Miami Herald (Sunday)

A Hialeah plastic surgery center liposuctio­n patient died. What happened to the doctor?

- BY DAVID J. NEAL dneal@miamiheral­d.com

The doctor in the 2021 death of a Brazilian butt lift patient at a Hialeah office plastic surgery center is no longer a doctor after giving up his license days before an investigat­ion into the death ended.

The state Board of Medicine’s final order accepting Dr. Luis Ramirez’s voluntary surrender of his license was posted on Dec. 28. But Ramirez turned in the license relinquish­ment paperwork Aug. 15, three days before Florida Department of Health Medical Quality Assurance investigat­or Dana Anderson filed her final report on the death of a patient identified only as “PR” at Your Cosmetic Surgery & Spa, 1255 W. 46th St.

Ramirez’s voluntary relinquish­ment says he states:

“[Ramirez’s] purpose in executing this Voluntary Relinquish­ment is to avoid further administra­tive action with respect to this cause.”

“[Ramirez] understand­s that acceptance by the Board of Medicine of this Voluntary Relinquish­ment shall be construed as disciplina­ry action against (his) license...”

“[Ramirez] agrees to never reapply for licensure as a medical doctor in the State of Florida.”

The Florida Department of Health online license profile shows no previous disciplina­ry action against the license Ramirez had held since 1991. The profile shows privileges at Larkin Community Hospital Miami, which is in South Miami, and Larkin Community Hospital’s Palm Springs Campus, the latter of which

AAAis where the tragedy ended.

Anderson’s report says the death of “PR,” a 45year-old woman, was being looked at for Ramirez possibly, among other violations, “failing to perform legal obligation­s, failing to keep records justifying the course of treatment, practicing below the standard of care” as well as inadequate medical records.

On March 24, 2021, PR might have to be held anyway. He also noted that under a new state law, many of the voters who do not know they have to request vote-bymail ballots again might not remember to participat­e in the election, lessening turnout.

Another point that was debated: In a special election, the highest votegetter came to Your Cosmetic Surgery desiring a “tummy tuck, liposuctio­n in both arms, liposculpt­ure and fat grafting in her buttocks.”

Ramirez, the report said, explained the risks and complicati­ons to PR and “advised her that it was too many procedures to do at one time and that he could do only one for her safety.”

She decided to do the fat grafting on her buttocks — a “Brazilian butt lift” — would win. There would be no runoff election.

Reyes and King repeatedly said they believe District 2 voters should decide for themselves, and the cost shouldn’t be an issue.

Through public comments, it became clear two candidates had mobilized supporters. Martin and the liposculpt­ure in that area.

Ramirez took out 4000ml of supernatan­t fat from PR, then used 800ml of that fat to insert into PR’s buttocks. With the surgery almost done, Ramirez noticed a slowed heart rate. The report said atropine was given via IV.

Atropine “is used to reduce saliva and fluid in the respirator­y tract during surgery,” the Cleveland Clinic said. “It can be used in an emergency to treat a slow heartbeat.”

That’s when her endtidal carbon dioxide (ETCO2) level disappeare­d from the monitor screen.

“End-tidal carbon dioxide is the level of carbon dioxide that is released at the end of an exhaled breath,” Capnograph­y for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings explains. “ETCO2 levels reflect the adequacy

Zilber, the attorney and former Miami-Dade judge who resigned from his position as he faced discipline following allegation­s of misconduct, and James Torres, president of the Downtown Neighbors Alliance. Several speakers also backed attorney Lorenzo Palomares.

One surprise candidate emerged from the group when he applied in the

11th hour during the meeting Saturday: former U.S. Attorney Kendall Coffey.

“I want to offer what I can in a more narrow, temporary, custodian role,” Coffey said, pledging to be a caretaker who would not run to hold onto the seat in the Nov 7 election. with which carbon dioxide is carried in the blood back to the lungs and exhaled.”

PR could be ventilated “easily, but no evidence of ETC02 tracing on the screen,” the investigat­ive report said. “No disconnect­ion of lines occurred.”

Hialeah Fire Rescue was called and workers shot PR with atropine again.

ETCO2 still “was not present at that point. PR was transferre­d to Larkin Community Hospital by Hialeah Fire Rescue, where, despite all-life saving efforts, PR expired,” the investigat­ive report said. “The report further indicates that the alleged cause of the incident was due to hypotensio­n, decreased heart rate and bradycardi­a.”

David J. Neal: 305-376-3559, @DavidJNeal

COMMISSION­ERS ARE EXPECTED TO RECONVENE TO CONTINUE THE DISCUSSION AT 2 P.M. SUNDAY. DISTRICT 2 INCLUDES MOST COASTAL NEIGHBORHO­ODS, FROM COCONUT GROVE TO BRICKELL, DOWNTOWN, EDGEWATER AND MORNINGSID­E.

A dwindling audience grew weary during each round of voting, with some commenting that the process started to resemble House Republican­s’ struggle to elected a new Speaker of the House in recent days.

Commission­ers are expected to reconvene to continue the discussion at 2 p.m. Sunday at Miami City Hall, 3500 Pan American Dr. District 2 includes most of Miami’s coastal neighborho­ods, from Coconut Grove north through Brickell, downtown, Edgewater and Morningsid­e.

Joey Flechas: 305-376-3602, @joeflech

 ?? DAVID J. NEAL dneal@miamiheral­d.com ?? A plastic surgery at Your Cosmetic Surgery & Spa in Hialeah had fatal consequenc­es.
DAVID J. NEAL dneal@miamiheral­d.com A plastic surgery at Your Cosmetic Surgery & Spa in Hialeah had fatal consequenc­es.

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