Several years after charges were initially filed, a Costa Rican doctor is set to face trial in the case of a botched cosmetic procedure that left a former Costa Rican model’s buttocks severely deformed.

The Criminal Court of Pavas decided on January 29^th that Dr. Andres Vargas Scott should face trial for the negligent injury of former model, Cristina Vargas, despite the fact that the prosecution itself requested the case be dismissed, citing a lack of evidence that the doctor “had committed a wrongful act.”

The case stems back to January 2013, when Vargas, a former model, filed charges against Vargas Scott claiming that the doctor had deformed her buttocks by injecting it with a dangerous and toxic substance.

According to the complaint, the doctor, who is not a plastic surgeon, injected 700 cubic centimeters of a substance known as PMMA biopolymer into the woman’s buttocks in September 2011. Shortly after, the model encountered serious complications, according to the complaint.

The woman stated that she began to feel discomfort immediately. She said it became difficult to walk, and she felt a very intense pain when sitting and laying down. She began to feel hot, and redness and bruises began to appear.

“As the days went by, instead of taking shape, the region where the PMMA had been injected, was deformed. The product began to form a sort of capsule on her lower back, which caused pressure, producing a very strong and constant pain,” the woman’s attorney said in 2013.

According to the original complaint, the woman returned to Vargas’s clinic two months after the initial procedure, and according to the model, the doctor withdrew part of the toxic material with a syringe.

“However, instead of feeling relieved, the pain worsened, for which the victim, who lives outside of Costa Rica, returned to the country again on January 23^rd, 2012, and the doctor suggested injecting more PMMA. In total, he introduced [an additional] 75 cubic centimeters on each gluteus, and he recommended a series of medications for pain,” the woman’s attorney explained.

In the end, the former model said she had no other option but to submit herself to an expensive reconstruction process in Mexico, which cost more than US $100,000.

After Vargas’ January 2013 complaint, prosecutors and agents from the Judicial Investigative Police (OIJ) raided the doctor’s plastic surgery center, called Lindora Cosmetic Center, in the western San Jose suburb of Santa Ana, in December of that year.

It was discovered that Dr. Vargas Scott was trained only as a general practitioner, with no training in cosmetic or other surgical procedures – though in Costa Rica, that minor detail doesn’t matter under the law.

 

Law allows unskilled doctors to perform surgery and other specialties

After the case came to light in 2013, Costa Rica’s accrediting agency in charge, known as the College of Physicians and Surgeons, admitted that under current law – which dates from 1962 – a loophole allows general practitioners such as Vargas Scott to perform surgery and other procedures without having any additional education or recognized specialty.

The loophole is the result of the fact that general practitioners graduate from Costa Rican universities with the title “Doctor in Medicine and Surgery,” and the College of Law does not differentiate between the two terms, even though the country’s medical union agrees there is a significant difference in practice.

Even the universities themselves confirm that their medical programs for GPs have at most one year of surgery education, though students attend only in order to observe surgical procedures and receive no hands-on experience.

The loophole allows general practitioners to perform anything from simple stitches to plastic surgeries – and even more complex procedures, without the need to be accredited or specialized in any form of surgery or as a surgeon.

The College of Physicians and Surgeons has routinely found itself involved in cases were doctors were conducting serious operations on patients without possessing any sort of surgical accreditation.

The College investigates hundreds of complaints per year – including the case of Dr. Vargas Scott – the majority for malpractice and in most instances, involving non-specialized doctors performing specialized procedures.

Alberto Arguello, president of the Costa Rican Association for Plastic, Aesthetical and Reconstructive Surgery, said in 2013 that he believes that the solution lies in the universities, which should simply provide the title of “Doctor of General Medicine,” excluding the words “ and Surgery,” for doctors graduating without surgical training or specialties.

Directors and deans at the universities also agree that their graduates are not qualified to perform surgeries without furthering education.

The same loophole also exists in the dental field in Costa Rica, according to the Professional College of Dentists, in which unqualified dentists are allowed to perform oral surgery that should instead be performed by qualified oral surgeons.

The Criminal Court in Pavas said that witnesses and parties in the case of Dr. Vargas Scott are currently being notified, after which time a trial date will be scheduled.