A doctor who prosecutors said recklessly performed liposuction on a woman with a transplanted heart, leading to her death, was arraigned Thursday on charges including manslaughter and falsification of records.
According to the indictment, the woman, Isel Pineda, 51, went to Dr. Oleg Davie's Manhattan office on Park Avenue for a consultation in April 2012 and filled out forms disclosing her heart transplant eight years earlier and the immunosuppressant drugs she was taking. The transplant had been performed by Dr. Mehmet Oz, the cardiothoracic surgeon who has become a television personality, prosecutors said.
"Any medical professional would clearly know if a patient has previously had heart transplant surgery because of the obvious scar on the chest," Charles J. Hynes, the Brooklyn district attorney, said in a statement, adding that anti-rejection drugs put Ms. Pineda at higher risk for infection. "Doctors are well aware of the fact that they are discouraged from performing liposuction and similar procedures on patients with heart disease."
Prosecutors charge that Dr. Davie, 51, was reckless in going ahead with the laser procedure known as SmartLipo on May 10, 2012, in his Brooklyn office, using a local anesthetic. Ms. Pineda went into cardiac arrest and was rushed to Coney Island Hospital, where she died.
Prosecutors charge that Dr. Davie falsified the medical history forms in an attempted cover-up, eliminating the references to heart disease, the transplant and anti-rejection drugs like Prednisone. The changes came to light after the original forms were found in Ms. Pineda's purse.
Dr. Davie's state medical license had been restricted to cosmetic procedures in 2011 because of professional negligence involving seven other patients. Since Ms. Pineda's death, his license has been suspended. On Thursday, he pleaded not guilty and was released on $175,000 bail.
James J. DiPietro, Dr. Davie's defense lawyer, disputed the district attorney's account of the cause of death, reading aloud from reports by two experts, including Dr. Michael Baden, a former city medical examiner who has become a TV personality himself. Both reports said the evidence showed that Ms. Pineda's death was not criminal and had nothing to do with her status as a heart transplant recipient. Rather, they said, she died from "fat embolism syndrome," a risk in this procedure regardless of the patient's history.
"She clearly signed a waiver form where risks were described to her," Mr. DiPietro said. "Her death is tragic, but it's not criminal."
Dr. Baden's report found that Ms. Pineda's transplanted heart had become enlarged and was 95 percent occluded, or blocked, by arteriosclerosis; most people who die of heart disease do so before their hearts are 80 percent occluded, he wrote.
"This woman was a walking time bomb," Mr. DiPietro said. "It's unusual she was even alive."
Why Ms. Pineda sought liposuction at all is unclear, said Michael Fruhling, a lawyer representing the family in a wrongful-death suit. He said she was "a very, very pretty woman," amicably divorced from the husband with whom she had run a custom tote bag design business. She had a boyfriend and lived in Midtown, was 5 foot 9 inches and weighed 130 pounds.
"Unfortunately, Isel is not here to answer those questions," he said. "You have to look at the doctor being the gatekeeper. Physicians are in the position to say yes or no."
No responsible plastic surgeon would do such a procedure on a heart transplant recipient in an office, Mr. Fruhling contended, and Dr. Davie was not even equipped to handle the complication known as "fat embolism syndrome."
And why did she choose this doctor, who had been disciplined, fined $100,000 and put on probation by the state health department?
"She answered an ad," the lawyer said. "He had advertised his services at a reduced rate."
This article has been revised to reflect the following correction:
Correction: April 3, 2013
An article on Friday about charges against a doctor in New York City who performed liposuction on a patient who had a transplanted heart misstated the surname of a lawyer representing the patient's family in a wrongful-death lawsuit. He is Michael Fruhling, not Fuhrling.
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