A Figure to Die For

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

He is certified by the American Board of Surgery, which gives him the credentials to perform bariatric procedures. He also belongs to the 20-year-old American Society of Bariatric Surgery, which means he's had at least 25 successful bariatric surgeries and passed two peer-committee reviews. That membership is not listed on the state medical board's Web site, however. Board spokeswoman Jill Wiggins says her board lists only American Board of Medical Specialities-recognized affiliations because that signifies a meaningful certification.

"Some of the [non-ABMS] boards are almost like mail-order-certificate type of things," she says. It is impossible, she says, to tell if some board certifications mean anything more than showing up for a golf weekend and leaving with a certificate.

Srungaram holds monthly seminars for prospective bariatric patients and has told reporters he's performed more than 500 bariatric procedures. He's also faced five medical malpractice and personal injury lawsuits since 1989. (Srungaram has also filed at least one lawsuit himself -- against Kmart, for a slip and fall.)

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.

One suit, filed two years ago, is nearly identical to the case involving Kaye Parsley. Srungaram is accused of malpractice in Janice Jo Urbantke's bariatric surgery. Urbantke died, but this never came up when Kaye asked about patient deaths at Srungaram's seminar.

The 2000 lawsuit says that Srungaram operated on Urbantke in 2000 and she complained of abdominal pain seven days later. He sent her to the Memorial Hermann emergency room, where doctors discovered she was leaking abdominal fluid into her chest and lungs. Urbantke underwent two more surgeries before dying of a heart attack about three weeks after the original procedure.

Urbantke's relatives sued Srungaram for failing to properly evaluate her, failing to adequately close her wounds and failing to sufficiently monitor her after surgery.

Srungaram responded to the allegations the same way he responded to his other suits, by stating that the patient's death was "unavoidable" and "an act of God" and that the problems were caused by her "pre-existing medical or psychological conditions or disabilities."

But Srungaram also has patients who laud him, and their testimonials can be found on the Association for Morbid Obesity Support Web site. There are dozens of postings saying that patients found that what he lacked in bedside manner he made up for with certain skill.

One former patient of Srungaram's even railed against the local media for allegedly trashing Srungaram when Eva Marie McNew died after the surgeries last July. The former patient, who lives in Houston, failed to respond to e-mails from the Houston Press. So did three other former patients who posted positive reviews.

Because of the life-changing ramifications of bariatric surgery, responsible surgeons put their patients through extensive testing and counseling before the operation.

According to Neil Hutcher, a bariatric surgeon from Richmond, Virginia, who sits on the American Obesity Association's advisory council, bariatric candidates should enter into a long- term relationship with their doctors.

The 60-year-old Hutcher, who says he's performed about 3,000 bariatric surgeries in 30 years, spends a great deal of time with his candidates prior to the procedure.

His first step is to hold a two-hour seminar with up to 20 candidates at a time, then to visit one-on-one with them for about 40 to 60 minutes. Each candidate then meets with a nurse-practitioner for 30 to 60 minutes. The potential patients then must complete five hours of classes at the hospital, where they are tested on a 100-page manual written by Hutcher and his colleagues. Candidates are also encouraged to enroll in pre-op support groups. Throughout the process, Hutcher advises each candidate to be accompanied by a family member or significant other.

And because the morbidly obese face a host of illnesses, from diabetes to sleep apnea, he likes to take a team approach to the surgery, having lung, heart and other specialists examine the patients.

He has never heard of COMPASS and says an Internet-based form of preparation conflicts with his methodology.

"We're old-fashioned dinosaurs," he says. "Patients are living, breathing, touching things. And that's the way we treat them."

Kaye saw Srungaram professionally only one more time after his seminar, stopping by his office to get a prescription for the B12 shots that bariatric patients have to take after surgery. She says her physical examination consisted of her lying down while he pressed on her stomach in three places. No X-rays, no request for medical records, no blood work -- nothing.

He told her he'd take care of everything else at the hospital. She was good to go.

Although Kaye was scheduled to undergo surgery at Cy-Fair, she received a letter in June from COMPASS, explaining that it was now handling Srungaram's bariatric affairs. The letter said that Cy-Fair was no longer allowing bariatric surgery there, so Srungaram would perform the operation at a hospital in Lubbock. Kaye was puzzled -- she had never heard of COMPASS -- but since they would be paying the airfare, she wasn't too worried.

What the letter didn't say was that Cy-Fair still allowed bariatric procedures. According to Cy-Fair spokeswoman Lisa Anderson, Srungaram voluntarily withdrew his privileges in June after less than one year with the hospital. Two weeks before he "voluntarily" quit, Srungaram performed bariatric surgery on Steven Burr, another COMPASS client who would later file suit against Srungaram for allegedly shredding his stomach, intestine and surrounding tissue.

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