» Part 1 of 2 (read Part 2 here)
With her wedding just two months away, Icilma Cornelius arrived at the Lilburn office of Dr. Windell Boutte to prepare for her special day.
The 54-year-old bride-to-be came to the doctor's full-service medical spa and cosmetic surgery center for Botox and another anti-wrinkle treatment. While there, the staff recommended cosmetic surgery that could give her a flat stomach before she married. Cornelius agreed to the surgical makeover by Boutte, whose website promotes the doctor as "nationally and internationally known" and a "doctor to the stars!"
Cornelius never got her perfected body. She never got to get married, either.
After eight hours of surgery in Boutte’s medical office, Cornelius’ heart stopped and a chaotic scene developed. The office wasn’t equipped to handle the emergency and had to call 911. Paramedics got the patient’s heart going, but getting her in the ambulance was delayed. Worried about possible infection from open incisions, Boutte and an employee sutured Cornelius’ skin, and then, because the stretcher wouldn’t fit in the elevator, paramedics had to carry it down stairs.
Cornelius made it to the hospital, but her injuries were catastrophic: Permanent brain damage, caused by lack of oxygen, left Cornelius unable to do almost anything for herself.
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Every surgery comes with risks, but the risks can increase when a facility doesn’t have the equipment, protocols and staff to handle emergencies.
In lawsuits over Boutte’s care of Cornelius and two other patients, an attorney said Boutte routinely cuts corners, uses unqualified staff, misleads patients about the surgeries they will receive, and subjects them to an office that is not safe for the types of surgeries performed. “Dr. Boutte and her staff are more concerned about increasing profits versus a focus on patient safety, which should be of foremost concern,” said Susan Witt, the attorney.
The case is just the latest to raise questions about the safety of cosmetic surgeries in Georgia. In 2013, two patients died during in-office liposuction procedures by a Cobb County physician, Nedra Dodds. Nathaniel Johnson was criminally charged last year for performing cosmetic surgeries even though his medical license was revoked. A patient of his died in 2010 during liposuction.
A physician reported Boutte to Georgia’s medical licensing board in 2016, but she continues to practice, still promoting herself as “Atlanta’s leading cosmetic surgeon,” The Atlanta Journal-Constitution and its investigative partner Channel 2 Action News found in a joint examination of the case.
‘Nurse manager’ not a nurse
Through an attorney, Boutte declined an interview. Her website says she has “over 100,000 satisfied patients” and the site is loaded with testimonials from patients.
The site describes her Premiére Aesthetic Center as a “state-of-the-art building” where patients can pick from a huge buffet of services, including Brazilian butt lifts, tummy tucks and liposuction.
Boutte also advertises that she is “board certified in both surgery and dermatology.”
The AJC found, though, that while she is a board-certified dermatologist, she is not a board-certified plastic surgeon or general surgeon.
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And Boutte’s surgery suite was not an accredited operating room or licensed surgery center. During Cornelius’ surgery, it didn’t have the monitoring equipment to quickly detect changes in respiration, the lawsuit alleged.
Lawsuits also have raised questions about whether Boutte allowed unqualified staff to do too much. Depositions revealed that a “nurse manager” wasn’t a nurse at all. And Boutte’s surgical assistant, who went to medical school in Peru but is not a licensed doctor here, was doing parts of procedures without Boutte staying in the same room and overseeing everything he did. “It’s absolutely outside the bounds of what he’s allowed to do,” Witt said.
In depositions, Boutte stood by her use of her staff and portrayed Cornelius’ result as something beyond her control, possibly the result of an allergic reaction.
But Witt, the attorney, and former patients say Boutte’s practice is a dangerous one that medical regulators have done nothing to rein in.
"The medical board's failure to take action in the two and a half years they have known about Ms. Cornelius' case, among others, amounts to gross negligence," Witt said.
At least seven malpractice lawsuits have been filed against Boutte, counting the three filed by Witt. Boutte’s public medical board profile lists two malpractice settlements, including one for $900,000. Witt said the Cornelius case was recently settled for an amount that is confidential, but she said that settlement is not yet listed on Boutte’s board profile.
Witt said Boutte’s lack of professionalism was apparent in videos she produced and posted online showing her dancing to music while making incisions or preparing to operate with patients’ nude backsides exposed. The videos were introduced in another malpractice case.
The Georgia Composite Medical Board is barred from discussing individual cases and won’t comment.
Few rules for office surgeries
In Georgia, doctors may set up an in-office cosmetic surgery shop and do all sorts of procedures. The medical board has safety guidelines for office-based surgeries, but they are guidelines, not rules.
Those guidelines recommend accreditation of in-office surgery suites, which would set safety standards for the facility and staff, but Boutte did not go through that process, according to a deposition.
Dr. Carmen Kavali, a board-certified plastic surgeon, noted that a medical license allows a doctor to do almost any treatment or procedure that the doctor sees fit to undertake. Some doctors will take a weekend course on liposuction and then start offering it in an office setting.
Hospitals are more restrictive, using credentialing to limit what a doctor can do at their facilities.
Kavali said she does short in-office surgeries with patients who are awake and able to speak. That would include minor liposuction, a scar revision or an upper eyelid procedure. Anything more than that, Kavali said, she and most other surgeons would do in a hospital because it’s safer.
“We’re fully-trained board-certified plastic surgeons,” Kavali said. “We do not have to cheat and keep people in the office.”
Boutte also didn’t follow a board guideline for office-based surgery that says adverse events — defined as an incident that leads to a patient death or transport to a hospital — should be reported.
In a deposition, Boutte explained why she didn’t report the Cornelius case to the board. “I believe she had an adverse event that was not caused by the surgery,” the doctor said.
Sisters file lawsuits
Without stronger rules, Georgia patients are left to sort out on their own whether a doctor is qualified and the office is well-equipped, the AJC and Channel 2 examination found.
Patients rarely know to ask about a facility’s accreditation or what board has certified their doctor.
When two sisters decided they both wanted liposuction, they found Boutte through online research and felt confident. “Her reviews were just stellar,” said Mitzi McFarland, one of the sisters.
McFarland said she was just 135 pounds and exercised. But after her third child, she said she could never get rid of the “muffin top.” She felt confident about something called SmartLipo because it was less invasive and had a short recovery.
Boutte advertises SmartLipo, and her prices were lower than other doctors, McFarland said. Plus, the office was beautiful and the qualifications Boutte posted appeared top-notch, she said.
The two sisters didn’t end up posting the next glowing reviews. Both have lawsuits pending against the doctor.
McFarland said she ended up with results that horrified her — her abdomen was bumpy and appeared disfigured. Boutte agreed to do a “revision” surgery, but that didn’t go as planned, either. McFarland said she was supposed to be able to drive home, but she woke up disoriented, with a hamburger in her hand, in a hotel room that she had no memory of checking into.
She would find out from a text message from the doctor that Boutte had taken her to the hotel after the procedure. McFarland said her family had no idea where she was. An expert who examined McFarland’s care for the lawsuit concluded that Boutte breached care standards.
Later, the sisters found out they had had conventional liposuction instead of the SmartLipo they wanted.
After learning through her lawsuit about the lack of safety measures, the reality of Boutte’s training and the qualifications of her staff, McFarland wondered how the doctor had not been reined in.
"It feels like there is no oversight," she said. "She hasn't even had her hand slapped."
» Coming next: It's consumer beware when it comes to cosmetic surgery in Georgia. The state has few limits on procedures doctors can do in their offices.
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