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Weston, Florida—last Friday, Rohie Kah-Orukaton went to her favorite spa to have a routine liposuction procedure performed. However, the procedure, described as minimally invasive, went terribly awry. After suffering a seizure, the nurse and mother of three is brain dead and on life support at the Cleveland Clinic in Weston, Florida.

Mrs. Kah-Orukaton was a patron of the Weston spa for approximately five years prior to receiving the liposuction procedure. Apparently, the facility was not licensed to perform liposuction. However, Doctor Omar J. Brito, the doctor who performed the procedure, is licensed. Furthermore, he alleges that he was unaware that Weston Medspa was unlicensed to perform liposuction procedures. Nevertheless, Michael Freedland, the Kah-Orukaton family’s attorney, believes that Rohie suffered a seizure as a result of an anesthetic called lidocaine. He has since requested a medical report from the spa, but has yet to receive it.

Dr. Brito maintains that he did not experience any difficulties during the procedure until the very end and then called 911 immediately. In spite of that statement, Dr. Brito’s profile on the spa’s website does not list any training or residency with cosmetic surgery. His attorney, Brian Bieber, however, maintains that the doctor has performed liposuction procedures for 4 years. Nonetheless, it is against Florida state law to perform liposuction in an unlicensed facility. Rohie’s husband declined to comment on the matter, as he and his family make a decision whether or not to take her off of life support. She will leave behind three children—ages 4, 5, and 7.


  1. Gravatar for Barry L. Friedberg, M.D.
    Barry L. Friedberg, M.D.

    Clearly, something went terribly wrong based on the obviously unacceptable outcome.

    The national rash of liposuction deaths in the late 1990s spurred the Florida legislature to enact a limit of 4,000 ccs on outpatient liposuction as well as it following lockstep with the American Society of Plastic Surgery Society's (ASPS) American Association for the Accreditation of Ambulatory Surgical Facilities (AAAASF) classifications for office based surgery facilities' anesthetic levels: Level A, B, & C.

    Level A = Local anesthesia only

    Level B = IV sedation including dissociative anesthesia

    Level C = General anesthesia

    California also responded in the late 1990s with a 5,000 ccs limit on outpatient liposuction.

    If this MedSpa had been equipped to handle a potential emergency, this disaster might have been averted and the issue of licensing of the facility would have never arisen.

    The probability was that there was no emergency resuscitative (i.e. oxygen, positive pressure Ambu bag, & suction) equipment on hand when disaster struck and by the time paramedics were summoned, the patient was doomed.

    I post this message because of the illogical position the Florida Medical Board (FMB) has taken with regard to maximizing patient safety in office based cosmetic surgery.

    On numerous occasions, I have requested a hearing regarding the classification of my PK (propofol ketamine) non-malignant hyperthermia (MH) triggering intravenous anesthetic. On every occasion, I was rebuffed.

    The FMB has arbitrarily classified PK as a general anesthetic meaning offices are required to maintain Level C facilities.

    Level C facilities mandate an anesthesia machine, scavenging of anesthetic gases and Dantrolene (the MH antidote), NONE of which are required for the administration or safety of PK anesthesia.

    Since its inception in 1992, there have been no deaths with PK intravenous anesthesia. There have also been no 911 calls, no near deaths, cardiac arrests, pulmonary embolisms, aspirations, or other airway disasters.

    In comparison, in only the past 3 years, the recent deaths of Stephanie Kuleba in Boca Raton and Donde West in Los Angeles were both directly related to general anesthesia as well as the recent near death of Tameka Foster.

    As a leading national advocate for patient safety,

    I find the lack of response by the FMB beyond shameful, especially after they exonerated the doctors in the Kuleba case.

    I am also the author of the first (& only) book in the field 'Anesthesia in Cosmetic Surgery' from Cambridge University Press, published 2007 and recently translated into Portuguese for the Brazilian market. That version went on sale this June.

    Additional points worthy of not include being a board certified anesthesiologist, recognition by the California Medical Board as an expert reviewer, Congressional Certificate of Recognition, appointment as Associate Professor of Anesthesia, founder & president of Goldilocks Anesthesia Foundation, & 36 years in private practice.

    BIS monitored PK anesthesia has been in use by me since Dec. 1997.

    The addition of a brain monitor, in my use a bispectral index or BIS, has added further safety because each patient receives only the amount of anesthetic their brain determines it needs instead of the former method of body weight determined dosages.

    The Goldilocks Anesthesia Foundation is a public non-profit dedicated to raising public awareness of the risks of routine anesthesia over-medication and the role of brain monitors in dramatically reducing, if not eliminating, those risks. Disclaimer: No funding from any maker of brain monitors has been received by either Dr. Friedberg or this foundation.

  2. Great article and the Comment from Dr. Friedberg is also thought provoking. We had a rash of thes ecases in Hawaii in the 1990s. I hope prospective patients will check ouyt the places that they go to for medical services.

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