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Zelaya's death had prompted threats of a malpractice suit from Vargas and several unflattering newspaper and television reports about Strax. "Be very careful about what you write, because I will respond in the courts," he warns New Times.
He explains Strax can afford to offer low-cost plastic surgery by buying supplies such as breast implants and sutures in bulk, at a lower cost than doctors who have their own, one-man businesses. Those savings are then passed on to customers. A breast augmentation can cost $3,500 at Strax and twice as much at a competing surgeon's office.
But he insists his doctors do not cut corners or perform sloppy surgery. "We do the same procedures in the same [operating rooms] by board-certified surgeons," he says. It's no different from the surgery "rich people could afford before."
Strax doctors are independent contractors, not full-time employees, and they are paid for the surgeries they perform at the facility. If anything, Feanny contends, this arrangement frees up doctors to concentrate on their patients. The surgeons don't have to worry about paying for rent, nurses, anesthesiologists, advertising, or other costs they would have to cover if they had their own offices. Strax takes care of those business concerns.
"The doctors do what they're trained to do and only what they're trained to do: practice medicine," Feanny says.
Feanny knew about Gordon's disciplinary record when he hired him. He says he had examined the two cases in which patients died but was not troubled by them. He notes that four outside doctors had cleared Roberts for surgery and that Smith died because her family "overdosed" her. (Gordon's attorney, Rick Woulfe, who also represents Hamm, did not respond to repeated requests for comment.)
In 2006, Gordon signed up to begin performing surgeries at Strax as an independent contractor. But he ran into another professional glitch in 2008, when he applied to renew his staff privileges at the Florida Medical Center hospital in Fort Lauderdale. He answered "no" to written questions about whether he had previously been disciplined by the state. A health department prosecutor filed a complaint, saying Gordon broke the law by making "deceptive, untrue, or fraudulent representations" related to his profession. He was fined $5,000. The Florida Medical Center terminated his staff privileges, and as of this spring, he no longer had privileges at any hospital in Florida. (If surgeons are operating in an outpatient facility and something goes wrong, privileges allow them to follow the patient to the hospital and fix the problem rather than having a new doctor pick up where they left off.)
In February 2009, a third patient of Gordon's died. Gordon performed a tummy tuck and liposuction on an unidentified woman at Strax. That night, the patient went to the ER at Palmetto General Hospital complaining of "bleeding," according to an incident report Gordon later submitted to the state health department. Staffers there couldn't find anything wrong and discharged her.
The next day, the patient "insisted" on returning to Strax for a post-op evaluation with Gordon, and once again, he didn't see a problem. He asked her to come back the next day, but she didn't keep the appointment. Six days later, Strax staffers reached her by phone and scheduled another appointment. "At that time, no information was ever relayed that the patient was in any kind of medical distress," Gordon wrote.
The next night, Palmetto hospital called Gordon. The patient had been admitted to the emergency room in shock. She died the next morning. The state health department found no probable cause to pursue the case. It's unclear if the patient's family has filed a lawsuit.
Among doctors at Strax, Gordon is not the only one with a questionable past. Mario Diaz, the anesthesiologist who assisted with Zelaya's surgery, was criminally prosecuted in Iowa for issuing Internet prescriptions in 2004. His license was suspended in Florida in 2007, but he's now able to work while on probation. John Nees, another Strax surgeon, had his Florida medical license suspended from 2004 to 2010.
Feanny has explanations for these blots: Diaz "got caught up in the early days of online prescriptions. He's a guy who made a mistake." And Nees's suspension stemmed from a romance with a patient in Washington state and "doesn't have anything to do with his surgical acumen."
Then there's Hamm, Gordon's colleague from the Florida Center for Cosmetic Surgery. In the past 15 years, Hamm has paid $1 million to settle malpractice cases filed against him involving patients who suffered infections and scarring. In a letter to Memorial Regional Healthcare Center, Hamm's attorney, Woulfe, argued those payments were not an indicator of fault; many settlements were arranged because Hamm's insurance company was ending its business in Florida and wanted to get the cases off its books.
In June 2005, a 32-year-old patient identified only as M.A. arrived at Strax asking for liposuction on her stomach, butt, and thighs. A pre-op blood test — which Hamm later contended he did not order or see before the surgery — revealed M.A. had diabetes, according to a complaint filed by a Florida Health Department attorney.
Hamm proceeded with her surgery. The patient developed a life-threatening chemical imbalance and was transferred to Broward General Hospital, where she spent a month recovering.