QB-2022-002633 - [2025] EWHC 2576 (KB)

C was born in 1983. Prior to the procedure, she was employed as a paramedic.

D was, at all material times, a Consultant Upper GI and Bariatric Surgeon. C was a private patient of the Defendant through his clinical practice at the Spire Hospital, Gatwick (the hospital).

In 2019, C contacted a company called Healthier Weight to explore the possibility of weight loss surgery, and a consultation was arranged for her to meet with D. C met with D in his clinic on 20 August 2019 to discuss her weight loss options, including surgical options. Following this consultation, C informed D that she wished to proceed with the proposed sleeve gastrectomy.

Prior to the procedure, C was reviewed by D’s team, including a specialist bariatric dietitian, a psychotherapist/counsellor and a bariatric nurse. She was found to be a suitable candidate for the planned procedure and underwent a thorough consenting process.

C proceeded with the sleeve gastrectomy surgery, under the care of D, on 24 September 2019.

C had regular contact with the bariatric nurse in the first week following her surgery, when she initially struggled with nausea and vomiting but gradually improved. At an appointment on 3 October 2019, she confirmed that she had transitioned from fluids to slushy foods but was struggling with comfort when her food was going down. She was given advice by the bariatric nurse.

C was reviewed by the bariatric nurse on 29 October 2019, and complained of food getting stuck in her throat, even foods of a sloppy texture. The bariatric nurse sought advice from D. As a result, D arranged for C to undergo a barium swallow to investigate her symptoms further.

The barium swallow procedure took place on 13 November 2019. The radiological report noted that:

“There is intermittent mild delay or hold up of contrast at the GOJ (gastro-oesophageal junction) with transient pooling of contrast within the lower oesophagus for 10-30 seconds…no fixed stricture or stenosis is demonstrated…”.

On 27 November 2019 D initiated contact with C via Facebook Messenger, a medium used by patients for communication, to ascertain whether her symptoms were improving. C advised him that she was “feeling quite weak at the mo as struggling to get enough food in”. Later the same day, D performed a gastroscopy on C which then led to a balloon dilatation procedure. [For consistency, I have referred throughout to a ‘gastroscopy’ for the first of these procedures, although it is also referred to as an ‘endoscopy’ in some of the evidence.]

Subsequent to the gastroscopy and dilatation C suffered a sleeve leak. She underwent a laparoscopic conversion of the sleeve to a gastric bypass, adhesiolysis (release of adhesions in the abdomen) and the insertion of a drain to the left upper quadrant of the abdomen under the care of a different surgeon at St George’s Hospital on 7 December 2019. C was transferred to intensive care post-operatively and was subsequently discharged on 12 December 2019.

Following conversion to a gastric bypass C continued to experience pain and symptoms of restriction and vomiting with poor oral intake, malnutrition and an inability to tolerate solid food. In September 2022 she underwent insertion of a JEJ (jejunal) feeding tube for supplementary nutrition. C has spent prolonged periods in hospital receiving dedicated nutritional care. She continues to experience significant health issues.