Mollye BarrowsPensacola News Journal
Show Caption
The Florida Department of Health has issued an emergency order immediately restricting the medical license of Dr. Ben Brown, the Gulf Breeze plastic surgeon whose wife died after he performed several procedures on her after hours in his office last November.
State Surgeon General Dr. Joseph A. Ladapo said Brown’s “inability or unwillingness” to follow basic medical procedure presents an “immediate serious danger to the health, welfare, and safety of the public” and to the citizens of the state of Florida.
In the findings of fact in the 30-page order, the health department describes numerous violations of basic standards of medical care that constitute “medical malpractice,” and Brown is now restricted to only performing procedures or surgeries in a licensed hospital while under the supervision of a licensed physician.
The health department talked to Brown’s patients and employees who told the state that Brown’s practice, Restore Plastic Surgery in the Tiger Point area of Gulf Breeze, was “tumultuous, poorly managed, and that Dr. Brown could be vindictive.” One medical assistant told the department the office was also “dirty and poorly maintained,” that he stored medication, including controlled substances, in an unlocked cabinet, and staff would take Versed, a medication that helps a patient relax or sleep before a surgical procedure, from the cabinet “to take the edge off.”
The findings are based on numerous interviews and the order also provides more information on what happened to Browns’s wife, Hillary. The 33-year-old mother of three was taken off life support on Nov. 28, about a week after her heart stopped during the procedures at Brown's office on Nov 21. Her death is being investigated by the Santa Rosa County Sheriff’s Office, as well as the state health department.
What happened to Hillary Brown at Restore Plastic Surgery
According to the emergency order restricting Brown’s license, Ben Brown disregarded basic medical procedure and care when preforming procedures on his wife. It also says he also waited 10 to 20 minutes before calling 911 when his wife became unresponsive.
The findings of fact state on Nov. 21, 2023, Hillary Brown was to undergo a miniature muscle plication/abdominal scar revision, bilateral arm liposuction, lip injection and ear adjustment procedures.
The state says the morning of the procedure Hillary Brown, who is not a state licensed medical care provider, prepared her own tumescent solution, or anesthetic solution, which included lidocaine, epinephrine and sodium bicarbonate. She filled one to two I.V. bags with the solution and also took a “handful” of pills, including Valium.
The state said Brown documented some of the pills Hillary ingested at noon − Valium, Tramadol, Cefadroxil, Zofra, and Versed − but there is no documentation of the “handful” of pills that she ingested at 11 a.m. Medical providers are required to document such things as procedures and medications.
After wife's death, years of complaints Florida launches investigation into Dr. Ben Brown
Employees told the state she also took Versed before Brown began the procedures early that afternoon. The state said Brown documented he used lidocaine among other medications in the tumescent solution but according to the health department Hillary prepared the solution and did not document it.
The health department said the minimum standard of care requires a physician to ensure that fluids injected into a patient are properly prepared. Brown injected the solution into her abdomen and both of her arms using all the contents of one of the IV bags and he asked staff to bring him Xylocain, which he reportedly injected into her but did not document.
He performed the scar revision and muscle plication procedures. Hillary Brown even assisted in her own procedure by suturing the skin back together, the state said. She then became restless and her feet began "twitching.” Brown then performed liposuction on her arms and the twitching worsened. He took a break then documented that he injected a more “concentrated solution” of lidocaine into her face and lips, but witnesses say he injected the undiluted Xylocaine into her face. The health department said Brown failed to accurately record the anesthetic medication and dosage during this procedure.
Hillary Brown told her husband her vision began to blur and she saw “orange.” Restlessness, muscle twitches, and blurred vision are all signs of lidocaine toxicity, the order says. Brown continued to inject lidocaine/Xylocaine into her face, and during the procedure she became unresponsive and began to have a seizure.
The state said when a patient has a seizure during a medical procedure or has failing vital signs the minimum prevailing professional standard of care requires a physician to immediately initiate transfer to a higher level of care, which the state said Ben Brown failed to do.
A medical assistant asked Ben Brown if they should call 911 and Dr. Brown said “No,” according to the report. Over the next 10 to 20 minutes a medical assistant asked Brown again if they should call 911 and Brown said “No” or “Wait,” the state reports, adding that the medical assistant was scared and a new employee, so she did as Brown instructed.
The health department said Brown told staff to retrieve equipment like a blood pressure cuff, stethoscope and oxygen tanks. Assistants went around the office trying to find the supplies but couldn’t find them, and they did not know if the office had a crash cart or other life-saving equipment. Brown was said to have also shouted to the staff, “What medication did she take!”
After 10 to 20 minutes Hillary’s breaths were shallow and her pulse and blood oxygen levels were low. Brown then asked the assistants to call 911 and began performing CPR. An ambulance soon arrived, and Hillary Brown was taken to Ascension Sacred Heart Hospital in cardiac arrest with suspected lidocaine toxicity.
Dr. Ben Brown performed multiple procedures on wife before her heart stopped
She was declared legally dead about a week later and taken off life support.
What other patients told the health department about Ben Brown of Restore Plastic Surgery
In the findings of fact, the health department said employees and patients said Brown’s practice began to decline in 2021 and he delegated “more and more” to his physician's assistant Sean Kirby and to Hillary, who the state said was not a licensed healthcare practitioner and was not qualified to practice medicine or perform cosmetic procedures.
However, patients reported she was allowed to perform procedures on them, including laser treatments.
One 40-year-old woman, called B.F. in the order, said Brown left her body “disfigured” when she went to him for a breast implant replacement, tummy tuck, liposuction and fat injections into her hips in 2021.
She said Ben Brown also suggested she have fat injected into her buttocks in a procedure that is known as a Brazilian Butt lift, or BBL. The patient told him she did not want a BBL and specifically did not authorize him to do it, but he did it anyway.
The state said Brown injected 2,200 milliliters of fat into her buttocks and after the procedure she experienced severe pain, blurred vision and swelling, and her incision began to open and leak. B.F. also said she needed scar revision procedures and Brown delegated the surgery to Kirby. B.F. said procedure was “pure torture,” leaving her crying and in excruciating pain. He also removed a large portion of skin and fat creating a large, open wound across her abdomen.
'That man has to be stopped': Dr. Ben Brown patients trusted surgeon - and regretted it
The health department also said there were several issues with sterility during the procedure as neither Kirby nor the other assistants wore surgical masks, which are essential during procedures to avoid contamination and risk of infection.
In 2022, patient J.H., a 55-year-old woman, came to see Brown about removing her breast implants and other procedures. Brown also suggested she have a BBL but J.H. specifically stated she did not want the procedure.
However, Brown did it anyway because he thought she would “love it,” according to the report. She had numerous medical problems after her tummy tuck and implant procedures including necrosis and a large wound, 7 inches by 4 inches, that did not heal properly and eventually required emergency care. The state said Brown failed to maintain proper records of the procedures and problems she experienced and failed to provide proper wound care, making her injuries worse.
Florida Health Department says Brown’s in-office practice “unsafe”
Based on the findings of fact, the health department issued the emergency order limiting Brown’s ability to practice medicine outside of a hospital and without another doctor’s supervision.
The state says the scope and variety of issues with Brown’s actions in an office setting resulted in an “unsafe environment for procedures to be performed” and “present a danger to future patients.”
The state said medical doctors must also have the good judgment to ensure people who work for them are licensed and trained.
“Dr. Brown’s blatant authorization of unlicensed activity indicates Brown has poor judgment and cannot be trusted to ensure that his patients receive appropriate care when in an office setting,” the order reads.
Most egregiously, Brown’s treatment of his wife was “careless and haphazard.”
“The level of disregard Brown paid to patient safety, even when the patient is his wife, indicates he is unwilling or incapable of providing the appropriate level of care to future patients,” the order reads.
The state health department began investigating Brown after the death of his wife and after numerous patients and employees came forward to the News Journal with a variety of complaints about the plastic surgeon.
Some patients said Brown left them with infections, wounds that wouldn’t heal and permanent injuries. Others said he also performed unauthorized procedures on them, like adding fat to their backsides, which they did not consent to.
Former employees said Brown repeatedly violated numerous medical regulations including performing or allowing others to perform certain surgical procedures in his office without properly trained staff or equipment, not following cleaning and sterilization protocol, and not following up properly on post-surgical wound care.
Brown has refused repeated requests for interviews but in response to previous requests for comment he responded through a crisis management public relations firm that he loved his wife and is devastated by her loss while performing “minor” procedures at his office.
“Ben is a dedicated and incredibly talented surgeon, with no previous disciplinary actions or marks,” the statement added.
According to Dr. Ladapo’s order, a procedure seeking formal discipline of Brown’s medical license will be promptly instituted.
