Florida puts limits on office plastic surgery after 8 deaths

In an attempt to crack down on problems with office-based surgeries, the Florida Board of Medicine has imposed a 90-day ban on combination abdominoplasty and liposuction procedures.

The board is responding to media reports and concerns about the deaths of eight patients during office surgeries since the summer of 2002. Three of those deaths involved combination liposuction and abdominoplasty.

The moratorium went into effect Feb. 11. It requires that liposuction and abdominoplasty procedures performed on the same patient in an office setting be separated by 14 days. Board officials said the combination of procedures increases the risks of a deadly blood clot.

In 2000, patient deaths prompted the medical board to issue a 90-day ban on office surgeries that required general anesthesia or heavy sedation. That led to new safety standards for office surgery, including accrediting of offices, mandatory reporting of adverse incidents and credentialing of surgeons.

But board Chair Lisa Tucker, MD, said the current regulations might not be enough to protect patients. Board officials said they would evaluate office surgery logs to determine if stricter measures are needed.

"This rule doesn't close anybody down," said Larry McPherson Jr., board executive director. "This is a very limited restriction."

The Florida Medical Assn. supports the board's decision, saying the ban is appropriate to allow time to review the mortality and morbidity of the two procedures. But Yoav Barnavon, MD, president of the Florida Society of Plastic Surgeons, has fears.

"We want office surgery to be as safe as it can possibly be," said Dr. Barnavon, who practices in Hollywood, Fla. "But a lot of us fear more rules will be promulgated that may or may not be justified."

As part of the moratorium, the board is requiring physicians who do office surgeries to submit to the state copies of office surgery logs from June 1, 2002, to Jan. 31, 2004. The board said the data would help determine if a permanent rule is necessary to protect patients.

"The purpose of collecting this is not to discipline [physicians]. It's to gather data so the board of medicine can better focus on its office surgery rules," McPherson said.

Dr. Barnavon said it's not clear if the regulations enacted after the 2000 ban did any good. He hopes the medical board is careful to review data during the new ban and to take the appropriate action.

"What I worry about is something is temporary, then it becomes permanent," he said.