Cosmetic Surgery Turns to Tragedy in Florida and Colorado
DEVASTATING OUTCOMES Osakatukei Omulepu, MD, (left) and Carlos Hernandez Fernandez both offered cosmetic surgery to trusting patients.

One is a licensed physician in Florida; the other is a surgical assistant who pretended to be a licensed physician in Colorado. Both offered cosmetic surgery to trusting patients who would experience devastating outcomes.

In Florida last week, a 30-year-old mother of 6 and a patient of Osakatukei Omulepu, MD, stopped breathing during an unidentified procedure at the Seduction Cosmetic Center in Doral, and later died in the emergency room of a nearby hospital. Dr. Omulepu, who specializes in liposuction and "butt lifts," had that same day been given a reprieve by an appeals court that denied an order to revoke his medical license.

The order had followed an April decision by an administrative law judge who found Dr. Omulepu guilty of 6 of 9 counts alleging standard-of-care violations and inadequate documentation of medical records. Four of his patients had complained that they were injured during procedures in 2015, and one of the 4 spent 28 days in a coma.

Meanwhile, in Colorado last week, Carlos Hernandez Fernandez, a surgical assistant who falsely claimed to have physician privileges at 2 Denver hospitals, was sentenced to 6 years in prison followed by 6 years of probation. As part of a plea bargain, Mr. Hernandez pleaded guilty to assault, criminal impersonation and unauthorized practice of physician.

He had posed as a plastic surgeon and run his own cosmetic surgery clinic, where he performed face lifts, tummy tucks and other procedures with local anesthesia or no anesthesia. He initially faced 126 charges, including sexual assault and child abuse, but he agreed to pay roughly $175,000 in restitution to his dozens of victims, and prosecutors dropped the remaining counts.

Many of his patients were immigrants. At his sentencing, one described what she felt while having a nose job done by Mr. Hernandez. "I could feel when he was cutting it open," she said. "I was totally bruised, my nose completely dropped, I had no more cartilage, and my septum was completely crooked." Mr. Fernandez apologized to his victims in court, saying, "It was never my intention to do anything malicious."

Meanwhile, in Florida, Dr. Omulepu's lawyer issued a statement after the death of his patient, saying that his client was "absolutely devastated by the complication that occurred in this case" and that it was "the first patient death he has had."

The patient had traveled from Illinois for the procedure. "Although what happened has been widely documented as a complication of the procedure the patient underwent," the statement continues, "it is not a situation any surgeon wants to have, nor does it make this any easier for the patient's family or for him."

After the incident, a sign appeared on the door of the Seduction Cosmetic Center, saying that it had temporarily been shut down because the City Manager found "emergency conditions" that could be a "serious danger" to public health.

Jim Burger

ASCA Wants to Be Your eBay
BOUGHT AND SOLD The online marketplace pairs sellers of gently used equipment, medications and other supplies with buyers looking to reap significant savings.

The Ambulatory Surgery Center Association announced yesterday the launch of an eBay-type service in which surgery centers can buy and sell excess inventory, supplies and equipment from each other.

The ASCA Asset Network is an online portal that provides a streamlined, vetted marketplace for new and refurbished equipment and ASC supplies, says ASCA.

"We thought members should have a specific place where they can go if they have spare inventory or if they're looking to buy products at reduced prices," says Steve Miller, CAE, ASCA's chief operating officer.

ASCA has partnered with Healthcare Asset Network (HAN) to launch the ASCA Asset Network. An algorithm determines the optimal negotiated price, "so there's no haggling between buyers and sellers. You just put in what you're looking for, and the site will match you with folks who are looking to sell," says Mr. Miller.

Android and iOS apps will let users quickly upload the surplus items they're ready to sell.

"When you get into some of the bigger equipment — a laser, for example — a service will certify the equipment to make sure it's in good operating shape," says Mr. Miller. "And if it's something with an expiration date, the platform will make sure that it's not expired or past its shelf life."

ASCA members pay no additional fee to join the ASCA Asset Network, according to Mr. Miller, and HAN and ASCA each receive "a very small portion" of the proceeds from each sale.

Bill Donahue

Study: Ketamine Didn't Decrease Delirium or Pain
REAL-WORLD RESULTS The findings measured the effectiveness of how anesthesia providers are currently practicing.

Anesthesia providers often administer ketamine during surgery to help manage post-op pain and prevent delirium, but a new study published in the journal The Lancet suggests the drug does neither in older patients.

A team of investigators from Washington University School of Medicine in St. Louis and the University of Michigan Medical School in Ann Arbor compared the outcomes of 672 surgical patients older than 60 years who received no ketamine, low-dose ketamine (0.5 mg/kg) or high dose ketamine (1.0 mg/kg) — doses typically used by anesthesia providers — after induction and before incisions were made.

"Unfortunately, we didn't find a decrease in delirium," says study lead author Michael Avidan, MBBCh, a professor of anesthesiology and surgery at Washington University. "Unexpectedly, we also didn't find a decrease in pain and opioid consumption."

Those were important findings, says Dr. Avidan, because there's been a recent uptick in ketamine use to prevent pain after surgery in a way that's safer than opioids. He says increasing the dose of ketamine might prove more effective, but he also cautioned that higher doses increased incidences of post-op hallucinations and nightmares among the study's patients.

Dr. Avidan believes more research is needed to explore the effectiveness of other opioid alternatives and suggests anesthesia providers should reconsider the common practice of administering low doses of ketamine during surgery.

Daniel Cook

InstaPoll: Which Best Describes Your Career Path?
Tell us in this week's InstaPoll.

Did you start your career in a hospital and then move to a freestanding surgical center? Or did you take the opposite route, starting off in an ASC and then moving to a hospital? Tell us in this week's InstaPoll.

Only 14% of the 319 respondents to last week's InstaPoll require the person(s) who accompanies the patient to your facility to sign the visitor log.

Do you make visitors sign in?

  • yes 14%
  • no 86%

Dan O'Connor

News & Notes
  • Opioid dependence in urology About 1 in 1,110 patients who undergo outpatient or inpatient urologic procedures such as kidney stone removal, hernia repairs and prostatectomies are likely to abuse opioids after surgery, according to a study published in the Journal of Urology. Risk factors for post-op opioid dependence or overdose included younger age, inpatient surgery, baseline depression, tobacco use and COPD.
  • Spinal fusion stimulators recalled Zimmer Biomet is recalling 2 of its implantable spinal fusion stimulators — the SpF PLUS-Mini and SpF XL IIb — because they were found to have higher-than-allowed levels of chemicals that can be toxic to tissues and organs. The company discovered the problem during routine monitoring.