British Obesity and Metabolic Surgery Society

Private and voluntary organisations · Health professional body

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First report 27 Apr 2016•Latest report 27 Apr 2016

Reports, concerns and published responses

Reports over time

Reports naming this recipient by issue year.

* 2026 is projected from reports observed to 7 Sep 2026.

Reports
1

Naming this recipient

Published responses
0%

Found for named reports

Concerns addressed
0

Across all linked responses

Stated actions
0

Described in responses

Concerns and recipient responses

Statements from British Obesity and Metabolic Surgery Society linked to the concerns in each report. Select any concern, action or position to view the source wording.

  1. London Greater Inner South

    AI-generated summary

    KATHRYN BULL · Prevention of Future Deaths report

    This summary was generated using AI from the published report. Please read the original report for the complete account.

    Report summary

    Kathryn Bull underwent gastric bypass surgery in January 2014 and subsequently experienced difficulty tolerating food, dizziness, lethargy, vomiting and blackouts. She was admitted to hospital after a fall, deteriorated with hyperammonaemia syndrome and multi-organ failure, and died following a cardiac arrest on 4 December 2014. The principal concern was that hyperammonaemia syndrome is an extremely rare adverse consequence of gastric bypass surgery, with symptoms that were not well understood and did not initially trigger concerns during follow-up.

    Read the report on judiciary.uk

    Source evidence

    How this individual concern was interpreted

    PFD Monitor created a concise, searchable interpretation from the report wording shown below. The report was sent to British Obesity and Metabolic Surgery Society; that does not assign responsibility.

    PFD Monitor interpretation

    Lack of understanding of hyperammonaemia syndrome symptoms following gastric bypass surgery

    Wider context from the report

    “(2) The pathologists, ████████ (the gastric bypass consultant who performed the surgery on Mrs Bull) and ████████ (the consultant intensivist who treated her in hospital) confirmed that hyperammonaemia syndrome has been identified as an adverse consequence of gastric bypass surgery. (3) However this is extremely rare: there appear to have been only 25 or so reported cases worldwide¹. Very little appears to be known about the condition and so the symptoms are not well understood. ”
    Open source report
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Information checked against published PFD reports and official responses · Data reviewed 7 Sep 2026 · About data quality and limitations

Data last updated 7 September 2026