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L.A. Doc Charged in Patient's Death During Home-Clinic Surgery

Surgeon used local anesthesia to get around state law prohibiting operations performed outside hospital or surgery center.

Published: April 27, 2010

Prosecutors have charged Los Angeles surgeon Robert Bonilla, MD, with involuntary manslaughter nearly 2 years after a patient died during gallbladder surgery at the home clinic where Dr. Bonilla treats poor patients who can't afford care.

Dr. Bonilla had planned to perform a mini-cholecystectomy on Osvaldo Hernandez, a 30-year-old illegal immigrant, using local anesthesia to get around a California law that prohibits doctors from performing surgery under general anesthesia outside a hospital or accredited surgical center, according to a Los Angeles Times report. Mr. Hernandez went into cardiac arrest soon after Dr. Bonilla administered lidocaine and made the first incision. Dr. Bonilla tried to revive the patient himself and did not call 911; after 3 hours, he called a funeral home to pick up Mr. Hernandez's body.

Dr. Bonilla had 3 medical assistants present during Mr. Hernandez's procedure, but no anesthesia provider. "This was not an appropriate setting for major surgery," L.A. County prosecutor John Lonergan tells the Times. "When the patient went into cardiac arrest, he should have immediately gotten a higher level of care. A hospital was just a short distance away."

A coroner initially classified Mr. Hernandez's death an accident, but a few months later the state Medical Board suspended Dr. Bonilla's ability to perform surgery outside a hospital or surgical center. Soon after that, the Times reports that the state attorney general's office formally accused Dr. Bonilla of negligence for performing the surgery at a home clinic, not having an anesthesiologist present, using local anesthesia, administering excessive amounts of lidocaine and failing to call 911, among other charges.

After a re-examination, the coroner concluded that Dr. Bonilla had overdosed Mr. Hernandez with lidocaine and ruled the death a homicide.

Mike Khouri, attorney for Dr. Bonilla, says the surgeon did all he could to save Mr. Hernandez and did not administer an overdose of anesthesia. He argues that Mr. Hernandez had an allergic reaction to the lidocaine.

Dr. Bonilla could face trial in the fall, prosecutors say.

Irene Tsikitas

More breaking news.

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