In a protracted effort that started in 2000, Reno resident Tracy Tootell changed jobs to get the right insurance coverage for her weight-control surgery, scheduled at Carson-Tahoe Hospital for Dec. 17, 2003.
But hospital officials imposed a moratorium on bariatric procedures in late November, and Tootell's surgery, along with 23 others, was canceled. They said the moratorium was necessary to update standards and guidelines for the difficult procedure. In addition to the canceled 24 scheduled surgeries, another 60 patients are on hold.
"For me and many other bariatric patients, this is an unbearable and heartbreaking situation," Tootell wrote in a letter protesting the moratorium. "It's a shocking and traumatic stop in a long-term plan to permanently improve my health and quality of life."
The procedure is the last resort for patients who have tried but cannot lose weight. Sealing off the stomach to reduce the amount of food or rearranging the small intestine to reduce calories are two of the surgical options known collectively as bariatric surgery.
On Thursday afternoon, Carson-Tahoe Hospital's marketing department issued a statement saying the moratorium was put in place following the death of a 31-year-old female at the hospital.
"After the death, questions were raised about the policies and procedures currently in place for this complex procedure," said Ed Epperson, chief executive officer at Carson-Tahoe Hospital "This suspension was not meant to cast aspersions on any one physician. The review of this program is clearly in the best interest of our patients. We're aware that the suspension may have caused some inconvenience, but any inconvenience is outweighed by the concerns for patient safety."
The hospital said it would reimburse any patient for out-of-pocket expenses incurred.
Leta Hollis, who had the surgery three years ago, was at a support-group meeting when the moratorium was announced.
"I was crushed for those people," she said. "I cried on the way home because they were turned away from the surgery.
"I lost 75 pounds, and I don't look like the same person. I'm not the same person," she said. "I'm 52 years old, and I just put in for a flight attendant's job. I'm healthier and happier than I've ever been. Life is awesome."
Preparation for the procedure involves numerous tests and consultations over months or even years. Tootell's letter was one of more than 35 either protesting the moratorium or supporting Skogerson, who started the program.
The patients make up 90 percent of his practice. A surgeon in Carson City for about 18 years, he's been doing bariatric procedures for 31Ú2 years and has done 300 bariatric surgeries.
His success rate is above the national average. He authored a set of the necessary procedures for the American Society of Bariatric Surgery, but says Carson-Tahoe Hospital officials disregarded his efforts. Skogerson said he learned of the moratorium from a misdirected letter just days before it was imposed.
Epperson said surgeons were notified 10 days before the moratorium was imposed and letters were sent to patients who were scheduled or preregistered for surgery..
"Many hospitals have taken time out to implement the newest, safest protocols. The American Society of Bariatric Surgery and the CDC have both suggested standards for patient safety, and these are the guidelines our staff is implementing," Epperson said.
Tootell said she doesn't understand why patients who had already been scheduled were given so little time to prepare.
"I applaud the board's choice to review this or any program, but the circumstances have created a heart-breaking situation for me and many other bariatric patients," she wrote. "I am already part of a comprehensive program and I have been for months.
"How can the C-TH board be so callous as to make this decision without consulting scheduled patients?" she added. "Was there an imminent and unforseen threat to patient safety?"
Hospital officials had not mentioned the 31-year-old woman's death before Thursday's statement. No other information on the death was provided.
Kevin Stansbury, C-TH chief operations officer, said earlier there is no imminent threat and the decision does not reflect on the competence of local surgeons who perform the procedure.
"We're hoping the medical staff will complete their recommendations soon," he said. "We're thinking no later than February."
Contact Susie Vasquez at svasquez@nevadaappeal.com or 881-1212.
BREAKOUT:
Obesity leads to several life-threatening conditions including hypertension, diabetes and pulmonary complications. The procedure is risky, but it does save and extend lives, according to local surgeon Dr. Kent Skogerson.
"Obesity is taking as much as 25 years off patients' lives and kills 300,000 people prematurely in this country every year," he said.
