Under Wraps

Many of Dr. Brian West's patients didn't know he was in the state medical board's substance-abuse-diversion program. At least six of them claim they're paying the price

Of the dozens of former patients whom Minasian says filed medical complaints against West, five have made it through the board's stringent tiered elimination process and to the investigation-and-accusation level at the attorney general's office. The board receives an average of 7,000 to 8,000 complaints per year. Of those, 1,200 were investigated last year, only 416 of which were referred to the attorney general's office for formal investigation.

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In 2006, Minasian started a blog with patients' stories about their experiences with West. She has been contacted by about 100 women, she says, who say they have had bad experiences with him. Minasian encourages them to file complaints with the medical board, "but not all have filed complaints because they don't think it will do any good," she says.

Dr. West performed Tina Minasian's surgery while he was enrolled in the state medical board's secretive program  for doctors with substance-abuse problems.
Jeremy Sykes
Dr. West performed Tina Minasian's surgery while he was enrolled in the state medical board's secretive program for doctors with substance-abuse problems.

Minasian, Anderson and McDonald are among the five women listed in the accusation against West filed in February, two years after the complaints were first submitted. The other patients listed at the time the accusation was filed are Sharon Mikulecky and another known only as M.H.

A sixth patient, Ruby Young, was added to the complaint in November 2007. West performed a Tram Flap procedure on Young in August 2000. Young's breast and abdomen became infected after her sutures ruptured, according to the complaint. "The sutures were coming undone, so [West] used his bare hands and took every stitch out, one by one, without any gloves on," she claims. West's bare-handed procedure is part of Young's allegation of gross negligence. Her wounds did not close for five months.

Ken Mikulecky, whose wife Sharon also had a Tram Flap procedure performed by West in August 1999, is alleging repeated acts of negligence by Dr. West. According to the complaint, her breast and abdomen became infected and did not heal for a full year following her surgery. "From one hip to another hip, her wound was wide open," Mikulecky says. The Mikuleckys tried to sue but could not afford the costs, he says. They eventually went to another doctor to close up her wounds in 2001.

Sharon Mikulecky died in August 2003 following an unrelated recurrence of her cancer. "I can't blame [West] for killing my wife because she had cancer before," says Mikulecky. "But I can blame him for weakening her to the point where she damn well died. If it hadn't been for his botched job, she wouldn't have spent a full year at two hospitals and at home healing up."

Minasian says about half a dozen of the women who have complained to her about West are from Southern California. To date, no lawsuits have been filed against West in Orange or Los Angeles counties. If there have been medical-board complaints filed, information cannot be known about them unless they are green-lighted for investigation and submitted as formal accusations by the attorney general.

West worked for the now-defunct Beverly Hills Plastic Surgery Institute for about one year beginning in the fall of 2006, according to Daniel Shin, the center's former medical director. Shin, an anesthesiologist, says West told him he was in the diversion program and asked if Shin would be his sponsor, which Shin agreed to. "He just needed to be watched, charts checked, to see if he was showing up to work late, because of the diversion thing," Shin says. "But none of those things ever occurred.

"He was in the diversion program, but he was very compliant. There were never any complaints that he was drunk or smelled of liquor," says Shin. "He was very productive. He was able to do four or five surgeries a day." Shin says West left the institute because of the company's financial issues, not because there were any problems with West's practices. Complaints Shin may have received regarding West's surgeries "are normal for any plastic surgeon," he says.

West now works for the Plastic Surgery Institute of California, which is also listed as the Advanced Surgical Institute and the Advanced Medical Institute at its Huntington Beach offices. The company has locations in Beverly Hills, Pasadena and Newport Beach. West splits his time between the Huntington Beach and Beverly Hills offices. Located on a large lot on Beach Boulevard between Utica and Yorktown, the Huntington Beach offices are spread out over the third floor of a wide, four-story realty building. The patient visitor's office is hidden down a long corridor. Huge Italian Riviera paintings and plush gold-and-dark-mustard-colored 17th-century-style chairs fill the snug, neat room.

An assistant to Dr. Mazin Alhakeem, president of the Plastic Surgery Institute of California, confirmed that West practices there. Alhakeem had no further comment by press time.

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This past June, in an audit meant to reveal whether the rest of a long list of recommendations made by Fellmeth in 2005 had been implemented, the state auditor's office found that the diversion program was still not working. "Inconsistent monitoring of participants and inadequate oversight of its service providers continue to hamper its ability to protect the public," the report read.

In July 2007, the Medical Board of California voted to abolish the diversion program altogether by June. The decision set off a firestorm among physicians who support the program and believe eliminating it will only make matters worse for doctors and patients. In October, the California Medical Association, California Psychiatric Association and California Society of Addiction Medicine issued a joint proposal for a "Public Protection and Physician Health Program," in lieu of the termination of the diversion program. Their proposed program, not unlike the one being abolished, would monitor doctors with substance abuse and other problems and allow them to participate in the program confidentially.

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