DOCSLIB.ORG

Procedure-Related Office Surgery Deaths in Florida

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Procedure-Related Office Surgery Deaths in Florida Table 1. 18 Procedure-related office surgery deaths in Florida. 3/1/00 – 7/1/14 Case # Patient Surgical Complication Provider Anesthesia Outcome Date problem Procedure Anes Facility Board Hosp Prob? Accredited? Cert? Priv.? To hospital, 1 Abdomino- Shortness of death from 4/12/00 plasty, breath at home Plastic General by pulmonary Obesity Liposuction following day Surgeon CRNA No embolus AAAASF Y Y 2 Bronchospasm 4/14/00 Hypertrophic Breast during Plastic General by MD To hospital, breast reduction induction Surgeon anesthesiologist Yes death No Y Y Shortness of breath 3 following day, To hospital, 6/6/00 Abdominal Abdomino- pulmonary Plastic General by MD cardiac deformity plasty embolus Surgeon anesthesiologist No arrest, death No Y Y 4 Intravenous 6/26/00 Facial Rhinoplasty, Facial Plastic sedation by To hospital, dystrophy chin implant Bradycardia Surgeon CRNA Yes death No Y Y 5 Anaphylaxis, 8/29/00 Unwanted Termination of cardiac arrest, To hospital, pregnancy pregnancy death OB/GYN Local Yes death No Y Y 6 Hemodialysis Unstable blood Inter- 9/15/00 End stage renal catheter pressure after ventional To hospital, disease placement procedure Radiologist Local No death AAAHC Y Y 7 Lipodystrophy Liposuction, Death that 2/13/01 of laser Death autopsy Plastic General by night at abdomen/hips Resurfacing pending Surgeon CRNA No home AAAASF Y Y Shortness of 8 Dialysis breath Inter- 6/8/01 Poor dialysis catheter Hypotension, ventional To hospital, catheter replacement death Radiologist Local No death No Y Y Cardio- Emergency 9 pulmonary Intravenous surgery, 1 11/29/01 distress, low Gastro- sedation by death soon Rectal bleeding Colonoscopy blood pressure enterologist operating MD No after No Y Y Taken to hospital, 10 corrective 2/4/02 Upper endo- Pharyngeal/ Intravenous surgery, Hemoccult scopy, colon- esophageal Gastro- sedation by death 8 days positive stool oscopy perforation enterologist operating MD No later No Y Y 11 Inter- 4/2/02 Internal ventional To hospital, Jaundice Liver Biopsy bleeding Radiologist Local No death No Y Y 12 Cardio- Intravenous 7/29/02 Cosmetic pulmonary Plastic sedation by To hospital, surgery Facelift arrest in office Surgeon operating MD Yes death AAAASF Y Y Neck lift, Collapsed 2 13 Cosmetic abdomino- days later, Pulmonary 8/7/02 surgery/ hernia plasty, hernia pulmonary Plastic General by MD embolus, repair repair embolus Surgeon anesthesiologist No Death AAAHC Y Y 14 236 Transported to 3/21/03 Unwanted Termination of Amniotic fluid IV sedation by hospital, pregnancy pregnancy embolism OB/GYN operating MD No deceased No Y Y 15 Excess abdominal Deceased at 5/12/03 skin & muscle Abdominoplasty & Pulmonary General by MD home post-op laxity liposuction embolism Plastic surgery Anesthesiologist No day 1 AAAASF Y Y 16 9/25/03 Hypotrophic Cosmetic IV sedation by Deceased on breasts Breast implant Rapid bradycardia surgeon operating MD Yes table in office No Y N 1 Deceased 24hrs Liposuction sub- after surgery at Deceased 17 Brow Ptosis, mental area/ home for General by MD following day 11/13/03 recessive chin Bleparoplasty unknown cause Plastic Surgery Anesthesiologist No unknown cause No Y Y 18 11/24/03 Deceased Fat excess Liposuction & fat General by MD 9 days post-op abdomen transfer Fat embolism Plastic Surgery anesthesiologist No at home AAAASF No Y 19 Transported 1/7/04 hospital, Abdominoplasty, Respiratory/Renal General by MD deceased 3 days Macromastia breast reduction failure post-op Plastic Surgery anesthesiologist Yes post-op No Y Y 20 Death in 4/13/04 Cardiorespitatory IV sedation evening at Lipodysmorphy Liposuction arrest Plastic Surgeon CRNA No facility No Y Y 21 5/4/04 Coronary Artery Cardiac Cardiorespitatory Transfer to Disease Catheterization arrest Cardiologist Local No hospital, death AAAHC Y Y Cardiorespitatory 22 arrest at home due 8/1/04 Abdominal to deep vein General by MD To hospital 3 lipodystrophy Abdominoplasty thrombus Plastic surgeon anesthesiologist No days later, death No Y Y Discharged home, to 23 Lipodystrophy hospital in 11/18/04 with redundant Liposuction/ General by MD evening, death skin Abdominoplasty Pulmonary edema Plastic surgeon anesthesiologist No at hospital No Y Y 24 Discharged 9/28/04 Bilateral Renal Shock wave Cardiorespiratory General by MD home, death in Calculi lithotripsy arrest at home Nephrologist anesthesiologist No evening JCAHO Y Y 25 9/29/04 Severe CAD, Cardiac Cardiacrespiratory Death on the Carotid Stenosis Catheterization arrest on the table Cardiologist Local No table in office JCAHO Y Y Dissection of distal left main ostium of 26 Cardiac LAD and proximal 4/15/05 catheterization, portion of intravascular circumflex Transfer to Chest pain , SDB ultrasound coronary artery Cardiologist Local No hospital, death No Y Y 27 Lung Cancer, 11/1/05 Bronchopleural Interventional IV sedation by MD Transfer to Fistula Stent placement Unknown Radiologist anesthesiologist No hospital, death No Y Y Transfer to hospital, never regained 28 consciousness, 4/19/06 Oral and removed from Fixation of Maxilllofacial IV sedation by life support 4 Fractured mandible fractured mandible Allergic reaction surgeon operating MD Yes days later No No Y Pulmonary 29 Facelift, minibreast embolus and 6/15/06 lift, Pulmonary death 3 days Cosmetic Surgery abdominoplasty embolus Plastic Surgeon Unknown No post-op No Y No 2 30 Abdominal and 11/13/06 upper arm Pulmonary General by MD Transfer to lipodystrophy Liposuction embolus Plastic Surgeon anesthesiologist No hospital, death AAAASF Y Y Transfer to 31 Oral and hospital, death 11/16/06 Maxillofacial IV Sedation by following Nasal deformity Septorhinoplasty Bradycardia Surgeon operating MD Yes morning AAAHC Y Y 32 3/7/07 Ultrasound guided Vascular Transfer to Varicose veins sclerotherapy Anaphylaxis surgeon None No hospital, death AAAHC Y Y 33 6/29/07 Change in visual Fluorescein Hypotension/pulsel Transfer to acuity angiogram ess Retina surgeon Local No hospital, death No Y Y Brow lift, cervicomeloplasty, 34 with submental 8/22/07 Brow ptosis, facial lipectomy and Post operative Transfer to rhytides platysmaplasty bleeding Plastic surgeon General No hospital, death AAAASF Y Y Cardiac arrest due to hypokalemia 35 (from previously 11/30/07 Breast undiagnosed Transfer to Breast hypoplasia augmentation bulimia) Plastic surgeon General No hospital, death JCAHO Y Y 36 Low back pain, Non-responsive, Anesthesiologist 2/6/08 lumbar Lumbar epidural pupils fixed and , pain Transfer to radiculopathy block dilated management Local No hospital, death JCAHO N Y 37 3/21/08 Cardiolite spect Ventricular Transfer to CAD/hypertension stress test fibrillation Cardiologist None No hospital, death No Y Y 38 3/21/08 Breast Malignanat Transfer to Hypomastia augmentation hyperthermia Plastic surgeon General Yes hospital, death AAAASF Y Y CoC 39 Pain, nausea, intra- (Commission on 4/24/08 Cirrhosis, r/o CT guided liver abdominal Interventional Transfer to Cancer), malignancy biopsy bleeding radiologist Local No hospital, death AAAHC Y Y 40 5/13/08 Aging face and Facelift and Myocardial Transfer to eyes blepharoplasty infarction Plastic surgeon Local No hospital, death AAAASF N Y Bilateral 41 brachioplasty and Cardiovascular 6/5/08 Skin laxity and bilateral collapse Transfer to breast ptosis mastopexy postoperatively Plastic surgeon General No hospital, death AAAASF Y Y Severe respiratory depression due to 42 Scars, overdose of pain rx 8/15/08 gynecomastia, Abdominoplasty from variety of lipodystrophy liposuction physicians Plastic surgeon General No Death at home FSMB Y Y 3 Breast Post operative 43 augmentation after Death due to admission, 8/26/08 placement of tissue patient’s illicit death due to AAAASF and Breast hypoplasia expander drug use Plastic surgeon General No illicit drug use FSMB Y Y Postop 44 admission to 10/14/08 Mitral Right/left heart Pulmonary artery MICU, death regurgitation catheterization rupture Cardiologist Local No 2/2 PEA AAAHC Y Y Abdominal 45 elastosis, Abdominoplasty 2/21/09 lipodystrophy of and liposuction of To hospital, flanks and bra rolls bra rolls/flanks Postop shock Plastic surgeon General No death 2/2 shock No Y Y 46 PEA, hypotension, To hospital, 7/15/09 LOC evolved into Interventional death presumed ESRD AV shuntogram vfib Radiologist Conscious sedation No 2/2 PE No Y Y Coded, to 47 hospital ICU, 3/4/10 death from Dental caries Extraction of teeth Pneumonia, sepsis OMFS Conscious sedation No sepsis N Y Y d/c home Breast initially, sudden 48 lift/augmentation respiratory 4/1/10 and revisional distress, Breast hypoplasia abdominoplasty PE, "clots" Plastic surgeon General No admitted, death AAAASF Y Y 49 4/26/10 Unwanted Termination of Amniotic fluid To hospital, Pregnancy pregnancy embolus OB/GYN General No death N N N 50 5/18/10 Angiogram with Retroperitoneal Vascular Hypotension, to Vascular stenosis intervention bleeding surgeon Conscious sedation No hospital, death N Y Y 51 Liposucation with Hypotension, To hospital, 10/25/10 fat transfer to tachypnea, death, ? PE vs Lipodystrophy buttocks tachycardia Plastic surgeon General No fat embolism N Y Y 52 11/16/10 Unwanted Termination of To hospital, pregnancy pregnancy Hemorrhage OB/GYN General No death N Y N Liposuction of 53 abdomen/flanks/ 12/27/10 back and fat To hospital, Lipodystrophy transfer to buttocks Fat embolism Plastic surgeon General No death N Y N Lower blepharoplasty, 54 neck lift revision, 5/16/11 Bilateral neck anterior To hospital, laxity platysmaplasty Cardiac arrest Plastic surgeon General No death N Y Y 55 Ultrasound guided 11/4/11 therapeutic To
Load more

Recommended publications
  • Top Doctors 2020
    TOP DOCTORS 2020 TOP DOCTORS PHOTO BY JOHNPHOTO HALPERN 46 November 2020 • www.hvmag.com TOP DOCTORS 2020 More than 500 of the region’s premier physicians, in 55 specialties — as chosen by their peers Plus, doctors weigh in on medical care in the pandemic era — and how the changes affect you EDITED BY SAMANTHA GARBARINI AND SIERRA GUARDIOLA FEATURING PHOTOGRAPHY BY JOHN HALPERN Hudson Valley • November 2020 47 TOP DOCTORS 2020 ALLERGY & IMMUNOLOGY Scott L. Osur Montefiore Medical Center Duane Bryan Heart Failure, Arrhythmias, Paula A. Brown Certified Allergy & Asthma Arrhythmias, Atrial Fibrillation, Advanced Cardiovascular Care Hypertension, Cardiac Imaging CareMount Medical Consultants Pacemakers/Defibrillators West Nyack Poughkeepsie Albany 845.268.0880 Jared S. Corriel 845.231.5600 518.434.1446 Seth J. Lessner Montefiore Nyack Hospital Advanced Cardiovascular Care Telemedicine Albany Medical Center, St. Crystal Run Healthcare Non-Invasive Cardiology, West Nyack Peter’s Hospital - Albany Middletown Echocardiography- 845.268.0880 Myrelle B. Castro Asthma, Food Allergy, Pediatric 845.703.6999 Transesophageal, Nuclear Montefiore Nyack Hospital Horizon Family Medical Group Allergy & Immunology Montefiore Nyack Hospital, Cardiology Echocardiography, Nuclear New Windsor Garnet Health Medical Center Cardiology, Non-Invasive 845.476.3016 Joon H. Park Arrhythmias, Pacemakers/ Michael Nam-Sung Cho Cardiology Montefiore St. Luke’s Cornwall ENT & Allergy Associates Defibrillators, Catheter Ablation, Crystal Run Healthcare Hospital Middletown Atrial Fibrillation Middletown Ronald P. Cuffe 845.467.6998 845.703.6999 The Heart Center Jocelyn Celestin Garnet Health Medical Center, Sarah B. Levin Garnet Health Medical Center, New Windsor Albany Med Allergy, Asthma Mount Sinai Hospital The Heart Center Garnet Health Medical Center 845.567.1800 and Immunology Food Allergy, Immune Poughkeepsie – Catskills Montefiore St.
    [Show full text]
  • Abdominoplasty - Tummy Tuck
    Abdominoplasty - Tummy Tuck Abdominoplasty, known more commonly as a "tummy tuck," is a major surgical procedure to remove excess skin and fat from the middle and lower abdomen and to tighten the muscles of the abdominal wall. The procedure can dramatically reduce the appearance of a protruding abdomen. But bear in mind, it does produce a permanent scar, which, depending on the extent of the original problem and the surgery required to correct it, can extend from hip to hip. If you're considering abdominoplasty, this will give you a basic understanding of the procedure- when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on the individual patient and the surgeon. Please ask your surgeon about anything you don't understand. The Best Candidates For Abdominoplasty The best candidates for abdominoplasty are men or women who are in relatively good shape but are bothered by a large fat deposit or loose abdominal skin that won't respond to diet or exercise. The surgery is particularly helpful to women who, through multiple pregnancies, have stretched their abdominal muscles and skin beyond the point where they can return to normal. Loss of skin elasticity in older patients, which frequently occurs with slight obesity, can also be improved. Patients who intend to lose a lot of weight should postpone the surgery. Also, women who plan future pregnancies should wait, as vertical muscles in the abdomen that are tightened during surgery can separate again during pregnancy. If you have scarring from previous abdominal surgery, your doctor may recommend against abdominoplasty or may caution you that scars could be unusually prominent.
    [Show full text]
  • PANNICULECTOMY/ABDOMINOPLASTY Advanced Laparoscopic Surgery
    Ara Keshishian, MD, FACS, FASMBS Tel : 818‐812‐7222 A Professional Medical Corporation Fax : 818‐952‐0990 10 Congress St., Suite #405 Pasadena, CA 91105‐3027 General Surgery Weight Loss Surgery PANNICULECTOMY/ABDOMINOPLASTY Advanced Laparoscopic Surgery Robotic Surgery Panniculectomy is the medical term for the surgical removal of excess abdominal tissue, which in lay terms, is called the "apron" or pannis. The Pannis is a redundant layer of skin and fat at the lowest portion of the abdominal wall. Because fat distribution is never even in all individuals, some people have significant deposit of fat at this most dependent part of the abdominal wall, which further aggravates various complications especially back and joint pain. The "apron" (pannis) in an individual may weigh as little as 5 pounds, or as much as 120 pounds. After the majority of your weight loss, “tummy tuck” abdominoplasty and panniculectomy can tighten loose sagging tissues. This surgery is designed to remove and re‐drape redundant lower and middle abdominal wall skin and fat. An incision above the pubic region and extending towards the hips places the scar where it can be hidden by most clothing. The skin and fat are separated from the underlying fascia (layer covering the muscles of the abdominal wall). In the standard operation this dissection continues up to the ribs exposing the vertical muscles (rectus muscles). The skin around the belly button (navel or umbilicus) is divided so the redundant tissue of the upper abdomen can be pulled down. This hole is usually extended far enough down to be removed with the excess tissue.
    [Show full text]
  • Abdominoplasty
    Panniculectomy (Abdominal skin/fat surgery) Date of Origin: 05/2002 Last Review Date: 07/28/2021 Effective Date: 08/01/2021 Dates Reviewed: 02/2004, 12/2004, 12/2005, 12/2006, 12/2007, 01/2009, 02/2011, 01/2012, 07/2013, 06/2014, 05/2015, 06/2016, 06/2017, 08/2018, 08/2019, 07/2020, 07/2021 Developed By: Medical Necessity Criteria Committee I. Description Abdominoplasty, often referred to as a tummy tuck, is a surgical procedure for a large, pendulous or protruding abdomen, which tightens lax anterior abdominal wall muscles and removes excess abdominal skin and fat. Traditional abdominoplasty can be performed as an open or endoscopic procedure. Panniculectomy, a procedure closely related to abdominoplasty, is the surgical excision of an abdominal apron of skin and subcutaneous fat located in the lower abdominal area. II. Criteria: CWQI HCS-0001 A. Moda Health covers the following procedure for patients who meet All of the following criteria: a. Panniculectomy will be covered for patients who have undergone substantial weight loss (usually greater than 100 lbs) and ALL of the following: i. The pannus hangs to or below the level of the symphysis pubis as documented in clinical notes ii. The patient’s weight has remained stable for a period of six months following massive weight loss or if weight loss is a result of bariatric surgery after 12-18 months following surgery iii. The panniculus causes chronic intertrigo, candidiasis or tissue necrosis that consistently recurs and has not responded to at least six months of medical treatment with documentation from the treating primary care physician or specialist (i.e.
    [Show full text]
  • A Clinical and Histological Study of Radiofrequency-Assisted Liposuction (RFAL) Mediated Skin Tightening and Cellulite Improvement ——RFAL for Skin Tightening
    Journal of Cosmetics, Dermatological Sciences and Applications, 2011, 1, 36-42 doi:10.4236/jcdsa.2011.12006 Published Online June 2011 (http://www.SciRP.org/journal/jcdsa) A Clinical and Histological Study of Radiofrequency-Assisted Liposuction (RFAL) Mediated Skin Tightening and Cellulite Improvement ——RFAL for Skin Tightening Marc Divaris1, Sylvie Boisnic2, Marie-Christine Branchet2, Malcolm D. Paul3 1Plastic and Maxillo-Facial Surgery, University of Pitie Salpetiere, Paris, France; 2Institution GREDECO, Paris, France; 3Department of Surgery, Aesthetic and PlasticSurgery Institute, University of California, Irvine, USA. Email: [email protected] Received May 1st, 2011; revised May 27th, 2011; accepted June 6th, 2011. ABSTRACT Background: A novel Radiofrequency-Assisted Liposuction (RFAL) technology was evaluated clinically. Parallel origi- nal histological studies were conducted to substantiate the technology’s efficacy in skin tightening, and cellulite im- provement. Methods: BodyTiteTM system, utilizing the RFAL technology, was used for treating patients on abdomen, hips, flanks and arms. Clinical results were measured on 53 patients up to 6 months follow-up. Histological and bio- chemical studies were conducted on 10 donors by using a unique GREDECO model of skin fragments cultured under survival conditions. Fragments from RFAL treated and control areas were examined immediately and after 10 days in culture, representing long-term results. Skin fragments from patients with cellulite were also examined. Results: Grad- ual improvement in circumference reduction (3.9 - 4.9 cm) and linear contraction (8% - 38%) was observed until the third month. These results stabilized at 6 months. No adverse events were recorded. Results were graded as excellent by most patients, including the satisfaction from minimal pain, bleeding, and downtime.
    [Show full text]
  • Counseling Issues in Tubal Sterilization I
    Counseling Issues in Tubal Sterilization I. CORI BAILL, M.D., The Menopause Center, Orlando, Florida VANESSA E. CULLINS, M.D., M.P.H., M.B.A., Planned Parenthood Federation of America, New York, New York SANGEETA PATI, M.D., Washington, D.C. Female sterilization is the number one contraceptive choice among women in the United States. Counseling issues include ensuring that the woman understands the permanence of O A patient informa- the procedure and knowing the factors that correlate with future regret. The clinician should tion handout on tubal sterilization, written be aware of the cumulative failure rate of the procedure, which is reported to be about 1.85 by the authors of this percent during a 10-year period. Complications of tubal sterilization include problems with article, is provided on anesthesia, hemorrhage, organ damage, and mortality. Some women who undergo tubal lig- page 1301. ation may experience increased sexual satisfaction. While the procedure is commonly per- formed postpartum, it can be done readily, without relation to recent pregnancy, by laparoscopy or, when available, by minilaparotomy. Surgery should be timed immediately postpartum, or coincide with the first half of the woman’s menstrual cycle or during a time period when the woman is using a reliable form of contraception. (Am Fam Physician 2003;67:1287-94,1301-2. Copyright© 2003 American Academy of Family Physicians.) emale sterilization is the most com- In the United States, interval sterilizations are monly used “modern”contraceptive usually same-day procedures performed under in the United States.1,2 The most general anesthesia in an outpatient facility.5 recent cycle of the National Survey Most U.S.
    [Show full text]
  • Refining the Abdominoplasty for Better Patient Outcomes
    Refining the Abdominoplasty for Better Patient Outcomes Karol A Gutowski, MD, FACS Private Practice University of Illinois & University of Chicago Refinements • 360o assessment & treatment • Expanded BMI inclusion • Lipo-abdominoplasty • Low scar • Long scar • Monsplasty • No “dog ears” • No drains • Repurpose the fat • Rapid recovery protocols (ERAS) What I Do and Don’t Do • “Standard” Abdominoplasty is (almost) dead – Does not treat the entire trunk – Fat not properly addressed – Problems with lateral trunk contouring – Do it 1% of cases • Solution: 360o Lipo-Abdominoplasty – Addresses entire trunk and flanks – No Drains & Rapid Recovery Techniques Patient Happy, I’m Not The Problem: Too Many Dog Ears! Thanks RealSelf! Take the Dog (Ear) Out! Patients Are Telling Us What To Do Not enough fat removed Not enough skin removed Patient Concerns • “Ideal candidate” by BMI • Pain • Downtime • Scar – Too high – Too visible – Too long • Unnatural result – Dog ears – Mons aesthetics Solutions • “Ideal candidate” by BMI Extend BMI range • Pain ERAS protocols + NDTT • Downtime ERAS protocols + NDTT • Scar Scar planning – Too high Incision markings – Too visible Scar care – Too long Explain the need • Unnatural result Technique modifications – Dog ears Lipo-abdominoplasty – Mons aesthetics Mons lift Frequent Cause for Reoperation • Lateral trunk fullness – Skin (dog ear), fat, or both • Not addressed with anterior flank liposuction alone – need posterior approach • Need a 360o approach with extended skin excision (Extended Abdominoplasty) • Patient
    [Show full text]
  • Advanced Techniques in Abdominoplasty: Optimizing
    Advanced Techniques in Abdominoplasty: Optimizing Results & the Patient Experience Karol A Gutowski, MD, FACS Private Practice Clinical Associate Professor – University of Illinois, Chicago Disclosures Merz – Trainer, Advisory Board Suneva Medical - Instructor Will use brand names due to lack of distinguishing generic names Abdominoplasty Evolution • Panniculectomy • Flap elevation and umbilical transposition • Concurrent non-flap liposuction • Extended & circumferential abdominoplasty • Lipo-abdominoplasty (flap liposuction) • No-drain techniques • Enhanced recovery protocols • Addition of energy devices? Patient Concerns • “Ideal candidate” by BMI • Pain • Downtime • Scar – Too high – Too visible – Too long • Unnatural result – Dog ears – Mons aesthetics Solutions • “Ideal candidate” by BMI Extend BMI range • Pain ERAS protocols + NDTT • Downtime ERAS protocols + NDTT • Scar Scar planning – Too high Incision markings – Too visible Scar care – Too long Explain the need • Unnatural result Technique modifications – Dog ears Lipo-abdominoplasty – Mons aesthetics Mons lift Lipo-Abdominoplasty Traditional limited liposuction Extensive liposuction with with abdominoplasty abdominoplasty Not a Lipo-Abdominoplasty Candidate Lipo-Abdominoplasty Lipo-Abdominoplasty Lipo-Abdominoplasty Extended BMI Range • Patients with BMI > 30 can still get good results – If fat is extra-abdominal – Use circumferential truck liposuction • BMI alone is not the deciding factor • Consider body shape and fat distribution • Manage expectations BMI 37.8 Circumferential
    [Show full text]
  • Essure Removal Reference Number: CP.MP.131 Coding Implications Last Review Date: 10/20 Revision Log
    Clinical Policy: Essure Removal Reference Number: CP.MP.131 Coding Implications Last Review Date: 10/20 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description This policy describes the medical necessity requirements for the removal of Essure®, a permanent birth control method that involves the bilateral placement of coils into the fallopian tubes, which results in the development of scar tissue and occlusion of the fallopian tubes. Policy/Criteria I. It is the policy of health plans affiliated with Centene Corporation® that the removal of Essure is medically necessary when meeting all of the following: A. Symptoms related to the device such as abdominal/pelvic pain or heavy/irregular menses not related to other gynecologic pathologies, device migration, or nickel allergy/hypersensitivity; B. Performed by a gynecologist or surgeon experienced in removing the device; C. Radiologic evaluation to determine the device location; D. One of the following procedures: 1. Hysteroscopy if ≤ 7 weeks post-placement; 2. Laparoscopy or laparotomy for one of the following: a. Linear salpingotomy, salpingostomy, or salpingo-oophorectomy; b. Cornual resection and repair; c. Removal of devices that have migrated from the fallopian tubes. Background Essure is a form of permanent birth control that can be performed in an office setting and does not require incisions or general anesthesia. It involves the placement of spring-like devices into the proximal section of each fallopian tube via hysteroscopy. Over the next three months, scar tissue forms around the Essure coils facilitating insert retention and pregnancy prevention. The build-up of tissue creates a barrier to block sperm from reaching the eggs, preventing pregnancy.
    [Show full text]
  • Determinations of a Safe Musculofascial Plication in Abdominoplasty
    ORIGINAL ARTICLE Determinations of a Safe Musculofascial Plication in Abdominoplasty A A H Al-Shaham, CABS Department of Surgery, Faculty of Medicine, UITM, 40450 Shah Alam SUMMARY might guess how much plication is required, but usually it is This study was conducted to determine a safe vertical less then the required correction to deal with abdominal musculo-fascial plication distance in abdominoplasty protrusion. operation in order to avoid the risk of developing respiratory distress during the post operative period. Abdominoplasty is Respiratory decompensation may occur as a result of undue a surgical procedure that removes excess abdominal skin and over plication of musculo-fascial procedures that reduce fat (panneculectomy), and tightens lax anterior abdominal respiratory reserve by decreasing intra-abdominal volume and wall muscle; in which musculo-fascial plication is a major diaphragmatic excursion thus raising intra-abdominal component of abdominoplasty in patient with significant pressure to a critical level, leading to abdominal divaricating of the recti muscles. Respiratory decompensation compartmental syndrome6,7,8. Direct and indirect may occur as a result of undue plication which reduces the measurement of the intra-abdominal pressure was evaluated intra abdominal volume with diaphragmatic excursion leading by several investigators in order to predict the development to abdominal compartmental syndrome. Fifty six patients for of respiratory derangement and eliminate the risk of post- abdominoplasty were selected prospectively, during the operative respiratory failure following abdominoplasty with period from June 1998 to February 2004, male to female ratio plication 6,7,9. 1:13, mean age 39.5, mean weight 95.2 kilogram. To determine a safe plication distance (PD).
    [Show full text]
  • Essure Post-Procedure Management
    Essure Post-Procedure Management Please see Important Safety Information, including Boxed Warning, on slides 3-8 of this presentation. For important information about Essure®, please see the accompanying Instructions for Use, including Boxed Warning. PP-250-US-1847 April2018 Table of Contents • Important Safety Information • Essure Post-Procedure Responsibilities • Essure Post-Procedure Adverse Events • Essure Confirmation Test • Interactions with Other Procedures • Management of Patients Unable to Rely • Insert Removal 2 Please see Important Safety Information, including Boxed Warning, on slides 3-8 of this presentation. For important information about Essure®, please see the accompanying Instructions for Use, including Boxed Warning. Indication and Important Safety Information Indication • Essure® is indicated for women who desire permanent birth control (female sterilization) by bilateral occlusion of the fallopian tubes. Important Safety Information WARNING: Some patients implanted with the Essure System for Permanent Birth Control have experienced and/or reported adverse events, including perforation of the uterus and/or fallopian tubes, identification of inserts in the abdominal or pelvic cavity, persistent pain, and suspected allergic or hypersensitivity reactions. If the device needs to be removed to address such an adverse event, a surgical procedure will be required. This information should be shared with patients considering sterilization with the Essure System for Permanent Birth Control during discussion of the benefits and risks of the device. IMPORTANT: • Caution: Federal law restricts this device to sale by or on the order of a physician. Device to be used only by physicians who are knowledgeable hysteroscopists; have read and understood the Instructions for Use and Physician Training Manual; and have successfully completed the Essure training program, including preceptoring in placement until competency is established, typically 5 cases.
    [Show full text]
  • Table 7 Pregnancy Rates for Temporary Birth Control Method^^,^-^,* ;OB.^ I Iw1" ($1I -Wj
    Anesthesia-Medically induced partial or complete loss of sensation, in all or part of the body, with or without loss of consciousness. General anesthesia is total loss of' consciousness and sensation Cervix-The passageway that connects the vagina to the uterus Contraceptive-Any process, device, or method that reduces the likelihood of pregnancy Delivery Catheter-A long tube-like device that helps the doctor place the Essure micro-inserts in the fallopian tubes Ectopic Pregnancy-The development of a fertilized egg outside of the uterus, but inside the body Expulsion-Forcing (expelling) something out Fallopian Tubes-The tubes that carry the eggs from the ovaries to the uterus Hystcrosalpingogram (HSG)-An X ray of the uterus and fallopian tubes after they have been filled with dye (contrast medium) Hysteroscope-A telescope-like instrument, which is used to view the inside of the uterus In Vitro Fertilization (rVF)-Fertilization of an egg outside of the body, followed by placement of the fertilized egg into the uterus Intrauterine Device (IUD)/Intrauterine System (IUS)-A medical device that is put into the uterus to prevent pregnancy Irreversible-Cannot be changed back to its original state Local Anesthetic-Medicine that is applied to or injected in a certain spot in the body to cause a loss of sensation in that part of the body Major Surgery-Surgery that requires general anesthesia and incisions in the body Micro-insert-A small, flexible, coil-type device that is put into your fallopian tube for permanent pregnancy prevention Occlusion-A closed or blocked part of a hollow tube Perforation-A hole in something Permancnt-Not able to change back and forth Reversible-Able to change back and forth Tubal Ligation-Permanent female sterilization by means of cutting, tying, burning, or clipping the fallopian tubes Uterus-'l'he womb in which a developing fetus grows Vasectomy-Permanent male sterilizatioii by meatis of cutting or blocking a segment of the vas deferens (the tube that carries the sperm) A 11 011 i t1.C i s io 11 il ~~~~~~~.~~~~~~~~to jP6'rgltLIIII:tll.
    [Show full text]