http://www.sfgate.com/cgi-bin/article.cgi?file=/examiner/archive/1999... San Francisco Examiner Page A 1 Carmen Sandino who says she nearly lost her leg because of an infection after cosmetic surgery by a Bay Area physician, testifies at a hearing in San Francisco on Wednesday before a Senate committee. Examiner photo by Dan Krauss Dr. Robert del Junco, a crusader for reform, tells the committee that physicians are stepping outside their specialties to perform lucerative cosmetic procedures. Examiner photo by Dan Krauss Lawmakers vow cosmetic surgery crackdown Elizabeth Fernandez OF THE EXAMINER STAFF Feb. 18, 1999 ©1999 San Francisco Examiner Infuriated by slick but deceptive cosmetic surgery ads and enraged by a mounting death toll, several California lawmakers vowed to toughen laws to better protect the public from unscrupulous or poorly trained doctors. Current regulations are failing to safeguard patients, putting them at risk in elective cosmetic procedures, a state Senate committee was told Wednesday during a hearing in San Francisco. I, for one, was shocked to find death rates as high as one in 5,000 for some of these procedures, said Sen. Liz Figueroa, D-Hayward, head of the Senate Committee on Business and Professions, which organized the nearly four-hour hearing. When healthy patients are dying as a result of voluntary . . . procedures, we have a duty to take notice. The lure of financial rewards is turning the healing arts into a big business. Following the session at San Francisco City Hall - called after an Examiner series on the hazards of cosmetic surgery - Figueroa said she planned to introduce legislation to to establish fair and reasonable credentialing to assure a physician's competence. Experts testified that the monitoring mechanism used traditionally by hospitals to pinpoint bad doctors does not address the growing number of physicians who work in office-_base_d clinics. About 60 percent of medical procedures today occur in such clinics. There is currently no system for assuring surgeon qualification, Figueroa said. This has to change. Additionally, Sen. Jackie Speier, D-South San Francisco, said she was considering a bill to restrict the amount of liposuction that could be performed on a patient. One of the nation's most popular cosmetic procedures, liposuction has been implicated in as many as 100 deaths out of 110,000 procedures performed in the United States in 1997. Some patients have bled to death a few hours after the surgery, others have succumbed days or weeks later from complications, such as infection, abdominal perforations, loss of blood or embolism, medical authorities say. Speier railed against weekend warriors (who) watch a video, then consider themselves fat-extraction experts. Liposuction is putting people, particularly women, at risk, Speier said in an interview. We have to put the brakes on it. Last year, a special committee of the Medical Board of California recommended a moratorium on so-called mega-liposuction outside hospitals until safety concerns could be resolved. Urging tighter accrediting standards in general, Speier lambasted misleading ads used to entice patients into all manner of body improvements. I'm of the opinion that photographs should be banned, she said. Earlier this month, Assemblyman Martin Gallegos, D-Baldwin Park, unveiled legislation to make malpractice insurance mandatory for doctors performing plastic surgery outside hospitals. His bill would also require cosmetic surgery complications to be reported to the medical board and would outlaw doctors keeping patients overnight in their clinics without sufficient equipment or staffing. There is no health benefit to cosmetic surgery, noted Dr. Robert del Junco, a consultant to the medical board's committee and a tireless crusader for reforms. He testified that the industry is overrun by a dizzying alphabet soup of acronyms and pseudo-certifications. Physicians are putting their interest above the patient's, del Junco said, by stepping outside their specialty to perform lucrative cosmetic procedures. While additional regulations would not guarantee patient safety because you can't legislate good judgment on the part of a physician, said Dr. Angelo Capozzi, president of the California Society of Plastic Surgeons, more guidelines would reduce the number of cases where people will be hurt. Also testifying Wednesday was Carmen Sandino, who was featured last September in Skin Deep, The Examiner series on pitfalls in the cosmetic surgery industry. She said she nearly lost her leg because of an infection after surgery by a Bay Area physician. I blamed myself . . . for not having a lot of common sense, Sandino said. I trusted him; he made me believe everything would be easy. Ted Pappas, a San Francisco resident whose 33-year-old brother, George, died two years ago from liposuction complications, said that state law needs to compensate for consumer ignorance. Doctors today are still put on a pedestal, said Pappas. I've been raised in a society that says, Trust the doctor.' People probably put more effort into looking for a car mechanic than a doctor. ©1999 San Francisco Examiner Page A 1
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