Las Vegas Plastic Surgery
As a dedicated plastic surgeon in Las Vegas I strive to keep the public aware of the dangers involved with “discount” aesthetic and cosmetic surgery procedures being performed by unlicensed and untrained personnel in un-certified facilities. Unfortunately, injuries and deaths from these “budget” procedures continue to occur. Several years ago three patients died while having liposuction done by an Arizona doctor with no training in plastic surgery who was operating in an un-certified procedure room. Now that doctor is on trial for murder.
Las week the Arizona Republic reported that Dr. Peter Normann, 50, will be charged with two counts of second-degree murder for the deaths of Ralph Gonzalez, 33, of Scottsdale, AZ and Leslie Ann Ray, 53, of California, and one count of manslaughter for the death of Alicia Santizo Blanco, 41, of Gilbert, AZ.
Medical examiners announced that two of the victims died from an overdose of anesthesia while undergoing typical liposuction procedures and the third died of a fat embolism when her own fat was re-injected into her buttocks. All three of the patients were not properly intubated during resuscitation and it was impossible to save them.
Gonzalez stopped breathing during his second liposuction procedure in December 2006, and, according to Deputy County Attorney Jeannette Gallagher, was improperly intubated by Normann in his attempts to resuscitate the patient. In fact, Gallagher asserted, Normann literally tussled over the tube with the EMTs who responded to the scene. The cause of death was listed as a reaction to anesthesia, and the level of Lidocaine in his body was found to be a lethal dose.
Blanco, too, was a repeat patient on a second surgical visit in April 2007 to reposition a breast implant that Normann had put in earlier. She also was having liposuction and fat augmentation to her buttocks. She stopped breathing in reaction to anesthesia, though the cause of death was fat embolism. Once again, according to Gallagher, the patient had been improperly intubated by Normann, making it impossible to attempt to restore her breathing.
After the second death, Normann had restrictions placed on his practice by the Arizona Medical Board, so he contracted with Page, a homeopathic physician, to take over the plastic surgery. A homeopathic doctor is not a Medical Doctor (M.D.), nor an Osteopathic Doctor, (D.O.)
Ray came from California to have liposuction in July 2007, which was performed by Page. Later the same evening, she was found unresponsive in the recovery room. Normann performed CPR. The cause of death was an adverse reaction to anesthesia, and an examination revealed a tear in Ray’s trachea, again from failed intubation. Gary Page was charged with manslaughter in the Blanco death and is scheduled for trial in July.
Normann also employed medical assistants with little or no medical training
One of the medical assistants, a massage therapist named Jose Andres Lopez, pleaded guilty to eight counts of unlawful practice of medicine and was sentenced last year to a total of five years in prison.
Normann opened his clinic in Anthem, AZ in 2005, and at first offered Botox, hair restoration and laser procedures before moving on to liposuction and breast augmentation. Gallagher claimed that Normann did not study to be a specialist in plastic surgery.
A check with the American Board of Medical Specialties shows Norman to not be board certified in any specialty. The Arizona Board of Medical Examiners notes that Dr. Norman states that he completed a residency in Internal Medicine. He also lists Emergency Medicine and Dermatology as interest areas. His Arizona license has been revoked since 2007. He was Board Certified in Internal Medicine in 1997, but his certificate is currently suspended.
But Normann’s defense attorney, Vikki Liles, asserts that, “This should not be a criminal case.” She points out that the medical examiners had classified the deaths as accidents or natural deaths and not as homicides. She states that these were all known risks of surgery.
One can argue the legal issue of criminality of procedures gone horribly wrong. The point here is, again, patients had cosmetic surgical procedures done by individuals who are not trained as plastic surgeons.
The procedure room was not certified. The assistants had no medical background. The doctor brought in to do the procedures after the first doctor was restricted from doing these procedures was not even an M.D. or D.O. There was no anesthesiologist present.
Plastic surgery patients should demand that certain requirements are met before undergoing any procedure. This helps minimize the potential for untoward and sometimes lethal events. When this is not done the risk for disaster or severe personal injury increases greatly.
Unforeseen complications can occur during any medical procedure. Board certified plastic surgeons receive years of education and training and are regulated by strict guidelines to prevent unnecessary risk. Members of the American Society of Plastic Surgeons are board certified in plastic surgery. They must operate in certified surgery centers and adhere to a code of ethics.
Having any cosmetic or plastic surgery procedure done at an unlicensed and unregulated clinic usually involves a lack of appropriate personnel and equipment. Professionally trained and experienced plastic surgery practitioners can often identify patients who may have potential for problems. If the patient does have a complication, properly trained and equipped cosmetic and aesthetic health personnel can help to identify and resolve the issue.
This is why it is important to seek out a board certified plastic surgeon. They will evaluate your goals and come up with the appropriate plastic or cosmetic procedure that is as safe and effective as one can make it. Any potential financial cost saved is clearly not worth putting yourself at risk or compromising your personal health and safety.
Jeffrey J. Roth, M.D., F.A.C.S.