Fred Schulte, KFF Health News
Not lengthy after California surgeon Andrew S. Hsu landed a job with a beauty surgical procedure chain in Georgia, a number of of his sufferers suffered disfiguring accidents, and even his new employer had doubts about his competence, court docket data allege.
Hsu, a board-certified common surgeon, was considered one of six out-of-state docs who joined the Atlanta Goals Aesthetics & Plastic Surgery middle through the pandemic. The surgeons acquired non permanent licenses to apply in Georgia, which state officials granted in response to the sudden want for extra medical personnel to deal with the covid-19 outbreak — despite the fact that the middle specialised in elective beauty surgical procedures, similar to Brazilian butt lifts, or BBLs, and liposuction, paid for in money or on credit score.
The Atlanta middle announced its opening in March 2021 as an enlargement of New York-based Goals Aesthetics & Plastic Surgery, which markets “precision body contouring” for a few dozen surgical procedure clinics in eight states, promising sufferers a “dream body in just one visit.”
But the Atlanta middle’s early days have been marred by allegations of substandard affected person care. Court data present that no less than 20 girls filed medical malpractice lawsuits in opposition to the ability, or its proprietor and surgeons. Hsu was named as a defendant in seven fits filed in opposition to the Atlanta middle, greater than every other doctor there. An eighth affected person sued Hsu alleging negligence in an operation he carried out at a Goals workplace in New York.
Hsu didn’t reply to requests for remark. Goals declined to remark. Both have denied any negligence.
Cosmetic surgical procedure chains throughout the nation are attracting sufferers by promising “minimally invasive” operations to reshape their our bodies or eliminate cussed fats — even serving to prepare exterior financing for individuals who can’t pay up entrance. Hundreds of 1000’s of sufferers are present process such procedures every year, and plastic surgeons could make greater than $500,000 every year in one of the highest-paid specialties in American drugs.
An investigation by KFF Health News discovered that lawsuits filed by injured sufferers have trailed the business’s development, in some instances alleging that surgeons lacked satisfactory coaching, had histories of malpractice lawsuits, or had confronted disciplinary motion by state medical licensing boards — but crossed into one other state and saved training.
In the Atlanta lawsuits, Goals has denied any negligence and gained dismissal of a number of of them as a result of sufferers had signed papers agreeing to exterior arbitration — which requires them to resolve disputes privately and out of doors the court docket system.
Yet Goals argued in a separate contract dispute that a number of of its Atlanta surgeons, together with Hsu, have been certainly liable to issues — both as a result of they lacked satisfactory coaching or had troubled pasts, together with investigations by state medical licensing boards into misconduct, court docket data present. One of Hsu’s Atlanta sufferers stated in a separate lawsuit that she suffered in ache for over a yr as a result of a chunk of a scalpel was left inside her physique after a BBL and liposuction.
In a June 2023 court docket submitting in that contract dispute, Goals blamed the issues on a medical staffing agency — Barton Associates, a private equity-owned agency in Massachusetts — it stated did not do satisfactory background checks on the docs it provided. Barton denied the allegations and stated it met all phrases of the contract.
No public database exists to assist sufferers study the total apply histories of physicians, together with beauty surgeons. And sufferers are largely left on their very own to decipher which certificates hanging on a surgeon’s wall, or ballyhooed in online advertising, signify applicable coaching and which don’t. Disputes amongst medical specialty teams over whose members are the best qualified to carry out beauty operations — and ship the very best outcomes — add to the confusion.
No authorities company tracks accidents or different complication charges at clinics providing beauty surgical procedure or every other kind of operations. And in lots of jurisdictions, together with Georgia, getting access to court docket data — a doable pink flag for recognizing issues — is laborious and expensive.
Charleetra Hornes, 52, who lives within the Atlanta suburbs and is suing the Goals middle for medical malpractice, stated she knew nothing of its alleged early troubles and selected the corporate as a result of its promoting promised “minimal downtime” for restoration and that she would stay awake through the operation.
She stated she paid $6,650 for a “double BBL,” during which fats is suctioned from the abdomen, purified, and injected into the buttocks and hips to create what Goals calls a “natural-looking enhancement.”
Goals went forward together with her surgical procedure on July 2, 2022, despite the fact that she had examined optimistic for covid that day, in response to the go well with. Hornes alleged that two days earlier than the surgical procedure Goals assigned her to surgeon Thomas Shannon, who has labored for Goals in Georgia and Texas.
Though employees gave her capsules to handle the discomfort, Hornes stated, she suffered “excruciating pain” through the process, in response to the go well with.
That night time, she spiked a fever that despatched her to the emergency room. She spent two weeks within the hospital recovering from accidents, together with a “severe burn on her side,” in response to the go well with.
“I’ve been disfigured and burned up, and it’s not fair,” she stated in an interview.
In June 2024, Hornes sued Shannon, the Goals middle, and Barton Associates, alleging malpractice. On Sept. 2, a Georgia decide dismissed Shannon from the case, ruling that Hornes did not serve him with the criticism in Texas earlier than the statute of limitations ran out. He didn’t reply to requests for remark.
In a separate order issued on the identical day, the decide additionally dismissed the opposite defendants, citing the statute of limitations challenge and that Hornes had beforehand signed an arbitration settlement. Some beauty surgical procedure chains and different medical practices ask sufferers to signal such agreements.
Hornes needs she had discovered extra in regards to the Atlanta surgical procedure middle, as a substitute of accepting what she calls its “flashy” come-ons. “I wish I would have taken it more seriously,” she stated in an interview, “because it was life-altering.”
Useful Tools
KFF Health News recognized greater than 200 lawsuits filed in opposition to multistate beauty surgical procedure corporations, largely over the previous seven years, together with instances involving a dozen deaths, utilizing databases of court docket data.
Lawsuits by themselves don’t show wrongdoing. Many instances are settled below confidential phrases that maintain essential particulars below wraps. Yet medical authorities and most doctor licensing boards regard malpractice instances and settlements as a helpful tool for detecting doable patterns of substandard well being care that will hurt sufferers.
Court recordsdata present that surgeons who have been sued quite a few occasions for malpractice — and in some instances disciplined by state medical boards for misconduct — have managed to get employed by beauty surgical procedure chains.
Goals, owned by doctor Sergey Voskin, has contracted with eight surgeons with three or extra malpractice instances filed in opposition to them, together with within the Atlanta space, court docket data allege. Gerald Hickson, founding director of the Vanderbilt Center for Patient and Professional Advocacy and an professional on medical malpractice points, referred to as that variety of fits a “warning” of doable issues, regardless of their end result.
Earlier this yr, a Pennsylvania lady recognized in court docket filings as “P.C.” sued Goals, Voskin, and surgeon Peter Driscoll, alleging Driscoll got here on board regardless of an “extensive history of malpractice allegations, licensing suspensions and discipline” in Texas and California, in response to medical board data cited within the go well with. Companies hiring docs have prepared entry to the nonpublic National Practitioner Data Bank, which particulars disciplinary issues in a physician’s previous. But it’s not clear from court docket data whether or not anyone made these commonplace background checks. Goals didn’t reply to a request for remark.
The go well with additionally accuses Goals of client fraud for touting its surgeons as “double if not triple board certified plastic surgeons.” According to the criticism, Driscoll was board-certified by the American Board of Otolaryngology, a specialty that focuses on therapy and surgical procedure of head and neck areas. Driscoll is no longer certified within the specialty, in response to the American Board of Medical Specialties web site.
The lady alleges that Driscoll sexually harassed her and made “unwanted and unwelcome sexual contact” throughout a BBL process in June 2022 at a Goals workplace in New Jersey.
According to the go well with, employees members overheard Driscoll watching pornography in an workplace toilet a number of occasions, however Goals didn’t terminate him on the time. New Jersey’s State Board of Medical Examiners suspended Driscoll’s license in February 2023 associated to the incident, and the lady’s lawsuit is pending in federal court docket in New Jersey. Goals and Voskin have denied the allegations within the go well with and filed a movement to dismiss or compel arbitration of the case. Driscoll, who has not filed a response with the court docket, couldn’t be reached for remark.
Performance Issues Not ‘Disqualifying’
Other beauty surgical procedure chains have confronted a number of malpractice actions concentrating on surgeons or different well being care suppliers who employees their clinics, court docket data present.
The surgeon roster at Mia Aesthetics, a Miami-based chain that operates 13 beauty surgical procedure places of work nationwide, lists 4 docs with three or extra malpractice actions since 2020, court docket data present.
Nearly a dozen injured sufferers have filed lawsuits criticizing the credentials of docs and nurse practitioners affiliated with Belle Medical, together with the household of a 70-year-old Utah lady with 5 kids who died within the automotive two days after liposuction as her husband rushed her from house to a hospital, in response to court docket data.
Her husband alleges he referred to as Belle Medical’s workplace the day after the process to say his spouse was having problem respiratory and coronary heart palpitations and couldn’t stroll greater than a brief distance, which the lawsuit argued have been “textbook symptoms of pulmonary embolism, or blood clot in the lung.” According to the go well with, no one at Belle Medical suggested the household to hunt speedy medical care. An post-mortem discovered she died from “bilateral pulmonary emboli,” in response to the go well with.
Backed by Peterson Partners, a Utah personal fairness and funding agency, Belle Medical operates in Utah, Idaho, and Oklahoma, providing liposuction and different beauty surgical procedure. Neither Belle Medical nor Peterson Partners responded to requests for remark. In court docket filings, Belle Medical has argued that its medical suppliers are unbiased contractors who’re solely liable for any procedures they carry out.
Private equity-backed Sono Bello, the biggest of the beauty surgical procedure chains with greater than 100 places nationwide, has defended greater than a dozen lawsuits alleging the corporate contracted with inadequately skilled docs or practitioners beforehand disciplined by medical licensing boards. In May 2023, Ohio’s medical board revoked the license of a Sono Bello contract surgeon after three of her sufferers died, two of them following procedures at a Sono Bello workplace within the Cleveland space, in response to medical board data.
Robert Centeno, Sono Bello’s medical director for the East area, instructed KFF Health News that many surgeons have previous efficiency points, which he referred to as “not, in fact, disqualifying.”
“The vast majority of our colleagues are extremely professional and committed to their profession,” he stated in an interview. “And while there may be a momentary lapse or issue with their practice, most of our surgeons take those sanctions, take that counseling, that advice, and improve their practices and go on to be very, very productive members of the medical community.”
Asked about malpractice lawsuits filed in opposition to the corporate, Centeno stated that Sono Bello has “performed over 300,000 procedures to date,” which he described as “more procedures for more patients completed safely than anyone else in the industry. It would be natural and understandable to know that at some point during that process, that a patient has actually sued us,” Centeno stated.
‘Unable To Perform’
In early 2020, because the pandemic slowed enterprise in New York City, Goals sought to increase to Atlanta — a scorching marketplace for its BBLs. In a PR Newswire release, Goals promised sufferers “amazing contours” and boasted of getting “some of the most experienced, and aesthetically forward surgeons in the industry.” BBLs and liposuction make up 95% of its enterprise, marketed to largely Black and Hispanic girls, Goals proprietor Voskin testified in a deposition filed this yr within the Driscoll case. Many Atlanta sufferers suing the corporate paid roughly $6,000 to $8,000 for his or her surgical procedures, court docket data present.
Goals initially staffed the Atlanta middle by way of Barton Associates. Many hospitals and medical places of work depend on such corporations to search out non permanent docs and different employees. Under the deal, Barton charged Goals $1,400 for every process and paid about $600 of that to the surgeon, in response to Goals’ court docket filings.
In 2023, Barton sued Goals in a Massachusetts court docket, alleging it was owed $487,000 in charges. Goals admitted that it “temporarily ceased payment” to Barton. But it fired again with a counterclaim accusing Barton of failing to examine the {qualifications} and backgrounds of surgeons as required by the settlement.
Goals named 5 surgeons Barton despatched to the middle, together with Hsu, and pointed to the spate of malpractice instances in Atlanta to bolster its argument.
Goals stated it “became immediately apparent” that one other surgeon was “fundamentally unable to perform his duties.” The surgeon was “abrasive, vulgar and could not conduct himself in accordance with reasonable professional standards that were expected in a medical workplace,” in response to Goals’ counterclaim.
A second surgeon Barton offered as “highly skilled” turned out to have “an extensive history of complaints about his professional conduct” in two different states, in response to the counterclaim.
Barton and Goals settled the case and counterclaim in April 2024 below confidential phrases. Barton didn’t reply to requests for remark. Barton denied Goals’ allegations in earlier court docket filings and stated that it “complied fully” with the phrases of its contract with the surgical procedure firm.
In its counterclaim, Goals argued that shortly after Hsu joined the employees in 2021, it discovered he had “multiple issues” in California and “was about to lose his medical license as a result,” in response to a court docket submitting.
Goals supplied “significant legal and other assistance” to maintain that from occurring and Hsu “required substantial training in order to do acceptable work on patients,” the corporate argued in court docket filings.
Seven girls filed malpractice fits in 2023 alleging they sustained accidents from BBLs and liposuction Hsu carried out on the Atlanta workplace between mid-February 2021 and the top of June 2021, court docket data present. Barton, the staffing agency, is also a defendant in these instances and has denied wrongdoing. Hsu has denied wrongdoing within the instances and sought to implement arbitration agreements.
Hsu’s emergency Georgia medical license, authorized in January 2021, expired in April 2022, state data present. Hsu is licensed in New York and California, the place he has additionally labored for Goals.
Two fits accuse Hsu of leaving a chunk of steel contained in the our bodies of ladies, a calamity affected person security consultants imagine should never occur.
In one Atlanta case, a affected person who alleged she had skilled fixed ache since her surgical procedure at Goals in 2021 stated she found why greater than a yr later when a chest X-ray ordered after a automotive crash confirmed a chunk of scalpel blade in her higher stomach, in response to her court docket filings. The motion in opposition to Hsu and Barton Associates was settled early this yr, court docket data present.
In the second case, a New Jersey lady who had a BBL at Goals’ Harlem workplace in New York City in February 2022 alleged she overheard Hsu say within the working room that he had “left something inside of her,” which turned out to be a steel liposuction cannula tip that had damaged off in her abdomen. A decide dismissed her lawsuit as a consequence of an arbitration clause. She filed a discover of attraction, however the case was settled in August.
The California medical board’s investigation of Hsu led to October 2023 with a settlement and disciplinary order. The state accused him of “repeated negligent acts” in treating six sufferers relationship to 2016, together with three individuals who died. None concerned beauty surgical procedure like his work at Goals.
The board revoked his license however stayed the motion and imposed a four-year probation, tacking on a $24,000 penalty to cowl prices of the investigation. The order additionally required Hsu to discover a practitioner to assist oversee his apply and prohibits him from serving on any on-call panel for common surgical procedure. In settling the case, Hsu didn’t admit any wrongdoing.
Goals has featured Hsu in a TikTok video, and boasts on its website that he’s a “highly skilled surgical specialist,” who gives “top-notch surgical care.”
Fellowship Training
How a lot coaching beauty surgical procedure chains demand of surgeons varies, judging by doctor service contracts obtained by KFF Health News by way of court docket filings. Some contracts merely require that the physician maintain a legitimate state medical license, whereas others specify that a physician “represents” that they are qualified to carry out beauty surgical procedure and haven’t been disciplined by licensing boards or been hit with main malpractice awards.
Sono Bello takes a distinct route. The firm sponsors a six- to eight-week coaching course for surgeons, which it calls a “fellowship,” and posts details online.
Sono Bello accepts candidates from greater than half a dozen surgical specialties and focuses its coaching on liposuction and a sort of tummy tuck procedure called AbEX.
Court data present that Sono Bello has defended no less than a dozen lawsuits from sufferers who argued some surgeons lacked enough coaching or had different issues, or alleged they have been misled by some promoting that described surgeons who accomplished the fellowship as “board certified plastic surgeons.”
Sono Bello’s credentialing course of got here below assault in a 2023 malpractice lawsuit filed by Shirley Webb, a 79-year-old Nevada lady who spent months in hospitals and rehabilitation care recovering from sepsis after a tummy tuck and liposuction carried out by surgeon Charles Kim in Las Vegas in December 2022.
Kim, a colorectal surgeon, took the Sono Bello fellowship from July 2022 to October 2022, court docket data present. In a deposition, Kim, who’s board-certified generally surgical procedure, acknowledged that Sono Bello knew he had been disciplined by Nevada’s state medical licensing board for alleged malpractice during which a affected person he operated on died. Kim paid a $4,000 effective and acquired a letter of reprimand in settling the medical board case with out admitting wrongdoing.
Kim additionally testified within the medical malpractice case that Sono Bello was conscious he had beforehand settled 4 medical malpractice instances, court docket data present. Christopher Chung, Sono Bello’s chief medical officer, stated the corporate verified that Kim’s state medical license and different credentials “were up to date and in good standing” earlier than it employed him. “We reviewed his surgical log, which detailed the voluminous and complex surgeries he had performed at the hospital where he was then employed, and received positive references from his employer and other surgeons,” Chung stated in an emailed assertion.
A medical professional employed by Webb’s authorized workforce opined that Sono Bello’s use of the time period “fellowship” is misleading as a result of this system will not be accredited, or acknowledged by any subspecialty certifying board, skilled society, or hospital. A medical fellowship is often a coaching program that lasts no less than a yr. “We strongly disagree with the suggestion that our website is misleading. We accurately state that our physicians are board-certified surgeons — because they are,” Sono Bello spokesperson Mark Firmani stated in response.
In her lawsuit, Webb testified that Sono Bello’s commercials on tv and on-line led her to imagine the corporate employed solely board-certified plastic surgeons.
Had she been instructed of Kim’s background upfront, “I wouldn’t have had the surgery done,” Webb testified in a 2024 deposition.
The events settled the go well with early this yr below confidential phrases.
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