Accidental Burn During Facial Feminization Surgery in San Francisco, December 2003

By Anonymous; edited by Anne A. Lawrence, M.D., Ph.D.

7/3/06

Dear Dr. Lawrence:

I am a 41-year-old male-to-female transsexual, fully transitioned for about two years. I'm writing to let you know about a very bad experience I had with Dr. Douglas Ousterhout, two-and-a-half years ago, during facial feminization surgery. I feel that other patients need to know about this, especially anyone contemplating going to him.

The reasons why I have waited to tell my story are very emotionally complex. Just as physical swelling takes a while to recede after surgery, so does emotional swelling.

To make a very long story short, my surgery was in December 2003. During the surgery, Dr. O laid his cautery instrument against my face and set it off, causing a deep third-degree burn, about 1 cm by 2 cm in size. The burn was located on my lower face, off to the side at the border of the chin and cheeks. Dr. O completed the rest of surgery satisfactorily.

He seemed to take as little responsibility for this incident. The morning after my surgery, his official pronouncement (with no apology) was "I don't know how this happened." He threatened me with needing a skin graft, but then said, "No, I don't think it will be necessary, let's let it heal and then we can deal with it."

I followed his advice, returned home, and did wound care. The burn did heal a few weeks later, but it left a raised, hypertrophic scar. Initially this did not bother me too much; his office kept telling me this would fade with time. The next few months were happy ones, as I proceeded with the rest of my transition, my job prospered, and I began my new life. There is no question that the feminizing results of the surgery helped in this process, even with the scar.

However, the scar contracted over time and started looking really ugly. I contacted Dr. O a few times, but eventually pursued care with local dermatologists. This has included chronic management and one local revision (excision) surgery. Now, two-and-a-half years later, the scar is somewhat smaller and the area is somewhat better, but it is still a cosmetic problem. I avoid standing under bright overhead lights because of the shadowing effect.

The thing I most want patients to know is not only that Dr. O is capable of this kind of injury, but that his attitude and his responses since then have been, in my opinion, deplorable, especially given the emotionally sensitive nature of the surgery. He has never apologized or offered any compensation, and he only called me once after my return home to check on my progress, despite the fact that he had caused a third-degree burn on my face.

In March 2005, fifteen months after the incident, I contacted him about it, and he made the comment that, "This happened in a very stupid way." I was angered by this comment, and I also noticed that he had never used language like this before. I suspected that the statute of limitations had expired and that was the reason for his choice of words. I called a lawyer on the West Coast, who confirmed my suspicions: The local statute of limitations for medical malpractice was only one year since discovery, and so had expired three months before.

One point in Dr. O's favor is that he has offered several times to address the problem if I go back to him in San Francisco. However, this effectively is useless to me, and I think he knows it. For one thing, the distance there from where I live, is considerable, and any travel would be at my own expense. Also, there is no "one-stop," quick fix here. If there were, my local dermatologist would have done it. In fact, I have been to her almost a dozen times for scar management. The issue of trust is another factor. Finally, Dr. O does not offer some things, such as laser, that are potential options for situations such as this.

I have pursued a Medical Board complaint and have also worked my complaint through the hospital. The risk manager there, Cynthia Leahy, is nice and sympathetic, but outside of promising to review the incident at the next credentialing, there isn't much she can do. The bottom line is that surgeons like Dr. O have a lot of power. Even pursuing legal action can be difficult in a case like this, because of the potentially controversial motive for having the surgery (at least that is the way a jury might see it).

This is something you need to post on your website as a warning to others.

Return To Facial Feminization Surgery Index Page

Return To TWR Main Page