After 8 patient deaths, FL moratorium announced

14-day interval required between procedures

Florida surgeons cannot perform liposuction and abdominoplasty procedures on the same patient within 14 days of each other as a result of a 90-day moratorium imposed by the Florida Board of Medicine on Feb. 11, 2004.

The board acted upon information from adverse incident reports, which included eight deaths reported between August 2002 and January 2004. Four of the deaths involved patients who had liposuction and abdominoplasty procedures on the same day in the office surgery setting.

"The current office surgery limitations may not be enough to protect patients," says Lisa Tucker, MD, chair of the board. "We must investigate this combination of procedures to determine whether or not the process is safe and take appropriate, long-term steps to ensure safe procedures for all patients." The board members’ concern is that the combination of procedures in a short period of time may increase abdominal pressure, which affects blood flow and increases the risk of pulmonary emboli.

A survey on lipoplasty safety that covered 94,000 lipoplasty procedures performed by board-certified plastic surgeons in 2001 showed the estimated risk of death from lipoplasty performed as an isolated procedure to be one per 47,415 procedures. When combined with abdominoplasty, the risk was significantly higher at one per 3,281 procedures.1

The rule that imposed the moratorium also requires physicians performing Level II and Level III office surgery to submit copies of their office surgery logs from June 1, 2002, through Jan. 31, 2004, to the state health department no later than May 10, 2004.

The Florida Board of Medicine members will use data from the logs to determine if the rule preventing both procedures within 14 days of each other will become a permanent rule.

This is the second time in recent years that the board has issued a moratorium on office-based surgery as a result of patient safety concerns.

The American Society for Aesthetic Plastic Surgery (ASAPS), in Los Alamitos, CA, supports the board’s investigation because the society’s members support the continued study of the safety of office-based surgery, says Robert Bernard, MD, a plastic surgeon and president of ASAPS.

"Our concern is that it is easy to jump to a conclusion based on limited information," he says. "We want the board to do its due diligence before enacting far-reaching restrictions impacting patient care."

For more information about the rule and the requirements for submission of office surgery logs, go to www.doh.state.fl.us. Look under "health notices" for the section titled "Attention Level II and III office surgery physicians." The link will take you to a detailed description of the rule and instructions on how to submit office logs.

Reference

  1. Hughes CE. Reduction of lipoplasty risks and mortality: An ASAPS survey. Aesthetic Surgery Journal 2001; 21:120-124.