A Miami plastic surgeon accused of using substandard surgical techniques and pre-signing blank prescriptions must pay $26,000 out of his own pocket as part of a fine imposed by the state medical board.

The committee’s final order on Tuesday to settle three of the Florida Department of Health’s four administrative complaints against Dr. Julio Clavijo-Alvarez has no impact on his day-to-day operations.

The settlement did not require the American Board of Plastic Surgery-certified doctor to be suspended or placed on probation. All Clavijo-Alvarez was asked to do was pay his time and money — time for four continuing education courses (liposuction, risk management, records and laws, rules and ethics), a $15,000 fine and $11,085 in Department of Health litigation costs.

Clavijo-Alvarez continues to work at his own business in Coral Gables, Ai Hair Transplant Miami and Ai Gaia Medspa, 2100 Ponce de Leon. He is still advertised on 305 Plastic Surgery’s website, but is not listed with the Department of Health as one of its surgeons.

He is still listed and advertising his practice at New Life Plastic Surgery, 8400 SW Eighth St., the scene of two complaints.

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Poor placement of the drain

A Brazilian butt lift, or BBL, is a popular form of liposuction at cosmetic surgery facilities like New Life. During a BBL procedure on October 28, 2021, a complaint states, Clavijo-Alvarez placed a Jackson-Pratt drain under the patient’s muscles between the ribs and pubic bone, in the abdominal cavity, and under the peritoneum.

(“A Jackson-Pratt (JP) drain is a thin, flexible tube with a ball on the end that drains fluid from your wound after surgery,” explains the Cleveland Clinic. “Your peritoneum is a membrane, a layer of smooth tissue, that lines your abdomen and surrounds your abdominal organs.”)

The complaint states that Clavijo-Alvarez would not have placed the drain where he did because that would have been the prevailing standard of care. The patient was eventually taken to Jackson West Medical Center and then to Jackson Memorial Hospital with back and abdominal pain. Doctors at JMH removed the drain on November 1, four days after Clavijo-Alvarez placed it.

The complaint also states that Clavijo-Alvarez, who met with the patient on November 3, “reported that the patient had not felt any pain since the BBL procedure on October 28, 2021.”

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Improper filling of gaps

During a visit to New Life on May 27, 2022, a Florida Department of Health inspector found “one or more prescriptions for oxycodone and/or diazepam pre-signed by (Clavijo-Alvarez) but containing no patient identification information or date and located in an unsecured area of ​​New Life.”

Whether it is a secure area or not, signing blank prescription forms in advance is a no-go.

The responsibility lies here

Back when Clavijo-Alvarez worked at Miami Lakes Cosmetic Surgery, 15450 New Barn Road, he was the physician in charge. That’s the doctor on the team who serves as the line supervisor and is responsible for making sure the surgery center complies with state guidelines. Violations of the facility’s rules are filed against both the surgery center’s license and the physician in charge’s license.

The complaint alleged that in at least one case, a surgeon failed to document the performance of a pre-operative examination or did not document it at all; a patient was not given the name and location of the hospital where the doctor was authorized to work or with which a referral agreement existed; and doctors did not always obtain a written statement from the patient stating that the patient consented to the procedures and level of anesthesia, was aware of the risks, and had the choice of anesthesiologist.

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Other violations included using a trained nurse with no experience in the recovery room to monitor patients after anesthesia.