Were You Given a Surgery to Which You Did Not Consent?

[Larra]

@julie, that's very sad. this may prove to be one of those things where time makes a big difference. Keep the lines of communication open, they may yet need your help.

 

[JackieOnLine]

yes, the surgeon worship should wear off I would think.

 

[Larra]

@JackieOnLine that's so true! Also, they are still in their honeymoon period. Even with gastric bypass, which we know all too well has a big issue with weight regain, the weight "falls off" for the first 12 months or so. Everyone is happy happy happy for awhile, but not forever. We'll see how these folks feel when the honeymoon is over and the work begins.

 

[southernlady]

Moreover, most of the surgeons are submitting for these experimental surgeries under the CPT code 43845 - which is the code for the standard duodenal switch! I suspect that this might be insurance fraud - in fact, BCBSNC has now refused to cover the SADI/SIPS, and is calling it an experimental/investigational procedure. I agree with them!

@DianaCox, do you know the ICD 10 code for the DS?

 

[DianaCox]

I think it is still CPT 43845 - see this: https://www.anthem.com/medicalpolicies/policies/mp_pw_a053317.htm

 

[Munchkin]

Ran into another person on FB. Had surgery 3/14. Not great loss. And the only number on her op report is 300cm and she thinks she was given the loop. I referred her here. We just had a brief conversation on FB not sure she knows how badly she was mistreated.

 

[southernlady]

Just had one find out that she had the Loop DS when she specified a DS. Her doc was Dr. Scarborough.

Given her the link to this thread.

 

[k9ophile]

@DianaCox, do you know the ICD 10 code for the DS?

I don't know if this has been mentioned before, but most procedures are billed with CPT codes. That system was developed solely for reimbursement purposes. ICD-10 is a revision of a coding set created to be a statistical tool and other reasons, none related to reimbursement. Most insurance carriers use a combination of CPT and ICD-10 codes for payment.

 

[marissamast]

I would like to start collecting names and contact information for people who woke up with surgeries to which they did NOT give consent. Please post a link to this thread to all the message boards you belong to, or some other way of getting the word out. I hope that when the ASMBS, state medical licensing boards, and insurance companies fully understand what is being done, they will put pressure on these unscrupulous surgeons who are operating on people without fully informed consent (or who are committing insurance fraud).

I am working with at least one surgeon who only does the standard, two-anastomosis DS, and am trying to get more on board, to take some sort of action that will put surgeons, insurance companies and PATIENTS on notice that THE NOMENCLATURE FOR A STANDARD DUODENAL SWITCH MUST BE CLEARLY DISTINGUISHED FROM ALL OF THE "NEW" PROCEDURES THAT ARE BEING DELIBERATELY CONFABULATED WITH THE DUODENAL SWITCH.

We are hearing about more and more cases of people who asked for a DS, were told they were getting a DS, but woke up with a SADI/SIPS/LoopDS. Some people had the procedure "disclosed" but misrepresented, as being "the new DS," "the improved DS," "the modern DS," and/or "just like the old DS, only better and/or safer." None of these things are true.

In fact, the SADI/SIPS/LoopDS are experimental procedures, at least in the US. In fact, there is a current clinical trial being conducted - presumably to rebut this allegation - which is being run by Covidien and/or Medtronic (they make surgical supplies) https://clinicaltrials.gov/ct2/show/NCT02275208. I believe that clinical trial is being conducted by Roslin (NY), Cottam (UT), Enochs (NC), possibly Sudan (NC), and Metz (NC). I submit that this proves that these surgeons know that the SIPS at least is an experimental procedure (and it is only VERY slightly different from the SADI).

I think these experimental procedures have promise - in fact, I hope they replace the RNY entirely. But at the moment, they are experimental, and they are being falsely characterized as "just like a DS" when in fact THEY ARE NOT - in particular, there is no selective fat malabsorption with these procedures, and FAR MORE fat, protein and carbohydrate absorption overall. I think that the authorities are going to find that claiming it is "just like a DS" is false and fraudulent advertising, and certainly is "bait-and-don't-switch." And the patients - who don't realize that they can't eat like a DSer - are going to pay dearly.

Moreover, most of the surgeons are submitting for these experimental surgeries under the CPT code 43845 - which is the code for the standard duodenal switch! I suspect that this might be insurance fraud - in fact, BCBSNC has now refused to cover the SADI/SIPS, and is calling it an experimental/investigational procedure. I agree with them!

Still further, I have been reviewing (and copying) websites and "informed" consent forms and surgery reports, and it is clear that this prevarication is deliberate - hoping to conflate the standard of care status, backed by years of research and results, of the standard two anastomosis duodenal switch, with sneaking these new procedures through under the radar of the patients' informed consent and the insurance companies' refusal to pay for experimental procedures.

And these surgeons who are trying to force these procedures on their patients? Shouldn't they be doing these EASIER procedures at a discount, especially for self-pays, since they are experimental? But no - they want their full payment, of course!

I can only imagine how angry, upset, devastated and betrayed I would be to find out that i had been deceived by my surgeon. THIS MUST STOP! There needs to IMMEDIATELY be a consensus on the nomenclature for these experimental, single anastomosis procedures that CLEARLY AND DEFINITIVELY DISTINGUISHES, with no ambiguity, between the standard DS which has almost 30 years of results and experience to rely on, and these new experimental procedures which have NO long term results yet. There needs to be a COMPLETELY SEPARATE AND DISTINCT CPT code for this procedure, so that patients and insurance companies KNOW WHAT THEY ARE GETTING AND PAYING FOR. At the very least, the surgeons should understand that there are lawsuits being prepared, and a flock of attorneys in each state looking to hit the up with charges of malpractice, battery, fraud, misrepresentation and anything else a clever med/mal attorney can come up with.

If you are one of these patients who woke up with a surgery to which you did not consent, please post - or send to me by PM or email or however you can get it to me - the following:

• Your name
• Your surgeon's name
• What procedure you thought you were getting and why you thought that
• A copy of your surgery consent form
• A copy of your surgery report

And feel free to detail how angry and betrayed you feel about this.

BRAVO!!!!!! I have said over and over and over again that this is insurance fraud at it's finest!!! I am in the insurance field and this really ticks me off.

 

[writegirl]

I would like to start collecting names and contact information for people who woke up with surgeries to which they did NOT give consent.

Diana,

I am brand new here and pre-surgery, but after reading around these boards and seeing your posts, I already feel safer knowing you're here. Wow, I did not even realize that this was a thing--the conflation of the terms to confuse them with the standard DS. Thank you for being an advocate for so many.

Much respect,
Tori

 

[Munchkin]

Ran across an interesting case on FB today. 2 days post, ended up with a sleeve because the surgeon said he found diabetic cirrhosis when he opened her up. She signed up for the DS. Hasn't yet been willing to name the surgeon.

 

[OrganicLife]

I'm not sure what those other surgeries are that are supposed to be "like" a DS. All I know that this time around when I go in for a revision with Dr K. I want a true DS done, and I will have to continue reading all the posts here late at night to catch up on all the correct terms and lengths so i can ask Dr. K to have that in my surgery contract. I am self pay, and I don't believe there will be a code for me.

I did go in for a DS back in 2010, and woke up with a sleeve and bipartition. I never heard of it, and no, I never gave consent to have anything but a DS done. I was devastated....and balled my eyes out in the hospital several times a day. I was told that it is safer then a ds because I won't have to take as many vitamins. I've yet to find anyone that has a bipartition done. Would love to speak to someone that has it. Here I am 6 years later, making plans to go under the knife again to get it undone, and to get the true DS.

 

[DSRIGGS]

No worries with Dr K. He will NOT give you axSADI. He is not a proponent.

As far as channel lengths he can't tell you that before surgery because he won't know how long to make the CC, AL and BPL until he gets in and measures you. The Hess method is named after Dr Hess under whom Dr K did his residency from what I understand. All it means in reality is that he measures the SBL and then makes the CC & AL roughly and respectively 10% and 40% of that SBL. Other factors lie your individual history will go into his decision as to exact lengths. The reason the Hess is the best and IMO the only way the DS should be completed is that it personalizes and optimizes the DS for each individual.

I am trying to rember what your surgery date us going to be. It is looking like he will be doing my colectomy in the 27th of this month so if yours is around that time it would be nice to meet you.

 

[OrganicLife]

No worries with Dr K. He will NOT give you axSADI. He is not a proponent.

As far as channel lengths he can't tell you that before surgery because he won't know how long to make the CC, AL and BPL until he gets in and measures you. The Hess method is named after Dr Hess under whom Dr K did his residency from what I understand. All it means in reality is that he measures the SBL and then makes the CC & AL roughly and respectively 10% and 40% of that SBL. Other factors lie your individual history will go into his decision as to exact lengths. The reason the Hess is the best and IMO the only way the DS should be completed is that it personalizes and optimizes the DS for each individual.

I am trying to rember what your surgery date us going to be. It is looking like he will be doing my colectomy in the 27th of this month so if yours is around that time it would be nice to meet you.

No surgery date yet. I was supposed to have a video conference today with Dr. K, but his office called me yesterday saying his computer was in for repair, and he didn't think he would have it back in time for the conference. so the conference was pushed to tuesday afternoon. I wanted to have it done by the end of this month, but it's not looking like it will happen then. More likely the 1st week of November. BUT, if it does happen at the end of the month, YES, I would like to meet you and anyone else that would be there at the same time.

 

[DSRIGGS]

No surgery date yet. I was supposed to have a video conference today with Dr. K, but his office called me yesterday saying his computer was in for repair, and he didn't think he would have it back in time for the conference. so the conference was pushed to tuesday afternoon. I wanted to have it done by the end of this month, but it's not looking like it will happen then. More likely the 1st week of November. BUT, if it does happen at the end of the month, YES, I would like to meet you and anyone else that would be there at the same time.

FYI Kristina told me today that the first week of November wasn't an option for me so not sure if he is out that week or already loaded.

Kristina is out of the office tomorrow as well but will be back monday. I have been trying to find a date that works for my wife or brother (his job ends the last week of october) and need to lock in before his slots are filled.. Dianna only has 7 days of time off from work for the rset of the year, and he wants me there closer to 15 days this time. My other two surgeries he released me to go home after roughly 7 days.

My brother will be able to stay that time since he won't be working. He is also very close to committing to the DS with Dr k as well so it will be good for him to see Dr k. It would really be nice if was healed up enough for me to be able to drive and then take care of him after his pricedure. His wife has MS and would not be able to take care if him because she is not able to drive in LA traffic and some days she is forgetful so I will need to be there for him....so if we can kill two birds with one stone that would be awesome.