The Monarch Med Spa Incident: State Report for Liposuctions Gone Bad now released

12 months ago a serious incident took place at Monarch Med Spa, a Med Spa in Maryland. 3 patients, after a liposuction surgery were infected with an aggresive strep form while one woman died. Now, the Health and Mental Hygiene Department of Marylantd relased the investigative report related to the incident.

The patients that were infected were between 28-60 and had multiple surgeries. One of the most important details presented in the report is about the interior environment of the spa: “There was visibly dirty equipment, no separation of clean and dirty areas for equipment sterilization, a clogged sink in the liposuction procedure room with debris and liquid leaking onto surgical supplies stored underneath, open surgical scrub materials, non-sterile surgical dressings stored open in high-traffic areas, autoclave logs unavailable, expired supplies on shelves, and unlabeled opened multi-use lidocaine vials.”. The report also states “conditions noted at the facility may have allowed potentially contaminated materials to come into contact with the patients’ surgical wounds.”

Besides 50{f4e1575822752660c3387461b06f16047197db710b64f29e8565d582c3a8cd4f} of the patients surveyed during the investigation noticed that at least one of the surgical team’s member didn’t wear a mask during the surgery while 25{f4e1575822752660c3387461b06f16047197db710b64f29e8565d582c3a8cd4f} claimed one or more of the surgical team didn’t wear gloves during the liposuction surgery!

And it is not only that! The plastic surgeon that carried out the unlucky woman’s lipo surgery, Dr. Daniel Francis was carrier of the Streptococcus Strain that infected the patients.

Though all these details create a really unattractive image of the Monarch Med Spa, the report team can’t complete the puzzle that will lead to clear conclusions! Dr. Lucy Wilson, Chief of Surveillance, Infection Prevention and Outbreak Response of Department of Health and Mental Hygiene of Maryland comments”We have patients, we have the environment and we have the health care workers and we are unable to put the puzzle together as to which came first and which mechanism occurred.”

Monarch Med Spa was closed after the incident took place (on 09.18.2012). In order for the center to reopen it needs to meet a 8 requirements list.

PS: A few other cases with liposuction surgeries that went wrong during the last months can be found  here, here, here and here

PS2: Credits go to ABC2. More details on the story can be found here!