Did Rocklin doc botch surgeries?

Gynecologist, cosmetic surgeon could lose license
By: Krissi Khokhobashvili, Placer Herald and Press Tribune editor
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A Rocklin doctor could lose his medical license after a series of alleged negligence against 15 women who had cosmetic surgery at Advanced Med Spa, according to the California Medical Board.

Dr. Efrain Gonzalez obtained his medical degree from the Universidad Central del Caribe School of Medicine in Puerto Rico in 1991, according to a 95-page complaint filed by Linda K. Whitney, executive director of the Medical Board of California. He was licensed by the Puerto Rico Medical Board, which suspended his license for five years in 1997 for practicing surgery without certification, according to the complaint.

Gonzalez did not return calls for comment for this story.

Since 2006, Gonzalez has held a physician’s and surgeon’s certificate from the Medical Board of California. He practices primarily as a cosmetic surgeon, according to the medical board, although his board certification is in obstetrics and gynecology.

Gonzalez is accused of gross negligence and incompetence throughout the complaint. The first accusation, filed in September 2011, outlines five causes for discipline, while the first amended accusation, filed Dec. 31, 2012, adds 51 more. The lengthy document outlines 56 causes for discipline going back to 2008, including one patient who reported that at the end of a surgery she awoke to find not Gonzalez, but rather an unlicensed surgical technician applying sutures to her abdomen, while Gonzalez was not in the room.

In another instance, a patient reported that she was given the wrong type of breast implants, and said Gonzalez admitted to her that he knew at the time of surgery that they did not have the implants the patient wanted and was aware they were inserting the wrong size.

Dr. Terry Zimmerman, president of the Greater Sacramento Society of Plastic Surgeons, said he has seen more than 10 patients who have undergone surgery by Gonzalez, including a woman who suffered an infection and went through three operations after a breast augmentation, ultimately losing one of her implants, which wasn’t in the right position in the first place.

There’s a high price tag that comes with fixing a botched surgery. Zimmerman said while breast augmentation typically costs around $5,000, it can easily run $15,000 to $20,000 to get reconstructed.

“Every patient who has come to me that had gone to him first, not a single one realized he was not a plastic surgeon,” Zimmerman said. “So it’s giving plastic surgery a black eye, because they see these complications and think less of the field.”

Zimmerman explained that in current law, there is nothing to prevent a doctor from practicing surgery in their offices, even though they won’t have hospital privileges if not board-certified in the field in which they are operating. The GSSPS has tried to get legislation passed to change the law, but has not been successful, he added.

“In Puerto Rico, where he lost his license, they have a law that says you cannot practice medicine outside of the scope of your training,” Zimmerman said. “It seems very logical, unfortunately California doesn’t see it that way, and they still have guys like him doing this, and he literally is hurting patients.”

In another incident outlined in the complaint, a patient reportedly went into respiratory arrest during a tummy tuck and breast augmentation, and Gonzalez attempted to perform a tracheotomy but instead allegedly performed a cricothyroidotomy, an incision made through the skin and cricothyroid that is nearly always performed as a last resort, according to the complaint. That procedure reportedly resulted in a tracheal laceration, air in the mediastinum, an abnormal collection of air in the pleural cavity and air or gas in the peritoneal cavity. When Gonzalez hastily closed the breast incision as the EMTs were en route, he allegedly left a breast fill-tube inside the wound. The patient was hospitalized for about two weeks, according to the complaint.

Another patient reported that following breast augmentation surgery in 2012, she is unable to use her right hand, according to the complaint. Another reportedly suffered necrosis of one of her nipples following a breast augmentation, and still another alleged a vaginal rejuvenation surgery so botched that it left her unable to have sex, use a tampon or even wear pants.

The complaint requests that a hearing be held to revoke or suspend Gonzalez’s physician’s and surgeon’s certificate; revoke, suspend or deny his authority to supervise physician assistants; and order that, if placed on probation, Gonzalez pay the medical board the costs of probation monitoring.

A hearing scheduled for Aug. 5 is expected to take about two weeks, according to the Office of Administrative Hearings calendar. The case is heard by an administrative law judge, who issues a proposed decision that must be adopted by the board in order to become final, according to Jennifer Simoes, chief of legislation for the Medical Board of California.

“It is possible that both sides (Dr. Gonzalez and the medical board) could agree on discipline before the hearing,” she added. “If that happens, a hearing will not be necessary.”

Advanced Med Spa remains open on Sunset Boulevard.