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Florida proposal to reform state's plastic surgery clinics advances  1 Week ago

Source:   USA Today  

NAPLES, Fla. – A lawmaker trying to rein in one of the state's most dangerous medical industries stood before her colleagues in the state capital Monday and recited the names of the dead.

Jasmine Smith from New Jersey. Heather Meadows from West Virginia. Kizzy London from Louisiana.

"These victims were coming from all over the country" for cosmetic surgery, said Republican state Sen. Anitere Flores, but "they will not be coming home."

The Miami legislator's speech to the Senate health committee about Florida's troubled plastic surgery centers led the members to approve a bill that could usher in the most sweeping changes to the industry in a generation.

The proposal, which will be heard in the House, follows an investigation by USA TODAY and the Naples Daily News in January that showed eight women died in the same plastic surgery business where doctors with little specialized training performed up to eight procedures a day.

The clinics also left women with devastating injuries, including perforated intestines, in facilities that ran like assembly lines.

Known as Jolie Plastic Surgery, the business is among more than a dozen centers that are owned by investors, offer discount prices and launch aggressive ad campaigns that target Hispanic and African-American women.

"We can give the Department of Health the tools to shut down the butcher shops," Flores said.

The plan, which would give the state for the first time the power to impose fines and suspensions and to strip the centers of their licenses, must pass through a host of committees that have been reluctant to impose regulation.

Not since the creation of the system for registering clinics in 2000 have Florida lawmakers moved this far forward to take on the businesses they blame for the deaths and injuries of dozens of women over the past decade.

Christopher Nuland, a health care lawyer who helped craft the first law in Florida governing the facilities, said the industry has become increasingly more dangerous because of the growth of high-volume clinics run by private investors.

Though the Department of Health had the authority to discipline the doctors who work in the clinics, it did not have the power to punish the investors or crack down on the clinics.

"And that’s where we have seen the problem. This bill fixes that loophole," he told the lawmakers Monday. "This bill will save lives."    

Some lawmakers said they were startled by the number of deaths in the centers and the national advertising campaigns waged by the clinics' social media blitzes to bring in more patients.

Despite the clinics' promotion of their staff doctors, USA TODAY found that of the 39 physicians hired by Jolie Plastic Surgery over the past eight years, 24 were not certified in plastic surgery.

“I think that what we need to look at with this bill are some of the real issues, which are the aggressive marketing tactics of these clinics,” said Sen. Janet Cruz, D-Tampa.

Though the Florida Medical Association and other groups support the bill, one organization said the legislation would unfairly diminish the role of nurse anesthetists in the surgery rooms.

Chris Lyon, a health care attorney for the Florida Association of Nurse Anesthetists, said the bill would add costs to consumers by requiring the certified registered nurse anesthetists (CRNAs) who provide the anesthesia to consult with anesthesiologists on each case, a process that's not required in any other state.

"We have mountains of data showing whether it's administered by a CRNA or an anesthesiologist, there is no difference" in the quality of care, Lyon said.

At the end of the hearing, Flores showed a video of a woman whose daughter died after what's known as a Brazilian butt lift, a popular procedure promoted by the clinics and the most dangerous in cosmetic surgery.

"Once at the hospital, I saw my daughter dead," said Arelys Gonzalez, who was born in Cuba.

Adianet Galvan, 30, a former nursing student, died from complications of the procedure at New Life Plastic Surgery in Miami after her doctor removed fat from one part of her body and injected it into the deep gluteal muscles, an area that physicians are warned to avoid, records and interviews show.   

One of the speakers who appeared before the panel was Michael Salzhauer, also known as Dr. Miami, a plastic surgeon with a wide social media following, who said the bill would fill a void in oversight.

Salzhauer said some private investors are known in the Miami area for pushing surgeons to perform procedures beyond safety practices. "This is an important bill," he said.

Since introducing her bill last month, Flores told the group, she has received an "outpouring from patients, doctors" and others "from across the country."

One former patient who was injured during a surgery at a Miami clinic in 2015 said the bill was important, but because of the deaths, "it's too little, too late."

"They should have done this six or seven deaths ago," said Nicola Mason, a Maryland mother who was left scarred "from hip to hip" after a botched procedure. "There's no accountability. They're flocking to a known tourist state, they're luring them with these low prices, and they're paying their lives."

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