2 Doctors Criticized in Liposuction Death

The physicians involved in Judy Fernandez’s 10-hour liposuction and plastic surgery in Irvine last March ignored repeated “red flags” about her condition before she was rushed to a hospital and died, a state’s attorney contended in court Wednesday.

“The evidence will show that what happened on March 17 was a medical abomination,” said Deputy Atty. Gen. Steven H. Zeigen in an opening statement in the California Medical Board’s efforts to revoke the licenses of plastic surgeon William Earle Matory Jr. and anesthesiologist Robert Hoo.

The licenses of both men were temporarily suspended after Fernandez bled to death following surgery at Matory’s outpatient surgical suite. A trial to permanently revoke their licenses began Wednesday in Santa Ana before Administrative Law Judge Vincent Nafarrete.

Fernandez, 47, of La Habra, underwent “large-volume” tumescent liposuction, in which a fluid is infused into fatty tissue to enable the fat to be sucked out. She underwent $20,000 worth of procedures, including liposuction of the arms, legs, hips, buttocks and back, a mini-face lift, brow lift and laser resurfacing of the skin on her face, neck and chest.

Fernandez was infused with so much anesthetic and tumescent liquid that when she was rushed to the hospital, pink liquid was rapidly oozing out of her, pouring off the paramedics’ gurney, Zeigen said.

Attorneys for the doctors said they will show evidence that the Medical Board attorneys are misinterpreting and misrepresenting the facts, and that the physicians acted appropriately.

The Medical Board’s first witness, widower Ruben Fernandez, fought back tears as he recalled seeing his wife as paramedics tried to resuscitate her.

“I went up to her and held her right hand. It was very cold,” he said in a choked voice. Not wanting to get in the way of the paramedics, he moved, he said. “Then I held her foot. Her body was so, so cold.” Her face and limbs were swollen and pink fluids dripped from her everywhere, he testified.

Deputy Atty. Gen. Zeigen, who is handling the case against the anesthesiologist, said in his opening statement that Hoo infused Fernandez with 19 liters of anesthesia fluid, in addition to the 14 liters of tumescent liposuction fluid Matory used. But no catheter was ever inserted to drain off urine or other fluids, despite a nurse’s concerns, he said.

“It was fluid in, but no fluid out,” Zeigen said.

A nurse saw that Fernandez’s blood pressure was falling during the procedures, Zeigen said. Fernandez’s body was so swollen that a nurse was unable to insert patches over Fernandez’s eyes during the face lift, and it was difficult to get a blood pressure reading, he said.

When Fernandez was slow to wake up after the anesthesia, Hoo made a note in the chart suggesting that she might need hospitalization, but the 911 call was not made until nearly two hours later, Zeigen said.

“There were red flags long before Judy Fernandez was transferred to Irvine Medical Center,” he said. She was “on death’s doorstep while she was still in the clinic.”

When Fernandez arrived at the hospital, the emergency room doctor found that “she was exsanguinated. This patient had no blood,” the state’s attorney said.

Lloyd Charton, Matory’s attorney, countered in his opening statement that the swelling and the oozing of fluids may appear aberrant to people unfamiliar with tumescent liposuction but in fact are normal parts of the procedure. Matory has performed 140 liposuction surgeries, 50 of which were “large volume,” Charton said.

Large-volume liposuction is a new field and “there are no standards of care,” he said. Doctors disagree on how much liposuction should be performed in one procedure and where it should be done.

“If the state is going to prove that there was an extreme departure from standards, the standards should be clear to doctors,” Charton said.