As we previously reported, Dr. Peter Normann, a self proclaimed cosmetic surgeon without formal training in surgery, was charged with 2 counts of second-degree murder and one count of manslaughter in the deaths of three of his surgical patients. Last Friday, after a day and a half of deliberations, a Maricopa County AZ Superior Court jury found him guilty on all counts.

Normann was found guilty of second-degree murder in the deaths of Ralph Gonzalez, 33, of Scottsdale AZ, and Leslie Ann Ray, 53, of California, and of manslaughter for the death of Alicia Santizo Blanco, 41, of Gilbert AZ. Since the trial began on June 10, Normann’s attorneys, John Johnsonand Vikki Liles, argued that the deaths were all accidental, the result of known risks of plastic surgery, and argued that if Normann, 50, were found guilty, all doctors would be criminally liable for procedures gone wrong. 

Deputy County Attorney Jeannette Gallagher said in her closing arguments that a “combination of incompetence and arrogance in trying to cover up his (Normann’s) incompetence led to their deaths.” Gallagher argued that two of the deaths constituted second-degree murder because of Normann’s “extreme indifference to human life,” and the third death was manslaughter because of Normann’s “conscious disregard of substantial and unjustified risk of death.” 

The prosecution successfully made their case despite the fact that the medical examiner had ruled the deaths accidental. And the evidence supporter their argument. Gallagher was able to show that Normann, who was an internal medicine physician with experience working in emergency rooms before reinventing himself as a cosmetic surgeon, had undergone a mere six days of training in liposuction and had done some “hands-on training” in liposuction and breast augmentation. He had never done training in fat augmentation, Gallagher said. In addition,  his office based operating room lacked proper oxygen and monitoring equipment, and he worked without anesthesiologists, nurse anesthetists or any nurses, relying on a massage therapist and a former restaurant worker with little or no training as medical technicians to assist him and administer IV sedation. The massage therapist has already pleaded guilty to eight counts of unlawful practice of medicine and was sentenced last year to five years in prison.

AZCetral.com provides a summary of the deaths:

Gonzalez stopped breathing during liposuction in December 2006, due to what Gallagher called a lethal dose of lidocaine, which is used in the procedure. Then, she claimed, Normann mistakenly inserted a breathing tube into Gonzalez’s esophagus instead of his trachea, depriving him of oxygen.

When paramedics arrived, they noted that Gonzalez’s belly was distended because of the oxygen being pumped into his stomach instead of into his lungs, and they maintained that they tussled with Normann, who insisted on riding in the ambulance and refused to let the EMTs reinsert the tube correctly.

David Duarte, one of the paramedics, told The Republic after the verdict, “He physically was holding onto it, from the get-go.”

Duarte threatened to break Normann’s arm and then tricked him into letting go of the tube so he could pull it out. Normann insisted on reinserting another.

Duarte said he filed complaints against Normann with the hospital and the state medical board.

Santizo died in April 2007 during multiple procedures, including repositioning a badly placed breast implant, liposuction and an attempt to inject fat into her buttocks to enhance its shape.

During the fat augmentation, Gallagher said, Normann injected the fat directly into a vein, which carried it to her lungs and killed her.

As had occurred during Normann’s attempts to resuscitate Gonzalez, Normann was unable to properly insert a breathing tube.

Duarte, coincidentally, was in the hospital when Santizo was brought in, and he filed another complaint.

After the second death, Normann agreed to a voluntary suspension of his medical license and he hired a homeopathic physician, Gary Page, to do liposuction. Gallagher maintained that as a homeopath, Page was not qualified or licensed to perform such procedures.

Ray had traveled from her home in Blythe, Calif., for the surgery in July 2007, which Page performed with no assistance, serving as surgeon, anesthesiologist and monitor.

After the surgery, Page left the clinic, and Ray was left in a recovery room, where later that night, Normann discovered her in respiratory distress because of a reaction to the combination of drugs she had been given. Normann was again unable to insert a breathing tube when she stopped breathing.

Page was charged with manslaughter in Ray’s death, but on Friday, he pleaded guilty to the lesser felony charge of endangerment. 

Normann’s arrogance knew no bounds as he physically wrestled with a paramedic who was entirely in the right when he tried desperately to remove and correctly insert an endotracheal tube which the doctor had placed in such a way as to guarantee the patient would die….the equivalent to strangling the patient. His arrogance was beyond pale when, after sanctioned by the medical board and prevented from performing liposuctions, he hired ANOTHER untrained individual, a homeopathic physician, to perform them on his patients in his office. While we would never place the blame for any of this on the patients, it certainly is a lesson to patients that you get what you pay for in the world of cosmetic surgery. Like no other medical specialty, cosmetic surgery can be fraught with untrained, inexperienced physicians looking to make a buck at the expense of patient care and safety. Patients are on notice to do their homework and seek out surgeons who are Board Certified in Plastic Surgery. 

Sentencing will take place on August 19. 

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