A plastic surgeon and his nurse are still accredited and allowed to practice medicine despite facing three lawsuits and six felony charges, including involuntary manslaughter.
Christian Jagusch, MD, is a physician and attorney representing three parties suing Carlos Chacon, MD, of Divino Plastic Surgery Center. Among those he represents is the family of Megan Espinoza, who died after undergoing a routine breast augmentation performed by Dr. Chacon. Dr. Jagusch questions the Accreditation Association for Ambulatory Health Care’s decision not to revoke the ambulatory surgery center’s accreditation.
Dr. Jagusch is quoted as saying, “I believe there’s at least some ethical responsibility for a credentialing organization to say, ‘Whoa. Maybe this isn’t who we want to validate as [an example of] excellence in healthcare safety,’ as they so claim.”
Dr. Carlos Chacon and the Divino Plastic Surgery Center
The Divino Plastic Surgery Center is in Bonita, California, an unincorporated community south of San Diego. The practice claims they provide “a full range of services from the latest plastic surgery procedures to the most advanced techniques in skin care.” According to his profile on the practice’s website, Dr. Carlos Chacon obtained his undergraduate and medical degrees from the University of Arizona. U.S. News and World Report listed the institution as #46 among public universities in 2022.
Dr. Chacon served as Chief Resident of the University of California San Francisco Division of Plastic Surgery at the UCSF Medical Center. Their 6-year residency program strives to provide students in-depth general and plastic surgery training. The UCSF Medical Center has been rated as the #2 hospital in neurology & neurosurgery in the United States in 2022. He also completed an advanced fellowship training program in aesthetic surgery at the University of Southern California, the oldest private research university in the state.
Dr. Chacon says, “I have come to the realization that not only I but also my patients have benefited greatly from the knowledge and experience I gained from an exceptional education and training.”
The plastic surgeon also participated in the Extreme Makeover: Weight Loss Edition television series. The 2011-2015 series featured individuals receiving makeovers to help them live their best lives.
The Divino Plastic Surgery Center offers patients the entire gamut of plastic surgery procedures and more. Patients are encouraged to schedule consultations for anything from lip augmentations to spa treatments.
Patient, Megan Espinoza
Megan Espinoza received a standard plastic surgery procedure from Dr. Chacon on December 19, 2018. A Medical Board of California report claims Dr. Chacon admitted that there was no discussion with Ms. Megan Espinoza regarding the absence of an anesthesiologist. Dr. Chacon’s nurse, Heather Lang, did not have proper anesthesia training but allegedly sedated Ms. Espinoza regardless. Dr. Chacon and his nurse also allegedly ordered an unlicensed medical assistant to inject medication into Espinoza’s IV.
According to the report, Espinoza went into cardiac arrest and was not promptly and properly attended to. Dr. Chacon reportedly did not seek emergency assistance when his patient made a gurgling noise and seizure-like gestures. Paramedics were allegedly contacted 3 hours later. Espinoza was placed in an intensive care unit, never regaining consciousness. She passed away on January 28, 2019.
Dr. Chacon and his nurse were criminally charged in December 2021 for the involuntary manslaughter of Megan Espinoza. Both pleaded not guilty. Their preliminary hearing in criminal court was scheduled for September 2, 2022.
Revocations, Reversals, and Restrictions
ASC Accreditation
The Accreditation Association for Ambulatory Health Care (AAAHC) revoked the surgery center’s accreditation in April 2022 but reversed its decision one month later. The center’s accreditations remain subject to a discretionary review. The AAAHC, founded in 1979, has accredited 6,600+ organizations. Their nationally-recognized standards help ensure organizations like endoscopy centers, student health centers, medical and dental group practices, and more consistently deliver high-quality health care. Accreditation is a peer-based review process that takes place onsite.
Organizations that seek AAAHC accreditation must meet a list of criteria, including:
- Provide healthcare services for at least six months before the survey.
- Comply with applicable federal, state, and local laws and regulations.
- Be licensed by the state in which it is located unless the organization is applying for a survey that will be used to obtain licensure in that state.
- Share the facilities, equipment, business management, and records involved in patient care among its members.
- Operates in compliance with the United States Equal Employment Opportunity Commission laws.
- Provide complete and accurate information to the AAAHC.
Per the AAAHC’s website, “AAAHC denies accreditation to an organization when it concludes that the organization is not substantially compliant with AAAHC Standards and policies and procedures. AAAHC reserves the right to revoke or deny the accreditation of any organization at any time without prior notice.”
The AAAHC responded to their decision regarding the Divino Plastic Surgery Center in a letter, stating, “AAAHC accreditation decisions are made in accordance with the policies and procedures of the applicable accreditation handbook.”
Dr. Chacon’s Medical License Status
The Medical Board of California restricted Dr. Chacon’s license. Dr. Chacon is allowed to practice medicine without notifying patients of any of the charges levied against him. Under the conditions of his license restriction, he can only perform surgeries with a licensed anesthesiologist or CRNA present. The Medical Board of California is a state government agency that licenses and disciplines medical doctors. They provide public access to physicians’ licensing information.
Dr. Chacon’s license was issued on January 5, 2007, and is set to expire on November 30, 2022, with the following statuses:
- An accusation filed: “A formal, public charge by the board alleging a physician violated the medical practice act. This is the result of a fully investigated complaint referred to the attorney general’s office for prosecution. Practice is permitted unless otherwise specified.” This was filed on December 23, 2021.
- Limits on practice: “Limitations have been placed on the physician’s practice.”
- Penal code section 23 order: “Licensee’s practice has been temporarily restricted or limited pursuant to a court order.”
- Administrative Action Taken By Other State Or Federal Govt
It is important to note that Dr. Chacon and his nurse have not been found guilty of any charges as of this writing.
California’s Medical Malpractice History
A comprehensive study found that California has had the most medical malpractice lawsuits over the past 30 years. Out of 1.41 national million cases, approximately 138,000 belong to the Golden State. California is ranked #4 among the states with the largest medical malpractice compensation awards. Over 30 years, payouts equaled $9.7 billion. The average payout was approximately $70,000. The national average payout was just over $101,000.
The state’s payouts could rise in the near future. On May 23, 2022, California Governor Gavin Newsom signed a bill increasing the amount of money patients can receive in medical malpractice cases.
Medical malpractice will dramatically change Under Assembly Bill 35, including:
- The amount plaintiffs can be awarded for pain and suffering will increase to $350,000. This cap will increase over ten years until it reaches $750,000.
- In cases involving a patient’s death, the cap will increase to $500,000. It will gradually rise to $1 million over the same 10-year period.
- Plaintiffs can receive up to 3 payments in lawsuits that involve multiple physicians, nurses, or hospitals. The potential award would be $1.5 million.
- Only medical malpractice cases filed after January 1, 2023, are eligible.
- These changes are slated to begin on January 1, 2023.
Plastic Surgery and Medical Malpractice
A recent survey found that 51% of physicians were named in a medical malpractice lawsuit in 2021. Of this group, 83% were plastic surgeons and general surgeons. Another study found that plastic surgery accounts for 3.31% of reported claims and 3.16% of paid claims. Plastic surgeons have a 15% per year of being sued.
However, history has shown that the results tend to be in favor of plastic surgeons regarding medical malpractice lawsuits:
- 93% of cases might close with a dismissal or a settlement.
- 75% might result in no payment.
- Of the cases that go to trial, over 20% typically lose.
- Only 7% percent might ever go to trial.
Nurses and Medical Malpractice
Can Heather Lang, Dr. Chacon’s nurse during the Megan Espinoza incident, be sued for medical malpractice? Yes. Nurses are also healthcare providers. They are also held to a particular standard of care. A nurse is expected to perform their job like any other nurse in a comparable situation. As such, when a nurse fails to act per the standard of care for their specialty, they could be held legally responsible for any negligence that results in injury.
A nurse can be sued for medical malpractice like any other healthcare provider. According to the National Practitioner Data Bank’s Data Analysis Tool, nursing malpractice judgments for the last six years have totaled over $1.4 billion. Since 1990, nurses have been responsible for 56% of all malpractice claims.
The Need for Medical Malpractice and Medical Professional Liability Insurance
Regardless of the validity of the charges filed against Dr. Chacon and his nurse, healthcare providers of any specialty should realize that they could be forced into a similar situation. Having medical malpractice charges looming can tear down the most upstanding physicians. Having to pay damages from them could prove devastating. Careers and lives could be irreversibly ruined.
Every year, nearly 17,000 malpractice cases are filed in the United States. 75% of doctors in low-risk specialties will face a malpractice claim during their careers. The average claim is just over $300,000. It is not a question of if a physician will encounter a malpractice claim. It is a matter of when. Per the New England Journal of Medicine, 99% of physicians in high-risk specialties and 75% in low-risk specialties will face a medical malpractice claim by age 65.
Medical malpractice insurance is crucial for healthcare providers in every specialty. Covering more than medical mistakes, insurance incorporates breaches of duty and wrongful acts. Whether or not a claim is valid, providers who do not own insurance can spend a lot of money out of their pockets defending themselves. Healthcare providers shopping for medical malpractice and medical professional liability insurance can struggle with all of the intricacies of insurance. Some providers do not know all of the terms and conditions of policies. Fortunately, they can find assistance to inform them and protect them from costly claims and litigation.
Medical malpractice insurance coverage is essential to protect one’s assets and reputation. Accidents happen. So do false claims of negligence. Providers have to consider every possible situation when they choose to practice medicine.
Conclusion
Following the best practices of medical malpractice prevention coupled with sufficient insurance coverage can give healthcare providers maximum protection against claims and lawsuits. Preventing malpractice in the first place is vital to keeping patients safe and providers free of civil and criminal charges.
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