In the days following our 2018 Complaints Kept Quiet investigation, a woman contacted us to say she’d filed a complaint against Cedar Park cosmetic surgeon Dr. Lawrence Broder. The woman claimed she went to Broder for a liposuction procedure and left Broder’s office with a butt lift procedure she never asked for — or consented to.
In August, the Texas Medical Board reached a settlement with Broder over multiple allegations that Broder violated the Texas Medical Practice Act involving multiple patients. The settlement ends nearly three years of complaint investigations and litigation against him.
Settlements are the way in which the TMB typically ends investigations involving doctors. TMB records show 364 settlements in the last two years.
Our 2018 Complaints Kept Quiet investigation found the average TMB investigation takes an average of 297 days to investigate, negotiate a settlement, then close the case. Our investigation also highlighted the Caitlin Duvall case: a 26-year-old woman who died days after surgery at Dr. Broder’s office. She didn’t know it at the time of her surgery, but Broder was under an active TMB investigation.
AUSTIN (KXAN) – After nearly three years of investigations and court battles between a Cedar Park cosmetic surgeon and the Texas Medical Board, both sides ended the legal back-and-forth.
In August, the TMB and Dr. Lawrence Broder signed a Mediated Agreed Order to settle two separate formal complaints the board filed against Broder: one from August 2017 and the other filed in March 2019.
The complaints detailed multiple allegations — stemming from TMB investigations — that Broder violated the Texas Medical Practice Act. Violations of the Act could lead to serious sanctions against a doctor’s medical license — including license revocation.
The alleged violations concerning Broder happened between 2016 and 2018.
Broder owns Beleza Medspa, with its main surgery center located in Cedar Park. The 2017 complaint against Broder and the death of a 26-year-old patient was at the center of a KXAN investigation into the time it takes the TMB to finish investigations into doctors that aired in February 2018.
LINK: 2018 KXAN INVESTIGATION: https://www.kxan.com/news/investigations/prolonged-investigations-of-doctors-in-texas-leave-patients-in-the-dark/1156455639
The agreed order dismissed the entire 2017 complaint against Broder, which was detailed in KXAN’s 2018 investigation.
However, the agreed order ended with three separate “findings” against Broder involving two patients in the 2019 complaint: Caitlin Duvall and an unidentified patient who went to Broder’s office for a liposuction procedure but left with an “unwanted” $999 butt lift.
The order requires Broder to:
- Have an “outside, independent physician” perform pre-operative clearances for any procedure involving sedation
- By August 2020 Broder must re-take the Medical Jurisprudence Exam and score at least 75 or the TMB will immediately suspend Broder’s medical license
- Pay $3,000 “administrative penalty” within 60 days of the order
- Enroll in and “successfully complete” 24 hours of continuing medical education
The Texas Medical Board would not confirm when Broder paid the $3,000 penalty, which the order shows must be paid by Oct. 12. “We can confirm that he is in compliance with his August 2019 order,” TMB spokesman Jarrett Schneider wrote in a Nov. 7 email to KXAN.
THE DUVALL CASE
“Everybody says time heals all and it’s not true, I don’t think,” Tim Duvall said as he and his wife, Laura, flipped through photographs of Caitlin Duvall. “It’s definitely not true,” Laura said in agreement.
We met the Duvalls to get their response to the TMB findings in their daughter’s case. Caitlin Duvall died within days of a cosmetic procedure Broder performed on her at his Cedar Park Beleza Medspa.
Both, still two years later, appear to enjoy remembering their daughter, Caitlin. They both laughed when they’d recall a funny memory from one of the pictures.
But, they haven’t yet perfected holding back the tears. “We’ve got hundreds of pictures,” Tim said as he pointed out a picture of Caitlin at one of her childhood birthday parties.
“Just doesn’t seem like she’s gone,” Laura said as they neared the end of the stack of photographs they brought with them to our interview. Unlike our previous interviews, both had to stop several times to compose themselves.
The Duvalls acknowledged they knew their search for answers about their daughter’s death was likely now over. From the outset, the Duvalls said all they hoped to know from the TMB investigation was how their daughter — who they said was in perfect health — died from complications following an elective cosmetic surgery.
The TMB investigation and settlement with Dr. Broder did not provide the answers the Duvalls hoped for.
“They settled and almost seemed to just make it go away with minimal impact in their decision,” Tim said, reacting to the TMB’s agreed order. The Duvalls said they still have trouble reconciling the amount of detail surrounding the TMB’s accusations related to their daughter’s death and the single recordkeeping violation the TMB settlement ended within August.
“It’s rather insulting, boiled it down to money — oh, we don’t want to tie up the court system — or the Texas board system — this is costly, let’s stop this now,” Laura said.
She was reacting to the line in the agreed order which gives some indication as to why both sides decided to end everything: “To avoid further investigation, hearings, and the expense and inconvenience of litigation, Respondent (Broder) agrees to the entry of this Agreed Order and to comply with its terms and conditions.”
The order also stated the evidence collected accusing Broder of not meeting the standard of care in the Duvall case was “insufficient.”
Duvall is identified as “Patient Three” in the March 2019 formal complaint. Because of patient privacy laws, the TMB did not publicly identify any of the patients by name in either complaint against Broder.
An initial autopsy report provided to KXAN in our 2018 investigation showed Duvall’s cause of death was “a result of complications of a cosmetic surgical procedure,” according to the medical examiner’s report. The examiner determined Duvall “developed a toxic shock-like syndrome for which she was hospitalized.”
Duvall died on July 25, 2017 just days after a liposuction and fat transfer procedure at Broder’s Cedar Park office. TMB investigators found errors in Broder’s pre-operative evaluation he performed on Duvall in May 2017, according to the formal complaint.
TMB investigators wrote in the 2019 formal complaint that Broder, “misdiagnosed” Duvall’s post-operative symptoms which “resulted in an unnecessary surgical procedure” and “delay in treatment for complications that ultimate [sic] caused Patient Three’s death.”
Following the July 21 surgery, Duvall returned to Broder’s office complaining of severe pain, according to her medical records. Duvall eventually ended up in the hospital and underwent emergency surgery.
During the TMB investigation, the board’s investigators examined additional Duvall autopsy records and found Duvall “had multiple puncture wounds of the anterior torso and had been in a toxic shock-like clinical state in the days following the elective procedure,” according to the 2019 complaint.
Broder “caused the surgical puncture wounds,” according to the TMB complaint.
The complaint further alleged Broder’s “misdiagnosis of fat necrosis resulted in an unnecessary surgical procedure to remove the recently transplanted fat and delay in treatment for complications that ultimate [sic] caused Patient Three’s death.”
“Due to Respondent’s delay,” the complaint stated, “by the time Patient Three presented to the Emergency Department she was in severe sepsis and toxic shock syndrome that was unresponsive to surgery, antibiotics, vasopressors, fluids, and steroids.”
The TMB complaint also accused Broder of a violation by failing to “timely report” Duvall’s “post-operative hospitalization and death to the Board,” which all Texas doctors are required to do.
Duvall was one of five different patients detailed in the March 2019 TMB complaint, which listed 15 separate violations the TMB accused Broder of committing.
In a Mediated Agreed Order Broder signed in August, the Texas Medical Board agreed to drop all but one of the allegations it made against Broder in the Duvall case. Broder accepted one violation involving Duvall, which the TMB described in the order as Broder “failed to maintain adequate medical records.”
Although Broder agreed to the one violation in the Duvall case, Broder “neither admits nor denies” the allegations contained in the agreed order, according to the document. Broder, the order shows, “took responsibility for his actions.”
AN UNWANTED BUTT LIFT
After battling what she called “thyroid issues” for about a year, a woman the 2019 TMB complaint identified as “Patient One” decided to go to Dr. Lawrence Broder’s Beleza Medspa to have a liposuction procedure done.
She wanted collections of fat removed from her torso, she told KXAN.
The patient contacted KXAN in February 2018 — less than a day after our investigation into Broder and the TMB aired. She sent an email to KXAN and attached a complaint she filed with the Texas Medical Board in January 2018.
The patient agreed to interview with KXAN if we concealed her face and would not use her name because of the medical information she’s making public in this report.
The patient’s complaint detailed how she showed up to her surgery appointment already under the influence of medications prescribed to her by Broder’s office and remembered waking up with a butt lift she said she never asked for.
“I don’t even remember the ride to the office. I remember hugging my husband in the office when I went back with them,” the patient told KXAN.
Prescription orders the patient provided to KXAN shows Broder’s office told her to begin taking sedatives the night before and the morning of the procedure. “I was high as a kite,” the woman said of her mental condition by the time she walked into Beleza Medspa on Jan. 11, 2018 for her surgery.
The woman said she’d taken four Lorazepam doses by the time she showed up to Broder’s office on Jan. 11 and was further medicated at the office. “I remember them drawing on my stomach and then the next thing I remember really is just being wheeled into the operating room,” the woman said during a 2018 interview with KXAN, “I don’t even really remember speaking with the doctor or seeing his face or anything like that.”
The woman’s next memory was being awakened on the operating table.
The woman’s TMB complaint shows that part of what she remembered was Broder asking her “if I wanted fat transferred to my butt for a butt lift.” The conversation happened while the woman was still on the operating room table, she said.
“I guess in my incoherent state I must have said yes,” the woman wrote in the TMB complaint. “I can’t say I did because I don’t remember.”
“I remember my wallet being in front of me and them having me sign papers and I remember them saying I was going to look like Barbie,” the woman told KXAN.
The patient’s Beleza Medspa medical chart shows the work started at 11:58 a.m. and the procedure ended at 2:15 p.m. Her medical file also shows a credit card receipt with a $999 “surgery deposit” charge added to her card at 12:56 p.m.
The charge was for the butt lift the woman said she never consented to. The timing in the medical records shows the credit card swipe happened one hour into her procedure.
“My next memory is when I woke up and I look in the mirror and low and behold, I had fat removed from one area, but put in another area,” the patient said. The butt lift happened one month after the woman signed informed consent forms for “Tumescent Liposuction” on three specific parts of her body: “stomach, flanks, bra area,” according to the consent forms provided to the patient by Broder’s office.
The liposuction was signed in December 2017, according to records contained in the woman’s medical files provided to her by Beleza Medspa.
The woman said she never discussed a butt lift with anyone at Beleza Medspa before the conversation she had with Broder and his nurse during the procedure on Jan. 11, “Outside of those areas, you never had a discussion with that doctor about any other area of your body being touched,” KXAN investigator Jody Barr asked the patient during the 2018 interview. “No. That was it,” the woman replied.
“I never went into that procedure wanting that,” the woman restated, “The first day when I looked in the mirror I just cried. All of a sudden, I turn around, and I don’t look anything like myself. At all,” the woman said.
Broder’s office provided the woman with an informed consent package claiming she did consent to the butt lift. The package is signed and dated Jan. 11, 2018 — the day of the patient’s liposuction procedure. The patient said she woke up on Jan. 11 with no way to consent to anything — including being too under the influence of the prescribed medication to drive herself to Broder’s office for the procedure.
In the March 2019 Texas Medical Board complaint against Broder, investigators wrote “Patient One has no memory of agreeing to the procedure and charges,” and that Broder “engaged in unprofessional conduct by attempting to consent an impaired patient who is unable to consent.”
Broder “violated the standard of care, committed unprofessional conduct, and engaged in fraud by directing his Staff to make unauthorized charges on Patient One’s credit card,” the complaint stated.
The TMB complaint also accused Broder of adding a note to the patient’s Operative Reports “claiming they discussed the fat transfer and she gave her consent while he was taking pre-operative pictures,” the complaint stated. The TMB believed Broder made the note “after learning he was the subject of a Board investigation,” the TMB wrote in the formal complaint.
The woman told KXAN she started piecing together the timeline of what happened in the hours after the sedation wore off. She did not return to Beleza Medspa for post-operation follow up appointments and only contacted Broder’s office after her initial call with KXAN to retrieve copies of her medical records and the credit card receipt.
The patient later filed a fraud complaint with her credit card company over the $999 charge. A note in her medical records shows a copy of an email sent to Broder’s personal email account from the patient’s credit card company detailing the charge complaint made by the patient. A handwritten note on the bottom of the document reads “not contested = refund of $999 for fat transfer.”
The handwritten note is not initialed or signed.
The patient confirmed with KXAN that she was refunded the $999 charge by Beleza Medspa following her fraud complaint.
The patient provided to KXAN and Texas Medical Board investigators what she believed was proof that she never consented to the butt lift procedure. It’s a voicemail Broder left for her on Feb. 2, 2018 — nearly a month after her surgery. The call was prompted after the woman refused to show up to Broder’s office for post-operation appointments and would not return calls from Beleza Medspa.
“If you’re unhappy with the fat transfer, you know, we didn’t — I didn’t do that to make money or — I did that because we were throwing fat away at that procedure; after that procedure and that was our only chance to use it,” Broder said in the recording.
“If it’s the fat transfer that’s bothering you, we can always remove the fat, we can adjust the fat that’s all very doable. We heavily discounted the price of that procedure, we weren’t trying to make money, we were just trying to — was just trying to give you the best results,” Broder said. “My goal wasn’t to take advantage of you or anything, it was just to try to give you the best results.”
“I’ve done thousands of these procedures and when I see — when I talk to the patient and I see that I can maybe do a little more instead of throwing fat away, that was my only goal,” Broder said in the voicemail to the patient.
The woman told KXAN she went to another doctor for post-operation checkups and never returned Broder’s call.
In a written response to the TMB complaint, Broder’s attorney wrote that Broder “…admits that she (Patient One) had taken medication but denies that the medication had time to take effect.” Broder also denied he performed the procedure without the patient’s consent — and claims he had permission to charge her credit card.
In the August 2019 agreed order, the TMB and Broder settled the allegations involving Patient One by Broder agreeing to violations related to the informed consent being signed the day of the surgery — after the patient was under the influence of the medication. The TMB listed the $999 refund as a “Mitigating Factor” in deciding Broder’s punishment.
The TMB dismissed all other allegations related to Patient One.
“I put total trust in the people around me because I was not capable of making a decision at that time,” the patient told KXAN, “They took away my right to make a decision and that’s something that needs to be not taken lightly by anybody,” the patient said, “I feel very taken advantage of.”
We asked Broder for an interview to be included as part of this report. Broder’s attorney told KXAN they’d provide a statement, but never did.
THE TMB RESPONSE
We interviewed Texas Medical Board Executive Director Brint Carlton about the decision to settle the complaints against Dr. Lawrence Broder without taking those complaints through the trial proceedings afforded to any occupational licensee accused of violations.
In the 2017 complaint against Broder, after the TMB could not reach a settlement with Broder, the board filed a case with the State Office of Administrative Hearings, commonly known as SOAH, to have a panel of judges hear evidence in the matter and rule on whether Broder committed the violations detailed in the formal complaint.
A two-judge panel found the TMB did not prove the 2017 allegations against Broder in that SOAH proceeding. The TMB could have appealed the SOAH decision but decided against an appeal when the TMB signed the Mediated Agreed Order with Broder in August 2019.
The March 2019 TMB complaint against Broder detail numerous allegations involving five separate patients. But, that 2019 formal complaint never made it to trial before the SOAH court because a settlement was reached before it got to that point in the process.
Carlton would not talk about his agency’s reasons for settling the Broder case the way it did but noted 94% of TMB complaints against doctors end up without any disciplinary action.
Only 1% of TMB complaints end up at SOAH, Carlton told KXAN.
“Whenever we go to an agreement, we’re talking about — from our perspective — the things that we feel like we can prove and also the respondent is talking about what evidence they’re going to put forward. And, through that process, we’ll talk about what we feel is a fair resolution at that point,” Carlton said.
The director likened the negotiation process between the TMB and accused doctors to the plea agreement process criminal prosecutors engage in with people accused of crimes.
“Do you always walk out of these closed-door negotiations feeling like the state of Texas got the best — justice, if you will — in some of these cases?” Barr asked Carlton, “We do, we come out of these looking as if this was the fairest resolution of what we could prove of the evidence that was before us.”
Carlton acknowledged part of the incentive to negotiate with accused doctors is the risk of SOAH judges finding the TMB did not prove its case and the board walking away without any sanctions against doctors they truly believe violated the law, “That is something that we do look at,” Carlton said.
“There is what you know and there’s what you can prove, so there are things we can look at based on the information available to us: is this the best resolution we can get out of the process,” Carlton told KXAN.
The August 2019 order ended all pending allegations against Dr. Broder.