An American mother-of-two tragically died just a day after having liposuction surgery in the UK for a rare disease.
Renee Brooks, 50, travelled from America for complex liposuction for lipoedema at Spire Parkway Hospital in Solihull, near Birmingham, on August 29 last year.
Mrs Brooks was at the end of her fifth operation with specialist surgeon Anne Dancey when a ‘rare and recognised’ complication sparked a cardiac arrest on the operating table.
Renee Brooks, 50, travelled from America for complex liposuction for lipoedema at Spire Parkway Hospital (pictured) in Solihull, near Birmingham, on August 29 last year
She was given CPR in theatre before being taken to the intensive care unit at Heartlands Hospital, as Spire no longer have the facilities. But a day later, on August 30, she died.
Mrs Brooks had been fighting a lifelong battle with lipoedema, a chronic condition characterised by a build-up of fat cells in the legs, buttocks, thighs and sometimes arms.
Her condition, for which the only cure is liposuction, is thought to affect 11 percent of women but it is often wrongly misunderstood as obesity.
Born in Mississippi, USA, Mrs Brooks had already undergone four operations to remove fat cells from her body in a desperate bid to improve her debilitating condition further.
Her recoveries for surgery in June, July and August 2018 had gone well, but she was said to have struggled more with healing from the fourth op in January 2019.
Husband John Brooks, who flew over to Birmingham for the final hearing, told Birmingham Coroner’s Court: ‘The first three went really, really well.
‘The fourth one the surgery went really well but my wife had some issues with recovery. She was somewhat protective of how much I knew.
‘She is a very smart person. She did do a great deal of research. She felt that the risks were very, very low. At least that’s what she conveyed to me.
‘She was told there was a small risk of injury or death. She spoke so highly of Ms Dancey and she put her trust in her.’
Pathologist Dr Andrew Warfield recorded Mrs Brooks cause of death as multiple organ failure due to fat embolism syndrome, where fat globules enter the blood stream, and large volume liposuction.
Interim guidelines regarding the volume of fat surgeons can take have been put in place at Spire for the ‘safety of patients’. Conferences are also set to be held
He added obesity as part of the cause of death, but the coroner later instructed this to be removed from the record as it would be ‘misleading’.
During the postmortem it was discovered that Mrs Brooks had an enlarged heart. While this did not cause her death, it made it harder for her to cope with the fat embolism syndrome which others perhaps could have survived.
Dr Warfield told the inquest: ‘It was a recognised but rare complication. These are complications that would occur even in the best hands, even in the best units, even in the best circumstances.
‘It appears to have been an inadvertent complication, it was a sudden and unexpected death at the end of the procedure. If she hadn’t have had the procedure she would not have died in that manner and at the time she did.’
Surgeon Ms Dancey, who has performed 600 successful liposuction surgeries for lipoedema in five years and has ‘one of the largest experiences with it worldwide’, was suspended while an investigation was carried out.
While it was noted that some equipment to measure hemoglobin was not available, no medical negligence or neglect was found by the coroner.
Interim guidelines regarding the volume of fat surgeons can take have been put in place at Spire for the ‘safety of patients.’
Conferences are set to be held in a bid to draft new guidelines for complex liposuction surgery for lipoedema, including reviewing the amount of adrenaline used in surgery to reduce blood loss.
Recording a narrative conclusion, coroner James Bennett said he was in ‘no doubt’ Mrs Brooks consented to the surgery. He added she was ‘well researched’ and, in her husband’s view, ‘familiar with the risks’ beforehand. Mr Bennett described Ms Dancey as a ‘leading surgeon in her field’, conducting ‘highly specialised’ surgery.
Mr Bennett said he would be writing a prevention of future deaths report to the leading organisations for lipoedema to address concerns over the lack of guidance for the surgery.
He added: ‘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 clear and medical justification for the procedure being undertaken.
‘I’m in no doubt she fully consented. It is agreed there is no known guidance for lipoedema liposuction. I have heard that in Canada and America, there is some guidance but it seems to be more cosmetic.’
Mr Brooks welcomed the changes to the guidelines, but hit back at what he branded were ‘mistakes’ and called for a better understanding of the condition worldwide.
Speaking after the verdict, he said: ‘We all need to do better. It’s pretty obvious that there were mistakes.
‘Obviously they were not prepared for that type of emergency. Had there been a full ICU in place, would that have made a difference or not we will never know. They were ill-prepared for what happened.’