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Thanks to Sandra for sending us the following. . .Myrl


Cosmetic surgery clinic had other woes

BY DANIEL de VISE

ddevise@herald.com


Ronald Jones went in for an eyelid job so his new
glasses would fit better. Jeanette Mordica thought a
tummy tuck would succeed where diets had failed. Olga
Myers, a 42-year-old real estate agent, sought a
younger face.

All three died after treatments at the Cosmetic
Surgery Center in Hollywood.

The Stirling Road clinic and its director, Dr. Richard
Edison, loom large in South Florida's
ultra-competitive plastic surgery community, where
practitioners vie for business in full-page newspaper
ads, late-night television pitches and in-your-face
Internet sites.

Now, Edison and his practice are at the center of a
different sort of media blitz -- over Myers, who
lapsed into a coma and died after a July 29 facelift
at the center.

Edison has publicly distanced himself from that death
and has parted ways with Dr. Alton Ingram, the surgeon
who operated on Myers.

But Edison and the clinic have had other problems. The
Florida Board of Medicine reprimanded the doctor in
1995 for leaving a sponge inside a woman's breast. And
a 2000 lawsuit accused him of conducting a major
surgical procedure without the aid of either an
anesthesiologist or a nurse with anesthetic training.

Clinics such as Edison's, which attempt complicated
surgical procedures inside office buildings or strip
malls, are the subject of debate within the health
care industry -- largely because of the dangers
surrounding anesthesia.

SURGERY RULES

State regulations require that ''qualified anesthesia
personnel'' be on hand during any surgery requiring
deep sedation.

But language in the regulations gives doctors
considerable leeway in obeying that rule.

A doctor's report released Friday by state regulators
indicates that no anesthesiologist or trained nurse
anesthetist was present during Myers' surgery.

That scenario echoes allegations made by relatives of
Jones, a former railroad worker who stopped breathing
midway through a 1997 procedure while under heavy
sedation.

''The other day was his birthday, and it's just too
much,'' said his mother, Rose LaVallee. ``He was my
only child, and I came down to Florida to be with him.
And now my husband and I are here by ourselves.''

Asked last week to comment, Edison replied in writing:
``We will be in contact with you next week.''

Three deaths at a single clinic in a five-year span is
''unusual'' in an industry that prides itself on a
fatality rate of about one patient in 50,000, said Dr.
Ed Luce, president of the American Society of Plastic
Surgeons and chief of plastic surgery at University
Hospital of Cleveland.

But blame is hard to assign. Each of the deaths at the
Stirling Road clinic involved a different doctor. In
one case, a jury concluded the doctor was not at
fault.

The clinic presents patient testimonials and
before-and-after photographs on its Web site, which
greets visitors with dancing words that dissolve into
an enormous pair of breasts.

TESTIMONIALS

Broward court records reveal a different list of
testimonials:

· Diane Grande collected $400,000 in 1992 after Edison
left a surgical sponge inside her breast.

''He actually insinuated that I put this sponge inside
of me,'' Grande said. ``He is an unbelievable human
being. He deserves to be crushed like a bug.''

The Florida Medical Board fined Edison $2,000 and
faulted the doctor for keeping count of surgical
sponges ``in his head.''

· Tina Marshall reaped a $297,500 malpractice
settlement in 1996 over complications caused,
according to her attorney, by breast implants too
large for her body.

''They really forced these implants into a space that
couldn't really accommodate them,'' attorney Maria
Luisa Rubio said. ``They were literally forcing her
body off the table, trying to squeeze these implants
in.''

Had the case gone to trial, Rubio said she would have
treated Edison ``much more as a businessman than as a
surgeon.''

''You see his Yellow Pages ads. He's on TV all the
time. When I see him, I can't help but smile. His
telephone number ends in F-A-C-E,'' Rubio said.

· Jeanette Mordica was ashamed to tell her husband she
was going for cosmetic surgery in March 1997, so she
said she was spending the night with some old sorority
pals. Mordica went into cardiac arrest the next
morning in a recovery room.

'I had just gone out to wash the car, and my daughter
rushed out to the garage and said, `You've got to get
to the hospital, something's happened to Mom,' '' said
Bernard Mordica, Jeanette's husband.

Mordica died of a blood clot in her lungs. A civil
jury found that Edison was not responsible for
Mordica's death, her husband said.

After a string of highly publicized deaths across
Florida in the late 1990s, state regulators ordered a
three-month moratorium on office surgery.

Lifting the ban in November 2000, the Florida Board of
Medicine enacted a new set of standards to govern
surgery performed in doctors' offices.

The new standards limit office surgeries to eight
hours, cap how much fat can be liposuctioned out in an
office setting and call for stricter monitoring of
anesthesia.

But state regulators have not policed plastic surgeons
effectively, experts say, and doctors have found ways
around the new regulations.

''If they were abiding by the rules, Myers would be
alive and the patient in Naples would be alive,'' said
one prominent South Florida doctor, who asked not to
be quoted by name.

``We've got a board that has this rule. They are not
enforcing it. Patients are continuing to die.''

The Naples patient, Maria Delaney, died July 2 after
anesthesia complications at the start of a facelift at
another facility.

RECENT DEATHS

Delaney's death was one of three recent fatalities at
separate Florida facilities that have reawakened
debate on the safety of cosmetic surgery.

New safety regulations divide surgical procedures into
three ''levels'' according to the depth of anesthesia.

The rules are strictest at Level 3, the deepest
sedation.

However, experts say some doctors get around the
tougher standards by treating a surgical procedure as
Level 2 when it ought to be carried out as a Level 3
procedure.

The result is ''a perilous state'' for the patient,
said Dr. Brian Boyd, chairman of plastic surgery at
the Cleveland Clinic in Weston.

Many plastic surgeons who operate outside hospitals do
not employ anesthesiologists, choosing instead to rely
upon specially trained nurse anesthetists.

Some surgeons forgo the trained nurses and essentially
supervise the anesthesia process themselves.

''I wouldn't like to be treated under those
conditions,'' Boyd said.

A lawsuit filed against Edison and the Cosmetic
Surgery Center by the family of Ronald Jones in 2000
includes a sworn affidavit from Dr. Joseph Boolbol of
Miami, an expert witness.

an anesthesiologist or a certified registered nurse
anesthetist'' during surgery.

Edison's response is not preserved in the court file,
and relatives say they are forbidden to discuss the
details because of a confidentiality agreement.

A newly released doctor's report on the August death
of Myers hints at possible similarities to the Jones
case.

In a three-page ''Adverse Incident Report'' to state
officials, Ingram lists two registered nurses on hand
for the surgery, neither one an anesthetist.

Ingram, contacted Thursday on his cellular phone,
stated: ``I'm not interested at all in speaking with
you, but thank you for the call.''

NOTE: A previous version of this story incorrectly
identified Dr. Richard Edison as Dr. Charles Edison.