New suspensions and complaints concerning office surgery centers from Miami to Palm Beach

Eight licensed office surgery centers, spanning from Miami to Palm Beach, were hit in December with either suspensions or administrative complaints, which may end with suspension.

Both the suspensions and the complaints come from the Florida Department of Health, although the time from violations to punitive actions can vary — some of the suspensions are based on inspections from 2021.

A few things to know:

▪ Office surgery centers aren’t hospitals. If something goes very wrong, the facility has to be equipped to handle the situation until emergency medical services can arrive and get the patient to a nearby hospital where there’s a transfer agreement or the surgeon has staff privileges. The “crash cart” is the mobile set of drawers or trays that should contain everything necessary to deal with a medical emergency until that patient transfer.

▪ There are three levels of office-based surgery in Florida. For Level I, the patient is fully conscious. At Level II, the patient can “tolerate unpleasant procedures,” the Department of Health says, but still has enough consciousness to respond to spoken requests or touch stimulation. Level III involves general anesthesia and pre-surgery sedation.

▪ The designated physician is the doctor in charge of making sure the office surgery center follows state laws. Usually, when an administrative complaint gets filed against the surgery center and starts the discipline ball rolling, a companion complaint will be filed against the designated physician.

The surgical centers in alphabetical order...

Beldor Group, 201 NW 70th Ave., Plantation. Inspectors found Beldor’s crash cart lacked adenosine, which treats irregular heartbeats. Also, at least once for each, the Beldor Group didn’t include medical clearance or the level of surgery on the surgical logs.

The designated physician is Dr. Abel Enrique Bello. The inspection was Aug. 25, 2021. Beldor’s 15-day suspension ends Saturday.

Beth Freedland, D.O., 7301 W. Palmetto Park Rd., Boca Raton. An administrative complaint filed Dec. 15 after a July 6, 2021 inspection said the surgery center allowed to do procedures “with moderate or conscious sedation” didn’t do or at least didn’t document doing, proper pre-op exams.

Also, the complaint says one physician was allowed to do surgery without staff privileges or a transfer agreement at a “licensed hospital within a reasonable proximity;” and another surgeon was allowed to work with an expired Advanced Cardiac Life Support certification.

Beth Freedland is the designated physician.

Dolls Plastic Surgery, 18205 Biscayne Blvd., Aventura. State records say Dolls managers are Leonardo Campo and Heriberto Martinez and the designated physician is Keith Berman.

According to an administrative complaint filed Dec. 15, a Feb. 22 inspection “found that Dolls had on at least one occasion failed to utilize complete Preoperative Evaluation Forms which showed that the surgeon had completed all steps of the preoperative evaluation.”

During at least one surgery, the complaint said, a Dolls surgeon exceeded Florida’s limit on how much supernatant fat could be removed during liposuction and the limit on how much supernatant fat could be involved in a liposuction “in a remote location from another procedure.”

Florida Pain & Rehabilitation Associates, 1930 NE 47th St., Fort Lauderdale. This place is owned by Maryland-based Cherian Sajan with Dr. Sergio Lenchig as designated physician.

A May 23, 2022, inspection found that a physician listed on the registration wasn’t working there anymore. Of more present matters, inspectors didn’t find documentation of a risk management program that met state requirements.

Speaking of risk, the crash cart didn’t have albuterol with a small volume nebulizer for bronchospasms; atropine, which can help with saliva during surgery and heart rhythm issues; epinephrine, which can cut blood loss during plastic surgery, and calcium chloride which can be used as a backup for some epinephrine functions; naloxone, which can reverse the effects of opiates given during surgery, according to the National Library of Medicine; or paralytic drug given during anesthesia.

Florida Pain’s 30-day suspension began Friday.

Hu-Ka Cosmetic Center, 9299 SW 152nd St., South Miami-Dade. Dr. Humberto Gonzalez is the designated physician for this center owned by Karen Figuredo Reyes.

An administrative complaint filed Dec. 15 said a July 31 inspection discovered that Hu-Ka hadn’t done a “timely...biomedical safety inspection of the biological spore incubator.”

Miami Vein Center, 1501 S. Miami Ave., Miami. Dr. Jose Almeida doubles as owner and his own designated physician for this Level II surgery center.

A Sept. 21, 2021, inspection found the vein center’s crash cart wanting as far as atropine; adenosine; flumazenil, which can quickly reverse the effects of anesthesia; lidocaine, which can be used as an anti-arrhythmic, “appropriate for cardiac administration; and magnesium sulfate, which can help with muscle relaxation in surgery.

Plastic Surgery Institute of the Palm Beaches, 4601 Military Tr., Jupiter. The owner and designated physician for this place are both Dr. Harold Bafitis. Bafitis personally was fined $5,000 as a designated physician and ordered to take continuing medical education courses in risk management and laws, rules and ethics.

A May 22, 2022, inspection showed at least one doctor who wasn’t registered to perform office-based surgery with the state Board of Medicine.

At least one patient chart didn’t include a consent form with the anesthesia provider, nor did it say where the surgeon had staff privileges. At least one surgical log didn’t tell the reader when the patient got there, the type of anesthesia, who handled the anesthesia and how long the surgery lasted.

Defibrillator pads were expired. At least one surgery lasted longer than eight hours. At least one patient wasn’t discharged within 24 hours and a patient chart showed only one staff member present during an overnight stay. The crash cart didn’t have dopamine or lidocaine.

The institute’s 30-day suspension began Thursday.

Surgery Institute of Westchester aka Xiluet Plastic Surgery, 8350 SW. Eighth St., West Miami-Dade. The numerous violations on the watch of company president Monica Vazquez and designated physician Dr. Gamaliel Mattos were detailed in a Dec. 31 article.

READ MORE: Poor anesthesia training among reasons a Miami surgery center is suspended

The strip mall little sister to the main Xiluet location across the parking lot is on suspension until Jan. 20.