Her decision to be cared for at home probably compounded a dangerous situation, said Dr. Michael F. McGuire, president-elect of the American Society of Plastic Surgeons and an associate clinical professor at UCLA.
"It's foolish to try to do it in a house," he said.
McGuire said that given West's health problems and the lengthy, invasive operation, she should have been sent to a recovery center equipped with monitors and staffed by nurses trained in postoperative care.
If investigators determine that Scoggins was negligent in his care, his nursing license might be at risk.
Scoggins stayed with West overnight after the operation, according to the coroner's report. Two other people, described in the report as "caregivers," were also there.
Scoggins later told officials that by the next morning, his aunt appeared to be doing so well that he left for the day, but intended to return that night to stay with her.
West spent her final hours warm to the touch, breathing heavily and reporting pain in her throat and tightness in her chest, the coroner's report states.
In the evening, a friend found West cold and clammy in her bed, without a pulse. She was pronounced dead after being rushed to Centinela Freeman Regional Medical Center.
West's high-profile death already has drawn attention to numerous issues related to cosmetic surgery. The state Legislature this year passed a bill with near-unanimous support to require people to undergo a physical examination, give a complete medical history and get a doctor's clearance before undergoing plastic surgery. The bill was vetoed in September by Gov. Arnold Schwarzenegger, who said the lengthy delay in passing the state budget left him with time to enact only the highest-priority legislation.
Adams, the surgeon who operated on West, is no longer licensed to practice medicine in California, although the lapse of his medical license in June was not related to her death.
In April 2007, the Medical Board of California filed a complaint seeking to revoke or suspend his medical license because of multiple alcohol- related convictions. That complaint has not been resolved, but state records show that on June 25, Adams' medical license expired. He had been denied the opportunity to renew his license to practice medicine because he failed to comply with a family support order, such as alimony or child support.
In the early hours of June 26, Adams was arrested on suspicion of drunk driving in Solano County. He pleaded no contest in October to a charge of driving with a blood-alcohol level of more than 0.08%. Sentencing is scheduled Jan. 5, but Adams is expected to serve 120 days in jail, said his attorney, Michael Cardoza.
Adams issued a brief statement Tuesday through his lawyer: "I'm pleased to hear that this portion of the investigation is moving forward. I'm hopeful it will reveal the truth as to what actually happened."
--
ron.lin@latimes.com
