An ‘outgoing’ mother of two tragically died only one day after a liposuction surgery that changed her life for a little known condition.
Renee Brooks, 50, traveled from the United States for a complex liposuction of lipoedema at Spire Parkway Hospital in Solihull on August 29 last year.
The 50-year-old woman was at the end of her fifth operation with specialist surgeon Anne Dancey when a ‘rare and recognized’ complication caused cardiac arrest at the operating table.
She was given CPR in the theater before taking her to the intensive care unit of Heartlands Hospital, since Spire no longer has the facilities. But one day later, on August 30, she died.
Mrs. Brooks had been fighting a lifelong battle with lipoedema, a chronic condition characterized by a buildup of fat cells in the legs, buttocks, thighs and sometimes arms.
It is believed that his condition, for which the only cure is liposuction, affects 11 percent of women, but is often misunderstood as obesity.
The housewife, born in Mississippi, USA UU., He had already undergone four operations to remove fat cells from his body in a desperate attempt to further improve his debilitating condition.
His recoveries for surgery in June, July and August 2018 had gone well, but it was said that he had more difficulty recovering from the fourth operation in January 2019.
Lipoedema is a long-term (chronic) condition where there is a Abnormal accumulation of fat cells in the legs, thighs and buttocks, and sometimes in the arms.
The condition usually only affects women, although in rare cases it can also affect men.
Symptoms of lipoedema
In lipoedema, the thighs, the buttocks, the lower legs and sometimes the arms, are enlarged due to the accumulation of abnormal fat cells. Both legs and / or arms generally enlarge at the same time and to the same extent.
The feet and hands are not affected, which creates a “bracelet” effect or a “band” appearance just above the ankles and wrists.
The size of the legs and arms may vary among people with lipoedema, and the condition may gradually get worse over time.
In addition to enlarging, the affected areas of the body can:
- feeling soft, “doughy” and cold
- easily dented
- pain or sensation of pain or tenderness
- has small broken veins under the skin
Someone with lipoedema may eventually have fluid retention (lymphedema) in their legs. This type of swelling may get worse at the end of the day and may improve at night, while the fat swelling of lipoedema is constant.
The combination of these symptoms can lead to reduced mobility and psychological problems, such as low self-esteem.
Husband John Brooks, who flew to Birmingham for the final hearing, told the coroner: “The first three went really well.
“In the room, the surgery went very well, but my wife had some problems with recovery. She protected a little how much she knew.
“He is a very intelligent person. He researched a lot. He felt that the risks were very, very low. At least that is what he transmitted to me.”
“They told her there was a small risk of injury or death. She spoke very well of Mrs. Dancey and trusted her.”
Pathologist Dr. Andrew Warfield recorded Ms. Brooks’s cause of death as multiple organ failure due to fatty embolism syndrome, where fat globules enter the bloodstream, and large volume liposuction.
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He added obesity as part of the cause of death, but the coroner later ordered it removed from the registry as it would be “misleading.”
During the autopsy, it was discovered that Mrs. Brooks had an enlarged heart. While this did not cause his death, it made it harder for him to cope with fatty embolism syndrome than others might have survived.
“It was a recognized but rare complication. These are complications that would occur even in the best hands, even in the best units, even in the best circumstances,” Dr. Warfield told the investigation.
“It seems to have been an involuntary complication, it was a sudden and unexpected death at the end of the procedure. If I had not had the procedure, I would not have died that way and at the time I did it.”
The Dancey surgeon, who performed five successful lipoedema liposuction surgeries in five years and has “one of the greatest experiences with her worldwide,” was suspended while an investigation was being conducted.
While it was noted that some equipment to measure hemoglobin was not available, the coroner found no medical malpractice or negligence.
Provisional guidelines have been established on the volume of fat surgeons in Spire for “patient safety.”
The lectures will be held in an attempt to write new guidelines for complex liposuction surgery for lipoedema, including the review of the amount of adrenaline used in surgery to reduce blood loss.
When recording a narrative conclusion, area coroner James Bennett said: “I have heard evidence from two senior consultants, Dr. Rees and Mrs. Dancey, who is a leading surgeon in her field who performs niches and highly specialized surgery for patients with lipoedema.
“I was impressed by their evidence. Dr. Warfield originally included the word cosmetic in his findings. I think it is right not to describe the procedure as cosmetic.”
“The four operations she had resulted in a significant improvement in her quality of life. There was a clear and medical justification for the procedure that was being performed.
“The question of consent was raised. She was well researched and, in her husband’s opinion, was familiar with the procedure and the risks. Ms. Brooks would have been familiar with [Ms Dancey’s] website and the amount of risks, including fat embolism syndrome.
“I have no doubt that she completely consented. She agrees that there is no known guide for lipoedema liposuction. I have heard that in Canada and the United States there is some guide, but it seems to be more cosmetic.”
Bennett added that he would write a report on prevention of future deaths to major lipoedema organizations to address concerns about the lack of guidance for surgery.
“I hope this can provide guidance to ensure that these procedures are carried out in a unified manner. I hope there is some comfort in that something good can come from the death of your wife,” the coroner added.
Brooks thanked the changes in the guidelines, but responded to what he called “mistakes” and asked for a better understanding of the condition worldwide.
Speaking after the verdict, he said: “We all have to do better. It is quite obvious that there were mistakes.”
“Obviously they weren’t prepared for that kind of emergency. If there had been a complete ICU in the place, that would have made a difference or we will never know.”
“They were poorly prepared for what happened. The main thing is that they learn that they should have been better prepared.”
“It was affecting his mobility a lot and this was the only way to eliminate it.
“This should be addressed and not considered cosmetic. I am very much in favor of forming better safety guidelines.”