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General Hospital

After two deaths, a hospital says plastic surgery now requires general anesthesia.

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Though the New York State Department of Health has yet to conclude its investigation into the two recent deaths at the Manhattan Eye, Ear and Throat Hospital, the hospital has already started adopting new measures it hopes will prevent such deaths (and PR nightmares) from occurring again. From now on, all aesthetic procedures requiring sedation—however minor—will be done under general anesthesia.

“We have made these changes on an interim basis,” says Ann Silverman, the hospital’s PR director. “We will be reevaluating them.”

It may seem counterintuitive that general anesthesia would be considered safer than lighter sedation, but since the patient is intubated and not breathing on his own, oxygen deprivation—a likely factor in novelist Olivia Goldsmith’s death—would be avoided.

“Patients believe that local anesthesia with sedation is perfectly safe, but it has risks equivalent to general anesthesia,” explains Gerald H. Pitman, one of MEETH’s plastic surgeons.

But not everyone applauds the hospital’s position. “Now we have to give general even with an upper- or lower-lid blepharoplasty,” sighs one prominent doctor. “The decision is no longer up to the surgeon.”

“They think it’s an easy way out, but it’s not,” says Dr. James E. Cottrell, immediate past president of the American Society of Anesthesiologists. “General anesthesia can be complicated. You have a loss of consciousness, your vital functions have to be supported, there are fluctuations in blood pressure, and it can cause an asthma attack and potential damage to the vocal cords.’’ Not to mention the jarring effect on stitches in the face when the tube is pulled out and a patient coughs or gags.

“General anesthesia requires much more medication,” adds Jane Recant, a well-respected anesthesiologist for some of the city’s top plastic surgeons. “I would never agree to have it unless I absolutely had to.”

“Many of us would prefer that the decisions be made by the consulting doctors on an individual basis,” agrees Alan Matarasso, another meeth plastic surgeon.

Meanwhile, there is another ripple effect to the recent deaths. Possibly to make up for any revenue lost as a result of patients’ rethinking their ops, doctors have received notice that the hospital's rates were increased by about 10 percent, as of April 1.


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