Federal Judge Alan Kay issued a $4.25 million judgment Tuesday against the United States for a botched bariatric gastric bypass surgery for weight loss on a healthy woman at Tripler Army Medical Center in 2010.

After the surgery, Christina Mettias, then 32, was in critical condition in intensive care due to complications. She still suffers from painful abdominal scar tissue, daily vomiting, chronic eating problems and intolerance to oral food.

Tripler pushed the bariatric gastric bypass surgery on Mettias, 37, who was otherwise healthy, a practice at Tripler and other Department of Defense hospitals, her attorneys said.

Had Mettias sought bariatric surgery through other medical insurance coverage, she would not have qualified, said her attorney Michael Livingston at a news conference. But this surgery is free at Tripler and other DOD hospitals for military dependants, although prohibited for active-duty military personnel.

Mettias did not meet the eligibility standards used by other hospitals and health insurance companies for bariatric surgery, the judge found.

Kay also found Mettias “was not provided with sufficient, accurate information such that she was able to give informed consent to the gastric bypass surgery,” the decision states.

A Tripler spokes­man declined to comment on the judgment, and referred a reporter to the U.S. Attorney’s Office.

The U.S. Attorney’s Office is reviewing the court’s opinion to determine whether there are any grounds for an appeal, an Army spokes­woman said.

The assistant U.S. attorney who handled the case could not be reached for comment.

Bariatric surgery shrinks the size of the stomach, thereby severely restricting food intake. The most common procedures are Roux-en-Y gastric bypass, which Mettias had and which reduces the stomach to about the size of an egg and bypasses part of the intestine; and sleeve gastrectomy, which lops off 80 percent of the stomach.

Mettias, then a military wife living at Wheeler Army Airfield housing, underwent gastric bypass surgery on Sept. 27, 2010, despite having lost about 34 pounds on an exercise and diet weight-loss program at Tripler. Mettias was 5 feet 11⁄2 inches tall and weighed 221 pounds when she entered the weight-loss program but was down to 189 pounds and a body mass index of 36 on the day of surgery. She had lost 15 percent of her body weight and 38 percent of her excess body weight, said her attorneys Livingston, Loretta Sheehan and Clare Connors.

She did not meet the criteria that would have qualified her for the surgery, namely the BMI criterion of 40 or above and serious illnesses associated with obesity.

All but one expert who testified at trial said the standard of care required that a patient must have tried nonsurgical weight loss and failed before being offered bariatric surgery, which was not the case with Mettias, the judge found.

She was never diagnosed with obesity problems until she was seen by her primary-care doctor for a checkup.

She was put on the weight-loss program and put on a conveyor belt path toward surgery, said her attorneys.

Despite concerns about the surgery, Mettias was told by the surgeon, just before her surgery, that if she did not undergo this most invasive of weight loss surgeries, she would regain her weight and develop diabetes, high blood pressure and other illnesses.

Tripler went from about 10 such surgeries in 2006 and 2007 to 67 in 2010, Livingston said.

There is a lack of accountability, the attorneys said.

Mettias’ attorneys said the data they received during discovery of the case showed that just under

30 percent of the weight-loss procedures, most of which are bariatric gastric bypass surgeries, at Tripler resulted in severe complications to less severe complications.

The surgery can lead to malnutrition and osteoporosis.

During the surgery, Mettias’ esophagus was perforated, and she suffered extreme complications after the surgery. She was in the intensive care unit for three months, on a ventilator at one point, because she could not breathe. She had to have surgeries for bleeds, repairs for leaking intra-abdominal fluid, and placement of a gastric feeding tube. Surgeons perforated her gastric pouch and diaphragm during the operations. She was in critical condition in January 2011, going into respiratory failure and from infection from the multiple bowel perforations.

She underwent 12 to 14 surgeries to repair problems, which occurs in 3 percent to 5 percent of cases.

Because of the adverse effects of the surgery, her husband, Angelo Rivera, who testified at trial, left her, and she lost her relationship with her minor son because she could not care for him due to her condition.

At the time, Mettias was living with her husband and minor son, who was awarded $100,000 of the $4.25 million for past and future loss of parental care and companionship.