A Palm Beach doctor’s face-lift errors caused brain damage and a heart attack, state says

A patient suffered severe brain damage, a heart attack and kidney failure after a Palm Beach County anesthesiologist dropped his blood pressure too low during a face-lift procedure, the Florida Department of Health says.

That’s in the administrative complaint against Delray Beach doctor Roger Gorman, filed on Jan. 14. Administrative complaints often are the first documents filed in the process of a possible medical discipline.

Gorman has been through that process before. He was fined $10,000 and ordered to complete 16 hours of continuing medical education courses after the death of a mother giving birth in 2013. The state alleged Gorman didn’t properly monitor the effects of the epidurals he gave her and he didn’t “administer epinephrine for the management of cardiac arrest” when she was unresponsive.

As for this complaint, Dr. Gorman said in a Tuesday email to the Miami Herald: “At this moment in time, we are formulating our response.”

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Dropping the blood pressure while lifting the skin

Gorman’s online license profile address is Boca Raton and claims staff privileges at Delray Medical Center and West Boca Medical Center, but the complaint doesn’t say where “S.G.” came for his outpatient face-lift procedure on Jan. 21, 2016.

The complaint says Gorman used Sevoflurane, “an agent used for induction and maintenance of general anesthesia;” Precedex, “a sedative agent...;” and Propofol, “a hypnotic agent which can be used for induction and maintanance of general anesthesia...”

Each can cause hypotension, low blood pressure.

Gorman “did not document justification for the usage for three separate anesthetic agents,” the complaint says. The doctor “did not document the dosages of Propofol and Precedex which he administered to Patient S.G.”

S.G.’s blood pressure fell more than 25% of his normal baseline. The complaint says Gorman should have known that would happen. It also says he:

▪ Didn’t record S.G.’s urine output and fluids;

▪ Didn’t record his end tidal carbon dioxide levels every 15 minutes, but did it instead every 30 minutes;

▪ Didn’t treat the hypotension with vasopressers, hormones that help raise blood pressure;

▪ Didn’t use fluid resuscitation for the hypotension.

Unable to bring S.G. back around, Gorman called 911. But, the complaint says, he didn’t treat the hypotension while waiting for emergency services to take S.G. to Boca Raton Regional Hospital.

Because of the prolonged hypotension during surgery, the complaint says, S.G. suffered “severe anoxic encephalopathy, type 2 myocardial infarction, lactic acidosis and acute renal failure.”

Respectively, that’s severe brain injury, heart attack, lactic acid buildup and kidney failure.