Coral Gables doctor faulted by state in a mother’s breast implant surgery death
Almost three years after a Wellington mother of three didn’t survive a breast implant exchange at a Coral Gables plastic surgery center, a state complaint alleged malpractice by the anesthesiologist.
The Florida Department of Health complaint, dated Aug. 29, says anesthesiologist Dr. Lazaro Martinez didn’t properly manage or monitor the mechanical ventilation of Liza Gonzalez Benitez, 43, who died in 2022 nine days after cardiac arrest at Careaga Plastic Surgery.
Online health department records say Martinez has no previous disciplinary actions against the license he’s held in Florida since May 7, 2003. Neither Martinez nor his lawyer, Bibiana Peasant, returned an email to their, respectively, Department of Health and Florida Bar email addresses requesting comment.
No complaint has been filed against the surgeon, Dr. Daniel Careaga, according to state health department records. But Careaga, along with Careaga Plastic Surgery and Martinez, are among the defendants in a pending October 2023 civil lawsuit filed by Gonzalez Benitez’s husband in Miami-Dade circuit court.
“The lawsuit accuses Martinez and Careaga each of being negligent in nine different ways, the first being ‘Negligently failing to establish and maintain an adequate airway.’”
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Breathing problems
Gonzalez Benitez walked into Careaga Plastic Surgery, 222 Alhambra Cir., on Nov. 14, 2022, for a breast implant exchange.
This wouldn’t be her first time she was put under general anesthesia at Careaga, the state complaint said. She’d had other cosmetic work done there in 2021 and, this time, her pre-op evaluation was “unremarkable.”
“(Gonzalez Benitez) demonstrated bilateral breath sounds at the time of her induction, and [Martinez] documented that the endotracheal tube was secured in place,” the complaint said.
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The endotracheal tube often is attached to a ventilator so the patient can breathe while under general anesthesia.
“[Martinez] did not adequately manage (Benitez’s) mechanical ventilation after her induction,” the complaint said. “[Martinez] did not adequately monitor (Benitez’s) ventilation status after her induction.”
The Cleveland Clinic explains, “Mechanical ventilation keeps your airways open, delivers oxygen and removes carbon dioxide. You might be on a ventilator during surgery or if your lungs aren’t working properly.”
Gonzalez Benitez had been under for about 15 minutes, the complaint said, but the exchange hadn’t begun when her end-tidal carbon dioxide — the amount of carbon dioxide exhaled — dropped to 18 to 22 millimeters of mercury “with a flattening curve.”
But, the complaint said, “Healthy end-tidal carbon dioxide levels for an adult undergoing general anesthesia are typically between 35 and 45 mmHg. A flattened end-tidal carbon dioxide curve is indicative of a significant issue preventing a patient from receiving enough air in their lungs.”
Pulse ‘not palpable’
When Martinez checked Gonzalez Benitez’s ventilation, her pulse, the complaint said, “was not palpable. (She) suffered from pulseless electrical activity cardiac arrest. Resuscitation was attempted, returning her to spontaneous circulation.”
That’s when she was transferred to Baptist Health Doctors Hospital in Coral Gables, where doctors tried induced hypothermia.
“Therapeutic hypothermia is a type of treatment to lower the body temperature,” Johns Hopkins Medicine says. “This reduces injury and long-term problems. It’s sometimes used for people who have a cardiac arrest. Cardiac arrest happens when the heart suddenly stops beating.”
The complaint said Gonzalez Benitez had suffered a “global cerebral anoxic injury,” meaning her brain cells didn’t get enough oxygen, along with swelling of the brain.
She “was given comfort care, until she died, on Nov. 23, 2022.”
