Table Procedure-related office surgery deaths in Florida. 3/1/00 7/1/14. Complication Provider Anesthesia Anes Prob? Plastic Surgeon.

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1 Table Procedure-related office surgery deaths in Florida. 3/1/00 7/1/14 Case # Date 1 4/12/00 2 4/14/00 3 6/6/00 4 6/26/00 5 8/29/00 6 9/15/00 7 2/13/01 Patient problem Obesity Hypertrophic breast Abdominal deformity Facial dystrophy Unwanted End stage renal Lipodystrophy of abdomen/hips 8 6/8/01 Poor dialysis catheter 9 11/29/ /4/ /2/ /29/ /7/02 Rectal bleeding Hemoccult positive stool Jaundice Cosmetic surgery Cosmetic surgery/ hernia repair /21/03 Unwanted 15 5/12/ /25/03 Excess abdominal skin & muscle laxity Surgical Procedure Abdominoplasty, Liposuction reduction Rhinoplasty, chin implant Termination of Hemodialysis catheter placement Liposuction, laser Resurfacing Dialysis catheter replacement Colonoscopy Liver Biopsy Facelift Neck lift, abdominoplasty, hernia repair Termination of Abdominoplasty & liposuction Complication Provider Anesthesia Anes Prob? Shortness of breath at home following day Bronchospasm during induction Shortness of breath following day, pulmonary embolus Plastic Surgeon Plastic Surgeon General by CRNA Abdominoplasty Plastic Surgeon Intravenous Facial Plastic sedation by Bradycardia Surgeon CRNA Anaphylaxis, cardiac arrest, death OB/GYN Local Unstable blood pressure after procedure Radiologist Local Death autopsy pending Shortness of breath Hypotension, death Cardiopulmonary distress, low blood pressure Pharyngeal/ esophageal perforation Intravenous Gastroenterologist sedation by operating MD Radiologist Local Intravenous Plastic sedation by Surgeon operating MD Internal bleeding Cardiopulmonary arrest in office Collapsed 2 days later, pulmonary embolus Amniotic fluid embolism Pulmonary embolism Hypotrophic breasts implant Rapid bradycardia Plastic Surgeon General by CRNA Radiologist Local Gastroenterologist Intravenous sedation by operating MD Upper endoscopy, colonoscopy Plastic Surgeon OB/GYN Plastic surgery Cosmetic surgeon IV sedation by operating MD IV sedation by operating MD Outcome Facility Accredited? Board Cert? Hosp Priv.? death from pulmonary embolus AAAASF Y Y death Y Y cardiac arrest, death Y Y death Y Y death Y Y death AAAHC Y Y Death that night at home AAAASF Y Y death Y Y Emergency surgery, death soon after Y Y Taken to hospital, corrective surgery, death 8 days later Y Y death Y Y death AAAASF Y Y Pulmonary embolus, Death AAAHC Y Y Transported to hospital, deceased Y Y Deceased at home post-op day 1 AAAASF Y Y Deceased on table in office Y N 1

2 17 11/13/03 Brow Ptosis, recessive chin Liposuction submental area/ Bleparoplasty Deceased 24hrs after surgery at home for unknown cause Plastic Surgery Deceased following day unknown cause Y Y 18 11/24/03 Fat excess abdomen Liposuction & fat transfer Fat embolism Plastic Surgery Deceased 9 days post-op at home AAAASF Y 19 1/7/04 Macromastia Abdominoplasty, breast reduction Respiratory/Renal failure post-op Plastic Surgery Transported hospital, deceased 3 days post-op Y Y 20 4/13/04 Lipodysmorphy Liposuction Cardiorespitatory arrest IV sedation CRNA Death in evening at facility Y Y 21 5/4/04 Coronary Artery Disease Cardiac Catheterization Cardiorespitatory arrest Cardiologist Local Transfer to hospital, death AAAHC Y Y 22 8/1/ /18/04 Abdominal lipodystrophy Lipodystrophy with redundant skin Abdominoplasty Cardiorespitatory arrest at home due to deep vein thrombus Plastic surgeon Liposuction/ Abdominoplasty Pulmonary edema Plastic surgeon To hospital 3 days later, death Y Y Discharged home, to hospital in evening, death at hospital Y Y 24 9/28/04 Bilateral Renal Calculi Shock wave lithotripsy Cardiorespiratory arrest at home Nephrologist Discharged home, death in evening JCAHO Y Y 25 9/29/ /15/05 Severe CAD, Carotid Stenosis Chest pain, SDB Cardiac Catheterization Cardiac catheterization, intravascular ultrasound Cardiacrespiratory arrest on the table Cardiologist Local Dissection of distal left main ostium of LAD and proximal portion of circumflex coronary artery Cardiologist Local Death on the table in office JCAHO Y Y Transfer to hospital, death Y Y 27 11/1/ /19/06 Lung Cancer, Bronchopleural Fistula Stent placement Unknown Fixation of Fractured mandible fractured mandible Allergic reaction Radiologist Oral and Maxilllofacial surgeon IV sedation by MD IV sedation by operating MD Transfer to hospital, death Y Y Transfer to hospital, never regained consciousness, removed from life support 4 days later Y 29 6/15/06 Cosmetic Surgery Facelift, minibreast lift, abdominoplasty Pulmonary embolus Unknown Pulmonary embolus and death 3 days post-op Y 2

3 30 11/13/06 Abdominal and upper arm lipodystrophy Liposuction Pulmonary embolus Transfer to hospital, death AAAASF Y Y 31 11/16/06 Nasal deformity Septorhinoplasty Bradycardia Oral and Maxillofacial Surgeon IV Sedation by operating MD Transfer to hospital, death following morning AAAHC Y Y 32 3/7/07 Varicose veins Ultrasound guided sclerotherapy Anaphylaxis Vascular surgeon ne Transfer to hospital, death AAAHC Y Y 33 6/29/ /22/ /30/07 Change in visual acuity Brow ptosis, facial rhytides hypoplasia Fluorescein angiogram Brow lift, cervicomeloplasty, with submental lipectomy and platysmaplasty augmentation Hypotension/pulsel ess Retina surgeon Local Post operative bleeding Plastic surgeon General Cardiac arrest due to hypokalemia (from previously undiagnosed bulimia) Plastic surgeon General Transfer to hospital, death Y Y Transfer to hospital, death AAAASF Y Y Transfer to hospital, death JCAHO Y Y 36 2/6/08 Low back pain, lumbar radiculopathy Lumbar epidural block n-responsive, pupils fixed and dilated, pain management Local Transfer to hospital, death JCAHO N Y 37 3/21/08 CAD/hypertension Cardiolite spect stress test Ventricular fibrillation Cardiologist ne Transfer to hospital, death Y Y 38 3/21/08 Hypomastia augmentation Malignanat hyperthermia Plastic surgeon General Transfer to hospital, death AAAASF Y Y 39 4/24/08 Cirrhosis, r/o malignancy CT guided liver biopsy Pain, nausea, intraabdominal bleeding radiologist Local Transfer to hospital, death CoC (Commission on Cancer), AAAHC Y Y 40 5/13/08 Aging face and eyes Facelift and blepharoplasty Myocardial infarction Plastic surgeon Local Transfer to hospital, death AAAASF N Y 41 6/5/ /15/08 Skin laxity and breast ptosis Scars, gynecomastia, lipodystrophy Bilateral brachioplasty and bilateral mastopexy Abdominoplasty liposuction Cardiovascular collapse postoperatively Plastic surgeon General Transfer to hospital, death AAAASF Y Y Severe respiratory depression due to overdose of pain rx from variety of physicians Plastic surgeon General Death at home FSMB Y Y 3

4 43 8/26/08 hypoplasia augmentation after placement of tissue expander Death due to patient s illicit drug use Plastic surgeon General Post operative admission, death due to illicit drug use AAAASF and FSMB Y Y 44 10/14/08 Mitral regurgitation Right/left heart catheterization Pulmonary artery rupture Cardiologist Local Postop admission to MICU, death 2/2 PEA AAAHC Y Y 45 2/21/09 Abdominal elastosis, lipodystrophy of flanks and bra rolls Abdominoplasty and liposuction of bra rolls/flanks Postop shock Plastic surgeon General death 2/2 shock Y Y 46 7/15/09 ESRD AV shuntogram PEA, hypotension, LOC evolved into vfib Radiologist Conscious sedation death presumed 2/2 PE Y Y 47 3/4/ /1/10 Dental caries Extraction of teeth Pneumonia, sepsis OMFS Conscious sedation hypoplasia lift/augmentation and revisional abdominoplasty PE, "clots" Plastic surgeon General Coded, to hospital ICU, death from sepsis N Y Y d/c home initially, sudden respiratory distress, admitted, death AAAASF Y Y 49 4/26/10 Unwanted Pregnancy Termination of Amniotic fluid embolus OB/GYN General death N N N 50 5/18/10 Vascular stenosis Angiogram with intervention Retroperitoneal bleeding Vascular surgeon Conscious sedation Hypotension, to hospital, death N Y Y 51 10/25/10 Lipodystrophy Liposucation with fat transfer to buttocks Hypotension, tachypnea, tachycardia Plastic surgeon General death,? PE vs fat embolism N Y Y 52 11/16/10 Unwanted Termination of Hemorrhage OB/GYN General death N Y N 53 12/27/ /16/11 Lipodystrophy Bilateral neck laxity Liposuction of abdomen/flanks/ back and fat transfer to buttocks Fat embolism Plastic surgeon General Lower blepharoplasty, neck lift revision, anterior platysmaplasty Cardiac arrest Plastic surgeon General death N Y N death N Y Y 55 11/4/ /2/11 Lung cancer ESRD Ultrasound guided therapeutic thoracentesis Pneumothorax Radiologist Conscious sedation Left anterior and posterior tibial intervention, right Laceration of right renal stent renal artery Cardiologist Conscious sedation death N Y Y death N Y Y 4

5 57 12/8/11 ESRD Fistulogram Caridac arrest- ACLS radiologist Conscious sedation death N Y Y 58 6/11/11 Lipodystrophy Tumescent liposculpture Shortness of breath, unresponsive General surgeon Local (Tumescent) death N N N 59 2/20/12 Anemia EGD Unresponsive, pulseless Gastroenterolog ist Conscious sedation death N Y Y 60 3/19/12 ESRD Thrombectomy of fistula Unresponsive, respiratory arrest, coded radiologist Conscious sedation ACLS initiated, intubated, to hospital, death JCAHO Y Y 61 3/22/12 Lipohypertrophy Liposuction (2500cc removed) Hypotension, desaturation (? Pulm. Or fat embolus) General death N Y Y 62 4/19/12 ESRD Access thrombectomy Desaturation, hypotension (?PE) Vascular surgeon General death JCAHO N N 63 4/30/12 Colon polyps Endoscopic ultrasound with polyp removal Nausea, vomiting, leg pain Gastroenterolog ist Conscious sedation death Y Y 64 5/2/12 PAD balloon angioplasty Nausea, emesis, hypotension Vascular Surgeon Local death N N Y 65 7/25/12 ESRD Vascular access declot Change in mental status, hypotension, PEA radiologist Conscious sedation ACLS initiated, death Y Y 66 7/27/12 ESRD Graft declot Unresponsive radiologist Conscious sedation death Y Y 67 9/26/12 Unwanted Termination of Perforation, sepsis OB-GYN Local death N Y Y 68 10/24/12 ESRD Removal of RIJ HD catheter, placement of LIJ HD catheter Agonal breaths, unresponsive Nephrologist Conscious sedation ACLS initiated, death Y Y 69 11/2/12 lipohypertrophy Tumescent (smartlipo laser) liposuction Seizure (? Acute anaphylactic rxn to lidocaine) Internal medicine ( cosmetic surgeon ) Local death N N Y 5

6 70 6/20/13 ESRD Catheter exchange Hemoptysis, hypoxemia, intubated Nephrologist Conscious sedation to hospice, death JCAHO Y Y 71 7/11/13 Atrophic buttoks, lipodystrophy 4L of liposuction, fat transfer to buttocks Hypotension, unresponsive, PE? from fat Dermatologist General Tranfser to hospital, Death Y Y 72 7/31/13 Chronic sinusitis Balloon sinuplasty Lethargy, seizure, pulseless arrest ENT Local Transfer to hospital, death Y Y 73 12/18/13 ESRD Fistula angioplasty Unresponsive, apneic, hypotensive Nephrologist Conscious sedation death Y Y 74 4/3/14 artery Endovascular intervention Unresponsive at home Vascular surgeon Conscious sedation pronounced dead Y Y 75 5/19/14 ESRD AV fistula declot Cardiopulmonary arrest cardiologist Conscious sedation ACLS initiated, BP and HR restored, to hospital, death AAAHC Table 2. Office procedures resulting in hospital transfer or other complication in Florida. 3/1/00 7/1/14. Case # Patient problem 1 2/10/00 Pregnancy 2 2/22/00 3 4/21/00 4 6/21/00 5 6/22/00 6 6/27/00 7 6/30/00 8 7/10/00 9 7/14/00 Skin Cancer Surgical Procedure Termination of Excision of skin cancer Complication Provider Anesthesia Uterine perforation 2 nd degree burn of face Facial laxity Facelift Hematoma Acute congestive Abdominal heart failure, Lipodystrophy Liposuction cardiomyopathy Internal Hemorrhoidal Hemorrhoids artery ligation Lipodystrophy Cosmetic breast Cosmetic liposuction Nasal deformity Cosmetic Liposuction OB/GYN Dermatologist Facial Plastic Surgeon Pudendal block by CRNA Intravenous sedation by CRNA Intravenous sedation by MD General by CRNA Anes Prob? Lost needle, vasovagal rxn Vascular Surgeon Topical Low BP in recovery Mastopexy/ Augmentation Pneumothorax Liposuction, breast Bronchcospasm on augmentation. extubation Rhinoplasty Bronchcospasm after procedure General by CRNA Outcome Facility Accredited? Boa rd Cert.? Hos p Priv.? recovered Y Y burns healed Y recovered AAAHC Y Y discharged 3 days later AAAASF Y Y no death Y Y Discharged hospital next day AAAHC Y Y discharged next day JCAHO Y Y To hospital. Recovered AAAHC Y Y To hospital discharged from hospital 2½ hours AAAASF Y Y 6

7 10 7/18/ /15/00 Liposuction/ Eye lift Fetal demise Liposuction/ Blepharoplasty Termination of Myocardial infarction Asystole, amniotic fluid embolus OB/GYN Intravenous sedation by operating MD To hospital. Recovered AAAHC Y Y recovered Y Y 12 9/19/00 Pregnancy termination Pregnancy 13 9/19/00 Facial laxity Rhytidectomy 14 9/19/ /29/ /31/ /08/ /20/ /30/00 Gynecomastia GI bleed/ Ventral hernia Cosmetic breasts Cosmetic liposuction surgery Circumcision 20 2/12/01 Basal cell cancer 21 4/10/01 Liposuction/ Excision Virtual colonoscopy augmentation Liposuction surgery Routine circumcision Uterine perforation OB/GYN Regional block Hematoma, Facial Plastic General by recurrent Surgeon CRNA Intravenous Hematoma/ low sedation by BP CRNA Bowel perforation at hernia Pneumothorax Post-operative Low PO2, no symptoms Possible early malignant Hyperthermia Radiologist Intravenous sedation by operating MD Intravenous sedation by CRNA Accidental cut of glans penis OB/GYN ne Excision of skin cancer Possible TIA Local Intravenous Gastric aspiration, sedation by MD Liposuction laryngospasm Lipodystrophy 22 5/01/01 implant implant Pneumothorax 23 5/12/01 Infertility Oocyte retrieval OB/GYN 24 5/16/01 implant implant Pneumothorax 25 5/17/ /15/01 Azospermia Hematuria, Foley removal 27 6/15/01 Undesired 28 6/19/ /30/ /3/01 Lipodystrophy Wrinkles 31 8/16/01 Excess abdominal skin 32 12/21/01 Lipodystrophy General by CRNA Intravenous Chest pain, SOB, sedation by MD no cause found Intravenous Vasectomy Pulse rate sedation by reversal increased Urologist CRNA? Office cystoscopy Syncopal episode Urologist Local Uterine perforation with Intravenous Termination of sigmoid colon sedation by tear OB/GYN operating MD Blepharoplasty Liposuction Laser peel, eyelid & neck lift Ptosis Blepharochalasis Abdominoplasty Liposuction Hypoxia s/p extubation, obtunded Low blood pressure in recovery Respiratory failure/acute pulmonary edema Premature ventricular contractions on induction Vasovagal on discharge from office Dermatologist General by CRNA Intravenous sedation by CRNA? General by CRNA no death Y Y no death AAAHC Y Y recovered AAAASF Y Y recovered Y Y discharged 4 hrs later AAAASF Y Y recovered AAAASF Y Y recovered AAAASF Y Y repaired same day Y Y no death Y Y no death AAAASF Y Y no death AAAASF Y Y no death Y Y no death AAAASF Y Y no death JCAHO Y Y no death Y Y no death Y Y discharged next day AAAHC Y Y Discharged next day AAAHC Y Y no death AAAASF Y Y no death Y Y discharged next day AAAHC Y Y 7

8 33 1/15/ /19/02 Lax anterior abdomen Colonic polyp Colonoscopy Urinary retention/ stricture Chest abdominal pain Abdominoplasty Gastroenterologist General by CRNA Intravenous sedation, by operating MD discharged same day AAAASF N Y no death Y Y 35 3/21/02 Cosmetic breast augmentation 36 3/22/02 Heme positive stool 37 3/26/02 Infertility 38 5/14/02 Basal cell carcinoma augmentation Colonoscopy Aspiration of ovary Excision of skin cancer Ventricular tachycardia Perforated colon during colonoscopy Hemorrhage; cardiac arrest Atrial fibrillation 2 hours following procedure Gastroenterologist OB/GYN Dermatologist Intravenous sedation by CRNA IV sedation by operating MD Intravenous sedation by MD Local (0.4 cc 2% lido) no death AAAASF Y Y no sequelae Y Y no death Y Y Drove self to hosp. admission Y Y 41 11/27/ /13/ /3/03 Bleeding during polyp removal Sinus arrhythmias; low blood pressure Gastroenterologist 39 6/11/02 Colonic polyp Colonoscopy 40 8/8/02 Abdominal Abdominoplasty laxity Facelift Facelift Atrial fibrillation Abdominoplastyplasty Abdomino- Hypotension, liposuction. liposuction. deceased P02 Hypotrophic breasts augmentation Pneumothorax 44 4/24/03 Infertility, endometriosis Oocyte retrieval Hypoxemia OB/GYN 45 5/6/03 Facial rhytids Abdominal 46 elastosis, 5/29/03 lipodystrophy 47 5/23/03 Gynecomastia, lipodystrophy 48 6/16/03 Excessive fat 49 6/17/03 Intravenous sedation, by operating MD General by DO? General by CRNA? General by CRNA IV sedation by CRNA Periorbital laser resurfacing, nasolabial fold implants Chest pain Plastic Surgery Local Abdominoplasty and liposuction Liposuction of chest and flanks Lipectomy Post-op elevated temperature Hypotensive, widecomplex tachycardia Post-operative infection Plastic Surgery Plastic Surgery Plastic Surgery Lipodystrophy Liposuction Bowel perforation Plastic Surgery 50 Pneumothorax, 7/1/03 breast augm. D Der 51 Dermatocholasis, Dermatoc 7/22/03 actinic damage 52 9/12/ /30/04 Fat excess of hips augmentation Pneumothorax two weeks later Plastic Surgery Laser treatment facial rhytids Seizure Plastic Surgery Liposuction/ left breast implant capsular plication Acute rise of systolic blood pressure Plastic Surgery Obesity Abdominoplasty Cellulitis Plastic surgeon General by operating MD Local by operating MD To hosp, no death Y Y no adverse sequelae AAAASF Y Y To hosp for cardioversio n AAAASF Y Y no death Y Y 48 hours in hospital, no chest tube AAAASF Y Y Transported to hospital, no death Y Y Transported to hospital, no death Y Y Complete recovery Y Y Transported to hospital, no death AAAAHC Y Y Complete recovery AAAASF Y Y Transported to hospital, no death AAAASF Y Y Transported to hospital, no death Y Y Complete recovery Y Y Complete recovery AAAASF Y Y Admitted to hospital AAAASF Y Y 8

9 54 2/18/ /27/ /3/ /22/03 Hypomastia Hypomastia augmentation Allergic to anesthesia Plastic Surgery augmentation Pneumothorax Plastic Surgery Colon polyps Polypectomy Bowel perforation Gastroenterologist Bilat. Endoscopic Bilateral breast breast involution augmentation Irregular heart rate Plastic Surgery IV sedation by CRNA Transported to hospital, no death AAAASF Y Y Transported to hospital, no death AAAASF Y Y Transported to hospital, no death Y Y Transported to hospital, no death AAAASF Y Y 58 9/9/03 Ptotic skin, gastric bypass and weight loss Reconstructive mastopexies and abdominoplasty Pneumothorax Plastic Surgery Transported to hospital, no death JCAHO N N 59 5/10/03 Abdominal elastosis Abdominoplasty Bleeding General CRNA to operating room, recovered Y Y 60 11/11/03 Cosmetic Ruptured silicone implants Hypotension work up Y Y 61 2/18/ /27/ /2/04 Hypomastia Hypomastia Augmentation Anaphylaxis Augmentation Pneumothorax Hepatitis Liver Biopsy Bleeding Radiologist Local observation AAAASF Y Y observation, discharged next day AAAASF Y Y overnight observation and discharge in a.m. Y Y 64 3/15/04 Hypoplasia of /Excess Fat Augmentation/ Liposuction Respiratory Depression/ Pulmonary Edema discharged next day AAAASF Y Y 65 3/16/04 Hypotension/ Carotid Stenosis Carotid Angiogram Retroperitoneal Bleed Cardiologist Local Operating MD To hospital Y Y 66 3/29/04 Eyelid Ptosis Blephroplasty Altered mental status Oculoplastic Surgeon observation Y Y 67 4/2/04 Abdominal Laxity/ Excess Fat 68 4/6/04 Abdominoplasty/ Reduction Syncope/ Orthostatic Hypotension General CRNA Colon Polyps Colonoscopy Bowel perforation Gastroenterologist IV sedation CRNA discharged next day Y Y To home then to hospital next day, surgical repair Y Y 69 4/29/04 Mammary Hypoplasia Augmentation Increased Heart Rate/ Blood pressure observation AAAASF Y Y 9

10 70 4/29/04 Colon Polyps Colonoscopy Rectal Bleeding Gastroenterologist IV sedation CRNA observation, discharged next day Y Y 71 4/29/04 Colon Polyps Colonoscopy Rectal Bleeding Gastroenterologist IV sedation Operating MD observation Y Y 72 5/3/04 Colon Polyps Colonoscopy Distended abdomen/ Colon perforation Gastroenterologist IV sedation Operating MD treatment Y Y 73 5/12/04 Macromastia/ Excess Fat/ Brow Ptosis/ Nasal Deformity/ Elastosis Reduction/ Liposuction/ Rhinoplasty/ Face lift/ Brow Lift Upper Airway Obstruction observation and extubation Y Y 74 7/2/04 Rectal Cancer PET Scan Bleeding/ Urethral Tear on catheter placement Nuclear medicine N/A evaluation and treatment Y Y 75 7/10/04 Abdominal Elastosis Abdominoplasty Hypotension following Syncope General CRNA Home then to hospital in am Y Y 76 7/23/04 Lipodystrophy Liposuction Blood Transfusion/ Hypoxia General CRNA evaluation and observation Y Y 77 7/29/04 Bilateral micromastia Augmentation Hematoma Home for 2 weeks then to hospital AAAASF Y Y 78 7/30/04 Lipodystrophy Liposuction Cellulitis/ Induration Facial Plastics IV sedation CRNA Home for 7 days then to hospital AAAHC Y Y 79 8/12/04 Tubal factor infertility Transvaginal oocyte retrieval Abdominal Pain OB/GYN IV sedation CRNA evaluatiaon Y Y 80 8/13/04 Laxity Facial Skin/ Brow Ptosis 81 9/13/04 Brow Ptosis/ Perceived mammary hypoplasia Face/ Neck Lift/ Blepharoplasty Augmentation/ Brow lift 82 10/4/04 Hypoplasia/ Reduction/ Lipodystrophy Liposuction Hypertension and irregular tachycardia Syncope/ Hypotension/ Tachycardia ST elevation/ Paroxysmal ventricular contractions To hospital Y Y evaluation and observation Y Y evaluation AAAASF Y Y 83 10/22/04 Facial aging Neck/ Brow/ Face lift Paroxysmal atrial fibrillation and hypotension General DO evaluation AAAASF Y Y 10

11 84 2/17/05 Ruptured silicone breast implant Capsular contracture High riding breast implants Exchange of implants/ Revision of submuscular pocket / Partial Capsulectomy Hematoma General DO Home for 12 days, then another surgery AAASF Y Y 85 3/14/05 Excessive skin and fat of abdomen Lipectomy Ventricular Fibrillation evaluation and treatment 86 3/19/05 Nasal deformity Rhinoplasty Laryngospasm observation Y Y 87 3/21/05 involution and ptosis Augmentation / mastopexy Hematoma Home for 10 days, then another surgery AAAASF Y Y 88 4/15/05 Abdominal elastosis Abdominoplasty Fell in hotel room, Low Hgb blood transfusion and observation Y 89 4/15/05 Spinal stenosis Vertebroplasty Vasovagal episode Orthopeadic Surgeon Local observation Y Y 90 4/21/05 Bilateral Renal Calculi Lithotripsy / Ureteroscopy / Cystoscopy Fever Urologist evaluation JCAHO Y Y 91 4/27/05 Facial Aging Browlift, Facelift Hyperthermia observation Y Y 92 5/4/05 Abdominal elastosis Abdominoplasty Hematoma To hospital to drain and for observation AAAASF Y Y 93 5/9/05 Abdominal laxity Abdominoplasty DVT To hospital 4 days later Y Y 94 5/11/05 Urinary retention, phimosis Treatment of paraphimosis Reaction to Demerol? Urologist Demerol 25 mg IM observation Y Y 95 5/12/ /24/05 Chest pain Dysphagia, screening colonoscopy Left Heart Catheteization Retroperitoneal bleed Cardiologist Conscious sedation Unable to intubate esophagus, bleeding noticed, Zenker s diverticulum EGD, colonoscopy discovered in hospital Gastroenterologist Conscious sedation observation Y Y surgery Y Y 97 5/24/05 Screening colonoscopy Screening colonoscopy Rectal perforation Gastroenterologist Conscious sedation surgical consult Y Y 98 6/16/05 Macromastia Reduction Pneumothorax General CRNA Admitted to hospital 4 days post op Y 11

12 99 6/21/05 Screening procedure Sigmoidoscopy Post polypectomy bleeding Gastroenterologist Conscious sedation Returned to office next day for treatment, then to hospital for observation Y Y 100 7/7/05 Mammary hypoplasia augmentation Seizure General by CRNA observation Y 101 7/18/05 Ischemic cardiomyopathy Heart catheterization Hematoma and hypotension Cardiologist Conscious sedation observation Y Y 102 7/26/05 Occlusive lesion of Esophagogastrodu esophagus odenoscopy (EGD) Esophageal perforation Gastroenterologist Conscious sedation surgery Y Y 103 7/18/05 Abdominal elastosis Abdominoplasty Respiratory Distress caused by Thyroid Storm 104 8/2/05 History of colon polyps Colonoscopy Colon perforation Gastroenterologist Conscious sedation observation and treatment Y Y Home, then to hospital that night for another surgery Y Y 105 8/8/05 Acquired nasal deformity Revision Rhinoplasty Atrial fibrillation Otolaryngologist General DO observation AAAHC Y Y 106 8/24/05 Lipodystrophy Liposuction Infection due to colon perforation Patient went to hospital 5 days post-op Y Y 107 9/18/05 Abdominal elastosis Abdominoplasty Anemia requiring transfusion Admitted to hospital 2 days post-op Y Y 108 9/30/05 Chest pain Heart catheterization Acute dissection of left main coronary artery Cardiologist Conscious Sedation / Local Analgesia evaluation and further intervention AAAHC Y Y /31/05 End stage renal SVC Gram, Bilateral Arm Venogram Allergic Reaction to contrast dye Radiologist Local observation Y Y /9/05 Labia hyperplasia Cosmetic Labiaplasty Supraventricular tachycardia OB/GYN IV Sedation by operating MD Patient went to hospital later that day Y Y /13/05 Colon polyps Colonoscopy Colon perforation Gastroenterologist Conscious sedation observation Y Y /14/05 Mammary hypoplasia Augmentation / Benelli lift Pneumothorax Patient went to hospital 13 days later Y Y /15/05 Dysphagia, constipation Endoscopic evaluation Colon perforation Gastroenterologist Conscious sedation surgical consult Y Y 12

13 114 1/12/06 Skin laxity following weight loss Abdominoplasty Orthostatic hypotension Patient kept overnight Y Y 115 1/30/06 Ureteral calculus Ureteroscopy Ureteral perforation Urologist CT and observation JCAHO Y Y 116 4/7/06 Facial rhytids Facelift Hematoma, 2 days post-op Otolaryngologist airway management, tracheostomy AAAHC Y Y 117 5/306 Abdominal lipodystrophy/ mammary hypoplasia Abdominoplasty, lipectomy, breast augmentation w/ Benelli lift Pneumothorax chest tube Y Y 118 5/18/ /23/ /24/ /5/ /5/06 deformity Facial cellulits/abscess reconstruction and implant exchange Bleeding Endoscopic browlift, midface lift, and bilateral upper and lower blepharoplasties Infertility Oocyte retrieval Bleeding Cutis laxa of abdomen Atrophic breasts and lipo dystrophy Abdominoplasty & suction assisted lipectomy augmentation & suction assisted lipectomy Infection, 16 days post-op Otolaryngologist MAC Anesthesia Infection, 16 days post-op Bilateral pneumothorax, 1 day post-op Reproductive Endocrinologist IV Sedation CRNA Physician trained abroad. 1year of surgery and 1 year fellowship in plastic surgery in US Physician trained abroad. 1year of surgery and 1 year fellowship in plastic surgery in US Patient observed overnight Y Y Patient presented to ER AAAHC Y Y observation Y Y surgery to remove bacteria from incision Y Admitted to hospital, discharged 5 days later Y 123 7/13/06 Screening colonoscopy Screening colonoscopy Renal failure, bowel perforation Gastroenterologist Conscious sedation Admitted to hospital next day Y Y 124 7/14/06 Lipodystrophy Liposuction and abdominoplasty Hypotension blood transfusion AAAHC Y Y 125 8/9/06 Hypomastia augmentation Negative pressure pulmonary edema Transferred to hospital for treatment Y 126 8/15/06 Excess skin Abdominoplasty Hematoma Transferred to hospital for evacuation Y Y 127 8/21/06 Lipodystrophy, macromastia augmentation, abdominoplasty Hypotension Transferred to hospital for treatment and observation Y Y 128 9/20/06 Cosmetic Surgery Autologous fat grafting Intravascular injection of local w/ epinephrine IV sedation, CRNA Transferred to hospital for BP management AAAASF Y Y 13

14 129 9/20/06 Gynecomastia 130 9/22/06 Screening colonoscopy Abdominoplasty, liposuction Infection, sepsis Screening colonoscopy Bowel perforation Gastroenterologist Conscious sedation Transferred to hospital for management of sepsis AAAASF Y Y Transferred to hospital for repair of perforation Y Y /13/06 Basal cell carcinoma MOHS Wrong surgical site Dermatology Local Wrong surgical site Y Y /18/06 UPJ stricture Ureteroscopy incision of UPJ stricture Severe post-op nausea Urology Sever post-op nausea JCAHO Y Y /25/ /25/ /6/06 Carotid Stenosis Angioplasty Bleeding Vascular Surgeon Local Hypomastia Screening upper endoscopy/ colonoscopy augmentation breathing from succinylcholine, pseudocholinesterase deficiency Screening upper endoscopy/ colonoscopy Colon perforation Gastroenterologist Conscious sedation Presented to ER same day Y Y Transferred to hospital for observation Y Transferred to hospital for repair of perforation Y Y /16/06 Varicose veins Endovascular vein closure EVLT Infection Radiologist Local antibiotic Tx Y Y /21/06 Cutis Laxa Face Lift Chest pain, tachycardia Transferred to hospital for observation Y Y /27/06 Rectal Bleeding Hx colon polyps Colonscopy Bowel perforation Gastroenterologist MAC Anesthesia MD Transferred to hospital for repair of perforation Y Y /28/06 Colorectal cancer & metastasis Liver Biopsy Severe abdomen pain /7/06 Claudication Lower extremity angioplasty & endovascular reconstruction Bleeding Diagnostic Radiologist Local Radiologist Local Transferred to hospital for observation Y Y Presented to ER same day Y Y 141 1/17/07 Varicose veins Endovascular vein closure EVLT Infection Radiologist Local antibiotic Tx Y Y 142 3/5/07 Facial cutis laxa Mini facelift Vasovagal reaction Plastic surgeon Local observation AAAASF Y Y 143 3/6/07 Renal failure Declot fistula Congestive heart failure radiologist Conscious sedation To ICU, d/c to nursing home Y Y 14

15 144 3/8/07 Abdominal laxity, breast ptosis 145 3/24/07 Lipohypertrophy lift, abdominoplasty, liposuction Pulmonary edema Plastic surgeon General Excision of excess skin Unarousable secondary to obstructive sleep apnea Plastic surgeon Conscious sedation diuretics, d/c home AAAASF Y Y Intubated, transfer to hospital, d/c home FSMB Y Y 146 4/3/07 Hypomastia augmentation n-cardiac pulmonary edema Plastic surgeon General Transfer to hospital, d/c home next day AAAASF Y Y 147 4/6/ /26/07 lymphoma bone marrow bx febrile, somnolent squamous intraepithelial dysplasia 149 5/8/07 cervical facial laxity 150 5/16/07 iron defic anemia 151 5/16/07 breast capsular contracture LEEP (loop electrosurgical excision procedure) face lift upper and lower endoscopy bladder perforation interventional radiologist conscious sedation no obstetrics - gynecology local no hypertensive emergency plastic surgeon general yes perforated diverticulum gastroenterologist MAC no capsular contracture release, breast implant post-op infection plastic surgeon general no observation no yes surgical repair of bladder, discharged AIUM yes coded in office, transferred to ICU, discharged home FSMB yes surgical repair of sigmoid colon, d/c home FSMB yes implant removed, IV abx, d/c home FSMB yes 152 6/18/07 peripheral vascular dz angioplasty hematoma with hypotension vasc surgeon conscious sedation no to hospital for observation ICAVL yes 153 6/28/ /29/07 Lipodystrophy liposculpture seizure activity vasc and gen surgeon tumescent yes lipohypertrophy abdominoplasty with suction assisted lipectomy deep vein thrombosis plastic surgeon general no to hospital for observation FSMB yes antigcoagulation treatment, d/c home FSMB yes 155 7/5/07 peripheral vascular dz angiogram atrial fibrillation vasc surgeon conscious sedation no 156 7/18/07 aortic stenosis, atrial fibrillation 157 7/25/07 renal artery stenosis 158 8/2/07 right and left cardiac catheterization renal artery angiogram and stent right leg embolus with pulselessness, subsequent hematoma retroperitoneal hematoma interventional cardiologist local no interventional radiologist local no buttock hypoplasia with lipohypertrophy of liposuction with fat abdomen transfer to buttocks cellulitis and anemia plastic surgeon general no d/c home no yes surgical repair and embolectomy. Later hematoma evac, then d/c home JCAHO yes supportive care, transfusion, d/c home yes supportive care, d/c home AAAASF yes 15

16 159 8/6/07 RT stent placement right renal calculus URS and SWL acute respiratory distress urologist general no supportive care, d/c home JCAHO yes 160 8/7/07 thrombocythemia, coagulopathy bone marrow bx vasovagal rxn hematology/oncologis t local no home yes 161 9/7/07 aging face and neck face lift and platysmaplasty hypotension, tachycardia with ectopy plastic surgeon general no home AAAASF yes 162 9/18/07 facial cutis laxa, blepharochalasis mini facelift and blepharoplasty oversedation plastic surgeon local and sedation yes home AAAASF yes 163 9/25/07 colitis colonoscopy atrial fibrillation with rapid ventricular response gastroenterologist sedation no rate control, d/c home yes 164 9/27/07 abdominal laxity, excess adiposity abdominoplasty postoperative infection (day 11), cellulitis plastic surgeon general no IV abx, I&D of abscess, d/c home AAAASF yes /1/07 hypomastia breast augmentation 1cm tear between 4-5th rib plastic surgeon general no monitoring for pneumothorax, d/c home no /15/07 mesenteric artery stenosis angiogram, poss mesenteric PTA/stent right foot pulselessness, pale, cool vascular surgeon local no thrombectomy, d/c home ICAVL yes /17/07 vertebral compression fracture vertebroplasty third degree heart block interventional radiologist local no home yes /29/07 lung cancer port insertion hypotension, hemothorax interventional radiologist local no chest tube and drainage, d/c home yes /1/07 ESRD fistulogram labored breathing, premature ventricular contractions interventional radiologist conscious sedation no home yes /7/07 facial cutis laxa rhytidectomy post operative infection otolaryngologist, facial plastic surgeon general no IV antibiotics, d/c home AAAASF yes /14/07 vertebral compression fracture vertebroplasty apnea due to oversedation interventional radiologist conscious sedation yes monitoring, d/c home yes /11/07 breast hypoplasia breast augmentation cardiopulmonary arrest plastic surgeon general yes resuscitated, d/c home AAAASF yes /14/07 claudication abdominal aortogram with angioplasty chest pain, htn interventional cardiologist local no home yes 16

17 174 1/3/08 facial cutis laxa mini facelift, brow lift facial cellulitis otolaryngologist, facial plastic surgeon general no IV antibiotics, d/c home yes 175 1/18/08 ESRD 176 2/4/08 abdominal laxity, excess adiposity 177 2/7/08 submental fat tesio catheter removal abdominoplasty patient became nonresponsive interventional radiologist local no pneumonitis, pulmonary edema with bloody emesis plastic surgeon general no submental liposuction and fat otolaryngologist, transplant overextended bladder facial plastic surgeon conscious sedation no neurologic work up, d/c home yes stabilized and diuresed, d/c home AAAASF yes foley catheter placement, d/c home AAAHC yes 178 2/19/ /23/08 CAD excess adiposity 180 2/25/08 heart failure, cardiomyopathy left heart cath and angiography liposuction cardiac catheterization acute pulmonary edema deep vein thrombosis with pulmonary embolus severe SOB, systolic dysfunction, worsened heart failure interventional cardiologist local no otolaryngologist, facial plastic surgeon general no interventional cardiologist local no ICD implantation, d/c home yes antigcoagulation treatment, d/c home yes aortic valve replacement, d/c home yes 181 2/27/ /4/08 hypomastia cardiac monitoring breast augmentation Left heart cath/aortography/ femoral runoff breast asymmetry due to retained sponge plastic surgeon general no ischemic right lower limb interventional cardiologist local no surgical removal of raytec sponge yes femoralpopliteal bypass graft surgically placed above the knee, embolectomy of femoral artery yes 183 3/12/08 ptosis of facial tissue partial facelift retroauricular hematoma plastic surgeon general no hematoma drained in office no 184 3/14/08 unacceptable appearance cosmetic surgery left lung atelectasis plastic surgeon general yes home yes 185 3/19/08 chronic abdominal pain, diverticulosis endoscopy, colonoscopy extraluminal air, abdominal bloating gastroenterologist conscious sedation no right hemicolectomy, d/c home AAAASF, FSMB yes 186 3/21/08 blepharochalasis blepharoplasty apnea due to oversedation plastic surgeon conscious sedation yes home yes 187 4/10/08 ESRD declot graft nausea, emesis, febrile interventional radiologist local no IV abx, d/c home yes 17

18 188 4/28/ /6/08 multiple sclerosis mild aortic stenosis pump fill right and left cardiac catheterization non-responsive due to fentanyl leak from pump hypoxemic, respiratory arrest, hypotensive PM&R, pain management local no interventional cardiologist local with versed for anxiety yes home yes aspiration and airway stabilization, tx to ICU yes 190 5/7/08 hypomastia breast augmentation tear in left intercostal pleura plastic surgeon general no home yes 191 5/16/08 chest pain, DOE left heart catheterization acute convulsive syncope and vasovagal episode interventional cardiologist local no home yes 192 5/18/07 severe CAD, severe aortic stenosis, htn 193 5/23/08 termination of right and left cardiac catheterization dilation and evacuation incoherent speech, fixed gaze, right sided weakness uterine perforation, bowel ischemia interventional cardiologist local no obstetrics - gynecology general no management of CVA yes surgical repair of uterus, partial bowel resection and reanastamosis no 194 5/23/08 breast hypoplasia breast augmentation seizure activity, chills, hypoxemic plastic surgeon local tumescent with versed yes home AAAASF yes 195 6/13/08 increasing chest pain left heart catheterization SOB, chest pain, bradycardia interventional cardiologist local no home yes 196 6/16/08 ESRD Renal artery stent placement Perforation (seen on imaging) cardiologist Conscious sedation 197 6/16/08 Chest pain Diagnostic heart catheterization Arrhythmia Cardiologist Conscious sedation 198 7/3/08 ischemic pain at rest, L foot 199 7/3/08 colon screening left lower extremity angiogram colonoscopy hematoma of L flank and abdominal wall vascular surgeon local no perforation of sigmoid colon gastroenterologist MAC no home yes partial colon resection with reanastamosis, d/c home AAAASF, FSMB yes 200 8/29/ /15/08 Colon screening colonoscopy rectal bleeding gastroenterologist conscious sedation no Colon screening colonoscopy Persistent po2 despite reversal meds gastroenterologist conscious sedation no bleeding scan neg., d/c home s/p 24h obs. yes To cardiologist s office/admitted, d/c home yes 18

19 202 9/16/08 Unwanted Pregnancy termination Status asthmaticus Ob/gyn general no Coded, CPR, to hospital ICU, d/c home yes 203 9/29/ /2/08 Persistent abdominal pain, colon screening Hypomastia colonoscopy augmentation Mucosal laceration observed, abdo. Pain/distention gastroenterologist Conscious sedation no Left tension pneumothorax Plastic surgeon General home yes chest tube inserted, admitted, home AAAASF yes /1/08 Recurrent small cell lung cancer /2/08 Facial volume loss 207 9/30/08 Deviated nasal septum, nasal deformity CT guided lung biopsy Autologous fat transfer Septoplasty, rhinoplasty Severe agitation and mental status changepresumed allergic drug reaction radiologist Conscious sedation Severe agitation, combativeness, mental status change Plastic surgeon local no Recurrent postoperative hemorrhage ENT General no home yes Pt using illicit GHB, to hospital, home yes hematologic w/u negative, repeat packing, embolization of internal maxillary artery, d/c home AAAHC yes /31/08 Unacceptable nasal appearance /27/08 ALS, progressive weight loss /17/ /21/08 Abnormal EKG Rhinoplasty/autolo guous fat transfer to face Fluoroscopic guided G-tube insertion Negative pressure pulmonary edema Plastic surgeon General no CO2 retention, somnolence radiologist Conscious sedation Adenosine myocardial perfusion stress exam Respiratory distress Cardiologist Local yes Claudication Angiogram Chest pressure radiologist Local home bipap home no Albuterol treatment, to hospital, home AAAHC yes NTG spray, labetalol, to hospital, home no /21/ /8/08 Abnormal cardiovascular study Right/left cardiac catheterization Prominent leg veins/telangiectas Ultrasound guided ia sclerotherapy Postop expanding hematoma Cardiologist local Allergic reaction to sotradecol Family Medicine Local no USN done and neg, d/c home yes Epipen injection, IM benadryl, to hospital, home no yes 214 6/23/08 Chest pain, abnormal stress test Right/left cardiac catheterization Retroperitoneal hematoma Cardiology Local CT A/P, home yes 19

20 215 1/6/09 Renal stenosis 216 1/16/ /7/08 (report rec d 1/09) 218 1/22/ /10/09 Left renal artery stent/angiography Bradycardia, hypotension, left flank pain Vascular Surgery Local Barrett s Esophagus; Hiatal Hernia EGD Arrhythmia Gastroenterologist Conscious sedation Ateriosclerotic heart Unwanted Pregnancy Unwanted Pregnancy /18/08 (report rec d 2/17/09) CAD, PAD 221 2/6/ /23/ /19/ /4/09 Abdominal laxity, excess adiposity Claudication w/ ulceration Recurrent colorectal mets Unacceptable cosmetic appearance 225 3/12/09 Elevated PSA 226 3/10/09 Abnormal stress test Left Heart Catheterization Pregnancy Termination (20 weeks gestation) Dilatation and evacuation Anaphylaxis (presumed 2/2 omnipaque) Cardiologist Local Hemorrhage 2/2 uterine artery rupture Ob/gyn Conscious sedation Hemorrhage 2/2 uterine artery rupture and cervical laceration Ob/gyn Conscious sedation Left heart catheterization and coronary angiography MS changes (word finding difficulty, confusion) similar to prior hx TIA s/p CEA Cardiology Local Abdominoplasty with f/u placation repair Angiogram CT guided percutaneous RFA mets lesion in lung Hematoma, abdominal pain Plastic surgery General Uncontrolled SVT with hypotension Vascular Surgery Conscious sedation Pneumothorax Radiology Conscious sedation Liposuction abdomen, hips, flanks, rhinoplasty Pneumothorax Plastic surgery General Prostate USN and Bx Diagnostic left heart catheterization Severe postop pain and transient unresponsiveness Urologist Local Coronary dissection and occlusion Cardiologist Local Stat CT, IVF, atropine, repeat renal angio with coil embolization, To Hospital, To Hospital in stable condition, Benadryl/Soluc ortef, To hospital, transfused PRBCs, home home neuro consult, hematoma evacuated, IVF, IV beta blockers, to hospital, To Hospital, chest tube chest tube, TO hospital, observation, pain control, d/c emergency cardiac surgery, 227 4/8/09 Colon screening Colonoscopy 228 4/22/09 CAD Diagnostic left heart catheterization Persistent abdominal pain Gastroenterologist Conscious sedation Ruptured right femoral artery pseudoaneurysm w/ large hematoma Cardiologist Local repair by vascular surgeon, d/c 20

21 229 5/11/09 Facial laxity 230 5/14/09 asymmetry and lipodystrophy 231 4/28/09 (report rec d mid 5/09) Hypomastia 232 5/13/ /8/09 Excessive adiposity and tissue laxity Hypomastia, breast asymmetry, tuberous breast deformity Facelift, neck liposuction Atrial fibrillation, MI Plastic surgeon General Left breast implant exchange and revision liposuction of outer thighs Hypertension, ventricular bigeminy Plastic surgeon General no augmentation Pneumothorax Plastic surgeon General Postoperative hypotension (? Smart Lipo Administration abdomen/bra unknown substance rolls/flanks/inner by pt s family thighs member?) General Circumareolar mastopexy and breast augmentation Dyspnea Plastic surgeon General cardiac cath, medical Rx home AAAASF chest tube, admission, obs, d/c To ER, observed, neg. w/u, d/c home AAAASF 234 6/16/09 ESRD Tunneled HD catheter exchange procedure Excessive secretions, arrhythmia with EKG changes Radiologist Conscious sedation 235 6/17/09 ESRD AV fistulogram 236 6/20/09 Hypomastia, lipodystophy augmentation, smart LIPO Hypotension, PEA w/ spontaneous respirations Radiologist Conscious sedation Loss of conciousmess (4 days s/p procedure, wound? infected) General Wound explored, LOC, transferred, pt treated for infection 237 6/23/09 Aging face, lipodystrophy Facelift, liposuction of trunk arrhythmia (presumed 2/2 hypomagnesemia) General 238 6/24/09 ESRD AV fistula exploration and declot hemorrhage Cardiologist Conscious sedation 239 6/26/09 Cancer- New R Lung mass CT guided R lung bx N/V, acute mental status change Radiologist Conscious sedation 240 6/30/09 Chest pain/pressure Diagnostic heart catheterization Hypertensive crisis Cardiologist Conscious sedation 241 7/1/09 Abdominal excess adiposity Abdominoplasty Hematoma Plastic surgeon General 242 7/2/09 Abnormal LFTs CT guided liver bx 243 7/9/09 Colon screening Colonoscopy Subcapsular hematoma radiologist Local Hematochezia s/p endoscopic polypectomy Gastroenterologist Conscious sedation IandD, d/c home AAAASF hepatic arteriogram with embolization, d/c bleeding scan positive, s/p clipping, d/c 21

22 244 8/5/09 Claudication Left leg angiogram Postop hemorrhage 245 Left renal PTA 8/7/09 Left renal stenosis /Stent Lost stent to free floating in arterial system radiologist Local Vascular surgeon Conscious Sedation 246 8/18/09 Colon screening Colonoscopy Postop rectal bleeding Gastroenterologist Conscious sedation 247 7/14/09 (report rec d 8/24/09) 248 8/19/ /18/ /25/ /16/09 (report rec d late aug) Hypomastia Abnormal stress test Unwanted augmentation Left heart catheterization Pregnancy termination Opiate withdrawal, combativeness leading to hematoma Plastic surgeon Conscious sedation? retroperitoneal bleed Cardiologist Local Hemorrhage 2/2 uterine artery rupture Ob/gyn Conscious sedation Female Sterilization Tubal ablation Pulmonary edema Ob/gyn Conscious sedation Guaiac positive stool Colonoscopy Decreased O2 sat, wheezing, difficulty swallowing 2/2 aspiration PNA Gastroenterologist Conscious sedation s/p surgical exploration no bleed found, d/c plan for surgical intervention, d/c s/p endoscopic injection/cauter y, d/c home no hematoma evacuated, d/c observation, USN and CT negative for bleed, d/c s/p transfusion and home To ER, aspiration PNA dx, tx, d/c 252 8/19/09 Colon screening Colonoscopy 253 9/2/ /17/ /15/09 Coronary artery Gender dysphoria, M to F Gender dysphoria, M to F Left heart catheterization Feminizing vaginoplasty Feminizing vaginoplasty Cecal perforation requiring hemicolectomy Gastroenterologist Conscious sedation Severe chest pain, hypotension Cardiologist Conscious sedation Acute psychotic episode Urologist General Urethral oozing, anemia Urologist General hemicolectomy, d/c IABP inserted, psych consult, PRBCs, 256 8/31/09 ESRD 257 9/23/09 Unacceptable cosmetic appearance 258 7/7/09 ESRD 259 9/23/09 DOE Vascular access declot Severe bradycardia Nephrologist Conscious sedation Rhinoplasty Fistulogram with angioplasty Rt/lt heart catheterization Hypoventilation 2/2 anesthesia General Rupture of cephalic vein adjacent to arterial anastamosis = hematoma Nephrologist Conscious sedation Inability to move right arm/leg (TIA) Cardiologist Conscious sedation T o hospital for further evaluation, d/c w/u negative, use regained, d/c 22

23 260 9/11/09 Ischemia, pain LLE Selective angiogram with balloon stenting to LLE L groin hematoma Vascular Surgeon Conscious sedation 261 9/24/09 lipodystrophy Liposuction Anemia, syncope Plastic surgeon General /13/09 Hepatic lesions CTguided core liver biopsy Subcapsular hematoma radiologist conscious sedation PRBCs, PRBCs, /5/09 Bladder outlet obstruction Prostatic laser treatment Severe bradycardia Urologist Conscious sedation /11/09 artery angioplasty Hematoma Cardiology Conscious sedation /22/ /30/09 Facial aging /3/09 ESRD angioplasty Respiratory distress, RLQ tenderness Cardiologist Conscious sedation Endoscopic brow lift, facelift w cervicoplasty, upper lid bleph, fat transfer to face Cardiac arrest Plastic surgeon General Thrombectomy of dialysis vascular access /16/09 Anemia Colonoscopy 269 1/18/10 Facial skin aging/ptosis Mini-facelift 270 1/18/10 Thrombosis Thrombectomy 271 2/9/10 Claudication and ulceration 272 2/12/10 Clotted AV Graft 273 2/12/10 Lower back pain angiogram with PTA/PTAS Postoperative hemorrhage Nephrologist Conscious sedation Abdominal pain (? Perforation) Gastroenterologist General NO New onset SVT, unresponsive to meds and fluids ENT/Facial Plastics Conscious sedation SOB/persistent coughing/desaturation Nephrology Conscious sedation Abdominal pain/hematoma Vascular Surgery Conscious sedation Fistulogram, Venogram, angioplasty, stent Hemorrhage Vascular surgery Conscious sedation Lumbar epidural, lysis of adhesions Lower extremity paralysis/hypoesthesi a (? Systemic absorption of anesthesia) Local d/c resuscitated, to SICU, d/c home AAAASF access reestablished, d/c To Hospital, CT showed perf. Viscus, to surgery, home To ER, workup performed, To EMS, home To Hospital, To surgery, cutdown done, sutured. To Hospital, 274 2/17/10 Sublingual mucocele Excision of mucocele Synocpe with possible seizure Oral Maxillofacial Surgeon Local home 23

24 275 2/25/ /3/10 Subclavian Stenosis Angiogram with angioplasty Synocpe post procedure, gross hematuria Vascular surgeon Conscious sedation GI bleed, diverticulosis, fam hx of colon cancer Colonoscopy Severe RLQ pain Gastroenterologist Conscious sedation d/c home once stabilized pain control, d/c home 277 3/11/10 Mesenteric stenosis 278 3/5/10 lipodystrophy 279 3/16/ /17/ /2/10 Dermatochalasis, ptosis Lipodystrophy, Lax facial skin Iliac vein occlusion 282 4/8/10 Lypodistrophy 283 4/13/ /22/10 Compression fracture of L4 vertebra Unwanted Aortogram/PTA/ Stent SmartLipo abdomen/flanks/ Back Facelift, browlift, lower bleph, lip augmentation, facial nevus excision, perioral chemical peel Severe RUQ pain, syncope Vascular Surgeon Conscious sedation Hypotension (? From anesthesia), respiratory distress (? From fluids given) Plastic surgeon Conscious sedation Pulmonary edema (desaturation, rales) General Facelift, fat augmentation Cardiac Arrythmia General Left Iliac Vein Recannulation Abdominoplasty, liposuction Pulmonary edema (tachycardia, SOB, desaturation, cough fits) Radiologist Conscious sedation Hypotension, anemia, nausea/vomiting General Scheduled vertebroplasty Chest discomfort Orthopedic surgeon Local Termination of Necrosis of left hand distal phalanges OB-GYN Conscious sedation PRBCs, home abx given, BiPAP placed, pt home access reestablished, d/c To OR, evacuated abdominal hematoma, d/c home next day To ER, pt dx with STEMI, d/c home after cath and stent placement vascular surg consult, angiography performed 285 4/22/10 Aortic insufficiency/ stenosis Heart Catheterization access site Cardiologist Conscious sedation negative USN, d/c 286 5/11/10 Liver lesion 287 5/20/10 Facial aging, laxity RFA and biopsy of liver lesion Facelift, necklift, endoscopic browlift, excision of mental creases Hypotension radiology Conscious sedation Hematoma x 2, persistent bleeding General To OR, hematoma evacuated, heme consult to r/o coagulopathy, d/c 288 5/24/10 Unwanted Termination of Hemorrhage OB-GYN Conscious sedation 289 6/4/10 intervention Severe pain Cardiologist Conscious sedation 24