During surgery at Torrance Memorial Medical Center, an anesthesiologist decorated a patient's face with stickers while the patient was unconscious — giving her a black mustache and teardrops under her left eye — and then a nurse's aide snapped her photo.
The 2011 incident has prompted a state investigation and a civil lawsuit by the patient against the hospital and the doctor over the alleged breach of medical privacy.
Torrance Memorial said in a statement that this "breach of professionalism regrettably did occur" and those involved "demonstrated poor judgment" while caring for Veronica Valdez, 36, who worked at the hospital for 13 years before the surgery.
Her anesthesiologist, Dr. Patrick Yang, was disciplined but kept his privileges at the hospital, and the employees involved in the incident likewise were disciplined but not fired, according to the hospital.
Also, as part of the litigation in Los Angeles County Superior Court, a hospital manager disclosed in a deposition an earlier incident at Torrance Memorial in which a medical-device salesman took photos of a naked patient without the patient's knowledge. The hospital disputes that photos were taken in that incident.
Nonetheless, the lawsuit raises fresh concerns about hospitals' ability to protect patients' privacy and sensitive information even with strict laws and tougher government enforcement, particularly as smartphones and tablets make sharing data so easy.
"The idea that people are using their cellphone or even have one in the operating room is crazy," said Dr. Deborah Peel, founder of Patient Privacy Rights, a nonprofit advocacy group in Austin, Texas. "It's a massive security risk and incredibly insensitive to patients."
In similar cases elsewhere, Peel said, hospital personnel often lose their jobs. In 2010, for instance, four employees at St. Mary Medical Center in Long Beach were terminated because they used cellphones to photograph a dead emergency-room patient and shared the photos with others, according to state records.
Torrance Memorial officials reported the incident involving Valdez to state regulators as a potential violation of medical privacy. A spokesman for the California Department of Public Health said the agency "cannot comment on an ongoing investigation."
In her job at the hospital, Valdez was responsible for ordering and maintaining supplies for the operating rooms. In October 2011, she went in for minor surgery on her finger.
Yang, the anesthesiologist, said he cut out and colored the stickers and then placed them on Valdez's face near the end of the hourlong procedure. In his deposition, Yang said, "I thought she would think this is funny and she would appreciate it."
A nursing attendant, Patricia Gomez, then took Valdez's photo. Gomez testified in her deposition that she didn't email or post the photo anywhere. She said she deleted the image after showing it to Valdez.
"I felt violated. I was in shock," Valdez said in court documents. She declined to comment further.
Others have testified in depositions about seeing a surgery photo of Valdez posted on Facebook. In court filings, lawyers for the hospital said there was no evidence the photo was published online.
Yang said his physician practice, Torrance Anesthesia Medical Group, suspended him for two weeks, but he remains in good standing at the hospital, according to court documents and interviews. Yang, through his attorney, declined to comment.
Gomez and two other hospital employees were suspended for a brief period, according to Torrance Memorial, and hospital staff were given additional training on patient privacy.
Valdez's civil suit is scheduled for trial in January. She's seeking damages from the hospital, the anesthesiologist and his medical group for violation of privacy, infliction of emotional distress and other allegations.
Her attorney, Andrew T. Ryan in Los Angeles, said Valdez had to leave her job because she was "ridiculed and humiliated while under anesthesia."
In response, Torrance Memorial said that many of the allegations in Valdez's lawsuit were "factually inaccurate, grossly exaggerated or fabricated." Its motion to dismiss the case is pending. In court filings, the hospital contends that Valdez is trying to "play litigation lottery" against a "deep-pocket defendant."
Many hospitals have a policy prohibiting the use of mobile phones in patient areas to help prevent these types of problems.
Arthur Ano, a nursing manager at Torrance Memorial, said in his deposition that a similar policy was implemented after the 2009 incident involving the sales representative.
"There was an incident, some years [ago], I walked in an operating room and the sales rep was taking a picture of a naked patient and I seized the phone," Ano said in his deposition. "We discovered more pictures of the patient on his cellphone."
In a statement, the hospital said a subsequent investigation found that no patient photos were taken. Torrance Memorial said a surgeon had asked the medical-device representative present in the operating room to take a photo for clinical purposes.
But the hospital said another employee interrupted and told them photos were forbidden without patient consent.
The sales representative was barred from future surgeries there, according to the hospital, and signs were posted that "cellphones and cameras are not permitted in the operating room."