(Fresno, CA, Dec 30,2001) Former nurse Cathy Ardemagni seemed like an unlikely candidate for the
operation. At 5 feet and 192 pounds, she could hardly be considered severely
overweight. Her body-mass index was 37.5, below the recommended 40. But she
suffered from back pain, and doctors told her the surgery could help.
She had the surgery three years ago at Fresno Community Hospital. Gladen was
After the operation, things went terribly wrong.
According to a lawsuit filed by Ardemagni, she developed an intestinal leak
that carried toxins throughout her body, threatening to kill her. She endured
four operations within a week. A fifth operation followed months later.
She survived, but for months Ardemagni had to use a wheelchair. She was
unable to eat solid food for six months. Today, at age 50, she walks with a limp
and can't stand for more than 15 minutes without back pain. She never returned
to her job at Sierra Kings District Hospital in Reedley.
Her back pain is worse.
"This is not a surgery to be taken lightly," she said. "It
backfired on me."
The doctors, when they explain the surgery, don't impress upon you that you
can die, she said. They don't dwell on the terrible side-effects.
"They don't tell you that you heave up your toe-nails ... or the
horrible pain that comes from not chewing your food thoroughly," Ardemagni
She sued Gladen and recently reached an out-of-court settlement. Ardemagni
signed a confidentiality agreement and won't disclose specifics of the case.
Dr. Edward Livingston, the UCLA surgeon, said gastric leaks are common and
manageable. If surgeons are doing their job correctly, they should be able to
detect them, he said.
"The real difference between a real good surgery and not real good
surgeries," he said, "is how you deal with the complications."
Deaths reviewed in The Bee's investigation show a majority of the patients
died from gastric leaks following their surgery.
Livingston said surgeons should provide adequate post-surgery care, but some
are taking on too many patients and can't monitor them all properly in the
critical days and weeks following the operation, when complications are most
likely to set in.
"Do the math," he said. "How are you are going to see 1,000
new patients a year and monitor them all?"
Tova Winrow, 28, of Fresno, suffered serious complications from a gastric
leak before her death last year.
Winrow was a strikingly beautiful woman. At 5-foot-4 and 250 pounds, she had
been unhappy with her weight for years. A single mother, she had four children
and put on weight with each pregnancy.
Gladen performed Winrow's gastric bypass surgery at UMC on March 15, 2000.
She went home two days later but returned to UMC on March 20 after complications
set in, including a gastric leak at one of the stapled intestinal connections.
Winrow's parents are suing Gladen on behalf of her children, who all are
younger than 12. The parents declined to be interviewed on the advice of their
attorney. Gladen declined comment about the lawsuit.
According to court documents, doctors operated on Winrow three times as her
problems escalated. Blood clots developed in her right leg. Doctors decided to
amputate the leg just below the knee on March 27, 2000. Winrow died the next
Winrow's death certificate lists "failed gastric stapling" leading
to "complications of sutural leak" following gastric bypass surgery.
Herman Praszkier, whose St. Louis law firm is handling five wrongful death
lawsuits related to gastric bypass surgeries, none of them in the Valley, says
many hospitals and surgeons are ill-equipped or too busy to deal adequately with
patients suffering complications.
In many cases, hospitals don't have a large enough CAT scan machine to
accommodate these overweight patients. CAT scans are the only sure-fire way to
detect a potentially deadly leak, he said.
A leak affects all other areas in the body, including the circulatory system,
then the organs. Said Praszkier: "It's a leak of gastric content with the
pH of battery acid."
He believes the number of fatalities caused by these operations is higher
than most people realize: "Nobody knows how many people have died from
this. Nobody wants to."