By Carla McClain, The Arizona Daily Star, Tucson
Sep. 1–The death of Tucson attorney Kimberley A. Taylor after undergoing cosmetic surgery was caused by a failed attempt to intubate her when she stopped breathing during the operation, a lawsuit filed by the family says.
The suit, claiming “malpractice and gross negligence,” was filed in Pima County Superior Court in August against Taylor’s plastic surgeon, Dr. Armando Alfaro, and his nurse anesthetist, Elizabeth Kayser.
Taylor, who was 53 when she died, was undergoing two minor cosmetic procedures — liposuction and tightening of the jaw line — in Alfaro’s office on Dec. 28 when the emergency occurred. Kayser had placed Taylor under conscious sedation — a form of anesthesia that does not require putting the patient on a breathing machine.
At some point during the surgery, Taylor’s breathing slowed and ultimately stopped. To revive her, Alfaro and Kayser intubated her — inserted an endotracheal tube down her throat — but inserted it into the esophagus instead of the lungs, the suit says.
That meant Taylor was getting no oxygen to her brain. Paramedics called to Alfaro’s office noted the improper placement of the breathing tube and tried to revive Taylor with bag ventilation. But she already had suffered severe brain damage by the time they arrived, according to the suit.
She was transported comatose to Tucson Medical Center’s emergency room and placed on life support. Taylor died 10 days later, on Jan. 6.
Doctors performing these kinds of procedures are required to have a device that indicates where the breathing tube should be placed in such an emergency, according to the Taylor family’s attorney, Ted Schmidt. Medical records show that Alfaro did have such a device in his office but did not use it when he tried to intubate Taylor, Schmidt said.
“This is a terribly sad and tragic story,” Schmidt said in a statement released Friday afternoon. “A perfectly healthy 53-year-old woman going in for rather routine outpatient plastic surgery should not die. Had the usual reasonable procedures and equipment been in place and used when needed in Kim’s care she would be with us today.
“She was extremely close to her two college-age daughters and mother. To have their mother and daughter taken from them so abruptly, unexpectedly and untimely will touch them deeply forever.”
The suit seeks unspecified damages for Taylor’s mother and her two grown daughters, Alexis and Lauren Cheadle. Relatives declined to comment Friday afternoon, Schmidt said.
Attempts to contact Alfaro and his attorney, Tom Slutes, were unsuccessful.
Kayser’s attorney, Edwin Gaines, said that Kayser has practiced as a certified nurse anesthetist for more than 30 years and has never had a problem before this.
“Liz is a very skilled nurse anesthetist who has done anesthesia for Dr. Alfaro for a number of years,” he said. “Kim (Taylor) had had a number of cosmetic procedures before this with no problems. Anesthesia always poses some risk, in any surgery.
“But an adverse outcome does not mean anyone fell below the standard of care. This is a tragic, tragic event, and I feel for Kim’s kids.”
Taylor’s death here brought attention to the nationwide controversy about the popular trend among cosmetic surgeons to increasingly perform these elective surgeries in their offices, rather than in hospitals fully equipped and staffed for emergencies.
A high rate of deaths in office settings uncovered in several states has resulted in the passage of stricter safety standards and inspections, and mandates to use physician anesthesiologists rather than nurse anesthetists in those states.
In response to the Taylor death and other bad outcomes in Arizona, the Arizona Medical Board has proposed new rules regulating office-based surgeries. The proposals — now under review by the governor — require doctors who perform these surgeries have specific monitoring and emergency equipment for all levels of anesthesia and sedation, from “minimal” to “deep.”
They also require specialized staff training and that patients be informed of the risks of having surgery in an office setting.
–Contact reporter Carla McClain at 806-7754 or at [email protected].
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