PENSACOLA - The Florida Board of Medicine has issued an 90-day ban on combined tummy tuck and liposuction procedures performed in doctors' offices while it looks into several deaths that resulted from such operations in recent years.
The decision prohibits doctors from conducting the two procedures, which cut away excess skin and vacuum out fat, within 14 days of each other. Doctors who perform such procedures in their offices must also must also submit surgery logs for a seven-month period from June 1, 2003, to Jan. 1.
The board will use that information to help determine if the state needs tougher safety standards.
"Our job is to protect public safety," said board member Nabil El Sanadi, an emergency room physician in Fort Lauderdale. "Maybe some physicians are more cavalier than they should be."
In its meeting on Friday, the board reviewed eight deaths that followed plastic surgery operations since mid-2002. Half of those deaths came after the combined tummy tuck-liposuction operation. El Sanadi said the board will try to determine why the deaths occurred.
In 2000, after four deaths within five months, the board placed a three-month moratorium on all office surgery. The board then issued a host of regulations, including accreditation of surgical offices, limits on the length of cosmetic procedures and a requirement that patients at high risk of complications undergo procedures at surgical centers.
There are an estimated 77,000 cosmetic operations annually in Florida, most of which take place in offices.
A report in the Archives of Surgery in September 2003 looked at Florida's in-office surgeries from April 2000 to 2002. The report found patients who underwent procedures in doctors' offices were 10 times more likely to die, compared with patients who went to surgical centers. Researchers concluded that moving all operations to surgical centers would have saved six lives and prevented 43 injuries per year.
Dr. Paul Barach, an anesthesiologist who directs the University of Miami School of Medicine/Jackson Memorial Hospital's Center for Patient Safety, said office operations lack the type of support system hospitals offer.
"When you're in a mall in Broward County, and you get anaphylactic shock, it's not like there are 26 people who can jump to attention. There's no one there," he said.