News paper article from UMass doctor

Weight-loss surgeries require seasoned team UMass doctor on panel issuing report Jennifer Peter THE ASSOCIATED PRESS Weight-loss surgeries should be conducted only by doctors who have been through a rigorous certification process in facilities that do at least 100 of these increasingly popular procedures each year, according to a report issued yesterday by a panel of medical experts. "Our charge was to make recommendations with patient safety in mind," said panel member Dr. John J. Kelly. He is director of minimally invasive and bariatric surgery at UMass Memorial Medical Center in Worcester, where 250 weight-loss procedures were performed last year. "If you have to have one common denominator to make a decision, you're going to make it based on volume," Dr. Kelly said. Hospitals with more experience have programs in which surgeons, anesthesiologists, nurses and other members of the weight-loss surgery team work more safely, with better quality, he said. "They avoid problems, recognize problems when they occur and treat problems aggressively," he said. "All of that promotes patient safety." State Public Health Commissioner Christine Ferguson established the panel this year in response to several recent deaths related to gastric bypass surgeries, whose prevalence in Massachusetts increased from 402 in 1998 to 2,761 in 2003. The 69-page report is the first major product of the Betsy Lehman Center for Patient Safety and Medical Error Reduction. The center was created by the state last year in memory of a Boston Globe columnist who died i***** after a chemotherapy overdose at Boston's Dana-Farber Cancer Institute. The 24-member panel - made up of obesity experts, doctors, nurses and an ethicist - also recommended that hospitals have specially equipped operating rooms, with extra-wide operating tables, extra-long abdominal tools, and wider wheelchairs, stretchers and walkers. Other recommendations cover nursing care, the criteria for selecting patients, pediatric obesity, pain management and areas for future research. "For many people, this surgery represents hope for the future," Ferguson said in a statement. "The report and the recommendations included in it increase the likelihood that they will be able to pursue that hope in safety." Weight-loss surgeries should be performed only on well-informed, motivated patients, who have a body mass index of at least 40 - 35 if they have other major obesity-related complications - and have not been able to achieve long-term weight loss through other means, the panel said. Three patients died after obesity surgery in Massachusetts during the past year. The most recent death occurred in January at Beth Israel Deaconess Medical Center when Howard Reid, 37, of Boston, went into cardiac arrest immediately after surgery. Brigham and Women's Hospital in Boston suspended obesity surgery last fall after Ann Marie Simonelli, 37, died in her hospital bed after surgery. The hospital resumed surgeries in January after an internal investigation found no deficiency in care. A doctor from Brigham and Women's Hospital was chairman of the panel, while a doctor from Beth Israel served as co-chairman. Elizabeth Cooney of the Telegram & Gazette staff contributed to this report. Copyright 2004 Worcester Telegram & Gazette Corp.