Julie's Story
On September 25, 2003, our 38 year-old daughter walked into a
Sarasota, Florida doctor’s office for a breast augmentation procedure.
She did not walk out. Julie lapsed into a coma and on Dec. 7, we flew
her home here in Wisconsin. She died on December 26, 2003 from a lack
of oxygen to the brain. Julie's surgical team did not include a
qualified anesthesia provider.
In January 2005, my wife and I sat front row center at a hearing by
the Florida Board of Medicine, which revoked the doctor's license. We
then decided to use Julie’s death as a poster case in any legislative
effort or media opportunities to improve patient safety.
Surgeries performed in doctor’s offices have a much higher risk than
in hospitals. Office surgeries are simply not held to the same high
standards. I attempted to focus attention on that in Washington but
ran into a wall of indifference.
Then we got a break. In November 2009, I received a call from the
Wisconsin Society of Anesthesiologists. A legislator here introduced
a bill that will require any Wisconsin surgery location to be licensed
and accredited. I made a statement at that hearing and that bill will
be up for a vote in 2011. We will be there also, front row center. It
is my intention to forward that bill to any state that does not have a
similar law.
To be successful, education is the key. Please post your comments or
questions here. IT IS IMPORTANT TO MAKE SURE THAT YOUR ENTIRE SURGERY
TEAM IS QUALIFIED, AND NOT PRACTICING OUTSIDE THEIR LIMITATIONS!
By the way, you can search two names for the media coverage on our
case: Julie Rubenzer or me, Don Ayer. I welcome our questions or
comments and look forward to improving patient safety.
Q - Is the office accredited?
A - The Florida Board of Medicine/State of Florida requires that a physician's office be inspected and accredited.
Q - Is the surgeon board certified and credentialed to perform the same or similar procedures at a local hospital?
A - This is significant because it assures you that the surgeon has been reviewed by his/her peers.
Q - Is the person administering the anesthesia board certified?
A - This is significant for the same reasons as above. It also means that the anesthesia provider has had the required amount of experience, with no adverse incidents.
Q - Will current anesthesia monitors and machines be used during the anesthetic?
A - The anesthesiologist not only ensures that the most up to date equipment is available, but that it is functioning properly. The anesthesiologist has the most training with the most advanced equipment.
Q - Is the necessary resuscitative equipment available in the event of a serious complication?
A - The anesthesiologist can ensure this, as well as a surgeon whose office has been inspected and accredited.
Q - What hospital will I be admitted to in the event of a complication?
A - It is important that the hospital is reasonably close to the office in which your surgery takes place, and that it is a major hospital.
Q - Who is ACLS (Advanced Cardiac Life Support) certified in the office?
A - The surgeon and one nurse should be ACLS certified.
Q - Who is responsible for determining when I am sent home?
A - The anesthesiologist's responsibility is to oversee the patient before, during and after surgery. The presence of the anesthesiologist ensures that your recovery is as smooth a process as possible and that you go home only when it is safe to do so.
You stated that surgery offices must be licensed and accredited by the state. Question is: Was that law in place, Sept. 25, 2003? If Florida requires licensing and accredation, does this mean inspection by a state agency?