Personal Injury Law

A Face-Lift For Cosmetic Procedures

By Jane Akre

Donda West, mother of rapper Kanye West, died six months ago following plastic surgery.

Now her death is influencing legislation among California lawmakers that could make the procedures safer for others.

Legislation has been introduced that pushes for increased oversight of doctors performing cosmetic procedures in an outpatient setting.

West had liposuction and breast implant surgery in an outpatient facility performed by Dr. Jan Adams. Hours later recovering at home, she had complications and died.

A coroner report found that clogged arteries and heart disease were a factor in her death, not any surgical errors.

Another doctor whom West had previously consulted, declined to operate saying she had risk factors for a heart attack.  

Assembly Bill 2968, requires patients to receive a physical exam before undergoing cosmetic surgery.   Donda West did not have a physical exam by surgeon Jan Adams, says her niece.

Increasingly common are the use of outpatient facilities that are not as strictly reviewed as a hospital.

Senate Bill 1454 would require outpatient facilities, such as the one in which West had her surgery, to undergo inspections every three years. Currently there are no inspection requirements in California.

"These [clinics] are not hospitals. You have to raise the standards," said state Sen. Mark Ridley-Thomas (D-Los Angeles) tells the Los Angeles Times.

Florida tightened some regulations in 2006.   

The "Truth in Medical Education" law required cosmetic surgeons to disclose their background, education and specialty training before treating patients. Increased oversight of non-hospital settings increased after a dozen people died in clinics in 1998.

Outpatient clinics are less likely to have life saving drugs such as the antidote, dantrolene, that may have saved 18-year-old Stephanie Kuleba, who died in March from a rare genetic disorder causing an allergic reaction to anesthesia known as malignant hyperthermia (MH).

During more than five hours of surgery, West had part of her right breast removed and both breasts enlarged. She had abdominal muscles tightened and liposuction.

She went home to recover but was not hooked up to any monitoring equipment.

Experts say that should have been required given her history.

And SB 1454 would disallow the "before" and "after" pictures that often promise startling results after plastic surgery. 

The vice president of the American Society of Plastic Surgeons, Dr. Michael F. McGuire tells the Los Angeles Times, "There's no way to control surgical judgment."

McGuire says he backs a law similar to the one in Florida, but also favors only allowing board certified plastic surgeons to perform cosmetic procedures.

Dr. Jan Adams, who made many television appearances and was well known in Hollywood, was not board certified in plastic surgery.

Ontario, Canada doctors are increasing scrutiny after the death of a Toronto woman from liposuction.

Canadian doctors in British Columbia must be certified by the Royal College of Physicians and Surgeons of Canada to perform plastic surgery.

The California Medical Association opposes those restrictions citing that doctors must already be approval by an independent medical staff and insurers before than can perform surgery.

Still largely unregulated are medical spas that offer Botox injections, laser hair removal and photo facials. Lasers can burn and scar patients and currently in California there is no rule requiring a doctor be on the premises.

There were 11.7 million cosmetic procedures in the U.S. in 2007 up 50 percent from 2000.    # 

Full post as published by InjuryBoard on May 27, 2008 (boomark / email).