Portsmouth plastic surgeon's suspension lifted: Dr. Gray gives his side of story

PORTSMOUTH — The New Hampshire Board of Medicine on Thursday announced it was immediately lifting the recent emergency suspension of a longtime Portsmouth plastic surgeon’s license.

Dr. Lawrence Gray's license to work as a physician had been suspended last month, following an investigation into complaints by two of Gray's patients, one who had breast augmentation surgery and one who had a breast lift procedure. He is the founder and medical director of Atlantic Plastic Surgery & Medi-Spa in Portsmouth, which opened in 1985.

The investigation that led to his suspension found Gray had recently performed wrong site surgery, conducted procedures with "shaking" hands and had "at least" 15-20 patients who needed corrective surgery because of work he botched, among other errors, such as marking patients incorrectly and giving incorrect instructions to staff. An investigator said one of the patients who filed the complaint stated she looked like "Frankenstein" after her surgery.

The decision to lift Gray's suspension came one day after he and his attorney, Bradley Holt, argued against it during a hearing with the Board of Medicine Wednesday in Concord. Holt called the suspension "way out of line."

Gray and Holt defended his record and fought back against the complaints and witness testimony in the hearing.

Final word on Gray's case is yet to come

The Board of Medicine did not immediately explain the reasoning behind the decision to lift Gray's suspension, stating, "A full narrative order shall follow." There was no immediate indication when the narrative would be released.

Jessica Kallipolites, director of the division of enforcement for the New Hampshire Office of Professional Licensure and Certification, answered a question about whether the Board of Medicine will continue its investigation into Gray in general terms after Wednesday's emergency hearing.

Kallipolites said an emergency hearing like the one held Wednesday "is not a final adjudication or disposition of the matter." She explained, "An emergency hearing is held after a board emergently suspends a license in order to provide due process to the licensee and to make a determination as to whether the emergency suspension should remain in place during the pendency of the investigation."

Previous story: Portsmouth plastic surgeon suspended after report of wrong site surgery, numerous errors

The National Institutes of Health defines wrong site surgery as a procedure performed on the wrong side or site of the body, the wrong surgical procedure performed, and surgery performed on the wrong patient.

State Office of Professional Licensure and Certification investigators Eric Goulet and Victoria Davies recommended Gray’s license suspension, which was ordered by the Board of Medicine on July 21.

Gray testified allegation of wrong site surgery was not correct

Testimony from witnesses outlined the allegation of wrong site surgery, in which a patient seeking removal of a left breast contracture ended up getting the same surgery on her right breast from Gray.

The procedure that took place is known as a capsulectomy, a surgical effort to remove hardened tissue around breast implants. Gray acknowledged the patient received the right-side breast surgery for the contracture from him when she was expecting surgery on the other side, but denied performing wrong site surgery.

Nurse anesthesiologist Zachary Chase testified he has worked with Gray dating back to 2018. He testified the patient was expecting the procedure on the left side but prior to surgery mentioned the same problem on the right side.

“She made a comment to the effect of, ‘Maybe I should just be getting this one as well,’” Chase stated. The nurse anesthesiologist said Gray found in his operating room examination the patient’s right-side contracture was what needed attention and that “not doing that would be a disservice.”

“There was no problem on the left side, I discovered,” Gray told the board. “So if I made an incision on the left, I could have created a potential problem. There was nothing for me to cure.”

Gray reported the patient felt “happy that I corrected where the problem was” post-surgery.

“I did what I saw was the appropriate thing to do,” he said. “I think it would have been wrong to do nothing and wake her up and tell her, 'We have to reschedule your surgery.'"

A board member asked Gray what he would do differently in the future in such a scenario, which he stated was the only time it has occurred in his 38-year career.

“The main thing I’d do in the future is I’d 100% examine someone and not rely upon what the previous visit showed,” he said. “So that would have been picked up before they went into the operating room.”

Gray and attorney argue suspension should not have been ordered

Holt called on the board to reverse its decision, arguing investigators didn’t consult outside medical experts on the allegations against Gray and never presented the surgeon with the opportunity to respond to the claims.

“In my view, your honor, this outcome is way out of line with the track record of the Board of Medicine for emergency suspensions, which typically involve things like sexual predators, substance abuse, drug diversion," Holt said. "If you look at all of them in the last seven years, as we did, (there is) nothing where an elective surgery and an unsatisfactory outcome would be basis for an emergency suspension of a license, especially without the physician knowing anything about it or being able to speak for himself."

Holt responded Thursday to the board's decision to end Gray's suspension with a written statement:

"The Board of Medicine is there to protect the public, and when a personal injury plaintiff’s lawyer provided the Office of Professional Licensure and Certification (OPLC) complaints that sounded serious the investigators alerted the Board, which quickly suspended Dr. Gray’s license. But in their effort to move quickly, they did so without having seen any of the medical records of the cases and without contacting Dr. Gray for an explanation. Yesterday the Board had a chance to see records and hear from Dr. Gray and the Board immediately lifted the suspension.  Dr. Gray was grateful for the chance to speak with the Board and he is glad to be back to helping patients, and he will continue to cooperate with the Board about any further questions."

Gray said he takes medication for tremor in his hands

Gray addressed the investigation's finding he has worked with "shaking hands" during Wednesday's hearing stating, "I have a little bit of a tremor," adding he has been prescribed medication for it.

“I just talked to my personal physician last November, and he put me on Inderal and propranolol — it’s the same drug — and felt it worked well,” Gray said.

The surgeon, who shared he does not perform microsurgery and doesn't perform procedures that will last longer than four-and-a-half hours, testified he couldn't recall an instance where a patient asked about his shaking hands.

"If they did, I’d tell them I have an essential tremor and I’m on medication for it and it doesn’t affect surgery," he said.

Chase said he had noticed Gray's tremor in his hands, adding it was similar to what he has seen with other senior surgeons.

“His tremor was never so concerning that I investigated it further because the outcome of his surgeries were never negatively impacted by his tremor,” Chase said.

Doctor who works for Gray testified his boss made errors

The allegations against Gray included claims from Dr. Alexander Slocum, his employee, who told investigators he had to perform numerous corrective surgeries on Gray’s patients, with upwards of a dozen in the last year. This included rhinoplasty, face lift and liposuction, among others.

“I’ve had a couple of patients tell me that they had the wrong procedure recited to them, either in pre-op or they were there for a follow-up and the incorrect procedure was recounted,” Slocum added. “However, for that latter point, most surgeons need a good reminder about what (procedure) the patient had.”

Slocum described his relationship with his boss and recent attempts to lessen Gray’s workload by passing off some procedures to Slocum.

“Dr. Gray and I so far have had a very positive, strong working relationship. When I brought concerns to him, I felt like he, at least initially, considered things,” he said. “More recently, I have been trying to encourage transferring some types of surgeries to me and trying to respectfully encourage that we transition him out of doing certain surgeries. Most recently, he indicated to me he had no interest in doing that and was planning on considering operating for the time being.”

On Monday, July 24, Slocum told investigators he arrived at work after several days off to find his personal belongings piled on the sidewalk outside Atlantic Plastic Surgery & Medi-Spa. Gray’s emergency license suspension had been issued three days earlier.

The contents of his belongings, he claimed, were mostly personal, though one binder contained patient procedural photos.

“The fact that my stuff was intermingled with protected health information was very concerning to me with regards to how it was handled by Atlantic Plastic Surgery,” he said.

Gray testified he intended to retire in the fall and had an agreement in place with Slocum to buy the practice, up until mid-July. Gray did not say if that agreement has fallen apart.

Slocum, questioned by Holt, denied there was an agreement in place for him to take over the practice.

“That was a follow-up potential, if I met certain criteria and performed adequately,” he said Wednesday.

Slocum said he is still employed at the practice, despite his belongings being placed outside.

Gray reached settlement with state on past complaint in 2000

State records show that in 2000, the Board of Medicine and Gray reached a settlement agreement regarding “allegations of professional misconduct” against the surgeon after a report he didn't give a patent laser safety eyewear during laser surgery on her eyelids in 1996, resulting in "small corneal scars to patient."

The settlement states Gray "admits that the patient was not provided safety eyewear ... but maintains that the laser supplier represented to him that eye shields were not necessary" during the procedure, and Gray "submitted evidence to support this contention.”

The settlement required Gray to “furnish a copy of the Settlement Agreement to any employer, any licensing, certificating or credentialing health care institution to which he may apply for employment and/or privileges” for a year after the agreement’s signage date.

This article originally appeared on Portsmouth Herald: Portsmouth plastic surgeon Dr. Gray's license suspension lifted