A bariatric surgery expert witness opines on a case where a patient died as a result of small bowel obstruction following initial discharge after conservative management. This case involves a thirty-eight-year-old female patient who presented to the ER complaining of severe abdominal pain for the past two days, nausea and vomiting. The patient was admitted to the hospital in Oklahoma for five days with a diagnosis of partial bowel obstruction and was discharged following conservative treatment. The patient had a past medical history significant for multiple abdominal surgeries for hernia repair, morbid obesity and a current ventral hernia. At the time of her admission she was undergoing evaluation at another facility for bariatric surgery as an intervention for her obesity. She returned to the hospital one day following discharge with feculent vomitus. The patient was admitted with an incarcerated ventral hernia, small bowel obstruction, and persistent abdominal pain. Her symptoms did not improve following conservative treatment and the decision was taken to the operating room for an exploratory laparotomy. This procedure resulted in the repair of incarcerated ventral hernia with Composix graft mesh. Postoperatively, it was decided to leave the patient intubated. She became hypotensive postoperatively and spiked a temperature of 102 degrees F. The patient remained intubated and required vasopressors to maintain her blood pressure. She became progressively more hypoxic, developed bilateral pleural effusions, and was acidotic. A week after surgery, the patient’s endotracheal tube became dislodged after the balloon burst. The patient was unable to be resuscitated and succumbed to her medical conditions.