Oct 13, 2011 7:52 PM
TUCSON - It's becoming increasingly common for doctors, not board-certified in plastic surgery, to perform cosmetic surgery procedures, from gynecologist doing liposuction to ER surgeons doing breast implants.
Last month in Phoenix, Dr. Peter Normann, an internist practicing as a plastic surgeon, was sentenced to 25 years in prison. Three of his patients died after suffering complications from botched procedures..
Dr. Gwen Maxwell, our plastic surgery contributor, stopped by the News 4 Tucson studios today to tell us what went wrong, and how we can keep this from happening to us.
Key Medical Shortcomings of in Dr. Normann's Cases
1. Practicing Outside of Scope
a. Dr. Normann was an ER Internist practicing outside his scope as a plastic surgeon and acting as an anesthesiologist in his own procedures. He was not trained or Board Certified, and did not do a residency in either Plastic Surgery or Anesthesia. The following fatal errors were a result of this:
i. Lethal doses of anesthesia in two of the cases
ii. Fat injected directly into a vein causing a fat embolism in one case.
2. Lack of Certified Medical Staff
a. According to prosecutors, a former massage therapist, a janitor, and Dr. Normann's mother were all used as assistants during surgeries. None of them are medically certified professionals.
3. Dr. and Staff Not Skilled in Intubation or Resuscitation Techniques
a. Dr. Normann did not know how to intubate his patients when they were in distress. He placed the breathing tube incorrectly in two of the three cases.
4. Surgical Facility Lacking Proper Equipment
a. The surgeries took place in Dr. Normann's office which was not equipped with the necessary life monitoring equipment.
Steps to Take When Selecting a Surgeon:
1. Remember there are risks with all surgeries, you can minimize risks by being proactive and selecting the most qualified surgeons and facilities possible.
2. Most importantly, make sure the surgeon is Board Certified by the American Board of Plastic Surgery not just "board certified". (The American Board of Cosmetic Surgery and the American Board of Facial Plastic and Reconstructive Surgery are not recognized by the AMA.)
3. Ensure the surgeon has a valid Arizona medical license.
4. Find out where the surgeon performs the procedures. Be wary if procedures can only be performed in the doctor's office.
5. Ask about the qualifications of the person giving anesthesia, and the surgical assistants. If anesthesia is given, a Board Certified Anesthesiologist or Nurse Anesthetists should be used. The assistants should be registered nurses and/or certified surgical assistants.
6. Ensure the surgical facility is accredited by the State and the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF).
7. Ask questions about the staff and surgeons' resuscitation skills/training and emergency protocols. Ideally, the surgeon should know how to place a breathing tube in the event of an emergency and there should be an emergency protocol in place.
8. Visit the American Society of Plastic Surgeons' website at www.asps.org for comprehensive information on choosing the best surgeon in your area.