STATE OF FLORIDA DEPARTMENT OF HEALTH DEPARTMENT OF HEALTH, Petitioner, Vv. DOH Case No. 2017-22531 ARNALDO VALLS, M.D., Respondent. y ADMINISTRATIVE COMPLAINT Petitioner Department of Health files this Administrative Complaint before the Board of Medicine against Respondent, Arnaldo Valls, M.D., and in support thereof alleges: 1. ‘Petitioner is the state agency charged with regulating the practice of medicine pursuant to Section 20.43, Florida Statutes, and Chapters 456 and 458, Florida Statutes. 2. Atall times material hereto, Respondent was a licensed physician within the state of Florida, having been issued license number ME 82727, 3. At all times material hereto, Respondent did not hold any certifications from specialty boards recognized by the Board of Medicine. Administrative Complaint Dep’t of Health v. Arnaldo Valls, M.D. 2017-22531 4. Respondent's address of record is 1825 SW 125 Court, Miami, Florida 33175 5. At all times material hereto, Respondent performed surgical procedures at Jolie Plastic Surgery, a surgical center located in Miami, Florida. 6. On or about December 14, 2017, Patient K.L., a 40-year-old female, presented to Respondent at Jolie to undergo a suction assisted lipectomy (SAL) and fat transfer, a procedure commonly referred to as a “Brazilian Butt Lift!” 7. On or about December 14, 2017, Respondent began the procedure on Patient K.L. 8. | Respondent removed fat from patient K.L.’s abdomen and then Patient K.L. was turned over to begin the transfer of fat to her gluteal area. 9. As Respondent was injecting fat into Patient K.L.’s gluteal area, Patient K.L.’s oxygen levels began to go down. 10. Respondent and the surgical team then turned Patient K.L. over, began CPR2, and called emergency medical services. 1 The Brazilian Butt Lift is a surgical procedure in which the patient undergoes liposuction of fat from the abdominal area, which is then injected into the gluteal area. 2CPR, or Cardiopulmonary resuscitation, is an emergency procedure for a person whose heart has stopped or is no longer breathing. CPR can maintain circulation and breathing until emergency medical help arrives. Administrative Complaint Dep't of Health v. Arnaldo Valls, M.D. 2017-22531 11. Patient K.L. was transported by emergency services to Kendall Regional Hospital. 12. The medical staff at Kendall were unable to revive Patient K.L. and she was pronounced deceased at 17:39 (5:39 P.M.). 13. Onor about December 15, 2017, the Miami-Dade County Medical Examiner Department (Medical Examiner), conducted an autopsy of Patient KL. 14. The Medical Examiner concluded that Patient K.L.’s cause of death was fat embolism associated with liposuction and fat transfer. 15. The Medical Examiner made autopsy findings, including, but not limited to: a. Fat emboli in heart and lungs, and b. Hemorrhage of right inferior gluteal vessel. 16. On or about June 7, 2018, Dr. Christopher Salgado, M.D., a Board Certified plastic surgeon with expertise in liposuction with fat transfer to the gluteal region, reviewed this case pursuant to Department request. 17, Dr. Salgado opined that Respondent's treatment of Patient K.L. fell below the minimum standard of care. Administrative Complaint Dep’t of Health v. Arnaldo Valls, M.D. 2017-22531 18. Dr. Salgado opined that Respondent fell below the standard of care by injecting fat into the deeper plane, rather than in the superficial plane. This led to Respondent injecting fat into the inferior gluteal vein, at which time the fat traveled to the lungs, causing immediate cardiac arrest. 19. Dr. Salgado reviewed Respondent’s curriculum vitae (CV). 20. Dr. Salgado opined that Respondent practiced outside the scope of his training when he performed this procedure on Patient K.L. and that a reasonable physician with Respondent’s training and experience would not do this procedure. Count I 21. Petitioner re-alleges and incorporates by reference paragraphs one through twenty as if fully set forth herein. 22. Section 458.331(1)(t), Florida Statutes (2017), subjects a physician to discipline for committing medical malpractice as defined in Section 456.50, Florida Statutes (2017). “Medical malpractice” is defined by Section 456.50(1)(g), Florida Statutes (2017), as “the failure to practice medicine in accordance with the level of care, skill and treatment recognized in general law related to health care licensure.” Section 456.50(1)(e), Florida Statutes (2017), provides that the “level of care, skill and treatment Administrative Complaint Dep't of Health v. Arnaldo Valls, M.D. 2017-22531 recognized in general law related to health care licensure” means the standard of care that is specified in Section 766.102(1), Florida Statutes (2017), which states: The prevailing professional standard of care for a given health care provider shall be that level of care, skill, and treatment which, in light of all relevant surrounding circumstances, is recognized as acceptable and appropriate by reasonably prudent similar health care providers. 23. At all times material hereto, the prevailing standard of care required Respondent to treat Patient K.L. in the following manner: a. Use large cannula (blunt, >4 mm), b. Continual motion during injection, c. Superficial injection (Subcutaneous injection within the danger triangle and knowing exact position of the injection cannula at all times), d. Avoid excessive graft fill pressure. 24. Respondent violated Section 458.331(1)(t)1, Florida Statutes (2017), in one or more of the following ways: a. Injecting fat into the deeper plane, rather than in the superficial plane, of Patient K.L.’s buttocks, and b. Injecting fat into Patient K.L.’s inferior gluteal vein. Administrative Complaint Dep’t of Health v. Arnaldo Valls, M.D. 2017-22531 25. Based on the foregoing, Respondent violated Section 458.331(1)(t)1, Florida Statutes (2017). Count II 26. Petitioner re-alleges and incorporates by reference paragraphs one through twenty as if fully set forth herein. 27. Section 458.331(1)(v), Florida Statutes (2017), subjects a physician to discipline for practicing or offering to practice beyond the scope permitted by law or accepting and performing professional responsibilities which the licensee knows or has reason to know that he or she is not competent to perform. 28. Respondent knew or had reason to know that he was not competent to perform a suction assisted lipectomy (SAL) and fat transfer procedure on Patient K.L. due to his lack of supervised training and experience in this procedure. 29. Based on the foregoing, Respondent violated section 458.331(1)(v), Florida Statutes (2017) WHEREFORE, Petitioner respectfully requests the Board of Medicine enter an order imposing one or more of the following penalties: permanent revocation or suspension of Respondent's license, restriction of practice, Administrative Complaint Dep't of Health v. Arnaldo Valls, M.D. 2017-22531 imposition of an administrative fine, issuance of a reprimand, placement of Respondent on probation, corrective action, refund of fees billed or collected, remedial education, and/or any other relief the Board of Medicine deems appropriate. SIGNED this _17th FILED DEPARTMENT OF HEALTH DEPUTY CLERK CLERK: ore S- A418 PCP: 8/17/2018 day of August Ci;«C 20018. Celeste Philip, M.D., M.P.H. Surgeon General and Secretary “sd Kittle Stamplrey Keith Humphrey Assistant General Counsel FL DOH Prosecution Services Unit 4052 Bald Cypress Way, Bin C-65 Tallahassee, FL 32399-3265 Florida Bar Number 93767 (P) (850) 558-9855 (F) (850) 245-4662 (E) Keith.Humphrey@fihealth.gov PCP Members: Mark Avila, MD, Robert London, MD, Andre Perez, (Deborah Gerbert, PA — Physician Assistant) Administrative Complaint Dep't of Health v. Arnaldo Valls, M.D. 2017-22531 NOTICE OF RIGHTS Respondent has the right to request a hearing to be conducted in accordance with Section 120.569 and 120.57, Florida Statutes, to be represented by counsel or other qualified representative, to present evidence and argument, to call and cross-examine witnesses and to have subpoena and subpoena duces tecum issued on his or her behalf if a hearing is requested. A request or petition for an administrative hearing must be in writing and must be received by the Department of Health within 21 days from the day Respondent received this Administrative Complaint, pursuant to Rule 28-106.111(2), Florida Administrative Code. If Respondent fails to request a hearing within 21 days of receipt of this Administrative Complaint, Respondent waives the right to request a hearing on the facts alleged in this Administrative Complaint pursuant to Rule 28-106.111(4), Florida Administrative Code. Any request for an administrative proceeding to challenge or contest the material facts or charges contained in this Administrative Complaint must conform to Rule 28-106.2015(5), Florida Administrative Code. Mediation under Section 120.573, Florida Statutes, is not available to resolve this Administrative Complaint. NOTICE REGARDING ASSESSMENT OF COSTS Respondent is placed on notice that Petitioner has incurred costs related to the investigation and prosecution of this matter. Pursuant to Section 456.072(4), Florida Statutes, the Board of Medicine shall assess costs related to the investigation and prosecution of a disciplinary matter, which may include attorney hours and costs, on Respondent in addition to any other discipline imposed. Administrative Complaint Dep’t of Health v. Arnaldo Valls, M.D. 2017-22531

Docket for Case No: 18-005697PL