A Cautionary Tale.

Most patients trust their doctors.  They do more research into the restaurant for tonight’s meal than they do into the qualifications of the surgeon who is going to perform surgery on them.  This level of trust without any investigation can lead to disastrous medical malpractice which can sometimes be fatal. What follows is drawn from a big story here in the Phoenix area from 2008 but its lessons are just as important today as they were then.

As is often the case, the malpractice involved cosmetic surgery.  Cosmetic surgery is rife with problems.  It is a huge money maker and therefore attracts a disproportionate number of money-hungry doctors.  There is nothing to prevent someone with no training in cosmetic surgery from holding himself or herself out as a cosmetic surgeon and performing procedures.  This is what Dr. Peter Normann did.

Dr. Normann was an internist and an emergency room doctor.  He never took a residency in anesthesiology or in plastic surgery.  He did take a six day course in liposuction and breast augmentation.  With this meager training in hand, he began to sign up patients.

Although there appear to have been many victims who complained that he malpracticed on them, at least they were alive to complain.  Three of Dr. Normann’s patients were not so fortunate.  During the investigations into their deaths, it was discovered that Dr. Normann was performing complicated cosmetic surgery in an operating room at his clinic that did not have proper equipment to monitor his patients.  Dr. Normann was also using a massage therapist as his medical assistant for the operations.  He had no anesthesiologist to assist him with the anesthesia needs of his patients.  This recipe for disaster provided just that.

The first patient to die was undergoing a liposuction procedure.  When Dr. Normann discovered that the patient was having serious respiratory problems, he called 911.  The paramedic who arrived reported that the breathing tube, which should have been in the airway, was instead delivering oxygen into the stomach.  Small wonder that the patient was having respiratory difficulties.  When the paramedic tried to place the tube properly, Dr. Normann physically prevented him from doing so.  The patient died as a result of an overdose of anesthesia.

The second patient to die was undergoing a buttocks enhancement procedure, a procedure for which Dr. Normann had received no training.  The procedure involves the injection of fat into the buttocks.  Dr. Normann erroneously injected fat directly into a vein which carried it to the lungs and caused the patient’s death due to pulmonary embolism.  In trying to resuscitate his dying patient, Dr. Normann once again inserted the endotracheal breathing tube into the stomach instead of the airway.  Following this death, and with investigations underway at the Arizona Medical Board, Dr. Normann voluntarily suspended his medical license.

This voluntary suspension did not slow down Dr. Normann’s cosmetic surgery practice for long.  He hired a homeopathic physician to perform liposuction procedures at his clinic, despite the fact that the homeopathic physician was not trained for or licensed to perform the procedures.  While making rounds on post-surgical patients at his clinic, Dr. Normann discovered one of the liposuction patients to be in respiratory distress.  Dr. Normann could not successfully place the breathing tube into the airway and this patient died as well.

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Dr. Normann was charged and convicted of two counts of second degree murder and one of manslaughter arising out of the three deaths.

Don’t let this happen to you.  Next week I will discuss some of the things you should do before you let someone operate on you.




Posted in Arizona Medical Board, Doctors, Fee for Service, Fraud, Informed Consent, medical errors, medical ethics, Medical Malpractice, medical mistakes, Medical Negligence, Surgical Errors |