Surgical centers could face changes after deaths

Florida’s plastic surgery centers could undergo a regulatory makeover to improve patient safety if state Sen. Anitere Flores is successful during the upcoming legislative session.

Flores, R-Miami, filed a 42-page bill (SB 732)Tuesday after news reports that highlighted a rash of patient deaths at two Southeast Florida plastic surgery centers. One key proposal would mandate that surgical centers be owned by Florida-licensed physicians in good standing and be registered with the state Department of Health.

The bill also would bar physicians affiliated with shuttered clinics from opening new surgery centers for a five-year period and would ban the transfer of center registrations when clinics are sold.

Flores told The News Service of Florida that the bill addresses a regulatory void that allowed the two Southeast Florida plastic surgery centers to thrive, despite a mounting death toll.

“I just want to make sure people are safe,” she said.

USA Today and the Naples Daily News reported last week that two Miami-area clinics overseen by physician Ismael Labrador have lost eight patients over the past six years and combined to account for about 20 percent of the plastic-surgery deaths in the state.

Labrador, 56, changed the names of the centers three times as the deaths mounted, the report said. The name changes made it more difficult for patients to connect the deaths to the clinics, now known as Jolie Plastic Surgery.

Flores’ bill identifies types of procedures that are performed in surgical centers and would require physicians to register as surgical centers if they perform any of those procedures.

Level 1 procedures involve minimum sedation and include excising of skin lesions, stitching of lacerations, drainage of cysts and casting simple breaks. Level II procedures are more complex and require moderate sedation and include procedures such as hernia repair, large joint dislocations, colonoscopies and liposuction procedures involving the removal of up to 1,000 cubic centimeters of supernatant fat.

Level III procedures are the most medically complex, requiring deep sedation with general anesthesia or spinal, regional or epidural anesthesia.

The bill would ban level III procedures from being performed at the centers unless physicians have hospital admitting privileges or the centers have emergency transportation agreements with nearby facilities.

Additionally, level III procedures could not be performed on older patients without complete medical workups.

The bill also would mandate that anesthesiologists be on site and available for high-risk procedures and that physicians who perform those procedures meet certain requirements.

Chris Nuland, a lobbyist for the Florida Society of Plastic Surgeons, told the News Service that “there’s a lot of good” in Flores’ legislation. However, Nuland said that requiring doctors who perform level 1 procedures to certify as surgical centers “is a bit extreme.”

Flores, who will be forced to leave office after the 2020 elections because of term limits, said the bill is a priority for her this session and said she wants to “work with everyone” on crafting legislation that will increase patient safety. The 60-day legislative session starts March 5.

A legislative veteran of 14 years, Flores acknowledged, though, that it may not be easy to pass the bill considering House Speaker Jose Oliva, R-Miami Lakes, is interested in reducing health care regulations, not increasing them.

But as the state touts itself as medical tourism mecca, Flores said it’s incumbent on the Legislature to ensure that people who flock to the state, as well as residents, are safe.

“I have two years left (in the Senate),” she said, adding, “This is a big problem. “