Thursday, May 05, 2016

People v. Mohamed (Cal. Ct. App. - May 3, 2016)

From this opinion:

"In 2010, appellant was a board certified gynecologist who practiced cosmetic surgery out of his Encino office. Appellant relied on 'cutting edge' technology in his practice and used a medical instrument called a “VASER” liposuction machine in his liposuction procedures. The VASER liposuction performed by appellant involves a three-step process: first, a solution of saline, epinephrine (a blood vessel constrictor), and lidocaine (a local anesthetic) is injected or “infiltrated” under the skin; next, a titanium probe is inserted under the skin to deliver ultrasound energy through the VASER amplifier to loosen the fat cells; and finally, the injected solution along with the loosened fat cells are sucked out, or 'aspirated' from the body, resulting in a liquid aspirate consisting of infiltrated solution, blood, and fat."

Okay.  That doesn't sound so bad.  Personally, I'm not down for it.  But I get that other people might be.

"Appellant performed his liposuction procedures in a room in his medical office, which was not an accredited surgical center. The office lacked an electrocardiogram (EKG) machine, pulse oximeter, backup oxygen, a backup power supply, and a 'crash cart,' and had only a limited supply of drugs to reverse the effects of narcotics. Appellant did not employ any certified advanced cardiac life support personnel, nor did he have an anesthesiologist or a nurse anesthetist to handle sedation during his surgeries. On occasion, appellant’s office assistant, Judy Evans, assisted him in his procedures. Hired in 2001, Evans did everything in the office from performing general office work to assisting in appellant’s surgeries and procedures. Evans received lip and facial injections from appellant at cost. She had attended one year of nursing school about 40 years earlier, but was not licensed as a nurse. As of 2011 she had not taken a CPR class in eight years."

Oh.  That doesn't sound good.  I have a sense this isn't going to turn out so well.  A sense that's only highlighted by the fact that this case is entitled People v. Mohamed.

"Zackie Handy went to see appellant in May 2010 about a treatment to reduce the wrinkles on her face. She was 77 years old. Appellant convinced her to undergo liposuction to remove fat from her abdomen, back, under her arms, and her legs, claiming the treatment was 'tax deductible' and would reduce the risk of heart attack and Alzheimer’s, lower her cholesterol 'by a lot,' and add 20 years to her life. He assured her she would have 'no downtime.' Appellant also told Handy she would be part of a 'Harvard study' and would receive a substantial discount. Handy agreed to the liposuction procedure on her abdomen, and paid appellant with a $55,000 cashier’s check from her equity line. She subsequently gave appellant two more postdated checks totaling $45,000."

Wait.  Elective surgery for $100,000 on a 77-year old?!  Based on these (alleged) representations?!

That's not sounding very good either.  At all.

"When Handy arrived for the procedure on her abdomen, she told 'Nurse Judy' she had taken baby aspirin that day. Evans said that would be fine and gave Handy four Vicodin pills (a combination of acetaminophen and the opioid hydrocodone) and 1.5 milligrams of Xanax (an anti-anxiety drug) to take orally. Handy told appellant not to do anything to her face. Handy fell asleep during the procedure and woke to find her face blotchy and lumpy from fillers appellant had injected into her lip, chin, eyelids, and eyebrows. Appellant told her that he had been forced to stop the liposuction because of excessive bleeding due to the aspirin and had worked on her face instead. . . . During a follow-up appointment, Handy complained about the appearance and pain from the lumps on her face. Appellant gave her a 'free' Botox injection, which she did not want. As a result of the injection, Handy could not close one eye, and she continued to experience pain and headaches from the fillers. Handy canceled further appointments with appellant, stopped payment on the two postdated checks she had given him, and reported him to the California Medical Board."

That's not good.  But it's not even this case.

"On August 17, 2010, Sharon Carpenter consulted with appellant about having 'whole body' liposuction. She was 61 years old. Appellant told her that he performed a unique form of liposuction, and she would receive a discount by being part of a 'Harvard study.' Carpenter was eager to have the procedure and agreed to pay appellant’s $100,000 fee. . . .

Appellant started Carpenter’s liposuction procedure assisted by Evans at 1:10 p.m. by placing 12 skin ports on Carpenter’s body. At 2:30 p.m. appellant began infiltration of approximately 5,000 cc’s of a normal saline solution containing 1 percent lidocaine and one part per million epinephrine. Carpenter received another milligram of Xanax at 2:35 p.m., and appellant started using the VASER at 3:35 p.m. Appellant gave Carpenter oral doses of Percocet (a combination of acetaminophen and the opioid oxycodone) at 4:45 p.m. and again at 7:00 p.m. Carpenter received an injection of Zofran (an anti-nausea medication) at 2:45 p.m. and another after she vomited, about nine hours into the procedure. The fentanyl patch was removed at 10:00 p.m. . . .

At approximately 11:30 p.m. Carpenter refused to take any more fluids, and appeared dehydrated. Appellant twice called Encino Hospital across the street seeking to borrow or purchase IV tubing, normal saline bags, and an 18-gauge cannula. According to the nursing supervisor who spoke with him, his voice sounded urgent. The hospital refused to give appellant any medical supplies.

After calling the hospital, appellant resumed the liposuction. Carpenter became sleepy and appellant assured her the procedure would only be 15 minutes longer. But appellant continued the liposuction for another 30 to 40 minutes, reaching a total of 5,000 cc’s of extracted aspirate. At 12:17 a.m.—11 hours into the procedure—appellant noticed that Carpenter’s breathing was shallow, and she was unresponsive. He also noticed her lips were slightly cyanotic (blue), which meant that she was not getting sufficient oxygen. As appellant began rescue efforts, Evans called 911. At 12:25 a.m. appellant lost Carpenter’s pulse, and appellant and Evans moved her to the floor to perform CPR.

Paramedics arrived at the building at 12:22 a.m., but the door was locked, delaying their entry. When they reached appellant’s medical office on the seventh floor, they found appellant performing CPR, and blood was everywhere. Carpenter had no pulse and was not breathing; the paramedics took over CPR, started epinephrine, and gave her atropine, to no effect. Twenty minutes later Carpenter was pronounced dead. . . .

Dr. Raffi Djabourian, the Senior Deputy Medical Examiner for the Los Angeles County Coroner, conducted an autopsy of Sharon Carpenter on August 23, 2010. Based on toxicology tests on blood and tissue samples, he concluded that the cause of death was opioid toxicity from the lidocaine, fentanyl and oxycodone she had received."

That's involuntary manslaughter.  And it gives you a fair piece of time in prison.

Not to mention a poor reputation in the community.