The story below was first published on 14/10/2007
A top hospital consultant is so worried about the shocking record of this woman’s surgery clinic that today he takes the remarkable step of going on record to warn that someone will die unless the authortie’s take action
By: Michael O’Farrell
Investigative Correspondent
SHORTLY before 11pm on Wednesday night, an ambulance sped down the short tree-lined avenue leading from the headquarters of Advanced Cosmetic Surgery (ACS) – Ireland’s largest and best known commercial surgery company.
On board was a terrified woman who had undergone cosmetic surgery with ACS on Monday. She was bleeding internally and her blood count was dropping by the minute.
Blue lights flashing, the emergency crew swung the vehicle into traffic on Foster’s Avenue, turned left onto the Stillorgan Road and headed at speed for nearby St Vincent’s University Hospital.
Minutes later, an ACS anaesthetist, who had accompanied the woman in the ambulance, told staff in Vincent’s A&E unit that the patient had received an abdominoplasty (tummy tuck) two days earlier.
He then left, placing her care in the hands of hospital staff. The role of ACS in the treatment of the patient was documented in the operative notes, transfer notes and nursing notes, all on ACS headed paper.
Working quickly, casualty doctors checked her vitals. They found the patient’s heart rate was racing, while her haemoglobin level (blood count) was dangerously low and dropping.
She was bleeding to death.
Doctors had to transfuse a full four pints of blood to save her life, as the on-call plastic surgeon carried out emergency surgery to remove a large haematoma (a build up of blood) from beneath her skin in the early hours of Thursday morning.
The patient also received a CT-scan to make sure there wasn’t any inter-abdominal injury. She is now in a stable condition in hospital.
Given that she was herself scheduled to undergo surgery, it is likely that the patient watched with interest the Late Late Show special on cosmetic surgery three weeks ago.
She must have cringed when she saw photos of a botched tummy tuck patient who had undergone the procedure in Dublin this May. Perhaps the photo even caused her to think twice about going ahead with her own procedure.
But she would have had no way of knowing that the awful gaping wound displayed in that photo – and greeted by gasps of horror by the Late Late studio audience – was the result of an Advanced Cosmetic Surgery procedure.
As he arrived at work on Thursday morning, consultant plastic surgeon Seán Carroll was immediately told of the ACS incident.
He was appalled. ‘She was bleeding internally and they couldn’t sort it out. Totally, utterly, unquestionably her life was in danger,’ he said.
Mr Carroll is so concerned about ACS that he has decided he must go public with his concerns. For a senior hospital consultant, such a move is almost unprecedented. But he is afraid that if he keeps his silence someone may die.
‘They just effectively left her, allowing another team to carry the can. A transfer from a private institution into a public hospital is always inappropriate if not done in the proper way because of the circumstances and this is totally, totally and utterly inappropriate.’ Mr Carroll’s concern is not simply based on this week’s incident. He is currently involved in the treatment of seven former ACS patients who need surgery following problems with procedures.
And there have been other ACS patients saved by St Vincent’s after an emergency dash from the ACS clinic, which is situated in a detached Georgian house to the rear of the nearby UCD campus.
‘They related primarily to weight-reduction surgery where, for instance, gastric banding was being done and the patient ended up in life-threatening situations because the expertise was not available in Advanced Cosmetic Surgery and an emergency transfer had to be made from their institution to St Vincent’s Hospital in order to save the life of a patient.
‘People are lucky to be alive because the institution is so close to St Vincent’s Hospital and the people running the institution realise that the expertise in the public sector exists to save the lives of these patients.’
Fronted by prominent 52-year-old socialite Halina Ashdown-Shiels, Advanced Cosmetic Surgery is by far the largest and longest-established cosmetic surgery company in Ireland. ACS is now run jointly by Miss Ashdown-Shiels and her 37-year-old daughter, Debbie.
Since 1993, the company claims to have carried out 20,000 cosmetic operations, the most popular being breast augmentation, breast reduction and liposculpture.
The daughter of a Polish miner who emigrated to Doncaster when she was just a year old, Ms Ashdown-Shiels real name – still used in her company filings – is Halina Ubermanowics.
Now, though, she has transformed herself into Ireland’s de facto cosmetic-surgery queen, featuring in numerous advice columns, magazine spreads and on hit makeover shows on national TV. She freely admits that gastric banding took her from a size 16 to an eight recently, after she reacted badly to the death of her sister by bingeing.
A walking endorsement of her own company, she has also had her breasts done twice, a neck lift, an eye job, liposculpture and a small thigh lift. Next year, a bottom lift is said to be on the cards.
As tough as they come – her idol is Margaret Thatcher – Ms AshdownShiels launched her company to national prominence in the 1990s with a billboard campaign.
’48 Years Old. Grandmother. Has Had Cosmetic Surgery,’ read the ad which featured a daring photo of the her reclining in the nude.
BACK then the company was called Transform Medical (Ireland) Ltd but would later change its name to the present logo. Now writing her memoirs, Halina told a Yorkshire newspaper this summer that her company had a turnover of E18.6m and employed 200 staff.
But the latest available company accounts – filed in July 2006 seem to show that the firm was largely reliant on creditors. While a profit of E200,000 was posted in 2005, the company owed creditors E2.4m at the end of the year.
Accounts have not yet been filed for 2006, since ACS has applied for permission to change its annual return date. It is likely though that SSIA spending last year has benefited the enterprise greatly.
Ms Ashdown-Shiels is also listed as a director of British company AHB Laboratories Ltd, a firm which only avoided insolvency in 2003 by entering into a special agreement with a rescue firm specialising in debt problems. In 2002, AHB Laboratories was the subject of a complaint which was upheld by the UK Advertising Standards Authority.
As the best-known face of the industry in Ireland, Mrs AshdownShiels has been seen to frequently call for better regulation of a business which is now worth in excess of E36m and is growing by 50pc annually.
‘One issue that we are particularly concerned about is in relation to lack of aftercare,’ she said recently.
ENDS
The story below was first published on 21/10/2007
WOMAN DIES IN COSMETIC OP CLINIC
Surgeon suspended, inquiry launched after patient’s death following high-risk’gastric banding’ procedure
By: MICHAEL O’FARRELL
Investigative Correspondent
A FEMALE patient died in Ireland’s best-known cosmetic surgery clinic earlier this year, the Irish Mail on Sunday can reveal.
The woman passed away in the Dublin headquarters of Advanced Cosmetic Surgery (ACS) hours after her surgeon had begun a gastric-banding procedure.
The controversial, high-risk operation involves fitting a band around an obese patient’s stomach to facilitate weight loss.
The keyhole operation was abandoned after the surgeon, Jerome Manuceau, spotted cancer-like cells – not picked up in pre-surgery tests – in the patient’s abdomen.
Dr Manuceau, a French gastric surgeon, is now the subject of a Medical Council inquiry and has been suspended from the medical register, because he was performing ‘high-risk’ procedures in a cosmetic clinic.
Run by prominent socialite Halina Ashdown-Shiels, ACS has an annual turnover in excess of E16m and claims to have carried out more than 20,000 cosmetic surgery procedures since 1993.
Confirmation of the death comes just a week after the MoS revealed that another ACS patient was rushed to St Vincent’s Hospital suffering from life-threatening internal bleeding as the result of a tummy-tuck procedure.
The MoS has also confirmed that numerous ACS patients have been admitted to hospitals throughout the country as a direct result of their cosmetic surgery.
Meanwhile, ACS and its surgeons are currently facing up to 30 medical-negligence High Court suits in Dublin and a further 27 cases in Belfast’s High Court. However, a spokeswoman for ACS said many patients had expressed satisfaction with ACS.
At least a dozen of the cases coming before the courts relate to the work of one former ACS surgeon – Samy Malhas.
A German citizen, Dr Malhas, who declined to comment this weekend, is understood to have had his insurance withdrawn by the Medical Defence Union and is thought to have returned to Germany with his Irish wife.
Speaking from Paris this weekend, Dr Manuceau said he believed his patient – a middle-aged woman from Dublin – simply died in her sleep.
‘She passed away in her sleep. The nurses went to give her some normal aftercare and they discovered she was dead,’ he said.
‘It was 12 to 15 hours after the operation. She died in the clinic in ACS. After the operation, she was perfect. She was awake. She was able to go to the toilet. She was normal. There was no problem. There was no reason for the death.’ Dr Manuceau said he stopped the surgery immediately when he saw cancer-like cells in the patient’s abdomen.
‘She only had the beginning of surgery, which was stopped immediately. The surgery was very short. There was no surgery at all really.
‘When I inserted into the abdomen, I saw she had cancer. I stopped the operation and took a biopsy. Results later proved the presence of digestive-system cancer.
Although an inquest is yet to take place, Dr Manuceau said an autopsy had found no obvious cause of death.
‘They found nothing so they concluded that she died in her sleep without any organic reason,’ he said.
An inquest into the patient’s death, which occurred on February 28 last, is scheduled before the Dublin Coroner’s Court early next year.
Dr Manuceau confirmed that he had ceased to work at ACS in August after the Medical Council suspended his registration pending the outcome of an inquiry.
‘During the inquiry, they asked me to stop. It was because they said I was doing high-risk operations in a cosmetic clinic,’ he said.
‘The Royal College of Surgeons in Ireland thinks gastric banding is too risky an operation and they don’t want it done in a cosmetic clinic.’ Dr Manuceau first registered with the Medical Council in June 2006, the month ACS began offering gastric banding for E10,000 per patient.
He says he completed more than 300 gastric banding procedures for ACS – a feat that would have netted the company in excess of E3m.
When Dr Manuceau was suspended in August, ACS hired a new gastric surgeon, Wojciech Jan Makarewicz, a Polish doctor with an address in Gdansk. Dr Makarewicz was entered on the medical register on August 30.
But Dr Manuceau said he now expected the Irish authorities to forbid all surgeons to carry out gastric banding in cosmetic clinics ‘He will have the same problem like me because the Irish surgeons do not want it happening in cosmetic surgeries,’ he said.
Dr Manuceau said he had sent only three ACS patients of more than 300, to hospital after surgery.
‘In France, 80pc of this surgery is performed in private clinics. Every time we have a problem we cannot solve in the clinic they go to the hospital.
‘In Ireland, it seems they do not like this. Three times I sent people to the hospital and they complained it was not normal. If I knew that, I would never have come to operate in Ireland.
‘But I loved Ireland. I would like to come to Ireland to discuss with the Irish surgeons and to train your surgeons for free. I don’t want any money. I would do it for free.’ In a letter to the MoS this weekend, Halina Ashdown-Shiels said she was always ‘disturbed if a patient has a problem in our clinic for whatever reason. It would be impossible to eliminate all risks and problems at any hospital.’ Miss Ashdown-Shiels said confidentiality prevented her from commenting on the death but she indicated that ACS was not at fault.
‘I can assure you that her death was not as a consequence of her being a patient of ours,’ she said.
‘We work very hard to satisfy all our clients and I believe I can say with some conviction that a patient at ACS is a safe patient.’ Miss Ashdown-Shiels complained that successive health ministers had not responded to calls for the industry to be regulated.
‘I first wrote to Micheál Martin, who categorically ruled out the introduction of regulations in our industry. Subsequent requests to Mary Harney have similarly been rejected.
‘We in ACS would welcome regulations as patients would then have a forum to approach. About 18 months ago, I wrote to all cosmetic surgery providers in Ireland to ask them to join in the creation of an association where we could initiate this issue. Apart from the Clane Hospital, there was no response.’ However, several consultant plastic surgeons have told the MoS that they are currently involved in treating patients who were allegedly disfigured by ACS operations.
Others said they were appalled at the fact that ACS was carrying out gastric banding in a setting that did not have all of the necessary backup should a problem occur.
‘This is a risky procedure and these are obese patients who are, by definition, susceptible to problems with anaesthesia,’ said one expert.
Last week, Seán Carroll, a prominent consultant plastic surgeon at St Vincent’s University Hospital, took the unprecedented step of publicly criticising ACS’s safety record.
Mr Carroll, who is involved in the care of several patients in need of corrective surgery after ACS procedures, said he was in no doubt some of the clinic’s patients were lucky to be alive.
This week, Mr Carroll said he was shocked to hear of the death.
‘I’m saddened but it was, perhaps, inevitable given the lack of postoperative expertise in many of these private, commercially-run, cosmetic institutions,’ he said.
Although just 10pc of all cosmetic operations carried out in Ireland are done by registered plastic surgeons, the Government has yet to take any action to regulate the industry.
A spokeswoman for Health Minister Mary Harney said that it was the job of the Medical Council to ‘protect the public through implementing appropriate standards and controls on the medical profession’.
The Medical Council did not respond to questions from the MoS on on whether there were any moves afoot to regulate the cosmetic surgery industry.
ENDS
The below story was first published on 28/10/2007
The cosmetic surgeon who is so risky, insurers can’t even cover him
SPECIAL INVESTIGATION: Medic behind plastic surgery clinics faces raft of complaints
By: MICHAEL O’FARRELL
Investigative Correspondent
A GERMAN surgeon who worked for Ireland’s best-known cosmetic surgery clinic is facing several complaints to the Medical Council from women who have been left disfigured by failed operations.
Samy Malhas worked with Advanced Cosmetic Surgery (ACS) for several years before helping to set up a new clinic in Wicklow last year.
However, the Medical Defence Union insurers took the rare step of suspending the 44-year-old doctor’s cover in August because of the number of negligence cases being taken against him.
Mr Malhas is currently the subject of at least a dozen medical negligence cases involving procedures he carried out at ACS.
Other cases have already been settled for undisclosed sums and several patients are preparing complaints to the Medical Council.
One prominent university hospital surgeon also sought to complain about Mr Malhas to the Medical Council in recent weeks.
However, since he was involved in assessing Mr Malhas’s work for ongoing High Court cases, he was advised by his lawyers not to do so.
The claims against ACS and Mr Malhas involve a number of procedures including tummy tucks, eye lifts, breast reductions and enlargements, facelifts and liposuction.
All of the patients concerned have either undergone, or are still undergoing, corrective surgery.
Mr Malhas, who holds a 1991 degree from the Westfälische Wilhelms-Universität in Münster, first registered with the Medical Council here in June 2002.
A year later, he upgraded his status to that of a general surgeon. However, he is not registered as a specialist plastic surgeon – and does not have to be since there is a complete lack of regulation of the area.
Mr Malhas declined to respond to questions from the MoS this week. His Irish wife and business partner, Elaine Galvin, also refused to comment. A lawyer representing ACS said the company could not comment on Mr Malhas, ‘as he is no longer employed by us and we cannot speak for him professionally or clinically’.
The pair have not been seen at their Dublin address in recent months and it is believed that Mr Malhas has returned to work in Germany.
Together with his wife and two other partners, Mr Malhas was a founding director of the Wicklowbased clinic, Cosmedico, in May 2006. He ceased working there in August when the Medical Defence Union withdrew his insurance.
Last night, a spokesman for Cosmedico said Mr Malhas and his wife no longer had any involvement with the company.
‘Dr Samy Malhas has no stake in Cosmedico Cosmetic Surgery Clinic nor will he at any stage in the future. He is no longer clinical director of Cosmedico Cosmetic Surgery Clinic.
‘He has never performed any procedures nor, indeed, reviewed or assessed any patients without full medical insurance.’ News of fresh complaints against an ACS surgeon comes just a week after the MoS revealed that another ACS surgeon had been suspended by the Medical Council.
French-based gastric-banding expert Dr Jerome Manuceau was suspended in August after Royal College of Surgeons President Pro fessor Gerald O’Sullivan complained that Dr Manuceau was carrying out ‘high risk’ procedures in the ACS clinic.
The complaint against the French surgeon is understood to have centred on cases in which Irish surgeons found themselves dealing with complications in public hospitals and were unable to contact Dr Manuceau.
An autopsy into the cause of the death of an ACS patient at its clinic in February was inconclusive and the matter is now the subject of an inquest scheduled for February.
Speaking to the MoS from Paris this weekend, Dr Manuceau denied gastric banding was a risky procedure and said his suspension was by no means connected to the ACS death.
‘All international specialists agree that gastric banding, performed by an experienced surgeon through keyhole surgery, is a very low-risk procedure,’ he said.
Dr Manuceau also denied assertions by Irish surgeons that the deceased ACS patient would have survived in a hospital setting.
‘I saw several similar deaths in the best French hospitals,’ he said. Dr Manuceau will now face a full Medical Council fitness-to-practise hearing – a process that typically takes several years.
Last year, ACS surgeon Hassan Sulaiman was the subject of a successful High Court negligence claim.
In February, the same surgeon settled another High Court negligence claim involving scarred eyelids for E38,000.
In total, ACS, which is run by prominent socialite Halina Ashdown-Shiels, is facing up to 60 negligence cases in Dublin and Belfast.
But Miss Ashdown-Shiels has this week repeatedly moved to reassure patients that ACS is a safe clinic.
‘I believe I can say with some conviction that a patient at ACS is a safe patient,’ she said adding that the clinic had been to the forefront of calls for industry regulation.
Reacting to MoS revelations in recent weeks, Health Minister Mary Harney this week warned patients to be wary of private cosmetic surgery clinics.
However, despite renewed calls for urgent regulation of the sector, the Government does not appear to have any intention of hastening the introduction of regulation.
‘The minister has asked the Commission on Patient Safety and Quality Assurance to develop proposals for a statutory system of licensing. It is expected the commission will report by mid-2008,’ a spokesman said.
But there already exist at least two templates for the regulation of the cosmetic-surgery sector. The Association of Irish Plastic Surgeons, which has been campaigning for regulation for years, has already sent its recommendations to Miss Harney.
Moreover, the British Association of Cosmetic Doctors recently appointed Dr Patrick Treacy, director of Dublin’s Ailesbury Clinic, as its Irish regulator.
Dr Treacy has just drawn up a list of recommendations that will shortly be forwarded to Miss Harney. Chief among the proposals is the creation of a new regulatory body that would have the ‘power to regulate and inspect all establishments in Ireland that carry out invasive and non-invasive cosmetic surgery’.
The body would also have the power to enforce standards and revoke licences to operate.
Other aspects of the plan include a demand that all cosmetic surgeons be registered on the Medical Council’s specialist register and have formal, specialist training.
‘Irish patients should be confident their treatment will be safe, that the practitioners who treat them are qualified and competent, and they have the information needed to make decisions,’ said Dr Treacy.
? Have you had problems at the hands of a plastic surgeon? Do you have a story to tell? If so, please ring Michael O’Farrell on (01) 637 5826.
My breast reduction has left me horribly scarred SINCE the MoS began investigating the cosmetic surgery industry in Ireland, more than 30 men and women have come forward to say they have been permanently disfigured in private clinics.
For legal reasons, we cannot, for the moment, identify the clinics or name the patients or doctors.
But many have ended up in A&E wards countrywide. More still have spent lengthy periods in hospital undergoing corrective surgery.
‘I’ve been left horribly scarred for life. The specialist told me it was beyond repair. I wasn’t even able to breast feed,’ said one woman whose breast reduction was botched.
Another, whose breast augmentation went drastically wrong, said: ‘I never got any aftercare. I tried ringing to ask could I come up but there was no answer. There was green stuff coming out of the stitches.
‘I had a tummy tuck six weeks ago and ended up in A&E with septic shock. It’s all been botched and I don’t know what to do now,’ said a tummy tuck patient who was hospitalised for nine days.
‘I went to A&E and was taken in straight away. They took scans and said they didn’t know how I was still alive,’ said another tummy tuck patient who is still undergoing treatment.
ENDS
The story below was first published on 04/11/2007
A timebomb in the tummy
With two doctors suspended, the cosmetic surgery now facing 30 High Court negligence cases has left vulnerable gastric-band patients in limbo and facing…
By: MICHAEL O’FARRELL
HUNDREDS of patients of Ireland’s best-known cosmetic surgery group are facing a gastric band timebomb after their surgeon was suspended by the Medical Council.
French surgeon Dr Jerome Manuceau carried out more than 300 gastric-banding procedures at Advanced Cosmetic Surgery (ACS) prior to being relieved of his duties in August.
The suspension followed a strongly worded complaint from the Royal College of Surgeons of Ireland (RCSI) which was concerned that Dr Manuceau was carrying out ‘high risk’ operations in a private clinic without the backup of emergency hospital facilities.
However, the suspension has left Dr Manuceau unable to supervise the care of his patients, who each paid E10,000 for their ACS operation on the understanding that a year’s aftercare would be available with their surgeon.
On his own website, Dr Manuceau highlights in bold type that ‘two or three years of medical and surgical surveillance are essential for your safety and weight loss’.
Routine aftercare following gastric banding includes intermittent tightening of the band around a patient’s stomach as they lose weight – a procedure which should ideally be supervised by the original surgeon.
The tightening of the band is achieved by injecting a solution into it through a receptor underneath a patient’s skin.
However, emergency complications, anticipated in up to 2pc of cases, can see the band slip, making it impossible for a patient to eat or drink. In such cases, emergency surgery must be carried out to rectify or remove the band to prevent a patient from dying.
Dr Manuceau claimed last night his suspension did not leave patients better off.
‘It is a serious problem. I am very very sad for this situation. I am very sad we cannot find agreement for the benefit of the patients. I don’t know what to do. I am completely lost.
‘The only thing I can say is that they can come to Paris. Or if the band has slipped they need to go to hospital to exclude the emergency. Then they can come to Paris and I can re-operate.’ Dr Manuceau said he was concerned that since his departure the aftercare of his patients was being carried out by an ACS nurse and a replacement Polish surgeon with an address in Gdansk.
The Polish surgeon – Dr Wojciech Jan Makarewicz – was registered with the Medical Council just eight days after the suspension of his predecessor.
He did not apply to the Medical Council’s specialist register as a plastic or gastric surgeon, although since specialist registration is voluntary, he is not obliged to do so.
‘It’s not me. It’s not my band. He has other methods. It’s not at all the same thing. I don’t think Irish patients are better off now than they were before,’ said Dr Manuceau.
‘When they have a band slip, he may not able to put a band back. I don’t know what he is able to do. He does not use the same method or the same band. But if they go to hospital they will have problems as well because they will take off the band and they will be worse than before they began.’ Dr Manuceau feels so strongly about the situation that he has written an open letter (see panel) to his 300 patients in an attempt to explain why they have been left with uncertain aftercare arrangements.
His letter offers to treat them for free in the future.
‘I would like my patients to understand I was obliged to leave Ireland.
‘The Royal College of Surgeons is only seeing the complications. It’s astonishing they didn’t try to see what was positive.
‘I can’t understand their [the Medical Council’s] behaviour.
‘They didn’t discuss this with me. They just went to the High Court to take away my registration. I told them about the aftercare problem but they just said this is a problem for ACS.’ Dr Manuceau said it was not acceptable for a nurse to adjust bands that had been fitted by him without his supervision.
‘There is a nurse in ACS who I trained myself. But it’s not enough. They have to be adjusted by me.
‘When I was there, she did it because I had too many people. But she only did the easy cases. I allowed the nurse to do that because I was there and I could be responsible for what she was doing. I accepted it only if it was very easy and the patient was happy. But now I am not there, it is not the same.’ Until the Irish Mail on Sunday first revealed Dr Manuceau’s suspension two weeks ago, his patients had been unaware their doctor had been ordered to cease working in Ireland pending a Medical Council inquiry.
They were also unaware that an ACS gastric-banding patient died in the clinic in February. An inquest into the death is scheduled for next February.
Speaking to the MoS this week, some gastric-banding patents said they were uncertain about their aftercare arrangements in the event of an emergency.
‘We’re not sure what’s happening. The other surgeon did my fill this week but he did not seem happy to do it. I expected my surgeon to be available when I signed up,’ said one patient.
A spokesman for the RCSI said ACS were responsible under contract to provide ‘routine follow-up’ but added that there were competent Irish surgeons capable of dealing with gastric-banding aftercare.
‘There are reputable consultant surgeons in this country well versed in the aftercare of this type of surgery.
‘As regards the delivery of care to those patients who develop complications in an emergency setting or otherwise, this will be available through any A&E department,’ the spokesman said.
The Medical Council said it could not comment on individual cases but advised concerned patients to contact their GP.
‘If any patient has concerns about continuity of care following any surgical procedure, the council would advise them to contact their local registered GP for advice,’ a spokesman said.
Meanwhile, an ACS tummy-tuck patient who was rushed to St Vincent’s Hospital with life threatening bleeding was released on Thursday after more than three weeks of treatment.
The case was first revealed by the MoS just three days after the incident as the patient was recovering in hospital.
In correspondence with this newspaper, lawyers acting for ACS at first denied that any patient had been rushed to hospital.
The company acknowledged the incident for the first time in a statement to a national radio station only a day after publication.
The patient, a mother of three, had to undergo an emergency operation to save her life during which she received a transfusion of four pints of blood.
Now having contracted an infection, she still has a gaping wound across her stomach which will require further medical treatment in the coming months.
Seán Carroll, a senior consultant at St Vincent’s, has already taken the unprecedented step of publicly criticising ACS for what he believes is an unacceptable level of basic complications. Mr Carroll is personally involved in the care of seven former ACS patients who need corrective surgery.
Now former ACS employees themselves have begun to come forward to express concern at conditions inside the company’s main Dublin clinic.
Two medical employees claim they have witnessed postoperative infections while working at ACS.
Women who claim to have suffered infections and other serious complications at ACS have also come forward to speak of their experiences. Their testimonies cannot be published for the moment for legal reasons.
In 2004, a Medical Council fitnessto-practice inquiry into the surgeon who carried out an operation in which one woman claimed to have suffered an infection folowing an ACS tummy tuck, cleared the doctor involved of any wrongdoing.
However, the hearing did not consider the role of ACS in the patient’s care as the Medical Council has no jurisdiction over private clinics.
Another woman spoke on condition of anonymity about her experience with Samy Malhas, a former ACS surgeon who accounts for a dozen of 30 current High Court medical negligence cases against the company.
Mr Malhas has not worked in Ireland since August when the Medical Defence Union withdrew his insurance.
In a letter to the MoS last week Dr Malhas said he could not comment on specific cases in ACS.
‘I cannot make a statement about my former time there. I have been advised by my insurers to make no comment regarding your enquiries.’
Dr Malhas said it was unfair to single him out for criticism saying he had performed corrective surgery at ACS to remedy the work of other surgeons who had gone on to work in other clinics and hospitals.
‘In my time in Ireland I have operated on more than 2,000 patients, many of whom say my surgery has been a positively life-changing experience for them. The cases you speak of would represent 0.5pc of my entire work.
‘I am an honest surgeon and have always had the very best interests of my patients at heart,’ he added.
Dr Malhas also said that unrealistic expectations often led to disappointment.
‘The end result of surgery is entirely subjective.
‘For example, I could consider the finished result as excellent work, from my point of view, yet a patient may just not like what they see.’ ? Have you had problems at the hands of a plastic surgeon? Do you have a story to tell? If so, please ring Michael O’Farrell on (01) 637 5826.
French doctor tells patients: I’m very sad I was forced to abandon all of you
Open letter to my patients from Professor Jerome Manuceau
FROM August 22, you did not see me in Ireland, and did not know what happened until two weeks ago.
The President of the Royal College of Surgeons of Ireland complained against me to the Irish Medical Council, saying I was doing high-risk operations in a cosmetic clinic.
The Medical Council asked the High Court to suspend my registration.
You already know that gastric banding, performed through keyhole surgery, by an experienced surgeon, is a very low-risk surgery with very rare complications. The only problem is that, it is really efficient only if the patient is very motivated.
Compared to banding, gastric bypass procedures are very invasive, are irreversible and have a lot of complications including death. This is not only an opinion, but an established scientific fact.
Now 20pc of Irish people are obese. Obesity is a very bad illness which kills three times more than smoking. Obese people are dramatically isolated in society, their life is a tragedy.
During one year, I operated on 300 patients. All have not succeeded, but 85pc of you have lost more than half of their excess weight and 30pc are not obese any more.
This is a very good result, much better than what I have in Paris.
But everyone knows that the band is not sufficient for losing weight.
The aftercare is essential and the relationship between the patient and his surgeon is momentous.
When the only serious complication occurs – a band slips in 1pc or 2pc of cases – it is simple for me to put it back at the right place .
But if I can’t do it myself, these patients will have to go to hospital, they will have the band removed, and one year later they will be heavier than before the first operation.
I am very sad I was forced to abandon all of you. But be sure that as soon as this situation will change, I will come back immediately, in any place in Ireland, to continue your aftercare for free.
During this year that I have been with you, I loved Ireland and I loved Irish people.
Thank you very much for your kindness and your trust in me.
ENDS
The story below was first published on 09/12/2007.
The Paris connection
Cosmetic clinic ducks a ban on surgeon by flying patients out to him in France
By: MICHAEL O’FARRELL
Investigative Correspondent
IRELAND’S best-known cosmetic surgery group is circumventing a Medical Council ban on one of its surgeons by sending patients directly to him in Paris, the Mail on Sunday can reveal.
Dr Jerome Manuceau – a prominent French gastric surgeon – has been suspended from the Medical Council register here pending an inquiry into the death of one of his patients at Advanced Cosmetic Surgery (ACS) in February.
However, he is now receiving ACS patients in Paris, where he continues to carry out gastric banding procedures despite his Irish suspension.
A controversial procedure, gastric banding involves the insertion of an internal rubber band around an obese patient’s stomach.
Two months ago, an extensive MoS investigation revealed that a female patient died in the Stillorgan headquarters of ACS after Dr Manuceau had begun a keyhole gastric banding procedure. Dr Manuceau called off the surgery when he saw a cancerous growth in the patient’s abdomen, but she died in her sleep that evening.
A fellow patient who witnessed the death told the MoS that desperate doctors and paramedics tried in vain to resuscitate the patient for at least half an hour in full view of five other patients. ACS later offered to pay for counselling for those present.
An inquest into the death is scheduled for February next year in the Dublin County Coroner’s Court.
In August, the Medical Council applied to the High Court to suspend Dr Manuceau after the Royal College of Surgeons of Ireland complained that high-risk procedures were being carried out in a private clinic.
Separately, the MoS revealed that another ACS patient had been rushed to St Vincent’s Hospital in September suffering from life-threatening internal bleeding as a result of a botched tummy-tuck procedure.
The MoS also revealed that a number of ACS patients have been admitted to hospitals throughout the country following surgery.
The company and its surgeons are currently facing up to 30 medical negligence suits in the High Court in Dublin and a further 27 cases in Belfast’s High Court.
Dr Manuceau’s fitness-to-practise hearing will not be held for at least two years, during which time he is forbidden from practising in Ireland.
ACS, fronted by prominent socialite Halina Ashdown-Sheils, initially sought the use of alternative hospital facilities in order to continue carrying out gastric banding procedures.
With Dublin operations suspended – and a price tag of e10,000 per patient – the procedures are crucial to ACS’s financial wellbeing.
But the MoS understands that approaches to private hospitals – including Mount Carmel Hospital in Churchtown – were not successful.
Instead, ACS has begun sending patients to Dr Manuceau in Paris despite the fact that medical authorities here have suspended his licence.
The necessary aftercare, which involves frequent adjustments and monitoring, is being carried out by a Polish surgeon in Dublin.
Some have begun to worry for the future of the company. Through its new solicitor, ACS said there was no question of ‘the business being in financial difficulty or of it closing’.
ACS did not comment on the fact that 14 staff have departed in recent weeks, while the firm’s financial controller has resigned.
ENDS
The story below was first published on 09/03/2008
Suspended plastic surgeon treats Irish patients in Belfast Display: Unformatted Line wrapped
By: Michael O’ Farrell
CLIENTS of Ireland’s best-known cosmetic surgery group are being treated in the North by a doctor who has been banned from treating them in the Republic.
Dr Jerome Manuceau, a prominent French gastric surgeon, was suspended by the Irish Medical Council pending a fitness-to-practise inquiry into the death of one of his patients at Advanced Cosmetic Surgery (ACS) in February 2007.
In 2006, he also received a year-long ban from French medical authorities forbidding him from treating any public patients.
But the Irish Mail on Sunday can reveal that, last Friday, he attended an ACS clinic in Belfast and treated patients sent to him by the firm’s Dublin office.
All of the patients in question have undergone gastric band operations – which cost E10,000 – through ACS in the past two years.
Gastric banding is a type of weight-loss surgery which reduces the size of the stomach so that only small meals can be eaten. Once inserted, the band requires supervision and regular adjustments, something ACS is contractually obliged to provide for a period of two years.
In a small number of cases, the band can result in a serious medical emergency if it slips out of place.
In the absence of Dr Manuceau, a Polish surgeon had been overseeing adjustments in Dublin in recent months. But he is understood to have left the company last month.
Many of the aftercare bookings to see Dr Manuceau in Belfast this week were made through the Dublin headquarters of ACS – a firm owned by prominent socialite Halina Ashdown-Shiels.
Patients from Dublin were given a reference number to obtain paid-for tickets for trains to Belfast, while others were flown from Cork at the expense of ACS.
Dr Manuceau’s suspension followed the death of Bernadette Kavenagh-Reid, who died in the ACS Mount Merrion clinic on February 5 last year.
An inquest into her death, initially scheduled for last month, is expected to take place during the summer. But on foot of an official complaint about aftercare standards from the Royal College of Surgeons, the Medical Council went to the High Court to suspend Dr Manuceau. A date for his fitness-to-practise hearing has not been set yet.
Approached by the MoS in Belfast on Friday, Dr Manuceau did not deny he had been treating ACS patients in the North.
When repeatedly asked why he was flouting the Irish authorities by seeing patients from the South, he refused to comment.
However, he then launched a scathing attack on this paper, blaming it for his Irish ban.
He shouted: ‘Michael O’Farrell, he tried to kill ACS, and he has killed a lot of patients who could not be operated on because of his articles.
‘Because of what he wrote, I am not allowed to operate in Ireland.’
The standard of aftercare provided by ACS is increasingly becoming a concern among banding patients, who communicate daily on a web forum.
Many patients are concerned that they have been left with uncertain aftercare arrangements despite having already paid E10,000 each for a package which includes up to two years of post-op care. Several have posted negative experiences and complaints about the care they are receiving.
‘This is a nightmare. We have a contract with them so they have to stand by it. I’m boiling mad,’ said one patient.
‘We’re just being fobbed off by ACS… I dread to think if any of us had an emergency what would happen. A&E don’t want to know. I’ve been really worried about the aftercare for months but I can’t believe it’s come to this,’ said another.
Others posting on the forum – but too embarrassed to go public – include an ACS patient who was admitted to hospital with kidney failure last October due to severe dehydration. Because her band had slipped, she ultimately had to undergo corrective surgery to allow her to eat and drink.
But the incident is not the first time an ACS patient has ended up in hospital as a result of a cosmetic procedure.
The MoS has revealed on several occasions that, in fact, numerous ACS patients have been admitted to hospitals throughout the country as a direct result of their cosmetic surgeries.
The company and its surgeons are currently facing up to 30 medical-negligence suits in the High Court in Dublin and a further 27 cases in Belfast’s High Court.
ENDS
The story below was first published on 16/03/2008
Collapse of ACS leaves clients in limbo… and owners silent
By: Michael O’Farrell
Investigative Correspondent
HUNDREDS of patients of Ireland’s largest cosmetic surgery group have been left in doubt over who will treat them after the company was sold this week.
After months of controversy and allegations of sub-standard care, Advanced Cosmetic Surgery (ACS) told patients in a letter on Thursday that the firm was to fold.
‘I just received the news this morning,’ one patient requiring after-care said. ‘I am still in shock. I don’t know what is going to happen now – they promised they would look after me.’
Former owner Halina Ashdown-Shiels wrote that the company had encountered significant financial difficulties in recent months and had no choice but to wind up.
The letter promised that all aftercare would be ‘taken over by the purchaser’.
But the new owners – Manchester property tycoon Carol Ainscow and Helen Roocroft – have yet to issue any guarantee.
However, the pair own the highly respected Artisan Construction Group. A just-established British company, Advanced Cosmetic Surgery (Europe) Ltd, will be responsible for running ACS.
But last night, worried gastric-banding patients continued to contact the MoS to tell of their uncertainty. ACS fitted more than 300 of the bands – a rubber device that restricts the stomach – and promised three years of aftercare.
‘For a whole week now, I’m ringing ACS but I’m just getting the run-around,’ said one patient.
Merseyside-based Howard Lipsey, a director of ACS (Europe), said: ‘I am not allowed to make any comment.’
It is understood that the new owners have been surprised at the level of controversy surrounding ACS. The firm is facing up to 50 personal injury cases in Dublin and Belfast.
Solicitors acting for the old ACS and Miss Ashdown-Shiels declined to answer questions last night.
Despite the expected liquidation, no notice has been received in the Company Registrations Office and notice of a meeting of creditors – some of whom are owed six-figure sums – has not yet been posted.
ENDS
The story below was first published on 30/03/2008
The internal ACS report which sets out a horror catalogue of health risks for their patients
Michael O’Farrell
Investigative Correspondent
AN INTERNAL report into Advanced Cosmetic Surgery (ACS), which was sold to a British businesswoman this month, has revealed a catalogue of faults and safety problems at the company.
The report was commissioned by Halina Ashdown-Shiels, the millionaire owner and face of the firm, following an exposé by this newspaper about its procedures.
However, the first draft of the study – by expert consultants Coyle Hamilton Willis – was an indictment of systems at ACS.
From the first sentence of its conclusions, the report – published in detail for the first time here – pulls no punches.
‘The existing standards and procedures in place are totally inadequate and are in need of urgent review and update,’ it says. ‘The clinic is not suitable for present use and is in need of total refurbishment.’ The surgical theatre, where most of the clinic’s operations were carried out, was particularly singled out for criticism.
Lapses include the fact that the building’s one fire escape can be accessed only through the theatre, windows are broken, isolation switches are inaccessible and an airconditioning system is described as ‘most unsuitable and inadequate’.
The document warns that there was ‘no informal or formal plan in place for the continuation of services in the event of an emergency or a loss of power supply’ – suggesting that had there been a power cut, a patient could have been left in the dark on the operating table.
Theatre hygiene and infection controls were also criticised. ‘Staff have not received education and training in the prevention and control of infection or in decontami-nation of surgical instruments,’ the review found.
The area for sterile equipment used in surgery was found to be too close to the storage of contaminated materials, and there were ‘no procedures for cleaning the operating theatre’.
Given such conditions, the chances of infection were high. But the company had not implemented any infection-control policies even after two reported cases of e-coli in the same week.
Medical records were found to be kept in a publicly accessible, unlocked filing cabinet. And a review of 20 random patient files found all were either badly filled out, had incomplete medical histories, were not signed by surgeons and nurses, had been altered, or did not contain the proper documentation and consents.
The report found that individual procedure sheets outlining details of the patient examination and risks discussed did not allow for the patient’s medical record number (MRN) to be documented, the date, time, sex of the patient and space for next of kin details.
It also noted that there was very limited space on the sheet for the surgeon to record additional details.
All of the charts reviewed contained surgical consent forms which were incomplete, for example no patient details, location of surgery or dates.
One of the 20 charts reviewed contained a consent form for one procedure but the patient appeared to have had additional surgery on another body part and no consent form was found within the chart.
Furthermore, the report concluded there were no arrangements in place with an acute hospital in the event of an unforeseen patient emergency and, when such emergencies occurred, the clinic had neglected to investigate or try to establish the root cause.
The report also found that: ● The person on duty at night had not undergone any form of training including CPR, manual handling and fire safety.
● There was no evidence found to suggest that patients underwent any counselling or psychological assessment prior to surgical procedures.
● There was no corporate or clinical governance structure for the organ-isation or clinic as a whole.
● Unregulated and inferior medical equipment and materials were being sourced from abroad.
● There was no evidence that any patients had undergone routine investigations prior to surgery; for example, an ECG and chest x-ray.
● None of the staff interviewed had received training in manual handling, CPR, infection control, incident reporting, health and safety issues and risk assessments Other concerns raised dealt with deficiencies in the provision of services to more than 300 gastric banding patients who paid E10,000 each for the weight-loss procedure.
Advanced Cosmetic Surgery The first signs of something amiss at ACS came last October when an extensive Irish Mail on Sunday investigation exposed serious concerns about the manner in which the clinic was being run.
Shocking cases, first revealed by this newspaper, included the case of a mother of three who almost died last October after a botched tummy-tuck operation. The patient’s life was saved only after surgeons in St Vincent’s University Hospital carried out emergency surgery.
At first ACS, through its solicitors, denied the near-miss incident had ever occurred. But there were more claims of injuries suffered by ACS patients , and plastic surgeons all over the country are treating former ACS patients.
One surgeon – St Vincent’s consultant Seán Carroll – was so concerned he took the unprecedented step of‘Other commercial institutions are suffering from the same problems but I have had far less complications and dealings with other institutions than I have with ACS,’ he said.
‘The things that I see from Advanced are complications that shouldn’t occur. They are at the extreme end of complications.’
Photos of unfortunate women undergoing reconstructive work to fix poor ACS surgery show horrific scars left as nipples were placed incorrectly and tummy tucks burst open from infection.
In a letter to the MoS last October, Miss Ashdown-Shiels insisted her clinic was safe. ‘I would ask you to appreciate that I am always disturbed if a patient has a problem in our clinic for whatever reason. It would be impossible to eliminate all risks and problems at any hospital.
‘We are very proud of our safety record. The claims made against us are in no way an indication of unsafe care. We work very hard to satisfy all our clients and I can say with conviction that a patient at ACS is a safe patient,’ the letter reads.
Miss Ashdown-Shiels did not respond to a request made through her solicitor last night for comment on the risk report.
On the face of it, business at ACS is continuing as usual. The company’s website is the same as it ever was. The same phone numbers are still answered by the same friendly staff and patients still call looking for appointments.
But behind the scenes, changes are happening as the original Irish company files for liquidation.
In its place, a new British-regis-tered company – Advanced Cosmetic Surgery (Europe) Ltd – has arisen, having bought the business and assets.
As a result, Miss Ashdown-Shiels seems set to wash her hands completely of the business.
She has already sold her business as a going concern to a British-based entrepreneur – multimillionaire property developer Carol Ainscow – for a sum understood to be in the order of E130,000.
Miss Ainscow established ACS Europe as a vehicle to run the firm. The new ACS owner has pledged to completely revamp the firm and its practices and use the name as a brand to build a new cosmetic surgery business in a purpose-built private hospital facility.
The care of existing patients who require aftercare has also been guaranteed by the new owners.
Meanwhile, the winding down of ACS Ireland will enter its final phase when a liquidator is appointed at a creditors meeting in Dublin on Thursday.
But as she walks away into the sunset, Miss Ashdown-Shiels’s company is leaving behind a stack of creditors and a growing list of patients who claim to have suffered horrifying wounds and injuries at her clinic.
And it is by no means clear whether those debts will be paid. In yet another twist to the saga, Jeffrey Burton – a former partner of Miss Ash-down-Shiels – has claimed that he offered to buy the company in January, debts and legal claims included.
Had the offer been accepted, it would have avoided the need for liquidation and all creditors would have been repaid.
Mr Burton, who was forced to step down as a director of ACS after being prosecuted by the director of corporate enforcement five years ago, told the MoS he was prepared to put enough money into ACS to keep it afloat and clear all debts.
The MoS has seen documentary proof of the purchase offer, dated January 22 this year.
This raises the question as to why Miss Ashdown-Shiels chose to liquidate her company.
Mr Burton’s offer may now have to be considered by the company’s liquidator. A third offer – from a British-based health firm – is also understood to have been rejected by Miss Ashdown-Shiels.
There is also considerable legal doubt as to whether all of the 50-plus personal injury cases against ACS will be settled in full, particularly since the company operated without insurance for many years.
Mr Burton said that the company had operated with no insurance from 2002 at least until he sold his 30pc stake in the firm back to Miss Ash-down-Shiels in 2006. During that period, ACS met the cost of legal claims from its own pocket although individual surgeons were insured by the Medical Defence Union (MDU).
Mr Burton said that from 2002 to 2006 the company had met every claim against it. ‘It was normal that a claim would be split between us and the MDU,’ he said. ‘The average split was 2 0 / 8 0 [ACS/MDU]. So, when a claim was settled for, say, E60,000 plus legal costs of around E20,000, it would cost us E16,000, less than the excess under the old policy.’
The fact that ACS appear to have had no insurance means that at least 50 patients with cases against ACS may lose out. Even in the event of a court ruling, there could be a shortfall.
Another unresolved matter – and one of the most serious legal cases against ACS – is the tragic case of Bernadette Kavanagh Reid.
Mrs Kavanagh Reid was an ACS gastric-banding patient who died in the clinic’s main theatre in Owenstown House in Mount Merrion last February after surgery had been initiated.
An inquest into the death has been postponed until this summer and the surgeon involved – Dr Jerome Manuceau – has been suspended pending a Medical Council fitnessto-practice hearing.
Aside from former patients, creditors are understood to include Dublin firm Teknosurgical, Premier Recruitment, Johnson and Johnson and other medical suppliers.
With some suppliers owed hundreds of thousands, each party to the liquidation will be keen to learn how the company was being run in recent times and whether it traded reck-lessly. They will also insist on a full financial trawl to establish just how much profit Miss Ashdown-Shiels withdrew from ACS.
The existing standards and procedures in place are totally inadequate and are in need of urgent review and update. The Owenstown House is not suitable for present use and is in need of total refurbishment. Given that the building is a listed structure this limits the scope for improvement or change and the only option therefore, in the short term, is to lease theatre space from another hospital.
Discussions with managers and staff would suggest that there is no awareness of health and safety within the organisation from a management or operational staff perspective. There is no corporate or clinical governance structure for the organisation or Clinic as a whole. There is no strategic plan for the organisation. There are no management team committees to over-see such activities as health and safety, risk management, infection control but to name a few.
There was no informal or formal plan in place for the continuation of services in the event of an emergency or a loss of power supply. It appears that there is no emergency standby power supply available. An uninterruptible power supply is provided for the anaesthetist equipment. In the event of a power failure during a surgical procedure the emergency lighting would not provide the level of lighting required for a surgeon to safely continue and complete a surgical procedure.
It appeared that no formal or informal arrangements were in place for a preferred 24 hour acute hospital in the event of an unforeseen patient emergency. It was reported that a number of serious patient adverse events had occurred in the Clinic but no investigation or Root Cause Analysis (RCA) had been undertaken.
There are no infection control policies, procedures or guidelines for the operating theatre or the remaining clinical and non clinical areas within the Clinic There is no senior member of staff responsible for the monitoring of infection control and preventative measures within the Clinic No consultation is sought from an infection control nurse/specialist or a microbiolo-gist& Infection rates, trends and surveillance are not recorded and no information is available on the seemingly high number of post operative infections. It was reported during the staff interviews that two patients had contracted E Coli within the same week .Staff and in particular operating theatre staff have not received education and training in the prevention and control of infection or in decontamination of surgical instruments.
It was noted during the site visits that potentially contaminated cleaning materials (mops and brushes) were stored in the linen room and placed beside the theatre uniforms and also ward linen& There was no evidence of an operating theatre cleaning policy and procedure.
There was no evidence found to suggest that patients underwent any counselling or psychological assessment prior to surgical procedures. It was also reported that no Dietician was affiliated with the Clinic especially for patients undergoing gastric banding or other abdominal weight loss surgery.
There was no evidence that any patients had undergone routine investigations prior to surgery for example and ECG and chest x-ray. There is no dedicated member of staff responsible for the treatment and care of post operative patients.
It was reported during the course of the interview process that none of the staff interviewed had received training in manual handling, CPR, infection control, incident reporting, health and safety issues and risk assessments.
ENDS
The story below was first published on 06/04/2008
ACS owner paid herself ?850k as debts mounted at cosmetic clinic
By: MICHAEL O’FARRELL
Investigative Correspondent
THE owner of Ireland’s best-known cosmetic surgery clinic paid herself E850,000 last year – while debts mounted at the controversial clinic.
Halina Ashdown-Shiels confirmed her massive salary this week when her company, Advanced Cosmetic Surgery (ACS), was officially wound up, owing more than €1.5m in unpaid debts. It has assets of just €154,452 and almost 150 creditors have now been left with unpaid bills from ACS.
In addition, the status of at least 50 pending personal-injury cases against the company and its surgeons is uncertain since ACS had been operating without insurance.
At a creditors’ meeting in Dublin this week, liquidator Liam Dowdall of BDO Simpson Xavier set up a special five-member committee of inspection to probe the insurance issue. The committee will also consider the recent sale of ACS to a Manchester-based associate of Miss Ashdown-Shiels.
The sale, which took place just weeks before ACS folded, saw the new owners acquire the company as a going concern without taking responsibility for debts or pending legal cases.
The family of Bernadette Kavanagh-Reid – a gastric banding patient who died in the ACS clinic last year – were also represented at this week’s creditors’ meeting.
On behalf of the family, lawyers asked about the lack of insurance at the clinic and sought answers about safety conditions at ACS.
When approached by the Irish Mail on Sunday after the creditors’ meeting, Miss Ashdown-Shiels declined to comment or respond to questions about safety standards at her clinic.
The first signs of something amiss at ACS came last October when an extensive MoS investigation first exposed serious concerns. Shocking cases included a mother of three who almost died last October after a botched tummy tuck operation at ACS.
A catalogue of serious deficiencies in standards of care and safety at ACS was finally detailed in January in an audit of the company.
However, despite owner Miss Ashdown-Shiels’ enormous salary, the €16,000 bill for the report has never been paid. Others who are owed money include former ACS surgeons.
The largest creditor is the Revenue Commissioners – owed €489,000, more than three times the value of ACS’ current assets.
Miss Ashdown-Shiels also told the creditors’ meeting that her former partner, Jeffrey Burton, was being paid €6,000 a month by ACS throughout 2007. Five years ago, Mr Burton was forced to resign as a director of ACS when he was prosecuted for unlawfully acting as a company director while being an undischarged bankrupt in Britain.
Last week, Mr Burton told the MoS he was prepared to put enough money into ACS to keep it afloat and clear all debts. This purchase offer – and another one understood to have been received – will be scrutinised by the liquidator’s committee of inspection.
ENDS
The story below was first published in 08/02/2009
Halina and her banned surgeon back into facelifts
By: Michael O’Farrell
A PROMINENT socialite whose cosmetic surgery group folded with debts of more than E2m is fronting a new business – sending clients to a surgeon banned from practising after one of his Irish patients died.
Halina Ashdown-Shiels, the former owner of Advanced Cosmetic Surgery (ACS), liquidated her E10m-a-year company last March following a series of Irish Mail on Sunday exposés.
Our findings included the death of a female patient in the firm’s Stillorgan clinic, and a near-fatal incident in which A& E staff at St Vincent’s University Hospital battled to save another patient’s life.
Jerome Manuceau, the Francebased surgeon involved in the death of ACS patient Bernadette Reid, was struck off the medical register and banned from practising in Ireland by the Irish Medical Council.
An inquest into the death of Mrs Reid, who passed away after a gastric banding operation was aborted by Dr Manuceau, concluded that she died of natural causes.
But the medical council found Dr Manuceau guilty of professional misconduct last September.
Now Dr Manuceau and Miss Ashdown-Shiels are involved in Cosmetic Surgery Overseas Ltd, which is recruiting patients to send to France.
Aside from his Irish ban, Dr Manuceau was once sanctioned by the French medical authorities, but he is free to carry out surgery in France.
His services are advertised on w w w. c o s m e t i c – s u r g e r y – o v e r seas.
com, registered in the name of his son, Vincent Manuceau.
The site boasts that the new company has ‘over 25 years of cosmetic surgery experience, over 150,000 successful cosmetic surgery procedures and the most experienced, skilled and regulated European surgeons’.
The site also attempts to demonstrate the importance of due care in choosing cosmetic surgery providers, by featuring press clippings of articles detailing fatal cases in other clinics. When contacted on the site’s British number, Miss Ashdown-Shiels said: ‘I promise you, I haven’t got a company. I was asked to front it by somebody I know for years. It was a good idea to start with, but I’m not going to do it now.
‘That woman dying – that hit me badly. I still have the guilt from that. Even though she died of natural causes, it’s still a very hard thing to have to deal with.’ A company called Cosmetic Surgery Overseas Ltd was registered in Britain on January 21 this year, but has not yet posted details of its directors. Its address is that of an accountancy firm in Bury.
Miss Ashdown-Shiels refused to name the firm’s owner but confirmed she had intended to send patients to struck-off surgeon Jerome Manuceau.
‘I was going to use Jerome because I do believe he is a good surgeon,’ she said.
She called the MoS back later to say she had instructed that the new website be taken down.
She liquidated Advanced Cosmetic Surgery last March, leaving creditors with unpaid bills of E2m.
More than 50 patients are in the process of taking personal injury cases against ACS
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