Report: #963662

Complaint Review: Mayo Clinic Department of General Surgery

  • Submitted: Fri, November 02, 2012
  • Updated: Fri, November 02, 2012
  • Reported By: MD — Cleveland Ohio U.S.A.
  • Mayo Clinic Department of General Surgery
    200 First Street SW
    Rochester, Minnesota
    United States of America

Mayo Clinic Department of General Surgery Michael Sarr MD unnecessarily doing neurectomies x15 years for abdominal nerve entrapments - 2% lidocaine injections are the treatment - without consultation with John Bundrick MD - without patient consent - using pr Rochester, Minnesota

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Dr. Michael Sarr (Chief General Surgery Mayo Clinic) has been unnecessarily doing abdominal wall surgeries for 'neurectomies' for the last 15 years at Mayo Clinic - painful abdominal nerve removal surgeries where he cuts the nerve out - for a benign condition of abdominal nerve entrapment syndrome (=ACNES).  Dr. John B. Bundrick hasn't said a word, and he's on YOUTUBE.   

These NEURECTOMIES are also very deforming, uncosmetic, and unaesthetic procedures.  Abdominal nerve entrapment happens commonly in old incisions or after vigorous sports exertions.  One resident at Cleveland Clinic showed up in the ER with it, after he exercised too vigorously on his newly bought abdominal exercise machine.  And he was almost operated on.  

Dr. Michael Sarr, however, does these procedures without patient consent, or teamwork medical consultation - quickie clearance. [continued below]....
.....  It's a semi-urgent case for Dr. Sarr - to get to the OR before Dr. Bundrick sees the patient - which is like high school or junior high guys.  

This NERVE ENTRAPMENT can happen in any old incision - even Pfannenstiel, umbilical hernia repairs, other hernia repairs, etc., or just spontaneously in children as they grow with growth spurts - Peds surgeons see it and try not do do surgery hopefully.  Sometimes Dr. Sarr justifies with saying that he saw some 'foreign material' - but it never shows up on Pathology, and he brings in only the worst 'help' - none of which will disagree with him.  Dr. Sarr's 'help:' 3-month interns and black medical students from God-only-knows-where stinking of cologne to cover the lack of showers.  No one introduces themselves by name, and no one admits the problem.

Dr. Sarr admits that he doesn't have patient consent, or discuss, before he does these procedures - surgeon's prerogative at Mayo Clinic.  Sarr rushes patients to surgery saying that he has to be out of town by the weekend - a PAN AM SURGEON - and he suddenly will have an open OR spot.  PATIENTS ARE WARNED NOT TO SIGN UP FOR ANY SUDDENLY AVAILABLE OR SPOT AT MAYO CLINIC - THE SURGEON HAS PROBLEMS.  Dr. Sarr does this to get his required surgeries/year, as he does too much traveling to do any real patient care, workups; no time to check with Dr. Bundrick or for formal Anesthesia Clearances.  

There's not even a formal Anesthesia Consult at times - and Legal doesn't care at Mayo Clinic - neither do the Board of Trustees.  The Mayo Anesthesia Department goes along with this - which is even more disturbing - as one of the treatments for refractory ACNES - before surgery - is a nerve block.  So Anesthesia doesn't get to examine and object, or offer an alternative option.  Anesthesia does whatever anesthesia Dr. Sarr wants, even if you say 'local,' 'no airway,' and isn't there something 'else' going on - what's the rush?  

No patient gets a list of their other treatment options, or a choice of anything except maybe to lobby for the best intern or resident, or is told the complications of a neurectomy.  Informed consent doesn't happen, there isn't even CONSENT - which is disturbing to family members, who post-surgery, try to figure out what happened.  There are retained suture problems in old incisions, but you stop before the muscles or nerves in that Surgery - that's all one woman agreed to.  Dr. Sarr never sees these patients post-op; he takes them off his patient list - there is no post-op visit.  Then Jill Smith puts in the computer that things are resolved - for John Bundrick MD's secretaries to read.      

John Bundrick MD never reviews these situations to see what is going on - John Bundrick MD doesn't know what is going on - there is no teamwork between Dr. Sarr and Dr. Bundrick at Mayo Clinic.  

Jill Smith Esq in Legal backs Dr. Sarr up and whitewashes - Mayo Clinic does not have to obtain informed consent, or any consent, for a procedure.  This has been going on for at least 15 years - when one woman MD objected.  The morbidity, or complications, of the common mass closure alone are terrible.  And at least one patient has requested that this closure be undone - this closure is being used without any data on long-term followup or the pathology of long-term followup.  They don't undo these closures and publish the results, and patients requested the undoing of these closures en mass in the 1980s at some medical centers.  They were commonly undone at Rhode Island Hospital in RI.  Dr. Sarr doesn't read the literature, even his own it appears - he's a talking-head.  

Common mass closures were thrown out in the 1980s for the sequelae of chronic pain and terrible abdominal wall deformities - the patients objected, and the surgeons had to stop doing this closure.  It's done to save a suture pack or two, to get a quickie closure in an emergency surgery with an unstable patient, or to allow four-handed medical students, interns & residents practice - while the patient is under general anesthesia of course, or the patient would have gotten up and walked.  

The common mass closure was a 'bad penny' that came back in the 1990s, resurrected by surgeons who needed a paper or two on their curriculum vitae - calling some of these surgeon authors is an experience.  Common mass closure came back when surgeons stopped following their patients post-op; now the internists see the chronic problems & the pain goes to Pain Clinics - but it's all as unnecessary as the nerve removal was.  

The unnecessary neurectomies, and the complications of the common mass closures, are the 'elephant in the room' at Mayo Clinic, in their literature, and at their conferences.  John Bundrick MD tells the world how Mayo Clinic treats abdominal wall pain, and Mayo Clinic does not do what John Bundrick publishes in THE MAYO CLINIC PROCEEDINGS.  

The literature on this common mass closure has very bad stats, no long-term followup - and the serious complications occur after 3 years - after the followup stops.  Most of the patients are male - not women or children.  It's the worst of the surgical 'literature.'      

Complications that you NEVER SEE ON A MAYO OPERATIVE CONSENT, IF YOU SEE AN OPERATIVE CONSENT: Neurectomies leave patients with skin atrophy over the area of sensory loss, loss of sensation, and horrible 'dead' feelings in areas of the abdominal wall - Dr. Sarr does not see post-op to document any of this.  No one does a neurological exam post-op.

The muscles that are cut will experience some atrophy, anywhere from 20-50% loss of strength and function, and the whole mess is a chronic pain problem.  Serious morbidity and complications of an unnecessary neurectomy done as Dr. Sarr does them.  And no one, even John Bundrick MD, who publishes the way to do the correct diagnosis and treatment in the Mayo Clinic Proceedings, says a word.   

These neurectomies are serious and dangerous 'overtreatment' of a very common problem.  It sounds esoteric, but Anterior Cutaneous Nerve Entrapment Syndrome - ACNES - is the most common cause of abdominal pain - and it is the most misdiagnosed and mistreated as none of the major surgical texts mention it.  WHEN A PATIENT IS SEEN FOR ABDOMINAL PAIN WITHOUT OTHER CLINICALLY SIGNIFICANT SYMPTOMS, ACNES SHOULD BE HIGH ON THE LIST OF LIKELY DIAGNOSES - ON THE CLINICAL CHART.  But not for Dr. Sarr - Chief of General Surgery.

Cope's Diagnosis of the Acute Abdomen does not have a word on this syndrome - but then an 80-some year old surgeon keeps re-editing, and even the illustrations are out-of-date & tacky, but the book gets 5 amazon stars from would-be surgeon readers that just don't know any better.    

One woman MD told Dr. Sarr straight-out 'no nerves, no muscles' and it didn't work - and Dr. Sarr admits that he has no consent to do these procedures, or cut into muscles and nerves without more medical investigation and workup.  Dr. Sarr then closes with a common mass closure, for intern and medical student practice, a closure requiring that he cut all abdominal muscles, and sew them all together creating a deformity that women patients don't want - and they didn't want their nerves removed without a trial of injection therapy that works for most patients.    

This is just doing surgery for the money.  Where the intern & medical student don't object to the lack of consent on the chart.  There isn't a training hospital that doesn't do this incentive: Honors for procedures.  The still-ambulatory children on the Peds Floors, after the guy medical students leave, go into hiding or want to be transporting like in C.S. Lewis.  

And just for the record Warner Andrew Oldenburg MD (Vascular Surgery Mayo Clinic), women classmates of yours missed Honors for refusing to put classmates, and other patients, out without consent for a procedure, or for refusing to do an examination on a classmate for Rounds.  It's a common practice to get cases at Medical Schools - which the interns, residents & students go along with - they don't look for the signed consent or anesthesia consults.  No one stopped ANY of Dr. Sarr's procedures missing consents or consults.  

Warner Andrew (that IS your name) while you were getting 'special' treatment to get to Mayo Clinic, and didn't object to anything even to marriage on demand, your women colleagues were silently enduring criticism, censure, and demotions of grades for saying 'No' to putting patients out without consent for procedures or exams.  Ultimatums should never be given: for marriage or surgery - the relationship and the procedure is wrong. 

Our male classmates at CWRU School of Medicine simply did not care to see the suffering, to have compassion, to pause to think or say 'No.'  You can do anything to a patient without consent if you knock them out - neurectomy even.  The men, students to attending, regard patient care as their 'divine right' - despite informed consent.    

Dr. John B. Bundrick needs to review all these Sarr Mayo cases for the last 15 years - to determine what 'repairs' can be done and why the procedures were even done in the first place - without all the options being offered the patient or physician-patient.  Andy/Warner you need to learn to help your women classmates when they need a 'friend' - we never gave you ultimatums - we said 'good luck.'  The correct treatment of this entity has been in the Surgery literature since 1972 - the anatomy of the problem.  Common mass closure can be undone, and this should be offered to all patients.  At least the deformity should be repaired.   

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