Mother sues surgeon for £200,000 over 'weight loss operation gone wrong'
Paramedic Alison Tarrant had struggled with her weight after having her children and in 2019, when 16 stone, decided to undergo a gastric sleeve operation.
The operation is "irreversible" and involves part of her stomach being removed to reduce its capacity to about the size of a banana to prevent overeating.
Top bariatric surgeon Simon Monkhouse carried out the operation successfully, the High Court heard, but after Ms Tarrant reported that she was struggling to eat solid food in the aftermath he went on to carry out another procedure to attempt to stretch out her new smaller stomach using a special medical balloon which he inflated inside her.
However after the balloon procedure, her newly-reduced stomach perforated and begin to "leak," the court has heard, leading to an emergency gastric bypass operation to save her life.
She was left in a life-threatening condition, which saw her hospitalised for "many months" and fed through a tube due to malnutrition.
Ms Tarrant still suffers "ongoing severe health difficulties" and is now suing the surgeon, claiming compensation of more than £200,000 for her life-changing ordeal.
She claims the bid to stretch her insides should not have happened and that she should have been given more support post-op.
But Mr Monkhouse's lawyers are defending the claim and deny negligence, insisting the balloon procedure was the best option given the symptoms she reported.
The court heard Mrs Tarrant, from Eastbourne, East Sussex, had paid privately to have the weight-loss op at the Spire Gatwick Park Hospital, in Horley, Surrey, in September 2019.
Sleeve gastrectomy is a surgical weight-loss procedure, in which approximately 75 to 85% of the stomach is removed, leaving a cylindrical or "sleeve"-shaped stomach, the size of a banana.
After the op, patients have to undergo a phased reintroduction to eating, starting with liquids before moving on to "mush" and then returning to solid food.
But Mrs Tarrant had expressed concerned that she was struggling to make normal progress after the op and to eat enough and keep food down.
After an investigation, the surgeon decided to go ahead in November 2019 with the balloon procedure, having decided that her issues were being caused by the new surgically-reduced stomach being too narrow.
But shortly after the stretching procedure, she developed a disastrous "leak" in her stomach, leading to an emergency gastric bypass operation in December 2019 - reducing her stomach even more to the size of a walnut - followed by months in hospital and ongoing serious issues relating to eating.
Holly Tibbitts, for Mrs Tarrant, who was still too ill to attend court and gave evidence via videolink from her home, told Judge Michael Simon that she didn't receive enough support around returning to eating after the initial op and that, had she done so, her difficulties would have passed without the need for her stomach being stretched.
She said that the risky procedure should not have been carried out without clear evidence that there was a physical "stricture" or a "stenosis" narrowing the stomach and causing the issues, and which she insisted was not the case.
"Sleeve gastrectomy is an irreversible operation which involves removal of a large part of the stomach decreasing its capacity to around 15% of its original volume," said the barrister.
"This results in a significant reduction in the amount of fluid and food that can be taken by the patient after surgery.
"Patients need access to robust support to deal with the dietary lifestyle and psychological changes following bariatric surgery.
"Mrs Tarrant was a vulnerable patient who had been assessed as likely requiring support to adjust post-operatively. She had not progressed as expected...and therefore required further support.
"She had not been seen or assessed by the dietician at all in the post-operative period, despite the recommendations of the guidelines.
"Her support should have been escalated to intensive follow up, including with the dietician, bariatric nurse and psychologist as required.
"Her position is that if her support had been escalated following the six-week post-operative review, her lack of progression in terms of oral intake and symptoms would have been addressed and her symptoms would gradually have resolved.
"She submits that the decision to proceed with balloon dilation at the gastroesophogal junction in the absence of a confirmed stricture or stenosis is illogical and does not stand up to scrutiny.
"Proceeding to balloon dilation in the absence of a confirmed diagnosis of stricture or stenosis falls outside established diagnostic pathways," she added, claiming it "amounted to a breach of duty".
"If there is no stricture or stenosis present, dilation will be of no benefit, but is likely to traumatise other tissues in the area," she continued.
"Both experts agree that she would have avoided the subsequent complications of conversion to gastric bypass- ongoing nausea, vomiting and food intolerance, malnutrition, hypoglycaemia and the need for enteral nutrition- but for the sleeve leak.
"In the circumstances, Mrs Tarrant invites the court to enter judgment in her favour."
Anna Hughes, for Mr Monkhouse, however insisted he had followed the right path and that the balloon stretching procedure had helped Mrs Tarrant eat more easily before her stomach began to leak.
"There is no suggestion at all that the problems experienced were due to a failure to stick to the diet or to any emotional eating problems," he said.
"In view of this, the claimant has not explained how it is that psychological support would have led to a resolution of her symptoms.
"The fact that the claimant's symptoms improved after she had been given the treatment designed to target the functional stenosis (narrowing) is strong evidence that it was in fact a functional stenosis that was causing her problems.
"Even if, which is denied, the dietician and/or psychologist ought to have been contacted prior to the balloon dilatation, there is no evidential basis for any finding that this would have either led to a resolution of the claimant's symptoms and/or that it would have meant that the balloon dilatation was avoided.
"This is an unfortunate case in which the claimant has clearly suffered a very significant injury. The care provided by the defendant was reasonable given the information he had, or could reasonably have had, to hand at that time.
"There has been no causative failure of care in the present case...accordingly, this claim must be dismissed," she said.
The judge will give his ruling in the case at a later date.
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