Kimberley Wall (pictured above) suffered complications from a gastric by-pass operation she had in 2008
A 23-stone mother-of-three starved to death after she struggled to eat following a gastric by-pass, an inquest has heard.
Kimberley Wall had undergone the procedure in 2008 over fears her obesity would kill her – but during the next ten years her weight plummeted until she weighed just five stone.
The 44-year-old from Rochdale, Greater Manchester, could only manage two mouthfuls of food when it was given to her and she was so weak she was barely able to walk or even get out of bed.
Despite repeated attempts by doctors to treat the former nursery nurse and hairdresser, Miss Wall, who had been due to see a specialist, was admitted to Fairfield Hospital in Bury after her condition deteriorated.
She died a week later with tests showing that she had suffered heart failure due to malnutrition contributed to by the gastric by-pass operation.
Last week a coroner concluded there were no errors with the procedure itself but said Miss Wall died on October 8 last year from long term complications of it.
Kimberley is pictured above, left and right, before the surgery. She had wanted to have it so she could ‘run around with the children in the garden’
Miss Hall’s mother Muriel Stephenson (right) said her daughter (left) had loved the fact that she had lost so much weight
Miss Hall had undergone the operation at a private hospital on the NHS after she began comfort eating when she suffered a miscarriage when she was 18.
She subsequently complained of suffering crippling stomach pains, nausea, fatigue and low self-confidence.
In 2014 she went public about her procedure saying she did it on the recommendation of a consultant despite concerns from her family.
Miss Wall (pictured above) died on October 8 last year
She told a newspaper: ‘I knew it was a drastic step, but I’d tried every diet under the sun without any success, so the idea of being able to make a lasting change was very appealing.’
She said she was drawn to the idea as she wanted to run around the park with her children, but stated she had gone from being ‘too fat to move to being weak and undernourished’.
‘I thought the operation would give me the life I’d dreamed of – but it turns out I couldn’t have been more wrong. I could barely eat any food. Whatever I did manage to swallow made my stomach turn. I felt sick all the time.’
‘I completely regret having the gastric bypass. I wish I’d never done it. It’s just such a shame that I had to get to this point to realise that I was happier when I was overweight.’
Miss Wall’s mother Muriel Stephenson told the Heywood inquest that her daughter had started to gain weight 18 years prior to her death and that it had been a steady increase until she reached the 23 stone mark.
‘She had the gastric bypass operation in 2008 and it was deemed to be a success and her weight plummeted in the first year.
Miss Wall (pictured above before surgery) gained weight 18 years prior to her death in October 2018
In her late 30s (pictured above) Miss Wall was obese and started to feel depressed with how she looked
‘She loved the fact she lost so much weight but she could hardly eat anything. It would just be a couple of spoonfuls and then by that stage she had had enough and she was also often sick.
‘As time went by she became more and more depressed, paranoid and worried about everything.’
She said her daughter had been living on her own with her children and that some days she had been unable to take the children to school and would instead spend the day in bed.
‘She never managed to eat very much – although she loved food. Over the last couple of years was very frail and could hardly walk or get out of bed.’
What is a gastric by-pass?
A gastric by-pass is one form of weight loss surgery which is usually carried out under general anesthetic.
Surgical staples are used to create a small pouch at the top of the stomach.
This is then connected to your small intestine but bypasses the rest of the stomach.
After the surgery it takes less food to make you feel full and you also absorb fewer calories from the food you eat.
A gastric by-pass is different to a gastric band. A gastric band is placed around the stomach.
Miss Wall was repeatedly admitted hospital over a six year period before being referred to see a specialist.
Her mother added that she had been admitted for stomach pains and had managed to put a little bit of weight on, but was unable to get answers to what was causing the pain.
‘She needed carers who came in to help with food and she was taking antibiotics. The hospital thought she had an eating disorder but we strongly disagree with that.
‘She wanted to eat but couldn’t manage to. She was admitted again in the August and was very ill with pains. She was frail and confused and she weighed around five stone.
‘She was ready to be discharged when her blood pressure dropped suddenly and she was transferred to Intensive care. Her condition then improved and she was sent home. We were away when we got a call from our other daughter saying
Kim had collapsed at home and was admitted once again.
‘When we got back we went straight to the hospital where she was on 24 hours a day oxygen. She was a little breathless but able to hold a conversation. At 1.30am we got a call from the hospital to say she had deteriorated. and that we should go but she had died before the family where able to get there.’
Miss Wall (left and right) was unable to eat much following the operation and her condition deteriorated
Miss Wall’s GP Dr Richard Darling said Miss Wall had a review following the surgery and had been struggling with food toleration.
‘There were questions about whether she could have Crohn’s disease but that was ruled out and bipolar disorder was not evident.
‘She was referred for counselling with a local mental health service for symptoms of depression and anxiety but she deteriorated and she was referred to the Gastroenterology department as she suffered nausea and abdominal pain after eating.’
Despite her weight having plummeted, Miss Wall (above before surgery) didn’t feel she had an eating disorder
Dr Darling said they had discussed an eating disorder but that Miss Wall felt this hadn’t been the case, claiming she wanted to eat but couldn’t.
‘She was prescribed some food supplements and a dietician reported she was managing well with eating and her weight was increasing.
‘I didn’t refer her for an eating disorder as I didn’t feel her problems were related to an eating disorder. I always felt the problem was as a result of her surgery and that was consistent with what Kimberley was saying.’
Medical expert Dr Khurshid Akthar a consultant surgeon said: ‘An assessment would have been made as to whether operation is the right thing to do. The majority of patients lose up to 70% excess body weight but the operation has got complications and risks.
‘All patients need some supplements and have to take minerals and vitamins – then there’s a lifelong supplement that you have to take.
There is a recognised complication where patients say they have pain or some problem with eating or malabsorption. No evidence that malabsorption was happening here but it is more likely had that malnutrition was happening as she not eating enough.’
Nicola Rimmington a lead nurse Fairfield hospital told the hearing: ‘She walked with a frame and could only manage one set of stairs. She was very thin with multiple skin breaks in her shins. A malnutrition assessment was completed and she was referred to a dietician although there was a two to three day delay in a referral being made.
‘She took small amounts of food and liquid but a nurse who attended to Kimberly said her condition changed and her breathing was none responsive and lifeless. I do not believe any nursing contributed to her loss but there was a delay in referring to the dietician and two staff who failed to follow through with observations have been spoken to. Lessons need to be learned about nutrition.’
Recording a narrative conclusion the coroner Matthew Cox said: ‘Following the gastric by-pass procedure Kimberley could hardly eat anything after a couple of mouthfuls and struggling with food retention.
‘She was referred to gastroenterologist and psychiatric services before her GP referred her urgently to a dietician due to on-going problems with eating.
‘We’ve have had little information about the operation itself as those who treated her are not here to give evidence. But there are risks as well as benefits to the procedure. Kimberly’s problem with nutrition is a rare but recognised complication of the gastric bypass surgery.
‘Given the extent of the problems Kimberly went on to suffer she had problems with anxiety and depression and this exasperated the eating difficulties. It is clear to me the source of her problem was investigated thoroughly over the years.’