California Lawmakers Seek Tighter Plastic Surgery Rules
Featured ArticleMain Category: Cosmetic Medicine / Plastic Surgery
Article Date: 27 May 2008 - 3:00 PST
Lawmakers in the state senate and assembly of California are pushing for tighter rules to govern plastic surgery after a 58-year-old woman died following breast reduction and other procedures last year.
Donda West died in November 2007 in a Los Angeles hospital, a day after having breast reduction, a tummy tuck and liposuction at an outpatient centre. Now Senator Mark Ridley-Thomas, Democrat, Los Angeles, and Assemblywoman Wilmer Amina Carter are each pushing for new legislation.
Ridley-Thomas, who chairs the senate Committee on Business, Professions and Economic Development, wants to introduce regular inspections of outpatient clinics that perform cosmetic surgery procedures.
His senate bill SB 1454, which is in its third reading, seeks to amend sections of the Business and Professions Code and the Health and Safety Code relating to healing arts so that cosmetic surgery centres are inspected at least every three years.
There are also proposals to tighten advertising, for instance banning pictures that create "unjustified expectations".
According to the Los Angeles Times, cosmetic surgery procedures are increasingly carried out in outpatient clinics, where "doctors can avoid the type of rigorous review they would expect at traditional hospitals".
Although there is a law that says such clinics have to be accredited, Ridley-Thomas said it's not enough. He told the LA Times yesterday, Monday, that:
"These [clinics] are not hospitals," adding that, "you have to raise the standards".
Assemblywoman Carter said West's niece, Yolanda Anderson, asked her to introduce a bill that would require every patient who undergoes cosmetic surgery to have a health check first. She is calling her bill the "Donda West Law".
Numbered AB 2968, Carter's bill also seeks changes to the Business and Professions Code, and so far it has passed one reading of the Senate.
The coroner's autopsy report said the exact cause of West's death was unknown, but heart disease and clogged coronary arteries were given as contributing factors. West was sent home five and half hours after the operation. The coroner did not cite any mistakes in the surgical procedures as contributing to her death.
The doctor who performed the surgery, Dr Jan Adams, has denied doing anything wrong, said a report by the Associated Press.
Anderson said her aunt did not receive a physical exam from Dr Adams before her surgery. A spokesman for Adams was reported by the LA Times to have said it was his understanding that West had been questioned thoroughly by Adams and the anesthesiologist before the surgery.
According to the paper, West had already been turned down by one doctor who said she was at risk of having a heart attack if she had cosmetic surgery.
California is not alone in pushing for tighter regulation of outpatient centres that do cosmetic surgery. Florida has a law that requires patients know more about the qualifications of the doctor who is proposing to carry out the surgery. And in Canada, the death of a Toronto woman prompted Ontario health officials to seek changes in the law governing such procedures.
Click here to go to the California State Legislature website for more information on the two bills (enter the bill number, SB 1454 or AB 2968 in the search box).
Sources: LA Times, Associated Press, California State Legislature.
Written by: Catharine Paddock, PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
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11 Feb. 2012. <http://www.medicalnewstoday.com/articles/108822.php>
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Cosmetic Surgery Anesthesia
posted by Barry L. Friedberg M.D. on 27 May 2008 at 10:35 amThe road to Hell is always paved with good intentions. One can most certainly empathsize with the niece of Donde West for her loss. However, AB 2968 will not make the slightest improvement in patient safety. Should all 18-25 year old otherwise healthy female patients be subjected to this unjustifiable expense? (No.) Would a physical exam revealed Donde West's pathology? (No.) Could any physician perform the physical exam? (What about a pathologist?)
Donde West did not die from 'clogged' coronary artery. Her autopsy revealed a 70% narrowing of her right coronary artery. There was NO clot inside the artery and there was no evidence of muscle damage downstream from her right coronary artery or anywhere else in her heart muscle. The autopsy was inconclusive as to the exact cause of death.
Blood analysis revealed 'normal' levels of narcotic for the doses prescribed for postop pain but this was likely to be too great for her system to tolerate.
The common denominator many of the Florida deaths (including Stephanie Kuleba), as well as Donde West's death, is the use of general (inhalation) anesthesia. In the West death it was the failure of general anesthesia to provide postoperative pain relief necessitating the use of opioids. In the Kuleba death it was the inadequate availability of Dantrolene as well as the paucity of people required to administer the antidote.
All of these deaths are avoidable by performing minimally invasive anesthesia (MIA).® More information available @ http://www.cosmeticsurgeryanesthesia.com - a patient oriented, non-commercial web site dedicated to improving patient safety through knowledge of a safer, simpler anesthetic.
MIA principles are also currently being utilized by the US military in the field hospitals in Iraq & Afghanistan. Surely, if this form of anesthesia is safe enough for wounded soldiers, it ought to be so for elective cosmetic surgery patients.
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