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FL Cosmetic Surgery Death- No CRNA or MD present???

Discussion in 'Anesthesiology' started by nradsoit3, Apr 17, 2004.

  1. nradsoit3

    nradsoit3 Senior Member
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    I don't know if anybody caught this story on 20/20 last night but I was interested in what others thought of this tragedy where a Florida woman went into cardiac arrest during a breast augmentation. Here is a link to the episode: http://more.abcnews.go.com/sections/2020/Living/2020_plastic_surgery_040415.html

    Is it legal to perform such cosmetic procedures without someone trained in the practice of anesthesia to monitor the patient? It appears that this was the routine in this doctor's practice when the assistant stated, " "at the beginning of the procedures, many times, I witnessed patients that would stop breathing." In the above article, Dr. Rod Rohrich, president of the American Society of Plastic Surgeons warns patients that "If you're not going to a hospital, be sure someone trained in anesthesiology is present, that the surgeon has privileges at a nearby hospital and that the operating room meets state regulations, with emergency equipment in case of a crisis." Ok, I am a little confused by this- I mean, i would think that all these things would be mandated by the state to protect the public. If I was going UNDER i would sure as heck want an anesthetist to make sure i didn't flatline.

    And what is a dentist/oral surgeon doing breast augmentations in the first place!!!
     
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  3. DireWolf

    DireWolf The Pride of Cucamonga
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    I think that any licensed physician can legally perform any procedure. But I am probably wrong.

    The catch is: good luck finding malpractice coverage, and good luck getting any insurance company to reimburse you for something you are not certified in.

    Since cosmetic procedures are usually not covered by insurance anyway, physicians can do them and collect payment directly from the patient. It's a shame that some patients don't take the time to research their physicians and realize they have no business doing these procedures.
     
  4. MechE

    MechE Med School's Slave
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    I was wondering the exact same thing when I saw the program. I think the women knew he was a licensed doctor, but didn?t know he wasn?t licensed in plastic surgery.

    Whenever doing all major surgeries your supposed to have someone licensed in anesthesia, either an anesthesiologist or a nurse anesthetist, around for the entire procedure to give the drugs and keep them alive. The surgeon should not be the one to do this since they don?t have training in anesthesiology.
     
  5. aphistis

    Moderator Emeritus 10+ Year Member

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    Incorrect. Oral surgeons receive anesthesiology training as part of their residency. Remember, these folks do a lot of outpatient surgery in addition to the inpatient stuff, and they receive this training to allow them to provide care without keeping a full-time anesthesiologist on staff. This helps reduce cost for patients, and if you'll check the statistics, it's an effective system.

    Having said that, if you're going to be in the OR doing an involved procedure, obviously the standard of care is to make sure you have all the help you need to get the job done safely. For complex outpatient procedures, dental anesthetists are commonly brought in, and in the hospital it'd be the DA or MDA, depending on the surgeon's preference.
     
  6. Fermata

    Fermata Hold me.
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    Maybe not too complex, but there was a DA present when I had my wisdom teeth yanked out.
     
  7. Tenesma

    Tenesma Senior Member
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    aphistis: while a dentist can do basic anesthesia he is not an anesthesiologist... and if a dentist wants to do "breast augmentation" (like the case cited) then he needs a surgeon and an anesthesia provider in the room.... or else it is just plain stupid and malpractice
     
  8. aphistis

    Moderator Emeritus 10+ Year Member

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    I didn't say "dentist," I said "oral surgeon." I'm not defending an OMS' decision to perform breast augmentations; that's way outside his scope of practice. Nor am I in any position to know at what point an OMS needs to bring in an outside anesthesiologist. But as I mentioned in my previous post that has bought me a solid 35 bad karma (and counting), they receive anesthesiology training as part of their residency. Afterward, many of them handle, perfectly legally and ethically, their own anesthesia.
     
  9. doc3341

    doc3341 Senior Member
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    :eek: WOW!!! What part of florida did this happen in??
     
  10. MacGyver

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    This is outrageous. OMFS docs should not be permitted to do breast augmentations, just as urologists should not be permitted to do open-heart surgeries.

    I cant believe people can get away with such blatant out of scope practice. Where is the state medical board? Why dont they crack down on this joker?

    This fool gives a bad name to all of us, and it hurts our efforts for tort reform when jackasses like this guy get a free pass to do whatever he wants.
     
  11. Intubater_X

    Intubater_X Membership Revoked
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    I concur with MacGyver..........How ridiculous!
     

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