The Insider's Guide

To Safe & Affordable Weight Loss Surgery in Mexico

Introduction

The idea of going to “Old Mexico” for an affordable life changing surgery is both exhilarating and terrifying at the same time.

We hear the horror stories of botched surgeries performed in ill-equipped locations putting patients in extreme danger and even worse.

And why would anyone go into surgery with a surgeon they cannot communicate with? Would you do it at home? If not, then why would you even think about doing it in a foreign country? However, there are great doctors outside the United States of America, you just should know how to find them. In Mexico, there are many great doctors, and many great medical facilities doing incredible work every single day.

The purpose of this booklet is to give you, the prospective patient, a little information and education on how to identify the good doctors and medical facilities from the bad ones.

Are medical standards in Mexico similar to that of the USA and Canada? How do you know if a medical facility is “Certified” by Mexico’s Federal Government or not? Do you have to subject yourself to substandard medical practices? How do you know if you are getting a good surgery or not? Recovery houses sound cool, but are they safe and legal? And what about recovering at hotels? These questions and many more we will try to answer in this booklet.

One of the biggest benefits and the biggest problems with medical tourism has been the internet, and more recently the rise of social media.

These new forms of information and communication have created a very fertile breeding ground for ruthless and unscrupulous characters that prey on innocent and unsuspecting people seeking to improve their lives.

In this business, what you don’t know can kill you. Please pay very close attention to the information in this booklet. It is our hope that you take this knowledge and use it wisely and to your benefit.

Don’t let the efforts of a few bad apples deter you from getting that life changing procedure you seek.

Elective Surgery

No One Should Ever Have To Die 

With this type of voluntary elective surgery (surgery that you choose to have) no one should every have to die. With any surgery anywhere on earth, there is a theoretical risk of complication, but that risk should be as close to zero as possible.

Your surgeon should have all the surgical skills, the medical facilities and the financial resources and/or insurance to deal with complications. If you are considering some low ball cut rate surgeon for your procedure, please remember, they are cutting corners somewhere to save money, but cutting those corners could cost you your life.

TRINITY MEDICAL – Surgical Track Record Is Perfect

The Ideal Protocol for Weight Loss Surgery in Mexico.

1. Arrive in Mexico for your Scheduled procedure.
2. Check into Certified Hospital where you stay two nights.
3. Hospital has private rooms with private bath.
4. EKG & lab work are required by law in Mexico and everywhere else.

5. Speak with your surgeon in English, ask questions.
6. Incisions finished with Surgical Glue. No Frankenstein stitching.
7. After surgery, you walk inside hospital.
8. 24 to 48 hours after surgery you get barium swallow.
9. You see and speak with your surgeon everyday.
10. After second night at Hospital you are discharged & ready to go home.

TRINITY MEDICAL – THIS IS OUR STANDARD PROTOCOL

What Does Self-Pay Mean In Mexico?

Self-Pay means you are responsible financially for everything, even complications! Something most patients never think of or realize is the potential for surgical complications, and the costs associated with them. You see the slick ads on the internet or posts on Facebook or Instagram offering some super cheap price for a procedure. Ask yourself, what happens if you need to stay extra days? What if you need to move from a clinic to a real full service hospital? The average hospital cost in Mexico is $1,000 USD per day. Multiply that by a week and it gets expensive fast.

In the past, these cut-rate clinics and surgeons simply pumped up the patient with drugs and pain killers then dumped the US and Canadian patient across the border and let them become someone else’s problem. As horrifying as it is true!

TRINITY MEDICAL – Medical Complication Insurance with Zero Deductible Included With Every Surgery Package

Medical Tourism Insurance:

Depending on the procedure, for you to buy medical tourism insurance if you can find it will cost you between $300 to $1,000 USD. Add that to the cost of your cut rate procedure and suddenly it is not so cheap.

TRINITY MEDICAL – Does Not Charge Extra For Insurance

DOCTORS

Does The Doctor Speak English? 

I personally would never go to a foreign country where I do not speak the language and go under the knife with a surgeon that I cannot communicate with. If you don’t see and hear a video clip of the Doctor speaking English, then he does not, it is that simple.

Doctor and Hospital errors are the third leading killer of Americans in the USA behind heart disease and cancer: why add communication barriers into the mix?

TRINITY MEDICAL – Surgeon Speaks English

Professional ID Card:

Is your Doctor properly licensed and insured? In Mexico, every medical professional must have a “Cedula Professional” It is an ID card issued by the Federal Government in Mexico City. It shows what they are properly licensed. This is the proof that they have met all the requirements to practice a specific type of medicine. For example, every medical doctor will have a Cedula that states they are certified for General Medicine, much like a family doctor (not including surgery). Beyond that, there is a different Cedula number that will list they are certified for General Surgery. There are specific disciplines that require their specific Cedula such as Plastic surgery, Pediatrics, etc.

TRINITY MEDICAL – Surgeon’s Cedula Is On Our Website

Certified Bariatric Surgeon?

Bariatric (Weight Loss) surgery is NOT a specialty in Mexico at the moment. Anyone that says that they are “Certified Bariatric Surgeon” is lying. Demand to see the “Cedula” and you will see that it says “ESPECIALIDAD EN CIRUJIA GENERAL” Translated that means “Specializing In General Surgery.” To do bariatric surgery in Mexico, any general surgeon is legally able to do it.

Where was your surgeon trained to do Bariatrics (Weight Loss Surgery)? This is perhaps the most interesting question to ask your prospective weight loss surgeon. In Mexico, Bariatric Surgeons are trained under another Bariatric Surgeon. It is important that you know who your surgeon was trained under. If you don’t get a straight answer, you can assume he watched a YouTube video on how to do your procedure. Is that what you signed up for?

TRINITY MEDICAL – Surgeon TRAINED AT OBESITY CONTROL CENTER

Name Of Doctor Match Cedula?

It is important that you verify that the name of the doctor/surgeon that you have chosen is a match to the name on the Cedula. If you see any discrepancy you need to investigate further.

Here is one example of what we are talking about. The screen shot below advertises a surgeon named “Dr. Gabby Ruiz” on a website called slimlifebariatrics.com

Sounds good, just one little problem. Dr Gabby Ruiz does not exist. If you ask her to show you her Cedula, it will be for a Dr. Gabriela Rodriguez, same doctor with different name at Obesity Control Center as shown below:

We have no idea who the owner is of slimlifebariatrics.com, and quite frankly we don’t care. We do have the utmost respect and admiration for Dr. Gabriela Rodriguez.

Our point is simple: You cannot go around pretending to have a different name on different websites. It is immoral, illegal and could be quite dangerous. Imagine having surgery and then having a complication from a surgeon that does not exist. It is just not right on so many levels.

TRINITY MEDICAL – YES, Surgeon’s Cedula Matches

Medical Malpractice Insurance:

Yes, like everywhere else in the developed world, medical malpractice insurance is an absolute requirement by the Mexican Government for physicians to work legally in Mexico. Don’t be shy, ask for a copy of their insurance documents and verify that it is current. Verify that the Name of the Doctor is exactly as it is on the Cedula. This is part of your insurance should something bad happen.

TRINITY MEDICAL: YES Surgeon Has Malpractice Insurance

M.D. or False Advertising?

“M.D.” is a designation awarded to doctors graduating from medical schools in the USA and CANADA. It is NOT a designation recognized in Mexico. When a medical student graduates from a Mexican medical school, they get the Dr. in front of their name and that is it. I have noticed that some Mexican doctors put “M.D.” in their advertising, and some have even bought a trademark to that effect. But the law in Mexico is still clear, there is no “M.D.” designation for Mexican trained doctors. If we are wrong then every Mexican medical doctor will be putting the “M.D.” after their name, and if you check, they do not. Unless they have successfully taken and passed the USMLE (United Stated Medical Licensing Exam) then they simply are not “M.D’s”.

TRINITY MEDICAL – We Do Not Claim M.D.

False Internet Advertising: Weight Loss Agents

Remember in the introduction we mentioned “ruthless and unscrupulous characters that prey on innocent and unsuspecting people seeking to improve their lives?”

With that in mind, we would like to give a special shout out to Mr. Jared Cohen of Ft. Lauderdale, Florida who owns WeightLossAgents.com and GastricSleeve.com and their

surgeon of choice Dr. Mario Almanza in Tijuana. A simple Google search on Almanza and WeightLossAgents will show dozens of terrible news reports in the USA and Canada. Take a look at their sneaky and deceptive advertising practices that we spotted on Bing the other day…..

In the search bar, you see that we put in Obesity Control Center, and you are looking at a Paid Ad from WeightLossAgents circled in red. An unsuspecting patient that tries to find Obesity Control Center might mistake that ad for the real OCC and wind up falling into Dr. Mario Almanza’s hands. It is sneaky, underhanded, but as far as we can tell, it is also not illegal at this time.

TRINITY MEDICAL: We Don’t Do That

Re-sleeve + Sleeve Revision = Botched Surgery

About 1/3 of our patients already have gastric sleeves from doctors on both sides of the border, lose some weight, then gain it back, and at the end of it all find they can eat just about as much as they could before they got the surgery in the first place. There is no such thing as a re-sleeve or sleeve revision. Look it up in any medical school text book on bariatric surgery. It simply does not exist. What they are talking about is a Botched surgery. The way to prove you have a botched surgery is to get a barium swallow to show that the sleeve is larger than it should be. If it were me, and I had a botched surgery, I would go back to the original surgeon and demand that either he fixes it for free, or give me my money back.

TRINITY MEDICAL: Lifetime Guarantee On Our Gastric Sleeves

MEDICAL FACILITIES

Are the medical standards in Mexico and USA similar?

Yes, absolutely! Would you go into someone’s garage to get a surgery at home? Of course not! Then why would you subject yourself to that in Mexico? The medical training, health department code requirements, local, state and Federal regulation in Mexico are just as strict as they are in the USA and Canada.

TRINITY MEDICAL: CSG CERTIFIED HOSPITAL for Medical Tourists

Sterile Operating Room?

It takes about 45 minutes between patients to properly clean and sterilize the operating room and surgical equipment between patients. If the typical gastric sleeve surgery takes say 45 minutes to an hour, then 45 minutes between patients to properly clean and sterilize the operating room. Honestly, 5 patients in a day is a full day, and this assumes there are no high-risk patients requiring more time. Any more than 5 per day is too many surgeries for any single surgeon. Some surgeons claim to do 15, 20 or more patients a day with one surgeon and one operating room = Disaster! Something is not getting done properly. It is simple math.

TRINITY MEDICAL – MAX 5 SURGERIES PER DAY

Hotel for Recovery?

Some outpatient (ambulatory) clinics in office buildings and strip malls are keeping bariatric patients overnight in the clinic then moving them to a hotel in Tijuana for one night. This is technically legal but it is very dangerous for the patient. It is illegal to give injections and medications in hotel rooms in Mexico. It violates health code laws and is not sterile. The proper procedure is to transport the patient back to the clinic or doctor’s office for treatment. NO medications and NO injections are to be done in the hotel under any circumstance.

TRINITY MEDICAL: TWO NIGHTS AT HOSPITAL – NO HOTEL

Recovery House:

Absolutely, illegal! At every level of government! Local, state and Federal in Mexico. Some groups offer a recovery house as an option for recover after surgery and to offer you a lower price. It is illegal in the USA, Canada and Mexico. You are taken care of by the housekeeper. One way you know this, is an IV port is left in your arm with the tip capped off. The housekeeper can give you an injection thru the port. Housekeepers giving you injections is totally illegal in Mexico. We often see patients walking around Tijuana with IV ports. This also is totally illegal. You can get a very serious and sometimes deadly infection which travels through your IV port and directly into your vein. Any properly licensed medical facility in Mexico will NEVER let you leave the building or be discharged with an IV port. It is illegal in the USA, and it is also illegal in Mexico.

TRINITY MEDICAL: TWO NIGHTS AT HOSPITAL – NO RECOVERY HOUSE

International Standards:

(JCI) Joint Commission International is a third-party organization based in Illinois, USA that certifies different medical facilities around the world except in the USA and Canada. They have a pretty little seal that you can put on your website if you pay them a fee and meet their guidelines, the most important part of that process of course is paying their fee. But as far as the Mexican Government is concerned JCI Accreditation means nothing.

There is one bariatric surgical facility located on the second floor of building in Tijuana that touts their JCI accreditation, but it turns out they are JCI accredited for ambulatory care. Basically, outpatient services. As a clinic, they are not certified under JCI’s Hospital Certification program.

And this is what JCI says on their own website about their own JCI Endorsement:

“Joint Commission International does not endorse the products, services, or devices of health care entities public or private, for profit or not-for-profit. If you have a question or concern about a group or individual claiming to be endorsed by or affiliated with JCI, please contact us…”

(CSG) CONSEJO DE SALUBRIDAD GENERAL is the Mexican Federal Government’s response to medical tourists seeking guidance on international medical standards for medical facilities in Mexico. And as such, there are only three surgical facilities in Tijuana that have CSG Certification. They are (1) Angeles Hospital, (2) Obesity Control Center, and (3) Hospital Guadalajara. That is it for now. There may be others attempting to get certified, but as of this writing these are the only three. Details can be found on our website.

To see for yourself follow this link to the official Mexican Government website at the following: http://www.csg.gob.mx/contenidos/certificacion2010/hospitales.html and the page will look like the following:

Then you can click on the area outlined in red that reads as “HOSPITALES CERTIFICADOS” which literally means “CERTIFIED HOSPITALS” and you will pull up a PDF document which looks like the following:

Scroll down several pages to rows 87, 88 and 93. These are the only 3 facilities in Tijuana that are “CERTIFIED HOSPITALS” by the Mexican Federal Government in Mexico City.

TRINITY MEDICAL – SURGERIES AT CSG “CERTIFIED HOSPITAL”

MEDICAL FACILITATORS

Internet Searches

Any search on the internet for weight loss surgery in Mexico will yield dozens and dozens of websites claiming to offer cheap, cheaper and cheapest prices for surgeries in Mexico. Some of these sites list medical facilities all over Mexico. They are brokers and you can spot them easily by scrolling to the bottom of the page and finding some disclaimer that says something like:

“www.alighterme.com “Bravo Development Group, Inc. (DBA: A Lighter Me) is a scheduling facilitator. We are not a healthcare provider. The information contained on this site is for educational purposes only and does not constitute medical advice nor does it create any physician – patient relationship. We recommend that visitors to this site discuss information contained here with their own physician”

Pretty much says it all right there….you are on your own!

TRINITY MEDICAL: A MEXICO CORPORATION – NOT A BROKER

Non-Refundable Deposits?

That is utter nonsense. We have noticed that several of these joker broker medical facilitators say that in order to schedule a surgery with their surgeon they take a non- refundable deposit. In their paper work they make you sign it states that if you change your mind and do not have the surgery then you lose your deposit money.

This is totally illegal and needs to stop. We know this is a bit legalistic but you need to know that it is illegal to take a non-refundable deposit for a “service” across international border with a credit card that is run through a virtual terminal. It is not the same as buying a product like a pair of shoes over the internet. It is also illegal to use a credit card to pay for a “service” like a surgery in one country, and receive that surgery in another country.

Whatever documents these joker brokers make you sign is totally irrelevant as far as the (PCI) Payment Card Industry is concerned. You know that little piece of paper you need to sign when you run your through a machine? That is the only worldwide document that is recognized by the major credit cards like Visa, MC and Amex. Call your joker broker and demand a refund. When they say no, pick up the phone and call your credit card’s number on the back of your card and do a “back charge.” All you need to say is that your card was run to pay in the USA for a surgery that was to be delivered in Mexico and was run through a virtual terminal. Your card company will give you the money back. Don’t take no for an answer.

TRINITY MEDICAL – FULLY REFUNDABLE DEPOSITS

Internet Websites:

gastricsleeve.com, bariatricpal.com, realself.com, obesityhelp.com, etc.

They are what is known in this business as “lead aggregators.” They exist to find unsuspecting patients, and steer them to one or more medical facilities and surgeons in exchange for a kick back. They have “moderators” that keep out any negative comments about them or any of their doctors and clinics. They also delete positive comments about their competitors. But how would the public, like you, even know? You don’t and that is the problem.

The inherent problem is that there is a conflict of interest in these lead aggregators. Even if they know the surgeon is bad, they make money sending people to them. But if something bad happens, they claim they have no responsibility – this is not entirely true. As Americans, these website owners have a legal responsibility to protect patients from surgeons and surgical facilities they know are bad.

GastricSleeve.com is owned by Jared Cohen of WeightLossAgents.com in Florida and sends patients to Dr. Mario Alamanza.

BariatricPal.com is owned by Alex Brecher in New York sends patients to Jaime Ponce De Leon.

ObesityHelp.com sends patients to Obesity Control Center. (not too bad, just too expensive)

RealSelf.com sends patients to Cosmed in Tijuana

You get the idea.

The owners of these internet sites have learned to leave a few good comments about their competitors, and a few minor negative comments about their own facilities to give you the impression they are fair and impartial. They are not – just don’t forget it.

TRINITY MEDICAL – WE Do Not Pay Kick Backs – Conflict of Interest

FACEBOOK/INSTAGRAM –
SOCIAL MEDIA

“Closed groups” – BEWARE – Bad News Kept Out!

The Closed Groups on Facebook are plentiful. But the same thing happens with these closed groups. The moderator is steering new prospects to a specific surgeon or surgical group in exchange for a kick back. Many housewives are staying at home moderating their Facebook groups and making money. Nothing is really wrong with that except any bad news never makes it inside the group, and the “moderators” are so territorial that if you say anything good about anyone other than their preferred clinic or doctor your post will be deleted and you kicked out of the group.

Take for example Alighterme’s Facebook group moderator. Around February 2016 their own surgeons operated on that poor lady, and she died. That same month they suffered several patient deaths, all hushed up and brushed under the carpet so to speak. Hours before the local medical authorities came to investigate the staff at the uncertified hospital where they do their surgeries called their unlicensed staff and told them to stay home. But if you get into their new Facebook group today you think everything is great!

So, when you get into one of these closed groups, just be aware and take it with a grain- of-salt. Stay alert and realize that if you say anything nice about their competitors you will face a backlash an eventually get kicked out of the group and unfriended.

COUNTERFEIT MEDICAL DEVICES
& COUNTERFEIT MEDICINES

A Global Problem

Walk along Revolution Avenue in Tijuana and you will find little hole in the wall places that sell beautiful Rolex watches for $20 USD and a gorgeous Louis Vuitton purse for $25. Do you think it is a real Rolex watch or a real Louis Vuitton purse? Of course not, it is counterfeit. Just like counterfeit watches and counterfeit purses, there are also counterfeit medical devices and counterfeit medications sold in the USA, Canada and yes even in Mexico.

This is a global problem. But you need to be aware that when you see a deeply discounted price for a surgical procedure, there is something wrong. Every legitimate and ethical surgical group in Mexico pays the same price for the patented name brand medical devices and medications from authorized distributors in Mexico. The unscrupulous ones buy products on the black market that are stolen or counterfeit Chinese made products at pennies on the dollar then turn around and use them on medical tourists to make greater profits.

TRINITY MEDICAL: WE ONLY BUY FROM AUTHORIZED DISTRIBUTORS

Before You Leave The Medical Facility

Make sure to ask for Copies of your original medical records, surgeon’s post-op notes, X- ray, and lab results before you leave the facility in Mexico. You can deal with the translating them later. This is important if you develop complications post-op. It is always best to have the records in your possession.

Before you leave Mexico ask for a written list of symptoms to watch out for before you leave Mexico. Your surgeon should give these to you in ENGLISH.

You Are Injured Or Dead – Now What?

It is absolutely and critically important that you follow the post-op written instructions of your surgeon no matter who or where you have surgery. Any deviation from those instructions might leave you holding the bag on huge medical bills. If you get back home and wind up in the Emergency Room or Hospital for weeks or months due to a nicked liver, cut spleen or nicked intestines, or have what should have been an easily detectable leak, make sure to collect all your medical records.

If a loved one DIES in Mexico, Call the Local Police, make a Police report, Call the US Consulate’s office in Tijuana and demand an autopsy before you leave Mexico. When your loved one gets stateside, demand another autopsy so experts can compare the two.

If it turns out there was a complication that could have been avoided, then you may have rights.

FIRST, in the event of a death, the only people with legal standing to file complaints and lawsuits in Mexico are blood relatives like children and parents, or legally married spouses at the time of death. Ex-spouses, fiancés, and friends do not count.

SECOND, you will need to prove that payment was made to the Mexican physician. Without proof of payment, you are fighting an uphill battle. Even if you paid cash, make sure you get a written receipt that includes the physicians name clearly written along with the date of the procedure.

THIRD, be prepared to come back to Mexico to file complaints in person along with two witnesses. Mexico has a completely foreign legal system (Roman Law) for most Americans and Canadians. Mexican law does not permit legal filings by attorneys or legal representatives without you being physically present. You must be on Mexican soil to file, else there will not be any legal proceedings.

COFEPRIS is the Mexican Government’s rough equivalent to the FDA in the USA, and this agency will be responsible for reviewing the conduct of the doctors that worked on you. They can revoke the medical license of an offending physician if they determine there was medical malpractice. This will basically be an administrative proceeding. You definitely will need a Mexican attorney well versed in COFEPRIS to handle the filing of complaints with this agency.

MINISTERIO PUBLICO is the rough equivalent of the “District Attorney” in the USA. They are responsible for criminal prosecution of physicians accused of medical malpractice, and will put them in jail. Again you will need a Mexican attorney well versed in criminal law in prosecuting a claim before the Ministerio Publico.

COMISION DE ARBITRAJE MEDICO is an arbitration commission for disputes with doctors in Mexico. It has no enforcement powers of any kind and is basically a waste of time.

FORTH, certain legal documents such as the death certificate will need to be Notarized and Apostilled to be valid in Mexico. They might also need to be translated into Spanish by Official Mexican Government Translators. Other documents, such as the medical records for hospitals or autopsies outside of Mexico will need to be translated into Spanish by Official Mexican Government Translators. This cost some money and depends on the volume of pages to be translated.

FIFTH, if possible, file the complaint in Mexico City. The reason to avoid the local officials in Tijuana is to eliminate the potential for corruption. A good Mexican malpractice attorney with two witnesses to a patient’s suffering and death can put a bad Mexican doctor in jail for a very long time. But you must follow the proper legal protocols.

Medical Malpractice Lawsuits

Yes, if you are a victim of medical malpractice and wind up spending weeks in an American hospital and a hefty medical bill, you can file a lawsuit against the Mexican doctor and if he is found guilty, he will have to pay your medical bills incurred by you state side. It is a lengthy legal process, just like it would be state side, but the idea that there is nothing you can do is wrong. You simply must know how to do it the right way in Mexico.

PERIODIC UPDATES

Please keep checking our website for regular updates to this booklet. There is so much more we could say but at the same time we do not want to write a novel.

We are Americans, and as Americans we believe that everyone has the right now know the truth: the good, the bad and the ugly. Then you make your own decision on what to do. We know that educated patients make our best patients.

Blessings,

TRINITY MEDICAL