Quebec’s coroner is investigating the death of a 42-year-old Laval woman, who died soon after receiving surgery at the private Westmount plastic surgery clinic Espace MD. Sources say plastic surgeon Dr. Sandra McGill was the operating physician and owns the clinic.
In a statement, Quebec Coroner’s office spokesman Jake Lamotta Granato told Global News, “We confirm that an investigation into this death is underway, to shed light on the causes and circumstances surrounding the death. As a reminder, the investigation is a private process by which the coroner collects the information he needs to fulfill his mandate. Thus, during the investigation, no information on it is disclosed.”
McGill declined to comment, with clinic manager Stephanie Garand saying in an email, “Unfortunately we are bound by professional secrecy, we are not authorized to communicate any information whatsoever related to patients, whether or not they received treatment at our clinic. Respect for professional secrecy is essential to preserve the trust of all of our patients.”
Global News has learned that the woman went to the clinic in early November for abdominal liposuction. She had been to the clinic before and had breast implants removed in March. On her Facebook page, she endorses Dr. McGill, writing, “I highly recommend Dr. McGill. She gave me confidence, respected all my requests and did a great job.”
Experts in the field say the surgery she was getting is fairly routine and is usually done in under two hours. Sources tell Global News that the procedure did not require general anesthetic, and the woman was put under sedation under the care of an experienced Respiratory Technician.
But, multiple sources say, something went terribly wrong. During the procedure, around 5:30 p.m., attending medical staff noticed the woman’s oxygen level was compromised, and she had entered an anoxic state. An ambulance was called, and the woman was rushed to the Montreal General Hospital. Sources told Global News the woman never regained consciousness and was declared brain dead. She was taken off life support on Nov. 13.
Global News is not identifying the woman, to protect her family’s privacy. But on her Facebook page, her husband wrote of her death, “Following complications during a minor surgery, (she) passed away on Sunday November 13th. I want to thank all my family and friends for all the support and love the past few days. The children and I are very grateful. Many more difficult times ahead but with you by our side it will be less painful.”
Exactly what happened during the surgery is the subject of furious debate and speculation in Montreal’s close-knit private plastic surgery community, with many physicians questioning how many minutes passed before somebody noticed the patient’s oxygen levels were compromised, and whether pulse oximeter alarms were working properly and alerted anyone to a problem.
A plastic surgeon with decades of experience was surprised to hear of the death and said “We do these cases every day, every year throughout Canada.”
Publicly, some experts caution people must wait for the coroner’s investigation, adding that complications can happen during surgery.
“It’s a very tragic incident. It’s obviously shocking when we hear of those incidents in our field,” said Dr. Eric Bensimon, president of the Quebec Society of Plastic Surgeons. “Our colleagues want to know what happened, they want to understand what happened … We want to make sure it doesn’t happen again … There are many different scenarios that could have happened.”
Bensimon added that private medical clinics in Quebec are extremely safe, and that they follow rigid certification standards, some of the toughest in North America.
Dr. Charles Guertin, the president of the Canadian Society of Aesthetic Plastic Surgery, said, “Everyone is sad, everyone is surprised … It’s extremely unusual, it almost never happens, but people in their 40s die.“
Guertin went on to say that plastic surgery-related deaths are extremely rare in Canada. Quebec’s College des Medecins says there have only been two in the last 20 years in Quebec. One victim was television producer Micheline Charest, who died in 2004 after suffering complications following surgery for a facelift and breast augmentation.
Guertin said aesthetic surgeries are usually much safer than surgeries in hospitals, because doctors choose who they operate on, and generally the patients are healthy.
“When you do aesthetic surgery, you want someone in good health. But something can happen, you never know. Even though we take extreme measures to be careful, it can happen. There is always the human factor there,” he said.
It is unknown exactly what transpired during the surgery.
Global News has spoken to several doctors who have worked with McGill, but left her clinic for myriad reasons. Many said they are concerned the woman’s death will impact the entire industry, casting a pall over a profession growing in popularity that is normally extremely safe.
Anesthesiologist Dr. Chris Woodruff said he worked twice at McGill’s clinic almost eight years ago but stopped working there quite quickly, primarily because of interpersonal issues, among other factors.
“Going back, I felt the anesthetic equipment wasn’t kept up to appropriate standards. I did not feel there was enough emphasis on anesthetic care,” Woodruff said in a phone interview, adding he has no idea if the equipment has been upgraded in the intervening years.
He continued: “I did think that other clinics – outside of a hospital setting – had better maintenance care of anesthetic equipment.”
Woodruff says any sort of sedation comes with risks. He said during surgery in general, someone – either an anesthesiologist or an RT, depending on the kind of sedation – must constantly be monitoring oxygen levels of the patient, in order to react quickly if something goes wrong.
“If you are giving sedation, there needs to be a qualified person who is monitoring constantly,” Woodruff said. “When a patient stops breathing, most likely their airways are obstructed because of deep sedation, perhaps deeper than intended which occurs, and if that happens you need to intervene.”
Woodruff said he had heard about the woman’s death. “It makes me sick to my stomach,” he said. “It’s completely shocking. If you stop supplying oxygen to your brain, you can go into brain death within six to seven minutes.”
McGill would not comment when asked about the safety of anesthetic equipment.
Quebec’s College of Physicians would not comment on whether it’s investigating the incident.
In a statement, spokesman Leslie Labranche said, “Under the Professional Code, investigations are confidential. However, a person can check on the College’s website to see if a physician has a limited practice.”
On their website, there is no indication that McGill’s practice has been limited in any way. The website also indicates there has never been any disciplinary action taken against her.
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