Thursday, June 25, 2009

CALIFORNIA LIPOSUCTION LEGAL STANDARDS


Weight Loss with Liposuction: Some patients get drama! This is 6 weeks after surgery.

I’ve reprinted the law regarding liposuction standards in California, below. I was involved in developing these standards. I testified several times before the California Medical Board and supplied them with materials and documentation to aid them in their decision-making process. I believe that these rules are important and necessary for safety. I want to make several points.
1) If you are seeing someone who does not start an intravenous line, they are violating the surgeon’s “standard of care” and also California law.
2) The other requirements that are seen below include blood oxygen and blood pressure monitoring, which are simple, modern devices to see how well you are breathing and how well your heart is working.
3) Modern liposuction is a very, very safe procedure in experienced hands. However, there are risks and if you find someone who says that it is risk free, you should look elsewhere. Common surgical complications such as infection are unlikely but possible.
4) If your surgeon uses no relaxation medicines at all, some sort of liposuction may be performed and the risks may be lower. However, like anything in life, there are trade-offs, in other words you have to accept possibly a lower standard of results—in particular less fat removal--in exchange for not going to sleep. Additionally, we have found that many of our patients find the option of having nothing but local anesthetic frightening and sometimes quite uncomfortable. This is not to say that I approve of general anesthesia for liposuction, I don’t. I think this compounds the risk.
5) For individuals who need significant amounts of fat removed, California law requires a certified surgical center, such as a hospital would have. Ask to see the certificate if this is the case.



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( 1 ) I n t r a v e n o u s A c c e s s a n d E m e r g e n c y P l a n . I n t r a v e n o u s a c c e s s s h a l l b e a v a i l a b l e f o r p r o c e d u r e s t h a t r e s u l t i n t h e e x t r a c t i o n o f l e s s t h a n 2 , 0 0 0 c u b i c c e n t i m e t e r s o f t o t a l a s p i r a t e a n d s h a l l b e r e q u i r e d f o r p r o c e d u r e s t h a t r e s u l t i n t h e e x t r a c t i o n o f 2 , 0 0 0 o r m o r e c u b i c c e n t i m e t e r s o f t o t a l a s p i r a t e . T h e r e s h a l l b e a w r i t t e n d e t a i l e d p l a n f o r h a n d l i n g m e d i c a l e m e r g e n c i e s a n d a l l s t a f f s h a l l b e i n f o r m e d o f t h a t p l a n . T h e p h y s i c i a n s h a l l e n s u r e t h a t t r a i n e d p e r s o n n e l , t o g e t h e r w i t h a d e q u a t e a n d a p p r o p r i a t e e q u i p m e n t , o x y g e n , a n d m e d i c a t i o n , a r e o n s i t e a n d a v a i l a b l e t o h a n d l e t h e p r o c e d u r e b e i n g p e r f o r m e d a n d a n y m e d i c a l e m e r g e n c y t h a t m a y a r i s e i n c o n n e c t i o n w i t h t h a t p r o c e d u r e . T h e p h y s i c i a n s h a l l e i t h e r h a v e a d m i t t i n g p r i v i l e g e s a t a l o c a l g e n e r a l a c u t e - c a r e h o s p i t a l o r h a v e a w r i t t e n t r a n s f e r a g r e e m e n t w i t h s u c h a h o s p i t a l o r w i t h a l i c e n s e d p h y s i c i a n w h o h a s a d m i t t i n g p r i v i l e g e s a t s u c h a h o s p i t a l .

( 2 ) A n e s t h e s i a . A n e s t h e s i a s h a l l b e p r o v i d e d b y a q u a l i f i e d l i c e n s e d p r a c t i t i o n e r . T h e p h y s i c i a n w h o i s p e r f o r m i n g t h e p r o c e d u r e s h a l l n o t a l s o a d m i n i s t e r o r m a i n t a i n t h e a n e s t h e s i a o r s e d a t i o n u n l e s s a l i c e n s e d p e r s o n c e r t i f i e d i n a d v a n c e d c a r d i a c l i f e s u p p o r t i s p r e s e n t a n d i s m o n i t o r i n g t h e p a t i e n t .

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( 5 ) D i s c h a r g e a n d P o s t o p e r a t i v e - c a r e S t a n d a r d s .

( A ) A p a t i e n t w h o u n d e r g o e s a n y l i p o s u c t i o n p r o c e d u r e , r e g a r d l e s s o f t h e a m o u n t o f t o t a l a s p i r a t e e x t r a c t e d , s h a l l n o t b e d i s c h a r g e d f r o m p r o f e s s i o n a l l y s u p e r v i s e d c a r e u n l e s s t h e p a t i e n t m e e t s t h e d i s c h a r g e c r i t e r i a d e s c r i b e d i n e i t h e r t h e A l d r e t e S c a l e o r t h e W h i t e S c a l e . U n t i l t h e p a t i e n t i s d i s c h a r g e d , a t l e a s t o n e s t a f f p e r s o n w h o h o l d s a c u r r e n t c e r t i f i c a t i o n i n a d v a n c e d c a r d i a c l i f e s u p p o r t s h a l l b e p r e s e n t i n t h e f a c i l i t y .

( B ) T h e p a t i e n t s h a l l o n l y b e d i s c h a r g e d t o a r e s p o n s i b l e a d u l t c a p a b l e o f u n d e r s t a n d i n g p o s t o p e r a t i v e i n s t r u c t i o n s .