The plaintiffs brought a medical malpractice action alleging that a surgeon breached the standard of care by recommending and performing revisional bariatric surgery following the failure of an earlier gastric partitioning procedure.
Liability was the sole issue at trial, as causation and damages were agreed upon subject to that determination.
The court considered extensive expert evidence concerning whether the patient was an appropriate candidate for revisionary bariatric surgery, including the relevance of the 1991 NIH bariatric surgery guidelines and the assessment of obesity‑related co‑morbidities.
The court held that candidacy for revisionary bariatric surgery involves the exercise of clinical judgment and that strict adherence to the NIH guidelines is not determinative, particularly where a prior bariatric procedure has mechanically failed.
The surgeon reasonably relied on the patient’s history, weight regain, gastroscopy findings confirming failure of the prior surgery, and a dietician’s assessment in determining candidacy.
The court concluded that the surgeon met the applicable standard of care.