Investigators: Autopsy reveals overdose caused cosmetic surgery death

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by LINDA BYRON / KING 5 News

NWCN.com

Posted on May 19, 2010 at 10:58 PM

Updated Friday, Jan 4 at 10:45 AM

Sono Bello has waged a marketing blitz in Western Washington promising a new kind of liposuction - so easy, recovery feels like you've had a hard workout.

You may have seen or heard the ads which promise "a micro procedure so tiny, it doesn’t even need stitches."

Twenty-eight-year-old Aura Javellana of Redmond must have been convinced. She’d promised her fiancé she would never turn to surgery for weight loss. But last May, she secretly went to Sono Bello in Bellevue for liposuction.

"She knows that I would have been very angry," said Justin Rogers. "We would have talked about it a lot. It would have been the first argument we ever had."

But Rogers never saw his fiancé again.

Aura had liposuction on what her contract lists as her "abds, & love handles and upper arms." She paid $8000. Then she checked into a Bellevue hotel to recover alone. Maids found her body the next day.

"I was angry at her in the beginning," said her friend Marni Casanova. "Why did you kind of run off and do this? You know, why, why, why? But when I found out what had happened and later, finding out the actual cause of her death, I mean I was angry."

The King County Medical Examiner ruled that Aura died from "acute lidocaine intoxication."

Lidocaine is the same numbing agent dentists use. It's used during liposuction to suppress pain.

When we asked Sono Bello for an explanation, they told us Aura’s death was unfortunate but not their fault.

Sono Bello’s Chief Medical Officer, Dr. Thomas Garrison, said, "We felt a great surgery was performed," and that internal reviews found lidocaine was used "well within accepted guidelines."

But the KING 5 Investigators obtained the King County Medical Examiner Autopsy Report and Sono Bello’s medical records of Aura's procedure, which show she was given an overdose of lidocaine.

The Death Investigation Toxicology Report was done by the Washington State Patrol. Their lab measured 8.8 milligrams of lidocaine per liter in her bloodstream, and 6.76 milligrams per liter in the blood around her heart.

We asked Dr. Lisa Sowder, the President of the Northwest Society of Plastic Surgeons, to interpret the numbers. Asked how she would characterize the levels of lidocaine in the toxicology report, Sowder responded: "Those levels are really, really high - stratospheric high. You would never want to see those in a patient."

But how did Aura get such a massive dose? We looked at Sono Bello’s own medical records including the "Tumescent Solution Table" from Aura’s procedure.

Tumescent solution is what's pumped into the body during liposuction to block pain, stem bleeding and break down fat cells. There's a recipe for the proper mix and here's where things went wrong.

Dr. Sowder examined the table and said, "Every single thing in this recipe is altered - the amount of epinephrine, the amount of lidocaine, the volume of the lidocaine, the percentage of lidocaine..."

The table calls for 1% lidocaine, but it's crossed out and 2% lidocaine is written in - double the potency.   Instead of using 50 cc's of lidocaine, 100 cc's are used - doubling the strength again. It’s all mixed into two liters of saline instead of one, which dilutes it by half, but still leaves double the potency.

"The concentration of lidocaine in the tumescent fluid was double what it should have been," Sowder said.

"They gave her twice as much lidocaine as they should have?" asked Linda Byron.

"Yes," said Sowder.

"And that was enough to kill her?" asked Byron.

"Yes," responded Sowder.

We tried to talk to the Medical Assistant who mixed the solution, but she didn't respond.

But the Washington State Medical Quality Assurance Commission, which is investigating Aura's death, says getting the formula right is the doctor's job.

"It doesn't matter who mixed the medication, the physician is ultimately responsible," said Mike Farrell, Legal Unit Manager for the Medical Quality Assurance Commission.

Dr. Marco Sobrino did Aura’s three-and-a-half-hour liposuction procedure. He refused our requests for an interview, so we went to Sono Bello.

We caught up with Dr. Sobrino in the parking lot as he was leaving the Bellevue clinic, but when we told him we wanted to ask about Aura Javellana’s death and we were looking for answers, he rushed back inside the clinic.

Aura’s family and friends want answers too. A year later, they still miss her spark.

"My perfect word for Aura was she was a firecracker," said Casanova. "She would come into any room and she would light up the room with a bang. Aura had this 'aura' and that’s who she was."

Through their attorney, Sono Bello told us they can't comment on Aura's specific case because of privacy laws. But the attorney says that Sono Bello uses lidocaine within established guidelines and that he is unaware of any patient that has been "double dosed" or received more than a safe amount of lidocaine. He also said the toxicology numbers are subject to interpretation and don't necessarily reflect the amount of lidocaine administered.

Meantime, the Washington State Medical Quality Assurance Commission is investigating Dr. Sobrino. He is one of seven doctors named in 21 complaints involving Sono Bello.

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