In what could become a landmark case, an obese Australian man sued his General Practitioner and won $364,000. The GP, Dr. Varipatis, a nutritional medicine specialist, was sued by Luis Almario, who was under Dr. Varipatis’ care from 1997 to 2011, and weighed up to 300 pounds. Now facing terminal liver cancer and given just 40 weeks to live, Mr. Almario claimed that Dr. Varipatis was “legally responsible for the consequences of his pre-existing liver disease progressing to cirrhosis, liver failure and eventually liver cancer”. The ruling agreed the doctor should have been more proactive in addressing the early stages of liver disease by treating the problem of Mr. Almario’s morbid obesity.
The Judge said Dr Varipatis should have referred him to a weight loss clinic or for assessment for bariatric surgery, and that there was no evidence Mr. Almario received “specific advice about the relationship between his obesity and the risk of progressive liver disease having the dire consequences he has now suffered”. Bariatric surgery procedures, such as gastric bypass, gastric sleeve and laparoscopic adjustable gastric banding, can be highly effective in inducing significant weight loss, in addition to improving or resolving many obesity-related conditions. The various procedures can work through restricting the amount of food eaten, helping patients feel more full from smaller meals, stopping the absorption of some calories, and/or creating metabolic changes in the body. In the United States, the National Institutes of Health (NIH) recommends bariatric surgery for obese people with a body mass index (BMI) of at least 40, and for people with BMI 35 and serious coexisting medical conditions such as diabetes. Under this guideline, Mr. Almario would qualify for weight loss surgery with a BMI of nearly 60 at his highest weight.
The ruling may prompt doctors to rethink their treatment of obese patients. If the judgment is upheld, the primary care physicians “may suddenly look at some of their obese patients and start giving them referrals to obesity clinics or bariatric surgery”. Dr Varipatis is appealing the judgment, and his legal team says it is in the best interest of GPs.
Dr. Mark Fusco, bariatric surgeon and Medical Director of LifeShape Advanced Bariatric Center of Florida, commented on the ruling: “Although it isn’t always advisable to alter medical practice because of fear of litigation, this judgement is a testament to the preponderance of data showing the benefits of weight loss surgery. Ironic that when I introduced the adjustable gastric band to my community 10 years ago, I had a family doctor tell me he avoided talking to his patients about bariatric surgery because he was worried about getting pulled into malpractice cases if the patient should have a complication.” You can read more about the case here.
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