By Lois W. Stern, Editor-at-Large, Makemeheal.com
A little over a year ago I wrote an article about the tragic death of Donda West, mother of the celebrity rapper, Kanye West, following plastic surgery. In the aftermath of Kanye’s rude mishap with Taylor Swift at the VMA Awards , I thought I would revisit his mom’s tragic story.
Why tragic? After doing some research on her case, I concluded that a significant factor in her death was due to poor medical judgment. Well, here we go again, some more bad news following plastic surgery. But this time, due diligence may avert the supreme tragedy of another life lost.
While investigating the Donda West tragedy, I had called both the ABPS (American Board of Plastic Surgery) and the ABMS (American Board of Medical Specialties) to inquire about the board certification of Donda West’s surgeon, Dr. Jan Adams. I learned two alarming facts. Dr. Jan Adams was not listed as a board certified plastic surgeon. Furthermore the only physician on record with the ABMS bearing the name Dr. Jan Thatcher Adams was board certified in Family Medicine – not plastic surgery.
I concluded that if Donda West had only made those phone calls prior to selecting her surgeon, she might have selected differently. She might even be with us today.
Donda’s autopsy results yielded no physical findings (such as a heart attack or blood clot) to explain why she went into cardiac arrest. According to Barry L. Friedberg M.D., a board certified, globally recognized leader in the field of office-based anesthesia, it was unlikely that either the length or extent of West’s surgeries caused her death. “More likely, it was the manner in which the surgery was performed; i.e. under general anesthesia which does not reliably produce pre-emptive analgesia and, therefore, often necessitates postop narcotics to manage pain. If West had sleep apnea as a pre-existing condition, even average doses of narcotics could easily prove fatal,” claims Dr. Barry Friedberg.
We will never know for sure what killed Donda West. But we do know that sound medical judgment comes only with quality training followed by lots of experience putting that training to practice.
On June 13th, 2009, the Hartford Courant ran a story about Dr. Efraim Gomez-Zapata, a name currently in the news for allegedly practicing plastic surgery without proper credentials. (According to the Hartford Courant, Dr. Efraim Gomez-Zapata is credentialed as a family practice physician, but because his name is not listed with the Connecticut State Medical Board, I was unable to verify this information.). His medical license has been suspended by this same board based on charges that he violated medical standards by performing plastic surgery without appropriate qualifications or standards to protect patient safety. The allegations of the Connecticut Department of Public Health against Dr. Efraim Gomez-Zapata include administering anesthesia and performing plastic surgery on patients without the proper license or qualifications and failing to keep proper records or have the appropriate staff, equipment, office setup and hospital privileges required in case of complications. In two patient cases cited where complications did occur, one woman had a seizure after Gomez-Zapata administered a combination of painkillers, anti-anxiety medication and a local anesthesia; while a second went into respiratory arrest after Gomez-Zapata gave her a spinal anesthesia.
What simple steps can the rest of us take to avoid fates similar to those of Donda West or the unfortunate patients treated by Dr. Gomez-Zapata? I like to think of the word TEE (short for Training, Experience and Expertise) as a handy acronym to help me remember how to investigate the credentials of any prospective surgeon.
TRAINING: Know that ANY board certified physician in any field of medicine can legally perform plastic surgery and call himself a cosmetic surgeon.
DO YOUR HOMEWORK. Be sure you have selected a surgeon board certified in the area that relates to your surgical needs or desires.
EXPERIENCE: You can check out the history of any prospective surgeon by calling the medical records department of the state where he practices. Visit http://www.floridamalpractice.com/linksotherstatebds.htm for the telephone number of the medical records department of the state where your surgery will take place.
I do not know how many cosmetic surgeries either Dr. Jan Adams or Dr. Efraim Gomez-Zapata has performed. But I do know that their surgical histories send up some immediate red flags. According to medical records from the state of California, in 2001 two malpractice lawsuits were filed against Adams, ending in payouts of close to half a million dollars. Prior to the Donda West tragedy, three new, unsettled medical malpractice lawsuits were pending against this same doctor. As for Dr. Gomez-Zapata’s record, we do know that one of his patients experienced seizures during surgery and a second went into respiratory arrest. These are enough red flags to alert us to quickly do an about face and walk away from either of these offices.
Another way to assess the adequacy of a surgeon’s experience is to inquire about the number of procedures of a particular type he performs each year and how long he has been performing them. Ask to speak with some of his patients and try to meet with them in person to assess the surgeon’s work.
EXPERTISE: Ask your surgeon where he has hospital privileges and place a phone call to that hospital to inquire if he has privileges to perform the exact procedures you are considering. This step is essential, even if your surgery is to take place in an outside surgical facility. Why? The chief of plastic surgery assesses the experience and skill of the surgeon before granting him privileges for any surgical procedure. Surgeons are often granted privileges for some procedures while having privileges for others withheld, based on their experience and expertise. If a surgeon skirts this issue or tells you it isn’t necessary for him to have hospital privileges since surgery will take place in an outside facility, turn around and walk!
It is important to learn how to separate the sound from the noise. Donda West’s surgeon, Dr. Jan Adams had appeared on numerous national TV shows, including Oprah, CNN, Entertainment Tonight, and Discovery Health, to name a few, as a plastic surgery ‘expert’. I congratulate his PR agent for doing a phenomenal job. But great hype does not a great surgeon make. Surgical expertise does not come from making TV appearances.
Statistically, cosmetic surgery procedures have a strong safety record, but you need to heed some cautions. In a study evaluating the safety of accredited office based surgical facilities, only 1 death occurred in 58,810 surgical procedures, but there is one important caveat to that study that should not be overlooked: All of these procedures were performed in office surgery facilities accredited by the AAAASF.
While in the process of writing my first book, I had the privilege of interviewing Dr. Keyes, the lead surgeon of the above study. He explained that each surgical facility accredited by the AAAASF mandates that a) the doctor be board certified in the medical specialty recommended for that procedure and b) that the doctor has been granted privileges to perform those same procedures in the hospitals with which he is affiliated. Again, remember to do your homework.
Here are just a few of the life saving questions you should ask before engaging a surgeon
Do you have hospital privileges to perform the procedures I am considering? If so, where?
What you should do next: Call the hospital(s) to inquire.
What is your board certification?
What you should do next: Contact the American Board of Medical Specialties (Internet: www.abms.org/ Phone:1-847-9091) Consider surgeons with board certification in: plastic surgery, ophthalmology, otolaryngology, dermatology. Here is where Experience and Expertise come into play.
Is the facility where your surgery will take place an accredited facility?
What you should do next: Ask by whom? You are in good hands if accredited by the AAAASF or AAAHC for ambulatory facilities or the JCAHO for hospital facilities.
Who will administer my anesthesia?
What you should do next: Find out if this person is a board certified anesthesiologist? Understand that the training of a board certified anesthesiologist is far more comprehensive than that of a nurse anesthetist. In determining the extent of your anesthesia needs, consider the extent of your surgery, your physical condition and age.
You need to consider the risks and rewards to your surgery. Here are some additional questions to ask your surgeon:
What are the risks to my surgical procedures?
Do you consider me a good candidate for the surgeries I am requesting?
Do I have any medical condition, health habits, etc. that we need to consider?
I am ever mindful of the words of Dr. Rohrich, former president of the ASAPS and a member of their Innovative Procedures Committee: Most women spend more time selecting a pair of shoes than selecting a plastic surgeon. You can take back your shoes, but you can’t take your face or your life back.
Lois is the author of Sex, Lies and Cosmetic Surgery and Tick Tock, Stop the Clock. She also has developed a special Support Tool DVD for Professional office use – a practical communication tool to help surgeons personalize their services while communicating with their patients. Check out Lois’s website at: www.sexliesandcosmeticsurgery.com.
Lois and Patty Kovacs are the co-founders of Coast2Coast – Eye on Beauty Newsletter.
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