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Donda West Death Results in New Law

December 10th, 2009

In response to the  death of Donda West,  Kanye West’s mother, the California State Senate recently approved a requirement that patients must be given a physical exam before elective surgery,  according to the  Los Angeles Times. The new law, AB 252, passed by an overwhelming margin.  The vote was 37 to 1.  This new California statute requires a history and physical examination be done prior to any elective cosmetic surgery or cosmetic medicine procedure that is performed in physician offices.   The goal, of course, is to reduce the risk of death or serious impairment associated with surgery.   Unfortunately the law does not address cosmetic surgery done in dentist offices or surgery related to body modifications carried out in non-medical facilities or surgery done by unqualified personnel.

I have always insisted that my patients have a History and Physical completed by their primary physician before having elective surgery.  The most important philosophy guiding most surgeons, in an effort to avoid complications from cosmetic surgery, directly relates to patient safety.   Risks are present in all medical procedures and surgical treatments, but certain steps minimize this risk.   Yet complications occur and cannot be eliminated entirely.   It is important to know that your surgeon has made every effort to reduce the risks and incidence of complications for any cosmetic surgery.

One of the cornerstones making cosmetic surgery safer is the pre-operative History and Physical.   This medical evaluation is usually completed in advance of having cosmetic surgery.   I require this evaluation to be done within two weeks prior to a patient’s surgery date.  It was my practice as I began my career as a surgeon and it is a policy that I have continued for the past twenty-five years.   However, I do not do pre-operative history and physicals on my own patients.   I prefer that an independent, unbiased physician complete the examination, order necessary laboratory tests and finally interpret the results and confirm that the patient is healthy enough for surgery.   I like to think of this division of patient care as an effective tool used to uncover any underlying medical condition that might lessen the safety of having elective surgery.

Whether or not your state requires this extra step, please consider having a pre-operative medical examination before all elective surgery.

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