A wrongful death case on behalf of liposuction patient Aura Javellana, 28, who died alone in a hotel room from lidocaine toxicity after surgery, underscores the need for liposuction surgeons to counsel patients beforehand, personally measure the lidocaine dose and make sure patients are driven home by someone they know.

The plastic surgeon at the center of the suit that ended in a $1.8 million award for Ms. Javellana's family did none of those things, court records show. In May 2009, Ms. Javellana left Sono Bello Body Contour Center in Bellevue, Wash., alone in a taxi and, without telling anyone, checked into a hotel to recover, where she was found dead the next day.

Ms. Javellana, a web designer, kept her liposuction a secret from friends and family in order to surprise her fiance. For an $8,000 charge, she had fat removed from her "abds [abdomen area], love handles, upper arms," according to the contract she signed.

In June 2011, plastic surgeon Marco Sobrino, MD, and Sono Bello Body Contour Center in Bellevue, Wash., part of a multi-state chain of 11 liposuction centers, settled a wrongful death lawsuit brought by Ms. Javellana's family, paying them $1.8 million. Sono Bello had initially offered the family a confidentiality agreement, under which they wouldn't have revealed the settlement amount or have discussed the case, but the family refused to sign in order that the public could see the risks of liposuction, according to the family's attorney, Cydney Webster.

An autopsy showed Ms. Javellana died of acute lidocaine toxicity, but the total amount of lidocaine used was within legal limits and her symptoms could have been treated if someone had been there to help her, said Penn Gheen, the attorney for Sono Bello. He said hypothermia and dehydration may have hastened her death.

Written materials that the patient may have read before the procedure stated that most patients can drive themselves home afterwards and that patients can return to normal, non-strenuous work the next day. Mr. Gheen says a Sono Bello employee created the materials without the company's knowledge. The material has been removed and that person has left the company, he added.

Liposuction is the most common plastic surgery procedure, but it presents serious risks, logging a mortality rate of 19 deaths per 100,000 cases, according to a report in Plastic & Reconstructive Surgery. Lidocaine, a local anesthetic, is one of the most common causes of liposuction deaths, lowering blood pressure and inducing the heart to slow and misfire.

In September 2011, the Department of Health suspended Dr. Sobrino's license for 30 days, put him on 3 years' probation and ordered him to complete 50 hours of medical education on topics such as anesthetic toxicity. Mr. Gheen says the clinic now requires surgeons to meet with the patient before surgery and personally mix the lidocaine. In addition, Sono Bello has made a few changes in its official marketing material and now requires patients to be driven home by someone they know. John Graffe, an attorney for Dr. Sobrino, did not respond to a request for comment.

Leigh Page