No shortage of drama at Day 1 of the Crewcut Charlie Weis trial. In his opening statement, attorney Michael Mone, pictured above, said that Weis decided to undergo gastric bypass surgery in part out of fear his morbid obesity could hurt his chances of becoming a head coach. Mone then asserted that two surgeons involved in Weis' gastric bypass surgery disregarded warning signs that Weis was bleeding internally after the June 14, 2002 operation.
William Dailey, attorney for doctors Charles Ferguson and Richard Hodin, countered that Weis' internal bleeding was not unusual for this type of surgery. Hodin said Weis was briefed about the dangers of the surgery, in which five to 10% of patients have serious complications and one out of 100 dies. Dailey said Weis was so desperate to lose weight that he once took the dangerous and now-banned diet drug Phen-fen.
Weis' surgery was on a Friday, and Jennifer Wilson, below, Weis' weekend nurse while he was in intensive care, was called to testify. Wilson said she suspected Weis was bleeding internally on Saturday morning, in part because of the amount of blood coming out of a tube that was draining his stomach. At Wilson's urging, doctors performed a barium swallow test on Sunday. Radiologists were able to detect from that test that the surgical staples were not tight enough to prevent leaks, and Hodin operated immediately to repair the leak on the already severely ill Weis. Weis was finally released from the hospital on July 5, 2002.
To break down the medical end of the Weis trial, we would like to bring in our expert, Gary Gaffney, M.D., University of Iowa Hospitals and Clinics. He is currently Associate Professor of Child and Adolescent Psychiatry at the Iowa College of Medicine. He also operates Steroid Nation, a weblog that examines the use of anabolic steroids and performance enhancing drugs in sports, youth and society.
"One of the sutures leaked. As pointed out in the accounts, that's not good. Bleeding and infection resulted. Could the doctors have determined there was a leak? ... The medical records will be introduced as evidence. It would be interesting to see what Weis' parameters were during those days. ... A key here will be the interpretation of the medical records and the nurse's notes."
Gary has also provided a medical perspective on obesity:
"Although not a surgeon, I spent my medical school time, while on surgery, in the gastric surgery service of Dr. Ed Mason at the University of Iowa. Dr. Mason was a pioneer in surgical treatments of obesity. Our team spent a great deal of time in surgery performing these 'gastroplasty' procedures, as Dr. Mason referred to them, or taking care of post-operative patients, and patients with past surgical procedures who experienced complications.
"The surgical treatment of obesity was developed as physicians looked at the terrible consequences of obesity. Complications include conditions like diabetes, hypertension, stroke, heart disease and many others. Morbid obesity looms as a significant and costly source of morbidity and mortality today.
"Obesity was defined as weight for a particular height, however now is defined as a BMI (Body Mass Index) over 30. The BMI is person's body weight in kilograms divided by the square of his height in meters (i.e., wt/ht) The BMI is more highly correlated with body fat than any other indicator of height and weight.
"Generally to qualify for surgery, a patient's BMI is either:
1.) Above 40 (which is at least 100 pounds overweight) or
2.) 35 with serious complication of obesity. Such serious life-threatening complications include diabetes, heart disease, sleep apnea.
"Coach Weis was at least 340 pounds at the time of his surgery. His father suffered two heart attacks, at 49 and 56, the second causing his death.
"Clearly, at age 50, over 340 pounds, with a highly significant family history of cardiac diseases, and cardiac death, Weis faced extremely serious medical consequences if he didn't take action. This statement can be made, even without knowledge of the coach's blood sugar, cholesterol, blood pressure, and other medical clues for potential disaster."
Our thanks to Gary and to Hester Graphics, who helped design our Weis trial logo.
Previous: Legal Perspective on Weis Trial.