1. A 55-year-old female patient presents to her bariatric surgeon for a routine checkup 1 week after

1. A 55-year-old female patient presents to her bariatric surgeon for a routine checkup 1 week after an LRYGB. She has been taking over-the-counter (OTC) phenylephrine and chlorpheniramine for her cold. Her vitals include HR, 121/min; RR, 16/min; BP, 110/70 mmHg; and temperature, 98.48F. Her abdomen is soft, nontender, and nondistended with normal bowel sounds. The surgeon notes that the OTC medication that she is taking can cause tachycardia but orders an upper gastrointestinal (UGI) contrast study, which is reported as normal. The patient is discharged home. Two weeks later, the surgeon’s office gets a phone call from a lawyer saying that the same patient had died and that he was being sued for negligence. The forensic pathologist reports the cause of death as peritonitis due to staple line leak. Which of the following statements is MOST ACCURATE regarding the same issue? A. Give a b-blocker to counter the effect of the OTC medication. B. The surgeon should not have ordered a UGI contrast study as it was not indicated. C. The surgeon should have performed a laparotomy in spite of a normal UGI. D. The surgeon is not at any fault as his management was in accordance with best practice guidelines.

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