Hello!

Welcome, Hannah, and I am so sorry you were deceived. How are you feeling physically? Please stay hydrated!

I am feeling ok, so far. I went back to work on Monday and that has been a drain in itself. Im just filling out my records request form now for the Drs office....
 
HI and welcome!
Ii am so glad our wonderful @southernlady found you and directed you here. As you are already seeing, people here are very knowledgeable about the different bariatric surgeries and unfortunately we are now learning about multiple people having the same experience you have had. I hope that you, and others in your situation, will not just accept what has been done and try to move forward, but that you will also take action to prevent others from the same fate WHILE you move forward.
If someone is fully and honestly informed about their alternatives and for whatever reason chooses the SADI rather than DS, or some other operation altogether, or not to have surgery at all, that's fine. It's their choice. But the right to make an informed choice was taken away from you, and I truly hope you don't take this sitting down.

Thanks Larra! I am not taking it sitting down at all. Im already in talks with my sisters boss (an attorney) to see who would be best to use. I just filled out my records release form for Cottams office.
 
Caveat: I am a lawyer, and a PhD in medical biochem, which makes me a PATENT attorney, not an insurance attorney. Larra and I help people with appeals, so I know a good deal about that area of law, but not enough to make me qualified to practice in that area, much less in medical malpractice - but I know enough to make suggestions, which is what I will contribute. But nothing I say is to be construed as legal (or medical) advice.

Having said that, I saw Cottam's "informed consent" agreement (see this thread: http://bariatricfacts.org/threads/crap-band-removal-approved-but-ds-denied-help.3175/), which I assume is substantially identical to the one he had you sign, and I think it is highly misleading. The title of the document is "Certification of Consent to Loop Duodenal Switch" (which is interesting in itself, since that is not what Cottam calls it - he has joined up with Roslin to call the procedure which they slightly tweaked the limb lengths from what is known internationally as the SADI, and they gave it their own name, SIPS - so why does he not use SIPS as the title of this paper? I submit because he's trying to deceive you with the use of the term Loop DS in the title), while the rest of the document just uses "duodenal switch" to refer to the procedure. There is NO attempt made to explain it is not a standard DS, or to specify what is being done
- in fact, it appears to me that it is describing a STANDARD DS:

* The Malabsorptive Component
The malabsorptive component of the DS procedure rearranges the small intestine to separate the
flow of food from the flow of bile and pancreatic juices.
This inhibits the absorption of calories
and some nutrients. Further down the digestive tract, these divided intestinal paths are rejoined;
food and digestive juices begin to mix, and limited fat absorption occurs in the common tract as
the food continues on its path toward the large intestine.​

The loopDS doesn't separate food from the flow of bile and pancreatic juices - the food leaves the stomach and IMMEDIATELY contacts bile and pancreatic juices - but in a shortened alimentary tract. The loopDS doesn't have two "divided intestinal paths" - it has one path.

If I were your attorney, I would argue that duodenal switch has a specific meaning in the art - it means a pylorus-preserving sleeve gastrectomy, with intestinal reconstruction to provide an alimentary tract of about 250 cm or 40% of the small intestine starting around the jejuno-ileal junction, with a SEPARATE (i.e., DIVIDED) biliopancreatic limb comprising the distal duodenum starting just above the insertion points of the bile and pancreatic ducts, and ending with an RNY anastomosis about 100-125 cm from the ileocecal valve, or a number that approximates 10% of the small intestine, and wherein the proximal end of the ileum is anastomosed to the proximal duodenal stump.

The "good news" is that your procedure can (I believe) rather easily be revised to something close to a standard DS (but with a somewhat longer - 300 cm - alimentary tract) by severing the small intestine just upstream of where Cottam anastomosed it to the proximal duodenal stump, sealing the side that stays attached to the stump, and moving the open end down to the place where it should be anastomosed to the ileum about 100-125 cm from the ileocecal valve. I'D WANT THAT DONE SOONER RATHER THAN LATER. However, I'm not sure I'd want Cottam to do it, because of the lack of trust I'd have in his ethics (rather than surgical skills).

I hope you can get an attorney to represent you and the other people DECEIVED by Cottam into being part of his study (with Roslin) on his "SIPS" procedure. I hope you can get your insurance company to revoke (or stop) their payment to him for fraudulently giving you a procedure other than what you consented to, and one which is EXPERIMENTAL and they would not have covered had they known exactly what he was going to do, since he used CPT code 43845, which refers to a STANDARD DS, and to warn him not to attempt to collect the denied payments from you.

The definition of battery under most versions of state law includes the concept of an unauthorized touching. I would argue that his misleading and unethical (in my opinion) practice, including information communicated (or NOT communicated) in his in-person consult and the inconsistent misleading consent form, followed by doing a procedure on you that is NOT what you (and others) understood you had given consent for, constitutes an actionable battery. He failed to obtain fully informed consent before doing surgery on you because he intentionally obfuscated the fact that he was doing his OWN procedure, which substantially and materially differs from the standard of care duodenal switch in the field, his motive being to get as many subjects as possible for his study (with Roslin) and to publish the results of this procedure that they named as being distinct even from the SADI that is being investigated in Europe, in order to make a name for himself in the field.

Moreover, since he is associated with a university, I would also file a complaint with the university, stating that you not only did not give informed consent to the procedure he did on you, you most certainly did not give informed consent to be part of a medical EXPERIMENT. This is a HUGELY serious charge, by the way.

Please (to the extent that your lawyer says is OK, of course) keep us informed of how this progresses. To the extent you can, it is important that you let us know WHILE it is going on, because the likely outcome is going to be a settlement with a gag order that you don't talk about the terms of the settlement or publicly disclose anything about the lawsuit - until you sign it, you should be free (within the confines of your legal advice) to post updates, so we can get the gist of things, including the accusations made in the legal filings. These could be useful for others who are similarly situated, either as Cottam patients, or patients of other surgeons who are also following this unethical (in my opinion) practice, and their attorneys.



I will find out for sure, because I don't remember reading anything that said Loop anywhere. He always referred to it as a DS, nothing else.
 
First of all, a warm hello and welcome to you Ms. Hannah and welcome to the best WLS site on the net. The folks here are all very like-minded, smart, funny, kind, forthright and VERY honest! With NO hidden agendas, so, you are in the right place for sure.

As @brooklyngirl said, history may show 10 yrs from know that he SADI is a great procedure, time will tell. Unfortunately or fortunately, you now get to be in the experiment without your previous knowledge or consent.

To me, this is some VERY serious shit!!! This is YOUR BODY!!!! HOW FLIPPIN DARE THEY or any “Doctor” presume to decept and deceive and carve and cut on someone making YOUR LIFE decisions to that level. I’d sue those arrogant condescending bastards for every GD dollar I could get. This has already happened way too many times (and from this “Doctor” as well) and it is only going to take one good lawsuit from one brave person with the right resolve and a large judgment and they will then stop all this LYING deceptive bullshit. I would be pissed.
Thank you very much! Oh Im beyond pissed and it is a load of bullshit.
To have him talk to me about one thing and then read something different in my Op Report was VERY upsetting.
 
I have no words how can a dr be.so arrogant to give a patient anything other than what they agreed upon. Hopefully you will have some type of way to hold him accountable. DID ins. Pay for the DS and u got SADI. IM sorry this happened to you

As far as I know, its all been billed as a DS. That is what my approval letter from my insurance said was covered.
 
Yup, you were given a SIPS/SADI/LoopDS with a 300 cm alimentary limb/common channel. You are almost certain part of their study (or they plan to use your data WITHOUT TELLING YOU you were part of their study).

And there is nothing in the op report that calls the procedure ANY of those names - in fact, he says: "Name of Operation: duodenal switch" - and then describes a Stomach, Intestinal and Pylorus Sparing (SIPS) procedure, which is what he is performing for this clinical trial:

https://clinicaltrials.gov/ct2/show/NCT02275208

"A Prospective, Multi-center, Single-arm Study of the Stomach, Intestinal and Pylorus Sparing (SIPS) Procedure"

Cottam is this surgeon:
United States, Utah
- Recruiting
- Salt Lake City, Utah, United States, 84101
- Contact: Annie Choi 508-261-6049 [email protected]
See also this news article, in which the self-promoting Roslin boasts about it:
http://www.medpagetoday.com/Endocrinology/Obesity/48868

Kristina Fiore: Tell us about the procedure.​

Mitchell Roslin, MD: SIPS is a modified duodenal switch, which was given its name by myself and Dr. Daniel Cottam in Utah. It involves the formation of a sleeve gastrectomy that is slightly larger than our usual sleeve, with an attachment placed beneath the pyloric valve, which controls emptying of the stomach into the mid gut, located three meters from the terminal ileum.

Dr. Cottam and I decided to standardize our approach, and now more surgeons are becoming very interested. In Spain, a similar procedure has been done by Juan Antonio Torres and Anders Sanchez. Their sleeve is larger and they bypass more intestine.​
 
I just want to cry. All I keep thinking is, ASSHOLE!! I wish I could find the paper that I got at my consultation that had the description. :(
 
I am feeling ok, so far. I went back to work on Monday and that has been a drain in itself. Im just filling out my records request form now for the Drs office....

Hannah, I'm glad your recovery is going well. Please make sure to take it easy and to hydrate, hydrate, hydrate. I know you are under particular stress now - make sure you put your health first above all else. Everything else can wait, if a nap is needed. Wishing you the best!
 

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