SmartLipo Procedure Leaves Woman Severely Scarred

This case involves a female patient who underwent a laser-assisted lipolysis (SmartLipo) procedure at a medical spa. The patient was prepped for the procedure and taken to the operating room that was no different from any of the examination rooms she had seen on her prior visits. The defending physician entered the room and started the procedure by turning the patient on her side. The patient states that she was not given any anesthesia and began to feel searing and extreme pain across her back, at which point she screamed and became unconscious. Upon discharge, the patient was not given antibiotics but only a topical prescription for pain that she could not use as it caused extreme burning and itching. On successive follow-up appointments, the patient displayed extreme bruising that included a necrotic area just above the pubic bone. She complained of excruciating pain and experienced itching over her entire body with serous drainage across the abdomen extending around to her back. No antibiotics were prescribed, but the doctor mentioned that she may need skin grafting due to some complications. The patient was then referred to a surgeon who performed a debridement of a 13 cm x 6 cm necrotic eschar with the evacuation of 200cc of fluid collection. The patient tolerated this procedure well and was discharged to a home health care aid with a wound vacuum, antibiotics, and pain medication. She still suffers from severe scar formation and debilitating pain syndrome.

Question(s) For Expert Witness

1. What is your experience with the SmartLipo procedure and what are your initial thoughts on the case?

Expert Witness Response E-000350

I do perform liposuction, with and without laser (SMART) assist. I perform approximately 150-180 liposuction cases a year and a minority with the laser. Some form of anesthesia is indicated and I can’t imagine why this patient was not sedated. Tumescence solution with lidocaine is considered a minimum standard of care when performing this type of procedure. This sounds like a case of physician error as the lasers used in the Smart procedure have no ends like a knife. Therefore, if the physician’s technique is inadequate, it is easy to lose sight and cause burns in unwanted areas. Another possibility would be related to the type of laser device used and a possible failure of the device, which is more unusual.