Tougher rules fail to prevent tragedies from plastic surgery
Young mothers, middle-aged men and grandparents. All were among at least 32 people who died in Florida in the past decade in the pursuit of beauty – soon after cosmetic surgery.
That's about the same number of deaths that occurred in the 1990s, leading the state Board of Medicine to pass rules restricting cosmetic procedures performed in doctors' offices – rules still considered among the toughest in the nation.
That's about the same number of deaths that occurred in the 1990s, leading the state Board of Medicine to pass rules restricting cosmetic procedures performed in doctors' offices – rules still considered among the toughest in the nation.
One reason for the continued deaths may be a huge growth in cosmetic surgeries, but some surgeons, malpractice attorneys and industry experts say problems persist, and the state needs to do more.
"If there are that many deaths, there's still something very wrong," said Becky Cherney, an Orlando health care advocate who was a member of the medical board that passed the rules. "People elect to have plastic surgery and they end up dying? It's a senseless loss of life."
The deceased include four South Florida mothers in their 30s who went under the knife in the past two years to have love handles and bra rolls shrunk via liposuction, state incident reports and police records show.
In one case, a 32-year-old Miami mother of six went for liposuction at a Broward County plastic surgery office in February 2010. She died the next afternoon from a toxic mix of the surgical anesthetic lidocaine and oxycodone pain pills "complicating elective cosmetic surgery,'' according to an autopsy report.
Dr. Brett Coldiron, a University of Cincinnati dermatology surgeon who has researched plastic surgery in Florida, tallied 26 deaths and 131 hospitalizations from 2000 through 2009. The Sun Sentinel documented six deaths since then, through autopsy and police reports.
The deaths have had various causes, including poor medical care by doctors, bad reactions to anesthesia, and heart and breathing emergencies during surgery. Some were due to unavoidable complications that can happen in any type of surgery, even under the best conditions. The causes of the two most recent deaths have not been determined.
Florida's medical board tracks cosmetic surgery deaths and complications, but so far has not identified any trends or patterns that would require a change in the rules, said two board members from Fort Lauderdale, Dr. Zachariah P. Zachariah and Dr. Nabil El Sanadi. The medical board enforces laws involving physicians.
Both said the board should take another look at the issue, based on a cluster of five deaths in the past 21 months in Broward County.
"It's easy to second guess, but there needs to be a systematic approach to looking at all this," El Sanadi said. "Is it one place not complying with laws, or is it the system letting us down?... We don't know.''
The medical board first addressed the dangers of plastic surgery in 1999, after a series by the Sun Sentinel that found 34 deaths in the preceding 12 years. Some were blamed on lengthy surgeries involving multiple procedures at doctors' offices that were not then being regulated.
The board wrangled for two years before imposing rules that included regular inspections of physician surgery offices, a ban on overnight stays, and limits on liposuction and lengthy operations.
Since then, demand for elective cosmetic surgery has mushroomed nationally, fueled in part by public interest in celebrity surgeries and makeover shows on TV. The number of procedures nearly doubled since 2000 to an estimated 13.1 million last year, according to surveys of doctors done by the American Society of Plastic Surgeons.
Appearance-conscious Florida has been in the forefront. The number of doctors' offices registered to perform surgery jumped from 285 in 2004 to more than 400 today, state figures show. Half of those are in South Florida, with about 50 each in Broward and Palm Beach counties, and 100 in Miami-Dade. Some doctors appeal to modest-income families by offering discounted prices and payment plans.
Nationally, studies show a death rate of 2 per 100,000 cosmetic surgeries in physician offices. But no one counts the number of plastic surgery procedures in Florida so a statewide death rate cannot be calculated.
Coldiron said the industry has gotten better, but "cosmetic surgery is still not as safe as it should be in Florida."
Several malpractice attorneys said the state has not done enough to enforce the present rules and does not punish violators severely.
"The governor and Legislature talk a lot about protecting the medical industry," said Michael Freedland, a Weston attorney who represents families in two liposuction death cases. "I'd like to hear more talk about how we protect patients."
"If there are that many deaths, there's still something very wrong," said Becky Cherney, an Orlando health care advocate who was a member of the medical board that passed the rules. "People elect to have plastic surgery and they end up dying? It's a senseless loss of life."
The deceased include four South Florida mothers in their 30s who went under the knife in the past two years to have love handles and bra rolls shrunk via liposuction, state incident reports and police records show.
In one case, a 32-year-old Miami mother of six went for liposuction at a Broward County plastic surgery office in February 2010. She died the next afternoon from a toxic mix of the surgical anesthetic lidocaine and oxycodone pain pills "complicating elective cosmetic surgery,'' according to an autopsy report.
Dr. Brett Coldiron, a University of Cincinnati dermatology surgeon who has researched plastic surgery in Florida, tallied 26 deaths and 131 hospitalizations from 2000 through 2009. The Sun Sentinel documented six deaths since then, through autopsy and police reports.
The deaths have had various causes, including poor medical care by doctors, bad reactions to anesthesia, and heart and breathing emergencies during surgery. Some were due to unavoidable complications that can happen in any type of surgery, even under the best conditions. The causes of the two most recent deaths have not been determined.
Florida's medical board tracks cosmetic surgery deaths and complications, but so far has not identified any trends or patterns that would require a change in the rules, said two board members from Fort Lauderdale, Dr. Zachariah P. Zachariah and Dr. Nabil El Sanadi. The medical board enforces laws involving physicians.
Both said the board should take another look at the issue, based on a cluster of five deaths in the past 21 months in Broward County.
"It's easy to second guess, but there needs to be a systematic approach to looking at all this," El Sanadi said. "Is it one place not complying with laws, or is it the system letting us down?... We don't know.''
The medical board first addressed the dangers of plastic surgery in 1999, after a series by the Sun Sentinel that found 34 deaths in the preceding 12 years. Some were blamed on lengthy surgeries involving multiple procedures at doctors' offices that were not then being regulated.
The board wrangled for two years before imposing rules that included regular inspections of physician surgery offices, a ban on overnight stays, and limits on liposuction and lengthy operations.
Since then, demand for elective cosmetic surgery has mushroomed nationally, fueled in part by public interest in celebrity surgeries and makeover shows on TV. The number of procedures nearly doubled since 2000 to an estimated 13.1 million last year, according to surveys of doctors done by the American Society of Plastic Surgeons.
Appearance-conscious Florida has been in the forefront. The number of doctors' offices registered to perform surgery jumped from 285 in 2004 to more than 400 today, state figures show. Half of those are in South Florida, with about 50 each in Broward and Palm Beach counties, and 100 in Miami-Dade. Some doctors appeal to modest-income families by offering discounted prices and payment plans.
Nationally, studies show a death rate of 2 per 100,000 cosmetic surgeries in physician offices. But no one counts the number of plastic surgery procedures in Florida so a statewide death rate cannot be calculated.
Coldiron said the industry has gotten better, but "cosmetic surgery is still not as safe as it should be in Florida."
Several malpractice attorneys said the state has not done enough to enforce the present rules and does not punish violators severely.
"The governor and Legislature talk a lot about protecting the medical industry," said Michael Freedland, a Weston attorney who represents families in two liposuction death cases. "I'd like to hear more talk about how we protect patients."
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