Infections Tied to Dirty Liposuction Tools

Nearly three dozen liposuction patients contracted an unusual infection after being treated with dirty equipment by an Orange County surgeon, according to a county health report.

The infections likely were caused by the reuse of disposable medical tubing or improper sterilization of other surgical tools, the report says. The source of the infection by a rapidly growing mycobacterium was traced to a faucet in the surgeon’s office.

The Orange County Health Care Agency report calls it “the first liposuction-related infection” of this kind in the nation.

Though the names of the cosmetic surgeon and the patients were removed from the report, lawsuits filed in Orange County Superior Court allege that Dr. Gerald K. Greenberg infected liposuction patients with a mycobacterium, causing them emotional distress and disfigurement.

The infections caused lesions and required extensive treatment with strong antibiotics, the report said. “For some patients, the impact was severe,” wrote Dr. Hildy Meyers, the county’s epidemiologist who investigated the outbreak, including “discomfort, disfigurement, loss of work” and embarrassment.

Neither Greenberg nor his attorney returned phone calls for comment.

Craig Walkon, attorney for more than a dozen of the patients, declined comment.

The patients had surgery between December 1996 and June 1997, according to the report. At the time, Greenberg was practicing in Laguna Beach under his name and as the South Coast Cosmetic Surgery Institute. He now practices in Laguna Niguel.

Former employees told the health agency that tubes used during liposuction “were reused on a regular basis, and that the surgeon would retrieve tubing from the trash if he saw it there,” according to the report.

The report quoted one employee who said that some liposuction tools “were never sterilized but were only rinsed and washed in dishwashing liquid.” Several employees told agency staff they “left because they found the surgeon’s practices careless or sloppy” and that the doctor used “untrained employees . . . to assist with liposuction and to remove sutures.”

The California Medical Board was made aware of the infection outbreak more than a year ago. Citing agency policy, a spokeswoman declined to comment on whether Greenberg is being investigated.

The Orange County investigation began in June 1997 after a dermatologist reported that he had seen three patients with internal abscesses following surgery by the same physician, officials said.

At least 34 patients--men and women--who had liposuction of the hips, thigh, abdomen or other areas developed the infection, the report said.

Mycobacterium chelonae is found in dirt, water or dust but is an infection commonly associated with trauma and not surgery, Stallworth said.

Neither county health officials nor state authorities have taken any disciplinary action against Greenberg. Dr. Hugh Stallworth, the county director of public health, said county officials have no disciplinary authority.

“Our function is to investigate a common source for a group of infections,” he said. “The fact that this doesn’t appear to be ongoing [means] there is nothing that we would do now.” If people were still being infected, Stallworth said, “It would be a public health issue, and we would have the authority” to close the office.