Extremely Perfect: Bypass Mania
"American Idol" judge Randy Jackson lost more than 100 pounds after weight loss surgery. So did singer Carnie Wilson, weatherman Al Roker and MTV's Sharon Osbourne.
It's the kind of advertising money can't buy. But are unskilled doctors costing some patients their lives? Correspondent Harold Dow reports on this broadcast that first aired in March.
Dr. Julie Ellner is one of the country's leading bypass surgeons. She practices at the renowned Alvarado Medical Center in San Diego. And the results are dramatic.
"It never fails to touch me when a patient comes in and tells me how I changed their life," says Ellner. "I get hugs from my patients every time they come in. And a lot of doctors can't say that."
People come to Dr. Ellner when they're desperate. "They realize they're going to die early if they don't do something drastic about this," says Ellner.
And a gastric bypass is drastic. Using a laparoscope, surgeons cut and staple inside the body to re-route intestines and create a much smaller stomach.
"Your new little golf-ball size stomach is completely separated away from the old stomach, so the patients eat a very small amount of food, but they feel like they've just eaten a huge turkey dinner," says Ellner.
Just last summer, then 16-year-old Raechel Arnold from Claremore, Okla., weighed 323 pounds.
"I had tried everything. I had tried exercising, dieting, anything -- everything under the sun, I had done. And nothing worked," says Raechel, who decided to go to Alvarado in July 2003 to undergo gastric bypass surgery. She was one of the youngest Americans ever to do that.
"I played softball and it was getting hard, you know, out in the heat and the tournaments. And my feet weren't handling the weight well," adds Raechel. "It was awful. You know, just knowing that it got that bad. That I couldn't be mobile anymore."
By January, she was 140 pounds lighter, and much happier, too.
"I like being able to fit into these clothes. It's really awesome. I like seeing myself in them. I'm really not that conceited. It's just weird seeing myself as how I look now, because I'm used to seeing something a lot bigger," says Raechel. "I'm just so blessed and lucky to have this - no pun intended - weight lifted off of me. It's just been great."
With results like that, it's no wonder the demand for weight-loss surgery is way up. Surgeons tell their patients they can go home from the hospital in three days, go back to work in a week, and start shedding pounds immediately.
Here's the problem: The demand is creating a gold rush, with doctors and hospitals racing to get in on this lucrative business. Surgical weight-loss centers are sprouting up all over the country -- but many of the surgeons being recruited just don't have the specific skills, experience, and training needed to perform the new procedure safely.
48 Hours found the consequences are devastating, even deadly: five dead in New England, six more in Iowa, and seven in Georgia -- all in a year and a half.
Incredibly, there is no official certification or mandatory training for weight-loss surgery, as there is for cardiology or even cosmetic surgery.
"There are a lot of training courses, where surgeons can learn how to do this in a weekend, and then go back to their home institutions and say that they're laparoscopic surgeons and try to start up a program," says Ellner. "These are some of the highest risk patients you could possibly operate on. And if you aren't appropriately trained, you could kill people."
Jane Covington has difficulty talking about her daughter, Donna Collins: "She was a great daughter. She took care of me. She took care of her father. The year that I had cancer, she was my caretaker. The year she passed away, she was still my caretaker."
At 235 pounds, Collins had hoped for a new start. But less than three weeks after laparoscopic bypass surgery at a Houston hospital, she was dead.
Right after her weight-loss surgery, she developed a deadly infection — either from undetected tears or nicks in her intestines or from leaks in her sutures.
"She never really started talking. I mean, she just never came around," says Donna's husband, David. "She never left [the hospital.]"
The family sued Houston Community Hospital, and later settled the case.
Her family would like to sue her surgeon, Dr. Ramesh Srungaram, but they've discovered he's been sued so often, he declared bankruptcy.
But Dr. Srungaram had another patient, Steve Burr, 30, a warehouse manager who lived near Houston with his wife, Denise, and kids Matthew and Casey.
At one time, he weighed more than 260 pounds. "I was having some health problems, always felt worn out, and wanted to try to make a better life for myself, for me and my children," says Steve.
After gastric bypass surgery, Burr lost 113 pounds.
The Burrs went to a seminar sponsored by a Houston hospital, Cypress Fairbanks, and Dr. Srungaram. Steve became convinced surgery would do the trick: "I was under the impression I was going to spend two days, three days max, at the hospital and then be back at work within a week after that."
At 263 pounds, Steve only barely fit the profile of an appropriate candidate for surgery. His insurance company wouldn't cover it, but Steve would not be dissuaded. He decided to "get some loans off some credit cards to finance the surgery."
"I wanted him to have this great life that they promised. And it was the total opposite," recalls Denise.
Within 24 hours, Steve says he was in critical condition: "At some point, my kidneys shut down and my lungs collapsed. And they told my wife I only had a 5 percent chance to live."
During Steve's surgery, a serious mistake was made -- his intestines were nicked, allowing a toxic mix of acids, enzymes and waste to leak into his body. Srungaram rushed Steve back into the operating room to fix the damage, but he only got worse.
"After, I think, the second or third surgery, they said he probably wouldn't make it," recalls Denise, who fired Dr. Srungaram. "I just screamed at him, 'Are you trying to kill my husband?' And he started out of there as fast as he could. And I never saw him again."
Other doctors were called in to help. In January, Steve still hadn't healed from all the surgery done 18 months earlier.
Steve says he ended up having six surgeries when he had the gastric bypass procedure done. But to add insult to injury, his mounting medical bills – almost a million dollars, just in medical -- left the family bankrupt.
The Burrs had no way of knowing, but it turns out that two months before Steve's operation, Cypress Fairbanks hospital had temporarily suspended Srungaram's privileges -- because of concern about his high complication rate.
Then, two months later, right after the disaster with Burr's case, the hospital forced Srungaram to resign. But that didn't stop him from moving to another hospital, Highland Medical Center, in Lubbock, Texas.
Just six weeks after Steve Burr's surgery, Kaye Parsley, 41, got her gastric bypass from Dr. Srungaram.
"I talked to one of the nurses, and she said, 'We need to pray.' And I'll never forget those words,'" says Parsley, who was one of four women Dr. Srungaram operated on during a two-day period in Lubbock.
All four women developed major complications, and were removed from Srungaram's care and rushed to another hospital for emergency treatment. One of the women died; Parsley survived.
"I thanked God I was alive, because I had at that time a 3-year-old boy waiting for me at home," says Parsley. "All I could think of was getting back to him."
In time, Parsley was able to get home to her son, Dakota. But she still has trouble breathing and memory loss.
"I'm angry about what happened to me," adds Parsley.
Parsley is one of more than two-dozen former patients, including the families of four people who died, who sued Dr. Srungaram and the hospitals where he performed surgery.
Dr. Srungaram had never been willing to respond to any of the allegations publicly, until 48 Hours found him in his office this last February.
"I'm not a butcher. I never intentionally killed anybody. I don't do the surgery for money," said Dr. Srungaram.
In spite of all the legal actions taken, and pending lawsuits, he was determined to continue operating.
"Anytime anybody dies, it hurts like hell. It stings to your heart, you know? You are the cause of it," said Srungaram. "And everybody who has a complication or loss of life, I feel real sorry for them. But just part of the business."
And even Srugaram admitted that he had gotten better at the procedure over time: "There is a learning curve. There is. In the beginning, it takes a little while to get used to it."
And that conclusion underscores the latest clinical findings – that complication rates go way down after a surgeon has done 100 of these cases. But that doesn't help a patient with an inexperienced or incompetent surgeon.
"These people were desperate for surgery. And they fell into the trap," says Richard Mithoff, a Houston lawyer who represents 28 of Srungaram's patients. "The real culprit in our view is the corporate hospital that continues to recruit third-rate physicians to do complicated surgery."
But while Mithoff continues to go after the hospitals, he shares his clients' feelings about Srungaram.
"He's obviously not qualified to be doing this," says Mithoff. "I don't know what motivates him to continue. Most importantly, I don't know why the State Board of Medical Examiners allows him to continue."
Last fall, after a year-long investigation, the Texas Board of Medical Examiners determined that Dr. Srungaram failed to practice medicine in an acceptable professional manner.
He was fined $25,000, placed on probation for seven and a half years, and required, among other things, to have another doctor observe him for his next 100 weight-loss surgeries. But incredibly, he still has a license to practice medicine.
Since 48 Hours first brought you this story in March, Dr. Srungaram closed down his Houston office. And according to the Texas Medical Board, he has no known hospital privileges anywhere in the state.
But that doesn't help his patient, Steve Burr. "Nothing can take back the time I've lost with my children," says Steve. "I went in thinking this was going to give me a better life."
Soon after 48 Hours met the Burrs, they settled their lawsuit against the doctor and the hospital. The case may be over, but Steve's suffering continues.
"I still currently have pain every day. I'm just in as bad shape as when I went in," says Steve. "If people are looking to get this surgery, just take one more step further. Take a look, a little deeper in who's going to be performing that surgery, and what hospital."