The following article summarizes changes taking place in Florida to limit liposuction. Florida has called for inspection of offices where liposuction of greater than 1000 cc of effluent is taking place.
South Florida deaths spark bills to regulate fat removal
December 12, 2011|By Bob Lame Ndola, Sun Sentinel
The deaths of four South Florida mothers in their 30s during liposuction procedures helped spark legislation to make the beauty procedure safer, officials said Monday.
A bill advancing in Tallahassee would force most liposuctions to be done in surgery offices inspected by the state and by doctors with life-support training, rather than in unregulated physician offices. That may push up liposuction prices by low-cost cosmetic surgeons at unregulated offices, some doctors say:
“The way liposuction is being done at some of these surgery offices is simply not safe,” said Dr. Russell Sassani, owner of the licensed outpatient surgery center Take Shape, in Plantation. “Making these places get certified and inspected … is a great idea.”
The bill last week cleared the Senate Health Regulation Committee and now goes to the Senate Budget Committee, where it is expected to pass. Statewide physician groups support it, and so far, no opponents have come out against it. A similar bill is pending in the state House.
If prices go up slightly at lower-cost cosmetic surgery operations, that’s a small price to pay to reduce the risk of complications and deaths, said state Sen. Eleanor Sobel, D-Hollywood, sponsor of the bill.
“It’s paying a little more versus living to talk about it,” Sobel said.
She filed the bill in reaction to four South Florida liposuction deaths since 2009, which are among 14 deaths of liposuction patients documented in the past decade.
In June, Davie mother Maria Shortall, 38, died when her bloodstream was blocked by fat sucked from her midsection and reinjected into her buttocks at an unregulated Weston physician office, autopsy results showed.
Autopsies also found that a Miami mother of six, Kellee Lee-Howard, 32, died of drug interactions in the hours after a liposuction at the same Weston office, and Davie nurse and mother Rohie Kah-Orukotan, 37, died of an overdose of lidocaine given during liposuction at an unregulated Weston medical spa.
Disciplinary action is pending against the doctor involved in the Shortall and Lee-Howard cases; the doctor in the Kah-Orukotan case surrendered his medical license.
Also, an autopsy found a fat blockage killed a Miami mother after liposuction at a licensed surgery center in December 2010. No disciplinary action has been taken.
The bill would tighten a loophole that allows doctors to perform extensive liposuction in their offices, which often are unregulated and uninspected.
Present state rules say physician surgery offices must be inspected by the state Department of Health or accrediting organizations, unless the doctor performs procedures using only local sedatives that leave the patient awake.
Cosmetic surgeons who perform liposuctions using local sedatives such as lidocaine do not have to have their offices inspected.
The bill says that any liposuction that removes more than 1 liter of fat — about two pounds’ worth — can only be done in a regulated office. Doctors said the bill would cover most liposuctions.
In regulated surgery offices, doctors must have basic life-support training and certain life-saving equipment, both of which have been absent in some of the fatal cases. Doctors may pass on the cost of complying with the rules.
“It won’t be expensive for the state to regulate these offices, and hopefully it will save a few lives,” said Christopher Nuland, general counsel for the Florida Society of Plastic Surgeons, which backs the bill.
Also, Nuland said his group hopes the inspections will detect doctors who may be using local sedatives, such as lidocaine, for extensive liposuctions that should warrant stronger sedatives and more safety measures. Those measures include advanced life-saving training and having an assistant give anesthesia.
“That’s dangerous. Lidocaine in higher doses can be toxic,” said Dr. Lawrence Gorfine, a Lake Worth anesthesiologist advising Sobel on the bill.
The new legislation does not go as far as some doctors have suggested. It does not ban liposuction in physician surgery offices, as some proposed. It does not force med-spas to be regulated, as Sobel proposed in bills that failed in the past. It does not force doctors to use an anesthetist for all liposuctions.
Tallahassee reporter Kathleen Haughney contributed to this report.