cataracts, which cloud the lens and make it difficult to see, is done using local anesthetic, and the patient is usually awake during the procedure. But Dr. Yue Michelle Wang, the resident responsible for numbing Goncalves' eye, injected the anesthetic "directly into Jose's eye instead of behind the eye," according to Goncalves' attorney, Christopher Bernard of the law firm Koskoff, Koskoff & Bieder.

"It is clear that Dr. Wang's training was seriously inadequate," Bernard said in a statement. "This should have been a routine procedure as it is for countless people every day. When proper techniques are used, this particular complication should never occur."

Wang and the U.S. attorney's office, which represented the VA, did not immediately respond to ABC News' request for a comment.

The lawsuit, filed in October 2009, argued that Goncalves' injuries were "a result of carelessness and negligence" by the doctors at the Veterans' Administration Hospital and that he "has been permanently deprived of his ability to carry on and enjoy life's activities."

Goncalves endured four more surgeries to try to save vision in the damaged eye, to no avail. Unable to return to his job as a roofer, he now works in the maintenance department at Central Connecticut State University. He can only drive short distances, according to Bernard, and struggles with reading and watching television because his undamaged eye tires quickly.

"Jose suffered excruciating pain after that botched surgery and continued to have severe pain for months afterward," Bernard said in a statement. "If anything should ever happen to the undamaged left eye, he could face total blindness."

Copyright 2011 ABC News Radio

Tuesday
Jun212011

Best, Worst Hospitals for Weight-Loss Surgery

Jupiterimages/Thinkstock(WASHINGTON) -- Hospitals that perform at least 375 weight loss operations a year have the best safety record for bariatric surgeries, while those that performed fewer than 75 a year had the highest rate of complications, according to a new study by a hospital rating group.

The complications from bariatric surgeries could include internal bleeding, a collapsed lung, and even death.

The study by HealthGrades, an independent health care ratings company, found 100 hospitals in the 19 states it surveyed that it rated as one star, or "poor performers," for weight loss operations.

Another 107 hospitals were rated five-star by the group, and 261 hospitals earned three stars. A total of 468 hospitals were studied and the survey reviewed 190,000 bariatric surgery patients treated between 2007 and 2009.

"When you're having a major procedure, a lot of times you choose a facility through word-of-mouth," said Kristin Reed, vice president of hospital rankings for HealthGrades. "But this report gives people objective information to make decisions based on real outcomes."

"We hope that hospitals use this information to compare their performance results" to those from five-star facilities and look for ways to "tighten up their practices," Reed said.

At facilities given a five-star rating, like Providence Saint Joseph Medical Center in Los Angeles or Saint Luke's Roosevelt Hospital in New York City, patients were nearly 70 percent less likely to experience complications.

Other five-star-rated hospitals, as rated by HealthGrades, include California Pacific Medical Center in San Francisco, Lowell General Hospital in Boston, Albert Einstein Medical Center in Philadelphia, and Bayshore Medical Center in Houston.

Patients who went to the top ranked hospitals had shorter hospital stays and a smaller bill, saving on average $6,692 compared to patients who checked into a "1-star" hospital like University of California, Irvine, or Staten Island University.

Other 1-star-rated hospitals include Mount Sinai Hospital in New York City, Temple Community Hospital in Los Angeles, Massachusetts General Hospital in Boston, and Baylor University Medical Center in Dallas.

Copyright 2011 ABC News Radio







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