A TOP IRISH surgeon has said there is grave concern amongst the medical community about people going abroad for weight loss (bariatric) surgeries.
Speaking in the Cork Coroner’s Court today, Professor Colm O’Boyle, a bariatric surgeon at the Bon Secours Hospital in Cork, warned that travelling patients seem to be at a higher risk of dying due to complications because of lower standards of care.
He said that the contrast between the number of people who die as a result of weight loss surgery in recognised international institutions (less than 1%) and the number of Irish people who have died abroad as a result of these types of surgeries is extremely worrying.
The court today held inquests into the death of two Cork-based women who went to Turkey for weight-related surgeries.
Pamela Canty died in October 2022, one day after returning to Ireland from Turkey, where she underwent a different bariatric surgery to the one she had booked. Estelita Hamelin died in October 2021 after being left comatose and in ICU after undergoing liposuction in Turkey.
The women were treated in two different hospitals but both stayed in hospital-linked hotel accommodation.
Between late 2020 and late 2023, at least nine people in Ireland are known to have died as a consequence of undergoing weight loss surgeries abroad. Dr Donal O’Shea, a bariatric medicine expert, has said that as many as 40 people a week are treated for complications arising from these surgeries.
O’Boyle today told the coroner that bariatric surgeons in Ireland have heard of terrible cases of patients travelling abroad for surgery.
These include one woman being told that she was ineligible for a gastric sleeve surgery after undergoing blood tests once she arrived at the hospital, and the staff there offering the procedure to her mother – who was not booked in for any procedure – instead.
Another patient travelled back to Ireland from an overseas hospital – where they underwent a complex bariatric surgery – with a surgical drain still in place (which is an external plastic container that is connected to the body via a rubber tube that’s inserted inside the patient, in order to collect excess fluid).
O’Boyle said that the medics abroad told the patient to fly with the drain in place, and get it removed in Ireland – a highly dangerous practice which he labelled as “bizarre”.
He voiced his fear that hospitals in Turkey and other countries – specifically those outside of the EU – are treating patients based on their ability to pay, rather than their suitability for major surgery.
While O’Boyle and his colleagues in Ireland (less than 10 surgeons in total) would meet patients multiple times, carry out a wide range of tests, and refer them to dieticians, physiotherapists and psychologists before scheduling them for bariatric surgery, typically, patients who go abroad are simply filling in a questionnaire and having blood tests the day before or day of their surgeries.
The court heard this is often too late, especially in cases where people have underlying illnesses, to recognise that they are not suitable for the procedure.
Speaking to media after today’s hearings, O’Boyle said that for many private hospitals which do not publish statistics on the outcomes of surgeries they perform, the priority is simply “making money”.
Coroner Philip Comyn today gave a verdict of medical misadventure in the death of Pamela Canty, a 53-year-old woman who underwent gastric bypass surgery in Turkey in October 2022, and died days later in Cork as a result of septic shock.
Clear symptoms of sepsis – including a fever – were raised with hospital staff who assessed Pamela in Turkey after she was discharged from the hospital to a hotel, but they said that she was able to travel home to Ireland, and advised her husband Finbarr that she was in need of rest.
Pamela had a gastric bypass on 17 October 2022 in Turkey. She was admitted to the Mercy University Hospital on 23 October after collapsing in her home.
Surgeon Michael O’Riordan said that Pamela was suffering from profound septic shock when she was admitted and brought into the emergency department resuscitation area. She had severe peritonitis.
Dr O’Riordan said that Pamela was put on maximum life support and given strong antibiotics, but her sepsis did not improve and she passed away.
He said that she did not show any signs of a normal bariatric procedure, and that the joining between her small bowel and stomach had come apart – which is a catastrophic condition for a patient to be in.
He said that he learned from Pamela’s family that the doctors in the Su Hospital in Izmir discovered a hernia in her oesophagus, and told her and her husband Finbarr that she would have to have it removed, and have a bypass instead of a gastric sleeve.
O’Riordan said that the type of bypass surgery performed on Pamela is not recommended for weight loss. He also said that in the condition the Cork city woman was in post-op, the hospital should not have discharged her.
Her husband Finbarr, who had undergone gastric sleeve surgery at a different Turkish hospital a year previous, said that he blamed himself for her death at times, because she knew about the surgery because of him.
“I am sure she would not want you to blame yourself,” the coroner told him.
Finbarr said that his wife was 5 foot 4 inches tall and weighed 23 stone, and that she was diagnosed with bipolar disorder.
He said that he had told Pamela that she should not go through with the surgery in Turkey after medics discovered her hernia, and that they should go back so she could have it removed in Ireland.
“She said she’d never come back to do the surgery if she didn’t go through with it. She wanted to do it,” he said.
Finbarr said that his wife appeared pale and unwell after her surgery, and that she was moved to the hotel used by the hospital two days later, and then sent to the airport a day later.
He said that she was so unwell she needed a wheelchair in the airports in Turkey, Munich and Dublin.
Finbarr said that when his wife got home, she caught up on the Late Late Show, and the programmes she liked to watch.
“She loved Ryan Tubridy,” he said. He added that when he gave her advice on staying mobile she’d reply, “Yes, doctor”.
“Pamela was funny like that. She was unique,” he said.
Finbarr was overcome with emotion when the coroner returned a verdict of medical misadventure.
Estelita Hamelin died in the Avrupamed Hospital in Istanbul on the 20 October 2021 after suffering major blood loss as a result of a liposuction surgery she underwent earlier that day.
The 46-year-old went on the trip to get the liposuction, along with a tummy tuck, with her daughter Hazel who was to have the same procedures.
The mother and daughter, based in Fermoy Co Cork, decided to book the abroad surgeries on the basis of a recommendation from the woman who did Estilita’s eyebrows.
Hazel told the coroner’s court today that she accompanied her mother for blood tests in the hospital the day before the surgery, and went with her on the morning of the operation, but she was not allowed to accompany her mother into any doctor’s office.
She said that nurses rushed her mother to sign documentation that she didn’t have time to fully read.
Hazel went back to the Ramade Hotel, which was linked to the hospital and where many other patients were staying, to retrieve her mother’s belongings.
When she returned to the hospital at 6pm she could not get any answers on her condition. She said that she ended up showing a cleaner pictures of her mother, and asking if she had seen her, as she was not allowed to access the ICU.
The cleaner told Hazel that her mother was comatose. She was later told that her mother was critical, and eventually told that she had died.
“The doctor said she might have had underlying issues.
“They didn’t let me see her, they brought me to a room with hospital staff, and then eventually they let me go. It felt like I was being held against my will,” she said.
She told the coroner that the hospital wanted her to agree to them cremating her mother’s body, and offered to refund the price of the surgery, and to fly Hazel back to Ireland.
She hired a solicitor who requested a post-mortem, and eventually returned to Ireland on the 27 October after finally being allowed to see her mother’s body in the hospital morgue.
Hazel said that the only medical records the hospital requested from her mother was a questionnaire she was sent to fill out.
Pathologist Margot Bolster, who performed a second post-mortem a year later in Ireland, said that the cause of Estelita’s death was a soft tissue haemorrhage and shock as a result of liposuction.
She said that liposuction is one of the most medically complex cosmetic surgeries.
The coroner said that as the hospital in Istanbul refused to provide any documentation related to the case, despite multiple requests from the court, including letters in Turkish, there was limited evidence available to him.
He returned an open verdict, and said that despite his “personal feelings”, the lack of documentation available meant a medical misadventure verdict could not be returned.
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