Lack of accreditation, licensing plague California surgical centers

In what reads almost like a season's worth of story lines for the now-defunct television series "Nip/Tuck", the Los Angeles Times examines the world of California-based plastic surgery centers, many of which lack accreditation and a majority are not licensed by the state. 

Specifically, the Times focuses on the trials and tribulations of the Anaheim-based Hills Surgical Institute, where in 2008, a 39-year-old woman--Maria Garcia--died, bleeding out from a puncture wound sustained during a vaginal reconstruction. The surgeon who performed her operation, Dr. Lawrence Hansen, was 82 years old at the time of the surgery, and had not performed a vaginoplasty in five years. Allegedly, Hansen failed to physically examine Garcia beforehand, and did not take down her patient history. His license remains active, according to the Times

The facility, which had been open for only 90 days before the incident, was one of many surgical centers neither accredited nor licensed by the state. Hills Surgical Institute also was under investigation by the California Medical Board at the time. 

Prior to 2007, roughly 480 surgical centers partly owned by a licensed doctor were licensed by California. After a challenge to the state's authority in court, that number now has dwindled to 45. According to the Times, hundreds are "cash-only businesses" without accreditation. 

"There are a lot of facilities that completely ignore the law and are not accredited or licensed or anything," Dr. Michael F. McGuire, chief of plastic surgery at St. John's Health Center in Santa Monica, told the newspaper. The Times also reports that while the state's medical board can fine unaccredited facilities as much as $1,000 daily, most of the time it doesn't due to inaccurate data on which centers to pursue. 

What's more, for those centers opting for accreditation that end up violating patient safety rules, regaining accreditation is as easy as "shopping around," according to state Sen. Gloria Negrete McLeod (D-Chino). The state Department of Public Health should oversee the clinics, she said. 

Hills is a case in point. Only five months after the Garcia incident, it was accredited by the Joint Commission. And because the facility was and still is physician-owned, the state medical board had no "authority to sanction" the center for its lack of accreditation. 

To learn more:
- read this Los Angeles Times article

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