A Figure to Die For

Community Health Systems cashed in big on the stomach stapling rage. It almost cost Kaye Parsley her life.

Kaye Parsley had always been overweight.

When she was 16, her family sent her to what she calls fat camp in Kerrville, where she and her hefty sisters spent long days waging war on their waistlines. It worked. She lost 30 pounds at camp and 20 more when she went home to Magnolia.

She spent the rest of her life gaining it back.

Despite CHS's assurances, Kaye Parsley almost died during surgery.
Despite CHS's assurances, Kaye Parsley almost died during surgery.
The gastric bypass creates a new, smaller stomach.
The gastric bypass creates a new, smaller stomach.

At her peak, Kaye, just shy of five foot eight, weighed 300 pounds. If the bathroom scale wasn't enough to make her shudder, there was also the calendar. Kaye was closing in on 40. She could handle one or the other, but she knew she didn't want to be fat and 40.

After everything else failed -- Weight Watchers, Jenny Craig, diet pills, Slim-Fast -- Kaye looked into bariatric surgery. Commonly known as stomach stapling, the procedure has been widely recognized for years as an extreme but effective solution for many who suffer from life-threatening weight disorders.

But last July, after Kaye checked into a Lubbock hospital for what should have been a safe, routine procedure, it looked like she was going to die.

From her stomach, which had been cut in two, stapled shut, then cut open again, an infectious fluid was leaking into her intestines. She spent the first 24 hours after her surgery in a fugue state, not really knowing where she was or how many times her surgeon, Ramesh Srungaram, had opened her stomach. When she came out of the second surgery, she could barely breathe. Lubbock's Highland Medical Center didn't have a ventilator for her, so Srungaram, a surgeon with malpractice and personal injury lawsuits in his past, had to have one delivered.

Soon afterward, Kaye blacked out. She was transferred to nearby University Medical Center, where doctors gave her parents a startling update: Her insides were so infected that she had only a 20 percent chance of survival. She needed surgery immediately.

Three more operations couldn't totally clear the infection. Faced with the prospect of losing a young mother of a four-year-old boy, doctors asked Kaye's parents to allow them to attempt to flush the infection with an experimental antibiotic. It was $10,000 a bag, and it wasn't FDA-approved. But it was possibly her only chance.

Her parents signed a waiver to allow the antibiotic that saved Kaye's life.

She was one of the lucky ones.

On July 29 and 30, Srungaram sent Kaye and three other women to UMC with similar complications. One of them, 49-year-old Eva Marie McNew, died.

In August, the Houston-based law firm of Richard Mithoff and Tommy Jacks sued Srungaram and Community Health Systems, the corporate giant that owns Highland Medical Center and owns or oversees 60 other U.S. hospitals. In addition to the four women who suffered in the July surgeries, the attorneys have rounded up more of Srungaram's patients for the suit. They're alleging that CHS lured the obese patients to rural, underequipped hospitals through an Internet marketing scheme that paired desperate people with sometimes negligent surgeons who cared more about the bottom line than patient care.

It turns out that some doctors at a CHS-owned hospital in Cleveland, Texas, also have complained about the corporation's money-versus-medicine mentality for years. What they and other CHS critics say is that what happened to those four patients was not just an accident. It was inevitable.

Weight loss is a big industry aimed at big people, and bariatric surgery is growing bigger every year.

A surgical alternative to late-night infomercials hawking a plethora of pills, snake oil shakes and medieval muscle stimulators, modern bariatric surgery offers the morbidly obese a true way out.

In 2001, 47,200 people had the surgery -- about 10,000 more than in the previous year, according to the American Society for Bariatric Surgery. The group estimated that 63,100 more would undergo the procedure in 2002.

Some surgeons attribute the increase to improved, less invasive methods and the fact that more insurance companies are covering the operation. The death rate is about three out of 1,000 patients, according to the ASBS.

Celebrity success stories also drive the popularity of this type of surgery. When NBC broadcaster and former Fat Albert doppelgänger Al Roker had the operation and lost more than 100 pounds, his familiar smile and streamlined gut soon graced the cover of People magazine. Three years earlier, 300-pound singer Carnie Wilson broadcast her bariatric surgery online.

About 127 million American adults are overweight, and approximately nine million are morbidly obese -- at least 100 pounds overweight, according to the American Obesity Association. Obesity is related to more than 30 medical conditions, including diabetes, heart disease and, among postmenopausal women, breast cancer.

In addition to the problems for adults, the AOA research found an earlier onset of obesity-related diseases in children. And a commentary in the November 2002 issue of the medical journal Pediatrics stated that childhood obesity borders on a "national crisis." The article wondered if the time had come to "establish bariatric pediatrics as a legitimate subspecialty."

Pioneered by an Iowa surgeon in the early 1960s, modern bariatric surgery was recognized by the National Institutes of Health in 1991 as the only safe and effective treatment for morbid obesity. Candidates must have a body mass index of at least 35, which means a person of Kaye's height would weigh 230 pounds.

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