By Fred Schulte, South Florida Sun-Sentinel Knight Ridder/Tribune Business News
Aug. 21--State health officials are investigating why three people died in a little more than a month after cosmetic surgery, a first step toward possibly tightening oversight of office surgery statewide.
'The Department of Health is doing a full and thorough investigation. We don't have all the facts. We need to try and find out what happened,' Dr. Zachariah P. Zachariah, chairman of the Florida Board of Medicine, said Tuesday.
Zachariah said investigators will interview the doctors and nurses involved in caring for the patients, whose deaths were reported Tuesday by the South Florida Sun-Sentinel. He said the review process could take several weeks or longer to complete, with an eye toward determining whether further quality standards need to be imposed to protect patients.
'We need to know where else to make changes in the regulations,' he said.
The medical board in the past two years has written some of the nation's toughest office surgery standards, including requiring offices to become accredited, limiting the length of cosmetic procedures and ordering that some patients at high risk of health complications be operated on in hospitals.
But the regulations haven't prevented deaths. Ralph DiGiovanni, 70, of Boynton Beach, a prominent Palm Beach County developer, died Aug. 7. He had surgery in the Boynton Beach office of Dr. Mark D. Schreiber, a Boynton Beach plastic surgeon who the state disciplined in 1998 after a patient of his died after lengthy office-based cosmetic surgery.
DiGiovanni collapsed outside his home about 10 a.m. Aug. 7, two days after having a five-hour neck lift, hernia repair and some other stomach surgery. He was on his way to see Schreiber for a follow-up appointment and was accompanied by a nurse from Schreiber's office when he was stricken, according to state records. The nurse called paramedics, who arrived within five minutes, but DiGiovanni was dead on arrival at Bethesda Memorial Hospital, according to the records.
Another death occurred in Naples on July 2, when Maria Delaney, 67, died after anesthesia complications at the start of a face lift, according to medical examiner files and other records obtained by the newspaper.
The third person to die was Olga Myers, 42, a Hollywood real estate agent who remained in a coma for several days after a face lift on July 29. She died less than a week later.
Dr. Alton Ingram, the plastic surgeon who operated on Myers at the Cosmetic Surgery Center at 3109 Stirling Road in Hollywood on July 29, has not yet reported her death to the Department of Health as required, officials said.
Under state law, doctors must report all deaths and serious injures to the state within 15 days along with steps they plan to take to correct any problems that might have contributed to the incident.
Ingram has not commented publicly on the case.
Zachariah, the medical board chairman, said doctors who fail to report office mishaps as required will face 'serious consequences and very serious punishment.'
The case files and autopsy reports will be reviewed by medical quality investigators with the state Department of Health, reporting to their department head, Dr. John Agwunobi.
If the investigation finds that a doctor seriously violated rules, Agwunobi has the power to order an immediate suspension of that doctor's medical license.
State officials have struggled to oversee office surgery since 1998, when the Sun-Sentinel first linked scores of deaths and disfiguring injuries to beauty-enhancing procedures. The newspaper has documented 28 deaths since January 1997, most of them in medical offices. Most who died had what appeared to be routine surgery such as liposuction, tummy tucks, in which loose fat is cut around the stomach area, and face lifts.
While accurate figures are hard to come by, as many as 77,000 cosmetic procedures are thought to be performed in the state annually.
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(c) 2002, South Florida Sun-Sentinel. Distributed by Knight Ridder/Tribune Business News.
