Connecticut Plastic Surgeon Shut Down for Dirty Clinic

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If the place looks shabby and has paint chipping off the walls or otherwise doesn't look professional, he said, it likely has deeper problems.

But, McGuire added, only 15 states require all surgery sites to be accredited (Connecticut is among them) and so patients may need to take some extra steps.

"You cannot assume that a place has been inspected. As a result, you have to ask the right questions," he said. "Frankly, they should be happy to show you their certificate. If you don't see these, it's really just common sense that you ask.

"Certainly, if these things are not in place, I would recommend going someplace else," he added. "It's the best evidence you can get that at least it's safe."

Also, he explained, all of the certifications need to be renewed at some point, with accreditation done at three-year intervals, board certification done at 10-year intervals, and credentialing done by hospitals every two years.

Picking Up on the Details

While it may be difficult to spot any and all violations, patients' observations can make a difference. The Connecticut Department of Public Health investigated Mascardo after complaints from patients, according to department spokesman William Gerrish.

While some of the violations Mascardo's office was cited for involve very visible problems, Abdelmalek said there are some things patients can watch for during preparations for surgery -- although part of being able to do so reliably depends upon knowing more about the surgery the patient is receiving.

The primary issue is sterility, because in some operations, instruments must be completely sterile, while in others the area needs to be clean but cannot be completely sterilized, such as oral and skin surgeries.

"If you're having a procedure, you should be mindful as a patient and look at the instruments," said Abdelmalek. "If those instruments are not coming out of a sealed package, then those instruments are not sterile."

He noted that other problems are apparent if sterile instruments are handled without gloves or are handled by someone wearing gloves who is touching the chart and computer keyboard and then the surgical instrument.

Labeling is also an important sign that a clinic is organized, said Abdelmalek.

He said many items are single use, such as scalpel blades, needles, IV tubing, suture equipment and gauze, and patients should be aware that those items are new.

Unfortunately, violations do take place.

"It happens, probably more than people think," he said, explaining that he has seen some doctors take gauze that was on the tray but not used in a procedure and use that gauze for another patient.

Unfortunately, it can be difficult to complain when you see that happening, he said.

"How are you going to prove something like that? Are you going to send in a hidden camera?" he said. "If it isn't documented, it didn't happen."

In the end, most people still possess the best tool to avoid surgical complications. While some patients have immune system problems, those with healthier immune systems have perhaps the best tool for preventing complications -- and that may be the reason why unsafe clinics don't always yield a flood of infections.

"Your body's job is to fight off infections," said Abdelmalek, "so there are a lot of times you will have bacteria introduced when you won't get an infection."

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