Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

In the wake of a surprising death, is outpatient surgery safe? An expert says yes.

TAMPA — It may be months before it's known for sure why a seemingly healthy 49-year-old St. Petersburg man died Friday after going to a surgery center for a simple hernia repair procedure. But a local expert says the case should not lead anyone to conclude that it is not safe to have surgery in an outpatient facility rather than a hospital, as Spiro Gogas did.

Gogas, an amateur bodybuilder who did not drink or smoke, was co-owner of the popular Athenian Garden restaurants. On Friday morning, he went to Carillon Surgery Center in St. Petersburg for a hernia operation. By 11 a.m., his family had been told that his heart had stopped while he was under anesthesia. Doctors at Northside Hospital, where he was transported from Carillon, were unable to save him.

The Pinellas-Pasco County Medical Examiner's Office is awaiting test results and does not expect to determine a cause of death before 60 to 90 days.

Dr. Hector Vila, an assistant professor of anesthesiology at Moffitt Cancer Center in Tampa, has studied extensively the safety of surgeries that are performed outside of hospitals. A leader in a national group that accredits outpatient surgical centers, Vila was not involved in Gogas' care.

Generally, he said Wednesday, you're much more likely to survive surgery in an outpatient surgery center than you are driving a car.

"It's very safe," said Vila, "One of the safest activities you can engage in."

How do surgery centers compare to hospitals for safety?

Studies show the chance of dying in an outpatient surgery center is one in a million. It approaches the safety of flying with a major airline. Statistically, it's safer than having surgery in a hospital because (hospitals are) where the sicker people go who have more complicated medical conditions. Also, in an outpatient center you aren't exposed to many of the serious infections that are present in hospitals.

How well-equipped are outpatient centers to handle an emergency?

You have the same basic safety equipment you would find in a hospital — the equipment necessary to perform an immediate cardiac resuscitation and rescue from medical complications. What you don't have is the more technologically advanced machines for cardiac bypass and ventilators to help with breathing, what we think of as high-tech, intensive care equipment. It would be rare to need that in a resuscitation.

What could go wrong that would require advanced emergency medical care beyond the scope of a surgery center?

Heart attack, stroke, an allergic reaction to medication or anesthesia that the patient didn't know about. There is a rare genetic disease, an allergy to commonly used anesthesia, called malignant hyperthermia. Families usually know about it because someone has had it in the past. It is life-threatening wherever it happens but surgery centers should have the antidote. In my 20 years in practice, I've seen it once.

What questions should patients ask when choosing a surgery center?

• Make sure the facility is accredited by one of three agencies: the Joint Commission; the American Association for Accreditation of Ambulatory Surgery Facilities (the group that Vila is affiliated with); or the Accreditation Association for Ambulatory Health Care.

• Talk with the surgical staff about what will happen if there is an emergency, so you know what plan is in place if something goes wrong.

• Make sure you talk with the surgeon or the anesthesiologist before the day of your procedure about your medical history, so everyone is aware of other medical conditions you may have.

• Be sure to discuss drug allergies and medications.

More questions

In addition to asking about accreditation, the nonprofit Institute for Safety in Office-Based Surgery has these recommendations for anyone considering an outpatient surgery or a procedure in a physician's office:

• Ask whether the physician has privileges at a local hospital. That means your doctor has been reviewed by his or her peers.

• Ask whether your physician is board certified, has undergone voluntary peer review in a medical specialty.

• Ask who will administer the anesthesia. If general anesthesia will be used a board certified anesthesiologist is best; for lower levels of sedation a registered nurse anesthetist may be used.

In the wake of a surprising death, is outpatient surgery safe? An expert says yes. 12/14/11 [Last modified: Wednesday, December 14, 2011 10:27pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Observations from a liberal, gay, Latino, feminist Florida House freshman


    State Rep. Carlos Guillermo Smith, D-Orlando,  rocked the Florida LGBTA Democratic Caucus dinner at Tallahassee's Hotel Duval Satursday night with his unabashedly liberal and passionate take on the myriad issues he said are key to LGBTQ Floridians. Among them: Access to guns, Reproductive rights, home …

    Carlos G. Smith
  2. Delta Sigma Theta honors outgoing national president

    Human Interest

    During her four years as national president of Delta Sigma Theta Sorority, Inc., Paulette Walker said she always focused on the comma between "Sorority" and "Inc."

    Paulette Walker, the former director of undergraduate programs and internship in the College of Education at the University of South Florida, will be honored on Saturday for her leadership in the Delta Sigma Theta sorority.
  3. 10 sailors missing, 5 hurt in collision of USS John S. McCain

    SEOUL —Ten U.S. Navy sailors are missing and five have been injured after the USS John S. McCain destroyer collided with an oil tanker near Singapore early Monday morning.

    In this Jan. 22, 2017, photo provided by U.S. Navy, the USS John S. McCain patrols in the South China Sea while supporting security efforts in the region. The guided-missile destroyer collided with a merchant ship on Monday, Aug. 21, in waters east of Singapore and the Straits of Malacca. Ten sailors were missing, and five were injured, the Navy said. [James Vazquez/U.S. Navy via AP]
  4. Pasco County Fire Rescue fighting a two-alarm fire started by an explosion


    Two houses are on fire and one victim has been critically burned and taken to a trauma center following an explosion at a home at 8652 Velvet Dr, in Port Richey.

  5. Rays see the Blake Snell they've been waiting for in win over Mariners

    The Heater

    ST. PETERSBURG — It was a one-run game Sunday when the Mariners' Robinson Cano singled with one out in the seventh inning, bringing the dangerous Nelson Cruz to the plate.

    Tampa Bay Rays starting pitcher Blake Snell (4) throwing in the third inning of the game between the Seattle Mariners and the Tampa Bay Rays at Tropicana Field in St. Petersburg, Fla. on Sunday, Aug. 20, 2017.