Another Geoffrey Kim?

[coffeebythelake]

Bonita Surgeon Facing Murder Charge in Death of Patient

A South Bay plastic surgeon is now facing a murder charge after prosecutors say they discovered new evidence that shows the death of a patient was the result of recklessness and an effort to put profits before patients.

www.nbcsandiego.com

Eerily similar in description. Plastic surgeon. Unqualified anesthesia provider. Refused to call 911 for hours after patient had cardiac arrest. Now he is being charged with murder.

https://drcarloschacon.co/wp-content/uploads/2021/12/doctor.jpg

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[Planktonmd]

Bonita Surgeon Facing Murder Charge in Death of Patient

A South Bay plastic surgeon is now facing a murder charge after prosecutors say they discovered new evidence that shows the death of a patient was the result of recklessness and an effort to put profits before patients.

www.nbcsandiego.com

Eerily similar in description. Plastic surgeon. Unqualified anesthesia provider. Refused to call 911 for hours after patient had cardiac arrest. Now he is being charged with murder.

Apparently he was doing the anesthesia himself.

 

[Beeftenderloin]

Apparently he was doing the anesthesia himself.

“Chacon made the “intentional decision” to conduct surgery using a nurse who wasn’t trained to properly administer anaesthesia”

I dunno, based on this quote from the article I see no reason to think they aren’t referring to a CRNA.

 

[psychbender]

“Chacon made the “intentional decision” to conduct surgery using a nurse who wasn’t trained to properly administer anaesthesia”

I dunno, based on this quote from the article I see no reason to think they aren’t referring to a CRNA.

To me, that sounds more like he was using an office RN, and telling her to provide sedation.

 

[anaesthetic]

Bonita Surgeon Facing Murder Charge in Death of Patient

A South Bay plastic surgeon is now facing a murder charge after prosecutors say they discovered new evidence that shows the death of a patient was the result of recklessness and an effort to put profits before patients.

www.nbcsandiego.com

Eerily similar in description. Plastic surgeon. Unqualified anesthesia provider. Refused to call 911 for hours after patient had cardiac arrest. Now he is being charged with murder.

Apparently he was doing the anesthesia himself.

Well, technically he’s probably the master of procedural sedation since he’s done thousands of these cases on ASA 1s/2s, not like us anesthesiologists who mostly have to intubate for our ASA 3 cases.

If anything, he’s probably more qualified than we are at these types of cases. Just look at the data. He’s only had one bad outcome!

 

[IMGASMD]

Well, technically he’s probably the master of procedural sedation since he’s done thousands of these cases on ASA 1s/2s, not like us anesthesiologists who mostly have to intubate for our ASA 3 cases.

If anything, he’s probably more qualified than we are at these types of cases. Just look at the data. He’s only had one bad outcome!

He was never sued until she was murdered.

 

[Angus Avagadro]

Our plastics guys were often asking us to lower our fees. We would agree only if they showed us how much they were willing to lower their fees along with the hospital. Somehow it never went any further than that.

 

[TheLoneWolf]

Patients pay top dollar out of pocket and place their lives in the hands of these hucksters for these elective procedures.

Let me be clear, this is not to save cost per procedure for the patients. This is to pocket the difference and increase profit margins.

Plastic surgeons in general....in my limited experience seem to be overrepresented in the trouble group. Many of the ones I have heard of had lost their licenses for sleeping with patients, uploading idiotic and dangerous intraop acts to social media.

 

[coffeebythelake]

Patients pay top dollar out of pocket and place their lives in the hands of these hucksters for these elective procedures.

Let me be clear, this is not to save cost per procedure for the patients. This is to pocket the difference and increase profit margins.

Plastic surgeons in general....in my limited experience seem to be overrepresented in the trouble group. Many of the ones I have heard of had lost their licenses for sleeping with patients, uploading idiotic and dangerous intraop acts to social media.

There is a lot of ego among some plastic surgeons.

 

[John Rawls]

“The fact that he’s never been sued until this event occurred I think speaks to the quality of his work,” Rosenberg said.

Because it's so difficult to put the equivalent of a shoe insole behind fatty tissue. Get a real job.

 

[Maz777]

If I remember the original post on this, his wife is the "RN" administering the "conscious sedation." I believe she is an NP.

His career and financial situation are over. All for the almighty dollar.

https://www2.mbc.ca.gov/BreezePDL/document.aspx?path=%5cDIDOCS%5c20211223%5cDMRAAAJD2%5c&did=AAAJD211223181714893.DID

 

[IMGASMD]

If I remember the original post on this, his wife is the "RN" administering the "conscious sedation." I believe she is an NP.

His career and financial situation are over. All for the almighty dollar.

https://www2.mbc.ca.gov/BreezePDL/document.aspx?path=%5cDIDOCS%5c20211223%5cDMRAAAJD2%5c&did=AAAJD211223181714893.DID

“Fentanyl (425 mcg), Ketamine (200 mg), Versed (4 mg), and Demerol (50 mg).”

 

[Agast]

If I remember the original post on this, his wife is the "RN" administering the "conscious sedation." I believe she is an NP.

His career and financial situation are over. All for the almighty dollar.

https://www2.mbc.ca.gov/BreezePDL/document.aspx?path=%5cDIDOCS%5c20211223%5cDMRAAAJD2%5c&did=AAAJD211223181714893.DID

This is so sad, and hard to read through. Because you know there was a point where she could still have been saved.

 

[RemyMcswain]

Because it's so difficult to put the equivalent of a shoe insole behind fatty tissue. Get a real job.

I really couldn’t agree more. They are some of the worst surgeons. Across the board. Over paid narcissists

 

[Maz777]

Guess it wasn't his wife.

'Robotic' plastic surgeon saw other patients, told staff not to call 911 after mom's heart stopped: Warrant

Years after a plastic surgeon was charged with involuntary manslaughter in the death of a patient, California authorities have charged the doctor with second-degree murder.

lawandcrime.com

 

[nimbus]

Patients pay top dollar out of pocket and place their lives in the hands of these hucksters for these elective procedures.

Let me be clear, this is not to save cost per procedure for the patients. This is to pocket the difference and increase profit margins.

Plastic surgeons in general....in my limited experience seem to be overrepresented in the trouble group. Many of the ones I have heard of had lost their licenses for sleeping with patients, uploading idiotic and dangerous intraop acts to social media.

Plastic surgeons and pain doctors. Both are highly compensated specialties and both can run their own fiefdoms with zero oversight.

 

[sevo00]

“Fentanyl (425 mcg), Ketamine (200 mg), Versed (4 mg), and Demerol (50 mg).”

wow wtf. all in a office setting. deserves to rot in jail

 

[Vandalia]

The Arrest Warrant

Of Note:

"The records indicate Chacon charged Espinoza $2000.00 for anesthesia."

"She discussed anesthesia with Chacon. Chacon told Mrs. Espinoza that an anesthesiologist who had privileges with two different Sharp Hospital locations would be coming to Divino to provide the anesthesia."

 

[coffeebythelake]

“Fentanyl (425 mcg), Ketamine (200 mg), Versed (4 mg), and Demerol (50 mg).”

That is an insane dose

This is so sad, and hard to read through. Because you know there was a point where should could still have been saved.

I'm assuming this was a respiratory arrest but there seem to be some reports that thr patient might have developed a pneumothorax as a complication of the surgery.. the criminal complaint says pt had a tension pneumothorax... so he couldn't even recognize a known complication of the surgery he was performing.. wow.. this was a tragic and entirely preventable death

Just like with the Geoffrey Kim case, what turns this from malpractice to criminal negligent homicide is the complete indifference to the patient's emergency, refusing to call 911 and preventing his staff from calling 911. And when he finally called for help he lied about the patient's clinical situation. His selfish motives and obstruction sealed that woman's fate. And he should go to prison for it.

 

[Agast]

Plastic surgeons and pain doctors. Both are highly compensated specialties and both can run their own fiefdoms with zero oversight.

Pain makes about the same as regular anesthesia. It’s the ability to invest in things that gets you the extra. But your average W2 pain doctor is getting a lower starting offer than anesthesiology right now…

 

[coffeebythelake]

'Robotic' plastic surgeon saw other patients, told staff not to call 911 after mom's heart stopped: Warrant

Years after a plastic surgeon was charged with involuntary manslaughter in the death of a patient, California authorities have charged the doctor with second-degree murder.

www.google.com

South Bay Plastic Surgeon Pleads Not Guilty to Murder in Patient's Death

A South Bay plastic surgeon already facing criminal charges stemming from the death of a patient pleaded not guilty Monday to a newly filed murder charge.

timesofsandiego.com

He called several anesthesiologists unrelated to the case to ask for advice on what to do but also lied to them about the patient's clinical condition... he refused help from an anesthesiologist who offered to come in to assist him... he lied to the 911 operator... when EMS showed up and got the full story they were in complete disbelief..

 

[Vandalia]

That is an insane dose

I'm assuming this was a respiratory arrest but there seem to be some reports that thr patient might have developed a pneumothorax as a complication of the surgery.. the story isn't entirely clear but I agree this was a tragic and entirely preventable death

Just like with the Geoffrey Kim case, what turns this from malpractice to criminal negligent homicide is the complete indifference to the patient's emergency, refusing to call 911 and preventing his staff from calling 911. And when he finally called for help he lied about the patient's clinical situation. His selfish motives and obstruction sealed that woman's fate. And he should go to prison for it.

The job of a criminal defense attorney is to confuse the jury.

For a lot of medical stuff that works in criminal cases, but this one is real simple for the prosecution, and almost impossible for the defense:

You didn't call 911.
You didn't call 911.
You didn't call 911.

"Well maybe she had some weird pre-existing condition that wasn't detected for at autopsy ..."
You didn't call 911.

I am also willing to bet that they are going to get the nurse to flip, which is gilding the lilly, but still is going to make it even more difficult.

It also reminds me of the Chernobyl disaster.

The chief engineer on duty simply refused to accept that the reactor exploded. Even with expert eyewitnesses, alarms going off like crazy, a video feed, he still clung to the idea "it just can't happen" for hours.

 

[nimbus]

Pain makes about the same as regular anesthesia. It’s the ability to invest in things that gets you the extra. But your average W2 pain doctor is getting a lower starting offer than anesthesiology right now…

You’re probably right but they still have a greater than average tendency to get in trouble.

 

[chessknt]

You’re probably right but they still have a greater than average tendency to get in trouble.

The one in my area seems to do sham nerve blocks in the same location for every condition. Chest pain? Nerve block. Shortness of breath? Nerve block. Dying of cancer with mets in your spine? Nerve block nowhere near the location. It depresses me that the 5 minute nerve block bills the same as 1.75 hours of cc time. She charges 2k cash to give IV Ativan in the office too while doing the procedure which not ally only bills 0.6 wrvu for. At least she doesn't sell narcotic prescriptions like the other one in the area but still.

 

[nimbus]

The one in my area seems to do sham nerve blocks in the same location for every condition. Chest pain? Nerve block. Shortness of breath? Nerve block. Dying of cancer with mets in your spine? Nerve block nowhere near the location. It depresses me that the 5 minute nerve block bills the same as 1.75 hours of cc time. She charges 2k cash to give IV Ativan in the office too while doing the procedure which not ally only bills 0.6 wrvu for. At least she doesn't sell narcotic prescriptions like the other one in the area but still.

Most pain docs are upstanding citizens. Occasionally there are other specialists like oncologists or ophthalmologists who get in trouble for running scams and pushing boundaries but it’s notable how frequently it happens in pain.

Port Clinton Physician Sentenced to Prison for Prescribing Controlled Substances Without Medical Necessity and Health Care Fraud

Acting U.S. Attorney Michelle M. Baeppler announced that William Bauer, 85, of Port Clinton, Ohio, was sentenced today by U.S. District Judge Jack Zouhary to 5 years in prison and was ordered to pay $464,099.14 in restitution, of which $253,300.55 will be paid to Medicare and $210,798.59 to...

www.justice.gov

West Virginia Doctor Found Guilty of Unlawfully Distributing Opioids

A federal jury found a West Virginia doctor guilty today of unlawfully distributing opioids to his patients. The defendant was charged in a September 2019 indictment as part of the second Appalachian Regional Prescription Opioid (ARPO) Strike Force Takedown, a coordinated effort by the Justice...

www.justice.gov

Doctor Arrested and Charged with Providing Prescriptions for Opioids and Other Scheduled Pharmaceutical Drugs to Patients in Exchange for Sex Acts

www.justice.gov

Doctor and Office Manager Indicted in Scheme to Defraud Medicare, Manufacture and Distribute Fentanyl

Dr. David J. Smith, a pain management physician, and his office manager, Julia Ann Oertle, are charged in a federal grand-jury indictment with perpetuating a long-running scheme to commit healthcare fraud and to manufacture and distribute adulterated fentanyl.

www.justice.gov

San Diego Doctor Pays $200,000 to Resolve Allegations that He Wrote Illegitimate Opioid Prescriptions

www.dea.gov

Poway Doctor Who Sexually Assaulted Patients Under Anesthesia Sentenced to Prison

An anesthesiologist who operated a pain management clinic in Escondido was sentenced Thursday to 17 years in state prison for his guilty plea to sexually assaulting patients while they were under anesthesia.

www.nbcsandiego.com

Doctor Sentenced for Role in Illegally Distributing 6.6 Million Opioid Pills and Submitting $250 Million in False Billings

A Michigan doctor was sentenced today to 16.5 years in prison for his role in a health care fraud scheme that resulted in over $250 million in false and fraudulent claims being submitted to Medicare, Medicaid, and other health insurance programs, exploited patients suffering from addiction by...

www.justice.gov

Manhattan Doctor Sentenced To More Than 17 Years In Prison For Bribery And Kickback Scheme, And For Distributing Oxycodone And Fentanyl For No Legitimate Medical Purpose

www.justice.gov

 

[deleted875186]

So many things wrong.

MA injecting local. MA pushing sedation drugs. Standing order of anesthesia drugs and no specific order by surgeon for RN to go by. Nobody can intubate. No end tidal or cardiac rhythm strip. Unrecognized pneumo. Bag mask for three hours. Didn’t call 911 the whole time. Called two anesthesiologists but ignored their advice. Lied to the patient about credentials.

Definitely meets criminal criteria.

 

[deleted875186]

The warrant further alleged that Carla Hernandez, the surgical technician who “admitted she had personally injected Espinoza with anesthetics,” pursued a business major for two years but did not graduate.

“Hernandez holds no certifications related to being a medical assistant,” the warrant said.

“Hernandez first knew that something had gone wrong during Espinoza’s surgery when the first implant was in,” the warrant continued. “At that time, Espinoza’s color began changing and the surgical monitor began making some sort of beeping sound.”


Sounds like pneumo from surgical complication was the real issue, made worse by the deep sedation, and failure to rescue. If they simply called 911 this is a malpractice case, and patient is probably still alive.

 

[nimbus]

The warrant further alleged that Carla Hernandez, the surgical technician who “admitted she had personally injected Espinoza with anesthetics,” pursued a business major for two years but did not graduate.

“Hernandez holds no certifications related to being a medical assistant,” the warrant said.

“Hernandez first knew that something had gone wrong during Espinoza’s surgery when the first implant was in,” the warrant continued. “At that time, Espinoza’s color began changing and the surgical monitor began making some sort of beeping sound.”


Sounds like pneumo from surgical complication was the real issue, made worse by the deep sedation, and failure to rescue. If they simply called 911 this is a malpractice case, and patient is probably still alive.

Pneumo could have been caused by local injection. Not sure if you meant that was the surgical complication.

 

[chessknt]

Pneumo could have been caused by local injection. Not if you meant that was the surgical complication.

You have to poke a big ****ing hole on somebody's lung to cause a tension pneumo or there needs to be underlying lung disease. A single poke from a 20g needle really shouldn't do that.

 

[nimbus]

You have to poke a big ****ing hole on somebody's lung to cause a tension pneumo or there needs to be underlying lung disease. A single poke from a 20g needle really shouldn't do that.

If a poorly trained MA is injecting the local, there could have been multiple punctures of the visceral pleura so it may have been more than a single stick.

Not saying it’s common but tension pneumo can be caused by a needlestick. She was also given PPV for a couple hours which increases the risk of a small pneumothorax becoming a tension pneumothorax.

https://cdn.mdedge.com/files/s3fs-public/issues/articles/ajo04410e407.pdf

Pneumothorax following ultrasound guided supraclavicular brachial plexus block

www.ncbi.nlm.nih.gov

https://www.ijca.in/journal-article-file/763

 

[coffeebythelake]

You have to poke a big ****ing hole on somebody's lung to cause a tension pneumo or there needs to be underlying lung disease. A single poke from a 20g needle really shouldn't do that.

Who said a single poke?

 

[coffeebythelake]

The Arrest Warrant

Of Note:

"The records indicate Chacon charged Espinoza $2000.00 for anesthesia."

"She discussed anesthesia with Chacon. Chacon told Mrs. Espinoza that an anesthesiologist who had privileges with two different Sharp Hospital locations would be coming to Divino to provide the anesthesia."

For $2000 this woman could have had an anesthesiologist and still some profit to thr plastic surgeon. And the patient would almost certainly be alive. But he wanted it all and it didn't matter the patient got shady substandard care because he probably got away with it plenty of times before. Chacon is a greedy son of a bitch.

 

[deleted875186]

For $2000 this woman could have had an anesthesiologist and still some profit to thr plastic surgeon. And the patient would almost certainly be alive. But he wanted it all and it didn't matter the patient got shady substandard care because he probably got away with it plenty of times before. Chacon is a greedy son of a bitch.

Precisely. Sounds like the surgeons done this a thousand times, and this was the one in a thousand chance of a pneumo happening. In fact, as ridiculous as the sedation regimen sounds, patient would have probably been fine if not for the pneumo.

 

[sloh]

Most pain docs are upstanding citizens. Occasionally there are other specialists like oncologists or ophthalmologists who get in trouble for running scams and pushing boundaries but it’s notable how frequently it happens in pain.

Port Clinton Physician Sentenced to Prison for Prescribing Controlled Substances Without Medical Necessity and Health Care Fraud

Acting U.S. Attorney Michelle M. Baeppler announced that William Bauer, 85, of Port Clinton, Ohio, was sentenced today by U.S. District Judge Jack Zouhary to 5 years in prison and was ordered to pay $464,099.14 in restitution, of which $253,300.55 will be paid to Medicare and $210,798.59 to...

www.justice.gov

West Virginia Doctor Found Guilty of Unlawfully Distributing Opioids

A federal jury found a West Virginia doctor guilty today of unlawfully distributing opioids to his patients. The defendant was charged in a September 2019 indictment as part of the second Appalachian Regional Prescription Opioid (ARPO) Strike Force Takedown, a coordinated effort by the Justice...

www.justice.gov

Doctor Arrested and Charged with Providing Prescriptions for Opioids and Other Scheduled Pharmaceutical Drugs to Patients in Exchange for Sex Acts

www.justice.gov

Doctor and Office Manager Indicted in Scheme to Defraud Medicare, Manufacture and Distribute Fentanyl

Dr. David J. Smith, a pain management physician, and his office manager, Julia Ann Oertle, are charged in a federal grand-jury indictment with perpetuating a long-running scheme to commit healthcare fraud and to manufacture and distribute adulterated fentanyl.

www.justice.gov

San Diego Doctor Pays $200,000 to Resolve Allegations that He Wrote Illegitimate Opioid Prescriptions

www.dea.gov

Poway Doctor Who Sexually Assaulted Patients Under Anesthesia Sentenced to Prison

An anesthesiologist who operated a pain management clinic in Escondido was sentenced Thursday to 17 years in state prison for his guilty plea to sexually assaulting patients while they were under anesthesia.

www.nbcsandiego.com

Doctor Sentenced for Role in Illegally Distributing 6.6 Million Opioid Pills and Submitting $250 Million in False Billings

A Michigan doctor was sentenced today to 16.5 years in prison for his role in a health care fraud scheme that resulted in over $250 million in false and fraudulent claims being submitted to Medicare, Medicaid, and other health insurance programs, exploited patients suffering from addiction by...

www.justice.gov

Manhattan Doctor Sentenced To More Than 17 Years In Prison For Bribery And Kickback Scheme, And For Distributing Oxycodone And Fentanyl For No Legitimate Medical Purpose

www.justice.gov

Wow. Those were...quite a read.

 

[secretasianman]

Damn. Met one back when I was in med school..

 

[teacher2md]

Fla. Plastic Surgeon Allegedly Killed Lawyer Representing Former Co-Workers He Was Suing

Dr. Tomasz Kosowski, 44, was arrested on a first-degree murder charge in connection with the disappearance of attorney Steven Cozzi

people.com

Another upstanding citizen!

 

[Dr. Rude]

Fla. Plastic Surgeon Allegedly Killed Lawyer Representing Former Co-Workers He Was Suing

Dr. Tomasz Kosowski, 44, was arrested on a first-degree murder charge in connection with the disappearance of attorney Steven Cozzi

people.com

Another upstanding citizen!

Possible defense: It could be viewed as merely an extension of the adversarial process.

 

[Helpful Troll]

Granted it's The Beast but this is a more detailed description of the crime. Kosowski is still licensed in Florida though I guess it's not relevant if he doesn't get released pre-trial. Was Kosowski ever Board Eligible in Plastic Surgery? Looks like he was a GS resident at Dartmouth?

 

[IMGASMD]

Granted it's The Beast but this is a more detailed description of the crime. Kosowski is still licensed in Florida though I guess it's not relevant if he doesn't get released pre-trial. Was Kosowski ever Board Eligible in Plastic Surgery? Looks like he was a GS resident at Dartmouth?

His eligibility ended in 2019….?

 

[DrOwnage]

I'm confused how they're doing breast augs under MAC in the first place

 

[Maz777]

At the dosages of midaz/ketamine/fentanyl/meperidine being given, calling these MACs is quite the stretch.

 

[Hoya11]

At the dosages of midaz/ketamine/fentanyl/meperidine being given, calling these MACs is quite the stretch.

and i bet a nasal cannula

 

[IMGASMD]

and i bet a nasal cannula

I can do it under room air. Since everyone is getting better at giving MAC than anesthesiologists…. I want to be the best, by doing the stupidest thing….

No one would ever stop breathing with that doses of narc, especially administered by a untrained nurse/MA.

/s

 

[IlDestriero]

At the dosages of midaz/ketamine/fentanyl/meperidine being given, calling these MACs is quite the stretch.

If they’re breathing on their own it’s a MAC, right?
Conscious sedation really.
Breathing is part of being conscious, so definitely!

 

[coffeebythelake]

I can do it under room air. Since everyone is getting better at giving MAC than anesthesiologists…. I want to be the best, by doing the stupidest thing….

No one would ever stop breathing with that doses of narc, especially administered by a untrained nurse/MA.

/s

Clearly this plastic surgeon should have done the case with a dentist since they are the experts in sedation cases and have a 1 in a million risk of bad outcomes (words spoken by SDN dentists).

 

[caligas]

If I remember the original post on this, his wife is the "RN" administering the "conscious sedation." I believe she is an NP.

His career and financial situation are over. All for the almighty dollar.

https://www2.mbc.ca.gov/BreezePDL/document.aspx?path=%5cDIDOCS%5c20211223%5cDMRAAAJD2%5c&did=AAAJD211223181714893.DID

How did you find the court document?

 

[Maz777]

If they’re breathing on their own it’s a MAC, right?
Conscious sedation really.
Breathing is part of being conscious, so definitely!

For sure. My LMA patients that breathe spontaneously are under MAC attacks.

 

[Maz777]

How did you find the court document?

All medical board complaints/decisions are publicly posted. This isn't the court documents. Those aren't frequently available.

 

[Test Boy]

This guy is not even board certified in his own specialty.

 

[coffeebythelake]

New Accusations Against Bonita Surgeon Facing Murder Charge in Death of Patient

Karina Jones couldn’t wait for her “mommy makeover.” The Chula Vista mother had just lost over 100 pounds and wanted to get rid of excess skin as well as have a tummy tuck, breast augmentation and liposuction.

www.nbcsandiego.com

Chacon was continuing with plastic surgery after the patient death... apparently with an anesthesiologist present. Can't imagine why anyone would want to work with Chacon.. the money must have been very good... patient had a stroke.