The evidence in the Medical Board of California's case against Dr. Scott Douglass Ewing gets more and more disturbing as you read it—so disturbing that you may find it miraculous, as I did, that the Huntington Beach cosmetic surgeon with drug, booze, record keeping, bedside manner, cop kicking, F-bomb launching and medical negligence problems in his past still has a chance to keep his license to practice.
Technically, the Medical Board revoked Ewing’s Physician’s and Surgeon’s Certificate but that order was stayed pending a seven-year probationary period. The order, which became effective 5 p.m. Friday, imposed several tough conditions that Ewing must follow if he wants to continue his medical career, as you'll read later.
Ewing had been the lone practitioner at Surf City's Breeze Cosmetic Surgery, which sounds from the Medical Board evidence that it could become a house of medical horrors.
According to the board, from 2005 through approximately 2011, Ewing performed multiple cosmetic surgery procedures on a female patient identified as “A.B.” To get to the extent of these procedures, medical board investigators had to rely on the statements of the doctor and the patient because Ewing claimed on Aug. 22, 2014, that he lost A.B.’s medical records.
A.B. had been employed as a phlebotomist—the health professional who draws blood from patients—for Ewing’s father. After meeting A.B., Ewing asked for her help in his continuing cosmetic surgery training by undergoing liposuction of her stomach and inner thighs. A.B. originally was not interested in cosmetic surgery but she ultimately relented.
She had the procedures done without Ewing having given A.B. an adequate pre-operative physical examination, taken down her medical history or conducted follow-up exams, according to the medical board. About two weeks after getting the work done, A.B. complained of numbness and swelling in the areas of the liposuction. Without examining her, Ewing told her the symptoms would dissipate with time.
A week or two after that, Ewing suggested A.B. undergo additional liposuction on her inner thighs, something she at first rejected but then agreed to for the sake of his cosmetic surgery training. It was deja vu all over again: no pre- or post-surgery exams, complaints of numbness, shooting pain and lumpiness in the effected areas—with Ewing’s assurances that time would heal her.
About three months after the procedure, A.B. again complained about numbness, shooting pains and lumpy bulges and indentations on her outer thighs, and she got the same reaction from Ewing: no exams and his assurances the symptoms would dissipate over time.
Something else significant happened in 2005: The medical license of Ewing’s father was suspended and he terminated A.B., who went on to work as the younger Ewing’s office administrator from 2006-08, a period during which she repeatedly complained about the liposuction complications.
She underwent revision procedures in 2008 and 2011 with Ewing, who again failed to keep adequate records or conduct appropriate pre- and post-exams, says the board. For the latter procedure, A.B. told investigators, Ewing extracted fat from her flanks, cleaned the fat with saline and “what appeared to be a common kitchen strainer” and then injected the fat into her thigh indentations. She eventually complained of more pain and received the same lack of post-operative care as before, the board found.
Besides the inadequate record keeping, the board faulted Ewing for “dishonest acts and/or false representations for patient A.B.” This stems from A.B.’s lawsuit against Ewing that was filed Jan. 16, 2013, in Orange County Superior Court. In a motion aimed at removing himself from the case, Ewing declared, under penalty of perjury, that “[w]ithin the last several months I have been diagnosed with bi-polar disorder that included a manic breakdown. Said condition resulted in having to receive both in-patient and out-patient treatment [and] has impaired my ability to operate my business and temporarily defend or participate in this litigation.”
However, in an Aug. 22, 2014, interview on behalf of the Medical Board, Ewing said he had never been diagnosed with or treated for bi-polar disorder and that the representations made in the lawsuit motion were a “gross exaggeration” of what he describes as irritability and stress.
The board also disciplined Ewing for “unprofessional conduct” and a “dishonest act and/or false or misleading advertisement” for a patient identified as V.S., who had purchased a discounted Botox treatment after seeing an ad for Breeze Cosmetic Surgery before August 2013. The ad claimed the Botox procedure would be performed by a “board-certified physician with post-doctoral training in facial surgery,” but—according to the board—Ewing "is not now, nor has he ever been, a board-certified physician and [he] has no post-doctoral training in facial surgery.” And he can't claim the ad was in reference to another doctor because, as mentioned previously, he was Breeze's lone practitioner.
Then there is the case of female patient “R.Z.,” who attend a consolation session with Ewing on June 20, 2013, because she wanted a lump in her breast excised. (It was possibly a scar tissue deposit from a breast augmentation procedure she received from another doctor in 2007.) Ewing’s office manager had told R.Z. that Ewing was board-certified.
During the consultation, Ewing told R.Z. that she needed a breast lift, to which the patient reminded the doctor she was there to get a lump removed. However, she ultimately relented and I believe it is best to let the Medical Board’s affidavit now pick up the story.
Following the procedure, Ewing “failed to adequately conduct and document monitoring” of R.Z.’s vital signs, according to the Medical Board,” which notes the doctor did say this of the patient to her waiting fiance: “she’s so sexy.” Meanwhile, a Ewing staffer showed R.Z. her own breasts that the doctor had augmented—and to the patient’s horror she saw “significant scar tissue.”
Warning: It’s about to get gross again.
Around Feb. 14, 2014, and again the following March 6, Ewing certified that he had no medical records for R.Z., but around July 18, 2014, he was able to produce her records.
The board is zinging Ewing for “unprofessional conduct,” “gross negligence and/or repeated acts of negligence and/or incompetence in the care and treatment of Patient R.Z.” as well as failing to maintain adequate medical records for her.
End it right there? We're just getting started …
A patient identified by the Medical Board of California as “R.B.” took a Groupon for discounted Botox treatments at Breeze Cosmetic Surgery to a June 10, 2013, appointment with Ewing. Without giving R.B. an adequate physical examination or documenting her medical history, Ewing entered the examination room and administered 10 Botox injections throughout her face.
During the appointment, R.B. discussed possibly returning for breast augmentation and liposuction to her chin area. She did just that, coming back in July 2013 for a consultation but, according to the board, Ewing again failed to perform a physical or take an adequate medical history. He did ask R.B. if she had AIDS but did not have any pre-operative blood samples taken, says the board, which adds the doctor “indicated that he was the best at what he does and instructed her not to ask him any questions.”
R.B. got the surgery done on July 12, 2013, without Ewing having first given her a physical or taken her medical history—with the board pointing out the three-hour surgery under intravenous and local anesthesia was being performed at “a non-accredited facility without an anesthesiologist and/or adequate monitoring of her vital signs” and without providing post-operative monitoring.
Due to profuse bleeding from her left breast, R.B. returned to Breeze Cosmetic Surgery on July 19, 2013, when Ewing said her stitches had opened, that she was healing nicely and that the incision would close on its own. About three days later, R.B. noticed a blood blister forming underneath her left breast and called Ewing for an appointment. He declined to see her, citing a prior personal engagement. So, she went to an urgent care center, where a doctor closed the incision with medical glue and told her to go back to Ewing.
On July 23, the protrusion reoccured and R.B. went to see Ewing, who was in the middle of a facelift, became agitated and told her to stop harassing his staff, the board says. Later, upon examining R.B., Ewing discovered the protrusion was actually the breast implant and, according to the board, he became agitated again and stated, “If you’re going to get an attitude with me then you can get the fuck out of my office!”
She left crying.
The woman tried to see three other cosmetic surgeons for relief, but they told her they would not see her while she remained under Ewing’s care. Ewing later called and asked R.B. to return to his office, where he pushed the implant back into the breast pocket and stitched the wound closed—a procedure he failed to document, the board says.
From July 30-Sept. 27, 2013, R.B. returned about once a week to have her left breast re-stitched, and when she expressed concern to Ewing, he admonished her for being overly active and repeatedly breaking the stitches—despite her insistence that she had not engaged in strenuous activities. During three such re-stitchings, Ewing popped an implant and reinserted new ones. After the third time, R.B. went to urgent care and was diagnosed with an active infection that would not heal unless the implant was removed. So, she went back to Ewing, who removed the implant and instructed her to irrigate the breast pocket with a pre-filled syringe for the next three days, states the board, which notes none of the office visits were documented by the doctor.
She returned to Ewing on Oct. 3, 2013, for breast revision surgery—without the pre-exam and medical history being taken. Not given an anesthetic, she was awake, felt each injection Ewing gave her and, when she screamed in pain, he said, “If you don’t shut up, I’m putting you in restraints,” the board was told. Her blood pressure dropped and she lost consciousness. She awoke, asked that someone call her husband and, when the office manager complied, Ewing punched the employee in the face, according to the board.
When R.B.’s husband arrived, he refused to sign a form indicating his wife had refused Ewing’s medical care. The office manager told Ewing, “Our patient is bleeding to death, call 9-1-1,” to which the doctor began closing R.B.’s wound, saying, “Holy shit, did I really put that much liquid in? But I have to go stitch it up anyways”—and then he immediately left the office. R.B. went home to recuperate without any post-operative vital sign monitoring being conducted, the board notes.
On Oct. 4, 2013, R.B. lost consciousness and was taken to Orange Coast Memorial Medical Center in Fountain Valley, where she was diagnosed with severe sepsis—harmful bacteria and toxins near a wound—resulting from a popped and deflated implant left inside her breast pocket. She received treatment from cosmetic surgeons and infectious disease specialists.
Ewing later texted R.B. notifying her he was terminating their doctor-patient relationship.
All this constituted unprofessional conduct and gross negligence and/or repeated acts of negligence and/or incompetence in the care and treatment of R.B., according to the board.
Nope, that’s not all.
The coup de grace for the Medical Board of California is Ewing’s February 2014 conviction for possession of a controlled substance and battery on a police officer.
On Oct. 23, 2013, a Huntington Beach police officer was sent to a private business where a fight had broken out. Once there, the officer saw Ewing screaming at other patrons in the parking lot. He was handcuffed to protect the public and responding officers. Ewing told police he had been drinking and was addicted to opiates. He was arrested on suspicion of public intoxication and a search of his person uncovered four Norco pills. But Ewing could produce no prescription for the pills, so he was also held on suspicion of possession.
At the Huntington Beach Police Department, Ewing began resisting, kicking one officer in the groin. That brought a charge of alleged battery on a peace officer. Ewing was ultimately charged with a felony for the Norco possession and misdemeanors for the public intoxication and battery on a cop. On Feb. 25, 2014, he pleaded guilty to possession and battery and the public intoxication count was dismissed. He got three years probation and an order to pay $850 in restitution, fines and fees.
During an Aug. 22, 2014, interview on behalf of the Medical Board, Ewing admitted to taking the Norco pills from his practice and of having done so intermittently in the past for pain.
The board also took into consideration for discipline Ewing’s Sept. 15, 2010, conviction for driving under the influence. A Huntington Beach police officer had found him unconscious behind the wheel of a car in the middle of an intersection—and still in drive. Ewing went on to fail a field sobriety test, produce a 0.19 percent blood alcohol concentration and find himself facing two misdemeanors. He was convicted of one, the other was dismissed, and he got 30 days in jail and five years probation.
During that court case, it was revealed that Ewing was convicted of misdemeanor DUI in Los Angeles County on Oct. 13, 2004.
What follows are the conditions the Medical Board placed on Ewing's license during probation:
*He is totally restricted from ordering, prescribing, dispensing, administering, furnishing or possessing a controlled substances.
*He must abstain from drinking alcohol or using controlled substances, and he must undergo drug testing, with the results submitted to the board. A positive test would lead to the board issuing a cease-practice order that would be shared with the doctor’s employers, supervisors and work monitors.
*He cannot give a patient an oral or written recommendation for medical marijuana. If he believes that would help a patient, he must send a referral to a different physician, who would have to make that call.
*He must undergo psychotherapy.
*He must undergo a clinical diagnostic evaluation by a licensed physician or surgeon with at least three years of experience in evaluating substance abusers.
*He must attend substance abuse support group meetings.
*His worksite must include a substance abuse monitor.
*He must also have a separate monitor of his practice of medicine.
*He must complete ethics, medical education and record keeping courses.
*He must enroll in the equivalent of UC San Diego’s Professional Boundaries Program—which includes a complete assessment of his competency, mental health and/or neuropsychological performance—and the school’s separate Clinical Training Program.
*He can no longer work as a solo practitioner.
*He cannot perform cosmetic surgery during his probation.
*He must notify all hospitals, clinics and related facilities where he has privileges of his probationary status.
*He cannot supervise physician assistants.
*He must obey all laws.
Failure to adhere to any of these can result in revocation of his license, according to the Medical Board agreement filed with the Superior Court that Ewing and his lawyer each signed on Sept. 30.