Doctor's Lawyer: Lipo Led To Coma

Health Regulator Says Stricter Regulations Needed In Florida

October 01, 2009|By Bob LaMendola and Lisa Huriash STAFF WRITERSWESTON — Complications during a type of liposuction procedure at a Weston beauty clinic are what put a 37-year-old nurse and mother of three in a coma and on life support, the attorney for the clinic's physician said Wednesday.

The physician who did the procedure, Dr. Omar J. Brito Marin, did not know that Weston Medspa was not state-licensed to perform full liposuctions, and did nothing wrong that caused Rohie Kah-Orukotan's severe reaction, said Brian Bieber, the doctor's attorney.

"She went in for a routine liposuction . . . performed by Dr. Brito without any complications until the very end, at which time Dr. Brito immediately administered emergency care and called 911," Bieber said. "Paramedics arrived; they noted all emergency procedures put into place were proper."

Florida officials said the privately owned clinic is not licensed to perform liposuctions under general anesthesia, but could do a scaled-down version using a local anesthetic that keeps the patient awake. Bieber said he did not know which type of liposuction was performed. If Brito did a procedure not allowed in the facility, he could be disciplined, a state health official said.

"He's not the owner of the facility," Bieber said. "The obtaining of the appropriate licensing is the responsibility of the owner. [Brito] did not know [it wasn't licensed for office surgery]."

Brito is not board-certified or trained in plastic surgery; his background is in occupational medicine, records show.

Weston Medspa reopened Wednesday but a spokeswoman declined to comment. Corporate records list it as Weston Tan & Spa, headed since 2007 by Patricia Gomez, Gustavo Galvez and Adriana Gomez. None could be reached Wednesday for comment.

The case has sparked a criminal investigation by homicide detectives at the Broward Sheriff's Office and a probe by the Florida Department of Health.

Kah-Orukotan remained unconscious Wednesday at Cleveland Clinic, where her family gathered, agonizing over whether to keep her on life support, the family's attorney said.

A top Florida medical regulator said the case shows a need for the state to write much stricter rules for medspas, which have worried doctors in Florida and nationally for years. Medspas are largely unregulated and often expand their services beyond what some consider safe, said Fort Lauderdale surgeon Robert Cline, chairman of a surgical quality committee for the Florida Board of Medicine.

The medical board has talked about trying to address medspas, which employ a doctor to supervise lesser-trained staff who perform beauty and cosmetic medical treatments.

"They have a lot of nonphysicians doing services doctors should do," Cline said. "Obviously this case is going to cause a lot of concern. We will be investigating it and trying to come up with some regulations."

Medspas in South Florida advertise a wide range of beauty-oriented treatments such as Botox shots, laser hair removal, fat-burning injections called mesotherapy and a weight-loss therapy using ultrasound waves called endermologie.

If supervised by a doctor, all the procedures can be administered by advance-trained nurses and physician assistants, said Eulinda Smith, a health department spokeswoman.

Kah-Orukotan's family has not seen her medical records and is not clear about the procedure she had, said their attorney, Michael Freedland. The family was told she may have had a seizure during the procedure.

The family's medical consultant believes she may have undergone a "light" liposuction, in which the fully awake patient is injected with the anesthetic lidocaine and a laser is inserted under the skin to liquefy fat tissue, which is then removed.

Dr. Brett Coldiron, a Cincinnati dermatologist who has studied cosmetic surgery problems in Florida, said seizures can be a side effect of excessive lidocaine, if the dosage were miscalculated or a very large area were treated. Also, patients can have allergic reactions to lidocaine.

Brito, who received his medical degree in BogotM-a, had listed the Weston clinic as his main office, according to his state licensing records. In 2006, the medical board fined him $5,000 and ordered him to perform community service for his role in an insurance fraud scheme, state records show.

Bob LaMendola can be reached at blamendola@SunSentinel.com, 954-356-4526 or 561-243-6600, ext. 4526.