Board Revokes License of Cosmetic Surgeon; Negligence, Fraud Alleged

The license of a Santa Ana physician who specializes in cosmetic surgery has been revoked for gross negligence and fraud in cases involving 13 patients, including one who died two months after he treated her, state medical board officials said Friday.

James D. Dean, 55, claims that he is the victim of a feud between plastic surgeons and cosmetic surgeons. Several of the doctors who have testified against him both in court and in medical hearings are plastic surgeons.

But Ronald L. Kraemer, enforcement program deputy for the state Board of Medical Quality Assurance, said Friday that “we could care less about any feud . . . our only concern is with patient care.”

Dean has specialized in “esthetic plastic surgery” in Santa Ana since 1978 and in Corona since 1976. Much of his work has been in breast reconstruction, face lifts and tummy tucks.

The state attorney general’s office claims that Dean failed to use correct procedures in several cases and should have performed surgery in a hospital rather than in his office. He also was accused of fraudulent billing to insurance companies.

State medical investigators in Santa Ana began looking into Dean’s practice more than two years ago after receiving complaints from some of his patients and from insurance companies.

The attorney general’s office managed to get Dean’s license suspended in April, 1985, by a Superior Court commissioner, pending a hearing by the state medical board. But Dean’s license was reinstated by a Superior Court judge three months later.

State Administrative Law Judge Frank Britton began conducting hearings on Dean’s case last March that lasted for 26 days. On Dec. 15, the state Board of Medical Quality Assurance approved Britton’s recommendation that Dean’s license be revoked. The revocation takes effect Jan. 14, 1987.

Dean can either petition for a new hearing or file a lawsuit against the board. But Kraemer said Dean has done neither so far.

Neither Dean nor his attorney, Richard P. Guluzza, could be reached for comment Friday. But in the past Dean has refused to discuss his case.

In court appearances last year, Dean’s former attorney, Ira Riskin, claimed that Dean was a cosmetic surgeon and that plastic surgeons and others in the medical field were attacking him because of their opposition to cosmetic surgeons.

Dean claimed that plastic surgeons fear competition from cosmetic surgeons. He claimed in court papers that he was a cosmetic surgeon, but he ran his practice under the name of the Institute of Plastic Surgery Medical Group. He later changed the name to Institute for Cosmetic Surgery Medical Group.

Dr. Frederick M. Grazer of Newport Beach, considered by state officials to be a leading authority on plastic surgery, stated in an affidavit that Dean was “an extreme danger to the public.”

Judge Britton’s strongest criticism of Dean, in his report to the state medical board, was in his treatment of Marvis Ferber, 36, of Huntington Beach, the patient who died.

Ferber had gone to Dean’s office at 3620 S. Bristol St. on Nov. 16, 1984, for a tummy tuck and face lift.

According to Britton’s report, Ferber had a blood disorder, which Dean knew about. Two days after her surgery, Ferber began to have complications, and a week after that her suture line began to spread, draining a foul-smelling mucus.

Dean treated the incision and sent her home on Nov. 30, according to the report. But by Dec. 5, the suture line was severely infected. She went to a different doctor, who immediately put her in a hospital, the report said. She was sent home on Dec. 14 but had to return to the hospital on Jan. 7, 1985, because of complications from the wound. She went into shock and died of multiple pulmonary emboli on Jan. 17, 1985, according to the report.

Britton stated that Dean should have recognized her as a high risk for such surgery because of her blood disorder and her obese condition. If the surgery was performed at all, Britton stated, it should have been done in a hospital.

Also, he said, Dean “failed to recognize the magnitude of the post-operative wound problem” and should have taken “appropriate action during the early stages of the infection.” He added that Dean mismanaged the subsequent infection.

Dean’s care of Ferber, Britton stated, constitutes “incompetence, gross negligence and repeated negligent acts.”

In another case, Britton found that Dean had mistakenly diagnosed a patient’s coughing and shortness of breath as after-effects of anesthesia, when in fact the woman was suffering from infection from the surgery he had performed.

Dean was also accused of failing to consult other doctors when complications occurred and failing to conduct adequate tests on patients.

Also, Britton found that Dean charged insurance companies for surgical procedures that never took place. In one case, where the insurance company would pay only for necessary surgery, Dean sent the company a bill for surgery which was strictly cosmetic but which he claimed was necessary, Britton found.

Four of Dean’s patients, all women who are included in the attorney general’s complaint against Dean, still have civil lawsuits pending against him.